GREAT PLAINS OF SMITH CO INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- GREAT PLAINS OF SMITH CO INC (EIN 48-1226830)
- Tax period
- 2021-04-01 to 2022-03-31
- Filed
- 2023-02-14
- IRS object ID
- 202340459349300724
- Schema version
- 2021v4.2
- 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 O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-02-14T08:52:51-06:00 | ReturnTs |
| Tax Period End | 2022-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FORVIS 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 | 2021-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 481226830 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREAT PLAINS OF SMITH CO INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % JASON BARB | InCareOfNm |
| Business Name Control | GREA | BusinessNameControlTxt |
| Phone | 7852826845 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 349 | AddressLine1Txt |
| City | SMITH CENTER | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 66967 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JASON BARB | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 3166851523 | PhoneNum |
| Signature | 2022-12-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | DAVE | PersonFirstNm |
| Person Last | DELLASEGA | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SHAWNELL LINOT | PreparerPersonNm |
| PTIN | P01663908 | PTIN |
| Phone | 3162652811 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-03-07 01:45:13Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SMITH COUNTY MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JASON BARB | PrincipalOfficerNm |
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 | $22,282,928 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SCMHKS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1999 | FormationYr |
| Legal Domicile State | KS | LegalDomicileStateCd |
| Activity Or Mission | THE OPERATION OF HOSPITAL FACILITIES FOR THE DELIVERY OF HEALTH CARE SERVICES, EDUCATION, AND WELLNESS WITHOUT REGARD TO RACE, CREED, COLOR, SEX OR FINANCIAL CIRCUMSTANCE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 188 | TotalEmployeeCnt |
| Total Volunteers | 8 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $4,968,472 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,995,344 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $18,643,887 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $19,995,796 | CYProgramServiceRevenueAmt |
| PY Investment Income | $44,184 | PYInvestmentIncomeAmt |
| CY Investment Income | $14,941 | CYInvestmentIncomeAmt |
| PY Other Revenue | $126,091 | PYOtherRevenueAmt |
| CY Other Revenue | $276,847 | CYOtherRevenueAmt |
| PY Total Revenue | $23,782,634 | PYTotalRevenueAmt |
| CY Total Revenue | $22,282,928 | 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 | $9,074,468 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,523,981 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $11,946,023 | PYOtherExpensesAmt |
| CY Other Expenses | $12,733,596 | CYOtherExpensesAmt |
| PY Total Expenses | $21,020,491 | PYTotalExpensesAmt |
| CY Total Expenses | $23,257,577 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,762,143 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$974,649 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $40,774,688 | TotalAssetsBOYAmt |
| Total Assets EOY | $35,531,329 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $33,614,200 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $29,346,878 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $7,160,488 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,184,451 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| 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 | $19,116,906 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $19,995,796 | RevenueAmt |
| Desc | Great Plains of Smith County, Inc., dba Smith County Memorial Hospital, delivers primary healthcare services to residents in an area that includes Smith County, Kansas. The service area also includes, to a lesser degree, Phillips, Jewell, and Osborne Counties in Kansas, as well as Franklin and Webster Counties in Nebraska. The primary healthcare services are delivered through a Critical Access Hospital, and a Provider Based Rural Health Clinic. SEE SCHEDULE O FOR CONTINUATION. | Desc |
| Total Program Service Expenses | $19,116,906 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | 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 | false | TaxExemptBondsInd |
| 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 | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (true) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 19 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 188 | 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 | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JASON BARB | PersonNm |
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|---|
| HANNAH HAACK | ||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $355,158 | $0 | $52,691 | ||
| JUSTIN OVERMILLER | ||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $327,422 | $0 | $55,945 | ||
| FERRILL CONANT | ||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $272,095 | $0 | $42,036 | ||
| DAVE DELLASEGA | ||||||||
| PRESIDENT/SECRETARY/DIRECTOR | 2.0 | 40.0 | $0 | $209,142 | $59,769 | Yes (X) | Yes (X) | |
| LEAH WIEHL | ||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $196,766 | $0 | $41,356 | ||
| ALLEN VANDRIEL | ||||||||
| ADMINISTRATOR | 40.0 | 0.0 | $188,251 | $0 | $36,401 | Yes (X) | ||
| MARK TOWNER | ||||||||
| PHYSICAL THERAPIST | 40.0 | 0.0 | Yes (X) | $153,880 | $0 | $37,875 | ||
| STEPHEN LEWIS | ||||||||
| CFO | 40.0 | 0.0 | $140,032 | $0 | $19,860 | Yes (X) | ||
| DURREL KELLEY | ||||||||
| SENIOR VP OF OPERATIONS | 2.0 | 40.0 | $0 | $127,901 | $30,947 | Yes (X) | ||
| JASON BARB | ||||||||
| CFO | 2.0 | 40.0 | $0 | $46,160 | $5,528 | Yes (X) | ||
| DAVE RANKIN | ||||||||
| CHAIRMAN/DIRECTOR | 0.25 | 2.25 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| CHARLES WESTIN | ||||||||
| CHAIRMAN/DIRECTOR | 0.25 | 2.25 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| JOHN TERRILL | ||||||||
| VICE PRESIDENT/DIRECTOR | 0.25 | 2.25 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| STEVE CARLSON | ||||||||
| TREASURER/DIRECTOR | 0.25 | 2.25 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| DR BARBARA BROWN APPLEGATE | ||||||||
| DIRECTOR | 0.25 | 2.25 | $0 | $0 | $0 | Yes (X) | ||
| ARTHUR HENRICKSON | ||||||||
| DIRECTOR | 0.25 | 2.25 | $0 | $0 | $0 | Yes (X) | ||
| ROGER JOHN | ||||||||
| DIRECTOR | 0.25 | 2.25 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,633,604 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $383,203 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $382,408 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 13 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| GPHA | |||||
| 250 N ROCK RD STE 160 | WICHITA | KS | 67206 | BILLING SERVICE/MGMT | $1,258,217 |
| QUEST DIAGNOSTICS | |||||
| PO BOX 719 | HAYS | KS | 67601 | REFERENCE LAB | $170,759 |
| WOUND CARE SPECIALISTS | |||||
| PO BOX 71849 | CHICAGO | IL | 606941849 | WOUND CARE | $131,275 |
| MIDWEST ANESTHESIA ALLIANCE | |||||
| PO BOX 306 | MEMPHIS | MO | 63555 | CRNA SERVICES | $394,486 |
| INTERSTAFF | |||||
| PO BOX 2138 | SAN ANTONIO | TX | 77406 | NURSE STAFFING | $166,368 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,728,230 | GovernmentGrantsAmt |
| All Other Contributions | $267,114 | AllOtherContributionsAmt |
| Total Contributions | $1,995,344 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621300 | $18,001,699 | $18,001,699 |
| 340B PRESCRIPTION DRUG REVENUE | 621300 | $1,994,097 | $1,994,097 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $19,995,796 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,941 | TotalRevenueColumnAmt |
| Exclusion | $14,941 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,248 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,248 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,248 | TotalRevenueColumnAmt |
| Exclusion | $2,248 | ExclusionAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| EMPLOYEE/GUEST MEALS | 722513 | $99,875 | $99,875 |
| VENDOR REBATES | 900099 | $20,956 | $20,956 |
| All Other Misc Revenue | 900099 | $153,768 | $153,768 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $153,768 | TotalRevenueColumnAmt |
| Exclusion | $153,768 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $274,599 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $22,282,928 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $19,995,796 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $291,788 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $209,094 | TotalAmt |
| Management And General | $209,094 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,031,733 | TotalAmt |
| Program Services | $6,991,663 | ProgramServicesAmt |
| Management And General | $1,040,070 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $602,310 | TotalAmt |
| Program Services | $526,235 | ProgramServicesAmt |
| Management And General | $76,075 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,133,761 | TotalAmt |
| Program Services | $914,308 | ProgramServicesAmt |
| Management And General | $219,453 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $547,083 | TotalAmt |
| Program Services | $463,591 | ProgramServicesAmt |
| Management And General | $83,492 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,264 | TotalAmt |
| Management And General | $139,264 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,962 | TotalAmt |
| Management And General | $17,962 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $228,920 | TotalAmt |
| Management And General | $228,920 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,734 | TotalAmt |
| Management And General | $2,734 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,240,432 | TotalAmt |
| Program Services | $2,638,168 | ProgramServicesAmt |
| Management And General | $602,264 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,088 | TotalAmt |
| Program Services | $1,314 | ProgramServicesAmt |
| Management And General | $39,774 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $585,398 | TotalAmt |
| Program Services | $542,752 | ProgramServicesAmt |
| Management And General | $42,646 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,732 | TotalAmt |
| Program Services | $23,540 | ProgramServicesAmt |
| Management And General | $47,192 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $411,352 | TotalAmt |
| Program Services | $299,433 | ProgramServicesAmt |
| Management And General | $111,919 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,698 | TotalAmt |
| Program Services | $3,148 | ProgramServicesAmt |
| Management And General | $550 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,853 | TotalAmt |
| Management And General | $7,853 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $739,395 | TotalAmt |
| Program Services | $528,355 | ProgramServicesAmt |
| Management And General | $211,040 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,346,884 | TotalAmt |
| Program Services | $1,677,029 | ProgramServicesAmt |
| Management And General | $669,855 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $182,309 | TotalAmt |
| Program Services | $130,274 | ProgramServicesAmt |
| Management And General | $52,035 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $4,192,599 | $4,192,599 | |
| EQUIPMENT RENTAL/MAINTENANCE | $221,712 | $132,140 | $89,572 |
| DUES & SUBSCRIPTIONS | $60,389 | $29,313 | $31,076 |
| _ | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $240,875 | TotalAmt |
| Program Services | $23,044 | ProgramServicesAmt |
| Management And General | $217,831 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,257,577 | TotalAmt |
| Program Services | $19,116,906 | ProgramServicesAmt |
| Management And General | $4,140,671 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,471,181 | BOYAmt |
| EOY | $3,490,371 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,679,899 | BOYAmt |
| EOY | $4,240,078 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $153,679 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,172,658 | BOYAmt |
| EOY | $2,404,939 | 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 |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| 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 | $276,263 | BOYAmt |
| EOY | $302,717 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $120,669 | BOYAmt |
| EOY | $126,087 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $31,011,455 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $8,696,095 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,504,700 | BOYAmt |
| EOY | $22,315,360 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,549,318 | BOYAmt |
| EOY | $2,498,098 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,774,688 | BOYAmt |
| EOY | $35,531,329 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,224,388 | BOYAmt |
| EOY | $2,291,940 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,709,001 | BOYAmt |
| EOY | $598,459 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | 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 | $26,680,811 | BOYAmt |
| EOY | $26,456,479 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,614,200 | BOYAmt |
| EOY | $29,346,878 | 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 | $6,188,456 | BOYAmt |
| EOY | $5,198,905 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $972,032 | BOYAmt |
| EOY | $985,546 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,160,488 | BOYAmt |
| EOY | $6,184,451 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,774,688 | BOYAmt |
| EOY | $35,531,329 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$974,649 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,388 | NetUnrlzdGainsLossesInvstAmt |
| 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| 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 | $2,734 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Total Lobbying Expenditures | $2,734 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $973,031 | BeginningYearBalanceAmt |
| Contributions | $171,687 | ContributionsAmt |
| Investment Earnings Or Losses | $8,634 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $166,807 | OtherExpendituresAmt |
| End Year Balance | $986,545 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $877,459 | BeginningYearBalanceAmt |
| Contributions | $66,240 | ContributionsAmt |
| Investment Earnings Or Losses | $93,680 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $65,348 | OtherExpendituresAmt |
| End Year Balance | $972,031 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $936,018 | BeginningYearBalanceAmt |
| Contributions | $13,269 | ContributionsAmt |
| Investment Earnings Or Losses | -$38,761 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $33,067 | OtherExpendituresAmt |
| End Year Balance | $877,459 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $910,903 | BeginningYearBalanceAmt |
| Contributions | $13,076 | ContributionsAmt |
| Investment Earnings Or Losses | $41,817 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $29,778 | OtherExpendituresAmt |
| End Year Balance | $936,018 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $982,411 | BeginningYearBalanceAmt |
| Contributions | $17,349 | ContributionsAmt |
| Investment Earnings Or Losses | -$27,421 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $61,436 | OtherExpendituresAmt |
| End Year Balance | $910,903 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.95710 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.04290 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $395,701 | OtherCostOrOtherBasisAmt |
| Book Value | $395,701 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $19,602,101 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,415,385 | DepreciationAmt |
| Book Value | $15,186,716 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,693,412 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,181,346 | DepreciationAmt |
| Book Value | $3,512,066 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,320,241 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,099,364 | DepreciationAmt |
| Book Value | $3,220,877 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $22,315,360 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Due from Third Party | $455,000 |
| FUNDS HELD BY ESCROW AGENT | $1,552,447 |
| OTHER RECEIVABLES | $490,651 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,498,098 | TotalBookValueOtherAssetsAmt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART V, LINE 4 | THE INTENDED USE OF THE ENDOWMENT FUNDS IS TO SUPPORT THE CONTINUING OPERATIONS OF THE REPORTING ORGANIZATION. |
| 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 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 | false | ExpensesExceedBudgetInd |
| 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 | $304,794 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $304,794 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01310 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,358,045 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $944,991 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $413,054 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01780 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,662,839 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $944,991 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $717,848 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03090 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $29,362 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $29,362 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $29,362 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $29,362 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,692,201 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $944,991 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $747,210 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03220 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $248,600 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $8,500,670 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $8,500,670 | CostOfCareReimbursedByMedcrAmt |
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 | GREAT PLAINS OF SMITH CO INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 921 E HWY 36 | AddressLine1Txt |
| City | SMITH CENTER | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 66967 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.SCMHKS.ORG | WebsiteAddressTxt |
| State License | H092001 | 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 |
| Other | RURAL HEALTH CLINIC | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREAT PLAINS OF SMITH CO INC | 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 | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SCHEDULE H, PART V, SECTION C | 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 | SEE SCHEDULE H, PART V, SECTION C | 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. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 0. | FPGFamilyIncmLmtDscntCarePct |
| 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 |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE SCHEDULE H, PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE SCHEDULE H, PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE SCH H, PART V, SECTION C | 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 (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, LINE 5 | THE OBJECTIVE OF THE SMITH COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS TO DETERMINE HEALTH NEEDS FROM THE PERSPECTIVE OF THE COMMUNITY IN COLLABORATION WITH THE HEALTH CARE PROVIDERS IN THE COMMUNITY. PARTICIPANTS IN A TOWN HALL MEETING HELD AS PART OF THE CHNA INCLUDED COMMUNITY RESIDENTS, GOVERNMENTAL, CIVIC, AND BUSINESS LEADERS IN THE COMMUNITY. THE ATTENDANCE ROSTER CAN BE FOUND IN SECTION V A OF THE CHNA DOCUMENT. |
| SCHEDULE H, PART V, LINE 7A | HTTPS://WWW.SCMHKS.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ |
| SCHEDULE H, PART V, LINE 10 | HTTPS://WWW.SCMHKS.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ |
| SCHEDULE H, PART V, LINE 11 | THE CHNA CONDUCTED IN APRIL 2021 HIGHLIGHTED 10 ISSUES FOR SMITH COUNTY. THE ISSUES WERE: 1. DENTAL SERVICES 2. MENTAL HEALTH (DIAGNOSIS, PLACEMENT, AFTERCARE) 3. CHRONIC DISEASE MANAGEMENT 4. HOUSING 5. SPECIALITY SERVICES (OPTOMETRY AND PODIATRY) 6. AFFORDABLE INSURANCE/ACCESS TO MEDICAID 7. OBESITY (ACCESS TO EXERCISE) 8. DRUG & SUBSTANCE ABUSE 9. CHILD CARE 10. NURSING HOME/SENIOR CARE The issues identified were reviewed by leadership and the governing board of Great Plains of Smith County, Inc. They were prioritized into an implementation plan, which was published later in 2021. The CHNA report, along with the implementation plan are posted to the public website (www.scmhks.org). The strategy addresses each of the priorities identified, but only two of the ten issues were recognized as being solely within the purview of Great Plains of Smith County, Inc. Those were items 3 and 5. Items 1, 2, 4, 6, 7, 8, 9, and 10 were identified as being only addressable through a collaborative approach involving other community partners. During the interval between completion of the CHNA and the end of the 2022 fiscal year, significant progress was demonstrated in addressing both item 3 and 5. The remaining 8 issues also had significant progress demonstrated through collaboration with outside agencies. |
| SCHEDULE H, PART V, LINE 16A | HTTPS://WWW.SCMHKS.ORG/SERVICES/FINANCIAL-ASSISTANCE/ |
| SCHEDULE H, PART V, LINE 16B | HTTPS://WWW.SCMHKS.ORG/SERVICES/FINANCIAL-ASSISTANCE/ |
| SCHEDULE H, PART V, LINE 16C | HTTPS://WWW.SCMHKS.ORG/SERVICES/FINANCIAL-ASSISTANCE-RESOURCES/ |
| 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 | SMITH COUNTY FAMILY PRACTICE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 921 E HWY 36 | AddressLine1Txt |
| City | SMITH CENTER | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 66967 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | FAMILY PRACTICE | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 3C | THE ORGANIZATION USED THE FOLLOWING CRITERIA TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE: ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, AND UNDER INSURANCE STATUS. |
| SCHEDULE H, PART VI, LINE 7 | THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS IN THE TABLE OF PART I, LINE 7, OF SCHEDULE H, IS A COST TO CHARGE RATIO. |
| SCHEDULE H, PART III, LINE 2 | 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 | 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 REASOBABLE 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 | NOT APPLICABLE DUE TO ADOPTION OF ASC 606 REVENUE FROM CONTRACTS WITH CUSTOMERS. |
| SCHEDULE H, PART III, LINE 8 | THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNT ON LINE 6 IS A COST TO CHARGE RATIO. |
| SCHEDULE H, PART III, LINE 9B | ALL CHARITY CARE AND CHARGES NOT TO BE COLLECTED DUE TO FINANCIAL ASSISTANCE COMPUTATIONS ARE EXEMPTED FROM COLLECTION POLICIES AND PRACTICES. THESE ACCOUNTS ARE REMOVED FROM THE COLLECTION CYCLE. |
| SCHEDULE H, PART VI, LINE 2 | GREAT PLAINS OF SMITH COUNTY, INC. (GPSC) USES FORMAL AND IN FORMAL METHODS TO DETERMINE THE NEEDS OF THE COMMUNITIES IT SERVES. OUTSIDE FACILITATORS HAVE BEEN USED TO ASSIST WITH FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT. THE FIRST OF THESE FORMAL ASSESSMENTS WAS PERFORMED IN 2012, FOLLOWED BY SUBSEQUENT ASSESSMENTS IN 2015 AND 2018. EACH OF THESE ASSESSMENTS INCLUDED SURVEYS MAILED TO MEMBERS OF THE COMMUNITY, FOLLOWED BY A PUBLIC FORUM DESIGNED TO GATHER INPUT IN AN INTERACTIVE FORMAT. FOLLOWING COMPLETION AND PUBLICATION OF EACH OF THE CHNAs, AN IMPLEMENTATION PLAN WAS DEVELOPED. IN 2021 THE SARS-COV-2 PANDEMIC AND ITS IMPACT ON THE COMMUNITY AND PUBLIC GATHERINGS NECESSITATED A CHANGE IN TACTICS FOR THE FOURTH COMMUNITY HEALTH NEEDS ASSESSMENT. INSTEAD OF A PUBLIC FORUM IN THE FORM OF A TOWN HALL MEETING, A VIRTUAL SESSION, PUBLICLY ADVERTISED AND WITH SPECIFIC INVITATIONS TO CERTAIN COMMUNITY LEADERS, WAS HELD. THE INPUT FROM THIS VIRTUAL SESSION WAS INCORPORATED IN TO A FINAL DOCUMENT WHICH WAS PUBLISHED IN MID-2021. LATER IN THE YEAR, AN IMPLEMENTAITON PLAN ADDRESSING THE IDENTIFIED NEEDS WAS COMPLETED AND PUBLISHED. |
| SCHEDULE H, PART VI, LINE 3 | Great Plains of Smith County, Inc. makes significant efforts to provide information to the public regarding the function of federal and state programs. We use frequent social media posts and newspaper articles to provide information about the Medicare and Medicaid programs, and the services they cover. We also publish a glossy, magazine-style report to the community three times per year to help educate the community about preventive health care, services available through GPSC, and topics related to insurance programs available in the community. For the past several years GPSC has arranged for an outside, non-partisan benefits advisor to present programs during the Medicare Open Enrollment Period. These programs are designed as purely educational offerings to assist beneficiaries in selecting the most beneficial Medicare related programs (especially supplemental plans) during the time when they can make their annual selection. Our Patient Care Advocate, a licensed Social Worker, provides individual assistance to uninsured patients in application for coverage under the KanCare (Kansas Medicaid) program. The Patient Advocate also assists patients with the initiation of applications for financial assistance under our Charity Care program. Every billing statement sent to patients contains information about our Financial Assistance Program, including instructions about how to initiate an application for assistance. Additionally, every telephone call made to patients regarding unpaid balances includes information regarding the option to apply for financial assistance. Our Financial Assistance Policy, along with the contact in formation and application forms, is accessible on our public website. |
| SCHEDULE H, PART VI, LINE 4 | The 2020 United States Census reported a total population in Smith County, Kansas of 3,570. This represents a decrease of 7.3% from the 2010 census of 3,853. The population density is approximately 4 persons per square mile, classifying the county as Frontier. Approximately 96% of the population of Smith County is reported as white, with less than 1% each reported as black, Asian, or native American. The population is nearly evenly divided between male and female. The median family income in Smith County was reported as $43,429, compared to a national median of $62,843. Despite this disparity in median income, the Census reported 11.6% of Smith County residents being below the poverty level, compared to 11.4% nationally. This indicates a higher population in the low-moderate income range, but above the poverty level. Of the residents less than 65 years of age in Smith County, 11.7% are reported as uninsured, compared to 10.2% nationally. These reported numbers on uninsured likely do not reflect the impact of the Covid-19 pandemic on the economy and employer-provided insurance. |
| SCHEDULE H, PART VI, LINE 5 | Great Plains of Smith County, Inc. maintains an open medical staff, striving for diversity to reflect the community and service area. The Smith County Memorial Hospital Board of Trustees, although not directly responsible for the governance of the operating entity, never the less serves as an important link to the community. The membership of the Board of Trustees represents the geographic diversity of Smith County, with members appointed to represent various regions and population centers of the county. Great Plains of Smith County, Inc. uses significant efforts to promote the health of the community. Among these efforts are communication regarding healthy lifestyle, disease prevention and detection, and community awareness. We use social media, our website, radio advertising, and newspaper articles and advertising to convey important information to the community. In addition to the topics addressed every year, the Covid-19 pandemic has created a need for increased communication with the community regarding the virus, its detection and treatment, and vaccination availability and delivery. We have worked collaboratively throughout the pandemic with the local Public Health Department, County Board of Health, Administration and School Board of the local school district, and the Recreation Commission on issues related to the pandemic. Our Director of Communications has been instrumental in assisting other entities with providing information to their constituencies. Early in the pandemic, GPSC Worked extensively and cooperatively with the long term care facilities in the community to provide testing for residents and staff. Federal grant funding channeled to GPSC was used to support much of this activity, and we provided the required accounting support for reporting of the use of these funds. During the pandemic, it became obvious that the nurse administrator of the public health department, who had been serving as the County Health Officer, was overwhelmed by the demands of the position, GPSC administration and medical staff met with the County Commissioners (acting as the County Board of Health) and reached an agreement for one of our employed physicians to serve as the County Health Officer. Although the pandemic disrupted many of the ongoing outreach offerings that GPSC had traditionally, other services continued unabated. Among these services and offerings are the Meals on Wheels program, telehealth services, cardiac and pulmonary rehabilitation programs, and education programs. The Meals on Wheels program is now completely managed by GPSC, including preparation and packaging of meals that are provided at a deeply discounted cost to homebound members of the community. GPSC has also assumed the responsibility for scheduling and coordinating the volunteer delivery drivers for the meals. Although access to facilities was limited for a period of time due to the pandemic, the Cardiac Rehabilitation and Pulmonary Rehabilitation programs have now resumed activity, providing service to growing numbers of beneficiaries. Education programs that have continued include healthy diet programs, childbirth education programs for expectant parents, as well as training and certification programs in a variety of basic and advanced lifesaving techniques. These include Basic Life Support (CPR), Advanced Cardiovascular Life Support, Pediatric Advanced Life Support, Neonatal Resuscitation, Trauma Nurse Core Curriculum, and Basic and Advanced Fetal Monitoring courses. The utilization of telehealth services to expand the availability of services, particularly behavioral health services, have seen significant increases in use during the past year. In general, when we become aware of a need for additional services to the community and service area, we take steps to assure development and delivery of programs to address the needs. |
| SCHEDULE H, PART VI, LINE 6 | SMITH COUNTY MEMORIAL HOSPITAL IS OPERATED BY GREAT PLAINS OF SMITH CO., INC., A SUBSIDIARY OF GREAT PLAINS HEALTH ALLIANCE. GPHA IS A 501(C)(3) NOT FOR PROFIT ORGANIZATION WHICH PROVIDES MANAGEMENT, FINANCE, BILLING, INFORMATION SYSTEMS, AND PHARMACY SUPPORT SERVICES TO ITS AFFILIATED ORGANIZATIONS. GPHA DOES NOT PROVIDE SERVICES DIRECTLY TO PATIENTS, BUT PROVIDES ACCESS TO PROFESSIONALS AND SYSTEMS WHICH MIGHT NOT OTHERWISE BE AVAILABLE OR AFFORDABLE TO SMALL RURAL HOSPITALS. GPHA PROVIDES EDUCATION AND ASSISTANCE IN AREAS SUCH AS HIPAA PRIVACY AND SECURITY, MEDICARE AND MEDICAID REIMBURSEMENT RULES AND REGULATIONS, MEANINGFUL USE REQUIREMENTS FOR ELECTRONIC HEALTH RECORDS, ETC. GREAT PLAINS HEALTH ALLIANCE BRINGS TOGETHER ITS NETWORKED CRITICAL ACCESS HOSPITALS IN KANSAS AND NEBRASKA TO LEARN FROM EACH OTHER AND DEVELOP BEST PRACTICES IN CARE PROVISION, MANAGEMENT, AND GOVERNANCE. AFFILIATED HOSPITALS RECEIVE POLICY GUIDANCE REGARDING FINANCIAL ASSISTANCE TO PATIENTS, CORPORATE COMPLIANCE, CONFLICTS OF INTEREST, AND MANY OTHER AREAS. GUIDANCE IS ALSO PROVIDED TO THE GOVERNING BOARDS OF AFFILIATED HOSPITALS TO ASSIST THEM IN FULFILLING THEIR FIDUCIARY RESPONSIBILITIES. |
| SCHEDULE H, PART VI, LINE 7 | N/A |
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 (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVE DELLASEGA | ||||||||||||||
| PRESIDENT/SECRETARY/DIRECTOR | $0 | $206,439 | $0 | $0 | $0 | $2,703 | $0 | $20,695 | $0 | $39,074 | $0 | $268,911 | $0 | $0 |
| ALLEN VANDRIEL | ||||||||||||||
| ADMINISTRATOR | $186,205 | $0 | $0 | $0 | $2,046 | $0 | $18,275 | $0 | $18,126 | $0 | $224,652 | $0 | $0 | $0 |
| STEPHEN LEWIS | ||||||||||||||
| CFO | $138,709 | $0 | $0 | $0 | $1,323 | $0 | $2,393 | $0 | $17,467 | $0 | $159,892 | $0 | $0 | $0 |
| DURREL KELLEY | ||||||||||||||
| SENIOR VP OF OPERATIONS | $0 | $126,271 | $0 | $0 | $0 | $1,630 | $0 | $12,293 | $0 | $18,654 | $0 | $158,848 | $0 | $0 |
| HANNAH HAACK | ||||||||||||||
| PHYSICIAN | $352,753 | $0 | $0 | $0 | $2,405 | $0 | $28,200 | $0 | $24,491 | $0 | $407,849 | $0 | $0 | $0 |
| JUSTIN OVERMILLER | ||||||||||||||
| PHYSICIAN | $325,017 | $0 | $0 | $0 | $2,405 | $0 | $31,942 | $0 | $24,003 | $0 | $383,367 | $0 | $0 | $0 |
| FERRILL CONANT | ||||||||||||||
| PHYSICIAN | $269,671 | $0 | $0 | $0 | $2,424 | $0 | $26,410 | $0 | $15,626 | $0 | $314,131 | $0 | $0 | $0 |
| LEAH WIEHL | ||||||||||||||
| PHYSICIAN | $194,712 | $0 | $0 | $0 | $2,054 | $0 | $19,656 | $0 | $21,700 | $0 | $238,122 | $0 | $0 | $0 |
| MARK TOWNER | ||||||||||||||
| PHYSICAL THERAPIST | $152,301 | $0 | $0 | $0 | $1,579 | $0 | $14,638 | $0 | $23,237 | $0 | $191,755 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, PART VII; SCHEDULE J, PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | COMPENSATION FOR DAVE DELLASEGA, DURRELL KELLEY, AND JASON BARB IS PROVIDED BY GREAT PLAINS HEALTH ALLIANCE, A RELATED ORGANIZATION. GREAT PLAINS HEALTH ALLIANCE'S BOARD OF DIRECTORS ANNUALLY APPROVE THE COMPENSATION FOR MR. DELLASEGA, MR. KELLEY, AND MR. BARB. THE AMERICAN COLLEGE HEALTHCARE EXECUTIVES AND THE KANSAS HOSPITAL ASSOCIATION ALSO HAVE COMPARABLE COMPENSATION DATA THAT CAN BE USED BY THE BOARD. A COMPENSATION REVIEW WAS DONE WHEN DAVE DELLASEGA TOOK OVER AS CEO AND WAS CONDUCTED BY THE BOARD, BUT SINCE THAT TIME THERE HAS BEEN NO FORMAL COMPENSATION REVIEW. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4A | The largest program services measured by expenses are: 1. Smith County Memorial Hospital - This 16 bed Critical Access Hospital provides a wide variety of inpatient and outpatient medical services to residents of the service area. Included among these services are the following: a. Inpatient Care - i. Acute and Observation (outpatient) care for patients with medical and surgical conditions. This includes neonatal, pediatric, adult, and geriatric patients. ii. Skilled Swing Bed care for patients requiring post-acute care, especially skilled nursing and rehabilitation services. iii. Private Pay custodial care is provided on a limited basis. Much of this care is provided to patients who have elected Hospice benefits but do not have family members able care for them in the home. b. Obstetrical Care including prenatal education, monitoring and diagnostic services during the prenatal period, as well as labor and delivery services during the perinatal period. This includes surgical care for scheduled and urgent c-sections needed for delivery. c. Emergency Care available 24 hours per day by a staff of specially trained Registered Nurses, Advanced Practice Registered Nurses, Physician Assistants, and physicians. All Emergency Department staff are certified in various types of advanced life support programs, including Advanced Cardiovascular Life Support, Pediatric Advanced Life Support, and advanced trauma care courses. This facility is certified as a Level IV Trauma Center, and is certified as a stroke care center. Telehealth services are available in each of the trauma rooms, connecting instantly to Registered Nurses and board certified Emergency Physicians at a dedicated response center in South Dakota. This telehealth service also provides evaluation of patients suffering from crisis level behavioral health emergency services. d. Ancillary diagnostic and therapeutic services. These include: i. Laboratory with staff available 24 hours per day to perform a wide variety of chemistry, hematology, coagulation, urinalysis, blood gas, as well as basic microbiology tests. Blood banking is also available. A contracted reference laboratory performs more complex testing. Pathology services are also provided through a contracted service. ii. Diagnostic Imaging services include digital x-ray, CT scan, Diagnostic Ultrasound, Echocardiography, portable Fluoroscopy, Mammography, and Bone Density. Mobile services provided under contract include MRI and Nuclear Imaging. iii. Anesthesia services are provided in the Emergency, ambulatory surgery, and inpatient surgical settings by a dedicated Certified Registered Nurse Anesthetist (CRNA). A separate pain management service was under development at the end of the fiscal year. iv. Respiratory Therapy and Pulmonary Function are available, including acute inpatient and Emergency Department assistance with airway management, supplemental Oxygen and aerosol therapy, short term mechanical ventilation, and assistance with neonatal resuscitation. v. Physical and Occupational Therapy, as well as Speech Language Pathology are available for inpatient and outpatient care. vi. Cardiac and Pulmonary Rehabilitation services are provided to patients on a scheduled basis. Patients recovering from cardiac events or surgery, and patients with chronic pulmonary disease benefit from these services. vii. Wound Care services are available through a contract service on a weekly basis. GPSC medical staff and nursing staff from the Rural Health Clinic help staff this clinic, which provides debridement and care for slow-healing wounds, as well as the application of skin substitute products to promote healing. viii. Diagnostic Sleep Services including both attended and home sleep studies and CPAP titration are provided under a contract arrangement. ix. Dietary Services to inpatients and outpatients are provided by a staff led by a Registered Clinical Dietician who is also our Executive Chef. Tailoring of meals to meet the therapeutic needs and desires of our inpatients, coupled with education regarding healthier food choices are provided to every inpatient. The Food Services staff also provide and package the meals for the Meals on Wheels program. x. Outpatient Specialty Clinic Services are provided at the CAH by a wide variety of providers. These arrangements allow us to offer specialty services to residents of the area without the need for travel to distant locations. Services provided at SCMH include Cardiology (3 providers), Pulmonology, Nephrology, General Surgery (2 providers), Podiatry, Orthopedic Surgery, Urology, OB/GYN, and Dermatology. 2. Smith County Family Practice - This Certified Rural Health Clinic provides primary care services to pediatric, adult and geriatric patients for a full range of medical conditions. Staffed by five board certified Family Medicine Physicians as well as Physician Assistants and Advanced Practice Registered Nurses. In addition to primary care services delivered in the RHC, these providers staff the Emergency Department and inpatient and outpatient areas of the CAH. They also provide services to patients (residents) in skilled nursing and ICF long term care facilities in Smith and Osborne counties. Physicians also serve as Medical Directors for two skilled nursing facilities, for Smith County EMS, and as the County Health Officer. 3. 340B Pharmacy Services - Great Plains of Smith County, Inc. utilizes the 340B program operated under the auspices of the Health Resources and Services Administration (HRSA) to obtain drugs and pharmaceuticals for use in the outpatient setting at Smith County Memorial Hospital (the CAH) as well as through contracted arrangements with three area retail pharmacies. The discounted pricing available under this program (although under threat currently by unilateral action by some drug manufacturers) allows us to offset the cost of delivery of services within our service area. |
| FORM 990, PART VI, SECTION A, LINE 2 | DAVE DELLASEGA, DURREL KELLEY, AND JASON BARB HAVE A BUSINESS RELATIONSHIP. THEY ARE ALL EMPLOYED BY, AND ALSO OFFICERS OF, A RELATED 501(C)(3) ORGANIZATION, GREAT PLAINS HEALTH ALLIANCE. |
| FORM 990, PART VI, SECTION A, LINE 6 | GREAT PLAINS HEALTH ALLIANCE, INC., A NOT-FOR-PROFIT 501(C)(3) ORGANIZATION, IS THE SOLE MEMEBER OF GREAT PLAINS OF SMITH CO., INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | GREAT PLAINS HEALTH ALLIANCE, INC., BEING THE SOLE MEMBER, HAS THE RIGHT TO ELECT AND APPROVE ALL THE BOARD MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 7B | 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, SECTION B, LINE 11B | 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, SECTION B, LINE 12C | 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, SECTION B, LINES 15A & B | THE CEO, COO, 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, SECTION C, LINE 19 | 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 IX LINE 11G | DESCRIPTION:CONTRACTED MEDICAL STAFF TOTAL FEES:2122225 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:BILLING/COLLECTIONS TOTAL FEES:443647 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:LAB SERVICES TOTAL FEES:212664 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PHARMACY SERVICES TOTAL FEES:234542 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:ADMIN/HUMAN RESOURCES TOTAL FEES:150488 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:MAINTENANCE/HOUSEKEEPING TOTAL FEES:48386 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PLANT OPERATIONS TOTAL FEES:28480 |
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 | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| GREAT PLAINS HEALTH CARE FOUNDATION INC | ||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 480955870 | SUPPORT | KS | 501(C)(3) | 10 | GPHA INC | Yes (true) |
| GREAT PLAINS HEALTH ALLIANCE INC | ||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 480617739 | MANAGEMENT | KS | 501(C)(3) | 3 | NA | false |
| GREAT PLAINS OF ELLINWOOD INC | ||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 481226976 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC | Yes (true) |
| GREAT PLAINS OF OTTAWA COUNTY INC | ||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 481226856 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC | Yes (true) |
| GREAT PLAINS OF SABETHA COUNTY INC | ||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 481236156 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC | Yes (true) |
| GREAT PLAINS OF REPUBLIC COUNTY INC | ||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 481226977 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC | Yes (true) |
| GREAT PLAINS OF CHEYENNE COUNTY INC | ||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 481226831 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC | Yes (true) |
| GPHA EMPLOYEE BENEFITS TRUST | ||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 476918582 | HEALTH PLAN | KS | 501(C)(9) | GPHA INC | Yes (true) | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|
| CHARITABLE REMAINDER TRUST (1) | |||
| CHARITABLE TRUST | KS | GP OF SMITH CTY | Yes (true) |
| CHARITABLE REMAINDER TRUST (1) | |||
| CHARITABLE TRUST | KS | GP OF SMITH CTY | Yes (true) |
| CHARITABLE REMAINDER TRUST (3) | |||
| CHARITABLE TRUST | KS | GP OF SMITH CTY | Yes (true) |
| 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 | false | 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 BENEFITS TRUST | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | R | TransactionTypeTxt |
| Involved | $902,320 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |