2022-05-09T14:04:48-05:00 2021-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2020-07-01 730579295 Farmers Union Hospital Association FARM 5802252511 PO Box 2339 Elk City OK 73648 Corey Lively CEO 5802252511 2022-04-28 1 Corey Lively 999009999 Kim Hunwardsen CPA P00484560 6122536500 2022-04-21 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z Great Plains Regional Medical Center Corey Lively PO Box 2339 Elk City OK 73648 61220028 0 X www.gprmc-ok.com X 1938 OK To provide comprehensive, cost-effective, high quality healthcare to our communities. 10 7 546 28 2642 0 1061755 5489196 50184675 49268507 764321 1377925 295852 548463 52306603 56684091 17739 7850 0 0 23398666 25682647 0 0 0 30771239 29848757 54187644 55539254 -1881041 1144837 74157151 83525987 47189176 52974053 26967975 30551934 X Great Plains Regional Medical Center will distinguish itself as the leader in Western Oklahoma and the Eastern Texas Panhandle for comprehensive, cost effective, high quality healthcare. We will meet the healthcare needs of patients in our service area while achieving cost effective quality outcomes. We will maintain and enhance collaborative relationships with physicians to better serve the healthcare needs of our service area. We will maintain and continually enhance health promotion, patient education and disease prevention for patients in our service area. 1 0 41966173 7850 49265865 Farmers Union Hospital Association, DBA Great Plains Regional Medical Center in Elk City, Oklahoma (hereinafter referred to as GPRMC) is a 62-bed hospital that provides quality health care regardless of race, religion, creed, sex, national origin, handicap, age or ability to pay. Reimbursement for services rendered is critical to the operation and stability of GPRMC, it is recognized that not all individuals possess the ability to purchase essential medical services. In keeping with the Hospital's commitment to serve all members of its community, free care and/or subsidized care, care provided to persons covered by government programs at below cost, and health care activities and programs to support the community will be considered whether the need and/or individual's inability to pay exists.GPRMC served over 1,835 Inpatients that include, Medical, Intensive Care, Inpatient Rehabilitation, Newborns, Swing Bed and Senior Care. These services produced more than 9,100 Inpatient days. During the year we treated 11,530 patients in the Emergency Department. Our Surgical teams performed 3,000 surgeries. GPRMC provides care to persons covered by governmental and other programs as part of its mission to the community. These programs may not pay full charges to the extent reimbursement is below full charges. GPRMC recognized these amounts as contractual adjustments in meeting its mission to the entire community. Also, in recognizing its mission to the community, GPRMC provides services for those unable to pay. Additionally, GPRMC has provided services to others who are either unwilling or unable to qualify for charity care guidelines but who are still unable to pay. Community benefit is also provided by GPRMC by providing reduced price services, free programs offered throughout the year which GPRMC believes will serve a bona fide community health need. See Schedule H for more information regarding these activities.The Hospital provides health care services to patients who meet certain criteria under its charity policy without charge or amounts less than established rates. Because the Hospital does not pursue collection amounts determined to qualify as charity care, they are not recorded as revenue. The amount of charges foregone for services provided under the Hospital's charity care policy were approximately $323,000 in 2021. Total direct and indirect cost related to these foregone charges were $102,000, based on an average ratio of cost to gross charges. 41966173 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 1 0 0 1 79 0 1 546 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 1 1 OK X Monica Scott 5808215500 1801 W 3rd Street Elk City OK 73544 Jeff Jackson - Chair until Sept/Member as of Oct 1.00 1.00 X X 0 0 0 J Coffey MD - Vice Chair until Sept/Chair as of Oct 1.00 1.00 X X 0 0 0 Colby Brewster - Secretary until Sept/Vice Chair as of Oct 1.00 1.00 X X 0 0 0 Kyle Zybach - Finance Chair and Secretary as of Oct 1.00 1.00 X X 0 0 0 Edward Albert Member 1.00 1.00 X 0 0 0 Erick DeRocher DO Member/Medical Staff 20.00 1.00 X 10500 0 0 Paul Kumpf Member 1.00 1.00 X 0 0 0 Jack Morrison DDS Member 1.00 1.00 X 0 0 0 Craig Phelps MD Member until Dec/Medical Staff 20.00 1.00 X 15600 0 0 Danny Sprowls Member 1.00 1.00 X 0 0 0 Roy Greenway MD Member as of Jan/Medical Staff 40.00 1.00 X 711752 0 33729 Corey Lively CEO 40.00 0.00 X 342997 0 21196 Monica R Scott CFO 40.00 0.00 X 147325 0 29268 Jon Gill COO 40.00 0.00 X 177125 0 33480 Steven Winham MD Surgery 40.00 0.00 X 290911 0 2053 Tyson Fisher MD Surgery 40.00 0.00 X 639769 0 42850 James Bass MD Family Practice 40.00 0.00 X 244856 0 42667 Tiffany Dupree DO Obstetrics & Gynecology 40.00 0.00 X 286618 0 25088 Brad Whinery MD Family Practice 40.00 0.00 X 196799 0 10740 3064252 0 241071 24 0 1 0 Premier Physician Staffing 20 E 5th St STE 620 Tulsa OK 74103 Physician ER coverage 3008643 Prime Physician Staffing PLLC 20 E 5th St STE 620 Tulsa OK 74103 Hospitalist physician coverage 1303125 Horizon PO Box 840839 Dallas TX 75284 Senior Care Management 669178 WebTPA 8500 Freeport Parkway Suite 400 Irving TX 75063 Insurance Management 549897 Western Oklahoma Anesthesia 1710 West 3rd Elk City OK 73644 Anesthesia Coverage 444604 8 4845794 643402 560000 5489196 Net patient service 621990 47848311 47848311 Cafeteria 722210 309099 306457 2642 Daycare center 624410 131796 131796 Plains Diag Imaging 900099 110365 110365 868936 868936 49268507 1287985 1287985 17221 17221 531242 0 531242 531242 531242 4625877 4535937 89940 89940 89940 56684091 49265865 2642 1926388 X 6350 6350 1500 1500 1403958 723996 679962 339030 339030 17990081 13895106 4094975 52134 41148 10986 4605210 3549388 1055822 1292234 981278 310956 124256 124256 10994823 7668025 3326798 122337 459 121878 1406567 734836 671731 408034 151710 256324 1059817 222854 836963 80152 70529 9623 28080 14270 13810 1390884 1296631 94253 3365589 3136673 228916 754204 208822 545382 Medical supplies 8676116 8648261 27855 Food 480867 3181 477686 Repairs and maintenance 451739 142760 308979 Dues and Subscriptions 225005 33040 191965 280287 96326 183961 55539254 41966173 13573081 0 3078 2765 5574753 4738213 7781081 7635947 1776879 1908189 696335 479639 92533978 61062522 31540723 31471456 23722320 34035327 2151573 2266263 817623 899528 84000 84000 8786 4660 74157151 83525987 4804884 6284665 9578614 13322854 810363 4094497 4094497 28711181 28461674 47189176 52974053 X 26967975 30551934 26967975 30551934 74157151 83525987 1144837 2439122 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 861828 861828 60314262 34351668 25962594 29674921 25295527 4379394 1682967 1415327 267640 31471456 Payable to related party 27873800 Estimated third-party payor settlements 587874 28461674 X 59123213 2439122 2439122 56684091 0 56684091 55539254 0 55539254 0 55539254 Part X, Line 2: The Hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. 1 1 X 1 X 1 X 1 1 0 0 102000 102000 0.00180 543617 543617 0.00980 645617 645617 0.01160 6174640 4196012 1978628 0.03560 6174640 4196012 1978628 0.03560 6820257 4196012 2624245 0.04720 1 8062821 1225549 14583188 16060819 -1477631 X 1 1 1 Plains Diagnostic Imaging LLC Radiology services 0.65720 0.00000 0.34280 1 1 Great Plains Regional Medical Center 1801 W 3rd Street Elk City OK 73644 www.gprmc-ok.com 2210 X X X Great Plains Regional Medical Center 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X www.gprmc-ok.com/about/chna X 1 18 1 www.gprmc-ok.com/about/chna 0 1 X 100.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X www.gprmc-ok.com/patient/assistance X www.gprmc-ok.com/patient/assistance X www.gprmc-ok.com/patient/assistance X X X X X 1 X 0 X X X X 1 X 0 0 Great Plains Regional Medical Center Part V, Section B, Line 5: Great Plains Regional Medical Center hosted three community meetings between March 6, 2019 and March 27, 2019. The Oklahoma Office of Rural Health facilitated these meetings. Community members in attendance at these meetings included representatives from: -Great Plains Regional Medical Center -City of Elk City -Elk City Fire Department -Elk City Chamber of Commerce -Area Agency on Aging -Hospital Foundation -Elk City Public Schools Average attendance at the community meetings was 15 community members. Community members received a mailed invitation from the hospital. Those invited included: board members, foundation members, Elk City and Western Oklahoma Wellness Initiatives coordinator, AirEvac, City of Elk City officials, Beckham County Health Department, and GPRMC department directors. The director of Western Oklahoma Family Care Center was invited because of the low-income population served. Therefore, a significant effort was placed on including representatives from the public health sector and those who serve the underserved, low-income or racially diverse populations to gain their perspective of needs in the community. Great Plains Regional Medical Center Part V, Section B, Line 11: The Community Health Needs Assessment (CHNA) was completed in 2018.The following are the needs addressed in FY2021:It must be noted that the Covid-19 pandemic greatly impacted the implementation of some of the priorities and outreach opportunities during 2021 to present. Due to the unprecedented Covid-19 pandemic, Great Plains Regional Medical Center was not able to host events to promote social distancing and following recommendations outlined the CDC's website.Insurance and uninsured individuals1. The hospital and local providers are continuing to collaborate in terms of providing physician services and staffing. The hospital has a financial assistance policy in place to assist uninsured patients. 2. The hospital also has a representative from the Department of Veterans Affairs one day each week to help with those that need assistance in obtaining state and federal veterans' benefits. Unfortunately, because of the Pandemic GPRMC had to suspend this service. Preventative care1. GPRMC hosted Go Red Women Event and Health Discussion for the community. 2. In terms of outreach and programs the community would like to see, it was noted the hospital and physician offices could take a larger focus on case management and increase the number of preventative exams, wellness exams, maximize smoking cessation, and counseling. 3. The hospital continued to make available smoking cessation pamphlet and information available to community members. 4. The hospital had to postpone annual health fair because of the Pandemic. Health Fair for 2022 has been scheduled for April.5. The Women's Center provided childbirth classes throughout the year at no charge to the community.6. Mental Health - Walk for Alzheimer's is another event we are passionate about here at GPRMC. Our Senior Care Unit (only geriatric inpatient facility in Western Oklahoma) leads the charge to show awareness and support for families dealing with this disease. Substance Abuse/Drug Abuse1. In terms of current programs, there is a female recovery center located in Sayre. There is also a grant for middle school students to prevent the use of e-cigarettes and tobacco. There is also the 1-800 quit line available for assistance with decreasing tobacco use. 2. The DARE program was previously successful in educating youth. It was also noted that there is a lack of knowledge of existing resources and partners in this area to refer patients for help. 3. The hospital does note that this is a concern in the community; however, it is largely beyond the scope of services provided by this facility. Great Plains Regional Medical Center Part V, Section B, Line 13h: Great Plains Regional Medical Center (GPRMC) provides 100% financial assistance for non-elective services under the presumptive guidelines if the patient/responsible party meets any of the below listed criteria:a. Is uninsured and has an estimated family income of less than 200% FPL, and a Health Care Credit score of less than 620 as determined by externally available data sources such as credit agenciesb. Is Homeless or received care from a homeless clinicc. Is deceased with no known estate or living spouse Part I, Line 3c: Great Plains Regional Medical Center (GPRMC) provides 100% financial assistance for non-elective services under the presumptive guidelines if the patient/responsible party meets any of the below listed criteria:a. Is uninsured and has an estimated family income of less than 200% FPL, and a Health Care Credit score of less than 620 as determined by externally available data sources such as credit agenciesb. Is Homeless or received care from a homeless clinicc. Is deceased with no known estate or living spouse Part I, Line 7: Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost report. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report. Part III, Line 2: The amount reported on line 2 represents implicit price concessions. The Hospital determines its estimate of implicit price concessions based on its historical collection experience with this class of patients. Part III, Line 3: An estimated 15.2% of implicit price concessions in 2020 are attributable to patients potentially eligible for financial assistance. This is based on the percentage of individuals in the county under the federal poverty level. Part III, Line 4: The footnote to the Organization's financial statements that describes implicit price concession is located in the audited financial statement report on pages 10 and 11. Part III, Line 8: Great Plains Regional Medical Center provides services to Medicare patients understanding there will be write-offs and knowing the Organization will not recover the costs of the services provided. Providing these services is essential to the community and therefore increases access to healthcare services, which is a community benefit. Both the total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by the Centers for Medicare and Medicaid Services. Part III, Line 9b: GPRMC patients who qualify for charity care and who are cooperating in good faith to resolve their discounted hospital bills, are offered extended payment plans. During this time GPRMC will not send unpaid bills to outside collection agencies, and will cease all collection efforts. Great Plains Regional Medical Center will not impose extraordinary collections actions such as wage garnishments; liens on primary residences, or other legal actions for any patient without first making reasonable efforts to determine whether that patient is eligible for charity care under the financial assistance policy. Patients have 120-days from their first statement to apply for charity care with no extraordinary collection actions.Patients are pre-screened for charitable services before receiving tests and a determination is made as to the financial ability to pay. If patients are pre-qualified for services, the collection process is ceased. Part VI, Line 2: GPRMC relies on input from physicians, other healthcare providers, community leaders, the Board of Directors and citizens in the community to assess the needs of the community. We look at out-migration studies to determine what services individuals from the community are seeking and receiving from outside locations. We also consider comparisons of the volume of physician specialties in our area to nationally recognized data. The factors are all considered in addition to feedback from patients in the community to determine shortages of care areas. Part VI, Line 3: Assistance is discussed with patients as part of the intake process. Patients are screened at registration to determine need for financial assistance and then are given copies of the financial assistance policy. Upon request, we try to assist patients with paperwork for medical assistance such as Medicare, Medicaid, disability, or financial assistance.Notification about financial assistance is disseminated from Great Plains Regional Medical Center through various means. This includes notice in patient bills and the Conditions of Admissions form. In addition, information is posted in emergency rooms, the admitting and registration departments and the hospital business offices. A request for financial assistance may be made by the patient, patient family member, close friend, or any associate of the patient, subject to applicable privacy laws. Part VI, Line 4: Great Plains Regional Medical Center is a 62 bed acute care facility located in Beckham County. The hospital provides 24-hour emergency department, acute inpatient services, hospitalist services, laboratory, diagnostic radiology (CT, ultrasound, MRI, nuclear medicine, echocardiograms, mammography, and cardiac catheterization), intensive care, and cancer treatment center (prostate, breast, and head and neck cancers).The primary medical service area of Great Plains Regional Medical Center includes the zip code areas of Elk City, Sayre, Erick, Hammon, Cheyenne, Cordell, Canute, Mangum, Sentinel and Clinton. The primary medical service area experienced a population increase of 7.3 percent from the 2000 Census to the 2010 Census. This same service area experienced a population decrease of 1.0 percent from the 2010 Census to the latest available, 2016-220, American Community Survey. The secondary medical services area is comprised of the zip code areas of Burns Flat, Carter, Weatherford, Sweetwater, Reydon, Arnett, Lone Wolf, Durham, Butler, Leedey, Foss, Dill City, Hobart, Granite, Hollis, and Altus. The secondary medical service area experienced an increase in population of 25.4 percent from 2000 to 2010 followed by a population decrease of 4 percent from 2010 to the 2016-2020 American Community Survey.The 2020 annual unemployment rate for Beckham County was 7.5 percent. This rate is higher than the state (6.1%) but lower the national (8.1%). All of these rates are non-seasonally adjusted. The most recent monthly estimates show Beckham County to be lower than 2020 with a 2 percent rate. This is slightly higher than the state (1.8%) but lower than the national (3.7%) rates. The share of individuals below the poverty threshold for income and household size is calculated by the U.S. Census Bureau. In 2020, the poverty rate for all ages in Beckham County was 18.8 percent. This is higher than the state and national rates. The poverty rate for children, or those under the age of 18, is higher than both the state and national rates. Part VI, Line 5: Our Board of Directors is comprised of citizens from the community, from business owners to retired individuals. This broadly based group provides us with a broad perspective on the needs of the community. GPRMC extends medical privileges to local and area physicians. They must apply for privileges and be approved by the medical staff and Board of Director. Surplus funds are reinvested into facility and equipment upgrades and free programs throughout the year.GPRMC publishes notices in the area newspapers reaching 8,000 to 10,000 homes. The notices provide information on new physicians and medical services.GPRMC provides education to community on CPR, pre-natal education and Heart Disease Prevention. The Medical Center is one of two designated donor locations for the community wide blood drive held several times per year.Great Plains Regional Medical Center sponsors healthcare initiatives for the community. Some of these include diabetes self-management classes for patients with new or uncontrolled diabetes and education to local nursing home staff regarding care of patients with dementia and other types of behavioral disorders. Due to the shortage of nurses in the area, scholarships are awarded to students wishing to pursue degrees in the medical field. Education programs are presented at the local adult learning center discussing education needed to fulfill the requirements for employment in a hospital setting. We also participate in several career fairs for different schools in our area. GPRMC works in cooperation with educators by providing a clinical rotation training environment for students of various fields including physician, nursing, pharmacy, lab, radiology and medical records. We participate with area high schools in the job shadow program. Students interested in health careers may observe our staff in the work setting and obtain a first-hand experience. The Medical Center developed a collaboration with Western Oklahoma State College to provide distance learning classes for those in the community wishing to pursue nursing degrees. GPRMC provides a classroom in the local community. Additionally, in-kind services are provided to Western Oklahoma State College. This is vital to prospective students pursuing nursing degrees that would not have been able to drive the long distance to the College.In-kind services are also provided to Southwestern Oklahoma State University for college classes. The Hospital provides a room, Monday - Friday for teaching general education classes in both fall and spring semesters. X X X X 0 0 0 0 0 0 0 0 0 Roy Greenway MD Member as of Jan/Medical Staff 503669 0 207541 0 542 0 1425 0 32304 0 745481 0 0 0 Tyson Fisher MD Surgery 538746 0 100490 0 533 0 1425 0 41425 0 682619 0 0 0 Corey Lively CEO 311537 0 29565 0 1895 0 0 0 21196 0 364193 0 0 0 Tiffany Dupree DO Obstetrics & Gynecology 260031 0 25000 0 1587 0 1263 0 23825 0 311706 0 0 0 Steven Winham MD Surgery 290737 0 0 0 174 0 0 0 2053 0 292964 0 0 0 James Bass MD Family Practice 241860 0 0 0 2996 0 1242 0 41425 0 287523 0 0 0 Jon Gill COO 168843 0 7295 0 987 0 0 0 33480 0 210605 0 0 0 Brad Whinery MD Family Practice 80320 0 115897 0 582 0 0 0 10740 0 207539 0 0 0 Monica R Scott CFO 138045 0 8019 0 1261 0 727 0 28541 0 176593 0 0 0 John Mark Phelps Family relation to Dr. Craig Phelps, Board Member 55558 Compensation as employee 0 Sarah Phelps Family relation to Dr. Craig Phelps, Board Member 139596 Compensation as employee 0 Jacob Jackson Family relation to Jeff Jackson, Board Chair 143876 Compensation as employee 0 X 1 560000 Appraisal 0 0 0 0 Part I, Column (b): The Organization is reporting in Part I, column (b) the number of items donated. Form 990, Part III, line 2 Robotic Joints - Orthopedic Surgeries began in August 2020. Form 990, Part VI, Section A, line 1 The Executive Committee is composed of the officers of the Board; President, Vice President, Secretary and Treasurer. The Hospital's Board President serves as the Chair of the Executive Committee. Other members may be added if advisable. The Executive Committee directly represents the Board and possesses the power to act for the Board within limits set for it by the Board, on matters needing immediate attention, prior to regular board meetings, and such other powers as delegated to it by the Board. The Executive Committee reports to the Board of Directors at the next regular or at the next special meeting called for that purpose. Form 990, Part VI, Section A, line 6 Members are individuals who have voting shares in Great Plains Regional Medical Center. Membership is obtained through transfers of existing memberships. Transfers normally result either through voluntary surrender of a membership from a current member who is no longer interested in retaining their membership or through the death of a member who has no immediate family interested in retaining the membership. Each individual is allowed only one membership and there is only one vote allowed per membership. Form 990, Part VI, Section A, line 7a Governing Board members are appointed through nomination and a majority vote election by the membership at annual meetings. Form 990, Part VI, Section A, line 7b Any amendments to the Governing Board Bylaws and Rules & Regulations have to be approved by a majority vote of the membership. Per the Organization's Bylaws, the members are the supreme authority of the Association in all its affairs. Form 990, Part VI, Section B, line 11b The Form 990 is presented and reviewed at the governing Board's monthly meeting. The 990 is also posted on the governing Board's website prior to the meeting. Form 990, Part VI, Section B, line 12c All members of the governing board, officers and key employees receive a copy of the Conflict of Interest Policy on an annual basis. The individuals are required to review the policy and complete and sign the questionnaire attesting to their understanding of the policy and that their answers are true and accurate. The board as a whole reviews the conflict of interest statements. Any potential conflicts are discussed and depending on the conflict the board decides the appropriate action to take. Form 990, Part VI, Section B, line 15a When determining the CEO's compensation, Human Resources conducts a comparative analysis of compensation by position using state, multi-state, regional and national compensation data. Data is selected from hospitals with similar bed size, revenue and other similar area comparatives. Human Resources then submits a report to the Executive Committee. This is completed on an annual basis. The Executive Committee reviews the data, confirms the data with an independent auditor and recommends appropriate CEO compensation to the Board of Directors. All other positions within the Hospital are reviewed annually by Human Resources and approved by the CEO. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Form 990, Part IX, line 11g Consulting: Program service expenses 3,912,936. Management and general expenses 1,792,357. Fundraising expenses 0. Total expenses 5,705,293. Service contracts: Program service expenses 535,986. Management and general expenses 467,788. Fundraising expenses 0. Total expenses 1,003,774. Contract labor: Program service expenses 3,207,931. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,207,931. Purchased services: Program service expenses 11,172. Management and general expenses 1,066,653. Fundraising expenses 0. Total expenses 1,077,825. GPRMC Holdings Inc PO Box 2339 Elk City OK 73648 824447018 Own property and lease to hospital to operate charitably OK 501(c)(3) Line 12b, II Great Plains Regional Medical Center 1 Plains Diagnostic Imaging LLC 1705 W 2nd St Elk City OK 73644 261530951 Radiology services and equipment rental OK Great Plains Regional Medical Center Related 110365 566172 0 1 0.65720 1 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 1 1 Plains Diagnostic Imaging LLC K 518000 General ledger Plains Diagnostic Imaging LLC S 110365 Amount from K-1 Plains Diagnostic Imaging LLC A 291 Amount from K-1 GPRMC Holdings Inc K 1385964 General ledger