2020-08-03T12:41:32-05:00 2019-09-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2018-10-01 480545183 Lindsborg Community Hospital Association LIND 7852273308 605 West Lincoln Lindsborg KS 674562328 Larry Van Der Wege Administrator 7852273308 2020-07-31 1 Kim Hunwardsen CPA P00484560 6122536500 2020-07-31 216.147.181.49 2020-07-31 15:16:14 CD P 5755687E6BF8D8D10BDE3B83E6631EF3D64C584D EFC25E59FA7409AE560978A003AFB9E955B778C6 2018 2020-11-19 02:30:22Z Larry Van Der Wege 605 West Lincoln Lindsborg KS 674562328 11714911 0 X www.lindsborghospital.org X 1944 KS Operation of critical access hospital. 9 9 0 17 0 0 67716 112625 11847394 11593250 11947 9036 0 0 11927057 11714911 0 0 0 0 7150757 6892500 0 0 6631 4609268 4418079 11760025 11310579 167032 404332 10538270 11896628 529196 1486710 10009074 10409918 X Partners caring for the health of the Smoky Valley communities. 0 1 8280681 0 11593250 Lindsborg Community Hospital (LCH) operates a critical access hospital in a community qualifying for such designation under federal law. The facilities are adequate for treatment or care of individuals suffering from mental or physical illness, disease, injury or deformity in an acute care, skilled nursing care, outpatient or emergency room setting. LCH cares for residents of the Smoky Valley with the operation of a 24/7 emergency room. 1,924 emergency room patients were seen in the 2019 fiscal year. 441 urgent care visits, 302 privately paid home health visits were made, and 299 cardiac rehab visits improved the health of community members. 13,708 visits were made in the Family Health Care Clinic to provide acute treatment, manage chronic conditions, or provide preventive care. 3,892 meals on wheels were supplied to community members. Education was provided to the Smoky Valley Community through Stepping On, Safe Sitter, and Chronic Disease Self-Management Program education. Employees of the LCH partner with various community groups to provide assistance to the Midsummer's Committee, Hyllningsfest Committee, Chamber of Commerce, and Strategic Alliance to name a few. Staff also provide leadership with the Sunflower Health Network, KHA Board of Directors, and the Sunflower (Kansas) HFMA Chapter. 8280681 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 X 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 0 X Laraine Gengler 7852273308 605 West Lincoln Lindsborg KS 674562328 X Chuck Oleen President 0.50 0.00 X X 0 0 0 Mike Rose Vice President 0.50 0.00 X X 0 0 0 Judy Neuschafer Secretary 0.50 0.00 X X 0 0 0 Tom Buffington Treasurer 0.50 0.00 X X 0 0 0 Denise Peterson Director 0.50 0.00 X 0 0 0 Ryan Biegert Director 0.50 0.00 X 0 0 0 Gretchen Norland Director 0.50 0.00 X 0 0 0 Robyn Johnson Director (Oct-Dec 2018) 0.10 0.00 X 0 0 0 Mary Ann Carlson Director 0.50 0.00 X 0 0 0 Kenneth Johnson DVM Director (Jan-Sept 2019) 0.50 0.00 X 0 0 0 Larry Van Der Wege Administrator 40.00 0.25 X 0 0 0 Laraine Gengler CFO 40.00 0.25 X 0 0 0 Wendy Dinkel DO 36.00 0.00 X 0 0 0 Benjamin Dolezal MD 36.00 0.00 X 0 0 0 Luke Rosenbraugh MD 36.00 0.00 X 0 0 0 Teresa Pearson PA 42.00 0.00 X 0 0 0 Amy Fitzgerald ARNP 39.00 0.00 X 0 0 0 0 0 0 0 0 0 0 Salina Regional Health Center 400 S Santa Fe Salina KS 67401 Payroll and other reimbursement 12930000 Simpson Construction 1831 S Anna Wichita KS 672771088 Construction 1955948 Rehabvisions 11623 Arbor St Omaha NE 68144 Therapy Services 678702 Integrated Solutions 3030 Cortland Circle Ste 200 Salina KS 67104 IT Infrastructure 224315 Smart Cabling 1205 N Winchester Ste K Olathe KS 66061 IT Infrastructure 121245 5 112625 112625 Net patient revenue 621400 10699590 10699590 Pharmacy revenue 621400 444692 444692 Sales Tax Revenue 900099 379064 379064 69904 69904 11593250 7682 7682 1354 0 1354 1354 1354 11714911 11593250 0 9036 X 306435 306435 57071 57071 5347907 4509118 838789 200693 172610 28083 603443 465498 137945 376951 297041 79910 3258 3258 12835 12835 2533 2533 1339941 1144436 195505 25426 25426 459068 151373 307695 242668 103591 139077 82997 2400 80597 14457 7711 6746 13598 8340 5258 2280 251 2029 815134 175980 639154 39785 13841 25944 Medical and Patient Sup 737326 704801 32525 Bad Debt 448265 448265 Food Costs 64459 1997 62462 Dues, Licenses, and Tax 31339 11396 19943 82710 2428 73651 6631 11310579 8280681 3023267 6631 37973 186151 4189502 3116327 150925 150899 121128 160135 11621409 5631035 2851892 5990374 1126905 1138961 2059945 1153781 10538270 11896628 413194 668811 116002 57002 0 760897 529196 1486710 X 9748520 10202171 260554 207747 10009074 10409918 10538270 11896628 X 404332 -3488 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2533 2533 0 Part II-B, Line 1: The portion of annual dues paid to hospital and medical associations attributed to lobbying activities by the associations. 10442 10442 5763832 2012187 3751645 5581031 3364816 2216215 266104 254032 12072 5990374 Other Assets 161 Receivable from Salina Regional Health Center 1153620 1153781 Estimated Third-Party Payor Settlements 760897 760897 X 11249102 0 11249102 465809 465809 11714911 12647968 1799710 1799710 10848258 462321 462321 11310579 Part X, Line 2: Lindsborg Community Hospital Assoication believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalities are incurred. Part XI, Line 4b - Other Adjustments: Bad Debts 448,265. Reclassification of revenue/expense accounts, net 7,425. Auxiliary revenue 10,119. Part XII, Line 4b - Other Adjustments: Bad Debts 448,265. Reclassification of revenue/expense accounts, net 7,425. Auxiliary expense 6,631. 1 1 X 1 X 1 X 1 1 0 0 49000 49000 0.00430 49000 49000 0.00430 71095 42235 28860 0.00260 34047 26158 7889 0.00070 4276762 922892 3353870 0.29650 1840 1840 0.00020 4383744 991285 3392459 0.30000 4432744 991285 3441459 0.30430 1 82 3748 3748 0.00030 1 35 785 785 0.00010 2 117 4533 4533 0.00040 1 448265 5116532 5148489 -31957 X 1 1 1 1 Lindsborg Community Hospital Association 605 W Lincoln St Lindsborg KS 67456 www.lindsborghospital.org H059001 X X X Lindsborg Community Hospital 1 0 0 1 X X X X X X X X 18 1 1 1 1 X See Line 10a X 1 18 1 www.lindsborghospital.org/about/message_from_ceo.php 0 1 X 200.000000000000 300.000000000000 X X X X X X 1 1 X X X 1 X www.lindsborghospital.org/patients/financial_assistance.php X www.lindsborghospital.org/patients/financial_assistance.php X www.lindsborghospital.org/patients/financial_assistance.php X X X X X 1 X 0 X X X X 1 X 0 0 Lindsborg Community Hospital Part V, Section B, Line 5: The McPherson County Health Needs Assessment data collection process included gathering opinions from county sources using a survey and quantitative data from secondary sources. The survey instrument utilized in past assessments was reviewed with changes suggested by a team of focus group members from throughout the county.On March 28, 2019, the electronic survey (along with an offered printable format) was made available to the general public. The publicized date for completion was April 12, but results continued to come in after that date. Publicity included local radio and newspaper announcements, social media pages, county hospital and public health websites, links sent to specific groups such as area businesses, senior populations, and personal invitations to individuals representing a broad spectrum of the population based on professional affiliations, interests and community engagement. Also included in the group receiving a specific invitation to complete the survey was an organization called Step MC who advocates for and meets regularly with medically underserved and low income populations in the county. "Step" stands for "Steps to End Poverty and their mission is to walk alongside those in the program to foster connections and create pathways to help them out of poverty. The survey was shared with the participants in the program who were encouraged to participate. The various other organizations who were provided links shared the link and encouraged their constituents to participate as well. All respondents were anonymous to survey administrators and paper copies were available as stated clearly in the communication process. Lindsborg Community Hospital Part V, Section B, Line 6a: McPherson Hospital, McPherson, Kansas Mercy Hospital, Moundridge, Kansas Lindsborg Community Hospital Part V, Section B, Line 6b: McPherson County Public Health Department Lindsborg Community Hospital Part V, Section B, Line 11: The community health needs assessment was completed during the tax year and as such the hospital has not taken specific actions with respect to the current implementation strategy. The following community health priority areas were identified: drug and alcohol abuse, mental health and obesity. The following actions will be taken by the hospital during future years:Drug and alcohol abuse typically go hand in hand. Part of the action plan is to continue to perform alcohol and drug screenings in the clinic and Emergency Department with referral to the Central Kansas Foundation or other facilities as needed. Standardized evaluation tools in the hospital and clinic EMRs will improve the consistency of screening for these behaviors.Another current nationwide challenge is the abuse of opioid medications. The Family Health Care Clinic has adopted policies to monitor and reduce the amount of opioids, as per Center for Disease Control (CDC) guidelines. A doctor has been certified in Suboxone treatment and has established care with patients to reduce opioid use. Improved standardization and policies have been developed in the Emergency Department as well. Mental Health treatment is a challenge throughout the state. Lindsborg Chief of Police and LCH Administrator participate in quarterly county-wide meetings with law enforcement and health care professionals to try and develop better options to care for those in our community suffering from a mental health crisis. We have seen an improvement in more timely access through discussion and collaboration with local mental health partners as well as the State facility in Larned. Also as a part of this, Prairie View Mental Health and LCH have partnered to provide emergency screening through telemedicine. By using an iPad on a secure application, the mental health screening can be performed from a distance, thus saving the time of a screener to drive to Lindsborg. LCH will continue to utilize their relationships with Prairie View Mental Health and Veridian Behavioral Health to provide mental health care to its patients. Central Kansas Foundation was also utilized to assist those benefitting from a referral to alcohol or drug treatment.LCH's Family Health Care Clinic offers supervised weight management services including special lab testing, dietary recommendations and chronic weight management. A fitness assessment is also available through the LCH physical therapy department to coincide with the program. LCH also has a registered dietition who provides dietary consultation for inpatient care and outpatient consultation.As part of managing the health of our clinic population, each patient's BMI will be recorded in the electronic medical record. For those patients whose BMI falls outside desired ranges, providers will be expected to address this health concern. Addressing it may take the form of education, consultation to a dietician or referral to the Medically Supervised Weight Management program.The organization will not address the following needs identified due to the priorities identified by the CHNA. These needs include risky behaviors (adults who smoke, physical inactivity, teen births, and STD) which have shown a reducing trend in McPherson County; access to food, especially for children, reflects a trend toward lower percentage of students approved for free lunches which mirrors the county's success in reducing the percentage of people and children in poverty; and the uninsured rate has fluctuated in the past five years with McPherson County historically seeing lower than average unemployment rates than the State of Kansas. Lindsborg Community Hospital Part V, Section B, Line 13h: The methodology used to determine eligibility for financial assistance takes into consideration income, net assets, family size and resources available to pay for care. In addition, presumptive charity care may be applied in situations where all other avenues have been exhausted. Lindsborg Community Hospital Part V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy. 1 1 - Family Health Care Clinic 605 W Lincoln St Lindsborg KS 67456 Physician clinic Part I, Line 3c: The methodology used to determine eligibility for financial assistance takes into consideration income, net assets, family size and resources available to pay for care. In addition, presumptive charity care may be applied in situations where all other avenues have been exhausted. Part I, Line 7: Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Amounts on lines 7e, 7f, and 7i are from the actual general ledger. Subsidized health services on line 7g were calculated utilizing the Medicare cost report. Part I, Line 7g: One provider based clinic is included in subsidized health services. Net revenues of $177,772 and costs of $2,196,634 were included for a net community benefit of $2,018,862. Part I, Ln 7 Col(f): The bad debt expense included on Form 990, Part IX, line 25, Column (A), but subtracted for purposes of calculating the percentage in this column, is $448,265. Part II, Community Building Activities: We provided health and education through the Lindsborg News-Record and the Marquette Tribune. We also provided support for the Smoky Valley Booster Club, Sandzen Memorial Gallery, Meet in the Middle Event, Midsummer Festival, sunscreen for the Lindsborg and Marquette swimming pools, Svensk Hyllingsfest and food support for the blood drive. Part III, Line 2: Patient's AR are reduced by an allowance for doubtful accounts. In evaluating the collectability of the AR, the Hospital analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with self-pay patients, the Hospital records a provision for bad debts in the period of the service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. Part III, Line 4: The footnote to the Organization's financial statements can be found on page ten of the attached audited financial statements. Part III, Line 8: The payments are compared to the actual cost of providing the service as arrived at through the Medicare cost reports. Medical services are provided to patients with Medicare coverage regardless of whether or not a surplus or deficit is realized. Providing Medicare services promotes access to healthcare services which are vitally needed by our community. Part III, Line 9b: LCH will not engage in extraordinary collection activities prior to making reasonable efforts to determine if a patient is eligible for financial assistance. The notification period for reasonable efforts starts with the date care is provided and ends 120 days after the date of the first statement. Statements and a final notice during the 120 days meet the reasonable efforts standard.Extraordinary collections activities may include referral to a collection agency and/or legal action. Collection/legal action may be used to collect amounts due if the responsible party refuses to cooperate in the financial assistance determination process and make and follow suitable payment arrangements. Failure to cooperate includes failure to submit required data and/or failure to submit required data within the specified time period. In addition, collection/legal action may be used to collect amounts due that remain after financial assistance determinations have been made and the responsible person fails to make and follow suitable payment arrangements. Part V, Line 7 Description of failureType of failure: 501(r)(3) - The hospital did not to post its tax year 2018 Community Health Needs Assessment to their website on or before September 30, 2019.Cause of the failure: Hospital management did not realize the Community Health Needs Assessment had not been posted to their website and inadvertently did not meet the posting requirement. Facility or facilities where the failure occurred: The failure occurred at Lindsborg Community Hospital AssociationThe date(s) of the failure and its discovery: Failure: September 30, 2019Discovery: July 29, 2020Description of the correction of the failureMethod of correction: The Community Health Needs Assessment has been made available on the website.Date of correction: 07/30/2020Description of the practices or procedures put into placeThe Community Health Needs Assessment was posted on the website at: https://www.lindsborghospital.org/about/message_from_ceo.php Part VI, Line 2: In addition to the CHNA process, LCHA participates in Strategic Alliance meetings which are held every 1-2 months. The Alliance consists of businesses and organizations in Lindsborg with the purpose of discussing strategic needs of the community and identifying where synergies can be developed. LCHA also participates in weekly meetings called the Ad Hoc RoundTable. This group meets to discuss activities and needs in the community. LCHA participates in a county Behavioral Health Task Force that meets every 2-3 months. The task force members include McPherson hospital administration and physicians, Prairie View Behavioral Health staff, law enforcement, the McPherson mayor and McPherson County Attorney, the Lindsborg Chief of Police, and LCHA's administrator.Medical Staff meets monthly to discuss clinical management of LCHA. Clinic providers and management meet monthly to discuss the operations of the Family Health Care Clinic. In both meetings, issues concerning needs of the community are discussed and addressed or at least brought to the attention of administration for development of an action plan.LCHA has a Patient and Family Advisory Council (PFAC) which is made up primarily of community members who are patients or family members of patients. The group meets monthly to discuss quality and other projects that LCHA is performing. As a part of the regular agenda, community members are given an opportunity to voice comments and concerns about needs of the community. Part VI, Line 3: The Hospital's charity care policy is posted in patient waiting rooms in a three-ring note book. Hospital employees have been instructed to direct anyone with questions regarding assistance to the Hospital's business office. Patients are educated by the financial services staff and social services staff who are able to provide assistance upon request and through policies posted to our website. Part VI, Line 4: The Organization serves the Smoky Valley Area including Lindsborg, Marquette, Falun, Roxbury, Gypsum, Assaria and other areas including McPherson, Salina, Smolan, Canton, and Galva. Approximately 8% of the Hospital's patients are uninsured or Medicaid patients. The community served by the Hospital is also served by two other hospitals, plus a Federally Qualified Health Center in Salina. Part VI, Line 5: The organization's governing body is comprised of individuals who reside within the Smoky Valley service area with members from Assaria, Lindsborg, Marquette, and Galva.Medical Staff privileges are extended to all qualified physicians in the community who apply. Surplus funds are utilized to provide home health services, health and education through the Lindsborg News-Record and the Marquette Tribune, Stepping On classes, Safe Sitter classes and frozen meals for purchase. The organization's governing body is comprised primarily of persons who reside in the organization's primary service area who are neither employees nor contractors of the organization nor family members thereof. The organization extends medical staff privileges to qualified physicians in its community for some or all of its departments. Surplus funds of the organization are returned to the organization to improve patient care through updated equipment and technology and care team member education. The organization operates an emergency room that is available 24/7 regardless of ability to pay. Through the assistance of a donor, the organization has trained 873 CNA students over the last 18 years through a partnership with Bethany Home and The Cedars. The students receive the training at no cost. The organization makes available to the surrounding area a wellness center open seven days a week without fees. Part VI, Line 6: The role of Lindsborg Community Hospital is to provide primary care to the members of the Smoky Valley and to provide emergency care, urgent care, and inpatient care when it is within our care limits. We also provide swing-bed (skilled nursing) care and respite care, accepting patients from Salina Regional Health Center. Kalli Weibert Daughter of Laraine Gengler, CFO 57071 Employment 0 Form 990, Part III, line 3 Home Health ceased in July 2019. Form 990, Part V, Line 2a, Number of employees on W-3: Under a management agreement, Salina Regional Health Center (SRHC) is responsible for the daily management and operation of the hospital, including employment of all staff. All payroll and benefits are paid by SRHC and payroll reporting is done by SRHC. Allocable compensation by individual is charged to Lindsborg Community Hospital Association and is shown on line 7 of Part IX. Form 990, Part VI, Section A, line 3 The Hospital entered into a management and operating agreement with Salina Regional Health Center (SRHC) effective October 1, 2012. Under the agreement, SRHC is responsible for the daily management and operation of the Hospital, including the employment of all staff needed to manage and operate Lindsborg Community Hospital. For tax year 2018, SRHC paid the following salaries and benefits to the individuals listed in Part VII: Larry Van Der Wege $193,894 Laraine Gengler $112,541 Wendy Dinkel $331,570 Benjamin Dolezal $315,798 Luke Rosebraugh $255,992 Teresa Pearson $231,947 Amy Fitzgerald $207,357 Form 990, Part VI, Section A, line 6 Lindsborg Community Health Care Foundation, Inc. a not-for-profit, 501c3 organization, is the sole member of Lindsborg Community Hospital. Form 990, Part VI, Section A, line 7a Lindsborg Community Health Care Foundation, Inc. being the sole member of Lindsborg Community Hospital, has the right to elect all board members. Form 990, Part VI, Section A, line 7b Lindsborg Community Health Care Foundation, Inc. is the sole member, and has the right to approve Lindsborg Community Hospital's by laws, articles of incorporation, and Board of Directors. Form 990, Part VI, Section A, line 8b There are no committees with broad authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The 990 is reviewed internally, and the Form 990 is made available to the board for review prior to filing. Form 990, Part VI, Section B, line 12c At the time of hire or election (in the case of directors) and annually thereafter, the officers, directors, and key employees provide the applicable conflict of interest disclosures which are completed to identify any relationships, positions, or circumstances in which it is believed a conflict may arise. If a conflict arises, the officer or director abstains from the vote of the conflicted position. The annual monitoring and review is part of the Organization's compliance plan. If a conflict is identified, it is either addressed by the board or referred to the management company for resolution. A report is submitted to the executive board concerning any interest disclosed. Form 990, Part VI, Section B, line 15a The Organization's process for determining Administrator's compensation begins with an initiative lead by the Executive Compensation Committee (ECC) of Salina Regional Health Center (SRHC). The ECC compares compensation and salary data provided by Integrated Health Strategies (IHS) for overall reasonableness of base compensation and total compensation for all SRHC executive staff. The ECC reviews the data and makes a recommendation to the SRHC board of trustees in a closed executive meeting. The process was last completed in 2019. Lindsborg Community Hospital's Administrator's salary is then set by the President/CEO of SRHC. The Lindsborg Community Hospital CFO's salary is set by Salina Regional Hospital Vice President of Finance using an annual salary survey and is increased using the same percentage as all other employees. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents and conflict of interest policy available to the public upon written request. Form 990, Part IX, line 11g Contract Labor : Program service expenses 1,106,946. Management and general expenses 189,444. Fundraising expenses 0. Total expenses 1,296,390. Service Contracts : Program service expenses 37,490. Management and general expenses 6,061. Fundraising expenses 0. Total expenses 43,551. Form 990, Part XI, line 9: Change in auxiliary -3,488. Lindsborg Community Health Care Foundation Inc 605 W Lincoln Lindsborg KS 67456 480947732 Hospital support KS 501(c)(3) Line 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0