2022-08-08T09:14:31-05:00 2021-09-30 FORVIS LLP 1551 N WATERFRONT PKWY STE 300 WICHITA KS 672066601 990 2020-10-01 481226976 GREAT PLAINS OF ELLINWOOD INC % DAVE DELLASEGA GREA 3166851523 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 JASON BARB CFO 3166851523 2022-08-15 true JASON BARB 999009999 SHAWNELL LINOT P01663908 3162652811 2 2020 2022-09-23 18:48:47Z DAVE DELLASEGA 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 11565756 false X WWW.ELLINWOODDISTRICTHOSPITAL.ORG X 1999 KS TO OPERATE AN ACUTE CARE HOSPITAL THAT PROVIDES MEDICAL CARE TO THE GENERAL PUBLIC IN ELLINWOOD, KANSAS AND THE SURROUNDING RURAL COMMUNITIES. 8 7 116 12 0 909226 3851477 6945753 7223129 18626 16080 369197 475070 8242802 11565756 0 0 0 0 4961276 5311088 0 0 0 3618152 4159245 8579428 9470333 -336626 2095423 6112717 4382268 5541621 1715749 571096 2666519 X 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. false false 8052815 0 7223129 ELLINWOOD DISTRICT HOSPITAL'S (EDH) PRIMARY PROGRAM IS THE DELIVERY OF HEALTHCARE AND RELATED SERVICES TO PATIENTS FROM OUR DISTRICT AND THE SURROUNDING AREA. SERVICES INCLUDE INPATIENT ACUTE, SKILLED SWING-BED, AND INTERMEDIATE SWING-BED CARE SERVICES ALONG WITH OUTPATIENTS SERVICES. SEE SCHEDULE O FOR CONTINUATION. 8052815 true true false true false false false false false false true false false false false false true true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true true false true 26 0 true 116 true false false false false false false false false false false false false X 8 7 true false false false true true true true true false false true true true true true true false false false X DAVE DELLASEGA 3166851523 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 CHRISTOPHER BROWN PHYSICIAN 40.0 0.0 X 290051 0 73560 CHARLES JOSLIN PHYSICIAN 40.0 0.0 X 234592 0 46604 DAVE DELLASEGA PRESIDENT/SECRETARY/DIRECTOR 2.0 40.0 X X 0 207874 33322 KILE MAGNER ADMINISTRATOR 40.0 0.0 X 126692 0 39617 DURREL KELLEY VP OF OPERATIONS 2.25 40.0 X 0 129966 27425 KELLI BROWN PHYSICIAN 40.0 0.0 X 116924 0 25146 DAVE RANKIN CHAIRMAN/DIRECTOR 0.25 2.25 X X 0 0 0 ROBERT HAMILTON SECRETARY/DIRECTOR 0.25 2.25 X X 0 0 0 JOHN TERRILL VICE PRESIDENT/DIRECTOR 0.25 2.25 X X 0 0 0 STEVE CARLSON TREASURER/DIRECTOR 0.25 2.25 X X 0 0 0 DR BARBARA BROWN APPLEGATE DIRECTOR 0.25 2.25 X 0 0 0 ARTHUR HENRICKSON DIRECTOR 0.25 2.25 X 0 0 0 CHARLES WESTIN DIRECTOR 0.25 2.25 X 0 0 0 768259 337840 245674 4 false true false GPHA 250 N ROCK RD STE 160 WICHITA KS 67206 MANAGEMENT AND CBO 659639 DOCS WHO CARE 800 W FRONTIER LN OLATHE KS 66061 CONTRACT SERVICES 129478 FORVIS LLP 1551 N WATERFRONT PKWY WICHITA KS 672066601 PROF SERVICES 113903 SIEMENS HEALTHCARE DIAGNOSTICS PO BOX 121102 DALLAS TX 753121102 PROF SERVICES 113646 4 3851477 3851477 NET PATIENT SERVICE REVENUE 621300 7223129 7223129 7223129 16080 16080 0 0 400 400 0 400 400 0 0 0 0 0 0 0 0 0 0 VENDOR REBATES 900099 14513 0 0 14513 EMPLOYEE/GUEST MEALS 722514 8289 0 0 8289 340B REVENUE 900099 422694 0 0 422694 29174 0 0 29174 474670 11565756 7223129 0 491150 0 0 0 0 171617 171617 0 4035933 3506681 529252 292619 246098 46522 525917 435741 90176 285002 238203 46799 65612 65612 0 37400 37400 1396 1396 0 0 1542588 1231930 310658 0 5539 5539 436176 413809 22367 0 0 118268 102323 15945 7506 5786 1720 0 5489 5218 271 45256 40224 5032 0 299688 288589 11099 77436 74552 2884 MEDICAL SUPPLIES 780229 780229 0 EQUIPMENT RENTAL & REPAIRS 95444 84284 11160 DUES & SUBSCRIPTIONS 29455 16850 12605 BAD DEBT EXPENSE 277309 277309 0 334454 304987 29467 9470333 8052815 1417518 0 2813422 988893 450821 0 0 0 1310391 1485361 0 0 0 0 0 0 146334 159438 21431 40072 4021559 2344764 1338544 1676795 0 0 0 0 0 0 0 0 31774 31709 6112717 4382268 988714 970441 0 0 2936312 82389 0 0 0 0 0 0 1616595 662919 0 0 0 0 5541621 1715749 X 571096 2666519 0 0 571096 2666519 6112717 4382268 2095423 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 1396 false false false 1396 false SCHEDULE C, PART II-B, LINE 1F A PORTION OF THE ANNUAL DUES PAID TO KHA AND AHA ARE USED FOR LOBBYING. 17983 17983 1593391 1132276 461115 2175172 1121246 1053926 235013 91242 143771 1676795 11288447 -277309 -277309 11565756 11565756 9193024 9193024 277309 277309 9470333 SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D BAD DEBT EXPENSE (277,309) SCHEDULE D, PART XII, LINE 4B BAD DEBT EXPENSE 277,309 true true X true X false true true true false true true 29101 29101 0.00320 348123 157749 190374 0.02070 377224 157749 219475 0.02390 21776 21776 0.00240 1071 1071 0.00010 22847 22847 0.00250 400071 157749 242322 0.02640 false 277309 4413259 4413259 X true true 1 1 ELLINWOOD DISTRICT HOSPITAL 605 N MAIN ELLINWOOD KS 67526 WWW.ELLINWOODDISTRICTHOSPITAL.ORG H005001 X X X X 1 ELLINWOOD DISTRICT HOSPITAL 1 false false true X X X X X X X X X 18 true false true true X SEE SCHEDULE H, PART V, SECTION C X true 18 true SEE SCHEDULE H, PART V, SECTION C false true X 200. 0. X X X X true true X X X true X SEE SCHEDULE H, PART V, SECTION C X SEE SCHEDULE H, PART V, SECTION C X SEE SCH H, PART V, SECTION C X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 THE ASSESSMENT PROCESS WAS INITIATED BY ELLINWOOD DISTRICT HOSPITAL AND COMPLETED IN COLLABORATION WITH BARTON COUNTY HEALTH DEPARTMENT. ALL OF THE EDUCATIONAL, GOVERNMENTAL, CIVIC AND HEALTH RELATED ORGANIZATIONS WITHIN THE COMMUNITY WERE INVITED TO PARTICIPATE. TO ENSURE INPUT FROM PERSONS WITH A BROAD KNOWLEDGE OF THE COMMUNITY, NOTICES OF ALL MEETINGS WERE ANNOUNCED BY MAILED LETTERS, EMAILS, AND ADVERTISEMENTS. REPRESENTATIVES AND INDIVIDUALS FROM THE COMMUNITY AND HEALTH ORGANIZATIONS ATTENDED THE TOWN HALL, FROM ELLINWOOD AND SURROUNDING AREAS INCLUDING HOISINGTON, GREAT BEND, CLAFLIN, AND BEAMER. SCHEDULE H, PART V, SECTION B, LINE 6B BARTON COUNTY HEALTH DEPARTMENT SCHEDULE H, PART V, SECTION B, LINE 7A HTTPS://WWW.ELLINWOODDISTRICTHOSPITAL.ORG/ABOUT SCHEDULE H, PART V, SECTION B, LINE 10A HTTPS://WWW.ELLINWOODDISTRICTHOSPITAL.ORG/ABOUT SCHEDULE H, PART V, SECTION B, LINE 11 THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED THREE HEALTH NEEDS. THE FIRST INITIATIVE IS ACCESS TO MENTAL HEALTH CARE. ELLINWOOD DISTRICT HOSPITAL (EDH) INTENDS TO MEET THIS COMMUNITY HEALTH NEED BY STRENGTHEN OUR REFERRAL WITH LOCAL MENTAL HEALTH PROVIDERS. WE WILL ALSO EXPLORE OUR OPTIONS FOR TELEHEALTH OPTIONS, SO THIS SERVICE CAN BE OBTAINED WITHOUT HAVING TO TRAVEL OUT OF TOWN. THE SECOND ITEM THE COMMUNITY ASKED FOR UPDATED HOSPITAL AND CLINIC FACILITIES. EDH INTENDS TO MEET THIS HEALTH NEED BY ADDRESSING UPGRADES AND HANDICAP ACCESSIBILITY. WE WILL PERFORM PERIODIC ASSESSMENTS OF THE FACILITY AND UPGRADE ACCORDINGLY. UPGRADES WILL BE DONE OVER THE SPAN OF THREE YEARS AS MONEY IS AVAILABLE. THE DEVELOPMENT PROCESS FOR A NEW OR REFURBISHED FACILITY HAS BEEN STARTED. FUNDING OPTIONS ARE BEING EXPLORED. THIRD, THE COMMUNITY ASKED FOR HEIGHTENED AWARENESS OF ALL LOCAL HEALTHCARE SERVICES. EDH INTENDS TO MEET THIS HEALTH NEED WITH A LETTER CAMPAIGN AS WELL AS ADVERTISING OFFERINGS IN ORDER TO BETTER EDUCATE THE SCOPE OF OUR SERVICES. THE FOURTH INIATIVE THE COMMUNITY ASKED FOR WAS A PHARMACY IN TOWN. SCHEDULE H, PART V, SECTION B, LINE 16A, B & C HTTPS://WWW.ELLINWOODDISTRICTHOSPITAL.ORG/FINANCIAL-ASSISTANCE 1 ELLINWOOD RURAL HEALTH CLINIC 611 N MAIN ELLINWOOD KS 67526 MEDICAL CLINIC 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 UNDERINSURANCE STATUS. SCHEDULE H, PART I, LINE 7, COLUMN F THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $277,309. SCHEDULE H, PART I, LINE 7 THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART I, LINE 7 OF SCHEDULE H, IS A COST TO CHARGE RATIO. SCHEDULE H, PART III, LINE 2 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 REASONABLE BASIS FOR ESTIMATING THIS FIGURE. IF ELIGIBILITY IS KNOWN, THE AMOUNT WOULD FALL UNDER CHARITY CARE AND NOT BAD DEBT. SCHEDULE H, PART III, LINE 4 SEE PAGE 9 OF THE AUDITED FINANCIALS UNDER NOTE 1. SCHEDULE H, PART III, LINE 8 THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNT ON LINE 6 IS COST TO CHARGE RATIO. SCHEDULE H, PART III, LINE 9B ALL CHARITY CARE CHARGES AND CHARGES NOT TO BE COLLECTED DUE TO FINANCIAL ASSISTANCE COMPUTATIONS ARE EXEMPT FROM COLLECTION POLICIES AND PRACTICES. THESE ACCOUNTS ARE REMOVED FROM THE COLLECTION CYCLE. SCHEDULE H, PART VI, LINE 2 In 2021, the hospital has continued to work to address the health needs identified by the 2018 Community Health Needs Assessment of our service area. The organization has surveyed district patrons on services currently provided at the hospital and what they see as future needs. Strategic planning and mission review is part of the annual advisory board's retreat. This year we reviewed the previous year's plan and planned for the next several years based on the needs assessment from survey and input received from the public. Two areas of focus were identified for the facility: 1. Develop a strategic plan going forward regarding the building of a new facility, including: funding opportunities and capital availability, public relations and community support, project management, budget, and timeline. 2. Develop and adopt a medical provider succession plan and build relationships to move forward with it. The current changes in health care at the federal, state, and community levels are communicated to the public via local media and town hall meetings as determined necessary. Advisory board meetings are considered open meetings and the public is encouraged to attend. The annual advisory board meeting informs the public of the hospital and clinic's most recent statistics and offered services. The hospital district supplies the clinic building for rural health clinic providers and for outside consulting physicians. SCHEDULE H, PART VI, LINE 3 The Financial Counselor consults with private pay patients to see if they qualify for the Hospital's financial assistance policy. We also have posted online and in both the hospital and clinic lobbies that financial assistance is available and to apply with the Financial Counselor at the Hospital. If discovered during the accounts receivable collection process that a patient is having trouble paying bills, both the hospital and the centralized billing office will inform the patient that financial assistance is available. As part of the financial assistance program all applicants must apply for Medicaid. If after the initial interview there is a consensus that the patient may qualify for financial assistance, the financial counselor gives patient forms to complete and asks to see bank statements, tax returns, etc. Computations based on current Federal Poverty Level Guidelines are completed to see if qualification is appropriate and the percentage of charges to be written off is determined, based on family size and household income. All instances of financial assistance are approved by upper management of the Hospital. SCHEDULE H, PART VI, LINE 4 The Ellinwood Hospital District consists of all of Lakin township (including the City of Ellinwood) and all of Comanche township (with the exception of the two tiers of sections along the western edge described as Sections 5,6,7,8,17,18,19,20,29,30,31, and 32, in West 20-12. This area is known as the Ellinwood Trade Area. The hospital is located in Ellinwood, Kansas which has a population of 2,063 as of the 2019 5-year estimates of the American Community Survey, by the U.S. Census Bureau, and serves the eastern part of Barton County. Total population of Barton County is 26,453 as of the same census. The median age of an Ellinwood resident is 42.2 years. Total households in Ellinwood are 834 plus the rural households from the district. The racial makeup of the community is 90% white, 7% Hispanic, and the remaining 3% are other races or multiple races. The median income per household in Ellinwood was $47,500, as compared to the state of Kansas which is $59,597. 40% of Ellinwood citizens are 50 or older. The percentage of people at the poverty level or below in Ellinwood is 12%, the same as compared to the state poverty rate of 12%. Poverty level of those under 18 is 11% and for those over the age of 65 it is 10%. The patient population also includes patients from Russell, Rice, and Stafford Counties. The patient mix is heavily weighted toward Medicare and Medicaid beneficiaries, especially acute, ER, and swing bed care. Citation: U.S. Census Bureau (2019). American Community Survey 5-year estimates. Retrieved from Census Reporter Profile page for Ellinwood, KS <https://censusreporter.org/profiles/16000US2020425-ellinwood-ks/> SCHEDULE H, PART VI, LINE 5 The hospital provides and promotes the health of the citizens of the Ellinwood district by constantly looking for opportunities to educate area residents about healthy activities and habits and offering opportunities for education about health care topics. Some of the activities to further the health of the area include: 1. Due to the COVID-19 pandemic, activities in which participants gather together, indoors or out, have been put on indefinite hold. Many of the normal events that EDH participates in were cancelled during this time frame. The impacts/reductions are listed in parentheses with each statement. 2. Reduced cost lab fairs are provided semi-annually with Ellinwood Hospital Foundation support. (None were held in 2021 due to COVID-19 numbers in Barton county / City of Ellinwood) 3. Educational classes are offered throughout the year, including classes to clubs and organizations in the community. Educational presentations are also made at local schools. (Two classes held in 2020) 4. We offer support to other healthcare related organizations, such as the local food bank, United Way, and Relay for Life, to raise awareness about health-related issues, such as cancer, and to ensure that their missions can be carried out, impacting the health and wellness of us all. 5. In conjunction with the community ambulance service, the hospital sponsors ACLS, PALS and CPR for professionals in Barton County. 6. TNCC classes for nurses are sponsored by the hospital for area health care professionals. 7. The hospital and its staff took the lead for the county medical organizations in emergency preparedness, especially concerning the new requirements faced by all other provider types. We host and participate in disaster/bioterrorism drills with other area health care facilities on a regular basis to encourage preparedness and awareness within our communities. (In-person meetings were cancelled for much of the year, but we still took an active part in assisting at the local and county level. Drills and emergency preparedness activities were cancelled for 2021) 8. We support medical education in all forms, but especially by giving support to our local community colleges: top management serves on advisory boards for nursing program and medical assistant/coding programs at Barton Community College (BCC). The hospital is a practice site for phlebotomists/MLT, medical assistant program and nursing program from BCC. We are also a practice site for the physical therapy assistant program at Hutchinson Community College. 9. EDH continues to dedicate itself and any surplus funds to improving the healthcare available to area residents and patients by updating equipment and ensuring that the hospital's technology is current and able to meet the patients' needs. SCHEDULE H, PART VI, LINE 6 ELLINWOOD DISTRICT HOSPITAL AND CLINIC ARE AFFILIATED WITH GREAT PLAINS HEALTH ALLIANCE, INC. (GPHA), A NON-PROFIT 501(C)(3) ORGANIZATION WHICH PROVIDES MANAGEMENT SERVICES AND OPERATIONAL, FINANCE, AND ACCOUNTING SUPPORT. GPHA DOES NOT PROVIDE SERVICES DIRECTLY TO PATIENTS, BUT DOES PROVIDE ACCESS TO PROFESSIONALS THAT MAY NOT BE AFFORDABLE TO THE NORMAL CRITICAL ACCESS HOSPITAL. GPHA PROVIDES EDUCATION AND ASSISTANCE IN AREAS SUCH AS HIPAA, MEDICARE REIMBURSEMENT, MEANINGFUL USE REQUIREMENTS FOR COMPUTER SYSTEMS, ETC. GPHA IS AN AFFILIATION OF CRITICAL ACCESS HOSPITALS IN KANSAS AND NEBRASKA THAT PROVIDES NETWORKING OPPORTUNITIES WITH OTHER RURAL HOSPITALS, COMMUNITIES, AND LEADERS. GPHA PROVIDES POLICIES AND GUIDANCE TO ITS CRITICAL ACCESS FACILITIES REGARDING FINANCIAL ASSISTANCE, CONFLICTS OF INTEREST, CORPORATE COMPLIANCE, AND MANY OTHER AREAS. GPHA ALSO PROVIDES EDUCATIONAL SESSIONS FOR BOARD MEMBERS, BUSINESS OFFICE MANGERS, BILLERS, MEDICAL RECORDS PERSONNEL, DIRECTORS OF NURSING, AND ADMINISTRATORS. GPHA IS A VITAL LINK IN ALLOWING CAH HOSPITALS TO OPERATE AT A HIGH QUALITY WITHIN THE CASH CONSTRAINTS IMPOSED BY THE CRITICAL ACCESS PROGRAM. false false false false false false false false false DAVE DELLASEGA PRESIDENT/SECRETARY/DIRECTOR 0 204939 0 0 0 2935 0 20567 0 12755 0 241196 0 0 KILE MAGNER ADMINISTRATOR 125490 0 0 0 1202 0 11869 0 27748 0 166309 0 0 0 DURREL KELLEY VP OF OPERATIONS 0 127708 0 0 0 2258 0 12224 0 15201 0 157391 0 0 CHRISTOPHER BROWN PHYSICIAN 287911 0 0 0 2140 0 28205 0 45355 0 363611 0 0 0 CHARLES JOSLIN PHYSICIAN 232374 0 0 0 2218 0 22659 0 23945 0 281196 0 0 0 FORM 990, PART VII; SCHEDULE J, PART I, LINE 3 COMPENSATION FOR DURREL KELLEY AND DAVE DELLASEGA IS PROVIDED BY GREAT PLAINS HEALTH ALLIANCE, A RELATED ORGANIZATION. GREAT PLAINS HEALTH ALLIANCE'S BOARD OF DIRECTORS ANNUALLY APPROVE THE COMPENSATION FOR MR. KELLEY AND MR. DELLASEGA. 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. FORM 990, PART III, LINE 4A During 2021, EDH completed several projects to increase the quality of service or safety to our patients and residents. 1) EDH CONTINUES TO ADD COMPONENTS OF THE ELECTRONIC HEALTH RECORD AND TO STRIVE TO MEET THE MEANINGFUL USE REQUIREMENT OF THE RECENT HEALTH REFORM LEGISLATION. 2) EDH MADE CHANGES TO PROCESSES AND PROTOCOLS TO PROTECT THE HEALTH AND SAFETY OF PATIENTS SEEKING CARE AND EMPLOYEES WORKING DURING THE COVID-19 PANDEMIC. THESE PROCESSES INCLUDING RESTRICTED AND SCREENED ACCESS TO FACILITIES, DEDICATED WAITING SPACES FOR SICK/WELL PATIENTS, AND INCREASED ACCESS TO TELEMEDICINE FOR PATIENTS. 3) EDH completed the remodel to our outreach clinic to accommodate specialist for our aging community, this allows patients to see specialists they need to see without having to travel over an hour. FORM 990, PART VI, SECTION A, LINE 2 DAVE DELLASEGA, DURREL KELLEY, AND JASON BARB HAVE A BUSINESS RELATIONSHIP. THEY ARE BOTH EMPLOYED BY, AND ALSO AN OFFICER OF, A RELATED 501(C)(3) ORGANIZATION, GREAT PLAINS HEALTH ALLIANCE. FORM 990, PART VI, SECTION A, LINE 6 GREAT PLAINS HEALTH ALLIANCE, INC., A NOT-FOR-PROFIT 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF GREAT PLAINS OF ELLINWOOD, INC. FORM 990, PART VI, 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 AND COO 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:879249 FORM 990 PART IX LINE 11G DESCRIPTION:BILLING/COLLECTIONS TOTAL FEES:277527 FORM 990 PART IX LINE 11G DESCRIPTION:PHARMACY SERVICE TOTAL FEES:191310 FORM 990 PART IX LINE 11G DESCRIPTION:LAB SERVICES TOTAL FEES:92467 FORM 990 PART IX LINE 11G DESCRIPTION:MAINTENANCE/HOUSEKEEPING TOTAL FEES:63011 FORM 990 PART IX LINE 11G DESCRIPTION:ADMINISTRATION/HUMAN RESOURCES TOTAL FEES:33131 FORM 990 PART IX LINE 11G DESCRIPTION:DIETARY SERVICES TOTAL FEES:5893 GREAT PLAINS HEALTH ALLIANCE 250 N ROCK ROAD STE 160 WICHITA KS 67206 480617739 MANAGEMENT KS 501(C)(3) 3 NA false GREAT PLAINS HEALTH CARE FOUNDATION INC 250 N ROCK ROAD STE 160 WICHITA KS 67206 480955870 SUPPORT KS 501(C)(3) 10 GPHA INC 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 true GREAT PLAINS OF SMITH COUNTY INC 250 N ROCK ROAD STE 160 WICHITA KS 67206 481226830 HOSPITAL KS 501(C)(3) 3 GPHA INC 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 true GREAT PLAINS OF CHEYENNE COUNTY 250 N ROCK ROAD STE 160 WICHITA KS 67206 481226831 HOSPITAL KS 501(C)(3) 3 GPHA INC 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 true GREAT PLAINS EMPLOYEE BENEFITS TRUST 250 N ROCK ROAD STE 160 WICHITA KS 67206 476918582 HEALTH PLAN KS 501(C)(9) GPHA INC true GREAT PLAINS OF KIOWA COUNTY INC 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 481226833 HOSPITAL KS 501(C)(3) 3 GPHA INC true false false false false false false false false false false true true true false true false false true false GPHA EMPLOYEE BENEFITS TRUST R 494838 FMV