2019-05-23T06:56:47-05:00 2018-06-30 450250958 EIDE BAILLY LLP 621 N ROBINSON AVE STE 200 OKLAHOMA CITY OK 731026232 990 2017-07-01 736617937 McCurtain Memorial Medical Management Inc MCCU 5802867623 1301 E Lincoln Rd Idabel OK 74745 Brad Morse Interim CEO 5802867623 2019-05-22 1 Kim Hunwardsen CPA P00484560 4055942000 2019-05-21 98.173.248.226 2019-05-22 13:07:40 CD P E10085862974BF89EE8F231EB831862A8F193D10 E10085862974BF89EE8F231EB831862A8F193D10 2017 2019-02-21 02:37:17Z McCurtain Memorial Hospital Brad Morse 1301 E Lincoln Rd Idabel OK 74745 19129632 0 X www.mmhok.com X 1975 OK To strive to be the healthcare provider of choice in our community 7 5 284 20 0 0 1655729 555094 30652770 18475585 160 9151 -52539 -47348 32256120 18992482 0 0 0 0 11660006 9897130 0 0 0 22085380 10994645 33745386 20891775 -1489266 -1899293 5088849 4150563 6675197 7636204 -1586348 -3485641 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. 0 1 18948642 18475585 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 $136,000 for the year ended June 30, 2018. The estimated cost of providing these services was approximately $48,000 for the year ended June 30, 2018.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. 18948642 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 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 52 0 1 284 1 1 1 0 0 0 0 0 0 0 0 0 X 7 5 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 0 1 0 0 OK X Donna Wallace 5802083104 1301 E Lincoln Rd Idabel OK 74745 Walter H Frey President 1.00 X X 0 0 0 John Migliaccio MD Vice President 1.00 X X 0 0 0 Julia Grigory Secretary/Treasurer 1.00 X X 0 0 0 Christopher Ray McKinney Trustee until 8/15/17 1.00 X 0 0 0 Robert C Chandler Trustee until 2/13/18 1.00 X 0 0 0 Ann Zimmer Trustee 1.00 X 0 0 0 Irvin C Jones Trustee 1.00 X 0 0 0 Johnnie Meredith Trustee began 8/17/17 1.00 X 0 0 0 Michael West MD Trustee/Chief of Staff 41.00 X 206899 0 19598 Jahni Tapley JD CEO until 12/29/17 40.00 X 120622 0 9145 Ray Whitmore Jr CFO 40.00 X 84562 0 14222 Robin E Lake Interim CEO began 12/28/17 40.00 X 0 0 0 Jeffrey Martin CRNA Nurse Anesthesiology 40.00 X 298312 0 9142 P Michael Hines MD FACS Surgeon 39.00 X 208926 0 5911 Monty Grugan DO Hospitalist 39.00 X 192556 0 28007 1111877 0 86025 5 0 1 0 Pacific Genomics 27 Technology Dr Suite 100 Irvine CA 92618 Contract reference lab services 4282607 Imed Management 3204 Long Prairie Rd Suite A-3 Flower Mound TX 75022 Contract reference lab services 1784822 Quick Med PLLC 1400 SE Adams Idabel OK 74745 ER physician coverage 661603 Western Healthcare PO Box 203152 Dallas TX 75320 ER physician coverage 586037 CPSI PO Box 850309 Mobile AL 36685 Computer support 208119 9 553569 1525 555094 Net Patient Serv Rev 622110 18433448 18433448 Cafeteria 900099 34407 34407 7730 7730 18475585 539 539 89802 137150 -47348 -47348 -47348 8612 0 8612 8612 8612 18992482 18475585 0 -38197 533268 225883 307385 7185078 6772909 412169 19550 19097 453 1618223 1505818 112405 541011 490574 50437 25620 25620 85706 85706 1677106 1294845 382261 2359 2359 452024 445502 6522 346582 346582 40913 23513 17400 199869 199869 376692 376692 574467 43919 530548 Provision for Bad Debts 5362097 5362097 Medical Supplies 1382785 1382785 Repairs and Maintenance 439550 429682 9868 Dues, Subcriptions, Lic 28875 28875 20891775 18948642 1943133 0 193707 129327 2187259 1623495 352120 308499 219195 201124 16968831 15267253 1865887 1701578 270681 186540 5088849 4150563 4545447 5387167 8997 381114 425721 293732 1695032 1574191 6675197 7636204 X -1586348 -3485641 -1586348 -3485641 5088849 4150563 -1899293 0 X 0 1 X 1 0 X 37450 37450 8349696 7533356 816340 8201344 7429177 772167 380341 304720 75621 1701578 Health insurance reserves 150000 Note payable to McCurtain County Hospital Authority 381369 Note payable to McCurtain Memorial Hospital Foundation 350000 Taxes payable 692822 1574191 X 14201930 434827 -5362097 -4927270 19129200 -136718 -136718 18992482 16101223 434827 136718 571545 15529678 5362097 5362097 20891775 Part X, Line 2: The Hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Part XI, Line 2d - Other Adjustments: Provision for Bad Debts included in Revenue for Financial Statements -5,362,097. Part XI, Line 4b - Other Adjustments: Loss on disposal of asset included in revenue for Form 990 432. Rental expenses included in revenue for Form 990 -137,150. Part XII, Line 2d - Other Adjustments: Loss on disposal of asset included in revenue for Form 990 -432. Rental expenses included in revenue for Form 990 137,150. Part XII, Line 4b - Other Adjustments: Provision for Bad Debts included in Revenue for Financial Statements 5,362,097. 1 1 X 1 X 1 X 1 1 1 0 0 48000 48000 0.00310 3696073 3058824 637249 0.04100 3744073 3058824 685249 0.04410 45526 12121 33405 0.00220 14442 8782 5660 0.00040 790247 109556 680691 0.04380 850215 130459 719756 0.04640 4594288 3189283 1405005 0.09050 627 627 0.00000 3480 3480 0.00020 2957 2957 0.00020 29393 29393 0.00190 36457 36457 0.00230 0 5362097 1394145 5139081 6017826 -878745 X 1 1 1 1 McCurtain Memorial Medical Management 1301 E Lincoln Rd Idabel OK 74745 www.mmhok.com 2202 X X X McCurtain Memorial Medical ManagementIn 1 0 0 1 X X X X X X X X X 15 1 0 1 1 X http://www.mmhok.com/about/CHNA_2015.html X See Part V X 1 15 1 http://www.mmhok.com/about/MMH-CHIP-FY16.pdf 0 1 X 100.000000000000 300.000000000000 X X X X 1 1 X X X X 1 X http://www.mmhok.com/financialasst.html X http://www.mmhok.com/financialasst.html X http://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 6b: McCurtain County Health Department and the McCurtain County Coalition for Change McCurtain Memorial Medical Management,Inc Part V, Section B, Line 11: The following outlines the Implementation Strategy from our 2015 CHNA. The fiscal year 2018 updates are listed below.Ongoing for each committee - We continue to provide meeting space for Coalition meetings as well as staff for service and education awareness at events such as health fairs, blood drives, and other community events. Access to Healthcare- One physician recruited and placed in the county as of Jan. 2018, though not directly employed by the Hospital this makes another provider available to improve access to healthcare - Dr. Jordan Paslay- One nurse practitioner (educational expense assisted by the Hospital) employed by the Hospital and clinic- Assistance provided to new VA CBOC such as vendor names/numbers, also arrangements made to provide lab and x-ray services at Medicare rates- Hospital property leased to Air Evac to establish a McCurtain County base where a helicopter is on stand-by to airlift critical condition patients- Fixed-wing air transportation also on stand-by as an alternative to helicopter service when weather is bad- Office space leases continued for nephrology and oncology services Chronic Disease Improvement Strategy- New mammography diagnostic and biopsy equipment purchased with grant assistance continues to be used- Upon completion of training, mammo screenings offered to community at reduced rates through use of "Diagnostic Live" for immediate results and faster treatment in positive cancer screenings- Continue to offer reduced rate mammo screenings through "Project Woman"- Partner with local charitable organization "Treasured Chests" who purchases coupons/vouchers for mammo screenings and provides to patients free of charge (specifically for community members who cannot afford mammo screenings even at reduced rates)- Provide contract rates to other Healthcare organizations for TB screenings (chest x-rays) - Stroke services continued in partnership with Plano Hospital during FY 2018- Provide GIP-Hospice Care in partnership with Mays Hospice Care (eff. 8/23/2017) and AspireMental Health Improvement Strategy- No success in recruiting licensed mental health professionals- Outpatient telemedicine for mental health services is still under consideration- Due to low volumes, geriatric psychiatric inpatient services were closed February 16, 2018Physical Activity Improvement Strategy- Continued maintenance of walking trail located in front of the Hospital, free and open to the public- Continued operation of Wellness Center at low cost for most community members or even free in some circumstances Part V, Section B, Line 7b: https://www.ok.gov/health2/documents/McCurtain%20County%20Community%20Health%20Assessment.pdf 2 1 - McCurtain Memorial Home Health 1301 E Lincoln Rd Idabel OK 74745 Home Health 3 - Idabel Primary Care Clinic 1425 E Lincoln Rd Suite B-4 Idabel OK 74745 Primary Care 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 amounts for community health improvement services, line 7e, and health professions education, line 7f, were determined based on actual costs from the general ledger. The cost for subsidized health services on line 7g was determined using the Medicare Cost Report. Part I, Line 7g: Idabel Primary Care Clinic is a physician clinic included as a subsidized service on the 990. Direct and indirect costs were $558,008. Part I, Ln 7 Col(f): The amount of bad debt expense removed from total expenses to determine the percentage was $5,362,097. Part II, Community Building Activities: The Hospital is an active member of the communities of its service area and is located in Idabel, Oklahoma the county seat of McCurtain County. The Hospital fully supports the promotion of community and economic development. The Hospital actively recruits physicians and Allied Health professionals (nurse practitioners) to serve the citizens of its service area and increase the availability of healthcare providers. The Hospital is also a participant in several community health improvement steering committees addressing topics such as fragmented healthcare, substance abuse and mental health issues, obesity and healthy living to name a few. In addition, the Hospital also has one member of the Board of Directors who participates in the McCurtain County Coalition for Change Program - Turning Point. 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 26%. 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: Generally the Hospital holds an annual Strategic Planning Meeting in which the needs of the community are evaluated with an environmental assessment identifying internal and external issues that affect the organization and its ability to meet the needs of the community it serves. There was not a Strategic Planning Meeting held during FYE 6/30/18. 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 U.S. Census Bureau 2013-2017 as provided by the 2017 Small Area Income and Poverty estimates (SAIPE), the percentage of individuals whose income was below poverty increased from 25.7% to 26.0%. Of the estimated population for 2012-2016, there were approximately 20.4% of persons under the age of 65 years without health insurance coverage, which is 4.3% above the estimated 16.1% 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 32,808 at July 1, 2017. Of the 2017 estimated population, 17.9% are in the age group 65 and older and 25.2% are under the age of 18. These county percentages are above the Oklahoma state percentages for the same categories, 15.3% and 24.4% 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 at 6.5% for June 2018 (not seasonally adjusted), well above the Oklahoma state rate of 3.7% (not seasonally adjusted) for the same time period. 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, with the exception of one member. Five members of the Board are non-physicians and two members are physicians as of June 30, 2018.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.Until March 2018, the Organization provided Geriatric Psychiatric inpatient services not otherwise available within the county. Emergency services are also 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 Hospital's Idabel Primary Care Clinic offers reduced price sports physicals to students for only $10.McCurtain Memorial Hospital is also a sponsor of Kids Safe Saturday and the Great American Smoke-Out. These events are organized by community advocacy groups to help raise awareness of domestic/child abuse and teen drug and tobacco abuse. The Organization participates in these planning meetings as well as the events.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 X 0 0 0 0 0 0 0 0 0 Michael West MD Trustee/Chief of Staff 206899 0 0 0 0 0 5325 0 14273 0 226497 0 0 0 Jeffrey Martin CRNA Nurse Anesthesiology 298312 0 0 0 0 0 0 0 9142 0 307454 0 0 0 P Michael Hines MD FACS Surgeon 208926 0 0 0 0 0 0 0 5911 0 214837 0 0 0 Monty Grugan DO Hospitalist 166515 0 26041 0 0 0 0 0 28007 0 220563 0 0 0 Quick Med PLLC Dr. Migliaccio, board member, is owner 609283 Payment for services 0 Form 990, Part III, line 3 Surgical Clinic closed - Aug 25, 2017 Wound Care Services closed - Dec 13, 2017 New Directions Geriatric Psychiatric Unit closed - Feb 16, 2018 ICU Unit closed - Mar 7, 2018 Home Health Services closed - Mar 26, 2018 Idabel Primary Care Clinic closed - Aug 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 6/30/2018. 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, 2017 and 2016 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 K 234300 General ledger Late filed return due to CCH Software outage.