2015-05-14T13:10:24-05:00 2014-09-30 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2013-10-01 430662495 HANNIBAL REGIONAL HEALTHCARE SYSTEM INC HANN 5732481300 6500 HOSPITAL DRIVE PO BOX 551 HANNIBAL MO 63401 ROGER DIX CHIEF FINANCIAL OFFICER 5732481300 2015-05-12 1 JEFF PARKER P00970069 3149254300 2013 2016-02-25 16:41:14Z C TODD AHRENS 6500 HOSPITAL DRIVE PO BOX 551 HANNIBAL MO 63401 129041646 0 X WWW.HRHONLINE.ORG X 1987 MO SYSTEM OPERATES A FULL SERVICE ACUTE CARE FACILITY 10 10 1065 260 0 0 455392 604340 117884481 123830316 1309570 2149338 2369718 2279316 122019161 128863310 97745 105252 0 0 65636188 66800149 0 0 336707 51938129 54557662 117672062 121463063 4347099 7400247 127649695 136145065 41438195 43425839 86211500 92719226 YOUR HEALTH IS OUR MISSION 0 0 105142539 105252 125082827 THE SYSTEM OPERATES A FULL SERVICE 91 BED ACUTE CARE HOSPITAL FACILITY, SEVERAL PHYSICIAN PRACTICES AND PRIMARY CARE CLINICS, AND A HOME HEALTH AGENCY IN HANNIBAL MISSOURI AND SURROUNDING COUNTIES. 17,564 TOTAL INPATIENT DAYS WERE PROVIDED DURING THE COURSE OF THE YEAR. THE SYSTEM PROVIDES SERVICES TO PATIENTS THAT MEET THE 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 - $3,709,555 AND STATE MEDICAID AND OTHER PUBLIC AID PROGRAMS -$4,658,256. 105142539 1 1 0 1 0 1 0 0 0 0 1 0 0 1 1 1 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 0 0 0 1 152 0 1065 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X ROGER DIX 5732481300 6000 HOSPITAL DRIVE HANNIBAL MO 63401 ROBERT GILSTRAP CHAIRPERSON 1.00 X X 0 0 0 JACK WHITAKER CHAIRPERSON 1.00 X X 0 0 0 CAROLYN SHAW SECRETARY 1.00 X X 0 0 0 PAUL EWERT VICE CHAIRPERSON 1.00 X X 0 0 0 DIRK SAUER SECRETARY PRO TEM 1.00 X X 0 0 0 STEVE MILLER SECRETARY PRO TEM 1.00 X X 0 0 0 JASON POAGE TREASURER 1.00 X X 0 0 0 JERRY TOWER ASST TREASURER 1.00 X X 0 0 0 LINDA STAUBE DIRECTOR 1.00 X 0 0 0 GENE SCHOLES JR DIRECTOR 1.00 X 0 0 0 RHONDA WRIGHT PAST DIRECTOR 1.00 X 0 0 0 C TODD AHRENS PRESIDENT & CEO 40.00 X 418363 0 130648 ROGER DIX VICE PRESIDENT - FINANCIAL SERVICES 40.00 X 351151 0 80393 TIMOTHY REUSCHEL VICE PRESIDENT - GENERAL COUNSEL 40.00 X 176419 0 49784 JULIE LEVERENZ VICE PRESIDENT - STATEGY A 40.00 X 195949 0 76843 SHARON NUNLEY VICE PRESIDENT - HUMAN RES 40.00 X 277437 0 20082 SARAH BRADSHAW VICE PRESIDENT - NURSING 40.00 X 199944 0 60215 G DOUG RUBLE VICE PRESIDENT - FACILITIE 40.00 X 163654 0 44886 JEFF EVANS VICE PRESIDENT - INFORMATI 40.00 X 180360 0 36259 PRANAV PARIKH MD VICE PRESIDENT - QUALITY A 20.00 X 203448 0 7121 LYNN OLSON CEO - HOSPITAL 40.00 X 327143 0 70919 TIMOTHY POLLEY EXECUTIVE DIRECTOR 40.00 X 223091 0 42888 LUVELL GLANTON ANESTHESIOLOGIST - PAIN MA 40.00 X 782330 0 38991 RICHARD VALUCK CARDIOLOGIST 40.00 X 579740 0 40935 PERVEZ ALVI CARDIOLOGIST 40.00 X 575752 0 26309 GLENN GORDON PHYSICIAN - GASTROENTEROLOGY 40.00 X 562008 0 27159 KEVIN LOLLAR PHYSICIAN 40.00 X 424571 0 27885 5641360 0 781317 67 0 1 0 BANC OF AMERICA LEASING PO BOX 100918 ATLANTA GA 30384 LEASING COMPANY 1496261 WEATHERBY LOCUMS PO BOX 972633 DALLAS TX 75397 LOCUM PHYSICIANS 1353822 DONALD A MILLER DO P LLC 3850 WASHINGTON ST HOLLYWOOD FL 33021 LOCUM PHYSICIANS 654475 ALLSCRIPTS HEALTHCARE LLC PO BOX 8538-0133 PHILADELPHIA PA 19171 IT SERVICES 581728 ADVANCE HANNIBAL HOSPITAL 3652 STARDUST DR HANNIBAL MO 63401 PHYSICAL THERAPY COMPANY 427159 39 604340 604340 NET PATIENT SERVICE REVENUE 621110 121634281 121634281 EHR MEANINGFUL USE 621110 2196035 2196035 123830316 1878439 1878439 338356 28173 310183 310183 310183 385462 35600 134136 16027 251326 19573 270899 270899 CHILDREN'S DEVELOPMENT CENTER 624410 763171 763171 CAFETERIA 722210 595191 595191 CONTRACTED SERVICES 621110 373699 373699 237072 115641 121431 1969133 128863310 125082827 0 3176143 105252 105252 3119616 490677 2628939 47334718 39999681 7081779 253258 2219919 1876468 332221 11230 10978066 9279613 1642917 55536 3147830 2660174 470973 16683 39307 39307 128675 128675 20200 17098 3102 9804369 9701030 103339 596169 596169 17163500 14528114 2635386 722650 611690 110960 1497283 1267381 229902 639336 541169 98167 78406 66367 12039 898490 760531 137959 8413105 8413105 793441 671611 121830 BAD DEBT EXPENSE 8304350 8304350 PHARMACY DRUGS 3129418 3129418 FOOD 688839 688839 RECRUITING EXPENSE 479047 405491 73556 1161077 1028311 132766 121463063 105142539 15983817 336707 15552782 17513688 1253469 1260378 13241261 13780703 1483198 1128047 2507309 2376402 672870 881968 136248150 90037963 50472155 46210187 36243113 44574801 394564 611358 264000 5828974 7543533 127649695 136145065 16191829 21455304 15380116 13952527 5665967 3885328 4200283 4132680 41438195 43425839 X 82966746 88881797 1426027 1920913 1818727 1916516 86211500 92719226 127649695 136145065 X 7400247 996594 -1889115 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 20200 0 0 0 20200 0 PART II-B, LINE 1: PORTION OF MISSOURI HOSPITAL ASSOCIATION DUES RELATED TO LOBBYING - $16,694.45 AND MEDICAID CAMPAIGN 2014 - $3,506.00 1 2238 8194 30161 0 0 2693370 2693370 69771513 40557718 29213795 63783267 49480245 14303022 46210187 BOND ISSUE COST 109772 RECEIVABLE FROM HANNIBAL REGIONAL HOSPITAL FOUNDATION 4808924 SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN 1799420 CONSTRUCTION IN PROGRESS 825417 7543533 MINIMUM PENSION LIABILITY 2333260 SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN LIABILITY 1799420 4132680 X PART X, LINE 2: THE SYSTEM HAS BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, THE SYSTEM IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE SYSTEM APPLIES THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE INCOME TAX STANDARD. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE SYSTEM'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE SYSTEM IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE SYSTEM IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. THE TAX RETURNS FOR THE FISCAL YEARS 2011 TO 2013 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES. 1 1 X 1 X 0 1 1 1 0 1 1 3445424 438072 3007352 0.02480 10014400 7065970 2948430 0.02430 13459824 7504042 5955782 0.04910 2182983 1202999 979984 0.00810 339482 339482 0.00280 5998563 3020909 2977654 0.02450 260064 260064 0.00210 8781092 4223908 4557184 0.03750 22240916 11727950 10512966 0.08660 1875108 771903 1103205 0.00910 1765 1765 0.00000 479047 479047 0.00390 2355920 771903 1584017 0.01300 1 8304350 6228262 36329292 41792507 -5463215 X 1 1 1 HANNIBAL MEDICAL SUPPLY DME COMPANY 0.33000 0.33000 2 HANNIBAL MOBILE DIAGNOSTICS MOBILE IMAGING/RADIOLOGY SERVICES 0.50000 0.50000 3 ADVANCE HANNIBAL REGIONAL HOSPITAL LLC OUTPATIENT PHYSICAL THERAPY 0.50000 0.50000 1 1 HANNIBAL REGIONAL HOSPITAL 6000 HOSPITAL DRIVE HANNIBAL MO 63401 X X X HANNIBAL REGIONAL HEALTHCARE SYSTEM INC 1 1 X X X X X X X X X 13 1 1 1 X HANNIBALHEALTH.ORG X X X X X X X X 0 0 1 1 200.000000000000 1 200.000000000000 1 X X X X X X X 1 1 X X X 1 0 X X X X X 1 X 0 0 HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 3: 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 4: PIKE COUNTY MEMORIAL HOSPITAL, LOUISIANA, MISSOURI HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 5D: POSTED ON THE WEB. HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 7: ALTHOUGH WE'VE EXPERIENCED PROGRESS, ACCESS TO DENTAL HEALTH AND MENTAL HEALTH CONTINUE TO BE SIGNIFICANT PROBLEMS. COORDINATION OF CARE IN THE COMMUNITY CONTINUES TO BE A HIGH PRIORITY. HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 14G: INFORMATION ABOUT THE POLICY IS INCLUDED IN THE PATIENT RIGHTS BROCHURE PROVIDED TO ALL ADMISSIONS HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 18E: COMMUNICATIONS THROUGH MAIL AND PHONE INTERVIEWS ARE PURSUED TO RESOLVE ISSUES AND OBTAIN NEEDED INFORMATION TO QUALIFY PATIENTS. HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 20D: ELIGIBILITY FOR CHARITY CARE IS BASED ON THE INDIVIDUALS ABILITY TO PAY. A PERSON IS CONSIDERED FOR CHARITY CARE IF THEY MEET ANY OF THE FOLLOWING CRITERIA: THEY ARE UNINSURED, THEY HAVE INADEQUATE INSURANCE, INCOME LESS THAN 200% OF THE FEDERAL POVERTY GUIDELINES, SPENDABLE INCOME LESS THAN 5% OF THE BALANCE OWED OR LESS THAN $2,000 IN ASSETS AVAILABLE TO PAY HEALTHCARE EXPENSES. PART I, LINE 3C: THE CRITERIA UTILIZED TO DETERMINE ELIGIBILITY FOR CHARITY CARE IS BASED ON THE ABILITY TO PAY. 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, THERE IS LESS THAN $2,000 IN TOTAL ASSETS AVAILABLE TO PAY HOSPITAL EXPENSES (EXCEPTIONS HOME EQUITY, AUTO EQUITY, LIFE INSURANCE EQUITY). PART I, LINE 6A: PART I, LINE 6A: THE MISSOURI HOSPITAL ASSOCIATION HAS INCLUDED HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. IN THEIR ANNUAL COMMUNITY BENEFIT REPORT. PART I, LN 7 COL(F): A GROSS ESTIMATE WAS MADE BASED ON CURRENT EXPERIENCE. PART III, LINE 2: HISTORICAL EXPERIENCE WAS USED TO ESTIMATE BAD DEBTS BY PAYER CLASSIFICATION AND AGING CO-HORT. PART III, LINE 3: AN ESTIMATE 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, 2014 AND 2013, THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS WAS APPROXIMATELY $5,338,000 AND $4,755,000, RESPECTIVELY. 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: THE ORGANIZATION MAINTAINS EDUCATIONAL PROGRAMS TO KEEP STAFF APPRISED OF ALL POTENTIAL PROGRAMS THAT MIGHT ASSIST PATIENTS IN PAYING THEIR HOSPITAL CLAIM. STAFF MEMBERS ARE ENCOURAGED TO UTILIZE THIS KNOWLEDGE TO RECONCILE ALL OUTSTANDING BALANCES. PART VI, LINE 4: HANNIBAL, MARION COUNTY ARE RURAL COMMUNITES OF APPROXIMATELY 30,000 POPULATION. ALSO SERVED ARE SEVEN OTHER RURAL COUNTIES IN NORTHEAST MISSOURI. PART VI, LINE 5: SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, LINE 4A. 1 AMERICAN CANCER SOCIETY 3145 HIGHWAY 61 HANNIBAL MO 63401 131788491 501(C)(3) 7535 2014 PREMIER SPONSOR AND THE 2014 JECCC ON T-SHIRT MHA CENTER FOR EDUCATION PO BOX 60 JEFFERSON CITY MO 65102 430898947 501(C)(3) 87717 MCE HEALTH IMPR., RESEARCH AND SCHOLARSHIP FUND, MHA SPECIAL PROJECTS, MISSOURI CENTER FOR PATIENT SAFETY CONTRIBUTION, MISSOURI POISON CENTER CONTRIBUTION. HANNIBAL FREE CLINIC 3145 HIGHWAY 61 HANNIBAL MO 63401 141979983 501(C)(3) 10000 DONATED FUNDS RECIEVED FROM SALE OF OLD EQUIPMENT 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. 1 X X X X X X 1 1 0 0 0 0 0 0 0 C TODD AHRENS PRESIDENT & CEO 372561 0 34171 0 11631 0 84990 0 45658 0 549011 0 0 0 ROGER DIX VICE PRESIDENT - FINANCIAL SERVICES 253379 0 22952 0 74820 0 51705 0 28688 0 431544 0 0 0 TIMOTHY REUSCHEL VICE PRESIDENT - GENERAL COUNSEL 161462 0 9783 0 5174 0 22038 0 27746 0 226203 0 0 0 JULIE LEVERENZ VICE PRESIDENT - STATEGY A 178803 0 7094 0 10052 0 37289 0 39554 0 272792 0 0 0 SHARON NUNLEY VICE PRESIDENT - HUMAN RES 3941 0 0 0 273496 0 0 0 20082 0 297519 0 0 0 SARAH BRADSHAW VICE PRESIDENT - NURSING 168718 0 5452 0 25774 0 17145 0 43070 0 260159 0 0 0 G DOUG RUBLE VICE PRESIDENT - FACILITIE 130861 0 5141 0 27652 0 13510 0 31376 0 208540 0 0 0 JEFF EVANS VICE PRESIDENT - INFORMATI 160836 0 6111 0 13413 0 0 0 36259 0 216619 0 0 0 PRANAV PARIKH MD VICE PRESIDENT - QUALITY A 195479 0 7969 0 0 0 0 0 7121 0 210569 0 0 0 LYNN OLSON CEO - HOSPITAL 293998 0 20014 0 13131 0 30360 0 40559 0 398062 0 0 0 TIMOTHY POLLEY EXECUTIVE DIRECTOR 204144 0 11529 0 7418 0 24310 0 18578 0 265979 0 0 0 LUVELL GLANTON ANESTHESIOLOGIST - PAIN MA 719830 0 62500 0 0 0 0 0 38991 0 821321 0 0 0 RICHARD VALUCK CARDIOLOGIST 579740 0 0 0 0 0 0 0 40935 0 620675 0 0 0 PERVEZ ALVI CARDIOLOGIST 545752 0 0 0 30000 0 0 0 26309 0 602061 0 0 0 GLENN GORDON PHYSICIAN - GASTROENTEROLOGY 427051 0 56250 0 78707 0 0 0 27159 0 589167 0 0 0 KEVIN LOLLAR PHYSICIAN 397071 0 0 0 27500 0 0 0 27885 0 452456 0 0 0 PART I, LINE 1B ALL EXPENSES WERE APPROVED THROUGH THE NORMAL CHECK REQUEST AND EXPENSE REPORT PROCESS WHICH REQUIRES TWO SIGNATURES. CEO EXPENSES ARE APPROVED BY A BOARD MEMBER AND VALIDATED BY THE CONTROLLER, ALL BOARD MEMBER EXPENSES ARE APPROVED BY THE CEO AND VALIDATED BY THE CONTROLLER, AND ALL OFFICER AND KEY EMPLOYEE EXPENSES ARE APPROVED BY THE CEO AND VALIDATED BY THE CONTROLLER OR ANOTHER OFFICER. PART I, LINES 4A-B ROGER DIX, SERP, $64,771 SARAH BRADSHAW, SERP, $17,145 G. DOUG RUBLE, SERP, $14,554 SHARON NUNLEY, SEVERANCE $264,699 A THE INDUSTRIAL DEVELOPMENT AUTHORITY OF THE CITY OF HANNIBAL MISSOURI 531320446 410632AT0 2006-04-01 24064011 HOSPITAL REFUNDING REVENUE BONDS 0 0 0 B THE INDUSTRIAL DEVELOPMENT AUTHORITY OF THE CITY OF HANNIBAL MISSOURI 531320446 410632BJ1 2010-07-29 7588694 HOSPITAL REFUNDING OF ER ADDITION BONDS 1 0 0 A 11210000 26630884 2144250 24075822 410812 1 0 1 1 B 7430000 7430000 7588694 120532 1 0 1 1 A 0 1 1 1 0 0 0 1 B 0 1 1 1 0 0 0 1 A 1 0 0 1 SOCIETE GENERALE 14.800000000000 1 0 1 B 0 0 0 1 0 0 0 0 1 A 1 B 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: THE INDUSTRIAL DEVELOPMENT AUTHORITY OF THE CITY OF HANNIBAL, DATE THE REBATE COMPUTATION WAS PERFORMED: 09/03/2013 FORM 990, PART VI, SECTION B, LINE 11 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 WILL PRESENT THE PREPARED FORM 990 TO THE BOARD OF DIRECTORS AND ENTERTAIN QUESTIONS FROM DIRECTORS AND OFFICERS. THE CHIEF EXECUTIVE OFFICER AND 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 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 C, LINE 19 THE ARTICLES OF INCORPORATION AND AMENDMENTS THERETO ARE AVAILABLE ON THE MISSOURI SECRETARY OF STATE'S WEBSITE. FORM 990, PART XI, LINE 9: CHANGE IN MINIMUM PENSION LIABILITY -2,581,936. PEARL LOWRIE FUND NET ACTIVITY -5,956. NET CONTRIBUTION REVENUE FROM FOUNDATION 698,777. 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 HANNIBAL REGIONAL HOSPITAL HANNIBAL REGIONAL HOSPITAL FOUNDATION 175 SHINN LANE HANNIBAL MO 63401 431658744 FUNDRAISING MO 501(C)(3) LINE 11A, TYPE 1 HANNIBAL REGIONAL HEALTHCARE SYSTEM INC 1 HANNIBAL MOBILE DIAGNOSTICS PO BOX 1254 HANNIBAL MO 63401 300234397 IMAGING MO N/A RELATED -150 12074 0 0 0.50000 HANNIBAL MEDICAL SUPPLIES PO BOX 40 QUINCY IL 62306 262362717 MEDICAL SUPPLIES MO N/A RELATED 72861 221336 0 0 0.33000 ADVANCE HANNIBAL REGIONAL HOSPITAL LLC 3652 STARDUST DRIVE HANNIBAL MO 63401 461561480 PT/OT SERVICES MO N/A RELATED 280890 316979 0 0 0.50000 HANNIBAL REGIONAL PHYSICIAN HOSPITAL ORGANIZATION INC 6500 HOSPITAL DRIVE HANNIBAL MO 64301 431706291 PHYSICIAN HOSPITAL ORGANIZATION MO C -19551 60969 0.50000 0 0 1 1 0 0 0 0 0 0 1 0 1 1 1 1 1 1 0 0 ADVANCE HANNIBAL REGIONAL HOSPITAL LLC J 67572 COST INCURRED ADVANCE HANNIBAL REGIONAL HOSPITAL LLC M 569829 COST INCURRED