2014-12-15T15:09:08-06:00 2014-04-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2013-05-01 237339737 LAKE REGIONAL HEALTH SYSTEM % DAVID HALSELL LAKE 5733488000 54 HOSPITAL DRIVE Suite OSAGE BEACH MO 65065 MICHAEL HENZE CEO 5733488000 2014-12-15 true Brian D Todd P00422601 5733488000 2013 2015-11-30 17:44:51Z MICHAEL E HENZE 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 156289893 false X WWW.LAKEREGIONAL.COM X 1973 MO LAKE REGIONAL HLTH SYSTEM PROVIDES AN EXTENSIVE VARIETY OF OUTPATIENT & INPATIENT HLTH CARE SERVICES AS WELL AS AN EMERGENCY DEPARTMENT TO RESIDENTS & VISITORS OF THE LAKE REGION. 15 6 1375 359 0 0 1228229 341782 146334557 154800801 2564570 4715947 -7442092 -5394899 142685264 154463631 35503 21538 0 0 60310138 60204919 0 0 0 85695998 89215383 146041639 149441840 -3356375 5021791 180227561 190034361 71313744 75089707 108913817 114944654 X TO PROVIDE EXCEPTIONAL HEALTH CARE. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. false false 59740654 69559652 LAKE REGIONAL HEALTH SYSTEM PROVIDES OUTPATIENT SERVICES SUCH AS DIAGNOSTIC IMAGING, LABORATORY AND PHYSICAL THERAPY SERVICES TO THE COMMUNITY AND SURROUNDING RURAL AREAS. THE HOSPITAL PROVIDED A TOTAL OF 277,932 OUTPATIENT SERVICES VISITS. 46701344 51799741 LAKE REGIONAL HEALTH SYSTEM PROVIDES INPATIENT SERVICES TO THE COMMUNITY AND SURROUNDING RURAL AREAS. THE HOSPITAL PROVIDED 18,452 INPATIENT DAYS, 3,545 SKILLED NURSING FACILITY INPATIENT DAYS AND 1,048 NURSERY PATIENT DAYS FOR A TOTAL OF 23,045 INPATIENT DAYS. 7098985 26639867 LAKE REGIONAL HEALTH SYSTEM'S EMERGENCY DEPARTMENT IS A LEVEL III TRAUMA CENTER (GRANTED THROUGH A SPECIAL STATE CREDENTIALING PROCESS REQUIRING EXTENSIVE EDUCATION AND SERVICE REVIEW) PROVIDING 24-HOUR EMERGENCY MEDICAL SERVICE TO A FIVE COUNTY AREA. THE UNIVERSITY OF MISSOURI STAFF FOR LIFE HELICOPTER IS BASED HERE. THE EMERGENCY DEPARTMENT PROVIDED 33,869 VISITS. 13742260 21538 6801541 127283243 true true false true false false false false false false true false false false true false false true false false false false false false true false true true true true true true false false false false false false false false true true true false false false false true true true false false true 146 0 true 1375 true false false false false false true true false false false false X 15 6 true false false false false false false true true false true true true true true true true true true true true true X X DAVID HALSELL 5733488000 54 HOSPITAL DR OSAGE BEACH MO 65065 X KEVIN BYRNE DO DIRECTOR 1.0 X 0 0 0 CHARLES MCELYEA ASSISTANT SECRETARY 1.0 1.0 X X 0 0 0 ROBERT G SCHWENDINGER SECRETARY 1.0 1.0 X X 0 0 0 GREG ANDERSON DIRECTOR 1.0 X 0 0 0 SUSAN BROWN DIRECTOR 1.0 X 0 0 0 JOHN CAINE DIRECTOR 1.0 X 0 0 0 WAYNE COMPTON TREASURER 1.0 X X 0 0 0 ROBERT MASON DO DIRECTOR 1.0 40.0 X 0 80648 3750 GRANT BARNUM DO DIRECTOR 1.0 40.0 X 0 249883 13755 JOHN PARRISH DIRECTOR 1.0 1.0 X 0 0 0 LARRY SHIELDS DIRECTOR 1.0 X 0 0 0 DENNIS MICHAELREE PRESIDENT 1.0 1.0 X X 0 0 0 JIM JUDAS DIRECTOR 1.0 X 0 0 0 COREY TEN BENSEL VICE PRESIDENT 1.0 X X 0 0 0 MICHAEL VIERRA MD CHIEF OF STAFF 1.0 X X 0 0 0 MICHAEL HENZE CEO 40.0 X 425551 0 70588 VICKI L FRANKLIN SENIOR VP/COO 40.0 X 239224 0 10715 DAVID W HALSELL CFO 40.0 X 211641 0 2385 JANICE L DUNGAN SENIOR VP - CLINICAL SERVICES 40.0 X 219442 0 9587 F JOE BUTTS SENIOR VP - FACILITY SERVICES 40.0 X 213870 0 11477 KEVIN G MCROBERTS SENIOR VP - BUSINESS DEVELOP. 40.0 X 186663 0 26521 ROBERT HYATT MD SENIOR VP - MEDICAL AFFAIRS 40.0 X 368490 0 10000 SCOTT POEST CIO 40.0 X 156110 0 20166 THOMAS MYLER DIRECTOR OF PHARMACY 40.0 X 172450 0 7920 MICHAEL DOW CLINICAL COORDINATOR 40.0 X 161849 0 6875 JOE SCOTT PHARMACIST 40.0 X 155425 0 7155 ERIC KAUFFMAN PHARMACIST 40.0 X 162506 0 6962 SCOTT D PETERS PHARMACIST 40.0 X 185176 0 6293 M DANIEL PROBSTFIELD FORMER SENIOR VP/CFO 40.0 X 115256 0 10000 2973653 330531 224149 34 true true false LAKE REGIONAL MEDICAL MGMT MEDICAL SERVICES 4278194 REHABVISIONS MEDICAL SERVICES 2750383 LAKE OZARK ANESTHESIA PHYSICIANS SERVICES 676000 CAMDEN EMERGENCY GROUP LLC MEDICAL SERVICES 641649 HEALOGICS WOUND CARE MEDICAL SERVICES 466099 13 223556 118226 80081 341782 PATIENT SERVICE 624100 147999260 147999260 ELECTRONIC HEALTH RECORDS 624100 1785279 1785279 MANAGEMENT FEES 541610 1459010 1459010 CAFETERIA INCOME 900099 896038 896038 AUXILIARY INCOME 900099 241441 241441 2419773 2419773 154800801 4879440 4879440 0 0 1156605 1170890 -14285 0 -14285 -14285 367007 530500 -163493 -163493 -163493 86492 223556 124872 -38380 -38380 0 0 CHANGE IN INTEREST IN EQUITY INVESTEES 900099 -5342234 -5342234 -5342234 154463631 154800801 -678952 X 18538 18538 3000 3000 0 0 2182429 1472264 710165 234920 234920 45770498 38298773 7471725 1181693 1029385 152308 7326618 6072367 1254251 3508761 2906623 602138 0 392709 392709 204908 204908 0 0 187492 187492 15847556 8802676 7044880 44319 44319 6247288 4756628 1490660 21008 21008 0 1734910 1530086 204824 212779 112151 100628 0 55274 12359 42915 1972257 1762009 210248 0 7694508 6874251 820257 1047301 1047301 MEDICAL SUPPLIES & DRUGS 25158001 25158001 0 BAD DEBTS 18712930 18712930 0 PROVIDER TAX 8812016 8812016 0 CAFETERIA/VENDING 755348 674826 80522 0 114779 39440 75339 149441840 127283243 22158597 0 2568 2668 22033442 27224093 944000 0 15435079 17741342 0 0 0 0 0 0 4878771 5638075 1228772 1555097 158295019 107656745 52347664 50638274 76641769 81356835 5217093 4965815 0 0 0 0 1498403 912162 180227561 190034361 11111316 14580313 0 0 0 0 48438885 45796005 0 0 0 0 3493269 5912144 0 0 8270274 8801245 71313744 75089707 X 107969817 113989904 0 0 944000 954750 108913817 114944654 180227561 190034361 5021791 1009046 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false true 10500 true 18933 29433 false SCHEDULE C, PART II-B, LINE 1(H) RALLIES, DEMONSTRATIONS, SEMINARS, CONVENTIONS, SPEECHES, LECTURES, ETC: LAKE REGIONAL HEALTH SYSTEM PARTICIPATED IN THE FOLLOWING DURING THE YEAR: $ 8,500 MEDICARE RURAL HOSPITAL COALITION 2,000 RURAL REFERRAL CENTER/SOLE COMMUNITY HOSPITAL COALITION ----- $10,500 TOTAL SCHEDULE C, PART II-B, LINE 1(I) OTHER LOBBYING ACTIVITIES: A PORTION OF THE DUES PAID TO THE MISSOURI HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION ARE USED FOR LOBBYING PURPOSES. $14,413 MISSOURI HOSPITAL ASSOCIATION 4,520 AMERICAN HOSPITAL ASSOCIATION ------- $18,933 TOTAL 5427936 5427936 87997921 55906614 32091307 61785606 49641065 12144541 3083556 2109066 974490 50638274 0 EST AMT DUE TO 3RD PTY PYRS 8801245 8801245 136707250 -18916521 -18916521 155623771 -1160140 -1160140 154463631 131696209 1170890 1170890 130525319 187492 18729029 18916521 149441840 SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D OTHER REVENUE INCLUDED ON LINE 1, BUT NOT FORM 990, PART VIII, LINE 12 $(18,712,930) BAD DEBT EXPENSE (187,492) INVESTMENT MANAGEMENT FEES (16,099) AUXILIARY EXPENSES ------------ $(18,916,521) TOTAL SCHEDULE D, PART XI, LINE 4B OTHER REVENUE INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT LINE 1 $(1,170,890) RENTAL EXPENSES 10,750 INCREASE IN PRNA ------------ $(1,160,140) TOTAL SCHEDULE D, PART XII, LINE 2D OTHER EXPENSE INCLUDED ON LINE 1, BUT NOT FORM 990, PART IX, LINE 25 $ 1,170,890 RENTAL EXPENSES SCHEDULE D, PART XII, LINE 4B OTHER EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT LINE 1 $ 18,712,930 BAD DEBT EXPENSE 16,099 AUXILIARY EXPENSES ------------ $ 18,729,029 TOTAL ANNUAL BALL 88180 42180 46000 31736 5550 22635 GOLF TOURNAMENT 216168 181176 34992 10400 22707 1850 16944 2200 10502 1 5700 200 5500 348 310048 223556 86492 10400 22707 1850 48680 7750 33485 124872 -38380 true true X true X true X true true false true true 7957583 5741584 2215999 0.01700 17343804 8474508 8869296 0.06780 25301387 14216092 11085295 0.08480 115795 31828 83967 0.00060 239886 239886 0.00180 120800 120800 0.00090 476481 31828 444653 0.00330 25777868 14247920 11529948 0.08810 2360 6935 0.00010 9295 0.00010 false 18712930 2617939 57199503 68320260 -11120757 X true true LAKE REG IMAGING PTR DIAGNOSTIC IMAGING SERVICES 0.51000 0.49000 1 1 LAKE REGIONAL HEALTH SYSTEM 54 HOSPITAL DR OSAGE BEACH MO 65065 WWW.LAKEREGIONAL.COM 291-35 X X X LAKE REGIONAL HEALTH SYSTEM 1 true X X X X X X X X X 12 true false true X WWW.LAKEREGIONAL.COM/ABOUT/DEFAULT.ASPX X X X X X X false false true true 200. true 300. true X X X X true true X X X X X X true false X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 3 COMMUNITY REPRESENTATION: PHONE INTERVIEWS WERE CONDUCTED WITH 25 COMMUNITY STAKEHOLDERS. PARTICIPANTS WERE IDENTIFIED BASED ON THEIR INVOLVEMENT IN LOCAL BUSINESSES, GOVERNMENTS, SCHOOLS OR IN SERVING LOW-INCOME POPULATIONS. STAKEHOLDERS INCLUDED PUBLIC HEALTH EXPERTS, CLINICIANS AND INDIVIDUALS WHO PROVIDE SERVICES TO THE MEDICALLY UNDERSERVED. SCHEDULE H, PART V, SECTION B, LINE 6 IMPLEMENTATION STRATEGY: IN RESPONSE TO THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED BY LAKE REGIONAL HEALTH SYSTEM, THE ORGANIZATION DEVELOPED AN IMPLEMENTATION STRATEGY, WHICH CAN BE FOUND AT THE FOLLOWING URL: http://www.lakeregional.com/about/default.aspx SCHEDULE H, PART V, SECTION B, LINE 7 ADDRESSING IDENTIFIED NEEDS: LAKE REGIONAL PRIORITIZED THE DATA COLLECTED. COMMON THEMES WERE IDENTIFIED, SCORED AND WEIGHTED. BASED ON THIS METHODOLOGY, TOP COMMUNITY HEALTH PRIORITIES INCLUDED HEART DISEASE, SMOKING/TOBACCO USE, CANCER, DIABETES AND MENTAL HEALTH. A CHRONIC DISEASE SELF-MANAGEMENT PROGRAM WAS DEVELOPED TO ADDRESS HEART DISEASE, DIABETES AND CANCER SCREENING. WE WILL CONTINUE TO WORK TOWARD ADDRESSING SMOKING/TOBACCO USE AND MENTAL HEALTH ISSUES. SCHEDULE H, PART V, SECTION B, LINE 12I FACTORS USED IN DETERMINING BASIS FOR AMOUNTS CHARGED TO PATIENTS: TO OBTAIN PRICING FOR GROSS CHARGES, LRHS USES REGIONAL COMPARATIVE PRICING DATA FROM MEDASSETS WHICH IS OUR STANDARD FOR DEFENSIBLE PRICING SCHEDULE H, PART V, SECTION B, LINE 14G OTHER METHODS OF PUBLICIZING CHARITY CARE POLICY: ALL PATIENTS THAT ARE IN A ROOM HAVE ACCESS TO A BINDER THAT EXPLAINS THE FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART V, SECTION B, LINE 20D METHOD FOR DETERMINING MAX AMOUNTS CHARGED TO FAP ELIGIBLE PATIENTS: THE DISCOUNTS FOR ALL INDIVIDUALS THAT QUALIFY FOR FREE OR DISCOUNTED CARE ARE DETERMINED USING THE FEDERAL POVERTY GUIDELINE MATRIX IN LRHS POLICY #112-190-2 UNCOMPENSATED CARE. THE DISCOUNT RANGES FROM 100% TO 35%. 35% APPROXIMATES THE AVERAGE WRITE OFF FOR COMMERCIAL PAYORS 5 LAKE REGIONAL IMAGING CENTER 54 HOSPITAL DR OSAGE BEACH MO 65065 IMAGING CENTER ELDON REHAB THERAPY 304 EAST 4TH STREET ELDON MO 65026 REHAB THERAPY LAKE OZARK REHAB THERAPY 1870 BAGNELL DAM BLVD LAKE OZARK MO 65049 REHAB THERAPY LAURIE REHAB THERAPY 156 MISSOURI BLVD LAURIE MO 65038 REHAB THERAPY CAMDENTON REHAB THERAPY 1930 N BUSINESS ROUTE 5 CAMDENTON MO 65020 REHAB THERAPY SCHEDULE H, PART I, LINE 7, COLUMN F PERCENT OF TOTAL EXPENSE: THE PERCENT OF TOTAL EXPENSE ON SCHEDULE H, PART I, LINE 7, COLUMN (F), WAS CALCULATED USING TOTAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A) LESS BAD DEBT EXPENSE OF $18,712,930. SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1 AND 3. SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES: LAKE REGIONAL HEALTH SYSTEM CONDUCTED COMMUNITY BUILDING ACTIVITIES BY PROVIDING THE FOLLOWING: -MEETING SPACE AND STAFF TIME TO THE TRIM KIDS GROUP. -MEETING SPACE AND A MENTOR TO NURSING CAREER CAMPS, WHICH IS FOR HIGH SCHOOL STUDENTS AND ADULTS THAT IS TWO DAYS IN THE WINTER AND FIVE DAYS IN THE SUMMER. -MEETING SPACE, STAFF TIME, AND FOOD FOR A CARREER CAMP THAT RUNS TWO DAYS IN THE SUMMER FOR KIDS. -MEETING SPACE AND STAFF TIME FOR THE SHOW-ME BETTER HEALTH PROGRAM, WHICH IS A NEW PROGRAM DEVELOPED BASED ON THE FINDINGS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT AND COSTING METHODOLOGY: THE HEALTH SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS, WHICH IS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. DELINQUENT RECEIVABLES ARE WRITTEN OFF BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. LINE 2 WAS DETERMINED BY TAKING THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS PER THE AUDITED FINANCIAL STATEMENTS. LINE 3 WAS DETERMINED BY TAKING THE BAD DEBT EXPENSE (LINE 2) TIMES THE PERCENT OF PERSONS BELOW THE POVERTY LEVEL FOR 2008-2012 BASED ON US CENSUS BUREAU DATA. BAD DEBT EXPENSE IS EXPLAINED ON LAKE REGIONAL HEALTH SYSTEM, INDEPENDENT AUDITOR'S REPORT AND CONSOLIDATED FINANCIAL STATEMENTS FOR APRIL 30, 2014, PAGE 9. SCHEDULE H, PART III, SECTION B, LINE 8 COMMUNITY BENEFIT: MEDICARE DATA COMPUTED USING THE MEDICARE COST REPORT FILED WITH CMS WAS UTILIZED FOR THE COMPUTATIONS IN PART III, SECTION B. MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT, AS LRHS IS CLASSIFIED AS A RURAL REFERRAL CENTER AND MEDICARE-DEPENDENT HOSPITAL, AND ALTERNATIVELY COULD QUALIFY AS A SOLE COMMUNITY HOSPITAL. THIS DEMONSTRATES THAT LRHS IS THE ONLY REASONABLE SOURCE OF HOSPITAL CARE AVAILABLE TO MEDICARE BENEFICIARIES IN OUR SERVICE AREA, AND LIKEWISE TREATS ALL BENEFICIARIES IN OUR SERVICE AREA THAT PRESENT THEMSELVES FOR CARE, DESPITE KNOWING WE WILL GENERALLY LOSE MONEY CARING FOR MEDICARE PATIENTS. ADDITIONALLY, SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION POLICY: COLLECTION ACTIVITY WILL BE SUSPENDED DURING THE CONSIDERATION OF A COMPLETED FINANCIAL ASSISTANCE APPLICATION OR AN APPLICATION FOR ANY OTHER HEALTHCARE BRACKET (I.E. MEDICARE, MEDICAID, ETC.) A NOTE WILL BE ENTERED INTO THE PATIENT'S ACCOUNT TO SUSPEND COLLECTION ACTIVITY UNTIL THE FINANCIAL ASSISTANCE PROCESS IS COMPLETE. IF THE ACCOUNT HAS BEEN PLACED WITH A COLLECTION AGENCY, THE AGENCY WILL BE NOTIFIED TO SUSPEND COLLECTION EFFORTS UNTIL A DETERMINATION IS MADE. THIS NOTIFICATION WILL BE DOCUMENTED IN THE ACCOUNT NOTES. THE PATIENT WILL BE NOTIFIED VERBALLY THAT THE COLLECTION ACTIVITY WILL BE SUSPENDED DURING CONSIDERATION. IF A FINANCIAL ASSISTANCE DETERMINATION ALLOWS FOR A PERCENT REDUCTION BUT LEAVES THE PATIENT WITH A SELF-PAY BALANCE, PAYMENT TERMS WILL BE ESTABLISHED ON THE BASIS OF DISPOSABLE INCOME. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: HIDI DATA: LRHS USES DATA COMPILED BY AN INDEPENDENT ENTITY, HOSPITAL INDUSTRY DATAINSTITUTE (HIDI), ON INPATIENT AND OUTPATIENT PROVIDER USE DIVIDED BYDEMOGRAPHIC AND GEOGRAPHIC SUBSET. LRHS CONSIDERS ITS PRIMARY MARKET AREA TO BE A 25 MILE RADIUS. THE HIDI DATA PROVIDES THE SERVICES USED BY ZIP CODE AND BY PROVIDER TO HELP DETERMINE MEDICAL NEEDS THAT WE ARE NOT MEETING IN OUR COMMUNITY. OTHER COMMUNITY DATA IS COLLECTED AT HEALTH FAIRS AND SCREENINGS AS WELL AS CIVIC ORGANIZATIONS. THESE SURVEYS PROFILE PARTICIPANTS BY ZIP CODE AND IDENTIFY DESIRED SERVICES. COMMUNITY HEALTH NEEDS ASSESSMENT EXECUTIVE SUMMARY THIS COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN 2012 BY LAKE REGIONAL HEALTH SYSTEM IN OSAGE BEACH, MO. THIS ASSESSMENT REVIEWED THE HEALTH NEEDS OF AREA RESIDENTS USING A SEVEN STEP PROCESS: (1) DEFINING THE COMMUNITY, (2) ANALYZING SELECTED DATA TO IDENTIFY THE KEY DEMOGRAPHIC, SOCIOECONOMIC AND HEALTH CHARACTERISTICS OF THE THREE-COUNTY SERVICE AREA, (3) IDENTIFYING DEMAND FOR HEALTH CARE SERVICES, (4) INTERVIEWING COMMUNITY STAKEHOLDERS, (5) CONDUCTING A SURVEY AMONG AREA RESIDENTS, (6) PRIORITIZING COLLECTED DATA, AND (7) DEVELOPING STRATEGIES TO ADDRESS IDENTIFIED HEALTH NEEDS. THE COMMUNITY IS DEFINED AS ZIP CODES WITHIN A 25-MILE RADIUS OF LAKE REGIONAL HEALTH SYSTEM LOCATED ENTIRELY WITHIN CAMDEN, MILLER OR MORGAN COUNTIES, WHERE MARKET SHARE IS AT LEAST 10 PERCENT. THE SURVEY AREA INCLUDES 24 ZIP CODES. COMMUNITY HEALTH ASSESSMENT PROCESS IN MAY 2012, THE PUBLIC RELATIONS DEPARTMENT BEGAN COLLECTING AND REVIEWING EXISTING DEMOGRAPHIC AND SOCIOECONOMIC DATA ABOUT THE COMMUNITY. STAFF INTERVIEWED PUBLIC HEALTH EXPERTS AT LOCAL COUNTY HEALTH DEPARTMENTS AND LAKE REGIONAL PRIMARY AND ACUTE CARE MANAGERS. KEY HEALTH CONCERNS IDENTIFIED THROUGH THESE INTERVIEWS INCLUDED CONGESTIVE HEART FAILURE, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, DIABETES AND MENTAL HEALTH. THIS INPUT WAS USED TO DEVELOP THE COMMUNITY HEALTH NEEDS ASSESSMENT QUESTIONNAIRE. INTERVIEWS WERE CONDUCTED WITH 25 COMMUNITY STAKEHOLDERS TO PROVIDE KEY INSIGHTS INTO THE PUBLIC'S PERCEPTION OF THE COMMUNITY'S HEALTH AND WELLNESS NEEDS. PARTICIPANTS WERE IDENTIFIED BASED ON THEIR INVOLVEMENT IN LOCAL BUSINESSES, GOVERNMENTS, SCHOOLS OR IN SERVING LOW-INCOME POPULATIONS. IN JUNE AND JULY 2012, THE COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY WAS CONDUCTED TO YIELD INFORMATION ABOUT THE OVERALL HEALTH OF THE COMMUNITY. SURVEY TOPICS INCLUDED DEMOGRAPHIC AND SOCIOECONOMIC CHARACTERISTICS, BEHAVIORAL RISK FACTORS, HEALTH CONDITIONS AND ACCESS TO HEALTH CARE. A TOTAL OF 657 SURVEYS WERE COLLECTED THROUGH A COMBINED METHOD OF PAPER AND ONLINE SURVEYS. PAPER SURVEYS WERE DISSEMINATED AT SUPPORT GROUPS, COMMUNITY EVENTS, COUNTY HEALTH DEPARTMENT SITES, A FREE CLINIC SITE, AND LAKE REGIONAL PRIMARY CARE CLINICS. LAKE REGIONAL STAFF WERE AVAILABLE TO HELP RESPONDENTS COMPLETE SURVEYS, AS NECESSARY, TO OVERCOME LITERACY ISSUES. NOTICE OF THE SURVEY WAS SHARED WITH THE COMMUNITY THROUGH LOCAL NEWSPAPERS, RADIO STATIONS AND COMMUNITY GROUPS. PRIORITIZATION PROCESS LAKE REGIONAL'S COMMUNITY BENEFIT COMMITTEE MET IN SEPTEMBER 2012 TO PRIORITIZE THE DATA COLLECTED FROM RESEARCH, INTERVIEWS WITH PUBLIC HEALTH EXPERTS AND COMMUNITY SURVEYS. COMMON THEMES WERE IDENTIFIED, SCORED AND WEIGHTED. BASED ON THIS METHODOLOGY, TOP COMMUNITY HEALTH PRIORITIES INCLUDED HEART DISEASE, SMOKING/TOBACCO USE, CANCER, DIABETES AND MENTAL HEALTH. IMPLEMENTATION PLAN A CHRONIC DISEASE SELF-MANAGEMENT PROGRAM HAS BEEN DEVELOPED USING THE EVIDENCE-BASED STANFORD UNIVERSITY MODEL IN PARTNERSHIP WITH THE CAMDEN AND MILLER COUNTY HEALTH DEPARTMENTS AND THE KATY TRAIL HEALTH CENTER IN MORGAN COUNTY TO ADDRESS HEART DISEASE, DIABETES AND CANCER SCREENING. PROGRAM SPECIFICS ARE OUTLINED IN THE "COMMUNITY HEALTH NEEDS IMPLEMENTATION PLAN." FOLLOWING APPROVAL OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN BY THE LAKE REGIONAL HEALTH SYSTEM BOARD OF DIRECTORS ON DEC. 7, 2012, THE ASSESSMENT REPORT WILL BE MADE AVAILABLE TO THE PUBLIC ONLINE AT LAKEREGIONAL.COM. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: SIGNAGE WILL BE POSTED IN ALL PATIENT INTAKE AREAS, INCLUDING, BUT NOT LIMITED TO, THE EMERGENCY ROOM AND THE ADMISSION/PATIENT REGISTRATION AREAS. ALL PUBLIC INFORMATION AND/OR FORMS REGARDING THE PROVISION OF FINANCIAL ASSISTANCE WILL USE LANGUAGES THAT ARE APPROPRIATE FOR LRHS SERVICE AREA IN ACCORDANCE WITH THE STATE'S LANGUAGE ASSISTANCE SERVICES ACT. THIS POLICY WILL BE MADE AVAILABLE IN SPANISH. THE FINANCIAL ASSISTANCE APPLICATION IS POSTED ON THE LRHS WEBSITE. LRHS HAS FINANCIAL COUNSELORS IN THE PATIENT FINANCIAL SERVICES DEPARTMENT. THESE COUNSELORS MEET WITH SELF PAY PATIENTS WHEN THEY ARE IN THE FACILITY TO DISCUSS THE POLICY, AS WELL AS EDUCATE PATIENTS ON ASSISTANCE THEY MAY BE ELIGIBLE FOR UNDER FEDERAL, STATE AND LOCAL GOVERNMENT PROGRAMS. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: LRHS IS LOCATED IN OSAGE BEACH, MISSOURI, AND SERVES THE AREA SURROUNDING THE LAKE OF THE OZARKS, A 54,000 ACRE MAN-MADE LAKE LOCATED IN CENTRAL MISSOURI. LRHS' SERVICE AREA ENCOMPASSES A THREE COUNTY AREA: CAMDEN, MILLER, AND MORGAN COUNTIES. THE SECONDARY SERVICE INCLUDES LACLEDE AND PULASKI COUNTIES. THE OVERALL SERVICE AREA 2010 POPULATION IS ESTIMATED AT 177,760. IN ADDITION TO THE RESIDENT POPULATION OF NEARLY 178,000, IN THE OVERALL SERVICE AREA, THE EVER-INCREASING VISITOR POPULATION IS A SIGNIFICANT FACTOR FOR THIS POPULAR TOURIST DESTINATION. THE LAKE OF THE OZARKS CONVENTION AND VISITORS BUREAU ESTIMATES THAT 5.0 MILLION VISITORS WILL TRAVEL TO THE REGION IN 2010. THE PROJECTED POPULATION GROWTH OF LRHS' SERVICE AREA AND ESPECIALLY THE CONTINUING MIGRATION INTO THE LAKE AREA OF RETIREES AND THE EVER-INCREASING VISITOR POPULATION, IS A SIGNIFICANT FACTOR IN THE RISING NEED FOR ACCESSIBLE AND EXPANDED MEDICAL SERVICES FOR THE LAKE AREA. THE MEDIAN HOUSEHOLD INCOME FOR EACH COUNTY IS AS FOLLOWS: CAMDEN = $44,617, LACLEDE = $37,294, MILLER = $35,838, MORGAN = $36,696 AND PULASKI = $43,155. THE CAMDEN COUNTY 2011 ANNUAL UNEMPLOYMENT RATE WAS 10.7%, ABOVE THE STATE (8.6%) AND NATIONAL (8.9%) AVERAGES. CAMDEN COUNTY HAS APPROXIMATELY 11.8% OF PERSONS BELOW POVERTY LEVEL. THE IMMEDIATE 3-COUNTY AREA OF CAMDEN, MILLER, & MORGAN ESTIMATES UNINSURED INDIVIDUALS AT 23.27%. THERE ARE NO OTHER HOSPITALS WITHIN A 25-MILE RADIUS. USING HOSPITAL INDUSTRY DATA INSTITUTE DATA, THE LRHS MARKET IS PRIMARILY SHARED WITH 4 HOSPITALS IN THE AREA. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: LRHS SHOWS ITS SUPPORT OF THE COMMUNITY BY PROVIDING A TRIM KIDS PROGRAM. TRIM KIDS IS A 12-WEEK PLAN TO BUILD HEALTHY KIDS, HEALTHY FAMILIES AND HEALTHY COMMUNITIES. THE TRIM KIDS PROGRAM IS A PROVEN, PRACTICAL GUIDE FOR PARENTS TO TAKE SPECIFIC SEQUENTIAL STEPS TO ENCOURAGE HEALTHY HABITS IN THEIR CHILDREN SUCH AS MAKING HEALTHY FOOD CHOICES AND ONGOING PHYSICAL ACTIVITY. THE PROGRAM IS FACILITATED BY A DIETITIAN, EXERCISE PHYSIOLOGIST, REGISTERED NURSE AND BEHAVIOR MODIFICATION PROFESSIONAL ASSOCIATED WITH LRHS. LRHS' WORKFORCE DEVELOPMENT PROGRAM INCLUDES A TWO-DAY CAREER CAMP FOR STUDENTS 10-14. THE STUDENTS LEARN ABOUT CAREERS IN NURSING, REHAB THERAPIES, LABORATORY, SURGERY AND RESPIRATORY THERAPY. CAMP INSTRUCTORS ALSO COVER TOPICS SUCH AS PATIENT CONFIDENTIALITY, INFECTION CONTROL, DISASTER MANAGEMENT, DATA MANAGEMENT, PROFESSIONAL SCHOOLS IN MISSOURI AND SCHOLARSHIP OPPORTUNITIES. ANOTHER WORKFORCE DEVELOPMENT PROGRAM AVAILABLE TO HIGH SCHOOL STUDENTS AND ADULTS INTERESTED IN PURSUING NURSING CAREERS IS A FIVE-DAY NURSING CAMP. PARTICIPANTS GAIN AN UNDERSTANDING OF NURSING FUNDAMENTALS AS THEY VISIT NURSING UNITS, JOB SHADOW EXPERIENCED NURSES, LEARN ABOUT STATE-OF-THE-ART EQUIPMENT, RECEIVE CPR TRAINING, PARTICIPATE IN DISASTER MANAGEMENT TRAINING AND INTERACT WITH STAFF. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: THE AFFILIATED HEALTH CARE SYSTEM OF THE ORGANIZATION INCLUDES LAKE REGIONAL MEDICAL MANAGEMENT AND LAKE REGIONAL IMAGING PARTNERS. A WHOLLY OWNED SUBSIDIARY, LAKE REGIONAL MEDICAL MANAGEMENT, INC., D/B/A LAKE REGIONAL MEDICAL GROUP (MEDICAL MANAGEMENT), OPERATES MEDICAL CLINICS AND RETAIL PHARMACIES IN CAMDEN, MILLER AND MORGAN COUNTIES. THE ORGANIZATION HAS A 51% OWNERSHIP OF LAKE REGIONAL IMAGING PARTNERS, LLC (IMAGING PARTNERS). IMAGING PARTNERS IS A LIMITED LIABILITY COMPANY THAT OPERATES AN IMAGING CENTER IN OSAGE BEACH, MISSOURI, WHICH OFFERS CLOSED HYBRID MRI SERVICES, PET AND CT SCANS, ULTRASOUND SERVICES AND RADIOGRAPHY IMAGING SERVICES. THE 49% MINORITY INTEREST IN IMAGING PARTNERS IS OWNED BY A GROUP OF LOCAL RADIOLOGISTS. true MHA CENTER FOR EDUCATION PO BOX 6766 JEFFERSON CITY MO 651020060 430898947 501(C)(3) 18538 SCHOLARSHIP FUND 1 NURSING SCHOLARSHIPS 4 3000 SCHEDULE I, PART 1, LINE 2 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S.: THE ORGANIZATION HAS AN AGREEMENT WITH MHA, AND DUE TO INCREASED PAYMENTS UNDER THE FEDERAL REIMBURSEMENT ALLOWANCE PROGRAM, THE ORGANIZATION MADE CHARITABLE CONTRIBUTIONS TO THE MHA CENTER FOR EDUCATION. THE CONTRIBUTIONS ARE USED FOR FUNDING SCHOLARSHIPS TO MEDICAL, NURSING AND ALLIED HEALTH PROFESSIONALS, AND WORKFORCE INITIATIVES TO ADDRESS THE SHORTAGES OF NURSING AND ALLIED HEALTH PROFESSIONALS. THE RECIPIENT OF THE SCHOLARSHIP MUST SUBMIT THEIR GRADES TO LAKE REGIONAL HEALTH SYSTEM. IN ORDER FOR THE GRADES TO BE GIVEN TO THE STUDENT, THEIR TUITION MUST BE PAID IN FULL. X X true true X X X X X false true false false false false false false false GRANT BARNUM DO DIRECTOR 0 247292 0 0 0 2591 0 9975 0 3780 0 263638 0 0 MICHAEL HENZE CEO 378055 0 0 0 47496 0 67373 0 3215 0 496139 0 0 0 VICKI L FRANKLIN SENIOR VP/COO 193228 0 0 0 45996 0 10000 0 715 0 249939 0 0 0 M DANIEL PROBSTFIELD FORMER SENIOR VP/CFO 80231 0 0 0 35025 0 10000 0 0 0 125256 0 0 0 JANICE L DUNGAN SENIOR VP - CLINICAL SERVICES 170961 0 0 0 48481 0 9217 0 370 0 229029 0 0 0 F JOE BUTTS SENIOR VP - FACILITY SERVICES 180570 0 0 0 33300 0 9477 0 2000 0 225347 0 0 0 KEVIN G MCROBERTS SENIOR VP - BUSINESS DEVELOP. 173417 0 0 0 13246 0 22741 0 3780 0 213184 0 0 0 ROBERT HYATT MD SENIOR VP - MEDICAL AFFAIRS 307274 0 0 0 61216 0 10000 0 0 0 378490 0 0 0 SCOTT POEST CIO 146022 0 0 0 10088 0 17886 0 2280 0 176276 0 0 0 THOMAS MYLER DIRECTOR OF PHARMACY 170757 0 0 0 1693 0 7205 0 715 0 180370 0 0 0 MICHAEL DOW CLINICAL COORDINATOR 161551 0 0 0 298 0 6875 0 0 0 168724 0 0 0 JOE SCOTT PHARMACIST 132326 0 0 0 23099 0 6440 0 715 0 162580 0 0 0 ERIC KAUFFMAN PHARMACIST 159228 0 0 0 3278 0 6182 0 780 0 169468 0 0 0 DAVID W HALSELL CFO 200629 0 0 0 11012 0 0 0 2385 0 214026 0 0 0 SCOTT D PETERS PHARMACIST 184908 0 0 0 268 0 5923 0 370 0 191469 0 0 0 SCHEDULE J, PART I, LINE 1A REIMBURSEMENT POLICY: THE ORGANIZATION HAS A WRITTEN POLICY FOR REIMBURSEMENT RELATED TO TRAVEL FOR COMPANIONS. DIRECTORS AND KEY EMPLOYEES ARE ELIGIBLE TO RECEIVE THIS BENEFIT. THE ORGANIZATION PROVIDES ONE TYPE OF GROSS UP PAYMENT FOR THE CEO'S AUTO ALLOWANCE. THE CEO IS THE ONLY PERSON THAT RECEIVES THIS BENEFIT. THIS PAYMENT IS REPORTED AS TAXABLE COMPENSATION ON THE CEO'S W-2 FORM EACH YEAR. SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: THE FOLLOWING PEOPLE PARTICIPATED IN A 457(F) NONQUALIFIED RETIREMENT PLAN AND RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION: $16,478 VICKI L FRANKLIN $17,525 M. DANIEL PROBSTFIELD $13,669 F. JOE BUTTS $13,809 JANICE DUNGAN $24,684 ROBERT HYATT THE FOLLOWING PEOPLE HAD A DEFERRED CONTRIBUTION TO A 457(F) NONQUALIFIED RETIREMENT PLAN: $57,373 MICHAEL E. HENZE $13,953 KEVIN MCROBERTS $11,200 SCOTT POEST A HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF MO 431178966 60635R8G5 2010-10-20 28426416 REFUND 1996 & 1998 REVENUES BONDS false false false B HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF MO 431178966 60636AFK4 2012-12-18 24701264 REFUND 2003 REVENUES BONDS false false false A 1725000 0 28426416 2875426 0 28188586 237830 0 0 0 0 0 1998 true false true true B 675000 0 24701264 1692250 0 24320921 380343 0 0 0 0 0 2012 true false true true A 0 B 0 A false true false false false false 0 true JPMORGAN CHASE BANK 12.82 false false true B false true false false false false 0 false 0 false true A true B true SCHEDULE K, PART IV, LINE 4D COLUMN A GIC FAIR MARKET VALUE THE GUARANTEED INVESTMENT CONTRACT FOR THE 2010 BONDS WAS ORIGINALLY ENTERED INTO WITH RESPECT TO THE 1998 BONDS. THE TAXPAYER BELIEVES THE BIDDING PROCEDURES ESTABLISHED BY 1.148-5(D)(6)(III) OF THE REGULATIONS WERE FOLLOWED BUT HAS BEEN UNABLE TO LOCATE COPIES OF THE BID SOLICITATION FORMS AND RELATED MATERIALS REQUIRED TO BE RETAINED UNDER THE REGULATION SAFE HARBOR. LAKE REGIONAL MEDICAL MANAGEMENT COMMON DRTRS - SEE PART V 9347824 CONTRIBUTIONS, REIMBURSEMENTS false MITCHELL SHIELDS FAMILY MEMBER L SHIELDS 46392 EMPLOYMENT false CENTRAL BANK OF LAKE OF THE OZARKS J. JUDAS PRESIDENT 145430 BANKING FEES false JULIE FRANKLIN FAMILY MEMBER V FRANKLIN 33574 EMPLOYMENT false BARBA PROBSTFIELD FAM MEMBER D PROBSTFIELD 29698 EMPLOYMENT false LAKE REGIONAL IMAGING PARTNERS M. VIERRA PRESIDENT 836530 INVESTMENT IN JOINT VENTURE false SCHEDULE L, PART IV, LINE 1, COLUMN B SHARED DIRECTORS: CHARLES MCELYEA, ROBERT G. SCHWENDINGER, JOHN PARRISH, AND DENNIS MICHAELREE ARE OFFICERS OR DIRECTORS OF BOTH LAKE REGIONAL MEDICAL MANAGEMENT AND LAKE REGIONAL HEALTH SYSTEM. CHARLES MCELYEA, ROBERT G. SCHWENDINGER, JOHN PARRISH, AND DENNIS MICHAELREE WERE DETERMINED TO BE NON-INDEPENDENT MEMBERS OF LAKE REGIONAL HEALTH SYSTEM BASED SOLELY ON THEIR ROLE AS COMMON OFFICERS OR DIRECTORS OF LAKE REGIONAL MEDICAL MANAGEMENT AND LAKE REGIONAL HEALTH SYSTEM. LAKE REGIONAL MEDICAL MANAGEMENT IS AN ACTIVE, WHOLLY-OWNED FOR-PROFIT SUBSIDIARY. IT OPERATES SEVEN PRIMARY CARE MEDICAL CLINICS, THREE RETAIL PHARMACIES, AND FIFTEEN SPECIALTY CLINICS. LAKE REGIONAL HEALTH SYSTEM VIEWS THE COMMON OFFICERS AND DIRECTORS AS AN IMPORTANT ROLE IN HELPING BOTH ORGANIZATIONS IN ACHIEVING THEIR MISSIONS WHILE SERVING THE COMMUNITY. X 5 5975 FMV X SILENT AUCTION 173 32706 COST X LIVE AUCTION 16 36400 COST X FLOWERS 1 5000 FMV false true false SCHEDULE M, PART I, COLUMN B NUMBER OF CONTRIBUTIONS: THE NUMBER OF CONTRIBUTIONS LISTED IN COLUMN B IS BASED ON THE NUMBER OF CONTRIBUTORS. FORM 990, PART III, LINE 1 ORGANIZATION'S MISSION: OUR MISSION: PROVIDE EXCEPTIONAL HEALTHCARE. OUR VISION: TO BE THE FIRST CHOICE FOR HEALTH CARE. OUR CORE COMPETENCIES: AGILITY, COMMUNITY FOCUS, SERVICE EXCELLENCE. OUR VALUES: INTEGRITY, PATIENT CENTERED, CLINICAL EXCELLENCE, COMMITMENT TO COMMUNITY. THE SYSTEM WAS ORGANIZED IN 1973 FOR THE PURPOSE OF ESTABLISHING A NEW HOSPITAL FOR MEDICAL AND SURGICAL CARE AND FOR THE TREATMENT OF PERSONS RESIDING OR VISITING IN THE LAKE OF THE OZARKS AREA OF CENTRAL MISSOURI. IN THE 30 YEARS SINCE THEN, THE SYSTEM HAS EVOLVED TO PROVIDE MORE COMPREHENSIVE HEALTH CARE, INCLUDING ADDING CARDIAC-CARE, OUTPATIENT SERVICES, CANCER AND ORTHOPEDIC PROGRAMS AND CONTINUALLY EXPANDING SERVICES AND FACILITIES OVER THE YEARS. IT IS NOW DESIGNATED AS A REGIONAL REFERRAL CENTER BY MEDICARE AND HAS NEARLY 1,400 EMPLOYEES. ITS BOARD HAS ADOPTED GOVERNANCE BEST PRACTICES AND A WIDE-RANGING CORPORATE COMPLIANCE PROGRAM. BASED ON PERIODIC COMMUNITY ASSESSMENTS, THE BOARD HAS ALSO COMMITTED TO ENHANCED UNCOMPENSATED CARE POLICIES AND NUMEROUS COMMUNITY PROGRAMS (E.G. HEALTH SCREENINGS, WELLNESS ENHANCED AND RELATED CARE PROGRAMS). THE SYSTEM IS ORGANIZED AS A COMMUNITY-BASED NONPROFIT PUBLIC BENEFIT CORPORATION UNDER THE LAWS OF THE STATE OF MISSOURI. THE SYSTEM OWNS AND OPERATES A 116-LICENSED BED ACUTE CARE HOSPITAL (THE "HOSPITAL") LOCATED ON HIGHWAY 54 IN OSAGE BEACH, MISSOURI. THE HOSPITAL IS LICENSED BY THE MISSOURI DEPARTMENT OF HEALTH AND ACCREDITED BY THE JOINT COMMISSION. THE HOSPITAL IS DESIGNATED AS MEDICARE DEPENDENT, MEANING THAT THE HOSPITAL IS THE PRIMARY HEALTH CARE PROVIDER FOR A MAJORITY OF MEDICARE PATIENTS WITHIN A 35-MILE RADIUS OF THE HOSPITAL. THE CORPORATION HAS ONE ACTIVE, WHOLLY-OWNED FOR-PROFIT SUBSIDIARY, LAKE REGIONAL MEDICAL MANAGEMENT, INC. ("LRMM"), WHICH OPERATES SEVEN PRIMARY CARE MEDICAL CLINICS, THREE RETAIL PHARMACIES AND FIFTEEN SPECIALTY CLINICS. OPERATIONS OF LRMM ARE GOVERNED BY A SEPARATE BOARD OF DIRECTORS. THE SYSTEM IS CURRENTLY GOVERNED BY A FIFTEEN-MEMBER BOARD OF DIRECTORS (THE "BOARD"). THE BOARD HAS GENERAL RESPONSIBILITY FOR THE BUSINESS AND AFFAIRS OF THE SYSTEM, AND MAY DO AND PERFORM ALL ACTS NECESSARY TO CARRY OUT ITS PURPOSES. UNDER THE TERMS OF THE BYLAWS, THE MEMBERS OF THE BOARD SERVE THREE-YEAR STAGGERED TERMS, AND NEW MEMBERS ARE ELECTED BY THE CURRENT BOARD MEMBERS. THE OFFICERS OF THE BOARD ARE ELECTED BY THE BOARD FOR TWO-YEAR TERMS. BOARD MEMBERS SERVE IN A VOLUNTARY CAPACITY AND RECEIVE NO REMUNERATION FOR SERVICE RENDERED IN SUCH CAPACITY. FORM 990, PART III, LINES 4A-C PROGRAM SERVICE ACCOMPLISHMENTS: THE HOSPITAL PROVIDES CHARITY CARE IN SUPPORT OF ITS MISSION. THE HOSPITAL VOLUNTARILY PROVIDES FREE CARE TO PATIENTS WHO LACK FINANCIAL RESOURCES AND ARE DEEMED TO BE MEDICALLY INDIGENT. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED IN NET PATIENT SERVICE REVENUE. IN ADDITION, THE HOSPITAL PROVIDES SERVICES TO OTHER MEDICALLY INDIGENT PATIENTS UNDER CERTAIN GOVERNMENT REIMBURSED PUBLIC AID PROGRAMS. SUCH PROGRAMS PAY PROVIDERS AMOUNTS WHICH ARE LESS THAN ESTABLISHED CHARGES FOR THE SERVICES PROVIDED TO THE RECIPIENTS AND MANY TIMES THE PAYMENTS ARE LESS THAN THE COST OF RENDERING THE SERVICES PROVIDED. UNCOMPENSATED CHARGES RELATING TO THESE SERVICES INCLUDE CHARITY CARE, BAD DEBT, UNPAID MEDICARE, FREE MEDICAL SERVICES, HEALTH PROFESSIONALS EDUCATION, FINANCIAL CONTRIBUTIONS, AND TAXES. IN ADDITION TO UNCOMPENSATED CHARGES, THE HOSPITAL ALSO COMMITS SIGNIFICANT TIME AND RESOURCES TO ENDEAVORS AND CRITICAL SERVICES WHICH MEET OTHERWISE UNFILLED COMMUNITY NEEDS. MANY OF THESE ACTIVITIES ARE SPONSORED WITH THE KNOWLEDGE THAT THEY WILL NOT BE SELF-SUPPORTING OR FINANCIALLY VIABLE. SUCH PROGRAMS INCLUDE HEALTH SCREENING AND ASSESSMENTS, PRENATAL EDUCATION AND CARE, COMMUNITY EDUCATIONAL SERVICES AND VARIOUS SUPPORT GROUPS. FORM 990, PART III, LINE 4D OTHER PROGRAM SERVICES: OTHER SERVICES INCLUDE ELECTRONIC HEALTH RECORDS INCENTIVES, MANAGEMENT FEES, CAFETERIA INCOME, INCOME FROM THE AUXILIARY, AND OTHER PROGRAM SERVICE ACTIVITIES. FORM 990, PART VI, SECTION A, LINE 2 FAMILY AND BUSINESS RELATIONSHIPS: F JOE BUTTS, M DANIEL PROBTSFIELD, VICKI L FRANKLIN, AND MICHAEL HENZE HAVE A BUSINESS RELATIONSHIP. MICHAEL HENZE & F JOE BUTTS HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE 990 WAS THOROUGHLY REVIEWED BY THE DIRECTOR OF ACCOUNTING, CFO, AND CEO. AFTER ANY NECESSARY CHANGES WERE MADE, THE MEMBERS OF THE BOARD OF DIRECTORS WERE PROVIDED A COPY. AT THE DECEMBER 2014 BOARD MEETING, THE 990 WAS PRESENTED TO THE BOARD BY THE INDEPENDENT ACCOUNTANTS WHO PREPARED THE 990, AND THE BOARD HAD THE OPPORTUNITY TO ASK ANY QUESTIONS BEFORE THE 990 WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: EACH YEAR, ALL MEMBERS OF THE BOARD OF DIRECTORS, SENIOR MANAGEMENT, AND DEPARTMENT HEADS ARE REQUIRED TO REVIEW THE CONFLICT OF INTEREST POLICY AND PROPERLY DISCLOSE ANY ACTUAL, POTENTIAL, OR PERCEIVED CONFLICT OF INTEREST. A COPY OF THE CONFLICT OF INTEREST POLICY IS PROVIDED TO EACH DIRECTOR AT THE TIME OF APPOINTMENT, TO EACH NEW PRINCIPAL OFFICER AND EMPLOYEE AT THE TIME OF EMPLOYMENT, AND ANNUALLY TO EVERY INTERESTED PERSON. EACH INTERESTED PERSON IS REQUIRED TO SUBMIT A STATEMENT TO THE CEO ANNUALLY VERIFYING THE UNDERSTANDING WITH THE POLICY AND STATING THAT ALL CONFLICTS HAVE BEEN DISCLOSED, OR THAT NO CONFLICTS EXIST. THE CEO SUBMITS HIS ANNUAL STATEMENT TO THE CHAIRMAN OF THE BOARD. IN THE EVENT AN INTERESTED PERSON DEVELOPS A POTENTIAL CONFLICT OF INTEREST, THE PERSON MUST IMMEDIATELY UPON LEARNING ABOUT THE POTENTIAL CONFLICT DISCLOSE THE NATURE OF THE CONFLICT TO THE BOARD OF DIRECTORS. THE PERSON THEN LEAVES THE BOARD OR COMMITTEE MEETING WHILE THE ISSUE IS DISCUSSED AMONG REMAINING BOARD MEMBERS TO DETERMINE WHETHER A CONFLICT EXISTS BY MAJORITY VOTE. IF A CONFLICT DOES EXIST, A SEPARATE PERSON IS ASSIGNED TO INVESTIGATE ALTERNATIVES TO THE CONFLICT AND DETERMINE IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS POSSIBLE. IF THIS IS NOT POSSIBLE, THE BOARD THEN DECIDES BY MAJORITY VOTE IF THE TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTEREST, IS FAIR AND REASONABLE, AND WHETHER IT SHOULD OR SHOULD NOT BE ENTERED. IF THE ORGANIZATION HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, THE PERSON WILL BE INFORMED OF THE BASIS FOR SUCH BELIEF AND WILL BE GIVEN AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE PERSON'S RESPONSE AND CONDUCTING FURTHER INVESTIGATION, THE ORGANIZATION DETERMINES THAT THE PERSON HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, APPROPRIATE CORRECTIVE ACTION WILL BE TAKEN. ADDITIONALLY, THE ORGANIZATION HAS IMPLEMENTED A TAX COMPLIANCE QUESTIONNAIRE THAT ASKS DETAILED QUESTIONS, AND PROVIDES RESPONDENTS WITH THE APPROPRIATE DEFINITIONS AND INSTRUCTIONS, TO ENABLE THE ORGANIZATION TO GATHER INFORMATION REQUIRED TO ANSWER QUESTIONS ON THE 990 RELATING TO THE FOLLOWING AREAS: 1) THE NUMBER OF INDEPENDENT VOTING BOARD MEMBERS, 2) RELATIONSHIPS BETWEEN INTERESTED PERSONS, 3) LOANS TO OR FROM INTERESTED PERSONS, 4) GRANTS OR ASSISTANCE BENEFITING INTERESTED PERSONS, AND 5) BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS. FORM 990, PART VI, SECTION B, LINES 15A & 15B COMPENSATION DETERMINATION: DURING 2013, THE ORGANIZATION USED IHSTRATEGIES, AN INDEPENDENT ORGANIZATION, TO HELP THEM EVALUATE AND SET THE COMPENSATION FOR THE ORGANIZATION'S CEO, OTHER OFFICERS AND KEY EMPLOYEES. THE COMPENSATION DELIBERATIONS WERE DOCUMENTED IN THE MINUTES OF BOTH THE COMPENSATION COMMITTEE AND THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENT AVAILABILITY: CERTAIN ASPECTS OF THE FINANCIAL STATEMENTS ARE AVAILABLE IN THE ORGANIZATION'S ANNUAL REPORT WHICH CAN BE FOUND ON THE ORGANIZATION'S WEBSITE. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE GENERAL PUBLIC. FORM 990, PART VII BOARD MEMBER COMPENSATION: BOARD MEMBER ROBERT MASON, DO, IS PAID AS A PRN EMPLOYEE OF LAKE REGIONAL MEDICAL MANAGEMENT AND RECEIVES NO OTHER BENEFITS. GRANT BARNUM, DO, IS PAID AS A PHYSICIAN OF LAKE REGIONAL MEDICAL MANAGEMENT. BOARD MEMBERS DO NOT RECEIVE ANY COMPENSATION FOR THEIR SERVICES PROVIDED AS A MEMBER OF THE BOARD DIRECTORS. FORM 990, PART IX, LINE 11G OTHER FEES FOR SERVICES: THE ORGANIZATION'S TOTAL OTHER FEES FOR SERVICES ON THE STATEMENT OF FUNCTIONAL EXPENSES IS COMPRISED OF THE FOLLOWING: $ 9,410,568 CLINICAL SERVICES 5,573,316 OUTSIDE SERVICES 750,915 COLLECTION AGENCIES 112,757 AGENCY STAFFING ------------ $15,847,556 TOTAL LAKE REGIONAL IMAGING PARTNERS 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 202107048 DIAGNOSTIC IM MO LRHS RELATED 1138046 4700592 false 0 true 0.51000 LAKE REGIONAL MEDICAL MANAGEMENT 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 431473438 PHYSICIAN SER MO LRHS C CORP 34446796 5724976 1.00000 true true true false false false false false false false true true true false false true true false false false LAKE REGIONAL MEDICAL MANAGEMENT A/J 1017920 FMV LAKE REGIONAL MEDICAL MANAGEMENT B 6015000 FMV LAKE REGIONAL IMAGING PARTNERS LLC K 78694 FMV LAKE REGIONAL MEDICAL MANAGEMENT L 439477 FMV LAKE REGIONAL IMAGING PARTNERS LLC L 1264911 FMV LAKE REGIONAL MEDICAL MANAGEMENT P 4188115 FMV