2020-10-26T16:48:55-05:00 2019-12-31 200079326 DINGUS ZARECOR & ASSOCIATES PLLC 12015 E MAIN AVE SPOKANE VALLEY WA 99206 990 2019-01-01 300078435 GREELEY COUNTY HEALTH SERVICES INC GREE 6203764221 506 THIRD STREET TRIBUNE KS 67879 TRICE WATTS CFO 6203764221 2020-06-05 true THOMAS DINGUS P00951009 5092420874 2020-10-26 13.64.95.211 2020-10-26 16:48:55 CD P 88E8E3E4BAC69E0C9162358B3AA4114E53627D17 BDB558D2839154CBA244025868728B30AD18FBA5 2019 2021-01-29 14:40:06Z TRICE WATTS 506 THIRD STREET TRIBUNE KS 67879 15413893 false X WWW.MYGCHS.COM X 2002 KS TO BE A COMPASSIONATE, INNOVATIVE AND CARING FAMILY WITH YOUR HEALTH AND WELL-BEING IN MIND. 5 3 160 8 0 1488524 4620662 9678865 10292792 47522 61096 557713 439343 11772624 15413893 0 0 7252399 7499862 0 0 4162814 4787596 11415213 12287458 357411 3126435 6292591 19662633 1329321 11572928 4963270 8089705 X TO ADDRESS THE HEALTHCARE NEEDS OF THE REGION THROUGH THE EFFECTIVE PARTNERING OF A COMPASSIONATE STAFF WITH QUALITY CARE ROOTED IN THE CONTINUOUS PURSUIT OF BEST PRACTICES. WE UTILIZE APPROPRIATE TECHNOLOGY TO MINIMIZE THE EFFECTS OF CHRONIC DISEASE, FOCUS ON PROVIDING PREVENTIVE MEDICINE AND TREAT EACH PATIENT'S MIND, BODY AND SOUL WITHIN THE FAMILY MEDICINE SPECTRUM OF CARE. false false 9912919 10292792 GREELEY COUNTY HEALTH SERVICES (GCHS) OPERATES AN 18-BED CRITICAL ACCESS HOSPITAL, TWO RURAL HEALTH CLINICS, AND A LONG-TERM CARE FACILITY WHICH PROVIDE HEALTHCARE SERVICES INCLUDING INPATIENT, OUTPATIENT, EMERGENCY CARE, AND RESIDENTIAL LONG-TERM CARE SERVICES TO PATIENTS IN THE GREELEY COUNTY AREA. GCHS PROVIDED 219 ADMISSIONS, 10,811 OUTPATIENT VISITS, 827 EMERGENCY VISITS, AS WELL AS 9,382 RESIDENT PATIENT DAYS IN 2019. GCHS PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS 138,845 FOR CHARITY CARE, 2,188,965 FOR MEDICARE, 175,421 FOR MEDICAID, AND 1,261,428 FOR OTHER THIRD PARTY PAYORS FOR THE YEAR. 9912919 true true false true false false false false false false true false false false true true true false false false false false false false false false true true false false true false false false false false true true false false false false false false true false false false true 11 0 true 160 true false false false false false false false false false false false false X 5 3 false true false false false false false true true false false true true true true true true true true false X TRICE WATTS 6203764221 506 THIRD STREET TRIBUNE KS 67879 STEVE MANGAN CHAIR 2.00 X X 0 0 0 CHRIS DIXON VICE CHAIR 2.00 X X 0 0 0 LINDA PETERSON SECRETARY/TR 2.00 X X 0 0 0 DAN HILD TRUSTEE 2.00 X 0 0 0 BROCK SLOAN TRUSTEE 2.00 X 0 0 0 BURKE KLINE CEO 40.00 X 0 0 0 TRICE WATTS CFO 40.00 X 97831 0 9392 WENDEL ELLIS CMO 40.00 X 315212 0 34436 SAMUEL LINDQUIST PHYSICIAN 40.00 X 275365 0 17286 SHEILA SCHEFFE PHYSICIAN 40.00 X 159805 0 14564 BRIAN MILLER PHYSICAL THE 40.00 X 123226 0 13684 MELISSA GREESON PHYSICIAN AS 40.00 X 122100 0 13421 1093539 102783 5 false true false QUORUM HEALTH RESOURCES 1573 MALLORY LANE STE 200 BRENTWOOD TN 37027 MANAGEMENT SVS 545060 GREAT PLAINS PHARMACY 422 BROADWAY TRIBUNE KS 67879 PHARMACY SVS 285783 2 4595377 25285 4620662 NET PATIENT SERVICE REVENUE 621110 10292792 10292792 10292792 61096 61096 3585 3585 3585 3585 OUTSIDE SERVICES 621110 355785 355785 EMPLOYEE/GUEST MEALS 722513 57184 57184 OTHER REVENUE 900099 22789 22789 435758 15413893 10292792 500439 X 97831 97831 5850432 5075530 774902 166445 142028 24417 933638 796673 136965 451516 385279 66237 187812 187812 11804 11804 65596 65596 1345942 811435 534507 13416 13416 383911 301961 81950 247951 231165 16786 61063 44847 16216 30489 28562 1927 934 934 722073 653273 68800 101232 78369 22863 MEDICAL SUPPLIES 888700 888700 REPAIRS & MAINTENANCE 395916 181427 214489 FOOD SERVICES 231292 231292 OTHER 99465 62378 37087 12287458 9912919 2374539 0 384995 68667 2107133 2216710 711258 1012574 103077 127475 172114 194332 20247060 4926343 2249785 15320717 564229 722158 6292591 19662633 1329321 1292568 10280360 1329321 11572928 X 4963270 8089705 4963270 8089705 6292591 19662633 3126435 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 2472 2472 false SCHEDULE C, PART II-B, LINE 1 THE HOSPITAL DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITIES. THE HOSPITAL PAYS MEMBERSHIP DUES TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS. THE ASSOCIATIONS USE A PORTION OF SUCH DUES TO CARRY OUT LOBBYING ACTIVITIES. 301707 301707 17512331 2673018 14839313 2391470 2252940 138530 41552 385 41167 15320717 GREELEY COUNTY BOND CONTRIBUTION 10280360 10280360 X 15413893 15413893 15413893 12287458 12287458 12287458 SCHEDULE D, PAGE 3, PART X GCHS IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. HOWEVER, BOTH ENTITIES ARE SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE ENTITIES EVALUATE UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. AS OF DECEMBER 31, 2019 AND 2018, THE HOSPITAL AND GCHS HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. true true true X true X true true false true true 122184 122184 0.00990 1284739 1284510 229 1406923 1284510 122413 0.01000 2592 2592 0.00020 1812201 1190081 622120 0.05060 38550 38550 0.00310 1853343 1190081 663262 0.05400 3260266 2474591 785675 0.06390 true 97980 5115375 5193073 -77698 X true true 1 1 GREELEY COUNTY HEALTH SERVICES 506 3RD STREET TRIBUNE KS 67879 H036001 X X X X GREELEY COUNTY HEALTH SERVICES 1 true false true X X X X X X X X X X 19 true false false true X WWW.MYGCHS.COM X true 19 true WWW.MYGCHS.COM false true X 200.000000000000 300.000000000000 X X X true true X X X true X HTTP://MYGCHS.COM/FINANCIAL-ASSISTANCE X HTTP://MYGCHS.COM/FINANCIAL-ASSISTANCE X HTTP://MYGCHS.COM/FINANCIAL-ASSISTANCE X X X X X X true X false X X X true X false false FACILITY 1, GREELEY COUNTY HEALTH SERVICES - PART V, LINE 3E IDENTIFICATION AND PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS BEGIN ON PAGE 24 OF THE CHNA LOCATED ON THE HOSPITAL'S WEBSITE. FACILITY 1, GREELEY COUNTY HEALTH SERVICES - PART V, LINE 5 GCHS TOOK INTO ACCOUNT INPUT FROM REPRESENTATIVES OF THE COMMUNITY BY SOLICITATING WRITTEN COMMENTS FROM A DIVERSE GROUP OF COMMUNITY MEMBERS, REPRESENTING VARIOUS ORGANIZATIONS AND POPULATIONS WITHIN THE COMMUNITY (PUBLIC HEALTH, DEPARTMENTS AND AGENCIES, PRIORITY POPULATIONS, CHRONIC DISEASE GROUPS, ELDERLY, SCHOOLS, ETC.). FACILITY 1, GREELEY COUNTY HEALTH SERVICES - PART V, LINE 11 GCHS DOES NOT HAVE ADEQUATE RESOURCES TO SOLVE ALL THE PROBLEMS IDENTIFIED IN ITS MOST RECENT HEALTH NEEDS ASSESSMENT. SOME ISSUES ARE BEYOND THE MISSION OF THE HOSPITAL AND ACTION IS BEST SUITED FOR A RESPONSE BY OTHERS. SOME IMPROVEMENTS WILL REQUIRE PERSONAL ACTIONS BY INDIVIDUALS RATHER THAN THE RESPONSE OF AN ORGANIZATION. ALONG WITH OTHER AREA ORGANIZATIONS AND AGENCIES, GCHS PLANS TO COLLABORATE TO BRING THE BEST EACH HAS TO OFFER TO SUPPORT CHANGE AND TO ADDRESS THE MOST PRESSING IDENTIFIED NEEDS. THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE MOST RECENT ASSESSMENT FOLLOW: 1. OBESITY 2. ACCESS TO PRIMARY CARE AND SPECIALTY CARE PHYSICIANS 3. AGING POPULATION/ELDER WELLNESS 4. MENTAL HEALTH/BEHAVIOR HEALTH 5. HEALTH EDUCATION/PREVENTION 6. ALCOHOLISM AND DRUG ABUSE WE ARE CONTINUALLY ASSESSING THE HEALTH NEEDS OF OUR COMMUNITY AND DECIDING HOW WE CAN BETTER SERVE OUR COMMUNITY BASED ON NEED. 3 GREELEY COUNTY FAMILY PRACTICE 321 E HARPER TRIBUNE KS 67879 RURAL HEALTH CLINIC WALLACE COUNTY FAMILY PRACTICE 504 E 6TH STREET SHARON SPRINGS KS 67758 RURAL HEALTH CLINIC GREELEY COUNTY LONG-TERM CARE 320 E GREELEY TRIBUNE KS 67879 LONG-TERM CARE SCHEDULE H, PART I, LINE 7G THE HOSPITAL HAS INCLUDED COSTS ASSOCIATED WITH PHYSICIAN CLINICS AS SUBSIDIZED HEALTH SERVICES IN PART I, LINE 7G IN THE AMOUNT OF 1,812,201 IN COLUMN C AND 1,190,081 IN COLUMN D. SCHEDULE H, PART I, LINE 7 THE HOSPITAL APPLIES THE RATIO OF PATIENT CARE COST-TO-CHARGES DERIVED FROM WORKSHEET 2, FOR AMOUNTS REPORTED IN THE TABLE (TOTAL OPERATING EXPENSES LESS NON-PATIENT CARE ACTIVITIES, TOTAL COMMUNITY BENEFIT AND TOTAL COMMUNITY BUILDING EXPENSES). SCHEDULE H, PART III, LINE 2 THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. SCHEDULE H, PART III, LINE 3 THE HOSPITAL DID NOT TRACK THE AMOUNT OF BAD DEBT EXPENSE THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARTIY CARE POLICY BUT FOR WHOM SUFFICIENT INFORMATION WAS NOT ABTAINED TO MAKE DETERMINATION OF THEIR ELIGIBILITY DURING THE YEAR. SCHEDULE H, PART III, LINE 4 THE PATIENT ACCOUNTS RECEIVABLE FOOTNOTE OF THE AUDITED FINANCIAL STATEMENTS IS FOUND IN FOOTNOTE 3 ON PAGE 11 OF THE AUDITED FINANCIAL STATEMENTS. THE PROVISION FOR BAD DEBTS IS INCLUDED IN FOOTNOTE 7 STARTING ON PAGE 16 OF THE AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, LINE 8 ANY MEDICARE ALLOWABLE COSTS OF PATIENT CARE SHORTFALLS ARE NOT COUNTED AS COMMUNITY BENEFIT. THESE ALLOWABLE COSTS ARE OBTAINED FROM THE MEDICARE COST REPORT FOR THE YEAR. SCHEDULE H, PART III, LINE 9B THE ACCOUNTS OF UNINSURED OR UNDER-INSURED PATIENTS WHO HAVE APPLIED FOR MEDICAL ASSISTANCE OR FINANCIAL ASSISTANCE ARE HELD WITHOUT FURTHER COLLECTION ACTION, UNTIL THE APPLICATION PROCESS HAS BEEN COMPLETE. SCHEDULE H, PART VI, LINE 2 GREELEY COUNTY HEALTH SERVICES USES LOCAL AND STATE BASED DATA TO ASSIST ITS MEDICAL STAFF IN ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES AND PROVIDES BASIC FAMILY BASED PRIMARY CARE. WE ARE CONTINUALLY TAKING IN INFORMATION AND DECIDING HOW WE CAN BETTER SERVE OUR COMMUNITY BASED ON NEED. COPIES ARE AVAILABLE AT THE HOSPITAL UPON REQUEST OF THE MOST RECENTLY ADOPTED COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY OR A COPY CAN BE FOUND AT THE HOSPITAL'S WEBSITE AT THE FOLLOWING URL: HTTPS://MYGCHS.COM/ SCHEDULE H, PART VI, LINE 3 ALL PATIENTS PRESENTING TO OUR FACILITY WHO ARE UNINSURED/UNDER-INSURED ARE PRESENTED WITH THE OPPORTUNITY FOR FINANCIAL ASSISTANCE APPLICATION. A PATIENT FINANCIAL ASSISTANCE COUNSELOR IS AVAILABLE FULL TIME FOR INQUIRIES AND CONSULTING REGARDING ALL AVAILABLE FINANCIAL AID PROGRAMS. SCHEDULE H, PART VI, LINE 4 THE COMMUNITY IS A FRONTIER, RURAL COMMUNITY IN WESTERN KANSAS. THE RURAL POPULATION AMONG THE THREE COUNTIES SERVED BY THE FACILITY IS APPROXIMATELY 3,000 PEOPLE. THE SERVICE AREA COVERS 8,000 SQUARE MILES. THE AREA IS PREDOMINANTLY AGRICULTURAL BASED. SCHEDULE H, PART VI, LINE 5 THE HOSPITAL DOES HAVE AN OPEN MEDICAL STAFF WITH SUPPORTING MID-LEVEL PRACTITIONERS. THE HOSPITAL HAS A COUNTY GOVERNMENT APPOINTED COMMUNITY BOARD THAT RECEIVES APPROXIMATELY 3% SUPPORT FROM LOCAL TAX APPROPRIATIONS. THE HOSPITAL'S BOARD MEMBERS RESIDE IN THE PRIMARY SERVICE AREA AND DEDICATE TIME TO ENSURING THEY UNDERSTAND THE HEALTH AND WELFARE NEEDS OF OUR COMMUNITY. THE HOSPITAL DOES NOT HAVE ANY SHAREHOLDERS AND ANY SURPLUS FUNDS ARE REINVESTED INTO THE FACILITY, EQUIPMENT, AND EMPLOYEE EDUCATION. THE HOSPITAL HOLDS NUMEROUS COMMUNITY ACTIVITIES SUCH AS HEALTH FAIRS, FREE FLU SHOT CLINICS, PROMOTES SCHOOL PROGRAMS, AND PROVIDES NUMEROUS HEALTH, WELLNESS, AND EDUCATION ACTIVITIES TO PROMOTE HEALTH WITHIN THE COMMUNITY. IN ADDITION, THE HOSPITAL IS CONTINUALLY COLLABORATING WITH OTHER FACILITIES AND ORGANIZATIONS TO PROVIDE NEEDED SERVICES AND DONATE TIME AND EFFORT TO THE COMMUNITY. WE PROVIDE SUBSTANTIAL AMOUNTS OF UNCOMPENSATED CARE TO INDIVIDUALS THAT ARE IN NEED. X X false false false false false false false false false WENDEL ELLIS CMO 315212 9502 24934 349648 SAMUEL LINDQUIST PHYSICIAN 275365 8264 9022 292651 SHEILA SCHEFFE PHYSICIAN 159805 4801 9763 174369 SCHEDULE J, PAGE 1, PART I, LINE 3 COMPENSATION FOR BURKE KLINE, CEO, IS SET BY QUOROM HEALTH RESOURCES, AN INDEPENDENT ORGANIZAITON THAT WAS CONTRACTED TO PERFORM THE MANAGEMENT SERVICES FOR GREELEY COUNTY HEALTH SERVICES, INC. QUOROM HEALTH RESOURCES USED A WRITTEN EMPLOYMENT CONTRACT AND APPROVED BY THE BOARD OR COMPENSATION COMMITTEE IN DETERMINING COMPENSATION. GREAT PLAINS PHARMACY TRUSTEE 598664 DRUGS & PRO FEES false DREW ZERR TRUSTEE FAMILY 33842 EMPLOYMENT false FORM 990 - ORGANIZATION'S MISSION TO ADDRESS THE HEALTHCARE NEEDS OF THE REGION THROUGH THE EFFECTIVE PARTNERING OF A COMPASSIONATE STAFF WITH QUALITY CARE ROOTED IN THE CONTINUOUS PURSUIT OF BEST PRACTICES. WE UTILIZE APPROPRIATE TECHNOLOGY TO MINIMIZE THE EFFECTS OF CHRONIC DISEASE, FOCUS ON PROVIDING PREVENTIVE MEDICINE AND TREAT EACH PATIENT'S MIND, BODY AND SOUL WITHIN THE FAMILY MEDICINE SPECTRUM OF CARE. FORM 990 DURING 2019, GREELEY COUNTY TRANSFERRED 13,713,018 OF BUILDINGS AND IMPROVEMENTS TO THE HOSPITAL. THE HOSPITAL RECOGNIZED AS A LIABILITY 10,280,360 FOR FUTURE BOND PAYMENT CONTRIBUTIONS AND 3,432,658 AS CAPITAL CONTRIBUTIONS FROM GREELEY COUNTY. THE HOSPITAL ALSO RECEIVES FINANCIAL SUPPORT DERIVED FROM PROPERTY TAXES LEVIED BY THE COUNTY TO SUPPORT OPERATIONS OF THE HOSPITAL. FORM 990, PAGE 6, PART VI, LINE 3 GREELY COUNTY HEALTH SERVICES HOLDS A MANAGEMENT CONTRACT WITH QUORUM HEALTH RESOURCES(QHR) OF BRENTWOOD, TENNESSEE. QHR APPOINTS A CHIEF EXECUTIVE OFFICER TO MANAGE DAY-TO-DAY OPERATIONS. DURING 2019, BURKE KLINE SERVED AS THE TOP MANAGEMENT OFFICIAL FOR GREELEY COUNTY HEALTH SERVICES. HIS COMPENSATION IS INCLUDED IN THE MANAGEMENT FEE PAID TO QHR AND REPORTED ON PART VII, SECTION B, OF THE 990. FORM 990, PAGE 6, PART VI, LINE 11B A COPY OF THE 990 IS PROVIDED TO THE CFO WHO REVIEWS THE FORM, SCHEDULES AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER AND A FINAL DRAFT IS PROVIDED TO THE BOARD OF DIRECTORS. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE CEO SIGNS THE FORM 8879-EO AUTHORIZING THE PREPARER TO E-FILE THE RETURN. FORM 990, PAGE 6, PART VI, LINE 12C THE CONFLICT OF INTEREST POLICY APPLIES TO ALL BOARD MEMBERS AND OFFICERS. IT IS REVIEWED ANNUALLY BY THE BOARD MEMBERS AND OFFICERS. ANY POTENTIAL CONFLICTS OF INTEREST THAT ARE DISCLOSED ARE REVIEWED BY THE BOARD CHAIRMAN TO DETERMINE IF AN ACTUAL CONFLICT OF INTEREST EXISTS. INDIVIDUALS WITH A POTENTIAL CONFLICT OF INTEREST ARE PROHIBITED FROM VOTING OR PARTICIPATING IN DISCUSSIONS REGARDING THE POTENTIAL CONFLICT. FORM 990, PAGE 6, PART VI, LINE 15A THE BOARD OF DIRECTORS AND QHR REVIEW BOTH THE CEO'S AND CFO'S COMPENSATION ANNUALLY. COMPARISON DATA FROM SIMILAR ORGANIZATIONS IS USED TO DETERMINE ANY PAY INCREASES. ALL DELIBERATIONS AND DECISIONS ARE DOCUMENTED. FORM 990, PAGE 6, PART VI, LINE 15B THE BOARD OF DIRECTORS AND QHR REVIEW KEY EMPLOYEE COMPENSATION AT CONTRACT RENEWALS. COMPARISON DATA FROM SIMILAR ORGANIZATIONS IS USED TO DETERMINE ANY PAY INCREASES. ALL DELIBERATIONS AND DECISIONS ARE DOCUMENTED. FORM 990, PAGE 6, PART VI, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G 811,435 534,507 0 GREELEY COUNTY HOSPITAL PO BOX 338 TRIBUNE KS 67879 480783240 HEALTHCARE KS GOVT N/A false false false false false false false false false false false true false false false false false false false false