2022-08-01T11:36:35-05:00 2021-09-30 481026809 Wendling Noe Nelson & Johnson LLC 623 SW 10th Ave Suite 300 Topeka KS 66612 990 2020-10-01 440668347 Cameron Regional Medical Center CAME 8166322101 1600 East Evergreen Street Cameron MO 64429 Joseph Abrutz Jr Administrator 8166322101 2022-07-28 1 Joseph Abrutz Jr 999009999 Heather R Eichem P01515553 7852334226 2022-07-28 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z Joseph Abrutz Jr 1600 East Evergreen Street Cameron MO 64429 89192182 0 X http://www.cameronregional.org/ X 1963 MO Provide inpatient and outpatient medical care to area residents regardless of ability to pay. 13 11 611 43 0 0 267964 15869887 53682338 62509114 1827222 4116692 230430 134886 56007954 82630579 27050 31650 0 0 34432474 35367260 0 0 1484 28380544 30947586 62840068 66346496 -6832114 16284083 101205646 104254147 50559184 33259260 50646462 70994887 X Our mission at Cameron Regional Medical Center (CRMC) is caring for all patients. To this end, we organize people, equipment, and facilities in a manner that best responds to their needs and to the needs of our service area. Our priorities are patients and families, physicians, and employees. Our goal is to be a regionally-recognized leader in patient satisfaction by exceeding customer expectations and continuing to achieve excellence in quality and cost-effective health care services. Cameron Regional Medical Center (CRMC) will provide services in an atmosphere that involves compliance with governmental mandates. Throughout our organization, our employees strive to provide sensitive and quality health care at all times by living our values. Lastly, CRMC recognizes the importance of viable and profitable operations to guarantee the continued existence and growth of the facility. 0 0 59427128 31650 62509114 Acute care hospital organized to provide inpatient and outpatient care to area residents regardless of ability to pay. 59427128 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 63 0 1 611 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 1 0 0 X Joseph Abrutz Jr 8166322101 1600 East Evergreen St Cameron MO 64429 Warren McElwain President 1.00 X X 0 0 0 Delvin Jackson Vice-President 1.00 X X 0 0 0 Jennifer White Secretary 1.00 X X 0 0 0 Michael Poland Treasurer 1.00 X X 0 0 0 Don Gitthens Director (Through 01/2021) 1.00 X 0 0 0 Barbara Ballew Director 1.00 X 0 0 0 Ken Raffety Director 1.00 X 0 0 0 Steve Tinnen Director 1.00 X 0 0 0 Mike Brown Director 1.00 X 0 0 0 David Just Director 1.00 X 0 0 0 JoEllen Pratt Director (Beg. 01/2021) 1.00 X 0 0 0 Laeeq Azmat Tahirkheli Physician & Director 41.00 X 912129 0 0 Laura Harbison Physician & Director 43.00 X 390923 0 0 Mark Baker Director 1.00 X 0 0 0 Joseph F Abrutz Jr Administrator 40.00 X 917620 0 15221 Rosa Patti Chief Financial Officer 40.00 X 189253 0 18051 Muhammad Amin Physician 40.00 X 533889 0 0 Barry Littlejohn Physician 39.00 X 526473 0 0 Shahzad Shafique Physician 40.00 X 655758 0 0 Ly Phan Physician 40.00 X 499751 0 0 Arihant Jain Physician 40.00 X 528231 0 0 5154027 0 33272 50 0 1 0 Premier Specialty Network 1835 E Republic Rd Suite 200 Springfield MO 65804 Physician specialists 1910961 Cameron Emergency Physicians PC 1600 E Evergreen Cameron MO 64429 Emergency physicians 1076571 Psychiatric Solutions Inc PO Box 840839 Dallas TX 75284 Operation of BHU unit 1035770 Laboratory Corporation of America PO Box 12140 Burlington NC 27216 Reference lab services 969706 CPSI PO Box 850309 Mobile AL 36685 Computer support services 627042 13 94329 15618911 156647 15869887 Patient service revenue 622110 62509114 62509114 62509114 814888 814888 453 453 45715 0 45715 45715 45715 9849218 13736 6561603 0 3287615 13736 3301351 3301351 Cafeteria 722210 113268 113268 Other income 900099 -24097 -24097 89171 82630579 62509114 0 4251578 X 2650 2650 29000 29000 2023608 1339681 683927 28149253 26314029 1835224 545001 500038 44963 2709517 2516156 193361 1939881 1779841 160040 388654 388654 155188 155188 9888535 9218885 669650 240610 66506 174104 1375707 1120465 255242 502010 432634 69376 246861 207559 39302 1046087 906999 139088 3054194 2637470 416724 548020 81213 466807 Medical supplies 6072288 6072288 Pharmaceuticals 4465082 4465082 Repairs and maintenance 1773552 1186457 587095 Collection fees 371083 1119 369964 819715 549056 269175 1484 66346496 59427128 6917884 1484 469572 388183 21172820 19192502 9450136 8709815 1497332 1682452 263428 339289 75960526 53532240 21707418 22428286 42227049 48793481 4417891 2720139 101205646 104254147 6653852 5796800 25479437 24420470 776741 625415 5301306 63130 12347848 2353445 50559184 33259260 X 49823634 70203446 822828 791441 50646462 70994887 101205646 104254147 X 16284083 4108450 -44108 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1890592 1890592 30229451 17191227 13038224 41484882 35646070 5838812 2355601 694943 1660658 22428286 Third party payor settlements 1131321 Advances 1222124 2353445 X Part X, Line 2: Management is not aware of any uncertainties in income tax positions. 1 1 1 X 1 X 1 1 0 1 1 140369 558316 0 0.00000 6842784 5837488 1005296 0.01520 6983153 6395804 1005296 0.01520 227048 1925 225123 0.00340 29000 29000 0.00040 20591358 11063926 9527432 0.14360 2500 2500 0.00000 20849906 11065851 9784055 0.14740 27833059 17461655 10789351 0.16260 1 5084840 508484 18927061 18445660 481401 X 1 1 1 1 Cameron Regional Medical Center 1600 East Evergreen Street Cameron MO 64429 X X X Cameron Regional Medical Center Inc 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X http://www.cameronregional.org X 1 18 0 1 0 1 X 100.000000000000 300.000000000000 X X X X 1 1 X X X 1 X https://cameronregional.org/ X https://cameronregional.org/ X https://cameronregional.org/ X X X X X 1 X 0 X X 1 X 0 0 Cameron Regional Medical Center, Inc. Part V, Section B, Line 5: The Medical Center conducted a town hall meeting and invited local hospital, public health community, mental health community, free clinics, community-based clinics, service providers, local residents, community leaders, opinion leaders, school leaders, business leaders, local government, faith-based organizations and persons (or organizations serving them), people with chronic conditions, uninsured community members, low income residents, and minority groups. Cameron Regional Medical Center, Inc. Part V, Section B, Line 11: With the onset of COVID-19 in late February 2020 and its relentless damaging effects that have extended to present day, Cameron Regional Medical Center (CRMC), like all hospitals, had to reallocate the bulk of its efforts and resources toward combatting this deadly pandemic. Throughout FYE September 30, 2021, COVID-19 mandated that quarantining, social distancing, and "no visitor" policies be maintained in the interest of public health, welfare, and safety, thereby cancelling our customary meetings of key stakeholders for discussing and updating CRMC's Community Health Needs Assessment and its associated Implementation Plan. Even though normal CHNA activities and collaborative efforts were thwarted by COVID-19, CRMC stepped up and became an integral part of the containment fight against the pandemic throughout northwest Missouri. As in FYE 2020, COVID-19 was once again the most severe and demanding of community health needs in FYE 2021.Operating in "survival mode" for an extended period of time created new and different problems than experienced earlier in the pandemic and exacerbated challenges in health care delivery, access, and health outcomes. Increased costs for treating higher acuity COVID-19 patients were incurred, and containment efforts brought higher expenses as CRMC faced increasing charges for labor, drugs, purchased services, personal protective equipment (PPE), and other medical and safety supplies needed for mitigation efforts. This complex and resource-intensive care created staffing shortages, exhaustion, and mental stress, which took a sharp toll on CRMC staff members. Wages and salaries had to be adjusted upward significantly for purposes of recruitment and retention. During COVID-19 mitigation efforts, lower revenues were experienced from decreased use of CRMC's other hospital services and the deferral of elective procedures and non-essential services. Outpatient visits, which typically result in lower expenses and higher margins, were depressed from normal levels throughout FYE 2021. Rural hospitals in particular suffered severe financial difficulties as result of the above challenges.Despite these financial stresses, CRMC was the "COVID testing and vaccine capital of rural Northwest Missouri." Since the inception of COVID-19 (early 2020), CRMC had tested approximately 22,011 individuals as of September 30, 2021, with 1,975 positives identified (9.0% overall). CRMC's 33 certified COVID vaccinators assisted area county health departments with numerous vaccination clinics in such locations as Mound City (Holt County), Savannah (Buchanan County), Bethany (Harrison County), Princeton (Mercer County), Hamilton (Caldwell County), Plattsburg (Clinton County), and Cameron (Clinton County). These same vaccinators administered vaccines to several hundred CRMC staff and local nursing home employees as well. CRMC's COVID expenses for the 12 months ended September 30, 2021, were just over $2.47 million.General notes addressing multiple CHNA priorities/objectives:a) CRMC's 19th Annual Health Fair was held in early Fall 2021. Due to COVID-19, the Health Fair was held in the same "distributed" format as the previous year, with services being provided in six different locations in order to decrease crowd size at each facility. Health Fair services were provided throughout five counties by utilizing the Orthopedic & Rehab Center at CRMC, plus five satellite clinic locations (Lathrop, Bethany, Hamilton, Jamesport, and Maysville). The number of offerings were downsized to reduce exposure time; however, extensive blood work (anemia, blood sugar, thyroid, cholesterol panel, iron, GFR, and BUN/Creatinine), blood pressures, and pulse oximetry were still provided, all free of charge. Medical providers were on site at each location and available to counsel/educate attendees regarding medications, vaccinations, mental health, exercise, nutrition, diabetes, etc. Over 450 participants from rural northwest Missouri attended this annual health and wellness event, representing an increase of approximately 110 from the previous year.b) Compiled by CRMC staff at the time of the ACA/IRS's enactment of CHNA legislation, a Regional Resource Directory was developed and is updated on a regular basis. Covering CRMC's four-county primary service area (Clinton, Caldwell, Daviess and DeKalb), the directory includes mental health resources/services, alcohol/drug treatment (substance abuse) programs, physicians, wellness/fitness centers, medical clinics/services, nutrition resources, weight loss programs, dentists, and several other categories affecting the health and well-being of area residents. The directory is distributed to the public upon request and disseminated at certain public meetings and education events as sponsored by CRMC. Priority/Objective No. 1 - Mental Health (Diagnosis/Treatment):Even though a shortage of mental health providers has continued in northwest Missouri, Cameron Regional Medical Center ("CRMC") remains committed to maintaining/growing its offerings in this specialty, particularly given the ever-increasing need. During FYE 2021, four part-time Psychiatrists (including a Child Psychiatrist) provided outpatient services on a regularly-scheduled basis, in addition to a full-time Geriatric Psychiatrist who provided inpatient services for CRMC's Behavioral Health Unit (BHU). For the past several years, CRMC's mental health services have been marketed widely throughout its service area and free transportation provided to those area residents in need of services. CRMC's 18 satellite clinics continue to serve as both education and referral centers for their patients' mental health needs. A CRMC calendar denoting mental health offerings is placed in 14-15 area newspapers on a monthly basis, as well as on the Medical Center's website. This calendar is also mailed to approximately 70 non-staff physicians in the surrounding area.CRMC continues to significantly underwrite/subsidize its mental health program financially in order to assure these services are readily available to all patients/payors (Medicare, Medicaid, self-pay, etc.).As previously referenced, CRMC has maintained its 10-bed BHU. During COVID-19, telepsychiatry services were utilized at least one day per week in order to enhance physician coverage. The BHU continues to play a vital role in CRMC's medical community by providing solutions and relief for area nursing homes, families, and physicians. A two-bed expansion of the Unit is contemplated.Through the CHNA process, Preferred Family Healthcare (PFH) in Kirksville, Missouri has become a valued partner for CRMC over the past few years, providing collective impact and resources/education otherwise unavailable in the area for both mental/behavioral health and substance abuse (see next section). Many CRMC staff members have participated in PFH's Mental Health First Aid classes that instruct on how to recognize signs of mental health or substance abuse challenges (see next section).The majority of CRMC's 18 satellite clinics continue to utilize the Patient Health Questionnaire-9 (PHQ-9) for depression screening purposes.Priority/Objective No. 2 - Substance Abuse (Opioids/Meth/Marijuana/Heroin, etc.):The CRMC Medical Staff and Board of Directors continue to prohibit the use and/or possession of marijuana on the CRMC campus, premises, and in its outlying/satellite facilities.CRMC primary care providers provide substance abuse counseling at both the Medical Center and in its 18 satellite clinics. Educational materials are provided per individual patient needs.Each year, the Medical Center assists the Cameron Police Department with marketing its annual "Prescription Drug Take-Back Day" held in conjunction with the DEA.CRMC, through its network of primary care clinics, physicians, mid-levels, and the hospital pharmacy, continues to facilitate and promote concerted efforts against prescription drug/medication abuse. The Medical Center's e-prescribing software and communication protocols with area pharmacies aid in monitoring and tracking "doctor shopping" efforts by patients suspected of abusing the system.As there is considerable "cross-over" in staff, CRMC pharmacists that also work locally in the retail setting have been taking the following precautions: a) Patients are not allowed to fill controlled prescriptions more than five days early; b) Any prescriptions presented by a patient not residing in the immediate area or written by a prescriber not in the immediate area will be investigated; c) Local retail pharmacy personnel and hospital pharmacy personnel communicate on a regular basis regarding suspicious controlled substance prescribing trends; and d) Any controlled prescriptions where the patient offers to pay by cash instead of using insurance will automatically be red-flagged for further investigation. Cameron Regional Medical Center, Inc. Part V, Section B, Line 11: In terms of health care professionals, the CRMC Medical Staff has been donating a substantial sum on an annual basis to the Missouri Association of Osteopathic Physicians and Surgeons' (MAOPS') Physicians Health Program (PHP). PHP provides addiction treatment resources and coordinates the care of the affected health care professional throughout his/her treatment program, with the goal of facilitating and expediting his/her return to health and a normal personal and professional life.Priority/Objective No. 3 - Available Affordable Health Insurance Coverage (Not directly addressed):While CRMC is not in the business of providing health insurance products, the Medical Center continually recognizes the financial stresses placed on area families and residents by medical costs and today's economy. Consequently, it provides support and financial assistance to its patients through various methods: a) The Medical Center assists individuals with both Medicare and Medicaid enrollment; b) CRMC subsidizes many of its Consulting Staff physicians (specialists) so they will see Medicaid patients, when otherwise they would not; c) Charity Care (financial assistance) is provided to qualifying individuals based on U.S. Federal Poverty Guidelines if the patient makes a good-faith effort and completes the applicable paperwork; d) A Prompt Pay Discount program is offered to anyone with self-pay balances, whether it be on hospital or satellite clinic services; e) Monthly audits are conducted internally to determine the public's satisfaction with CRMC's billing and collection practices; and f) Free public education meetings are held at least twice per year, focusing on the Patient Protection and Affordable Care Act (PPACA), Medicare, Medicaid, Part D, Advantage plans, and other third-party payors. These question-and-answer sessions cover all facets of public health care concerns, including billing, collecting, and insurance specifics/details.Priority/Objective No. 4 - Child Care Services (Not directly addressed):As child care is not a central component of CRMC's mission or operations, the Medical Center plays only a supporting role in addressing this need. The Medical Center cooperates in economic development efforts toward promoting new businesses whenever feasible in the hope of realizing additional pre-schools and child care centers in rural northwest Missouri. Priority/Objective No. 5 - Smoking/Vaping:Detailed information on smoking cessation continues to be included in all CRMC admission packets. For those emergency room patients who smoke, smoking cessation information is provided at the time of discharge. The Medical Center continues to assist its employees financially with smoking cessation products.CRMC primary care providers provide smoking cessation counseling at both the Medical Center and in its 18 satellite clinics. Educational materials are provided per individual patient needs.Smoking/vaping is prohibited within all CRMC facilities.Priority/Objective No. 6 - Poverty/Employment Readiness (Not directly addressed):While CRMC does not delve into the particulars of poverty and employment preparedness, it strives to provide public support and assistance whenever possible. As CRMC is situated close to the intersection of I-35 and U.S. Highway 36, this is particularly evident with indigent patients presenting to the Emergency Room in need of money for food and/or travel (bus/taxi). For this reason, CRMC maintains a close working relationship with area ministerial alliances to address individuals and/or families in need. Other assistance efforts come in the following forms: a) CRMC donates free-of-charge the use of a small building in Stewartsville, Missouri for Food Pantry purposes; b) Through the Caldwell County Health Department, the CRMC Foundation has made two sizeable donations to the Hideaway Lakes project at Polo, Missouri, with the funds earmarked for children, the elderly, and the installation of a fresh water supply for this impoverished community; and c) As previously mentioned under Priority/Objective No. 1 - Mental Health, perhaps the single largest expenditure CRMC commits to area poverty is the provision of free transportation to allow individuals to obtain needed medical services. For those who have no other viable means of travel, the Medical Center operates five Patient Courtesy Vans five to six days per week throughout more than eight counties in rural northwest Missouri. Patients are transported to and from the Medical Center, area physicians' offices, CRMC's satellite clinics, and/or CRMC's outpatient specialty clinics. Based on need, free transportation to area tertiary centers is also made available. Priority/Objective No. 7 - Alcohol/Drunk Driving (Not directly addressed):Although CRMC primary care providers continue to provide alcohol counseling and customized education materials to their patients at both the Medical Center and its 18 satellite clinics, alcohol abuse and resultant drunk driving are not a central component of CRMC's day-to-day operations. CRMC financially supports many post-graduation and post-prom parties throughout five-counties to assist in providing alternative activities to drinking for the safety of area high school students.Priority/Objective No. 8 - Obesity (Nutrition and Fitness):CRMC continues to sponsor free training/education classes focusing on diabetes, nutrition, food labels, and healthy eating. These are performed by CRMC's Registered Dieticians at least every-other month, with excellent participation rates and feedback from the public.CRMC still provides a regimented physician-assisted weight loss program at lower-than-normal rates via one of its satellite clinics.The CRMC Foundation continues to sponsor its annual 4-Mile Run, 2-Mile Walk, and Children's Fun Run. Approximately 250 runners, walkers, and children participate each year in these fitness/wellness events. However, for the first time ever, the Foundation's 33rd Annual 4-Mile Run and associated events that were scheduled for Saturday, October 2, 2021, had to be cancelled due to increasing concerns surrounding COVID-19. CRMC's Fitness Committee continues to sponsor fitness challenges for CRMC employees at least twice a year. CRMC continues to financially assist its employees and their family members with membership fees at area fitness centers.The CRMC Foundation still operates and maintains a one-mile wellness/fitness trail on the CRMC campus. This facility is available free-of-charge to the public 365 days per year during daylight hours. Annual maintenance expenses for the Trail average approximately $8,200.Due to the 2018 closing of the Cameron Nutrition Site (Stella Grinstead Center) in Cameron, Missouri because of State funding withdrawal, CRMC is still operating the Meals on Wheels Program to benefit homebound Cameron residents living in Clinton County. This effort provides hot, nutritious meals, to participants, as well as a daily "eyes-on" well-check encounter by the program's volunteer drivers. This service did not stop during COVID-19; however, delivery details were altered somewhat to protect both program participants and the volunteer drivers.CRMC primary care providers continue to provide weight control counseling at both the Medical Center and in its 18 satellite clinics.Priority/Objective No. 9 - Health Care Staffing Shortages:CRMC's high school scholarship program for FYE 2021 represented its 32nd annual offering. As an avenue for promoting the health care industry as a viable employment opportunity/consideration, a total of $14,000 was awarded to 25 graduating high school seniors entering a health care field of study. The number of awards was increased in FYE 2021 due to COVID-19 considerations and need. Awards are available to students residing throughout a five-county area and are renewable for an additional three years to cover undergraduate studies, provided the student remains in a health-care field of study and maintains at least a 3.0 GPA. CRMC continues to provide a total of $10,000 to second-year Allied Health Care students at North Central Missouri College in Trenton, Missouri on an annual basis. As a third prong to the Medical Center's scholarship efforts, the CRMC Medical Center still awards a $5,000 scholarship each year to a promising first-year medical student. Cameron Regional Medical Center, Inc. Part V, Section B, Line 11: CRMC serves as a clinical rotation site for the following colleges/universities/career schools: a) North Central Missouri College in Trenton, Missouri (Nursing); b) Missouri State University - West Plains (Nursing); c) Allen College (Occupational Therapy); d) Penn Valley Community College (Occupational Therapy); e) MHPC NW Consortium (Occupational Therapy); f) Barton Community College (Lab); g) Concorde Career College (Respiratory Therapy); h) University of Missouri - Kansas City (Family Nurse Practitioners); i) University of Missouri - Columbia (Family Nurse Practitioners); j) Various online study programs (Family Nurse Practitioners); and k) Excelsior Springs Area Career Center (Surgery). This allows CRMC to have first-hand exposure to the "best and the brightest" for recruitment purposes.When filling hard-to-find health care positions, CRMC will financially assist select employees, prospective employees, and providers with past or present education efforts.CRMC financially supports the HOSA (Health Occupations Students of America) BioMedical Science Program at Cameron High School to cultivate/promote continued interest in the health care professions.As previously indicated, telepsychiatry services are utilized in CRMC's BHU to assure the Medical Director is always available to provide patient care. 19 1 - Westside Medical Offices 1608 E Evergreen Cameron MO 64429 Medical Clinic 2 - Cameron Medical Clinic 1600 E Evergreen Cameron MO 64429 Medical Clinic 3 - Walnut Medical Clinic 921 N Walnut Cameron MO 64429 Rural Health Clinic 4 - Bethany Health Services 903 North 25th Street Bethany MO 64424 Medical Clinic 5 - Hamilton Family Health Center 103 N Davis Hamilton MO 64644 Rural Health Clinic 6 - Cameron Specialists - Internal Medicine 1608 E Evergreen Cameron MO 64429 Medical Clinic 7 - NW Missouri Obstetrics & Gynecology 221 E 7th Street Cameron MO 64429 Medical Clinic 8 - Maysville Family Health 1007 S Polk Maysville MO 64469 Rural Health Clinic 9 - Lathrop Medical Clinic 106 North Street Lathrop MO 64465 Medical Clinic 10 - Polo Family Health Center 198 Main Street Polo MO 64671 Rural Health Clinic 11 - Gallatin Family Medicine 502 S Main Gallatin MO 64640 Rural Health Clinic 12 - Jamesport Outreach Clinic 409 W Auberry Grove Jamesport MO 64648 Rural Health Clinic 13 - Pattonsburg Medical Clinic 110 N Central Ave Pattonsburg MO 64670 Rural Health Clinic 14 - Cameron Nephrology Clinic 1600 E Evergreen Suite B Cameron MO 64429 Medical Clinic 15 - Plattsburg Family Medicine 214 N Main Plattsburg MO 64477 Rural Health Clinic 16 - Eagleville Medical Clinic 12050 12th Street Eagleville MO 64442 Rural Health Clinic 17 - Gilman City Medical Clinic 427 Main Street Gilman City MO 64642 Rural Health Clinic 18 - Stewartsville Medical Clinic 106 E 4th Stewartsville MO 64490 Rural Health Clinic 19 - Cameron Obstetrics & Gynecology 1600 E Evergreen Suite A Cameron MO 64429 Medical Clinic Part I, Line 7: A cost-to-charge ratio derived from Worksheet 2 was used to calculate the amounts reported on line 7. Part I, Line 7g: The costs of subsidized health services include costs attributable to multiple physician clinics in the amount of $8,978,955. Part III, Line 4: See note B (beginning on page 11) of the audited financial statements regarding the allowance for uncollectible accounts.Part III Line 2:This amount was determined by multiplying a cost-to-charge ratio derived from Worksheet 2 by the Medical Center's bad debt expense for the tax year.Part III, Line 3:This amount was determined based on the overall income level of patients that submit all required documentation under the Medical Center's financial assistance policy. As a tax-exempt hospital, we must provide necessary services regardless of the patient's ability to pay for that care. Making quality patient care available to all in our community, regardless of their economic means, qualfies these bad debts as a community benefit. Part III, Line 8: Medicare costs were obtained from the Medical Center's as-filed Medicare cost report for the tax year.Any shortfalls are a benefit to the Medical Center's community since it represents health care provided at less than cost to elderly and needy residents of the Medical Center's service area.Revenue included in Medicare Cost Report $18,927,061Fee schedule revenue excluded from Medicare Cost Report 640,688Total Medicare revenue 19,567,749Expenses included in Medicare Cost Report $18,445,660Fee schedule expenses excluded from Medicare Cost Report 1,283,729Total Medicare expense 19,729,389Total net Medicare loss 161,640 Part III, Line 9b: At the time of admission and before discharge, each patient will receive a notice that the Medical Center has a Financial Assistance Policy (with a brief description of such policy) and directions for obtaining additional information about such policy. All itemized statements sent to the patient include a notice that the Medical Center has a Financial Assistance Policy and directions for obtaining additional information about such policy. If a patient submits a Financial Assistance Policy application, all payment notifications and collection actions are suspended until it is determined whether the patient is eligible for the Financial Assitance Policy (and if so, notifications and collection actions will cease). Part VI, Line 2: The Medical Center relies on the feedback and requests taken from patients of the Medical Center and its numerous clinics, as well as residents from its primary service area. Part VI, Line 3: The Medical Center employs a social worker that informs all patients of all available payment options. Part VI, Line 4: Cameron Regional Medical Center and its eleven rural health clinics are located in Northwest Missouri. The primary service area is comprised of four rural counties consisting of Daviess, Caldwell, DeKalb, and Clinton. There are approximately 49,458 individuals that reside in the primary service area. Of these residents approximately 11.6% of them have an annual income below the federal poverty level. The median annual income per household for the four counties is approximately $56,060. Approximately 37% of the total services provided are for Medicare patients and 10% are for Medicaid patients. The nearest surrounding hospitals are located in Smithville, Excelsior Springs, and Richmond. The distance between these facilities and Cameron Regional Medical Center is approximately 28, 28, and 31 miles respectively. Part VI, Line 5: Cameron Regional Medical Center's governing body is comprised of residents from its primary service area. The Medical Center extends medical privileges to all local physicians who meet the requirements of the medical staff bylaws. All surplus funds are used to maintain and improve the medical facility and medical equipment in order to provide the best medical treatment possible to every patient. 1 College scholarships 45 29000 Part I, Line 2: Scholarships are paid directly to the college of the recipient. X X X 0 1 0 0 0 1 0 1 0 Joseph F Abrutz Jr Administrator 339317 0 578303 0 0 0 0 0 15221 0 932841 0 0 0 Laeeq Azmat Tahirkheli Physician & Director 668164 0 243965 0 0 0 0 0 0 0 912129 0 0 0 Shahzad Shafique Physician 531347 0 124411 0 0 0 0 0 0 0 655758 0 0 0 Muhammad Amin Physician 429041 0 104848 0 0 0 0 0 0 0 533889 0 0 0 Arihant Jain Physician 510285 0 17946 0 0 0 0 0 0 0 528231 0 0 0 Barry Littlejohn Physician 489304 0 37169 0 0 0 0 0 0 0 526473 0 0 0 Ly Phan Physician 463107 0 36644 0 0 0 0 0 0 0 499751 0 0 0 Laura Harbison Physician & Director 384648 0 6275 0 0 0 0 0 0 0 390923 0 0 0 Rosa Patti Chief Financial Officer 98763 0 90490 0 0 0 0 0 18051 0 207304 0 0 0 Part I, Line 4b The Medical Center has established a deferred compensation plan (a 457 Plan subject to Code section 457(b)). The name of the Plan as adopted by the Medical Center is Cameron Regional Medical Center, Inc. 457(b) Plan. During the fiscal year end 09/30/2021, $17,538 was contributed to the Plan on behalf of Joseph F. Abrutz, Jr., Administrator of the Medical Center. Part I, Line 6 The Administrator is eligible for an annual bonus that is partially contingent on meeting a specific operating margin percentage. Part I, Line 7 The Administrator is eligible for an annual bonus that is partially contingent on meeting quality measures goals and strategic planning goals. The Chief Financial Officer also received a bonus during the fiscal year ending in 2021 for completing a variety of special projects for the Medical Center. A The Industrial Development Authority of Clinton County Missouri 431619770 18746NAM2 2017-09-06 10000000 Refund Series 2007B bonds issued on 05/17/2007 0 0 0 B The Industrial Development Authority of Clinton County Missouri 431619770 18746NAQ3 2017-09-06 3990000 Financing of capital project and equipment 0 0 0 C The Industrial Development Authority of the City of Cameron Missouri 431679396 133451BS2 2017-12-21 6105000 Refund Series 2011 bond and financing of capital project 0 0 0 D The Industrial Development Authority of the City of Cameron Missouri 431679396 NoneAvail 2019-08-22 2730000 Financing of capital projects 0 0 0 A 150000 10000000 480986 170257 9348788 2017 1 0 1 1 B 3990000 399025 68386 3504535 21250 2018 0 0 1 1 C 1205000 6105000 240015 121226 2827033 2939863 2019 1 0 1 1 D 2730000 175005 54600 2513835 2020 0 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 D 0 0 0 0 0 0 0 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 Form 990, Part VI, Section B, line 11b A copy of form 990 is made available to the governing body prior to filing. Form 990, Part VI, Section B, line 12c Employees and Directors are required to complete an annual disclosure information form. Form 990, Part VI, Section B, line 15a The Board of Trustees is responsible for deteriming the job performance standards for the Administrator/CEO and determining compensation according to the organization's policies. Form 990, Part VI, Section C, line 19 Organization makes its governing documents available upon request. Form 990, Part IX, line 11g Professional fees: Program service expenses 6,361,332. Management and general expenses 75,892. Fundraising expenses 0. Total expenses 6,437,224. Purchased services: Program service expenses 2,192,629. Management and general expenses 394,531. Fundraising expenses 0. Total expenses 2,587,160. Reference lab fees: Program service expenses 630,069. Management and general expenses 0. Fundraising expenses 0. Total expenses 630,069. Other fees for services: Program service expenses 34,855. Management and general expenses 199,227. Fundraising expenses 0. Total expenses 234,082. Form 990, Part XI, line 9: Change in beneficial interest in net assets of Foundation net of transfers -44,108. Form 990, Part XII, Line 2C: The audit committee assumes the responsibility for the oversight of the audited financial statements, review of the Form 990, and selection of the independent accounting firm. Cameron Regional Medical Center Provider Management Service Organization LL 1600 East Evergreen Street Cameron MO 64429 472649803 To provide support and administrative services to physician groups MO Cameron Regional Medical Center Cameron Regional Medical Center Foundation 1600 East Evergreen Street Cameron MO 64429 742933060 To support the operation of the Cameron Regional Medical Center, Inc. MO 501(c)(3) Line 7 0 0 0 1 0 1 0 0 0 0 0 0 1 1 1 1 0 0 0 0