2024-05-10T14:31:36-05:00 2023-06-30 481026809 Wendling Noe Nelson & Johnson LLC 623 SW 10th Ave Suite 300 Topeka KS 66612 990 2022-07-01 480559088 Hays Medical Center Inc HAYS 7856235000 2220 Canterbury Drive Hays KS 67601 EDWARD HERRMAN CEO 7856235000 2024-05-10 1 EDWARD HERRMAN 999009999 0 Eric L Otting P00298454 7852334226 2024-05-10 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Edward Herrman 2220 Canterbury Drive Hays KS 67601 232312932 0 X www.haysmed.com X 1944 KS Hays Medical Center is a tax-exempt charitable organization under Section 501(c)(3) of the Internal Revenue Code and is licensed by the State of Kansas Department of Health and Environment. The purpose of the Organization is to provide healthcare facilities and services for the care and treatment of inpatients and outpatients who are acutely ill or who otherwise require medical care and related services. The core purpose of the Organization is to help people be healthy. The Organization is striving to become the best tertiary care center in rural America. 12 9 1780 137 0 0 8070104 1013060 211683373 224265221 17969085 5216705 1026569 1101925 238749131 231596911 14783 20681 0 0 117255057 117498640 0 0 219344 118080850 124270499 235350690 241789820 3398441 -10192909 266498873 258450921 83631802 81196845 182867071 177254076 X Hays Medical Center is a tax-exempt charitable organization under Section 501(c)(3) of the Internal Revenue Code and is licensed by the State of Kansas Department of Health and Environment. The purpose of the Organization is to provide healthcare facilities and services for the care and treatment of inpatients and outpatients who are acutely ill or who otherwise require medical care and related services. The core purpose of the Organization is to help people be healthy. The Organization is striving to become the best tertiary care center in rural America. 0 0 219569144 20681 225367146 Patient Care Program services consist of routine and ancillary department healthcare services provided by a healthcare organization as defined in Section 501(c)(3) of the IRS code. Admissions: Acute-4,024, Newborn ICU-26, Newborn-535, Total admissions-4,585. Patient days: ICU/CPCU-6,866, Medical/Surgical-10,466, Obstetrics-1,138, Newborn ICU-398, Newborn-887, Total patient days-19,755. Other statistical information: Surgical procedures-8,375, Cardiac caths-1,599, Emergency room visits-12,798, Outpatient procedures-163,988, Medical oncology service visits-6,044, Clinic visits-147,914. 219569144 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 1 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 182 0 1 1780 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Michelle Beckner 7856232350 2220 Canterbury Drive Hays KS 67601 Brian Lang Chair 0.50 X X 0 0 0 Alan Moore Vice-Chair thru. Dec. 2022 0.50 X X 0 0 0 Kenneth Beran Treasurer 0.50 X X 0 0 0 Jayne Clarke Secretary thru. Dec. 2022 0.50 X X 0 0 0 Daniel Schippers Board Member 0.50 X 0 0 0 Wayne Kieffer Board Member 0.50 X 0 0 0 Mary Martin Board Member 0.50 X 0 0 0 Roger Dietz MD Physician/Board Member thru Dec. 2022 40.00 X 318962 0 45729 Jana Horsfall Vice-Chair begin. Jan. 2023 0.50 X X 0 0 0 DG Bickle Secretary begin. Jan. 2023 0.50 X X 0 0 0 Ernesto Lopez-Corona MD Physician/Board Member 40.00 X 602025 0 54888 Edward Herrman President & CEO 36.00 4.00 X X 586768 0 141118 Melissa Romme Board Member begin. Jan. 2023 0.50 X 0 0 0 Kayla Gray MD Board Member begin. Jan. 2023 40.00 X 339589 0 21574 George Harms Chief Financial Officer thru. Aug 2022 36.00 4.00 X 248555 0 71587 Michelle Beckner Chief Financial Officer begin. Nov 2022 36.00 4.00 X 41108 0 5716 Terry Siek Chief Nursing Officer 36.00 4.00 X 234484 0 58979 Shae Veach VP Regional Development 36.00 4.00 X 253558 0 83537 Joannah Applequist Chief Legal Officer 36.00 4.00 X 311181 0 69296 Manmohan Biring Physician 40.00 X 1701198 0 53122 Max Decarvalho Physician 40.00 X 1203376 0 46183 Gulraiz Cheema Physician 40.00 X 1085979 0 45236 Douglas Tangel Physician 40.00 X 748079 0 42817 Oluwaseun Akinbo Physician 40.00 X 697774 0 35493 Bryce Young Former COO (key employee) 0.00 X 1358171 0 0 9730807 0 775275 176 1 1 0 Favorite Healthcare Staffing Inc PO Box 26225 Overland Park KS 66225 Contract Staffing 10859148 Quest Diagnostics Inc PO Box 772976 Chicago IL 606770276 Lab Services 5718094 Weatherby Healthcare PO Box 972633 Dallas TX 753972633 Physician Services 4359470 SHI International Inc PO Box 952121 Dallas TX 753952121 Maintenance Services 1103421 Interstaff Inc PO Box 2138 San Antonio TX 78297 Contract Staffing 824068 57 986469 12105 14486 1013060 Patient service revenue 621990 215121305 215121305 Services to CAH network and afill 900099 4060801 4060801 Retail pharmacy 456110 2822085 2822085 Fitness center 713940 1237392 1237392 1023638 1023638 224265221 1821986 1821986 367053 0 367053 367053 367053 3499281 611459 0 716021 3499281 -104562 3394719 3394719 Cafeteria revenue 722210 523750 523750 Physician practice billing 900099 211122 211122 734872 231596911 225367146 0 5216705 X 20681 20681 3578569 1399386 2179183 93165631 86761522 6348855 55254 3747273 3721850 22948 2475 11080030 10227748 845533 6749 5927137 5424516 499065 3556 590830 590830 183149 183149 15536 15536 195035 195035 30742427 27262726 3460595 19106 926286 56436 869850 1170035 253993 914543 1499 7010821 5272168 1738653 2498192 1928929 564332 4931 224626 201020 23171 435 696993 642661 51965 2367 1330672 1039255 287957 3460 8597971 6715015 1860601 22355 1148309 1120504 27805 Pharmaceuticals 33158302 33158302 Medical Supplies 21112532 21112532 Repairs and maintenance 5055191 4663864 388525 2802 Taxes and assessments 4808663 4754400 54263 4804929 3831636 878938 94355 241789820 219569144 22001332 219344 356576 441667 25454311 12558202 26292754 29147082 5972701 5803878 8249356 7007985 265190641 206540757 59998682 58649884 79939745 85752179 43896381 39988806 16338367 19101238 266498873 258450921 29573004 31934781 3010882 50105000 47410000 942916 1852064 83631802 81196845 X 170927071 164079076 11940000 13175000 182867071 177254076 266498873 258450921 X -10192909 3344914 1235000 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 15536 0 0 0 15536 0 Part II-B, Line 1: Hays Medical Center, Inc., is a member of the Kansas Hospital Association and the American Hospital Association. Both of these organizations engage in lobbying activities for hospital and general health care interests as part of the services provided to members. 15364152 -291800 1114489 13957863 13716519 1549264 1229200 1130831 15364152 11952988 647679 1866539 750687 13716519 11177350 1258089 342717 825168 11952988 11240794 569494 292554 925492 11177350 0.13830 0.67320 0.18850 0 1 1 315200 315200 85936047 59217529 26718518 165581083 136534178 29046905 13358311 10789050 2569261 58649884 75000 F Hedge funds 21293321 F Private equity fund 6802072 F Real estate limited partnership 6019915 F Limited partnership 5798498 F 39988806 Beneficial interest in net assets of foundations 13175000 Intercompany receivables 868828 Estimated third-party payor settlements 1198349 Deferred financing costs 555010 Other receivables 2627661 Interest receivable 102149 Operating right of use lease assets 574241 19101238 Estimated third-party payor settlements 1277823 Right of use lease liabilities 574241 1852064 X Part V, Line 4: The endowed funds held by the Hays Medical Center Foundation are used to help meet both the immediate and long range health care needs of patients of Hays Medical Center, Inc. The Hays Medical Center Foundation provides grants and assistance to Hays Medical Center, Inc., for property and equipment acquisitions, education, and community health issues. Part X, Line 2: Management is not aware of any uncertainties in income tax positions. Central American/Caribbean 0 0 Investments 18626674 Switzerland 0 0 Investments 5979117 0 0 0 0 0 0 24605791 0 24605791 0 0 1 0 1 0 Part III Accounting Method: 1 1 X 1 X 130.000000000000 1 X 1 1 0 1 1 1774551 1774551 0.00730 14831471 9967436 4864035 0.02010 16606022 9967436 6638586 0.02740 1705183 1276513 428670 0.00180 884686 84338 800348 0.00330 72784760 36147881 36636879 0.15150 8561 8561 0.00000 75383190 37508732 37874458 0.15660 91989212 47476168 44513044 0.18400 61322 61322 0.00030 61322 61322 0.00030 1 1298355 0 64580151 81434446 -16854295 X 1 1 2 1 Hays Medical Center Inc 2220 Canterbury Hays KS 67601 X X X 2 Pawnee Valley Community Hospital Inc 923 Carroll Ave Larned KS 67550 X X X X Hays Medical Center Inc 1 0 0 1 X X X X X X X X X 20 1 0 1 1 X https://www.haysmed.com/wp-content/uploads/2023/03/CHNA/2021_EllisCoKS_Hay X 1 20 1 https://www.haysmed.com/wp-content/uploads/2023/03/CHNA/2021_ImpDetailPlan_ 0 1 X 130.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X https://www.haysmed.com/wp-content/uploads/2023/03/BUS116A.pdf X https://www.haysmed.com/billing-financial/#/financial-assistance-applicatio X X X X 1 X 0 X X X X 1 X 0 0 Pawnee Valley Community Hospital Inc 2 0 0 1 X X X X X X X X X 20 1 0 1 1 X https://www.pawneevalleyhospital.com/wp-content/uploads/2021/07/June-29-CHN X http://www.pawneecountykansas.com/ X X 1 20 1 https://pawneevalleyhospital.com/wp-content/uploads/2022/01/CHNA2021_ImpDet 0 1 X 130.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X https://pawneevalleyhospital.com/billing/#financial-assistance-policy X https://pawneevalleyhospital.com/billing/#financial-assistance-policy X X X X 1 X 0 X X X X 1 X 0 0 Hays Medical Center, Inc. Part V, Section B, Line 5: The CHNA conducted in collaboration with the Ellis County Health Department identified significant health needs within the Ellis County and Hays Medical Center community. A town hall meeting was organized to provide an objective consensus building method of reviewing and prioritizing county health issues. During the Town Hall meetings, the group reflected on the size and seriousness of any health concerns cited and discussed current community health strengths. The group identified and ranked top community health concerns, and all Town Hall attendees and community members were encouraged to continue to contribute ideas by going online and taking a feedback survey that addresses any additional thoughts related to the CHNA. All Town Hall priority-setting and scoring processes involved the input of a diverse group with knowledge and/or expertise in public health as well as persons who represent the broad interest of the community served by the Hospital. Key stakeholders in attendance included representatives from: Ellis County Health Department, Ellis County EMS, Ellis County Sheriff's Office, First Care Clinic FQHC, Fort Hays State University, Early Childhood Connections, High Plains Mental Health, Kansas Department for Children and Families, City of Hays, and Hays Medical Center. The CHNA was coordinated and produced by VVV Consultants, LLC, from Olathe, Kansas. Pawnee Valley Community Hospital, Inc. Part V, Section B, Line 5: The CHNA was conducted in collaboration with the Pawnee County Health Department. A Town Hall meeting was organized to provide an objective consensus building method of reviewing and prioritizing county health issues. During the Town Hall meeting, the group reflected on the size and seriousness of any health concerns cited and discussed current community health strengths. The group identified and ranked top community health concerns, and all Town Hall attendees were encouraged to continue to contribute ideas by going online and taking a feedback survey that addresses any additional thoughts related to the CHNA. All Town Hall priority-setting and score processes involved the input of a diverse group with knowledge and/or expertise in public health as well as persons who represent the broad interests of the community served by the hospital. Key stakeholders in attendance included Larned State Hospital, Pawnee County Attorney's Office, Reed Pharmacy, County Living of Larned, Frick Vet, The Center for Counseling & Consulation, Heart of Kansas Family Health Care, Larned City Council, Pawnee County Sheriff's office, Pawnee County Health Department, County Commissioners, members of the Chamber of Commerce, members of the USD 495 School Board, local members of the media, local religious organizations and representatives of Pawnee Valley Community Hospital. The CHNA was coordinated and produced by VVV Research & Development, Inc. from Olathe, Kansas. Hays Medical Center, Inc. Part V, Section B, Line 6b: Ellis County, KS Pawnee Valley Community Hospital, Inc. Part V, Section B, Line 6b: Pawnee County, KS Pawnee Valley Community Hospital, Inc. Part V, Section B, Line 7d: Available on Facebook Hays Medical Center, Inc. Part V, Section B, Line 11: Hays Medical Center, Inc. conducted its fourth Community Health Needs Assessment along with the Ellis County Health Department in calendar year 2021. The Hospital and County Health Department will work with others in the community to address the needs that were identified in the survey. The needs that received the most votes are as follows: Drug & Alcohol Abuse - 13.9% Mental Health (Diagnosis, Placement, Aftercare) - 13.9% Owning Your Health/Awareness of Healthcare Services - 11.1% Access to BH Workforce - 9.7% Child Care Options - 8.3% Food Insecurity/Nutrition - 8.3% Access to Health Funding - 6.9% Nursing Home/Senior Care - 5.6% Poverty/Employment Readiness - 5.6% Suicide - 5.6%The Town Hall meeting also noted the Community's Health Strengths, which are as follows: Emergency & Ambulance Services Specialty Services Available Robust Medical System (Birth - Death) Usage of Telehealth/Telemedicine School Nurse Clinic Access Hospice Services Infant Care (Neonatal) Patient Referral (PC)In the 2021 CHNA Implementation Plan, it is noted that several areas are not part of hospital mission critical operations and that the Medical Center will be a partner with others to address these needs. These needs and the lead partner are listed below.Drug & Alcohol Abuse - the lead partners are Smokey Hill Foundation and Valley Hope - Hays Medical Center's goal, in collaboration with other community partners, is to reduce substance abuse among target populations through early detection and intervention. We have been able to develop a system of care to address substance abuse with the Smokey Hill Foundation and Valley Hope and support collaborating agencies that address substance use issues through primary care and other medical services for jointly served patients. Mental Health (Diagnosis, Placement, Aftercare) - the lead partner is High Plains Mental Health - Camber Health continues to operate an Inpatient and Outpatient youth acute mental health treatment facility in Hays. The new facility treats youth 6-18 who are experiencing depression, anxiety, suicidal thoughts, the impacts of trauma, and other mental health conditions. Hays Medical Center worked with Camber on the building, which HaysMed owns, that houses the facility. Hays Medical Center has partnered with High Plains Mental Health to establish on-site providers in Hays Medical Center and Medical Specialists who work collaboratively with the Primary Care Provider.Access to Behavioral Health Workforce - the lead partner is High Plains Mental Health - High Plains Mental Health works closely with Fort Hays State University and other organizations to help identify Behavioral Health workforce in the region to provide the workforce needed. This initiative will continue to evolve as the unemployment rate in Ellis County is so low. Hays Medical Center, Inc. Part V, Section B, Line 11: Child Care Options - the lead partners are City of Hays and Ellis County - A child care task force was developed with stakeholders in the community that continues to collaborate on a variety of different opportunities to provide childcare and access to childcare. Hays Medical Center finished the construction of a Childcare facility that holds 77 children. HaysMed has also donated land to Grow Hays that is finalizing the development of a Community Center that will house a Childcare Center on the land. Food Insecurity/Nutrition - the lead partners are Catholic Health Initiatives & Schools - The extension of the Public Health Emergency has been beneficial to children in the school system. The Community works closely with the local food pantry to ensure adequate food is secured and filled as needed. Nursing Home/Senior Care - the lead partners are City of Hays and Ellis CountyPoverty/Employment Readiness - the lead partners are City of Hays and Ellis CountySuicide - the lead partner is High Plains Mental Health - High Plains Mental Health has contracted to expand services through telemedicine in the region and Ellis County. This has helped to alleviate some of the needs, but they continually look to provide other resources that are useful in schools, hospitals, and other area agencies. HaysMed has partnered and supported Ellis county groups to educate on the importance of suicide prevention and warning signs.Hays Medical Center is dedicated to continually learning, engaging, and fulfilling the health needs of the community we serve. As a result of this commitment the following is the description of the actions taken during the most recent fiscal year to address the significant health needs identified through the CHNA for which HaysMed is a lead partner.Updates to the progress are outlined below.Owning Your Health/Awareness of Healthcare Services Affordable Care - As a result of feedback from the CHNA, the Imagine Ellis County Coalition was formed comprising stakeholders from Hays Medical Center, private business, local county and city government, school representatives, and elected officials. Imagine Ellis County is an engaged group of Ellis County citizens collaborating on a vision for the future. An area of focus and planning centers around a comprehensive guide of resources available in Ellis County and sponsored by the United Way of Ellis County. The awareness of health care services available can be located at Health Services (elliscountykshelp.com). Hays Medical Center's Center for Health Improvement has started a number of different programs to engage the community including:Walk with a Doc LiveWell - Senior focused exercise programDiabetes SolutionYouth Performance TrainingWeight Loss SolutionsCOVID Recovery ProgramAccess to Health Funding - Hays Medical Center has led efforts and continues to collaborate with Grow Hays, Imagine Ellis County, United Way of Ellis County, and the Chamber of Commerce to provide workshops and opportunities for funding of health related programs. Pawnee Valley Community Hospital, Inc. Part V, Section B, Line 11: Pawnee Valley Community Hospital, Inc. conducted its fourth Community Health Needs Assessment along with the Pawnee County Health Department in calendar year 2021. The Hospital and County Health Department will work with others in the community to address the needs that were identified in the survey. The needs that received the most votes are listed below. Mental Health (Diagnosis, Placement, Aftercare) - 16.5% Drug (Opioids) & Alcohol Abuse - 14.8% Access to Care After Hours - 8.7% Affordable Care - 7.8% Awareness of Health Services - 7.8% Teen Tobacco/Vaping - 7.8% Awareness of Exercise/Fitness Activities - 6.1% Insurance Coverage - 6.1% Women's Health (Maternal & Fetal, Breastfeeding, etc.) - 6.1%The Town Hall meeting also noted the Community's Health Strengths, which are listed below. Nutrition - Health Food Options Nursing Home/Senior Care Access to Services Growth Opportunity Charity Care Care Coordination/Leadership Recreational Activities Stable Health Services Health Department - Communication/Collaboration Ratio of ProvidersOn the 2020 CHNA Implementation Plan, it is noted that several areas are not part of hospital mission critical operations and that the Hospital will be a partner with others to address these needs. These needs and the lead partner are listed below.Mental Health (Diagnosis, Placement, Aftercare) - Mental Health Agency/Pawnee County Health DepartmentDrug (Opioids) & Alcohol Abuse - Mental Health Agency/Pawnee County Health Department Teen Tobacco/Vaping - Pawnee County Health Department Awareness of Exercise/Fitness Activities - Pawnee County Health DepartmentInsurance Coverage - No lead partner identified at this timeThe remaining CHNA Health Areas of Need will be addressed with Pawnee Valley Community Hospital as the lead partner. Updates to the progress are outlined below.Access to Care After Hours - Heart of Kansas (non-PVCH clinic) has extended clinic hours every Thursday evening which compliments our Tuesday evening. PVCH launched the patient portal for our family medicine clinic in April 2022, which allows access to healthcare results and messaging. PVCH continues to offer family telemedicine clinic visits. PVCH family medicine clinic implemented home visits in February 2023.Affordable Care - PVCH decreased the outpatient charges for physical therapy, occupational therapy, speech therapy, imaging charges and lab by 1/3 on July 1, 2021, and again by 1/3 in January 1, 2022. PVCH has a financial assistance program available to all patients meeting the program's guidelines. PVCH is an active participant along with KHA to support Medicaid expansion in Kansas. A Case Manager is actively working with acute and swing bed patients to transition away from Medicare Advantage programs that are not meeting their health coverage needs and assisting them with application for Medicaid, etc. if applicable.Awareness of Health Services - A Marketing/Communications/Community Relations position was added at PVCH in November 2021. PVCH has also contracted with a marketing firm to assist with understanding which services are of greatest need for our community. The firm identifed inpatient and outpatient rehab and inpatient respiratory therapy. A full marketing campaign for family medicine services and rehab services was kicked off in January 2023 and continues with radio, news articles, and social marketing. PVCH also participates in local Larned Area Chamber Coffee and After Hours to highlight our health services. Administration, providers, and associates attended more community events in Pawnee County and surrounding area to inform people of our services such as Coffee Hours in Great Bend and Burdett and United Way of Central Kansas events. A new website went live in August 2023, which highlights services and allows for increased search engine optimization (SEO) words, allowing our services to appear readily when people search with those words online.Women's Health (Maternal & Fetal, Breastfeeding, etc.) - PVCH added in 2022 a family medicine provider who has over 20 years of women's health services experience to our family medicine clinic. PVCH has initiated a weight loss program for women in 2022 and currently provides consultations and birth control options for women of all ages and annual women's health visits. Pawnee County Health Department currently provides maternal/fetal and breast feeding resources and education. Pawnee County Health Department has free home, Healthy Start Home Visit. Our providers will refer patients to them if they feel there is a need for a new mother. (Education and support in addition to breastfeeding support for expecting mothers). PVCH is actively working on the addition of a pediatric experienced nurse practitioner in our family medicine clinic and performing additional procedures including women's procedures in the family medicine clinic. Hays Medical Center, Inc. Part V, Section B, Line 13h: The balance of the patient account is also considered. Pawnee Valley Community Hospital, Inc. Part V, Section B, Line 13h: The balance of the patient account is also considered. 4 1 - HaysMed Convenient Care Walk-in Clinic 3216 Vine Street Suite 20 Hays KS 67601 Convenient care services 2 - Hays Family Medicine 2509 Canterbury Hays KS 67601 Family medicine 3 - HaysMed Multispecialty Clinic 2300 N 14th Ave Suite 200 Dodge City KS 67801 Various medical specialties 4 - HaysMed Multispecialty Clinic 3720 10th St Great Bend KS 67550 Various medical specialties Part I, Line 7: Hays Medical Center, Inc.'s, cost accounting system was used to calculate community health improvement services, health professions education, and subsidized health services costs. A cost-to-charge ratio derived from Worksheet 2 was used to calculate financial assistance at cost and the community benefit expense attributable to serving Medicaid beneficiaries. Part I, Line 7g: Subsidized health services community benefit expenses include $70,430,243 of expenses attributable to physician clinics that have net operating losses. Part III, Line 4: See Note B (pages 13-16 of the financial statements) for a description of the Medical Center's bad debt expensePart III, Line 2:Costing methodology: A cost-to-charge ratio derived from Worksheet 2 was used to calculate bad debt expense at cost. Part III, Line 8: The Medicare cost report was the costing methodology used to determine Medicare allowable costs. Allowable costs of care reported on line 6 were determined using amounts from Worksheet D, Part V and Worksheet D-1 in the Hays Medical Center, Inc., Medicare cost report for the fiscal year ended June 30, 2023. Part III, Line 9b: Whenever possible, the customer service representatives (CSR's) of Hays Medical Center, Inc., try to determine the estimated self-pay balance prior to the patient receiving services. FAP eligibility is first considered at this point in time. In addition, if full payment is not received or if payment is not made within 30 days, the patient will receive a statement that includes a copy of the FAP. If the patient contacts the CSR and it is determined that at least a 2-year payment plan cannot be established with the patient, the CSR will screen for charity care and request that the charity care application be completed by the patient. Part VI, Line 3: Information regarding the Hays Medical Center, Inc., charity care program is located on the Hays Medical Center, Inc., website for patients and community members to view, and the financial assistance application is also on the website to print off and complete. In addition, if a customer service representative of Hays Medical Center, Inc., contacts a patient about a bill and in visiting with them they determine that the patient could possibly qualify for the Hospital's charity care policy, they will send the application to the patient as well. Part VI, Line 4: Hays Medical Center, Inc., is located in Hays, Kansas, which has a population of approximately 21,000 people per the 2020 population census performed by the U.S. Census Bureau. One of the State of Kansas Regents universities is also located in Hays, Kansas, so the population includes many college-aged students. The median household income of Hays, Kansas, is approximately $55,300. Approximately 17.1% of the population was below the poverty line. Almost 5% of the Hospital's revenue is from services provided to patients eligible for Medicaid. Hays Medical Center, Inc., is the only hospital in the city of Hays. In addition, since this is a rural area and because it is the only hospital providing tertiary level care in the region, Hays Medical Center, Inc., provides certain services to the whole western half of the State of Kansas. Part VI, Line 5: Hays Medical Center, Inc., promotes the health of the community by extending medical privileges to most qualified, local physicians. In addition, the majority of the Board of Directors live and work in the city of Hays, but they are not employed by Hays Medical Center, Inc. Part VI, Line 6: Hays Medical Center is not part of an affiliated health system. 1 Grow Hays 219 West 10th Hays KS 67601 481048442 501(c)(3) 10000 0 Cash paid Improve community served by the Medical Center 1 Part I, Line 2: The Medical Center has implemented processes to ensure that all contributions are approved by the appropriate authorizing individual. It only disburses contributions to approved reputable organizations. 1 X X X X 1 1 0 0 0 1 0 0 0 Manmohan Biring Physician 550419 0 907967 0 242812 0 18300 0 34822 0 1754320 0 0 0 Bryce Young Former COO (key employee) 0 0 0 0 1358171 0 0 0 0 0 1358171 0 682479 0 Max Decarvalho Physician 788340 0 413104 0 1932 0 18300 0 27883 0 1249559 0 0 0 Gulraiz Cheema Physician 935935 0 146432 0 3612 0 18300 0 26936 0 1131215 0 0 0 Douglas Tangel Physician 643765 0 77613 0 26701 0 18300 0 24517 0 790896 0 0 0 Oluwaseun Akinbo Physician 642851 0 54167 0 756 0 18300 0 17193 0 733267 0 0 0 Edward Herrman President & CEO 584336 0 107 0 2325 0 107525 0 33593 0 727886 0 0 0 Ernesto Lopez-Corona MD Physician/Board Member 585593 0 0 0 16432 0 18300 0 36588 0 656913 0 0 0 Joannah Applequist Chief Legal Officer 293378 0 869 0 16934 0 64954 0 4342 0 380477 0 0 0 Roger Dietz MD Physician/Board Member thru Dec. 202 312188 0 0 0 6774 0 18300 0 27429 0 364691 0 0 0 Kayla Gray MD Board Member begin. Jan. 2023 284167 0 41064 0 14358 0 18300 0 3274 0 361163 0 0 0 Shae Veach VP Regional Development 242717 0 0 0 10841 0 54434 0 29103 0 337095 0 0 0 George Harms Chief Financial Officer thru. Aug 20 202710 0 0 0 45845 0 52864 0 18723 0 320142 0 0 0 Terry Siek Chief Nursing Officer 232921 0 0 0 1563 0 49290 0 9689 0 293463 0 0 0 Part I, Lines 4a-b Executive benefit plan distribution: Bryce Young - $1,358,172 Contributions to plan: Edward Herrman - $89,225 George Harms - $37,760 Terry Siek - $35,207 Shae Veach - $38,881 Joannah Applequist - $46,654 Part I, Line 6 A portion of incentive compensation for officers and key employees is determined by net earnings exceeding budget for the fiscal year. Form 990, Part VI, Section B, line 11b The Form 990 is prepared and reviewed by an independent accounting firm. It is then reviewed by the organization's officers and accounting personnel. Their questions and concerns are addressed and either corrected or clarified in the Form 990. The final Form 990 is then provided to the board for review prior to filing. Form 990, Part VI, Section B, line 12c Officers, directors & key employees, along with all associates, are required to complete a conflict of interest statement annually. The statements are reviewed by the Board, the Compliance Officer, and Governance Director, as well. When conflict of interest issues arise during a Board meeting, the board members with the conflict are asked to remove themselves from discussion or from the room entirely. They are not allowed to vote on that particular issue. Form 990, Part VI, Section B, line 15 The CEO's, officers', and key employees' salaries are reviewed annually by an independent consulting group and the Compensation Committee, which is made up of members of the Board. They base the review on salary comparisons obtained by the consulting group from peer hospitals in similiar geographic regions. The last review was conducted in March 2023. Form 990, Part VI, Section C, line 19 These documents are not made available to the public. Form 990, Part IX, line 11g Contract labor: Program service expenses 10,824,487. Management and general expenses 264,110. Fundraising expenses 143. Total expenses 11,088,740. Medical professional fees: Program service expenses 7,435,553. Management and general expenses 0. Fundraising expenses 0. Total expenses 7,435,553. Laboratory services: Program service expenses 5,560,230. Management and general expenses 0. Fundraising expenses 18,819. Total expenses 5,579,049. Consulting services: Program service expenses 5,027. Management and general expenses 1,009,939. Fundraising expenses 0. Total expenses 1,014,966. Recruiting fees: Program service expenses 81,109. Management and general expenses 103,706. Fundraising expenses 1. Total expenses 184,816. Non-medical professional fees: Program service expenses 1,870,784. Management and general expenses 13,117. Fundraising expenses 123. Total expenses 1,884,024. Collection and billing fees: Program service expenses 0. Management and general expenses 774,387. Fundraising expenses 0. Total expenses 774,387. Other purchased services: Program service expenses 1,485,536. Management and general expenses 1,295,336. Fundraising expenses 20. Total expenses 2,780,892. Form 990, Part XI, line 9: Change in beneficial interest in foundations 1,235,000. Hays Medical Center Foundation 2220 Canterbury Hays KS 67601 481179684 Provide grants and allocations to Hays Medical Center, Inc. KS 501(c)(3) Line 11a, I Hays Medical Center Inc 1 HaysMed Partners Inc 2220 Canterbury Hays KS 67601 270877152 Management contract for Pawnee Valley Community Hospital KS 501(c)(3) Line 3 Hays Medical Center Inc 1 Pawnee Valley Community Hospital Inc 2220 Canterbury Hays KS 67601 481253246 Hospital operated by Hays Medical Center KS 501(c)(3) Line 3 HaysMed Partners Inc 1 Hadley Foundation Inc 1200 Main Hays KS 67601 481107034 Support for Hays Medical Center KS 501(c)(3) Line 11c, III-FI N/A 0 0 0 1 1 1 0 0 0 0 1 0 1 1 1 1 0 1 0 0 Hays Medical Center Foundation C 986469 FMV Hays Medical Center Foundation Q 318544 FMV Pawnee Valley Community Hospital Inc D 247740 FMV Pawnee Valley Community Hospital Inc L 680575 FMV Pawnee Valley Community Hospital Inc O 354400 FMV Pawnee Valley Community Hospital Inc Q 3050000 FMV