2019-08-09T09:34:08-05:00 2018-09-30 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2017-10-01 430662495 HANNIBAL REGIONAL HEALTHCARE SYSTEM INC HANN 5732481300 6500 HOSPITAL DRIVE PO BOX 551 HANNIBAL MO 63401 ROB GASAWAY VICE PRESIDENT - FINANCE 5732481300 2019-08-08 1 JEFF PARKER P00970069 3149254300 67.137.57.251 2019-08-08 14:52:51 CD P B9410AED5E3544F88E7F1364350661432485FF60 DBE5E9100BD705C5801F05FB9419F1388E8E9FDA 2017 2019-02-21 02:37:17Z C TODD AHRENS 6500 HOSPITAL DRIVE PO BOX 551 HANNIBAL MO 63401 194801425 0 X HOSPITAL.HANNIBALREGIONAL.ORG X 1987 MO THE SYSTEM OPERATES A FULL SERVICE ACUTE CARE FACILITY. 13 12 1279 267 0 0 599661 735026 147462759 179219832 3118772 5456248 2308837 1959016 153490029 187370122 108678 96931 0 0 84528833 97074664 0 0 437437 66796523 78455955 151434034 175627550 2055995 11742572 152196009 195591528 42304066 75616963 109891943 119974565 X TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES FOR A BETTER LIFE. 1 1 156450147 96931 179091867 THE SYSTEM OPERATES A FULL SERVICE 86 BED ACUTE CARE HOSPITAL FACILITY, A 13 BED INPATIENT REHAB FACILITY, SEVERAL PHYSICIAN PRACTICES AND PRIMARY CARE CLINICS, AND A HOME HEALTH AGENCY IN HANNIBAL MISSOURI AND SURROUNDING COUNTIES. 18,887 TOTAL INPATIENT DAYS WERE PROVIDED DURING THE COURSE OF THE YEAR. THE SYSTEM PROVIDES SERVICES TO PATIENTS THAT MEET THE HOSPITAL'S CHARITY CARE POLICY AS WELL AS SERVICES TO OTHER MEDICALLY INDIGENT PATIENTS UNDER CERTAIN GOVERNMENT-REIMBURSED PUBLIC AID PROGRAMS. THE TOTAL COST OF UNCOMPENSATED CARE WAS: CHARITY CARE - $3,329,459 AND STATE MEDICAID AND OTHER PUBLIC AID PROGRAMS - $2,090,190. 907781 723502 THE HANNIBAL CHILDREN'S CENTER IS A LEARNING CENTER FOR CHILDREN AGES 6 WEEKS TO 12 YEARS. THE HCC IS A MISSION DRIVEN CENTER IN WHICH TEAM MEMBERS, FAMILIES, AND THE COMMUNITY COLLABORATE TO EMPOWER EACH CHILD TO BECOME HEALTHY, SELF-CONFIDENT, INDIVIDUALS BY PROVIDING THE RESOURCES TO DEVELOP A PASSION FOR LEARNING THROUGH INTERACTIVE PLAY.HANNIBAL CHILDREN'S CENTER IS LICENSED BY THE STATE OF MISSOURI - DEPARTMENT OF HEALTH AND SENIOR SERVICES AND ACCREDITED BY THE MISSOURI ACCREDITATION OF PROGRAMS FOR CHILDREN AND YOUTH. 157357928 1 1 0 1 0 1 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 201 0 1279 1 0 0 0 0 0 0 0 0 0 0 X 13 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X ROB GASAWAY 5732481300 6500 HOSPITAL DRIVE HANNIBAL MO 63401 PAT BENSON CHAIR 1.00 X X 0 0 0 DEBORAH THORNBURG VICE CHAIR 1.00 X X 0 0 0 CAROLYN SHAW SECRETARY 1.00 X X 0 0 0 STEVE MILLER ASST SECRETARY 1.00 X X 0 0 0 JASON POAGE TREASURER 1.00 X X 0 0 0 JACK WHITAKER DIRECTOR 1.00 X 0 0 0 DIRK SAUER DIRECTOR 1.00 X 0 0 0 LINDA STRAUBE DIRECTOR 1.00 X 0 0 0 GENE SCHOLES JR DIRECTOR 1.00 X 0 0 0 LACEY YOUNG DIRECTOR 1.00 X 0 0 0 BRAD KURZ DIRECTOR 1.00 X 0 0 0 PAUL EWERT DIRECTOR AND PAST CHAIR 1.00 X X 0 0 0 ROBERT GILSTRAP DIRECTOR (TERM ENDED) 1.00 X 0 0 0 RICHARD VALUCK DIRECTOR & CARDIOLOGIST 40.00 X 606080 0 35689 C TODD AHRENS PRESIDENT & CEO 40.00 1.00 X 506241 0 144510 ROGER DIX VICE PRESIDENT - FINANCE (LEFT 11/2016) 40.00 X 136704 0 0 ROB GASAWAY VICE PRESIDENT - FINANCE 40.00 X 174586 0 56032 TIMOTHY REUSCHEL VICE PRESIDENT - GENERAL COUNSEL 40.00 X 270552 0 69439 PRANAV PARIKH MD V.P. - QUALITY & MEDICAL AFFAIRS 40.00 X 1025688 0 110348 AARON ZOOK VICE PRESIDENT - OPERATIONS 40.00 X 118041 0 24860 JULIE LEVERENZ VICE PRESIDENT - PATIENT EXPERIENCE 40.00 X 914058 0 30903 SUSAN WATHEN VICE PRESIDENT - HUMAN RESOURCES 40.00 X 181572 0 37436 G DOUG RUBLE VICE PRESIDENT - FACILITIES 40.00 X 180565 0 33201 PATRICIA BRAWNER VICE PRESIDENT - NURSING 40.00 X 183439 0 66373 KURT EBERS CLINIC ADMINISTRATOR 40.00 X 208877 0 39949 TIMOTHY POLLEY V.P. HRHS DEVELOPMENT (LEFT 12/2017) 40.00 X 286665 0 21727 WENDY HARRINGTON V.P. - HRHS DEVELOPMENT 1.00 40.00 X 194356 0 49036 LUVELL GLANTON ANESTHESIOLOGIST - PAIN MANAGEMENT 40.00 X 794728 0 42973 JOHN BENNETT OBSTETRICIAN AND GYNECOLOGIST 40.00 X 627003 0 42613 LAURA MAPLE OBSTETRICIAN AND GYNECOLOGIST 40.00 X 641416 0 12150 ASHRAF ALMASHHRAWI GASTROENTEROLOGIST 40.00 X 680049 0 31625 SHAYIBU HARRUNA CARDIOLOGIST 40.00 X 679300 0 40299 8409920 0 889163 110 0 1 0 MURRAY COMPANY INC 1215 FERN RIDGE PARKWAY SUITE 213 ST LOUIS MO 63141 CONSTRUCTION 16811111 INTERIM PHYSICIANS LLC PO BOX 679139 DALLAS TX 75267 LOCUM PHYSICIAN 2532393 ALLSCRIPTS LLC PO BOX 8538-0133 PHILADELPHIA PA 19171 IT SYSTEMS 1775892 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 LOCUM PHYSICIAN 1474120 BURWOOD GROUP INC 8582 SOLUTION CENTER CHICAGO IL 60677 IT SYSTEMS 1377466 59 735026 735026 NET PATIENT SERVICE REVENUE 621110 178385830 178385830 CHILDREN'S DEVELOPMENT CENTER 624410 723502 723502 EHR MEANINGFUL USE 621110 110500 110500 179219832 1479071 1479071 387385 17015 370370 370370 370370 11197385 194080 7371214 43074 3826171 151006 3977177 3977177 CAFETERIA 722210 678529 678529 OTHER OPERATING REVENUES 621110 328868 328868 OTHER ADMINISTRATION 621110 314580 314580 266669 266669 1588646 187370122 179815369 0 6819727 X 96931 96931 4959585 766120 4080335 113130 69996503 60673806 9054546 268151 2467555 2462648 4907 15247851 14304231 904153 39467 4403170 3912360 479028 11782 114316 114316 97500 97500 9633 8556 1077 19815197 19749510 65687 725683 725683 19825555 17609861 2215694 1840661 1634950 205711 2115831 1879367 236464 935422 830880 104542 98423 87423 11000 405678 360340 45338 8262913 8262913 740555 657791 82764 BAD DEBT EXPENSE 12162002 12162002 PHARMACY DRUGS 9201536 9201536 FOOD 766470 766470 RECRUITING EXPENSE 490073 435303 54770 848507 769247 79260 175627550 157357928 17832185 437437 15033473 11473836 1031240 1042999 18000470 20148849 837888 870862 3055896 3143048 1102034 1152306 178752393 113292778 47382706 65459615 58604731 83733697 652993 527412 1686020 1477647 4808558 6561257 152196009 195591528 25710322 24727765 64270 7529351 43395485 6445428 5554150 2554695 1939563 42304066 75616963 X 105059949 114994511 4831994 4980054 109891943 119974565 152196009 195591528 X 11742572 -2800193 1140243 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 9633 9633 0 PART II-B, LINE 1: A PORTION OF THE MEMBERSHIP DUES PAID TO THE MISSOURI HOSPITAL ASSOCIATION IS RELATED TO LOBBYING. 1 1057 0 24498 0 0 2479295 2479295 68052583 43722743 24329840 8825604 6483355 2342249 76777041 63086680 13690361 22617870 22617870 65459615 SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN 1939563 1939563 1 1 X 1 X 0 1 1 1 0 1 1 2706780 12018974 0 0.00000 15631819 21340558 0 0.00000 18338599 33359532 0 0.00000 24585645 11941380 12644265 0.07200 373213 373213 0.00210 513729 513729 0.00290 25472587 11941380 13531207 0.07700 43811186 45300912 13531207 0.07700 2165885 754132 1411753 0.00800 1125 1125 0.00000 232211 232211 0.00130 2399221 754132 1645089 0.00930 1 12162002 9121502 39629361 44871627 -5242266 X 1 1 1 HANNIBAL MEDICAL SUPPLY DME COMPANY 0.33330 0.33330 2 ADVANCE HANNIBAL REGIONAL HOSPITAL LLC OUTPATIENT PHYSICAL THERAPY 0.50000 0.50000 3 HANNIBAL REGIONAL PHYSICIAN HOSPITAL ORGANIZATION INC INSURANCE REPRICING 0.50000 0.50000 1 1 HANNIBAL REGIONAL HOSPITAL 6000 HOSPITAL DRIVE HANNIBAL MO 63401 HANNIBALREGIONAL.ORG 101-57 X X X HANNIBAL REGIONAL HEALTHCARE SYSTEM INC 1 0 0 1 X X X X X X X X X 15 1 0 1 1 X SEE PART V, SECTION C FOR URL OF CHNA X 1 16 1 SEE PART V, SEC. C FOR IMPLEMENTATION STRATEGY URL 0 1 X 200.000000000000 200.000000000000 X X X X X 1 1 X X X X 1 X SEE PART V, SECTION C FOR URL X SEE PART V, SECTION C FOR URL X SEE PART V, SECTION C FOR URL X X X X X 1 X 0 X X X X X 1 X 0 0 HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 5: A BROAD-BASED STEERING COMMITTEE OF HEALTHCARE LEADERS FROM THROUGHOUT THE SIX COUNTY REGION WAS FORMED TO GUIDE THE ASSESSMENT PROCESS AND ESTABLISH THE THREE-YEAR STRATEGY TO ADDRESS THE PRIORITIES IDENTIFIED. HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 6B: SIX COUNTY HEALTH DEPARTMENTS, FREE CLINIC, FQHC, MULTIPLE SOCIAL SERVICE AGENCIES, NON-EMPLOYED PHYSICIAN GROUPS AND OTHERS. HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 11: A BROAD-BASED OVERSIGHT GROUP IS MEETING ON A QUARTERLY BASIS TO ASSESS PROGRESS AND INFLUENCE THE WORK ESTABLISHED IN THE PLAN; A VARIETY OF BEHAVIORAL HEALTH SERVICES HAVE EMERGED IN THE REGION DUE TO THE VISIBILITY OF THIS PROBLEM; MENTAL HEALTH FIRST AID CLASSES ARE RAISING HEALTH LITERACY; SERVICES HAVE BEEN EXPANDED AT THE LOCAL FREE CLINIC TO ADDRESS BY ACCESS TO CARE, MENTAL HEALTH AND DENTAL HEALTH; A POPULATION HEALTH GRANT IS RESULTING IN REDUCING THE INCIDENCE OF EMERGENCY DEPARTMENT VISITS FOR PATIENTS WITH CHRONIC DISEASE WHO WERE FORMERLY HIGH UTILIZERS; A NEW FQHC HAS ADDED MENTAL HEALTH AND DENTAL HEALTH CAPACITY IN THE REGION; A COMMUNITY HEALTH INITIATIVE KNOWN AS "LIVING BETTER" IS BEGINNING TO EMERGE AND IS INTENDED TO ENHANCE THE SOCIAL VALUING OF HEALTH; COME COMMITTED COALITIONS FOCUSING ON THE PRIORITY PROBLEMS IDENTIFIED IN THE CHNA ARE NOW IN PLACE. HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 13B: THE PATIENTS ABILITY TO PAY OUTSIDE OF NORMAL LIVING EXPENSES AND DEBT. HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 16J: PERSONAL CONTACT AND WEBSITE ACCCESS ARE THE MAIN POINTS OF CONTACT. HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 20E: COMMUNICATIONS THROUGH MAIL AND PHONE INTERVIEWS ARE PURSUED TO RESOLVE ISSUES AND OBTAIN NEEDED INFORMATION TO QUALIFY PATIENTS. SCHEDULE H, PART V, SECTION B, LINE 7B THE ORGANIZATION'S MOST RECENT CHNA REPORT CAN BE FOUND AT:HTTPS://HANNIBALREGIONAL.ORG/COMMUNITYHEALTH/CHNA/2016-2019REGIONALHEALTHSTRATEGY/TABID/208/DEFAULT.ASPX SCHEDULE H, PART V, SECTION B, LINE 10 THE ORGANIZATION'S CURRENT IMPLEMENTATION STRATEGY CAN BE FOUND AT: HTTPS://HANNIBALREGIONAL.ORG/COMMUNITYHEALTH/CHNA/2016-2019REGIONALHEALTHSTRATEGY/TABID/208/DEFAULT.ASPX SCHEDULE H, PART V, SECTION B, LINE 16A THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY (FAP) CAN BE FOUND AT:HTTPS://HANNIBALREGIONAL.ORG/PATIENTSVISITORS/PATIENTSERVICES/FINANCIALASSISTANCE/TABID/241/DEFAULT.ASPX SCHEDULE H, PART V, SECTION B, LINE 16B THE ORGANIZATION'S FINANCIAL ASSISTANCE APPLICATION CAN BE FOUND AT:HTTPS://HANNIBALREGIONAL.ORG/PATIENTSVISITORS/PATIENTSERVICES/FINANCIALASSISTANCE/TABID/241/DEFAULT.ASPX SCHEDULE H, PART V, SECTION B, LINE 16C THE ORGANIZATION'S PLAIN LANGUAGE SUMMARY OF THE FAP CAN BE FOUND AT:HTTPS://HANNIBALREGIONAL.ORG/PATIENTSVISITORS/PATIENTSERVICES/FINANCIALASSISTANCE/TABID/241/DEFAULT.ASPX 22 1 - HANNIBAL REGIONAL MEDICAL GROUP 6500 HOSPITAL DRIVE HANNIBAL MO 63401 RURAL HEALTH CLINICS, SPECIALTY CLINIC, SAME DAY/URGENT CARE 2 - JAMES E CARY CANCER CENTER 5985 HOSPITAL DRIVE HANNIBAL MO 63401 CANCER CENTER 4 - COMPLETE FAMILY MEDICINE - KIRKSVILLE 1611 S BALTIMORE KIRKSVILLE MO 63501 RURAL HEALTH, SAME DAY/URGENT CARE, FAMILY PRACTICE CLINIC 5 - MONROE CITY FAMILY PRACTICE 821 BUSINESS HWY 24 WEST MONROE CITY MO 63456 RURAL HEALTH CLINIC 6 - PIKE MEDICAL CLINIC - BOWLING GREEN 8 TOWN CENTER DR BOWLING GREEN MO 63334 RURAL HEALTH CLINIC, SAME DAY/URGENT CARE 7 - PIKE MEDICAL CLINIC - LOUISIANA 211 S 3RD ST LOUISIANA MO 63353 RURAL HEALTH CLINIC 8 - CANTONLAGRANGE FAMILY PRACTICE 1802 ELM STREET CANTON MO 63435 RURAL HEALTH CLINIC 9 - SHELBINA FAMILY PRACTICE 400 S CENTER STREET SHELBINA MO 63486 RURAL HEALTH CLINIC 10 - PEDIATRIC THERAPY 150 MEDICAL DR HANNIBAL MO 63401 PEDIATRIC THERAPY 11 - EXPRESS CARE AT WAL-MART 3650 STARDUST DRIVE WAL-MART HANNIBAL MO 63401 RURAL HEALTH CLINIC, SAME DAY CLINIC 12 - COMPLETE FAMILY MEDICINE MOBERLY UC 1600 N MORLEY SUITE A-120-A MOBERLY MO 65270 SAME DAY/URGENT CARE CLINIC 13 - COMPLETE FAMILY MEDICINE MACON UC 1206 N MISSOURI ST MACON MO 63552 SAME DAY/URGENT CARE CLINIC 14 - SPEECH THERAPY 188A MEDICAL DRIVE HANNIBAL MO 63401 SPEECH THERAPY 15 - COMPLETE FAMILY MEDICINE LANCASTER RHC 1000 W WASHINGTON LANCASTER MO 63548 RURAL HEALTH CLINIC 16 - COMPLETE FAMILY MEDICINE LAPLATA RHC 29934 JULY RD LA PLATA MO 63549 RURAL HEALTH CLINIC 17 - HANNIBAL MEDICAL SUPPLIES 188A MEDICAL DRIVE HANNIBAL MO 63401 JOINT VENTURES - MEDICAL SUPPLIES 18 - ADVANCE HANNIBAL REGIONAL HOSPITAL LLC 188A MEDICAL DRIVE HANNIBAL MO 63401 JOINT VENTURES - THERAPY 19 - ADVANCE HANNIBAL REGIONAL HOSPITAL LLC 710 S BUSINESS 61 SUITE 100 BOWLING GREEN MO 63334 JOINT VENTURES - THERAPY 20 - ADVANCE HANNIBAL REGIONAL HOSPITAL LLC 55 TROY SQUARE TROY MO 63379 JOINT VENTURES - THERAPY 21 - ADVANCE HANNIBAL REGIONAL HOSPITAL LLC 821 US 24 WEST MONROE CITY MO 63456 JOINT VENTURES - THERAPY 22 - ADVANCE HANNIBAL REGIONAL HOSPITAL LLC 1804 ELM ST CANTON MO 63435 JOINT VENTURES - THERAPY 23 - ADVANCE HANNIBAL REGIONAL HOSPITAL LLC 1605 S BALTIMORE ST STE C KIRKSVILLE MO 63501 JOINT VENTURES - THERAPY PART I, LINE 3C: THE ORGANIZATION USED AN ABILITY TO PAY STANDARD TO DETERMINE ELIGIBILITY. A PERSON IS ELIGIBLE FOR CHARITY CARE IF THEY MEET ANY OF THE FOLLOWING CRITERIA: THEIR INSURANCE IS INADEQUATE, THEY ARE UNINSURED, PATIENTS WITH A FAMILY INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINE, PATIENTS WITH A SPENDABLE INCOME THAT IS LESS THAN 5% OF THE BALANCE OWED TO THE HOSPITAL, THE PATIENT HAS LESS THAN $2,000 IN TOTAL ASSETS AVAILABLE TO PAY HOSPITAL EXPENSES (EXCEPTIONS INCLUDE HOME EQUITY, AUTO EQUITY, LIFE INSURANCE EQUITY). PART I, LINE 6A: THE MISSOURI HOSPITAL ASSOCIATION HAS INCLUDED HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. IN THEIR ANNUAL COMMUNITY BENEFIT REPORT. PART I, LINE 7: THE COST TO CHARGES RATIO WAS USED AS DERIVED FORM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. PART I, LN 7 COL(F): A GROSS ESTIMATE WAS MADE BASED ON CURRENT EXPERIENCE. SCHEDULE H, PART I, LINE 7A(D) AND 7B(D) THE AMOUNTS REPORTED INCLUDE $9,742,111 OF DISPROPORTIONATE SHARE HOSPITAL (DSH) FUNDS RECEIVED IN PRIOR YEARS THAT WERE BEING RESERVED AS A POTENTIAL LIABILITY RELATED TO A 2008 FINAL RULE ISSUED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS). THIS FINAL RULE WAS CHALLENGED IN FEDERAL COURT. IN LATE 2018, CMS COMMUNICATED IT WOULD WITHDRAW CERTAIN GUIDANCE INCLUDED IN THE 2008 FINAL RULE. THIS WITHDRAWAL SIGNIFICANTLY REDUCED THE HEALTH SYSTEM'S POTENTIAL RECOUPMENT OF MEDICAID DSH PAYMENTS, AND THIS REDUCTION IN LIABILITY WAS RECOGNIZED IN FISCAL YEAR 2018 REVENUE. THIS WAS A ONE-TIME EVENT THAT RESULTED IN THE DIRECT OFFSETTING REVENUE AMOUNTS REPORTED ON LINE 7 TO BE SIGNIFICANTLY HIGHER THAN PAST YEARS. PART II, COMMUNITY BUILDING ACTIVITIES: THE ORGANIZATION'S COMMUNITY BUILDING ACTIVITIES THAT PROMOTE THE HEALTH OF THE HOSPITAL'S COMMUNITY INCLUDES ITS CHILDREN'S CENTER FOR EDUCATION, DISASTER RECOVERY PLANNING, INTERPRETIVE SERVICES FOR NON-ENGLISH SPEAKING PATIENTS, AND RECRUITMENT COSTS FOR PHYSICIANS. PART III, LINE 2: HISTORICAL EXPERIENCE WAS USED TO ESTIMATE BAD DEBTS BY PAYOR CLASSIFICATION AND AGING CO-HORT. PART III, LINE 3: THE ESTIMATE WAS BASED ON AVAILABLE DATA. PART III, LINE 4: THE SYSTEM REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYORS, PATIENTS AND OTHERS. THE SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE SYSTEM BILLS THIRD-PARTY PAYORS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. AT SEPTEMBER 30, 2018 AND 2017, THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS WAS APPROXIMATELY $6,511,000 AND $7,732,000, RESPECTIVELY. PART III, LINE 8: SOME MEDICARE SERVICES ARE PAID AT SUBSTANTIALLY LESS THAN COST THROUGH THE PROGRAM. THESE SERVICES COULD BE ELIMINATED TO INCREASE MARGIN BUT ARE PROVIDED IN THIS COMMUNITY DESPITE THE LOSS. PART III, LINE 9B: WHEN CHARITY CONSIDERATION IS REQUESTED ALL COLLECTION EFFORTS ARE HALTED UNTIL A DETERMINATION ON ELIGIBILITY IS MADE. COLLECTION EFFORTS ARE RESUMED ONLY IF THE INDIVIDUAL DOES NOT MEET ONE OF THE CHARITY CRITERIA. PART VI, LINE 2: THE ORGANIZATION RECEIVES ANNUAL UPDATES ON THE HEALTH STATUS OF ITS POPULATION FROM THE STATE THAT INCLUDE MORTALITY AND DISEASE STATUS. THE ORGANIZATION ALSO MONITORS NATIONAL DATA ON TRENDS AND DISEASE STATUS. PART VI, LINE 3: PERSONAL CONTACT AND WEBSITE ACCESS ARE THE MAIN POINTS OF CONTACT. PART VI, LINE 4: THE ORGANIZATION SERVES THE POPULACE OF A 12 COUNTY REGION IN NORTHEAST MISSOURI. THE AREA IS PRIMARILY A RURAL FARMING AREA WITH NUMEROUS POCKETS OF MEDICALLY UNDERSERVED AREAS. RESIDENTS ARE SERVED BY DISTANT ORGANIZATIONS IN COLUMBIA, MO AND ST. LOUIS, MO. CARE CAN ALSO BE ACCESSED AT LOCAL HOSPITALS IN QUINCY, IL, MACON, MO, MOBERLY, MO, AND KIRKSVILLE, MO. PART VI, LINE 5: SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, LINE 4A. 1 CULVER STOCKTON 1 COLLEGE HILL CANTON MO 63435 430610813 501(C)(3) 10000 BASKETBALL LOCKER ROOM KIRKSVILLE R-III BOOSTER CLUB 1901 E HAMILTON KIRKSVILLE MO 63501 431802445 501(C)(3) 17500 TITLE SPONSORSHIP DIGITAL SCOREBOARD MHA CENTER FOR EDUCATION PO BOX 60 JEFFERSON CITY MO 65102 430898947 501(C)(3) 69431 MCE HEALTH IMPR., RESEARCH AND SCHOLARSHIP FUND, MHA SPECIAL PROJECTS, MISSOURI CENTER FOR PATIENT SAFETY CONTRIBUTION AND DELIVERABLES, MISSOURI POISON CENTER CONTRIBUTION. 3 PART I, LINE 2: POLICY GA 1-112 CORPORATE CITIZENSHIP GUIDES THE ORGANIZATION IN CONTRIBUTING TO OTHER ORGANIZATIONS. ALL ACTIVITIES WHICH CONSTITUTE A CHARITABLE CONTRIBUTION ARE DOCUMENTED ON THE CHARITABLE CONTRIBUTION FORM. X X X X 0 1 0 0 0 0 0 0 0 RICHARD VALUCK DIRECTOR & CARDIOLOGIST 603758 0 0 0 2322 0 12150 0 23539 0 641769 0 0 0 C TODD AHRENS PRESIDENT & CEO 469995 0 0 0 36246 0 113139 0 31371 0 650751 0 0 0 ROB GASAWAY VICE PRESIDENT - FINANCE 168650 0 0 0 5936 0 29897 0 26135 0 230618 0 0 0 TIMOTHY REUSCHEL VICE PRESIDENT - GENERAL COUNSEL 263551 0 0 0 7001 0 39825 0 29614 0 339991 0 0 0 PRANAV PARIKH MD V.P. - QUALITY & MEDICAL AFFAIRS 445084 0 573344 0 7260 0 79644 0 30704 0 1136036 0 0 0 JULIE LEVERENZ VICE PRESIDENT - PATIENT EXPERIENCE 189855 0 716051 0 8152 0 9114 0 21789 0 944961 0 446404 0 SUSAN WATHEN VICE PRESIDENT - HUMAN RESOURCES 174394 0 0 0 7178 0 26414 0 11022 0 219008 0 0 0 G DOUG RUBLE VICE PRESIDENT - FACILITIES 156276 0 15937 0 8352 0 14168 0 19033 0 213766 0 0 0 PATRICIA BRAWNER VICE PRESIDENT - NURSING 176549 0 0 0 6890 0 45992 0 20381 0 249812 0 0 0 KURT EBERS CLINIC ADMINISTRATOR 201810 0 0 0 7067 0 9510 0 30439 0 248826 0 0 0 TIMOTHY POLLEY V.P. HRHS DEVELOPMENT (LEFT 12/2017) 278061 0 0 0 8604 0 12150 0 9577 0 308392 0 0 0 WENDY HARRINGTON V.P. - HRHS DEVELOPMENT 170830 0 16868 0 6658 0 22952 0 26084 0 243392 0 0 0 LUVELL GLANTON ANESTHESIOLOGIST - PAIN MANAGEMENT 716688 0 77500 0 540 0 12150 0 30823 0 837701 0 0 0 JOHN BENNETT OBSTETRICIAN AND GYNECOLOGIST 520355 0 105406 0 1242 0 12150 0 30463 0 669616 0 0 0 LAURA MAPLE OBSTETRICIAN AND GYNECOLOGIST 531956 0 108650 0 810 0 12150 0 0 0 653566 0 0 0 ASHRAF ALMASHHRAWI GASTROENTEROLOGIST 647009 0 20000 0 13040 0 12150 0 19475 0 711674 0 0 0 SHAYIBU HARRUNA CARDIOLOGIST 678588 0 0 0 712 0 12150 0 28149 0 719599 0 0 0 PART I, LINE 4B JULIE LEVERENZ, SERP, $716,051 G. DOUG RUBLE, SERP, $15,937 A THE INDUSTRIAL DEVELOPMENT AUTHORITY OF THE CITY OF HANNIBAL MISSOURI 531320446 410632CP6 2017-11-06 44088479 CONSTRUCTION 0 0 0 A 44088479 3643238 445241 19696883 20303117 2019 0 0 0 1 A 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 SCHEDULE K, 2015 BONDS THE SERIES 2015 HEALTH FACILITIES REFUNDING REVENUE BONDS (THE 2015 BONDS) WERE ISSUED IN THE ORIGINAL AMOUNT OF $10,560,000. THE INDUSTRIAL DEVELOPMENT AUTHORITY OF THE CITY OF HANNIBAL, MISSOURI ISSUED THE 2017 BONDS ON BEHALF OF THE SYSTEM. THE PROCEEDS OF THE BOND ISSUE WERE LOANED TO THE SYSTEM UNDER A TRUST INDENTURE AND A LOAN AGREEMENT, BOTH DATED DECEMBER 1, 2015. THESE BONDS WERE DEFEASED DURING 2018 BY INTERNAL FUNDS PRIOR TO THE ISSUANCE OF THE SERIES 2017 BONDS. AS A RESULT, THESE BONDS HAVE BEEN REMOVED FROM SCHEDULE K AS THEY ARE NO LONGER OUTSTANDING AS OF THE END OF THE YEAR. PART II, LINE 17 ALTHOUGH THE FINAL ALLOCATION OF PROCEEDS HAS NOT BEEN MADE, THE ORGANIZATION WILL HAVE BOOKS AND RECORDS TO SUPPORT THE ALLOCATION ONCE MADE. FORM 990, PART III, LINE 2 ORGANIZATION OPENED BOWLING GREEN SAME DAY CARE AND WALMART EXPRESS CARE WAS CONVERTED TO A RHC. FORM 990, PART III, LINE 3 THE ORGANIZATION CLOSED THE VISION CENTER. FORM 990, PART VI, SECTION A, LINE 1 THE BOARD OF DIRECTORS HAS DELEGATED TO THE COMPENSATION COMMITTEE, PURSUANT TO A CHARTER ADOPTED BY THE BOARD OF DIRECTORS, THE RESPONSIBILITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS IN ADMINISTERING COMPENSATION PLANS AND IN MAKING DECISIONS ON THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER AND THOSE EXECUTIVES WHO REPORT DIRECTLY TO THE CHIEF EXECUTIVE OFFICER WHO QUALIFY AS "DISQUALIFIED PERSONS" WITHIN THE MEANING OF SECTION 4958 OF THE INTERNAL REVENUE CODE. THE COMMITTEE THEN REPORTS ITS ACTIONS TO THE BOARD OF DIRECTORS. THE COMMITTEE IS COMPOSED SOLELY OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE SCOPE OF THE COMMITTEE INCLUDES, BUT IS NOT LIMITED TO, REVIEWING AND APPROVING THE ANNUAL BASE SALARY LEVELS, ANNUAL INCENTIVE OPPORTUNITY LEVELS, EXECUTIVE PERQUISITES, EMPLOYMENT AGREEMENTS, BENEFITS AND SUPPLEMENTAL BENEFITS. FORM 990, PART VI, SECTION B, LINE 11B THE PREPARED FORM 990 WILL BE FORWARDED TO EACH MEMBER OF THE BOARD OF DIRECTORS, AS WELL AS THE OFFICERS OF THE CORPORATION APPROXIMATELY ONE WEEK PRIOR TO A REGULAR BOARD MEETING AT WHICH THE PREPARED FORM 990 WILL BE ON THE AGENDA. THE CHIEF FINANCIAL OFFICER OR CHIEF EXECUTIVE OFFICER WILL PRESENT THE PREPARED FORM 990 TO THE BOARD OF DIRECTORS AND ENTERTAIN QUESTIONS FROM DIRECTORS AND OFFICERS. THE GENERAL COUNSEL FOR THE CORPORATION WILL ALSO BE PRESENT TO ASSIST WITH QUESTIONS FOR THE DIRECTORS AND OFFICERS. THIS PROCEDURE WILL BE COMPLETED PRIOR TO THE FILING OF THE PREPARED FORM 990. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A POLICY TITLED BUSINESS ETHICS AND CONFLICT OF INTEREST WHICH REQUIRES THAT ALL DIRECTORS, OFFICERS, AND EMPLOYEES OF THE SYSTEM ALWAYS ACT IN THE BEST INTEREST OF THE SYSTEM WITHOUT CONFLICTS OF INTEREST. ANNUALLY EACH MEMBER OF THE BOARD OF DIRECTORS, EACH OFFICER OF THE ORGANIZATION, AND CERTAIN OTHER MANAGERS RECEIVE A COPY OF THE POLICY AND ARE REQUIRED TO COMPLETE A CONFIDENTIALITY AGREEMENT AND A CONFLICT OF INTEREST QUESTIONNAIRE WHEREBY THE INDIVIDUAL ANSWERS QUESTIONS REGARDING FAMILY MEMBERS, SUBSTANTIAL BUSINESS OR INVESTMENT HOLDINGS, AND OTHER TRANSACTIONS OR AFFILIATIONS WITH BUSINESSES OR OTHER ORGANIZATIONS THAT MIGHT AFFECT THEIR RELATIONSHIP WITH THE SYSTEM. AS PART OF THE CONFLICTS OF INTEREST QUESTIONNAIRE THE INDIVIDUAL IS ASKED TO ACKNOWLEDGE THAT THEY HAVE RECEIVED AND READ A COPY OF THE POLICY, AGREE TO COMPLY WITH THE POLICY, ACKNOWLEDGE THAT THE SYSTEM IS A CHARITABLE ORGANIZATION, WHICH MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH OUR TAX EXEMPT PURPOSES IN ORDER TO MAINTAIN OUR TAX EXEMPT STATUS, AGREE TO REPORT PROMPTLY TO THE BOARD OF DIRECTORS ANY CHANGES IN THEIR ANSWERS TO THE QUESTIONS OR ANY CHANGE IN CIRCUMSTANCE THAT MIGHT DEVELOP PRIOR TO THE COMPLETION OF THEIR NEXT ANNUAL QUESTIONNAIRE. WITH RESPECT TO DIRECTORS OF THE ORGANIZATION, THEY ALSO ACKNOWLEDGE THAT NONE OF THE CONDITIONS OF THE POLICY WHICH WOULD MAKE THEM INELIGIBLE TO REMAIN ON THE BOARD EXIST AT THE TIME THEY SIGN THE ACKNOWLEDGMENT AND THAT THEY WOULD REPORT ANY CONDITIONS WHICH BECOME APPLICABLE IMMEDIATELY TO THE CHAIRPERSON OF THE BOARD OF DIRECTORS. ON AN ANNUAL BASIS THESE DOCUMENTS ARE SENT BY THE SECRETARY OF THE SYSTEM TO EACH INTERESTED PERSON AND TO THOSE EMPLOYEES OF THE SYSTEM THAT THE BOARD DETERMINES. THE DOCUMENT IS COMPLETED BY THE INDIVIDUAL AND RETURNED TO THE SECRETARY OF THE BOARD THROUGH GENERAL COUNSEL, WHO ANNUALLY ANALYZES ANY DISCLOSED CONFLICT OF INTEREST OR ANY OTHER FACT THAT MIGHT MAKE THE INDIVIDUAL NOT INDEPENDENT FOR IRS TAX EXEMPT PURPOSES. THE SECRETARY THEN SUBMITS TO THE BOARD OF DIRECTORS A CONFIDENTIAL REPORT CONCERNING ANY INTEREST OF EMPLOYEES OF THE SYSTEM DISCLOSED BY SUCH QUESTIONNAIRE, ANY INTEREST OF DIRECTORS AND OFFICERS WHO ARE NOT EMPLOYEES OF THE SYSTEM, AND WHAT ACTIONS THE PRESIDENT OF THE ORGANIZATION MAY TAKE AS A RESULT OF ANY CONFLICTS DISCLOSED BY SUCH INDIVIDUALS. AN INDIVIDUAL IS INELIGIBLE TO SERVE ON THE BOARD OF DIRECTORS FOR ANY OF THE FOLLOWING REASONS AS TAKEN FROM HANNIBAL REGIONAL SYSTEM BOARD OF DIRECTORS POLICY B-VII: A. FAILURE TO ADHERE COMPLETELY TO DISCLOSURE REQUIREMENTS; B. THE INDIVIDUAL IS AN OWNER, PARTNER, EMPLOYEE, BOARD MEMBER OR INVESTOR IN A DIRECT COMPETITOR OF THE SYSTEM, OR ANY ENTITY AFFILIATED WITH THE SYSTEM. AN OWNERSHIP OR INVESTMENT INTEREST IN A DIRECT COMPETITOR OF THE SYSTEM, OR ANY ENTITY AFFILIATED WITH THE SYSTEM, OF FIVE (5) PERCENT OR LESS WILL NOT MAKE INDIVIDUAL INELIGIBLE TO SERVE ON THE BOARD OF DIRECTORS; C. THE INDIVIDUAL IS AN EMPLOYEE OF THE SYSTEM, OR ANY ENTITY AFFILIATED WITH THE SYSTEM, OR A FAMILY MEMBER IS A MEMBER OF THE MANAGEMENT TEAM OF THE SYSTEM, OR ANY ENTITY AFFILIATED WITH THE SYSTEM; D. THE INDIVIDUAL RECEIVES DIRECT COMPENSATORY BENEFIT FOR ONGOING SERVICES PROVIDED TO THE SYSTEM, OR ANY ENTITY AFFILIATED WITH THE SYSTEM (SERVING AS A "DE FACTO EMPLOYEE"); E. THE INDIVIDUAL IS AN OWNER, PARTNER, EMPLOYEE, BOARD MEMBER OR INVESTOR OR OTHER VENDOR WHO RECEIVES A SUBSTANTIAL AMOUNT OF REVENUE FROM THE SYSTEM, OR ANY ENTITY AFFILIATED WITH THE SYSTEM - THE GREATER OF $200,000.00 OR 2% OF THE ANNUAL REVENUES OF THAT VENDOR IN THE PRECEDING OR CURRENT YEAR. F. THE INDIVIDUAL IS AN OWNER, PARTNER, EMPLOYEE, BOARD MEMBER OR INVESTOR OF AN ENTITY WHO HAS CONTRACTED WITH SYSTEM FOR THE EXCLUSIVE PROVISION OF ANY MEDICAL SERVICES WITHIN THE SYSTEM, OR ITS AFFILIATES. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS HAS DELEGATED TO THE COMPENSATION COMMITTEE, PURSUANT TO A CHARTER ADOPTED BY THE BOARD OF DIRECTORS, THE RESPONSIBILITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS IN ADMINISTERING COMPENSATION PLANS AND IN MAKING DECISIONS ON THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER AND THOSE EXECUTIVES WHO REPORT DIRECTLY TO THE CHIEF EXECUTIVE OFFICER WHO QUALIFY AS "DISQUALIFIED PERSONS" WITHIN THE MEANING OF SECTION 4958 OF THE INTERNAL REVENUE CODE. THE COMMITTEE ENGAGES AN INDEPENDENT CONSULTANT TO ASSIST THE COMMITTEE WITH ITS GOVERNANCE AND OVERSIGHT ROLE AND ITS COMPLIANCE WITH SECTION 4958 OF THE INTERNAL REVENUE CODE, BY PROVIDING AN OPINION ON THE REASONABLENESS OF THE ORGANIZATION'S COMPENSATION PLAN. THE CONSULTANT USES PUBLISHED SURVEY DATA TO PROVIDE COMPARATIVE MARKET DATA FOR EACH POSITION. THE COMMITTEE THEN REPORTS ITS ACTIONS TO THE BOARD OF DIRECTORS. THE COMMITTEE IS COMPOSED SOLELY OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE SCOPE OF THE COMMITTEE INCLUDES, BUT IS NOT LIMITED TO, REVIEWING AND APPROVING THE ANNUAL BASE SALARY LEVELS, ANNUAL INCENTIVE OPPORTUNITY LEVELS, EXECUTIVE PERQUISITES, EMPLOYMENT AGREEMENTS, BENEFITS AND SUPPLEMENTAL BENEFITS. ANNUALLY, HRHS, THROUGH ITS COMPENSATION COMMITTEE ENGAGES AN INDEPENDENT OUTSIDE COMPENSATION CONSULTANT TO PROVIDE OPINIONS RELATED TO THE REASONABLENESS OF EXECUTIVE COMPENSATION AND TO PROVIDE ADVICE AND GUIDANCE AS TO CURRENT TRENDS AND ISSUES. IN 2018, INTEGRATED HEALTHCARE STRATEGIES (IHS) PROVIDED THIS SERVICE TO HRHS. FORM 990, PART VI, SECTION C, LINE 19 THE ARTICLES OF INCORPORATION AND AMENDMENTS THERETO ARE AVAILABLE ON THE MISSOURI SECRETARY OF STATE'S WEBSITE. FORM 990, PART IX, LINE 11G CONSULTING FEES: PROGRAM SERVICE EXPENSES 73,050. MANAGEMENT AND GENERAL EXPENSES 9,191. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 82,241. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 5,781,754. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,781,754. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 12,745,129. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,745,129. LAUNDRY SERVICE: PROGRAM SERVICE EXPENSES 283,614. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 283,614. COLLECTION FEES: PROGRAM SERVICE EXPENSES 416,944. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 416,944. CLEANING SERVICE: PROGRAM SERVICE EXPENSES 449,019. MANAGEMENT AND GENERAL EXPENSES 56,496. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 505,515. FORM 990, PART XI, LINE 9: CHANGE IN MINIMUM PENSION LIABILITY 992,183. PEARL LOWRIE FUND NET ACTIVITY 1,062. NET CONTRIBUTION REVENUE FROM FOUNDATION 146,998. FORM 990, PART XII, LINE 2C THE ORGANIZATION'S POLICY REGARDING OVERSIGHT OF AUDIT IS CONSISTENT WITH THE PRIOR YEAR. LANAC 6000 HOSPITAL DRIVE HANNIBAL MO 63401 431822503 REAL ESTATE MO 0 0 HANNIBAL REGIONAL HOSPITAL HANNIBAL MOBILE DIAGNOSTICS LLC 6000 HOSPITAL DRIVE HANNIBAL MO 63401 300234397 DIAGNOSTIC IMAGING MO 629293 75594 HANNIBAL REGIONAL HOSPITAL HANNIBAL REGIONAL HOSPITAL FOUNDATION 175 SHINN LANE HANNIBAL MO 63401 431658744 FUNDRAISING MO 501(C)(3) LINE 12A, I HANNIBAL REGIONAL HEALTHCARE SYSTEM INC 1 HANNIBAL MEDICAL SUPPLIES LLC PO BOX 40 QUINCY IL 62306 262362717 MEDICAL SUPPLIES MO N/A RELATED 85029 205289 0 0 0.33330 ADVANCE HANNIBAL REGIONAL HOSPITAL LLC 3652 STARDUST DRIVE HANNIBAL MO 63401 461561480 PT/OT SERVICES MO N/A RELATED 262093 190672 0 0 0.50000 HEALTH NETWORK OF MISSOURI LLC 227 UNIVERSITY HALL COLUMBIA MO 65211 471248962 COLLABORATIVE HEALTH NETWORK MO N/A RELATED -28879 22363 0 1 0.16670 HANNIBAL REGIONAL PHYSICIAN HOSPITAL ORGANIZATION INC 6500 HOSPITAL DRIVE HANNIBAL MO 64301 431706291 PHYSICIAN HOSPITAL ORGANIZATION MO C -17734 49845 0.50000 0 0 0 1 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1 0 HANNIBAL REGIONAL HOSPITAL FOUNDATION C 735026 COST INCURRED HANNIBAL REGIONAL HOSPITAL FOUNDATION O 264921 COST INCURRED ADVANCE HANNIBAL REGIONAL HOSPITAL LLC J 76005 COST INCURRED ADVANCE HANNIBAL REGIONAL HOSPITAL LLC K 1167279 COST INCURRED HANNIBAL REGIONAL HOSPITAL FOUNDATION P 98140 COST INCURRED SCHEDULE R, PAGE 2, PART III HRHS MAINTAINS CONTROL OF THE JOINT VENTURE ACTIVITIES LISTED ON SCHEDULE R, PART III BY HAVING ITS LEADERSHIP TEAM MEMBERS ON EACH JOINT VENTURE BOARD OF DIRECTORS. AS A RESULT, THE ENTITIES ARE LISTED ON SCHEDULE R, PART III AND RESULTING INCOME FROM THOSE ACTIVITIES ARE NOT BEING SUBJECTED TO UBIT.