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GREAT PLAINS OF SMITH CO INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
GREAT PLAINS OF SMITH CO INC (EIN 48-1226830)
Tax period
2020-04-01 to 2021-03-31
Filed
2022-01-17
IRS object ID
202230179349300608
Schema version
2020v4.1
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 ReturnHeader

FieldValueIRS element (for citing)
Return2022-01-17T09:20:34-06:00ReturnTs
Tax Period End2021-03-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11551 N WATERFRONT PKWY STE 300AddressLine1Txt
CityWICHITACityNm
State AbbreviationKSStateAbbreviationCd
ZIP672066601ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-04-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN481226830EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GREAT PLAINS OF SMITH CO INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% DAVE DELLASEGAInCareOfNm
Business Name ControlGREABusinessNameControlTxt
Phone7852826845PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 349AddressLine1Txt
CitySMITH CENTERCityNm
State AbbreviationKSStateAbbreviationCd
ZIP66967ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDAVE DELLASEGAPersonNm
Person TitleCEOPersonTitleTxt
Phone3166851523PhoneNum
Signature2021-12-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstDAVEPersonFirstNm
Person LastDELLASEGAPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSHAWNELL LINOTPreparerPersonNm
PTINP01663908PTIN
Phone3162652811PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1SMITH COUNTY MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerDAVE DELLASEGAPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1250 NORTH ROCK ROAD STE 160AddressLine1Txt
CityWICHITACityNm
State AbbreviationKSStateAbbreviationCd
ZIP67206ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$23,782,634GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.SCMHKS.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1999FormationYr
Legal Domicile StateKSLegalDomicileStateCd
Activity Or MissionTHE 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 Body8VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee172TotalEmployeeCnt
Total Volunteers8TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$1,279,158PYContributionsGrantsAmt
CY Contributions Grants$4,968,472CYContributionsGrantsAmt
PY Program Service Revenue$17,633,623PYProgramServiceRevenueAmt
CY Program Service Revenue$18,643,887CYProgramServiceRevenueAmt
PY Investment Income$35,372PYInvestmentIncomeAmt
CY Investment Income$44,184CYInvestmentIncomeAmt
PY Other Revenue$138,331PYOtherRevenueAmt
CY Other Revenue$126,091CYOtherRevenueAmt
PY Total Revenue$19,086,484PYTotalRevenueAmt
CY Total Revenue$23,782,634CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$8,405,196PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$9,074,468CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$10,327,606PYOtherExpensesAmt
CY Other Expenses$11,946,023CYOtherExpensesAmt
PY Total Expenses$18,732,802PYTotalExpensesAmt
CY Total Expenses$21,020,491CYTotalExpensesAmt
PY Revenues Less Expenses$353,682PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,762,143CYRevenuesLessExpensesAmt
Total Assets BOY$33,157,652TotalAssetsBOYAmt
Total Assets EOY$40,774,688TotalAssetsEOYAmt
Total Liabilities BOY$28,836,264TotalLiabilitiesBOYAmt
Total Liabilities EOY$33,614,200TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,321,388NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$7,160,488NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO 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 SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$17,777,446ExpenseAmt
Grant$0GrantAmt
Revenue$18,643,887RevenueAmt
DescGreat 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$17,777,446TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgYes (true)TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document40IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee172EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonDAVE DELLASEGAPersonNm
Phone3166851523PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1250 NORTH ROCK ROAD STE 160AddressLine1Txt
CityWICHITACityNm
State AbbreviationKSStateAbbreviationCd
ZIP67206ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerInd
HANNAH HAACK
PHYSICIAN40.00.0Yes (X)$339,058$0$49,774
JUSTIN OVERMILLER
PHYSICIAN40.00.0Yes (X)$325,506$0$49,774
FERRILL CONANT
PHYSICIAN40.00.0Yes (X)$253,701$0$38,951
LEAH WIEHL
PHYSICIAN40.00.0Yes (X)$208,127$0$38,841
DAVE DELLASEGA
PRESIDENT/SECRETARY/DIRECTOR2.040.0$0$207,871$33,322Yes (X)Yes (X)
ALLEN VANDRIEL
ADMINISTRATOR40.00.0$168,701$0$32,977Yes (X)
TAMARA WINDSCHEFFEL
ARNP40.00.0Yes (X)$161,633$0$31,393
DURREL KELLEY
SENIOR VP OF OPERATIONS2.040.0$0$129,966$27,425Yes (X)
DAVE RANKIN
CHAIRMAN/DIRECTOR0.252.25$0$0$0Yes (X)Yes (X)
ROBERT HAMILTON
SECRETARY/DIRECTOR0.252.25$0$0$0Yes (X)Yes (X)
JOHN TERRILL
VICE PRESIDENT/DIRECTOR0.252.25$0$0$0Yes (X)Yes (X)
STEVE CARLSON
TREASURER/DIRECTOR0.252.25$0$0$0Yes (X)Yes (X)
DR BARBARA BROWN APPLEGATE
DIRECTOR0.252.25$0$0$0Yes (X)
ARTHUR HENRICKSON
DIRECTOR0.252.25$0$0$0Yes (X)
CHARLES WESTIN
DIRECTOR0.252.25$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,456,726TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$337,837TotReportableCompRltdOrgAmt
Total Other Compensation$302,457TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K11IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
GPHA
250 N ROCK RD STE 160WICHITAKS67206BILLING SERVICE/MGMT$1,142,701
QUEST DIAGNOSTICS
PO BOX 719HAYSKS67601REFERENCE LAB$229,439
WOUND CARE SPECIALISTS
PO BOX 71849CHICAGOIL606941849WOUND CARE$120,700
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
Government Grants$4,820,877GovernmentGrantsAmt
All Other Contributions$147,595AllOtherContributionsAmt
Total Contributions$4,968,472TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE621300$16,062,302$16,062,302
340B PRESCRIPTION DRUG REVENUE621300$2,581,585$2,581,585
FieldValueIRS element (for citing)
Total Program Service Revenue$18,643,887TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$44,184TotalRevenueColumnAmt
Exclusion$44,184ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$191RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$191RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$191TotalRevenueColumnAmt
Exclusion$191ExclusionAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
EMPLOYEE/GUEST MEALS722513$98,743$98,743
VENDOR REBATES900099$24,547$24,547
All Other Misc Revenue900099$2,610$2,610

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,610TotalRevenueColumnAmt
Exclusion$2,610ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$125,900OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$23,782,634TotalRevenueColumnAmt
Related Or Exempt Func Income$18,643,887RelatedOrExemptFuncIncomeAmt
Exclusion$170,275ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$201,402TotalAmt
Management And General$201,402ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$6,937,485TotalAmt
Program Services$6,161,105ProgramServicesAmt
Management And General$776,380ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$480,968TotalAmt
Program Services$436,860ProgramServicesAmt
Management And General$44,108ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$983,938TotalAmt
Program Services$834,588ProgramServicesAmt
Management And General$149,350ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$470,675TotalAmt
Program Services$401,068ProgramServicesAmt
Management And General$69,607ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$135,365TotalAmt
Management And General$135,365ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$14,970TotalAmt
Management And General$14,970ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$151,273TotalAmt
Management And General$151,273ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$3,264TotalAmt
Management And General$3,264ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,876,029TotalAmt
Program Services$2,409,169ProgramServicesAmt
Management And General$466,860ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$26,938TotalAmt
Program Services$2,476ProgramServicesAmt
Management And General$24,462ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$426,554TotalAmt
Program Services$400,276ProgramServicesAmt
Management And General$26,278ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$33,425TotalAmt
Program Services$15,599ProgramServicesAmt
Management And General$17,826ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$300,609TotalAmt
Program Services$219,960ProgramServicesAmt
Management And General$80,649ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$2,581TotalAmt
Program Services$1,900ProgramServicesAmt
Management And General$681ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$17,336TotalAmt
Program Services$11,061ProgramServicesAmt
Management And General$6,275ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$753,039TotalAmt
Program Services$538,104ProgramServicesAmt
Management And General$214,935ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,336,240TotalAmt
Program Services$1,669,423ProgramServicesAmt
Management And General$666,817ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$144,071TotalAmt
Program Services$102,950ProgramServicesAmt
Management And General$41,121ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$3,539,936$3,539,936
PROVISION FOR BAD DEBTS$883,353$883,353
EQUIPMENT RENTAL/MAINTENANCE$161,788$116,762$45,026
DUES & SUBSCRIPTIONS$38,571$9,615$28,956

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$100,681TotalAmt
Program Services$23,241ProgramServicesAmt
Management And General$77,440ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$21,020,491TotalAmt
Program Services$17,777,446ProgramServicesAmt
Management And General$3,243,045ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$9,870BOYAmt
EOY$3,471,181EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,071,052BOYAmt
EOY$3,679,899EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,157,766BOYAmt
EOY$3,172,658EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$258,902BOYAmt
EOY$276,263EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$109,191BOYAmt
EOY$120,669EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$30,853,911LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$6,349,211LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$26,635,178BOYAmt
EOY$24,504,700EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$915,693BOYAmt
EOY$5,549,318EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$33,157,652BOYAmt
EOY$40,774,688EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,666,797BOYAmt
EOY$3,224,388EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$3,709,001EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$27,169,467BOYAmt
EOY$26,680,811EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$28,836,264BOYAmt
EOY$33,614,200EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,443,929BOYAmt
EOY$6,188,456EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$877,459BOYAmt
EOY$972,032EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,321,388BOYAmt
EOY$7,160,488EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$33,157,652BOYAmt
EOY$40,774,688EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$2,762,143ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$76,957NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsYes (true)GrantsOtherOrganizationsInd
Grants Other Organizations$3,264GrantsOtherOrganizationsAmt
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesfalseOtherActivitiesInd
Total Lobbying Expenditures$3,264TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1FFormAndLineReferenceDesc
ExplanationA PORTION OF THE ANNUAL DUES PAID TO KHA AND AHA ARE USED FOR LOBBYING.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$877,459BeginningYearBalanceAmt
Contributions$66,240ContributionsAmt
Investment Earnings Or Losses$93,680InvestmentEarningsOrLossesAmt
Other Expenditures$65,348OtherExpendituresAmt
End Year Balance$972,031EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$936,018BeginningYearBalanceAmt
Contributions$13,269ContributionsAmt
Investment Earnings Or Losses-$38,761InvestmentEarningsOrLossesAmt
Other Expenditures$33,067OtherExpendituresAmt
End Year Balance$877,459EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$910,903BeginningYearBalanceAmt
Contributions$13,076ContributionsAmt
Investment Earnings Or Losses$41,817InvestmentEarningsOrLossesAmt
Other Expenditures$29,778OtherExpendituresAmt
End Year Balance$936,018EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$982,411BeginningYearBalanceAmt
Contributions$17,349ContributionsAmt
Investment Earnings Or Losses-$27,421InvestmentEarningsOrLossesAmt
Other Expenditures$61,436OtherExpendituresAmt
End Year Balance$910,903EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$931,434BeginningYearBalanceAmt
Contributions$49,072ContributionsAmt
Investment Earnings Or Losses$67,637InvestmentEarningsOrLossesAmt
Other Expenditures$65,732OtherExpendituresAmt
End Year Balance$982,411EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.97180PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.02820TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (true)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$395,701OtherCostOrOtherBasisAmt
Book Value$395,701BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$19,602,101OtherCostOrOtherBasisAmt
Depreciation$3,211,133DepreciationAmt
Book Value$16,390,968BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,535,868OtherCostOrOtherBasisAmt
Depreciation$2,348,717DepreciationAmt
Book Value$4,187,151BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,320,241OtherCostOrOtherBasisAmt
Depreciation$789,361DepreciationAmt
Book Value$3,530,880BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$24,504,700TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
Due from Third Party$35,765
FUNDS HELD BY ESCROW AGENT$5,183,013
OTHER RECEIVABLES$330,540
FieldValueIRS element (for citing)
Total Book Value Other Assets$5,549,318TotalBookValueOtherAssetsAmt
Total Rev Etc Audited Fincl Stmt$22,976,238TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$76,957NetUnrealizedGainsInvstAmt
Other Revenue-$883,353OtherRevenueAmt
Revenue Not Reported-$806,396RevenueNotReportedAmt
Revenue Subtotal$23,782,634RevenueSubtotalAmt
Total Revenue Per Form990$23,782,634TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$20,137,138TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$20,137,138ExpensesSubtotalAmt
Other Expenses Not Included$883,353OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$883,353ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$21,020,491TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4THE INTENDED USE OF THE ENDOWMENT FUNDS IS TO SUPPORT THE CONTINUING OPERATIONS OF THE REPORTING ORGANIZATION.
SCHEDULE D, PART X, LINE 2MANAGEMENT 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 2DPROVISION FOR UNCOLLECTIBLE ACCOUNTS (883,353)
SCHEDULE D, PART XII, LINE 4BPROVISION FOR UNCOLLECTIBLE ACCOUNTS 883,353

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CarefalseFPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$448TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$448NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$857,885TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$474,625DirectOffsettingRevenueAmt
Net Community Benefit Expns$383,260NetCommunityBenefitExpnsAmt
Total Expense0.01900TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$858,333TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$474,625DirectOffsettingRevenueAmt
Net Community Benefit Expns$383,708NetCommunityBenefitExpnsAmt
Total Expense0.01900TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$22,310TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$22,310NetCommunityBenefitExpnsAmt
Total Expense0.00110TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$22,310TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$22,310NetCommunityBenefitExpnsAmt
Total Expense0.00110TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$880,643TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$474,625DirectOffsettingRevenueAmt
Net Community Benefit Expns$406,018NetCommunityBenefitExpnsAmt
Total Expense0.02010TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$883,353BadDebtExpenseAmt
Reimbursed By Medicare$7,853,984ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$7,853,984CostOfCareReimbursedByMedcrAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GREAT PLAINS OF SMITH CO INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1921 E HWY 36AddressLine1Txt
CitySMITH CENTERCityNm
State AbbreviationKSStateAbbreviationCd
ZIP66967ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.SCMHKS.ORGWebsiteAddressTxt
State LicenseH092001StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherRURAL HEALTH CLINICOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1GREAT PLAINS OF SMITH CO INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE SCHEDULE H, PART V, SECTION COwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSEE SCHEDULE H, PART V, SECTION CStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care0.FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE SCHEDULE H, PART V, SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE SCHEDULE H, PART V, SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE SCH H, PART V, SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Prospective Medicare MedicaidYes (X)ProspectiveMedicareMedicaidInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, LINE 5THE 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 7AHTTPS://WWW.SCMHKS.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/
SCHEDULE H, PART V, LINE 10https://www.scmhks.org/files/2019/04/2018-Plan-Implementation.pdf
SCHEDULE H, PART V, LINE 11THE CHNA CONDUCTED IN APRIL 2018 HIGHLIGHTED 7 ISSUES FOR SMITH COUNTY. THE ISSUES WERE: 1. BEHAVIORAL & MENTAL HEALTH 2. WELLNESS/DISEASE PREVENTION 3. DENTAL SERVICE ACCESS 4. POVERTY/AFFORDABLE INSURANCE 5. CHILD CARE AND DEVELOPMENT ACCESS 6. ALCOHOL AND DRUG PREVENTION 7. ELDER CARE/HOUSING THE ISSUES IDENTIFIED WERE REVIEWED BY GREAT PLAINS OF SMITH COUNTY, INC. LEADERSHIP AND GOVERNING BOARD, AND WERE PRIORITIZED INTO AN IMPLEMENTATION STRATEGY, WHICH WAS PUBLISHED LATER IN 2018. THE IMPLEMENTATION STRATEGY IS POSTED ON THE PUBLIC WEBSITE (WWW.SCMHKS.ORG). THE STRATEGY ADDRESSES ITEMS 1, 2, 6, AND 7 AS PRIORITIES THAT GREAT PLAINS OF SMITH COUNTY, INC. CAN DIRECTLY IMPACT USING RESOURCES OF THE HEALTH CARE COMMUNITY. ITEMS 3, 5, AND 7 ARE PRIORITIES THAT CANNOT BE ADDRESSED SOLELY BY GPSC, BUT WHICH WE CONTINUE TO WORK COLLABORATIVELY WITH OTHER ORGANIZATIONS AND PARTNERS TO ADDRESS. ITEM 4 WAS IDENTIFIED AS A DETERMINANT OF HEALTH STATUS WITHIN THE GPSC SERVICE AREA, BUT IS BEYOND THE PURVIEW OF GPSC TO ADDRESS. RATHER, IT IS VIEWED AS AN OVERALL ECONOMIC DEVELOPMENT PRIORITY.
SCHEDULE H, PART V, LINE 16AHTTPS://WWW.SCMHKS.ORG/SERVICES/FINANCIAL-ASSISTANCE/
SCHEDULE H, PART V, LINE 16BHTTPS://WWW.SCMHKS.ORG/SERVICES/FINANCIAL-ASSISTANCE/
SCHEDULE H, PART V, LINE 16CHTTPS://WWW.SCMHKS.ORG/SERVICES/FINANCIAL-ASSISTANCE-RESOURCES/
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SMITH COUNTY FAMILY PRACTICEBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1921 E HWY 36AddressLine1Txt
CitySMITH CENTERCityNm
State AbbreviationKSStateAbbreviationCd
ZIP66967ZIPCd
FieldValueIRS element (for citing)
FacilityFAMILY PRACTICEFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART I, LINE 3CTHE 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 7THE 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 I, LINE 7, COLUMN FTHE 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 $883,353.
SCHEDULE H, PART III, LINE 2HOSPITAL 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 3THE 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 4SEE PAGE 35 OF THE AUDITED FINANCIALS UNDER NOTE 22.
SCHEDULE H, PART III, LINE 8THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNT ON LINE 6 IS A COST TO CHARGE RATIO.
SCHEDULE H, PART III, LINE 9BALL 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 2Great 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 Assessments. The first of these formal assessments was completed 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 on public gatherings necessitates a change in tactics for the fourth Community Health Needs Assessment. Although not complete as of the end of the fiscal year, plans and work were underway for gathering input from the public using a virtual forum Following completion of the public input session, a needs assessment document will be published, as well as an implementation plan based on the needs identified in the study. The Board of Trustees of Smith County Memorial Hospital, which consists of five members appointed by the Smith County Board of Commissioners, is responsible for the delivery of healthcare through SCMH. The Board of Trustees has maintained a lease arrangement with Great Plains Health Alliance since 1951. This lease arrangement creates the Great Plains of Smith County, Inc. as the operating entity for the delivery of services. The Board of Trustees, although not directly involved in the governance of the delivery system, serve as an important conduit for public input regarding the needs and delivery of healthcare by Great Plains of Smith County, Inc.
SCHEDULE H, PART VI, LINE 3Great 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. 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 4The 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 5Great 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 manages 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 6SMITH 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 7N/A

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DAVE DELLASEGA
PRESIDENT/SECRETARY/DIRECTOR$0$204,936$0$0$0$2,935$0$20,567$0$12,755$0$241,193$0$0
DURREL KELLEY
SENIOR VP OF OPERATIONS$0$127,708$0$0$0$2,258$0$12,224$0$15,201$0$157,391$0$0
ALLEN VANDRIEL
ADMINISTRATOR$167,004$0$0$0$1,697$0$16,300$0$16,677$0$201,678$0$0$0
JUSTIN OVERMILLER
PHYSICIAN$323,324$0$0$0$2,182$0$27,700$0$22,074$0$375,280$0$0$0
HANNAH HAACK
PHYSICIAN$336,903$0$0$0$2,155$0$27,700$0$22,074$0$388,832$0$0$0
FERRILL CONANT
PHYSICIAN$251,462$0$0$0$2,239$0$24,570$0$14,381$0$292,652$0$0$0
LEAH WIEHL
PHYSICIAN$206,262$0$0$0$1,865$0$20,561$0$18,280$0$246,968$0$0$0
TAMARA WINDSCHEFFEL
ARNP$160,136$0$0$0$1,497$0$15,513$0$15,880$0$193,026$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFORM 990, PART VII; SCHEDULE J, PART I, LINE 3FormAndLineReferenceDesc
ExplanationCOMPENSATION FOR DAVE DELLASEGA AND DURRELL KELLEY 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 AND MR. KELLEY. 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 ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 4AThe 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 Advance 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, and pathology services. 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 and Pain Management services are provided in the Emergency, ambulatory surgery, and inpatient surgical setting by a dedicated Certified Registered Nurse Anesthetist. 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. 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, Osborne, and Phillips 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 four 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 2DAVE DELLASEGA AND DURREL KELLEY HAVE A BUSINESS RELATIONSHIP. THEY ARE BOTH EMPLOYED BY, AND ALSO OFFICERS OF, A RELATED 501(C)(3) ORGANIZATION, GREAT PLAINS HEALTH ALLIANCE.
FORM 990, PART VI, SECTION A, LINE 6GREAT 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 7AGREAT 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 7BGREAT 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 11BTHE 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 12CTHE 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 & BTHE 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 19THE 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 11GDESCRIPTION:CONTRACTED MEDICAL STAFF TOTAL FEES:1878867
FORM 990 PART IX LINE 11GDESCRIPTION:BILLING/COLLECTIONS TOTAL FEES:372904
FORM 990 PART IX LINE 11GDESCRIPTION:LAB SERVICES TOTAL FEES:266783
FORM 990 PART IX LINE 11GDESCRIPTION:PHARMACY SERVICES TOTAL FEES:175231
FORM 990 PART IX LINE 11GDESCRIPTION:ADMINISTRATION/HUMAN RESOURCES TOTAL FEES:87630
FORM 990 PART IX LINE 11GDESCRIPTION:MAINTENANCE/HOUSEKEEPING TOTAL FEES:72450
FORM 990 PART IX LINE 11GDESCRIPTION:PLANT OPERATIONS TOTAL FEES:22164

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
GREAT PLAINS HEALTH ALLIANCE INC
250 N ROCK ROAD STE 160WICHITAKS67206480617739MANAGEMENTKS501(C)(3)3NAfalse
GREAT PLAINS HEALTH CARE FOUNDATION INC
250 N ROCK ROAD STE 160WICHITAKS67206480955870SUPPORTKS501(C)(3)10GPHA INCYes (true)
GREAT PLAINS OF ELLINWOOD INC
250 N ROCK ROAD STE 160WICHITAKS67206481226976HOSPITALKS501(C)(3)3GPHA INCYes (true)
GREAT PLAINS OF OTTAWA COUNTY INC
250 N ROCK ROAD STE 160WICHITAKS67206481226856HOSPITALKS501(C)(3)3GPHA INCYes (true)
GREAT PLAINS OF SABETHA COUNTY INC
250 N ROCK ROAD STE 160WICHITAKS67206481236156HOSPITALKS501(C)(3)3GPHA INCYes (true)
GREAT PLAINS OF REPUBLIC COUNTY INC
250 N ROCK ROAD STE 160WICHITAKS67206481226977HOSPITALKS501(C)(3)3GPHA INCYes (true)
GREAT PLAINS OF CHEYENNE COUNTY INC
250 N ROCK ROAD STE 160WICHITAKS67206481226831HOSPITALKS501(C)(3)3GPHA INCYes (true)
GPHA EMPLOYEE BENEFITS TRUST
250 N ROCK ROAD STE 160WICHITAKS67206476918582HEALTH PLANKS501(C)(9)GPHA INCYes (true)
GREAT PLAINS OF KIOWA COUNTY INC
250 NORTH ROCK ROAD STE 160WICHITAKS67206481226833HOSPITALKS501(C)(3)3GPHA INCYes (true)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Primary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
CHARITABLE REMAINDER TRUST (1)
CHARITABLE TRUSTKSGP OF SMITH CTYYes (true)
CHARITABLE REMAINDER TRUST (1)
CHARITABLE TRUSTKSGP OF SMITH CTYYes (true)
CHARITABLE REMAINDER TRUST (3)
CHARITABLE TRUSTKSGP OF SMITH CTYYes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1GPHA EMPLOYEE BENEFITS TRUSTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeRTransactionTypeTxt
Involved$765,721InvolvedAmt
Method Of Amount DeterminationFMVMethodOfAmountDeterminationTxt