2025-11-17T12:32:05+00:00 2024-12-31 440160260 Forvis Mazars LLP 1201 Walnut Street Suite 1700 Kansas City MO 641062246 990 2024-04-01 742826278 RURAL HEALTH RESOURCES OF JACKSON CO INC RURA 7853642116 1110 COLUMBINE DRIVE HOLTON KS 66436 CARRIE LUTZ CHIEF EXECUTIVE OFFICER 2025-11-17 true Michael Engle P00482834 8162216300 2025-11-17 2024 2025-03-06 01:10:19Z HOLTON COMMUNITY HOSPITAL CARRIE LUTZ 1110 COLUMBINE DRIVE HOLTON KS 66436 22491264 false X WWW.HOLTONHOSPITAL.COM X 1997 KS PROVIDE HIGH QUALITY HEALTHCARE SERVICES TO JACKSON COUNTY AND SURROUNDING COMMUNITIES WHILE CONSISTENTLY DEMONSTRATING PROFESSIONALISM WITH THE HOMETOWN TOUCH. 8 7 246 31 0 675949 272968 27582759 21945791 98435 171783 211804 100722 28568947 22491264 0 0 15113469 12210943 0 0 14692730 11217726 29806199 23428669 -1237252 -937405 24653883 22175081 18233559 16709696 6420324 5465385 TO PROVIDE PROFESSIONALISM, COMPASSION AND EXCELLENCE IN HEALTHCARE FOR A HEALTHIER COMMUNITY. false false 15812030 19241810 SEE SCHEDULE O. 2881497 2324777 THERE ARE 3 RURAL HEALTH CLINICS: 1 RURAL HEALTH CLINIC WITHIN THE SAME COMMUNITY WHERE THE HOSPITAL RESIDES, AND 2 RURAL HEALTH CLINICS LOCATED IN 2 SMALLER NEARBY COMMUNITIES. THE RURAL HEALTH CLINICS REPORTED 10,989 VISITS FROM 4/1/24 THROUGH 12/31/24. PROVIDERS FOR THE RURAL HEALTH CLINICS LIVE AND WORK IN THE SAME COMMUNITY AND ARE ACTIVELY INVOLVED IN COMMUNITY ACTIVITIES, OFFERING A LARGE VARIETY OF EDUCATIONAL SERVICES AS WELL AS CLINICAL SERVICES SUCH AS PROVIDING 2 LOCAL HIGH SCHOOLS SPORTS PHYSICALS AT LITTLE TO NO CHARGE. 698121 379204 A HOSPITAL BASED HOME HEALTH AND HOSPICE AGENCY PROVIDES IN-HOME NURSING AND REHABILITATION CARE TO JACKSON COUNTY AND SURROUNDING COUNTY RESIDENTS. THE VISITS TOTALED 1,910 VISITS FROM 4/1/2024 TO 12/31/2024, HOSPICE SERVICES TOTAL 1,310 HOSPICE PATIENT DAYS FOR THE SAME PERIOD. 19391648 true true false true false false false false false true true false false false true false true false false false false false false false false false true true false false true false false false false false false false false false false false false false false false false false false false false true 26 0 true 246 true false false false false false false false false false false false false X 8 7 false false false false false false false true true false false false true true true true true true true false false false KS X BART KENTON 7853649636 1110 COLUMBINE DRIVE HOLTON KS 66436 Chad Bontrager Director/Board Secretary 1.0 0.0 X X 0 0 0 Gloria Stavropoulos Board Chair/Director 1.0 0.0 X X 0 0 0 Healther Schrick Vice Chair/Director 1.0 0.0 X X 0 0 0 Mark Aeschliman Director/Board Treasurer 1.0 0.0 X X 0 0 0 Lee Schnee MD Chief of Medical Staff 40.0 0.0 X 246814 0 48649 Marilyn Watkins Director 1.0 0.0 X 0 0 0 Paula Taylor Director 1.0 0.0 X 0 0 0 Rodney Whittmer Director 1.0 0.0 X 0 0 0 Bart E Kenton CFO 40.0 0.0 X 167313 0 9088 Carrie L Lutz CEO 40.0 0.0 X 204937 0 23432 Clint M Colberg Physician/MD 40.0 0.0 X 372568 0 54480 Denis S Jimenez Physician, MD 40.0 0.0 X 518613 0 9995 LaDona M Schmidt Physician, MD 40.0 0.0 X 329960 0 37947 Malia Sm Warner Physician, MD 40.0 0.0 X 357876 0 44071 Marija K Lawless Physician, MD 40.0 0.0 X 280490 0 46985 2478571 0 274647 33 false true false ATHENAHEALTH 311 ARSENAL STREET WATERTOWN MA 02472 SUPPORT/SOFTWARE 778741 RURAL PARTNERS IN MEDICINE LLC 8181 ARISTA PLACE BROOMFIELD CO 80021 SPECIALTY PHYSICIAN 542415 PREMIER SPECIALTY NETWORK 1835 E REPUBLIC RD SPRINGFIELD MO 65804 SPECIALTY PHYSICIAN 483836 PSYCHIATRIC MEDICAL CARE LLC 8 CADILLAC DRIVE 230 NASHVILLE TN 66606 PHYSICIAN CONSULTING 359189 MOSS ANETHESIA LLC 8401 NW US HWY 75 TOPEKA KS 66618 ANESTHESIA SERVICES 262503 13 9469 263499 272968 NET PATIENT SERVICE REVENUE 622110 20688094 20688094 340B REVENUE 623000 1091255 1091255 MEDICAID PROVIDER ASSESSMENT INCOME 622110 166442 166442 0 0 0 0 21945791 71783 71783 0 0 100000 0 0 100000 100000 100000 CAFETERIA 623000 17044 17044 83678 0 0 83678 100722 22491264 21945791 0 272505 X 303578 303578 9833765 8237128 1596637 223683 180835 42848 1262937 1009778 253159 586980 470598 116382 79813 79813 3577 3577 4026898 3670073 356825 0 44984 4566 40418 308495 110020 198475 859648 662806 196842 273473 54158 219315 152922 145755 7167 287037 219835 67202 1206374 928908 277466 162509 52728 109781 MEDICAL SUPPLIES 2349639 2349639 BAD DEBT EXPENSE 959675 959675 REPAIRS AND MAINTENANCE 364505 315793 48712 DUES & SUBSCRIPTIONS 53413 7631 45782 84764 11722 73042 0 23428669 19391648 4037021 0 84718 142785 3307405 1793244 0 0 5369947 5223403 0 0 0 0 239954 281950 296097 375851 25578765 11533512 15152205 14045253 0 0 203557 312595 24653883 22175081 1939100 1594323 26988 4471 0 0 15308709 15019803 958762 91099 18233559 16709696 X 6356524 5349119 63800 116266 6420324 5465385 24653883 22175081 X -937405 -17534 X false true true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 3577 3577 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY THIS AMOUNT REPRESENTS THE PORTION OF THE DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND THE KANSAS HOSPITAL ASSOCIATION THAT ARE FOR LOBBYING. 46266 1519 1519 46266 46266 1955 1955 46266 46266 268 268 46266 46266 267 267 46266 46266 1038 1038 46266 0.0 1.0 0.0 false false 9983 9983 17806682 6042094 11764588 866167 728456 137711 6047314 4161648 1885666 848619 601314 247305 14045253 Federal Income Taxes Due to Third-Party Payers 50876 Operating Lease Liability 40223 91099 21514055 0 0 21514055 977209 977209 22491264 22468994 0 0 22468994 959675 959675 23428669 Schedule D, Part X, Line 2 UNCERTAIN TAX POSITIONS MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. Schedule D, Part V, Line 4 Intended uses of endowment funds THE PERMANENTLY RESTRICTED DONOR ENDOWMENT ONLY ALLOWS THE ORGANIZATION TO USE INTEREST INCOME FOR OPERATIONS. Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements PROVISION FOR UNCOLLECTIBLE ACCOUNTS - 959675 NET ASSETS RELEASED FROM RESTRICTION - 17534 Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statements PROVISION FOR UNCOLLECTIBLE ACCOUNTS - 959675 true true X true X true X 36349 0 36349 0.00155 1550223 785966 764257 0.03262 0 0 0 0.0 0 0 1586572 785966 800606 0.03417 15096 0 15096 0.00064 228235 0 228235 0.00974 698121 379204 318917 0.01361 0 0 0 0.0 27531 0 27531 0.00118 0 0 968983 379204 589779 0.02517 0 0 2555555 1165170 1390385 0.05935 0 0 0.0 0 0 0.0 0 0 0.0 0 0 0.0 0 0 0.0 0 0 0.0 0 0 0.0 0 0 0.0 0 0 0.0 0 0 0 0 0 0.0 false 959676 119960 9200234 9851040 -650806 X true true 1 1 HOLTON COMMUNITY HOSPITAL 1110 COLUMBINE DRIVE HOLTON KS 66436 WWW.HOLTONHOSPITAL.COM H043001 X X X HOLTON COMMUNITY HOSPITAL 1 false false true X X X X X X X X X 24 true false true true X https://holtonhospital.com/about/community-health/ X X true 24 true HTTPS://HOLTONHOSPITAL.COM/ABOUT/COMMUNITY-HEALTH/ false true X 100.0 200.0 X X true true X X X X true X https://holtonhospital.com/hospital-care/patient-financial-assistance-information/ X https://holtonhospital.com/hospital-care/patient-financial-assistance-information/ X https://holtonhospital.com/hospital-care/patient-financial-assistance-information/ X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E Through surveys sent out to area stakeholders significant health needs were identified. During a town hall with Area Stakeholders, those key areas were reviewed, discussed, and then prioritized by votes of those in attendance. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - HOLTON COMMUNITY HOSPITAL. HOLTON COMMUNITY HOSPITAL LEADERSHIP ALONG WITH JACKSON COUNTY HEALTH DEPARTMENT STARTED OFF BY ESTABLISHING A TIMELINE AND ROLES FOR THE CHNA. A CONSULTANT WAS HIRED TO ASSIST IN THE PROCESS. THIS GROUP THEN DEVELOPED A LIST OF INDIVIDUALS AND ENTITIES WITHIN JACKSON COUNTY THAT WOULD CONNECT WITH THE MAJORITY OF THE POPULATION OF JACKSON COUNTY. THE LIST INCLUDED PHYSICIANS, PUBLIC HEALTH OFFICIALS, OTHER HEALTHCARE PROVIDERS, CLERGY, COMMUNITY AND CIVIC LEADERS, EDUCATION STAFF, FAMILY CARE-GIVERS, AND MEMBERS OF AT-RISK POPULATIONS. A SURVEY WAS THEN CREATED CONSISTING OF 17 QUESTIONS TO ASSESS AREAS OF NEED WITHIN JACKSON COUNTY AND EMAILED TO THE LIST. PRESS RELEASES AND EMAIL REMINDERS WERE SENT TO HELP ENCOURAGE PARTICIPATION IN THE SURVEY PROCESS. A TOWN HALL MEETING WAS SET UP TO GET ADDITIONAL INPUT FROM THE COMMUNITY. THE DATE AND TIME WAS POSTED IN THE LOCAL NEWSPAPER AND FLYERS WERE PUT IN LOCAL BUSINESSES. SURVEY DATA WAS PRESENTED AT THE TOWN HALL MEETING WHICH WAS ATTENDED BY 32 INDIVIDUALS. IN ADDITION TO THE HOSPITAL AREAS OF HEALTHCARE REPRESENTED AT THE TOWN HALL MEETING WERE PROFESSIONALS IN THE AREAS OF FAMILY MEDICINE, MENTAL HEALTH, COMMUNITY HEALTH, AND LONG-TERM CARE. OTHERS ATTENDING WERE REPRESENTATIVES FROM THE LOCAL SCHOOLS, NEWSPAPER, BANKS, SEVERAL CIVIC ORGANIZATIONS AS WELL AS COMMUNITY MEMBERS. THROUGH INPUT FROM THE ATTENDEES INCLUDING A VOTING PROCESS BY EACH INDIVIDUAL, THE LIST OF NEEDS WAS NARROWED DOWN TO 8 ITEMS. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - HOLTON COMMUNITY HOSPITAL. NEK MULTI-COUNTY HEALTH DEPARTMENTS KANZA MENTAL HEALTH SERVICES NEKCAP-NORTHEAST KANSAS COMMUNITY ACTION PROGRAM FAITH HOME HEALTH & HOSPICE JACKSON COUNTY CITY OF HOLTON Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - HOLTON COMMUNITY HOSPITAL. COPIES ARE ALSO AVAILABLE AT OTHER HEALTHCARE PROVIDERS IN THE COUNTY. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - HOLTON COMMUNITY HOSPITAL. DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT OF 2024. THE FOLLOWING WERE IDENTIFIED AS THE TOP CHALLENGES TO RESIDENTS OF JACKSON COUNTY: 1. MENTAL HEALTH 2. OBESITY 3. SUBSTANCE ABUSE 4. CHRONIC DISEASE MANAGEMENT/EDUCATION 5. ADEQUATE HOUSING 6. UNINSURED (LACK OF MEDICAID) 7. SENIOR LIFE (QUALITY) A FOLLOW-UP MEETING WAS CONDUCTED TO FINALIZE AN IMPLEMENTATION STRATEGY TO ADDRESS THE IDENTIFIED NEEDS ATTENDING WERE REPRESENTATIVES FROM THE JACKSON COUNTY PUBLIC HEALTH DEPARTMENT, KANZA MENTAL HEALTH SERVICES, NEKCAP- NORTHEAST KANSAS COMMUNITY ACTION PROGRAM, AND HOLTON CITY COUNCIL. DURING THE PROCESS, IT WAS FIRST DETERMINED WHETHER THE NEED WAS PART OF HOLTON COMMUNITY HOSPITAL'S MISSION OF CRITICAL OPERATIONS. AFTER THAT IT WAS THEN DETERMINED IF THE SPECIFIC ACTIONS IDENTIFIED TO ADDRESS EACH NEED WOULD BE PERFORMED BY HOLTON COMMUNITY HOSPITAL AND IF THE HOSPITAL WOULD ALLOCATE FUNDS TO THE ACTION. IN ADDITION TO THE ITEMS LISTED BELOW, THERE ARE SEVERAL COMMUNITY RELATED SPECIFIC ACTIONS THAT ARE LISTED ON OUR CHNA STRATEGIC PLAN. THE FOLLOWING ITEMS ARE DIRECTLY RELATED TO ACTIONS THAT THE HOSPITAL WILL ADDRESS AND DOLLAR AMOUNTS ALLOCATED TO THE SPECIFIC ACTIONS. 1. Mental Health (Diagnosis, Placement, Aftercare, Providers) Key Actions: - Develop relationships with key community partners and explore regional partnerships for mental health support (Lead: Kanza & Senior Life Solutions; Partners: 4H/FFA, Clergy, Clinic, DOH, EMS, Law Enforcement, Senior, Teen). - Increase depression screenings and referrals in primary care; add pediatric trauma assessments (Lead: Holton Family Health). - Provide mental health first aid training to law enforcement, schools, and first responders. - Recruit and retain mental health providers, including locum/visiting providers. - Educate all age groups about mental health, suicide prevention, and social media bullying (Lead: Senior Life/KANZA). - Maintain a 24-hour crisis hotline (Statewide numbers: 800-273-8255, 1-800-784-2433, 988) (Lead: KANZA). - Seek grants to fund mental health services and prevention ($500). - Continue school-based suicide prevention training and launch an anti-suicide campaign. - Educate medical staff, EMS, and police on mental health care delivery ($1,000). - Expand hospital telehealth for mental health (Lead: Holton Family Health; $15,000). - Update community mental health service inventories and educate the public (Leads: HCH/KANZA/SLS). - Continue outpatient community-based programs and promote available services. - Explore transportation options for mental health patients. 2. Obesity (Affordable Fitness & Nutrition) - This health need is a community Social determinant, thus not part Hospital's Mission or Critical operations. Will partner with others as appropriate. Key Actions: - Offer community education through K-State Extension (cooking demos, grocery tours, farmers' market promotion, gardening classes) (Lead: HCH & DOH; Partners: 4H/FFA, Clinic, Parks, Senior). - Expand diabetic education services with providers and public health ($500). - Sponsor fitness activities such as "Walk with a Doc community-wide fitness challenges (Lead: Holton Family Health; $1,000). - Provide employer health fairs and screenings ($2,000). - Partner with Parks & Recreation for expanded fitness opportunities ($500). - Promote budget-friendly healthy shopping and increase access to healthy foods (Lead: Meadowlark District). - Seek grants for free nutrition and fitness education. - Continue "Meals on Wheels" (Lead: Jackson Co. Senior Center; ongoing). - Inventory local fitness centers and promote free fitness options ($500). - Support school backpack programs and campaigns for healthier school food. - Expand Parks & Rec and create social media for events. - Encourage use of hospital dieticians ($1,000). - Provide free/low-cost sports physicals and wellness exams (Holton Family Medicine; $1,000). - Expand walking/biking trails and add water fill stations (Lead: Holton Community Hospital; target: March 31, 2025). - Introduce grocery discounts/vouchers for healthy foods. - Share local success stories through social media and public campaigns. 3. Substance Abuse (Drugs) - This health need is a community Social determinant, thus not part Hospital's Mission or Critical operations. Will partner with others as appropriate. Key Actions: - Raise community awareness about drug abuse and launch educational campaigns (Leads: Kanza & Prairieland). - Support school programs on smoking/vaping prevention and host substance abuse speakers. - Build recovery support networks and recruit outpatient treatment providers. - Expand youth activities to prevent drug abuse and research local risk factors. - Monitor and discourage prescription drug abuse (Lead: HCH; ongoing; $1). - Seek grants for alcohol and drug abuse education. - Support DARE and post-prom programs ($300/year). - Expand hospital pain clinic services and provider education to reduce opioid prescriptions ($1). - Maintain a directory of substance abuse services. - Support AA/NA groups and law enforcement crisis intervention training ($1). - Promote safe disposal of old prescriptions. - Educate providers on drug abuse resources ($1). - Expand screening, brief intervention, and referral treatment (SBIRT). - Explore local advertising campaigns and create a Substance Abuse Coalition. 4. Chronic Disease Management / Education Key Actions: - Organize community physical activity programs (walking clubs, yoga, fitness challenges) (Leads: HCH & DOH; Partners: 4H/FFA, Clinics; $1). - Implement reminder programs for preventative screenings ($1). - Explore Medicare Chronic Disease Programs and invest in resources ($1). - Provide care coordination services with Jackson County Health Department ($1). - Increase education on cancer screenings and mammograms. - Promote referrals to nutritionists and launch support groups for diabetes, cancer, and cardiac rehab (Lead: HCH; $1,500). - Expand Kansas Healthcare Collaborative outreach ($1,000). - Partner with schools for health fairs ($1,000). - Provide occupational health education through Jackson County Health Dept. ($1). - Conduct community chronic disease assessments. - Investigate telemedicine for chronic disease management ($500). - Partner with pharmacies to offer discounted or free medications. 5. Adequate Housing - This health need is a community Social determinant, thus not part Hospital's Mission or Critical operations. Will partner with others as appropriate. Key Actions: - Develop and promote a county housing plan for affordable, safe housing (Lead: County). - Compare housing outcomes with similar communities and collect resident feedback. - Explore a re-home store for low-cost renovation items. - Build new apartment complexes for young families and seniors. - Offer rental tenant support and flexible payment plans. - Research population data to identify housing needs. - Support Habitat for Humanity and teach home rehab skills ($1). - Partner with banks to provide home improvement loans. - Seek grants for safe housing ($1). - Support development of Medicare (62+) housing. - Host housing education workshops. - Encourage mortgage loans for first-time homebuyers and explore TOTO programs. - Collaborate with private developers for mixed-income communities. - Recruit builders and research housing estate options. 6. Uninsured (Lack of Medicaid) -This health need is a community Social determinant, thus not part Hospital's Mission or Critical operations. Will partner with others as appropriate. Key Actions: - Educate the public on payment options and enhance price transparency (Lead: KHA & HCH; $500). - Partner with nonprofits to provide free/low-cost insurance navigation services. - Participate in Kansas Hospital Association campaigns for Medicaid expansion. - Assist uninsured individuals with medical debt issues. - Research federal insurance assistance for rural health organizations. - Explore debt relief programs with banks or private foundations. - Develop educational materials on affordable health insurance. - Support clinics with sliding-scale payment options ($5,000). - Establish a community health fund for emergency care. - Encourage providers to accept Medicaid and offer free care days ($1,000). 7. Senior Health (Quality) Key Actions: - Create a Healthy Seniors Club with programs to help seniors age in place and explore an "Adopt a Senior" program (Lead: Faith Home Health & Hospice, HCH; $500). - Host biannual stakeholder meetings with nursing homes and local providers ($500). - Maintain access to in-home, nursing home, and assisted living care. - Explore senior care programs and apply for grants (Lead: Meadowlark Extension; $500). - Promote discounted wellness visits and labs for u Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - HOLTON COMMUNITY HOSPITAL. 8) DENTAL SERVICES TAKING MEDICAID (THIS HEALTH NEED IS NOT PART OF THE HOSPITAL MISSION OF CRITICAL OPERATIONS. WILL PARTNER WITH OTHERS AS APPROPRIATE) A. REQUEST ALL AREA DENTISTS TO SEE MEDICAID PATIENT 1 DAY A MONTH - COMMUNITY SERVICE. B. CONTINUE TO SUPPORT KHA'S POLITICAL ADVOCACY INITIATIVES TOEXPAND KS MEDICAID COVERAGE WITH A SPECIAL FOCUS ON DENTAL COVERAGE. GRANT FUNDS $3,000 - $5,000 C. CONTINUE TO REQUEST LOCAL DENTAL PROVIDERS TO TAKE MEDICAID PATIENTS. D. EXPLORE GRANTS TO ASSIST IN DENTAL CARE FOR THOSE UNINSURED / UNDERINSURED 3 FAMILY PRACTICE ASSOCIATES - HOLTON 1100 COLUMBINE DRIVE HOLTON KS 66436 RURAL HEALTH CLINIC FAMILY PRACTICE ASSOCIATES - HOYT 117 W 3RD HOYT KS 66440 RURAL HEALTH CLINIC FAMILY PRACTICE ASSOCIATES - WETMORE 323 SECOND STREET WETMORE KS 66550 RURAL HEALTH CLINIC Schedule H, Part I, Line 3c CRITERIA USED FOR DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE INSURANCE STATUS AND UNDERINSURANCE STATUS ARE OTHER FACTORS USED IN THE ELIGIBILITY CRITERIA EXPLAINED IN THE FAP FOR PROVIDING FREE AND DISCOUNTED CARE. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance Lines 7a, 7b, and 7g are all based on Cost-to-Charge ratio. All others are based on actual costs. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount 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 DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HOSPITAL BILLS THIRD PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN ACCORDANCE WITH A PREDETERMINED PAYMENT PLAN BASED ON THE VALUE OF THE PATIENT'S BALANCE. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBT BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. Schedule H, Part III, Line 3 Bad Debt Expense Methodology BAD DEBT EXPENSE (AT COST) IDENTIFIED THE PROVISION FOR UNCOLLECTIBLES FROM 12/31/24 AUDITED STATEMENT OF OPERATIONS. MULTIPLIED THAT AMOUNT BY THE COST TO CHARGE RATIO. CHARITY CARE (AT COST): LOGS MAINTAINED BY CASH COLLECTOR. LOG CONTAINS DATA OF THE DOLLAR AMOUNT TURNED TO BAD DEBT WHERE A CHARITY CARE APPLICATION WAS SENT BUT NOT RETURNED AND WHEN CHARITY CARE APPLICATION WAS RETURNED BUT PATIENT DID NOT FULFILL FINANCIAL OBLIGATION. SUBSEQUENTLY, MULTIPLIED THAT AMOUNT BY THE COST-TO-CHARGE RATIO IDENTIFIED IN SCHEDULE H, PART I. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote SEE PAGE 14 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs SERVING PATIENTS WITH GOVERNMENT HEATH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance FOR INDIVIDUALS WHO HAVE FINANCIAL DIFFICULTIES, THE HOSPITAL USES REASONABLE EFFORTS TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY. THESE EFFORTS INCLUDE PROVIDING THE INDIVIDUAL WITH A PLAIN LANGUAGE SUMMARY (BROCHURE) OF THE FINANCIAL ASSISTANCE PROGRAM, A NOTICE ON ALL PATIENT BILLING STATEMENTS AND OTHER WRITTEN COMMUNICATIONS REGARDING BILLINGS, ORAL COMMUNICATIONS REGARDING AMOUNT DUE, AND OTHER MEANS AVAILABLE TO THE HOSPITAL TO IDENTIFY INDIVIDUALS WHO MAY BE ELIGIBLE FOR INSURANCE COVERAGE OR FINANCIAL ASSISTANCE. THE HOSPITAL WILL NOT ENGAGE IN EXTRAORDINARY COLLECTIONS ACTIONS (ECA) AGAINST AN INDIVIDUAL UNTIL IT IS DETERMINED THAT THE INDIVIDUAL HAS THE INCOME TO PAY OR THE INDIVIDUAL HAS NOT COOPERATED IN AN EFFORT TO ESTABLISH FINANCIAL ASSISTANCE ELIGIBILITY. IF A FINANCIAL ASSISTANCE APPLICATION HAS NOT BEEN SUBMITTED BY THE 120TH DAY AFTER THE HOSPITAL PROVIDED THE INDIVIDUAL WITH THE FIRST PATIENT BILLING STATEMENT, THE HOSPITAL MAY ENGAGE IN EXTRAORDINARY COLLECTIONS ACTIONS (ECA). IF AN APPLICATION IS SUBMITTED WITHIN THE 240TH DAY AFTER THE FIRST PATIENT BILLING STATEMENT, THE HOSPITAL WILL DISCONTINUE ECA UNTIL IT IS DETERMINED IF THE INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. Schedule H, Part V, Section B, Line 16a FAP website - HOLTON COMMUNITY HOSPITAL: Line 16a URL: https://holtonhospital.com/hospital-care/patient-financial-assistance-information/; Schedule H, Part V, Section B, Line 16b FAP Application website - HOLTON COMMUNITY HOSPITAL: Line 16b URL: https://holtonhospital.com/hospital-care/patient-financial-assistance-information/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - HOLTON COMMUNITY HOSPITAL: Line 16c URL: https://holtonhospital.com/hospital-care/patient-financial-assistance-information/; Schedule H, Part VI, Line 2 Needs assessment OUR CURRENT 14-BED HOSPITAL IS LOCATED WITHIN THE OUTER REGION OF THE HOLTON CITY LIMITS. OUR EXPANDED FACILITIES ALLOW US TO PROVIDE A BROAD RANGE OF HEALTHCARE SERVICES TO ALL MEMBERS OF OUR COMMUNITY WITHOUT REGARD TO AGE, RACE, SEX OR FINANCIAL CONSTRAINTS. WE REGULARLY EVALUATE THE SERVICES WE PROVIDE TO SEE IF THEY ARE BEING UTILIZED AND TO SEE WHAT ADDITIONAL SERVICES CAN BE PROVIDED. WE UTILIZE OUR COMMUNITY HEALTH NEEDS ASSESSMENT AND PATIENT FAMILY ADVISORY COMMITTEE INPUT TO DETERMINE IF ADDITIONAL SERVICES NEED TO BE PROVIDED. WE ARE COMMITTED TO PROVIDING QUALITY HEALTHCARE TO ALL MEMBERS OF OUR COMMUNITY. BECAUSE WE ARE A SMALL-TOWN HOSPITAL, A MAJORITY OF OUR PATIENTS HAVE A STRONG BOND WITH OUR STAFF. THIS ALLOWS US TO PROVIDE CARE THAT EXTENDS BEYOND JUST MEDICAL NEEDS. THE COST AND DIFFICULTY IN SEEKING CARE IN OTHER AREAS FOR OUR ELDERLY AND POOR POPULATION REINFORCES THE NEED FOR A STRONG COMMUNITY HOSPITAL. WE STRIVE TO MEET THIS NEED BY PROVIDING ALL SERVICES POSSIBLE. WE HAVE BEEN DISTRIBUTING PATIENT SATISFACTION SURVEYS THROUGHOUT OUR SURGICAL, INPATIENT, OUTPATIENT, RURAL HEALTH CLINIC, EMERGENCY ROOM AND REHABILITATION SERVICES FOR APPROXIMATELY 8 YEARS. THE RESULTS OF THESE SURVEYS ARE COMPILED MONTHLY AND ARE USED TO BETTER OUR PATIENT SERVICES. WE HAVE ALSO ESTABLISHED A SURGICAL OVERSIGHT COMMITTEE THAT MEETS MONTHLY ON HOW TO IMPROVE SERVICES AND PROCESSES IN THE SURGERY DEPARTMENT. LISTED BELOW ARE SOME OF THE SERVICES PROVIDED BY HOLTON COMMUNITY HOSPITAL. HOLTON COMMUNITY HOSPITAL IS PROUD TO BE A CERTIFIED 'STROKE READY' FACILITY. OUR REHABILITATION SERVICES DEPARTMENT PROVIDES A FULL-COMPLIMENT OF OCCUPATIONAL AND PHYSICAL THERAPIES, INCLUDING A LYMPHEDEMA MANAGEMENT PROGRAM AND SPEECH THERAPY. OUR CARDIOVASCULAR SERVICES DEPARTMENT PROVIDES CARDIAC REHAB, AS WELL AS PERFORMS PULMONARY FUNCTION PROCEDURES AND STRESS TESTS, AND PROVIDES ONE-ON-ONE CERTIFIED DIABETES EDUCATION AND TOBACCO CESSATION COUNSELING. THE SURGERY DEPARTMENT PROVIDES 24/7 SURGICAL SERVICES. WE HAVE A LARGE VARIETY OF SPECIALTY PHYSICIANS WHO TREAT PATIENTS IN THE FACILITY AS WELL AS PERFORM NUMEROUS SURGICAL PROCEDURES. THE RADIOLOGY DEPARTMENT PROVIDES NUCLEAR MEDICINE TESTING ON SITE. THE FACILITY ALSO CONTRACTS WITH SHARED MEDICAL SERVICES, INC. TO PROVIDE ON-SITE MOBILE MRI TESTING. THE RADIOLOGY DEPARTMENT IS ALSO VERY PROUD TO HAVE A 32-SLICE CT SCANNER WHICH PROVIDES HIGH RESOLUTION IMAGES. WE ALSO INSTALLED A STATE-OF-THE-ART 3D MAMMOGRAPHY UNIT TO HELP WITH EARLY DIAGNOSIS OF BREAST CANCER. OUR HOSPITAL OFFERS A FULL-SERVICE, 24-7 EMERGENCY DEPARTMENT WITH A PHYSICIAN AVAILABLE AT ALL TIMES. WE HAVE TRANSFER AGREEMENTS WITH SURROUNDING HOSPITALS FOR THOSE PATIENTS WHO PRESENT TO THE HOSPITAL EMERGENCY DEPARTMENT AND REQUIRE CARE BEYOND OUR CAPABILITIES. OUR 14-BED IN-PATIENT UNIT PROVIDES CARE TO MEDICAL-SURGICAL PATIENTS, SUB-ACUTE PATIENTS, PEDIATRICS AND GERIATRICS. WE ARE ALSO LICENSED TO PROVIDE SWINGBED SERVICES. THIS ALLOWS PATIENTS TO RECEIVE TRANSITIONAL INPATIENT REHABILIATION AND RECOVERY SERVICES. HOLTON COMMUNITY HOSPITAL HAS A FULL-SERVICE HOME HEALTH AND HOSPICE PROGRAM. OUR AWARD-WINNING HOSPICE DELIVERS END OF LIFE CARE TO PATIENTS OF PROVIDERS THROUGHOUT NORTHEAST KANSAS. OUR RURAL HEALTH CLINIC (FAMILY PRACTICE ASSOCIATES) HAS THREE LOCATIONS IN HOLTON, HOYT AND WETMORE, KANSAS. OUR MIX OF SIX PHYSICIANS, TWO PHYSICIAN ASSISTANTS AND EIGHT ADVANCED REGISTERED NURSE PRACTITIONERS ALLOWS OUR COMMUNITY MEMBERS TO FIND A PROVIDER THAT BEST SERVES THEIR HEALTH CARE NEEDS. WE ALSO OFFER LOW-COST OR FREE SPORTS PHYSICALS TO LOCAL JUNIOR HIGH AND HIGH SCHOOL STUDENTS TWO EVENINGS EACH YEAR. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance HOLTON COMMUNITY HOSPITAL POSTS SIGNS AT ITS REGISTRATION LOCATIONS REGARDING THE AVAILABILITY OF OUR FINANCIAL ASSISTANCE PROGRAM. THE FAP POLICY IS ALSO AVAILABLE AT SEVERAL LOCATIONS IN THE COMMUNITY. THE AVAILABILITY OF A FINANCIAL ASSISTANCE PROGRAM IS ALSO IDENTIFIED ON ALL HOSPITAL PATIENT SERVICE-RELATED LETTERS AND GUARANTOR STATEMENTS. ONCE A PATIENT CALLS TO INQUIRE ABOUT THE FINANCIAL ASSISTANCE PROGRAM THE PATIENT FINANCIAL COUNSELOR WORKS ONE-ON-ONE WITH THE PATIENTS OUTLINING THE REQUIREMENTS, DOCUMENTS NEEDED AND EXPLAINS OUR FINANCIAL ASSISTANCE PROGRAM IN DETAIL. Schedule H, Part VI, Line 4 Community information Jackson Co, KS, on average was ranked 32nd in Health Outcomes, 56th in Health Factors, and 78th in Physical Environmental Quality out of the 105 Counties per 2023 Robert Woods Jackson County's population is 13,286 (based on 2023 findings). About seven percent (6.5%) of the population is under the age of 5, while the population that is over 65 years old is 20%. Children in single parent households make up a total of 18.4% compared to the rural norm of 15.8%, and 87% are living in the same house as one year ago. In Jackson County, the average per capita income is $32,499 while 8.8% of the population is in poverty. The severe housing problem was recorded at 13.5% compared to the rural norm of 10%. Those with food insecurity in Jackson County is 11%, and those having limited access to healthy foods (store) is 5.6%. Individuals recorded as having a long commute while driving alone is 43.2% compared to the norm of 34.6%. Children eligible for a free or reduced-price lunch in Jackson County is 41.1%. Findings found that 93.8% of Jackson County ages 25 and above graduated from high school while 21% have a bachelor's degree or higher. The percentage of births where prenatal care began in the first trimester was recorded at 74.1% compared to the rural norm of 79%. Additionally, the percentage of births with low birth weight was 7.1%. Jackson County recorded 6.1% of births occurring to teens between ages 15-19. The percentage of births where mothers smoked during pregnancy was 10.9% compared to the rural norm of 10.8%. The Jackson County primary care service coverage ratio is 1 provider (county based officed physician who is a MD and/or DO) to 779 residents. There were 2,709 preventable hospital stays in compared to the rural norm of 3,301. Patients who gave their hospital a rating of 9 or 10 (scale 0-10) was 88% while patients who reported they would definitely recommend the hospital was recorded at 89%. The average time patients spent in the emergency department before leaving was 117 minutes. In Jackson County, adults ever diagnosed with depression as of 2021 was 21%. The Mental Behavioral hospital admissions rate per 100k was 60.2 compared to the rural norm of 58.2. Jackson County has an obesity percentage of 37.1% and a physical inactivity percentage is 23%. The percentage of adults who smoke is 19.5%, while the excessive drinking percentage is 19.2%. The percentage of adults who have taken medication for high blood pressure is 81%, while their heart failure admissions rate was recorded at 26.4. Those with kidney disease is 3.3% compared to the rural norm of 3.2%. The percentage of adult individuals who were recorded with cancer was 8.2% while adults recorded with diabetes (20+) is 8.1% compared to the rural norm of 8.4%. The adult uninsured rate for Jackson County is 12.1% compared to the rural norm of only 9.6%. The life expectancy rate in Jackson County for males and females is roughly 78 years of age (78.2). Alcohol-impaired driving deaths for Jackson County is 25% while age-adjusted Cancer Mortality rate per 100,000 is 131.8. The age-adjusted heart disease mortality rate per 100,000 is at 199.8. A recorded 48.8% of Jackson County has access to exercise opportunities. Continually, 45% of women have done a mammography screening compared to the rural norm of 43.3%. Adults recorded in Jackson County who have had regular routine check Schedule H, Part VI, Line 5 Promotion of community health HOSPITAL EMPLOYEES ARE ENCOURAGED TO PARTICIPATE IN LOCAL COMMUNITY ACTIVITIES. EMPLOYEES ARE MEMBERS OF THE LOCAL CHAMBER OF COMMERCE, SERVE AS BOARD MEMBERS WITH SEVERAL LOCAL ORGANIZATIONS, AND ARE BOARD MEMBERS OF A STATE ORGANIZATION PROMOTING THE PATIENT FINANCIAL SERVICES SEGMENT OF HEALTHCARE. EMPLOYEES ARE INVOLVED ON SEVERAL LEVELS WITH YOUTH PROGRAMS. EMPLOYEES PROVIDE IN-SERVICE TRAINING TO VARIOUS LOCAL AGENCIES ON HEALTH ORIENTED SUBJECTS SUCH AS MEDICAL ADMINISTRATION. Schedule H, Part VI, Line 7 State filing of community benefit report KS X X X X false false false false false false false false false Lee Schnee MD Chief of Medical Staff 246814 0 0 0 0 0 9873 0 38776 0 295463 0 0 0 Carrie L Lutz CEO 204937 0 0 0 0 0 8197 0 15235 0 228369 0 0 0 Bart E Kenton CFO 167313 0 0 0 0 0 6692 0 2396 0 176401 0 0 0 LaDona M Schmidt Physician, MD 329960 0 0 0 0 0 13198 0 24749 0 367907 0 0 0 Malia Sm Warner Physician, MD 357876 0 0 0 0 0 14315 0 29756 0 401947 0 0 0 Denis S Jimenez Physician, MD 518613 0 0 0 0 0 8170 0 1825 0 528608 0 0 0 Marija K Lawless Physician, MD 280490 0 0 0 0 0 11220 0 35765 0 327475 0 0 0 Clint M Colberg Physician/MD 372568 0 0 0 0 0 14903 0 39577 0 427048 0 0 0 Form 990, Part III, Line 4a PROGRAM SERVICE DESCRIPTION RURAL HEALTH RESOURCES OF JACKSON COUNTY (RHRJC) IS A 14-BED CRITICAL ACCESS HOSPITAL IN A SMALL RURAL COMMUNITY. RHRJC OFFERS A WIDE RANGE OF SERVICES INCLUDING PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, REGISTERED DIETICIAN SERVICES, MRI, MRA, NUCLEAR MEDICINE, CT SCAN ALONG WITH OTHER RADIOLOGY SERVICES, SURGERY (INCLUDING ORTHOPEDIC), LABORATORY, A CERTIFIED DIABETIC EDUCATION PROGRAM, CARDIOVASCULAR SERVICES, CERTIFIED LYMPHEDEMA PROGRAM, OUTPATIENT GERIATRIC PSYCHOLOGY, AND ROUND CARE SERVICES AS WELL A VARIETY OF SPECIALTY PROVIDER SERVICES. THE HOSPITAL IS A CERTIFIED 'STROKE READY' FACILITY AND STAFF ARE TRAINED TO TEACH OUTREACH SERVICES UNDER THE NATIONAL ARTHRITIS FOUNDATION EXERCISE PROGRAM. THE HOSPITAL ALSO OFFERS HOME HEALTH AND HOSPICE SERVICES. THE HOSPITAL PROVIDED 24/7 EMERGENCY ROOM SERVICES WITH 2,959 EMERGENCY ROOM VISITS RECORDED FROM 4/1/24 THROUGH 12/31/24. EMERGENCY ROOM SERVICES ARE SUPPORTED BY STAFF TRAINED IN ADVANCED CARDIAC LIFE SUPPORT, CPR, EMERGENCY NURSING PEDIATRICS, TRAUMA NURSING CORE CURRICULUM, AND PEDIATRIC ADVANCED LIFE SUPPORT. THE HOSPITAL IDENTIFIED 7,370 INPATIENT HOURS, 13,577 SWING BED HOURS AND 8,273 OBSERVATION HOURS FROM 4/1/24 THROUGH 12/31/24. Form 990, Part VI, Line 1a Material differences in voting rights THE CLASS C DIRECTOR SHALL BE THE CHIEF OF MEDICAL STAFF AND SERVE (1) YEAR TERM. THE CLASS C DIRECTOR SHALL BE ENTITLED TO PARTICIPATE AND VOTE ON ALL MATTERS EXCEPT FOR: (A) EMPLOYEE COMPENSATION AND (B) EMPLOYEE PERSONNEL MATTERS. Form 990, Part VI, Line 11b Review of form 990 by governing body AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE FORM 990. THE 990 IS THEN REVIEWED BY THE CEO AND CFO OF RURAL HEALTH RESOURCES OF JACKSON COUNTY (RHRJC). ANY QUESTIONS OR CONCERNS THAT ARISE ARE ADDRESSED WITH THE ACCOUNTING FIRM AND CORRECTIONS, CLARIFICATIONS OR REVISIONS ARE MADE AS NECESSARY. THE FINAL 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD OF RHRJC PRIOR TO FILING THE 990. Form 990, Part VI, Line 12c Conflict of interest policy UPON HIRE (OR IN THE CASE OF ELECTION OF BOARD MEMBERS) AND ANNUALLY THEREAFTER, THE CEO OR DESIGNEE(S) SHALL PROVIDE TO THE BOARD, STAFF AND EMPLOYED PROVIDERS OF RURAL HEALTH RESOURCES OF JACKSON COUNTY (RHRJC) A COPY OF THE CONFLICT OF INTEREST POLICY AND THE APPLICABLE CONFLICT OF INTEREST DISCLOSURE FORM. THESE DOCUMENTS WILL BE COMPLETED TO IDENTIFY ANY RELATIONSHIPS, POSITIONS, OR CIRCUMSTANCES IN WHICH IT IS BELIEVED A CONFLICT MAY ARISE. THE ANNUAL MONITORING AND REVIEW PROCESS WILL BE PART OF RHRJC'S CORPORATE COMPLIANCE PLAN. ANY POTENTIAL CONFLICT OF INTEREST CONCERNS THAT ARISE SHALL BE REPORTED BY THE CEO TO THE BOARD CHAIR. SHOULD THE CONCERN INVOLVE THE BOARD CHAIR, THE BOARD VICE-CHAIR WILL BE INFORMED INSTEAD. EACH BOARD MEMBER, STAFF MEMBER OR EMPLOYED PROVIDER SHALL FULLY DISCLOSE ANY AND ALL ACTUAL OR POTENTIAL CONFLICTS, DUALITY OF INTEREST OR RESPONSIBILITY INVOLVING INDIVIDUAL, PERSONAL, OR BUSINESS ISSUES WHICH MAY EXIST. IF THERE IS A CONFLICT, THE CONFLICTED INDIVIDUALS ABSTAIN FROM VOTING. Form 990, Part VI, Line 15a Process to establish compensation of top management official ANNUALLY AT THE EMPLOYEE REVIEW PERIOD (USUALLY DURING AUGUST AND SEPTEMBER) THE BOARD OF DIRECTORS IS SUPPLIED WITH A SALARY SURVEY FROM THE KANSAS HOSPITAL ASSOCIATION FOR THE CURRENT YEAR. THE BOARD THEN EVALUATES THE CEO SALARY SURVEY TO DETERMINE IF THE CEO'S SALARY IS APPROPRIATE AND WHAT ANNUAL PAY ADJUSTMENT IS APPROPRIATE FOR THE CURRENT YEAR. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue MISCELLANEOUS REVENUE - Total Revenue: 83678, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 83678; Form 990, Part IX, Line 11g Other Fees CONTRACT SERVICES - Total Expense: 2685370, Program Service Expense: 2328545, Management and General Expenses: 356825, Fundraising Expenses: ; PHYSICIAN SERVICES - Total Expense: 1129140, Program Service Expense: 1129140, Management and General Expenses: , Fundraising Expenses: ; ER PROVIDER SERVICES - Total Expense: 212388, Program Service Expense: 212388, Management and General Expenses: , Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances NET ASSETS RELEASED FROM RESTRICTION - -17534; Total - -17534;