2014-05-14T12:52:51-05:00 2013-09-30 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2012-10-01 430662495 HANNIBAL REGIONAL HEALTHCARE SYSTEM INC HANN 5732481300 6500 HOSPITAL DRIVE PO BOX 551 HANNIBAL MO 63401 ROGER DIX 5732481300 2014-05-13 1 JEFF PARKER P00970069 3149254300 2012 2015-11-30 17:44:51Z X C TODD AHRENS 6500 HOSPITAL DRIVE PO BOX 551 HANNIBAL MO 63401 122692272 0 X WWW.HRHONLINE.ORG X 1987 MO SYSTEM OPERATES A FULL SERVICE ACUTE CARE FACILITY 14 14 1079 260 0 0 543122 455392 119603490 117884481 969819 1309570 2368056 2369718 123484487 122019161 86652 97745 0 0 67282982 65636188 0 0 326057 48810102 51938129 116179736 117672062 7304751 4347099 131068696 127649695 55335893 41438195 75732803 86211500 YOUR HEALTH IS OUR MISSION 0 0 102052989 97745 119215167 THE SYSTEM OPERATES A FULL SERVICE 91 BED ACUTE CARE HOSPITAL FACILITY IN HANNIBAL, MISSOURI AS ITS PRIMARY SERVICE ACTIVITY. 17,974 TOTAL INPATIENT DAYS WERE PROVIDED DURING THE COURSE OF THE YEAR. THE HOSPITAL 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 - $2,783,810 AND STATE MEDICAID AND OTHER PUBLIC AID PROGRAMS - $2,883,116. 102052989 1 1 0 1 0 1 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 112 0 1 1079 1 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X ROGER DIX 5732481300 6000 HOSPITAL DRIVE HANNIBAL MO 63401 ROBERT GILSTRAP 1.00 X X 1324 0 0 JERRY TROWER 1.00 X 0 0 0 TIMOTHY A REUSCHEL 1.00 X 930 0 0 PAUL EWERT 1.00 X X 0 0 0 JACK WHITAKER 1.00 X X 0 0 0 TOM LENNON 1.00 X 0 0 0 GENE SCHOLES JR 1.00 X 0 0 0 CAROLYN SHAW 1.00 X X 0 0 0 JENNIFER VALUCK 1.00 X 0 0 0 DIRK SAUER 1.00 X X 0 0 0 STEVE MILLER 1.00 X 0 0 0 JASON POAGE 1.00 X 0 0 0 LINDA STAUBE 1.00 X 0 0 0 RONDA WRIGHT 1.00 X 0 0 0 JOHN GROSSMEIER 40.00 X 589688 0 95935 ROGER DIX 40.00 X 350723 0 52586 C TODD AHRENS 40.00 X 297024 0 81244 TIMOTHY REUSCHEL 40.00 X 0 0 0 JULIE LEVERENZ 40.00 X 189300 0 43099 SHARON NUNLEY 40.00 X 213380 0 42880 SARAH BRADSHAW 40.00 X 195682 0 24447 G DOUG RUBLE 40.00 X 155442 0 15062 JEFF EVANS 40.00 X 169384 0 17841 PRANAV PARIKH MD 20.00 X 159142 0 0 LYNN OLSON 40.00 X 309309 0 31157 TIMOTHY POLLEY 40.00 X 193562 0 18983 MARK SHIMA 40.00 X 756733 0 5023 LUVELL GLANTON 40.00 X 697839 0 3305 PERVEZ ALVI 40.00 X 560056 0 944 RICHARD VALUCK 40.00 X 542040 0 9960 DONALD MILLER 40.00 X 539806 0 0 5921364 0 442466 67 0 1 0 WEATHERBY LOCUMS PO BOX 972633 DALLAS TX 75397 LOCUM PHYSICIANS 1710434 BANC OF AMERICA LEASING 2059 NORTHLAKE PARKWAY TUCKER GA 30384 LEASING COMPANY 1663416 MISSOURI HOSPITAL PLAN 4700 COUNTRY CLUB DRIVE JEFFERSON CITY MO 65102 INSURANCE PROVIDER 1257024 ALLSCRIPTS HEALTHCARE LLC PO BOX 8538-0133 PHILADELPHIA PA 19171 IT SERVICES 584452 HEALTHLINK PO BOX 6501 CAROL STREAM IL 60197 HEALTH PLAN 529109 34 455392 455392 NET PATIENT SERVICE REVENUE 621110 117884481 117884481 117884481 1093254 1093254 310001 28173 281828 281828 281828 847489 13765 607209 37729 240280 -23964 216316 -23964 240280 CHILDREN'S DEVELOPMENT CENTER 624410 843219 843219 CAFETERIA 722210 569756 569756 CONTRACTED SERVICES 621110 413764 413764 261151 97667 163484 2087890 122019161 119215167 0 2348602 97745 97745 2566870 420182 2146688 47301603 39989925 7080052 231626 2257775 1909261 338027 10487 10392158 8765041 1579005 48112 3117782 2634845 466489 16448 132573 132573 132630 132630 12425 10517 1908 293287 293287 11794658 9983636 1811022 1466002 1240903 225099 694147 587564 106583 83516 70692 12824 1218293 1031229 187064 8390733 8390733 832418 704604 127814 BAD DEBT EXPENSE 7504203 7504203 HEALTHCARE PURCHASED SE 4899664 4899664 PROFESSIONAL FEES 4589350 4589350 EQUIPMENT RENTAL 3161511 2676074 485437 6732719 6253534 459801 19384 117672062 102052989 15293016 326057 15259185 16806251 15290528 13241261 42500 1208898 1483198 2302730 2507309 538825 672870 132930100 82457945 48352807 50472155 34312519 36243113 13760704 6223538 131068696 127649695 14249860 16191829 23036676 15380116 7369297 5665967 10680060 4200283 55335893 41438195 X 73151989 82966746 803492 1426027 1777322 1818727 75732803 86211500 131068696 127649695 X 4347099 1652655 4478943 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 7725 0 0 0 7725 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: LOBBYING ACTIVITY PROVIDED THROUGH MEMBERSHIP IN THE MISSOURI HOSPITAL ASSOCIATION 1 1684 4426 36117 0 0 2693370 2693370 68475995 38386161 30089834 61760735 44071784 17688951 50472155 MINIMUM PENSION LIABILITY 2845164 SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN LIABILITY 1355119 4200283 X 127484602 1652655 3812786 5465441 122019161 0 122019161 117672062 0 117672062 0 117672062 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE SYSTEM HAS BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501 OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, THE SYSTEM IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE SYSTEM APPLIES THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE INCOME TAX STANDARD. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE SYSTEM'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE SYSTEM IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE SYSTEM IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. THE TAX RETURNS FOR THE FISCAL YEARS 2010 TO 2012 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: MINIMUM PENSION LIABILITY EXPENSE 3,812,786. 1 1 1 X 0 1 1 0 1 1 2783810 2783810 0.02370 10286985 7403869 2883116 0.02450 13070795 7403869 5666926 0.04820 1192376 294801 897575 0.00760 190195 190195 0.00160 9275042 4748197 4526845 0.03850 14896 14896 0.00010 10672509 5042998 5629511 0.04780 23743304 12446867 11296437 0.09600 2056624 870742 1185882 0.01010 1089713 1089713 0.00930 3146337 870742 2275595 0.01940 1 7504203 5628365 32088042 37910205 -5822163 X 1 1 1 HANNIBAL MEDICAL SUPPLY DME COMPANY 0.33000 0.33000 2 HANNIBAL MOBILE DIAGNOSTICS MOBILE IMAGING/RADIOLOGY SERVICES 0.50000 0.50000 3 ADVANCE HANNIBAL REGIONAL HOSPITAL LLC OUTPATIENT PHYSICAL THERAPY 0.50000 1 1 HANNIBAL REGIONAL HEALTHCARE SYSTEM INC

6000 HOSPITAL DRIVE HANNIBAL MO 63401

X X X HANNIBAL REGIONAL HEALTHCARE SYSTEM INC 1 1 X X X X X X X X X 12 1 1 1 X X X X X X X X 0 0 1 1 200.000000000000 0 1 X X 1 1 X X 1 0 1 X 0 0 PART I, LINE 3C: THE CRITERIA UTILIZED TO DETERMINE ELIGIBILITY FOR CHARITY CARE IS BASED ON THE ABILITY TO PAY. 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, THERE IS LESS THAN $2,000 IN TOTAL ASSETS AVAILABLE TO PAY HOSPITAL EXPENSES (EXCEPTIONS HOME EQUITY, AUTO EQUITY, LIFE INSURANCE EQUITY). PART I, LINE 6A: 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: A COST ACCOUNTING SYSTEM UTILIZING A SPECIFIC COSTING METHODOLOGY FOR THE SERVICES REFERENCED IN WORKSHEETS ONE, THREE AND SIX WAS UTILIZED FOR COST. PART I, LINE 7G: COSTS ATTRIBUTABLE TO PHYSICIANS CLINICS INCLUDE $3,375,286 FOR RURAL HEALTH CLINICS AND $926,620 FOR MENTAL HEALTH CLINICS. PART I, L7 COL(F): A GROSS ESTIMATE WAS MADE BASED ON CURRENT EXPERIENCE. 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, 2013 AND 2012, THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS WAS APPROXIMATELY $4,755,000 AND $5,444,000, RESPECTIVELY. 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. HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 3: THE HOSPITAL CONSULTED WAS PIKE COUNTY MEMORIAL HOSPITAL IN LOUISIANA, MISSOURI. HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 4: PIKE COUNTY MEMORIAL HOSPITAL, LOUISIANA, MISSOURI HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 5C: POSTED ON THE WEB. HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 7: MENTAL HEALTH AND DENTAL HEALTH ACCESSIBILTY CONTINUE TO BE SIGNIFICANT GAPS WITHIN THE HEALTHCARE DELIVERY SYSTEM OF NORTHEAST MISSOURI. EXPANSION OF MISSOURI MEDICAID WILL ENHANCE ACCESS TO EXISTING RESOURCES. HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 20D: ELIGIBILITY FOR CHARITY CARE IS BASED ON THE INDIVIDUALS ABILITY TO PAY. A PERSON IS ELIGIBLE FOR CHARITY CARE IF THEY MEET ANY OF THE FOLLOWING CRITERIA: THEY ARE UNINSURED, THEY HAVE INADEQUATE INSURANCE, INCOME LESS THAN 200% OF THE FEDERAL POVERTY GUIDELINES, SPENDABLE INCOME LESS THAN 5% OF THE BALANCE OWED OR LESS THAN $2,000 IN ASSETS AVAILABLE TO PAY HEALTHCARE EXPENSES. 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: THE ORGANIZATION MAINTAINS EDUCATIONAL PROGRAMS TO KEEP STAFF APPRISED OF ALL POTENTIAL PROGRAMS THAT MIGHT ASSIST PATIENTS IN PAYING THEIR HOSPITAL CLAIM. STAFF MEMBERS ARE ENCOURAGED TO UTILIZE THIS KNOWLEDGE TO RECONCILE ALL OUTSTANDING BALANCES. PART VI, LINE 4: HANNIBAL, MARION COUNTY ARE RURAL COMMUNITES OF APPROXIMATELY 30,000 POPULATION. ALSO SERVED ARE SEVEN OTHER RURAL COUNTIES IN NORTHEAST MISSOURI. PART VI, LINE 5: SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, LINE 4A. 1 AMERICAN CANCER SOCIETY 3145 HIGHWAY 61 HANNIBAL MO 63401 131788491 501(C)(3) 7535 2013 PREMIER SPONSOR AND THE 2013 JECCC ON T-SHIRT MHA CENTER FOR EDUCATION PO BOX 60 JEFFERSON CITY MO 65102 430898947 501(C)(3) 90210 MCE HEALTH IMPR., RESEARCH AND SCHOLARSHIP FUND, MHA SPECIAL PROJECTS, MISSOURI CENTER FOR PATIENT SAFETY CONTRIBUTION, MISSOURI POISON CENTER CONTRIBUTION. 2 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: 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. X 1 1 X X X X X X 1 1 0 0 0 0 0 0 0 JOHN GROSSMEIER 460281 0 36377 0 93030 0 92087 0 3848 0 685623 0 0 0 ROGER DIX 251721 0 20585 0 78417 0 52586 0 0 0 403309 0 0 0 C TODD AHRENS 276755 0 20269 0 0 0 72206 0 9038 0 378268 0 0 0 JULIE LEVERENZ 183077 0 6223 0 0 0 37714 0 5385 0 232399 0 0 0 SHARON NUNLEY 170279 0 6158 0 36943 0 37032 0 5848 0 256260 0 0 0 SARAH BRADSHAW 170439 0 4698 0 20545 0 20599 0 3848 0 220129 0 0 0 G DOUG RUBLE 137126 0 4602 0 13714 0 13714 0 1348 0 170504 0 0 0 JEFF EVANS 163811 0 5573 0 0 0 16456 0 1385 0 187225 0 0 0 PRANAV PARIKH MD 152939 0 6203 0 0 0 0 0 0 0 159142 0 0 0 LYNN OLSON 289138 0 20171 0 0 0 28618 0 2539 0 340466 0 0 0 TIMOTHY POLLEY 181487 0 12075 0 0 0 18542 0 441 0 212545 0 0 0 MARK SHIMA 756733 0 0 0 0 0 0 0 5023 0 761756 0 0 0 LUVELL GLANTON 565156 0 132683 0 0 0 0 0 3305 0 701144 0 0 0 PERVEZ ALVI 560056 0 0 0 0 0 0 0 944 0 561000 0 0 0 RICHARD VALUCK 542040 0 0 0 0 0 0 0 9960 0 552000 0 0 0 DONALD MILLER 539806 0 0 0 0 0 0 0 0 0 539806 0 0 0 PART I, LINE 1A COMPANION TRAVEL EXPENSES : ROBERT GILSTRAP $1,324; TIMOTHY REUSCHEL $930 PART I, LINE 1B ALL EXPENSES WERE APPROVED THROUGH THE NORMAL CHECK REQUEST AND EXPENSE REPORT PROCESS WHICH REQUIRES TWO SIGNATURES. CEO EXPENSES ARE APPROVED BY A BOARD MEMBER AND VALIDATED BY THE CONTROLLER, ALL BOARD MEMBER EXPENSES ARE APPROVED BY THE CEO AND VALIDATED BY THE CONTROLLER, AND ALL OFFICER AND KEY EMPLOYEE EXPENSES ARE APPROVED BY THE CEO AND VALIDATED BY THE CONTROLLER OR ANOTHER OFFICER. PART I, LINES 4A-B JOHN GROSSMEIER, SERP, $92,087 ROGER DIX, SERP, $78,555 SHARON NUNLEY, SERP, $37,032 SHARON NUNLEY, SEVERANCE, $264,699 RICHARD DRAPER, SERP, $2,000 G.DOUG RUBLE, SERP, $13,714 SARAH BRADSHAW, SERP, $20,599 A THE INDUSTRIAL DEVELOPMENT AUTHORITY OF THE CITY OF HANNIBAL MISSOURI 531320446 410632AT0 2006-04-01 24064011 HOSPITAL REFUNDING REVENUE BONDS 0 0 0 B THE INDUSTRIAL DEVELOPMENT AUTHORITY OF THE CITY OF HANNIBAL MISSOURI 531320446 410632BJ1 2010-07-29 7588694 HOSPITAL REFUNDING OF ER ADDITION BONDS 1 0 0 A 9805000 26630884 2144250 24075822 410812 2022 1 0 1 1 B 7430000 7430000 7588694 120532 2020 1 0 1 1 A 0 1 1 1 0 0 0 1 B 0 1 1 1 0 0 0 1 A 1 0 0 1 SOCIETE GENERALE 14.800000000000 1 0 1 B 0 0 0 1 0 0 0 0 1 A 1 B 1 SCHEDULE K, PART II, LINE 14, ISSUANCE A PURPOSE OF 2006 REFUNDING BOND ISSUANCE THE HEALTH FACILITIES REFUNDING REVENUE BONDS SERIES 2006 BOND ISSUANCE WAS ISSUED TO REFUND THE REMAINING OUTSTANDING 1996 REVENUE BONDS. SCHEDULE K, PART II, LINE 14, ISSUANCE B PURPOSE OF 2010 REFUNDING BOND ISSUANCE THE HEALTH FACILITIES REFUNDING REVENUE BONDS SERIES 2010 BOND ISSUANCE WAS ISSUED TO REFUND THE REMAINING OUTSTANDING 2007 REVENUE BONDS. SCHEDULE K, PART IV, LINE 2C, ISSUANCE B REBATE CALCULATION THE DATE THE REBATE CALCULATION WAS PERFORMED WAS SEPTEMBER 3, 2013. FORM 990, PART VI, SECTION A, LINE 4 HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. (THE "SYSTEM") IS A NOT-FOR-PROFIT ORGANIZATION AND PARENT COMPANY OF HANNIBAL REGIONAL HOSPITAL(THE "HOSPITAL") AND HANNIBAL REGIONAL HOSPITAL FOUNDATION (THE "FOUNDATION"). THE SYSTEM'S BOARD OF DIRECTORS APPOINTS AND CONTROLS THE HOSPITAL AND FOUNDATION BOARDS. DURING THE YEAR ENDING SEPTEMBER 30, 2013 THE HOSPITAL AND SYSTEM FORMED AN OBLIGATED GROUP RELATED TO THE REVENUE BONDS AS DISCUSSED IN NOTE 6 OF THE FINANCIAL STATEMENTS. FORM 990, PART VI, SECTION B, LINE 11 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 WILL PRESENT THE PREPARED FORM 990 TO THE BOARD OF DIRECTORS AND ENTERTAIN QUESTIONS FROM DIRECTORS AND OFFICERS. THE CHIEF EXECUTIVE OFFICER AND 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 THEN REPORTS ITS ACTIONS TO THE BOARD OF DIRECTORS. THE COMMITTEE IS COMPOSED SOLEY 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 C, LINE 19 THE ARTICLES OF INCORPORATION AND AMENDMENTS THERETO ARE AVAILABLE ON THE MISSOURI SECRETARY OF STATE'S WEBSITE. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN MINIMUM PENSION LIABILITY 3,812,786. PEARL LOWRIE FUND NET ACTIVITY -2,743. TEMP. RESTRICTED NET ASSETS RELEASED FOR CAPITAL EXPENDITURES -455,392. NET CONTRIBUTION REVENUE FROM FOUNDATION 1,124,292. FORM 990, PART XII, LINE 2C THE ORGANIZATION'S POLICY REGARDING OVERSIGHT OF AUDIT IS CONSISTENT WITH THE PRIOR YEAR. FORM 990, PART VI, LINE 4 DURING TAX YEAR 2012, HANNIBAL REGIONAL HOSPITAL'S NAME WAS CHANGED TO HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. AND THE FORMER HANNIBAL REGIONAL HEALTHCARE SYSTEM'S NAME WAS CHANGED TO HANNIBAL REGIONAL HOSPITAL, INC. EFFECTIVELY SWAPPING NAMES OF EACH RESPECTIVE ORGANIZATION. THE BOARDS OF DIRECTORS FOR EACH CORPORATION EXCHANGED PLACES AND THE PURPOSES/RESERVED POWERS OF THE RESPECTIVE CORPORATIONS WERE SWITCHED. THE END RESULT IS THAT THE CORPORATION THAT PREVIOUSLY WAS HANNIBAL REGIONAL HOSPITAL STILL OWNS ALL THE PROPERTY AND RETAINS THE SAME TAX ID NUMBER BUT THAT ENTITY'S LEGAL NAME IS NOW HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. APPROPRIATE CORPORATE RESOLUTIONS FOR EACH COMPANY WERE DRAFTED AND APPROVED BY THE GOVERNING BODIES ON SEPTEMBER 3, 2013. ON SEPTEMBER 4, 2013, REVISED ARTICLES OF INCORPORATION FOR BOTH COMPANIES WERE DELIVERED TO THE MISSOURI SECRETARY OF STATE WHO ACCEPTED THE FILINGS AND ISSUED NEW CERTIFICATES OF GOOD STANDING FOR EACH ORGANIZATION ON THAT DATE. LANAC 6000 HOSPITAL DRIVE HANNIBAL MO 63401 431822503 REAL ESTATE MO 0 0 HANNIBAL REGIONAL HOSPITAL HANNIBAL REGIONAL HOSPITAL FOUNDATION 175 SHINN LANE HANNIBAL MO 63401 431658744 FUNDRAISING MO 501(C)(3) LINE 11A, TYPE 1 0 HANNIBAL MOBILE DIAGNOSTICS PO BOX 1254 HANNIBAL MO 63401 300234397 IMAGING MO N/A RELATED 45129 28376 0 0 0.50000 HANNIBAL MEDICAL SUPPLIES PO BOX 40 QUINCY IL 62306 262362717 MEDICAL SUPPLIES MO N/A RELATED 29158 193336 0 0 0.33000 ADVANCE HANNIBAL REGIONAL HOSPITAL LLC 3652 STARDUST DRIVE HANNIBAL MO 63401 461561480 PT/OT SERVICES MO N/A RELATED 92332 92332 0 0 0.50000 HANNIBAL REGIONAL PHYSICIAN HOSPITAL ORGANIZATION INC 6500 HOSPITAL DRIVE HANNIBAL MO 64301 431706291 PHYSICIAN HOSPITAL ORGANIZATION MO C -36323 80520 0.50000 0 0 1 1 0 0 0 0 0 0 1 0 1 1 1 1 1 1 0 0 HANNIBAL MOBILE DIAGNOSTICS J 600 COST INCURRED ADVANCE HANNIBAL REGIONAL HOSPITAL LLC B 9357 COST INCURRED ADVANCE HANNIBAL REGIONAL HOSPITAL LLC J 38838 COST INCURRED ADVANCE HANNIBAL REGIONAL HOSPITAL LLC M 325176 COST INCURRED ADVANCE HANNIBAL REGIONAL HOSPITAL LLC Q 14813 COST INCURRED