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COFFEYVILLE REGIONAL MEDICAL CENTER INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
COFFEYVILLE REGIONAL MEDICAL CENTER INC (EIN 48-1178846)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-11-08
IRS object ID
202113129349300916
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)
Return2021-11-08T07:33:14-06:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN481026809PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Wendling Noe Nelson & Johnson LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1623 SW 10th Ave Suite 300AddressLine1Txt
CityTopekaCityNm
State AbbreviationKSStateAbbreviationCd
ZIP66612ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN481178846EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Coffeyville Regional Medical Center IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOFFBusinessNameControlTxt
Phone6202511200PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11400 W 4th StreetAddressLine1Txt
CityCoffeyvilleCityNm
State AbbreviationKSStateAbbreviationCd
ZIP67337ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBRIAN LAWRENCEPersonNm
Person TitleCEOPersonTitleTxt
Phone6202511200PhoneNum
Signature2021-11-04SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstBRIANPersonFirstNm
Person LastLAWRENCEPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonEric L OttingPreparerPersonNm
PTINP00298454PTIN
Phone7852334226PhoneNum
Preparation2021-11-04PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerBrian LawrencePrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11400 W 4th StreetAddressLine1Txt
CityCoffeyvilleCityNm
State AbbreviationKSStateAbbreviationCd
ZIP67337ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$50,894,205GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresshttp://crmcinc.org/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1996FormationYr
Legal Domicile StateKSLegalDomicileStateCd
Activity Or MissionMedical care and services by an acute care hospital.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee462TotalEmployeeCnt
Total Volunteers62TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,402,524PYContributionsGrantsAmt
CY Contributions Grants$8,336,538CYContributionsGrantsAmt
PY Program Service Revenue$36,909,962PYProgramServiceRevenueAmt
CY Program Service Revenue$42,288,064CYProgramServiceRevenueAmt
PY Investment Income$221,878PYInvestmentIncomeAmt
CY Investment Income$109,780CYInvestmentIncomeAmt
PY Other Revenue$191,052PYOtherRevenueAmt
CY Other Revenue$159,823CYOtherRevenueAmt
PY Total Revenue$38,725,416PYTotalRevenueAmt
CY Total Revenue$50,894,205CYTotalRevenueAmt
PY Grants And Similar Paid$14,777PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$5,591CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$25,204,216PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$25,937,277CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$69,290CYTotalFundraisingExpenseAmt
PY Other Expenses$19,461,657PYOtherExpensesAmt
CY Other Expenses$22,660,004CYOtherExpensesAmt
PY Total Expenses$44,680,650PYTotalExpensesAmt
CY Total Expenses$48,602,872CYTotalExpensesAmt
PY Revenues Less Expenses-$5,955,234PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,291,333CYRevenuesLessExpensesAmt
Total Assets BOY$27,096,000TotalAssetsBOYAmt
Total Assets EOY$38,132,182TotalAssetsEOYAmt
Total Liabilities BOY$7,365,277TotalLiabilitiesBOYAmt
Total Liabilities EOY$16,298,761TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$19,730,723NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$21,833,421NetAssetsOrFundBalancesEOYAmt
MissionTo promote general health and well being through the development, promotion, improvement, and support of all forms of health care services in Coffeyville, Kansas and the surrounding area.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$43,322,687ExpenseAmt
Grant$5,591GrantAmt
Revenue$42,288,064RevenueAmt
DescCoffeyville Regional Medical Center operates an acute care hospital located in southeast Kansas. We provide inpatient, outpatient, urgent and emergent care, and physician services to all patients regardless of race, creed, sex, national origin, sexual preference, or ability to pay.Desc
Total Program Service Expenses$43,322,687TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document60IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee462EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Dale GuffeyBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6202511200PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11400 W 4thAddressLine1Txt
CityCoffeyvilleCityNm
State AbbreviationKSStateAbbreviationCd
ZIP67337ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Neal Barkley
Director2.00Yes (X)Yes (X)$0$0$0
Monte Coffman
Chairman2.00Yes (X)Yes (X)$0$0$0
Debbie Carter
Secretary/Treasurer2.00Yes (X)Yes (X)$0$0$0
Mike Ewy
Vice-Chairman2.00Yes (X)$0$0$0
Craig Correll
Director2.00Yes (X)$0$0$0
Jeff Morris
Director2.00Yes (X)$0$0$0
Dr Garrick Rettele
Director2.00Yes (X)$0$0$0
Brian Lawrence
CEO40.00Yes (X)$276,383$0$27,876
Dale Guffey
CFO beginning June 202040.00Yes (X)$90,410$0$14,747
Michael Orr
CFO through May 202040.00Yes (X)$210,914$0$0
Russell Allison
Physician40.00$650,344$0$45,190Yes (X)
Michelle McGuirk
Physician40.00$472,311$0$36,336Yes (X)
Aaron Russell
Physician40.00$434,778$0$52,257Yes (X)
Shravan Gangula
Physician40.00$412,664$0$55,581Yes (X)
Baba Abudu
Anesthesiologist40.00$376,897$0$44,578Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,924,701TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$276,565TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K25IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
BKD
PO Box 1190SpringfieldMO65801Consulting services$1,692,561
Green Country Emergency Physician
1145 S Utica 365TulsaOK74104ER Coverage$1,215,469
Spinal Neurosurgical Associates
6921 E 109th St STulsaOK74133Physician services$453,911
Regional Medical Laboratory
4142 South Mingo RoadTulsaOK74146Lab services$315,818
Medical Information Technology
MEDITECH CircleWestwoodMA02090Computer support$291,687
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K15CntrctRcvdGreaterThan100KCnt
Related Organizations$454,249RelatedOrganizationsAmt
Government Grants$7,860,256GovernmentGrantsAmt
All Other Contributions$22,033AllOtherContributionsAmt
Total Contributions$8,336,538TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net patient service revenue621110$40,658,668$40,658,668
340b Pharmacy446110$1,277,600$1,277,600
Ambulance services621910$229,563$229,563
Education, wellness, and miscella900099$111,059$111,059
Other patient related services621110$11,174$11,174
FieldValueIRS element (for citing)
Total Program Service Revenue$42,288,064TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$106,780TotalRevenueColumnAmt
Exclusion$106,780ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$27,364RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$27,364RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$27,364TotalRevenueColumnAmt
Exclusion$27,364ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$3,000OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$3,000OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,000TotalRevenueColumnAmt
Exclusion$3,000ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescCafeteria and dietary incomeDesc
Business722310BusinessCd
Total Revenue Column$132,459TotalRevenueColumnAmt
Exclusion$132,459ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$132,459OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$50,894,205TotalRevenueColumnAmt
Related Or Exempt Func Income$42,288,064RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$269,603ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$5,591TotalAmt
Program Services$5,591ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$620,329TotalAmt
Management And General$620,329ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$20,038,310TotalAmt
Program Services$19,073,842ProgramServicesAmt
Management And General$918,486ManagementAndGeneralAmt
Fundraising$45,982FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,696,935TotalAmt
Program Services$1,623,953ProgramServicesAmt
Management And General$68,998ManagementAndGeneralAmt
Fundraising$3,984FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,261,451TotalAmt
Program Services$2,122,908ProgramServicesAmt
Management And General$133,434ManagementAndGeneralAmt
Fundraising$5,109FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,320,252TotalAmt
Program Services$1,237,736ProgramServicesAmt
Management And General$79,479ManagementAndGeneralAmt
Fundraising$3,037FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$116,580TotalAmt
Management And General$116,580ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$51,707TotalAmt
Management And General$51,707ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$8,619,238TotalAmt
Program Services$6,372,925ProgramServicesAmt
Management And General$2,244,099ManagementAndGeneralAmt
Fundraising$2,214FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$105,645TotalAmt
Management And General$105,645ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$131,294TotalAmt
Program Services$83,484ProgramServicesAmt
Management And General$45,634ManagementAndGeneralAmt
Fundraising$2,176FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$54,324TotalAmt
Program Services$47,718ProgramServicesAmt
Management And General$6,508ManagementAndGeneralAmt
Fundraising$98FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$750,278TotalAmt
Program Services$599,097ProgramServicesAmt
Management And General$149,940ManagementAndGeneralAmt
Fundraising$1,241FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$55,700TotalAmt
Program Services$49,227ProgramServicesAmt
Management And General$6,444ManagementAndGeneralAmt
Fundraising$29FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$8,892TotalAmt
Program Services$8,084ProgramServicesAmt
Management And General$808ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$114,360TotalAmt
Program Services$114,360ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,845,954TotalAmt
Program Services$2,416,275ProgramServicesAmt
Management And General$425,512ManagementAndGeneralAmt
Fundraising$4,167FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$361,843TotalAmt
Program Services$317,843ProgramServicesAmt
Management And General$43,349ManagementAndGeneralAmt
Fundraising$651FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
Pharmacy drugs$4,283,556$4,283,556
Medical supplies$4,076,673$4,076,673
Medicaid provider asses$254,808$254,808
Dues & subscriptions$214,927$163,804$51,062$61

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$614,225TotalAmt
Program Services$470,803ProgramServicesAmt
Management And General$142,881ManagementAndGeneralAmt
Fundraising$541FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$48,602,872TotalAmt
Program Services$43,322,687ProgramServicesAmt
Management And General$5,210,895ManagementAndGeneralAmt
Fundraising$69,290FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,141,237BOYAmt
EOY$2,178,095EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,104,881BOYAmt
EOY$9,984,806EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,679,325BOYAmt
EOY$5,610,610EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,333,231BOYAmt
EOY$1,667,097EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$365,094BOYAmt
EOY$270,559EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$70,327,827LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$54,739,661LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$16,000,200BOYAmt
EOY$15,588,166EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,472,032BOYAmt
EOY$2,832,849EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$27,096,000BOYAmt
EOY$38,132,182EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$5,211,279BOYAmt
EOY$5,465,175EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
EOY$9,205,451EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,978,378BOYAmt
EOY$1,598,135EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$175,620BOYAmt
EOY$30,000EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,365,277BOYAmt
EOY$16,298,761EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$17,244,198BOYAmt
EOY$19,497,323EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,486,525BOYAmt
EOY$2,336,098EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$19,730,723BOYAmt
EOY$21,833,421EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$27,096,000BOYAmt
EOY$38,132,182EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$2,291,333ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$188,635OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

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)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other OrganizationsYes (1)GrantsOtherOrganizationsInd
Grants Other Organizations$5,523GrantsOtherOrganizationsAmt
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other Activities0OtherActivitiesInd
Total Lobbying Expenditures$5,523TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationCoffeyville Regional Medical Center, Inc. is a member of the Kansas Hospital Association and American Hospital Association. These organizations engage in lobbying activities for hospital and general health care interests as part of the services provided to members.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$370,668BeginningYearBalanceAmt
Contributions$30,000ContributionsAmt
Investment Earnings Or Losses$17,809InvestmentEarningsOrLossesAmt
Other Expenditures$17,809OtherExpendituresAmt
End Year Balance$400,668EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$370,668BeginningYearBalanceAmt
Investment Earnings Or Losses$22,011InvestmentEarningsOrLossesAmt
Other Expenditures$22,011OtherExpendituresAmt
End Year Balance$370,668EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$370,668BeginningYearBalanceAmt
Investment Earnings Or Losses$28,901InvestmentEarningsOrLossesAmt
Other Expenditures$28,901OtherExpendituresAmt
End Year Balance$370,668EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$370,668BeginningYearBalanceAmt
Investment Earnings Or Losses$33,894InvestmentEarningsOrLossesAmt
Other Expenditures$33,894OtherExpendituresAmt
End Year Balance$370,668EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$370,668BeginningYearBalanceAmt
End Year Balance$370,668EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$76,477OtherCostOrOtherBasisAmt
Book Value$76,477BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$26,538,970OtherCostOrOtherBasisAmt
Depreciation$19,075,906DepreciationAmt
Book Value$7,463,064BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$24,877,439OtherCostOrOtherBasisAmt
Depreciation$18,640,042DepreciationAmt
Book Value$6,237,397BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$18,834,941OtherCostOrOtherBasisAmt
Depreciation$17,023,713DepreciationAmt
Book Value$1,811,228BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$15,588,166TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
Other receivables$291,355
Beneficial interest in net assets of foundation$1,947,521
Sales tax receivable$212,903
Estimated third-party payor settlements$381,070
FieldValueIRS element (for citing)
Total Book Value Other Assets$2,832,849TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescLiability for receivables sold with recourseDesc
Amt$30,000Amt
FieldValueIRS element (for citing)
Total Liability$30,000TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$50,705,570TotalRevEtcAuditedFinclStmtAmt
Other Revenue-$188,635OtherRevenueAmt
Revenue Not Reported-$188,635RevenueNotReportedAmt
Revenue Subtotal$50,894,205RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$50,894,205TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$48,602,872TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$48,602,872ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$48,602,872TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:The Coffeyville Regional Medical Center Foundation's endowment consists of a fund established for dietary scholarships.
Part X, Line 2:The Medical Center is a not-for-profit corporation as described in Section 501(c)(3) of the Internal Revenue Code and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code.
Part XI, Line 2d - Other Adjustments:Decrease in beneficial interests in net assets of Foundation -188,635.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other250.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically Available0ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$886,517TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$197,461DirectOffsettingRevenueAmt
Net Community Benefit Expns$689,056NetCommunityBenefitExpnsAmt
Total Expense0.01420TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,864,407TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,250,310DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,614,097NetCommunityBenefitExpnsAmt
Total Expense0.09490TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,750,924TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,447,771DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,303,153NetCommunityBenefitExpnsAmt
Total Expense0.10910TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,148,220TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,028,009DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,120,211NetCommunityBenefitExpnsAmt
Total Expense0.10530TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,148,220TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,028,009DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,120,211NetCommunityBenefitExpnsAmt
Total Expense0.10530TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,899,144TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,475,780DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,423,364NetCommunityBenefitExpnsAmt
Total Expense0.21440TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$1,190,652BadDebtExpenseAmt
Bad Debt Expense Attributable$147,978BadDebtExpenseAttributableAmt
Reimbursed By Medicare$11,923,683ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$12,577,073CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$653,390MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Coffeyville Regional Medical CenterBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11400 W 4th StreetAddressLine1Txt
CityCoffeyvilleCityNm
State AbbreviationKSStateAbbreviationCd
ZIP67337ZIPCd
FieldValueIRS element (for citing)
State LicenseH063102StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Coffeyville Regional Medical Center IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)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 Conducted19CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttp://crmcinc.org/about/publications-reports/OwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt19ImplementationStrategyAdptYr
Strategy Posted Website0StrategyPostedWebsiteInd
Strategy AttachedYes (1)StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care250.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttp://crmcinc.org/patients-visitors/billing-insurance/financial-assistanceFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttp://crmcinc.org/patients-visitors/billing-insurance/financial-assistanceFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttp://crmcinc.org/patients-visitors/billing-insurance/financial-assistanceFAPSummaryOnWebsiteURLTxt
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 Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
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 (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Coffeyville Regional Medical Center, IncPart V, Section B, Line 5: In August 2019, Coffeyville Regional Medical Center in conjunction with the Montgomery County Health Department began the process of updating the 2016 CHNA. The process included requesting various stakeholders in completing an on-line survey which was followed by a Town Hall Discussion in August 2019. The process included a wide variety of stake holders including business owners, civic leaders, consumers of health care, hospital personnel, and other local health care professionals.
Coffeyville Regional Medical Center, IncPart V, Section B, Line 6b: Montgomery County Health Department
Coffeyville Regional Medical Center, IncPart V, Section B, Line 11: Area of need: Economic development-CRMC continues to be very active in the Montgomery County Action Council (MCAC), which is the economic development engine for our county. The Director of Government Relations attends the quarterly meetings and is involved in an ongoing basis to assist in the recruitment of businesses to the region. -CRMC works closely with area Chambers of Commerce to promote healthcare services and education to new businesses and families. Area of need: Primary Care Providers-CRMC continues its effort to recruit primary care providers to join the CRMC medical staff.-CRMC had a total of 9 new physicians and specialists that began working at the Medical Center in 2020. -CRMC continues to work with regional medical schools and residency programs to enhance our visibility to medical students.-CRMC assists community members looking for a primary care provider or those who need assistance in making an appointment for a needed screening. CRMC offers Care Navigation Services to make this an easy process.-CRMC began offering virtual care telemedicine services in the spring of 2020 for primary care visits.Area of need: Chronic Disease Management-CRMC Medical Group Primary Care Clinic offers a full-time registered nurse to serve as the Chronic Care Management Nurse and make visits to chronic care patients of the clinic and transitional care patients.-CRMC did not provide diabetes and self-management classes during 2020 due to the COVID-19 pandemic. -CRMC continues to participate in the Montgomery County Health Coalition via email. -CRMC provided free Colon Cancer Screening kits during the month of March.-CRMC provides monthly health education posters to area businesses and industries and hosts quarterly health challenges.-CRMC provided comprehensive COVID-19 info and updates through various health articles in local newspapers, magazines, and our CRMC Facebook page. Area of need: Obesity, Nutrition, Fitness-CRMC provides on-going low cost or no cost health screenings in the community by hosting on-site workplace wellness events at Kansas Aviation, John Deere, Four County Mental Health, CRMC, and the City of Coffeyville Fire Department.
FieldValueIRS element (for citing)
Facility4FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - CRMC Medical Group
1400 W 4th StreetCoffeyvilleKS67337Surgery and Speciality Clinic
2 - CRMC Medical Group - Coffeyville
1400 W 4th StreetCoffeyvilleKS67337Primary Care Physician Clinic
3 - CRMC Medical Group
1717 W 8th StreetCoffeyvilleKS67337Women's Health, Obstetrics, and Gynocology
4 - CRMC Medical Group - Independence
122 W Myrtle StIndependenceKS67301Primary Care Physician Clinic

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 7:Amounts for financial assistance and certain other community benefit programs were obtained using known related charges and cost to charge ratios. The cost to charge ratios used include the overall cost to charge ratio derived from Worksheet 2 as well as individual department cost to charge ratios identified for the calculation of subsidized health services information.
Part I, Line 7g:Subsidized health services are made up of services that the Medical Center provides despite a financial loss to the organization. These services include ambulance, home health, respiratory therapy, physical therapy, occupational therapy, speech therapy, and physician clinics. Total costs for physician clinics amount to $7,149,208.
Part III, Line 4:The Medical Center provides for accounts receivable that could become uncollectible in the future by establishing an allowance to reduce the carrying value of such receivables to their estimated net realizable value. The Medical Center estimates this allowance based on the aging of its accounts receivable and its historical collection experience.Part III, Line 2Provisions for bad debts are related to accounts that have been deemed uncollectible during the year. The uncollectible amount is then written off pursuant with Hospital policy. The cost of the bad debts reported was determined based upon the cost to charge ratio multiplied by the total charges written off to bad debt expense.Part III, Line 3The estimate of bad debt expense attributable to patients who we believe would be eligible under the organization's financial assistance policy was estimated at 15%. The gross charge amount was then adjusted to cost using the overall cost to charge ratio obtained from worksheet 2. It is our belief that much more of the amount written off to bad debts relates to patients that would qualify for charity; however, do not take the time to complete the application process due to their individual circumstances. We believe that this amount should be considered a community benefit because we are legally required to provide medical services to patients regardless of the ability to pay.
Part III, Line 8:The 2020 Medicare Cost Report was used to determine the Medicare revenue and related cost. The shortfall is a benefit to the Medical Center's community since it represents health care provided at less than cost to elderly and needy residents of the Medical Center's service area.
Part III, Line 9b:Admission representatives review accounts during the admissions process to identify patients with possible financial need. To be considered for charity care, the financial policy states that financial advisors will determine if the patient is eligible to apply for Medicaid or other financial assistance programs. The advisors will then assist the patient through the process of applying for financial assistance programs within and outside of the Medical Center. Whenever possible, prior to admission, the Hospital will conduct a pre-admission interview with the patient, the guarantor, and or legal representative. Patients who may qualify for financial assistance from a governmental program will be referred to the appropriate program prior to being considered for charity care.
Part VI, Line 2:The Medical Center periodically engages a consulting firm to assist with developing a strategic plan. Part of that process is to interview people in the community for their opinion on what the Medical Center can do to meet the community needs. Interviews include physicians, board members, auxiliary personnel, and business leaders in the community to help get a feel for what they see as most important for our community.
Part VI, Line 3:The hospital has signs posted in each admission window and other locations in the hospital encouraging patients to ask about the available payment options and how to apply for financial assistance. The financial assitance policy and application form is also made available on the hospitals website. The patient may be referred to meet with one of the hospital's Financial Advisors, who will determine the patients' eligibility for benefits and help them through the process of applying for assistance.
Part VI, Line 4:Coffeyville is located in the southeastern part of Montgomery County, located in Southeast Kansas. It is located 64 miles north of Tulsa, Oklahoma. The US Census Bureau estimates the 2020 population of Montgomery County, Kansas to be 31,829. 20.3% of the population is 65 years of age or older, the median household income is $45,157, and 15.7% of individuals are below poverty level.
Part VI, Line 5:Health fairs, fundraising for relay for life, public education, and resources on Coffeyville Regional Medical Center's website are some examples of activities the Medical Center does to support health in the community.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 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
Russell Allison
Physician$599,026$0$51,318$0$0$0$24,539$0$20,651$0$695,534$0$0$0
Michelle McGuirk
Physician$418,061$0$54,250$0$0$0$24,539$0$11,797$0$508,647$0$0$0
Aaron Russell
Physician$414,778$0$20,000$0$0$0$24,539$0$27,718$0$487,035$0$0$0
Shravan Gangula
Physician$278,625$0$134,039$0$0$0$24,539$0$31,042$0$468,245$0$0$0
Baba Abudu
Anesthesiologist$376,897$0$0$0$0$0$24,539$0$20,039$0$421,475$0$0$0
Brian Lawrence
CEO$225,430$0$50,953$0$0$0$23,759$0$4,117$0$304,259$0$0$0
Michael Orr
CFO through May 2020$210,914$0$0$0$0$0$0$0$0$0$210,914$0$0$0

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonMark SlavinPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionSon-in-law of Board MemberRelationshipDescriptionTxt
Transaction$106,407TransactionAmt
TransactionEmployee CompensationTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section B, line 11bA draft copy of the 990 is reviewed with the finance committee prior to filing.
Form 990, Part VI, Section B, line 12cThe organization reviews concerns when identified. Members are required to remove themselves from any discussion which may involve a conflict of interest.
Form 990, Part VI, Section B, line 15aThe salary for the CEO is determined by the Board of Directors and is based upon performance and comparative information obtained from the Kansas Hospital Association wage survey.
Form 990, Part VI, Section C, line 19The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon written request.
Form 990, Part IX, line 11gPhysician and specialist fees: Program service expenses 2,147,640. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,147,640. Contract labor: Program service expenses 624,564. Management and general expenses 217,694. Fundraising expenses 0. Total expenses 842,258. Other fees for services: Program service expenses 3,600,721. Management and general expenses 2,026,405. Fundraising expenses 2,214. Total expenses 5,629,340.
Form 990, Part XI, line 9:Decrease in beneficial interest in net assets of CRMC Foundation -188,635.
Form 990 Part XI, Line 2c:The Finance Committee reviews the audit prior to the presentation to the Board by the auditor.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1Coffeyville Regional Medical Center Foundation IncBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11400 W 4th StreetAddressLine1Txt
CityCoffeyvilleCityNm
State AbbreviationKSStateAbbreviationCd
ZIP67337ZIPCd
FieldValueIRS element (for citing)
EIN480981990EIN
Primary ActivitiesTo provide philanthropic assistance to Coffeyville Regional Medical CenterPrimaryActivitiesTxt
Legal Domicile StateKSLegalDomicileStateCd
Exempt Code Section501(c)(3)ExemptCodeSectionTxt
Public Charity StatusLine 7PublicCharityStatusTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd