2021-07-21T15:25:49-05:00 2020-09-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2019-10-01 480545183 Lindsborg Community Hospital Association LIND 7852273308 605 West Lincoln Lindsborg KS 674562328 Larry Van Der Wege Administrator 7852273308 2021-07-15 1 Kim Hunwardsen CPA P00484560 6122536500 2021-07-07 2019 2022-09-23 18:48:47Z Larry Van Der Wege 605 West Lincoln Lindsborg KS 674562328 11528442 0 X www.lindsborghospital.org X 1944 KS Operation of critical access hospital. 9 9 0 9 0 0 112625 486447 11593250 11026521 9036 -3283 0 0 11714911 11509685 0 1500 0 0 6892500 7186769 0 0 12937 4418079 4108618 11310579 11296887 404332 212798 11896628 14784279 1486710 4157748 10409918 10626531 X Partners caring for the health of the Smoky Valley communities. 0 0 8209966 1500 11026521 Lindsborg Community Hospital (LCH) operates a critical access hospital in a community qualifying for such designation under federal law. The facilities are adequate for treatment or care of individuals suffering from mental or physical illness, disease, injury or deformity in an acute care, skilled nursing care, outpatient or emergency room setting. LCH cares for residents of the Smoky Valley with the operation of a 24/7 emergency room. 1,487 emergency room patients were seen in the 2020 fiscal year. 3,238 urgent care visits and 212 cardiac rehab visits improved the health of community members. 10,626 visits were made in the Family Health Care Clinic to provide acute treatment, manage chronic conditions, or provide preventive care. 4,589 meals on wheels and 3,858 frozen meals were supplied to community members. Education was provided to the Smoky Valley Community through Stepping On, Safe Sitter, and Chronic Disease Self-Management Program education. Employees of the LCH partner with various community groups to provide assistance to the Midsummer's Committee, Hyllningsfest Committee, Chamber of Commerce, and Strategic Alliance to name a few. Staff also provide leadership with the Sunflower Health Network, KHA Board of Directors, and the Sunflower (Kansas) HFMA Chapter. 8209966 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 X 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 0 X Laraine Gengler 7852273308 605 West Lincoln Lindsborg KS 674562328 X Chuck Oleen President 0.50 0.00 X X 0 0 0 Mike Rose Vice President 0.50 0.00 X X 0 0 0 Judy Neuschafer Secretary 0.50 0.00 X X 0 0 0 Tom Buffington Treasurer 0.50 0.00 X X 0 0 0 Denise Peterson Director 0.50 0.00 X 0 0 0 Ryan Biegert Director 0.50 0.00 X 0 0 0 Gretchen Norland Director 0.50 0.00 X 0 0 0 Mary Ann Carlson Director 0.50 0.00 X 0 0 0 Kenneth Johnson DVM Director 0.50 0.00 X 0 0 0 Larry Van Der Wege Administrator 40.00 0.25 X 0 0 0 Laraine Gengler CFO 40.00 0.25 X 0 0 0 Wendy Dinkel DO 36.00 0.00 X 0 0 0 Benjamin Dolezal MD 36.00 0.00 X 0 0 0 Luke Rosenbraugh MD 36.00 0.00 X 0 0 0 Teresa Pearson PA 42.00 0.00 X 0 0 0 Esther Carlson ARNP 39.00 0.00 X 0 0 0 0 0 0 0 0 0 0 Salina Regional Health Center 400 S Santa Fe Salina KS 67401 Payroll and other reimbursement 13730000 Simpson Construction Services Inc 567 W Douglas Wichita KS 67213 Construction 1388892 Rehabvisions 11623 Arbor St Omaha NE 68144 Therapy Services 623906 3 390538 95909 486447 Patient Revenue 621400 9979373 9979373 Pharmacy Revenue 621400 609567 609567 Sales Tax Revenue 900099 373809 373809 63772 63772 11026521 15474 15474 18757 -18757 -18757 -18757 11509685 11026521 0 -3283 X 1500 1500 324638 324638 71276 71276 5530148 4639832 890316 217729 184621 33108 654834 498118 156716 388144 305722 82422 3629 3629 12850 12850 2736 2736 1406387 1204486 201901 17543 17543 258933 123239 135694 247700 91140 156560 71901 2400 69501 7220 2920 4300 20692 16259 4433 900 900 940387 177568 762819 46701 16123 30578 Medical and Patient Sup 863327 858908 4419 Food Costs 69049 1582 67467 Dues, Licenses, and Tax 42867 9937 32930 Recruitment and Retenti 16712 1106 15606 79084 493 65654 12937 11296887 8209966 3073984 12937 186151 138255 3116327 1113148 150899 163360 160135 165881 11846464 6518852 5990374 5327612 1138961 1157962 1153781 6718061 11896628 14784279 668811 700505 3457243 57002 0 760897 0 1486710 4157748 X 10202171 10412469 207747 214062 10409918 10626531 11896628 14784279 X 212798 3815 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2736 2736 0 Part II-B, Line 1: The portion of annual dues paid to hospital and medical associations attributed to lobbying activities by the associations. 10442 10442 5772028 2334987 3437041 5727861 3923539 1804322 336133 260326 75807 5327612 Other Assets 161 Estimated Third-Party Payor Settlements 426568 Receivable from Salina Regional Health Center 6291332 6718061 X 11499038 0 11499038 10647 10647 11509685 13295246 2012821 2012821 11282425 14462 14462 11296887 Part X, Line 2: Lindsborg Community Hospital Assoication 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 financial statements. The organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalities are incurred. Part XI, Line 4b - Other Adjustments: Reclassification of revenue/expense accounts, net 1,525. Auxiliary revenue 9,122. Part XII, Line 4b - Other Adjustments: Reclassification of revenue/expense accounts, net 1,525. Auxiliary expense 12,937. 1 1 X 1 X 1 X 1 1 1 0 0 60000 60000 0.00530 319434 40327 279107 0.02470 379434 40327 339107 0.03000 62932 36382 26550 0.00240 2503 2503 0.00020 4501446 1456346 3045100 0.26960 2792 2792 0.00020 4569673 1492728 3076945 0.27240 4949107 1533055 3416052 0.30240 309 309 0.00000 309 309 0.00000 1 428902 5529038 5517751 11287 X 1 1 1 1 Lindsborg Community Hospital Association 605 W Lincoln St Lindsborg KS 67456 www.lindsborghospital.org H059001 X X X X Lindsborg Community Hospital 1 0 0 1 X X X X X X X X 18 1 1 1 1 X See Line 10a X 1 18 1 www.lindsborghospital.org/about/message_from_ceo.php 0 1 X 200.000000000000 300.000000000000 X X X X X X 1 1 X X X 1 X www.lindsborghospital.org/patients/financial_assistance.php X www.lindsborghospital.org/patients/financial_assistance.php X www.lindsborghospital.org/patients/financial_assistance.php X X X X X 1 X 0 X X X X 1 X 0 0 Lindsborg Community Hospital Part V, Section B, Line 5: The McPherson County Health Needs Assessment data collection process included gathering opinions from county sources using a survey and quantitative data from secondary sources. The survey instrument utilized in past assessments was reviewed with changes suggested by a team of focus group members from throughout the county.On March 28, 2019, the electronic survey (along with an offered printable format) was made available to the general public. The publicized date for completion was April 12, but results continued to come in after that date. Publicity included local radio and newspaper announcements, social media pages, county hospital and public health websites, links sent to specific groups such as area businesses, senior populations, and personal invitations to individuals representing a broad spectrum of the population based on professional affiliations, interests and community engagement. Also included in the group receiving a specific invitation to complete the survey was an organization called Step MC who advocates for and meets regularly with medically underserved and low income populations in the county. "Step" stands for "Steps to End Poverty and their mission is to walk alongside those in the program to foster connections and create pathways to help them out of poverty. The survey was shared with the participants in the program who were encouraged to participate. The various other organizations who were provided links shared the link and encouraged their constituents to participate as well. All respondents were anonymous to survey administrators and paper copies were available as stated clearly in the communication process. Lindsborg Community Hospital Part V, Section B, Line 6a: McPherson Hospital, McPherson, Kansas Mercy Hospital, Moundridge, Kansas Lindsborg Community Hospital Part V, Section B, Line 6b: McPherson County Public Health Department Lindsborg Community Hospital Part V, Section B, Line 11: The needs identified in the most recent CHNA were barriers to access, risky behaviors, and health problems.In the current year the facility has taken the following actions to address barriers to access. An Orthopedic Surgeon has begun rounding on acute and skilled care patients as needed at LCH. A rheumatology specialty clinic is in development, and the doctor will begin visits at LCH in February 2021. Weekly cardiology and general surgery clinics continue. To make patients accessible to Avera eEmergency in our negative air flow rooms, an iPad was furnished by Avera Health and contractual arrangements were made for the iPad coverage. By the end of 2020, LCH has performed 900 telemedicine visits due to primary care visits that had been cancelled or converted to telemedicine as a result of COVID-19. These visits were especially useful with our area nursing homes due to closing down the facilities to outside visitors, including physicians. The Urgent Care space that was remodeled in 2019 became the space where we were able to isolate, examine, and test those with COVID symptoms. Other Urgent Care patients were seen in the family medicine clinic exam rooms. As the rate of COVID patients increased in the fall of 2020, our Urgent Care exam and testing shifted to outside and then into the ambulance bay. It has been an incredibly valuable access point for our community. LCH also developed an access point for Bamlanivimab, a monoclonal antibody treatment for individuals with COVID. It has been administered with success. Another COVID access point has been vaccines. Vaccine planning commenced late in 2020 and vaccine administration to employees began in late 2020. We will begin vaccinating the general public in 2021 and it will continue through the pandemic. The following actions were taken to address risky behaviors. We plan to continue to perform alcohol and drug screening in the clinic and Emergency Department with referral to the Central Kansas Foundation or other facilities as needed. The Family Health Care Clinic has adopted policies to monitor and reduce the number of opioids, per Center for Disease Control (CDC) guidelines. Improved standardization and policies have been developed in the Emergency Department as well. A doctor joined LCH in 2018 and has become certified in prescribing Suboxone for treatment of opioid dependency. He will continue to provide and expand those services.The following actions were taken to address health problems. Mental health is a challenge throughout the state and county. Through discussion and collaboration with local mental health partners as well as the State facility in Larned, more timely access has improved. LCH continues to utilize the service of Prairie View Mental Health Services for emergency screening through telemedicine. LCH will continue to utilize their relations with Prairie View Mental Health and Veridian Behavioral Health to provide mental health care to its patients. Central Kansas Foundation is also utilized to assist those benefitting from a referral for alcohol or drug treatment. Lindsborg Community Hospital Part V, Section B, Line 13h: The methodology used to determine eligibility for financial assistance takes into consideration income, net assets, family size and resources available to pay for care. In addition, presumptive charity care may be applied in situations where all other avenues have been exhausted. Lindsborg Community Hospital Part V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy. 2 1 - Family Health Care Clinic 605 W Lincoln St Lindsborg KS 67456 Physician clinic 2 - Lindsborg Community Hospital Urgent Care 605 W Lincoln St Lindsborg KS 67456 Urgent care Part I, Line 3c: The methodology used to determine eligibility for financial assistance takes into consideration income, net assets, family size and resources available to pay for care. In addition, presumptive charity care may be applied in situations where all other avenues have been exhausted. 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. Amounts on lines 7e, 7f, and 7i are from the actual general ledger. Lines 7b and 7g were calculated utilizing the cost reports. Part I, Line 7g: Two provider based clinics are included in subsidized health services. Net revenues of $719,823 and costs of $2,450,987 were included for a net community benefit of $1,731,164. Part II, Community Building Activities: LCH participates in the Lindsborg Business Roundtable, a non-profit group. Part III, Line 2: The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concession based on its historical collection experience with this class of patients. 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 18 and 19. Part III, Line 8: The payments are compared to the actual cost of providing the service as arrived at through the Medicare cost reports. Medical services are provided to patients with Medicare coverage regardless of whether or not a surplus or deficit is realized. Providing Medicare services promotes access to healthcare services which are vitally needed by our community. Part III, Line 9b: LCH will not engage in extraordinary collection activities prior to making reasonable efforts to determine if a patient is eligible for financial assistance. The notification period for reasonable efforts starts with the date care is provided and ends 120 days after the date of the first statement. Statements and a final notice during the 120 days meet the reasonable efforts standard.Extraordinary collections activities may include referral to a collection agency and/or legal action. Collection/legal action may be used to collect amounts due if the responsible party refuses to cooperate in the financial assistance determination process and make and follow suitable payment arrangements. Failure to cooperate includes failure to submit required data and/or failure to submit required data within the specified time period. In addition, collection/legal action may be used to collect amounts due that remain after financial assistance determinations have been made and the responsible person fails to make and follow suitable payment arrangements. Part VI, Line 2: In addition to the CHNA process, LCHA participates in Strategic Alliance meetings which are held every 1-2 months. The Alliance consists of businesses and organizations in Lindsborg with the purpose of discussing strategic needs of the community and identifying where synergies can be developed. LCHA also participates in weekly meetings called the Ad Hoc RoundTable. This group meets to discuss activities and needs in the community. LCHA participates in a county Behavioral Health Task Force that meets every 2-3 months. The task force members include McPherson hospital administration and physicians, Prairie View Behavioral Health staff, law enforcement, the McPherson mayor and McPherson County Attorney, the Lindsborg Chief of Police, and LCHA's administrator.Medical Staff meets monthly to discuss clinical management of LCHA. Clinic providers and management meet monthly to discuss the operations of the Family Health Care Clinic. In both meetings, issues concerning needs of the community are discussed and addressed or at least brought to the attention of administration for development of an action plan.LCHA has a Patient and Family Advisory Council (PFAC) which is made up primarily of community members who are patients or family members of patients. The group meets monthly to discuss quality and other projects that LCHA is performing. As a part of the regular agenda, community members are given an opportunity to voice comments and concerns about needs of the community. Part VI, Line 3: The Hospital's charity care policy is posted in patient waiting rooms in a three-ring note book. Hospital employees have been instructed to direct anyone with questions regarding assistance to the Hospital's business office. Patients are educated by the financial services staff and social services staff who are able to provide assistance upon request and through policies posted to our website. Part VI, Line 4: The Organization serves the Smoky Valley Area including Lindsborg, Marquette, Falun, Roxbury, Gypsum, Assaria and other areas including McPherson, Salina, Smolan, Canton, and Galva. Approximately 8% of the Hospital's patients are uninsured or Medicaid patients. The community served by the Hospital is also served by two other hospitals, plus a Federally Qualified Health Center in Salina. Part VI, Line 5: The organization's governing body is comprised of individuals who reside within the Smoky Valley service area with members from Assaria, Lindsborg, Marquette, and Galva.Medical Staff privileges are extended to all qualified physicians in the community who apply. Surplus funds are utilized to provide home health services, health and education through the Lindsborg News-Record and the Marquette Tribune, Stepping On classes, Safe Sitter classes and frozen meals for purchase. The organization's governing body is comprised primarily of persons who reside in the organization's primary service area who are neither employees nor contractors of the organization nor family members thereof. The organization extends medical staff privileges to qualified physicians in its community for some or all of its departments. Surplus funds of the organization are returned to the organization to improve patient care through updated equipment and technology and care team member education. The organization operates an emergency room that is available 24/7 regardless of ability to pay. Through the assistance of a donor, the organization has trained 873 CNA students over the last 18 years through a partnership with Bethany Home and The Cedars. The students receive the training at no cost. The organization makes available to the surrounding area a wellness center open seven days a week without fees. Part VI, Line 6: Lindsborg Community Hospital is an affiliate of Salina Regional Health Center. We have a management and operating agreement. SRHC works with us to provide marketing services which reach the community members of the Smoky Valley, our service area. This may include marketing our services as well as those offered by SRHC and marketing our providers as well as SRHC providers. Kalli Weibert Daughter of Laraine Gengler, CFO 71276 Employment 0 Form 990, Part V, Line 1a, Number reported in Box 3 of Form 1096: Lindsborg Community Hospital Association has independent contractors, however, Salina Regional Health Center, the management company, pays all the independent contractors directly. The actual expense of each independent contractor is directly charged to the assigned entity. Form 990, Part V, Line 2a, Number of employees on W-3: Under a management agreement, Salina Regional Health Center (SRHC) is responsible for the daily management and operation of the hospital, including employment of all staff. All payroll and benefits are paid by SRHC and payroll reporting is done by SRHC. Allocable compensation by individual is charged to Lindsborg Community Hospital Association and is shown on line 7 of Part IX. Form 990, Part VI, Section A, line 3 The Hospital entered into a management and operating agreement with Salina Regional Health Center (SRHC) effective October 1, 2012. Under the agreement, SRHC is responsible for the daily management and operation of the Hospital, including the employment of all staff needed to manage and operate Lindsborg Community Hospital. For tax year 2019, SRHC paid the following salaries and benefits to the individuals listed in Part VII: Larry Van Der Wege $209,498 Laraine Gengler $115,140 Wendy Dinkel $331,499 Benjamin Dolezal $319,941 Luke Rosebraugh $275,094 Teresa Pearson $186,381 Esther Carlson $185,980 Form 990, Part VI, Section A, line 6 Lindsborg Community Health Care Foundation, Inc. a not-for-profit, 501c3 organization, is the sole member of Lindsborg Community Hospital. Form 990, Part VI, Section A, line 7a Lindsborg Community Health Care Foundation, Inc. being the sole member of Lindsborg Community Hospital, has the right to elect all board members. Form 990, Part VI, Section A, line 7b Lindsborg Community Health Care Foundation, Inc. is the sole member, and has the right to approve Lindsborg Community Hospital's by laws, articles of incorporation, and Board of Directors. Form 990, Part VI, Section A, line 8b There are no committees with broad authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The 990 is reviewed internally, and the Form 990 is made available to the board for review prior to filing. Form 990, Part VI, Section B, line 12c At the time of hire or election (in the case of directors) and annually thereafter, the officers, directors, and key employees provide the applicable conflict of interest disclosures which are completed to identify any relationships, positions, or circumstances in which it is believed a conflict may arise. If a conflict arises, the officer or director abstains from the vote of the conflicted position. The annual monitoring and review is part of the Organization's compliance plan. If a conflict is identified, it is either addressed by the board or referred to the management company for resolution. A report is submitted to the executive board concerning any interest disclosed. Form 990, Part VI, Section B, line 15a The Organization's process for determining Administrator's compensation begins with an initiative lead by the Executive Compensation Committee (ECC) of Salina Regional Health Center (SRHC). The ECC compares compensation and salary data provided by Integrated Health Strategies (IHS) for overall reasonableness of base compensation and total compensation for all SRHC executive staff. The ECC reviews the data and makes a recommendation to the SRHC board of trustees in a closed executive meeting. The process was last completed in 2020. Lindsborg Community Hospital's Administrator's salary is then set by the President/CEO of SRHC. The Lindsborg Community Hospital CFO's salary is set by Salina Regional Hospital Vice President of Finance using an annual salary survey and is increased using the same percentage as all other employees. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents and conflict of interest policy available to the public upon written request. Form 990, Part IX, line 11g Contract Labor: Program service expenses 1,108,649. Management and general expenses 193,738. Fundraising expenses 0. Total expenses 1,302,387. Service Contracts: Program service expenses 95,837. Management and general expenses 8,163. Fundraising expenses 0. Total expenses 104,000. Form 990, Part XI, line 9: Change in Auxiliary 3,815. Lindsborg Community Health Care Foundation Inc 605 W Lincoln Lindsborg KS 67456 480947732 Hospital support KS 501(c)(3) Line 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0