2011-12-15T15:14:30-05:00 2011-04-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2010-05-01 237339737 LAKE REGIONAL HEALTH SYSTEM LAKE 5733488000 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 DAN PROBSTFIELD 2011-11-18 true Brian D Todd 4178658701 2010 2016-02-24 21:20:13Z MICHAEL E HENZE 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 157793918 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. 14 6 1141 401 0 0 154328 819907 155426399 160273614 1519673 1733573 -4209557 -6332946 152890843 156494148 157522 110074 0 0 57766253 60347837 0 0 0 89475804 88615726 147399579 149073637 5491264 7420511 168899989 176979780 73112645 71977895 95787344 105001885 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 59245639 64553939 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 238,807 OUTPATIENT SERVICES VISITS. 50973211 60246772 LAKE REGIONAL HEALTH SYSTEM PROVIDES INPATIENT SERVICES TO THE COMMUNITY AND SURROUNDING RURAL AREAS. THE HOSPITAL PROVIDED 22,308 INPATIENT DAYS, 3,976 SKILLED NURSING FACILITY INPATIENT DAYS AND 1,141 NURSERY PATIENT DAYS FOR A TOTAL OF 27,425 INPATIENT DAYS. 13556032 31373302 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 36,993 VISITS. 5451755 110074 4099601 129226637 true true false true 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 false false false true 148 0 true 1141 true false false false false false true true false false false false X 14 6 true false false 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 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 56612 0 OTIS MOSELEY MD 1.0 X 0 0 0 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 315330 0 MICHAEL HENZE 40.0 X 482343 0 73062 VICKI L FRANKLIN 40.0 X 247272 0 31985 M DANIEL PROBSTFIELD 40.0 X 286907 0 32028 JANICE L DUNGAN 40.0 X 239316 0 27459 F JOE BUTTS 40.0 X 220833 0 30565 KEVIN G MCROBERTS 40.0 X 211208 0 27765 CINDY J OTRADOVEC 40.0 X 166828 0 22587 ROBERT HYATT 40.0 X 338622 0 24708 STEVEN GROTEWIEL 40.0 X 184373 0 9635 THOMAS MYLER 40.0 X 170462 0 17544 MICHAEL DOW 40.0 X 159874 0 14724 KELLY PHILLIPS 40.0 X 154676 0 11240 JOE SCOTT 40.0 X 146220 0 11322 3008934 371942 334624 42 false true false LAKE EMERGENCY SPECIALISTS PHYSICIAN SERVICES 4302255 NATIONAL THERAPEUTIC ASSOCIATES MEDICAL SERVICES 2456175 LAKE OZARK ANESTHESIA ASSOC PHYSICIAN SERVICES 625755 NATIONAL WOUND CARE HYPERBARIC WOUND CARE MGMT SRVC 450999 REVENUE CYCLE PARTNERS HOLDINGS LL BILLING SERVICES 413033 15 283622 536285 594656 819907 PATIENT SERVICE 624100 156174013 156174013 AUXILIARY 900099 421577 421577 CAFETERIA INCOME 722210 964135 964135 OTHER 624100 2713889 2713889 160273614 1733573 1733573 0 0 989586 1153933 -164347 -164347 -164347 0 53254 283622 145837 -92583 -92583 0 0 CHANGE IN INTEREST IN EQUITY INVESTEES 900099 -5306639 -5306639 LOSS ON EXTINGUISHMENT OF DEBT 900099 -769377 -769377 -6076016 156494148 160273614 -4599373 69658 69658 40416 40416 0 0 2463488 555405 1908083 141290 141290 45606403 39707743 5898660 1722514 1593300 129214 6876094 5794671 1081423 3538048 2976456 561592 0 377365 377365 155722 155722 0 0 109202 109202 16062465 11710530 4351935 503674 503674 5277086 4160744 1116342 683213 683213 0 1953917 1725168 228749 246093 128997 117096 0 39287 2050 37237 2733768 2442341 291427 0 8131358 7264532 866826 1142489 1142489 MEDICAL SUPPLIES & DRUGS 26097907 26096563 1344 BAD DEBT 16071466 16071466 PROVIDER TAX 7891364 7891364 CAFETERIA/VENDING 817750 730576 87174 LICENSES, DUES & SUBSCRIPTIONS 231685 86247 145438 89915 37120 52795 149073637 129226637 19847000 0 2468 2818 53689040 46374525 14091 21540 13063732 15120389 4867294 4791215 1600502 866298 144749103 86724808 59840015 58024295 32289474 46401270 3284265 5044166 249108 333264 168899989 176979780 12862775 12052112 55450000 51410000 3522831 3225233 1277039 5290550 73112645 71977895 X 95770086 104984627 17258 17258 95787344 105001885 168899989 176979780 X 7420511 1794030 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 11471 11471 false OTHER LOBBYING ACTIVITIES SCHEDULE C, PART II-B, LINE 1(I) A PORTION OF THE DUES PAID TO THE MISSOURI HOSPITAL ASSOCATION AND THE AMERICAN HOSPITAL ASSOCIATION ARE USED FOR LOBBYING PURPOSES: $ 6,985 MISSOURI HOSPITAL ASSOCIATION 4,486 AMERICAN HOSPITAL ASSOCIATION ------- $11,471 530500 4272244 4802744 82067266 43901778 38165488 53229576 40979453 12250123 4649517 1843577 2805940 58024295 0 EST AMT DUE TO 3RD PTY PYR 5290550 5290550 156494148 149073637 7420511 1794030 1794030 9214541 159478746 1794030 1794030 157684716 109202 -1299770 -1190568 156494148 150264205 1299770 1299770 148964435 109202 109202 149073637 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 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 TAX RETURN: RENTAL EXPENSES $ 1,153,933 SPECIAL EVENTS EXPENSE 145,837 ---------- $ 1,299,770 ANNUAL BALL 130428 113974 16454 28939 4800 16152 GOLF TOURNEY 203713 166913 36800 2425 21953 24543 47025 0 334141 280887 53254 2425 21953 53482 4800 63177 145837 -92583 true true X true X true X true true true false true true 3933819 3933819 0.02640 23663062 22734680 928382 0.00620 27596881 22734680 4862201 0.03260 98574 32335 66239 0.00040 247226 247226 0.00170 240372 240372 0.00160 586172 32335 553837 0.00370 28183053 22767015 5416038 0.03630 5292 5292 39603 39603 0.00030 44895 44895 0.00030 false 4829503 753403 60710907 70051065 -9340158 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

X X X LAKE REGIONAL HEALTH SYSTEM 1 5 LAKE REGIONAL IMAGING PARTNERS

54 HOSPITAL DR OSAGE BEACH MO 65065

IMAGING CENTER ELDON REHAB THERAPY

304 EAST 4TH STREET ELDON MO 65026

REHAB THERAPY LAKE OZARK REHAB THERAPY

1870 BAGNELL DAM BLVD LAKE OZARK MO 65049

REHAB THERAPY LAURIE REHAB THERAPY

156 MISSOURI BLVD LAURIE MO 65038

REHAB THERAPY CAMDENTON REHAB THERAPY

1930 N BUSINESS ROUTE 5 CAMDENTON MO 65020

REHAB THERAPY PART III, 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 TIMES THE RATIO OF PATIENT CARE COST TO CHARGES FROM WORKSHEET 2, LINE 11. LINE 3 WAS DETERMINED BY TAKING THE BAD DEBT EXPENSE AT COST (LINE 2) TIMES THE PERCENT OF PERSONS BELOW THE POVERTY LEVEL FOR 2009 BASED ON US CENSUS BUREAU DATA. PART III, 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. PART III, 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. NEEDS ASSESSMENT 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. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE 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 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 2009 POPULATION IS ESTIMATED AT 167,899. IN ADDITION TO THE RESIDENT POPULATION OF NEARLY 168,000, 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 = $43,720, LACLEDE = $35,325, MILLER = $36,069, MORGAN = $35,533 AND PULASKI = $44,540. THE CAMDEN COUNTY 2009 ANNUAL UNEMPLOYMENT RATE WAS 9.6%, ABOVE THE STATE (9.3%) AND NATIONAL (9.3%) AVERAGES. CAMDEN COUNTY HAS APPROXIMATELY 15.6% OF PERSONS BELOW POVERTY LEVEL. THE IMMEDIATE 3-COUNTY AREA OF CAMDEN, MILLER, & MORGAN ESTIMATES UNINSURED INDIVIDUALS AT 20.97%. THERE ARE NO OTHER HOSPITALS WITHIN A 25-MILE RADIUS. USING HOSPITAL INDUSTRA DATA INSTITUTE DATA, THE LRHS MARKET IS PRIMARILY SHARED WITH 4 HOSPITALS IN THE AREA. COMMUNITY BUILDING ACTIVITIES 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. OTHER ACTIVITIES 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. true ST LOUIS REGIONAL DSH FUNDING AUTHORITY PO BOX 6766 JEFFERSON CITY MO 651026766 061642698 501(C)(3) 69658 SUPPORT 1 NURSING SCHOLARSHIPS 12 40416 MONITORING GRANT FUNDS SCHEDULE I, PART I, LINE 2 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. THROUGH AMENDMENT 3 OF THE ORGANIZATION'S AGREEMENT WITH MHA MANAGEMENT SERVICES CORPORATION AND INCREASED DISPROPORTIONATE SHARE HOSPITAL PAYMENTS TO ALL MISSOURI HOSPITALS UNDER THE FEDERAL REIMBURSEMENT ALLOWANCE PROGRAM, THE HOSPITAL MADE CHARITABLE CONTRIBUTIONS TO THE DSH FUNDING AUTHORITY. THESE CONTRIBUTIONS ARE USED TO SUSTAIN THE VARIOUS CHARITY CARE CLINICS IN THE ST. LOUIS AREA, WITH LOCAL COMMUNITY HOSPITALS ABSORBING THE INPATIENT AND OUTPATIENT NEEDS OF THE COMMUNITY'S MEDICALLY INDIGENT POPULATION. X X true true X X X X X false true false false false true true false false MICHAEL HENZE 354250 0 86256 0 41837 0 69833 0 3229 0 555405 0 55166 0 VICKI L FRANKLIN 184759 0 31521 0 30992 0 30706 0 1279 0 279257 0 16155 0 M DANIEL PROBSTFIELD 199820 0 30919 0 56168 0 31442 0 586 0 318935 0 16851 0 JANICE L DUNGAN 176145 0 26286 0 36885 0 26515 0 944 0 266775 0 13472 0 F JOE BUTTS 157208 0 26148 0 37477 0 27979 0 2586 0 251398 0 13401 0 KEVIN G MCROBERTS 166330 0 25314 0 19564 0 22940 0 4825 0 238973 0 13416 0 CINDY J OTRADOVEC 144808 0 18648 0 3372 0 21001 0 1586 0 189415 0 11392 0 ROBERT HYATT 325282 0 0 0 13340 0 24000 0 708 0 363330 0 24200 0 STEVEN GROTEWIEL 131842 0 6148 0 46383 0 0 0 9635 0 194008 0 0 0 THOMAS MYLER 149553 0 7239 0 13670 0 0 0 17544 0 188006 0 0 0 MICHAEL DOW 151472 0 7184 0 1218 0 0 0 14724 0 174598 0 0 0 KELLY PHILLIPS 136538 0 0 0 18138 0 0 0 11240 0 165916 0 0 0 JOE SCOTT 128184 0 0 0 18036 0 0 0 11322 0 157542 0 0 0 ANDREW MCKIBBEN MD 0 315330 0 0 0 0 0 0 0 0 0 315330 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 INDIVIDUALS PARTICIPATED IN OR RECEIVED PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN IN THE FOLLOWING AMOUNTS: MICHAEL E. HENZE $53,850 VICKI L. FRANKLIN $15,760 M. DANIEL PROBSTFIELD $44,291 F. JOE BUTTS $13,074 JANICE DUNGAN $38,773 KEVIN MCROBERTS $12,657 CINDY OTRADOVEC $10,850 ROBERT HYATT $24,000 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 28309448 1901821 480231 25929727 2007 false false true true 695000 28426416 2875426 28188586 237830 1998 true false true true false false true false true 0.00000 0.00000 0.00000 true false false false true BAYERISCHE LANDESBAN 2.33 false true false false false false 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 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 8995208 CONTRIBUTIONS, REIMBURSEMENTS false MITCHELL SHIELDS FAMILY MEMBER L SHIELDS 38129 EMPLOYMENT false CENTRAL BANK OF LAKE OF THE OZARKS SEE PART V 196917 BANKING FEES false JULIE FRANKLIN FAMILY MEMBER V FRANKLIN 29981 EMPLOYMENT false BARBA PROBSTFIELD FAM MEMBER D PROBSTFIELD 73180 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. IN ADDITION, 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 FOURTEEN 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 1 530500 APPRAISAL X 12 26434 FMV X SILENT AUCTION 291 37722 COST 1 true true false ARRANGEMENTS FOR HOLDING PROPERTY CONTRIBUTED SCHEDULE M, PART 1, LINE 30B THE ORGANIZATION RECIEVED A CONTRIBUTION OF REAL ESTATE THAT WILL BE HELD FOR THREE YEARS. THE HOUSE LOCATED ON THE PROPERTY IS VACANT AT THIS TIME. NEITHER THE HOUSE NOR THE LAND ARE REQUIRED TO BE USED FOR EXEMPT PURPOSES. 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 100-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 FOURTEEN SPECIALTY CLINICS. OPERATIONS OF LRMM ARE GOVERNED BY A SEPARATE BOARD OF DIRECTORS. THE SYSTEM IS CURRENTLY GOVERNED BY A FOURTEEN-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 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 ARE AS FOLLOWS: CHARITY CARE AT COST $4,828,708 BAD DEBT AT COST 5,928,186 UNPAID MEDICARE AT COST 12,277,770 FREE MEDICAL SERVICES 323,523 HEALTH PROFESSIONALS EDUCATION 57,592 FINANCIAL CONTRIBUTIONS 203,698 TAXES 4,524,589 ------------- TOTAL $28,144,066 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 CAFETERIA INCOME AND INCOME FROM THE AUXILIARY. FAMILY & 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. 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 2011 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 ORGANZATION'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 AND RECEIVES NO OTHER BENEFITS. BOARD MEMBERS DO NOT RECEIVE ANY COMPENSATION FOR THEIR SERVICES PROVIDED AS A MEMBER OF THE BOARD DIRECTORS. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 5 UNREALIZED GAINS & LOSSES $1,794,030 LAKE REGIONAL IMAGING PARTNERS 54 HOSPITAL DRIVE OSAGE BEACH MO 202107048 202107048 DIAGNOSTIC IM MO NA RELATED 530788 3454828 false 0 true 0.51000 LAKE REGIONAL MEDICAL MANAGEMENT 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 431473438 PHYSICIAN SER MO NA C CORP 30574434 6402292 1.00000 true false false false false false false false true false true false true true true false true false LAKE REGIONAL MEDICAL MANAGEMENT Q 7415000 LAKE REGIONAL MEDICAL MANAGEMENT A/I 936180 LAKE REGIONAL MEDICAL MANAGEMENT K 520222 LAKE REGIONAL IMAGING PARTNERS LLC K 1158834 LAKE REGIONAL MEDICAL MANAGEMENT O 2440524