2019-08-15T07:24:55-05:00 2018-09-30 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2017-10-01 350211370 CAMERON MEMORIAL COMMUNITY HOSPITAL INC CAME 2606652141 416 E MAUMEE STREET ANGOLA IN 46703 DOUGLAS C BOMBA CHIEF FINANCIAL OFFICER 2606652141 2019-08-13 1 MARGOT BURKE P01588992 3176334705 2019-08-13 47.227.233.166 2019-08-13 21:47:12 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 B19D0506B86ED19F1A0FD2AFEEB91090E576B51F 2017 2019-02-21 02:37:17Z DOUGLAS BOMBA 416 E MAUMEE STREET ANGOLA IN 46703 68709125 0 X WWW.CAMERONMCH.COM X 1972 IN CMCH IS AN INDEPENDENT, NOT FOR PROFIT, CRITICAL ACCESS HOSPITAL OFFERING HEALTH & WELLNESS SERVICES. 13 11 616 76 0 151 81903 40914 56559045 61692232 673299 433610 959230 1267649 58273477 63434405 90185 0 0 0 27768247 30194768 0 0 0 32522869 34831049 60381301 65025817 -2107824 -1591412 92745216 87970455 53031106 49420631 39714110 38549824 X CAMERON MEMORIAL COMMUNITY HOSPITAL IS TO PROVIDE A WIDE RANGE OF HEALTH CARE SERVICES TO THE PEOPLE OF STEUBEN COUNTY AND THE SURROUNDING AREA, IN A SPIRIT OF CHARITY, CONCERN, AND EXCELLENCE. 0 0 41955944 61749557 CAMERON MEMORIAL COMMUNITY HOSPITAL, INC. (HOSPITAL), A NOT FOR PROFIT ORGANIZATION, IS A GENERAL ACUTE CARE FACILITY IN ANGOLA, INDIANA WITH 25 LICENSED BEDS AND ASSOCIATED ANCILLARY SERVICE DEPARTMENTS INCLUDING OUTPATIENT SERVICES, HOME HEALTH CARE AND AN URGENT CARE CENTER IN ANGOLA, INDIANA. THE HOSPITAL PROVIDES HEALTH CARE SERVICES PRIMARILY IN THE NORTHEAST PORTION OF INDIANA. EXPENSES RELATE TO THE PROVISION OF MEDICAL CARE AND RELATED GENERAL AND ADMINISTRATIVE COSTS. 3937000 RADIOLOGY SERVICE IS OFFERED TO PATIENTS AT THE HOSPITAL. ANNUALLY THE HOSPITAL PERFORMS OVER 35,200 PROCEDURES, INCLUDING GENERAL RADIOLOGY SERVICES, CT SCANS, PET SCANS AND AN OPEN BORE MRI. RADIOLOGY GROSS REVENUE IS $31,316,000 BEFORE CONTRACTUAL ALLOWANCES AND CHARITY CARE. 4522000 SURGERY SERVICE IS A PROGRAM OFFERED TO PATIENTS AT THE HOSPITAL. OVER 5,500 PROCEDURES ARE PERFORMED ANNUALLY, WITH 78% OF THE PROCEDURES BEING OUTPATIENT RELATED. SURGERY GROSS REVENUE SERVICE IS $22,973,000 BEFORE CONTRACTUAL ALLOWANCES AND CHARITY CARE. 2077000 EMERGENCY ROOM SERVICES IS THE THIRD LARGEST PROGRAM OFFERED TO PATIENTS AT CMCH. OVER 15,400 PATIENTS CAME THROUGH CAMERON'S EMERGENCY ROOM. EMERGENCY ROOM SERVICES GROSS REVENUE IS $16,623,000 BEFORE CONTRACTUAL ALLOWANCES AND CHARITY CARE. 2780000 LAB SERVICES IS THE FOURTH LARGEST PROGRAM OFFERED TO PATIENTS AT THE HOSPITAL. OVER 182,300 ARE DONE WITH 87% BEING OUTPATIENT RELATED. LAB GROSS REVENUE SERVICES IS $15,140,000 BEFORE CONTRACTUAL ALLOWANCES AND CHARITY CARE. 4857000 55271944 1 1 0 1 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 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 79 0 1 616 1 1 1 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 1 1 1 1 0 IN X DOUGLAS BOMBA 2606652141 416 E MAUMEE STREET ANGOLA IN 46703 X JENNIFER DANIC CHAIR 2.00 3.00 X X 0 0 0 DEBORAH MCHENRY VICE CHAIR 2.00 2.00 X X 0 0 0 BARBARA SHORT TREASURER 2.00 2.00 X X 0 0 0 DANIEL CARUSO SECRETARY 2.00 3.00 X X 0 0 0 TOM MILLER MD IMMEDIATE PAST CHAIR 40.00 2.00 X X 387592 0 20507 JONATHAN ALLEY DO BOARD MEMBER 2.00 2.00 X 0 0 0 JONATHAN CRESS BOARD MEMBER 2.00 2.00 X 0 0 0 JOHN MCCOY BOARD MEMBER - BEGAN FEB'18 2.00 2.00 X 0 0 0 JEFFERY NICKEL MD BOARD MEMBER - BEGAN FEB'18 2.00 2.00 X 0 0 0 TODD RUMSEY MD BOARD MEMBER - BEGAN NOV'17 40.00 2.00 X 173463 0 6951 OREN SKINNER BOARD MEMBER - BEGAN OCT'17 2.00 2.00 X 0 0 0 TERRY VANETTE BOARD MEMBER 2.00 2.00 X 0 0 0 DENNIS ZENT DDS BOARD MEMBER - BEGAN NOV'17 2.00 2.00 X 0 0 0 CONSTANCE M MCCAHILL CHIEF EXECUTIVE OFFICER 38.00 2.00 X 229120 0 14575 DOUGLAS C BOMBA CHIEF FINANCIAL OFFICER 36.00 4.00 X 199389 0 20587 TERESA KING PHYSICIAN 40.00 1.00 X 510145 0 19147 LYNN FAUR URGENT CARE MEDICAL DIRECTOR 40.00 0.00 X 279956 0 22953 CHARLES MACLEAN PHYSICIAN 40.00 0.00 X 255373 0 15747 JAMES HUNTER PHYSICIAN ASSISTANT 40.00 0.00 X 164991 0 24478 KRISTOPHER D KEEN CHIEF INFORMATION OFFICER 40.00 0.00 X 160745 0 24478 2360774 0 169423 16 0 1 0 HOSPITAL CARE GROUP 6435 WEST JEFFERSON BLVD FORT WAYNE IN 46804 SEE SCHEDULE O 973751 APRN - ALLIED MEDICAL SERVICES 1133 CORPORATE DRIVE HOLLAND OH 43528 SEE SCHEDULE O 950670 ORTHOPAEDIC SURGICARE CARE INST 516 N WOLFENBERGER ST SULLIVAN IN 47882 SEE SCHEDULE O 850000 AMERI EBO LLC 1851 S ALVERNO ROAD MANITOWOC WI 54221 SEE SCHEDULE O 604813 SOUTH BEND MEDICAL FOUNDATION PO BOX 2030 MISHAWAKA IN 46546 SEE SCHEDULE O 560410 15 40914 40914 NET PATIENT SERVICE REVENUE 621400 61667573 61667573 MEALS ON WHEELS 624200 14156 14156 COMMUNITY HEALTH 624200 10503 10503 61692232 351386 351386 57325 0 57325 57325 57325 5344644 12300 5214921 59799 129723 -47499 82224 82224 CAFETERIA 900099 239502 239502 PHARMACY 900099 26573 26573 VENDING 900099 16256 16256 927993 927993 1210324 63434405 61749557 0 1643934 X 1358991 1155142 203849 21185748 18007886 3177862 779663 662714 116949 5235392 4450083 785309 1634974 1389729 245245 85889 73006 12883 110785 94167 16618 4638 4638 11240933 9554793 1686140 334783 284566 50217 908951 772608 136343 4738966 4028121 710845 45576 38740 6836 180307 153261 27046 1633341 1388340 245001 6113847 5196771 917076 516144 438722 77422 MEDICAL SUPPLIES 5848147 4988469 859678 HAF EXPENSE 1789860 1526751 263109 DUES & SUB. 579806 494575 85231 MINOR EQUIPMENT 336778 287272 49506 362298 286228 76070 65025817 55271944 9753873 0 23341 276421 2396988 10794738 9809507 646473 586817 1827074 1745445 981327 911631 77776369 30435284 52297155 47341085 18128448 20176608 5989161 3329021 913149 885713 1144350 511219 92745216 87970455 6708314 4754984 46322792 44194465 0 471182 53031106 49420631 X 37008510 38105240 2705600 444584 39714110 38549824 92745216 87970455 X -1591412 303020 124106 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 4638 4638 0 PART II-B, LINE 1: DURING FISCAL YEAR 2018 A PORTION OF THE HOSPITAL'S ASSOCIATION MEMBERSHIP DUES PAID TO INDIANA HOSPITAL ASSOCIATION (IHA) AND AMERICAN HOSPITAL ASSOCIATION (AHA) WAS ALLOCATED TO LOBBYING EXPENDITURES. 2705600 40914 124106 2426036 444584 238610 2546669 166722 246401 2705600 402557 47003 1780 212730 238610 498767 262296 -6126 352380 402557 576326 147403 3945 228907 498767 1.00000 0 1 1 1462868 1462868 56435107 17089344 39345763 19354014 13345940 6008074 524380 524380 47341085 ESTIMATED THIRD-PARTY SETTLEMENT 471182 471182 X PART V, LINE 4: THE HOSPITAL HAS TEMPORARILY RESTRICTED NET ASSETS, THE USE OF WHICH IS RESTRICTED BY DONORS OR GRANTORS, INTENDED FOR USE ON HEALTH CARE SERVICES FOR HOME HEALTH CARE AND THE HOSPITAL'S EXPANSION PROJECT. DURING FISCAL YEAR 2018, THE CAMERON HOSPITAL FOUNDATION WAS DISSOLVED AND BECAME A DEPARTMENT OF CAMERON HOSPITAL. THE HOSPITAL IS THE SOLE BENEFICIARY OF THE MONIES GIVEN BY DONORS OR GRANTORS. PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CENTER AND RECOGNIZE A TAX LIABILITY IF THE CENTER HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CENTER, AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2018 AND 2017, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE CENTER IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. 1 1 X 1 X 1 X 1 1 1 0 1 1 303701 303701 0.00470 9125037 4782472 4342565 0.06680 9428738 4782472 4646266 0.07150 165380 165380 0.00250 16415 16415 0.00030 181795 181795 0.00280 9610533 4782472 4828061 0.07430 38500 38500 0.00060 19151 19151 0.00030 57651 57651 0.00090 1 6784213 288891 16421096 16902932 -481836 X 1 1 1 1 CAMERON MEMORIAL COMMUNITY HOSPITAL INC 416 E MAUMEE STREET ANGOLA IN 46703 WWW.CAMERONMCH.COM 18-005037-1 X X X X CAMERON MEMORIAL COMMUNITY HOSPITAL INC 1 0 0 1 X X X X X X X X X 15 1 0 1 1 X SEE PART V X X 1 16 1 SEE PART V 0 1 X 100.000000000000 350.000000000000 X X X X X X 1 1 X X X 1 X SEE PART V X SEE PART V X SEE PART V X X X X X X 1 X 0 X X X X X 1 X 0 0 CAMERON MEMORIAL COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 5: DESCRIPTION OF COMMUNITY INPUT:CAMERON MEMORIAL COMMUNITY HOSPITAL (CMCH) CONTRACTED WITH THE INDIANA RURAL HEALTH ASSOCIATION (IRHA) TO CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). IRHA FIRST IDENTIFIED THE COMMUNITY SERVED BY CMCH THROUGH CONVERSATIONS WITH THE HOSPITAL. BASED ON A REVIEW OF PATIENT ZIP CODES, THE HOSPITAL WAS ABLE TO DEFINE THE COMMUNITY SERVED AS ALL POSTAL CODES WITHIN THE GEOGRAPHIC AREA OF STEUBEN COUNTY. THE HOSPITAL PROVIDED A PRIMARY SERVICE AREA MAP WITH ZIP CODES. NEXT, A STEERING COMMITTEE OF STEUBEN COUNTY REPRESENTATIVES WAS ORGANIZED WITH THE HELP OF THE CAMERON MEMORIAL COMMUNITY HOSPITAL CEO. BUSINESS OWNERS, LOCAL OFFICIALS, HEALTHCARE PROVIDERS, MINORITY LEADERS, CLERGY, STUDENT REPRESENTATIVES, AND ANY OTHER INTERESTED PARTIES WERE INVITED TO ATTEND THE MEETING TO DISCUSS THE HEALTH-RELATED NEEDS OF THE COUNTY WITH A VIEW TO IDENTIFYING THE AREAS OF GREATEST CONCERN. FROM THE INFORMATION OBTAINED IN THE STEERING COMMITTEE, A 43-QUESTION SURVEY WAS DEVELOPED TO GAIN THE PERSPECTIVE OF THE INHABITANTS OF THE COMMUNITY. QUESTIONS INCLUDED QUERIES ABOUT THE EFFECT OF VARIOUS FACTORS (SUCH AS ILLEGAL DRUGS, TEEN PREGNANCY, AND OBESITY), AS WELL AS PROBES INTO THE PERCEIVED NEED FOR VARIOUS SERVICES AND FACILITIES IN THE COUNTY. THE SURVEY WAS WIDELY DISSEMINATED TO THE RESIDENTS OF STEUBEN COUNTY THROUGH INCLUSION ON THE CAMERON MEMORIAL COMMUNITY HOSPITAL'S WEBSITE, FACE-TO-FACE POLLING AT FREMONT VILLAGE FOODS, A POPULAR GROCERY STORE IN FREMONT, IN; SUTTON'S DELI, A RESTAURANT ON THE TOWN SQUARE IN ANGOLA; AND THE ANGOLA RURAL KING. AN ONLINE SURVEY POSTED ON SURVEYMONKEY.COM WAS ALSO MADE AVAILABLE TO THE PUBLIC. CAMERON MEMORIAL COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 6B: CAMERON MEMORIAL COMMUNITY HOSPITAL (CMCH) CONTRACTED WITH THE INDIANA RURAL HEALTH ASSOCIATION (IRHA) TO CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). CAMERON MEMORIAL COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 7D: LOCATION TO CHNA:ON THE WEB PAGE UNDER "ABOUT US" CLICK ON THE LINK "COMMUNITY HEALTH NEEDS ASSESSMENT" TO ACCESS THE HOSPITAL'S MOST CURRENT COMMUNITY HEALTH NEEDS ASSESSMENT OR COPY AND ENTER THE FOLLOWING WEB ADDRESS INTO THE INTERNET BROWSER: HTTPS://WWW.CAMERONMCH.COM/DOCS/CAMERON_2016_CHNA_FINAL.PDF CAMERON MEMORIAL COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 11: IMPLEMENTATION UPDATE:THERE WERE FOUR SIGNIFICANT NEEDS IDENTIFIED IN THE HOSPITAL'S MOST RECENTLY CONDUCTED FISCAL YEAR ENDING 2016 CHNA. BELOW IS A SUMMARY OF THE NEEDS IDENTIFIED AND PRIORITIZED IN THE APPROVED IMPLEMENTATION STRATEGY WITH AN UPDATE FOR THE YEAR.NEED 1: EDUCATION AND PREVENTIONNEED IS BEING ADDRESS DURING THE YEAR: CMCH WILL INVESTIGATE OPPORTUNITIES FOR PARTNERSHIPS WITH AREA AGENCIES WHO ARE THE "EXPERTS" ON THE TOPICS IDENTIFIED, TO OFFER EDUCATION (EX. ILLEGAL DRUG USE, ALCOHOL ABUSE, METHAMPHETAMINE, TOBACCO USE, OBESITY) WITHIN THE COMMUNITY. CAMERON WILL ALSO RESEARCH HOSTING EDUCATIONAL OPPORTUNITIES WHERE AND WHEN IT MAKES SENSE.UPDATE: CAMERON MEMORIAL COMMUNITY HOSPITAL HAS A CERTIFIED DIABETIC EDUCATOR WHO OFFERS COMMUNITY CLASSES AND EDUCATION. NUMEROUS LEADERSHIP PEOPLE FROM THE CAMERON MEMORIAL COMMUNITY HOSPITAL SIT ON COMMUNITY BOARDS SUCH AS UNITED WAY AND THE YMCA AND ARE REGULARLY COLLABORATING ON PROGRAMS THAT ARE AIMED AT EDUCATING THE COMMUNITY ON A VARIETY OF HEALTH AND WELLNESS TOPICS. CAMERON MEMORIAL COMMUNITY HOSPITAL RESTRUCTURED THE POSITION OF HEALTH AND WELLNESS COORDINATOR DURING FISCAL YEAR 2018. THIS POSITION COLLABORATES WITH LOCAL ORGANIZATIONS SUCH AS 'SHAPE UP STEUBEN' TO ENSURE THE HOSPTIAL HAS A VOICE AT THE TABLE FOR HEALTH AND WELLNES INITIATIVES IN THE COMMUNITY. THIS POSITION IS ADDITIONALLY RESPONSIBLE TO HELP PROMOTE HEALTH AND WELLNESS INTERNALLY BY ORGANIZING A WEIGHT WATCHERS PROGRAM FOR OUR INTERNAL EMPLOYEES, WHICH WAS MADE AVAILABLE FOR PAYROLL DEDUCTION. NEED 2: MENTAL HEALTH AND DRUG TREATMENTNEED IS BEING ADDRESSED DURING THE YEAR: CMCH WILL DEMONSTRATE LEADERSHIP AS A CHAMPION OF INCREASED AVAILABILITY OF MENTAL AND BEHAVIORAL HEALTH SERVICES FOR RESIDENTS OF STEUBEN COUNTY. UPDATE: IN SEPTEMBER 2016 CAMERON MEMORIAL COMMUNITY HOSPITAL OPENED THE CAMERON SENIOR LIFE SOLUTIONS SERVICE FOR THE COMMUNITY. THIS SERVICE WAS DESIGNED TO ASSIST THE SENIOR POPULATION OF THE AREA TO DEAL WITH ISSUES SUCH AS ANXIETY, DEPRESSION, AND INABILITY TO DEAL WITH GRIEF, ANGER, ETC. IN JULY 2018, CAMERON SENIOR LIFE SOLUTIONS WAS DISSOLVED AND A PSYCHIATRIST WAS RECRUITED FOR CAMERON PSYCHIATRY. THE PSYCHIATRIST DIDN'T START SEEING PATIENTS IN STEUBEN COUNTY UNTIL JUNE OF 2019.NEED 3: CHRONIC DISEASENEED IS BEING ADRESSED DURING THE YEAR: CMCH WILL SERVE AS THE CHAMPION IN STEUBEN COUNTY TO LEAD THE WORK IN IMPROVING OVERALL HEALTH IN THE AREA AS IT RELATES TO CHRONIC DISEASE (INCLUDING, BUT NOT LIMITED TO; OBESITY, DIABETES, HEART DISEASE AND STROKE.)UPDATE: CMCH STILL PARTICIPATES IN THE STROKE CARE NOW NETWORK. DURING FISCAL YEAR 2018, WE HAVE ENSURED A CERTIFIED DIABETIC EDUCATOR IS EXCLUSIVELY AVAILABLE FOR DIABETIC EDUCATION FROM 7:30 AM - 4:00 PM ON TUESDAYS. THE PROGRAM THEY PROVIDE IS RECOGNIZED THROUGH THE AMERICAN DIABETES ASSOCIATION. WE ALSO PROVIDE EDUCATIONAL PROGRAMS AND SCREENINGS TO THE COMMUITY AND EMPLOYERS THROUGH OUR OCCUPATIONAL HEALTH DEPARTMENT. NEED 4: PARENTING AND FAMILY SUPPORT AND EDUCATION NEED IS BEING ADDRESSED DURING THE YEAR: CMCH WILL PARTNER WITH AREA AGENCIES WHEN APPROPRIATE TO OFFER EDUCATIONAL OPPORTUNITIES THAT SUPPORT RESIDENTS OF ALL AGES.UPDATE: CMCH CONTINUES TO HAVE A BIRTH PLANNER NURSE EDUCATOR TO SUPPORT AND EDUCATE NEW PARENTS AND MOMS ON PARENTING SKILLS. A GRANT WAS SECURED IN PARTNERHSHIP WITH THE PURDUE EXTENSION OFFICE TO BEGIN THE WORKSHOP OF BRINGING BABY HOME. THIS WORKSHOP PROVIDES TOOLS TO PARENTS THEY CAN USE TO BECOME THE BEST PARENTING TEAM POSSIBLE. CAMERON MEMORIAL COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 13B: IN ADDITION TO FPG, ELIGIBILITY FOR FINANCIAL ASSISTANCE ALSO CONSIDERS THE FOLLOWING INCOME SOURCES IF PATIENTS CLAIM NO INCOME: INCOME FROM CHILD SUPPORT, PENSION, RENTAL, EDUCATION, AND OTHER FINANCIAL SUPPORT FROM FAMILY MEMBERS NOT LIVING IN THE HOUSEHOLD. CAMERON MEMORIAL COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 16J: LOCATION TO FINANCIAL ASSITANCE POLICIES AND FORMS:ON THE WEB PAGE UNDER "ABOUT US" CLICK ON THE LINK "BUSINESS OFFICE" TO ACCESS THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY INFORMATION. CAMERON MEMORIAL COMMUNITY HOSPITAL, INC. PART V, SECTION B, LINE 20E: OTHER ACTIONS TAKEN BEFORE INITIATING ANY COLLECTION ACTIONS:FOR INPATIENTS A HOSPITAL REPRESENTATIVE VISITS THE PATIENT AND DISCUSSES WITH THEM ABOUT PAYMENT OPTIONS INCLUDING THE FINANCIAL ASSISTANCE POLICY; FOR OUTPATIENTS AND OTHER PATIENTS THE BUSINESS OFFICE CALLS AND DISCUSSES THE SAME OPTIONS. CAMERON MEMORIAL COMMUNITY HOSPITAL, INC.: PART V, SECTION B, LINE 7A HOSPITAL FACILITY'S WEBSITE: HTTPS://WWW.CAMERONMCH.COM/GETPAGE.PHP?NAME=COMMUNITY_NEEDS_ASSESSMENT&SUB=ABOUT%20US CAMERON MEMORIAL COMMUNITY HOSPITAL, INC.: PART V, SECTION B, LINE 10A URL FOR IMPLEMENTATION STRATEGY:HTTPS://WWW.CAMERONMCH.COM/GETPAGE.PHP?NAME=COMMUNITY_NEEDS_ASSESSMENT&SUB=ABOUT%20US CAMERON MEMORIAL COMMUNITY HOSPITAL, INC.: PART V, LINE 16A, FAP WEBSITE:HTTPS://WWW.CAMERONMCH.COM/GETPAGE.PHP?NAME=OFFICECAMERON MEMORIAL COMMUNITY HOSPITAL, INC.:PART V, LINE 16B, FAP APPLICATION WEBSITE:HTTPS://WWW.CAMERONMCH.COM/GETPAGE.PHP?NAME=OFFICECAMERON MEMORIAL COMMUNITY HOSPITAL, INC.:PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.CAMERONMCH.COM/GETPAGE.PHP?NAME=OFFICE PART I, LINE 3C: CAMERON MEMORIAL COMMUNITY HOSPITAL INC.'S FINANCIAL ASSISTANCE POLICY EXPLAINS THE FOLLOWING ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE IN ADDITION TO THE FPG:INCOME LEVEL OTHER THAN FPG (E.G. CHILD SUPPORT, PENSION INCOME, RENTAL INCOME, EDUCATIONAL INCOME, AND OTHER FINANCIAL SUPPORT FROM FAMILY MEMBERS NOT LIVING IN THE HOUSEHOLD), ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS, AND RESIDENCY. PART I, LINE 7: CAMERON MEMORIAL COMMUNITY HOSPITAL CALCULATED THE COST OF FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS USING THE COST-TO-CHARGE RATIO DERIVED FROM IRS WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. PART II, COMMUNITY BUILDING ACTIVITIES: CAMERON MEMORIAL COMMUNITY HOSPITAL HAS ROOTS IN THIS AREA DATING BACK TO 1926, HELPING GENERATION AFTER GENERATION ENJOY BETTER HEALTH AND LIVE COMFORTABLY. TODAY, WE'RE A 25-BED, NOT-FOR-PROFIT FACILITY THAT PROUDLY SERVES ANGOLA AND STEUBEN COUNTY AS A TOP 100 CRITICAL ACCESS HOSPITAL, A RECOGNITION THAT ILLUSTRATES THE EXCEPTIONAL VALUE CAMERON PROVIDES TO THE COMMUNITY. CAMERON IS ALSO THE ONLY CRITICAL ACCESS HOSPITAL IN A 50-MILE RADIUS TO BE NAMED AS A 4-STAR HOSPITAL BY THE CENTERS FOR MEDICARE & MEDICAID SERVICES. THE HOSPITAL'S MISSION IS TO IMPROVE THE QUALITY OF LIFE FOR THOSE WE SERVE THROUGH RELATIONSHIPS FOCUSED ON HEALTH AND WELLNESS. OUR TEAM OF EXPERIENCED PHYSICIANS, PROFESSIONAL HEALTHCARE PROVIDERS AND KNOWLEDGEABLE STAFF STRIVE TO MEET THIS MISSION EVERY DAY BY PROVIDING OUTSTANDING, PERSONALIZED CARE BACKED BY ADVANCED TECHNOLOGY AND A COMMITMENT TO OUR COMMUNITY. EACH YEAR, CAMERON HOSPITAL HOSTS HIGH SCHOOL STUDENTS THROUGH THE HEALTH OCCUPATIONS EDUCATION PROGRAM (HOE). THESE STUDENTS ARE SELECTED BASED ON THEIR INTEREST IN PURSUING A CAREER IN HEALTHCARE AFTER GRADUATION. DURING THEIR SENIOR YEAR, THE STUDENTS ARE ASSIGNED TO VARIOUS DEPARTMENTS IN THE HOSPITAL, CLINICS, AND MEDICAL OFFICES TO OBSERVE AND IN MANY INSTANCES, HAVE "HANDS-ON" EXPERIENCE, MONITORED BY EXPERTS IN THE FIELD. THE STUDENTS ARE ALSO TRAINED IN CPR, PARTICIPATE IN HEALTH FAIRS AND SCREENINGS THROUGHOUT THE COMMUNITY. BY SUPPORTING THE HOE PROGRAM, CAMERON HOSPITAL CONTINUOUSLY ENCOURAGES AND PROMOTES QUALITY HEALTHCARE FOR OUR COMMUNITY FOR GENERATIONS TO COME. IN 2016, OUR COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED AREAS OF OPPORTUNITY FOR MENTAL HEALTH SUPPORT. IN 2019, CAMERON HOSPITAL WILL ADD CAMERON PSYCHIATRY TO OUR SERVICE LINE OFFERINGS, BRINGING A LICENSED PSYCHIATRIST WITH OVER 40 YEARS' EXPERIENCE TO STEUBEN COUNTY. AS PART OF CAMERON MEDICAL GROUP, DR. MERCADO AND HIS TEAM CARE FOR THE PSYCHOLOGICAL WELL-BEING OF PATIENTS 18 YEARS AND OLDER STRUGGLING WITH TRAUMA, ANXIETY OR DEPRESSION IN AN OUTPATIENT SETTING. IN 2019, CAMERON HOSPITAL WILL AGAIN LAUNCH A COMMUNITY HEALTH NEEDS ASSESSMENT FOCUS GROUP AND SURVEY TO DETERMINE THE CHANGING NEEDS OF THE COMMUNITY. LASTLY, WE UNDERSTAND THE IMPORTANCE OF ACCESS TO HEALTHY FOOD AND BALANCED NUTRITION. THE CAMERON COMMUNITY WELLNESS GARDEN IS OPEN TO COMMUNITY MEMBERS AT NO COST TO THEM. THE GARDENERS RESERVE THEIR SPOTS IN THE GARDEN AND MAINTAIN THEIR CROPS UNTIL THE FALL. FOR THE SECOND YEAR IN A ROW, THE PLOTS HAVE ALL BEEN FILLED. PART III, LINE 2: MANAGEMENT REGULARY REVIEWS DATA ABOUT THE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF PAY PAYMENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD PARTY COVERAGE EXISTS FOR PART OF THE BILL, THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE PROVISION FOR BAD DEBTS RELATING TO PATIENT SERVICE REVENUE HAS BEEN PRESENTED AT THE ACTUAL AMOUNT OF CHARGES WRITTEN OFF. PART III, LINE 3: THE HOSPITAL HAS A DETAILED FINANCIAL ASSISTANCE POLICY WHICH STATES THAT TO PARTICIPATE IN CHARITY CARE CANDIDATES MUST COOPERATE FULLY. IN ADDITION THE HOSPITAL EDUCATES PATIENTS WILL LIMITED ABILITY TO PAY REGARDING FINANCIAL ASSISTANCE. FOR THIS REASON THE ORGANIZATION BELIEVES THAT IT ACCURATELY CAPTURES ALL CHARITY CARE DEDUCTIONS PROVIDED ACCORDING TO THE FINANCIAL ASSISTANCE POLICY AND THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS NEGLIGIBLE. PART III, LINE 4: EXPLANATION OF FINANCIAL STATEMENT FOOTNOTE:SEE THE AUDITED FINANCIAL STATEMENT FOOTNOTE 2 "ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS" LOCATED ON PAGE 8 AND 9 OF THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE YEAR ENDED 9/30/2018 MEDICARE COST REPORT: HOSPITAL STATEMENT OF REIMBURSABLE COST. PART III, LINE 9B: THE BILLING AND COLLECTION POLICY ADDRESSES THE ACTIONS THAT MAY BE TAKEN IN THE EVENT OF NONPAYMENT FOR MEDICAL CARE, ENSURES APPROPRIATE BILLING AND COLLECTION PROCEDURES ARE UNIFORMLY FOLLOWED, AND ENSURES THAT REASONABLE EFFORTS ARE MADE TO DETERMINE WHETHER THE INDIVIDUAL(S) RESPONSIBLE FOR PAYMENT OF ALL OR A PORTION OF A PATIENT ACCOUNT IS ELIGIBLE FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY. FINANCIAL ASSISTANCE STAFF AND MANAGEMENT ARE RESPONSIBILITY FOR ENSURING REASONABLE EFFORTS HAVE BEEN MET ON APPLICABLE ACCOUNTS PRIOR TO INITIATION OF ANY EXTRAORDINARY COLLECTION ACTIONS. PART VI, LINE 2: DESCRIPTION OF HOW COMMUNITY HEALTH CARE NEEDS ARE ASSESSED:IN ADDITION TO CONDUCTING THE TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) THE HOSPITAL BOARD OF DIRECTORS AND MANAGEMENT WORK ONGOING THROUGHOUT THE YEAR WITH COMMUNITY LEADERS, VOLUNTEERS, LOCAL COMMUNITY MEMBERS TO KEEP UP-TO-DATE ON ISSUES WITHIN THE COMMUNITY. THE HOSPITAL PROVIDES MANY EDUCATIONAL OPPORTUNITIES AND SUPPORT ACTIVITIES BEYOND ACUTE MEDICAL AND SURGICAL CARE. PART VI, LINE 3: DESCRIPTION OF PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:THE CHARITY CARE POLICY IS AVAILABLE IN THE ER AND REGISTRATION AREAS OF THE HOSPITAL. CAMERON DISTRIBUTES AN "IMPORTANT BILLING INFORMATION FOR UNINSURED PATIENTS" HANDOUT TO EVERY UNINSURED PATIENT. THIS HANDOUT IS DESIGNED TO HELP PATIENTS UNDERSTAND THE BILLING PROCESS, PAYMENT OPTIONS AND FINANCIAL ASSISTANCE THAT IS AVAILABLE. WE HAVE FINANCIAL COUNSELORS AVAILABLE TO DISCUSS WITH THE PATIENTS' FEDERAL, STATE AND HOSPITAL FINANCIAL ASSISTANCE PROGRAMS AND ASSIST WITH ENROLLMENT PROGRAMS, WHEN APPLICABLE. CAMERON IS AN APPROVED INDIANA MEDICAID ENROLLMENT CENTER FOR OUR PATIENTS. PART VI, LINE 4: DESCRIPTION OF COMMUNITY DEMOGRAPHICS:CAMERON MEMORIAL COMMUNITY HOSPITAL WAS OPENED IN 1926 AND IS LOCATED IN ANGOLA, INDIANA. ANGOLA IS LOCATED IN STEUBEN COUNTY, APPROXIMATELY 45 MILES NORTH OF FORT WAYNE, INDIANA. SINCE CAMERON HOSPITAL IS LOCATED IN EXTREME NORTHEAST INDIANA, IT SERVES PATIENTS FROM COMMUNITIES IN SOUTHWEST MICHIGAN AND NORTHWEST OHIO AS WELL. CAMERON HOSPITAL IS ONE OF THE LARGEST EMPLOYERS IN STEUBEN COUNTY. THE HEALTH CARE SECTOR IS IMPORTANT TO THE COUNTY'S ECONOMY, AS IT EMPLOYS A LARGE NUMBER OF ITS RESIDENTS, WHO PURCHASE A LARGE AMOUNT OF GOODS AND SERVICES FROM THE BUSINESSES LOCATED IN STEUBEN COUNTY. AS OF THE 2010 CENSUS, THE CITY OF ANGOLA HAD A POPULATION OF 8,612, WHILE THE STEUBEN COUNTY POPULATION WAS 34,185. DURING THE SUMMER MONTHS THE POPULATION IN STEUBEN COUNTY DRASTICALLY INCREASES DUE TO THE NUMEROUS LAKES IN THE COUNTY. THE CHARACTERISTICS OF THE POPULATION ARE FACTORS IN DETERMINING THE HEALTH CARE SERVICES THAT OUR COMMUNITY REQUIRES. THE PERCENTAGE OF THE POPULATION IN THE COMMUNITY OVER 65 YEARS OLD IS 20.2%. IN FISCAL YEAR 2018, CAMERON HOSPITAL HAD 135,000 OUTPATIENT VISITS AND 85% OF OUR PATIENT REVENUE WAS OUTPATIENT. THE FACILITY OPERATES AS AN INDEPENDENT CRITICAL ACCESS HOSPITAL AND RECEIVES COST-BASED REIMBURSEMENT. PART VI, LINE 5: DESCRIPTION OF OTHER COMMUNITY HEALTH PROMOTION:THE HOSPITAL IS VERY COMMITTED TO THE COMMUNITY BY SUPPORTING VARIOUS GROUPS AND NOT-FOR-PROFIT ORGANIZATIONS. NUMEROUS HAVE BEEN PROVIDED THROUGHOUT THE YEAR, SUPPORTING THE AREAS OF HEALTH, EDUCATION, AND SAFETY. ADDITIONALLY, HOSPITAL STAFF AND PHYSICIANS DONATE MANY HOURS OF THEIR TIME TO SERVE IN THE FAITH COMMUNITY CLINIC WHICH ASSISTS THE POOR AND UNDERSERVED OF THE COMMUNITY. FINALLY, THE HOSPITAL PARTNERS WITH AREA EMERGENCY PERSONNEL TO ASSIST WITH DISASTER PREPAREDNESS IN OUR COUNTY. THE HOSPITAL FEELS THAT DISASTER PREPAREDNESS IS AN IMPORTANT ROLE FOR IT TO PLAY IN OUR COMMUNITY, ASSISTING RESIDENTS IN THE EVENT OF A NATURAL DISASTER, INDUSTRIAL ACCIDENT OF OTHER LARGE SCALE EMERGENCY. THE HOSPITAL OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY. IN ADDITION TO PROVIDING EMERGENCY SERVICES, THE HOSPITAL PROVIDES MINOR EMERGENCY AND URGENT CARE SERVICES TO ALL REGARDLESS OF ABILITY TO PAY. THE HOSPITAL PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, AND/OR OTHER GOVERNMENT SPONSORED HEALTH PROGRAMS. IN ADDITION TO OUR PARTICIPATION IN THESE PROGRAMS, THE HOSPITAL ABSORBED MORE THAN $481,836 IN UNREIMBURSED MEDICARE COSTS DURING FISCAL YEAR 2018. IN ADDITION, THE HOSPITAL ALSO ABSORBED $4,343,044 IN UNREIMBURSED MEDICAID COSTS DURING FISCAL YEAR 2018. THE HOSPITAL ALSO PARTICIPATES IN A COMMUNITY CLINIC FOR POOR AND LOW INCOME RESIDENTS, WHEREIN LAB, RADIOLOGY, AND REHAB COST ARE ENTIRELY WRITTEN OFF. ALTHOUGH THE PRIMARY CARE PHYSICIANS ARE NOT EMPLOYEED STAFF OF THE HOSPITAL, A NUMBER OF PHYSICIANS VOLUNTEER THEIR SERVICES AT THE CLINIC. THE HOSPITAL OFFERS A COMPASSIONATE CARE PROGRAM TO ELIGIBLE PARTICIPANTS BASED ON THE FEDERAL POVERTY GUIDELINES AT THE 300% LEVEL. IN FISCAL YEAR 2018 THE HOSPITAL ABSORBED $303,717 IN CHARITY CARE COSTS. CAMERON ALSO PROVIDES SCREENINGS FOR RESIDENTS WHO ARE UNINSURED OR UNDERINSURED INCLUDING: PSA SCREENINGS, SKIN CANCER SCREENINGS, BREAST CANCER SCREENINGS AND BLOOD GLUCOSE TESTING FOR DIABETES OR PRE-DIABETES. THE HOSPITAL HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED IN THE AREA. THE GOVERNING BODY (BOARD OF DIRECTORS) CONSISTS OF INDEPENDENT PEOPLE REPRESENTATIVE OF THE COMMUNITY WE SERVE. THE HOSPITAL RECEIVES STRONG SUPPORT FROM AREA RESIDENTS AS EVIDENCED BY THE LARGE BODY OF VOLUNTEERS COMMITTED TO FURTHERING THE HOSPITAL'S MISSION. CAMERON IS PROUD TO PROVIDE OUR COMMUNITY WITH AN STI CLINIC WHICH OPENED IN AUGUST 2018. WE ARE ALSO HONORED TO STAFF THE CLINIC WITH AN AMAZING TEAM OF SKILLED CAMERON VOLUNTEERS INCLUDING A CAMERON MIDWIFE, NURSE PRACTITIONER, STAFF NURSE (OUR CEO), A LICENSED COUNSELOR, AND A MEMBER OF OUR OFFICE STAFF WHO HELPS TO REGISTER PATIENTS. FURTHERMORE, THIS INCREDIBLE TEAM HAS VOLUNTEERED 108 HOURS OF TIME IN FISCAL YEAR 2018 TO ENSURE PATIENT NEEDS AT THIS CLINIC ARE BEING FULFILLED. X X X 0 0 0 0 0 0 0 0 0 TOM MILLER MD IMMEDIATE PAST CHAIR 377592 0 10000 0 0 0 6190 0 14317 0 408099 0 0 0 TODD RUMSEY MD BOARD MEMBER - BEGAN NOV'17 173463 0 0 0 0 0 0 0 6951 0 180414 0 0 0 CONSTANCE M MCCAHILL CHIEF EXECUTIVE OFFICER 229120 0 0 0 0 0 8928 0 5647 0 243695 0 0 0 DOUGLAS C BOMBA CHIEF FINANCIAL OFFICER 199389 0 0 0 0 0 4840 0 15747 0 219976 0 0 0 TERESA KING PHYSICIAN 470145 0 40000 0 0 0 3400 0 15747 0 529292 0 0 0 LYNN FAUR URGENT CARE MEDICAL DIRECTOR 264956 0 15000 0 0 0 0 0 22953 0 302909 0 0 0 CHARLES MACLEAN PHYSICIAN 255373 0 0 0 0 0 0 0 15747 0 271120 0 0 0 JAMES HUNTER PHYSICIAN ASSISTANT 154991 0 10000 0 0 0 0 0 24478 0 189469 0 0 0 KRISTOPHER D KEEN CHIEF INFORMATION OFFICER 135745 0 25000 0 0 0 0 0 24478 0 185223 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE PROCESS OF REVIEWING THE FORM 990 INCLUDES A DETAILED REVIEW OF THE FORM AND REQUIRED SCHEDULES BY THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, AND INDEPENDENT ACCOUNTING FIRM. EACH VOTING MEMBER OF THE GOVERNING BODY RECEIVES A COPY OF THE FORM 990 INCLUDING REQUIRED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C A QUESTIONNAIRE IS SENT OUT ANNUALLY TO ALL OFFICERS, DIRECTORS OR TRUSTEES, AND KEY EMPLOYEES TO DISCLOSE PERSONAL AND BUSINESS RELATIONSHIPS. THE QUESTIONNAIRES ARE REVIEWED ANNUALLY. IF A CONFLICT EXISTS RESTRICTIONS WILL BE IMPOSED ON PERSONS WITH A CONFLICT SUCH AS PROHIBITING THEM FROM PARTICIPATING IN THE GOVERING BODY'S DELIBERATIONS AND DECISIONS IN THE TRANSACTIONS. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING COMPENSATION OF THE CEO, COO, CFO, AND KEY EMPLOYEES INVOLVES REVIEW AND APPROVAL BY THE BOARD INCLUDING REVIEW OF COMPARABLE DATA FROM INDIANA HOSPITAL ASSOCIATION AND COMPDATA. THIS PROCESS IS DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 CAMERON MEMORIAL COMMUNITY HOSPITAL KEEPS COPIES OF THEIR GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS ON SITE AND ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION B, LINE 1, COLUMN B: DESCRIPTION OF SERVICES - INDEPENDENT CONTRACTORS: NAME: HOSPITAL CARE GROUP: SERVICE: HOSPITALIST PROGRAM NAME: APRN-ALLIED MEDICAL SERVICES: SERVICE: RESPIRATORY AND SLEEP THERAPY NAME: ORTHOPAEDIC SURGICARE CARE INST.: SERVICE: ORTHOPAEDICS NAME: AMERI EBO LLC SERVICE: BUSINESS OFFICE EXTENSION NAME: SOUTH BEND MEDICAL FOUNDATION SERVICE: LABORATORY FORM 990, PART IX, LINE 11G PURCHASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 8,508,216. MANAGEMENT AND GENERAL EXPENSES 1,501,450. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,009,666. COLLECTION FEE SERVICES: PROGRAM SERVICE EXPENSES 1,046,577. MANAGEMENT AND GENERAL EXPENSES 184,690. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,231,267. FORM 990, PART XI, LINE 9: CHANGE IN NET ASSETS OF FOUNDATION 124,106. FORM 990, PART XII, LINE 2C, OVERSIGHT OF AUDIT: THE AUDIT COMMITTEE ASSUMES RESPONSIBLITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT, AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR. CAMERON MEDICAL OUTREACH INC 416 E MAUMEE STREET ANGOLA IN 46702 261105702 ASSISTED LIVING IN 501(C)(3) LINE 10 CAMERON MEMORIAL COMMUNITY HOSPITAL 1 CAMERON HOSPITAL FOUNDATION 416 E MAUMEE STREET ANGOLA IN 46702 351722087 FUNDRAISING IN 501(C)(3) LINE 7 CAMERON MEMORIAL COMMUNITY HOSPITAL 1 0 0 1 0 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 CAMERON MEDICAL OUTREACH K 138912 FMV CAMERON MEDICAL OUTREACH Q 3982623 FMV