2019-05-15T07:23:45-05:00 2018-06-30 450250958 EIDE BAILLY LLP 621 N ROBINSON AVE STE 200 OKLAHOMA CITY OK 731026232 990 2017-07-01 730579295 Farmers Union Hospital Association FARM 5802252511 1801 W 3rd Street Elk City OK 73644 Corey Lively CEO 5802252511 2019-05-10 1 Kim Hunwardsen P00484560 4055942000 2019-05-09 98.173.248.226 2019-05-10 08:20:14 CD P E10085862974BF89EE8F231EB831862A8F193D10 E10085862974BF89EE8F231EB831862A8F193D10 2017 2019-02-21 02:37:17Z Great Plains Regional Medical Center Corey Lively 1801 W 3rd Street Elk City OK 73644 59512778 0 X www.gprmc-ok.com X 1938 OK To provide comprehensive, cost-effective, high quality healthcare to our communities. 10 9 521 32 50647 -12146 79781 290667 51880074 50547689 803146 488409 309248 327721 53072249 51654486 5813 6152 0 0 24190739 23157273 0 0 0 33119796 33170735 57316348 56334160 -4244099 -4679674 71122019 66339063 36025210 36176243 35096809 30162820 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 50752952 6152 50497042 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 1,596 patients with more than 5,821 patient days on an inpatient basis. We also had 55,651 outpatient encounters. During the year we treated 13,283 patients in the Emergency Department. Our Surgical teams performed 2,570 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 $680,264 in 2018. Total direct and indirect cost related to these foregone charges were $215,000 at June 30, 2018, based on an average ratios of cost to gross charges. 50752952 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 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 69 0 1 521 1 1 1 0 0 0 0 0 0 0 0 0 X 10 9 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 Jack Morrison DDS Chair 1.00 0.10 X X 0 0 0 Jeff Jackson Vice Chair 1.00 0.00 X X 0 0 0 Emory Thomas Secretary (until Nov 2017) 1.00 0.00 X X 0 0 0 J Coffey MD Secretary (as of Dec 2017) 1.00 0.00 X X 0 0 0 Craig Phelps MD Chief of Staff 20.00 0.00 X 14300 0 0 Erick DeRocher DO Vice Chief of Staff 20.00 0.00 X 9625 0 0 Paul Kumpf Member 1.00 0.00 X 0 0 0 Danny Sprowls Member 1.00 0.00 X 0 0 0 Kyle Zybach Member 1.00 0.00 X 0 0 0 Edward Albert Member 1.00 0.00 X 0 0 0 Colby Brewster Member as of Dec 2017 1.00 0.00 X 0 0 0 Corey Lively CEO 40.00 0.10 X 301677 0 0 Monica Scott CFO 40.00 0.00 X 135407 0 3250 Lindsey Pena MD Surgery 40.00 0.00 X 376756 0 1350 Tiffany Dupree DO Obstetrics & Gynecology 40.00 0.00 X 323456 0 0 Roy Greenway MD Surgery 40.00 0.00 X 451347 0 1350 Brad Whinery MD Family Practice 40.00 0.00 X 328007 0 0 Tim Teel DO ENT 40.00 0.00 X 418284 0 1350 2358859 0 7300 16 0 1 0 Premier Physician Staffing 19992 W Woodhaven Road Owasso OK 74055 Physician ER coverage 2929896 Prime Physician Staffing PLLC 19992 W Woodhaven Road Owasso OK 74055 Hospitalist physician coverage 1340625 Nightrays PA 10901 W Toller Dr Suite 105 Littleton CO 80124 Radiologist services 881570 WebTPA 8500 Freeport Parkway Suite 400 Irving TX 75063 Insurance Management 560291 Labcorp 531 S Spring Street Burlington NC 27215 Reference lab services 196875 13 7650 283017 290667 Net patient service 621990 49172751 49172751 Cafeteria 722210 483164 432517 50647 Income from Plains Diagnostic Ima 900099 319512 319512 Daycare center 624410 128218 128218 444044 444044 50547689 507876 507876 58609 58609 269112 0 269112 269112 269112 7838225 600 7857438 854 -19213 -254 -19467 -19467 51654486 50497042 50647 816130 X 6152 6152 461975 26100 435875 116663 116663 17989162 15929892 2059270 57525 50275 7250 3308438 2864515 443923 1223510 1059166 164344 44628 44628 37413 37413 27615 27615 8910341 7636882 1273459 140624 1021 139603 1750084 1510318 239766 284562 110213 174349 892041 882495 9546 70868 67392 3476 64081 33542 30539 1699414 1699414 3722576 3722576 799920 569051 230869 Bad debt expense 7074426 7074426 Medical supplies 6377739 6377739 Food 552105 552105 Dues and subscriptions 266358 110856 155502 455940 352159 103781 56334160 50752952 5581208 0 2967 2967 1696166 666589 5497825 6332315 1424381 1542044 587984 734175 87586644 50961042 39920626 36625602 19390272 16701574 1450147 1637919 925339 1413290 84000 84000 142312 598588 71122019 66339063 3849480 4940324 32108530 31161919 67200 74000 36025210 36176243 X 35096809 30162820 35096809 30162820 71122019 66339063 -4679674 -254315 0 X 0 1 X 1 0 X 748759 748759 59421836 27159097 32262739 25752032 22580426 3171606 1664017 1221519 442498 36625602 Payable to related party 74000 74000 X Part X, Line 2: The Hospital is organized as an Oklahoma nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Hospital is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Hospital is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Hospital has determined it is subject to unrelated business income tax and has filed an Exempt Organization Business Income Tax Return (Form 990T) with the IRS. 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 215000 215000 0.00440 215000 215000 0.00440 7571 7571 0.00020 6420541 3818664 2601877 0.05280 6428112 3818664 2609448 0.05300 6643112 3818664 2824448 0.05740 5207 5207 0.00010 4850 4850 0.00010 10057 10057 0.00020 0 7074426 990420 11752923 14530727 -2777804 X 1 1 1 Plains Diagnostic Imaging LLC Radiology services 0.84550 0.00000 0.15450 1 1 Great Plains Regional Medical Center 1801 W 3rd Street Elk City OK 73644 www.gprmc-ok.com X X X Great Plains Regional Medical Center 1 0 0 1 X X X X X X X X X 15 1 0 0 1 X www.gprmc-ok.com/about/chna X 1 15 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 five community meetings between March - May 2016. Average attendance at the community meetings was 20-25 community members consisting of retired individuals, local business owners, city government, local bank employees/officers, local volunteer organizations, Great Plains Regional Medical Center representatives and individuals from the County Cooperative Extension office. Great Plains Regional Medical Center Part V, Section B, Line 11: The following are the needs addressed in FY2018:Insurance and uninsured individuals1. The hospital and local providers are continuing to collaborate with the Hope Clinic in terms of providing physician services and staffing. The hospital also has a financial assistance policy in place to assist uninsured patients. 2. The hospital also has a representative from the Department of Veterans Affairs one day each week to help with those that need assistance in obtaining state and federal veterans benefits.Preventative care1. The physician offices are increasing case management and insurance plans have case managers to assist patients. In the area of teen pregnancy and sexually transmitted infections, the county health department does provide free condoms, and they employ a health educator who goes to the schools to teach students about sexual health. 2. In terms of outreach and programs the community would like to see, it was noted the hospital and physician offices could take a larger focus on case management and increase the number of preventative exams, wellness exams, maximize smoking cessation, and counseling. 3. The hospital will provide free room space for smoking cessation classes offered to community members 4. The hospital continues to host an annual health fair. There were several booths set up to expand beyond health care. Students are also being invited to attend for the educational opportunity and to see first-hand the careers available to them. 5. Dr. Roy Greenway provided free seminars and discussion about obesity and its associated illnesses along with information about nutrition.6. Dr. Lindsay Pena provided free seminars and discussion about the new treatment for spider veins, varicose veins, leg fatigue, swelling, discoloration, and restlessness.7. The Women's Center provided 6 childbirth classes throughout the year at no charge to the community.8. The dietician and Medical/Surgical Director assisted in hosting a diabetes education seminar in conjunction with Western Oklahoma Family Care Center that was also free to the community.Substance Abuse/Drug Abuse1. In terms of current programs, there is a female recovery center located in Sayre. There is also a grant for middle school students to prevent the use of e-cigarettes and tobacco. There is also the 1-800 quit line available for assistance with decreasing tobacco use. 2. The DARE program was previously successful in educating youth. It was also noted that there is a lack of knowledge of existing resources and partners in this area to refer patients for help. 3. The hospital does note that this is a concern in the community; however, it is largely beyond the scope of services provided by this facility. This priority cannot be addressed at this time outside of provide space for smoking cessation education. 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 $7,074,426. Part II, Community Building Activities: Employees of the Medical Center provide many hours of volunteer service to civic and other community benefit clubs in the area. Involvement in community building activities also extends through other programs such as Meals On Wheels which delivers meals to the homebound. GPRMC assists with a blood drive and provides an athletic trainer. Blood drive initiatives helps to prevent a shortage of blood. Athletic trainer is provided to high schools athletes for health and injury prevention and provide the first medical aid with an injury.GPRMC has a free shuttle service to provide patients without transportation access to physicians' offices and clinics. The shuttle travels in Elk city and area communities. 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 14% 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 page 8 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: The Organization relies on input from physicians, other healthcare providers, community leaders, the Board of Directors and citizens in the community to assess the needs of the community. We look at 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. Part VI, Line 3: Assistance is discussed 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 try to 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 estimated primary and secondary service area population exceeds 100,000. The median household income in Beckham County is $48,851 and 14% of the county is living in poverty. Part VI, Line 5: Our Board of Directors is comprised of citizens from the community, from business owners to retired individuals. This broadly 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 Director. 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 provides breast self-exam, CPR and pre-natal education to community members. The Medical Center is one of two designated donor locations for the communitywide blood drive held five times per year.Great Plains Regional Medical Center sponsors healthcare initiatives for the community. Some of these include diabetes self-management classes for patients with new or uncontrolled diabetes and education to local nursing home staff regarding care of patients with dementia and other types of behavioral disorders. Due to the shortage of nurses in the area, scholarships are awarded to students wishing to pursue degrees in the medical field. Education programs are presented at the local adult learning center discussing education needed to fulfill the requirements for employment in a hospital setting. We also participate in several career fairs for different schools in our area. GPRMC works in cooperation with educators by providing a clinical rotation training environment for students of various fields including physician, nursing, pharmacy, lab, radiology and medical records. We participate with area high schools in the job shadow program. Students interested in health careers may observe our staff in the work setting and obtain a first-hand experience. The Medical Center developed a collaboration with Western Oklahoma State College to provide distance learning classes for those in the community wishing to pursue nursing degrees. GPRMC provides a classroom in the local community. Additionally, in-kind services are provided to Western Oklahoma State College. This is vital to prospective students pursuing nursing degrees that would not have been able to drive the long distance to the College.In-kind services are also provided to Southwestern Oklahoma State University for college classes. The Hospital provides a room, Monday - Friday for teaching general education classes in both fall and spring semesters. X X X X 0 0 0 0 0 0 0 0 0 Corey Lively CEO 301677 0 0 0 0 0 0 0 299 0 301976 0 0 0 Lindsey Pena MD Surgery 351706 0 25050 0 0 0 1350 0 324 0 378430 0 0 0 Tiffany Dupree DO Obstetrics & Gynecology 298456 0 25000 0 0 0 0 0 268 0 323724 0 0 0 Roy Greenway MD Surgery 425455 0 25892 0 0 0 1350 0 448 0 453145 0 0 0 Brad Whinery MD Family Practice 296316 0 31691 0 0 0 0 0 298 0 328305 0 0 0 Tim Teel DO ENT 418284 0 0 0 0 0 1350 0 666 0 420300 0 0 0 A The Oklahoma Development Finance Committee 731083741 678910DB3 2007-06-26 40000000 Construct and furnish a 62-bed hospital 0 0 0 A 8210000 39448937 2653544 562777 36232616 2009 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 Date Rebate Computation Performed Issuer Name: The Oklahoma Development Finance Committee Date the Rebate Computation was Performed: 08/04/2017 Form 990, Schedule K, Part II, Line 3: The total issue price of $40,000,000 reported on Part I, Line A, Column (e) less the Original Issue Discount of $551,063 is the amount reported on Part II, Line 3. John Mark Phelps Family relation to Dr Craig Phelps, Board Member 42218 Compensation as employee 0 Sarah Phelps Family relation to Dr Craig Phelps, Board Member 74445 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 3,623,125. Management and general expenses 350,160. Fundraising expenses 0. Total expenses 3,973,285. Service contracts: Program service expenses 829,792. Management and general expenses 273,445. Fundraising expenses 0. Total expenses 1,103,237. Contract labor: Program service expenses 3,094,719. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,094,719. Purchased services: Program service expenses 89,246. Management and general expenses 649,854. Fundraising expenses 0. Total expenses 739,100. 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 319513 572261 0 1 0.84550 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 Plains Diagnostic Imaging LLC K 825000 General ledger Plains Diagnostic Imaging LLC S 318880 Amount from K-1 Plains Diagnostic Imaging LLC A 633 Amount from K-1