2014-04-16T09:59:11-07:00 2013-06-30 990 2012-07-01 440546366 CAPITAL REGION MEDICAL CENTER CAPI 5736325103 1125 South Madison Jefferson City MO 65101 Tom Luebbering 5736325103 2014-04-16 2012 2015-11-30 17:44:51Z Ed Farnsworth 1125 Madison Street Jefferson City MO 65101 154477763 0 X crmc.org X 1945 MO Capital Region Medical Center embraces its mission: To improve the health and promote wellness of the people and communities we serve to reflect commitment to a charitable purpose. 12 8 1565 186 22667 22667 360878 293636 167278790 153592408 431808 455520 1314 -2074 168072790 154339490 0 0 0 0 85277771 83121627 0 0 0 75334524 64686961 160612295 147808588 7460495 6530902 171320321 172140454 58681834 54495492 112638487 117644962 Capital Region Medical Center embraces its mission: To improve the health and promote wellness of the people and communities we serve to reflect commitment to a charitable purpose, in the form of a resident clinic as well as general inpatient and outpatient charity care. The medical center provides many services to the community at little or no financial gain. 0 0 2720772 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. In FY2013, the medical center provided $2720772 in charitable care. 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 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 the CRMC provides care without regard to ability to pay, to individuals with limited financial resources and explain how patients appy 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. 1844224 0 828334 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, and the Linn State Physical Therapy Assistant Program. In addition to the direct financial support the 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 Saint Louis University and University of Missouri PTA and PT programs. As well as assistance to the University of Missouri dietetics program. Our support for these programs is not only through the provision of training facilities but also adjunct faculty and resources. 244023 0 116673 Resident Clinic: The Resident clinic is unopposed, giving residents a great deal of hands on experience. The mission of our program is to train capable, compassionate family physicians in an environment of mutual respect based in real-world experiences. In addition to providing a valuable training tool, the resident clinic serves a unique community benefit by providing approximately 2600 patient visits from the eight county service area which bases the charge on the individual's ability to pay, which in many cases is free. 126426109 0 152150676 All Other Inpatient and Outpatient Services provided to patients. 126426109 0 152150676 131235128 1 1 0 1 0 0 0 0 0 0 1 1 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 1 0 0 0 0 0 1 0 0 0 1 95 0 1 1565 1 1 1 0 0 0 0 0 X 12 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Tom Luebbering 5736325100 1432 Southwest Blvd Jefferson City MO 65109 Carrie Carroll 2 0 X 0 0 0 Mitchell Wasden 2 0 X 0 0 0 Lorelei Schwartz 2 0 X 0 0 0 James Ross 2 0 X 0 0 0 Charlie Dudenhoeffer 2.5 0 X 0 0 0 Dr Neal G Lapointe 40 X 213215 0 32271 Kenneth Littlefield 2.5 0 X 0 0 0 Anne Lock 2 0 X 0 0 0 Naught Sharon 2.5 0 X 0 0 0 John Pletz 2.5 0 X 0 0 0 James Wisch 2 0 X 0 0 0 Dr Lisa Kolb 40 0 X 214566 0 36349 Dr Lorenzo McKnelly 40 0 X 292846 0 40298 Samuel Bushman 2 0 X 0 0 0 Ed Farnsworth 40 0 X 364684 0 37695 Jim McMillan 40 0 X 233615 0 36249 Jason Cecil 40 0 X 141012 0 30602 Janet Weckenborg 40 0 X 188135 0 33705 Robert Mazur 40 0 X 139583 0 25888 Tawny Sandifer 40 0 X 174459 0 32759 Thomas Niekamp 40 0 X 99972 0 0 Dr Randall Haight 40 0 X 269282 0 39307 Thomas Luebbering 40 0 X 28760 0 3945 Dr Mitchell Godbee 40 0 X 896474 0 53284 Dr Matthew Hrastich 40 0 X 740167 0 50080 Dr Dennis Luetkemeyer 40 0 X 649786 0 42967 Dr Eston Schwartz 40 0 X 499997 0 45157 Pat Macfarlane 40 0 X 501348 0 45157 5647901 0 585713 95 0 1 1 Aramark Healthcare Support Services 25271 Network Place Chicago IL 606731252 Management Services 1812844 University of Missouri One Hospital Drive Columbia MO 65212 Professional and Medical Services 1188313 Boyce and Bynum Laboratory PO Box 7406 Columbia MO 65205 lab services 1159753 General Electric 8200 W Tower Ave Milwaukee WI 53223 Equipment Maintenance 802304 Healthlink Inc P O Box 6501 Carol Stream IL 601976501 Managed Care 380427 42 0 0 0 293636 0 0 0 293636 Net Patient Service Revenue (less Allow for Uncollectibles) 622000 149198025 149175358 22667 0 Other 900099 4394383 4394383 0 0 0 0 0 0 153592408 450717 450717 0 0 22306 22306 0 0 0 0 0 0 0 0 0 120770 0 138273 0 -17503 -17503 -17503 0 0 0 Share of K-1 loss 611710 -2074 -2074 0 0 0 0 0 0 -2074 154339490 154023187 22667 0 0 0 0 0 0 0 0 0 2559260 0 2559260 0 0 0 0 0 65020862 57387413 7633449 0 2246287 1982573 263714 9135382 8062887 1072495 4159836 3671471 488365 0 0 0 190122 167799 22323 181850 160498 21352 0 0 0 0 0 0 10394588 9497563 897025 213282 188240 25042 0 0 0 0 0 0 0 0 0 658823 581469 77354 0 0 0 0 0 0 343874 303499 40375 1218305 1218305 0 0 0 0 10433250 8360118 2073132 1601231 1413226 188005 Supplies 28407333 28016155 391178 0 Repairs and Maintenance 3568754 3149737 419017 0 Utilities/Phone 2627217 2318748 308469 0 FRA 4056977 4056977 0 0 791355 698450 92905 147808588 131235128 16573460 0 8379167 5018140 1921608 1938033 17208953 17444924 3485763 3321878 1788715 2169898 196520733 138210890 63866370 58309843 67840756 76463675 6828989 7474063 171320321 172140454 22312204 19594410 32835000 31120000 3534630 3781082 58681834 54495492 X 109487984 114413210 3080157 3161406 70346 70346 112638487 117644962 171320321 172140454 X 6530902 0 0 0 0 -1524427 X 1 X 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 0 0 1 20903 20903 0 SchC_P2B_S00_L01 Schedule C, Part II-B, Line 1 CRMC joined the Medicare Dependent Hospital Coalition ($9,750). This group lobbied in an attempt to protect the Medicare Dependent Hospital Status for hospitals. We are also members of the Missouri Hospital Association. Just one of the many benefits of this membership is tha MHA communicates with governments on issues that are important to Missouri hospitals. A portion of our annual dues is attributable to lobbying. ($11,153) Senior Leaders also met with representatives and senators to encourage them to support the MDH status. 0 7374188 7374188 0 115031865 80642094 34389771 0 2889626 1841317 1048309 0 70979742 55727479 15252263 0 245312 0 245312 58309843 Money Market Accounts 33831134 F Mortgage Backed Securities 12994626 F Interest Receivable 30755 F US Treasury Obligations 73678 F Corporate Bonds 5453726 F Certificates of Deposit 21478185 F Bond - Money Market Accounts 4504659 F Bond - Interest Receivable 34945 F Current Amounts -1938033 F 76463675 Insurance Payable 2211002 457(b) plan 1393515 Other Long Term Liabilities 176565 3781082 154047928 0 0 0 2074 2074 154045854 0 293636 293636 154339490 147924358 0 0 0 115770 115770 147808588 0 0 0 147808588 SchD_P11_S00_L02d Schedule D, Part XI, Line 2d Share of K-1 Loss SchD_P11_S00_L04b Schedule D, Part XI, Line 4b Contribution from Foundation SchD_P12_S00_L02d Schedule D, Part XII, Line 2d Foundation Expenses paid by Hospital Stmt10 1 1 1 X 1 X 1 1 1 0 1 1 2720772 789469 1931303 0.0131 15261241 12965238 2296003 0.0155 0 0 17982013 13754707 4227306 0.0286 566 15600 290582 148129 142453 0.0009 1844224 828334 1015890 0.0069 2178102 1709480 468622 0.0032 1348 0 1348 0 125083 0 125083 0.0008 566 15600 4439339 2685943 1753396 0.0118 566 15600 22421352 16440650 5980702 0.0404 4724 0 4724 0 6777 0 6777 0 52104 0 52104 0.0004 5954254 4351716 1602538 0.0108 0 0 6017859 4351716 1666143 0.0112 0 1542141 0 42933112 41706705 1226407 X 1 1 1 1 Capital Region Medical Center

1125 Madison Street Jefferson City MO 65101

crmc.org X X X X Capital Region Medical Center 1 1 X X X X X X X X X X 12 1 1 1 X X X X X X X X X 1 0 1 1 200 0 1 X X X X X 1 1 X X X X X X 1 X X 1 X X X X X X 1 X 0 0 16 Capital Region Southwest

1432 Southwest Blvd Jefferson City MO 65109

Outpatient Services CRMC-Women & Children Building

1014 Madison Street Jefferson City MO 65109

OB/GYN and Pediatrics CRMC Cap City Medical Assoc

1505 Southwest Blvd Jefferson City MO 65109

Family Practice and Internal Medicine Mid Mo Medical Associ and CRMC Surgical and Cardio

1125 Madison Jefferson City MO 65101

Specialty Outpatient Clinic CRMC-SW Clinic

1500 Southwest Blvd Jefferson City MO 65109

Family Practice Resident Clinic-Doctor's Park

1111 Madison Street Jefferson City MO 65109

Low Income Health Clinic and OB/GYN CRMC Healthplex West

3308 West Edgewood Drive Jefferson City MO 65109

Outpatient Services CRMC-Eldon

103 Business Highway 54 North Eldon MO 65026

Family Practice CRMC-Owensville

3536 Kuhne Road Owensville MO 65066

Family Practice CRMC-Versailles Clinic

901 Kidwell Drive PO Box 160 Versailles MO 65084

Family Practice CRMC-California

704 Buchanan Highway 50 West California MO 65018

Family Practice Capital Region Family Medical Center

420 East High Street Jefferson City MO 65101

Family Practice Capital Region Family Medicine

1616 Southridge Suite 203 Jefferson City MO 65109

Family Practice CRMC-Holts Summit

180 North Star Holts Summit MO 65043

Family Practice Integrative Medicine

1002 Diamond Ridge Suite 203 Jefferson City MO 65109

Family Practice CRMC-Linn Clinic

916 East Main Street Linn MO 65051

Family Practice SchH_P01_S00_L07 Schedule H, Part I, Line 7 Cost to charge ratio SchH_P02_S00_L00 Schedule H, Part II Capital Region's mission is to improve the health and promote wellness of the people and communities we serve, and this mission is carried out through community building activites. Board members and leaders travel to communities in which the hospital has a clinic presence to educate and update community members about hospital activities, wellness initiatives, expansion projects, wellness screenings and educational opportinities, etc. Senior leaders meet with leaders of St. Mary's and area cardiologists to collaborate on cardiac care. The purpose is to provide the best quality care for patients while considering the most efficient use of resources. CRMC expended many resources to recruit and employ physicians to provide services in medical shortage areas. SchH_P03_S0A_L04 Schedule H, Part III, Section A, Line 4 The Medical Center maintains an allowance for doubtful accounts for estimated losses inherent in its accounts receivable portfolio. In establishing the required allowance, management considers historical bad debt write offs and current receivable aging. The amount in Line 2 was determined using Cost to Charge ratios from worksheet 2. We have no means of determining the amount to report on Line 3. SchH_P03_S0B_L08 Schedule H, Part III, Section B, Line 8 no shortfall SchH_P03_S0C_L09b Schedule H, Part III, Section C, Line 9b CRMC will use Presumptive Charity software to score potential accounts meeting the charity guideline. CRMC will use the Federal Poverty Level, estimated household income and family size identified by the Presumptive software product in lieu of a completed application. Each patient account will proceed through the normal collection process up to and including a Final Notice Letter. Prior to referral to the collection agency, CRMC will batch each account and process through the software to identify potential accounts meeting the established guidelines for charity. These accounts will then be processed for adjustment to 100% of the charity discount and not forwarded to the collection agency. If a patient/guarantor after receiving the charity care discount, are financially responsible for a portion of the charges and do not meet the obligation of the account we will then follow the credit policies of the hospital. These policies may include colleciton activity up to and including placement to a collection agency, reporting to the credit bureau and filing lawsuits. SchH_P05_S0B_L01 Schedule H, Part V, Section B, Line 1 CRMC is developing an individual strategic implementation plan as part of the organization's strategic planning process. SchH_P05_S0B_L04 Schedule H, Part V, Section B, Line 4 The CHNA was done in cooperation with St. Mary's Health Center SchH_P05_S0B_L05 Schedule H, Part V, Section B, Line 5 Review of the CHNA was provided to the Medical Center managers, Board of Directors, the Foundation, and also at Community outreach meetings. SchH_P05_S0B_L11 Schedule H, Part V, Section B, Line 11 We use the average discount of the 3 highest managed care plans SchH_P05_S0B_L13 Schedule H, Part V, Section B, Line 13 The policy is explained on the back of the charity application. SchH_P05_S0B_L14 Schedule H, Part V, Section B, Line 14 The policy is explaned on the back of the charity application. SchH_P06_S00_L02 Schedule H, Part VI, Line 2 The study was conducted May through August 2012, to identify health issues of primary concern and to provide critical information to those in a position to make an impact on the health of our region - governments, social service agencies, businesses, health care providers and consumers, to name just a few. The results enable all of us to more strategically establish priorities, delvelop interventions, and commit resources to improve the health of our communities and the region. SchH_P06_S00_L03 Schedule H, Part VI, Line 3 Patient Financial Services consels patients/persons regarding financial assistance via telephone and in person as needed. This information is presented to the patient in the patient handbook, at the time of registration. Information also appears on our website at crmc.org SchH_P06_S00_L04 Schedule H, Part VI, Line 4 8 County service area in Mid-Missouri, including counties of Callaway, Cole, Gasconade, Maries, Miller, Moniteau, Morgan and Osage. SchH_P06_S00_L05 Schedule H, Part VI, Line 5 Capital Region is a 100-bed facility offering a continuum of care in-house from prenatal and maternity services to home health services. It also offers one of the few accredited rehabilitation centers in the state, and advanced cardiac and oncology services. In addition to being a full-service hospital, Capital Region Medical Center operates an extensive clinic system from the urgent care centers to specialty physician practices. Throughout the history of Capital Region Medical Center, the mission has stayed the same - to improve the health and promote wellness of the people and communities we serve. SchH_P06_S00_L06 Schedule H, Part VI, Line 6 On October 21, 1997, Capital Region formed an affiliation with the University of Missouri Health System. The affiliation combines the strengths of an academic medical center with the strengths of a community-based hospital. The relationship has been positive for employees, hospital families, and the people served. SchH_P06_S00_L07 Schedule H, Part VI, Line 7 Missouri. CHNA is also provided vis public website, having multi-state transparency. X X 1 1 X X X 0 0 0 1 0 1 0 1 0 Dr Neal G Lapointe 146145 0 17105 0 49965 0 7480 0 24791 0 245486 0 Ed Farnsworth 271010 0 93674 0 0 0 12500 0 25195 0 402379 0 Jim McMillan 188941 0 44674 0 0 0 9499 0 26750 0 269864 0 Thomas Luebbering 18760 0 10000 0 0 0 0 0 3945 0 32705 0 Janet Weckenborg 159911 0 28224 0 0 0 8250 0 25455 0 221840 0 Robert Mazur 124408 0 15174 0 0 0 6340 0 10697 0 156619 0 Tawny Sandifer 147935 0 26524 0 0 0 7750 0 25009 0 207218 0 Jason Cecil 125238 0 15774 0 0 0 6500 0 24102 0 171614 0 Dr Randall Haight 239319 0 29963 0 0 0 11680 0 27627 0 308589 0 Dr Lorenzo McKnelly 239197 0 53649 0 0 0 12163 0 28135 0 333144 0 Dr Lisa Kolb 196344 0 18222 0 0 0 9848 0 26500 0 250914 0 Dr Mitchell Godbee 787833 0 108642 0 0 0 12500 0 40784 0 949759 0 Dr Matthew Hrastich 625952 0 114214 0 0 0 12500 0 37580 0 790246 0 Dr Dennis Luetkemeyer 577112 0 72673 0 0 0 7500 0 35467 0 692752 0 Pat Macfarlane 501348 0 0 0 0 0 12500 0 25308 0 539156 0 Dr Eston Schwartz 499947 0 50 0 0 0 12500 0 32657 0 545154 0 SchJ_P01_S00_L01a Schedule J, Part I, Line 1a Ed Farnsworth - CRMC pays monthly dues for the Jefferson City Country Club. This is used for many business reasons. If Ed incurs any personal expenses, he reimburses the medical center. Bob Mazur- CRMC pays for his YMCA membership. Bob is a member of the YMCA board, and it is expected that he be a member. Gross up Payment of Taxes - The medical center gives most employees a gift card for the holidays. This is taxable income to the employee. The hospital pays the employee's portion of the taxes on this, and the employee's taxable gross is increased accordingly. SchJ_P01_S00_L03 Schedule J, Part I, Line 3 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 three board members, including the Chair and the 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. SchJ_P01_S00_L05 Schedule J, Part I, Line 5 For all employees, annual merit increases are partially based on the achievement of goals (personal and organizational). Some of these organizational goals may be tied to revenues. SchJ_P01_S00_L06 Schedule J, Part I, Line 6 For all employees, annual merit increases are partially based on the achievement of goals (personal and organizational). Some of these organizational goals may be tied to net earnings. SchJ_P01_S00_L07 Schedule J, Part I, Line 7 Some 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 receive a base salary, but also are paid an additional amount based on production. A Health Facilities Revenue Bonds Series 2011 431178966 60637ACF7 2011-11-22 32690247 Refund Series 1998 and 2004 Bonds (issued 12/29/98 and 6/29/2004) 0 0 0 A 1715000 0 32690247 2908325 0 0 460920 0 0 0 29321002 0 2004 1 0 1 1 A 0 0 0 0 0 1 0 0 A 0 1 0 0 0 0 0 0 0 Sharon Naught board member 38659 Purchased insurance through a bid from Sharon Naught's family business 0 James Wisch board member 12862 Construction services from family business 0 Dayna Lapoint Employee and wife or board member 39573 salary and benefits 0 Central Bank board member is officer of bank 151770 Banking fees and pension administration 0 DBSW Docs LLC Lisa Kolb, board member is part owner of DBSW 205824 CRMC rents office from DBSW 0 F990_P06_S0A_L06 Form 990, Part VI, Section A, Line 6 The organization has 2 members; The University of Missouri Medical Alliance and CRMC Healthcare INC. F990_P06_S0A_L07a 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. F990_P06_S0A_L07b 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 the major service lines. F990_P06_S0B_L11b Form 990, Part VI, Section B, Line 11b The Form 990 is reviewed by the Director of Accounting, legal counsel, the Vice President of Finance, and the President. The President presents it to the board chair and the Executive Committee of the Board. The Executive Committee makes a presentation to the Board and copies are available to each member. F990_P06_S0B_L12c 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 Director of Accounting reviews payments and identifies any potential conflcts. F990_P06_S0B_L15 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 them to the compensation committee, consisting of three board members, including the Chair and the Vice Chair. The compensation committee reviews the evaluation results with the CEO and determines the CEO's salary based on the 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 arrangement. The committee documents their review and decisions. The committee meets at least once annually. The CEO sets the recommended salaries for key employees using comparable data from from the three salary surveys. The Vice President of Human Resources participates in determining the appropriate salaries for key employees. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 Capital Region includes financial statements in the annual report provided to the Board fo Governors (approximately 500 people). Financial information is reviewed at the Medical Executive and Medical Staff meetings monthly. The information is then shared at the managers meeting, and communicated to all staff at department meetings. The Capital Region website (crmc.org) provides important information about the medical center to the community. The "Fraud and Wrongdoing" policy, "Privacy" policy, "Affiliation and Accreditations" policy, leader profiles, site locations, and contact information are all disclosed on the website. F990_P11_S00_L09 Form 990, Part XI, Line 9 Increases: SFAS#136 $81,249, K1 Loss $2,074 Decreases: Cash Transfers to Related Party ($115,770) Transfers to UMHS ($1,491,980) Capital Region Medical Foundation PO Box 1128 Jefferson City MO 651021128 431506900 Raise money and manage funds to be used in the furtherance of the exempt purpose of the medical ctr MO 501(c)(3) Support 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, and the communities i MO 501(c)(3) Supporting Org Typ 1 N/A 0 Osteopathic Postdoctural Training 800 W Jefferson Kirksville MO 63501 431831943 To promote the highest quality of osteopathic postdoctoral education training. MO N/A Related -1845 26202 0 1 0.087 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 Capital Region Medical Foundation o 115770 Salary of Foundation Director is actually salary paid in addition to estimated benefit cost. Capital Region Medical Foundation c 293636 Cash Value Capital Region Medical Center Partners m 337574 The Partners have donated 46,562 volunteer service hours in 2012. At minimum wage, this would be valued at $337,574 Still Osteopathic Medical Foundation q 1629 The Foundation reimburses CRMC for the costs associated with the Physician Health Program. July 7 2013 - Efiled Form 8868, Extension approved. Deadline extended to February 15 2014 September 24, 2013 - Mailed Form 8868. November 25, 2013 deadline extended to May 15 2014.