2020-11-13T10:20:14-06:00 2019-12-31 481026809 Wendling Noe Nelson & Johnson LLC 623 SW 10th Ave Suite 300 Topeka KS 66612 990 2019-01-01 480684878 Southwest Medical Center SOUT 6206241651 PO Box 1340 Liberal KS 679011340 Amber Williams CFO 6206241651 2020-11-12 1 Heather R Eichem P01515553 7852334226 2020-11-12 98.172.114.81 2020-11-12 11:15:00 CS P F0E9D68BE8BC320701B66DC14B92886E48CE6A91 CBC0F47676845489EE702DC5696EEF73C6303BAA 2019 2021-01-29 14:40:06Z Amber Williams PO Box 1340 Liberal KS 679011340 74085531 0 X www.swmedcenter.com X 1963 KS The Medical Center is a county hospital dedicated to the provision of personalized and quality care of the sick and injured at a reasonable cost. 7 7 645 130 0 0 328090 523261 62176807 72524480 322677 405926 626747 631864 63454321 74085531 0 0 0 0 32589089 36972938 0 0 0 25624412 29951103 58213501 66924041 5240820 7161490 77528248 86151476 37629098 39090836 39899150 47060640 The Medical Center is a county hospital dedicated to the provision of personalized and quality care of the sick and injured at a reasonable cost. 0 0 60110941 72842629 Southwest Medical Center provides necessary medical care to the community. It is the only facility in the area providing certain medical equipment and services. 60110941 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 99 0 1 645 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 1 1 0 X Amber Williams CFO 6206296680 PO Box 1340 Liberal KS 679011340 Mark Schepers Chairman 1.00 X X 0 0 0 Ray E Allen MD Vice-Chairman 1.00 X X 0 0 0 Ivanhoe Love Jr Trustee 1.00 X 0 0 0 Frederick Miller Treasurer 1.00 X X 0 0 0 Tammy Lenear Asst. Secretary/Treasurer 1.00 X X 0 0 0 Thomas Willis Trustee 1.00 X 0 0 0 Dennis Sander Secretary 1.00 X X 0 0 0 William Ermann CEO 40.00 X 306936 0 55292 Amber Williams CFO 40.00 X 153014 0 27543 Jose Maeda Physician 40.00 X 610746 0 59542 Andrey Ilyasov Physician 40.00 X 721476 0 60643 Rama Chanda Physician 40.00 X 635366 0 59813 Pingal Desai Physician 40.00 X 681638 0 60300 Fadi Darwiche Physician 40.00 X 645631 0 59930 3754807 0 383063 27 0 1 0 Kansas Emergency Room Services PA 7032 Collection Center Drive Chicago IL 60693 ER services 803336 Account Recovery Specialist Inc 200 W Wyatt Earp Blvd Dodge City KS 67801 Collection Fees 692467 Guymon Physical Therapy and Wellness 211 NW 5th St Guymon OK 73942 Therapy Services 566466 Aureus Nursing Inc PO Box 3037 Omaha NE 68103 Contract Services 404466 Fusion Medical Staffing PO Box 82674 Lincoln NE 68501 Contract Services 334237 29 494603 28658 523261 Net patient service revenue 622110 72524480 72524480 72524480 405926 405926 109760 0 109760 109760 109760 Cafeteria & dietary 722210 313715 313715 Miscellenous revenue 900099 208389 208389 522104 74085531 72842629 0 719641 529795 529795 28399119 26230475 2168644 3328478 3061154 267324 2778822 2546825 231997 1936724 1759959 176765 35872 35872 4240 4240 927208 280847 646361 60099 30242 29857 651940 518056 133884 88124 17611 70513 1168448 1152125 16323 137154 90717 46437 66504 42397 24107 598722 598722 2899142 2749038 150104 490430 427979 62451 Purchased services 8925162 8008561 916601 Medical supplies 7784059 7784059 Repair & maintenance 2065602 1330974 734628 Pharmacy drugs and supp 1937964 1937964 2110433 1543236 567197 66924041 60110941 6813100 0 4174 4524 32664936 37528356 10501648 13540148 1539113 1487489 2344502 2569410 88403218 64440478 23929006 23962740 1634918 1664994 4909951 5393815 77528248 86151476 4914724 5324013 15350000 14870000 4739 17359635 18896823 37629098 39090836 X 38994488 45724384 904662 1336256 39899150 47060640 77528248 86151476 7161490 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 5456 0 0 0 5456 0 Part II-B, Line 1: Southwest Medical Center is a member of the Kansas Hospital Association. This organization engages in lobbying activities for hospital and general health care interests as part of the services provided to members. 1298500 81081 264500 1115081 1230394 79295 11189 1298500 1130458 109686 9750 1230394 1158096 -16388 11250 1130458 1167152 897 -4703 5250 1158096 0.59770 0.40230 0 1 1 104046 104046 46075361 30416394 15658967 38134174 32423584 5710590 4089637 1600500 2489137 23962740 Interest receivable 2570 Other receivables 96192 Deferred outflows of resources - pension 4383402 Deferred outflow on advance refunding 892234 Estimated third-party payor settlements 19417 5393815 Unamortized premium 459087 Deferred inflows of resources - Pension 488419 Net pension liability 17949317 18896823 X 74085531 0 74085531 0 74085531 66924041 0 66924041 0 66924041 Part V, Line 4: Southwest Medical Center Foundation, Inc.'s endowment consists of approximately six individual funds established for scholarships and general support of Southwest Medical Center. Part X, Line 2: Management is not aware of any uncertainties in income tax positions. 1 1 0 1 X 1 1 1 0 0 714544 84855 629689 0.00940 9383262 4686212 4697050 0.07020 10097806 4771067 5326739 0.07960 38191 25083 13108 0.00020 12640920 5537170 7103750 0.10610 500 500 0.00000 12679611 5562253 7117358 0.10630 22777417 10333320 12444097 0.18590 1 3960677 188163 14281570 15261673 -980103 X 1 1 1 1 Southwest Medical Center 315 W 15th Street Liberal KS 679011304 X X X Skilled nursing facility Southwest Medical Center 1 0 0 1 X X X X X X X X X 19 1 0 0 1 X www.swmedcenter.com X 1 19 1 www.swmedcenter.com 0 1 X 350.000000000000 X X X X X 1 1 X X X X 1 X www.swmedcenter.com X www.swmedcenter.com X www.swmedcenter.com X X X X X X 1 X 0 X X X X 1 X 0 0 Southwest Medical Center Part V, Section B, Line 5: SWMC contacted community leaders via email and requested that these individuals complete an online survey with questions addressing the various health issues of the community.Persons who completed this survey included physicians, public health representatives, other health professionals, social service providers and a variety of other community leaders. Southwest Medical Center Part V, Section B, Line 11: Southwest Medical Center is currently working to improve maternal and child health through collaborative effots with the Seward County Health Department and Liberal Coalition for Families.The Medical Center provided communication to patients that are need of maternal and child health to improve the promotion of these resources in Seward County. This communication gives guidance and suggests contacts for these services.The Medical Center sought to improve the amount of education and prevention programs by working to setup these programs and supporting many Liberal Kid's teams with sponsorships. The Medical Center also hired an additional dietician to have more coverage for patient support.The Medical Center also sought to provide the community with more health care services and access points by continuing to recruit for new providers to offer additional services and continue current services offered.The Medical Center sought to increase access and availability to health care services by conducting a Community Health Fair in October 2019. This health fair offers discounted labs for participants and has many booths that offer health education and free screenings.The Medical Center sought to reduce mental health problems caused by drug and alcohol abuse by working to foster a relationship with City on A Hill.The Medical Center sought to improve mental health by continuing a close relationship with Southwest Gudiance Center and inviting the director of this Center to come to the hospital to conduct educational training about mental health issues and how to properly manage a mentally ill patient.The Medical Center sought to provide safety and support for victims of domestic abuse and/or sexual assault by working with LARC DVS regarding domestic violence occcurring to patients as well as working with LARC DVS on sexual assault victims which are also handled by our Southwest Sexual Assault Services program that was started at the Medical Center.Sexually transmitted infections (STI) are addressed primary by Seward County Health Department. The Medical Center provides information to patients that are identified to need these services including contact information for these services. Southwest Medical Center Part V, Section B, Line 15e: A presumptive eligibility determination in unusual or extenuating circumstances when a patient is unable to submit a complete application. Presumptive eligibility may be determined on the basis of individual life circumstances which may include, but is not limited to:-Homelessness or receipt of care from a homeless shelter;-Eligibility for out of state or out of area medical assistance programs;-Patient is deceased with no known estate;-Patient who has filed bankruptcy and whose bill has been fully discharged by the court. 8 1 - 15th Street Family Care Center 555 W 15th Street Liberal KS 67901 Family practice 2 - General Surgery Care Center 305 W 15th Street Suite 204 Liberal KS 67901 General Surgery 3 - Women's Specialty Center of Liberal 305 W 15th Street Suite 104 Liberal KS 67901 OB/GYN Services 4 - Orthopedic & Sports Medicine 305 W 15th Street Suite 101 Liberal KS 67901 Orthopedics 5 - Sleep Disorders Laboratory 101 E 11th Street Liberal KS 67901 Sleep Studies 6 - Women's Specialty Center of Guymon 421 Medical Drive Guymon OK 73942 OB/GYN Services 7 - McMurry Family Center 123 Medical Drive Guymon OK 73942 Family practice 8 - Urology Care Center 305 W 15th Street Suite 102 Liberal KS 67901 Urology Part I, Line 7: Amounts for Financial Assistance and Certain Other Community Benefits programs were obtained using known related charges and several 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 skilled nursing services and physician clinics. Of the $12,640,920 in total costs associated with subsidized health services, $10,804,622 were due to physician clinics. 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 for each type of payor.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 Medical Center policy. The cost of the bad debts reported was determined using the cost to charge ratio and total bad debt expense.Part III, Line 3The estimate of provisions for bad debts attributable to patients eligible under the organization's financial assistance policy was determined using the amount of charges included in incomplete charity care applications multiplied by the Medical Center's cost to charge ratio. It is our belief that the portion of the Medical Center's bad debt expense attributable to patients eligible under the Medical Center's financial assistance policy should be included as community benefit. As a not-for-profit, patient care is provided to all, regardless of ability to pay for that care. Making quality patient care available to all in our community, regardless of their economic means, qualifies bad debts as a community benefit. Part III, Line 8: Amounts were obtained from the cost report filed with Medicare for the period ending December 31, 2019. The Medicare shortfall should be considered a community benefit because our mission is to promote health in the community and we do not limit the care available to any patients, including those covered by Medicare. We are relieving a government burden by providing care to Medicare patients. Tax-exempt hospitals are expected to participate in the Medicare program. Part III, Line 9b: The Medical Center's collection policy does not contain a provision on the collection practices for patients who are known to qualify for charity care or financial assistance. To be considered for charity care, however, the charity care policy states that the patient must cooperate with the Medical Center to provide the information and documentation necessary to apply for other existing financial resources that may be available to pay for health care services, such as Medicaid. Then the information is gathered and assessed in order to determine eligibility for charity care. Whenever possible, prior to admission, the Medical Center will conduct a pre-admission interview with the patient, the guarantor, and/or legal representative. Those patients who may qualify for financial assistance from a governmental program will be referred to the appropriate program, prior to the consideration for charity care. Part VI, Line 2: SWMC conducts a community needs assessment approximately every 3 years. The assessment includes conducting community focus group meetings to hear what the citizens believe are the community's most critical needs. Additionally, SWMC monitors Kansas Hospital Association patient origin and destination data to look for patterns of migration for services that might be made available locally as a new service. Part VI, Line 3: PFS refers self pay patients to Midland Professionals and Midland assists them in seeing if they are eligible for any federal, state, or local programs. The collectors send out charity care paperwork to patients as they are calling and collecting or if a patient calls for the packet. Part VI, Line 4: SWMC's total service area is rural and is made up of southwest Kansas and the neighboring areas of Oklahoma, Colorado and New Mexico. SWMC's primary service area, however, is Seward County, KS, which has a population of approximately 21,428. According to the U.S. Census Bureau this population is approximately 63% Hispanic, has a median household income of $47,025, and 15.1% of all people in Seward County are below the Federal poverty level.SWMC is a County owned hospital and is the only hospital in the county. It therefore provides care to all patients regardless of their ability to pay. 7.5% of services provided by SWMC are provided to Uninsured patients while an additional 13.8% is provided to Medicaid patients. Part VI, Line 5: SWMC's seven Board of Trustees members are appointed by the Seward County Board of County Commissioners. Trustees are required to reside in Seward County, KS, and cannot be employed by the Hospital. SWMC extends medical staff privileges to all qualified physicians in the community who so desire to have such privileges.All surplus funds are reinvested back into the Hospital to fund capital needs and additional services that are identified as needed to continue to provide high quality services to the community. SWMC works with other community agencies, including the Seward County Health Department, to provide educational programs to the public throughout the year and an annual Health Fair that provides laboratory testing and health screening to over 830 participants. SWMC provides clinical training facilities for many area educational institutions' nursing, respiratory therapy, and radiology students. This includes Seward County Community College, Fort Hays State University, the University of Kansas, Oklahoma State University, Texas Tech University and others, all without any financial compensation. X X X 0 0 0 0 0 0 0 0 0 William Ermann CEO 306126 0 810 0 0 0 26462 0 28830 0 362228 0 0 0 Amber Williams CFO 152608 0 406 0 0 0 13667 0 13876 0 180557 0 0 0 Jose Maeda Physician 583222 0 27524 0 0 0 27692 0 31850 0 670288 0 0 0 Andrey Ilyasov Physician 361714 0 359762 0 0 0 27692 0 32951 0 782119 0 0 0 Rama Chanda Physician 337306 0 298060 0 0 0 27692 0 32121 0 695179 0 0 0 Pingal Desai Physician 453055 0 228583 0 0 0 27692 0 32608 0 741938 0 0 0 Fadi Darwiche Physician 372332 0 273299 0 0 0 27692 0 32238 0 705561 0 0 0 A Seward County Kansas 486009370 818427ER3 2010-05-27 18167463 Expand and renovate facilities, purchase equipment, and fund debt. 0 0 0 B Seward County Kansas 486009370 818427FR2 2016-03-30 9921376 Partially refund 2010 bond issue 0 0 0 A 3665000 8335000 18182121 1125259 213247 148667 16727638 1005550 86889 2012 0 1 1 1 B 280000 9921376 8671709 149800 1458625 15000 2016 0 1 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 0 0 1 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 Date Rebate Computation Performed Issuer Name: Seward County, Kansas Date the Rebate Computation was Performed: 05/01/2015 Schedule K, Part II The difference between Part I, column (e) and Part II, line 3 is due to the accumulation of investment income. Kathlene Ermann Sister of William Ermann, CEO 47062 Employment 0 Form 990, Part VI, Section B, line 11b The Form 990 is reviewed by the CFO and Controller. Form 990, Part VI, Section B, line 12c A conflict of interest policy disclosure form is provided with a copy of the current conflict of interest policy. This disclosure is completed by each Trustee upon election and annually thereafter. Form 990, Part VI, Section B, line 15 The Board of Trustees is responsible for determining the job performance standards for the Administrator/CEO and determining compensation according to the organization's policies. 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 XI, Line 2C The organization has an audit committee that is responsible for the oversight of the financial statement audit and selection of the independent accountant. Southwest Medical Center Foundation PO Box 1340 Liberal KS 67901 480908781 Fundraising for the benefit of Southwest Medical Center KS 501(c)(3) Line 12d, III-O 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0