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1407 WHISENANT DR DUNCAN OK 73533

WWW.DUNCANREGIONAL.COM X X X DUNCAN REGIONAL HOSPITAL 1 true X X X X X X X X X 12 true false true X X X X X X X X X X X false false true true 100 true 300. true X X true true X X X X true false X X true X X false false 1 PART III, LINE 4 THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. AMOUNTS REPORTED ON LINE 2 ARE BASED UPON BAD DEBTS PER THE AUDITED FINANCIAL STATEMENTS AFTER APPLYING THE COST TO CHARGE RATIO. AMOUNTS REPORTED ON LINE 3 ARE THE ORGANIZATION'S ACTUAL WRITE OFF OF ACCOUNTS OF PATIENTS WHO QUALIFY UNDER THE HOSPITAL'S CHARITY CARE GUIDELINES. 2 PART III, LINE 8 THE ORGANIZATION UTILIZES MEDICARE COST REPORT METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS (ROOM AND BOARD) BASED UPON MEDICAID OR MEDICARE DAYS TO TOTAL DAYS, AND THE ANCILLARY PORTION IS APPORTIONED BASED UPON PROGRAM CHARGES TO TOTAL CHARGES. 3 PART III, LINE 9B IN SUPPORT OF ITS MISSION, THE HOSPITAL VOLUNTARILY PROVIDES FREE CARE TO PATIENTS WHO LACK FINANCIAL RESOURCES AND ARE DEEMED MEDICALLY INDIGENT IN ACCORDANCE WITH THE HOSPITAL'S WRITTEN CHARITY CARE CRITERIA. NO FURTHER COLLECTION EFFORTS ARE MADE. 4 PART VI, LINE 2 THE HOSPITAL ASSESSES COMMUNITY NEEDS ON AN ONGOING BASIS, THROUGH INVOLVEMENT IN COMMUNITY PROGRAMS AND SURVEYS WITH OUR PHYSICIANS. THE HOSPITAL WILL UNDERGO THE REQUIRED COMMUNITY HEALTH NEEDS ASSESSMENT UNDER THE 501R REQUIREMENTS BY THE REQUIRED TIME. 5 PART VI, LINE 3 DUNCAN REGIONAL HOSPITAL PROVIDES MANY OPPORTUNITIES FOR PATIENT EDUCATION ON FINANCIAL ASSISTANCE. THE PROGRAMS ARE OUTLINED ON THE HOSPITAL'S WEBSITE, BROCHURES ARE AVAILABLE AT EVERY REGISTRATION POINT, PRE-ADMISSION LETTERS ARE PROVIDED TO SURGERY PATIENTS THAT CONTAIN FINANCIAL ASSISTANCE INFORMATION AND APPLICATIONS ARE GIVEN TO UNINSURED PATIENTS. 6 PART VI, LINE 4 DUNCAN REGIONAL HOSPITAL IS ACTIVELY DELIVERING CARE TO THE STEPHENS COUNTY AREA WITH A BROAD RANGE OF DEMOGRAPHICS. 7 PART VI, LINE 5 DUNCAN REGIONAL HOSPITAL PROMOTES THE OVERALL HEALTH OF THE COMMUNITY BY CONTINUALLY WORKING TO BRING QUALITY PHYSICIANS TO PARTICIPATE IN OUR OPEN MEDICAL STAFF. SURPLUS FUNDS ARE REINVESTED INTO THE ORGANIZATION TO IMPROVE THE QUALITY OF SERVICES TO THE COMMUNITY. 8 PART V, LINE 20 ON KNOWN FAP=ELIGIBLE PATIENTS, THE AMOUNT CHARGED IS BASED ON INCOME LEVELS AND INSURANCE STATUS. THE PATIENT WOULD COMPLETE A CHARITY APPLICATION. FROM THAT INFORMATION, WE WOULD DETERMINE WHERE THEIR INCOME FELL ON THE FEDERAL POVERTY GUIDELINE GRID. 100% OF FPG = 100% DISCOUNT 101% - 125% = 75% DISCOUNT 126% - 150% = 50% DISCOUNT 151% - 175% = 25% DISCOUNT 176% - 300% = MEDICARE RATE INCOME LEVELS COMPARED WITH FEDERAL POVERTY GUIDELINE (SEE #10 & #11). 9 Schedule H, Part V, line 3 A COMMITTEE WAS FORMED THAT COMPRISED INDIVIDUALS WHO ENCOMPASSED THE DIVERSITY OF STEPHENS COUNTY. THE HOSPITAL PARTICIPATED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED BY THE PATHWAYS TO A HEALTHY STEPHENS COUNTY COMMITTEE. THE INPUT CAME FROM SURVEYS, FOCUS GROUPS, AND COMMUNITY INFORMANT INTERVIEWS. 10 SCHEDULE H, PART V, LINE 7 In partnership with the Stephens County Health department, United Way of Stephens County, and numerous other organizations, Duncan Regional Hospital participated in the Pathways to a Healthy Stephens County committee to complete the Community Health Needs Assessment for Stephens County, Oklahoma, in early 2012. From the data and analysis, the county at large had four key areas of health concern: 1. Healthy living and the lack of exercise opportunities, fruit and vegetable consumption, increasing obesity rate, increasing cardiovascular disease, diabetes, sexual health and the dental health needs of the community. 2. Mental Health/Substance Abuse Services and the lack of trained, qualified, mental health/substance abuse programs and access in Stephens County. 3. Safety/Injury prevention education and opportunities for providing better shelter, safety and options during inclement weather, after tornado effects, safety at local schools and other needs of the community during adverse situations. 4. Prevention, education, and needs of the community around cancer and the need to decrease the number of preventable cancer deaths in our county. (Full assessment can be found at: http://duncanregional.com/magazine/stephenscohealth/stephenscohealth/ index.html) Pathways to a Healthy Stephens County discussed the four areas and selected two (2) main areas of focus for the next three (3) years. Pathways, as a whole, selected to concentrate on the two heaviest areas of concern reported by our citizens: (1) Healthy Living and (2) Mental Health/Substance Abuse. The Pathways group approved tackling these two areas instead of all four areas so the organizations and community could focus on the two greatest areas of concern. The plan has been to work on our key areas and as momentum increases and the community sees sustainable results, come back to the other two areas for re-evaluation within our county. The areas identified in the Community Health Needs Assessment that will not be tackled are (3) Safety/Injury prevention and (4) Cancer. While we feel both areas need to be worked on, the limitations available to us as a community and within DRH limit the number of items we can effectively tackle at one time. DRH and the Pathways group both plan to work together in support of these two areas at a later date but cannot effectively manage these within the scope of what is available to us at this time. As part of the Pathways group, Duncan Regional Hospital has been extremely supportive of taking on the two key areas of citizen concern only. Duncan Regional Hospital has committed resources, both human and financial, meeting space, food, advertising, and numerous other items to the Pathways group in support of programs to improve the two key areas of focus. At this time, DRH is one of the main partners in the Pathways group and has two of our top executives serving as committee chairs over working task forces over both major areas of focus. Duncan Regional Hospital is committed to working with the Pathways group to help formalize, fund, and monitor results in both major areas for the improvement of health in Stephens County. formalize, fund, and monitor results in both major areas for the improvement of health in Stephens County. 11 SCHEDULE H, PART V, LINE 5A&C URL where CHNA can be found: http://duncanregional.com/magazine/stephenscohealth/stephenscohealth/ index.html THE CHNA REPORT IS PRINTED AND PUT IN WAITING ROOMS AND OTHER PLACES IN THE HOSPITAL. X true true X X X X X false true false false false false false true false JAY JOHNSON 311312 0 46883 0 38966 9290 406451 0 0 0 WILLIAM STEWART 245449 0 0 25040 9290 279779 0 0 DOUG VOLINSKI 202374 0 19222 0 0 0 23988 0 5690 0 251274 0 0 0 CYNTHIA RAUH 183556 0 16503 0 0 0 20653 0 5690 0 226402 0 0 0 MARK W RHOADES 147470 0 14252 0 0 0 18495 0 5690 0 185907 0 0 0 ROGER NEAL 159881 0 14815 0 0 0 19179 0 14189 0 208064 0 0 0 THOMAS EISER 355614 131167 0 0 0 0 17161 0 5690 0 378465 131167 0 0 JOHN MCGATH 396733 0 0 0 0 0 20000 0 9290 0 426023 0 0 0 PRESTON WATERS 248573 9610 0 0 0 0 12531 0 14189 0 275293 9610 0 0 CHRISTOPHER CRIMMINS 343845 0 0 0 0 0 17000 0 9290 0 370135 0 0 0 TERRY CRISSMAN 154756 0 0 0 0 0 11515 0 11381 0 177652 0 0 0 1 PART I, LINE 1A THE ORGANIZATION PAID THE CEO'S COUNTRY CLUB DUES. ANY PERSONAL USE IS REIMBURSED TO THE HOSPITAL BY THE CEO. 2 PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICPIATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN DESCRIBED IN 457(F): JAY JOHNSON DOUG VOLINSKI CYNTHIA RAUH MARK RHOADES ROGER NEAL 3 PART I, LINE 4C THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 409(A) PLAN: WILLIAM STEWART 4 SCHEDULE J, PART I, LINE 7 SENIOR MANAGEMENT IS PAID VARIABLE COMPENSATION BASED UPON GOALS APPROVED BY THE GOVERNING BOARD ANNUALLY. THE GOALS VARY YEAR TO YEAR. THERE IS A FIXED PERCENTAGE SET AT THE BEGINNING OF THE YEAR WHEN THE GOALS ARE APPROVED. A PERCENTAGE OF THAT AMOUNT IS PAID BASED ON THE ACHIEVEMENT OF THOSE GOALS. A THE OKLAHOMA DEVELOPMENT FINANCE AUTHORITY 731083741 678910CB4 2004-01-07 30368690 BONDS 2003A false false false B THE OKLAHOMA DEVELOPMENT FINANCE AUTHORITY 731083741 67909PBG9 2008-10-31 20000000 BONDS 2008 false false false A 8680000 0 30368690 2425118 0 0 0 225000 0 27719734 0 0 2005 false false true true B 0 0 20023920 0 0 0 416539 0 0 19607382 0 0 2009 false false true true A false false false false 0 false false true B false false false false 0 false false false true A false false true false false false 0 false 0 false true B false false true false true false 0 false 0 false true A false B false 1 FORM 990, PART VI, LINE 11 THE FORM 990 WAS PREPARED AND REVIEWED BY AN OUTSIDE ACCOUNTING FIRM AND REVIEWED INTERNALLY BY MANAGEMENT. PRIOR TO FILING, COPIES OF THE 990 WERE DISTRIBUTED TO BOARD MEMBERS AT A BOARD MEETING. TIME WAS PROVIDED FOR REVIEW AND QUESTIONS AT THE MEETING. BOARD MEMBERS WERE OFFERED COPIES TO TAKE WITH THEM AFTER THE MEETING. 2 FORM 990, PART VI, LINE 12C BOARD MEMBERS ARE REQUIRED TO DISCLOSE ANNUALLY INTERESTS THAT COULD GIVE RISE TO CONFLICTS. IF A BOARD MEMBER BELIEVES THAT HE OR SHE MAY HAVE A CONFLICT OF INTEREST, THEN THE CONFLICT SHOULD BE IMMEDIATELY DISCLOSED. THE BOARD MEMBER MAY LEAVE THE BOARD MEETING AND THE REMAINING BOARD DISCUSSES AND VOTES ON IF A CONFLICT OF INTEREST EXISTS. IF ITS DECIDED THAT A CONFLICT EXISTS, THE AFFECTED BOARD MEMBER SHOULD ABSTAIN FROM ANY ACTION TO THE INTEREST AND SHOULD ABSENT HIMSELF OR HERSELF FROM ANY PORTION OF ANY PROCEEDINGS AT WHICH ACTION IS CONSIDERED OR TAKEN REGARDING THE INTEREST. 3 FORM 990, PART VI, LINE 15 THE COMPENSATION COMMITTEE OF THE BOARD SETS THE EXECUTIVE TEAM'S SALARY. THEY RELY HEAVILY ON SALARY SURVEY DATA AND RECOMMENDATIONS FROM A NATIONAL CONSULTING FIRM. 4 FORM 990, PART VI, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. 5 FORM 990, PART X1, LINE 5 EQUITY IN ADVANCED MEDICAL SUPPLY (486,062) EQUITY IN SOLUTIONS PHYS PRACTICE MGMT (250,850) ----------- (736,912) SOLUTIONS PHYS PRACTICE MGMT 2210 DUNCAN REGIONAL LOOP ROAD DUNCAN OK 73533 260618405 PRACTICE MGMT OK 5096146 1072416 NA ADVANCED MEDICAL SUPPLY LLC 1503 NORTH HIGHWAY 81 SUITE A DUNCAN OK 73533 731539867 DME OK 2131080 1195490 NA DRH HEALTH FOUNDATION INC 14407 WHISENANT DRIVE DUNCAN OK 73533 202772056 SUPPORT. 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