PAWNEE VALLEY COMMUNITY HOSPITAL INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- PAWNEE VALLEY COMMUNITY HOSPITAL INC (EIN 48-1253246)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-15
- IRS object ID
- 201941359349310464
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-15T15:10:42-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1201 Walnut Suite 1700 | AddressLine1Txt |
| City | Kansas City | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 641062246 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 481253246 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pawnee Valley Community Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % GEORGE HARMS TREASURER | InCareOfNm |
| Business Name Control | PAWN | BusinessNameControlTxt |
| Phone | 6202853161 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 923 Carroll Ave | AddressLine1Txt |
| City | Larned | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67550 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRYCE YOUNG | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 6202853161 | PhoneNum |
| Signature | 2019-05-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Michael J Engle | PreparerPersonNm |
| PTIN | P00482834 | PTIN |
| Phone | 8162216300 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 167.68.126.162 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 43372220191355000032 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2019-05-15 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 2FDF6C8628F65582BED0B107C709513F48D8570B | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | B63AEF58A3948584CFC9994E7E12F4E53EEB27F2 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BRYCE YOUNG | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 923 Carroll Ave | AddressLine1Txt |
| City | Larned | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67550 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $18,737,550 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.pawneevalleyhospital.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2001 | FormationYr |
| Legal Domicile State | KS | LegalDomicileStateCd |
| Activity Or Mission | Pawnee Valley Community Hospital, Inc. is a tax-exempt charitable organization under Section 501(c)(3) of the Internal Revenue Code and is licensed (see Schedule O) | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 2 | VotingMembersIndependentCnt |
| Total Employee | 152 | TotalEmployeeCnt |
| Total Volunteers | 94 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $580 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $152,936 | PYContributionsGrantsAmt |
| CY Contributions Grants | $63,086 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $17,590,974 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $18,363,867 | CYProgramServiceRevenueAmt |
| PY Investment Income | $20,752 | PYInvestmentIncomeAmt |
| CY Investment Income | $42,474 | CYInvestmentIncomeAmt |
| PY Other Revenue | $181,108 | PYOtherRevenueAmt |
| CY Other Revenue | $268,123 | CYOtherRevenueAmt |
| PY Total Revenue | $17,945,770 | PYTotalRevenueAmt |
| CY Total Revenue | $18,737,550 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $28,716 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,409,323 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,616,295 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,536,447 | PYOtherExpensesAmt |
| CY Other Expenses | $6,709,294 | CYOtherExpensesAmt |
| PY Total Expenses | $17,974,486 | PYTotalExpensesAmt |
| CY Total Expenses | $15,325,589 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$28,716 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,411,961 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $10,623,043 | TotalAssetsBOYAmt |
| Total Assets EOY | $12,730,812 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,269,859 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,368,918 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,353,184 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,361,894 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Pawnee Valley Community Hospital, Inc. is a tax-exempt charitable organization under Section 501(c)(3) of the Internal Revenue Code and is licensed by the State of Kansas Department of Health and Environment. The purpose of the Organization is (see Schedule O) | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $11,403,246 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $18,363,867 | RevenueAmt |
| Desc | Patient care: Program services consist of routine and ancillary department healthcare services provided by a healthcare organization as described in 501(c)(3) of the IRS code. | Desc |
| Total Program Service Expenses | $11,403,246 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 152 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 2 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GEORGE HARMS TREASURER | PersonNm |
| Phone | 7856235000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2220 CANTERBURY | AddressLine1Txt |
| City | Hays | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67601 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Bryce Young | ||||||||
| President | 4.0 | 40.0 | Yes (X) | Yes (X) | $0 | $273,220 | $85,038 | |
| Shae Veach | ||||||||
| Vice President | 4.0 | 40.0 | Yes (X) | Yes (X) | $0 | $211,544 | $69,083 | |
| George Harms | ||||||||
| Treasurer | 4.0 | 40.0 | Yes (X) | Yes (X) | $0 | $279,856 | $71,874 | |
| Edward Herrman | ||||||||
| Director | 4.0 | 40.0 | Yes (X) | $0 | $68,143 | $12,388 | ||
| David Sanger MD | ||||||||
| Director/Physician non-voting | 40.0 | 0.0 | Yes (X) | $284,906 | $0 | $41,713 | ||
| John Haas | ||||||||
| Secretary | 4.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Lynn Barger | ||||||||
| Director | 4.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| John Jeter MD | ||||||||
| Director | 4.0 | 40.0 | Yes (X) | $0 | $573,058 | $120,521 | ||
| Eric Lybarger | ||||||||
| Administrator | 40.0 | 0.0 | Yes (X) | $145,396 | $0 | $21,246 | ||
| Kendra Barker | ||||||||
| Administrator | 40.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| Christian Whittington | ||||||||
| Physician | 40.0 | 0.0 | $320,175 | $0 | $44,213 | Yes (X) | ||
| MC Hill | ||||||||
| Physician | 40.0 | 0.0 | $277,486 | $0 | $38,801 | Yes (X) | ||
| Debbie Tomlinson | ||||||||
| APRN | 40.0 | 0.0 | $143,008 | $0 | $11,410 | Yes (X) | ||
| Calvin Kruger | ||||||||
| PHYSICIAN ASSISTANT | 40.0 | 0.0 | $134,215 | $0 | $9,005 | Yes (X) | ||
| Amanda Bickle | ||||||||
| APRN | 40.0 | 0.0 | $124,503 | $0 | $28,768 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,429,689 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,405,821 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $554,060 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 11 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Hays Medical Center | |||||
| 2220 Canterbury Drive | HAYS | KS | 67601 | Contract Services | $2,877,755 |
| GE Healthcare | |||||
| 9900 W Innovation Drive | WAUWATOSA | WI | 53226 | Repairs/Maintenance | $185,855 |
| Quest Diagnostics | |||||
| PO Box 14730 | ST LOUIS | MO | 63150 | Lab Services | $150,453 |
| Anesthesiologist Associates of Hays | |||||
| PO Box 821 | HAYS | KS | 67601 | Anesthesia Services | $125,000 |
| Wendling Noe Nelson Johnson | |||||
| 534 South Kansas Suite 1500 | TOPEKA | KS | 66603 | Accounting Services | $115,598 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $11,223 | GovernmentGrantsAmt |
| All Other Contributions | $51,863 | AllOtherContributionsAmt |
| Total Contributions | $63,086 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net patient service revenue | 622000 | $17,232,535 | $17,232,535 |
| 340b drug program | 900099 | $1,089,130 | $1,089,130 |
| Outreach therapy services | 900099 | $15,063 | $15,063 |
| Lab fairs | 900099 | $27,139 | $27,139 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $18,363,867 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $42,048 | TotalRevenueColumnAmt |
| Exclusion | $42,048 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,600 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,600 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,600 | TotalRevenueColumnAmt |
| Exclusion | $1,600 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $426 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $426 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $426 | TotalRevenueColumnAmt |
| Exclusion | $426 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| Meals sold to employees and guest | 722210 | $156,534 | $156,534 |
| ALL OTHER REVENUE | 900099 | $109,989 | $109,989 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $109,989 | TotalRevenueColumnAmt |
| Exclusion | $109,989 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $266,523 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,737,550 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $18,363,867 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $310,597 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $420,640 | TotalAmt |
| Program Services | $321,153 | ProgramServicesAmt |
| Management And General | $99,487 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,485,355 | TotalAmt |
| Program Services | $5,836,787 | ProgramServicesAmt |
| Management And General | $648,568 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $299,885 | TotalAmt |
| Program Services | $267,486 | ProgramServicesAmt |
| Management And General | $32,399 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $940,311 | TotalAmt |
| Program Services | $838,723 | ProgramServicesAmt |
| Management And General | $101,588 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $470,104 | TotalAmt |
| Program Services | $419,316 | ProgramServicesAmt |
| Management And General | $50,788 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,218,400 | TotalAmt |
| Management And General | $2,218,400 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,357 | TotalAmt |
| Management And General | $18,357 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,340 | TotalAmt |
| Management And General | $18,340 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,226,792 | TotalAmt |
| Program Services | $1,029,911 | ProgramServicesAmt |
| Management And General | $196,881 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,957 | TotalAmt |
| Program Services | $87 | ProgramServicesAmt |
| Management And General | $64,870 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $131,444 | TotalAmt |
| Program Services | $67,160 | ProgramServicesAmt |
| Management And General | $64,284 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,345 | TotalAmt |
| Program Services | $57,807 | ProgramServicesAmt |
| Management And General | $38,538 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $607,301 | TotalAmt |
| Program Services | $471,122 | ProgramServicesAmt |
| Management And General | $136,179 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,331 | TotalAmt |
| Program Services | $25,847 | ProgramServicesAmt |
| Management And General | $11,484 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,823 | TotalAmt |
| Management And General | $2,823 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,487 | TotalAmt |
| Program Services | $56,692 | ProgramServicesAmt |
| Management And General | $37,795 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Pharmaceuticals | $784,884 | $784,884 | |
| Medical Supplies | $441,383 | $441,383 | |
| Dietary | $176,410 | $176,410 | |
| Professional Fees/Dues/Subs | $719,694 | $605,983 | $113,711 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,346 | TotalAmt |
| Program Services | $2,495 | ProgramServicesAmt |
| Management And General | $67,851 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,325,589 | TotalAmt |
| Program Services | $11,403,246 | ProgramServicesAmt |
| Management And General | $3,922,343 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $925,211 | BOYAmt |
| EOY | $1,023,480 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,256,421 | BOYAmt |
| EOY | $5,753,164 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,066,682 | BOYAmt |
| EOY | $3,218,449 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $284,579 | BOYAmt |
| EOY | $314,443 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $151,199 | BOYAmt |
| EOY | $119,222 | EOYAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $122,160 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,938,951 | BOYAmt |
| EOY | $2,179,894 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,623,043 | BOYAmt |
| EOY | $12,730,812 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $992,734 | BOYAmt |
| EOY | $981,180 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,277,125 | BOYAmt |
| EOY | $10,387,738 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,269,859 | BOYAmt |
| EOY | $11,368,918 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $347,347 | BOYAmt |
| EOY | $356,057 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,005,837 | BOYAmt |
| EOY | $1,005,837 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,353,184 | BOYAmt |
| EOY | $1,361,894 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,623,043 | BOYAmt |
| EOY | $12,730,812 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,411,961 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$3,403,251 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (true) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $3,436 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Total Lobbying Expenditures | $3,436 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule C, Part II-B, Line 1f | FormAndLineReferenceDesc |
| Explanation | Pawnee Valley Community Hospital is a member of the Kansas Hospital Association and the American Hospital Association. Both of these organizations engage in lobbying activities for hospitals and health care as part of the services provided to members. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,266,232 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$72,582 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,193,650 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,169,777 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $96,455 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,266,232 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $934,796 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $234,981 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,169,777 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $372,016 | BeginningYearBalanceAmt |
| Contributions | $1,515,575 | ContributionsAmt |
| Other Expenditures | $952,795 | OtherExpendituresAmt |
| End Year Balance | $934,796 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $142,777 | BeginningYearBalanceAmt |
| Contributions | $408,437 | ContributionsAmt |
| Other Expenditures | $179,198 | OtherExpendituresAmt |
| End Year Balance | $372,016 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (true) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (true) | RelatedOrgListSchRInd |
| Land | LandGrp | |
| Buildings | BuildingsGrp | |
| Leasehold Improvements | LeaseholdImprovementsGrp | |
| Equipment | EquipmentGrp | |
| Other Land Buildings | OtherLandBuildingsGrp |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| AMOUNTS DUE FROM 3RD PARTY PAY | $818,000 |
| BENEFICIAL INTEREST FOUNDATION | $1,361,894 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,179,894 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| Pension Liability | $122,160 |
| Due to University of Kansas Hospital Authority | $220,282 |
| Due to Pawnee County | $9,247,180 |
| Due to Hays Medical Center | $567,116 |
| Estimated amounts due to third-party payors | $231,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $10,387,738 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part V, Line 4 | FormAndLineReferenceDesc |
| Explanation | Donations are requested for specific items or improvements to the Hospital. When a donation is received for that specific item, it is restricted for that use by the Board until the specific item or improvement is purchased. At any one time, one or more such projects can be in progress. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 130. | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $115,500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $115,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00870 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $987,919 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $565,153 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $422,766 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03190 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,103,419 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $565,153 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $538,266 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04060 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,100 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,100 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,789,352 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,349,514 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,439,838 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10870 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,793,452 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,349,514 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,443,938 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10900 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,896,871 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,914,667 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,982,204 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14960 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $483,426 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $10,232,644 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $10,570,956 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$338,312 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pawnee Valley Community Hospital Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 923 Carroll Avenue | AddressLine1Txt |
| City | Larned | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67550 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pawnee Valley Community Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 17 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | see part v, section c | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | see part v, section c | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 130. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400. | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | see part v, section c | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | see part v, section c | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | see part v, section c | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5 | The CHNA was conducted in collaboration with the Pawnee County Health Department. A Town Hall meeting was organized to provide an objective consensus building method of reviewing and prioritizing county health issues. During the Town Hall meeting, the group reflected on the size and seriousness of any health concerns cited and discussed current community health strengths. The group identified and ranked top community health concerns, and all Town Hall attendees were encouraged to continue to contribute ideas by going online and taking a feedback survey that addresses any additional thoughts related to the CHNA. All Town Hall priority-setting and score processes involved the input of a diverse group with knowledge and/or expertise in public health as well as persons who represent the broad interests of the community served by the hospital. Key stakeholders in attendance included representatives from: United Way, Welcome Inn Senior Center, Center for Counseling, Angels Care Home Health, Golden Belt Foundation, Larned City Council, Burdett City Council and Garfield City Council and Rozel Community, Pawnee County Sherriff's office, Larned Police Department, Pawnee County Health Department, County Commissioners, members of the Chamber of Commerce, members of the USD 495 School Board, school nurses of USD 495, local members of the media, local religious organizations and representative of Pawnee Valley Community Hospital. The CHNA was coordinated and produced by VVV Research & Development, Inc. from Olathe, Kansas. |
| Schedule H, Part V, Section B, Line 6b | Pawnee County, KS |
| Schedule H, Part V, Section B, Line 7a | https://pawneevalleyhospital.com/wp-content/uploads/2018/06/CommunityHealt hNeedsAssessnent_PawneeCo_2018.pdf |
| Schedule H, Part V, Section B, Line 10a | https://pawneevalleyhospital.com/wp-content/uploads/2018/09/CHNA-Improveme ntPlan-Pawnee-2018.pdf |
| Schedule H, Part V, Section B, Line 11 | Annual description of the actions taken by the Hospital during the fiscal year to address the significant health needs identified throughout the most recently conducted CHNA: 1.) Build and/or Develop Exercise Facilities - 37 votes, 22.8% Construction on the Fort Larned USD #495 community fitness center is complete and is expected to be open to the public August 2017. Any Pawnee County taxpayer can get a membership to the fitness center for $25 a year. PVCH is planning their annual fun run for August 2017. The money raised will be used to help purchase physical education equipment and playground equipment for the new elementary school. The community continues to support other local exercise entities such as spin class, taekwondo, Yoga, and an independently owned exercise gym. 2.) Expand Oncology Services - 25 votes, 15.4% We have explored the feasibility of offering oncology services and providers in Pawnee County and it was determined not to be feasible at this time. The services that PVCH provides to Oncology patients through our special nursing services department are Central Line Maintenance, Transfusions, Injections, non-chemo infusions, and removal of chemotherapy pumps. 3.) Improve Air Quality (Feed Lots) - 20 votes, 12.3% We plan to continue to look into improving air quality in Pawnee County. More research needs to be done to determine if it is feasible for PVCH to implement a plan to address air quality issues. 4.) Reduce Drug/Alcohol Abuse - 20 votes , 12.3% PVCH currently does education and discharge instructions in our Emergency Department for any patients that come in under the influence of drugs and/or alcohol. The Pawnee County Health Department and Pawnee Valley Community Hospital continues to partner with The Center for Counseling through an "Improving Health in Rural Counties" grant. The grant project focuses on public mental health awareness and utilization campaign focusing on (1) recognition and understanding of the importance of mental health and substance abuse issues; (2) public recognition of local behavior health resources/services (including substance use); and (3) increased utilization of those services. - Print and radio advertisements are ongoing to increase behavioral health awareness and assist with increasing understanding of available community resources. - A community behavioral health resource has been created to assist linking people to appropriate treatment. - Crisis mental health screenings are being performed by telemedicine to help make the screenings more accessible and get people to assistance more rapidly. - Mental health kiosks "Get a Checkup from the Neck Up" are available at the health department for people to take an anonymous screening (eight different categories) and results are given to the person and they are directed by information on the screen to access assistance. - Information is provided at community health fairs on mental health and substance use issues. The Pawnee County Commissioners signed a resolution on April 3rd, 2017 for the "Stepping Up Initiative". This initiative is to help reduce the number of people with mental illnesses in jails, including those with substance abuse, as three quarters of those with mental healtlh illness in jails also have substance abuse issues. The first community partner meeting for this initiative will be April 19th and includes the following: 1. Larned State Hospital 2. Law Enforcement 3. EMS 4. Pawnee Valley Community Hospital 5. The Center for Counseling 6. Pawnee County Ministerial Alliance 7. Community Corrections 8. Family Crisis Center 9. County Attorney 10. Public Health 11. Medical Provider The health department, as part of our comprehensive data collection, screens individuals accessing the health department for alcohol and substance abuse and then refers if help is needed. 5.) Provide Health Food Options - 14 votes, 8.6% Pawnee Valley Community Hospital is promoting healthy eating lifestyles focusing on food labels, healthy meal options, nutrition, and portion control. In 2016 PVCH signed the healthy Kansas hospital initiative. We are in the process of forming an internal committee and developing a policy. The plan is to then extend the committee to include community members and focus on what changes we can make in the community such as grocery store options and healthy meal options at local restaurants. We continue to offer diabetic education classes which is a two day session 6 times a year. Participants eat at the facility and go through the cafeteria line and are encouraged to make healthier food choices. PVCH continues to educate children at their annual sixth grade health fair and includes education on portion control, label reading, and exercise. The health department promotes the diabetes support group and sends out their meeting reminders each month. The diabetes support group discusses nutrition with people in attendance. 6.) Increase Access to Home Health/Hospice - 11 votes, 6.8% PVCH continues to be a partner with the Kansas Heart and Stroke Collaborative and we have a part time staff member that goes into the home and checks on the patient and makes sure they are following the guidelines provided by their physician, pertaining to heart and stroke. PVCH has obtained an agreement with Golden Belt Home Health and Hospice for respite care. 7.) Offer Nursing Home Dementia Services - 11 votes, 6.8% Country Living Assisted Living facility in Pawnee County will be operating another building for "Memory Care" in November 2017. Number of beds dedicated to memory care is based on availability and need of care level of the patient. Staff is trained with dementia and Alzheimer's training. Country Living is a member of the Alzheimer's association. |
| Schedule H, Part V, Section B, Line 13b | Financial assistance may be given for catastrophic medical expenses, even if patient's income exceeds the Federal poverty guidelines. |
| Schedule H, Part V, Section B, Line 16a | https://www.pawneevalleyhospital.com/wp-content/uploads/2018/12/Financial- Assistance-Policy-PVCH11-2018.pdf |
| Schedule H, Part V, Section B, Line 16b | https://www.pawneevalleyhospital.com/wpcontent/uploads/2019/02/BUS136.pdf and https://www.pawneevalleyhospital.com/wpcontent/uploads/2019/02/BUS116a.pdf |
| Schedule H, Part V, Section B, Line 16c | https://www.pawneevalleyhospital.com/billing/financial-assistance-policy-s ummary/ |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pawnee Valley Medical Associates | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 713 W 11th St | AddressLine1Txt |
| City | Larned | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67550 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | Family Medicine | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part I, Line 7 | A cost-to-charge ratio derived from Worksheet 2 was used to determine financial assistance at cost and the cost of subsidized health services. A cost-to-charge ratio derived from Worksheet 2 was used to determine the costs of serving Medicaid beneficiaries. |
| Schedule H, Part I, Line 7g | Subsidized health services community benefit expenses include $983,269 of expenses attributable to physician clinics that have net operating losses. |
| Schedule H, Part III, Line 2 | Costing methodology: A cost-to-charge ratio derived from Worksheet 2 was used to calculate bad debt expense at cost. |
| Schedule H, Part III, Line 4 | The footnote from the hospital's financial statements follows: 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 8 | The Medicare cost report was the costing methodology used to determine the allowable Medicare costs pertaining to Medicare net revenue. Allowable costs of care reported on line 6 were determined using amounts from Worksheet D, Part V and Worksheet D-1 in the Pawnee Valley Community Hospital, Inc., Medicare cost report for fiscal year ended June 30, 2018. |
| Schedule H, Part III, Line 9b | Whenever possible, the customer service representatives (CSR's) of Pawnee Valley Community Hospital try to determine the estimated self-pay balance prior to the patient receiving services. Charity care eligibility is first considered at this point in time. In addition, if full payment is not received or payment is not made with 30 days, the CSR contacts the patient. If it is determined that at least a two-year payment plan cannot be established with the patient, the CSR will screen for charity care and request that the charity care application be completed by the patient. |
| Schedule H, Part VI, Line 3 | Information regarding the Pawnee Valley Community Hospital, Inc. charity care program is located on the Pawnee Valley Community Hospital and Hays Medical Center, Inc. website for patients and community members to view, and the financial assistance application is also on the HMC website to print off and complete. A financial assistance policy summary is included with every statement that is sent to an uninsured patient. In addition, if a customer service representative contacts a patient about a bill and in visiting with them they determine that patient could possibly qualify for the hospital's charity care policy, the CSR will send the application to the patient as well. |
| Schedule H, Part VI, Line 4 | Pawnee Valley Community Hospital, Inc. is located in Larned, Kansas, which has a population of approximately 4,050 people, as of the 2010 census. The median household income of Larned was $43,250. Approximately 5.9% of families were below the poverty line, and 7.4% of the total population was below the poverty line. Approximately 8.6% of the hospital's revenue is from services provided to patients eligible for Medicaid. Pawnee Valley Community Hospital, Inc. is the only hospital in Larned, Kansas. It mainly serves the community of Larned. |
| Schedule H, Part VI, Line 5 | Pawnee Valley Community Hospital, Inc. promotes the health of the community by extending medical privileges to most qualified, local physicians. |
| Schedule H, Part VI, Line 6 | Pawnee Valley Community Hospital, Inc. is a component unit of Hays Medical Center, Inc. As of January 1, 2017, Hays Medical Center, Inc. became a component unit of the University of Kansas Hospital Authority. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Bryce Young | ||||||||||||||
| President | $0 | $273,220 | $0 | $0 | $0 | $0 | $0 | $57,845 | $0 | $27,193 | $0 | $358,258 | $0 | $0 |
| Shae Veach | ||||||||||||||
| Vice President | $0 | $195,390 | $0 | $0 | $0 | $16,154 | $0 | $43,242 | $0 | $25,841 | $0 | $280,627 | $0 | $0 |
| George Harms | ||||||||||||||
| Treasurer | $0 | $279,856 | $0 | $0 | $0 | $0 | $0 | $56,552 | $0 | $15,322 | $0 | $351,730 | $0 | $0 |
| David Sanger MD | ||||||||||||||
| Director/Physician non-voting | $245,572 | $0 | $25,000 | $0 | $14,334 | $0 | $16,200 | $0 | $25,513 | $0 | $326,619 | $0 | $0 | $0 |
| John Jeter MD | ||||||||||||||
| Director | $0 | $570,992 | $0 | $569 | $0 | $1,497 | $0 | $102,168 | $0 | $18,353 | $0 | $693,579 | $0 | $0 |
| Eric Lybarger | ||||||||||||||
| Administrator | $96,008 | $0 | $0 | $0 | $49,388 | $0 | $2,277 | $0 | $18,969 | $0 | $166,642 | $0 | $0 | $0 |
| Christian Whittington | ||||||||||||||
| Physician | $243,075 | $0 | $15,000 | $0 | $62,100 | $0 | $16,200 | $0 | $28,013 | $0 | $364,388 | $0 | $0 | $0 |
| MC Hill | ||||||||||||||
| Physician | $245,381 | $0 | $15,000 | $0 | $17,105 | $0 | $12,208 | $0 | $26,593 | $0 | $316,287 | $0 | $0 | $0 |
| Debbie Tomlinson | ||||||||||||||
| APRN | $142,639 | $0 | $311 | $0 | $58 | $0 | $8,646 | $0 | $2,764 | $0 | $154,418 | $0 | $0 | $0 |
| Amanda Bickle | ||||||||||||||
| APRN | $124,088 | $0 | $207 | $0 | $208 | $0 | $3,923 | $0 | $24,845 | $0 | $153,271 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Schedule J, Part I, Line 3 | A related organization uses a compensation committee, independent compensation consultant, written employment contract, and approval by the board or compensation committee to establish the compensation of the Hospital's Administrator. |
| Form 990, Schedule J, Part I, Line 4a | ERIC LYBARGER $43,762 |
| Form 990, Schedule J, Part I, Line 4b | Contributions to the plan: John Jeter, M.D. - $85,968 Bryce Young - $41,991 George Harms - $42,148 Shae Veach - $30,195 Edward Herrman - $9,692 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part I, Line 1 | by the state of Kansas Department of Health and Environment. The purpose of the Organization is to improve the quality of life for the communities we service through exceptional healthcare and service excellence. The Organization is striving to be the best Critical Access Hospital in rural America. |
| Form 990, Part III, Line 1 | to provide healthcare facilities and services for the care and treatment of inpatients and outpatients who are acutely ill or who otherwise require medical care and related services. The core purpose of the Corporation is to improve the quality of life for the communities we serve through exceptional healthcare and service excellence. |
| Form 990, Part VI, Section A, Line 6 | The organization has one member, HaysMed Partners, Inc., which became the sole member as of March 1, 2010. HaysMed Partners, Inc., is a wholly-owned subsidiary of Hays Medical Center, Inc. |
| Form 990, Part VI, Section A, Line 7a | The Board members of HaysMed Partners, Inc., the sole member of Pawnee Valley Community Hospital, appoint the Board members of Pawnee Valley Community Hospital, Inc. |
| Form 990, Part VI, Section A, Line 7b | HaysMed Partners, Inc., the sole member of Pawnee Valley Community Hospital, elects the Board members of Pawnee Valley Community Hospital. |
| Form 990, Part VI, Section B, Line 11b | Form 990 was reviewed with the Board members prior to filing. |
| Form 990, Part VI, Section B, Line 12c | Officers, directors & key employees, along with all associates, are required to complete a conflict of interest statement annually. The statements are used to monitor and enforce compliance with the policy. |
| Form 990, Part VI, Section B, Lines 15a & 15b | The hospital administrator and officers' salaries are reviewed annually by an independent consulting group and the Board members. |
| Form 990, Part VI, Section C, Line 19 | These documents are not made available to the public. |
| Form 990, Part XI, Line 9 | Transfers to Pawnee County $ 3,535,460 Change in assets held by foundation $ 132,209 ------------ Total $ 3,403,251 |
| Form 990, Part XII, Line 2c | The Pawnee Valley Community Hospital, Inc. board is responsible for the oversight of Pawnee Valley Community Hospital, Inc's., financial statement audit and the selection process of an independent accountant. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| HaysMed Partners Inc | |||||||||||
| 2220 Canterbury Dr | Hays | KS | 67601 | 270877152 | Management | KS | 501(c)(3) | 3 | HMC | Yes (true) | |
| Hays Medical Center Inc | |||||||||||
| 2220 Canterbury Dr | Hays | KS | 67601 | 480559088 | Hospital | KS | 501(c)(3) | 3 | UKHA | Yes (true) | |
| Pawnee Valley Community Hospital Fdn | |||||||||||
| 923 Carroll Ave | Larned | KS | 67550 | 455333776 | Support | KS | 501(c)(3) | 12a | PVCH | Yes (true) | |
| University of Kansas Hospital Authority | |||||||||||
| 3901 Rainbow Blvd | Kansas City | KS | 66160 | 481202402 | Hospital | KS | false | N/A | |||
| St Rose Health Center | |||||||||||
| 2220 Canterbury Dr | Hays | KS | 67601 | 472117443 | Health center | KS | 501(c)(3) | 3 | HMC | Yes (true) | |
| HADLEY FOUNDATION INC | |||||||||||
| 1200 MAIN | HAYS | KS | 67601 | 481107034 | GRANTS | KS | 501(C)(3) | 12C | NA | false | |
| TURNING POINT THE CENTER FOR HOPE | |||||||||||
| 8900 STATE LINE ROAD STE 240 | LEAWOOD | KS | 66206 | 431900039 | HEALTHCARE | KS | 501(C)(3) | 7 | UKHA | Yes (true) | |
| KANSAS UNIVERSITY PHYSICIANS INC | |||||||||||
| 3901 RAINBOW BLVD 4070 DELP | KANSAS CITY | MO | 66160 | 481163756 | HEALTHCARE | KS | 501(C)(3) | 10 | UKP | Yes (true) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|
| KU MEDWEST AMBULATORY SURGERY | ||||||||
| 7405 RENNER ROAD | SHAWNEE | KS | 66217 | 020664568 | HEALTHCARE | KS | UKHA | false |
| UKH SPORTS MED LLC | ||||||||
| 2330 SHAWNEE MISSION PKWY STE 200 | WESTWOOD | KS | 66205 | 463123647 | HEALTHCARE | KS | UKHA | false |
| KH ALLIANCE LLC | ||||||||
| 4000 CAMBRIDGE STREET | KANSAS CITY | KS | 66160 | 472838147 | HEALTHCARE | KS | UKHA | false |
| KANSAS CLINICAL IMPROVEMENT COLLABORATIV | ||||||||
| 112 SW 7TH STREET SUITE 3C | TOPEKA | KS | 66603 | 812776361 | HEALTHCARE | KS | UKHA | false |
| KANSAS PRIMARY CARE ALLIANCE LLC | ||||||||
| 2330 SHAWNEE MISSION PKWY SUITE 200 | WESTWOOD | KS | 66205 | 463164140 | HEALTHCARE | KS | UKHA | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| JAYHAWK PRIMARY CARE INC | |||||||||
| 2300 SHAWNEE MISSION PARKWAY STE 3 | WESTWOOD | KS | 66205 | 481159444 | HEALTHCARE | KS | UKHA | C-CORP | Yes (true) |
| MID-AMERICA CARDIOLOGY ASSOCIATES INC | |||||||||
| 4000 CAMBRIDGE STREET STE G600 | KANSAS CITY | KS | 66160 | 480980010 | HEALTHCARE | MO | UKHA | C-CORP | Yes (true) |
| UNIVERSITY OF KANSAS PHYSICIANS INC | |||||||||
| 2330 SHAWNEE MISSION PKWY STE 200 | WESTWOOD | KS | 66205 | 471214865 | HEALTHCARE | KS | UKHA | C-CORP | Yes (true) |
| UKHA PROGRAM SUPPORT INC | |||||||||
| 2330 SHAWNEE MISSION PKWY STE 200 | WESTWOOD | KS | 66205 | 455571151 | REAL ESTATE | KS | UKHA | C-CORP | Yes (true) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (6 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Hays Medical Center Inc | ||
| e | $166,881 | FMV |
| Hays Medical Center Inc | ||
| m | $462,021 | FMV |
| Hays Medical Center Inc | ||
| o | $294,841 | FMV |
| Hays Medical Center Inc | ||
| p | $2,232,938 | FMV |
| Pawnee Valley Community Hospital Foundation | ||
| c | $123,499 | FMV |
| Pawnee Valley Community Hospital Foundation | ||
| l | $66,807 | FMV |