2020-07-21T14:15:39-05:00 2019-06-30 450250958 EIDE BAILLY LLP 621 N ROBINSON AVE STE 200 OKLAHOMA CITY OK 731026232 990 2018-07-01 736617937 McCurtain Memorial Medical Management Inc MCCU 5802867623 1301 E Lincoln Rd Idabel OK 74745 Brad Morse CEO 5802867623 2020-07-15 1 Kim Hunwardsen CPA P00484560 4055942000 2020-07-15 216.147.181.47 2020-07-15 14:01:06 CD P E10085862974BF89EE8F231EB831862A8F193D10 96EA8C5DFC6EFE4FCBF1129FDB3AF0E7B3BD41AE 2018 2020-09-23 17:36:50Z McCurtain Memorial Hospital Brad Morse 1301 E Lincoln Rd Idabel OK 74745 22485331 0 X www.mmhok.com X 1975 OK To strive to be the healthcare provider of choice in our community 6 5 274 11 0 0 555094 2412519 18475585 19892322 9151 97905 -47348 -71239 18992482 22331507 0 0 0 0 9897130 7715953 0 0 0 10994645 12618180 20891775 20334133 -1899293 1997374 4150563 5175909 7636204 6664176 -3485641 -1488267 X McCurtain Memorial Hospital exists to provide appropriate, cost effective healthcare to our patients in a safe, healing environment while striving to be the healthcare leader of choice in our community. 1 1 18131392 19892322 We continue to provide quality health care to McCurtain County, Oklahoma and its surrounding areas. In addition, we endeavor to serve the public through such activities as wellness programs, community education programs, special programs for the elderly, handicapped and medically underserved and a variety of broad community support activities.To fulfill our mission of community service, we provide care to patients who meet certain criteria under our charity care policy without charge or at amounts less than our established rates. We maintain records to identify and monitor the level of charity care we provide.These records include the amount of charges foregone for services and supplies furnished under our charity care policy and equivalent service statistics. The amount of charges forgone, based on established rates were approximately $343,376 for the year ended June 30, 2019. The estimated cost of providing these services was approximately $100,865 for the year ended June 30, 2019.The Hospital has a Wellness Center-exercise area that community members can subscribe to and use the exercise equipment. Personnel are available to assist them. This program is available to all community members at a low-cost with discounted rates for seniors and is free to employees in order to help advocate healthy lifestyles. Total expense includes overhead cost (administrative & utilities) and the cost of depreciation for equipment. The Garden Meadows Walking Trail located at the Hospital is open to the public, in addition to employees, 24 hours a day, 7 days a week at no charge and is intended to promote physical activity for healthier lifestyles. Hospital expense to maintain the walking track includes labor, water, electricity, and depreciation. 18131392 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 49 0 1 274 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 5 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 0 1 0 0 OK X Chuck Cave 5802083104 1301 E Lincoln Rd Idabel OK 74745 Walter H Frey President 1.00 X X 0 0 0 John Migliaccio MD Vice President until 6/20/19 1.00 X X 0 0 0 Julia Grigory Secretary/Treasurer 1.00 X X 0 0 0 Ann Zimmer Trustee January - March 2019 1.00 X 0 0 0 Irvin C Jones Trustee 1.00 X 0 0 0 Johnnie Meredith Trustee 1.00 X 0 0 0 Michael West MD - Trustee Chief of Staff until March 2019 41.00 X 206039 0 22871 Brennan Hill Trustee starting April 2019 1.00 X 0 0 0 Dr Tom Salyer - Trustee Chief of Staff starting March 2019 1.00 X 0 0 0 Robin E Lake Interim CEO until Dec 2018 40.00 X 223849 0 0 Brad Morse - Interim CEO Dec 2018-May 2019; CEO as of June 2019 40.00 X 1538 0 0 Ray Whitmore Jr CFO until January 2019 40.00 X 84073 0 7398 Stephanie Helton Interim CFO from 1/14/19-2/20/19 40.00 X 0 0 0 Donna Wallace Interim CFO starting March 2019 40.00 X 0 0 0 David Flores - Nurse Anesthesiology (resigned 6/1/19) 40.00 X 239038 0 0 Monty Grugan DO Hospitalist (resigned 6/3/19) 40.00 X 191092 0 42284 945629 0 72553 4 0 1 0 Quick Med PLLC 1400 SE Adams Idabel OK 74745 ER Physician 710615 Western Healthcare PO Box 203152 Dallas TX 75320 CRNA Coverage 546854 Create a Storehouse 1970 Marie Drive Durant OK 74701 ER Physician 328620 CPSI PO Box 850309 Mobile AL 36685 Computer support 320573 Delta Locum Tenen LLC PO Box 202940 Dallas TX 75320 ER Physician 115118 5 2410019 2500 2412519 Net Patient Serv Rev 622110 19846438 19846438 Cafeteria 900099 27878 27878 18006 18006 19892322 1252 1252 79238 150477 -71239 -71239 -71239 100000 3347 96653 96653 96653 22331507 19892322 0 26666 626533 243913 382620 6154387 5764550 389837 177 157 20 463012 435493 27519 471844 418093 53751 19650 19650 86288 86288 1830248 1363776 466472 1865 1865 380686 342752 37934 333795 333795 93035 40101 52934 -329 -2354 2025 98297 98297 366410 366410 784632 109573 675059 Provision for Bad Debts 6826665 6826665 Medical Supplies 1282566 1282566 Repairs and Maintenance 481743 480205 1538 Dues, Subcriptions, Lic 32465 27236 5229 164 164 20334133 18131392 2202741 0 129327 255591 1623495 1874696 10000 308499 433707 201124 369511 17617166 15535543 1701578 2081623 186540 150781 4150563 5175909 5387167 3458282 381114 585355 293732 325916 1574191 2294623 7636204 6664176 X -3485641 -1488267 -3485641 -1488267 4150563 5175909 1997374 0 X 0 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 37450 37450 8377036 7625947 751089 8830453 7598412 1232041 372227 311184 61043 2081623 Health insurance reserves 19865 Taxes payable 692822 Estimated third-party payor settlements 1581936 2294623 1 1 X 1 X 1 X 1 1 1 0 0 100865 100865 0.00750 253552 253552 0.01880 354417 354417 0.02630 68900 51849 17051 0.00130 68900 51849 17051 0.00130 423317 51849 371468 0.02760 0 6826665 2136746 5952109 5990541 -38432 X 1 1 1 1 McCurtain Memorial Medical Management 1301 E Lincoln Rd Idabel OK 74745 www.mmhok.com 2202 X X X X McCurtain Memorial Medical ManagementIn 1 0 0 1 X X X X X X X X X 18 1 0 1 1 X www.mmhok.com/about/CHNA_2019.html X www.osururalhealth.blogspot.com/p/chna.html X 1 18 1 www.mmhok.com/about/CHNA_2019.html 0 1 X 100.000000000000 300.000000000000 X X X X 1 1 X X X X 1 X www.mmhok.com/financialasst.html X www.mmhok.com/financialasst.html X www.mmhok.com/financialasst.html X X X X X 1 X 0 X X X X 1 X 0 0 McCurtain Memorial Medical Management,Inc Part V, Section B, Line 5: McCurtain Memorial Hospital participated as the main speaker for March 2019 Coalition for Change meeting. This meeting was held on March 19, 2019. During this time, the Executive Director of Little Dixie Community Action Agency shared the findings of the Little Dixie Community Needs Assessment, and the Oklahoma Office of Rural Health presented demographic and health data and facilitated the discussion to identify health priorities for McCurtain Memorial Hospital to address. Data input was provided by the Little Dixie Community Action Agency needs assessment previously completed in January 2019 which was comprised of data gathered via survey, focus groups, and community meetings during May 2018 through November 2018. The complete methodology and findings of the Little Dixie Community Needs Assessment can be found at: https://www.littledixie.org/resources.Community members in attendance at this meeting included: -McCurtain Memorial Hospital -Little Dixie Community Action Agency -McCurtain County Health Department -Oklahoma Healthcare Authority -DHS This group was selected due to their broad representation of the community and the diverse populations they serve. These individuals work with diverse populations and low-income populations, and they provide great insight into the needs of the community. Representatives from the public health sector were included to provide insight into what they see from a public health and underserved population perspective of community needs. McCurtain Memorial Medical Management,Inc Part V, Section B, Line 6b: McCurtain County Health Department, McCurtain County Coalition for Change, Little Dixie Community Action Agency, Oklahoma Office of Rural Health, OSU Center for Rural Health McCurtain Memorial Medical Management,Inc Part V, Section B, Line 11: The following needs were identified in the CHNA completed in 2018. The hospital began addressing the following needs in fiscal year 2019 and will continue over the next 3 years. Two of the needs will not be addressed:The hospital has chosen to focus on five identified needs and regrets that a lack of hospital resources prevents us from specifically addressing all of the needs identified in the community meeting. Although the hospital will not specifically address motor vehicle crash death rate and potential correlation with substance abuse and teen birth rate along with STI's, they will fully support any education efforts made by other community organizations by providing meeting space and limited resources for educational events aimed at achieving overall healthcare improvement in our community. Further, the hospital will continue to serve as an active member of the local health coalition and other partnerships. Other community agencies do exist with specific goals and objectives aimed at addressing these needs: - Teen birth rate along with STIs - Motor vehicle crash death rate and potential correlation with substance abuse Overall wellness and education, improve quality of life In continuing efforts in actively recruiting and retaining physicians and other healthcare professionals for the medical service area. A general surgeon with trauma care experience has been recruited and employed by the Hospital effective 6/17/19.A new family practice physician has been contracted to open a family practice clinic and is scheduled to arrive in mid-October 2019.Concerning Nurse Practitioner recruitment, the hospital will provide a location to provide medical services rent free for one year effective Mar 15, 2018 - March 14,2019.The hospital will provide higher quality of nursing staff through increased level of standards and by encouraging staff to obtain further education and certifications.Skills fairs are held at least annually to keep nurses and other clinical personnel up to date in certifications.CNO, pharmacist and new hospitalist team is working to train nursing staff in the administration of certain drugs in order for care to be continued on an inpatient basis rather than transferring patients to other facilities.The Hospital is working to partner with Oklahoma State University to offer specialty services not currently provided in the county.Partnership plans are in progress with OSU School of Medicine to provide telemedicine services for Cardiology patients.Increased access to healthcare is provided through outpatient clinics with extended hours. Plans have been completed and purchases made for the 7/1/19 opening of an Urgent Care clinic with hours of operation outside of regular business hours. The Clinic will be staffed by a newly hired nurse practitioner and supervised by a family practice physician.The Hospital continues to provide reduced rate medical screenings which will offer the opportunity for services to those who may not normally be able to afford the usual rates despite having insurance. Special rate mammography screenings are offered during Breast Cancer awareness month. Special rate PSA screenings are offered at certain times of the year.The Hospital provided health screening booths at the annual Hospital Foundation festival on 5/18/2019.The Hospital participated in RAM Clinic providing free dental, vision, and limited medical care provided on first-come first-served basis. There were no income qualifications. This was a Hospital volunteer booth.Plans are in progress to open a Free Care clinic one half-day a week to provide health care evaluations and lab tests to uninsured/underinsured individuals and to provide education in types of health insurance and how to obtain public assistanceThe Hospital will continue to provide meeting space and other resources, such as public speaking, for Hospital and community healthcare educational events as well as at civic organizations and other public venues. Efforts will continue in researching and securing outside grants and other funding as well as committing its own resources to the improvement of overall community health. ObesityThe Hospital will continue operation of the Patricia R. Baggs Rehabilitation and Wellness Center at low cost to all community members with discounted rates for seniors and free access to employees of the hospital and other groups of the community such as teachers. The Hospital will continue to maintain the Garden Meadows Walking Trail located in the front of the hospital which is free and open to the public. Encouraging the consumption of healthy snacks to all patients, visitors and guests will continue by making fresh popcorn available during weekdays in the front lobby of the hospital. SmokingInformation will be provided on smoking cessation and other alternatives to assist patients in their efforts to discontinue smoking. There will be continued enforcement of a "No Smoking" campus policy. The Hospital will encourage the use of other community resources such as the smoking cessation hotline.Access to mental health providers The Hospital will continue to actively recruit licensed mental health professionals and work to partner with Oklahoma State University to provide telehealth mental health services on an outpatient treatment basis.The Hospital will explore the possibility of intensive outpatient treatment programs. Meeting space will continue to be provided along with other resources for educational events addressing Mental Health issues, such as an Alzheimer's support group. Trauma Informed CareThe Hospital will create awareness among care providers and staff of Trauma Informed Care through resources available through the Oklahoma Department of Mental Health and Substance Abuse Services. Part V, Section B, Line 7b: https://osururalhealth.blogspot.com/p/chna.html#mccurtain 1 1 - Surgery Clinic 1425 E Lincoln Rd Suite B-3 Idabel OK 74745 Surgery Outpatient Clinic Part I, Line 7: Charity care at cost on line 7a was calculated based on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. The cost for subsidized health services on line 7g was determined using the Medicare Cost Report. Part I, Ln 7 Col(f): The amount of bad debt expense removed from total expenses to determine the percentage was $6,826,665. Part III, Line 2: Accounts are not written off to bad debt until all payments, discounts and contractual allowances are applied and internal collection efforts have been exhausted. When a payment is received on an account previously written off to bad debt, the payment reduces the current year's bad debt expense. Part III, Line 3: The amount of bad debt estimated to be attributable to patients under the Organization's charity care policy is 31.3%. This is determined by using the percentage of the population in the service area that is under the federal poverty guideline established for charity care. Part III, Line 4: The footnote to the Organization's financial statements can be found on page 8 of the attached audited financial statements. Part III, Line 8: McCurtain Memorial Hospital had a Medicare shortfall. The Hospital continues to provide services to these patients because access to healthcare and individual's health is important. Therefore, the Medicare shortfall is considered a community benefit. Total revenue received from Medicare (including DSH and IME) is the gross reimbursement plus settlement (including LSA). Both the total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. Part III, Line 9b: Self-pay patients will be notified of the Financial Assistance Program upon registration during face-to-face interviews if possible. First time billing statements will be mailed to the responsible party of all patients within approximately 15 days of discharge. Information regarding making application for financial assistance is included in the statement. Applicants are notified by mail or phone call when their application is incomplete and are given an opportunity to provide the missing documentation or information within 90 days of notification. Before finding a patient eligible for assistance under this Policy, McCurtain Memorial may require patients to apply for public health coverage programs, such as Medicaid, for which McCurtain Memorial presumes the patients are eligible, as instructed by the hospital's Financial Services Department. McCurtain Memorial may deny eligibility for the Financial Assistance Program to patients who have been screened for a public health coverage program and are presumed to be eligible but are not cooperating with the process to apply for the health coverage program. If the individual does not provide the required information or the application is denied, normal collection procedures will commence. A patient has 120 days to apply for financial assistance from the date of discharge the account is sent to an outside collection agency. McCurtain Memorial, as well as third parties working on behalf of McCurtain Memorial, will not use extraordinary collections efforts within the first 120 days post discharge. Nor will McCurtain Memorial use extraordinary collection efforts while the patient or representative is actively in the process of applying for financial assistance. In the event that a patient or responsible party applies for financial assistance within 240 days of first statement date and has been found to be eligible, any extraordinary collection efforts by McCurtain Memorial or third parties working on behalf of McCurtain Memorial will cease and retraction will be made for any adverse reporting to credit bureaus in regards to the services for which they have been approved. Part VI, Line 2: Hospital Administration continually communicates with the Board of Trustees and seeks their input each month on community health needs and the Hospital's ability to meet those needs, evaluating internal and external issues that affect the organization. The Administrator's report each month gives an update from previously discussed items to include progress reports on how the Hospital is addressing or intends to address each need identified. Part VI, Line 3: The Hospital posts its charity care policy summary with financial assistance contact information in the financial services office. Financial Assistance guidance and information is provided to patients upon completion of medical evaluation and screening at which time potentially eligible patients are counseled by Financial Services. Financial Assistance information is not provided with discharge materials. Financial Assistance information is provided in "first-time" statements of patient bills. Financial Services counsels all patients who are potentially eligible for financial assistance by providing guidance in applying for assistance through federal, state and county programs. Should a patient not qualify for one of these programs and is not eligible for nor enrolled in private or public insurance plans, the patient may still be eligible for financial assistance through the Hospital's Financial Assistance Program upon meeting the criteria outlined in the policy (78-06-20). Part VI, Line 4: McCurtain Memorial Hospital is the only hospital located in McCurtain County, which is the 3rd largest county in the state. The entire county is designated as a Medically Underserved Area with portions of the county designated as Health Professional Shortage Areas due to geographical area, census tracts, and/or a Native American tribal population. According to the 2018 U.S. Census Bureau QuickFacts (Small Area Income and Poverty Estimates, SAIPE) estimates, the percentage of McCurtain County individuals (all ages) whose income was below poverty decreased from 26% to 21.1%. Of the estimated population for 2014-2018, there were approximately 21.4% of persons under the age of 65 years without health insurance coverage, compared to 16.7% for the same category in the entire state of Oklahoma. Approximately 30% of the people in McCurtain County are covered by Medicaid and the unemployment rate ranks as one of the highest in the state. The primary service area is approximately a 35-mile radius around Idabel. The 2010 US Census Bureau population estimates base for McCurtain County is 33,154, with an estimated 32,832 at July 1, 2018. Of the 2018 estimated population, 18.2% are in the age group 65 and older and 25.1% are under the age of 18. These county percentages are above the Oklahoma state percentages for the same categories, 15.7% and 24.3% respectively. With the exception of McCurtain Memorial Hospital there are no other major hospitals located within the county. McCurtain County has major employers such as International Paper, Tyson Foods, Hagale Industries, Huber Paper, Georgia Pacific Pan Pacific Products and the Hospital. McCurtain County continues to have one of the highest unemployment rates in the state averaging 5.7% in 2019 and 5.5% in 2018, above the Oklahoma state average rate of 3.3% in 2019 and 3.4% in 2018. Part VI, Line 5: McCurtain Memorial Hospital is a sole community provider with a Board of Directors comprised of persons who reside in the Organization's primary service area. Five members of the Board are non-physicians and one member is a physician as of June 30, 2019. The Hospital extends medical staff privileges to all qualified physicians in its community for all of its departments. The Hospital applies surplus funds to improvements in patient care and medical education. The Hospital continuously evaluates and monitors quality control initiatives. The Hospital's emergency room is available to all regardless of ability to pay. Continuing education classes are provided to personnel on a regular basis including EKG monitoring classes, Venous Thrombo-embolism Prevention and Prophylaxis, ACLS, PALS, CPI, CPR, Medicare Workshops, Credentialing Updates in addition to allowances provided to employed physicians and CRNA for continuing medical education workshops and seminars.Emergency services are available to all regardless of ability to pay. McCurtain Memorial Hospital is an active community member within the county and participates in community events such as health fairs, blood drives, seasonal festivals and parades, county fairs, etc. with the purpose of educating people of the community in health, wellness and disease and illness prevention. Pamphlets and other useful information are provided as well as free blood pressure checks and glucose screenings.The Wellness Center is an exercise area that community members can subscribe to and use the exercise equipment on a regular basis. Personnel are available to assist them. This program is available to all community members at a low cost with discounted rates for seniors and is free to employees in order to help advocate healthy lifestyles. The Garden Meadows Walking Trail located at the Hospital is open to the public 24 hours a day, 7 days a week at no charge and is intended to promote physical activity for healthier lifestyles. X 1 1 X X 0 0 0 0 0 0 0 0 0 Michael West MD - Trustee Chief of Staff until March 2019 206039 0 0 0 0 0 1037 0 22871 0 229947 0 0 0 Robin E Lake Interim CEO until Dec 2018 193516 0 0 0 30333 0 0 0 0 0 223849 0 0 0 David Flores - Nurse Anesthesiology (resigned 6/1/19) 239038 0 0 0 0 0 0 0 0 0 239038 0 0 0 Monty Grugan DO Hospitalist (resigned 6/3/19) 164009 0 27083 0 0 0 0 0 42284 0 233376 0 0 0 Part I, Line 1a Robin Lake, Interim CEO, was provided a housing allowance. The amount was included on her W-2 as taxable income. Quick Med PLLC Dr. Migliaccio, board member, is owner 710615 Payment for services 0 Form 990, Part III, line 2 -Added Occupational Therapy services February 2019 -Resumed Speech Therapy services March 2019 with addition of part-time speech pathologist -Resumed Hospital Surgical Services and re-opened Surgery Clinic with addition of new surgeon June 17, 2019 Form 990, Part III, line 3 Idabel Primary Care Clinic closed August 17, 2018 Form 990, Part IV, Line 20b: The Organization is in the process of an audit of the financial statements for the year ended 6/30/2019. However, at the time of filing this return, the audit is not yet complete. The Organization has attached a copy of its most recent audited financial statements for the years ended June 30, 2018 and 2017 to the Form 990 and answered yes to Part IV, line 20b. Form 990, Part VI, Section A, line 1 The Executive Committee of the Board of Trustees consists of the officers of the Board of Trustees. The President serves as Chairman of the Executive Committee and calls the meetings on as need basis. The Executive Committee may make decisions on the Board's behalf for issues needing immediate attention. Form 990, Part VI, Section A, line 6 The membership of McCurtain Memorial Medical Management, Inc., shall be those appointed by the existing Board of Trustees. Non-voting memberships include honorary memberships, sustaining memberships, ex-officio memberships, and memberships otherwise designated. Form 990, Part VI, Section B, line 11b The return is reviewed by the CFO and is emailed to the Board of Directors prior to filing. The Form 990 is also an agenda item for discussion at the subsequent Board of Director's meeting. Form 990, Part VI, Section B, line 12c All officers, directors, and key employees complete a conflict of interest disclosure annually. The disclosure forms are reviewed initially by the CEO and CFO for potential conflicts. Any actual conflicts are reviewed by the Board of Directors. A board member with a conflict is restricted from voting on related matters. Similarly, an officer or key employee with a conflict is restricted from participating in decision making related to the conflict. Form 990, Part VI, Section B, line 15a Compensation for the CEO is determined by the Board of Directors based on comparability data and an annual evaluation included in an employment contract. Documentation is provided in the Board minutes and personnel file. Compensation for the CFO is determined by the CEO based on an annual evaluation. Documentation is provided in the personnel file. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy, and financial statements are available upon request during normal business hours. McCurtain Memorial Hospital Foundation 1301 East Lincoln Rd Idabel OK 74745 731455422 Provide financial support to McCurtain Memorial Hospital OK 501(c)(3) Line 12b, II McCurtain Memorial Medical Management Inc 1 McCurtain County Hospital Authority 1301 East Lincoln Rd Idabel OK 74745 731512938 Lessor/owner of McCurtain County Hospital's premises/land OK McCurtain County 0 0 0 1 0 1 0 0 0 0 0 1 0 1 1 1 0 0 0 1 McCurtain Memorial Hospital Foundation C 1356219 General ledger McCurtain Memorial Hospital Foundation K 176750 General ledger