Civic Intelligence

Hannibal Regional Healthcare System Inc

EIN 43-0662495 • 501(c)3 • Hannibal, MO

Profile

Your health is our mission

6500 Hospital Drive PO Box 551Hannibal, MO 63401

www.hrhonline.org

Siviq Scores

Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.

Liabilities / Assets

62nd percentile

0.42x

Higher debt load relative to assets than 62% of similar nonprofits.

501(c)3 • $250M-$1B nonprofits • Source year 2024

Liabilities / Revenue

32nd percentile

0.28x

Higher debt load relative to revenue than 32% of similar nonprofits.

501(c)3 • $250M-$1B nonprofits • Source year 2024

Net Margin

25th percentile

-2.2%

Higher net margin than 25% of similar nonprofits.

501(c)3 • $250M-$1B nonprofits • Source year 2024

Top Officer Pay

88th percentile

$2,957,017

Higher top officer pay than 88% of similar nonprofits.

Top officer pay equals 1.0% of source-year revenue.

501(c)3 • $250M-$1B nonprofits • Source year 2024

Asset Growth

23rd percentile

0.2%

Faster asset growth than 23% of similar nonprofits.

501(c)3 • $250M-$1B nonprofits • Annualized from 2023 to 2024

Revenue Growth

61st percentile

12%

Faster revenue growth than 61% of similar nonprofits.

501(c)3 • $250M-$1B nonprofits • Annualized from 2023 to 2024

Assets

Up

$199,318,413

Up $354,458 (+0.2%) from 2023

Liabilities

Up

$83,162,640

Up $1,748,182 (+2.1%) from 2023

Net Assets

Down

$116,155,773

Down $1,393,724 (-1.2%) from 2023

Revenue

Up

$301,905,675

Up $33,230,310 (+12%) from 2023

Expenses

Up

$308,403,818

Up $34,468,516 (+13%) from 2023

Net Income

Down

-$6,498,143

Down $1,238,206 (-24%) from 2023

Trend Graphs

Balance Sheet Trend

Grouped bars show assets, liabilities, and net assets across loaded filings.

$300M$200M$100M$0Assets 2010: $116,939,024Liabilities 2010: $50,791,935Net Assets 2010: $66,147,0892010Assets 2011: $121,818,390Liabilities 2011: $54,767,600Net Assets 2011: $67,050,7902011Assets 2012: $131,068,696Liabilities 2012: $55,335,893Net Assets 2012: $75,732,8032012Assets 2013: $127,649,695Liabilities 2013: $41,438,195Net Assets 2013: $86,211,5002013Assets 2014: $136,145,065Liabilities 2014: $43,425,839Net Assets 2014: $92,719,2262014Assets 2015: $142,040,624Liabilities 2015: $48,497,274Net Assets 2015: $93,543,3502015Assets 2016: $143,832,455Liabilities 2016: $40,716,317Net Assets 2016: $103,116,1382016Assets 2017: $152,196,009Liabilities 2017: $42,304,066Net Assets 2017: $109,891,9432017Assets 2018: $195,591,528Liabilities 2018: $75,616,963Net Assets 2018: $119,974,5652018Assets 2019: $194,629,855Liabilities 2019: $73,086,240Net Assets 2019: $121,543,6152019Assets 2020: $216,422,031Liabilities 2020: $98,733,986Net Assets 2020: $117,688,0452020Assets 2021: $223,721,631Liabilities 2021: $92,716,126Net Assets 2021: $131,005,5052021Assets 2022: $201,828,924Liabilities 2022: $80,809,945Net Assets 2022: $121,018,9792022Assets 2023: $198,963,955Liabilities 2023: $81,414,458Net Assets 2023: $117,549,4972023Assets 2024: $199,318,413Liabilities 2024: $83,162,640Net Assets 2024: $116,155,7732024

Highlighted filing

2024

Assets$199,318,413
Liabilities$83,162,640
Net Assets$116,155,773

Operations Trend

Revenue, expenses, and net income by year, with the latest filing highlighted.

$400M$300M$200M$100M$0-$100MExpenses 2010: $105,095,6322010Expenses 2011: $110,451,9242011Expenses 2012: $116,179,7362012Revenue 2013: $122,019,161Expenses 2013: $117,672,062Net Income 2013: $4,347,0992013Revenue 2014: $128,863,310Expenses 2014: $121,463,063Net Income 2014: $7,400,2472014Revenue 2015: $127,193,535Expenses 2015: $120,921,909Net Income 2015: $6,271,6262015Revenue 2016: $139,115,589Expenses 2016: $129,874,599Net Income 2016: $9,240,9902016Revenue 2017: $153,490,029Expenses 2017: $151,434,034Net Income 2017: $2,055,9952017Revenue 2018: $187,370,122Expenses 2018: $175,627,550Net Income 2018: $11,742,5722018Revenue 2019: $191,942,476Expenses 2019: $186,970,433Net Income 2019: $4,972,0432019Revenue 2020: $193,719,615Expenses 2020: $196,883,081Net Income 2020: -$3,163,4662020Revenue 2021: $228,715,872Expenses 2021: $220,903,077Net Income 2021: $7,812,7952021Revenue 2022: $251,384,087Expenses 2022: $250,765,313Net Income 2022: $618,7742022Revenue 2023: $268,675,365Expenses 2023: $273,935,302Net Income 2023: -$5,259,9372023Revenue 2024: $301,905,675Expenses 2024: $308,403,818Net Income 2024: -$6,498,1432024

Highlighted filing

2024

Revenue$301,905,675
Expenses$308,403,818
Net Income-$6,498,143

Filings

Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024Facts available. Structured filing facts are available, but richer extracted sections are limited.$199$83.2$116$302$308$6.50
2023Summary only. Only limited summary data is available for this year.$199$81.4$118$269$274$5.26
2022Facts available. Structured filing facts are available, but richer extracted sections are limited.$202$80.8$121$251$251$0.62
2021Summary only. Only limited summary data is available for this year.$224$92.7$131$229$221$7.81
2020Summary only. Only limited summary data is available for this year.$216$98.7$118$194$197$3.16
2019XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$195$73.1$122$192$187$4.97
2018Facts available. Structured filing facts are available, but richer extracted sections are limited.$196$75.6$120$187$176$11.7
2017XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$152$42.3$110$153$151$2.06
2016Detailed filing. Detailed filing data is available for this year.$144$40.7$103$139$130$9.24
2015Detailed filing. Detailed filing data is available for this year.$142$48.5$93.5$127$121$6.27
2014Detailed filing. Detailed filing data is available for this year.$136$43.4$92.7$129$121$7.40
2013Summary only. Only limited summary data is available for this year.$128$41.4$86.2$122$118$4.35
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.$131$55.3$75.7$116
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.$122$54.8$67.1$110
2010Facts available. Structured filing facts are available, but richer extracted sections are limited.$117$50.8$66.1$105
Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Oct 1, 2023 to Sep 30, 2024
Signed
Aug 11, 2025
Return Version
2023v6.0
Gross Receipts
$302,944,595
Mission and Program Overview

Mission

To provide exceptional healthcare services for a better life.

The system operates a full service acute care facility.

Balance Sheet Detail
LineBeginningEndChange
Assets
Land, Buildings, and Equipment, Net$79,327,951$73,059,168▼ $6,268,783
Investments in Publicly Traded Securities$47,186,126$45,362,455▼ $1,823,671
Accounts Receivable$33,027,665$44,530,500▲ $11,502,835
Cash and Non-Interest-Bearing Accounts$14,344,009$9,401,715▼ $4,942,294
Inventories for Sale or Use$6,509,911$6,027,616▼ $482,295
Investments Program Related$3,864,009$3,561,095▼ $302,914
Prepaid Expenses and Deferred Charges$2,350,079$3,163,919▲ $813,840
Other Notes and Loans Receivable, Net$1,661,526$2,288,232▲ $626,706
Savings and Temporary Cash Investments$1,088,007$1,102,729▲ $14,722
Pledges and Grants Receivable$59,778--
Investments Other Securities$49,942$49,942→ $0
Total Assets$198,963,955$199,318,413▲ $354,458
Other Assets Total$9,494,952$10,771,042▲ $1,276,090
Liabilities
Tax Exempt Bond Liabilities$40,196,313$39,204,956▼ $991,357
Accounts Payable and Accrued Expenses$34,520,756$35,515,234▲ $994,478
Other Liabilities$6,595,823$8,355,259▲ $1,759,436
Mortgage Notes Payable Secured by Investment Property$101,566$68,486▼ $33,080
Deferred Revenue-$18,705-
Total Liabilities$81,414,458$83,162,640▲ $1,748,182
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$111,316,254$110,811,777▼ $504,477
Net Assets With Donor Restrictions$6,233,243$5,343,996▼ $889,247
Total Net Assets Fund Balance$117,549,497$116,155,773▼ $1,393,724
Total Liabilities and Net Assets / Fund Balance$198,963,955$199,318,413▲ $354,458

Asset Categories

AssetBook ValueDepreciationBasis
Equipment$28,663,867$87,030,271$115,694,138
Buildings$34,063,316$55,200,889$89,264,205
Leasehold Improvements$2,131,102$9,302,501$11,433,603
Land$6,283,577-$6,283,577
Other Land Buildings$1,917,306-$1,917,306
Other Assets Org$2,792,084--
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseOtherTotal
C Todd AhrensPresident & CEOFT$711,872$2,245,145$2,957,017
Blake KramerRadiologistFT$551,094$496,836$1,047,930
Lance DorseyRadiologistFT$594,426$430,752$1,025,178
John BennettObstetrician and GynecologistFT$506,512$471,977$978,489
Joseph BassRadiologistFT$564,401$371,184$935,585
Laura MapleObstetrician and GynecologistFT$549,484$348,673$898,157
Pranav Parikh MdVP - Chief Medical OfficerFT$607,358$272,304$879,662
Richard Valuck MdDirector & CardiologistFT$602,237$87,816$690,053
Rob GasawayVP - FinanceFT$343,352$155,504$498,856
Aaron ZookVP - OperationsFT$332,208$152,431$484,639
Teresa GenerousVP - General CounselFT$292,980$130,521$423,501
Wendy HarringtonVP - Hrhs DevelopmentPT$252,494$122,202$374,696
Susan WathenVP- Human ResourcesFT$232,727$121,499$354,226
Patricia BrawnerVP - NursingFT$237,046$40,033$277,079
Karmon KindhartVP - NursingFT$154,674$56,275$210,949
John BleighSecretary-$1,740-$1,740
Devon McclainDirector-$1,191-$1,191

Board Members and Trustees

NameTitle
Brad KurzChair
Michael HollidayVice Chair
Amy LehenbauerDirector
Carolyn ShawDirector
Deborah ThornburgDirector
Eric JonesDirector
Justin TranthamDirector
Rahul Basho MdDirector
Susan JohnsonDirector
Dirk SauerDirector (term Ended 01/24)
Jason PoageDirector (term Ended 01/24)
Pat BensonDirector (term Ended 01/24)
John ZimmerTreasurer

Highest Paid Contractors

ContractorServicesLocationCompensation
Qualivis LLCProfessional Services2000 CENTER POINT RD SUITE 2360, Columbia, SC 29210$8,504,167
Interim Physicians LLCProfessional ServicesPO BOX 679139, Dallas, TX 75267$2,817,979
Allscripts LLCIt Systems24630 NETWORK PLACE, Chicago, IL 60673$2,145,851
Trimedx Holdings LLCContracted Maintenance5451 LAKEVIEW PKWY S DRIVE, Indianapolis, IN 46268$1,722,158
Advance Hannibal Regional Hospital LLCTherapy Services188 MEDICAL DRIVE, Hannibal, MO 63401$1,452,368
Revenue and Support

Revenue Composition

Contributions and Grants
$5,880,588
Program Service Revenue
$292,613,212
Investment Income
$1,083,087
Other Revenue
$2,328,788
Change in Net Assets
$-6,498,143
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$178,331,172
Other Expenses$129,793,231
Grants and Similar Amounts Paid$279,415
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$117,642,840$13,633,056-$131,275,896
Fees for Services Other$31,080,439$5,809,729-$36,890,168
Other Employee Benefits$24,065,075$3,781,051-$27,846,126
Office Expenses$27,053,498$762,984-$27,816,482
Depreciation Depletion$9,257,216$945,019-$10,202,235
Payroll Taxes$7,256,714$1,140,159-$8,396,873
Current Officers, Directors, Trustees, and Key Employees$690,053$5,052,128-$5,742,181
Pension Plan Contributions$4,381,660$688,436-$5,070,096
Information Technology$3,038,191$1,212,469-$4,250,660
Occupancy$2,633,325$258,291-$2,891,616
Insurance$2,428,890--$2,428,890
All Other Expenses$480,540$1,708,843-$2,189,383
Interest$1,570,506$160,325-$1,730,831
Other Expenses$1,278,071--$1,278,071
Advertising$3,267$1,224,767-$1,228,034
Travel$831,238$154,315-$985,553
Grants to Domestic Orgs$279,415--$279,415
Fees for Services Legal-$240,292-$240,292
Fees for Services Accounting-$166,200-$166,200
Conferences and Meetings$114,129$24,640-$138,769
Fees for Services Lobbying$67,951$10,140-$78,091
Total Functional Expenses$271,430,974$36,972,844$0$308,403,818
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
Culver-stockton CollegeCanton, MO501(c)(3)Year 1 Nursing Program Mou Pledge, 2024 Summit Sponsor$201,000
Mha Center for EducationJefferson City, MO501(c)(3)Mce Health Impr Research and Scholarship Fund, Mha Special Projects, Missouri Center for Patient Safety Contribution, Mha Health Institute, and Missouri Poison Center Contribution.$51,765
Ymca of HannibalHannibal, MO501(c)(3)Corporate Sponsorships, Strong Community Campaign Pledge, 2024 Gold Level Giving$19,150
Hannibal Regional Economic Development CouncilHannibal, MO501(c)(6)To Provide Assistance to New and Existing Businesses in the Hannibal Region That Will Help Them Sustain, Grow, and Excel.$7,500
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
Yes
Subject to proxy tax
No
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Financing and Operating Lease Obligations$5,342,628
Supplemental Employee Retirement Plan$3,012,631

Bond Issues

BondIssuerIssuedIssue PricePurpose
AThe Industrial Development Authority of the City of Hannibal Missouri2017-11-06$44,088,479CONSTRUCTION

Bond Proceeds

BondTotal ProceedsSpentRetiredIssuance Costs
A$44,088,479-$2,955,000$445,241

Bond Financing Compliance

No rebate due
Yes
Rebate not yet due
No
Form 8038-T filed
No
Gross proceeds invested
No
Gross proceeds invested in GIC
No
Exception to rebate
No
Corrective action procedures
Yes
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Business relationship with 35% controlled entity
No
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, Line 1A

The board of directors has delegated to the compensation committee, pursuant to a charter adopted by the board of directors, the responsibility to act on behalf of the board of directors in administering compensation plans and in making decisions on the compensation of the chief executive officer and those executives who report directly to the chief executive officer who qualify as "disqualified persons" within the meaning of section 4958 of the internal revenue code. The committee then reports its actions to the board of directors. The committee is composed solely of independent members of the board of directors. The scope of the committee includes, but is not limited to, reviewing and approving the annual base salary levels, annual incentive opportunity levels, executive perquisites, employment agreements, benefits and supplemental benefits. The board of directors has also delegated to the finance committee the responsibility to approve the annual financial audit. The committee then reports its actions to the board of directors, and shares and discusses the audit report with the board.

Form 990, Part VI, Section B, Line 11B

The form 990 is reviewed in detail by management. The form is then provided to the finance committee and board of directors for review and comment. Any changes are incorporated prior to filing.

Form 990, Part VI, Section B, Line 12C

The organization has a policy titled business ethics, conflict of interest and tax exempt compliance which requires that all directors, officers, and employees of the hospital always act in the best interest of the hospital without conflicts of interest. Annually each member of the board of directors, each officer of the organization, and certain other managers receive a copy of the policy and are required to complete a confidentiality agreement and a conflict of interest questionnaire whereby the individual answers questions regarding family members, substantial business or investment holdings, and other transactions or affiliations with businesses or other organizations that might affect their relationship with the hospital. As part of the conflicts of interest questionnaire the individual is asked to acknowledge that they have received and read a copy of the policy, agree to comply with the policy, acknowledge that the hospital is a charitable organization, which must engage primarily in activities which accomplish our tax exempt purposes in order to maintain our tax exempt status, agree to report promptly to the board of directors any changes in their answers to the questions or any change in circumstance that might develop prior to the completion of their next annual questionnaire. With respect to directors of the organization, they also acknowledge that none of the conditions of the policy which would make them ineligible to remain on the board exist at the time they sign the acknowledgment and that they would report any conditions which become applicable immediately to the chairperson of the board of directors. On an annual basis the general counsel sends these documents to each director, officer and certain key employees. Once the documents are completed and returned, the general counsel reviews the questionnaires and confers with both the secretary of the organization and chair of the governance committee as to the results and any issues that need to be addressed regarding actual or potential conflicts disclosed or any other fact that might make the individual not independent for irs tax exempt purposes. The secretary, with the assistance of the general counsel, then submits to the board of directors a confidential report concerning any interest of employees of the hospital disclosed by such questionnaire, any interest of directors and officers who are not employees of the hospital, and what actions the president of the organization may take as a result of any conflicts disclosed by such individuals. An individual is ineligible to serve on the board of directors for any of the following reasons as taken from hannibal regional healthcare system board of directors policy b-iii: a. Failure to adhere completely to disclosure requirements; b. The individual is an owner, partner, employee, board member or investor in a direct competitor of the hospital, or any entity affiliated with the hospital. An ownership or investment interest in a direct competitor of the hospital, or any entity affiliated with the hospital, of five (5) percent or less will not make individual ineligible to serve on the board of directors; c. The individual is an employee of the hospital, or any entity affiliated with the hospital, or a family member is a member of the management team of the hospital, or any entity affiliated with the hospital; d. The individual receives direct compensatory benefit for ongoing services provided to the hospital, or any entity affiliated with the hospital (serving as a "de facto employee"); e. The individual is an owner, partner, employee, board member or has a material investment interest in an entity which has contracted for the exclusive provision of any medical services with the hospital or any of its affiliates.

Form 990, Part VI, Section B, Line 15

The board of directors has delegated to the compensation committee, pursuant to a charter adopted by the board of directors, the responsibility to act on behalf of the board of directors in administering compensation plans and in making decisions on the compensation of the chief executive officer and those executives who report directly to the chief executive officer who qualify as "disqualified persons" within the meaning of section 4958 of the internal revenue code. The committee engages an independent consultant to assist the committee with its governance and oversight role and its compliance with section 4958 of the internal revenue code, by providing an opinion on the reasonableness of the organization's compensation plan. The consultant uses published survey data to provide comparative market data for each position. The committee then reports its actions to the board of directors. The committee is composed solely of independent members of the board of directors. The scope of the committee includes, but is not limited to, reviewing and approving the annual base salary levels, annual incentive opportunity levels, executive perquisites, employment agreements, benefits and supplemental benefits. Annually, hrhs, through its compensation committee engages an independent outside compensation consultant to provide opinions related to the reasonableness of executive compensation and to provide advice and guidance as to current trends and issues.

Form 990, Part VI, Section C, Line 19

The articles of incorporation and amendments thereto are available on the missouri secretary of state's website.

Filing and Contact Details

Filer

Filer Name
Hannibal Regional Healthcare System Inc
EIN
43-0662495
Phone
5732481300
Address
6500 HOSPITAL DRIVE PO BOX 551, HANNIBAL, MO 63401

Signing Officer

Name
Rob Gasaway
Title
Vice President - Finance
Phone
5732481300
Signed
2025-08-11
Discuss with paid preparer
Yes

Organization Details

Principal Officer
C Todd Ahrens
Formed
1987
Legal Domicile
Mo
Voting Board Members
13
Independent Board Members
12
Employees
1,840
Volunteers
235

Preparer

Firm
Cliftonlarsonallen Llp
Address
600 WASHINGTON AVENUE SUITE 1800, ST LOUIS, MO 63101
Preparer
Amber Hamilton
Phone
3149254300
Supplemental Narrative

Additional Explanations

Form 990, Part IX, Line 11G

Purchased services/professional fees: program service expenses 30,163,317. Management and general expenses 5,155,101. Fundraising expenses 0. Total expenses 35,318,418. Laundry service: program service expenses 511,095. Management and general expenses 13,751. Fundraising expenses 0. Total expenses 524,846. Cleaning service: program service expenses 366,789. Management and general expenses 1,575. Fundraising expenses 0. Total expenses 368,364. Consulting fees: program service expenses 35,684. Management and general expenses 0. Fundraising expenses 0. Total expenses 35,684. Collection fees: program service expenses 3,554. Management and general expenses 639,302. Fundraising expenses 0. Total expenses 642,856.

Form 990, Part XII, Line 2C

The organization's policy regarding oversight of audit is consistent with the prior year.

Raw XML AppendixShowing 400 of 1,627 raw XML fields

This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

Path#Value
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IRS990/AccountsReceivableGrp/EOYAmt044530500
IRS990/ActivitiesConductedPrtshpInd00
IRS990/ActivityOrMissionDesc0THE SYSTEM OPERATES A FULL SERVICE ACUTE CARE FACILITY.
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