HANNIBAL REGIONAL HEALTHCARE SYSTEM INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
HANNIBAL REGIONAL HEALTHCARE SYSTEM INC (EIN 43-0662495)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-05-27
IRS object ID
201131479349300208
Schema version
2009v1.7
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-05-27T10:26:01-05:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1LarsonAllen LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1600 Washington Avenue Suite 1800AddressLine1
CitySt LouisCity
StateMOState
ZIP Code63101ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN430662495EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Hannibal Regional HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHANNNameControl
Phone5732481300Phone

US Address USAddress

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

Officer Officer

FieldValueIRS element (for citing)
NameRoger DIxName
TitleChief Financial OfficerTitle
Phone5732481300Phone
Date Signed2011-05-27DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone3149254300Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJOHN GROSSMEIeRNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line16000 HOSPITAL DRIVE PO BOX 551AddressLine1
CityHANNIBALCity
StateMOState
ZIP Code63401ZIPCode
FieldValueIRS element (for citing)
Gross Receipts137140254GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.HRHONLINE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1987YearFormation
State Legal DomicileMOStateLegalDomicile
Activity Or Mission DescriptionHOSPITAL OPERATES A FULL SERVICE ACUTE CARE FACILITYActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees1141TotalNbrEmployees
Total Nbr Volunteers250TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year638746ContributionsGrantsPriorYear
Contributions Grants Current Year683092ContributionsGrantsCurrentYear
Program Service Revenue Prior Year102644525ProgramServiceRevenuePriorYear
Program Service Revenue CY109199153ProgramServiceRevenueCY
Investment Income Prior Year-3620109InvestmentIncomePriorYear
Investment Income Current Year366209InvestmentIncomeCurrentYear
Other Revenue Prior Year1785614OtherRevenuePriorYear
Other Revenue Current Year1630332OtherRevenueCurrentYear
Total Revenue Prior Year101448776TotalRevenuePriorYear
Total Revenue Current Year111878786TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year58599844SalariesEtcPriorYear
Salaries Etc Current Year63354257SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year376695TotalFundrsngExpCurrentYear
Other Expense Prior Year41647761OtherExpensePriorYear
Other Expenses Current Year41741375OtherExpensesCurrentYear
Total Expenses Prior Year100247605TotalExpensesPriorYear
Total Expenses Current Year105095632TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1201171RevenuesLessExpensesPriorYear
Revenues Less Expenses CY6783154RevenuesLessExpensesCY
Total Assets BOY105970314TotalAssetsBOY
Total Assets EOY116939024TotalAssetsEOY
Total Liabilities BOY48861436TotalLiabilitiesBOY
Total Liabilities EOY50791935TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY57108878NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY66147089NetAssetsOrFundBalancesEOY
Mission DescriptionHealthier residents of our region.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense86214563Expense
Revenue110096538Revenue
DescriptionThe system operates a full service 105 bed acute care hospital facility in Hannibal, Missouri as its primary service activity. 24,095 total inpatient days were provided during the course of the year. The hospital provides services to patients that meet the hospital's charity care policy as well as services to other medically indigent patients under certain government-reimbursed public aid programs. The total cost of uncompensated care was, Charity Care - $4,010,948 and State Medicaid and other public aid programs - $4,849,918.Description
Total Program Service Expense86214563TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds1DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP1LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096124NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1141NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Form8899 Filed0Form8899Filed
Form1098 C Filed0Form1098CFiled
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Roger DixBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5732481300TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16000 Hospital DriveAddressLine1
CityHannibalCity
StateMOState
ZIP Code63401ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (36 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Gene Scholes Jr
Chairperson1.00XX000
Robert Gilstrap
Vice Chairperson1.00XX000
B Stevens Plowman
Secretary1.00XX000
Jerry Trower
Chairperson1.00XX000
Darren Smith
Chairperson1.00XX000
Tom Lennon
Vice Chairperson1.00XX000
Gordon Spilker
Assistant Secretary1.00XX000
Jim Humphreys
Treasurer1.00XX000
Timothy A Reuschel
Director1.00X000
Carolyn Shaw
Director1.00X000
Jennifer Valuck MD
Director1.00X000
Jack Whitaker
Director1.00X000
Roderick Bartlett MD
Director1.00X000
Pranav Parikh MD
Director1.00X000
Robert Chriscinske
Director1.00X000
William Craigmiles
Director1.00X000
Jill Janes PhD
Director1.00X000
Jeffry Evans MD
Director1.00X000
John Grossmeier
President & CEO40.00X547005030625
Roger Dix
Vice President - Financial Services40.00X29209109770
C Todd Ahrens
Vice President - General Counsel40.00X21396409747
David Hevel
Vice President - Quality40.00X14242909936
Julie Leverenz
Vice President - Strategy and Plann40.00X13717604854
Sharon Nunley
Vice President - Human ResourCes40.00X206562013418
Sarah Bradshaw
Vice President - Nursing40.00X133020017028
G Doug Ruble
Vice President - Facilities40.00X11676509996
Jeffrey Evans
Vice President - Information and Te40.00X8116602444
Scott Siemer
Vice President - Service Lines40.00X000
Suzanne Koehler
Vice President - Clinical Services40.00X000
Richard Draper
Physician/Medical Director - HRMG40.00515762011025X
Dean Akerson
Executive Director - HRMG40.0020249109030X
Mark Shima
Cardiologist40.00774472011025X
Pervez Alvi
Cardiologist40.0056515500X
Richard Valuck
Cardiologist40.00560619011025X
Luvell Glanton
Anesthesiologist - Pain Management40.00544050011025X
Anne Delonais-Turner
Physician40.00443704011025X
FieldValueIRS element (for citing)
Total Reportable Comp From Org5476431TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation171973TotalOtherCompensation
Number Individuals GT100 K53NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Healthlink Inc
PO BOX 66971St LouisMO63166Insurance Provider470663
Heimer Construction Company
6811 County Road 344TaylorMO63471ConstRuction439871
CellDox
PO BOX 916HannibalMO63401Pathology Services420762
Emercon Emergency Medical
8021 Cornell AveSt LouisMO63130Locum Physicians381994
SCC Soft Computer
5400 Tech Data DriveClearwaterFL33760Computer Services290423
FieldValueIRS element (for citing)
Number Of Contractors GT100 K25NumberOfContractorsGT100K
Related Organizations683092RelatedOrganizations
Total Contributions683092TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICE REDescription
Business Code621110BusinessCode
Total Revenue Column109199153TotalRevenueColumn
Related Or Exempt Function Income109199153RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue109199153TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column611456TotalRevenueColumn
Exclusion$611,456ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real247569Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real30298Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real217271Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column217271TotalRevenueColumn
Exclusion$217,271ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities24945323Securities
Other40600Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities25167928Securities
Other63242Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-222605Securities
Other-22642Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-245247TotalRevenueColumn
Related Or Exempt Function Income-22642RelatedOrExemptFunctionIncome
Exclusion-$222,605ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
CHILDREN'S DEVELOPMENT624410615462615462
CAFETERIA722210534009$534,009
CONTRACTED SERVICES621110214201214201

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column49389TotalRevenueColumn
Related Or Exempt Function Income90364RelatedOrExemptFunctionIncome
Exclusion-$40,975ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue1413061TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column111878786TotalRevenueColumn
Related Or Exempt Function Income110096538RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$1,099,156ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2706306Total
Program Services402865ProgramServices
Management And General2058217ManagementAndGeneral
Fundraising245224Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total45351440Total
Program Services36330080ProgramServices
Management And General9006720ManagementAndGeneral
Fundraising14640Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total3455338Total
Program Services2754500ProgramServices
Management And General682878ManagementAndGeneral
Fundraising17960Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total8771792Total
Program Services6992630ProgramServices
Management And General1733568ManagementAndGeneral
Fundraising45594Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3069381Total
Program Services2445956ProgramServices
Management And General606386ManagementAndGeneral
Fundraising17039Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total286193Total
Management And General286193ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total75000Total
Management And General75000ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total8018Total
Program Services6381ProgramServices
Management And General1637ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total284676Total
Program Services284676ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total11404772Total
Program Services9075981ProgramServices
Management And General2328791ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1441875Total
Program Services1147452ProgramServices
Management And General294423ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total551941Total
Program Services439238ProgramServices
Management And General112703ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total64673Total
Program Services51467ProgramServices
Management And General13206ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1251413Total
Program Services995881ProgramServices
Management And General255532ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total7650100Total
Program Services7650100ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total650690Total
Program Services517823ProgramServices
Management And General132867ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Bad Debt Expense43822144382214
Healthcare Purchased Se34001983400198
Pharmacy Drugs30446243044624
equipment rental25359732018141517832
Professional Fees17772321777232

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2931783Total
Program Services2497124ProgramServices
Management And General398421ManagementAndGeneral
Fundraising36238Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total105095632Total
Program Services86214563ProgramServices
Management And General18504374ManagementAndGeneral
Fundraising376695Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3118750BOY
EOY8050601EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY12115408BOY
EOY14060513EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY227000EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY1234335BOY
EOY1395375EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2121135BOY
EOY2301765EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY395276BOY
EOY549085EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis121200616LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec63527806LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY60241809BOY
EOY57672810EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY22590544BOY
EOY27374246EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY4153057BOY
EOY5307629EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY105970314BOY
EOY116939024EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY10048854BOY
EOY11248266EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY28293739BOY
EOY26918499EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY3725456BOY
EOY5136796EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY6793387BOY
EOY7488374EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY48861436BOY
EOY50791935EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY55096493BOY
EOY63376049EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2012385BOY
EOY2771040EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY57108878BOY
EOY66147089EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY105970314BOY
EOY116939024EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations1GrantsOtherOrganizations
Grants Other Organizations$8,018GrantsOtherOrganizationsAmount
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB8018TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B, Line 1i:Identifier
Return ReferenceExplanation of Other Lobbying Activities:ReturnReference
ExplanationLobbying activity provided through membership in the Missouri Hospital AssociationExplanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Number Funds Held1NumberFundsHeld
Contrib To Funds And Other Accounts2131ContribToFundsAndOtherAccounts
Grants Funds And Other Accounts26536GrantsFundsAndOtherAccounts
Aggregate Fund Value51892AggregateFundValue
Disclosed Orgs Legal Control0DisclosedOrgsLegalControl
Disclosed For Charitable Purposes0DisclosedForCharitablePurposes

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis2172770OtherCostOrOtherBasis
Book Value2172770BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis68457338OtherCostOrOtherBasis
Depreciation28908769Depreciation
Book Value39548569BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis50259749OtherCostOrOtherBasis
Depreciation34619037Depreciation
Book Value15640712BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis310759OtherCostOrOtherBasis
Book Value310759BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings57672810TotalOfBookValueLandBuildings

Other Securities OtherSecurities (10 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
CASH43162F
US GOVERNMENT SECURITIES4880188F
US Coporate bonds161102F
MUTUAL FUNDS - EQUITY SECURITIES15028771F
MUTUAL FUNDS - FIXED INCOME3151316F
MUTUAL FUNDS - REAL ESTATE1096222F
ACCRUED INVESTMENT INCOME38919F
HELD BY TRUSTEE UNDER INDENTURE AGREEMENT2903128F
RESTRICTED BY DONOR51892F
Held by trustee accrued investment income19546F
FieldValueIRS element (for citing)
Total Of Book Value Securities27374246TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Minimum Pension Liability$5,501,701
Supplemental Employer Retirement Plan Liability$1,986,673
FieldValueIRS element (for citing)
Total Of Amounts7488374TotalOfAmounts
Total Revenue111878786TotalRevenue
Total Expenses105095632TotalExpenses
Excess Or Deficit For Year6783154ExcessOrDeficitForYear
Net Unrealized GL On Investments1954116NetUnrealizedGLOnInvestments
Other$300,941OtherAmount
Total Adjustments2255057TotalAdjustments
Excess Or Deficit Per FS9038211ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt111195694TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal111195694RevenueSubtotal
Other Revenues Not Included683092OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt683092RevenueNotRptdOnFinStmt
Total Revenue Per Form990111878786TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt105095632TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal105095632ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form990105095632TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part X:Description of Uncertain Tax Positions Under FIN 48:The Hospital has been recognized as exempt from income taxes under Section 501 of the Internal Revenue Code and a similar provision of state law. However, the Hospital is subject to federal income tax on any unrelated business taxable income. The Hospital applies the income tax standard for uncertain tax positions. This standard clarifies the accounting for uncertainty in income taxes recognized in an organization's financial statements in accordance with the income tax standard. This standard prescribes recognition and measurement of tax positions taken or expected to be taken on a tax return that are not certain to be realized. The Hospital's income tax returns are subject to review and examination by federal, state, and local authorities. The Hospital is not aware of any activities that would jeopardize its tax-exempt status. The Hospital is not aware of any activities that are subject to tax on unrelated business income or excise or other taxes. The tax returns for the fiscal years 2008 to 2010 are open to examination by federal, local, and state authorities.
Part XI, Line 8 - Other Adjustments:Change in Minimum Pension Liability: -457714. pearl lowrie fund net activity: -24405. temp. Restricted Net Assets released for Capital expenditures: -683092. Net Contribution Revenue from Foundation: 1466152.
Part XII, Line 4b - Other Adjustments:NET ASSETS RELEASED FROM RESTRICTION FOR PROPERTY AND EQUIPMENT ADDITIONS: 683092.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care0FPGReferenceFreeCare
FPG Reference Discounted Care0FPGReferenceDiscountedCare
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report0AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense4010948TotalCommunityBenefitExpense
Net Community Benefit Expense4010948NetCommunityBenefitExpense
Percent Of Total Expense0.03980PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense13975764TotalCommunityBenefitExpense
Direct Offsetting Revenue9125846DirectOffsettingRevenue
Net Community Benefit Expense4849918NetCommunityBenefitExpense
Percent Of Total Expense0.04820PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense17986712TotalCommunityBenefitExpense
Direct Offsetting Revenue9125846DirectOffsettingRevenue
Net Community Benefit Expense8860866NetCommunityBenefitExpense
Percent Of Total Expense0.08800PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense2365049TotalCommunityBenefitExpense
Direct Offsetting Revenue803706DirectOffsettingRevenue
Net Community Benefit Expense1561343NetCommunityBenefitExpense
Percent Of Total Expense0.01550PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense399048TotalCommunityBenefitExpense
Net Community Benefit Expense399048NetCommunityBenefitExpense
Percent Of Total Expense0.00400PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense18907TotalCommunityBenefitExpense
Net Community Benefit Expense18907NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense2783004TotalCommunityBenefitExpense
Direct Offsetting Revenue803706DirectOffsettingRevenue
Net Community Benefit Expense1979298NetCommunityBenefitExpense
Percent Of Total Expense0.01970PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense20769716TotalCommunityBenefitExpense
Direct Offsetting Revenue9929552DirectOffsettingRevenue
Net Community Benefit Expense10840164NetCommunityBenefitExpense
Percent Of Total Expense0.10770PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served920PersonsServed
Total Community Building Expense2094634TotalCommunityBuildingExpense
Direct Offsetting Revenue746094DirectOffsettingRevenue
Net Community Building Expense1348540NetCommunityBuildingExpense
Percent Of Total Expense0.01340PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense87757TotalCommunityBuildingExpense
Net Community Building Expense87757NetCommunityBuildingExpense
Percent Of Total Expense0.00090PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served920PersonsServed
Total Community Building Expense2182391TotalCommunityBuildingExpense
Direct Offsetting Revenue746094DirectOffsettingRevenue
Net Community Building Expense1436297NetCommunityBuildingExpense
Percent Of Total Expense0.01430PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense$1,898,953BadDebtExpenseAmount
Amount Attributable To949477AmountAttributableTo
Amount Reimbursed By Medicare34553072AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare45430180CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-10877108MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost Accounting SystemXCostAccountingSystem
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care0ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
Hannibal Medical Supply
DME Company0.330000.33000
Hannibal Mobile Diagnostics
Mobile imaging/radiology services0.500000.50000

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

FieldValueIRS element (for citing)
Business Name Line1Hannibal Regional HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line16000 hospital driveAddressLine1
CityhannibalCity
StateMOState
ZIP Code63401ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Income Based CriteriaPart I, Line 3c: The criteria utilized to determine eligibility for charity care is based on the ability to pay. A person is eigible for charity care if they meet any of the following criteria : Their insurance is inadequate, if they are uninsured, if they have an income that is at or below 200% of the Federal Poverty Guideline, if their spendable income is less than 5% of the balance owed on a month-to-month basis, if their total demonstrable assets are less than $2,000 or if they are unable to borrow funds.IncomeBasedCriteria
Annual Community Benefit ExplnPart I, Line 6a: Part I, Line 6a: The Missouri Hospital Association has included Hannibal Regional Hospital in their annual Community Benefit Report.AnnualCommunityBenefitExpln
Debt Collection PolicyPart III, Line 9b: When Charity consideration is requested all collection efforts are halted until a determination on eligibility is made. Collection efforts are resumed only if the individual does not meet one of the Charity criteria.DebtCollectionPolicy
Needs AssessmentPart VI, Line 2: The organization receives annual updates on the health status of its population from the State that include mortality and disease status. The organization also monitors national data on trends and disease status.NeedsAssessment
Patient Education AssistancePart VI, Line 3: The organization maintains educational programs to keep staff apprised of all potential programs that might assist patients in paying their hospital claim. Staff members are encouraged to utilize this knowledge to reconcile all outstanding balances.PatientEducationAssistance
Community InformationPart VI, Line 4: Hannibal, Marion County are rural communites of approximately 30,000 population. Also served are seven other rural counties in northeast Missouri.CommunityInformation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
First Class Or Charter TravelXFirstClassOrCharterTravel
Travel For CompanionsXTravelForCompanions
Written Policy Re T And E Expenses0WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
John Grossmeier
397152000149853000306250577630000
Roger Dix
21909202013105286800097700301861000
C Todd Ahrens
213964000000097470223711000
David Hevel
1166720002575700099360152365000
Sharon Nunley
15392200052640000134180219980000
Sarah Bradshaw
1330200000000170280150048000
Richard Draper
5107620500000000110250526787000
Dean Akerson
202491000000090300211521000
Mark Shima
7744720000000110250785497000
Pervez Alvi
565155000000000565155000
Richard Valuck
5606190000000110250571644000
Luvell Glanton
427619011643100000110250555075000
Anne Delonais-Turner
4437040000000110250454729000

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 1aJohn Grossmeier - Spouse Travel $1,284 not in taxable compensation; Gordon Spilker - Spouse Travel $540.79 no 1099; Roderick Bartlett - Spouse Travel $577.00 no 1099; Jerry Trower - Spouse Travel $743.00 sent 1099; Jeffrey Evans - Charter travel $1,227.54 not in taxable compensation; Richard Draper - Charter Travel $1,227.54 not in taxable compensation
Part I, Line 1bAll expenses were approved through the normal check request and expense report process which requires two signatures. CEO expenses are approved by a board member and validated by the Controller, all board member expenses are approved by the CEO and validated by the Controller, and all officer and key employee expenses are approved by the CEO and validated by the Controller or another officer.
Part I, Line 4aJohn Grossmeier, SERP, $149,853 Roger Dix, SERP, $52,868 David Hevel, SERP, $25,757 C. Todd Ahrens, SERP, $0 Sharon Nunley, SERP, $52,640 Richard Draper, SERP, $0 Julie Levernz, SERP, $0 Dean Akerson, SERP, $0
Part I, Line 6Dr. Glanton receives 50% of all pain medicine physician service net collections generated as a result of professional services and collected in excess of one hundred thousand dollars each year. Total Salary plus bonus not to exceed the ninetieth percentile of the prior year's range as reported for the Southern Region by the Medical Group Management Association.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuer
The industrial development authority of the city of hannibal missouri
531320446410632AT02006-04-0123725000hospital refunding revenue bonds00
The industrial development authority of the city of hannibal missouri
531320446410632BH52007-08-018000000er addition00
The industrial development authority of the city of hannibal missouri
531320446410632bj12010-07-297430000Hospital Refunding of ER Addition Bonds00

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Total ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundAmount DefeasedAmountDefeasedIssuance Costs From ProceedsIssuanceCostsFromProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindCapital ExpendituresCapitalExpenditures
2663088421442502407582241081220221111
8000000124758201000117875242
7863694774316212053220201111

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
000001
000001
000001

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICTerm Of GICTermOfGICRegulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfiedGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
Societe Generale
100115.830000000000100
(no name)
010001

Schedule L IRS990ScheduleL

Loan Table LoanTable (6 entries)

Purpose Of LoanPurposeOfLoanLoan From OrganizationLoanFromOrganizationOriginal PrincipalOriginalPrincipalAmountBalance DueBalanceDueDefaultDefaultApproved By BoardApprovedByBoardWritten AgreementWrittenAgreement
Pervez Alvi
Physician RelocationX$60,00054000011
Anne Delonais
Physician RelocationX$20,00018000011
Luvell Glanton
Physician RelocationX$40,00030000011
Richard Draper
Physician RelocationX$25,00012500011
Allen Duplantis
Physician RelocationX$100,00090000111
Mark Shima
Physician RelocationX$25,00022500011
FieldValueIRS element (for citing)
Total Balance Due227000TotalBalanceDue

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section B, line 11The prepared form 990 will be forwarded to each member of the Board of Directors, as well as the officers of the corporation approximately one week prior to a regular board meeting at which the prepared form 990 will be on the agenda. The Chief Financial Officer will present the prepared form 990 to the Board of DIrecotrs and entertain questions from directors and officers. The Chief Executive Officer and General Counsel for the corporation will also be present to assist with questions for the directors and officers. This procedure will be completed prior to the filing of the prepared form 990.
Form 990, Part VI, Section B, line 12cThe organization has a policy titled Business Ethics and Conflict of Interest which requires that all directors, officers, and employees of the hospital always act in the best interest of the hospital without conflicts of interest. Annually each member of the Board of Directors, each officer of the organization, and certain other managers receive a copy of the policy and are required to complete a confidentiality agreement and a conflict of interest questionnaire whereby the individual answers questions regarding family members, substantial business or investment holdings, and other transactions or affiliations with businesses or other organizations that might affect their relationship with the hospital. As part of the conflicts of interest questionnaire the individual is asked to acknowledge that they have received and read a copy of the policy, agree to comply with the policy, acknowledge that the hospital is a charitable organization, which must engage primarily in activities which accomplish our tax exempt purposes in order to maintain our tax exempt status, agree to report promptly to the Board of Directors any changes in their answers to the questions or any change in circumstance that might develop prior to the completion of their next annual questionnaire. With respect to directors of the organization, they also acknowledge that none of the conditions of the policy which would make them ineligible to remain on the board exist at the time they sign the acknowledgment and that they would report any conditions which become applicable immediately to the chairperson of the Board of Directors. On an annual basis these documents are sent by the Secretary of the Hospital to each interested person and to those employees of the Hospital that the Board determines. The document is completed by the individual and returned to the Secretary of the board through General Counsel, who annually analyzes any disclosed conflict of interest or any other fact that might make the individual not independent for IRS tax exempt purposes. The Secretary then submits to the Board of Directors a confidential report concerning any interest of employees of the Hospital disclosed by such questionnaire, any interest of directors and officers who are not employees of the hospital, and what actions the President of the organization may take as a result of any conflicts disclosed by such individuals. An individual is ineligible to serve on the Board of Directors for any of the following reasons as taken from Hannibal Regional Hospital Board of Directors Policy B-VII: a. Failure to adhere completely to disclosure requirements; b. the individual is an owner, partner, employee, board member or investor in a direct competitor of the Hospital, or any entity affiliated with the Hospital. An ownership or investment interest in a direct competitor of the Hospital, or any entity affiliated with the Hospital, of five (5) percent or less will not make individual ineligible to serve on the Board of Directors; c. The individual is an employee of the Hospital, or any entity affiliated with the Hospital, or a family member is a member of the management team of the Hospital, or any entity affiliated with the Hospital; d. The individual receives direct compensatory benefit for ongoing services provided to the Hospital, or any entity affiliated with the Hospital (serving as a "de facto employee"); e. The individual is an owner, partner, employee, board member or investor or other vendor who receives a substantial amount of revenue from the Hospital, or any entity affiliated with the hospital - the greater of $200,000.00 or 2% of the annual revenues of that vendor in the preceding or current year. f. The individual is an owner, partner, employee, board member or investor of an entity who has contracted with Hospital for the exclusive provision of any medical services within the Hospital, or its affiliates.
Form 990, Part VI, Section B, line 15The board of directors has delegated to the Compensation Committee, pursuant to a charter adopted by the board of directrors, the responsibility to act on behalf of the board of directors in administering compensation plans and making decisions on the compensation of the Chief Executive Officer and those executives who report directly to the Chief Executive Officer who qualify as "disqualified persons" within the meaning of section 4958 of the Internal Revenue Code. The committee engages an independent consultant to assist the committee with its governance and oversight role and its compliance with Section 4958 of the Internal Revenue Code, by providing an opinion on the reasonableness of the organization's compensation plan. The consultant uses published survey data to provide comparative market data for each position. The committee then reports its actions to the board of directors. The committee is composed solely of independent members of the board of directors. The scope of the committee includes, but is not limited to, reviewing and approving the annual base salary levels, annual incentive opportunity levels, executive perquisites, employment agreements, benefits and supplemental benefits.
Form 990, Part VI, Section C, line 19The articles of incorporation and amendments thereto are available on the Missouri Secretary of State's website.
Form 990, Part XI, Line 2cThe organization's policy regarding oversight of audit is consistent with the prior year.
Form 990, Part I, Line 15 and Line 17Employee health insurance costs for tax year 2008 were reclassified in the 2009 Form 990 to Line 15 from Line 17 to be consistent with the 2009 presentation.
Form 990, Part VI, Section AIn its continuing effort to better serve the residents of the Hannibal, Missouri region, a separate entity and board was previously created for the Hannibal Regional Healthcare System (HRHS) to provide the necessary oversight and to begin to foster ideas to expand the service offerings of not only the hospital, but the entire system. The hospital and HRHS boards meet and vote separately on their respective issues and several members are on both boards to provide continuity and to better share ideas. The HRHS board elects the members of the hospital board.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1LanacBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16000 hospital driveAddressLine1
CityhannibalCity
StateMOState
ZIP Code63401ZIPCode
FieldValueIRS element (for citing)
EIN431822503EIN
Primary Activitiesreal estatePrimaryActivities
Legal Domicile StateMOLegalDomicileState
Total Income0TotalIncome
EOY Assets0EOYAssets
Direct Controlling Entity NAN/ADirectControllingEntityNA

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Hannibal Regional Hospital FoundationBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1175 shinn laneAddressLine1
CityhannibalCity
StateMOState
ZIP Code63401ZIPCode
FieldValueIRS element (for citing)
EIN431658744EIN
Primary ActivitiesfundraisingPrimaryActivities
Legal Domicile StateMOLegalDomicileState
Exempt Code Section501(c)(3)ExemptCodeSection
Public Charity StatusLine 11a, Type 1PublicCharityStatus

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Hannibal Mobile DiagnosticsBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO Box 1254AddressLine1
CityHannibalCity
StateMOState
ZIP Code63401ZIPCode
FieldValueIRS element (for citing)
EIN300234397EIN
Primary ActivityimagingPrimaryActivity
Legal Domicile StateMOLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Share Of Total Income49896ShareOfTotalIncome
Share Of EOY Assets448ShareOfEOYAssets
Disproportionate Allocations0DisproportionateAllocations
General Or Managing Partner0GeneralOrManagingPartner

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Hannibal regional physician hospital organization incBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16500 hospital driveAddressLine1
CityhannibalCity
StateMOState
ZIP Code64301ZIPCode
FieldValueIRS element (for citing)
EIN431706291EIN
Primary ActivityPhysician Hospital OrganizationPrimaryActivity
Legal Domicile StateMOLegalDomicileState
Type Of EntityCTypeOfEntity
Share Of Total Income6071ShareOfTotalIncome
Share Of EOY Assets149950ShareOfEOYAssets
Percentage Ownership0.50000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Hannibal regional hospital foundation
C683092
Hannibal regional physician hospital organization inc
B88200
Hannibal regional physician hospital organization inc
A6071

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.