2012-12-13T09:14:32-06:00 2012-04-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2011-05-01 237339737 LAKE REGIONAL HEALTH SYSTEM % DAN PROBSTFIELD LAKE 5733488000 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 DAN PROBSTFIELD 2012-11-15 true Brian D Todd 4178658701 2011 2016-02-24 21:20:13Z MICHAEL E HENZE 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 164525936 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 6 1184 415 381 819907 388577 160273614 165010891 1733573 2372881 -6332946 -4579770 156494148 163192579 110074 69466 0 0 60347837 63940768 0 0 0 88615726 94730010 149073637 158740244 7420511 4452335 176979780 182513513 71977895 73122740 105001885 109390773 X LAKE REGIONAL HEALTH SYSTEM WILL PROVIDE COMPREHENSIVE HEALTH CARE SERVICES TO THE RESIDENTS AND VISITORS OF THE LAKE REGION WITH EMPHASIS ON QUALITY OUTCOMES AND SERVICE SATISFACTION WHILE OPERATING IN A SOUND FISCAL MANNER. false false 56507404 57924229 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 225,218 OUTPATIENT SERVICES VISITS. 53603081 59556533 LAKE REGIONAL HEALTH SYSTEM PROVIDES INPATIENT SERVICES TO THE COMMUNITY AND SURROUNDING RURAL AREAS. THE HOSPITAL PROVIDED 24,433 INPATIENT DAYS, 3,779 SKILLED NURSING FACILITY INPATIENT DAYS AND 1,189 NURSERY PATIENT DAYS FOR A TOTAL OF 29,401 INPATIENT DAYS. 14411966 39075985 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 37,862 VISITS. 10754350 69466 8454144 135276801 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 172 0 true 1184 true false false false false false true true false false false false X 15 6 true false true false false false false true true false true true true true true true true true true true true true X DAN PROBSTFIELD 5733488000 54 HOSPITAL DR OSAGE BEACH MO 65065 X KEVIN BYRNE DO 1.0 X X 0 0 0 CHARLES MCELYEA 1.0 X X 0 0 0 ROBERT G SCHWENDINGER 1.0 X X 0 0 0 GREG GAGNON 1.0 X X 0 0 0 GREG ANDERSON 1.0 X 0 0 0 SUSAN BROWN 1.0 X 0 0 0 JOHN CAINE 1.0 X 0 0 0 WAYNE COMPTON 1.0 X 0 0 0 ROBERT MASON DO 1.0 X 0 96741 3870 GRANT BARNUM DO 1.0 X 0 262763 27053 JOHN PARRISH 1.0 X 0 0 0 LARRY SHIELDS 1.0 X 0 0 0 DENNIS MICHAELREE 1.0 X X 0 0 0 ANDREW MCKIBBEN MD 1.0 X 0 285124 26914 COREY TEN BENSEL 1.0 X 0 0 0 MICHAEL HENZE 40.0 X 829323 0 74952 VICKI L FRANKLIN 40.0 X 360751 0 17186 M DANIEL PROBSTFIELD 40.0 X 299478 0 19093 JANICE L DUNGAN 40.0 X 230783 0 16054 F JOE BUTTS 40.0 X 319029 0 18255 KEVIN G MCROBERTS 40.0 X 276452 0 33214 ROBERT HYATT MD 40.0 X 424431 0 10744 SCOTT POEST 40.0 X 157676 0 21157 THOMAS MYLER 40.0 X 171587 0 17771 MICHAEL DOW 40.0 X 169599 0 15874 STEVEN GROTEWIEL 40.0 X 159135 0 10360 JOE SCOTT 40.0 X 157326 0 11569 DARLA WILKERSON-ERVIN 40.0 X 141875 0 8812 CYNTHIA OTRADOVEC 40.0 X 108421 0 4740 3805866 644628 337618 47 true true false LAKE EMERGENCY SPECIALISTS PHYSICIAN SERVICES 4410014 NATIONAL THERAPEUTIC ASSOCIATES MEDICAL SERVICES 2590581 LAKE OZARK ANESTHESIA ASSOC PHYSICIAN SERVICES 624000 ARMSTRONG TEASDALE LLP LEGAL SERVICES 547682 REVENUE CYCLE PARTNERS HOLDINGS LL COLLECTION SERVICES 525947 15 263255 125322 84898 388577 PATIENT SERVICE 624100 156556747 156556747 ELECTRONIC HEALTH RECORDS 624100 3297073 3297073 MANAGEMENT FEES 541610 1301426 1301426 CAFETERIA INCOME 722210 993971 993971 AUXILIARY 900099 290914 290914 2570760 2570760 165010891 2386506 2386506 0 0 1027860 1114929 -87069 -87069 381 -87450 96674 110299 -13625 -13625 -13625 63742 263255 108129 -44387 -44387 0 0 CHANGE IN INTEREST IN EQUITY INVESTEES 900099 -4448314 -4448314 -4448314 163192579 165010891 381 -2207270 38466 38466 31000 31000 0 0 3108578 1885733 1222845 266696 266696 47864671 40310500 7554171 1948442 1670821 277621 7031274 5838186 1193088 3721107 3087877 633230 0 641465 641465 103997 103997 0 0 152933 152933 19281699 12385679 6896020 30995 30995 6898544 5021312 1877232 53111 53111 0 1977564 1684396 293168 303682 161113 142569 0 51521 10197 41324 2503873 2236953 266920 0 7810274 6977676 832598 1083507 1083507 BAD DEBT 20806792 20806792 MEDICAL SUPPLIES & DRUGS 23799863 23799863 PROVIDER TAX 8246957 8246957 CAFETERIA/VENDING 862041 770145 91896 121192 46439 74753 158740244 135276801 23463443 0 2818 2568 46374525 31952018 21540 0 15120389 14684518 0 0 0 0 0 0 4791215 4617959 866298 963701 148101019 90870385 58024295 57230634 46401270 63858177 5044166 5125960 0 0 0 0 333264 4077978 176979780 182513513 12052112 13045665 0 0 0 0 51410000 49175000 0 0 0 0 3225233 3776066 0 0 5290550 7126009 71977895 73122740 X 104984627 109373515 17258 17258 0 0 105001885 109390773 176979780 182513513 X 4452335 -63447 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 11504 11504 false 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: $ 6,985 MISSOURI HOSPITAL ASSOCIATION 4,519 AMERICAN HOSPITAL ASSOCIATION -------- $ 11,504 530500 4322066 4852566 84550830 47936293 36614537 56006324 40997217 15009107 2691299 1936875 754424 57230634 0 EST AMT DUE TO 3RD PTY PYRS 7126009 7126009 163192579 158740244 4452335 -63447 -63447 4388888 164095578 -63447 17500 -165983 -211930 164307508 -1114929 -1114929 163192579 159706690 17500 1114929 1132429 158574261 152933 13050 165983 158740244 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. RECONCILIING ITEMS SCHEDULE D, PART XII, LINE 2D THE FOLLOWING ITEMS WERE INCLUDED WITH REVENUES ON THE AUDIT REPORT; HOWEVER, HAVE BEEN MOVED TO BE PROPERLY INCLUDED ON THE STATEMENT OF FUNCTIONAL EXPENSES ON THE FORM 990: $ 152,933 INVESTMENT FEES 13,050 AUXILIARY EXPENSES ------------ $ 165,983 SCHEDULE D, PART XII, LINE 4B AND PART XIII, LINE 2D THE FOLLOWING ITEMS WERE INCLUDED WITH EXPENSES ON THE AUDIT REPORT; HOWEVER, HAVE BEEN MOVED TO BE PROPERLY INCLUDED ON THE STATEMENT OF REVENUE ON THE FORM 990: $ 1,114,929 RENTAL EXPENSES SCHEDULE D, PART XIII, LINE 4B THE FOLLOWING ITEMS WERE INCLUDED WITH REVENUES ON THE AUDIT REPORT; HOWEVER, HAVE BEEN MOVED TO BE PROPERLY INCLUDED ON THE STATEMENT OF FUNCTIONAL EXPENSES ON THE FORM 990: $ 13,050 AUXILIARY EXPENSES ANNUAL BALL 125356 104813 20543 28148 5250 15429 GOLF TOURNAMENT 197475 158192 39283 20736 7685 3844 14778 3250 7773 0 322831 263005 59826 20736 7685 3844 42926 8500 23202 106893 -47067 true true X true X true X true true true false true true 3124184 3124184 0.02270 24626885 23810778 816107 0.00590 27751069 23810778 3940291 0.02860 84636 40324 44312 0.00030 255202 255202 0.00190 169477 169477 0.00120 509315 40324 468991 0.00340 28260384 23851102 4409282 0.03200 5292 5292 42096 42096 0.00030 47388 47388 0.00030 false 20806792 3495541 61480617 70225114 -8744497 X true true LAKE REG IMAGING PTR DIAGNOSTIC IMAGING SERVICES 0.51000 0.49000 1 1 LAKE REGIONAL HEALTH SYSTEM

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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) OF $158,740,244 LESS BAD DEBT EXPENSE OF $20,806,792. 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 AND 3. BAD DEBT AND COSTING METHODOLOGY SCHEDULE H, PART III, SECTION A, LINE 4 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 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 AND MEDICARE-DEPENDENT HOSPITAL, AND ALTERNATIVELY COULD QUALIFY AS A SOLE COMMUNITY HOSPITAL. THIS DEMONSTRATES THAT LRHS IS THE ONLY REASONABLE SOURCE OF HOSPITAL CARE AVAILABLE TO MEDICARE BENEFICIARIES IN OUR SERVICE AREA, AND LIKEWISE TREATS ALL BENEFICIARIES IN OUR SERVICE AREA THAT PRESENT THEMSELVES FOR CARE, DESPITE KNOWING WE WILL GENERALLY LOSE MONEY CARING FOR MEDICARE PATIENTS. ADDITIONALLY, SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. 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. FACTORS USED IN DETERMINING BASIS FOR AMOUNTS CHARGED TO PATIENTS SCHEDULE H, PART V, SECTION B, LINE 11 TO OBTAIN PRICING FOR GROSS CHARGES, THE ORGANIZATION USES REGIONAL COMPARATIVE PRICING DATA FROM MEDASSETS AS A STANDARD FOR DEFENSIBLE PRICING. OTHER METHODS OF PUBLICIZING CHARITY CARE POLICY SCHEDULE H, PART V, SECTION B, LINE 13G ALL PATIENTS OF THE HOSPITAL IN ROOMS HAVE ACCESS TO A BINDER THAT EXPLAINS THE FINANCIAL ASSISTANCE POLICY. THIS BINDER IS ALSO AVAILABLE AT THE CASHIERS DESK. METHOD FOR DETERMINING MAX AMOUNTS CHARGED TO FAP ELIGIBLE PATIENTS SCHEDULE H, PART V, SECTION B, LINE 19D FULL CHARGES ARE BILLED TO ALL PATIENTS. IF THE SELF-PAY PATIENT PAYS THE BILL WITHIN THE FIRST 30 DAYS, THEY WILL RECEIVE A 40% DISCOUNT. OTHERWISE, THEY RECEIVE NO DISCOUNT. THE DISCOUNTS FOR ALL INDIVIDUALS THAT QUALITY FOR FREE OR DISCOUNTED CARE, INCLUDING EMERGENCY OR MEDICALLY NECESSARY CARE, ARE DETERMINED USING THE FEDERAL POVERTY GUIDELINE MATRIX IN LRHS POLICY #112-190-2 UNCOMPENSATED CARE. NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2 LRHS USES DATA COMPILED BY AN INDEPENDENT ENTITY, HOSPITAL INDUSTRY DATA INSTITUTE (HIDI), ON INPATIENTS AND OUTPATIENT PROVIDER USE DIVIDED BY DEMOGRAPHIC AND GEOGRAPHIC SUBSET. LRHS PERFORMS A BIENNIAL COMMUNITY ASSESSMENT WHICH IS A RANDOM SAMPLE, FACE-TO-FACE SURVEY, WHICH ASKS WHAT SERVICES LRHS SHOULD ADD AND WHY. 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. SURVEYS PROFILE PARTICIPANTS BY ZIP CODE AND IDENTIFY DESIRED SERVICES. 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. LRHS MAINTAINS AN OPEN MEDICAL STAFF BY ALLOWING ANY PHYSICIAN, DENTIST, ORAL SURGEON OR PODIATRIST ENTRY WHO CONTINUOUSLY MEET THE QUALIFICATIONS, STANDARDS, AND REQUIREMENTS SET FORTH BY LRHS. MEMBERS OF THE BOARD OF DIRECTORS MUST BE REPRESENTATIVE OF THE COMMUNITIES AND POPULATION SERVED BY LRHS. NO DIRECTOR RECEIVES COMPENSATION FOR ANY SERVICE THEY MAY RENDER AS A DIRECTOR. ALL SURPLUS FUNDS ARE RE-INVESTED INTO THE CORPORATION BY PURCHASING CAPITAL EQUIPMENT. INTO THE CORPORATION BY PURCHASING CAPITAL EQUIPMENT. 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) 25226 SCHOLARSHIP FUND 1 NURSING SCHOLARSHIPS 8 31000 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 257634 0 0 0 5129 0 22813 0 4240 0 289816 0 0 ANDREW MCKIBBEN MD 0 284942 0 0 0 182 0 24114 0 2800 0 312038 0 0 MICHAEL HENZE 366047 0 110479 0 352797 0 71073 0 3879 0 904275 0 308316 0 VICKI L FRANKLIN 189324 0 36348 0 135079 0 15907 0 1279 0 377937 0 89087 0 M DANIEL PROBSTFIELD 209040 0 37914 0 52524 0 15907 0 3186 0 318571 0 0 0 JANICE L DUNGAN 180361 0 30311 0 20111 0 15110 0 944 0 246837 0 0 0 F JOE BUTTS 160102 0 30153 0 128774 0 15169 0 3086 0 337284 0 77527 0 KEVIN G MCROBERTS 163666 0 28677 0 84109 0 28389 0 4825 0 309666 0 71962 0 ROBERT HYATT MD 305561 0 54450 0 64420 0 9800 0 944 0 435175 0 0 0 SCOTT POEST 140327 0 5607 0 11742 0 18099 0 3058 0 178833 0 0 0 THOMAS MYLER 154655 0 7450 0 9482 0 11070 0 6701 0 189358 0 0 0 MICHAEL DOW 155043 0 7393 0 7163 0 10894 0 4980 0 185473 0 0 0 STEVEN GROTEWIEL 135176 0 6327 0 17632 0 9774 0 586 0 169495 0 0 0 JOE SCOTT 135925 0 0 0 21401 0 9744 0 1825 0 168895 0 0 0 DARLA WILKERSON-ERVIN 125128 0 5870 0 10877 0 7868 0 944 0 150687 0 0 0 CYNTHIA OTRADOVEC 19150 0 0 0 89271 0 4642 0 98 0 113161 0 64186 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. VICKI L. FRANKLIN $16,155 M. DANIEL PROBSTFIELD $16,851 F. JOE BUTTS $13,401 JANICE DUNGAN $13,472 CYNTHIA OTRADOVEC $11,392 ROBERT HYATT $24,200 THE FOLLOWING PEOPLE HAD A DEFERRED CONTRIBUTION TO A 457(F) NONQUALIFIED RETIREMENT PLAN. MICHAEL E. HENZE $55,166 KEVIN MCROBERTS $13,416 SCOTT POEST $9,333 THE FOLLOWING PARTICIPANTS ALSO RECEIVED A 457(F) DISTRIBUTION, WHICH WAS REPORTED AS DEFERRED COMPENSATION ON A PRIOR FORM 990. MICHAEL E. HENZE $308,316 VICKI L. FRANKLIN $89,087 F. JOE BUTTS $77,527 KEVIN MCROBERTS $71,962 CYNTHIA OTRADOVEC $64,186 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. COMPENSATION REPORTED IN PRIOR YEAR FORM 990 SCHEDULE J, PART II, COLUMN F COMPENSATION IS REPORTED ON THE FORM 990 IN THE YEAR THAT THE COMPENSATION IS EARNED BY OR AWARDED TO AN INDIVIDUAL, EVEN IF THE COMPENSATION IS NOT PAID TO THE INDIVIDUAL, IS NOT FULLY VESTED, OR IS SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. IF COMPENSATION IS EARNED OR AWARDED IN ONE YEAR BUT PAID IN A LATER YEAR, THEN THE COMPENSATION IS GENERALLY REPORTED A SECOND TIME ON THE FORM 990 IN THE YEAR THE COMPENSATION IS PAID TO THE INDIVIDUAL. AS A RESULT OF THE REPORTING REQUIREMENT, AN ORGANIZATION COULD BE REQUIRED TO REPORT THE SAME COMPENSATION AMOUNTS ON THE FORM 990 FOR TWO CONSECUTIVE YEARS. THE AMOUNTS REPORTED IN COLUMN F: INCLUDE INCENTIVE AMOUNTS AND CAPITAL ACCUMULATION AMOUNTS WHICH WERE REPORTED IN PREVIOUS 990S AS DEFERRED COMPENSATION. HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF MO 431178966 60635RH67 2003-12-10 27463751 BUILDING EQUIPMENT false false false HEALTH AND EDUCATIONAL FACILITIES AUTHORITY OF MO 431178966 60635R8G5 2010-10-20 28426416 REFUND 1996 & 1998 REVENUES BONDS false false false 3345000 0 28309448 1901821 0 0 480231 0 0 25929727 0 0 2007 false false true true 695000 0 28426416 2875426 0 28188586 237830 0 0 0 0 0 1998 true false true true false false true true false 0.00000 0.00000 0.00000 true 0 false false false 0 true BAYERISCHE LANDESBAN 2.33 false true false false false false 0 true JPMORGAN CHASE BANK 12.82 false false true GIC FAIR MARKET VALUE SCHEDULE K, PART IV, LINE 4D 4(D), COLUMN A AND B. THE GUARANTEED INVESTMENT CONTRACT FOR THE 2003 BONDS WAS ENTERED INTO AFTER THE ISSUE DATE OF THE BONDS. 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 IN EACH CASE, BUT HAS BEEN UNABLE TO LOCATE COPIES OF THE BID SOLICITATION FORMS AND RELATED MATERIALS REQUIRED TO BE RETAINED UNDER THE REGULATION SAFE HARBOR. PROCEEDS INVESTED BEYOND A TEMPORARY PERIOD SCHEDULE K, PART IV, LINE 5 THE PROJECT FUND WAS INVESTED BEYOND THE 3-YEAR TEMPORARY PERIOD. ALL PROCEEDS IN THE PROJECT FUND HAVE BEEN SPENT. THE YIELD ON INVESTMENTS WAS NOT MATERIALLY HIGHER THAN THE YIELD ON THE ISSUE AND NO YIELD REDUCTION PAYMENT LIABILITY WAS GENERATED ON THE BONDS. LAKE REGIONAL MEDICAL MANAGEMENT COMMON DRTRS - SEE PART V 8088852 CONTRIBUTIONS, REIMBURSEMENTS false MITCHELL SHIELDS FAMILY MEMBER L SHIELDS 39113 EMPLOYMENT false CENTRAL BANK OF LAKE OF THE OZARKS SEE PART V 242106 BANKING FEES false JULIE FRANKLIN FAMILY MEMBER V FRANKLIN 37252 EMPLOYMENT false BARBA PROBSTFIELD FAM MEMBER D PROBSTFIELD 77170 EMPLOYMENT false INTERESTED PERSONS RELATIONSHIP SCHEDULE L, PART IV, COLUMN B GREG GAGNON, BOARD TREASURER, IS 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 14 25303 FMV X SILENT AUCTION 281 43210 COST X LIVE AUCTION 21 16385 COST false true false ORGANIZATION'S MISSION FORM 990, PART I, LINE 1 OUR MISSION: LAKE REGIONAL HEALTH SYSTEM WILL PROVIDE COMPREHENSIVE HEALTH CARE SERVICES TO THE RESIDENTS AND VISITORS OF THE LAKE REGION WITH EMPHASIS ON QUALITY OUTCOMES AND SERVICE SATISFACTION WHILE OPERATING IN A SOUND FISCAL MANNER. OUR VISION: OUR SHARED VISION IS FOR LAKE REGIONAL HEALTH SYSTEM TO BE RECOGNIZED AS THE FIRST CHOICE FOR PATIENTS, PHYSICIANS, AND WORKFORCE. OUR VALUES: PATIENT CENTERED, CONTINUOUS IMPROVEMENT, TEAMWORK, INTEGRITY, SERVICE QUALITY, SAFETY. 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. THE HOSPITAL IS DESIGNATED AS MEDICARE DEPENDENT, MEANING THAT THE HOSPITAL IS THE PRIMARY HEALTH CARE PROVIDER FOR A MAJORITY OF MEDICARE PATIENTS WITHIN A 35-MILE RADIUS OF THE HOSPITAL. THE CORPORATION HAS ONE ACTIVE, WHOLLY-OWNED FOR-PROFIT SUBSIDIARY, LAKE REGIONAL MEDICAL MANAGEMENT, INC. ("LRMM"), WHICH OPERATES SEVEN PRIMARY CARE MEDICAL CLINICS, THREE RETAIL PHARMACIES AND FIFTEEN SPECIALTY CLINICS. OPERATIONS OF LRMM ARE GOVERNED BY A SEPARATE BOARD OF DIRECTORS. THE SYSTEM IS CURRENTLY GOVERNED BY A FIFTEEN-MEMBER BOARD OF DIRECTORS (THE "BOARD"). THE BOARD HAS GENERAL RESPONSIBILITY FOR THE BUSINESS AND AFFAIRS OF THE SYSTEM, AND MAY DO AND PERFORM ALL ACTS NECESSARY TO CARRY OUT ITS PURPOSES. UNDER THE TERMS OF THE BYLAWS, THE MEMBERS OF THE BOARD SERVE THREE-YEAR STAGGERED TERMS, AND NEW MEMBERS ARE ELECTED BY THE CURRENT BOARD MEMBERS. THE OFFICERS OF THE BOARD ARE ELECTED BY THE BOARD FOR TWO-YEAR TERMS. BOARD MEMBERS SERVE IN A VOLUNTARY CAPACITY AND RECEIVE NO REMUNERATION FOR SERVICE RENDERED IN SUCH CAPACITY. 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 GREG GAGNON AND ROBERT MASON HAVE A BUSINESS RELATIONSHIP. 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. SIGNIFICANT CHANGES TO ORGANIZING DOCUMENTS FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION AMENDED THEIR BYLAWS IN JUNE OF 2011. SIGNIFICANT CHANGES FROM THIS AMENDMENT INCLUDE THE REMOVAL OF THE REQUIREMENT FOR BOARD MEMBERS TO ATTEND HALF OF ALL BOARD MEETINGS AND THE ADDITION OF AN ADDITIONAL REVIEW OF BOARD ATTENDANCE FOR CONSIDERATION OF REMOVAL ON THE BOARD DUE TO LOW ATTENDANCE. 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 2012 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 2012, 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 BOARD MINUTES. 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. ANDREW MCKIBBEN, MD, IS PAID AS A PHYSICIAN OF LAKE REGIONAL MEDICAL MANAGEMENT. 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. EACH WORKS APPROXIMATELY 40 HOURS PER WEEK FOR THE RELATED ORGANIZATION. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 5 UNREALIZED GAINS & LOSSES $ 63,447 LAKE REGIONAL IMAGING PARTNERS 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 202107048 DIAGNOSTIC IMAGE MO NA RELATED 701795 3018204 false 0 true 0.51000 LAKE REGIONAL MEDICAL MANAGEMENT 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 431473438 PHYSICIAN SER MO NA C CORP 33303319 6894089 1.00000 true true false false false false false false true true true false true true true false false false LAKE REGIONAL MEDICAL MANAGEMENT A/I 879038 FMV LAKE REGIONAL MEDICAL MANAGEMENT B 5250000 FMV LAKE REGIONAL IMAGING PARTNERS LLC J 78694 FMV LAKE REGIONAL MEDICAL MANAGEMENT K 595457 FMV LAKE REGIONAL IMAGING PARTNERS LLC K 1158834 FMV LAKE REGIONAL MEDICAL MANAGEMENT O 3850902 FMV