GREAT PLAINS OF ELLINWOOD INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- GREAT PLAINS OF ELLINWOOD INC (EIN 48-1226976)
- Tax period
- 2022-10-01 to 2023-09-30
- Filed
- 2024-08-15
- IRS object ID
- 202402289349303625
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-08-15T16:07:03+00:00 | ReturnTs |
| Tax Period End | 2023-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 440160260 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Forvis Mazars LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1551 N Waterfront Pkwy Ste 300 | AddressLine1Txt |
| City | Wichita | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 672066601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 481226976 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Great Plains of Ellinwood Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GREA | BusinessNameControlTxt |
| Phone | 3166851523 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 NORTH ROCK ROAD STE 160 | AddressLine1Txt |
| City | WICHITA | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67206 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JASON BARB | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3166851523 | PhoneNum |
| Signature | 2024-08-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Michael Engle | PreparerPersonNm |
| PTIN | P00482834 | PTIN |
| Phone | 3162652811 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2024-08-08 14:25:15Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JASON BARB | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 NORTH ROCK ROAD STE 160 | AddressLine1Txt |
| City | WICHITA | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67206 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $11,209,301 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | https://www.ellinwooddistricthospital.org/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1999 | FormationYr |
| Legal Domicile State | KS | LegalDomicileStateCd |
| Activity Or Mission | TO OPERATE AN ACUTE CARE HOSPITAL THAT PROVIDES MEDICAL CARE TO THE GENERAL PUBLIC IN ELLINWOOD, KANSAS AND THE SURROUNDING RURAL COMMUNITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 124 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,930,542 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,036,766 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,656,242 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $9,068,215 | CYProgramServiceRevenueAmt |
| PY Investment Income | $19,480 | PYInvestmentIncomeAmt |
| CY Investment Income | $30,836 | CYInvestmentIncomeAmt |
| PY Other Revenue | $497,271 | PYOtherRevenueAmt |
| CY Other Revenue | $73,484 | CYOtherRevenueAmt |
| PY Total Revenue | $10,103,535 | PYTotalRevenueAmt |
| CY Total Revenue | $11,209,301 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $5,960,223 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,006,749 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,026,309 | PYOtherExpensesAmt |
| CY Other Expenses | $4,619,998 | CYOtherExpensesAmt |
| PY Total Expenses | $9,986,532 | PYTotalExpensesAmt |
| CY Total Expenses | $10,626,747 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $117,003 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $582,554 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,223,279 | TotalAssetsBOYAmt |
| Total Assets EOY | $17,291,831 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,439,757 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $13,925,755 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,783,522 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,366,076 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO OPERATE HOSPITAL FACILITIES FOR THE DELIVERY OF HOSPITAL AND RELATED HEALTH CARE SERVICES, HEALTH RELATED EDUCATION, AS WELL AS THE PROMOTION OF HEALTH AND WELLNESS, WITHOUT REGARD TO RACE, CREED, COLOR, SEX OR FINANCIAL CIRCUMSTANCE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $9,059,733 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $9,068,215 | RevenueAmt |
| Desc | Ellinwood District Hospital's (EDH) primary program is the delivery of healthcare and related services to patients from our district and the surrounding area. Services include inpatient acute, skilled swing-bed, and intermediate swing-bed care services along with outpatient services. During 2023, EDH completed several projects to increase the quality of service or safety to our patients and residents. 1) Ground was broken for our New Hospital that was on our 2021 Community Health Needs Assessment for an Improved Hospital Facility. The process entailed applying for a USDA Grant to make sure we didn't increase district taxes. During the process of designing the new facility, we also had to decide what equipment we would be able to replace and what equipment could move to the new facility with us. 2) EDH restructured our ER schedule so we can have more staff in the facility to cover the ER more hours out of the day. This added an additional position to our Nursing schedule, but in doing so we believe we can better serve our community. Now our inpatient nurse doesn't have to cover the ER during the night. This makes sure the ER patient gets the full attention they need while our inpatients still have a nurse available to them. 3) In 2023 we updated our inpatient communication boards. This allowed our patients to know the name of their physical therapist, medical doctor, nurse, state what their goals are and to make sure they let us know how they are feeling for the day. This simple tool helped all ancillary departments work with the patient and made patient care flow easier. | Desc |
| Total Program Service Expenses | $9,059,733 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (true) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 34 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 124 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JASON BARB | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3166851523 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 NORTH ROCK ROAD STE 160 | AddressLine1Txt |
| City | WICHITA | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67206 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| CHARLES WESTIN | ||||||||
| DIRECTOR/CHAIRMAN | 0.2 | 1.2 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| CURT COLSON | ||||||||
| PRESIDENT/CEO/DIRECTOR | 0.2 | 41.2 | Yes (X) | Yes (X) | $0 | $216,245 | $49,307 | |
| JOHN TERRILL | ||||||||
| VICE PRESIDENT/DIRECTOR | 0.2 | 1.2 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| STEVE CARLSON | ||||||||
| TREASURER/DIRECTOR | 0.2 | 1.2 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ARTHUR HENDRICKSON | ||||||||
| DIRECTOR | 0.2 | 1.2 | Yes (X) | $0 | $0 | $0 | ||
| DR BARBARA BROWN APPLEGATE | ||||||||
| DIRECTOR | 0.2 | 1.2 | Yes (X) | $0 | $0 | $0 | ||
| ROGER JOHN | ||||||||
| DIRECTOR | 0.2 | 1.2 | Yes (X) | $0 | $0 | $0 | ||
| JASON BARB | ||||||||
| CFO | 0.2 | 41.2 | Yes (X) | $0 | $176,924 | $31,708 | ||
| KILE MAGNER | ||||||||
| ADMINISTRATOR | 40.0 | 0.0 | Yes (X) | $124,677 | $0 | $39,760 | ||
| CHARLIE JOSLIN | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $217,408 | $0 | $52,326 | Yes (X) | ||
| CHRISTOPHER BROWN | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $286,652 | $0 | $48,273 | Yes (X) | ||
| Kaylee Kaiser | ||||||||
| Physician | 40.0 | 0.0 | $109,889 | $0 | $27,912 | Yes (X) | ||
| KELLI BROWN | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $110,686 | $0 | $38,440 | Yes (X) | ||
| TROY MOORE | ||||||||
| DEPT HEAD PT | 40.0 | 0.0 | $136,174 | $0 | $38,623 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $985,486 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $393,169 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $326,349 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line2ContractorAddress/USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|
| HEALTH FACILITIES GROUP LLC | ||||||
| 330 N MEAD ST | WICHITA | KS | 67202 | ARCHITECTURE SERVICES | $1,229,688 | |
| GPHA | ||||||
| 250 N ROCK RD STE 160 | WICHITA | KS | 67206 | MANAGEMENT AND SERV | $781,287 | |
| SIEMENS HEALTHCARE DIAGNOSTICS | ||||||
| PO BOX 121102 | DALLAS | TX | 753121102 | PROFESSIONAL SERVICES | $152,934 | |
| AYA HEALTHCARE INC | ||||||
| 5930 CORNERSTONE CT | SAN DIEGO | CA | 92121 | NURSING AND LAB CONTRACT SERVICES | $106,465 | SUITE 300 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,961,671 | GovernmentGrantsAmt |
| All Other Contributions | $75,095 | AllOtherContributionsAmt |
| Total Contributions | $2,036,766 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621300 | $8,718,082 | $8,718,082 |
| 340B REVENUE | 621300 | $350,133 | $350,133 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $9,068,215 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $30,836 | TotalRevenueColumnAmt |
| Exclusion | $30,836 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,760 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,760 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,760 | TotalRevenueColumnAmt |
| Exclusion | $1,760 | ExclusionAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| VENDOR REBATES | 900099 | $36,642 | $36,642 |
| EMPLOYEE/GUEST MEALS | 722514 | $9,800 | $9,800 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,282 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $25,282 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $71,724 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,209,301 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,068,215 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $104,320 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $173,470 | TotalAmt |
| Management And General | $173,470 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,518,476 | TotalAmt |
| Program Services | $4,038,917 | ProgramServicesAmt |
| Management And General | $479,559 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $322,796 | TotalAmt |
| Program Services | $282,837 | ProgramServicesAmt |
| Management And General | $39,959 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $671,552 | TotalAmt |
| Program Services | $565,233 | ProgramServicesAmt |
| Management And General | $106,319 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $320,455 | TotalAmt |
| Program Services | $270,347 | ProgramServicesAmt |
| Management And General | $50,108 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,237 | TotalAmt |
| Management And General | $126,237 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $258 | TotalAmt |
| Management And General | $258 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,514 | TotalAmt |
| Management And General | $44,514 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,492 | TotalAmt |
| Management And General | $1,492 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,815,121 | TotalAmt |
| Program Services | $1,502,068 | ProgramServicesAmt |
| Management And General | $313,053 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,022 | TotalAmt |
| Management And General | $18,022 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $445,736 | TotalAmt |
| Program Services | $427,185 | ProgramServicesAmt |
| Management And General | $18,551 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $122,268 | TotalAmt |
| Program Services | $110,547 | ProgramServicesAmt |
| Management And General | $11,721 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,266 | TotalAmt |
| Program Services | $8,571 | ProgramServicesAmt |
| Management And General | $3,695 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,315 | TotalAmt |
| Program Services | $9,100 | ProgramServicesAmt |
| Management And General | $2,215 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,440 | TotalAmt |
| Program Services | $24,488 | ProgramServicesAmt |
| Management And General | $9,952 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $359,794 | TotalAmt |
| Program Services | $243,815 | ProgramServicesAmt |
| Management And General | $115,979 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,059 | TotalAmt |
| Program Services | $72,243 | ProgramServicesAmt |
| Management And General | $4,816 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $1,034,049 | $1,034,049 | |
| BAD DEBT EXPENSE | $242,494 | $242,494 | |
| EQUIPMENT RENTAL & REPAIRS | $156,801 | $149,479 | $7,322 |
| DUES & SUBSCRIPTIONS | $35,945 | $15,989 | $19,956 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,187 | TotalAmt |
| Program Services | $62,371 | ProgramServicesAmt |
| Management And General | $19,816 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,626,747 | TotalAmt |
| Program Services | $9,059,733 | ProgramServicesAmt |
| Management And General | $1,567,014 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,039,037 | BOYAmt |
| EOY | $217,496 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $923,353 | BOYAmt |
| EOY | $983,384 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $154,315 | BOYAmt |
| EOY | $161,387 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,887 | BOYAmt |
| EOY | $41,668 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $18,517,117 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,007,283 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,795,818 | BOYAmt |
| EOY | $15,509,834 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $274,869 | BOYAmt |
| EOY | $378,062 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,223,279 | BOYAmt |
| EOY | $17,291,831 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,950,687 | BOYAmt |
| EOY | $2,055,518 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $11,558,783 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $489,070 | BOYAmt |
| EOY | $188,462 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $122,992 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,439,757 | BOYAmt |
| EOY | $13,925,755 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,783,522 | BOYAmt |
| EOY | $3,366,076 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,783,522 | BOYAmt |
| EOY | $3,366,076 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,223,279 | BOYAmt |
| EOY | $17,291,831 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $582,554 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (true) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $1,492 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Total Lobbying Expenditures | $1,492 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule C, Part II-B, Line 1f | FormAndLineReferenceDesc |
| Explanation | A PORTION OF THE ANNUAL DUES PAID TO KHA AND AHA ARE USED FOR LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $255,733 | OtherCostOrOtherBasisAmt |
| Book Value | $255,733 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,742,035 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,250,883 | DepreciationAmt |
| Book Value | $491,152 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,293,658 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,665,158 | DepreciationAmt |
| Book Value | $628,500 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,225,691 | OtherCostOrOtherBasisAmt |
| Depreciation | $91,242 | DepreciationAmt |
| Book Value | $14,134,449 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $15,509,834 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | FINANCE LEASE LIABILITIES | Desc |
| Amt | $122,992 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $122,992 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $10,966,807 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $0 | OtherRevenueAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $10,966,807 | RevenueSubtotalAmt |
| Other Revenues Not Included | $242,494 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $242,494 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $11,209,301 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $10,384,253 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $0 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $10,384,253 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $242,494 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $242,494 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $10,626,747 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part X, Line 2 | MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements | PROVISION FOR UNCOLLECTIBLE ACCOUNTS - 242494 |
| Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statements | PROVISION FOR UNCOLLECTIBLE ACCOUNTS - 242494 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,177 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $24,177 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0023 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $503,263 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $314,503 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $188,760 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0182 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $527,440 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $314,503 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $212,937 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0205 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,950 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $19,950 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0019 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0001 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $20,950 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $20,950 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0020 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $548,390 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $314,503 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $233,887 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0225 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $242,494 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $5,083,959 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $5,083,959 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $0 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ELLINWOOD DISTRICT HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 605 N MAIN | AddressLine1Txt |
| City | ELLINWOOD | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67526 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.ELLINWOODDISTRICTHOSPITAL.ORG | WebsiteAddressTxt |
| State License | H005001 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Facility Reporting Group | 1 | FacilityReportingGroupCd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https://www.ellinwooddistricthospital.org/about | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://www.ellinwooddistricthospital.org/about | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 0.0 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://www.ellinwooddistricthospital.org/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://www.ellinwooddistricthospital.org/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://www.ellinwooddistricthospital.org/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5 Facility 1, 1 | Facility 1, 1 - ELLINWOOD DISTRICT HOSPITAL. THE ASSESSMENT PROCESS WAS INITIATED BY ELLINWOOD DISTRICT HOSPITAL AND COMPLETED IN COLLABORATION WITH BARTON COUNTY HEALTH DEPARTMENT. ALL OF THE EDUCATIONAL, GOVERNMENTAL, CIVIC AND HEALTH RELATED ORGANIZATIONS WITHIN THE COMMUNITY WERE INVITED TO PARTICIPATE. TO ENSURE INPUT FROM PERSONS WITH A BROAD KNOWLEDGE OF THE COMMUNITY, NOTICES OF ALL MEETINGS WERE ANNOUNCED BY MAILED LETTERS, EMAILS, AND ADVERTISEMENTS. REPRESENTATIVES AND INDIVIDUALS FROM THE COMMUNITY AND HEALTH ORGANIZATIONS ATTENDED THE TOWN HALL, FROM ELLINWOOD AND SURROUNDING AREAS INCLUDING HOISINGTON, GREAT BEND, CLAFLIN, AND BEAMER. |
| Schedule H, Part V, Section B, Line 6b Facility 1, 1 | Facility 1, 1 - ELLINWOOD DISTRICT HOSPITAL. BARTON COUNTY HEALTH DEPARTMENT |
| Schedule H, Part V, Section B, Line 11 Facility 1, 1 | Facility 1, 1 - ELLINWOOD DISTRICT HOSPITAL. The hospital provides and promotes the health of the citizens of the Ellinwood district by constantly looking for opportunities to educate area residents about healthy activities and habits and offering opportunities for education about health care topics. Some of the activities to further the health of the area include: 1. Due to the COVID-19 pandemic, activities in which participants gather together, indoors or out, have been put on indefinite hold. Many of the normal events that EDH participates in were cancelled during this time frame. The impacts/reductions are listed in parentheses with each statement. 2. Reduced cost lab fairs are provided semi-annually with Ellinwood Hospital Foundation support. (None were held in 2022 due to COVID-19 numbers in Barton county / City of Ellinwood) 3. Educational classes are offered throughout the year, including classes to clubs and organizations in the community. Educational presentations are also made at local schools. (Two classes held in 2020) 4. We offer support to other healthcare related organizations, such as the local food bank, United Way, and Relay for Life, to raise awareness about health-related issues, such as cancer, and to ensure that their missions can be carried out, impacting the health and wellness of us all. 5. In conjunction with the community ambulance service, the hospital sponsors ACLS, PALS and CPR for professionals in Barton County. 6. TNCC classes for nurses are sponsored by the hospital for area health care professionals. 7. The hospital and its staff took the lead for the county medical organizations in emergency preparedness, especially concerning the new requirements faced by all other provider types. We host and participate in disaster/bioterrorism drills with other area health care facilities on a regular basis to encourage preparedness and awareness within our communities. 8. We support medical education in all forms, but especially by giving support to our local community colleges: top management serves on advisory boards for nursing program and medical assistant/coding programs at Barton Community College (BCC). The hospital is a practice site for phlebotomists/MLT, medical assistant program and nursing program from BCC. We are also a practice site for the physical therapy assistant program at Hutchinson Community College. We also have a job shadowing program with our local high school. This allows students to shadow a professional in the medical field they might be interested in pursuing in college. 9. EDH continues to dedicate itself and any surplus funds to improving the healthcare available to area residents and patients by updating equipment and ensuring that the hospital's technology is current and able to meet the patients' needs. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ELLINWOOD RURAL HEALTH CLINIC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 611 N MAIN | AddressLine1Txt |
| City | ELLINWOOD | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67526 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | MEDICAL CLINIC | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part VI, Line 2 Needs Assessment | In 2023, the hospital has continued to work to address the health needs identified by the 2021 Community Health Needs Assessment of our service area. The organization has surveyed district patrons on services currently provided at the hospital and what they see as future needs. Strategic planning and mission review is part of the annual advisory board's retreat. This year we reviewed the previous year's plan and planned for the next several years based on the needs assessment from survey and input received from the public. Two areas of focus were identified for the facility: 1. Develop a strategic plan going forward regarding the building of a new facility, including: funding opportunities and capital availability, public relations and community support, project management, budget, and timeline. 2. Develop and adopt a medical provider succession plan and build relationships to move forward with it. The current changes in health care at the federal, state, and community levels are communicated to the public via local media and town hall meetings as determined necessary. Advisory board meetings are considered open meetings and the public is encouraged to attend. The annual advisory board meeting informs the public of the hospital and clinic's most recent statistics and offered services. The hospital district supplies the clinic building for rural health clinic providers and for outside consulting physicians. |
| Schedule H, Part VI, Line 3 Patient Education of Eligibility for Assistance | The Financial Assistance Program employs a sliding scale discount that takes into consideration a patient's household income and qualifying assets. The Financial Counselor consults with private pay patients to see if they qualify for the Hospital's financial assistance policy. We also have posted online and in both the hospital and clinic lobbies that financial assistance is available and to apply with the Financial Counselor at the Hospital. If discovered during the accounts receivable collection process that a patient is having trouble paying bills, both the hospital and the centralized billing office will inform the patient that financial assistance is available. As part of the financial assistance program all applicants must apply for Medicaid. If after the initial interview there is a consensus that the patient may qualify for financial assistance, the financial counselor gives patient forms to complete and asks to see bank statements, tax returns, etc. Computations based on current Federal Poverty Level Guidelines are completed to see if qualification is appropriate and the percentage of charges to be written off is determined, based on family size and household income. All instances of financial assistance are approved by upper management of the Hospital. |
| Schedule H, Part VI, Line 4 Community Information | The Ellinwood Hospital District consists of all of Lakin township (including the City of Ellinwood) and all of Comanche township (with the exception of the two tiers of sections along the western edge described as Sections 5,6,7,8,17,18,19,20,29,30,31, and 32, in West 20-12. This area is known as the Ellinwood Trade Area. The hospital is located in Ellinwood, Kansas which has a population of 2,063 as of the 2019 5-year estimates of the American Community Survey, by the U.S. Census Bureau, and serves the eastern part of Barton County. Total population of Barton County is 26,453 as of the same census. The median age of an Ellinwood resident is 39.9 years. Total households in Ellinwood are 834 plus the rural households from the district. The racial makeup of the community is 90% white, 7% Hispanic, and the remaining 3% are other races or multiple races. The median income per household in Ellinwood was $47,500, as compared to the state of Kansas which is $59,597. 40% of Ellinwood citizens are 50 or older. The percentage of people at the poverty level or below in Ellinwood is 12%, the same as compared to the state poverty rate of 12%. Poverty level of those under 18 is 11% and for those over the age of 65 it is 10%. The patient population also includes patients from Russell, Rice, and Stafford Counties. The patient mix is heavily weighted toward Medicare and Medicaid beneficiaries, especially acute, ER, and swing bed care. Citation: U.S. Census Bureau (2019). American Community Survey 5-year estimates. Retrieved from Census Reporter Profile page for Ellinwood, KS <https://censusreporter.org/profiles/16000US2020425-ellinwood-ks/> |
| Schedule H, Part VI, Line 5 Promotion of community health | The hospital provides and promotes the health of the citizens of the Ellinwood district by constantly looking for opportunities to educate area residents about healthy activities and habits and offering opportunities for education about health care topics. Some of the activities to further the health of the area include: 1. Due to the COVID-19 pandemic, activities in which participants gather together, indoors or out, have been put on indefinite hold. Many of the normal events that EDH participates in were cancelled during this time frame. The impacts/reductions are listed in parentheses with each statement. 2. Reduced cost lab fairs are provided semi-annually with Ellinwood Hospital Foundation support. (None were held in 2022 due to COVID-19 numbers in Barton county / City of Ellinwood) 3. Educational classes are offered throughout the year, including classes to clubs and organizations in the community. Educational presentations are also made at local schools. (Two classes held in 2020) 4. We offer support to other healthcare related organizations, such as the local food bank, United Way, and Relay for Life, to raise awareness about health-related issues, such as cancer, and to ensure that their missions can be carried out, impacting the health and wellness of us all. 5. In conjunction with the community ambulance service, the hospital sponsors ACLS, PALS and CPR for professionals in Barton County. 6. TNCC classes for nurses are sponsored by the hospital for area health care professionals. 7. The hospital and its staff took the lead for the county medical organizations in emergency preparedness, especially concerning the new requirements faced by all other provider types. We host and participate in disaster/bioterrorism drills with other area health care facilities on a regular basis to encourage preparedness and awareness within our communities. 8. We support medical education in all forms, but especially by giving support to our local community colleges: top management serves on advisory boards for nursing program and medical assistant/coding programs at Barton Community College (BCC). The hospital is a practice site for phlebotomists/MLT, medical assistant program and nursing program from BCC. We are also a practice site for the physical therapy assistant program at Hutchinson Community College. We also have a job shadowing program with our local high school. This allows students to shadow a professional in the medical field they might be interested in pursuing in college. 9. EDH continues to dedicate itself and any surplus funds to improving the healthcare available to area residents and patients by updating equipment and ensuring that the hospital's technology is current and able to meet the patients' needs. |
| Schedule H, Part VI, Line 6 Affiliated health care system | Ellinwood District Hospital and Clinic are affiliated with Great Plains Health Alliance, Inc. (GPHA), a non-profit 501(c)(3) organization which provides management services and operational, finance, and accounting support. GPHA does not provide services directly to patients, but does provide access to professionals that may not be affordable to the normal critical access hospital. GPHA provides education and assistance in areas such as HIPAA, Medicare reimbursement, meaningful use requirements for computer systems, etc. GPHA is an affiliation of Critical Access Hospitals in Kansas and Nebraska that provides networking opportunities with other rural hospitals, communities, and leaders. GPHA provides policies and guidance to its Critical Access facilities regarding financial assistance, conflicts of interest, corporate compliance, and many other areas. GPHA also provides educational sessions for Board Members, Business Office Mangers, Billers, Medical Records personnel, Directors of Nursing, and Administrators. GPHA is a vital link in allowing CAH hospitals to operate at a high quality within the cash constraints imposed by the Critical Access program. |
| Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care | THE ORGANIZATION USED THE FOLLOWING CRITERIA TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE: ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, AND UNDERINSURANCE STATUS. |
| Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation | 242494 |
| Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance | THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART I, LINE 7 OF SCHEDULE H, IS A COST TO CHARGE RATIO. |
| Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount | HOSPITAL CHARGES THAT ARE NOT COLLECTED AND ARE NOT APPROVED FOR FINANCIAL ASSISTANCE ARE CLASSIFIED AS BAD DEBTS FROM PATIENTS WHO WILL NOT PAY. |
| Schedule H, Part III, Line 3 Bad Debt Expense Methodology | THE COSTING METHODOLOGY IS BASED ON THE ORGANIZATION'S MEDICARE COST-TO-CHARGE RATIO. WHILE WE RECOGNIZE THAT THERE WOULD BE SOME BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY, WE HAVE NO REASONABLE BASIS FOR ESTIMATING THIS FIGURE. IF ELIGIBILITY IS KNOWN, THE AMOUNT WOULD FALL UNDER CHARITY CARE AND NOT BAD DEBT. |
| Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote | NOT APPLICABLE DUE TO ADOPTION OF ASC 606 REVENUE CONTRACTS WITH CUSTOMERS. |
| Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs | THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNT ON LINE 6 IS COST TO CHARGE RATIO. |
| Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance | ALL CHARITY CARE CHARGES AND CHARGES NOT TO BE COLLECTED DUE TO FINANCIAL ASSISTANCE COMPUTATIONS ARE EXEMPT FROM COLLECTION POLICIES AND PRACTICES. THESE ACCOUNTS ARE REMOVED FROM THE COLLECTION CYCLE. |
| Schedule H, Part V, Section B, Line 16a FAP website | 1 - ELLINWOOD DISTRICT HOSPITAL: Line 16a URL: https://www.ellinwooddistricthospital.org/; |
| Schedule H, Part V, Section B, Line 16b FAP Application website | 1 - ELLINWOOD DISTRICT HOSPITAL: Line 16b URL: https://www.ellinwooddistricthospital.org/; |
| Schedule H, Part V, Section B, Line 16c FAP plain language summary website | 1 - ELLINWOOD DISTRICT HOSPITAL: Line 16c URL: https://www.ellinwooddistricthospital.org/; |
| Schedule H, Part VI, Line 7 State filing of community benefit report | KS |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CURT COLSON | ||||||||||||||
| PRESIDENT/CEO/DIRECTOR | $0 | $214,367 | $0 | $0 | $0 | $1,878 | $0 | $18,997 | $0 | $30,310 | $0 | $265,552 | $0 | $0 |
| KILE MAGNER | ||||||||||||||
| ADMINISTRATOR | $124,490 | $0 | $0 | $0 | $187 | $0 | $12,934 | $0 | $26,826 | $0 | $164,437 | $0 | $0 | $0 |
| JASON BARB | ||||||||||||||
| CFO | $0 | $175,716 | $0 | $0 | $0 | $1,208 | $0 | $2,692 | $0 | $29,016 | $0 | $208,632 | $0 | $0 |
| CHRISTOPHER BROWN | ||||||||||||||
| PHYSICIAN | $278,739 | $0 | $0 | $0 | $7,913 | $0 | $20,827 | $0 | $27,446 | $0 | $334,925 | $0 | $0 | $0 |
| CHARLIE JOSLIN | ||||||||||||||
| PHYSICIAN | $215,659 | $0 | $0 | $0 | $1,749 | $0 | $22,425 | $0 | $29,901 | $0 | $269,734 | $0 | $0 | $0 |
| TROY MOORE | ||||||||||||||
| DEPT HEAD PT | $136,174 | $0 | $0 | $0 | $0 | $0 | $13,747 | $0 | $24,876 | $0 | $174,797 | $0 | $0 | $0 |
| KELLI BROWN | ||||||||||||||
| PHYSICIAN | $110,686 | $0 | $0 | $0 | $0 | $0 | $11,552 | $0 | $26,888 | $0 | $149,126 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule J, Part I, Line 3 Form 990, Part VII | FormAndLineReferenceDesc |
| Explanation | ANNUAL COMPENSATION REVIEWS ARE COMPLETED BY THE CEO AND CHIEF FINANCIAL OFFICER USING RECOMMENDATIONS PROVIDED BY DEPARTMENT MANAGERS AND CURRENT MARKET CONDITIONS. ALL EXECUTIVE EMPLOYEE SALARIES, INCLUDING THE PRESIDENT/CEO, ARE APPROVED BY THE GPHA BOARD OF DIRECTORS. THE AMERICAN COLLEGE HEALTHCARE EXECUTIVES AND THE KANSAS HOSPITAL ASSOCIATION ALSO HAS COMPARABLE COMPENSATION DATA THAT CAN BE USED BY THE BOARD. THE CEO RETAINS DOCUMENTATION IN ADDITION TO THAT IN THE BOARD MINUTES. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ELLINWOOD HOSPITAL DISTRICT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 480931413 | BondIssuerEIN |
| CUSIP | 000000000 | CUSIPNum |
| Bond Issued | 2023-01-24 | BondIssuedDt |
| Issue Price | $26,000,000 | IssuePriceAmt |
| Purpose | NEW HOSPITAL CONSTRUCTION | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $11,843,703 | TotalProceedsAmt |
| Capitalized Interest | $101,396 | CapitalizedInterestAmt |
| Issuance Costs From Proceeds | $440,300 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $11,301,982 | CapitalExpendituresAmt |
| Unspent | $25 | UnspentAmt |
| Refunding Tax Exempt Bonds | false | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | false | RefundingTaxableBondsInd |
| Final Allocation Made | false | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | false | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | Yes (true) | MgmtContractBondFincdPropInd |
| Engage Bond Counsel Contracts | Yes (true) | EngageBondCounselContractsInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.0 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.0 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.0 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | false | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (true) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (true) | RebateNotDueYetInd |
| Exception To Rebate | false | ExceptionToRebateInd |
| No Rebate Due | false | NoRebateDueInd |
| Variable Rate Issue | false | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (true) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (true) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule K, Part II, Line 3 PROCEEDS | FormAndLineReferenceDesc |
| Explanation | THE PROCEEDS OF THE BOND ARE FUNDED IN INSTALLMENTS. AS OF THE END OF THE YEAR, $11,824,963 OF THE TOTAL AVAILABLE $26,000,000 HAD BEEN DRAWN DOWN AND $18,740 OF INTEREST INCOME HAD BEEN EARNED, RESULTING IN $11,843,703 OF TOTAL PROCEEDS OF THE BOND ISSUE. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS | JASON BARB AND CURT COLSON HAVE A BUSINESS RELATIONSHIP. THEY ARE BOTH EMPLOYED BY, AND ALSO AN OFFICER OF, A RELATED 501(C)(3) ORGANIZATION, GREAT PLAINS HEALTH ALLIANCE. |
| Form 990, Part VI, Line 15a & 15B | THE CEO AND CFO ARE COMPENSATED BY GREAT PLAINS HEALTH ALLIANCE, A RELATED ORGANIZATION. GPHA'S BOARD USES COMPARABILITY DATA IN SETTING THEIR SALARIES, AND DOCUMENTATION IS RETAINED OF THE BOARD'S DELIBERATIONS AND DECISIONS. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | GREAT PLAINS HEALTH ALLIANCE, INC., A NOT-FOR-PROFIT 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF GREAT PLAINS OF ELLINWOOD, INC. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | GREAT PLAINS HEALTH ALLIANCE, INC., BEING THE SOLE MEMBER, HAS THE RIGHT TO ELECT AND APPROVE ALL THE BOARD MEMBERS. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | GREAT PLAINS HEALTH ALLIANCE, INC (GPHA) IS THE SOLE MEMBER AND HAS THE AUTHORITY TO APPROVE THE ARTICLES OF INCORPORATION, BYLAWS, ELECTION TO OR REMOVAL FROM THE BOARD OF DIRECTORS, THE ANNUAL OPERATING AND CAPITAL BUDGETS, AND THE LONG RANGE OR STRATEGIC PLANS. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | THE 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE 990 IS THEN PROVIDED TO THE CHIEF EXECUTIVE OFFICER FOR REVIEW AND APPROVAL. AN ELECTRONIC DRAFT OF THE 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO THE FULL BOARD FOR REVIEW PRIOR TO FILING THE 990 WITH THE IRS. |
| Form 990, Part VI, Line 12c Conflict of interest policy | THE ORGANIZATION IS REQUIRED TO ADOPT GPHA'S CONFLICT OF INTEREST POLICY. ALL BOARD MEMBERS, OFFICERS, AND EMPLOYEES ARE SUBJECT TO THE CONFLICT OF INTEREST POLICY AND SIGN AN ANNUAL ACKNOWLEDGEMENT THAT THEY HAVE READ, UNDERSTAND AND COMPLIED WITH THE GPHA CONFLICT OF INTEREST POLICY. UNDER THE POLICY, ANY MEMBER WHO HAS A DIRECT OR INDIRECT (VIA FAMILY) FINANCIAL INTEREST IS CHARACTERIZED AS AN INTERESTED PERSON. INTERESTED PERSONS ARE REQUIRED TO DISCLOSE FINANCIAL INTERESTS WITH COMPANIES DOING BUSINESS WITH GPHA. THE INTERESTED PERSON MUST RECUSE THEMSELVES FROM FURTHER DISCUSSIONS OF THE TRANSACTION AND LEAVE THE ROOM. THE REMAINING NON-INTERESTED MEMBERS DECIDE IF A CONFLICT OF INTEREST EXISTS. THE BOARD CHAIR MAY APPOINT ANOTHER DISINTERESTED PARTY TO DISCUSS THE TRANSACTION OR THE REMAINING BOARD MEMBERS MAY VOTE TO ENTER INTO OR ABSTAIN FROM THE SUSPECT TRANSACTION. FAILURE TO DISCLOSE FINANCIAL INTERESTS BY INTERESTED BOARD MEMBERS WILL RESULT IN DISCIPLINARY ACTION, INCLUDING SANCTIONING BY BOARD. ALL CONFLICTS OF INTEREST AND THEIR ULTIMATE RESOLUTION ARE DOCUMENTED IN THE BOARD MINUTES. THE BOARD CONDUCTS PERIODIC REVIEWS TO DETERMINE THAT CONFLICTS ARE BEING IDENTIFIED AND RESOLVED ACCORDING TO POLICY DOCUMENTATION. REVIEWS BY OUTSIDE EXPERTS ARE PERMITTED, BUT NOT REQUIRED. |
| Form 990, Part VI, Line 19 Required documents available to the public | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE COMPANY'S KANSAS ANNUAL REPORT IS ALSO AVAILABLE UPON REQUEST FROM THE KANSAS SECRETARY OF STATE. |
| Form 990, Part VIII, Line 11d Other Miscellaneous Revenue | MISCELLANEOUS REVENUE - Total Revenue: 25282, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 25282; |
| Form 990, Part IX, Line 11g Other Fees | CONTRACTED MEDICAL STAFF - Total Expense: 1128367, Program Service Expense: 1128367, Management and General Expenses: , Fundraising Expenses: ; BILLING/COLLECTIONS - Total Expense: 283616, Program Service Expense: , Management and General Expenses: 283616, Fundraising Expenses: ; LAB SERVICES - Total Expense: 209298, Program Service Expense: 209298, Management and General Expenses: , Fundraising Expenses: ; MAINTENANCE/HOUSEKEEPING - Total Expense: 98487, Program Service Expense: 98487, Management and General Expenses: , Fundraising Expenses: ; PHARMACY SERVICES - Total Expense: 62771, Program Service Expense: 62771, Management and General Expenses: , Fundraising Expenses: ; ADMINISTRATION/HUMAN RESOURCES - Total Expense: 29437, Program Service Expense: , Management and General Expenses: 29437, Fundraising Expenses: ; DIETARY SERVICES - Total Expense: 3145, Program Service Expense: 3145, Management and General Expenses: , Fundraising Expenses: ; |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| GREAT PLAINS HEALTH ALLIANCE | |||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 480617739 | MANAGEMENT | KS | 501(c)(3) | 3 | N/A | false | |
| GREAT PLAINS HEALTH CARE FOUNDATION INC | |||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 480955870 | SUPPORT | KS | 501(c)(3) | 10 | Yes (true) | GPHA INC | |
| GREAT PLAINS OF SABETHA COUNTY INC | |||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 481236156 | HOSPITAL | KS | 501(c)(3) | 3 | Yes (true) | GPHA INC | |
| GREAT PLAINS OF SMITH COUNTY INC | |||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 481226830 | HOSPITAL | KS | 501(c)(3) | 3 | Yes (true) | GPHA INC | |
| GREAT PLAINS OF REPUBLIC COUNTY IN | |||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67037 | 481226977 | HOSPITAL | KS | 501(c)(3) | 3 | Yes (true) | GPHA INC | |
| GREAT PLAINS OF CHEYENNE COUNTY | |||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 481226831 | HOSPITAL | KS | 501(c)(3) | 3 | Yes (true) | GPHA INC | |
| GREAT PLAINS OF OTTAWA COUNTY INC | |||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 481226856 | HOSPITAL | KS | 501(c)(3) | 3 | Yes (true) | GPHA INC | |
| GREAT PLAINS EMPLOYEE BENEFITS TRUST | |||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 476918582 | HEALTH PLAN | KS | 501(c)(9) | Yes (true) | GPHA INC | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GPHA Employee Benefit Plan | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | R | TransactionTypeTxt |
| Involved | $627,103 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |