2020-06-30T15:18:22-05:00 2019-06-30 450250958 EIDE BAILLY LLP 621 N ROBINSON AVE STE 200 OKLAHOMA CITY OK 731026232 990 2018-07-01 730579295 Farmers Union Hospital Association FARM 5802252511 1801 W 3rd Street Elk City OK 73644 Corey Lively CEO 5802252511 2020-06-24 1 Kim Hunwardsen P00484560 4055942000 2020-06-24 216.147.181.47 2020-06-24 16:58:38 CD P E10085862974BF89EE8F231EB831862A8F193D10 96EA8C5DFC6EFE4FCBF1129FDB3AF0E7B3BD41AE 2018 2021-01-29 14:40:06Z Great Plains Regional Medical Center Corey Lively 1801 W 3rd Street Elk City OK 73644 70608173 0 X www.gprmc-ok.com X 1938 OK To provide comprehensive, cost-effective, high quality healthcare to our communities. 10 8 514 32 40529 -1903 290667 27098 50547689 56054138 488409 997292 327721 402358 51654486 57480886 6152 15539 0 0 23157273 22785887 0 0 0 33170735 36584248 56334160 59385674 -4679674 -1904788 66339063 62476514 36176243 33954577 30162820 28521937 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 46168362 15539 56054138 Farmers Union Hospital Association, DBA Great Plains Regional Medical Center in Elk City, Oklahoma (hereinafter referred to as GPRMC) is a 62-bed hospital that provides quality health care regardless of race, religion, creed, sex, national origin, handicap, age or ability to pay. Reimbursement for services rendered is critical to the operation and stability of GPRMC, it is recognized that not all individuals possess the ability to purchase essential medical services. In keeping with the Hospital's commitment to serve all members of its community, free care and/or subsidized care, care provided to persons covered by government programs at below cost, and health care activities and programs to support the community will be considered whether the need and/or individual's inability to pay exists.GPRMC served over 1,713 patients with more than 7,572 patient days on an inpatient basis. We also had 43,132 outpatient encounters. During the year we treated 14,194 patients in the Emergency Department. Our Surgical teams performed 2,659 outpatient 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 $581,000 in 2019. Total direct and indirect cost related to these foregone charges were $193,000 at June 30, 2019, based on an average ratios of cost-to-gross charges. 46168362 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 64 0 1 514 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 Janet Miller 5808215302 1801 W 3rd Street Elk City OK 73544 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 Edward Albert Member 1.00 1.00 X 0 0 0 Erick DeRocher DO Vice Chief of Staff 20.00 1.00 X 10500 0 0 Paul Kumpf Member 1.00 1.00 X 0 0 0 Jack Morrison DDS Member 1.00 1.00 X 0 0 0 Craig Phelps MD Chief of Staff 20.00 1.00 X 15600 0 0 Danny Sprowls Member 1.00 1.00 X 0 0 0 Kyle Zybach Member 1.00 1.00 X 0 0 0 Corey Lively CEO 40.00 0.00 X 301677 0 20411 Monica R Scott CFO 40.00 0.00 X 134566 0 26550 Roy Greenway MD Surgery 40.00 0.00 X 574716 0 32483 Timothy Teel DO ENT 40.00 0.00 X 418251 0 22669 Lindsay Pena MD Surgery 40.00 0.00 X 376706 0 21786 Tiffany Dupree DO Obstetrics & Gynecology 40.00 0.00 X 322331 0 6652 Royal Whinery MD Family Practice 40.00 0.00 X 302886 0 10240 2457233 0 140791 18 0 1 0 Premier Physician Staffing 4105 South Orange Circle Broken Arrow OK 74011 Physician ER coverage 2932396 Prime Physician Staffing PLLC 19992 W Woodhaven Road Owasso OK 74055 Hospitalist physician coverage 1331250 WebTPA 8500 Freeport Parkway Suite 400 Irving TX 75063 Insurance Management 583375 Nightrays PA 10901 W Toller Dr Suite 105 Littleton CO 80124 Radiologist services 498180 Cronin Enterprises Inc DBA Healthcare C 8000 Summerlin Lakes Drive Fort Myer FL 33907 Contract coding services 262731 10 8644 18454 27098 Net patient service 621990 54410336 54410336 Cafeteria 722210 485974 445445 40529 Income from Plains Diagnostic Ima 900099 356913 356913 Daycare center 624410 136948 136948 663967 663967 56054138 1185727 1185727 49776 49776 265303 0 265303 265303 265303 12938852 13127090 197 -188238 -197 -188435 -188435 Gain on termination of repurchase 900099 715000 715000 Loss on refinancing of debt 900099 -627721 -627721 87279 57480886 56013609 40529 1399650 X 3289 3289 12250 12250 509189 26100 483089 118920 118920 17552180 13506437 4045743 40209 25043 15166 3375659 2539550 836109 1189730 895480 294250 11080 11080 40470 40470 83885 83885 10850903 6684836 4166067 112778 149 112629 1910052 1456593 453459 269701 83893 185808 913152 199262 713890 116505 110930 5575 47832 36354 11478 1699594 1699594 3667375 3667375 795533 242615 552918 Bad debt expense 7872134 7872134 Medical supplies 6750021 6722541 27480 Food 585880 4442 581438 Repairs and maintenance 369390 193702 175688 487963 66873 421090 59385674 46168362 13217312 0 2967 3078 666589 3689353 6332315 7062865 1542044 1563023 734175 759547 88363222 54608449 36625602 33754773 16701574 11781039 1637919 1887596 1413290 1601150 84000 84000 598588 290090 66339063 62476514 4940324 4599726 31161919 74000 29354851 36176243 33954577 X 30162820 28521937 30162820 28521937 66339063 62476514 -1904788 263905 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 748759 748759 59495877 29790769 29705108 26431252 23480992 2950260 1687334 1336688 350646 33754773 Payable to related party 29354851 29354851 X 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 193000 193000 0.00370 193000 193000 0.00370 3212 3212 0.00010 4530863 2801455 1729408 0.03360 4534075 2801455 1732620 0.03370 4727075 2801455 1925620 0.03740 0 7872134 991889 14348656 15650004 -1301348 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 that will be addressed over the next three years. Some needs were carried over from the prior CHNA.Insurance and uninsured individuals Service Implemented/Partnerships: The Hope Clinic is open week days in Elk City. This is a low cost clinic with a sliding scale to benefit those who are under or uninsured. Specialists are available certain days per week. Providers from Great Plains Regional Medical Center volunteer often at the clinic to provide care to the un and underinsured. There is a food pantry and additional services associated with the clinic to provide assistance to those in need. Estimated numbers of those who benefited vary due to the services provided. Preventative care Service Implemented/Partnerships: Case management The hospital has two case managers who are both RNs. These individuals follow up with all of their discharged inpatients to make sure their home is safe, healthy foods are available, they have an understanding of their medication, and provide information to assist with their overall health. They also assist in coordinating care with their primary care providers to make sure they have their follow up appointments and can make those appointments or if alternate resources/services need to be identified. Every discharged patient is eligible for this follow up. Every day each case manager meets with the provider, nursing staff, and sometimes families before discharge to determine the appropriate plan of action. Since this planning is available to all inpatients, the estimate of those who benefitted is roughly 1,700 per year or 5,100. Preventative care Service Implemented/Partnerships: Smoking cessation Patients in the clinic and emergency department are screened to see if they are current smokers and if they would like to quit. Those who respond that they are interested are then provided follow up information and resources, particularly those available through TSET. This is now an automated question series within the EHR. Therefore, every patient is screened and made aware of the services. An estimation of those who directly benefitted from this offering is not available. Preventative care Service Implemented/Partnerships: Health fair The health fair is an annual event that is held at the Great Plains Regional Medical Center. Services offered include labs, blood pressure checks, balance assessments, and physical and occupational therapy assessments. This is an event for all providers in the community. The police and fire departments also provide safety information. It is estimated that an average of 200 attendees participate and benefit each year. This event was offered in 2016, 2017, 2018. Therefore, it is assumed that this event reached a gross number of 600. Substance abuse/Drug abuse Service Implemented/Partnerships: Wellness Week This is a weeklong event that the hospital participates in and collaborates with others in the community. This is a community-wide event with a focus each day of the week, including spiritual wellness, mental health, and physical health. The hospital participates by providing educational health information and is an overall sponsor of the entire week and event. This is held in mid-May annually. Different audiences are reached through each event. Therefore, estimation is difficult for the entire event. However, it is estimated that 3,000 to 5,000 benefit from this partnership and offering. This is an annual event that was also held in 2016, 2017, 2018. 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. Community health improvement services, line 7e, was compiled using actual costs recorded in the general ledger. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report. Part I, Ln 7 Col(f): The amount of bad debt expense removed from total expenses to determine the community benefit percentage was $7,872,134. Part III, Line 2: All forms of payment, including self-pay, insurance, contractual allowances, and discounts, are applied to the patient's account before the account is classified as bad debt. A payment received on an account previously written off as bad debt reduces bad debt expense. Great Plains Regional Medical Center does not refuse services to patients that generate bad debt.Bad debt expense on line 2 is reported at charges as presented on the financial statements. Part III, Line 3: A reasonable estimate of the Organization's bad debt expense attributable to patients under the Organization's financial assistance policy is 12.6% of bad debt expense. 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 can be found on pages 10 and 11 of the attached audited financial statements. 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: 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.For patients who qualify for charity care and who are cooperating in good faith to resolve their discounted hospital bills, Great Plains Regional Medical Center may offer extended payment plans, 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. 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 contastly 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: Trained staff offer assistance and discussion 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 assist patients with paperwork for medical assistance such as Medicare, Medicaid, disability or financial assistance.Notification about charity available from Great Plains Regional Medical Center, which includes a contact number, is disseminated by Great Plains Regional Medical Center 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 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 primary medical service area of Great Plains Regional Medical Center includes the zip code areas of Elk City, Sayre, Erick, Hammon, Cheyenne, Cordell, Burns Flat and Clinton. The primary medical service area experienced a population decrease of 1.9% from April 1, 2010 to July 1, 2018. The median household income in 2018 was $48,725. 14.3% of the population is persons ages 65 years and over.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 broad based group provides us with a broad perspective on the needs of the community. GPRMC extends medical privileges to area physicians. They must apply for privileges and be approved by the medical staff and Board of Directors. 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 is one of two designated donor locations for the communitywide blood drive held five times per year. Hospital Employees work 150 hours a year to assist with this initiative in order to help prevent a shortage of blood. Meals On Wheels - Employees Volunteered 40 hours to deliver meals to the homebound. Education programsGPRMC provided education for pregnant women, even if they already have a child, the labor and birth process can be both overwhelming and joyful. Our staff educates Women and their partner on what to expect during the birth and follow-up care with the newborn. Diabetes and Nutritional events gave us an opportunity to team up and work with our community to raise awareness of diabetes and other nutritional illnesses. The educational programs we provided are in hopes to raise awareness of symptoms and promote healthy living and to ensure people are aware of risk factors. GPRMC staff also provided education to local nursing home staff regarding care of patients with dementia and other types of behavioral disorders. This education will provide information and help those working or living with individuals with that disease. Job shadowing is promoted along with being a host for clinical rotations with many students in the healthcare field. GPRMC developed collaboration with Western Oklahoma State College to provide distance learning classes for those in the community wishing to pursue nursing degrees. Great Plains Regional Medical Center sponsors healthcare initiatives for the community. To celebrate American Heart Month, February 2019 GPRMC hosted an educational and inspirational event to employees and community members by have a Cardiologist discuss heart health awareness and heart attack prevention tactics for women and men. GPRMC organized a community event with over 20 hours of volunteer time that benefited the Alzheimer's Association. The Longest Day Walk event was to bring awareness to the community about this disease. GPRMC also awarded Scholarships to students wishing to pursue degrees in the medical field. 1 High school students health care scholarships 5 2500 Nursing scholarships 3 9750 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 Corey Lively CEO 301378 0 0 0 299 0 0 0 21791 0 323468 0 0 0 Monica R Scott CFO 134318 0 0 0 248 0 700 0 26816 0 162082 0 0 0 Roy Greenway MD Surgery 416833 0 149260 0 8623 0 1375 0 31108 0 607199 0 0 0 Timothy Teel DO ENT 411123 0 0 0 7128 0 1375 0 21294 0 440920 0 0 0 Lindsay Pena MD Surgery 346743 0 25000 0 4963 0 1375 0 21791 0 399872 0 0 0 Tiffany Dupree DO Obstetrics & Gynecology 292666 0 25050 0 4615 0 635 0 6018 0 328984 0 0 0 Royal Whinery MD Family Practice 290543 0 7429 0 4914 0 0 0 11620 0 314506 0 0 0 John Mark Phelps Family relation to Dr. Craig Phelps, Board Member 43104 Compensation as employee 0 Sarah Phelps Family relation to Dr. Craig Phelps, Board Member 75816 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 1,669,143. Management and general expenses 1,851,575. Fundraising expenses 0. Total expenses 3,520,718. Service contracts: Program service expenses 577,467. Management and general expenses 440,115. Fundraising expenses 0. Total expenses 1,017,582. Contract labor: Program service expenses 2,777,856. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,777,856. Purchased services: Program service expenses 45,650. Management and general expenses 1,486,630. Fundraising expenses 0. Total expenses 1,532,280. Other Professional Fees: Program service expenses 1,614,720. Management and general expenses 387,747. Fundraising expenses 0. Total expenses 2,002,467. 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 356913 566173 0 1 0.62770 1 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 1 1 Plains Diagnostic Imaging LLC K 888000 General ledger Plains Diagnostic Imaging LLC S 354982 Amount from K-1 Plains Diagnostic Imaging LLC A 1931 Amount from K-1 GPRMC Holdings Inc E 358496 General ledger