2025-03-14T16:43:09+00:00 2024-04-30 440160260 Forvis Mazars LLP 910 E St Louis 200 PO Box 1190 Springfield MO 658062523 990 2023-05-01 237339737 Lake Regional Health System LAKE 5733488000 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 PAULA LITTLETON CFO 5733488388 2025-03-14 true true Brian Todd P00422601 4178658701 2025-03-14 2023 2025-03-06 01:10:19Z KEVIN MCROBERTS 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 287700868 false X www.lakeregional.com X 1973 MO LAKE REGIONAL HEALTH SYSTEM PROVIDES AN EXTENSIVE VARIETY OF OUTPATIENT AND INPATIENT HEALTHCARE SERVICES AS WELL AS AN EMERGENCY DEPARTMENT TO RESIDENTS AND VISITORS. 16 11 1797 61 0 0 163961 8248686 237343871 242148511 3183365 9451812 -324110 -2370096 240367087 257478913 75851 56623 0 108352698 118502299 0 0 127544009 134325519 235972558 252884441 4394529 4594472 251009196 255217055 90720379 95700155 160288817 159516900 X TO PROVIDE EXCEPTIONAL HEALTHCARE. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. false false 136484811 0 162183346 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 392,229 OUTPATIENT SERVICE VISITS. 49678660 0 55538135 LAKE REGIONAL HEALTH SYSTEM PROVIDES INPATIENT SERVICES TO THE COMMUNITY AND SURROUNDING RURAL AREAS. THE HOSPITAL PROVIDED 17,617 INPATIENT DAYS, 2,418 SKILLED NURSING FACILITY INPATIENT DAYS AND 1,032 NURSERY PATIENT DAYS FOR A TOTAL OF 21,067 INPATIENT DAYS. 9440389 0 22276014 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 38,899 VISITS. 3030927 56623 2151016 OTHER SERVICES INCLUDE MANAGEMENT FEES, CAFETERIA INCOME, INCOME FOR THE AUXILIARY, AND OTHER PROGRAM SERVICE ACTIVITIES. 3030927 56623 2151016 198634787 true true false true false false false false true true false false false true false false true false false false false false false false false true true false true true true false false false false false false false false true true false false false false false true true true false false true 146 0 true 1797 true false false false false false false false false false false false false X 16 11 true false false false false false false true true false true true true true true true true true true true true true X KEVIN MCROBERTS 5733488000 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 CHARLES MCELYEA ASSISTANT SECRETARY 1.0 0.0 X X 0 0 0 DENNIS MICHAELREE SECRETARY 1.0 0.0 X X 0 0 0 JASON HULETT VICE PRESIDENT 1.0 0.0 X X 0 0 0 KAREN FAIFERLICK PRESIDENT 1.0 0.0 X X 0 0 0 WAYNE COMPTON TREASURER 1.0 0.0 X X 0 0 0 ALAN MEAD MD BOARD MEMBER 1.0 0.0 X 0 0 0 COREY TEN BENSEL BOARD MEMBER 1.0 0.0 X 0 0 0 GREGORY ANDERSON BOARD MEMBER 1.0 0.0 X 0 0 0 JAMES JUDAS JR BOARD MEMBER 1.0 1.0 X 0 0 0 JEFFREY JONES CHIEF OF STAFF 1.0 40.0 X 0 511247 15037 JOHN CAINE BOARD MEMBER 1.0 0.0 X 0 0 0 JOHN PARRISH BOARD MEMBER 1.0 0.0 X 0 0 0 JOHN PATTON BOARD MEMBER 1.0 40.0 X 0 725994 15795 KEVIN BYRNE DO BOARD MEMBER 1.0 40.0 X 0 931985 18834 LARRY SHIELDS BOARD MEMBER 1.0 0.0 X 0 0 0 MARK RECTOR BOARD MEMBER 1.0 0.0 X 0 0 0 DENNIS LOCKARD INTERIM CFO BEG 11/23 40.0 2.0 X 111589 0 0 HENRY ZEISEL CFO END 10/23 40.0 2.0 X 587418 0 17030 KEVIN MCROBERTS CEO 40.0 2.0 X 584663 0 99638 JENNIFER BETHUREM VP OF PUBLIC AFFAIRS 40.0 0.0 X 201367 0 29067 MELISSA HUNTER COO 40.0 0.0 X 377632 0 51070 PATRICK NEECE CIO 40.0 0.0 X 315928 0 43453 THOMAS WILLIAMS VP OF HUMAN RESOURCES 40.0 0.0 X 240335 0 35928 AMY THOMPSON PHYSICIAN 40.0 0.0 X 532481 0 18634 CHRISTINE LIVEK PHYSICIAN 40.0 0.0 X 519987 0 15749 HARBAKSH SANGHA PHYSICIAN 40.0 0.0 X 978658 0 138824 MICHELLE HELTON PHYSICIAN 40.0 0.0 X 509590 0 18530 SHAHID WAHEED PHYSICIAN 40.0 0.0 X 704863 0 16632 GRANT BARNUM DO FORMER BOARD MEMBER 40.0 0.0 X 146676 0 0 JOSH BRICKNER DO FORMER BOARD MEMBER 40.0 0.0 X 0 579125 14727 MICHAEL BURCHAM FORMER LRMG ADMINISTRATION 0.0 0.0 X 187727 0 924 5998914 2748351 549872 169 true true false R3 DYNAMICS PO BOX 640 ST PETERS MO 63376 COLLECTION 1346009 WYRICK MECHANICAL LLC 43352 HWY CC RUSSELLVILLE MO 65074 REPAIRS 1046261 HAMMES COMPANY HEALTHCARE 1400 N WATER STREET SUITE 500 MILWAUKEE WI 53202 CONSULTING 587434 CCS SALYER LLC 45211 HELM ST PLYMOUTH MI 48170 PATIENT CARE 530584 ALL-STAR RECRUITING LOCUMS LLC 800 FAIRWAY DRIVE STE 300 DEERFIELD BEACH FL 33441 RECRUITING SERVICE 445366 25 1305808 4000000 2942878 8248686 PATIENT SERVICE 624100 234989329 234989329 CAFETERIA INCOME 722320 1851290 1851290 AUXILIARY INCOME 900099 2696711 2696711 OTHER INCOME 900099 2611181 2611181 0 0 0 0 242148511 3931120 3931120 93806 634450 -540644 0 -540644 -540644 35106897 1300 29581845 5660 5525052 -4360 5520692 5520692 CHANGE IN INTEREST IN EQUITY INVESTEES 900099 -1829452 -1829452 0 0 0 0 -1829452 257478913 242148511 0 7081716 X 43590 43590 13033 13033 2695118 1113003 1582115 158139 158139 94682224 72248710 22433514 2177238 1847906 329332 12060752 9881224 2179528 6728828 5507351 1221477 281200 281200 349208 349208 207256 207256 36080195 22953246 13126949 0 93457 93457 10837707 6880681 3957026 13981 13981 3427648 2646239 781409 601507 346125 255382 90531 66825 23706 1991668 1564207 427461 13120829 9392359 3728470 2916790 97789 2819001 MEDICAL SUPPLIES & DRUGS 54200678 54200678 PROVIDER TAX 8683809 8683809 CAFETERIA/VENDING 1236469 971092 265377 MISCELLANEOUS 192586 18781 173805 0 0 0 0 252884441 198634787 54249654 0 132545 773457 7363040 6442269 28383086 28961187 0 0 0 0 5643190 6146650 4095644 3160699 275926120 184435095 93155122 91491025 103626709 109248401 3376570 498050 0 2025485 868065 3207805 7627252 251009196 255217055 25733741 29952132 60243884 58347226 0 0 222546 140499 4520208 7260298 90720379 95700155 X 159334067 158562150 954750 954750 160288817 159516900 251009196 255217055 X 4594472 2008268 -7374657 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false true 12500 true 23039 35539 true Schedule C, Part II-B, Line 1h RALLIES, DEMONSTRATIONS, SEMINARS, CONVENTIONS, ETC LAKE REGIONAL HEALTH SYSTEM PARTICIPATED IN THE FOLLOWING DURING THE YEAR: $12,500 RURAL REFERRAL CENTER/SOLE COMMUNITY HOSPITAL COALITION Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY A PORTION OF THE DUES PAID TO THE MISSOURI HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION ARE USED FOR LOBBYING PURPOSES. $16,698 MISSOURI HOSPITAL ASSOCATION $6,340 AMERICAN HOSPITAL ASSOCIATION 954750 34282 34282 954750 954750 29036 29036 954750 954750 46470 46470 954750 954750 4268 4268 954750 954750 31695 31695 954750 0.0 1.0 0.0 false false 7171609 7171609 131612630 86318408 45294222 128839744 93820417 35019327 8302137 4296270 4005867 91491025 EST AMT DUE TO 3RD PTY PYRS 5601316 MALPRACTICE PAYABLE 200000 ROU LIABILITIES 1458982 7260298 Schedule D, Part X, Line 2 UNCERTAIN TAX POSITIONS 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. Schedule D, Part V, Line 4 Intended uses of endowment funds THE ENDOWMENT FUND WAS ESTABLISHED BASED ON A CONTRIBUTION TO LAKE REGIONAL HEALTH SYSTEM. THIS CONTRIBUTION INCLUDED THE DONOR RESTRICTION THAT THE ENDOWMENT WOULD BE ESTABLISHED WITH THE INTENTION OF GENERATING INVESTMENT INCOME TO BE USED IN THE DAILY OPERATIONS OF THE ORGANIZATION AND THE PRINCIPLE OF THE ENDOWMENT FUND WOULD REMAIN IN PERPETUITY. true true X true X false true true true false false 5908537 0 5908537 0.0234 41737109 32882624 8854485 0.0350 0 0 0 0.0 0 0 47645646 32882624 14763022 0.0584 100755 11450 89305 0.0004 491935 0 491935 0.0019 0 0 0 0.0 0 0 0 0.0 181113 0 181113 0.0007 0 0 773803 11450 762353 0.0030 0 0 48419449 32894074 15525375 0.0614 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 false 21292360 3900760 53955042 58008412 -4053370 X true true LAKE REG IMAGING PTR DIAGNOSTIC IMAGING SERVICES 0.0051 0.0 0.0049 1 1 LAKE REGIONAL HEALTH SYSTEM 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 WWW.LAKEREGIONAL.COM 291-35 X X X LAKE REGIONAL HEALTH SYSTEM 1 false false true X X X X X X X X X 21 true false false true X HTTPS://WWW.LAKEREGIONAL.COM/ABOUT-US/REPORTS/ true 21 true HTTPS://WWW.LAKEREGIONAL.COM/ABOUT-US/REPORTS/ false true X 200.0 0.0 X X X true true X X X true X https://www.lakeregional.com/patients-and-visitors/patients/billing-and-insurance/ X https://www.lakeregional.com/patients-and-visitors/patients/billing-and-insurance/ X https://www.lakeregional.com/patients-and-visitors/patients/billing-and-insurance/ X X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - LAKE REGIONAL HEALTH SYSTEM. FROM MAY TO JULY 2021, A TOTAL OF 724 COMMUNITY SURVEYS WERE COLLECTED ONLINE AND VIA PAPER COPY. THE SURVEY WAS INTENDED TO YIELD INFORMATION ABOUT THE OVERALL HEALTH OF THE COMMUNITY. SURVEY TOPICS INCLUDE DEMOGRAPHIC AND SOCIOECONOMIC CHARACTERISTICS, BEHAVIORAL RISK FACTORS, HEALTH CONDITIONS, RESPONSE TO COVID-19, AND ACCESS TO HEALTH CARE. NOTICE OF THE SURVEY WAS SHARED WITH THE COMMUNITY THROUGH LOCAL MEDIA AND SOCIAL MEDIA. TO REACH LOW-INCOME, MEDICALLY UNDERSERVED AND CHRONICALLY ILL POPULATIONS, A PAPER VERSION OF THE SURVEY WAS DISTRIBUTED AT SUPPORT GROUPS, COMMUNITY EVENTS, COUNTY HEALTH DEPARTMENT SITES, A FREE CLINIC SITE, A FEDERALLY-QUALIFIED HEALTH CENTER AND LAKE REGIONAL PRIMARY CARE CLINICS. THE ONLINE SURVEY WAS SHARED WITH LAKE-AREA COMMUNITY PARTNERS, INCLUDING SCHOOL DISTRICTS; POPULATION HEALTH PARTNERS, INCLUDING COUNTY HEALTH DEPARTMENTS; AND BUSINESS PARTNERS, INCLUDING CHAMBERS OF COMMERCE. LAKE REGIONAL EMPLOYEES ALSO PARTICIPATED IN THE SURVEY. ADDITIONALLY, DIRECT INTERVIEWS WITH LOCAL FIRST RESPONDERS, BUSINESS OWNERS, SCHOOL HEALTH COORDINATORS, AND OTHER HEALTH ORGANIZATION REPRESENTATIVES ALSO WERE RECORDED. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - LAKE REGIONAL HEALTH SYSTEM. LAKE AREA COMMUNITY HEALTH PARTNERS MET IN AUGUST 2021 TO REVIEW THE DATA COLLECTED FROM SECONDARY RESEARCH AND THE COMMUNITY NEEDS ASSESSMENT SURVEY. THE COMMITTEE INCLUDED LAKE REGIONAL EMPLOYEES; LOCAL HEALTH DEPARTMENT ADMINISTRATORS; AND A REPRESENTATIVE FROM A FEDERALLY-QUALIFIED HEALTH CENTER. COMMON THEMES WERE IDENTIFIED, SCORED AND WEIGHTED TO PRIORITIZE THE HEALTH NEEDS OF THE COMMUNITY. THE TOP COMMUNITY HEALTH PRIORITIES IDENTIFIED WERE: - MENTAL HEALTH - ACCESS TO HEALTH CARE - ABILITY TO PAY AND/OR LACK OF INSURANCE MENTAL HEALTH WAS CITED AS THE HIGHEST PRIORITY NEED TO BE ADDRESSED. THE AREA FACES LIMITED RESOURCES FOR TREATMENT OF MENTAL HEALTH, INCLUDING LACK OF ACCESS TO BEHAVIOR HEALTH SPECIALISTS. GOALS RELATED TO MENTAL HEALTH INCLUDED: - INCREASE STAFF AND COMMUNITY KNOWLEDGE ABOUT RISK FACTORS AND WARNING SIGNS OF MENTAL ILLNESS, AS WELL AS HOW TO INTERACT WITH A PERSON IN CRISIS. - OFFER MONTHLY SUPPORT GROUP MEETINGS TO ASSIST INDIVIDUALS IN ENHANCING COPING SKILLS FOLLOWING PHYSICAL, MENTAL AND/OR EMOTIONAL TRAUMA, THROUGH EDUCATION, MUTUAL SUPPORT AND INFORMATION SHARING IN A CONFIDENTIAL SETTING. - CONNECT BEHAVIORAL HEALTH PATIENTS TO COUNSELING AND COMMUNITY RESOURCES. - ACCESS TO HEALTH CARE WAS CITED AS ONE OF THE MOST PRESSING HEALTH CONCERNS AS IT RELATES TO LACK OF HEALTH PROVIDERS OR RECEIVING MEDICAL ATTENTION IN A TIMELY MANNER. GOALS RELATED TO ACCESS TO HEALTH CARE INCLUDED: - EXPANSION IN LACLEDE COUNTY, INCLUDING BUILDING A NEW CLINIC INCLUDING SPECIALTY, REHAB, AND OTHER SERVICES. - OUTREACH SERVICES IN LACLEDE COUNTY, INCLUDING CARDIAC AND ORTHOPEDIC SERVICES CURRENTLY AND PLANS TO ADD GASTROENTEROLOGY, NEPHROLOGY, AND SLEEP MEDICINE. - TELEHEALTH EXPANSION AND PROMOTION AT ALL SPECIALTY AND PRIMARY CARE CLINICS. - ABILITY TO PAY FOR HEALTH CARE AND LACK OF INSURANCE WAS CITED AS ANOTHER ONE OF THE MOST PRESSING HEALTH CONCERNS AND RELATES TO ECONOMIC FACTORS INCLUDING LOW-PAYING JOBS, SEASONAL EMPLOYMENT, HIGH HEALTH-CARE COSTS, LIMITED LOW-COST HOUSING AND AFFORDABILITY OF BASIC NECESSITIES. GOALS RELATED TO ABILITY TO PAY INCLUDED: - EDUCATE LAKE REGIONAL STAFF AND COMMUNITIES REGARDING ASSISTANCE PROGRAMS, AS WELL AS FREE, LOW-COST, AND SLIDING SCALE CLINICS AND SERVICES. - OFFERING FINANCIAL ASSISTANCE THROUGH COMMERCE BANK HEALTH SERVICES FINANCING PROGRAM. - MISSOURI HEALTHNET EXPANSION AND ENROLLMENT Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - LAKE REGIONAL HEALTH SYSTEM. FINANCIAL ASSISTANCE WILL BE CONSIDERED ON CATASTROPHICALLY NEEDY PATIENTS ON A CASE-BY-CASE BASIS. THE HOSPITAL WILL USE PRESUMPTIVE ELIGIBILITY WHEN A PATIENT IS PROVEN TO HAVE THE FOLLOWING CIRCUMSTANCES: -HOMELESS OR RECEIVING CARE FORM A HOMELESS CLINIC -PARTICIPATION IN WOMEN'S INFANTS AND CHILDREN'S PROGRAMS (WIC) -FOOD STAMP ELIGIBILITY -ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED (E.G. MEDICAID SPEND-DOWN) -LOW INCOME/SUBSIDIZED HOUSING (SECTION 8) IS PROVIDED AS A VALID ADDRESS -PATIENT IS DECEASED WITH NO KNOWN ESTATE -INCARCERATED PRISONERS NOT EXPECTED TO BE RELEASED SOON -MENTALLY INCAPACITATED Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - LAKE REGIONAL HEALTH SYSTEM. ALL PATIENTS THAT ARE IN A ROOM HAVE ACCESS TO A BINDER THAT EXPLAINS THE FINANCIAL ASSISTANCE POLICY. Schedule H, Part V, Section B, Line 16 Facility , 2 Facility , 2 - LAKE REGIONAL HEALTH SYSTEM. LEP TRANSLATIONS: THERE ARE NO GROUPS WITH LIMITED ENGLISH PROFICIENCY THAT RISE TO THE THRESHOLD REQUIRED UNDER IRC SECTION 501(R). HOWEVER, A SPANISH TRANSLATION IS AVAILABLE. 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 Schedule H, Part I, Line 7 PERCENT OF TOTAL EXPENSE 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). Schedule H, Part I, Line 7 COSTING METHODOLOGY THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEET 1, 3, AND 6 Schedule H, Part III, Line 9b COLLECTION POLICY COLLECTION ACTIVITY WILL BE SUSPENDED DURING THE CONSIDERATION OF 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. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HEALTH SYSTEMS DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HEALTH SYSTEM'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED APRIL 30, 2024. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2. Schedule H, Part III, Line 3 Bad Debt Expense Methodology LINE 3 WAS DETERMINED BY TAKING THE BAD DEBT EXPENSE (LINE 2) TIMES THE PERCENT OF PERSONS BELOW THE POVERTY LEVEL BASED ON US CENSUS BUREAU DATA. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENTS ACCOUNTS RECEIVABLE, THAT NOTE CAN BE FOUND ON PAGE 11 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs 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 SOLE COMMUNITY HOSPITAL, AND ALTERNATIVELY COULD QUALIFY AS A MEDICARE-DEPENDENT 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 FOR 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. Schedule H, Part V, Section B, Line 16a FAP website - LAKE REGIONAL HEALTH SYSTEM: Line 16a URL: https://www.lakeregional.com/patients-and-visitors/patients/billing-and-insurance/; Schedule H, Part V, Section B, Line 16b FAP Application website - LAKE REGIONAL HEALTH SYSTEM: Line 16b URL: https://www.lakeregional.com/patients-and-visitors/patients/billing-and-insurance/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - LAKE REGIONAL HEALTH SYSTEM: Line 16c URL: https://www.lakeregional.com/patients-and-visitors/patients/billing-and-insurance/; Schedule H, Part VI, Line 2 Needs assessment IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT DESCRIBED IN SCHEDULE H, PART V, SECTION B, A SECONDARY DATA REPORT WAS COMPILED FROM WWW.EXPLOREMOHEALTH.ORG, WHICH SUPPLIES COUNTY HEALTH DATA WITH ZIP CODE LEVEL DATA AND ANALYSIS FROM THE WASHINGTON SCHOOL OF MEDICINE AND HOSPITAL INDUSTRY DATA INSTITUTE. THIS REPORT REFERENCES SEVERAL SOURCES INCLUDING BUT NOT LIMITED TO THE U.S. CENSUS BUREAU, MISSOURI DEPARTMENT OF HEALTH AND SENIOR SERVICES, AND CENTERS FOR DISEASE CONTROL AND PREVENTION. PRIMARY DATA COLLECTION INVOLVED CONDUCTING A NEEDS ASSESSMENT SURVEY. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance SIGNAGE WILL BE POSTED IN ALL PATIENT INTAKE AREAS, INCLUDING, BUT NOT LIMITED TO, THE EMERGENCY ROOM AND THEY ADMISSION/PATIENT REGISTRATION AREAS. ALL PUBLIC INFORMATION AND/OR FORMS REGARDING THE PROVISIONS 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 SERVICE 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. Schedule H, Part VI, Line 4 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 FOUR COUNTY AREA: CAMDEN, LACLEDE, MILLER, AND MORGAN COUNTIES. THE OVERALL SERVICE AREA 2019 POPULATION IS ESTIMATED AT 96,469. IN ADDITION TO THE RESIDENT POPULATION OF NEARLY 100,000, 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 ANNUALLY. 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 = $53,478, LACLEDE = $47,257, MILLER = $47,171 AND MORGAN = $39,003. THE CAMDEN COUNTY 2022 ANNUAL UNEMPLOYMENT RATE AT 2.8%, BELOW THE STATE (3.4%) AND NATIONAL (3.6%) AVERAGES. CAMDEN COUNTY HAS APPROXIMATELY 14.8% OF PERSONS BELOW POVERTY LEVEL. THE IMMEDIATE 4-COUNTY AREA OF CAMDEN, LACLEDE, MILLER, AND MORGAN ESTIMATES UNINSURED INDIVIDUALS AT 34.25%. 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. Schedule H, Part VI, Line 5 Promotion of community health LRHS SHOWS ITS SUPPORT OF THE COMMUNITY BY PROVIDING A TWO-DAY CAREER CAMP FOR STUDENTS 10-14. THE STUDENTS LEARN ABOUT CAREERS IN NURSING, REHAB THERAPIES, LABORATORY, SURGERY AND RESPIRATION THERAPIES, AND LABORATORY. CAMP INSTRUCTORS ALSO COVER TOPICES SUCH AS PATIENT CONFIDENTIALITY, INFECTION CONTROL, DISASTER MANAGEMENT, DATA MANAGEMENT, PROFESSIONAL SCHOOLS IN MISSOURI AND SCHOLARSHIP OPPORTUNITIES. ANOTHER APPROACH TO SUPPORTING THE COMMUNITY IS THORUGH LRHS'S COLLARBORATION WITH LAKE AREA COMMUNITY PARTNERS (INCLUDING SCHOOL DISTRICTS, POPULATION HEALTH PARTNERS SUCH AS THE COUNTY HEALTH DEPARTMENTS AND BUSINESS PARTNERS SUCH AS THE CHAMBER OF COMMERCE) TO CREATE AN ACTIONABLE PLAN ADDRESSING THE COMMUNITY'S KEY HEALTH NEEDS. THIS OCCURS DURING OUR COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. ACTION PLANS ARE CREATED AND MAINTAINED TO ENSURE WORK IS BEING DONE TO IMPROVE THE ISSUES IDENTIFIED. Schedule H, Part VI, Line 6 Affiliated health care system 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. Lake Regional Health Foundation (the "Foundation") is a wholly owned subsidiary of the Health System. The Foundation is a not-for-profit entity whose sole purpose is to support the Health System's fundraising efforts to assist with educational and healthcare needs. true SCHOLARSHIPS 5 13033 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. 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 AND HOSPITAL EMPLOYEES. X X true true X X X X X true true false false false true false false false JOSH BRICKNER DO FORMER BOARD MEMBER 0 556092 0 0 0 23033 0 13200 0 1527 0 593852 0 0 GRANT BARNUM DO FORMER BOARD MEMBER 146676 0 0 0 0 0 0 0 0 0 146676 0 0 0 KEVIN BYRNE DO BOARD MEMBER 0 911441 0 15000 0 5544 0 13200 0 5634 0 950819 0 0 JOHN PATTON BOARD MEMBER 0 714734 0 10000 0 1260 0 13200 0 2595 0 741789 0 0 JEFFREY JONES CHIEF OF STAFF 0 494346 0 15000 0 1901 0 13200 0 1837 0 526284 0 0 KEVIN MCROBERTS CEO 518185 0 40500 0 25978 0 94706 0 4932 0 684301 0 0 0 HENRY ZEISEL CFO END 10/23 340826 0 30457 0 216135 0 13200 0 3830 0 604448 0 0 0 MICHAEL BURCHAM FORMER LRMG ADMINISTRATION 86950 0 0 0 100777 0 0 0 924 0 188651 0 0 0 MELISSA HUNTER COO 336289 0 24505 0 16838 0 48035 0 3035 0 428702 0 0 0 THOMAS WILLIAMS VP OF HUMAN RESOURCES 224363 0 15234 0 738 0 31438 0 4490 0 276263 0 0 0 JENNIFER BETHUREM VP OF PUBLIC AFFAIRS 186971 0 14006 0 390 0 26249 0 2818 0 230434 0 0 0 PATRICK NEECE CIO 292930 0 22322 0 676 0 41287 0 2166 0 359381 0 0 0 HARBAKSH SANGHA PHYSICIAN 954226 0 0 0 24432 0 132200 0 6624 0 1117482 0 0 0 MICHELLE HELTON PHYSICIAN 493131 0 16000 0 459 0 13200 0 5330 0 528120 0 0 0 SHAHID WAHEED PHYSICIAN 677558 0 10000 0 17305 0 13200 0 3432 0 721495 0 0 0 AMY THOMPSON PHYSICIAN 516261 0 15000 0 1220 0 13200 0 5434 0 551115 0 0 0 CHRISTINE LIVEK PHYSICIAN 494903 0 17500 0 7584 0 13200 0 2549 0 535736 0 0 0 Schedule J, Part I, Line 1a Travel for companions REIMBURSEMENT POLICY: 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. THE AUTO ALLOWANCE FOR 2023 WAS $3,770. Schedule J, Part I, Line 4a Severance or change-of-control payment The following people received a severance or change-of-control payment: $ 97,230 Michael Burcham 211,935 Henry Zeisel Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan THE FOLLOWING PEOPLE PARTICIPATED IN A 457(F) NONQUALIFIED RETIREMENT PLAN AND HAD A DEFERRED CONTRIBUTION TO A 457(F) NONQUALIFIED RETIREMENT PLAN: CONTRIBUTIONS: $18,100 JENNIFER BETHUREM 35,835 MELISSA HUNTER 28,848 PATRICK NEECE 21,656 THOMAS WILLIAMS 81,506 KEVIN MCROBERTS Schedule J, Part I, Line 5a COMPENSATION CONTINGENT ON REVENUES OF THE ORGANIZATION INDIVIDUALS RECEIVING INCENTIVE COMPENSATION ON PART II OF SCHEDULE J ARE ELIGIBLE TO RECEIVE THESE PAYMENTS IN AN AMOUNT THAT IS A PERCENTAGE OF BASE COMPENSATION FOR MEETING CERTAIN PERFORMANCE CRITERIA, INCLUDING SPECIFIED REVENUE TARGETS. A HEALTH & EDUCATIONAL FACILITIES AUTHORITY OF MO 431178966 2021-08-18 60252593 DEFEASE 2012, FUND 2016 & CAPITAL false false false A 60252593 3091348 12414490 874760 43871995 true false true true A false false false false 0.0 false false true A false true false false false false false false true A true MITCH SHIELDS FAMILY MEMBER OF L SHIELDS 40473 WAGES false SHERRIE WILLIAMS VP TOM WILLIAMS SPOUSE 118665 WAGES false LAKE OZARK ANESTHESIA & ASSOC OWNED BY ALAN MEAD 2427170 PHYSICIAN SERVICES false Form 990, Part III, Line 1 ORGANIZATION'S MISSION OUR MISSION: PROVIDE EXCEPTIONAL HEALTHCARE. OUR VISION: TO BE THE FIRST CHOICE FOR HEALTH CARE. OUR CORE COMPETENCIES: AGILITY, COMMUNITY FOCUS, SERVICE EXCELLENCE. OUR VALUES: INTEGRITY, PATIENT CENTERED, CLINICAL EXCELLENCE, COMMITMENT TO COMMUNITY. THE SYSTEM WAS ORGANIZED IN 1973 FOR THE PURPOSE OF ESTABLISHING A NEW HOSPITAL FOR MEDICAL AND SURGICAL CARE AND FOR THE TREATMENT OF PERSONS RESIDING OR VISITING IN THE LAKE OF THE OZARKS AREA OF CENTRAL MISSOURI. IN THE MORE THAN 40 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 1,400 EMPLOYEES. ITS BOARD HAD 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-LICEENSED 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 A SOLE COMMUNITY HOSPITAL, MEANING THAT THE HOSPITAL IS THE PRIMARY HEALTH CARE PROVIDER FOR A MAJORITY OF MEDICARE PATIENTS WITHIN A 35-MILE RADIUS OF THE HOSPITAL. THE CORPORATION HAS ONE ACTIVE, WHOLLY-OWNED FOR-PROFIT SUBSIDIARY, LAKE REGIONAL MEDICAL MANAGEMENT, INC. ("LRMM"), WHICH OPERATES FOUR RETAIL PHARMACIES AND FIFTEEN SPECIALTY CLINICS. OPERATIONS OF LRMM ARE GOVERNED BY A SEPARATE BOARD OF DIRECTORS. THE SYSTEM IS CURRENTLY GOVERNED BY A SIXTEEN-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. Form 990, Part III, Line 4 PROGRAM SERVICE ACCOMPLISHMENTS 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 RELATED 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 SERVICE 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. Form 990, Part III, Line 4d Description of other program services (Expenses $ 3,030,927 including grants of $ 56,623)(Revenue $ 2,151,016) OTHER SERVICES INCLUDE MANAGEMENT FEES, CAFETERIA INCOME, INCOME FOR THE AUXILIARY, AND OTHER PROGRAM SERVICE ACTIVITIES. Form 990, Part VI, Line 2 Family/business relationships amongst interested persons OFFICERS KEVIN MCROBERTS, MELISSA HUNTER, AS WELL AS BOARD MEMBERS CHARLES MCELYEA AND DENNIS MICHAELREE ARE ALL BOARD MEMBERS OF LAKE REGIONAL MEDICAL MANAGEMENT (LRMM), A RELATED TAXABLE ORGANIZATION. BOARD MEMBER JAMES JUDAS JR IS A BOARD MEMBERS OFLAKE REGIONAL HEALTH FOUNDATION, A RELATED TAX EXEMPT ORGANIZATION. KEVIN BYRNE, DO, JOHN PATTON, DO, AND JEFFREY JONES ARE ALSO EMPLOYED BY LRMM - Business relationship Form 990, Part VI, Line 11b Review of form 990 by governing body 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 MANAGER OF ACCOUNTING AND CFO. AFTER ANY CHANGES WERE MADE, THE MEMBERS OF THE BOARD OF DIRECTORS WERE PROVIDED A COPY. 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. Form 990, Part VI, Line 12c Conflict of interest policy EACH YEAR, ALL MEMBERS OF THE BOARD OF DIRECTORS, SENIOR MANAGEMENT, AND THE 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 THIS 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 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 PERSON, AND 5) BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS. Form 990, Part VI, Line 15b Process to establish compensation of other employees THE ORGANIZATION USED ARTHUR J GALLAGHER & CO, AN INDEPENDENT ORGANIZATION, TO HELP EVALUATE AND SET THE COMPENSATION FOR THE ORGANIZATION'S CEO. THE COMPENSATION DELIBERATIONS WERE DOCUMENTED IN THE MINUTES OF BOTH THE COMPENSATION COMMITTEE AND THE BOARD. THE REPORT IS DATED NOVEMBER 2022. Form 990, Part VI, Line 19 Required documents available to the public 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. Form 990, Part IX, Line 11g Other Fees OUTSIDE SERVICES - Total Expense: 14603935, Program Service Expense: 9944974, Management and General Expenses: 4658961, Fundraising Expenses: ; AGENCY FEES - Total Expense: 4154800, Program Service Expense: 4132650, Management and General Expenses: 22150, Fundraising Expenses: ; PROFESSIONAL FEES - Total Expense: 6740830, Program Service Expense: 6740830, Management and General Expenses: 0, Fundraising Expenses: ; CONTRACT SERVICES - Total Expense: 5686349, Program Service Expense: 674142, Management and General Expenses: 5012207, Fundraising Expenses: ; COLLECTION - Total Expense: 3064546, Program Service Expense: 0, Management and General Expenses: 3064546, Fundraising Expenses: ; OTHER FEES - Total Expense: 1685920, Program Service Expense: 1324080, Management and General Expenses: 361840, Fundraising Expenses: ; LAB FEES - Total Expense: 143815, Program Service Expense: 136570, Management and General Expenses: 7245, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances TRANSFER TO AFFILIATES - -7374657; LAKE REGIONAL HEALTH FOUNDATION 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 881797380 SUPPORT MO 501(c)(3) Type I LRHS true LAKE REGIONAL IMAGING CENTER 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 202107048 DIAGNOSTIC IMAGING MO LRHS Related 1478885 1951479 false false 0.5100 LAKE REGIONAL MEDICAL MANAGEMENT 54 HOSPITAL DRIVE OSAGE BEACH MO 65065 431473438 PHYSICIANS MO LRHS C Corporation 17551287 6917452 1.0000 true true false true false false false false false false true true true false false true true false true true LAKE REGIONAL MEDICAL MANAGEMENT R 7471502 FMV LAKE REGIONAL IMAGING PARTNERS K 78694 FMV LAKE REGIONAL MEDICAL MANAGEMENT L 1256502 FMV LAKE REGIONAL IMAGING PARTNERS L 1563216 FMV LAKE REGIONAL HEALTH FOUNDATION S 96845 FMV LAKE REGIONAL HEALTH FOUNDATION C 1035808 FMV