2013-12-13T13:28:34-06:00 2013-04-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2012-05-01 237339737 LAKE REGIONAL HEALTH SYSTEM % DAVID HALSELL LAKE 5733488000 54 HOSPITAL DRIVE Suite OSAGE BEACH MO 65065 DAVID HALSELL 5733488000 2013-10-31 true Brian D Todd 4178658701 2012 2016-02-25 16:41:14Z MICHAEL E HENZE 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 143964282 false X WWW.LAKEREGIONAL.COM X 1973 MO LAKE REGIONAL HLTH SYSTEM PROVIDES AN EXTENSIVE VARIETY OF OUTPATIENT & INPATIENT HLTH CARE SERVICES AS WELL AS AN EMERGENCY DEPARTMENT TO RESIDENTS & VISITORS OF THE LAKE REGION. SEE SCHEDULE O FOR MORE INFO. 15 7 1142 350 0 0 388577 1228229 165010891 146334557 2372881 2564570 -4579770 -7442092 163192579 142685264 69466 35503 0 0 63940768 60310138 0 0 0 94730010 85695998 158740244 146041639 4452335 -3356375 182513513 180227561 73122740 71313744 109390773 108913817 X TO PROVIDE EXCEPTIONAL HEALTH CARE. false false 56159051 66766171 LAKE REGIONAL HEALTH SYSTEM PROVIDES OUTPATIENT SERVICES SUCH AS DIAGNOSTIC IMAGING, LABORATORY AND PHYSICAL THERAPY SERVICES TO THE COMMUNITY AND SURROUNDING RURAL AREAS. THE HOSPITAL PROVIDED A TOTAL OF 224,332 OUTPATIENT SERVICES VISITS. 48660216 54748259 LAKE REGIONAL HEALTH SYSTEM PROVIDES INPATIENT SERVICES TO THE COMMUNITY AND SURROUNDING RURAL AREAS. THE HOSPITAL PROVIDED 20,549 INPATIENT DAYS, 3,676 SKILLED NURSING FACILITY INPATIENT DAYS AND 1,150 NURSERY PATIENT DAYS FOR A TOTAL OF 25,375 INPATIENT DAYS. 8052617 18638377 LAKE REGIONAL HEALTH SYSTEM'S EMERGENCY DEPARTMENT IS A LEVEL III TRAUMA CENTER (GRANTED THROUGH A SPECIAL STATE CREDENTIALING PROCESS REQUIRING EXTENSIVE EDUCATION AND SERVICE REVIEW) PROVIDING 24-HOUR EMERGENCY MEDICAL SERVICE TO A FIVE COUNTY AREA. THE UNIVERSITY OF MISSOURI STAFF FOR LIFE HELICOPTER IS BASED HERE. THE EMERGENCY DEPARTMENT PROVIDED 35,351 VISITS. 10534881 35503 6181750 123406765 true true false true false false false false false false true false false false true false false true false false false false false false true false true true true true true true false false false false false false false false true true true false false false false true true true false false true 88 0 true 1142 true false false false false false true true false false false false X 15 7 true false false false false false false true true false true true true true true true true true true true true true X X DAVID HALSELL 5733488000 54 HOSPITAL DR OSAGE BEACH MO 65065 X KEVIN BYRNE DO 1.0 0.0 X X CHARLES MCELYEA 1.0 1.0 X X ROBERT G SCHWENDINGER 1.0 1.0 X X GREG GAGNON 1.0 1.0 X X GREG ANDERSON 1.0 0.0 X SUSAN BROWN 1.0 0.0 X JOHN CAINE 1.0 0.0 X WAYNE COMPTON 1.0 0.0 X X ROBERT MASON DO 1.0 40.0 X 0 93745 3870 GRANT BARNUM DO 1.0 40.0 X 0 247595 27193 JOHN PARRISH 1.0 1.0 X LARRY SHIELDS 1.0 0.0 X DENNIS MICHAELREE 1.0 1.0 X X JIM JUDAS 1.0 0.0 X COREY TEN BENSEL 1.0 0.0 X MICHAEL VIERRA MD 1.0 0.0 X X ANDREW MCKIBBEN 1.0 0.0 X 0 0 0 MICHAEL HENZE 40.0 0.0 X 477730 0 77886 VICKI L FRANKLIN 40.0 0.0 X 261608 0 17513 M DANIEL PROBSTFIELD 40.0 0.0 X 287664 0 17340 JANICE L DUNGAN 40.0 0.0 X 232574 0 16101 F JOE BUTTS 40.0 0.0 X 235312 0 19320 KEVIN G MCROBERTS 40.0 0.0 X 215009 0 35013 ROBERT HYATT MD 40.0 0.0 X 414358 0 17160 SCOTT POEST 40.0 0.0 X 164528 0 23898 THOMAS MYLER 40.0 0.0 X 174895 0 13774 MICHAEL DOW 40.0 0.0 X 167061 0 11956 STEVEN GROTEWIEL 40.0 0.0 X 188739 0 7173 JOE SCOTT 40.0 0.0 X 156900 0 11042 ERIC KAUFFMAN 40.0 0.0 X 153062 0 7390 3129440 341340 306629 46 false true false NATIONAL THERAPEUTIC ASSOC MEDICAL SERVICES 2721882 LAKE OZARK ANESTHESIA ASSOC PHYSICIAN SERVICES 652000 HEALOGICS WOUND CARE HYPERBARIC MEDICAL SERVICES 567192 ARMSTRONG TEASDALE LLP LEGAL SERVICES 539418 CAMDEN EMERGENCY GROUP LLC MEDICAL SERVICES 459633 15 187105 1041124 64512 1228229 PATIENT SERVICE 624100 140152807 140152807 ELECTRONIC HEALTH RECORDS 624100 1518297 1518297 MANAGEMENT FEES 541610 1385649 1385649 CAFETERIA INCOME 722210 940609 940609 AUXILIARY INCOME 900099 243730 243730 2093465 2093465 146334557 2570937 2570937 0 0 1032172 1163411 -131239 0 -131239 -131239 1295 7662 -6367 -6367 -6367 97907 187105 107945 -10038 -10038 0 0 CHANGE IN INTEREST IN EQUITY INVESTEES 900099 -5573797 -5573797 LOSS ON EXTINGUISHMENT OF DEBT 900099 -1727018 -1727018 -7300815 142685264 146334557 -4877522 X 19003 19003 16500 16500 0 0 2513014 1652394 860620 155364 155364 0 45062814 37666511 7396303 1186829 1037374 149455 7753489 6423700 1329789 3638628 3013512 625116 0 486289 486289 160354 160354 0 0 168552 168552 16304881 9075675 7229206 26388 26388 6185458 4712805 1472653 39928 39928 0 1596351 1361695 234656 220157 123770 96387 0 49444 6045 43399 2283318 2039910 243408 0 7849500 7012721 836779 1091405 1091405 MEDICAL SUPPLIES & DRUGS 22330784 22330784 BAD DEBT 17430838 17430838 PROVIDER TAX 8580320 8580320 CAFETERIA/VENDING 801361 715934 85427 90670 31910 58760 146041639 123406765 22634874 0 2568 2568 31952018 22033442 0 944000 14684518 15435079 0 0 0 0 0 0 4617959 4878771 963701 1228772 151522923 99175259 57230634 52347664 63858177 76641769 5125960 5217093 0 0 0 0 4077978 1498403 182513513 180227561 13045665 11111316 0 0 0 0 49175000 48438885 0 0 0 0 3776066 3493269 0 0 7126009 8270274 73122740 71313744 X 109373515 107969817 17258 0 0 944000 109390773 108913817 182513513 180227561 -3356375 2879419 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false true 15250 true 18444 33694 false RALLIES, DEMONSTRATIONS, SEMINARS, CONVENTIONS, SPEECHES, LECTURES, ETC. SCHEDULE C, PART II-B, LINE 1(H) LAKE REGIONAL HEALTH SYSTEM PARTICIPATED IN THE FOLLOWING DURING THE YEAR: $ 8,750 MEDICARE RURAL HOSPITAL COALITION 6,500 RURAL REFERRAL CENTER/SOLE COMMUNITY HOSPITAL COALITION ----- $15,250 TOTAL OTHER LOBBYING ACTIVITIES SCHEDULE C, PART II-B, LINE 1(I) A PORTION OF THE DUES PAID TO THE MISSOURI HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION ARE USED FOR LOBBYING PURPOSES. $13,950 MISSOURI HOSPITAL ASSOCIATION 4,494 AMERICAN HOSPITAL ASSOCIATION ------- $18,444 TOTAL 530500 4322066 4852566 84886199 51914535 32971664 58865995 45233041 13632954 2918163 2027683 890480 52347664 0 EST AMT DUE TO 3RD PTY PYRS 8270274 8270274 129117072 2879419 -17611022 -14731603 143848675 -1163411 -1163411 142685264 129594028 1163411 1163411 128430617 168552 17442470 17611022 146041639 UNCERTAIN TAX POSITIONS SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. OTHER REVENUE INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12 SCHEDULE D, PART XI, LINE 2D $(17,430,838) BAD DEBT EXPENSE (168,552) INVESTMENT MANAGEMENT FEES (11,632) AUXILIARY EXPENSES ------------ $(17,611,022) TOTAL OTHER REVENUE INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1 SCHEDULE D, PART XI, LINE 4B $(1,163,411) RENTAL EXPENSES OTHER EXPENSE INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25 SCHEDULE D, PART XII, LINE 2D $ 1,163,411 RENTAL EXPENSES OTHER EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1 SCHEDULE D, PART XII, LINE 4B $ 17,430,838 BAD DEBT EXPENSE 11,632 AUXILIARY EXPENSES ------------ $ 17,442,470 TOTAL ANNUAL BALL 99476 44226 55250 27492 5400 20344 GOLF TOURNAMENT 181749 142629 39120 22361 5015 2594 17372 1350 4596 0 281225 186855 94370 22361 5015 2594 44864 6750 24940 106524 -12154 true true X true X true X true true false true true 3542777 3542777 0.02730 19559254 14960654 4598600 0.03550 23102031 14960654 8141377 0.06280 165041 21078 143963 0.00110 227623 227623 0.00180 9103601 8620822 482779 0.00370 155518 155518 0.00120 9651783 8641900 1009883 0.00780 32753814 23602554 9151260 0.07060 12000 12000 0.00010 37118 37118 0.00030 49118 49118 0.00040 false 17430838 2492610 55518477 66699502 -11181025 X true true LAKE REG IMAGING PTR DIAGNOSTIC IMAGING SERVICES 0.51000 0.49000 1 1 LAKE REGIONAL HEALTH SYSTEM

54 HOSPITAL DR OSAGE BEACH MO 65065

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304 EAST 4TH STREET ELDON MO 65026

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156 MISSOURI BLVD LAURIE MO 65038

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1930 N BUSINESS ROUTE 5 CAMDENTON MO 65020

REHAB THERAPY PERCENT OF TOTAL EXPENSE SCHEDULE H, PART I, LINE 7, COLUMN F THE PERCENT OF TOTAL EXPENSE ON SCHEDULE H, PART I, LINE 7, COLUMN (F), WAS CALCULATED USING TOTAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A) LESS BAD DEBT EXPENSE. COSTING METHODOLOGY SCHEDULE H, PART I, LINE 7G THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1, 3 AND 6. BAD DEBT AND COSTING METHODOLOGY SCHEDULE H, PART III, SECTION A, LINE 4 THE HEALTH SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS, WHICH IS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. DELINQUENT RECEIVABLES ARE WRITTEN OFF BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. LINE 2 WAS DETERMINED BY TAKING THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS PER THE AUDITED FINANCIAL STATEMENTS. LINE 3 WAS DETERMINED BY TAKING THE BAD DEBT EXPENSE (LINE 2) TIMES THE PERCENT OF PERSONS BELOW THE POVERTY LEVEL FOR 2007-2011 BASED ON US CENSUS BUREAU DATA. BAD DEBT EXPENSE IS EXPLAINED ON LAKE REGIONAL HEALTH SYSTEM, INDEPENDENT AUDITOR'S REPORT AND CONSOLIDATED FINANCIAL STATEMENTS FOR APRIL 30, 2013, PAGE 7. COMMUNITY BENEFIT SCHEDULE H, PART III, SECTION B, LINE 8 MEDICARE DATA COMPUTED USING THE MEDICARE COST REPORT FILED WITH CMS WAS UTILIZED FOR THE COMPUTATIONS IN PART III, SECTION B. MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT, AS LRHS IS CLASSIFIED AS A RURAL REFERRAL CENTER. EFFECTIVE OCTOBER 1, 2012, LRHS IS NOW DESIGNATED AS A SOLE COMMUNITY HOSPITAL. THIS DEMONSTRATES THAT LRHS IS THE ONLY REASONABLE SOURCE OF HOSPITAL CARE AVAILABLE IN OUR SERVICE AREA, AND LIKEWISE TREATS ALL BENEFICIARIES IN OUR SERVICE AREA THAT PRESENT THEMSELVES FOR CARE, DESPITE KNOWING WE WILL GENERALLY LOSE MONEY CARING FOR MEDICARE PATIENTS. ADDITIONALLY, SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE OBLIGATED TO PROVIDE. THUS, IT IS IMPLICIT THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. COLLECTION POLICY SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION ACTIVITY WILL BE SUSPENDED DURING THE CONSIDERATION OF A COMPLETED FINANCIAL ASSISTANCE APPLICATION OR AN APPLICATION FOR ANY OTHER HEALTHCARE BRACKET (I.E. MEDICARE, MEDICAID, ETC.) A NOTE WILL BE ENTERED INTO THE PATIENT'S ACCOUNT TO SUSPEND COLLECTION ACTIVITY UNTIL THE FINANCIAL ASSISTANCE PROCESS IS COMPLETE. IF THE ACCOUNT HAS BEEN PLACED WITH A COLLECTION AGENCY, THE AGENCY WILL BE NOTIFIED TO SUSPEND COLLECTION EFFORTS UNTIL A DETERMINATION IS MADE. THIS NOTIFICATION WILL BE DOCUMENTED IN THE ACCOUNT NOTES. THE PATIENT WILL BE NOTIFIED VERBALLY THAT THE COLLECTION ACTIVITY WILL BE SUSPENDED DURING CONSIDERATION. IF A FINANCIAL ASSISTANCE DETERMINATION ALLOWS FOR A PERCENT REDUCTION BUT LEAVES THE PATIENT WITH A SELF-PAY BALANCE, PAYMENT TERMS WILL BE ESTABLISHED ON THE BASIS OF DISPOSABLE INCOME. COMMUNITY REPRESENTATION SCHEDULE H, PART V, SECTION B, LINE 3 PHONE INTERVIEWS WERE CONDUCTED WITH 25 COMMUNITY STAKEHOLDERS. PARTICIPANTS WERE IDENTIFIED BASED ON THEIR INVOLVEMENT IN LOCAL BUSINESSES, GOVERNMENTS, SCHOOLS OR IN SERVING LOW-INCOME POPULATIONS. STAKEHOLDERS INCLUDED PUBLIC HEALTH EXPERTS, CLINICIANS AND INDIVIDUALS WHO PROVIDE SERVICES TO THE MEDICALLY UNDERSERVED. NEEDS ADDRESSED IN COMMUNITY HEALTH NEEDS ASSESSMENT SCHEDULE H, PART V, SECTION B, LINE 7 LAKE REGIONAL PRIORITIZED THE DATA COLLECTED. COMMON THEMES WERE IDENTIFIED, SCORED AND WEIGHTED. BASED ON THIS METHODOLOGY, TOP COMMUNITY HEALTH PRIORITIES INCLUDED HEART DISEASE, SMOKING/TOBACCO USE, CANCER, DIABETES AND MENTAL HEALTH. A CHRONIC DISEASE SELF-MANAGEMENT PROGRAM WAS DEVELOPED TO ADDRESS HEART DISEASE, DIABETES AND CANCER SCREENING. WE WILL CONTINUE TO WORK TOWARD ADDRESSING SMOKING/TOBACCO USE AND MENTAL HEALTH ISSUES. FACTORS USED IN DETERMINING BASIS FOR AMOUNTS CHARGED TO PATIENTS SCHEDULE H, PART V, SECTION B, LINE 12H TO OBTAIN PRICING FOR GROSS CHARGES, LRHS USES REGIONAL COMPARATIVE PRICING DATA FROM MEDASSETS WHICH IS OUR STANDARD FOR DEFENSIBLE PRICING. OTHER METHODS OF PUBLICIZING CHARITY CARE POLICY SCHEDULE H, PART V, SECTION B, LINE 14G ALL PATIENTS THAT ARE IN A ROOM HAVE ACCESS TO A BINDER THAT EXPLAINS THE FINANCIAL ASSISTANCE POLICY. METHOD FOR DETERMINING MAX AMOUNTS CHARGED TO FAP ELIGIBLE PATIENTS SCHEDULE H, PART V, SECTION B, LINE 20D THE DISCOUNTS FOR ALL INDIVIDUALS THAT QUALIFY FOR FREE OR DISCOUNTED CARE ARE DETERMINED USING THE FEDERAL POVERTY GUIDELINE MATRIX IN LRHS POLICY #112-190-2 UNCOMPENSATED CARE. THE DISCOUNT RANGES FROM 100% TO 35%. 35% APPROXIMATES THE AVERAGE WRITE OFF FOR COMMERCIAL PAYORS. NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2 HIDI DATA: LRHS USES DATA COMPILED BY AN INDEPENDENT ENTITY, HOSPITAL INDUSTRY DATAINSTITUTE (HIDI), ON INPATIENT AND OUTPATIENT PROVIDER USE DIVIDED BYDEMOGRAPHIC AND GEOGRAPHIC SUBSET. LRHS CONSIDERS ITS PRIMARY MARKET AREA TO BE A 25 MILE RADIUS. THE HIDI DATA PROVIDES THE SERVICES USED BY ZIP CODE AND BY PROVIDER TO HELP DETERMINE MEDICAL NEEDS THAT WE ARE NOT MEETING IN OUR COMMUNITY. OTHER COMMUNITY DATA IS COLLECTED AT HEALTH FAIRS AND SCREENINGS AS WELL AS CIVIC ORGANIZATIONS. THESE SURVEYS PROFILE PARTICIPANTS BY ZIP CODE AND IDENTIFY DESIRED SERVICES. COMMUNITY HEALTH NEEDS ASSESSMENT EXECUTIVE SUMMARY THIS COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN 2012 BY LAKE REGIONAL HEALTH SYSTEM IN OSAGE BEACH, MO. THIS ASSESSMENT REVIEWED THE HEALTH NEEDS OF AREA RESIDENTS USING A SEVEN STEP PROCESS: (1) DEFINING THE COMMUNITY, (2) ANALYZING SELECTED DATA TO IDENTIFY THE KEY DEMOGRAPHIC, SOCIOECONOMIC AND HEALTH CHARACTERISTICS OF THE THREE-COUNTY SERVICE AREA, (3) IDENTIFYING DEMAND FOR HEALTH CARE SERVICES, (4) INTERVIEWING COMMUNITY STAKEHOLDERS, (5) CONDUCTING A SURVEY AMONG AREA RESIDENTS, (6) PRIORITIZING COLLECTED DATA, AND (7) DEVELOPING STRATEGIES TO ADDRESS IDENTIFIED HEALTH NEEDS. THE COMMUNITY IS DEFINED AS ZIP CODES WITHIN A 25-MILE RADIUS OF LAKE REGIONAL HEALTH SYSTEM LOCATED ENTIRELY WITHIN CAMDEN, MILLER OR MORGAN COUNTIES, WHERE MARKET SHARE IS AT LEAST 10 PERCENT. THE SURVEY AREA INCLUDES 24 ZIP CODES. COMMUNITY HEALTH ASSESSMENT PROCESS IN MAY 2012, THE PUBLIC RELATIONS DEPARTMENT BEGAN COLLECTING AND REVIEWING EXISTING DEMOGRAPHIC AND SOCIOECONOMIC DATA ABOUT THE COMMUNITY. STAFF INTERVIEWED PUBLIC HEALTH EXPERTS AT LOCAL COUNTY HEALTH DEPARTMENTS AND LAKE REGIONAL PRIMARY AND ACUTE CARE MANAGERS. KEY HEALTH CONCERNS IDENTIFIED THROUGH THESE INTERVIEWS INCLUDED CONGESTIVE HEART FAILURE, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, DIABETES AND MENTAL HEALTH. THIS INPUT WAS USED TO DEVELOP THE COMMUNITY HEALTH NEEDS ASSESSMENT QUESTIONNAIRE. INTERVIEWS WERE CONDUCTED WITH 25 COMMUNITY STAKEHOLDERS TO PROVIDE KEY INSIGHTS INTO THE PUBLIC'S PERCEPTION OF THE COMMUNITY'S HEALTH AND WELLNESS NEEDS. PARTICIPANTS WERE IDENTIFIED BASED ON THEIR INVOLVEMENT IN LOCAL BUSINESSES, GOVERNMENTS, SCHOOLS OR IN SERVING LOW-INCOME POPULATIONS. IN JUNE AND JULY 2012, THE COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY WAS CONDUCTED TO YIELD INFORMATION ABOUT THE OVERALL HEALTH OF THE COMMUNITY. SURVEY TOPICS INCLUDED DEMOGRAPHIC AND SOCIOECONOMIC CHARACTERISTICS, BEHAVIORAL RISK FACTORS, HEALTH CONDITIONS AND ACCESS TO HEALTH CARE. A TOTAL OF 657 SURVEYS WERE COLLECTED THROUGH A COMBINED METHOD OF PAPER AND ONLINE SURVEYS. PAPER SURVEYS WERE DISSEMINATED AT SUPPORT GROUPS, COMMUNITY EVENTS, COUNTY HEALTH DEPARTMENT SITES, A FREE CLINIC SITE, AND LAKE REGIONAL PRIMARY CARE CLINICS. LAKE REGIONAL STAFF WERE AVAILABLE TO HELP RESPONDENTS COMPLETE SURVEYS, AS NECESSARY, TO OVERCOME LITERACY ISSUES. NOTICE OF THE SURVEY WAS SHARED WITH THE COMMUNITY THROUGH LOCAL NEWSPAPERS, RADIO STATIONS AND COMMUNITY GROUPS. PRIORITIZATION PROCESS LAKE REGIONAL'S COMMUNITY BENEFIT COMMITTEE MET IN SEPTEMBER 2012 TO PRIORITIZE THE DATA COLLECTED FROM RESEARCH, INTERVIEWS WITH PUBLIC HEALTH EXPERTS AND COMMUNITY SURVEYS. COMMON THEMES WERE IDENTIFIED, SCORED AND WEIGHTED. BASED ON THIS METHODOLOGY, TOP COMMUNITY HEALTH PRIORITIES INCLUDED HEART DISEASE, SMOKING/TOBACCO USE, CANCER, DIABETES AND MENTAL HEALTH. IMPLEMENTATION PLAN A CHRONIC DISEASE SELF-MANAGEMENT PROGRAM HAS BEEN DEVELOPED USING THE EVIDENCE-BASED STANFORD UNIVERSITY MODEL IN PARTNERSHIP WITH THE CAMDEN AND MILLER COUNTY HEALTH DEPARTMENTS AND THE KATY TRAIL HEALTH CENTER IN MORGAN COUNTY TO ADDRESS HEART DISEASE, DIABETES AND CANCER SCREENING. PROGRAM SPECIFICS ARE OUTLINED IN THE "COMMUNITY HEALTH NEEDS IMPLEMENTATION PLAN." FOLLOWING APPROVAL OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN BY THE LAKE REGIONAL HEALTH SYSTEM BOARD OF DIRECTORS ON DEC. 7, 2012, THE ASSESSMENT REPORT WILL BE MADE AVAILABLE TO THE PUBLIC ONLINE AT LAKEREGIONAL.COM. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI, LINE 3 SIGNAGE WILL BE POSTED IN ALL PATIENT INTAKE AREAS, INCLUDING, BUT NOT LIMITED TO, THE EMERGENCY ROOM AND THE ADMISSION/PATIENT REGISTRATION AREAS. ALL PUBLIC INFORMATION AND/OR FORMS REGARDING THE PROVISION OF FINANCIAL ASSISTANCE WILL USE LANGUAGES THAT ARE APPROPRIATE FOR LRHS SERVICE AREA IN ACCORDANCE WITH THE STATE'S LANGUAGE ASSISTANCE SERVICES ACT. THIS POLICY WILL BE MADE AVAILABLE IN SPANISH. THE FINANCIAL ASSISTANCE APPLICATION IS POSTED ON THE LRHS WEBSITE. LRHS HAS FINANCIAL COUNSELORS IN THE PATIENT FINANCIAL SERVICES DEPARTMENT. THESE COUNSELORS MEET WITH SELF PAY PATIENTS WHEN THEY ARE IN THE FACILITY TO DISCUSS THE POLICY, AS WELL AS EDUCATE PATIENTS ON ASSISTANCE THEY MAY BE ELIGIBLE FOR UNDER FEDERAL, STATE AND LOCAL GOVERNMENT PROGRAMS. COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4 LRHS IS LOCATED IN OSAGE BEACH, MISSOURI, AND SERVES THE AREA SURROUNDING THE LAKE OF THE OZARKS, A 54,000 ACRE MAN-MADE LAKE LOCATED IN CENTRAL MISSOURI. LRHS' SERVICE AREA ENCOMPASSES A THREE COUNTY AREA: CAMDEN, MILLER, AND MORGAN COUNTIES. THE SECONDARY SERVICE INCLUDES LACLEDE AND PULASKI COUNTIES. THE OVERALL SERVICE AREA 2010 POPULATION IS ESTIMATED AT 177,760. IN ADDITION TO THE RESIDENT POPULATION OF NEARLY 178,000, IN THE OVERALL SERVICE AREA, THE EVER-INCREASING VISITOR POPULATION IS A SIGNIFICANT FACTOR FOR THIS POPULAR TOURIST DESTINATION. THE LAKE OF THE OZARKS CONVENTION AND VISITORS BUREAU ESTIMATES THAT 5.0 MILLION VISITORS WILL TRAVEL TO THE REGION IN 2010. THE PROJECTED POPULATION GROWTH OF LRHS' SERVICE AREA AND ESPECIALLY THE CONTINUING MIGRATION INTO THE LAKE AREA OF RETIREES AND THE EVER-INCREASING VISITOR POPULATION, IS A SIGNIFICANT FACTOR IN THE RISING NEED FOR ACCESSIBLE AND EXPANDED MEDICAL SERVICES FOR THE LAKE AREA. THE MEDIAN HOUSEHOLD INCOME FOR EACH COUNTY IS AS FOLLOWS: CAMDEN = $44,617, LACLEDE = $37,294, MILLER = $35,838, MORGAN = $36,696 AND PULASKI = $43,155. THE CAMDEN COUNTY 2011 ANNUAL UNEMPLOYMENT RATE WAS 10.7%, ABOVE THE STATE (8.6%) AND NATIONAL (8.9%) AVERAGES. CAMDEN COUNTY HAS APPROXIMATELY 11.8% OF PERSONS BELOW POVERTY LEVEL. THE IMMEDIATE 3-COUNTY AREA OF CAMDEN, MILLER, & MORGAN ESTIMATES UNINSURED INDIVIDUALS AT 23.27%. THERE ARE NO OTHER HOSPITALS WITHIN A 25-MILE RADIUS. USING HOSPITAL INDUSTRY DATA INSTITUTE DATA, THE LRHS MARKET IS PRIMARILY SHARED WITH 4 HOSPITALS IN THE AREA. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 5 LRHS SHOWS ITS SUPPORT OF THE COMMUNITY BY PROVIDING A TRIM KIDS PROGRAM. TRIM KIDS IS A 12-WEEK PLAN TO BUILD HEALTHY KIDS, HEALTHY FAMILIES AND HEALTHY COMMUNITIES. THE TRIM KIDS PROGRAM IS A PROVEN, PRACTICAL GUIDE FOR PARENTS TO TAKE SPECIFIC SEQUENTIAL STEPS TO ENCOURAGE HEALTHY HABITS IN THEIR CHILDREN SUCH AS MAKING HEALTHY FOOD CHOICES AND ONGOING PHYSICAL ACTIVITY. THE PROGRAM IS FACILITATED BY A DIETITIAN, EXERCISE PHYSIOLOGIST, REGISTERED NURSE AND BEHAVIOR MODIFICATION PROFESSIONAL ASSOCIATED WITH LRHS. LRHS' WORKFORCE DEVELOPMENT PROGRAM INCLUDES A TWO-DAY CAREER CAMP FOR STUDENTS 10-14. THE STUDENTS LEARN ABOUT CAREERS IN NURSING, REHAB THERAPIES, LABORATORY, SURGERY AND RESPIRATORY THERAPY. CAMP INSTRUCTORS ALSO COVER TOPICS SUCH AS PATIENT CONFIDENTIALITY, INFECTION CONTROL, DISASTER MANAGEMENT, DATA MANAGEMENT, PROFESSIONAL SCHOOLS IN MISSOURI AND SCHOLARSHIP OPPORTUNITIES. ANOTHER WORKFORCE DEVELOPMENT PROGRAM AVAILABLE TO HIGH SCHOOL STUDENTS AND ADULTS INTERESTED IN PURSUING NURSING CAREERS IS A FIVE-DAY NURSING CAMP. PARTICIPANTS GAIN AN UNDERSTANDING OF NURSING FUNDAMENTALS AS THEY VISIT NURSING UNITS, JOB SHADOW EXPERIENCED NURSES, LEARN ABOUT STATE-OF-THE-ART EQUIPMENT, RECEIVE CPR TRAINING, PARTICIPATE IN DISASTER MANAGEMENT TRAINING AND INTERACT WITH STAFF. AFFILIATED HEALTH CARE SYSTEM SCHEDULE H, PART VI, LINE 6 THE AFFILIATED HEALTH CARE SYSTEM OF THE ORGANIZATION INCLUDES LAKE REGIONAL MEDICAL MANAGEMENT AND LAKE REGIONAL IMAGING PARTNERS. A WHOLLY OWNED SUBSIDIARY, LAKE REGIONAL MEDICAL MANAGEMENT, INC., D/B/A LAKE REGIONAL MEDICAL GROUP (MEDICAL MANAGEMENT), OPERATES MEDICAL CLINICS AND RETAIL PHARMACIES IN CAMDEN, MILLER AND MORGAN COUNTIES. THE ORGANIZATION HAS A 51% OWNERSHIP OF LAKE REGIONAL IMAGING PARTNERS, LLC (IMAGING PARTNERS). IMAGING PARTNERS IS A LIMITED LIABILITY COMPANY THAT OPERATES AN IMAGING CENTER IN OSAGE BEACH, MISSOURI, WHICH OFFERS CLOSED HYBRID MRI SERVICES, PET AND CT SCANS, ULTRASOUND SERVICES AND RADIOGRAPHY IMAGING SERVICES. THE 49% MINORITY INTEREST IN IMAGING PARTNERS IS OWNED BY A GROUP OF LOCAL RADIOLOGISTS. true MHA CENTER FOR EDUCATION PO BOX 6766 JEFFERSON CITY MO 651020060 430898947 501(C)(3) 19003 SCHOLARSHIP FUND 1 NURSING SCHOLARSHIPS 6 16500 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S. SCHEDULE I, PART 1, LINE 2 THE ORGANIZATION HAS AN AGREEMENT WITH MHA, AND DUE TO INCREASED PAYMENTS UNDER THE FEDERAL REIMBURSEMENT ALLOWANCE PROGRAM, THE ORGANIZATION MADE CHARITABLE CONTRIBUTIONS TO THE MHA CENTER FOR EDUCATION. THE CONTRIBUTIONS ARE USED FOR FUNDING SCHOLARSHIPS TO MEDICAL, NURSING AND ALLIED HEALTH PROFESSIONALS, AND WORKFORCE INITIATIVES TO ADDRESS THE SHORTAGES OF NURSING AND ALLIED HEALTH PROFESSIONALS. THE RECIPIENT OF THE SCHOLARSHIP MUST SUBMIT THEIR GRADES TO LAKE REGIONAL HEALTH SYSTEM. IN ORDER FOR THE GRADES TO BE GIVEN TO THE STUDENT, THEIR TUITION MUST BE PAID IN FULL. X X true true X X X X X false true false false false true true false false GRANT BARNUM DO 0 246958 0 0 0 637 0 23113 0 4080 0 274788 0 0 MICHAEL HENZE 370452 0 65402 0 41876 0 73377 0 4509 0 555616 0 0 0 VICKI L FRANKLIN 190005 0 26117 0 45486 0 16004 0 1509 0 279121 0 0 0 M DANIEL PROBSTFIELD 213757 0 28695 0 45212 0 16004 0 1336 0 305004 0 0 0 JANICE L DUNGAN 183360 0 22128 0 27086 0 14926 0 1175 0 248675 0 0 0 F JOE BUTTS 177688 0 22059 0 35565 0 16005 0 3315 0 254632 0 0 0 KEVIN G MCROBERTS 167567 0 21278 0 26164 0 29957 0 5056 0 250022 0 0 0 ROBERT HYATT MD 303749 0 40420 0 70189 0 16005 0 1155 0 431518 0 0 0 SCOTT POEST 142734 0 16772 0 5022 0 21093 0 2805 0 188426 0 0 0 THOMAS MYLER 166710 0 6492 0 1693 0 7073 0 6701 0 188669 0 0 0 MICHAEL DOW 166763 0 0 0 298 0 6976 0 4980 0 179017 0 0 0 STEVEN GROTEWIEL 182357 0 5749 0 633 0 6357 0 816 0 195912 0 0 0 JOE SCOTT 136260 0 0 0 20640 0 6341 0 4701 0 167942 0 0 0 ERIC KAUFFMAN 149855 0 0 0 3207 0 5758 0 1632 0 160452 0 0 0 REIMBURSEMENT POLICY SCHEDULE J, PART I, LINE 1A THE ORGANIZATION HAS A WRITTEN POLICY FOR REIMBURSEMENT RELATED TO TRAVEL FOR COMPANIONS. DIRECTORS AND KEY EMPLOYEES ARE ELIGIBLE TO RECEIVE THIS BENEFIT. THE ORGANIZATION PROVIDES ONE TYPE OF GROSS UP PAYMENT FOR THE CEO'S AUTO ALLOWANCE. THE CEO IS THE ONLY PERSON THAT RECEIVES THIS BENEFIT. THIS PAYMENT IS REPORTED AS TAXABLE COMPENSATION ON THE CEO'S W-2 FORM EACH YEAR. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B THE FOLLOWING PEOPLE PARTICIPATED IN A 457(F) NONQUALIFIED RETIREMENT PLAN AND RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION: $16,478 VICKI L FRANKLIN $17,525 M. DANIEL PROBSTFIELD $13,669 F. JOE BUTTS $13,809 JANICE DUNGAN $24,684 ROBERT HYATT THE FOLLOWING PEOPLE HAD A DEFERRED CONTRIBUTION TO A 457(F) NONQUALIFIED RETIREMENT PLAN: $57,373 MICHAEL E. HENZE $13,953 KEVIN MCROBERTS $11,200 SCOTT POEST COMPENSATION PAID OR ACCRUED CONTINGENT ON NET EARNINGS SCHEDULE J, PART I, LINES 6A & 6B THE CEO AND SENIOR MANAGEMENT ARE ELIGIBLE FOR INCENTIVE COMPENSATION AS PART OF THEIR OVERALL COMPENSATION PLAN. TARGETED BENCHMARKS INCLUDE CONSOLIDATED OPERATING MARGIN, PATIENT SATISFACTION, EMPLOYEE SATISFACTION, CLINICAL OUTCOMES, PATIENT SAFETY AND INDIVIDUAL GOALS. A HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF MO 431178966 60635R8G5 2010-10-20 28426416 REFUND 1996 & 1998 REVENUES BONDS false false false B HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF MO 431178966 60636AFK4 2012-12-18 24701264 REFUND 2003 REVENUES BONDS false false false A 1725000 0 28426416 2875426 0 28188586 237830 0 0 0 0 0 1998 true false true true B 75000 0 24701264 1692250 0 24320921 380343 0 0 0 0 0 2012 true false true true A 0 B 0 A false true false false 0 true JPMORGAN CHASE BANK 12.82 false false true B false true false false 0 false 0 false true A true B true GIC FAIR MARKET VALUE SCHEDULE K, PART IV, LINE 4D COLUMN A THE GUARANTEED INVESTMENT CONTRACT FOR THE 2010 BONDS WAS ORIGINALLY ENTERED INTO WITH RESPECT TO THE 1998 BONDS. THE TAXPAYER BELIEVES THE BIDDING PROCEDURES ESTABLISHED BY 1.148-5(D)(6)(III) OF THE REGULATIONS WERE FOLLOWED BUT HAS BEEN UNABLE TO LOCATE COPIES OF THE BID SOLICITATION FORMS AND RELATED MATERIALS REQUIRED TO BE RETAINED UNDER THE REGULATION SAFE HARBOR. LAKE REGIONAL MEDICAL MANAGEMENT COMMON DRTRS - SEE PART V 9744191 CONTRIBUTIONS, REIMBURSEMENTS false MITCHELL SHIELDS FAMILY MEMBER L SHIELDS 40093 EMPLOYMENT false CENTRAL BANK OF LAKE OF THE OZARKS SEE PART V 242058 BANKING FEES false JULIE FRANKLIN FAMILY MEMBER V FRANKLIN 35945 EMPLOYMENT false BARBA PROBSTFIELD FAM MEMBER D PROBSTFIELD 79326 EMPLOYMENT false INTERESTED PERSONS RELATIONSHIP SCHEDULE L, PART IV, COLUMN B GREG GAGNON, BOARD MEMBER, WAS THE BANK PRESIDENT AT CENTRAL BANK OF LAKE OF THE OZARKS. JIM JUDAS, BOARD MEMBER, IS NOW THE BANK PRESIDENT AT CENTRAL BANK OF LAKE OF THE OZARKS. ROBERT MASON, BOARD DIRECTOR, IS ALSO A BOARD DIRECTOR AT THE BANK. SHARED DIRECTORS SCHEDULE L, PART IV INTERESTED PERSON, COLUMN A: LAKE REGIONAL MEDICAL MANAGEMENT RELATIONSHIP, COLUMN B: CHARLES MCELYEA, ROBERT G. SCHWENDINGER, GREG GAGNON, JOHN PARRISH, AND DENNIS MICHAELREE ARE OFFICERS OR DIRECTORS OF BOTH LAKE REGIONAL MEDICAL MANAGEMENT AND LAKE REGIONAL HEALTH SYSTEM. ROBERT G. SCHWENDINGER, JOHN PARRISH, DENNIS MICHAELREE, AND CHARLES MCELYEA WERE DETERMINED TO BE NON-INDEPENDENT MEMBERS OF LAKE REGIONAL HEALTH SYSTEM BASED SOLELY ON THEIR ROLE AS COMMON OFFICERS OR DIRECTORS OF LAKE REGIONAL MEDICAL MANAGEMENT AND LAKE REGIONAL HEALTH SYSTEM. LAKE REGIONAL MEDICAL MANAGEMENT IS AN ACTIVE, WHOLLY-OWNED FOR-PROFIT SUBSIDIARY. IT OPERATES SEVEN PRIMARY CARE MEDICAL CLINICS, THREE RETAIL PHARMACIES, AND FIFTEEN SPECIALTY CLINICS. LAKE REGIONAL HEALTH SYSTEM VIEWS THE COMMON OFFICERS AND DIRECTORS AS AN IMPORTANT ROLE IN HELPING BOTH ORGANIZATIONS IN ACHIEVING THEIR MISSIONS WHILE SERVING THE COMMUNITY. X 46 14009 FMV X SILENT AUCTION 190 28653 COST X LIVE AUCTION 14 16850 COST X FLOWERS 1 5000 FMV false true false ORGANIZATION'S MISSION FORM 990, PART I, LINE 1 OUR MISSION: PROVIDE EXCEPTIONAL HEALTHCARE. OUR VISION: TO BE THE FIRST CHOICE FOR HEALTH CARE. OUR CORE COMPETENCIES: AGILITY, COMMUNITY FOCUS, SERVICE EXCELLENCE. OUR VALUES: INTEGRITY, PATIENT CENTERED, CLINICAL EXCELLENCE, COMMITMENT TO COMMUNITY. THE SYSTEM WAS ORGANIZED IN 1973 FOR THE PURPOSE OF ESTABLISHING A NEW HOSPITAL FOR MEDICAL AND SURGICAL CARE AND FOR THE TREATMENT OF PERSONS RESIDING OR VISITING IN THE LAKE OF THE OZARKS AREA OF CENTRAL MISSOURI. IN THE 30 YEARS SINCE THEN, THE SYSTEM HAS EVOLVED TO PROVIDE MORE COMPREHENSIVE HEALTH CARE, INCLUDING ADDING CARDIAC-CARE, OUTPATIENT SERVICES, CANCER AND ORTHOPEDIC PROGRAMS AND CONTINUALLY EXPANDING SERVICES AND FACILITIES OVER THE YEARS. IT IS NOW DESIGNATED AS A REGIONAL REFERRAL CENTER BY MEDICARE AND HAS NEARLY 1,300 EMPLOYEES. ITS BOARD HAS ADOPTED GOVERNANCE BEST PRACTICES AND A WIDE-RANGING CORPORATE COMPLIANCE PROGRAM. BASED ON PERIODIC COMMUNITY ASSESSMENTS, THE BOARD HAS ALSO COMMITTED TO ENHANCED UNCOMPENSATED CARE POLICIES AND NUMEROUS COMMUNITY PROGRAMS (E.G. HEALTH SCREENINGS, WELLNESS ENHANCED AND RELATED CARE PROGRAMS). THE SYSTEM IS ORGANIZED AS A COMMUNITY-BASED NONPROFIT PUBLIC BENEFIT CORPORATION UNDER THE LAWS OF THE STATE OF MISSOURI. THE SYSTEM OWNS AND OPERATES A 116-LICENSED BED ACUTE CARE HOSPITAL (THE "HOSPITAL") LOCATED ON HIGHWAY 54 IN OSAGE BEACH, MISSOURI. THE HOSPITAL IS LICENSED BY THE MISSOURI DEPARTMENT OF HEALTH AND ACCREDITED BY THE JOINT COMMISSION. EFFECTIVE OCTOBER 1, 2012, THE HOSPITAL IS DESIGNATED AS A SOLE COMMUNITY HOSPITAL, MEANING THAT THE HOSPITAL IS THE PRIMARY HEALTH CARE PROVIDER FOR A MAJORITY OF MEDICARE PATIENTS WITHIN A 35-MILE RADIUS OF THE HOSPITAL. THE CORPORATION HAS ONE ACTIVE, WHOLLY-OWNED FOR-PROFIT SUBSIDIARY, LAKE REGIONAL MEDICAL MANAGEMENT, INC. ("LRMM"), WHICH OPERATES SEVEN PRIMARY CARE MEDICAL CLINICS, THREE RETAIL PHARMACIES AND FIFTEEN SPECIALTY CLINICS. OPERATIONS OF LRMM ARE GOVERNED BY A SEPARATE BOARD OF DIRECTORS. THE SYSTEM IS CURRENTLY GOVERNED BY A FIFTEEN-MEMBER BOARD OF DIRECTORS (THE "BOARD"). THE BOARD HAS GENERAL RESPONSIBILITY FOR THE BUSINESS AND AFFAIRS OF THE SYSTEM, AND MAY DO AND PERFORM ALL ACTS NECESSARY TO CARRY OUT ITS PURPOSES. UNDER THE TERMS OF THE BYLAWS, THE MEMBERS OF THE BOARD SERVE THREE-YEAR STAGGERED TERMS, AND NEW MEMBERS ARE ELECTED BY THE CURRENT BOARD MEMBERS. THE OFFICERS OF THE BOARD ARE ELECTED BY THE BOARD FOR TWO-YEAR TERMS. BOARD MEMBERS SERVE IN A VOLUNTARY CAPACITY AND RECEIVE NO REMUNERATION FOR SERVICE RENDERED IN SUCH CAPACITY. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINES 4A-C THE HOSPITAL PROVIDES CHARITY CARE IN SUPPORT OF ITS MISSION. THE HOSPITAL VOLUNTARILY PROVIDES FREE CARE TO PATIENTS WHO LACK FINANCIAL RESOURCES AND ARE DEEMED TO BE MEDICALLY INDIGENT. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED IN NET PATIENT SERVICE REVENUE. IN ADDITION, THE HOSPITAL PROVIDES SERVICES TO OTHER MEDICALLY INDIGENT PATIENTS UNDER CERTAIN GOVERNMENT REIMBURSED PUBLIC AID PROGRAMS. SUCH PROGRAMS PAY PROVIDERS AMOUNTS WHICH ARE LESS THAN ESTABLISHED CHARGES FOR THE SERVICES PROVIDED TO THE RECIPIENTS AND MANY TIMES THE PAYMENTS ARE LESS THAN THE COST OF RENDERING THE SERVICES PROVIDED. UNCOMPENSATED CHARGES RELATING TO THESE SERVICES INCLUDE CHARITY CARE, BAD DEBT, UNPAID MEDICARE, FREE MEDICAL SERVICES, HEALTH PROFESSIONALS EDUCATION, FINANCIAL CONTRIBUTIONS, AND TAXES. IN ADDITION TO UNCOMPENSATED CHARGES, THE HOSPITAL ALSO COMMITS SIGNIFICANT TIME AND RESOURCES TO ENDEAVORS AND CRITICAL SERVICES WHICH MEET OTHERWISE UNFILLED COMMUNITY NEEDS. MANY OF THESE ACTIVITIES ARE SPONSORED WITH THE KNOWLEDGE THAT THEY WILL NOT BE SELF-SUPPORTING OR FINANCIALLY VIABLE. SUCH PROGRAMS INCLUDE HEALTH SCREENING AND ASSESSMENTS, PRENATAL EDUCATION AND CARE, COMMUNITY EDUCATIONAL SERVICES AND VARIOUS SUPPORT GROUPS. OTHER PROGRAM SERVICES FORM 990, PART III, LINE 4D OTHER SERVICES INCLUDE ELECTRONIC HEALTH RECORDS INCENTIVES, MANAGEMENT FEES, CAFETERIA INCOME, INCOME FROM THE AUXILIARY, AND OTHER PROGRAM SERVICE ACTIVITIES. FAMILY AND BUSINESS RELATIONSHIPS FORM 990, PART VI, SECTION A, LINE 2 F JOE BUTTS, M DANIEL PROBTSFIELD, VICKI L FRANKLIN, AND MICHAEL HENZE HAVE A BUSINESS RELATIONSHIP. MICHAEL HENZE & F JOE BUTTS HAVE A BUSINESS RELATIONSHIP. FORM 990 REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE 990 WAS THOROUGHLY REVIEWED BY THE DIRECTOR OF ACCOUNTING, CFO, AND CEO. AFTER ANY NECESSARY CHANGES WERE MADE, THE MEMBERS OF THE BOARD OF DIRECTORS WERE PROVIDED A COPY. AT THE DECEMBER 2013 BOARD MEETING, THE 990 WAS PRESENTED TO THE BOARD BY THE INDEPENDENT ACCOUNTANTS WHO PREPARED THE 990, AND THE BOARD HAD THE OPPORTUNITY TO ASK ANY QUESTIONS BEFORE THE 990 WAS FILED. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, ALL MEMBERS OF THE BOARD OF DIRECTORS, SENIOR MANAGEMENT, AND DEPARTMENT HEADS ARE REQUIRED TO REVIEW THE CONFLICT OF INTEREST POLICY AND PROPERLY DISCLOSE ANY ACTUAL, POTENTIAL, OR PERCEIVED CONFLICT OF INTEREST. A COPY OF THE CONFLICT OF INTEREST POLICY IS PROVIDED TO EACH DIRECTOR AT THE TIME OF APPOINTMENT, TO EACH NEW PRINCIPAL OFFICER AND EMPLOYEE AT THE TIME OF EMPLOYMENT, AND ANNUALLY TO EVERY INTERESTED PERSON. EACH INTERESTED PERSON IS REQUIRED TO SUBMIT A STATEMENT TO THE CEO ANNUALLY VERIFYING THE UNDERSTANDING WITH THE POLICY AND STATING THAT ALL CONFLICTS HAVE BEEN DISCLOSED, OR THAT NO CONFLICTS EXIST. THE CEO SUBMITS HIS ANNUAL STATEMENT TO THE CHAIRMAN OF THE BOARD. IN THE EVENT AN INTERESTED PERSON DEVELOPS A POTENTIAL CONFLICT OF INTEREST, THE PERSON MUST IMMEDIATELY UPON LEARNING ABOUT THE POTENTIAL CONFLICT DISCLOSE THE NATURE OF THE CONFLICT TO THE BOARD OF DIRECTORS. THE PERSON THEN LEAVES THE BOARD OR COMMITTEE MEETING WHILE THE ISSUE IS DISCUSSED AMONG REMAINING BOARD MEMBERS TO DETERMINE WHETHER A CONFLICT EXISTS BY MAJORITY VOTE. IF A CONFLICT DOES EXIST, A SEPARATE PERSON IS ASSIGNED TO INVESTIGATE ALTERNATIVES TO THE CONFLICT AND DETERMINE IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS POSSIBLE. IF THIS IS NOT POSSIBLE, THE BOARD THEN DECIDES BY MAJORITY VOTE IF THE TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTEREST, IS FAIR AND REASONABLE, AND WHETHER IT SHOULD OR SHOULD NOT BE ENTERED. IF THE ORGANIZATION HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, THE PERSON WILL BE INFORMED OF THE BASIS FOR SUCH BELIEF AND WILL BE GIVEN AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE PERSON'S RESPONSE AND CONDUCTING FURTHER INVESTIGATION, THE ORGANIZATION DETERMINES THAT THE PERSON HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, APPROPRIATE CORRECTIVE ACTION WILL BE TAKEN. ADDITIONALLY, THE ORGANIZATION HAS IMPLEMENTED A TAX COMPLIANCE QUESTIONNAIRE THAT ASKS DETAILED QUESTIONS, AND PROVIDES RESPONDENTS WITH THE APPROPRIATE DEFINITIONS AND INSTRUCTIONS, TO ENABLE THE ORGANIZATION TO GATHER INFORMATION REQUIRED TO ANSWER QUESTIONS ON THE 990 RELATING TO THE FOLLOWING AREAS: 1) THE NUMBER OF INDEPENDENT VOTING BOARD MEMBERS, 2) RELATIONSHIPS BETWEEN INTERESTED PERSONS, 3) LOANS TO OR FROM INTERESTED PERSONS, 4) GRANTS OR ASSISTANCE BENEFITING INTERESTED PERSONS, AND 5) BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS. COMPENSATION DETERMINATION FORM 990, PART VI, SECTION B, LINES 15A & 15B DURING 2011, THE ORGANIZATION USED IHSTRATEGIES, AN INDEPENDENT ORGANIZATION, TO HELP THEM EVALUATE AND SET THE COMPENSATION FOR THE ORGANIZATION'S CEO, OTHER OFFICERS AND KEY EMPLOYEES. THE COMPENSATION DELIBERATIONS WERE DOCUMENTED IN THE MINUTES OF BOTH THE COMPENSATION COMMITTEE AND THE BOARD. GOVERNING DOCUMENT AVAILABILITY FORM 990, PART VI, SECTION C, LINE 19 CERTAIN ASPECTS OF THE FINANCIAL STATEMENTS ARE AVAILABLE IN THE ORGANIZATION'S ANNUAL REPORT WHICH CAN BE FOUND ON THE ORGANIZATION'S WEBSITE. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE GENERAL PUBLIC. BOARD MEMBER COMPENSATION FORM 990, PART VII BOARD MEMBER ROBERT MASON, DO, IS PAID AS A PRN EMPLOYEE OF LAKE REGIONAL MEDICAL MANAGEMENT AND RECEIVES NO OTHER BENEFITS. GRANT BARNUM, DO, IS PAID AS A PHYSICIAN OF LAKE REGIONAL MEDICAL MANAGEMENT. BOARD MEMBERS DO NOT RECEIVE ANY COMPENSATION FOR THEIR SERVICES PROVIDED AS A MEMBER OF THE BOARD DIRECTORS. OTHER FEES FOR SERVICES FORM 990, PART IX, LINE 11G THE ORGANIZATION'S TOTAL OTHER FEES FOR SERVICES ON THE STATEMENT OF FUNCTIONAL EXPENSES IS COMPRISED OF THE FOLLOWING: $9,297,518 CLINICAL SERVICES 6,029,626 OUTSIDE SERVICES 977,737 COLLECTION AGENCIES --------- $16,304,881 TOTAL LAKE REGIONAL IMAGING PARTNERS 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 202107048 DIAGNOSTIC IM MO LRHS RELATED 1175122 2833192 false 0 true 0.51000 LAKE REGIONAL MEDICAL MANAGEMENT 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 431473438 PHYSICIAN SER MO LRHS C CORP 35341697 7545576 1.00000 true true true false false false false false false false true true true false false true true false false false LAKE REGIONAL MEDICAL MANAGEMENT A/J 979062 FMV LAKE REGIONAL MEDICAL MANAGEMENT B 6560000 FMV LAKE REGIONAL IMAGING PARTNERS LLC K 78694 FMV LAKE REGIONAL MEDICAL MANAGEMENT L 781344 FMV LAKE REGIONAL IMAGING PARTNERS LLC L 1158834 FMV LAKE REGIONAL MEDICAL MANAGEMENT P 4030435 FMV