2019-07-26T13:34:08-05:00 2018-09-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2017-10-01 480545183 Lindsborg Community Hospital Association LIND 7852273308 605 West Lincoln Lindsborg KS 674562328 Larry Van Der Wege Administrator 7852273308 2019-07-26 1 Kim Hunwardsen CPA P00484560 6122536500 2019-07-25 199.247.43.26 2019-07-26 09:18:44 CD P D8A1E5117AA53286D53F57459EBB2DE5C7CA50FC F9BEE9501A3B4F00F190E63700B8BF2BC70C7B96 2017 2019-02-21 02:37:17Z Larry Van Der Wege 605 West Lincoln Lindsborg KS 674562328 11927057 0 X www.lindsborghospital.org X 1944 KS Operation of critical access hospital. 9 9 0 9 0 0 3800627 67716 10749173 11847394 1559 11947 5000 0 14556359 11927057 15000 0 0 0 6503969 7150757 0 0 7583 4526227 4609268 11045196 11760025 3511163 167032 8825092 10538270 578947 529198 8246145 10009072 X Partners caring for the health of the Smoky Valley communities. 0 0 10647403 0 11847394 Lindsborg Community Hospital (LCH) operates a critical access hospital in a community qualifying for such designation under federal law. The facilities are adequate for treatment or care of individuals suffering from mental or physical illness, disease, injury or deformity in an acute care, skilled nursing care, outpatient or emergency room setting. LCH cares for residents of the Smoky Valley with the operation of a 24/7 emergency room. 1,966 emergency room patients were seen in the 2018 fiscal year. 562 urgent care visits, 565 privately paid home health visits were made, and 263 cardiac rehab visits improved the health of community members. 12,485 visits were made in the Family Health Care Clinic to provide acute treatment, manage chronic conditions, or provide preventive care. 3,156 meals on wheels were supplied to community members. Education was provided to the Smoky Valley Community through Stepping On, Safe Sitter, and Chronic Disease Self-Management Program education. Employees of the LCH partner with various community groups to provide assistance to the Midsummer's Committee, Hyllningsfest Committee, Chamber of Commerce, and Strategic Alliance to name a few. Staff also provide leadership with the Sunflower Health Network, KHA Board of Directors, and the Sunflower (Kansas) HFMA Chapter. 10647403 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 X 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 0 X Laraine Gengler 7852273308 605 West Lincoln Lindsborg KS 674562328 X Chuck Oleen President 1.00 0.00 X X 0 0 0 Robyn Johnson Vice President 1.00 0.00 X X 0 0 0 Judy Neuschafer Secretary 1.00 0.00 X X 0 0 0 Tom Buffington Treasurer 1.00 0.00 X X 0 0 0 Denise Peterson Director 1.00 0.00 X 0 0 0 Ryan Biegert Director 1.00 0.00 X 0 0 0 Gretchen Norland Director 1.00 0.00 X 0 0 0 Mike Rose Director 1.00 0.00 X 0 0 0 Mary Ann Carlson Director 1.00 0.00 X 0 0 0 Larry Van Der Wege Administrator 40.00 0.10 X 0 0 0 Laraine Gengler CFO 40.00 0.10 X 0 0 0 0 0 0 0 0 0 0 Salina Regional Health Center 400 S Santa Fe Salina KS 67401 Payroll and other reimbursement 12592500 Simpson Construction 1831 S Anna Wichita KS 672771088 Construction 674011 Rehabvisions 11623 Arbor St Omaha NE 68144 Therapy Services 558714 Spangenberg Phillips Tice 121 N Mead Wichita KS 67202 Architecture 145059 4 67716 67716 Net patient revenue 621400 10901336 10901336 Pharmacy revenue 621400 536587 536587 Sales Tax Revenue 900099 332185 332185 77286 77286 11847394 11947 11947 11927057 11847394 0 11947 X 267570 267570 58756 58756 5590258 5271153 319105 177767 171427 6340 700014 654251 45763 356392 316421 39971 54291 54291 24566 24566 15272 15272 1337964 1337964 31988 31988 353749 283409 70340 245888 128204 117684 90059 90059 11225 8791 2434 7751 4450 3301 3257 3257 613772 523645 90127 26627 14285 12342 Medical and Patient Sup 786788 785953 835 Bad Debts 292004 292004 Food Costs 67185 63118 4067 Dues, Licenses, and Tax 34179 20075 14104 612703 565890 39230 7583 11760025 10647403 1105039 7583 60612 37973 5451670 4189502 178350 150925 111833 121128 7633505 4781613 1942584 2851892 1079882 1126905 161 2059945 8825092 10538270 319909 413196 171002 116002 88036 0 578947 529198 X 7985587 9748518 260558 260554 8246145 10009072 8825092 10538270 X 167032 1595895 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 2232 2232 0 Part II-B, Line 1: The portion of annual dues paid to hospital and medical associations attributed to lobbying activities by the associations. 10442 10442 3613456 1790980 1822476 3752351 2737985 1014366 257256 252648 4608 2851892 Other Assets 161 Receivable from Salina Regional Health Center 2059784 2059945 X 11612847 0 11612847 314210 314210 11927057 11446217 0 11446217 313808 313808 11760025 Part X, Line 2: Lindsborg Community Hospital Association is organized as a Kansas not-for-profit 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). Lindsborg Community Hosptial Association is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the organization is subject to income tax on net income that is derived from business activites that are unrelated to its exempt purpose. In this case, the organization would file an Exempt Organization Business Income Tax Return (990T) with the IRS to report unrelated business taxable income. Lindsborg Community Hospital Assoication believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalities are incurred. Part XI, Line 4b - Other Adjustments: Bad Debts 292,004. Reclassification of revenue/expense accounts, net 14,221. Auxiliary revenue 7,985. Part XII, Line 4b - Other Adjustments: Bad Debts 292,004. Reclassification of revenue/expense accounts, net 14,221. Auxiliary expense 7,583. 1 1 X 1 X 1 X 1 1 0 0 88 22155 22155 0.00190 88 22155 22155 0.00190 8678 5908 5908 0.00050 247 30418 23561 6857 0.00060 3570419 885640 2684779 0.22830 8925 3606745 909201 2697544 0.22940 9013 3628900 909201 2719699 0.23130 9482 657 7985 0 0.00000 9482 657 7985 0 0.00000 1 292004 4954612 4971153 -16541 X 1 1 1 1 Lindsborg Community Hospital Association 605 W Lincoln St Lindsborg KS 67456 www.lindsborghospital.org H059001 X X X Lindsborg Community Hospital 1 0 0 1 X X X X X X X X X 15 1 1 1 1 X See Line 10a X 1 15 1 www.lindsborghospital.org/about/message_from_ceo.php 0 1 X 200.000000000000 300.000000000000 X X X X X X 1 1 X X X 1 X www.lindsborghospital.org/patients/financial_assistance.php X www.lindsborghospital.org/patients/financial_assistance.php X www.lindsborghospital.org/patients/financial_assistance.php X X X X X X 1 X 0 X X X X 1 X 0 0 Lindsborg Community Hospital Part V, Section B, Line 6a: McPherson Hospital, McPherson, Kansas Mercy Hospital, Moundridge, Kansas Lindsborg Community Hospital Part V, Section B, Line 6b: McPherson County Health Department Lindsborg Community Hospital Part V, Section B, Line 11: The Implementation Strategy was completed in July 2016. All identified needs are being addressed.Health Issues - The CHNA identified a need for services that target obesity, cancer, and mental health issues. To address obesity a Medically Supervised Weight Management program has been expanded with the addition of Jade Banning, PA. Jade provides services one afternoon per week. Renee Riedel, RDLD, CDE also joined the LCH healthcare team. She provides inpatient and outpatient consultation. We are targeting cancer by utilizing our EMR to identify patients who use tobacco. We offer smoking cessation programs and early cancer detection through mammography and colonoscopy. The percentage of patients receiving appropriate screenings are being measured and compared against national benchmarks. Mental health is a challenge throughout the state. LCH partnered with Prairie View Mental Health to provide emergency screening through telemedicine. We also continue our partnership with Veridian Behavioral Health to provide care. Central Kansas Foundation is utilized for those who've received a referral for alcohol or drug treatment. Education on many of these health issues has been performed since the inception of our implementation plan.Specific Populations with Barriers to Access and Risky Behaviors - The CHNA identified availability to medical specialists and hours of operation as the barriers to access. The risky behaviors were identified as drug abuse, texting/cell phone use while driving, and alcohol abuse. We hope to improve upon Access to specialists with the addition of orthopedics through our managing entity, Salina Regional Health Center. We are in search of further Orthopedic services, as a part of SRHC. With our patient centered remodel allowing for the expansion of urgent care we will have the ability to offer Urgent Care services seven days per week in the fall of 2019. This will greatly expand access to our service area and beyond. Drug and alcohol abuse typically go hand in hand. Part of the action plan will be to continue to perform alcohol and drug screening in the clinic and Emergency Department with referral to the Central Kansas Foundation or other facilities as needed. Standardized evaluation tools in the hospital and clinic EMRs improve the consistency of screening for these behaviors. Another current nationwide challenge is the abuse of opioid medications. The Family Health Care Clinic has adopted policies to monitor and reduce the amount of opioids, as per Center for Disease Control (CDC) guidelines. Improved standardization and policies are being developed in the Emergency Department as well. These actions will be ongoing in development, education and enforcement. Texting and cell phone use while driving was also identified as a risky behavior. Facebook and newspaper will be used to provide public safety announcements around texting and cell phone use while driving. Partnerships with the local schools, as well as local law enforcement will also be developed to enhance the outreach. Action plan for Strengthening Families: Circles of McPherson County is part of a national program to assist families. Taken from its website, "Circles connects people in relationships across income lines and helps develop clear goals for education and stable income. Circles also focuses on supporting families to help themselves completely out of poverty." LCH Administrator Larry Van Der Wege began serving on the board of the local chapter, Circles of Smoky Valley, in the fall of 2017. The LCH Employee Committee has also designated three months' worth of employee donations to this entity. Although not specific for just "strengthening families", LCH took part in training local lay people and two non-clinical employees in teaching management of chronic conditions. The program - developed by Stanford University - is designed to teach people from the community on how to manage their chronic condition, through research, goal setting and partnership with their medical provider(s). LCH has already begun providing the session course at no cost to members of their service area. The initial training for the local teachers was provided through a partnership with the Kansas Department of Health and Environment and the Kansas Foundation for Medical Care. Lindsborg Community Hospital Part V, Section B, Line 13h: The methodology used to determine eligibility for financial assistance takes into consideration income, net assets, family size and resources available to pay for care. In addition, presumptive charity care may be applied in situations where all other avenues have been exhausted. Lindsborg Community Hospital Part V, Section B, Line 16j: The FAP application and plain language summary can be found at the URL listed on lines 16b and 16c by clicking on the link "Learn More - financial assistance program form." Lindsborg Community Hospital Part V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy. 1 1 - Family Health Care Clinic 605 W Lincoln St Lindsborg KS 67456 Physician clinic Part I, Line 3c: The methodology used to determine eligibility for financial assistance takes into consideration income, net assets, family size and resources available to pay for care. In addition, presumptive charity care may be applied in situations where all other avenues have been exhausted. Part I, Line 7: Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Amounts on lines 7e and 7f are from the actual general ledger. Subsidized health services on line 7g were calculated utilizing the Medicare cost report. Part I, Line 7g: One provider based clinic is included in subsidized health services. Net revenues of $144,656 and costs of $2,106,217 were included for a net community benefit of $1,961,561. Part I, Ln 7 Col(f): The bad debt expense included on Form 990, Part IX, line 25, Column (A), but subtracted for purposes of calculating the percentage in this column, is $292,004. Part II, Community Building Activities: We provided health and education through the Lindsborg News-Record and the Marquette Tribune. Part III, Line 4: The footnote to the Organization's financial statements can be found on page ten of the attached audited financial statements. Part III, Line 8: The payments are compared to the actual cost of providing the service as arrived at through the Medicare cost reports. Medical services are provided to patients with Medicare coverage regardless of whether or not a surplus or deficit is realized. Providing Medicare services promotes access to healthcare services which are vitally needed by our community. Part III, Line 9b: Patients who qualify for financial assistance will be entered into the system with an insurance company of 1.FINASST which prevents the patient from entering into the collection practices as a statement is never issued. Part VI, Line 2: In addition to the CHNA process, LCHA participates in Strategic Alliance meetings which are held every 1-2 months. The Alliance consists of businesses and organizations in Lindsborg with the purpose of discussing strategic needs of the community and identifying where synergies can be developed. LCHA also participates in weekly meetings called the Ad Hoc RoundTable. This group meets to discuss activities and needs in the community. LCHA participates in a county Behavioral Health Task Force that meets every 2-3 months. The task force members include McPherson hospital administration and physicians, Prairie View Behavioral Health staff, law enforcement, the McPherson mayor and McPherson County Attorney, the Lindsborg Chief of Police, and LCHA's administrator.Medical Staff meets monthly to discuss clinical management of LCHA. Clinic providers and management meet monthly to discuss the operations of the Family Health Care Clinic. In both meetings, issues concerning needs of the community are discussed and addressed or at least brought to the attention of administration for development of an action plan.LCHA has a Patient and Family Advisory Council (PFAC) which is made up primarily of community members who are patients or family members of patients. The group meets monthly to discuss quality and other projects that LCHA is performing. As a part of the regular agenda, community members are given an opportunity to voice comments and concerns about needs of the community. Part VI, Line 3: The Hospital's charity care policy is posted in patient waiting rooms in a three-ring note book. Hospital employees have been instructed to direct anyone with questions regarding assistance to the Hospital's business office. Patients are educated by the financial services staff and social services staff who are able to provide assistance upon request and through policies posted to our website. Part VI, Line 4: The Organization serves the Smoky Valley Area including Lindsborg, Marquette, Falun, Roxbury, Gypsum, Assaria and other areas including McPherson, Salina, Smolan, Canton, and Galva. Approximately 8% of the Hospital's patients are uninsured or Medicaid patients. The community served by the Hospital is also served by two other hospitals, plus a Federally Qualified Health Center in Salina. Part VI, Line 5: The organization's governing body is comprised of individuals who reside within the Smoky Valley service area with members from Assaria, Lindsborg, Marquette, and Galva.Medical Staff privileges are extended to all qualified physicians in the community who apply. Surplus funds are utilized to provide home health services, health and education through the Lindsborg News-Record and the Marquette Tribune, Stepping On classes, Safe Sitter classes and frozen meals for purchase. The organization's governing body is comprised primarily of persons who reside in the organization's primary service area who are neither employees nor contractors of the organization nor family members thereof. The organization extends medical staff privileges to qualified physicians in its community for some or all of its departments. Surplus funds of the organization are returned to the organization to improve patient care through updated equipment and technology and care team member education. The organization operates an emergency room that is available 24/7 regardless of ability to pay. Through the assistance of a donor, the organization has trained 825 CNA students over the last 16 years through a partnership with Bethany Home and The Cedars. The students receive the training at no cost. The organization makes available to the surrounding area a wellness center open seven days a week without fees. Part VI, Line 6: The role of Lindsborg Community Hospital is to provide primary care to the members of the Smoky Valley and to provide emergency care, urgent care, and inpatient care when it is within our care limits. We also provide swing-bed (skilled nursing) care and respite care, accepting patients from Salina Regional Health Center. Kalli Weibert Daughter of Laraine Gengler, CFO 58756 Employment 0 Form 990, Part V, Line 1a, Number reported in Box 3 of Form 1096: Lindsborg Community Hospital Association has independent contractors, however, Salina Regional Health Center, the management company, pays all the independent contractors directly. The actual expense of each independent contractor is directly charged to the assigned entity. Form 990, Part V, Line 2a, Number of employees on W-3: Under a management agreement, Salina Regional Health Center (SRHC) is responsible for the daily management and operation of the hospital, including employment of all staff. All payroll and benefits are paid by SRHC and payroll reporting is done by SRHC. Allocable compensation by individual is charged to Lindsborg Community Hospital Association and is shown on line 7 of Part IX. Form 990, Part VI, Section A, line 3 The Hospital entered into a management and operating agreement with Salina Regional Health Center (SRHC) effective October 1, 2012. Under the agreement, SRHC is responsible for the daily management and operation of the Hospital, including the employment of all staff needed to manage and operate Lindsborg Community Hospital. For tax year 2017, SRHC paid $156,843 for Larry Van Der Wege, the Hospital Administrator's salary and benefits, and $110,727 for Laraine Gengler, the Hospital CFO's salary and benefits. Form 990, Part VI, Section A, line 6 Lindsborg Community Health Care Foundation, Inc. a not-for-profit, 501c3 organization, is the sole member of Lindsborg Community Hospital. Form 990, Part VI, Section A, line 7a Lindsborg Community Health Care Foundation, Inc. being the sole member of Lindsborg Community Hospital, has the right to elect all board members. Form 990, Part VI, Section A, line 7b Lindsborg Community Health Care Foundation, Inc. is the sole member, and has the right to approve Lindsborg Community Hospital's by laws, articles of incorporation, and Board of Directors. Form 990, Part VI, Section A, line 8b There are no committees with broad authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The 990 is reviewed internally, and the Form 990 is made available to the board for review prior to filing. Form 990, Part VI, Section B, line 12c At the time of hire or election (in the case of directors) and annually thereafter, the officers, directors, and key employees provide the applicable conflict of interest disclosures which are completed to identify any relationships, positions, or circumstances in which it is believed a conflict may arise. If a conflict arises, the officer or director abstains from the vote of the conflicted position. The annual monitoring and review is part of the Organization's compliance plan. If a conflict is identified, it is either addressed by the board or referred to the management company for resolution. A report is submitted to the executive board concerning any interest disclosed. Form 990, Part VI, Section B, line 15a The Organization's process for determining Administrator's compensation begins with an initiative lead by the Executive Compensation Committee (ECC) of Salina Regional Health Center (SRHC). The ECC compares compensation and salary data provided by Integrated Health Strategies (IHS) for overall reasonableness of base compensation and total compensation for all SRHC executive staff. The ECC reviews the data and makes a recommendation to the SRHC board of trustees in a closed executive meeting. The process was last completed in 2018. Lindsborg Community Hospital's Administrator's salary is then set by the President/CEO of SRHC. The Lindsborg Community Hospital CFO's salary is set by Salina Regional Hospital Vice President of Finance using an annual salary survey and is increased using the same percentage as all other employees. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents and conflict of interest policy available to the public upon written request. Form 990, Part IX, line 11g Contract Labor : Program service expenses 1,317,355. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,317,355. Service Contracts : Program service expenses 20,609. Management and general expenses 0. Fundraising expenses 0. Total expenses 20,609. Form 990, Part XI, line 9: Change in auxiliary -402. Intercompany Transfer 1,596,297. Lindsborg Community Health Care Foundation Inc 605 W Lincoln Lindsborg KS 67456 480947732 Hospital support KS 501(c)(3) Line 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0