2021-05-12T13:23:55-05:00 2020-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2019-07-01 730579295 Farmers Union Hospital Association FARM 5802252511 PO Box 2339 Elk City OK 73648 Corey Lively CEO 5802252511 2021-05-12 1 Kim Hunwardsen CPA P00484560 6122536500 2021-05-07 2019 2022-09-23 18:48:47Z Great Plains Regional Medical Center Corey Lively PO Box 2339 Elk City OK 73648 56003442 0 X www.gprmc-ok.com X 1938 OK To provide comprehensive, cost-effective, high quality healthcare to our communities. 10 8 575 38 37265 -4177 27098 1061755 56054138 50184675 997292 764321 402358 295852 57480886 52306603 15539 17739 0 0 22785887 23398666 0 0 0 36584248 30771239 59385674 54187644 -1904788 -1881041 62476514 74157151 33954577 47189176 28521937 26967975 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. 0 0 40624810 17739 50184675 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 2,057 Inpatients that include, Medical, Intensive Care, Inpatient Rehabilitation, Newborns, Swing Bed and Senior Care. These services produced more than 10,220 Inpatient days. During the year we treated 13,432 patients in the Emergency Department. Our Surgical teams performed 2,680 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 $925,000 in 2020. Total direct and indirect cost related to these foregone charges were $276,000 at June 30, 2020, based on an average ratios of cost to gross charges. 40624810 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 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 51 0 1 575 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 8 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 Roy Greenway MD Surgery 40.00 X 633633 0 32508 Royal Whinery MD Family Practice 40.00 X 437087 0 39891 Tyson Fisher MD Surgery 40.00 X 411675 0 27483 Lindsay Pena MD Surgery 40.00 X 387728 0 21811 Tiffany Dupree DO Obstetrics & Gynecology 40.00 X 322282 0 25989 Corey Lively CEO 40.00 X 301728 0 20411 Monica R Scott CFO 40.00 X 134095 0 28235 Craig Phelps MD Member/Medical Staff 20.00 1.00 X 15600 0 0 Erick DeRocher DO Member/Medical Staff 20.00 1.00 X 10500 0 0 Jeff Jackson Chairman 1.00 1.00 X X 0 0 0 J Coffey MD Vice Chairman 1.00 1.00 X X 0 0 0 Colby Brewster Secretary 1.00 1.00 X X 0 0 0 Kyle Zybach Finance Chairman 1.00 1.00 X X 0 0 0 Edward Albert Member 1.00 1.00 X 0 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 Danny Sprowls Member 1.00 1.00 X 0 0 0 2654328 0 196328 22 0 1 0 Premier Physician Staffing 4105 South Orange Circle Broken Arrow OK 74011 Physician ER coverage 2974852 Prime Physician Staffing PLLC 19992 W Woodhaven Road Owasso OK 74055 Hospitalist physician coverage 1293750 Horizon PO Box 840839 Dallas TX 75284 Senior Care Management 675974 WebTPA 8500 Freeport Parkway Suite 400 Irving TX 75063 Insurance Management 501819 Western Oklahoma Anesthesia 603 West Broadway Elk City OK 73644 Anesthesia Coverage 473371 8 952299 109456 25000 1061755 Net patient service 621990 48234848 48234848 Cafeteria 722210 473153 435888 37265 Plains Diagnostic Imaging 900099 398410 398410 Daycare center 624410 124018 124018 954246 954246 50184675 972187 972187 23540 23540 272312 0 272312 272312 272312 3488973 3696839 -207866 -207866 -207866 52306603 50147410 37265 1060173 X 8245 8245 9494 9494 510352 26100 484252 143282 143282 17789373 13660970 4128403 49234 36835 12399 3705495 2774609 930886 1200930 902739 298191 32732 32732 35582 35582 13759 13759 11778802 7296407 4482395 71170 71170 2004742 1479703 525039 301292 113896 187396 870903 199573 671330 62987 57754 5233 40154 21351 18803 1423338 1326953 96385 3134619 2923540 211079 751011 751011 Medical supplies 8485675 8460792 24883 Food 564403 4090 560313 Repairs and maintenance 460331 173740 286591 Dues and Subscriptions 282842 60767 222075 456897 192959 263938 54187644 40624810 13562834 0 3078 3078 3689353 5574753 7062865 7781081 1563023 1776879 759547 696335 89283789 57743066 33754773 31540723 11781039 23722320 1887596 2151573 1601150 817623 84000 84000 290090 8786 62476514 74157151 4599726 4804884 9578614 4094497 29354851 28711181 33954577 47189176 X 28521937 26967975 28521937 26967975 62476514 74157151 -1881041 327079 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 808759 808759 59615228 32039405 27575823 27182224 24326484 2855740 1677578 1377177 300401 31540723 Payable to related party 28658530 Estimated third-party payor settlements 52651 28711181 X 52619923 327079 327079 52292844 13759 13759 52306603 54173885 0 54173885 13759 13759 54187644 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 276000 276000 0.00510 276000 276000 0.00510 4552736 2832185 1720551 0.03180 4552736 2832185 1720551 0.03180 4828736 2832185 1996551 0.03690 1 7387006 1048955 15709347 17118904 -1409557 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: -Great Plains Regional Medical Center representatives -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 include: 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 were all invited to attend. 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 FY2020:Insurance and uninsured individuals1. The hospital and local providers are continuing to collaborate with the Hope Clinic 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 for the last three months of the Fiscal Year.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 free room space for smoking cessation classes offered to community members. 4. The hospital had to postpone annual health fair because of the Pandemic. 5. Dr. Roy Greenway provided free seminars and discussion about obesity and its associated illnesses along with information about nutrition.6. GPRMC in conjuction with Elk City Schools hosted project AWARE with Dr. Chan Hellman for the Power of Hope during FY 2020.7. The Women's Center provided 4 childbirth classes throughout the year at no charge to the community.8. The dietician and Medical/Surgical Director assisted in hosting a diabetes education seminar in conjunction with Western Oklahoma Family Care Center that was also free to the community.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. This priority cannot be addressed at this time outside of provide space for smoking cessation education. 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. 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 14.2% of implicit price concession in 2019 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 hosted community meetings to discuss not only the economic impact of the health sector but to identify top health concerns as well as examine various sources of local health data. The Organization relies on input from physicians, other healthcare providers, community leaders, the Board of Directors and citizens in the community to improve and assess current needs for the community. GPRMC is consistently evaluating 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. Finally, the use of surveys are designed to gauge hospital usage, satisfaction and community health needs. 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 charity care is available from Great Plains Regional Medical Center, which includes a contact number, is disseminated by various means including notices 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 charity care may be made by the patient or a family member, close friend, or associate of the patient, subject to applicable privacy laws. Part VI, Line 4: Great Plains Regional Medical Center is an acute care hospital located in Elk City, Oklahoma in Beckham County. The Medical Center provides a comprehensive range of general, acute and specialized care, as well as outpatient and ancillary services to residents in its primary and secondary service areas covering ten counties. The estimated primary and secondary service area population exceeds 100,000. The median household income in Beckham County is $48,851 and 14% of the county is living in poverty.The secondary medical services area is comprised of the zip code areas Woodward, Leedey, Foss, Canute, Dill City, Sentinel, Hobart, Granite, Mangum, Martha, and Altus. 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. 1 High school students health care scholarships 6 9494 Part I, Line 2: The Hospital provides scholarships for high school seniors that will pursue health related fields and nursing scholarships. Students complete an application and essay. Administration reviews the applications and chooses the recipients. X X X X 0 0 0 0 0 0 0 0 0 Roy Greenway MD Surgery 443374 0 180451 0 9808 0 1400 0 31108 0 666141 0 0 0 Royal Whinery MD Family Practice 293778 0 141629 0 1680 0 0 0 39891 0 476978 0 0 0 Tyson Fisher MD Surgery 369500 0 41899 0 276 0 1400 0 26083 0 439158 0 0 0 Lindsay Pena MD Surgery 347309 0 36023 0 4396 0 1400 0 20411 0 409539 0 0 0 Tiffany Dupree DO Obstetrics & Gynecology 289863 0 25000 0 7419 0 1211 0 24778 0 348271 0 0 0 Corey Lively CEO 299998 0 0 0 1730 0 0 0 20411 0 322139 0 0 0 Monica R Scott CFO 132881 0 0 0 1214 0 700 0 27535 0 162330 0 0 0 John Mark Phelps Family relation to Dr. Craig Phelps, Board Member 41205 Compensation as employee 0 Sarah Phelps Family relation to Dr. Craig Phelps, Board Member 76689 Compensation as employee 0 Jacob Jackson Family relation to Jeff Jackson, Board Chair 25388 Compensation as employee 0 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 2,481,022. Management and general expenses 1,772,381. Fundraising expenses 0. Total expenses 4,253,403. Service contracts: Program service expenses 665,284. Management and general expenses 427,408. Fundraising expenses 0. Total expenses 1,092,692. Contract labor: Program service expenses 3,046,019. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,046,019. Purchased services: Program service expenses 35,081. Management and general expenses 1,928,286. Fundraising expenses 0. Total expenses 1,963,367. Other Professional Fees: Program service expenses 1,069,001. Management and general expenses 354,320. Fundraising expenses 0. Total expenses 1,423,321. 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 398410 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 944000 General ledger Plains Diagnostic Imaging LLC S 398410 Amount from K-1 Plains Diagnostic Imaging LLC A 1292 Amount from K-1 GPRMC Holdings Inc E 1419876 General ledger