HANNIBAL REGIONAL HEALTHCARE SYSTEM INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- HANNIBAL REGIONAL HEALTHCARE SYSTEM INC (EIN 43-0662495)
- Tax period
- 2016-10-01 to 2017-09-30
- Filed
- 2018-08-09
- IRS object ID
- 201832219349301453
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-08-09T16:34:35-05:00 | ReturnTs |
| Tax Period End | 2017-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 WASHINGTON AVENUE SUITE 1800 | AddressLine1Txt |
| City | ST LOUIS | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 430662495 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HANNIBAL REGIONAL HEALTHCARE SYSTEM INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HANN | BusinessNameControlTxt |
| Phone | 5732481300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6500 HOSPITAL DRIVE PO BOX 551 | AddressLine1Txt |
| City | HANNIBAL | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63401 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROB GASAWAY | PersonNm |
| Person Title | VICE PRESIDENT - FINANCE | PersonTitleTxt |
| Phone | 5732481300 | PhoneNum |
| Signature | 2018-08-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEFF PARKER | PreparerPersonNm |
| PTIN | P00970069 | PTIN |
| Phone | 3149254300 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | C TODD AHRENS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6500 HOSPITAL DRIVE PO BOX 551 | AddressLine1Txt |
| City | HANNIBAL | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63401 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $155,492,563 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HOSPITAL.HANNIBALREGIONAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1987 | FormationYr |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Activity Or Mission | THE SYSTEM OPERATES A FULL SERVICE ACUTE CARE FACILITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 1105 | TotalEmployeeCnt |
| Total Volunteers | 281 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $480,397 | PYContributionsGrantsAmt |
| CY Contributions Grants | $599,661 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $133,507,994 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $147,462,759 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,895,120 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,118,772 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,232,078 | PYOtherRevenueAmt |
| CY Other Revenue | $2,308,837 | CYOtherRevenueAmt |
| PY Total Revenue | $139,115,589 | PYTotalRevenueAmt |
| CY Total Revenue | $153,490,029 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $38,323 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $108,678 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $69,329,159 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $84,528,833 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $405,224 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $60,507,117 | PYOtherExpensesAmt |
| CY Other Expenses | $66,796,523 | CYOtherExpensesAmt |
| PY Total Expenses | $129,874,599 | PYTotalExpensesAmt |
| CY Total Expenses | $151,434,034 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $9,240,990 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,055,995 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $143,832,455 | TotalAssetsBOYAmt |
| Total Assets EOY | $152,196,009 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $40,716,317 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $42,304,066 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $103,116,138 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $109,891,943 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE EXCEPTIONAL HEALTHCARE SERVICES FOR A BETTER LIFE. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $134,509,844 | ExpenseAmt |
| Grant | $108,678 | GrantAmt |
| Revenue | $148,649,841 | RevenueAmt |
| Desc | THE SYSTEM OPERATES A FULL SERVICE 86 BED ACUTE CARE HOSPITAL FACILITY, A 13 BED INPATIENT REHAB FACILITY, SEVERAL PHYSICIAN PRACTICES AND PRIMARY CARE CLINICS, AND A HOME HEALTH AGENCY IN HANNIBAL MISSOURI AND SURROUNDING COUNTIES. 18,014 TOTAL INPATIENT DAYS WERE PROVIDED DURING THE COURSE OF THE YEAR. THE SYSTEM PROVIDES SERVICES TO PATIENTS THAT MEET THE HOSPITAL'S CHARITY CARE POLICY AS WELL AS SERVICES TO OTHER MEDICALLY INDIGENT PATIENTS UNDER CERTAIN GOVERNMENT-REIMBURSED PUBLIC AID PROGRAMS. THE TOTAL COST OF UNCOMPENSATED CARE WAS: CHARITY CARE - $3,519,350 AND STATE MEDICAID AND OTHER PUBLIC AID PROGRAMS - $7,995,649. | Desc |
| Total Program Service Expenses | $134,509,844 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | Yes (1) | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 168 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1105 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROB GASAWAY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5732481300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6500 HOSPITAL DRIVE | AddressLine1Txt |
| City | HANNIBAL | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63401 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| ROBERT GILSTRAP | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JACK WHITAKER | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| CAROLYN SHAW | |||||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| PAUL EWERT | |||||||||
| CHAIRPERSON | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| DIRK SAUER | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| STEVE MILLER | |||||||||
| ASST SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| JASON POAGE | |||||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| LINDA STRAUBE | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| GENE SCHOLES JR | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| PAT BENSON | |||||||||
| VICE CHAIRPERSON | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| DEBORAH THORNBURG | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| LACEY YOUNG | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| RICHARD VALUCK | |||||||||
| DIRECTOR & CARDIOLOGIST | 40.00 | Yes (X) | $602,816 | $0 | $36,749 | ||||
| C TODD AHRENS | |||||||||
| PRESIDENT & CEO | 40.00 | $581,294 | $0 | $138,987 | Yes (X) | 1.00 | |||
| ROGER DIX | |||||||||
| VICE PRESIDENT - FINANCE | 40.00 | $358,441 | $0 | $17,292 | Yes (X) | ||||
| ROB GASAWAY | |||||||||
| VICE PRESIDENT - FINANCE | 40.00 | $0 | $0 | $0 | Yes (X) | ||||
| TIMOTHY REUSCHEL | |||||||||
| VICE PRESIDENT - GENERAL COUNSEL | 40.00 | $326,965 | $0 | $70,397 | Yes (X) | ||||
| PRANAV PARIKH MD | |||||||||
| V.P. - QUALITY & MEDICAL AFFAIRS | 40.00 | $469,982 | $0 | $110,097 | Yes (X) | ||||
| JULIE LEVERENZ | |||||||||
| VICE PRESIDENT - STRATEGY & PLANNING | 40.00 | $222,773 | $0 | $72,648 | Yes (X) | ||||
| SUSAN WATHEN | |||||||||
| VICE PRESIDENT - HUMAN RESOURCES | 40.00 | $193,812 | $0 | $38,109 | Yes (X) | ||||
| G DOUG RUBLE | |||||||||
| VICE PRESIDENT - FACILITIES | 40.00 | $188,318 | $0 | $37,441 | Yes (X) | ||||
| PATRICIA BRAWNER | |||||||||
| VICE PRESIDENT - NURSING | 40.00 | $176,177 | $0 | $24,797 | Yes (X) | ||||
| KURT EBERS | |||||||||
| CLINIC ADMINISTRATOR | 40.00 | $167,152 | $0 | $32,709 | Yes (X) | ||||
| TIMOTHY POLLEY | |||||||||
| V.P. - HRHS BUSINESS DEVELOPMENT | 40.00 | $333,472 | $0 | $22,508 | Yes (X) | ||||
| WENDY HARRINGTON | |||||||||
| V.P. - HRHS DEVELOPMENT | 1.00 | $189,805 | $0 | $53,726 | Yes (X) | 40.00 | |||
| LUVELL GLANTON | |||||||||
| ANESTHESIOLOGIST - PAIN MANAGEMENT | 40.00 | $802,938 | $0 | $44,737 | Yes (X) | ||||
| HARSHA DESAI | |||||||||
| PATHOLOGIST | 40.00 | $629,555 | $0 | $44,990 | Yes (X) | ||||
| PERVEZ ALVI | |||||||||
| CARDIOLOGIST | 40.00 | $540,746 | $0 | $29,672 | Yes (X) | ||||
| THELMA PEERY | |||||||||
| EMERGENCY ROOM PHYSICIAN | 40.00 | $549,040 | $0 | $21,018 | Yes (X) | ||||
| SATHISH KODALI | |||||||||
| CARDIOLOGIST | 40.00 | $555,743 | $0 | $521 | Yes (X) | ||||
| LYNN OLSON | |||||||||
| FORMER CEO - HOSPITAL | 0.00 | $134,119 | $0 | $0 | 0.00 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $7,023,148 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $796,398 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 91 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ALLSCRIPTS LLC | |||||
| PO BOX 8538-0133 | PHILADELPHIA | PA | 19171 | IT SYSTEMS | $1,318,498 |
| ADVANCE HANNIBAL REGIONAL HOSPITAL | |||||
| 188A MEDICAL DRIVE | HANNIBAL | MO | 63401 | PT/OT PROVIDER | $1,031,500 |
| INTERIM PHYSICIANS LLC | |||||
| PO BOX 679139 | DALLAS | TX | 75267 | LOCUM PHYSICIAN | $872,380 |
| HOUSE AFH LLC | |||||
| 148 STONE RIDGE DRIVE | HANNIBAL | MO | 63401 | LOCUM PHYSICIAN | $870,813 |
| BANC OF AMERICA LEASING | |||||
| PO BOX 100918 | ATLANTA | GA | 30384 | LEASING COMPANY | $804,787 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 49 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $599,661 | RelatedOrganizationsAmt |
| Total Contributions | $599,661 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $146,730,694 | $146,730,694 |
| EHR MEANINGFUL USE | 621110 | $732,065 | $732,065 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $147,462,759 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,502,297 | TotalRevenueColumnAmt |
| Exclusion | $1,502,297 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $339,611 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $17,015 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $322,596 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $322,596 | TotalRevenueColumnAmt |
| Exclusion | $322,596 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,559,950 | SecuritiesAmt |
| Other | $42,044 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,964,497 | SecuritiesAmt |
| Other | $21,022 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,595,453 | SecuritiesAmt |
| Other | $21,022 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,616,475 | TotalRevenueColumnAmt |
| Exclusion | $1,616,475 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| CHILDREN'S DEVELOPMENT CENTER | 624410 | $708,749 | $708,749 | |
| CAFETERIA | 722210 | $660,208 | $660,208 | |
| CONTRACTED SERVICES | 621110 | $260,689 | $260,689 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $356,595 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $217,644 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $138,951 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,986,241 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $153,490,029 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $148,649,841 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,240,527 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,678 | TotalAmt |
| Program Services | $108,678 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,763,954 | TotalAmt |
| Program Services | $788,496 | ProgramServicesAmt |
| Management And General | $3,858,833 | ManagementAndGeneralAmt |
| Fundraising | $116,625 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,345,316 | TotalAmt |
| Program Services | $53,081,067 | ProgramServicesAmt |
| Management And General | $7,030,959 | ManagementAndGeneralAmt |
| Fundraising | $233,290 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,275,615 | TotalAmt |
| Program Services | $2,210,130 | ProgramServicesAmt |
| Management And General | $58,554 | ManagementAndGeneralAmt |
| Fundraising | $6,931 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,149,732 | TotalAmt |
| Program Services | $11,579,938 | ProgramServicesAmt |
| Management And General | $1,533,581 | ManagementAndGeneralAmt |
| Fundraising | $36,213 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,994,216 | TotalAmt |
| Program Services | $3,487,642 | ProgramServicesAmt |
| Management And General | $494,409 | ManagementAndGeneralAmt |
| Fundraising | $12,165 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $174,293 | TotalAmt |
| Management And General | $174,293 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,500 | TotalAmt |
| Management And General | $97,500 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,552 | TotalAmt |
| Program Services | $10,955 | ProgramServicesAmt |
| Management And General | $1,597 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,639,145 | TotalAmt |
| Program Services | $16,557,913 | ProgramServicesAmt |
| Management And General | $81,232 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $640,579 | TotalAmt |
| Program Services | $640,579 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,975,531 | TotalAmt |
| Program Services | $16,561,746 | ProgramServicesAmt |
| Management And General | $2,413,785 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,094,873 | TotalAmt |
| Program Services | $955,600 | ProgramServicesAmt |
| Management And General | $139,273 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,721,911 | TotalAmt |
| Program Services | $1,502,875 | ProgramServicesAmt |
| Management And General | $219,036 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $843,991 | TotalAmt |
| Program Services | $736,631 | ProgramServicesAmt |
| Management And General | $107,360 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,347 | TotalAmt |
| Program Services | $91,946 | ProgramServicesAmt |
| Management And General | $13,401 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $333,225 | TotalAmt |
| Program Services | $290,837 | ProgramServicesAmt |
| Management And General | $42,388 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,783,443 | TotalAmt |
| Program Services | $7,783,443 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $639,745 | TotalAmt |
| Program Services | $558,366 | ProgramServicesAmt |
| Management And General | $81,379 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT EXPENSE | $9,876,627 | $9,876,627 | |
| PHARMACY DRUGS | $5,734,246 | $5,734,246 | |
| FOOD | $699,620 | $699,620 | |
| RECRUITING EXPENSE | $612,479 | $534,569 | $77,910 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $811,416 | TotalAmt |
| Program Services | $717,940 | ProgramServicesAmt |
| Management And General | $93,476 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $151,434,034 | TotalAmt |
| Program Services | $134,509,844 | ProgramServicesAmt |
| Management And General | $16,518,966 | ManagementAndGeneralAmt |
| Fundraising | $405,224 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,239,051 | BOYAmt |
| EOY | $15,033,473 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,520,546 | BOYAmt |
| EOY | $1,031,240 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,051,045 | BOYAmt |
| EOY | $17,563,230 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,313,654 | BOYAmt |
| EOY | $1,275,128 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,523,994 | BOYAmt |
| EOY | $3,055,896 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $832,787 | BOYAmt |
| EOY | $1,102,034 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $155,979,765 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $108,597,059 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,949,262 | BOYAmt |
| EOY | $47,382,706 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,212,051 | BOYAmt |
| EOY | $58,604,731 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $333,782 | BOYAmt |
| EOY | $652,993 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $336,908 | BOYAmt |
| EOY | $1,686,020 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,519,375 | BOYAmt |
| EOY | $4,808,558 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $143,832,455 | BOYAmt |
| EOY | $152,196,009 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,211,323 | BOYAmt |
| EOY | $25,710,322 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,921 | BOYAmt |
| EOY | $64,270 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,015,000 | BOYAmt |
| EOY | $7,529,351 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,087,420 | BOYAmt |
| EOY | $6,445,428 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,323,653 | BOYAmt |
| EOY | $2,554,695 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,716,317 | BOYAmt |
| EOY | $42,304,066 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $98,575,052 | BOYAmt |
| EOY | $105,059,949 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,541,086 | BOYAmt |
| EOY | $4,831,994 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,116,138 | BOYAmt |
| EOY | $109,891,943 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $143,832,455 | BOYAmt |
| EOY | $152,196,009 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $2,055,995 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $2,133,926 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $2,585,884 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $12,552 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $12,552 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | A PORTION OF THE MEMBERSHIP DUES PAID TO THE MISSOURI HOSPITAL ASSOCIATION IS RELATED TO LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Funds And Other Accounts Held | 1 | FundsAndOtherAccountsHeldCnt |
| Funds And Other Accounts Contri | $1,070 | FundsAndOtherAccountsContriAmt |
| Funds And Other Accounts Grants | $650 | FundsAndOtherAccountsGrantsAmt |
| Funds And Other Accounts Vl EOY | $23,436 | FundsAndOtherAccountsVlEOYAmt |
| Disclosed Org Leg Ctrl | 0 | DisclosedOrgLegCtrlInd |
| Disclosed For Charitable Prps | 0 | DisclosedForCharitablePrpsInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,479,295 | OtherCostOrOtherBasisAmt |
| Book Value | $2,479,295 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $65,323,044 | OtherCostOrOtherBasisAmt |
| Depreciation | $41,408,865 | DepreciationAmt |
| Book Value | $23,914,179 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,096,883 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,102,604 | DepreciationAmt |
| Book Value | $994,279 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $77,113,817 | OtherCostOrOtherBasisAmt |
| Depreciation | $61,085,590 | DepreciationAmt |
| Book Value | $16,028,227 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,966,726 | OtherCostOrOtherBasisAmt |
| Book Value | $3,966,726 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $47,382,706 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| MINIMUM PENSION LIABILITY | $547,554 |
| SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN | $2,007,141 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,554,695 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,970,512 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $480,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,490,512 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01640 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,153,738 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,306,355 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,847,383 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03200 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,124,250 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,786,355 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,337,895 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04840 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,765,725 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,400,685 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,365,040 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05520 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $276,279 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $276,279 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $502,185 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $502,185 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00330 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,544,189 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,400,685 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,143,504 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06030 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $34,668,439 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $18,187,040 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,481,399 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10870 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,102,850 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $737,769 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,365,081 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00900 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,545 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,545 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $458,969 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $458,969 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00300 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,563,364 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $737,769 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,825,595 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01200 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $9,876,627 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $7,407,470 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $36,621,306 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $41,249,189 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$4,627,883 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (3 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Org Profit Or OwnershipOrgProfitOrOwnershipPct | Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct |
|---|---|---|
| 1 HANNIBAL MEDICAL SUPPLY | ||
| DME COMPANY | 0.33330 | 0.33330 |
| 3 ADVANCE HANNIBAL REGIONAL HOSPITAL LLC | ||
| OUTPATIENT PHYSICAL THERAPY | 0.50000 | 0.50000 |
| 4 HANNIBAL REGIONAL PHYSICIAN HOSPITAL ORGANIZATION INC | ||
| INSURANCE REPRICING | 0.50000 | 0.50000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HANNIBAL REGIONAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6000 HOSPITAL DRIVE | AddressLine1Txt |
| City | HANNIBAL | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63401 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HRHONLINE.ORG | WebsiteAddressTxt |
| State License | 101-57 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HANNIBAL REGIONAL HEALTHCARE SYSTEM INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C FOR URL OF CHNA | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SEC. C FOR IMPLEMENTATION STRATEGY URL | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SECTION C FOR URL | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C FOR URL | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, SECTION C FOR URL | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. | PART V, SECTION B, LINE 5: A BROAD-BASED STEERING COMMITTEE OF HEALTHCARE LEADERS FROM THROUGHOUT THE SIX COUNTY REGION WAS FORMED TO GUIDE THE ASSESSMENT PROCESS AND ESTABLISH THE THREE-YEAR STRATEGY TO ADDRESS THE PRIORITIES IDENTIFIED. |
| HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. | PART V, SECTION B, LINE 6B: SIX COUNTY HEALTH DEPARTMENTS, FREE CLINIC, FQHC, MULTIPLE SOCIAL SERVICE AGENCIES, NON-EMPLOYED PHYSICIAN GROUPS AND OTHERS. |
| HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. | PART V, SECTION B, LINE 11: A BROAD-BASED OVERSIGHT GROUP IS MEETING ON A QUARTERLY BASIS TO ASSESS PROGRESS AND INFLUENCE THE WORK ESTABLISHED IN THE PLAN; A VARIETY OF BEHAVIORAL HEALTH SERVICES HAVE EMERGED IN THE REGION DUE TO THE VISIBILITY OF THIS PROBLEM; MENTAL HEALTH FIRST AID CLASSES ARE RAISING HEALTH LITERACY; SERVICES HAVE BEEN EXPANDED AT THE LOCAL FREE CLINIC TO ADDRESS BY ACCESS TO CARE, MENTAL HEALTH AND DENTAL HEALTH; A POPULATION HEALTH GRANT IS RESULTING IN REDUCING THE INCIDENCE OF EMERGENCY DEPARTMENT VISITS FOR PATIENTS WITH CHRONIC DISEASE WHO WERE FORMERLY HIGH UTILIZERS; A NEW FQHC HAS ADDED MENTAL HEALTH AND DENTAL HEALTH CAPACITY IN THE REGION; A COMMUNITY HEALTH INITIATIVE KNOWN AS "LIVING BETTER" IS BEGINNING TO EMERGE AND IS INTENDED TO ENHANCE THE SOCIAL VALUING OF HEALTH; COME COMMITTED COALITIONS FOCUSING ON THE PRIORITY PROBLEMS IDENTIFIED IN THE CHNA ARE NOW IN PLACE. |
| HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. | PART V, SECTION B, LINE 13B: THE PATIENTS ABILITY TO PAY OUTSIDE OF NORMAL LIVING EXPENSES AND DEBT. |
| HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. | PART V, SECTION B, LINE 16J: PERSONAL CONTACT AND WEBSITE ACCCESS ARE THE MAIN POINTS OF CONTACT. |
| HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. | PART V, SECTION B, LINE 20E: COMMUNICATIONS THROUGH MAIL AND PHONE INTERVIEWS ARE PURSUED TO RESOLVE ISSUES AND OBTAIN NEEDED INFORMATION TO QUALIFY PATIENTS. |
| SCHEDULE H, PART V, SECTION B, LINE 7B | THE ORGANIZATION'S MOST RECENT CHNA REPORT CAN BE FOUND AT:HTTPS://HANNIBALREGIONAL.ORG/COMMUNITYHEALTH/CHNA/2016-2019REGIONALHEALTHSTRATEGY/TABID/208/DEFAULT.ASPX |
| SCHEDULE H, PART V, SECTION B, LINE 10 | THE ORGANIZATION'S CURRENT IMPLEMENTATION STRATEGY CAN BE FOUND AT: HTTPS://HANNIBALREGIONAL.ORG/COMMUNITYHEALTH/CHNA/2016-2019REGIONALHEALTHSTRATEGY/TABID/208/DEFAULT.ASPX |
| SCHEDULE H, PART V, SECTION B, LINE 16A | THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY (FAP) CAN BE FOUND AT:HTTPS://HANNIBALREGIONAL.ORG/PATIENTSVISITORS/PATIENTSERVICES/FINANCIALASSISTANCE/TABID/241/DEFAULT.ASPX |
| SCHEDULE H, PART V, SECTION B, LINE 16B | THE ORGANIZATION'S FINANCIAL ASSISTANCE APPLICATION CAN BE FOUND AT:HTTPS://HANNIBALREGIONAL.ORG/PATIENTSVISITORS/PATIENTSERVICES/FINANCIALASSISTANCE/TABID/241/DEFAULT.ASPX |
| SCHEDULE H, PART V, SECTION B, LINE 16C | THE ORGANIZATION'S PLAIN LANGUAGE SUMMARY OF THE FAP CAN BE FOUND AT:HTTPS://HANNIBALREGIONAL.ORG/PATIENTSVISITORS/PATIENTSERVICES/FINANCIALASSISTANCE/TABID/241/DEFAULT.ASPX |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 22 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (22 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - HANNIBAL REGIONAL MEDICAL GROUP | ||||
| 6500 HOSPITAL DRIVE | HANNIBAL | MO | 63401 | CLINICS |
| 2 - JAMES E CARY CANCER CENTER | ||||
| 5985 HOSPITAL DRIVE | HANNIBAL | MO | 63401 | CANCER CENTER |
| 3 - VISION INSTITUTE | ||||
| 175 SHINN LANE | HANNIBAL | MO | 63401 | CLINICS |
| 4 - COMPLETE FAMILY MEDICINE - KIRKSVILLE | ||||
| 1611 S BALTIMORE | KIRKSVILLE | MO | 63501 | RURAL HEALTH, SAME DAY/URGENT CARE, FAMILY PRACTICE CLINIC |
| 5 - MONROE CITY FAMILY PRACTICE | ||||
| 821 BUSINESS HWY 24 WEST | MONROE CITY | MO | 63456 | CLINIC |
| 6 - PIKE MEDICAL CLINIC - BOWLING GREEN | ||||
| 8 TOWN CENTER DR | BOWLING GREEN | MO | 63334 | CLINIC |
| 7 - PIKE MEDICAL CLINIC - LOUISIANA | ||||
| 211 S 3RD ST | LOUISIANA | MO | 63353 | CLINIC |
| 8 - CANTONLAGRANGE FAMILY PRACTICE | ||||
| 1802 ELM STREET | CANTON | MO | 63435 | CLINIC |
| 9 - SHELBINA FAMILY PRACTICE | ||||
| 400 S CENTER STREET | SHELBINA | MO | 63486 | CLINIC |
| 10 - PEDIATRIC THERAPY | ||||
| 150 MEDICAL DR | HANNIBAL | MO | 63401 | PEDIATRIC THERAPY |
| 11 - EXPRESS CARE AT WAL-MART | ||||
| 3650 STARDUST DRIVE WAL-MART | HANNIBAL | MO | 63401 | SAME DAY CLINIC |
| 12 - COMPLETE FAMILY MEDICINE MOBERLY UC | ||||
| 1600 N MORLEY SUITE A-120-A | MOBERLY | MO | 65270 | SAME DAY/URGENT CARE CLINIC |
| 13 - COMPLETE FAMILY MEDICINE MACON UC | ||||
| 1206 N MISSOURI ST | MACON | MO | 63552 | SAME DAY/URGENT CARE CLINIC |
| 14 - SPEECH THERAPY | ||||
| 188A MEDICAL DRIVE | HANNIBAL | MO | 63401 | SPEECH THERAPY |
| 15 - COMPLETE FAMILY MEDICINE LANCASTER RHC | ||||
| 1000 W WASHINGTON | LANCASTER | MO | 63548 | RURAL HEALTH CLINIC |
| 16 - COMPLETE FAMILY MEDICINE LAPLATA RHC | ||||
| 29934 JULY RD | LA PLATA | MO | 63549 | RURAL HEALTH CLINIC |
| 17 - HANNIBAL MEDICAL SUPPLIES | ||||
| 188A MEDICAL DRIVE | HANNIBAL | MO | 63401 | JOINT VENTURES - MEDICAL SUPPLIES |
| 18 - ADVANCE HANNIBAL REGIONAL HOSPITAL LLC | ||||
| 188A MEDICAL DRIVE | HANNIBAL | MO | 63401 | JOINT VENTURES - THERAPY |
| 19 - ADVANCE HANNIBAL REGIONAL HOSPITAL LLC | ||||
| 710 S BUSINESS 61 SUITE 100 | BOWLING GREEN | MO | 63334 | JOINT VENTURES - THERAPY |
| 20 - ADVANCE HANNIBAL REGIONAL HOSPITAL LLC | ||||
| 55 TROY SQUARE | TROY | MO | 63379 | JOINT VENTURES - THERAPY |
| 21 - ADVANCE HANNIBAL REGIONAL HOSPITAL LLC | ||||
| 821 US 24 WEST | MONROE CITY | MO | 63456 | JOINT VENTURES - THERAPY |
| 22 - ADVANCE HANNIBAL REGIONAL HOSPITAL LLC | ||||
| 1804 ELM ST | CANTON | MO | 63435 | JOINT VENTURES - THERAPY |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | THE ORGANIZATION USED AN ABILITY TO PAY STANDARD TO DETERMINE ELIGIBILITY. A PERSON IS ELIGIBLE FOR CHARITY CARE IF THEY MEET ANY OF THE FOLLOWING CRITERIA: THEIR INSURANCE IS INADEQUATE, THEY ARE UNINSURED, PATIENTS WITH A FAMILY INCOME AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINE, PATIENTS WITH A SPENDABLE INCOME THAT IS LESS THAN 5% OF THE BALANCE OWED TO THE HOSPITAL, THE PATIENT HAS LESS THAN $2,000 IN TOTAL ASSETS AVAILABLE TO PAY HOSPITAL EXPENSES (EXCEPTIONS INCLUDE HOME EQUITY, AUTO EQUITY, LIFE INSURANCE EQUITY). |
| PART I, LINE 6A: | THE MISSOURI HOSPITAL ASSOCIATION HAS INCLUDED HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. IN THEIR ANNUAL COMMUNITY BENEFIT REPORT. |
| PART I, LINE 7: | THE COST TO CHARGES RATIO WAS USED AS DERIVED FORM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. |
| PART I, LN 7 COL(F): | A GROSS ESTIMATE WAS MADE BASED ON CURRENT EXPERIENCE. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THE ORGANIZATION'S COMMUNITY BUILDING ACTIVITIES THAT PROMOTE THE HEALTH OF THE HOSPITAL'S COMMUNITY INCLUDES ITS CHILDREN'S CENTER FOR EDUCATION, DISASTER RECOVERY PLANNING, INTERPRETIVE SERVICES FOR NON-ENGLISH SPEAKING PATIENTS, AND RECRUITMENT COSTS FOR PHYSICIANS. |
| PART III, LINE 2: | HISTORICAL EXPERIENCE WAS USED TO ESTIMATE BAD DEBTS BY PAYOR CLASSIFICATION AND AGING CO-HORT. |
| PART III, LINE 3: | THE ESTIMATE WAS BASED ON AVAILABLE DATA. |
| PART III, LINE 4: | THE SYSTEM REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYORS, PATIENTS AND OTHERS. THE SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE SYSTEM BILLS THIRD-PARTY PAYORS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. AT SEPTEMBER 30, 2017 AND 2016, THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS WAS APPROXIMATELY $7,732,000 AND $5,310,000, RESPECTIVELY. |
| PART III, LINE 8: | SOME MEDICARE SERVICES ARE PAID AT SUBSTANTIALLY LESS THAN COST THROUGH THE PROGRAM. THESE SERVICES COULD BE ELIMINATED TO INCREASE MARGIN BUT ARE PROVIDED IN THIS COMMUNITY DESPITE THE LOSS. |
| PART III, LINE 9B: | WHEN CHARITY CONSIDERATION IS REQUESTED ALL COLLECTION EFFORTS ARE HALTED UNTIL A DETERMINATION ON ELIGIBILITY IS MADE. COLLECTION EFFORTS ARE RESUMED ONLY IF THE INDIVIDUAL DOES NOT MEET ONE OF THE CHARITY CRITERIA. |
| PART VI, LINE 2: | THE ORGANIZATION RECEIVES ANNUAL UPDATES ON THE HEALTH STATUS OF ITS POPULATION FROM THE STATE THAT INCLUDE MORTALITY AND DISEASE STATUS. THE ORGANIZATION ALSO MONITORS NATIONAL DATA ON TRENDS AND DISEASE STATUS. |
| PART VI, LINE 3: | PERSONAL CONTACT AND WEBSITE ACCESS ARE THE MAIN POINTS OF CONTACT. |
| PART VI, LINE 4: | THE ORGANIZATION SERVES THE POPULACE OF A 12 COUNTY REGION IN NORTHEAST MISSOURI. THE AREA IS PRIMARILY A RURAL FARMING AREA WITH NUMEROUS POCKETS OF MEDICALLY UNDERSERVED AREAS. RESIDENTS ARE SERVED BY DISTANT ORGANIZATIONS IN COLUMBIA, MO AND ST. LOUIS, MO. CARE CAN ALSO BE ACCESSED AT LOCAL HOSPITALS IN QUINCY, IL, MACON, MO, MOBERLY, MO, AND KIRKSVILLE, MO. |
| PART VI, LINE 5: | SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, LINE 4A. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| AMERICAN CANCER SOCIETY | |||||||
| 3145 HIGHWAY 61 | HANNIBAL | MO | 63401 | 131788491 | 501(C)(3) | $7,500 | RELAY FOR LIFE-MULTI COUNTIES |
| MHA CENTER FOR EDUCATION | |||||||
| PO BOX 60 | JEFFERSON CITY | MO | 65102 | 430898947 | 501(C)(3) | $56,178 | MCE HEALTH IMPR., RESEARCH AND SCHOLARSHIP FUND, MHA SPECIAL PROJECTS, MISSOURI CENTER FOR PATIENT SAFETY CONTRIBUTION AND DELIVERABLES, MISSOURI POISON CENTER CONTRIBUTION. |
| HANNIBAL SCHOOL DISTRICT #60 | |||||||
| 4650 MCMASTERS AVE | HANNIBAL | MO | 63401 | 436001555 | GOVERNMENT | $45,000 | SCOREBOARD PROGRAM |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 3 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | POLICY GA 1-112 CORPORATE CITIZENSHIP GUIDES THE ORGANIZATION IN CONTRIBUTING TO OTHER ORGANIZATIONS. ALL ACTIVITIES WHICH CONSTITUTE A CHARITABLE CONTRIBUTION ARE DOCUMENTED ON THE CHARITABLE CONTRIBUTION FORM. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RICHARD VALUCK | ||||||||||||||
| DIRECTOR & CARDIOLOGIST | $592,166 | $0 | $10,650 | $0 | $0 | $0 | $11,925 | $0 | $24,824 | $0 | $639,565 | $0 | $0 | $0 |
| C TODD AHRENS | ||||||||||||||
| PRESIDENT & CEO | $451,706 | $0 | $117,957 | $0 | $11,631 | $0 | $107,198 | $0 | $31,789 | $0 | $720,281 | $0 | $0 | $0 |
| ROGER DIX | ||||||||||||||
| VICE PRESIDENT - FINANCE | $255,416 | $0 | $0 | $0 | $103,025 | $0 | $0 | $0 | $17,292 | $0 | $375,733 | $0 | $0 | $0 |
| TIMOTHY REUSCHEL | ||||||||||||||
| VICE PRESIDENT - GENERAL COUNSEL | $253,431 | $0 | $66,533 | $0 | $7,001 | $0 | $38,794 | $0 | $31,603 | $0 | $397,362 | $0 | $0 | $0 |
| PRANAV PARIKH MD | ||||||||||||||
| V.P. - QUALITY & MEDICAL AFFAIRS | $463,071 | $0 | $750 | $0 | $6,161 | $0 | $78,592 | $0 | $31,505 | $0 | $580,079 | $0 | $0 | $0 |
| JULIE LEVERENZ | ||||||||||||||
| VICE PRESIDENT - STRATEGY & PLANNING | $189,895 | $0 | $25,551 | $0 | $7,327 | $0 | $49,574 | $0 | $23,074 | $0 | $295,421 | $0 | $0 | $0 |
| SUSAN WATHEN | ||||||||||||||
| VICE PRESIDENT - HUMAN RESOURCES | $165,350 | $0 | $21,627 | $0 | $6,835 | $0 | $26,450 | $0 | $11,659 | $0 | $231,921 | $0 | $0 | $0 |
| G DOUG RUBLE | ||||||||||||||
| VICE PRESIDENT - FACILITIES | $145,453 | $0 | $19,157 | $0 | $23,708 | $0 | $15,037 | $0 | $22,404 | $0 | $225,759 | $0 | $0 | $0 |
| PATRICIA BRAWNER | ||||||||||||||
| VICE PRESIDENT - NURSING | $155,043 | $0 | $16,115 | $0 | $5,019 | $0 | $8,047 | $0 | $16,750 | $0 | $200,974 | $0 | $0 | $0 |
| KURT EBERS | ||||||||||||||
| CLINIC ADMINISTRATOR | $149,098 | $0 | $13,000 | $0 | $5,054 | $0 | $6,930 | $0 | $25,779 | $0 | $199,861 | $0 | $0 | $0 |
| TIMOTHY POLLEY | ||||||||||||||
| V.P. - HRHS BUSINESS DEVELOPMENT | $238,306 | $0 | $62,455 | $0 | $32,711 | $0 | $11,925 | $0 | $10,583 | $0 | $355,980 | $0 | $0 | $0 |
| WENDY HARRINGTON | ||||||||||||||
| V.P. - HRHS DEVELOPMENT | $161,757 | $0 | $21,420 | $0 | $6,628 | $0 | $24,212 | $0 | $29,514 | $0 | $243,531 | $0 | $0 | $0 |
| LUVELL GLANTON | ||||||||||||||
| ANESTHESIOLOGIST - PAIN MANAGEMENT | $716,688 | $0 | $86,250 | $0 | $0 | $0 | $11,925 | $0 | $32,812 | $0 | $847,675 | $0 | $0 | $0 |
| HARSHA DESAI | ||||||||||||||
| PATHOLOGIST | $470,334 | $0 | $158,735 | $0 | $486 | $0 | $11,925 | $0 | $33,065 | $0 | $674,545 | $0 | $0 | $0 |
| PERVEZ ALVI | ||||||||||||||
| CARDIOLOGIST | $540,746 | $0 | $0 | $0 | $0 | $0 | $11,925 | $0 | $17,747 | $0 | $570,418 | $0 | $0 | $0 |
| THELMA PEERY | ||||||||||||||
| EMERGENCY ROOM PHYSICIAN | $541,040 | $0 | $0 | $0 | $8,000 | $0 | $11,925 | $0 | $9,093 | $0 | $570,058 | $0 | $0 | $0 |
| SATHISH KODALI | ||||||||||||||
| CARDIOLOGIST | $555,743 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $521 | $0 | $556,264 | $0 | $0 | $0 |
| LYNN OLSON | ||||||||||||||
| FORMER CEO - HOSPITAL | $0 | $0 | $0 | $0 | $134,119 | $0 | $0 | $0 | $0 | $0 | $134,119 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINES 4A-B | FormAndLineReferenceDesc |
| Explanation | ROGER DIX, SERP, $94,197 G. DOUG RUBLE, SERP, $15,473 TIMOTHY POLLEY, SERP $24,021 LYNN OLSON, SEVERANCE, $90,663 | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE INDUSTRIAL DEVELOPMENT AUTHORITY OF THE CITY OF HANNIBAL MISSOURI | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 531320446 | BondIssuerEIN |
| Bond Issued | 2015-12-11 | BondIssuedDt |
| Issue Price | $10,560,000 | IssuePriceAmt |
| Purpose | HOSPITAL REFUNDING REVENUE BONDS | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $2,980,000 | RetiredAmt |
| Total Proceeds | $10,560,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $49,428 | IssuanceCostsFromProceedsAmt |
| Other Spent Proceeds | $10,510,572 | OtherSpentProceedsAmt |
| Substantial Completion | 2017 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | Yes (1) | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | Yes (1) | MgmtContractBondFincdPropInd |
| Engage Bond Counsel Contracts | Yes (1) | EngageBondCounselContractsInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 2 | THE SYSTEM ADDED 3 NEW RURAL HEALTH CARE CLINICS, 3 URGENT CARE LOCATIONS, AND 1 FAMILY PRACTICE LOCATION IN NORTHEAST MISSOURI AND ADDED PROFESSIONAL IMAGING SERVICES IN HOUSE. |
| FORM 990, PART VI, SECTION A, LINE 1 | THE BOARD OF DIRECTORS HAS DELEGATED TO THE COMPENSATION COMMITTEE, PURSUANT TO A CHARTER ADOPTED BY THE BOARD OF DIRECTORS, THE RESPONSIBILITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS IN ADMINISTERING COMPENSATION PLANS AND IN MAKING DECISIONS ON THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER AND THOSE EXECUTIVES WHO REPORT DIRECTLY TO THE CHIEF EXECUTIVE OFFICER WHO QUALIFY AS "DISQUALIFIED PERSONS" WITHIN THE MEANING OF SECTION 4958 OF THE INTERNAL REVENUE CODE. THE COMMITTEE THEN REPORTS ITS ACTIONS TO THE BOARD OF DIRECTORS. THE COMMITTEE IS COMPOSED SOLELY OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE SCOPE OF THE COMMITTEE INCLUDES, BUT IS NOT LIMITED TO, REVIEWING AND APPROVING THE ANNUAL BASE SALARY LEVELS, ANNUAL INCENTIVE OPPORTUNITY LEVELS, EXECUTIVE PERQUISITES, EMPLOYMENT AGREEMENTS, BENEFITS AND SUPPLEMENTAL BENEFITS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE PREPARED FORM 990 WILL BE FORWARDED TO EACH MEMBER OF THE BOARD OF DIRECTORS, AS WELL AS THE OFFICERS OF THE CORPORATION APPROXIMATELY ONE WEEK PRIOR TO A REGULAR BOARD MEETING AT WHICH THE PREPARED FORM 990 WILL BE ON THE AGENDA. THE CHIEF FINANCIAL OFFICER OR CHIEF EXECUTIVE OFFICER WILL PRESENT THE PREPARED FORM 990 TO THE BOARD OF DIRECTORS AND ENTERTAIN QUESTIONS FROM DIRECTORS AND OFFICERS. THE GENERAL COUNSEL FOR THE CORPORATION WILL ALSO BE PRESENT TO ASSIST WITH QUESTIONS FOR THE DIRECTORS AND OFFICERS. THIS PROCEDURE WILL BE COMPLETED PRIOR TO THE FILING OF THE PREPARED FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A POLICY TITLED BUSINESS ETHICS AND CONFLICT OF INTEREST WHICH REQUIRES THAT ALL DIRECTORS, OFFICERS, AND EMPLOYEES OF THE SYSTEM ALWAYS ACT IN THE BEST INTEREST OF THE SYSTEM WITHOUT CONFLICTS OF INTEREST. ANNUALLY EACH MEMBER OF THE BOARD OF DIRECTORS, EACH OFFICER OF THE ORGANIZATION, AND CERTAIN OTHER MANAGERS RECEIVE A COPY OF THE POLICY AND ARE REQUIRED TO COMPLETE A CONFIDENTIALITY AGREEMENT AND A CONFLICT OF INTEREST QUESTIONNAIRE WHEREBY THE INDIVIDUAL ANSWERS QUESTIONS REGARDING FAMILY MEMBERS, SUBSTANTIAL BUSINESS OR INVESTMENT HOLDINGS, AND OTHER TRANSACTIONS OR AFFILIATIONS WITH BUSINESSES OR OTHER ORGANIZATIONS THAT MIGHT AFFECT THEIR RELATIONSHIP WITH THE SYSTEM. AS PART OF THE CONFLICTS OF INTEREST QUESTIONNAIRE THE INDIVIDUAL IS ASKED TO ACKNOWLEDGE THAT THEY HAVE RECEIVED AND READ A COPY OF THE POLICY, AGREE TO COMPLY WITH THE POLICY, ACKNOWLEDGE THAT THE SYSTEM IS A CHARITABLE ORGANIZATION, WHICH MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH OUR TAX EXEMPT PURPOSES IN ORDER TO MAINTAIN OUR TAX EXEMPT STATUS, AGREE TO REPORT PROMPTLY TO THE BOARD OF DIRECTORS ANY CHANGES IN THEIR ANSWERS TO THE QUESTIONS OR ANY CHANGE IN CIRCUMSTANCE THAT MIGHT DEVELOP PRIOR TO THE COMPLETION OF THEIR NEXT ANNUAL QUESTIONNAIRE. WITH RESPECT TO DIRECTORS OF THE ORGANIZATION, THEY ALSO ACKNOWLEDGE THAT NONE OF THE CONDITIONS OF THE POLICY WHICH WOULD MAKE THEM INELIGIBLE TO REMAIN ON THE BOARD EXIST AT THE TIME THEY SIGN THE ACKNOWLEDGMENT AND THAT THEY WOULD REPORT ANY CONDITIONS WHICH BECOME APPLICABLE IMMEDIATELY TO THE CHAIRPERSON OF THE BOARD OF DIRECTORS. ON AN ANNUAL BASIS THESE DOCUMENTS ARE SENT BY THE SECRETARY OF THE SYSTEM TO EACH INTERESTED PERSON AND TO THOSE EMPLOYEES OF THE SYSTEM THAT THE BOARD DETERMINES. THE DOCUMENT IS COMPLETED BY THE INDIVIDUAL AND RETURNED TO THE SECRETARY OF THE BOARD THROUGH GENERAL COUNSEL, WHO ANNUALLY ANALYZES ANY DISCLOSED CONFLICT OF INTEREST OR ANY OTHER FACT THAT MIGHT MAKE THE INDIVIDUAL NOT INDEPENDENT FOR IRS TAX EXEMPT PURPOSES. THE SECRETARY THEN SUBMITS TO THE BOARD OF DIRECTORS A CONFIDENTIAL REPORT CONCERNING ANY INTEREST OF EMPLOYEES OF THE SYSTEM DISCLOSED BY SUCH QUESTIONNAIRE, ANY INTEREST OF DIRECTORS AND OFFICERS WHO ARE NOT EMPLOYEES OF THE SYSTEM, AND WHAT ACTIONS THE PRESIDENT OF THE ORGANIZATION MAY TAKE AS A RESULT OF ANY CONFLICTS DISCLOSED BY SUCH INDIVIDUALS. AN INDIVIDUAL IS INELIGIBLE TO SERVE ON THE BOARD OF DIRECTORS FOR ANY OF THE FOLLOWING REASONS AS TAKEN FROM HANNIBAL REGIONAL SYSTEM BOARD OF DIRECTORS POLICY B-VII: A. FAILURE TO ADHERE COMPLETELY TO DISCLOSURE REQUIREMENTS; B. THE INDIVIDUAL IS AN OWNER, PARTNER, EMPLOYEE, BOARD MEMBER OR INVESTOR IN A DIRECT COMPETITOR OF THE SYSTEM, OR ANY ENTITY AFFILIATED WITH THE SYSTEM. AN OWNERSHIP OR INVESTMENT INTEREST IN A DIRECT COMPETITOR OF THE SYSTEM, OR ANY ENTITY AFFILIATED WITH THE SYSTEM, OF FIVE (5) PERCENT OR LESS WILL NOT MAKE INDIVIDUAL INELIGIBLE TO SERVE ON THE BOARD OF DIRECTORS; C. THE INDIVIDUAL IS AN EMPLOYEE OF THE SYSTEM, OR ANY ENTITY AFFILIATED WITH THE SYSTEM, OR A FAMILY MEMBER IS A MEMBER OF THE MANAGEMENT TEAM OF THE SYSTEM, OR ANY ENTITY AFFILIATED WITH THE SYSTEM; D. THE INDIVIDUAL RECEIVES DIRECT COMPENSATORY BENEFIT FOR ONGOING SERVICES PROVIDED TO THE SYSTEM, OR ANY ENTITY AFFILIATED WITH THE SYSTEM (SERVING AS A "DE FACTO EMPLOYEE"); E. THE INDIVIDUAL IS AN OWNER, PARTNER, EMPLOYEE, BOARD MEMBER OR INVESTOR OR OTHER VENDOR WHO RECEIVES A SUBSTANTIAL AMOUNT OF REVENUE FROM THE SYSTEM, OR ANY ENTITY AFFILIATED WITH THE SYSTEM - THE GREATER OF $200,000.00 OR 2% OF THE ANNUAL REVENUES OF THAT VENDOR IN THE PRECEDING OR CURRENT YEAR. F. THE INDIVIDUAL IS AN OWNER, PARTNER, EMPLOYEE, BOARD MEMBER OR INVESTOR OF AN ENTITY WHO HAS CONTRACTED WITH SYSTEM FOR THE EXCLUSIVE PROVISION OF ANY MEDICAL SERVICES WITHIN THE SYSTEM, OR ITS AFFILIATES. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OF DIRECTORS HAS DELEGATED TO THE COMPENSATION COMMITTEE, PURSUANT TO A CHARTER ADOPTED BY THE BOARD OF DIRECTORS, THE RESPONSIBILITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS IN ADMINISTERING COMPENSATION PLANS AND IN MAKING DECISIONS ON THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER AND THOSE EXECUTIVES WHO REPORT DIRECTLY TO THE CHIEF EXECUTIVE OFFICER WHO QUALIFY AS "DISQUALIFIED PERSONS" WITHIN THE MEANING OF SECTION 4958 OF THE INTERNAL REVENUE CODE. THE COMMITTEE ENGAGES AN INDEPENDENT CONSULTANT TO ASSIST THE COMMITTEE WITH ITS GOVERNANCE AND OVERSIGHT ROLE AND ITS COMPLIANCE WITH SECTION 4958 OF THE INTERNAL REVENUE CODE, BY PROVIDING AN OPINION ON THE REASONABLENESS OF THE ORGANIZATION'S COMPENSATION PLAN. THE CONSULTANT USES PUBLISHED SURVEY DATA TO PROVIDE COMPARATIVE MARKET DATA FOR EACH POSITION. THE COMMITTEE THEN REPORTS ITS ACTIONS TO THE BOARD OF DIRECTORS. THE COMMITTEE IS COMPOSED SOLELY OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE SCOPE OF THE COMMITTEE INCLUDES, BUT IS NOT LIMITED TO, REVIEWING AND APPROVING THE ANNUAL BASE SALARY LEVELS, ANNUAL INCENTIVE OPPORTUNITY LEVELS, EXECUTIVE PERQUISITES, EMPLOYMENT AGREEMENTS, BENEFITS AND SUPPLEMENTAL BENEFITS. ANNUALLY, HRHS, THROUGH ITS COMPENSATION COMMITTEE ENGAGES AN INDEPENDENT OUTSIDE COMPENSATION CONSULTANT TO PROVIDE OPINIONS RELATED TO THE REASONABLENESS OF EXECUTIVE COMPENSATION AND TO PROVIDE ADVICE AND GUIDANCE AS TO CURRENT TRENDS AND ISSUES. IN 2017, INTEGRATED HEALTHCARE STRATEGIES (IHS) PROVIDED THIS SERVICE TO HRHS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ARTICLES OF INCORPORATION AND AMENDMENTS THERETO ARE AVAILABLE ON THE MISSOURI SECRETARY OF STATE'S WEBSITE. |
| FORM 990, PART IX, LINE 11G | CONSULTING FEES: PROGRAM SERVICE EXPENSES 117,030. MANAGEMENT AND GENERAL EXPENSES 17,057. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 134,087. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 4,844,515. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,844,515. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 10,551,500. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,551,500. LAUNDRY SERVICE: PROGRAM SERVICE EXPENSES 270,748. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 270,748. COLLECTION FEES: PROGRAM SERVICE EXPENSES 333,798. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 333,798. CLEANING SERVICE: PROGRAM SERVICE EXPENSES 440,322. MANAGEMENT AND GENERAL EXPENSES 64,175. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 504,497. |
| FORM 990, PART XI, LINE 9: | CHANGE IN MINIMUM PENSION LIABILITY 2,294,976. PEARL LOWRIE FUND NET ACTIVITY 1,725. NET CONTRIBUTION REVENUE FROM FOUNDATION 289,183. |
| FORM 990, PART XII, LINE 2C | THE ORGANIZATION'S POLICY REGARDING OVERSIGHT OF AUDIT IS CONSISTENT WITH THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| LANAC | |||||||||
| 6000 HOSPITAL DRIVE | HANNIBAL | MO | 63401 | 431822503 | REAL ESTATE | MO | $0 | $0 | HANNIBAL REGIONAL HOSPITAL |
| HANNIBAL MOBILE DIAGNOSTICS LLC | |||||||||
| 6000 HOSPITAL DRIVE | HANNIBAL | MO | 63401 | 300234397 | DIAGNOSTIC IMAGING | MO | $13,660 | $246,598 | HANNIBAL REGIONAL HOSPITAL |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HANNIBAL REGIONAL HOSPITAL FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 175 SHINN LANE | AddressLine1Txt |
| City | HANNIBAL | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63401 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 431658744 | EIN |
| Primary Activities | FUNDRAISING | PrimaryActivitiesTxt |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12A, I | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HANNIBAL REGIONAL HEALTHCARE SYSTEM INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct | Share Of EOY AssetsShareOfEOYAssetsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HANNIBAL MOBILE DIAGNOSTICS | |||||||||||||
| PO BOX 1254 | HANNIBAL | MO | 63401 | 300234397 | IMAGING | MO | N/A | RELATED | $26,646 | 0 | 0 | 0.50000 | |
| HANNIBAL MEDICAL SUPPLIES LLC | |||||||||||||
| PO BOX 40 | QUINCY | IL | 62306 | 262362717 | MEDICAL SUPPLIES | MO | N/A | RELATED | $60,134 | 0 | 0 | 0.33330 | $169,567 |
| ADVANCE HANNIBAL REGIONAL HOSPITAL LLC | |||||||||||||
| 3652 STARDUST DRIVE | HANNIBAL | MO | 63401 | 461561480 | PT/OT SERVICES | MO | N/A | RELATED | $344,330 | 0 | 0 | 0.50000 | $28,833 |
| HEALTH NETWORK OF MISSOURI LLC | |||||||||||||
| 227 UNIVERSITY HALL | COLUMBIA | MO | 65211 | 471248962 | COLLABORATIVE HEALTH NETWORK | MO | N/A | RELATED | -$31,350 | 0 | Yes (1) | 0.16670 | $19,242 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HANNIBAL REGIONAL PHYSICIAN HOSPITAL ORGANIZATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6500 HOSPITAL DRIVE | AddressLine1Txt |
| City | HANNIBAL | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 64301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 431706291 | EIN |
| Primary Activities | PHYSICIAN HOSPITAL ORGANIZATION | PrimaryActivitiesTxt |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Entity Type | C | EntityTypeTxt |
| Share Of Total Income | $42,262 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $67,579 | ShareOfEOYAssetsAmt |
| Ownership | 0.50000 | OwnershipPct |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (6 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| HANNIBAL REGIONAL HOSPITAL FOUNDATION | ||
| C | $599,661 | COST INCURRED |
| HANNIBAL REGIONAL HOSPITAL FOUNDATION | ||
| O | $290,655 | COST INCURRED |
| ADVANCE HANNIBAL REGIONAL HOSPITAL LLC | ||
| J | $79,478 | COST INCURRED |
| ADVANCE HANNIBAL REGIONAL HOSPITAL LLC | ||
| K | $1,057,381 | COST INCURRED |
| HANNIBAL REGIONAL HOSPITAL FOUNDATION | ||
| P | $117,027 | COST INCURRED |
| ADVANCE HANNIBAL REGIONAL HOSPITAL LLC | ||
| R | $175,000 | COST INCURRED |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE R PART I AND PART III | THE ORGANIZATION BECAME THE SOLE OWNER OF HANNIBAL MOBILE DIAGNOSTICS, LLC ON 8/1/17. AS A RESULT, THIS ENTITY IS INCLUDED ON PART I AS A DISREGARDED ENTITY FOR THE TIME PERIOD 8/1/17-9/30/17 AND PART III AS A PARTNERSHIP FOR THE TIME PERIOD 10/1/16-7/31/17. |
| SCHEDULE R, PAGE 2, PART III | HRHS MAINTAINS CONTROL OF THE JOINT VENTURE ACTIVITIES LISTED ON SCHEDULE R, PART III BY HAVING ITS LEADERSHIP TEAM MEMBERS ON EACH JOINT VENTURE BOARD OF DIRECTORS. THAT IS WHY THE ENTITIES ARE LISTED ON SCHEDULE R, PART III AND WHY ANY RESULTING INCOME FROM THOSE ACTIVITIES HAS NOT BEEN SUBJECTED TO UBIT. |
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