2025-05-13T13:02:39-05:00 2024-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2023-07-01 730579295 Farmers Union Hospital Association FARM 5802252511 PO Box 2339 Elk City OK 73648 Monica Scott CFO 5802252511 2025-05-12 1 1 Kim Hunwardsen CPA P00484560 6122536500 2025-05-12 2023 2025-03-06 01:10:19Z Great Plains Regional Medical Center Monica Scott PO Box 2339 Elk City OK 73648 59212646 0 X www.gprmc-ok.com X 1938 OK To provide comprehensive, cost-effective, high quality healthcare to our communities. 10 7 567 22 19800 0 485118 123509 51314975 54697655 500135 829456 584979 487787 52885207 56138407 27859 17911 0 0 26777683 28436751 0 0 0 32627148 34635141 59432690 63089803 -6547483 -6951396 63686130 62498665 37258427 40478949 26427703 22019716 X Great Plains Regional Medical Center will distinguish itself as the leader in Western Oklahoma and the Eastern Texas Panhandle for comprehensive, cost effective, high quality healthcare. We will meet the healthcare needs of patients in our service area while achieving cost effective quality outcomes. We will maintain and enhance collaborative relationships with physicians to better serve the healthcare needs of our service area. We will maintain and continually enhance health promotion, patient education and disease prevention for patients in our service area. 0 0 48549455 17911 54677855 Farmers Union Hospital Association, DBA Great Plains Regional Medical Center in Elk City, Oklahoma (hereinafter referred to as GPRMC) is a 62-bed hospital that provides quality health care regardless of race, religion, creed, sex, national origin, handicap, age, or ability to pay. Reimbursement for services rendered is critical to the operation and stability of GPRMC, it is recognized that not all individuals possess the ability to purchase essential medical services. In keeping with the Hospital's commitment to serve all members of its community, free care and/or subsidized care, care provided to persons covered by government programs at below cost, and health care activities and programs to support the community will be considered whether the need and/or individual's inability to pay exists. Continued on Schedule O.GPRMC served over 1,619 Inpatients that include, Medical, Intensive Care, Inpatient Rehabilitation, Newborns, Swing Bed and Senior Care. These services produced more than 8,742 Inpatient days. During the year we treated 12,666 patients in the Emergency Department. Our Surgical teams performed 2,433 surgeries. GPRMC provides care to persons covered by governmental and other programs as part of its mission to the community. These programs may not pay full charges to the extent reimbursement is below full charges. GPRMC recognized these amounts as contractual adjustments in meeting its mission to the entire community. Also, in recognizing its mission to the community, GPRMC provides services for those unable to pay. Additionally, GPRMC has provided services to others who are either unwilling or unable to qualify for charity care guidelines but who are still unable to pay. Community benefit is also provided by GPRMC by providing reduced price services, free programs offered throughout the year which GPRMC believes will serve a bona fide community health need. See Schedule H for more information regarding these activities.The Hospital provides health care services to patients who meet certain criteria under its charity policy without charge or amounts less than established rates. GPRMC does not pursue collection amounts determined to qualify as charity care, they are not recorded as revenue. The amount of charges foregone for services provided under the Hospital's charity care policy were approximately $27,000 in 2024. Total direct and indirect cost related to these foregone charges were $9,000, based on an average ratio of cost to gross charges. 48549455 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 309 0 1 567 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 1 1 OK X Monica Scott 5808215500 1801 W 3rd Street Elk City OK 73544 Kyle Zybach Chair 1.00 1.00 X X 0 0 0 Joe Allen Vice Chair 1.00 1.00 X X 0 0 0 Jeff Jackson Secretary 1.00 1.00 X X 0 0 0 Edward Albert Member 1.00 1.00 X 0 0 0 J Coffey MD Member 1.00 1.00 X 0 0 0 Danny Sprowls Member 1.00 1.00 X 0 0 0 Erick DeRocher DO Member/Chief of Staff 10.00 1.00 X 11700 0 0 Paul Kumpf Member 1.00 1.00 X 0 0 0 Daniel Garbarino Member 1.00 1.00 X 0 0 0 Tyson Fisher MD Member/Vice Chief of Staff 40.00 1.00 X 636789 0 41541 Corey Lively CEO 40.00 1.00 X 357051 0 21061 Monica R Scott CFO 40.00 1.00 X 156423 0 17256 Misty Carter Chief Human Resources 40.00 0.00 X 153742 0 22800 Steven Riley Winham MD Surgery 40.00 0.00 X 1116786 0 41252 Donald Lesslie III DO FACS FSSO General & Bariatric Surgery 40.00 0.00 X 504845 0 26689 Millard L Henry III MD Urology 40.00 0.00 X 487685 0 23327 Edward Zdobylak MD Neurology 40.00 0.00 X 337593 0 14693 Stacy Brown PA-C Orthopedic Surgery 40.00 0.00 X 249950 0 30020 4012564 0 238639 27 0 1 0 Premier Physician Staffing 20 E 5th St Suite 620 Tulsa OK 74103 Physician ER coverage 3021754 Prime Physician Staffing PLLC 20 E 5th St Suite 620 Tulsa OK 74103 Hospitalist physician coverage 1364625 Qualivis LLC PO Box 123847 Dallas TX 75312 Contract Labor Staffing 986695 Lifepoint Rehabilitation PO Box 502096 St Louis MO 63150 Rehab Management 802383 Horizon Health PO Box 840839 Dallas TX 75284 Senior Care Management 627875 20 120133 3376 123509 Net patient service 621990 52528748 52528748 Pharmacy 456110 1519592 1519592 Cafeteria 722514 447779 427979 19800 Daycare center 624410 109805 109805 Plains Diag Imaging 900099 58167 58167 33564 33564 54697655 770858 770858 35459 35459 452328 0 452328 452328 452328 3132837 3074239 58598 58598 58598 56138407 54677855 19800 1317243 X 6625 6625 11286 11286 1448835 687716 761119 144723 144723 19513185 15342822 4170363 61834 48607 13227 5911624 4546841 1364783 1356550 1041715 314835 33426 33426 13776064 10490943 3285121 124317 51 124266 1777804 1051525 726279 468981 237533 231448 1063313 304694 758619 99765 80211 19554 37838 25167 12671 1386148 1290730 95418 3447805 3201786 246019 800488 185943 614545 Medical supplies 9546706 9520445 26261 Food 745335 4012 741323 Repairs and maintenance 629957 204165 425792 Dues and Subscriptions 298570 57251 241319 398624 64664 333960 63089803 48549455 14540348 0 2765 2765 392811 375424 9196961 9363914 1819543 1913802 643822 603582 96377659 71283876 26579022 25093783 20688225 19980978 3045318 3446664 1132737 1191097 84000 84000 100926 442656 63686130 62498665 9944042 12746888 27314385 27732061 37258427 40478949 X 26427703 22019716 26427703 22019716 63686130 62498665 -6951396 2543407 2 0 X 0 1 X 1 0 X 1003365 861828 1865193 60808185 41394582 19413603 107083 30340 76743 31889702 28323699 3566003 1707496 1535255 172241 25093783 Investment in captive insurance 2376145 F Investment in LifeCare Health Services, LLC 906689 F Investment in UMCSC 163830 F 3446664 Payable to related party 25594289 Estimated third-party payor settlements 1091328 Operating Lease Liabilities 419224 Finance Lease Liabilities 627220 27732061 X Part X, Line 2: The Hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. 1 1 X 1 X 1 X 1 1 0 0 9000 9000 0.00010 9000 9000 0.00010 3907856 2372323 1535533 0.02430 3907856 2372323 1535533 0.02430 3916856 2372323 1544533 0.02440 1 5919930 1373424 13363893 15381181 -2017288 X 1 1 1 Plains Diagnostic Imaging LLC Radiology services 0.76700 0.00000 0.23300 1 1 Great Plains Regional Medical Center 1801 W 3rd Street Elk City OK 73644 www.gprmc-ok.com 2210 X X X 2 Provider Based Rural Health Clinics Great Plains Regional Medical Center 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X www.gprmc-ok.com/about/chna X https://osururalhealth.blogspot.com/p/chna.html X 1 21 1 www.gprmc-ok.com/about/chna 0 1 X 100.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X https://gprmc-ok.com/patient/financial-assistance/ X https://gprmc-ok.com/patient/financial-assistance/ X https://gprmc-ok.com/patient/financial-assistance/ X X X X X X 1 X 0 X X X X 1 X 0 0 Great Plains Regional Medical Center Part V, Section B, Line 5: Due to the unprecedented Covid-19 pandemic, Great Plains Regional Medical Center was not able to host three community meetings as they have in the past to seek feedback from key stakeholders. In an effort to promote social distancing and following recommendations outlined the CDC's website, the hospital hosted one single community meeting to gather community feedback. The meeting was held on March 23, 2022. All stakeholders received primary and secondary data prior to the meeting.Community members invited to the community meeting included representatives from Great Plains Regional Medical Center, City of Elk City, Elk City Fire Department, Elk City Chamber of Commerce, Area Agency on Aging, Hospital Foundation, Elk City Public Schools and Vocational Technology Schools. Community members received a phone invitation and/or an email invitation from the hospital. Specific representatives included: board members, foundation members, Elk City and Western Oklahoma Wellness Initiatives coordinator, AirEvac, City of Elk City Farmers Union Hospital Association officials, Beckham County Health Department, and GPRMC department directors. The director of Western Oklahoma Family Care Center was invited because of the low-income population served. Therefore, a significant effort was placed on including representatives from the public health sector and those who serve the underserved, low-income or racially diverse populations to gain their perspective of needs in the community. Great Plains Regional Medical Center Part V, Section B, Line 11: The community health needs assessment (CHNA) was completed in fiscal year 2022. The following needs were identified and the actions taken in fiscal year 2024 to address those needs.Mental Health including services for youth and adolescents Drug, alcohol, and tobacco abuse Lack of OBGYN care Limited outdoor youth activities Mental Health including services for youth and adolescentsIn recognition of Mental Health Awareness Month, GPRMC placed flyers and banners throughout the hospital to bring awareness and open dialog to this issue. GPRMC's Community Education Manager along with our Social Worker, continue their commitment to Western Oklahoma Alzheimer's Collaborative. This non-profit organization is based in Elk City, Oklahoma, and its mission is to raise awareness and funds for Alzheimer's and provide community support and resources for education and coping strategies to families and friends. GPRMC partnered with WOAC to organize "A Night in Nashville," a concert fundraiser as well as managed a booth at the Suicide Awareness Walk in Elk City. In a show of solidarity, the hospital approved casual Fridays, allowing staff to wear jeans when dressed in green to support mental health awareness. GPRMC proudly partnered with WOAC to present scholarships at Canute High School. Drug, alcohol, and tobacco abuseInformational materials were placed in public areas for free support along with information on tools and medications that can help people quit tobacco. Events were organized such as "Healthy Living for Your Brain and Body" to engage the community on the importance of abuse of substances. . Lack of OB/GYN careGreat Plains Regional Medical Center employees a Certified Nurse Midwife and recently secured recruitment efforts for a Full-Time OBGYN in Elk City. Limited outdoor youth activitiesKids, Incorporated of Elk City, in partnership with the City of Elk City, provides amateur sports programs for children and families in the region. Special Events in 2024, Oklahoma City Thunder hosted a youth basketball camp in Elk City for kids aged 6-14, focusing on basketball fundamentals and sportsmanship. Great Plains Regional Medical Center Part V, Section B, Line 13h: Great Plains Regional Medical Center (GPRMC) provides 100% financial assistance for non-elective services under the presumptive guidelines if the patient/responsible party meets any of the below listed criteria:a. Is uninsured and has an estimated family income of less than 200% FPL, and a Health Care Credit score of less than 620 as determined by externally available data sources such as credit agenciesb. Is homeless or received care from a homeless clinicc. Is deceased with no known estate or living spouse Part I, Line 3c: Great Plains Regional Medical Center (GPRMC) provides 100% financial assistance for non-elective services under the presumptive guidelines if the patient/responsible party meets any of the below listed criteria:a. Is uninsured and has an estimated family income of less than 200% FPL, and a Health Care Credit score of less than 620 as determined by externally available data sources such as credit agenciesb. Is Homeless or received care from a homeless clinicc. Is deceased with no known estate or living spouse Part I, Line 7: Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report. Part III, Line 2: The amount reported on line 2 represents implicit price concessions. The Hospital determines its estimate of implicit price concessions based on its historical collection experience with this class of patients. Part III, Line 3: An estimated 23.2% of implicit price concession in 2024 are attributable to patients potentially eligible for financial assistance. This is based on the percentage of individuals in the county under the federal poverty level. Part III, Line 4: The footnote to the Organization's financial statements that describes implicit price concession is located in the audited financial statement report on pages 13 and 14. Part III, Line 8: Great Plains Regional Medical Center provides services to Medicare patients understanding there will be write-offs and knowing the Organization will not recover the costs of the services provided. Providing these services is essential to the community and therefore increases access to healthcare services, which is a community benefit. Both the total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by the Centers for Medicare and Medicaid Services. Part III, Line 9b: GPRMC patients who qualify for charity care and who are cooperating in good faith to resolve their discounted hospital bills, are offered extended payment plans. During this time GPRMC will not send unpaid bills to outside collection agencies, and will cease all collection efforts. Great Plains Regional Medical Center will not impose extraordinary collections actions such as wage garnishments; liens on primary residences, or other legal actions for any patient without first making reasonable efforts to determine whether that patient is eligible for charity care under the financial assistance policy. Patients have 120-days from their first statement to apply for charity care with no extraordinary collection actions.Patients are pre-screened for charitable services before receiving tests and a determination is made as to the financial ability to pay. If patients are pre-qualified for services, the collection process is ceased. Part VI, Line 2: GPRMC utilizes public health data from CDC, state and local health departments. We also review Hospital & Clinic Records for disease prevalence and ER visit trends. GPRMC relies on direct input from residents about their health concerns and reviews follow-up surveys submitted from GPRMC patients. Census data and other factors affecting health, such as income and housing are reviewed as well. Input from Medical Staff meetings, board meetings, as well as feedback from local health providers, nonprofits, and government agencies is also considered. Part VI, Line 3: Registration staff are trained to ask about financial concerns and provide information on assistance programs. The GPRMC Website clearly displays charity care details under "Billing & Financial Assistance."Language is present on Billing Statements and Notices to inform patients who receive bills. Assistance is discussed with patients as part of the intake process. Patients are screened at registration to determine need for financial assistance and then are given copies of the financial assistance policy. Upon request, we try to assist patients with paperwork for medical assistance such as Medicare, Medicaid, disability or financial assistance.In addition, information is posted in emergency rooms, the admitting and registration departments and the hospital business offices. A request for charity may be made by the patient or a family member, close friend, or associate of the patient, subject to applicable privacy laws. Part VI, Line 4: Great Plains Regional Medical Center is a 62-bed acute care facility located in Beckham County. The hospital provides 24-hour emergency department, acute inpatient services, hospitalist services, laboratory, diagnostic radiology (CT, ultrasound, MRI, nuclear medicine, echocardiograms, mammography, and cardiac catheterization), intensive care, and a cancer treatment center (prostate, breast, and head and neck cancers).The primary medical service area of Great Plains Regional Medical Center includes the zip code areas of Elk City, Sayre, Erick, Hammon, Cheyenne, Cordell, Canute, Mangum, Sentinel and Clinton. The primary medical service area experienced a population decrease of 1.0 percent from the 2010 Census to the latest available, 2016-2020, American Community Survey. The secondary medical services area is comprised of the zip code areas of Burns Flat, Carter, Weatherford, Sweetwater, Reydon, Arnett, Lone Wolf, Durham, Butler, Leedey, Foss, Dill City, Hobart, Granite, Hollis, and Altus. The secondary medical service area experienced a population decrease of 4 percent from 2010 to the 2016-2020 American Community Survey.The 2023 annual unemployment rate for Beckham County was 2.3%. In 2024, Oklahoma's unemployment rate experienced slight fluctuations landing on the average of 3.4%. All of these rates are non-seasonally adjusted. The most recent monthly estimates show Beckham County to be lower than 2020. The share of individuals captured below the poverty threshold for income and household size is calculated by the U.S. Census Bureau.As of the latest available data, approximately 23.2% of individuals in Beckham County, Oklahoma, live below the poverty line. This rate is higher than both the state average of 15.3% and the national average of 12.4%. Specifically, about 32% of children under 18 and 11% of seniors aged 65 and over in the county experience poverty. These figures underscore significant economic challenges faced by residents across all age groups in Beckham County. Part VI, Line 5: The GPRMC Board of Directors is comprised of citizens from the community, from business owners to retired individuals. This broadly based group provides us with a broad perspective on the needs of the community. GPRMC extends medical privileges to local and area physicians. Physicians must apply for privileges and be approved by the medical staff and Board of Directors. Surplus funds are reinvested into facility and equipment upgrades and free programs throughout the year.In 2024, Elk City, Oklahoma, hosted several health-related events aimed at promoting community wellness such as the Kids Fishing Derby & Family Day. This event provided a fun-filled day of fishing and family activities, encouraging outdoor recreation and healthy lifestyles among children and families. The Community Health Fair offered free screenings, tests, and health-related services to the public. In addtion, GPRMC also provides valuable health resources to the community such as blood drives held several times per year.Great Plains Regional Medical Center Foundation held "Evening at the Derby" event which successfully raised funds toward enhancing cancer treatments. GPRMC, in collaboration with Southwestern Oklahoma State University (SWOSU), introduced a Surgical Technology program in Western Oklahoma. Set to commence in Fall 2025, the program will be based at the GPRMC Education Center in Elk City. This two-year curriculum includes classroom instruction and hands-on clinical experience in GPRMC's operating rooms, aiming to prepare students for careers as surgical technologists.In 2024 GPRMC implemented TeamBirth, an initiative designed to enhance the labor and delivery experience for expectant mothers. This program focuses on improving communication and teamwork among healthcare providers and patients, ensuring that mothers are actively involved in decision-making during childbirth.Additionally, in-kind services are provided to Western Oklahoma State College. This is vital to prospective students pursuing nursing degrees that would not have been able to drive the long distance to the College. 1 High school health care scholarships 4 11286 Part I, Line 2: The Hospital provides scholarships for high school seniors who will pursue health related fields and nursing scholarships. Students complete an application and essay. Administration reviews the applications and chooses the recipients. X X X X 0 0 0 0 0 0 0 0 0 Steven Riley Winham MD Surgery 861073 0 254836 0 877 0 1650 0 39602 0 1158038 0 0 0 Tyson Fisher MD Member/Vice Chief of Staff 566564 0 69595 0 630 0 1650 0 40521 0 678960 0 0 0 Donald Lesslie III DO FACS FSSO General & Bariatric Surgery 503677 0 0 0 1168 0 1650 0 25039 0 531534 0 0 0 Millard L Henry III MD Urology 487349 0 0 0 336 0 1650 0 21677 0 511012 0 0 0 Corey Lively CEO 356501 0 0 0 550 0 0 0 22441 0 379492 0 0 0 Edward Zdobylak MD Neurology 336904 0 0 0 689 0 1650 0 13043 0 352286 0 0 0 Stacy Brown PA-C Orthopedic Surgery 134769 0 113450 0 1731 0 144 0 30128 0 280222 0 0 0 Misty Carter Chief Human Resources 153446 0 0 0 296 0 787 0 23099 0 177628 0 0 0 Monica R Scott CFO 155857 0 0 0 566 0 798 0 17559 0 174780 0 0 0 Jacob Jackson Family relation to Jeff Jackson, Board Member 144723 Compensation as employee 0 Form 990, Part VI, Section A, line 1a The Executive Committee is composed of the officers of the Board; President, Vice President, Secretary and Treasurer. The Hospital's Board President serves as the Chair of the Executive Committee. Other members may be added if advisable. The Executive Committee directly represents the Board and possesses the power to act for the Board within limits set for it by the Board, on matters needing immediate attention, prior to regular board meetings, and such other powers as delegated to it by the Board. The Executive Committee reports to the Board of Directors at the next regular or at the next special meeting called for that purpose. Form 990, Part VI, Section A, line 6 Members are individuals who have voting shares in Great Plains Regional Medical Center. Membership is obtained through transfers of existing memberships. Transfers normally result either through voluntary surrender of a membership from a current member who is no longer interested in retaining their membership or through the death of a member who has no immediate family interested in retaining the membership. Each individual is allowed only one membership and there is only one vote allowed per membership. Form 990, Part VI, Section A, line 7a Governing Board members are appointed through nomination and a majority vote election by the membership at annual meetings. Form 990, Part VI, Section A, line 7b Any amendments to the Governing Board Bylaws and Rules & Regulations have to be approved by a majority vote of the membership. Per the Organization's Bylaws, the members are the supreme authority of the Association in all its affairs. Form 990, Part VI, Section B, line 11b The Form 990 is presented and reviewed at the governing Board's monthly meeting. The 990 is also posted on the governing Board's website prior to the meeting. Form 990, Part VI, Section B, line 12c All members of the governing board, officers and key employees receive a copy of the Conflict of Interest Policy on an annual basis. The individuals are required to review the policy and complete and sign the questionnaire attesting to their understanding of the policy and that their answers are true and accurate. The board as a whole reviews the conflict of interest statements. Any potential conflicts are discussed and depending on the conflict the board decides the appropriate action to take. Form 990, Part VI, Section B, line 15a When determining the CEO's compensation, Human Resources conducts a comparative analysis of compensation by position using state, multi-state, regional and national compensation data. Data is selected from hospitals with similar bed size, revenue and other similar area comparatives. Human Resources then submits a report to the Executive Committee. This is completed on an annual basis. The Executive Committee reviews the data, confirms the data with an independent auditor and recommends appropriate CEO compensation to the Board of Directors. The CFO and Key employees' compensation is reviewed annually by Human Resources and approved by the CEO. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Form 990, Part IX, line 11g Consulting: Program service expenses 6,463,463. Management and general expenses 1,836,465. Fundraising expenses 0. Total expenses 8,299,928. Service contracts: Program service expenses 564,047. Management and general expenses 672,066. Fundraising expenses 0. Total expenses 1,236,113. Contract labor: Program service expenses 3,463,433. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,463,433. Purchased services: Program service expenses 0. Management and general expenses 776,590. Fundraising expenses 0. Total expenses 776,590. GPRMC Holdings Inc PO Box 2339 Elk City OK 73648 824447018 Own property and lease to hospital to operate charitably OK 501(c)(3) Line 12b, II Great Plains Regional Medical Center 1 Plains Diagnostic Imaging LLC 1705 W 2nd St Elk City OK 73644 261530951 Radiology services and equipment rental OK Great Plains Regional Medical Center Related 58168 1047115 0 1 0.76700 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 1 0 Plains Diagnostic Imaging LLC K 685200 General ledger GPRMC Holdings Inc R 1306052 General ledger