TY 2022 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) Warren McElwain...................................................................... President	1.00 .................	X	X		0	0
(2) Delvin Jackson...................................................................... Vice-President	1.00 .................	X	X		0	0
(3) Jennifer White...................................................................... Secretary	1.00 .................	X	X		0	0
(4) Michael Poland...................................................................... Treasurer	1.00 .................	X	X		0	0
(5) Barbara Ballew...................................................................... Director	1.00 .................	X			0	0
(6) Ken Raffety...................................................................... Director (Thru May 2023)	1.00 .................	X			0	0
(7) Steve Tinnen...................................................................... Director	1.00 .................	X			0	0
(8) Mike Brown...................................................................... Director	1.00 .................	X			0	0
(9) David Just...................................................................... Director	1.00 .................	X			0	0
(10) JoEllen Pratt...................................................................... Director	1.00 .................	X			0	0
(11) Laeeq Azmat Tahirkheli...................................................................... Physician & Director	40.00 .................	X			1,000,678	0
(12) Laura Harbison...................................................................... Physician & Director	40.00 .................	X			408,518	0
(13) Mark Baker...................................................................... Director	1.00 .................	X			0	0
(14) Joseph F Abrutz Jr...................................................................... Administrator	40.00 .................		X		450,404	13,899
(15) Rosa Patti...................................................................... Chief Financial Officer	40.00 .................		X		200,903	16,729
(16) Muhammad Amin...................................................................... Physician	40.00 .................			X	583,178	0
(17) Shahzad Shafique...................................................................... Physician	40.00 .................			X	669,733	0

(A) Name and business address	(B) Description of services	(C) Compensation
Premier Specialty Network 1835 E Republic Rd Suite 200 Springfield,MO65804	Physician specialists	1,765,930
Psychiatric Solutions Inc PO Box 840839 Dallas,TX75284	Operation of BHU unit	1,564,821
Cameron Emergency Physicians PC 1600 E Evergreen Cameron,MO64429	Emergency physicians	1,105,963
Laboratory Corporation of America PO Box 12140 Burlington,NC27216	Reference lab services	820,614
Comp Health PO Box 972651 Dallas,TX75397	Physician services	765,166
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 20

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public
Inspection

Name of the organization

Cameron Regional Medical Center

Employer identification number

44-0668347

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2022

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2022 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2022. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2021. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990) 2022

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2022 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2021 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2022 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2021 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2022. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2021. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2022

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2022

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2022

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2022

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2022 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2022	(iii) Distributable Amount for 2022
1 Distributable amount for 2022 from Section C, line 6
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2022:
a From 2017.......
b From 2018.......
c From 2019.......
d From 2020.......
e From 2021.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2022 distributable amount
i Carryover from 2017 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2022 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2022 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2022, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2022. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2023. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2018.....
b Excess from 2019.....
c Excess from 2020.....
d Excess from 2021.....
e Excess from 2022.....

Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2022

Name of the organization

Cameron Regional Medical Center

Employer identification number

44-0668347

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990) (2022)

Schedule B (Form 990) (2022) Page 2

Name of organization Cameron Regional Medical Center

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2022)

Schedule B (Form 990) (2022)

Page 3

Name of organization Cameron Regional Medical Center		Employer identification number 44-0668347

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2022)

Schedule B (Form 990) (2022)

Page 4


Name of organization Cameron Regional Medical Center			Employer identification number 44-0668347
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2022)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Cameron Regional Medical Center

Employer identification number

44-0668347

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2021

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	3,263,004		3,263,004
b	Buildings ....	30,982,202	19,152,869	11,829,333
c	Leasehold improvements
d	Equipment ....	44,926,004	38,805,428	6,120,576
e	Other .....	4,049,600	1,254,490	2,795,110
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				24,008,023

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)Deferred debt issuance costs				451,728
(2)Third party payor settlements				3,549,904
(3)Beneficial interest in net assets of CRMC Foundation				490,973
(4)Other receivables				216,231
(5)Accrued interest and dividends				52,736
(6)Cash value of life insurance				49,167
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				4,810,739

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	1,815,864
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2021

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
Part X, Line 2:	Management is not aware of any uncertainties in income tax positions.

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

Cameron Regional Medical Center

Employer identification number

44-0668347

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	645,469	585,938	59,531	0.080 %
b	Medicaid (from Worksheet 3, column a) . . . . .	10,554,670	5,392,458	5,162,212	7.100 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	11,200,139	5,978,396	5,221,743	7.180 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	350,968	850	350,118	0.480 %
f	Health professions education (from Worksheet 5) . . .	57,500		57,500	0.080 %
g	Subsidized health services (from Worksheet 6) . . . .	21,991,735	12,152,797	9,838,938	13.530 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	10,000		10,000	0.010 %
j	Total. Other Benefits . .	22,410,203	12,153,647	10,256,556	14.100 %
k	Total. Add lines 7d and 7j .	33,610,342	18,132,043	15,478,299	21.280 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022

Schedule H (Form 990) 2022

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

4,207,262

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

420,726

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

13,334,965

Enter Medicare allowable costs of care relating to payments on line 5.....

16,909,322

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-3,574,357

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2022

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	Cameron Regional Medical Center 1600 East Evergreen Street Cameron,MO64429	X	X	X

Schedule H (Form 990) 2022

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	Cameron Regional Medical Center Inc
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): http://www.cameronregional.org

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 21

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): http://www.cameronregional.org

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2022

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Cameron Regional Medical Center Inc
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 100.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

https://cameronregional.org/

The FAP application form was widely available on a website (list url):

https://cameronregional.org/

A plain language summary of the FAP was widely available on a website (list url):
https://cameronregional.org/

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2022

Page 6

Part VFacility Information (continued)

Billing and Collections

	Cameron Regional Medical Center Inc
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2022

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	Cameron Regional Medical Center Inc
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2022

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Cameron Regional Medical Center, Inc.	Part V, Section B, Line 5: The Medical Center conducted a town hall meeting and invited local hospital, public health community, mental health community, free clinics, community-based clinics, service providers, local residents, community leaders, opinion leaders, school leaders, business leaders, local government, faith-based organizations and persons (or organizations serving them), people with chronic conditions, uninsured community members, low income residents, and minority groups.
Cameron Regional Medical Center, Inc.	Part V, Section B, Line 11: Although COVID-19 began its decline in calendar year 2023, Cameron Regional Medical Center (CRMC) continued to assign a significant portion of its resources throughout FYE 09/30/2023, to addressing patient cases and the long-term, lingering effects of this virus. Given the many unknowns associated with COVID-19, CRMC remained persistent in its containment and mitigation efforts such as maintaining its vigilance toward tracking county transmission rates and the Medical Center's positivity rates. Since the onset of COVID-19 in 2020, CRMC has tested approximately 32,489 individuals, with 3,034 positive results (9.3% overall positivity rate). In FYE 09/30/2023, CRMC tested approximately 3,920 individuals, with 236 positive results (6.0% overall positivity rate). As in the previous three years, attending to the impact of COVID-19 was once again a distinct COMMUNITY HEALTH NEED in FYE 2023.CRMC's COVID-19 Task Force continued to meet on a monthly basis until April 1, 2023, at which time it was combined with the Infection Surveillance/Prevention Committee and its quarterly meetings. The Medical Center's mask mandate, screening/temping protocols at the main entrance, secondary entrance closures, social distancing, and visitor restrictions were also lifted effective April 1, 2023. In the interest of public health, CRMC continued to make masks and infection prevention, disinfecting, and hygiene products readily available to all patients, visitors, and employees.CRMC's COVID CARE Line that was enacted June 1, 2020, remained intact for the public throughout FYE 2023. This telephone call-in line was initiated for the purpose of fielding COVID-related questions and/or concerns. CARE Line personnel continued to work closely with area physicians, clinics, and other providers.COVID-19 containment and mitigation efforts throughout the Medical Center, Home Health, Hospice, and CRMC's 18 satellite clinics continued to bring higher expenses via increasing charges for labor, inflation, purchased services, drugs, personal protective equipment (PPE), infection prevention/disinfecting/hygiene products, and other medical and safety supplies. Severe staffing shortages still presented one of the worst challenges experienced in the health care sector in years. Rural hospitals in particular continued to suffer major financial stressors as a result of the above issues/concerns.CRMC's COVID-19 expense figure for the 12-month period ended September 30, 2023, was approximately $335,549.Priority/Objective No. 1 - Mental HealthEven though a shortage of mental health providers persisted in northwest Missouri, CRMC remained persistent in shrinking this deficit and maintaining/growing its offerings in this specialty. During FYE 2023, five part-time Psychiatrists (including a Child Psychiatrist) provided outpatient clinics and services at CRMC on a regularly-scheduled basis. In addition, a full-time Geriatric Psychiatrist continued to provide inpatient services for CRMC's Behavioral Health Unit (BHU). CRMC continued to significantly underwrite/subsidize its mental health program financially in order to assure these services remained readily available to all patients/payors (Medicare, Medicaid, veterans, self-pay, etc.).In November 2022, Chacy Lancaster, M.D., Psychiatrist, provided a free two-hour public education session on Fentanyl (opioids) and other illicit drugs, addiction, anxiety, peer pressure, and depression/suicide. Due to the relevant and timely nature of the topic, the session was videotaped and placed on CRMC's website for online viewing.For the past many years, CRMC's mental health services have been marketed extensively throughout its service area. An Outpatient Clinic Calendar denoting mental health offerings is placed in approximately 14 area newspapers each month, as well as on the Medical Center's website. This monthly Outpatient Clinic Calendar is also distributed via CRMC's 18 satellite clinics and mailed to approximately 80 physicians and providers throughout northern Missouri.For over 30 years, CRMC has operated a free transportation system for its patients to obtain needed medical services. This essential service has been expanded continuously over the years and takes struggling patients who have no other viable means of travel to/from area physicians' offices, CRMC, its satellite clinics, its outpatient specialty clinics, and other medical facilities. Free transportation to area tertiary centers and ancillary services (dentist, drug store, etc.) is also made available based on need and special circumstances. Toward this purpose, five courtesy vans and the necessary drivers were utilized in FYE 2023 on a full-time basis (six days per week) to cover ten-plus counties in rural northwest Missouri. A high percentage of patients who utilize this service are seeking mental health services. As previously referenced, CRMC operates a system of 18 primary care satellite clinics located throughout five counties in northwest Missouri to facilitate ease of access for its patients. In FYE 2023, these 18 satellite clinics continued to serve as both education and referral centers for their patients' mental health needs. The majority of CRMC's satellite clinics still utilize the Patient Health Questionnaire-9 (PHQ-9) for depression screening purposes.CRMC's BHU utilized TelePsychiatry services at least one day per week during FYE 2023 in order to maintain/enhance physician coverage. The BHU continued to play a vital role in CRMC's medical community by providing solutions and relief for area nursing homes, families, and physicians. A new two-bed expansion of the Behavioral Health Unit (BHU) opened in August 2023, taking the Unit from 10 to 12 beds at a construction cost of approximately $696,670, plus soft costs, architectural/engineering fees, and start-up costs. As the BHU rooms are all semi-private, this provided more flexibility for admissions due to male/female demographics and room assignment.Through the CHNA process, Preferred Family Healthcare (PFH) in Kirksville, Missouri has become a valued partner for CRMC over the past many years, providing collective impact, resources, education, and brochures otherwise unavailable in the area for both mental/behavioral health and substance abuse (see next section). Many CRMC staff members have participated in PFH's annual Mental Health First Aid classes that instruct on how to recognize signs of mental health and/or substance abuse challenges.CRMC and area Family Guidance offices continued to work together closely on mental health cases in FYE 2023, particularly on suicidal patients presenting to the Emergency Room. Upon notification to their hotline, Family Guidance will send a representative to perform the screening process and intake evaluation, day or night, 24/7. Working closely with the E.R. physician on a treatment plan, Family Guidance will facilitate transfer to an appropriate Psychiatric facility, if needed.In the last calendar quarter of 2022, CRMC and the CRMC Foundation collectively donated $20,000 to Clinco Sheltered Industries in Cameron, Missouri. This sheltered workshop is a not-for-profit entity, providing employment for numerous developmentally- and intellectually-disabled individuals, while offering valuable services such as recycling, custodial work, and retail establishments (Dollar Barn and Thrift Store) to the area. Priority/Objective No. 2 - Substance AbuseCRMC primary care physicians and providers continued to deliver counseling on alcohol temperance, smoking cessation, proper use of drugs/medications (including opioids), and other substance abuse issues to their patients at both the Medical Center and its 18 satellite clinics in an effort to combat abuse, addiction, resultant drunk driving, altered mental states, and relapse. Educational materials are provided according to individual patient need.CRMC continued to include detailed information on smoking cessation in all admission packets in FYE 2023. For those Emergency Room patients whose diagnosis was related to smoking, cessation information was provided at the time of discharge. For many years, CRMC has financially supported area post-graduation and post-prom parties to assist in providing alternative activities to drinking for the safety of area high school students. This continued in FYE 2023.As previously referenced, in November 2022, Chacy Lancaster, M.D., Psychiatrist, provided a free two-hour public education session on Fentanyl (opioids) and other illicit drugs, addiction, anxiety, peer pressure, and depression/suicide. The session was videotaped and placed on CRMC's website for extended online viewing.
Cameron Regional Medical Center, Inc.	Part V, Section B, Line 11: In FYE 2023, the CRMC Medical Staff and Board of Directors continued to prohibit the use and/or possession of marijuana (medical or otherwise) on CRMC's campus, premises, and all outlying/satellite facilities. None of CRMC's Active Staff physicians provide Physician Certification for Qualifying Medical Conditions for the use of marijuana.CRMC continued to assist the Cameron Police Department with marketing its annual "Prescription Drug Take-Back Day" that is held in concert with the DEA. A similar effort by a local drug store was also marketed by CRMC in FYE 2023.For referral purposes, CRMC's Emergency Room still maintains a list of area substance abuse/addiction treatment facilities, disseminating to patients and family members as appropriate. CRMC's Regional Resource Directory also provides a listing of area substance abuse programs (see further discussion under Priority/Objective No. 3).CRMC, through its network of primary care clinics, physicians, mid-levels, and the hospital Pharmacy, continued to facilitate and promote concerted efforts against prescription drug/medication abuse. The Medical Center's e-prescribing software and communication protocols with area pharmacies assisted in monitoring/tracking "doctor shopping" efforts by patients suspected of abusing the system. As there is a distinct cross-over in staff, CRMC pharmacists who also work locally in the retail setting continued to take the following precautions: a) Patients are not allowed to fill controlled prescriptions more than five days early; b) Any prescription presented by a patient not residing in the immediate area or written by a prescriber not in the immediate area will be investigated; c) Local retail pharmacy personnel and hospital pharmacy personnel communicate on a regular basis regarding suspicious controlled substance prescribing trends; and d) Any controlled prescription where the patient offers to pay by cash instead of using insurance will automatically be red-flagged by the pharmacist for further investigation.Starting in 2023, Missouri enacted a statewide prescription drug monitoring program (PDMP). Pharmacies are required to submit information to the PDMP when they dispense any Schedule II, III, or IV prescriptions to patients. Prescribers and pharmacists can also use this tool to make informed decisions and reduce risk for patients.In terms of health-care professionals, the CRMC Medical Staff continued in FYE 2023 to donate a substantial sum on an annual basis to the Missouri Association of Osteopathic Physicians and Surgeons' (MAOPS') Physicians Health Program (PHP). PHP provides addiction treatment resources and coordinates the care of the affected health-care professional throughout his/her treatment program, with the goal of facilitating and expediting his/her return to health and a normal personal and professional life.The Medical Center continued to assist its employees financially with smoking cessation products.Smoking/vaping is still prohibited within all CRMC facilities.As previously mentioned above, PFH in Kirksville, Missouri has remained a valued partner for CRMC over the past many years through the CHNA process, providing collective impact, resources, education, and brochures otherwise unavailable in the area for both mental/behavioral health and substance abuse. Many CRMC staff members have participated in PFH's annual Mental Health First Aid classes that instruct on how to recognize signs of mental health and/or substance abuse challenges.Priority/Objective No. 3 - Comprehensive Four-County Health Care Resource Guide (Combined with Priority/Objective No. 8 - see below)Priority/Objective No. 8 - Public Awareness of Health Care ServicesAs previously referenced, CRMC's Regional Resource Directory was developed several years ago and is updated on a regular basis. Covering CRMC's four-county primary service area (Clinton, Caldwell, Daviess and DeKalb), plus regional resources of importance, the Directory includes mental health services, alcohol/drug treatment (substance abuse) programs, physicians/medical clinics, wellness/fitness centers, nutrition resources, dentists, applicable government agencies, and several other categories addressing the health and well-being of area residents. It is distributed to the public upon request and disseminated at certain public meetings and educational events sponsored by CRMC. It is also shared with area organizations, health departments, coalitions, etc. upon request. During FYE 2023, CRMC's Regional Resource Directory was enhanced by the addition of a list of area Inpatient Mental Health facilities as provided by the staff of CRMC's BHU. Additionally, a list of basic living resources such as housing and utilities assistance had been developed as a result of CRMC's Diversity, Equity, and Inclusion (DEI) efforts and added to the Regional Resource Directory.CRMC's 21st Annual Health Fair was held in early Fall 2023 and was widely publicized, as it is each year. This Fair represented the fourth such event whereby a "distributed" format was used in order to decrease crowd size and help protect somewhat from COVID-19. The Health Fair was held in six different locations throughout five counties in rural northwest Missouri: 1) Orthopedic & Rehab Center at CRMC (Cameron, MO - Clinton County); 2) Bethany Health Services in Bethany, MO - Harrison County; 3) Hamilton Family Health Center in Hamilton, MO - Caldwell County; 4) Jamesport Outreach Clinic in Jamesport, MO - Daviess County; 5) Maysville Family Health Clinic in Maysville, MO - DeKalb County; and 6) Lathrop Medical Clinic in Lathrop, MO - Clinton County. Extensive blood work (anemia, blood sugar, thyroid, cholesterol panel, iron, hemoglobin A1C, GFR, and BUN/creatinine), blood pressures, and pulse oximetry were provided free of charge at all six locations. Moreover, carotid artery screenings and skin cancer screenings were offered free of charge at CRMC. Medical providers were on site at each location and available to counsel/educate attendees regarding medications, vaccinations, mental health, exercise, nutrition, diabetes, CRMC and satellite clinic services, etc. A record turn-out was experienced, with approximately 463 participants attending this annual health and wellness event.In FYE 2023, K.U. Medical Center and its Urology Residency Program, as hosted by CRMC under the direction of Moben Mirza, M.D., provided free quarterly education sessions at CRMC on various medical topics of interest for the public, such as UTIs, kidney stones, hematuria, and prostate cancer. These sessions continue to present day and are held in an attempt to enlighten area residents of the variety of Urology health care services available at CRMC.In FYE 2023, CRMC's Active Staff physicians provided free periodic education sessions for the public on various medical topics of interest, including antibiotic stewardship, abdominal pain, cardiac disease, and wound care. These sessions continue to present day and are held to inform area residents of the variety of health care services offered at CRMC.In FYE 2023, CRMC continued to sponsor free training/education classes focusing on diabetes, nutrition, food labels, and healthy eating. These are performed by CRMC's Registered Dieticians at least every 60 days, with excellent participation rates and feedback. These classes help inform the public of CRMC's available Health & Wellness services.In tandem with the Caldwell County Health Department, CRMC offered Prenatal Classes in FYE 2023. Breastfeeding and other prenatal topics were included to help create an awareness of CRMC's Obstetrics program.As previously mentioned, CRMC's monthly Outpatient Clinic Calendar denoting all specialists' clinics is still placed in approximately 14 area newspapers on a monthly basis, as well as on the Medical Center's website, in order to increase public awareness of CRMC's available health care services. This Outpatient Clinic Calendar is also distributed via CRMC's 18 satellite clinics and mailed to approximately 80 physicians and providers throughout northern Missouri.In FYE 2023, CRMC continued to utilize a broad spectrum of marketing mediums to educate the public on the health care services available at the Medical Center and its 18 satellite clinics. Marketing efforts include newspaper, radio, promotional flyers, website, social media, search engine optimization, and two large electronic message centers located on major highways.Priority/Objective No. 4 - Affordable and Safe Child Care Services (Not directly addressed - see below) Priority/Objective No. 5 - School Health (Not directly addressed - see below)Priority/Objective No. 6 - Long-Term Care Staffing and Training (Not directly addressed - see below)Priority/Objective No. 7 - Reimbursement for Providers
Cameron Regional Medical Center, Inc.	Part V, Section B, Line 11: As hospitals and physicians are at the mercy of their private third-party payors, CRMC has hired an outside firm for the past several years to audit/review the Medical Center's incoming remit advices to make sure reimbursement is in compliance with the respective third-party payor contract. In particular, this effort includes commercial insurance plans and Medicare Advantage plans.As third-party Recovery Audit Contractors (RACs) over the years have increasingly become a source of Lost Revenue for hospitals, CRMC continued to conduct monthly RACs meetings in FYE 2023 to investigate each claim being challenged by RACs. These RACs challenges originally involved Medicare and Medicare Advantage claims; however, in recent years, private third-party payors such as United HealthCare and Ambetter have joined in the "take-back" program and hired companies such as Optum and Cotiviti to audit CRMC's health care claims on a percentage basis. These post-service RACs practices continue even though the pre-authorization requirements of the third-party payor are always followed by CRMC. For these reasons, CRMC continues to appeal each RACs challenge to the maximum extent allowed by regulations. Free public education meetings continue to be held two to three times per year, centering on Medicare, Medicaid, the Patient Protection and Affordable Care Act (PPACA), Medicare Advantage, and other third-party payor plans. In an attempt to assist individuals with understanding the complexities of health care reimbursement, these question-and-answer sessions cover all facets of the public's health-care concerns, including insurance coverage specifics, Open Enrollment periods, deductibles/co-pays, CRMC billing/ collecting, Medigap policies, Part D, etc.Part of a nationwide issue, rural northwest Missouri has been experiencing for some time certain "health care deserts," including Obstetric and Renal Dialysis services. Both of these are critical, life-saving services where long drive-times are not conducive to favorable medical outcomes. Additionally, both services are costly to operate, with low reimbursement levels. CRMC has continued to underwrite these services because they are crucial to area residents and not readily available due to area closures being executed by other health care entities. Being the only hospital in a four-county area (Clinton, Caldwell, Daviess, and DeKalb), CRMC provides vital medical services such as these to a rural, low-income population of approximately 50,000 in its primary service area. Likewise, CRMC's secondary service area encompasses another six counties, stretching to the Iowa border and representing an even-more-so, low-income, underserved population, with a high percentage of elderly. As CRMC has continued to provide Obstetric and Renal Dialysis services on a long-standing basis, and as the State of Missouri has begun realizing the severity of these rural "deserts," the Medical Center continues to work with the State and MO HealthNet on a special budget designation to assist in covering some of the costs associated with these much-needed, scarce, and under-reimbursed services.Priority/Objective No. 8 - Awareness of Health Care Services (Combined with Priority/Objective No. 3 - see above)Priority/Objective No. 9 - Transitional Senior CareIn addition to general acute and surgical care, CRMC has provided multiple services and care settings over the years to assist with the various transitional phases of the aging process. From 18 satellite outpatient (primary care) clinics providing physician care, to Skilled, SwingBed, Behavioral Health (GeroPsychiatric), and Inpatient Rehabilitation hospital care; from outpatient Cardiac Rehab and Home Health services, to Comfort Care Hospice - CRMC has numerous programs designed to help individuals regain strength, restore function, and improve health through professional care and effective rehabilitation services. Social Workers throughout the CRMC system provide and guide a path from hospital to home, assisting physicians and other health care providers with their patients' smooth transition from one health care setting to another.CRMC maintains good working relationships with all area nursing homes and tertiary centers, providing free transportation to/from these facilities for medically-appropriate patients in need of same. As a Level III Stroke Center certified by the State of Missouri, CRMC has a special collaboration agreement with St. Luke's for the timely transfer of stroke patients in need of further neurovascular care.The following identified needs were not a direct part of the Medical Center's mission or normal operations in FYE 9-30-23. Rather, CRMC provided support measures and partnered with other entities throughout the area ("key stakeholders") as needed and appropriate.Priority/Objective No. 4 - Affordable and Safe Child Care ServicesAs child care is not a core component of CRMC's mission or operations, the Medical Center plays only a supporting role in addressing this need. The Medical Center has continuously cooperated with area economic development efforts toward promoting new businesses whenever feasible in the hope of realizing additional pre-schools and child daycare centers in rural northwest Missouri. CRMC supports the Cameron R-1 School District in multiple ways, indirectly benefitting the District's extensive and sorely-needed pre-kindergarten/pre-school program.Priority/Objective No. 5 - School HealthAlthough School Health is not a main focus of the Medical Center, CRMC has become increasingly involved with Sports Medicine and area high school athletics over the past three years. Athletic trainer coverage is provided year-round for numerous area high school sporting events. This service is offered in tandem with a comprehensive program covering annual sports physicals and annual baseline concussion testing with balance assessment, as well as baseline EKGs for those student athletes with cardiac risk factors. Approximately 10 - 12 area school districts take advantage of these health/wellness services.Priority/Objective No. 6 - Long-Term Care Staffing and TrainingAs CRMC does not provide long-term care, this Priority/Objective does not pertain to the Medical Center's mission or operations, other than the cooperative and interactive nature of its relationships with area nursing homes and assisted-living facilities. That being said, CRMC sponsors three separate scholarship programs for students entering a specific health care field of study after high school and/or entering medical school. Recipients can be going into nursing, medicine, any of the therapies, Laboratory Technology, Radiologic Technology, or other Allied Health field. The oldest of these offerings has been in existence for 35 years, is renewable, and will address four years of college study. It is entirely possible that recipients of these scholarships could ultimately choose the long-term care field as their profession.

Schedule H (Form 990) 2022

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?19
Name and address		Type of Facility (describe)
1	1 - Cameron Medical Clinic 1600 E Evergreen Cameron,MO64429	Medical Clinic
2	2 - Westside Medical Offices 1608 E Evergreen Cameron,MO64429	Medical Clinic
3	3 - Walnut Medical Clinic 921 N Walnut Cameron,MO64429	Rural Health Clinic
4	4 - Bethany Health Services 903 North 25th Street Bethany,MO64424	Medical Clinic
5	5 - Hamilton Family Health Center 103 N Davis Hamilton,MO64644	Rural Health Clinic
6	6 - Cameron Specialists - Internal Medicine 1608 E Evergreen Cameron,MO64429	Medical Clinic
7	7 - NW Missouri Obstetrics & Gynecology 221 E 7th Street Cameron,MO64429	Medical Clinic
8	8 - Maysville Family Health 1007 S Polk Maysville,MO64469	Rural Health Clinic
9	9 - Gallatin Family Medicine 502 S Main Gallatin,MO64640	Rural Health Clinic
10	10 - Lathrop Medical Clinic 106 North Street Lathrop,MO64465	Medical Clinic
11	11 - Cameron Nephrology Clinic 1600 E Evergreen Suite B Cameron,MO64429	Medical Clinic
12	12 - Jamesport Outreach Clinic 409 W Auberry Grove Jamesport,MO64648	Rural Health Clinic
13	13 - Plattsburg Family Medicine 214 N Main Plattsburg,MO64477	Rural Health Clinic
14	14 - Polo Family Health Center 198 Main Street Polo,MO64671	Rural Health Clinic
15	15 - Eagleville Medical Clinic 12050 12th Street Eagleville,MO64442	Rural Health Clinic
16	16 - Pattonsburg Medical Clinic 110 N Central Ave Pattonsburg,MO64670	Rural Health Clinic
17	17 - Gilman City Medical Clinic 427 Main Street Gilman City,MO64642	Rural Health Clinic
18	18 - Stewartsville Medical Clinic 106 E 4th Stewartsville,MO64490	Rural Health Clinic
19	19 - Cameron Obstetrics & Gynecology 1600 E Evergreen Suite A Cameron,MO64429	Medical Clinic

Schedule H (Form 990) 2022

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Part I, Line 7:	A cost-to-charge ratio derived from Worksheet 2 was used to calculate the amounts reported on line 7.
Part I, Line 7g:	The costs of subsidized health services include costs attributable to multiple physician clinics in the amount of $17,351,369.
Part III, Line 4:	See Note B (beginning on page 16) of the audited financial statements regarding the allowance for uncollectible accounts.Part III Line 2:This amount was determined by multiplying a cost-to-charge ratio derived from Worksheet 2 by the Medical Center's bad debt expense for the tax year.Part III, Line 3:This amount was determined based on the overall income level of patients that submit all required documentation under the Medical Center's financial assistance policy. As a tax-exempt hospital, we must provide necessary services regardless of the patient's ability to pay for that care. Making quality patient care available to all in our community, regardless of their economic means, qualfies these bad debts as a community benefit.
Part III, Line 8:	Medicare costs were obtained from the Medical Center's as-filed Medicare cost report for the tax year.Any shortfalls are a benefit to the Medical Center's community since it represents health care provided at less than cost to elderly and needy residents of the Medical Center's service area.Revenue included in Medicare Cost Report $13,334,965Fee schedule revenue excluded from Medicare Cost Report 497,256Total Medicare revenue 13,832,221Expenses included in Medicare Cost Report $16,909,322Fee schedule expenses excluded from Medicare Cost Report 1,187,274Total Medicare expense 18,096,596Total net Medicare loss 4,264,375
Part III, Line 9b:	At the time of admission and before discharge, each patient will receive a notice that the Medical Center has a Financial Assistance Policy (with a brief description of such policy) and directions for obtaining additional information about such policy. All itemized statements sent to the patient include a notice that the Medical Center has a Financial Assistance Policy and directions for obtaining additional information about such policy. If a patient submits a Financial Assistance Policy application, all payment notifications and collection actions are suspended until it is determined whether the patient is eligible for the Financial Assitance Policy (and if so, notifications and collection actions will cease).
Part VI, Line 2:	The Medical Center relies on the feedback and requests taken from patients of the Medical Center and its numerous clinics, as well as residents from its primary service area.
Part VI, Line 3:	The Medical Center employs a social worker that informs all patients of all available payment options.
Part VI, Line 4:	Cameron Regional Medical Center and its eleven rural health clinics are located in Northwest Missouri. The primary service area is comprised of four rural counties consisting of Daviess, Caldwell, DeKalb, and Clinton. There are approximately 48,953 individuals that reside in the primary service area. Of these residents approximately 13.1% of them have an annual income below the federal poverty level. The median annual income per household for the four counties is approximately $63,095. Approximately 31% of the total services provided are for Medicare patients and 14% are for Medicaid patients. The nearest surrounding hospitals are located in Smithville, Excelsior Springs, and Richmond. The distance between these facilities and Cameron Regional Medical Center is approximately 28, 28, and 31 miles respectively.
Part VI, Line 5:	Cameron Regional Medical Center's governing body is comprised of residents from its primary service area. The Medical Center extends medical privileges to all local physicians who meet the requirements of the medical staff bylaws. All surplus funds are used to maintain and improve the medical facility and medical equipment in order to provide the best medical treatment possible to every patient.

Schedule H (Form 990) 2022

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2022

Open to Public
Inspection

Name of the organization
Cameron Regional Medical Center

Employer identification number
44-0668347

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) Clinco Sheltered Industries Inc 1205 W Grand Ave Cameron,MO64429	43-1064239	501(c)(3)	10,000	0			Operation of sheltered workshop for developmentally disabled individuals

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2022

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) College scholarships	52	57,500
(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
Part I, Line 2:	Scholarships are paid directly to the college of the recipient. When making grants to domestic organizations, funds are disbursed directly to each organization with the Board of Directors' authorization.

Schedule I (Form 990) 2022

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

Cameron Regional Medical Center

Employer identification number

44-0668347

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Yes

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2022

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Laeeq Azmat Tahirkheli Physician & Director	(i) (ii)	688,446 ------------- 0	312,232 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	1,000,678 ------------- 0	0 ------------- 0
2Shahzad Shafique Physician	(i) (ii)	549,662 ------------- 0	120,071 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	669,733 ------------- 0	0 ------------- 0
3Muhammad Amin Physician	(i) (ii)	447,930 ------------- 0	135,248 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	583,178 ------------- 0	0 ------------- 0
4Ly Phan Physician	(i) (ii)	517,868 ------------- 0	61,428 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	579,296 ------------- 0	0 ------------- 0
5Damond Erickson Pharmacy Director	(i) (ii)	549,879 ------------- 0	4,211 ------------- 0	0 ------------- 0	0 ------------- 0	16,870 ------------- 0	570,960 ------------- 0	0 ------------- 0
6Arihant Jain Physician	(i) (ii)	535,745 ------------- 0	22,258 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	558,003 ------------- 0	0 ------------- 0
7Joseph F Abrutz Jr Administrator	(i) (ii)	354,169 ------------- 0	96,235 ------------- 0	0 ------------- 0	0 ------------- 0	13,899 ------------- 0	464,303 ------------- 0	0 ------------- 0
8Laura Harbison Physician & Director	(i) (ii)	403,068 ------------- 0	5,450 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	408,518 ------------- 0	0 ------------- 0
9Rosa Patti Chief Financial Officer	(i) (ii)	121,552 ------------- 0	79,351 ------------- 0	0 ------------- 0	0 ------------- 0	16,729 ------------- 0	217,632 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2022

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
Part I, Line 4b	The Medical Center has established a deferred compensation plan (a 457 Plan subject to Code section 457(b)). The name of the Plan as adopted by the Medical Center is Cameron Regional Medical Center, Inc. 457(b) Plan. During the fiscal year end 09/30/2023, $2,962 was contributed to the Plan on behalf of Joseph F. Abrutz, Jr., Administrator of the Medical Center.
Part I, Line 6	The Administrator is eligible for an annual bonus that is partially contingent on meeting a specific operating margin percentage.
Part I, Line 7	The Administrator is eligible for an annual bonus that is partially contingent on meeting quality measure goals and strategic planning goals. The Chief Financial Officer also received a bonus during the fiscal year ending in 2023 for completing a variety of special projects for the Medical Center.

Schedule J (Form 990) 2022

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
Cameron Regional Medical Center

Employer identification number
44-0668347

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	The Industrial Development Authority of Clinton County Missouri	43-1619770	18746NAM2	09-06-2017	10,000,000	Refund Series 2007B bonds issued on 05/17/2007		X		X		X
B	The Industrial Development Authority of Clinton County Missouri	43-1619770	18746NAQ3	09-06-2017	3,990,000	Financing of capital project and equipment		X		X		X
C	The Industrial Development Authority of the City of Cameron Missouri	43-1679396	133451BS2	12-21-2017	6,105,000	Refund Series 2011 bond and financing of capital project		X		X		X
D	The Industrial Development Authority of the City of Cameron Missouri	43-1679396	NoneAvail	08-22-2019	2,730,000	Financing of capital projects		X		X		X
	Health and Educational Facilties Authority of the State of Missouri	43-1178966	NoneAvail	04-20-2022	5,615,000	Financing of capital projects		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	150,000				2,065,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	10,000,000		3,990,000		6,105,000		2,730,000
4 Gross proceeds in reserve funds .............	486,592		403,675		242,812		177,051
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	170,257		68,386		121,226		54,600
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	5,124,183		3,504,535		2,827,033		2,513,835
11 Other spent proceeds .............	9,348,788		21,250		2,939,863
12 Other unspent proceeds .............	1,163
13 Year of substantial completion .............	2017		2018		2019		2020
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........	X			X	X			X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........		X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X	X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........	X		X		X			X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X		X		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
Date Rebate Computation Performed	Issuer Name: The Industrial Development Authority of Clinton County, Missou Date the Rebate Computation was Performed: 09/01/2022 Issuer Name: The Industrial Development Authority of Clinton County, Missou Date the Rebate Computation was Performed: 09/01/2022 Issuer Name: The Industrial Development Authority of the City of Cameron, M Date the Rebate Computation was Performed: 12/01/2022

Schedule K (Form 990) 2021

Additional Data

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
Cameron Regional Medical Center

Employer identification number
44-0668347

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	The Industrial Development Authority of Clinton County Missouri	43-1619770	18746NAM2	09-06-2017	10,000,000	Refund Series 2007B bonds issued on 05/17/2007		X		X		X
B	The Industrial Development Authority of Clinton County Missouri	43-1619770	18746NAQ3	09-06-2017	3,990,000	Financing of capital project and equipment		X		X		X
C	The Industrial Development Authority of the City of Cameron Missouri	43-1679396	133451BS2	12-21-2017	6,105,000	Refund Series 2011 bond and financing of capital project		X		X		X
D	The Industrial Development Authority of the City of Cameron Missouri	43-1679396	NoneAvail	08-22-2019	2,730,000	Financing of capital projects		X		X		X
	Health and Educational Facilties Authority of the State of Missouri	43-1178966	NoneAvail	04-20-2022	5,615,000	Financing of capital projects		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	150,000				2,065,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	10,000,000		3,990,000		6,105,000		2,730,000
4 Gross proceeds in reserve funds .............	486,592		403,675		242,812		177,051
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	170,257		68,386		121,226		54,600
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	5,124,183		3,504,535		2,827,033		2,513,835
11 Other spent proceeds .............	9,348,788		21,250		2,939,863
12 Other unspent proceeds .............	1,163
13 Year of substantial completion .............	2017		2018		2019		2020
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........	X			X	X			X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........		X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X	X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........	X		X		X			X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X		X		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
Date Rebate Computation Performed	Issuer Name: The Industrial Development Authority of Clinton County, Missou Date the Rebate Computation was Performed: 09/01/2022 Issuer Name: The Industrial Development Authority of Clinton County, Missou Date the Rebate Computation was Performed: 09/01/2022 Issuer Name: The Industrial Development Authority of the City of Cameron, M Date the Rebate Computation was Performed: 12/01/2022

Schedule K (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

Cameron Regional Medical Center

Employer identification number

44-0668347

Return Reference	Explanation
Form 990, Part VI, Section B, line 11b	A copy of Form 990 is made available to the governing body prior to filing.
Form 990, Part VI, Section B, line 12c	Employees and Directors are required to complete an annual disclosure information form.
Form 990, Part VI, Section B, line 15a	The Board of Trustees is responsible for determining the job performance standards for the Administrator/CEO and determining compensation according to the organization's policies.
Form 990, Part VI, Section C, line 19	Organization makes its governing documents available upon request.
Form 990, Part IX, line 11g	Professional fees: Program service expenses 6,794,666. Management and general expenses 83,465. Fundraising expenses 0. Total expenses 6,878,131. Purchased services: Program service expenses 2,398,414. Management and general expenses 477,244. Fundraising expenses 0. Total expenses 2,875,658. Reference lab fees: Program service expenses 622,987. Management and general expenses 0. Fundraising expenses 0. Total expenses 622,987. Other fees for services: Program service expenses 65,342. Management and general expenses 172,642. Fundraising expenses 0. Total expenses 237,984.
Form 990, Part XI, line 9:	Change in beneficial interest in net assets of Foundation net of transfers 30,979.
Form 990, Part XII, Line 2C:	The audit committee assumes the responsibility for the oversight of the audited financial statements, review of the Form 990, and selection of the independent accounting firm.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Cameron Regional Medical Center

Employer identification number

44-0668347

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(f) Direct controlling entity
(1) Cameron Regional Medical Center Provider Management Service Organization LL 1600 East Evergreen Street Cameron,MO64429 47-2649803	To provide support and administrative services to physician groups	MO	Cameron Regional Medical Center

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)Cameron Regional Medical Center Foundation 1600 East Evergreen Street Cameron,MO64429 74-2933060	To support the operation of the Cameron Regional Medical Center, Inc.	MO	501(c)(3)	Line 7			No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2021

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No

Schedule R (Form 990) 2021

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

Yes

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2021

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2021

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2021

Additional Data

Software ID:
Software Version:

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,350,984	1,618,704
9	Program service revenue (Part VIII, line 2g) .........	65,012,147	59,395,434
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	2,497,314	2,201,266
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	163,933	171,440
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	70,024,378	63,386,844
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	30,000	67,500
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	40,465,650	40,100,634
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 5,007
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	32,489,719	32,573,928
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	72,985,369	72,742,062
19	Revenue less expenses. Subtract line 18 from line 12.......	-2,960,991	-9,355,218
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	97,363,822	89,246,397
21	Total liabilities (Part X, line 26).............	40,071,011	37,975,399
22	Net assets or fund balances. Subtract line 21 from line 20.....	57,292,811	51,270,998

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 64,198,966 including grants of $ 67,500 ) (Revenue $ 59,395,434 )
	Acute care hospital organized to provide inpatient and outpatient care to area residents regardless of ability to pay.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses64,198,966

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	5,004,803	0	47,498

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	1,458,544

f	All other contributions, gifts, grants, and similar amounts not included above		1f	160,160

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		1,618,704

1	Briefly describe the organization’s mission or most significant activities: Provide inpatient and outpatient medical care to area residents regardless of ability to pay.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	12
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	10
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	614
6	Total number of volunteers (estimate if necessary) .............	6	40
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)		(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) Ly Phan........................................................................ Physician	40.00 .......................	X	579,296	0	0
(19) Arihant Jain........................................................................ Physician	40.00 .......................	X	558,003	0	0
(20) Damond Erickson........................................................................ Pharmacy Director	40.00 .......................	X	554,090	0	16,870

		Business Code
2a	Patient service revenue	622110	59,395,434	59,395,434
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		59,395,434

3 Investment income (including dividends, interest, and othersimilar amounts) ......			1,082,236			1,082,236
4 Income from investment of tax-exempt bond proceeds			110,181			110,181
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		37,190	6a
b	Less: rental expenses		0	6b
c	Rental income or (loss)		37,190	6c
d	Net rental income or (loss).......			37,190			37,190
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		14,131,715	7a
b	Less: cost or other basis and sales expenses		13,122,866	7b
c	Gain or (loss)		1,008,849	7c
d	Net gain or (loss).........			1,008,849			1,008,849
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	Cafeteria		722210	124,648			124,648
b	Other income		900099	9,602			9,602
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			134,250
12	Total revenue. See instructions.....			63,386,844	59,395,434	0	2,372,706

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	10,000	10,000
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	57,500	57,500
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	2,133,899	1,481,389	652,510
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	31,764,650	29,565,777	2,198,873
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	533,000	488,601	44,399
9	Other employee benefits .......	3,375,781	3,122,510	253,271
10	Payroll taxes ...........	2,293,304	2,102,272	191,032
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	447,994		447,994
c	Accounting ...........
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	150,716		150,716
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	10,614,760	9,881,409	733,351
12	Advertising and promotion ....	315,597	82,731	232,866
13	Office expenses .......	1,429,662	1,153,802	275,860
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	668,101	565,368	102,733
17	Travel ............	257,637	193,346	64,291
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	1,154,388	995,235	159,153
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	2,683,596	2,266,227	417,369
23	Insurance ...	1,256,759	79,197	1,177,562
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Medical supplies	5,897,735	5,897,735
b	Pharmaceuticals	4,247,380	4,247,380
c	Repairs and maintenance	2,070,862	1,405,150	665,712
d	Collection fees	504,034	545	503,489
e	All other expenses	874,707	602,792	266,908	5,007
25	Total functional expenses. Add lines 1 through 24e	72,742,062	64,198,966	8,538,089	5,007
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			273,176	1	1,072,858
2	Savings and temporary cash investments .........			15,489,984	2	5,978,389
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			10,969,906	4	11,268,679
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			1,911,047	8	1,926,640
9	Prepaid expenses and deferred charges ......			351,941	9	364,174
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	83,220,810
b	Less: accumulated depreciation	10b	59,212,787	23,839,091	10c	24,008,023
11	Investments—publicly traded securities .			40,210,306	11	39,816,895
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			4,318,371	15	4,810,739
16	Total assets. Add lines 1 through 15 (must equal line 33)...			97,363,822	16	89,246,397

17	Accounts payable and accrued expenses .....	7,751,065	17	8,074,721
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	28,947,595	20	27,764,120
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	472,115	23	313,791
24	Unsecured notes and loans payable to unrelated third parties ..	35,371	24	6,903
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	2,864,865	25	1,815,864
26	Total liabilities. Add lines 17 through 25..	40,071,011	26	37,975,399

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	56,537,898	27	50,475,092
28	Net assets with donor restrictions ...........	754,913	28	795,906
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	57,292,811	32	51,270,998
33	Total liabilities and net assets/fund balances ........	97,363,822	33	89,246,397