2018-08-06T14:27:07-05:00 2017-09-30 481026809 Wendling Noe Nelson & Johnson LLC 534 S Kansas Ave Suite 1500 Topeka KS 666033491 990 2016-10-01 440668347 Cameron Regional Medical Center CAME 8166322101 1600 East Evergreen Street Cameron MO 64429 Joseph Abrutz Jr Administrator 8166322101 2018-07-30 1 Heather R Eichem P01515553 7852334226 2018-07-30 2016 2022-09-23 18:48:47Z Joseph Abrutz Jr 1600 East Evergreen Street Cameron MO 64429 66332865 0 X http://www.cameronregional.org/ X 1963 MO To provide acute inpatient and outpatient medical care to area residents regardless of ability to pay. 13 11 599 73 0 0 197677 274001 58642250 57321365 1538264 1639155 222271 190513 60600462 59425034 31000 33500 0 0 30666399 31534924 0 0 4965 26504772 27327242 57202171 58895666 3398291 529368 84509768 82203943 24951095 28347920 59558673 53856023 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. CRMC will provide services in an atmosphere that involves compliance with governmental mandates. Throughout our organization, our employees strive to provide sensitive, 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 52963045 33500 58138153 Acute care hospital organized to provide inpatient and outpatient care to area residents regardless of ability to pay. 52963045 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 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 1 0 0 0 0 0 1 1 0 0 0 1 50 0 1 599 1 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 MO X Joseph Abrutz Jr 8166322101 1600 East Evergreen St Cameron MO 64429 Warren McElwain President 1.00 X X 0 0 0 Steve Huitt 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 1.00 X 0 0 0 Rick Hatten Director 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 Frederick Kiehl Physician & Director 25.00 X 156374 0 0 Stephanie Davis Physician & Director 1.00 X 22950 0 0 Joseph F Abrutz Jr Administrator 42.00 X 383495 0 9024 Rosa Patti Chief Financial Officer 44.00 X 171249 0 12502 Muhammad Amin Physician 42.00 X 395594 0 0 Doak Doolittle Physician 42.00 X 545988 0 0 Shahzad Shafique Physician 42.00 X 451491 0 0 Laeeq Tahirkheli Physician 42.00 X 736351 0 0 Daut Gjoni Physician 42.00 X 474361 0 0 3337853 0 21526 33 0 1 0 Premier Specialty Network 1835 E Republic Rd Suite 200 Springfield MO 65804 Physician specialists 1650583 Cameron Emergency Physicians PC 1600 E Evergreen Cameron MO 64429 Emergency physicians 1389136 Psychiatric Solutions Inc PO Box 840839 Dallas TX 75284 Operation of BHU unit 1120920 CPSI PO Box 850309 Mobile AL 36685 Computer support services 434309 Orthopedic Surgeons Inc 2790 Clay Edwards Dr Suite 650 North Kansas City MO 64116 Surgeons 270890 12 26790 247211 274001 Patient service revenue 621990 56971238 56971238 EHR incentive payments 900099 350127 350127 57321365 813253 813253 9114 9114 62375 0 62375 62375 62375 7688209 36410 6872521 35310 815688 1100 816788 816788 Cafeteria 722210 99929 99929 Other income 900099 28209 28209 128138 59425034 58138153 0 1012880 X 33500 33500 743266 182037 561229 25581459 23770470 1810989 386397 351827 34570 3107874 2847851 260023 1715928 1562410 153518 228760 228760 8024607 7405924 618683 291255 117628 173627 1190876 912596 278280 730273 678398 51875 556403 489706 66697 323743 275708 48035 1142944 1142944 3052963 2687523 365440 473278 48793 424485 Medical supplies 4576567 4576567 Pharmaceuticals 4358760 4358760 Repairs and maintenance 865796 728915 136881 Collection fees 325274 325274 1185743 791488 389290 4965 58895666 52963045 5927656 4965 112666 232471 7782616 9288559 20312687 12229866 1080890 1049261 280345 229773 62246942 41816226 19964067 20430716 30657658 34217879 4318839 4525418 84509768 82203943 4892563 5364408 19374336 22406183 665016 577329 19180 0 24951095 28347920 X 58789815 53061316 768858 794707 59558673 53856023 84509768 82203943 X 529368 1749130 -8000000 18852 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1421032 1421032 23488411 13270059 10218352 34257624 28139072 6118552 3079875 407095 2672780 20430716 Deferred debt issuance costs 344615 Third party payor settlements 3457354 Beneficial interest in net assets of CRMC Foundation 563403 Other receivables 85880 Accrued interest and dividends 26850 Cash value of life insurance 47316 4525418 X Part X, Line 2: Management is not aware of any uncertainties in income tax positions. 1 1 1 X 1 X 1 1 1 0 1 1 960412 926023 34389 0.00060 8184398 6482775 1701623 0.02890 9144810 7408798 1736012 0.02950 285988 3859 282129 0.00480 33500 33500 0.00060 11349486 7035379 4314107 0.07330 25000 25000 0.00040 11693974 7039238 4654736 0.07910 20838784 14448036 6390748 0.10860 1 7278860 727886 17056911 19915458 -2858547 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 15 1 0 0 1 X http://www.cameronregional.org X 1 15 0 1 0 1 X 100.000000000000 300.000000000000 X X X X 1 1 X X X 1 X http://www.cameronregional.org/business-office/ X http://www.cameronregional.org/business-office/ X http://www.cameronregional.org/business-office/ 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: The following is the description of the actions taken during the most recent fiscal year to address the significant needs identified through the CHNA:No. 1 Mental Health: Due to a continuing shortage of Mental Health providers in rural northwest Missouri and the ever-growing need forthis service, Cameron Regional Medical Center ("CRMC") continues to focus on increasing its offerings in this arena. Five Psychiatrists, including a Child Psychiatrist and a Geriatric Psychiatrist, provide inpatient and outpatient services at CRMC on a regularly-scheduled basis. In addition, Mental Health counselors for both adults and children are available at CRMC on an expanded outpatient basis. Flyers noting these services are made available to patients, visitors, providers, and the public at large. A calendar denoting these offerings is placed in 15 area publications on a monthly basis. TelePsych services are utilized one day per week to enhance GeroPsychiatric coverage. It is estimated that CRMC underwrites over $110,000 annually in order to provide the above-referenced Mental Health services.No. 2 Substance Abuse (Alcohol/Drugs/Prescriptions/Tobacco): A regional resource directory for CRMC's service area has been developed and is maintained. It is distributed to area residents upon request and disseminated at certain public meetings and events as sponsored by the Medical Center. In addition to medical, Mental Health, governmental, fitness, and social support services, it includes area alcohol and drug treatment programs. Detailed information on smoking cessation is included in all CRMC admission packets, and in discharge packets for those patients who smoke. The Medical Center assists its employees financially with smoking cessation. CRMC, through its network of primary care clinics, physicians, hospital Pharmacy, and mid-level providers, has facilitated and promoted concerted efforts against prescription drug/medication abuse. The Medical Center's e-prescribing software and a straightforward communication system with area pharmacies both serve to aid in monitoring and tracking "doctor shopping" efforts by patients suspected of same. The Medical Center assists the Cameron Police Department with it annual "Prescription Drug Take-Back Day" held in conjunction with the DEA.No. 3 Obesity/Nutrition/Fitness: In terms of addressing obesity, CRMC continues to provide a regimented physician-assisted weight loss program at highly-discounted rates via one of its satellite clinics. Free bi-monthly training classes in diabetes, nutrition, and healthy eating are held, with excellent participation rates. From fitness/wellness and anti-obesity standpoints, CRMC and its Medical Staff both make sizeable annual donations to the recent relocation and expansion of the Cameron YMCA under terms of five-year pledges. The CRMC Foundation makes sizeable annual donations to two area walking/fitness trails via three-year pledges. CRMC and the CRMC Foundation continue to sponsor their 4-Mile Run, 2-Mile Walk, and Children's Fun Run on the Fourth of July each year. Approximately 250 runners, walkers, and children participate each year in this fitness/wellness event. Fitness challenges are sponsored for CRMC employees at least twice a year. CRMC assists its employees financially with their membership fees at area fitness centers. CRMC initiated a Community Garden in 2016, with organic produce being offered to the local Women's Shelter and Food Pantry. The CRMC Foundation continues to operate 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. The Foundation's Trail upkeep and maintenance expenses run approximately $15,000 annually. CRMC's 15th Annual Health Fair was again expanded, with extensive blood work (anemia, blood sugar, thyroid, cholesterol panel, iron, GFR, & BUN/Creatinine), weight management education with BMI calculations, medication counseling, kidney function screenings, podiatry screenings, skin cancer spot checks, carotid screenings, shingles education, abdominal aortic aneurysm screenings, balance testing, macular degeneration screenings, sleep disorders education, glucose testing, blood pressures, diabetes/nutrition education, memory screenings, stroke education, and pulse oximetry all being offered to the public free of charge. Flu vaccinations were offered for a nominal charge. Over 400 participants from 19 counties and three states attended the comprehensive event.No. 4 Parenting & Social Support: While CRMC does not delve into "parenting" per se, the Medical Center recognizes the financial stresses placed on area families by medical costs and today's economy/environment. From a social support aspect, CRMC's collection policies remain extremely lenient. The Medical Center and its clinics offer a prompt pay discount on all self-pay balances. Charity care is available if the patient makes a good-faith effort, meets U.S. Federal Poverty Guidelines, and completes the applicable paperwork. CRMC's temperate collection policies are widely publicized in area media. Monthly audits are conducted to determine the public's satisfaction with CRMC's billing formats and practices. Prenatal, childbirth, and breastfeeding classes are held at CRMC at least twice annually. Immunization education is provided to young families at CRMC's satellite (primary care) clinics. The CRMC Foundation purchased and donated six Infant CPR Kits to the Cameron Parents as Teachers program for their family safety endeavors. The CRMC Foundation purchased and donated early childhood vision screening equipment to be used by eight school districts in the Medical Center's service area. CRMC maintains a close working relationship with area Ministerial Alliances and is readily available as a resource for families. As a means of social support, CRMC is currently operating five full-time Patient Courtesy Vans throughout eight counties in rural northwest Missouri. Free transportation is provided Monday through Saturday to patients in need of medical services, but who have no other viable means of transportation. Patients are transported to and from the hospital, physicians' offices, CRMC's satellite clinics, and/or CRMC's outpatient specialty clinics. Based on need, transportation to tertiary centers is also made available under certain circumstances. This free service is utilized heavily by many seeking Mental Health assistance. In terms of social support, CRMC continues to provide free public education seminars on Medicare, Medicaid, Medicare Advantage, managed care, commercial insurance, Part D, the PPACA, and other third-party payors two or three times per year. The Medical Center also provides individuals with free enrollment assistance for bothMedicaid and Medicare.No. 5 Urgent Care Services: As feasibility studies show the area's population is not sufficient to support an Urgent Care Center in Cameron, CRMC's After-Hours Care Program at Walnut Medical Clinic continues to provide evening health care services as an alternative. After-hour providers are available Monday thru Thursday nights, 5:00 8:00 p.m., and are utilized to capacity approximately 95% of the time. Additionally, early morning hours have been implemented five days per week at Westside Medical Offices in Cameron. The possible implementation of Saturday clinic hours remains under consideration. In order to promote easy access to care, CRMC provides primary care services via 18 satellite clinics located throughout five counties. CRMC's 24-hour Emergency Room sees all patients, regardless of ability to pay and circumstances.Description of the actions not taken during the most recent fiscal year:No. 1 Child Care: As child care is not a central component of CRMC's mission or operations, the Medical Center plays a SUPPORTING ROLE ONLY in addressing this need. The Medical Center does cooperate in economic development efforts toward promoting new businesses (such as pre-schools and child care centers) on an area wide basis whenever feasible. 18 1 - Cameron Medical Clinic 1600 E Evergreen Cameron MO 64429 Medical Clinic 2 - Bethany Health Services 903 North 25th Street Bethany MO 64424 Medical Clinic 3 - Westside Medical Offices 1608 E Evergreen Cameron MO 64429 Medical Clinic 4 - Walnut Medical Clinic 221 E 7th Street Cameron MO 64429 Medical Clinic 5 - Cameron Specialists - Internal Medicine 1608 E Evergreen Cameron MO 64429 Medical Clinic 6 - Maysville Family Health 1007 S Polk Maysville MO 64469 Rural Health Clinic 7 - Cameron Obstetrics & Gynecology 1600 E Evergreen Suite A Cameron MO 64429 Medical Clinic 8 - Gallatin Family Medicine 502 S Main Gallatin MO 64640 Rural Health Clinic 9 - Hamilton Family Health Center 212 N Davis Hamilton MO 64644 Rural Health Clinic 10 - Lathrop Medical Clinic 106 North Street Lathrop MO 64465 Medical Clinic 11 - Polo Family Health Center 198 Main Street Polo MO 64671 Rural Health Clinic 12 - Pattonsburg Medical Clinic 110 N Central Ave Pattonsburg MO 64670 Rural Health Clinic 13 - Plattsburg Family Medicine 214 N Main Plattsburg MO 64477 Rural Health Clinic 14 - Stewartsville Medical Clinic 106 E 4th Stewartsville MO 64490 Rural Health Clinic 15 - Jamesport Outreach Clinic 409 W Auberry Grove Jamesport MO 64648 Rural Health Clinic 16 - Gilman City Medical Clinic 427 Main Street Gilman City MO 64642 Rural Health Clinic 17 - Cameron Nephrology Clinic 1600 E Evergreen Suite B Cameron MO 64429 Medical Clinic 18 - Eagleville Medical Clinic 12050 12th Street Eagleville MO 64442 Rural Health 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 $8,205,397. Part III, Line 4: See note A3 (page 8) 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. After the portion of bad debt cost attributed to subsidized health services, The Medical Center considers $613,588 of bad debt cost as community benefit. 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 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.The shortfall is 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. 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 ten 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 50,603 individuals that reside in the primary service area. Of these residents approximately 12.5% of them have an annual income below the federal poverty level. The median annual income per household for the four counties is approximately $47,354. Approximately 42% of the total services provided are for Medicare patients and 14% 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 33500 Part I, Line 2: Scholarships are paid directly to the college of the recipient. X X X 0 0 0 0 0 1 0 1 0 Frederick Kiehl Physician & Director 155369 0 1005 0 0 0 0 0 0 0 156374 0 0 0 Joseph F Abrutz Jr Administrator 276987 0 106508 0 0 0 0 0 9024 0 392519 0 0 0 Rosa Patti Chief Financial Officer 89410 0 81839 0 0 0 0 0 12502 0 183751 0 0 0 Muhammad Amin Physician 319382 0 76212 0 0 0 0 0 0 0 395594 0 0 0 Doak Doolittle Physician 471942 0 74046 0 0 0 0 0 0 0 545988 0 0 0 Shahzad Shafique Physician 397215 0 54276 0 0 0 0 0 0 0 451491 0 0 0 Laeeq Tahirkheli Physician 569788 0 166563 0 0 0 0 0 0 0 736351 0 0 0 Daut Gjoni Physician 332536 0 141825 0 0 0 0 0 0 0 474361 0 0 0 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 2017 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 A 10000000 480955 170257 9348788 2017 1 0 1 1 B 3990000 399000 68386 2274285 21250 1227079 0 0 0 1 A 0 0 0 0 0 0 0 B 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 A 1 B 1 Karley Patti Family member of Rosa Patti, CFO 23206 Employment 0 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 organizations 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 4,565,493. Management and general expenses 31,495. Fundraising expenses 0. Total expenses 4,596,988. Purchased services: Program service expenses 2,295,374. Management and general expenses 587,188. Fundraising expenses 0. Total expenses 2,882,562. Reference lab fees: Program service expenses 545,057. Management and general expenses 0. Fundraising expenses 0. Total expenses 545,057. Form 990, Part XI, line 9: Change in beneficial interest in net assets of Foundation net of transfers 18,852. 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