HANNIBAL REGIONAL HEALTHCARE SYSTEM INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
HANNIBAL REGIONAL HEALTHCARE SYSTEM INC (EIN 43-0662495)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-05-14
IRS object ID
201311349349303301
Schema version
2011v1.5
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-05-14T12:11:10-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN410746749EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1600 WASHINGTON AVENUE SUITE 1800AddressLine1
CityST LOUISCity
StateMOState
ZIP Code63101ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN430662495EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HANNIBAL REGIONAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHANNNameControl
Phone5732481300Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line16000 HOSPITAL DRIVE PO BOX 551AddressLine1
CityHANNIBALCity
StateMOState
ZIP Code63401ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameROGER DIXName
TitleCHIEF FINANCIAL OFFICERTitle
Phone5732481300Phone
Date Signed2013-05-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJEFF PARKERName
PTINP00970069PTIN
Phone3149254300Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonC TODD AHRENSNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line16000 HOSPITAL DRIVE PO BOX 551AddressLine1
CityHANNIBALCity
StateMOState
ZIP Code63401ZIPCode
FieldValueIRS element (for citing)
Gross Receipts123794546GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.HRHONLINE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1987YearFormation
State Legal DomicileMOStateLegalDomicile
Activity Or Mission DescriptionHOSPITAL OPERATES A FULL SERVICE ACUTE CARE FACILITYActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees1079TotalNbrEmployees
Total Nbr Volunteers250TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year608133ContributionsGrantsPriorYear
Contributions Grants Current Year543122ContributionsGrantsCurrentYear
Program Service Revenue Prior Year108459190ProgramServiceRevenuePriorYear
Program Service Revenue CY119603490ProgramServiceRevenueCY
Investment Income Prior Year432915InvestmentIncomePriorYear
Investment Income Current Year969819InvestmentIncomeCurrentYear
Other Revenue Prior Year2583243OtherRevenuePriorYear
Other Revenue Current Year2368056OtherRevenueCurrentYear
Total Revenue Prior Year112083481TotalRevenuePriorYear
Total Revenue Current Year123484487TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year30792GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY86652GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year64975831SalariesEtcPriorYear
Salaries Etc Current Year67282982SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year363428TotalFundrsngExpCurrentYear
Other Expense Prior Year45445301OtherExpensePriorYear
Other Expenses Current Year48810102OtherExpensesCurrentYear
Total Expenses Prior Year110451924TotalExpensesPriorYear
Total Expenses Current Year116179736TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1631557RevenuesLessExpensesPriorYear
Revenues Less Expenses CY7304751RevenuesLessExpensesCY
Total Assets BOY121818390TotalAssetsBOY
Total Assets EOY131068696TotalAssetsEOY
Total Liabilities BOY54767600TotalLiabilitiesBOY
Total Liabilities EOY55335893TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY67050790NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY75732803NetAssetsOrFundBalancesEOY
Mission DescriptionYOUR HEALTH IS OUR MISSIONMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense98354113Expense
Revenue121056662Revenue
DescriptionTHE SYSTEM OPERATES A FULL SERVICE 91 BED ACUTE CARE HOSPITAL FACILITY IN HANNIBAL, MISSOURI AS ITS PRIMARY SERVICE ACTIVITY. 17,830 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 - $3,191,272 AND STATE MEDICAID AND OTHER PUBLIC AID PROGRAMS - $631,455.Description
Total Program Service Expense98354113TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds1DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP1LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096112NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1079NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ROGER DIXBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5732481300TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16000 HOSPITAL DRIVEAddressLine1
CityHANNIBALCity
StateMOState
ZIP Code63401ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (40 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
JACK WHITAKER
SECRETARY PRO TEM1.00XX000
ROBERT GILSTRAP
CHAIRPERSON1.00XX137000
JERRY TROWER
VICE CHAIRPERSON1.00XX115900
TIMOTHY A REUSCHEL
SECRETARY1.00XX000
TOM LENNON
VICE CHAIRPERSON1.00XX73700
PAUL EWERT
TREASURER1.00XX000
CAROLYN SHAW
DIRECTOR1.00X000
GENE SCHOLES JR
DIRECTOR1.00X000
JENNIFER VALUCK MD
DIRECTOR1.00X000
ROBERT M CHRISCINSKE
SECRETARY1.00XX000
GORDON SPILKER
ASSISTANT SECRETARY1.00XX000
JIM HUMPHREYS
TREASURER1.00XX000
PRANAV PARIKH MD
VICE PRESIDENT - QUALITY AND MEDICAL AFFAIRS1.00XX000
JEFFRY EVANS MD
DIRECTOR1.00X000
PAT BENSON
DIRECTOR1.00X000
JILL JANES MD
DIRECTOR1.00X000
DARREN SMITH
DIRECTOR1.00X000
TOM WOOTEN
DIRECTOR1.00X000
SANDRA AHLUM MD
VICE PRESIDENT - MEDICAL STAFF1.00X000
RALPH EAGAN
DIRECTOR1.00X000
RANDY PARK
DIRECTOR1.00X000
JOHN GROSSMEIER
PRESIDENT & CEO40.00X545817088518
ROGER DIX
VICE PRESIDENT - FINANCIAL40.00X302221046946
C TODD AHRENS
VICE PRESIDENT - GENERAL C40.00X238360049712
DAVID HEVEL
VICE PRESIDENT - QUALITY40.00X151866025720
JULIE LEVERENZ
VICE PRESIDENT - STRATEGY40.00X160264035667
SHARON NUNLEY
VICE PRESIDENT - HUMAN RES40.00X181715038036
SARAH BRADSHAW
VICE PRESIDENT - NURSING40.00X184206030721
G DOUG RUBLE
VICE PRESIDENT - FACILITIES40.00X157789024823
JEFF EVANS
VICE PRESIDENT - INFORMATI40.00X160960029432
SUZANNE KOEHLER
VICE PRESIDENT - CLINICAL40.00X172712032885
LYNN OLSON
CEO - HOSPITAL40.00X1883000
DEAN AKERSON
EXECUTIVE DIRECTOR40.003091250671X
RICHARD DRAPER
PHYSICIAN/MEDICAL DIRECTOR40.00729072048048X
MARK SHIMA
CARDIOLOGIST40.0075407605181X
RICHARD VALUCK
CARDIOLOGIST40.0054523907761X
LUVELL GLANTON
ANESTHESIOLOGIST - PAIN MA40.0057660902305X
PERVEZ ALVI
CARDIOLOGIST40.0055272002280X
ANNE DELONAIS-TURNER
PHYSICIAN- FORMER HIGHEST PAID EMPLOYEE40.0041870802996X
MARK BELCHER
ANESTHESIOLOGIST- FORMER HIGHEST PAID EMPLOYEE40.0044324106484X
FieldValueIRS element (for citing)
Total Reportable Comp From Org6606796TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation478186TotalOtherCompensation
Number Individuals GT100 K67NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MISSOURI HOSPITAL PLAN
4700 COUNTRY CLUB DRIVEJEFFERSON CITYMO65102INSURANCE PROVIDER1201217
BANC OF AMERICA LEASING & CAPITAL
2059 NORTHLAKE PARKWAYTUCKERGA30384LEASING COMPANY1187031
LOCUMTENENSCOM
PO BOX 405547ATLANTAGA30384LOCUM PHYSICIANS1019287
EMERCON EMERGENCY MEDICAL
8021 CORNELL AVEST LOUISMO63130LOCUM PHYSICIANS445800
FMH CORESOURCE
PO BOX 25946OVERLAND PARKKS66225INSURANCE PROVIDER402668
FieldValueIRS element (for citing)
Number Of Contractors GT100 K25NumberOfContractorsGT100K
Related Organizations543122RelatedOrganizations
Total Contributions543122TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICE REDescription
Business Code621110BusinessCode
Total Revenue Column119603490TotalRevenueColumn
Related Or Exempt Function Income119603490RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue119603490TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column956219TotalRevenueColumn
Exclusion$956,219ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real283075Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real30282Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real252793Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column252793TotalRevenueColumn
Exclusion$252,793ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities274795Securities
Other18582Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities278757Securities
Other1020Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-3962Securities
Other17562Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column13600TotalRevenueColumn
Related Or Exempt Function Income17562RelatedOrExemptFunctionIncome
Exclusion-$3,962ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
CHILDREN'S DEVELOPMENT624410760447760447
CAFETERIA722210572443$572,443
CONTRACTED SERVICES621110511685511685

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column270688TotalRevenueColumn
Related Or Exempt Function Income163478RelatedOrExemptFunctionIncome
Exclusion$107,210ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue2115263TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column123484487TotalRevenueColumn
Related Or Exempt Function Income121056662RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$1,884,703ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total86652Total
Program Services86652ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2583865Total
Program Services384638ProgramServices
Management And General1965098ManagementAndGeneral
Fundraising234129Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total48260957Total
Program Services39730569ProgramServices
Management And General8490341ManagementAndGeneral
Fundraising40047Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total3442218Total
Program Services2820847ProgramServices
Management And General602809ManagementAndGeneral
Fundraising18562Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total9734623Total
Program Services7957819ProgramServices
Management And General1721825ManagementAndGeneral
Fundraising54979Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3261319Total
Program Services2672536ProgramServices
Management And General571116ManagementAndGeneral
Fundraising17667Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total139313Total
Management And General139313ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total119641Total
Management And General119641ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total12425Total
Program Services10193ProgramServices
Management And General2232ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total244615Total
Program Services244615ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total11313742Total
Program Services9281159ProgramServices
Management And General2032583ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1504571Total
Program Services1234266ProgramServices
Management And General270305ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total661517Total
Program Services542671ProgramServices
Management And General118846ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total106628Total
Program Services87472ProgramServices
Management And General19156ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1310350Total
Program Services1074938ProgramServices
Management And General235412ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total7408060Total
Program Services7408060ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total788919Total
Program Services647185ProgramServices
Management And General141734ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT EXPENSE92291719229171
HEALTHCARE PURCHASED SE43571844357184
EQUIPMENT RENTAL28749852358476516509
PHARMACY DRUGS25945062594506

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total6144475Total
Program Services5631156ProgramServices
Management And General515275ManagementAndGeneral
Fundraising-1956Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total116179736Total
Program Services98354113ProgramServices
Management And General17462195ManagementAndGeneral
Fundraising363428Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY7660293BOY
EOY15259185EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY15073541BOY
EOY15290528EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY98750BOY
EOY42500EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY1450730BOY
EOY1208898EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2403874BOY
EOY2302730EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY586866BOY
EOY538825EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis129729709LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec74304661LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY57788916BOY
EOY55425048EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY30337121BOY
EOY34312519EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY300000BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY6118299BOY
EOY6688463EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY121818390BOY
EOY131068696EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY11516738BOY
EOY14249860EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY25026012BOY
EOY23036676EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY8951150BOY
EOY7369297EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY9273700BOY
EOY10680060EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY54767600BOY
EOY55335893EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY63854864BOY
EOY72252697EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3195926BOY
EOY3480106EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY67050790BOY
EOY75732803EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY121818390BOY
EOY131068696EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses7304751ReconcilationRevenueExpenses
Reconcilation Other Changes1377262ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations1GrantsOtherOrganizations
Grants Other Organizations$12,425GrantsOtherOrganizationsAmount
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB12425TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationLOBBYING ACTIVITY PROVIDED THROUGH MEMBERSHIP IN THE MISSOURI HOSPITAL ASSOCIATIONExplanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Number Funds Held1NumberFundsHeld
Contrib To Funds And Other Accounts2804ContribToFundsAndOtherAccounts
Grants Funds And Other Accounts0GrantsFundsAndOtherAccounts
Aggregate Fund Value38860AggregateFundValue
Disclosed Orgs Legal Control0DisclosedOrgsLegalControl
Disclosed For Charitable Purposes0DisclosedForCharitablePurposes

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis2693370OtherCostOrOtherBasis
Book Value2693370BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis68263932OtherCostOrOtherBasis
Depreciation35351666Depreciation
Book Value32912266BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis51700166OtherCostOrOtherBasis
Depreciation38952995Depreciation
Book Value12747171BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis7072241OtherCostOrOtherBasis
Book Value7072241BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings55425048TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
BOND ISSUE COST253539
RECEIVABLE FROM HANNIBAL REGIONAL HOSPITAL FOUNDATION3441246
INVESTMENT IN JOINT VENTURES314268
SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN2679410
FieldValueIRS element (for citing)
Total Book Value Other Assets6688463TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
MINIMUM PENSION LIABILITY$8,000,650
SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN LIABILITY$2,679,410
FieldValueIRS element (for citing)
Total Of Amounts10680060TotalOfAmounts
Total Revenue123484487TotalRevenue
Total Expenses116179736TotalExpenses
Excess Or Deficit For Year7304751ExcessOrDeficitForYear
Net Unrealized GL On Investments3214499NetUnrealizedGLOnInvestments
Other-$1,837,237OtherAmount
Total Adjustments1377262TotalAdjustments
Excess Or Deficit Per FS8682013ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt124577569TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments3214499NetUnrealizedGainsInvestments
Other Revenues-2121417OtherRevenues
Revenue Not Rptd F9901093082RevenueNotRptdF990
Revenue Subtotal123484487RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form990123484487TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt116179736TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal116179736ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990116179736TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE HOSPITAL 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 HOSPITAL IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE HOSPITAL 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 HOSPITAL'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE HOSPITAL IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE HOSPITAL 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 2009 TO 2011 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES.
PART XI, LINE 8 - OTHER ADJUSTMENTS:CHANGE IN MINIMUM PENSION LIABILITY -2,121,417. PEARL LOWRIE FUND NET ACTIVITY 2,804. TEMP. RESTRICTED NET ASSETS RELEASED FOR CAPITAL EXPENDITURES -543,122. NET CONTRIBUTION REVENUE FROM FOUNDATION 824,498. TOTAL TO SCHEDULE D, PART XI, LINE 8: -1,837,237.
PART XII, LINE 2D - OTHER ADJUSTMENTS:MINIMUM PENSION LIABILITY EXPENSE -2,121,417.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care0FPGReferenceDiscountedCare
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense8963280TotalCommunityBenefitExpense
Direct Offsetting Revenue6958470DirectOffsettingRevenue
Net Community Benefit Expense2004810NetCommunityBenefitExpense
Percent Of Total Expense0.01730PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense9749807TotalCommunityBenefitExpense
Direct Offsetting Revenue6958471DirectOffsettingRevenue
Net Community Benefit Expense2791336NetCommunityBenefitExpense
Percent Of Total Expense0.02400PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense18713087TotalCommunityBenefitExpense
Direct Offsetting Revenue13916941DirectOffsettingRevenue
Net Community Benefit Expense4796146NetCommunityBenefitExpense
Percent Of Total Expense0.04130PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1259716TotalCommunityBenefitExpense
Direct Offsetting Revenue290537DirectOffsettingRevenue
Net Community Benefit Expense969179NetCommunityBenefitExpense
Percent Of Total Expense0.00830PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense327783TotalCommunityBenefitExpense
Net Community Benefit Expense327783NetCommunityBenefitExpense
Percent Of Total Expense0.00280PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense12474402TotalCommunityBenefitExpense
Direct Offsetting Revenue4328522DirectOffsettingRevenue
Net Community Benefit Expense8145880NetCommunityBenefitExpense
Percent Of Total Expense0.07010PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense21209TotalCommunityBenefitExpense
Net Community Benefit Expense21209NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense14083110TotalCommunityBenefitExpense
Direct Offsetting Revenue4619059DirectOffsettingRevenue
Net Community Benefit Expense9464051NetCommunityBenefitExpense
Percent Of Total Expense0.08140PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense32796197TotalCommunityBenefitExpense
Direct Offsetting Revenue18536000DirectOffsettingRevenue
Net Community Benefit Expense14260197NetCommunityBenefitExpense
Percent Of Total Expense0.12270PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense2384720TotalCommunityBuildingExpense
Direct Offsetting Revenue940316DirectOffsettingRevenue
Net Community Building Expense1444404NetCommunityBuildingExpense
Percent Of Total Expense0.01240PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense391578TotalCommunityBuildingExpense
Net Community Building Expense391578NetCommunityBuildingExpense
Percent Of Total Expense0.00340PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense2776298TotalCommunityBuildingExpense
Direct Offsetting Revenue940316DirectOffsettingRevenue
Net Community Building Expense1835982NetCommunityBuildingExpense
Percent Of Total Expense0.01580PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$9,229,171BadDebtExpenseAmount
Amount Attributable To5537503AmountAttributableTo
Amount Reimbursed By Medicare32587604AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare35847007CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-3259403MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost Accounting SystemXCostAccountingSystem
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
1 HANNIBAL MEDICAL SUPPLY
DME COMPANY0.330000.33000
2 HANNIBAL MOBILE DIAGNOSTICS
MOBILE IMAGING/RADIOLOGY SERVICES0.500000.50000
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1HANNIBAL REGIONAL HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line16000 HOSPITAL DRIVEAddressLine1
CityHANNIBALCity
StateMOState
ZIP Code63401ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1HANNIBAL REGIONAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Take Into Account1TakeIntoAccount
Other Facilities0OtherFacilities
CHNA Widely Available0CHNAWidelyAvailable
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
All Needs Addressed1AllNeedsAddressed
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted0UsesFPGDiscounted
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)

ExplanationExplanationIdentifierIdentifier
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 HOSPITAL IN THEIR ANNUAL COMMUNITY BENEFIT REPORT.
PART III, LINE 4: THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYORS, PATIENTS AND OTHERS. THE HOSPITAL 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 HOSPITAL 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, 2012 AND 2011, THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS WAS APPROXIMATELY $5,444,000 AND $4,022,000, RESPECTIVELY.
PART III, LINE 8: THE HOSPITAL'S COST ACCOUNTING SYSTEM IS UTILIZED IN DETERMINING THE ORGANIZATRIONS COMMUNITY BENEFIT.
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 V, SECTION B, LINE 19D: 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.HANNIBAL REGIONAL HOSPITAL
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.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
AMERICAN CANCER SOCIETY
3145 HIGHWAY 61HANNIBALMO63401131788491501(C)(3)82142012 HOPE CONTRIBUTION AND THE 2012 PINK RIBBON GOLF TOURNAMENT
MHA CENTER FOR EDUCATION
PO BOX 60JEFFERSON CITYMO65102430898947501(C)(3)78438MCE HEALTH IMPR., RESEARCH AND SCHOLARSHIP FUND, MHA SPECIAL PROJECTS, MISSOURI CENTER FOR PATIENTS SAFETY CONTRIBUTION, MISSOURI POISON CENTER CONTRIBUTION.
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE 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.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (18 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
JOHN GROSSMEIER
432265029882083670083670048480634335000
ROGER DIX
234664012803054754046946000349167000
C TODD AHRENS
22563001273000045827038850288072000
DAVID HEVEL
12165705818024391023720020000177586000
JULIE LEVERENZ
1464110811105742030282053850195931000
SHARON NUNLEY
16008709111012517032188058480219751000
SARAH BRADSHAW
14199706968035241028409023120214927000
G DOUG RUBLE
12405306678027058023375014480182612000
JEFF EVANS
1473990793705624028047013850190392000
SUZANNE KOEHLER
1649120780000031500013850205597000
DEAN AKERSON
1884860001206390006710309796000
RICHARD DRAPER
4667790321940230099042200058480777120000
MARK SHIMA
750326000375000051810759257000
RICHARD VALUCK
545239000000077610553000000
LUVELL GLANTON
430335013627401000000023050578914000
PERVEZ ALVI
543720000900000022800555000000
ANNE DELONAIS-TURNER
415708000300000029960421704000
MARK BELCHER
443241000000064840449725000

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1ACOMPANION TRAVEL EXPENSES : ROBERT GILSTRAP $1,370; JERRY TROWER $1,159; TOM LENNON $737
PART I, LINE 1BALL 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, LINE 4BJOHN GROSSMEIER, SERP, $83,670 ROGER DIX, SERP, $54,754 DAVID HEVEL, SERP, $24,391 C. TODD AHRENS, SERP, $0 SHARON NUNLEY, SERP, $12,517 RICHARD DRAPER, SERP, $198,599 JULIE LEVERNZ, SERP, $0 G. DOUG RUBLE, SERP, $22,332 SARAH BRADSHAW, SERP, $28,409
PART I, LINE 6DR. GLANTON RECEIVES 50% OF ALL PAIN MEDICINE PHYSICIAN SERVICE NET COLLECTIONS GENERATED AS A RESULT OF PROFESSIONAL SERVICES COLLECTED IN EXCESS OF ONE HUNDRED THOUSAND DOLLARS EACH YEAR. TOTAL SALARY PLUS BONUS NOT TO EXCEED THE NINETIETH PERCENTILE OF THE PRIOR YEAR'S RANGE AS REPORTED FOR THE SOUTHERN REGION BY THE MEDICAL GROUP MANAGEMENT ASSOCIATION.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
THE INDUSTRIAL DEVELOPMENT AUTHORITY OF THE CITY OF HANNIBAL MISSOURI
531320446410632AT02006-04-0124064011HOSPITAL REFUNDING REVENUE BONDS000
THE INDUSTRIAL DEVELOPMENT AUTHORITY OF THE CITY OF HANNIBAL MISSOURI
531320446410632BJ12010-07-297588694HOSPITAL REFUNDING OF ER ADDITION BONDS000

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Amount RetiredAmountRetiredTotal ProceedsTotalProceedsRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
7314381240640112386828019573120221011
13016487588694774316212053220201001

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
011101
011101

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICTerm Of GICTermOfGICRegulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfiedGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
SOCIETE GENERALE
100114.800000000000100
(no name)
000000
FieldValueIRS element (for citing)
Fed Tax Requirements ComplianceXFedTaxRequirementsCompliance

Form990 Schedule K Part VI Form990ScheduleKPartVI (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SCHEDULE K, PART II, LINE 14, ISSUANCE APURPOSE OF 2006 REFUNDING BOND ISSUANCETHE 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 BPURPOSE OF 2010 REFUNDING BOND ISSUANCETHE HEALTH FACILITIES REFUNDING REVENUE BONDS SERIES 2010 BOND ISSUANCE WAS ISSUED TO REFUND THE REMAINING OUTSTANDING 2007 REVENUE BONDS.

Schedule L IRS990ScheduleL

Loan Table LoanTable (4 entries)

Purpose Of LoanPurposeOfLoanLoan From OrganizationLoanFromOrganizationOriginal PrincipalOriginalPrincipalAmountBalance DueBalanceDueDefaultDefaultApproved By BoardApprovedByBoardWritten AgreementWrittenAgreement
PERVEZ ALVI
PHYSICIAN RELOCATIONX$60,00030000011
ANNE DELONAIS
PHYSICIAN RELOCATIONX$20,000011
LUVELL GLANTON
PHYSICIAN RELOCATIONX$40,000011
MARK SHIMA
PHYSICIAN RELOCATIONX$25,00012500011
FieldValueIRS element (for citing)
Total Balance Due42500TotalBalanceDue

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11THE 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 12CTHE ORGANIZATION HAS A POLICY TITLED BUSINESS ETHICS AND CONFLICT OF INTEREST WHICH REQUIRES THAT ALL DIRECTORS, OFFICERS, AND EMPLOYEES OF THE HOSPITAL ALWAYS ACT IN THE BEST INTEREST OF THE HOSPITAL 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 HOSPITAL. 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 HOSPITAL 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 HOSPITAL TO EACH INTERESTED PERSON AND TO THOSE EMPLOYEES OF THE HOSPITAL 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 HOSPITAL DISCLOSED BY SUCH QUESTIONNAIRE, ANY INTEREST OF DIRECTORS AND OFFICERS WHO ARE NOT EMPLOYEES OF THE HOSPITAL, 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 HOSPITAL 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 HOSPITAL, OR ANY ENTITY AFFILIATED WITH THE HOSPITAL. AN OWNERSHIP OR INVESTMENT INTEREST IN A DIRECT COMPETITOR OF THE HOSPITAL, OR ANY ENTITY AFFILIATED WITH THE HOSPITAL, 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 HOSPITAL, OR ANY ENTITY AFFILIATED WITH THE HOSPITAL, OR A FAMILY MEMBER IS A MEMBER OF THE MANAGEMENT TEAM OF THE HOSPITAL, OR ANY ENTITY AFFILIATED WITH THE HOSPITAL; D. THE INDIVIDUAL RECEIVES DIRECT COMPENSATORY BENEFIT FOR ONGOING SERVICES PROVIDED TO THE HOSPITAL, OR ANY ENTITY AFFILIATED WITH THE HOSPITAL (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 HOSPITAL, OR ANY ENTITY AFFILIATED WITH THE HOSPITAL - 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 HOSPITAL FOR THE EXCLUSIVE PROVISION OF ANY MEDICAL SERVICES WITHIN THE HOSPITAL, OR ITS AFFILIATES.
FORM 990, PART VI, SECTION B, LINE 15THE 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 19THE ARTICLES OF INCORPORATION AND AMENDMENTS THERETO ARE AVAILABLE ON THE MISSOURI SECRETARY OF STATE'S WEBSITE.
FORM 990, PART XI, LINE 5:NET UNREALIZED GAINS ON INVESTMENTS: 3,214,499. CHANGE IN MINIMUM PENSION LIABILITY -2,121,417. PEARL LOWRIE FUND NET ACTIVITY 2,804. TEMP. RESTRICTED NET ASSETS RELEASED FOR CAPITAL EXPENDITURES -543,122. NET CONTRIBUTION REVENUE FROM FOUNDATION 824,498. TOTAL TO FORM 990, PART XI, LINE 5: 1,377,262.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 2CTHE ORGANIZATION'S POLICY REGARDING OVERSIGHT OF AUDIT IS CONSISTENT WITH THE PRIOR YEAR.
FORM 990, PART VI, SECTION AIN ITS CONTINUING EFFORT TO BETTER SERVE THE RESIDENTS OF THE HANNIBAL, MISSOURI REGION, A SEPARATE ENTITY AND BOARD WAS PREVIOUSLY CREATED FOR THE HANNIBAL REGIONAL HEALTHCARE SYSTEM (HRHS) TO PROVIDE THE NECESSARY OVERSIGHT AND TO BEGIN TO FOSTER IDEAS TO EXPAND THE SERVICE OFFERINGS OF NOT ONLY THE HOSPITAL, BUT THE ENTIRE SYSTEM. THE HOSPITAL AND HRHS BOARDS MEET AND VOTE SEPARATELY ON THEIR RESPECTIVE ISSUES AND SEVERAL MEMBERS ARE ON BOTH BOARDS TO PROVIDE CONTINUITY AND TO BETTER SHARE IDEAS. THE HRHS BOARD ELECTS THE MEMBERS OF THE HOSPITAL BOARD.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1LANACBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16000 HOSPITAL DRIVEAddressLine1
CityHANNIBALCity
StateMOState
ZIP Code63401ZIPCode
FieldValueIRS element (for citing)
EIN431822503EIN
Primary ActivitiesREAL ESTATEPrimaryActivities
Legal Domicile StateMOLegalDomicileState
Total Income0TotalIncome
EOY Assets0EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1HANNIBAL REGIONAL HOSPITALBusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1HANNIBAL REGIONAL HOSPITAL FOUNDATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1175 SHINN LANEAddressLine1
CityHANNIBALCity
StateMOState
ZIP Code63401ZIPCode
FieldValueIRS element (for citing)
EIN431658744EIN
Primary ActivitiesFUNDRAISINGPrimaryActivities
Legal Domicile StateMOLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity StatusLINE 11A, TYPE 1PublicCharityStatus
Controlled Org0ControlledOrg

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1HANNIBAL MOBILE DIAGNOSTICSBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 1254AddressLine1
CityHANNIBALCity
StateMOState
ZIP Code63401ZIPCode
FieldValueIRS element (for citing)
EIN300234397EIN
Primary ActivityIMAGINGPrimaryActivity
Legal Domicile StateMOLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Predominant Income TypeRELATEDPredominantIncomeType
Share Of Total Income20874ShareOfTotalIncome
Share Of EOY Assets32368ShareOfEOYAssets
Disproportionate Allocations0DisproportionateAllocations
General Or Managing Partner0GeneralOrManagingPartner
Percentage Ownership0.50000PercentageOwnership

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1HANNIBAL REGIONAL PHYSICIAN HOSPITAL ORGANIZATION INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16500 HOSPITAL DRIVEAddressLine1
CityHANNIBALCity
StateMOState
ZIP Code64301ZIPCode
FieldValueIRS element (for citing)
EIN431706291EIN
Primary ActivityPHYSICIAN HOSPITAL ORGANIZATIONPrimaryActivity
Legal Domicile StateMOLegalDomicileState
Type Of EntityCTypeOfEntity
Share Of Total Income-23687ShareOfTotalIncome
Share Of EOY Assets116843ShareOfEOYAssets
Percentage Ownership0.50000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
HANNIBAL REGIONAL HOSPITAL FOUNDATION
C543122COST INCURRED
HANNIBAL REGIONAL HOSPITAL FOUNDATION
N303462COST INCURRED
HANNIBAL REGIONAL HOSPITAL FOUNDATION
O162612COST INCURRED

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