GREAT PLAINS OF CHEYENNE CO INC: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- GREAT PLAINS OF CHEYENNE CO INC (EIN 48-1226831)
- Tax period
- 2024-01-01 to 2024-12-31
- Filed
- 2025-11-14
- IRS object ID
- 202543189349310879
- Schema version
- 2024v5.1
- 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 | 2025-11-14T14:19:43+00:00 | ReturnTs |
| Tax Period End | 2024-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 440160260 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Forvis Mazars LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1551 N Waterfront Pkwy Ste 300 | AddressLine1Txt |
| City | Wichita | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 672066601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 481226831 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREAT PLAINS OF CHEYENNE COUNTY INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GREA | BusinessNameControlTxt |
| Phone | 3166851523 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 NORTH ROCK ROAD STE 160 | AddressLine1Txt |
| City | WICHITA | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67206 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JASON BARB | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3166851523 | PhoneNum |
| Signature | 2025-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kevin Ensminger | PreparerPersonNm |
| PTIN | P01310558 | PTIN |
| Phone | 3162652811 | PhoneNum |
| Preparation | 2025-11-14 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JASON BARB | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 NORTH ROCK ROAD STE 160 | AddressLine1Txt |
| City | WICHITA | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67206 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $22,281,661 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CHEYENNECOUNTYHOSPITAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1999 | FormationYr |
| Legal Domicile State | KS | LegalDomicileStateCd |
| Activity Or Mission | TO OPERATE AN ACUTE CARE HOSPITAL THAT PROVIDES MEDICAL CARE TO THE GENERAL PUBLIC IN ST. FRANCIS, KANSAS AND SURROUNDING RURAL COMMUNITIES IN CHEYENNE COUNTY, KANSAS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 111 | TotalEmployeeCnt |
| Total Volunteers | 5 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,032,167 | PYContributionsGrantsAmt |
| CY Contributions Grants | $769,472 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $18,284,398 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $20,873,990 | CYProgramServiceRevenueAmt |
| PY Investment Income | $66,644 | PYInvestmentIncomeAmt |
| CY Investment Income | $85,196 | CYInvestmentIncomeAmt |
| PY Other Revenue | $444,745 | PYOtherRevenueAmt |
| CY Other Revenue | $553,003 | CYOtherRevenueAmt |
| PY Total Revenue | $19,827,954 | PYTotalRevenueAmt |
| CY Total Revenue | $22,281,661 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,868,350 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,125,509 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $11,259,518 | PYOtherExpensesAmt |
| CY Other Expenses | $13,307,857 | CYOtherExpensesAmt |
| PY Total Expenses | $20,127,868 | PYTotalExpensesAmt |
| CY Total Expenses | $22,433,366 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$299,914 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$151,705 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $8,629,067 | TotalAssetsBOYAmt |
| Total Assets EOY | $8,055,672 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,077,280 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,655,590 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,551,787 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,400,082 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO OPERATE HOSPITAL FACILITIES FOR THE DELIVERY OF HOSPITAL AND RELATED HEALTH CARE SERVICES, HEALTH RELATED EDUCATION, AS WELL AS THE PROMOTION OF HEALTH AND WELLNESS, WITHOUT REGARD TO RACE, CREED, COLOR, SEX OR FINANCIAL CIRCUMSTANCE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $20,527,687 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $20,873,990 | RevenueAmt |
| Desc | CHEYENNE COUNTY HOSPITAL (CCH) IS A CRITICAL ACCESS, LEVEL IV TRAUMA, 16 BED HOSPITAL PROVIDING EMERGENCY, ACUTE AND SWING BED CARE TO CHEYENNE COUNTY AND SURROUNDING AREAS; IT EMPLOYS TWO FULL TIME PHYSICIANS, THREE NURSE PRACTITIONERS (APRN'S), ONE PHYSICIAN ASSISTANT (PA-C), 28 REGISTERED NURSES (RN/FT/PT/PRN), A CERTIFIED REGISTERED NURSE ANESTHETISTS (CRNA), AND OTHER ALLIED HEALTH PROFESSIONALS. CHEYENNE COUNTY HOSPITAL'S AIM IS TO PROVIDE SAFE, HIGH QUALITY, TEAM BASED HEALTHCARE TO CHEYENNE COUNTY, KANSAS AND SURROUNDING AREAS. CCH IS A CRITICAL ACCESS HOSPITAL SERVING A FRONTIER AREA POPULATION (POPULATION DENSITY OF 2.70) AND HAS BEEN DESIGNATED AS A MEDICALLY UNDERSERVED AREA SINCE 2005. WE PROVIDE A VARIETY OF CARE INCLUDING PRIMARY CARE IN TWO RURAL HEALTH CLINICS, INPATIENT CARE (INCLUDING ACUTE CARE), OBSERVATION, SWING BED, INTERMEDIATE SWING BED SERVICES AND OBSTETRICS. IN ADDITION WE PROVIDE A VARIETY OF OUTPATIENT AND DIAGNOSTIC PROCEDURES AND HAVE GENERAL SURGERY PERFORMED ONSITE. WE PROVIDE 24/7 COVERAGE OF AN EMERGENCY ROOM THAT IS STAFFED WITH OUR OWN PROVIDERS. CHEYENNE COUNTY HOSPITAL'S MOST EXPENSIVE ENTITIES IN 2024 INCLUDED OUR PHARMACY WITH $4,864,942 TOTAL EXPENSES. OF THIS, $3,865,094 WAS 340B EXPENSES. OUR NURSING DEPARTMENT WITH $2,159,378 IN EXPENSES, WHICH INCLUDES $668K FOR CONTRACT NURSES. THE RURAL HEALTH CLINIC WITH $1,852,699 IN EXPENSES WHICH INCLUDES $48K FOR CONTRACT PROVIDERS TO COVER THE RHC. OUR SUCCESS BY WAY OF THESE CAPACITIES IS REFLECTED IN THE NUMBER OF PATIENTS SERVED, AS HIGHLIGHTED BELOW, AND THE INNOVATIVE WAYS WITH WHICH WE CONTINUE TO FIND NEW WAYS TO MEET THE EVOLVING NEEDS OF OUR PATIENTS. PHARMACY PHARMACY WAS THE LARGEST EXPENSE FOR 2024 WITH $4,864,942 TOTAL EXPENSES. OF THIS, $3,865,094 WAS 340B EXPENSES. NURSING: THE SECOND LARGEST EXPENSE BY DEPARTMENT FOR 2024 WAS NURSING. NOT ONLY IN SERVICE TO THE MORE THAN 192 ACUTE INPATIENTS, 72 SWING BED ADMISSIONS, AND 31 OBSTETRIC ADMISSIONS IN 2024, NURSING WAS INSTRUMENTAL IN OVERSEEING KEY FACILITY SERVICES SUCH AS HOSPITAL PHARMACY (WHICH INCLUDED THE COST SAVING 340B PROGRAM), INFECTION CONTROL, CASE MANAGEMENT, UTILIZATION REVIEW, EDUCATION AND OTHER OUTPATIENT SERVICES. NURSING WAS A KEY VOICE ON THE COUNTY'S RURAL HEALTHCARE TASK FORCE WHOSE MAJOR ACHIEVEMENT WAS LEVERAGING FEDERAL AND PRIVATE GRANT DOLLARS TO ESTABLISH A PROGRAM BY WHICH ROUTINE AND AFFORDABLE IN-HOME VISITS CAN BE EXTENDED TO CHEYENNE COUNTY'S MOST VULNERABLE CHRONICALLY ILL PATIENTS. ADDITIONALLY, THE NURSING DEPARTMENT STAFFED CCH'S 24-HOUR EMERGENCY ROOM, PROVIDING COMPASSIONATE CARE TO THE MORE THAN 934 PATIENTS PRESENTING TO THE ER IN 2024 REGARDLESS OF THEIR ABILITY TO PAY. IN SUM, AS THE PRIMARY FRONT LINE STAFF FOR THE FACILITY, THE NURSING DEPARTMENT WAS ESSENTIAL TO CCH'S ABILITY TO EXTEND QUALITY CARE TO APPROXIMATELY 2,700 RESIDENTS OF CHEYENNE COUNTY. RURAL HEALTH CLINIC: OUR RURAL HEALTH CLINIC (RHC) IS DESIGNATED AS A SAFETY NET CLINIC BY THE STATE OF KANSAS. THE CLINIC SERVED 8,367 PATIENT VISITS IN 2024, FOCUSING ON ACTIVITIES CONCERNED WITH PREVENTION AND TREATMENT OF COMMON MEDICAL PROBLEMS IN AN OUTPATIENT SETTING. CARE IS DELIVERED BY PRIMARY CARE PRACTITIONERS TO INDIVIDUALS WHO PRESENT FOR SERVICE REGARDLESS OF THEIR ABILITY TO PAY. EXPENSE IS OFTEN A BARRIER TO CARE IN OUR COMMUNITY AND FOR THAT REASON THE RURAL HEALTH CLINIC REMAINS RESPONSIVE TO A POPULATION OFTEN WITH FIXED INCOMES. IN 2024, THE RHC WAS AWARDED A PRIMARY CARE CLINIC GRANT OF $101,539. THIS CRITICAL FUNDING ASSISTED THE CLINIC IN PROVIDING ACCESS TO QUALITY, COMMUNITY-BASED HEALTHCARE, REDUCING HEALTH DISPARITIES FOR OUR COUNTY'S UNDERSERVED POPULATIONS, AND PROVIDING ACCESS TO PRESCRIPTION DRUGS FOR PATIENTS THAT COULD NOT OTHERWISE AFFORD MEDICATION. AS EVIDENCE OF OUR COMMITMENT TO PROVIDE QUALITY HEALTHCARE TO OUR PATIENT BASE, IN JUNE OF 2015 THE CCH RURAL HEALTH CLINIC ACHIEVED A LEVEL III CERTIFICATION AS A PATIENT CENTERED MEDICAL HOME (PCMH) FROM THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE. UNQUESTIONABLY, THIS NATIONAL ACCREDITATION SPEAKS TO THE COMMITMENT OF OUR PROVIDERS AND STAFF TO DELIVER OUTSTANDING MEDICAL ATTENTION TO OUR PATIENTS AND THE SIGNIFICANT PROCESS IMPROVEMENTS INDUCED BY THE ENDEAVOR IS EVIDENCE OF THE CLINIC'S COMMITMENT TO OVERCOMING TRADITIONAL RURAL HEALTHCARE BARRIERS. | Desc |
| Total Program Service Expenses | $20,527,687 | 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 |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | 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 |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| 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 With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| 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 | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (true) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 62 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 111 | 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 |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | 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 |
| Policies Reference Chapters | false | PoliciesReferenceChaptersInd |
| 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 | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JASON BARB | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3166851523 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 NORTH ROCK ROAD STE 160 | AddressLine1Txt |
| City | WICHITA | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67206 | 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 |
|---|---|---|---|---|---|---|---|---|
| CURT COLSON | ||||||||
| PRESIDENT/DIRECTOR | 0.2 | 41.2 | Yes (X) | Yes (X) | $0 | $227,653 | $57,031 | |
| JOHN TERRILL | ||||||||
| CHARIMAN/DIRECTOR | 0.2 | 1.2 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ROGER JOHN | ||||||||
| SECRETARY/DIRECTOR | 0.2 | 1.2 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| STEVE CARLSON | ||||||||
| TREASURER/DIRECTOR | 0.2 | 1.2 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ARTHUR HENDRICKSON | ||||||||
| DIRECTOR | 0.2 | 1.2 | Yes (X) | $0 | $0 | $0 | ||
| DR BARBARA BROWN APPLEGATE | ||||||||
| DIRECTOR | 0.2 | 1.2 | Yes (X) | $0 | $0 | $0 | ||
| HEIDI TICE | ||||||||
| CFO | 40.0 | 0.0 | Yes (X) | $129,410 | $0 | $47,181 | ||
| JASON BARB | ||||||||
| CFO | 0.2 | 41.2 | Yes (X) | $0 | $198,487 | $53,974 | ||
| JEREMY CLINGENPEEL | ||||||||
| CEO | 40.0 | 0.0 | Yes (X) | $204,526 | $0 | $53,179 | ||
| BENJAMIN BOSEN | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $439,687 | $0 | $66,651 | Yes (X) | ||
| CELESTE HAYS | ||||||||
| DEPT HD DISCHARGE PLANNER & RN | 40.0 | 0.0 | $131,377 | $0 | $18,371 | Yes (X) | ||
| HEATHER LICKE | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $511,577 | $0 | $59,532 | Yes (X) | ||
| JEFFREY PARSONS | ||||||||
| NURSE PRACTIONER | 40.0 | 0.0 | $309,023 | $0 | $61,427 | Yes (X) | ||
| Tyler Raile | ||||||||
| PA | 40.0 | 0.0 | $137,528 | $0 | $44,890 | Yes (X) | ||
| ALLEN VANDRIEL | ||||||||
| Director | 0.2 | 1.2 | $0 | $0 | $0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,863,128 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $426,140 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $462,236 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 14 | 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 |
|---|---|---|---|---|---|
| The Center for Wound Care | |||||
| PO box 19000-308 | Avon | CO | 81620 | Wound Care mgmt services | $2,514,325 |
| GPHA | |||||
| 250 NORTH ROCK ROAD STE 160 | WICHITA | KS | 67206 | MGMT, CBO, COMP SUPP | $1,107,754 |
| Keith Gist Anesthesia | |||||
| 6700 W CR 44 | Midland | TX | 79707 | Contract CRNA | $836,263 |
| PSYCHIATRIC MEDICAL CARE LLC | |||||
| 8 Cadillac Drive 230 | Brentwood | TN | 37027 | SENIOR LIFE PROVIDER | $593,887 |
| Malone Staffing | |||||
| PO Box 890802 | Charlotte | NC | 282890802 | Contract Nursing | $453,386 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $563,911 | GovernmentGrantsAmt |
| All Other Contributions | $205,561 | AllOtherContributionsAmt |
| Total Contributions | $769,472 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621300 | $15,750,431 | $15,750,431 |
| 340B REVENUE | 621300 | $5,123,559 | $5,123,559 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $20,873,990 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $83,127 | TotalRevenueColumnAmt |
| Exclusion | $83,127 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,112 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,112 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,112 | TotalRevenueColumnAmt |
| Exclusion | $1,112 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,069 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $2,069 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,069 | TotalRevenueColumnAmt |
| Exclusion | $2,069 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| EMPLOYEE/GUEST MEALS | 722513 | $29,563 | $29,563 |
| HEALTH FAIR | 900099 | $104,494 | $104,494 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $417,834 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $417,834 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $551,891 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $22,281,661 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,873,990 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $638,199 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $414,045 | TotalAmt |
| Management And General | $414,045 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,609,568 | TotalAmt |
| Program Services | $6,446,976 | ProgramServicesAmt |
| Management And General | $162,592 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $531,658 | TotalAmt |
| Program Services | $519,519 | ProgramServicesAmt |
| Management And General | $12,139 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,198,954 | TotalAmt |
| Program Services | $1,183,947 | ProgramServicesAmt |
| Management And General | $15,007 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $371,284 | TotalAmt |
| Program Services | $338,916 | ProgramServicesAmt |
| Management And General | $32,368 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,876 | TotalAmt |
| Management And General | $54,876 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,922 | TotalAmt |
| Management And General | $7,922 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,041 | TotalAmt |
| Management And General | $65,041 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,481 | TotalAmt |
| Management And General | $3,481 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,973,744 | TotalAmt |
| Program Services | $5,308,386 | ProgramServicesAmt |
| Management And General | $665,358 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,657 | TotalAmt |
| Management And General | $28,657 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $535,600 | TotalAmt |
| Program Services | $524,342 | ProgramServicesAmt |
| Management And General | $11,258 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,571 | TotalAmt |
| Program Services | $1,264 | ProgramServicesAmt |
| Management And General | $1,307 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $408,375 | TotalAmt |
| Program Services | $207,074 | ProgramServicesAmt |
| Management And General | $201,301 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,254 | TotalAmt |
| Program Services | $6,575 | ProgramServicesAmt |
| Management And General | $679 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,605 | TotalAmt |
| Program Services | $39,531 | ProgramServicesAmt |
| Management And General | $9,074 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,936 | TotalAmt |
| Management And General | $8,936 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $445,765 | TotalAmt |
| Program Services | $445,765 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,315 | TotalAmt |
| Management And General | $37,315 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | $4,860,370 | $4,860,170 | $200 |
| EQUIPMENT RENTAL & MAINTENAN | $623,639 | $553,098 | $70,541 |
| DUES & SUBSCRIPTIONS | $104,180 | $15,336 | $88,844 |
| RECRUITING | $58,181 | $58,181 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,345 | TotalAmt |
| Program Services | $18,607 | ProgramServicesAmt |
| Management And General | $14,738 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,433,366 | TotalAmt |
| Program Services | $20,527,687 | ProgramServicesAmt |
| Management And General | $1,905,679 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,437,606 | BOYAmt |
| EOY | $996,948 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,071,702 | BOYAmt |
| EOY | $2,200,956 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,683,284 | BOYAmt |
| EOY | $2,444,267 | 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 | $6,765 | BOYAmt |
| EOY | $32,084 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $192,858 | BOYAmt |
| EOY | $162,426 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $92,891 | BOYAmt |
| EOY | $138,454 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $8,231,909 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,331,056 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,866,203 | BOYAmt |
| EOY | $1,900,853 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $277,758 | BOYAmt |
| EOY | $179,684 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,629,067 | BOYAmt |
| EOY | $8,055,672 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,768,280 | BOYAmt |
| EOY | $2,553,161 | 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 | $309,000 | BOYAmt |
| EOY | $102,429 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,077,280 | BOYAmt |
| EOY | $2,655,590 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,430,226 | BOYAmt |
| EOY | $5,363,564 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $121,561 | BOYAmt |
| EOY | $36,518 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,551,787 | BOYAmt |
| EOY | $5,400,082 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,629,067 | BOYAmt |
| EOY | $8,055,672 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$151,705 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
| 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
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | $3,481 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Total Lobbying Expenditures | $3,481 | 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 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | FormAndLineReferenceDesc |
| Explanation | A PORTION OF THE ANNUAL DUES PAID TO KHA AND AHA ARE USED FOR LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $34,436 | OtherCostOrOtherBasisAmt |
| Book Value | $34,436 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,522,458 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,885,208 | DepreciationAmt |
| Book Value | $637,250 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,394,091 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,273,398 | DepreciationAmt |
| Book Value | $1,120,693 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $280,924 | OtherCostOrOtherBasisAmt |
| Depreciation | $172,450 | DepreciationAmt |
| Book Value | $108,474 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,900,853 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $22,281,661 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $0 | OtherRevenueAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $22,281,661 | RevenueSubtotalAmt |
| Other Revenues Not Included | $0 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $22,281,661 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $22,433,366 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $0 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $22,433,366 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $0 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $22,433,366 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 UNCERTAIN TAX POSITIONS | FormAndLineReferenceDesc |
| Explanation | MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. | 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 |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $183,439 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $183,439 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00818 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,135,266 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $612,516 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $522,750 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02330 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $1,318,705 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $612,516 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $706,189 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03148 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $313,741 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $247,186 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $66,555 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00297 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $313,741 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $247,186 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $66,555 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00297 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $1,632,446 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $859,702 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $772,744 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03445 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $264,025 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $7,967,103 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,967,103 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $0 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| 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 | GREAT PLAINS OF CHEYENNE COUNTY INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 W First Street | AddressLine1Txt |
| City | St Francis | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67756 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.cheyennecountyhospital.com | WebsiteAddressTxt |
| State License | H012001 | StateLicenseNum |
| 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 | GREAT PLAINS OF CHEYENNE COUNTY 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 | 23 | 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 | https://cheyennecountyhospital.com/about/2023-community-health-needs-assessment/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 23 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://cheyennecountyhospital.com/about/2023-community-health-needs-assessment/ | 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 | 200.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 0 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| 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 |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://cheyennecountyhospital.com/patients-visitors/financial-assistance/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://cheyennecountyhospital.com/patients-visitors/financial-assistance/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://cheyennecountyhospital.com/patients-visitors/financial-assistance/ | 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 Translated | Yes (X) | FAPTranslatedInd |
| 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 |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5 Facility , 1 | Facility , 1 - GREAT PLAINS OF CHEYENNE COUNTY, INC. A PRIORITY OF THE PROGRAM IS TO SOLICIT INPUT FROM A BROAD CROSS SECTION OF THE COMMUNITY, NOT SIMPLY MEMBERS OF THE LOCAL HEALTHCARE SECTOR. THE MEETING PARTICIPANTS INCLUDED COMMUNITY RESIDENTS AND GOVERNMENTAL AND BUSINESS LEADERS WITHIN THE COMMUNITY. |
| Schedule H, Part V, Section B, Line 6b Facility , 1 | Facility , 1 - GREAT PLAINS OF CHEYENNE COUNTY, INC. THE ASSESSMENT PROCESS WAS INITIATED BY BOTH CHEYENNE COUNTY HOSPITAL AND CHEYENNE COUNTY HEALTH DEPARTMENT WITH THE CONSULTANT CAROL SLOPER. |
| Schedule H, Part V, Section B, Line 7 Facility , 1 | Facility , 1 - GREAT PLAINS OF CHEYENNE COUNTY, INC. THE CHNA RESULTS WERE SHARED AT A TOWN HALL MEETING. |
| Schedule H, Part V, Section B, Line 11 Facility , 1 | Facility , 1 - GREAT PLAINS OF CHEYENNE COUNTY, INC. A NUMBER OF PRIORITIES WERE DETERMINED THROUGH THE 2023 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND ADDRESSED BY CHEYENNE COUNTY HOSPITAL. 1) MENTAL HEALTH SERVICES (LOCAL AVAILABILITY, COST, SUBSTANCE RECOVERY SERVICES) ONE OF THE TOP PRIORITIES IDENTIFIED IN THE 2020 AS WELL AS THE 2023 CHNA WAS ACCESS AND LOCAL AVAILABILITY TO BEHAVIORAL AND MENTAL HEALTH SERVICES. IN EFFORTS TO MEET THIS NEED, CHEYENNE COUNTY HOSPITAL (CCH) OBTAINED THE NECESSARY FUNDING FOR HIGH PLAINS MENTAL HEALTH TO PROVIDE ON SITE SERVICES AT CCH FOR THE 2021 CALENDAR YEAR. DUE TO COVID RESTRICTIONS, HIGH PLAINS MENTAL HEALTH PROVIDED REMOTE SERVICES VIA THE ZOOM PLATFORM THROUGH THE MONTHS OF JANUARY AND FEBRUARY 2021. AFTERWARDS, HIGH PLAINS WAS ABLE TO RETAIN AN ONSITE THERAPIST UNTIL DECEMBER 2022 AT WHICH POINT THE THERAPIST RELOCATED OUT OF STATE. SINCE THAT POINT, HIGH PLAINS HAS ONCE AGAIN REVERTED TO REMOTE SERVICES AND WILL CONTINUE THAT PLATFORM UNTIL ANOTHER LOCAL THERAPIST IS HIRED. CCH WILL ALSO CONTINUE TO SUPPORT AND PROVIDE THE ON-SITE SERVICES OF SENIOR LIFE SOLUTIONS WHICH IS IN THE LOWER LEVEL OF CHEYENNE COUNTY CLINIC. 2) SUBSTANCE ABUSE AS SUBSTANCE ABUSE CONTINUES TO RISE, CCH BELIEVES THAT EDUCATION IS ONE OF THE MOST IMPORTANT AND EFFECTIVE STRATEGIES TO COMBAT AGAINST IT AND IF WE CAN PARTNER WITH LOCAL PROGRAMS TO EDUCATE OUR CHILDREN AT A YOUNG AGE, WE CAN GET AHEAD AND REACH OUR KIDS BEFORE SUBSTANCE ABUSE HAS A CHANCE TO CATCH UP TO THEM. WE WANT TO COME TO THEM FROM MANY DIFFERENT ANGLES INCLUDING, TEACHERS, OFFICERS, PARENTS, YOUTH GROUPS, AND THE LOCAL MINISTERIAL ALLIANCE JUST TO NAME A FEW. WE WILL ALSO ACTIVELY ENGAGE IN THE "PRESCRIPTION TAKEBACK PROGRAM" HTTPS://WWW.DEADIVERSION.USDOJ.GOV/DRUG_DISPOSAL/TAKEBACK/ IN OUR COMMUNITY TO ASSIST IN REMOVAL OF OUTDATED OR UNUSED PRESCRIPTIONS TO PREVENT DRUGS GETTING INTO THE WRONG HANDS. 3) RETAINING / RECRUITING JOBS IN CHEYENNE COUNTY (ATTRACT YOUTH, ECONOMIC DEVELOPMENT) CCH HAS HELD JOB FAIRS, PROVIDED JOB SHADOWING OPPORTUNITIES FOR STUDENTS FROM LOCAL SCHOOLS, AND OFFERED STUDENT SCHOLARSHIPS FOR GRADUATING SENIORS WHO ARE PURSUING A CAREER IN THE MEDICAL FIELD. ADDITIONALLY, CCH HAS RECENTLY ENGAGED CHEYENNE COUNTY SCHOOLS TO CONSIDER CHARTERING A NEW HOSA CHAPTER TO HELP LOCAL STUDENTS INTERESTED IN MEDICAL CAREERS. CCH HAS ALSO PARTNERED WITH NEX-GENERATION TO PROVIDE HIGH SCHOOL AND COLLEGE STUDENTS WITH INTERNSHIP OPPORTUNITIES AT THE HOSPITAL, HEALTH DEPARTMENT, AND CLINIC. THROUGH THIS INTERNSHIP PROGRAM, STUDENTS WILL GAIN VALUABLE INSIGHT INTO LOCAL CAREER OPPORTUNITIES IN THE HEALTHCARE FIELD AND POTENTIALLY ENCOURAGE THEM TO RETURN HOME FOLLOWING COLLEGE TO PURSUE THAT CAREER. 4) LOCAL ACCESS TO HEALTH CARE SPECIALISTS THE 2020 AND 2023 CHNA ALSO IDENTIFIED THE NEED FOR LOCAL ACCESS TO HEALTH CARE SPECIALISTS. CCH HAS ALREADY MOVED TOWARD INCREASED LOCAL ACCESS TO SPECIALTY SERVICES AND OPPORTUNITIES. CURRENTLY CCH OFFERS OBSTETRIC SERVICES WITH BOTH DR. HEATHER LICKE, MD AND DR. BENJAMIN BOSEN, DO PROVIDING THOSE SERVICES LOCALLY. CCH ALSO OFFERS AN ON-SITE CARDIOLOGY CLINIC WITH CARDIOLOGIST DR. SEAN DENNEY, MD INCLUDING ON-SITE STRESS TESTS AND CARDIAC REHAB. DR. MATTHEW UYEMURA PROVIDES ON-SIGHT OPHTHALMOLOGY SERVICES, INCLUDING CATARACT SURGERIES ON A MONTHLY BASIS. LAPAROSCOPIC, COLORECTAL, AND GENERAL SURGERY IS OFFERED TWICE A MONTH WITH DR. CHARLES FRANKUM, MD. WE'RE EXCITED TO ANNOUNCE THAT WITH THE RECENT ADDITION OF A NEW HYPERBARIC OXYGEN CHAMBER, HBO, WE WILL NOW HAVE PODIATRY SPECIALIST PARICHART VALKAYEE, MD VISITING ONCE A MONTH. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| CHEYENNE COUNTY CLINIC - ST FRANCIS | ||||
| 221 W 1ST STREET | ST FRANCIS | KS | 67756 | OUTPATIENT CLINIC |
| CHEYENNE COUNTY CLINIC - BIRD CITY | ||||
| 233 W 4TH STREET | BIRD CITY | KS | 67731 | OUTPATIENT CLINIC |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care | THE ORGANIZATION USED THE FOLLOWING CRITERIA TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE: ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, AND UNDERINSURANCE STATUS. |
| Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance | THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART I, LINE 7, OF SCHEDULE H, IS A COST TO CHARGE RATIO. |
| Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount | HOSPITAL CHARGES THAT ARE NOT COLLECTED AND ARE NOT APPROVED FOR FINANCIAL ASSISTANCE ARE CLASSIFIED AS BAD DEBTS FROM PATIENTS WHO WILL NOT PAY. |
| Schedule H, Part III, Line 3 Bad Debt Expense Methodology | THE COSTING METHODOLOGY IS BASED ON THE ORGANIZATION'S MEDICARE COST-TO-CHARGE RATIO. WHILE WE RECOGNIZE THAT THERE WOULD BE SOME BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY, WE HAVE NO REASONABLE BASIS FOR ESTIMATING THIS FIGURE. IF ELIGIBILITY IS KNOWN, THE AMOUNT WOULD FALL UNDER CHARITY CARE AND NOT BAD DEBT. |
| Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote | NOT APPLICABLE DUE TO ADOPTION OF ASU 606 REVENUE FROM CONTRACTS WITH CUSTOMERS. |
| Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs | THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNT ON LINE 6 IS A COST TO CHARGE RATIO. |
| Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance | ALL CHARITY CARE CHARGES AND CHARGES NOT TO BE COLLECTED DUE TO FINANCIAL ASSISTANCE COMPUTATIONS ARE EXEMPT FROM COLLECTION POLICIES AND PRACTICES. THESE ACCOUNTS ARE REMOVED FROM THE COLLECTION CYCLE. |
| Schedule H, Part V, Section B, Line 16a FAP website | - GREAT PLAINS OF CHEYENNE COUNTY, INC: Line 16a URL: https://cheyennecountyhospital.com/patients-visitors/financial-assistance/; |
| Schedule H, Part V, Section B, Line 16b FAP Application website | - GREAT PLAINS OF CHEYENNE COUNTY, INC: Line 16b URL: https://cheyennecountyhospital.com/patients-visitors/financial-assistance/; |
| Schedule H, Part V, Section B, Line 16c FAP plain language summary website | - GREAT PLAINS OF CHEYENNE COUNTY, INC: Line 16c URL: https://cheyennecountyhospital.com/patients-visitors/financial-assistance/; |
| Schedule H, Part VI, Line 2 Needs assessment | CHEYENNE COUNTY WILL CONTINUE TO OFFER COMMUNITY HEALTH FAIRS TO EXPOSE RESIDENTS TO HEALTH CARE RESOURCES AND CAREERS. IN ADDITION, THE HOSPITAL PARTNERS WITH THE SCHOOLS IN THE COUNTY AND NEARBY COLLEGES TO SPREAD AWARENESS ON JOBS THAT ARE AVAILABLE IN HEALTHCARE ON THE LOCAL LEVEL. CHEYENNE COUNTY IS DETERMINED TO GROW OUR OWN PROVIDERS AND HEALTH CARE WORKERS BY SPENDING TIME ON OPEN HOUSES, JOB SHADOWING, AND FOSTERING OUR RELATIONSHIPS WITH THE SCHOOLS AND CLOSE BY LOCAL HOSPITALS. CHEYENNE COUNTY HOSPITAL CONDUCTS A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS TO IDENTIFY THE MOST URGENT NEEDS OF OUR COUNTY. HOSPITAL LEADERSHIP THEN CREATES A COMMUNITY HEALTH IMPROVEMENT PLAN AND IMPLEMENTATION STRATEGY WHICH IS ADOPTED BY THE HOSPITAL BOARD OF DIRECTORS. THE HOSPITAL LEADERS WILL USE CRITERIA SUCH AS URGENCY, SEVERITY, FEASIBILITY, DISPARITIES, OR COMMUNITY ESTABLISHED PRIORITIES TO DETERMINE THE NEEDS IN THAT WILL FORMALLY BE ADDRESS. THE MENTAL HEALTH NEEDS FOR ALL AGE GROUPS IN THE COUNTRY HAVE MADE THEIR MARK ON WHAT WE NEED TO LOOK AT AND ACCOMPLISH IN THE NEXT FEW YEARS. CHEYENNE COUNTY HOSPITAL HAS SUCCESSFULLY INITIATED AN OUTPATIENT GERIATRIC PSYCH PROGRAM THAT ADDRESSES PERSONAL LOSS, CHANGES THAT ALL PEOPLE OF LATER YEARS GO THROUGH, DEPRESSION, AND OTHER AGE CHANGE ILLNESSES. WE ARE TAKING ON THE ROLE OF SPEARHEAD AS WE ARE WORKING ON THE LOCAL LEVEL WITH THE COUNTY GOVERNMENT, LAW ENFORCEMENT, SCHOOLS, CLERGY TO ESTABLISH A LONG-LASTING TASK FORCE THAT WILL ADDRESS THE ONGOING CONCERNS OF MENTAL HEALTH ISSUES OF TODAY AND INTO THE FAR-REACHING FUTURE. WE TAKE GREAT CARE TO LOOK AT EDUCATING ALL STAFF ON THE DELIVERY OF MENTAL HEALTH SERVICES. |
| Schedule H, Part VI, Line 3 Patient education of eligibility for assistance | CHEYENNE COUNTY HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM INCLUDES BOTH A CHARITY CARE PROGRAM AND A SLIDING SCALE DISCOUNT THAT TAKES INTO CONSIDERATION A PATIENT'S HOUSEHOLD INCOME AND QUALIFYING ASSETS. A CHEYENNE COUNTY HOSPITAL FINANCIAL COUNSELOR CONSULTS WITH PRIVATE PAY PATIENTS TO SEE IF THEY QUALIFY FOR FINANCIAL ASSISTANCE. CCH HAS POSTED INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE THROUGHOUT ITS FACILITIES AND ON THEIR WEBSITE. IF DISCOVERED DURING THE ACCOUNTS RECEIVABLE COLLECTION PROCESS THAT A PATIENT IS HAVING TROUBLE PAYING BILLS, BOTH THE HOSPITAL, CLINIC AND THE CENTRALIZED BILLING OFFICE WILL INFORM THE PATIENT THAT FINANCIAL ASSISTANCE IS AVAILABLE. IF AFTER THE INITIAL INTERVIEW THERE IS CONSENSUS THAT THE PATIENT MAY QUALIFY FOR FINANCIAL ASSISTANCE, THE FINANCIAL COUNSELOR PROVIDES TO THE PATIENT THE NECESSARY FORMS IN ADDITION TO SOLICITING SUPPORTING DOCUMENTATION FOR THE REQUEST (PATIENT BANK STATEMENTS, TAX RETURNS, ETC.). COMPUTATIONS BASED ON CURRENT FEDERAL POVERTY LEVEL GUIDELINES ARE COMPLETED TO SEE IF QUALIFICATIONS ARE APPROPRIATE AND THE PERCENTAGE OF CHARGES TO BE WRITTEN OFF IS DETERMINED BASED ON FAMILY SIZE AND HOUSEHOLD INCOME. ADDITIONALLY, WITH THE IMPLEMENTATION OF THE AFFORDABLE CARE ACT HEALTH INSURANCE INFORMATION IS MADE AVAILABLE FOR PATIENTS AND THEIR FAMILIES REGARDING THE INSURANCE MARKETPLACE AS WELL AS INSTRUCTION ON HOW TO CONTACT A NAVIGATOR FOR ASSISTANCE. ALL INSTANCES OF CHARITY CARE ARE APPROVED BY THE ADMINISTRATOR OR DESIGNATED REPRESENTATIVE OF THE HOSPITAL. THE SLIDING FEE SCALE IS LIMITED TO THE CLINIC WHERE THE CARE WAS OBTAINED. THE CLINIC ALSO HAS A PRESCRIPTION ASSISTANCE PROGRAM WHICH LEVERAGES INDIGENT DRUG PROGRAMS OFFERED BY PHARMACEUTICAL COMPANIES. ADDITIONALLY, THE HOSPITAL HAS POSTED ITS' CHARGE MASTER ON ITS WEBSITE (WWW.CHEYENNECOUNTYHOSPITAL.COM) TO ENSURE HEALTH CONSUMERS HAVE A REASONABLE EXPECTATION OF CHARGES. |
| Schedule H, Part VI, Line 4 Community information | CHEYENNE COUNTY HOSPITAL SERVES PATIENTS CHIEFLY FROM THE GEOGRAPHICAL BOUNDARIES OF CHEYENNE COUNTY, KANSAS; THIS INCLUDES THE PRIMARY POPULATION CENTERS OF ST. FRANCIS AND BIRD CITY. ADDITIONALLY, PATIENTS FROM SURROUNDING COMMUNITIES INCLUDING MCDONALD, ATWOOD, GOODLAND, KANSAS, AS WELL AS BURLINGTON, IDALIA, AND WRAY, COLORADO, AND HAIGLER AND BENKELMAN, NEBRASKA PATRON OUR FACILITY. CHEYENNE COUNTY IS THE REMOTE NORTHWESTERN MOST COUNTY OF KANSAS AND IS BORDERED BY DUNDY COUNTY, NEBRASKA TO THE NORTH; YUMA AND KIT CARSON COUNTIES IN COLORADO TO THE WEST; SHERMAN COUNTY, KANSAS TO THE SOUTH; AND RAWLINS COUNTY, KANSAS TO THE EAST. WE ARE EQUIDISTANT BETWEEN DENVER, COLORADO AND HAYS, KANSAS; EACH BEING 180 MILES AWAY. CHEYENNE COUNTY HOSPITAL (CCH) IS THE LAST HOSPITAL WESTBOUND ON US HIGHWAY 36 UNTIL REACHING THE DENVER METRO AREA. CHEYENNE COUNTY HAS A POPULATION ESTIMATE OF APPROXIMATELY 2,700 RESIDENTS AS OF JULY 1, 2019, LOWER THAN THE KANSAS RURAL NORM OF 9,240. THE PERCENT CHANGE IN POPULATION IN CHEYENNE COUNTY FROM APRIL 1, 2010 TO JULY 1, 2019 IS -2.5%, HIGHER THAN THE KANSAS RURAL NORM OF -2.0%. THE PERCENT OF PERSONS 65 YEARS AND OVER IN CHEYENNE COUNTY IS 27.3%, HIGHER THAN THE KANSAS RURAL NORM OF 20.9%. THE PERCENT OF WHITE ALONE PERSONS IN CHEYENNE COUNTY IS 97.0%, HIGHER THAN THE KANSAS RURAL NORM OF 94.6%. THE PERCENT OF HISPANIC OR LATINO PERSONS IN CHEYENNE COUNTY IS 7.1%, HIGHER THAN THE KANSAS RURAL NORM OF 4.6%. THE PERCENT OF LANGUAGES OTHER THAN ENGLISH SPOKEN AT HOME BY PERSONS AGE 5 YEARS+ IS 8.3%, HIGHER THAN THE KANSAS RURAL NORM OF 3.9%. THE PERCENT OF PERSONS AGE 1 YEAR+ LIVING IN THE SAME HOUSE AS ONE YEAR AGO IN CHEYENNE COUNTY IS 92.1%, HIGHER THAN THE KANSAS RURAL NORM OF 87.0%. THE TOTAL VETERANS IN CHEYENNE COUNTY IS 218, LOWER THAN THE KANSAS RURAL NORM OF 697. THE POPULATION PER SQUARE MILE IN CHEYENNE COUNTY IS 2.7, LOWER THAN THE KANSAS RURAL NORM OF 11.8. THE PERCENT OF CHILD IN SINGLE-PARENT HOUSEHOLDS IN CHEYENNE COUNTY IS 22.0%, LOWER THAN THE KANSAS RURAL NORM OF 25.2%. THE PERCENT OF LIMITED ACCESS TO HEALTHY FOODS IN CHEYENNE COUNTY IS 37.0%, HIGHER THAN THE KANSAS RURAL NORM OF 14.1%. |
| Schedule H, Part VI, Line 5 Promotion of community health | THE HOSPITAL PROVIDES FOR AND PROMOTES THE HEALTH OF THE CITIZENS OF CHEYENNE COUNTY BY OFFERING THE FOLLOWING SERVICES: DIABETES EDUCATION/COUNSELING, SMOKING PREVENTION/CESSATION AND CONTROL, HEALTH EDUCATION FOR STUDENTS, PRENATAL CLASSES AND NUMEROUS OTHER TAILORED PROGRAMS. HEALTH FAIRS ARE OFFERED BOTH IN THE FALL AND SPRING EACH YEAR THROUGH THE COUNTY HEALTH DEPARTMENT. OUR PROFESSIONAL STAFF, INCLUDING TWO PHYSICIANS, THREE NURSE PRACTITIONERS, ONE PHYSICIAN ASSISTANT, RN'S, LPN'S AND PHYSICAL AND RESPIRATORY THERAPY STAFF, PROVIDE COMMUNITY EDUCATION ON A VARIETY OF HEALTH ISSUES IN A VARIETY OF VENUES. DURING THE FLU SEASON WE OFFER NUMEROUS IMMUNIZATION CLINICS TO PROVIDE MUCH NEEDED FLU VACCINATIONS TO OUR POPULACE. PRIOR TO THE START OF THE SCHOOL YEAR, WE ALSO OFFER ANNUAL SPORTS PHYSICALS TO AREA ATHLETES AT A DISCOUNTED PRICE. WE PROMOTE CANCER AWARENESS BY SUPPORTING THE ANNUAL RELAY FOR LIFE ACTIVITIES IN CHEYENNE COUNTY. IN CONJUNCTION WITH THE COMMUNITY AMBULANCE SERVICE, THE HOSPITAL SPONSORS CPR AND NRP TRAINING FOR PROFESSIONALS IN CHEYENNE COUNTY. THE CCH PHYSICAL THERAPIST CONDUCTS IN-HOME SAFETY ASSESSMENTS FOR COUNTY RESIDENTS TO PREVENT TRIPS AND FALLS AS WELL AS ASSESSMENTS TO DECIDE IF PATIENTS CAN RETURN TO THEIR HOMES. THE HOSPITAL MAINTAINS BIOHAZARD EQUIPMENT THAT CAN BE USED IN THE EVENT OF TOXIC SPILLS OR BIOHAZARD EMERGENCIES IN THE COUNTY TO INCLUDE ISOLATION ROOMS AND SHOWERS. EQUIPMENT FOR AIRBORNE PATHOGENS IS ALSO AVAILABLE. THE HOSPITAL ANNUALLY PARTICIPATES IN EMERGENCY PREPAREDNESS TRAININGS WITH LOCAL POLICE AND FIREFIGHTING UNITS WITHIN THE COUNTY AND REGION. THE DECONTAMINATION TEAM, WHICH IS COMPRISED OF HOSPITAL HEALTHCARE PROFESSIONALS, PRACTICES VARIOUS DRILLS AND REHEARSALS TO ENSURE PREPAREDNESS. CHEYENNE COUNTY STARTED AN OUTPATIENT GERIATRIC PSYCH SERVICE IN THE LATTER PART OF 2017. THE SERVICE IS CALLED SENIOR LIFE SOLUTIONS WHICH IS AN INTENSIVE OUTPATIENT PSYCHIATRIC PROGRAM DESIGNED TO MEET THE NEEDS OF ADULTS OVER THE AGE OF 65 IN OUR COMMUNITY. CCH ALSO PARTNERS WITH HIGH PLAINS MENTAL HEALTH TO PROVIDE MENTAL HEALTH COUNSELING SERVICES TO PATIENTS OF ALL AGES AT THE HOSPITAL CAMPUS. THE PROGRAM ADDRESSES ISSUES SUCH AS DEPRESSION AND ANXIETY THAT CAN OFTEN BE RELATED TO AGING. THE PATIENT IS OFFERED SERVICES BY AN INTERDISCIPLINARY TEAM OF CARING, EXPERIENCED, BEHAVIORAL HEALTH PROFESSIONALS, WHICH INCLUDES A PSYCHIATRIST, LICENSED THERAPIST, AND A REGISTERED NURSE. CHEYENNE COUNTY HOSPITAL ALSO PARTICIPATES IN A VARIETY OF COMMUNITY BUILDING ACTIVITIES. THE HOSPITAL MAKES ITS FITNESS EQUIPMENT AVAILABLE TO CHEYENNE COUNTY CITIZENS FOR A MINIMAL MONTHLY COST. THE HOSPITAL IS VERY ACTIVE IN COMMUNITY EDUCATION ON THE BENEFITS OF IMMUNIZATIONS FOR THE PREVENTION OF INFLUENZA, PNEUMONIA, AND COVID-19. WE WORK THROUGH THE CHEYENNE COUNTY HEALTH DEPARTMENT, NURSING HOME, RURAL HEALTH CLINICS AND THE LOCAL PHARMACY TO IMPROVE IMMUNIZATION RATES. CCH ADDITIONALLY PARTNERS CLOSELY WITH THE COUNTY EMS IN THE DELIVERY OF EMERGENCY SERVICES; APPROXIMATELY 50% OF AMBULATORY SERVICES/TRANSFERS HAVE A CHEYENNE COUNTY HOSPITAL EMPLOYEE ON BOARD. ADDITIONALLY, WITH THE ASSISTANCE OF FEDERAL AND PRIVATE GRANTS, CCH HELPED LAUNCH A REVOLUTIONARY PROGRAM WHEREBY PATIENTS WITH TWO OR MORE CHRONIC CONDITIONS AND/OR QUALIFYING CARDIAC PROBLEMS RECEIVE PERIODIC ASSESSMENTS IN THEIR HOME BY A LOCAL HEALTHCARE PROFESSIONAL. CCH ADDITIONALLY SERVES AS A RURAL ROTATION SITE FOR MEDICAL STUDENTS AND RESIDENTS FROM VARIOUS KANSAS EDUCATIONAL PROGRAMS AND HAS FUNCTIONED AS A DIDACTIC AND CLINICAL PRACTICE SITE FOR VOCATIONAL INSTITUTIONS THROUGHOUT THE AREA. FURTHERMORE, CCH CONTINUES TO PROVIDE AN ANNUAL SCHOLARSHIP PROGRAM FOR GRADUATING CHEYENNE COUNTY STUDENTS INTENDING TO PURSUE A VOCATION IN HEALTHCARE. THE HOSPITAL PARTICIPATES IN ALL GOVERNMENT HEALTHCARE PROGRAMS/PLANS WHICH INCLUDE THE FOLLOWING: MEDICARE, KANCARE (UNITED, SUNFLOWER AND AMERIGROUP) AND TRICARE. THE HOSPITAL HAS RECEIVED DESIGNATION FROM THE MEDICARE PROGRAM AS A CRITICAL ACCESS HOSPITAL AND IS THE ONLY HOSPITAL IN CHEYENNE COUNTY. SUPPORTED BY OUR OWN MEDICAL STAFF, THE HOSPITAL PROVIDES 24-HOUR EMERGENCY ROOM CARE. ADDITIONALLY, MULTIPLE SPECIALTY PHYSICIANS PROVIDE OUTPATIENT CARE IN OUR FACILITY WHICH GREATLY MITIGATES THE NEED FOR PERSONS IN OUR COMMUNITY TO TRAVEL LONG DISTANCES FOR THEIR UNIQUE MEDICAL NEEDS. TO COMPLIMENT THESE OUTPATIENT SERVICES, AS MENTIONED, CCH DEVELOPED A GROWING TELEMEDICINE PROGRAM IN 2016 WHICH HAS FURTHER ENABLED LOCAL ACCESS TO EXPANDED SCOPES OF PRACTICE. EDUCATION PROMOTED BY THE HOSPITAL THROUGHOUT THE COUNTY ALSO PROVIDES RESIDENTS WITH VITAL INFORMATION ON HOW TO MINIMIZE THEIR AFFLICTIONS AND MAXIMIZE THEIR QUALITY OF LIFE THROUGH PROACTIVE PREVENTATIVE CARE. |
| Schedule H, Part VI, Line 6 Affiliated health care system | THE ORGANIZATION IS AFFILIATED WITH GREAT PLAINS HEALTH ALLIANCE, INC. (GPHA), A NON-PROFIT 501(C) (3) ORGANIZATION, WHICH PROVIDES MANAGEMENT SERVICES AND OPERATIONAL, FINANCIAL, AND ACCOUNTING SUPPORT TO THE HOSPITAL. GPHA IS AN AFFILIATION OF CRITICAL ACCESS HOSPITALS IN KANSAS AND NEBRASKA THAT PROVIDES NETWORKING OPPORTUNITIES WITH OTHER RURAL HOSPITALS, COMMUNITIES, AND LEADERS. ALTHOUGH GPHA DOES NOT PROVIDE SERVICES DIRECTLY TO PATIENTS, IT DOES PROVIDE ACCESS TO HEALTHCARE PROFESSIONALS THAT MAY OTHERWISE BE COST PROHIBITIVE. GPHA PROVIDES EDUCATION AND ASSISTANCE IN AREAS SUCH AS CORPORATE COMPLIANCE, HIPAA, MEDICARE REIMBURSEMENT, PROMOTING INTEROPERABILITY (PREVIOUSLY MEANINGFUL USE), HOSPITAL FINANCE AND MANY OTHER AREAS. ADDITIONAL EDUCATION/TRAINING OPPORTUNITIES ARE EXTENDED THROUGH GPHA TO BOARD MEMBERS, BUSINESS OFFICE MANAGERS, BILLERS, MEDICAL RECORDS PERSONNEL, DIRECTORS OF NURSING, ADMINISTRATORS, ETC. GPHA SERVES AS A VITAL LINK TO ALLOWING CRITICAL ACCESS HOSPITALS THE ABILITY TO OFFER HIGH QUALITY MEDICINE IN FRONTIER POPULATION AREAS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | 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 (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CURT COLSON | ||||||||||||||
| PRESIDENT/DIRECTOR | $0 | $223,989 | $0 | $0 | $0 | $3,664 | $0 | $22,342 | $0 | $34,689 | $0 | $284,684 | $0 | $0 |
| JASON BARB | ||||||||||||||
| CFO | $0 | $197,209 | $0 | $0 | $0 | $1,278 | $0 | $19,491 | $0 | $34,483 | $0 | $252,461 | $0 | $0 |
| HEIDI TICE | ||||||||||||||
| CFO | $129,410 | $0 | $0 | $0 | $0 | $0 | $13,545 | $0 | $33,636 | $0 | $176,591 | $0 | $0 | $0 |
| JEREMY CLINGENPEEL | ||||||||||||||
| CEO | $204,019 | $0 | $0 | $0 | $507 | $0 | $20,855 | $0 | $32,324 | $0 | $257,705 | $0 | $0 | $0 |
| BENJAMIN BOSEN | ||||||||||||||
| PHYSICIAN | $439,119 | $0 | $0 | $0 | $568 | $0 | $33,700 | $0 | $32,951 | $0 | $506,338 | $0 | $0 | $0 |
| HEATHER LICKE | ||||||||||||||
| PHYSICIAN | $510,625 | $0 | $0 | $0 | $952 | $0 | $33,700 | $0 | $25,832 | $0 | $571,109 | $0 | $0 | $0 |
| JEFFREY PARSONS | ||||||||||||||
| NURSE PRACTIONER | $308,767 | $0 | $0 | $0 | $256 | $0 | $31,165 | $0 | $30,262 | $0 | $370,450 | $0 | $0 | $0 |
| Tyler Raile | ||||||||||||||
| PA | $137,307 | $0 | $0 | $0 | $221 | $0 | $14,097 | $0 | $30,793 | $0 | $182,418 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule J, Part I, Line 3 FORM 990, PART VII | FormAndLineReferenceDesc |
| Explanation | ANNUAL COMPENSATION REVIEWS ARE COMPLETED BY THE CEO AND CHIEF FINANCIAL OFFICER USING RECOMMENDATIONS PROVIDED BY DEPARTMENT MANAGERS AND CURRENT MARKET CONDITIONS. ALL EXECUTIVE EMPLOYEE SALARIES, INCLUDING THE PRESIDENT/CEO, ARE APPROVED BY THE GPHA BOARD OF DIRECTORS. THE AMERICAN COLLEGE HEALTHCARE EXECUTIVES AND THE KANSAS HOSPITAL ASSOCIATION ALSO HAS COMPARABLE COMPENSATION DATA THAT CAN BE USED BY THE BOARD. THE CEO RETAINS DOCUMENTATION IN ADDITION TO THAT IN THE BOARD MINUTES. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 2 BUSINESS RELATIONSHIPS | JASON BARB AND CURT COLSON HAVE A BUSINESS RELATIONSHIP. THEY ARE ALL EMPLOYED BY, AND ALSO OFFICERS OF, A RELATED 501(C)(3) ORGANIZATION, GREAT PLAINS HEALTH ALLIANCE. |
| Form 990, Part VI, Line 15a & 15b - PROCESS FOR DETERMINING COMPENSATION | THE CEO AND CFO ARE COMPENSATED BY GREAT PLAINS HEALTH ALLIANCE, A RELATED ORGANIZATION. GPHA'S BOARD USES COMPARABILITY DATA IN SETTING THEIR SALARIES, AND DOCUMENTATION IS RETAINED OF THE BOARD'S DELIBERATIONS AND DECISIONS. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | GREAT PLAINS HEALTH ALLIANCE, INC., A NOT-FOR-PROFIT, 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF GREAT PLAINS OF CHEYENNE COUNTY, INC. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | GREAT PLAINS HEALTH ALLIANCE, INC., BEING THE SOLE MEMBER, HAS THE RIGHT TO ELECT AND APPROVE ALL THE BOARD MEMBERS. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | GREAT PLAINS HEALTH ALLIANCE, INC. (GPHA) IS THE SOLE MEMBER AND HAS THE AUTHORITY TO APPROVE THE ARTICLES OF INCORPORATION, BYLAWS, ELECTION TO OR REMOVAL FROM THE BOARD OF DIRECTORS, THE ANNUAL OPERATING AND CAPITAL BUDGETS, AND THE LONG RANGE OR STRATEGIC PLANS. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | THE 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE 990 IS THEN PROVIDED TO THE CHIEF FINANCIAL OFFICER FOR REVIEW AND APPROVAL. AN ELECTRONIC DRAFT OF THE 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO THE FULL BOARD FOR REVIEW PRIOR TO FILING THE 990 WITH THE IRS. |
| Form 990, Part VI, Line 12c Conflict of interest policy | THE ORGANIZATION IS REQUIRED TO ADOPT GPHA'S CONFLICT OF INTEREST POLICY. ALL BOARD MEMBERS, OFFICERS AND EMPLOYEES ARE SUBJECT TO THE CONFLICT OF INTEREST POLICY AND SIGN AN ANNUAL ACKNOWLEDGEMENT THAT THEY HAVE READ, UNDERSTAND AND COMPLIED WITH THE GPHA CONFLICT OF INTEREST POLICY. UNDER THE POLICY, ANY MEMBER WHO HAS A DIRECT OR INDIRECT (VIA FAMILY) FINANCIAL INTEREST IS CHARACTERIZED AS AN INTERESTED PERSON. INTERESTED PERSONS ARE REQUIRED TO DISCLOSE FINANCIAL INTERESTS WITH COMPANIES DOING BUSINESS WITH GPHA. THE INTERESTED PERSON MUST RECUSE THEMSELVES FROM FURTHER DISCUSSIONS OF THE TRANSACTION AND LEAVE THE ROOM. THE REMAINING NON-INTERESTED MEMBERS DECIDE IF A CONFLICT OF INTEREST EXISTS. THE BOARD CHAIR MAY APPOINT ANOTHER DISINTERESTED PARTY TO DISCUSS THE TRANSACTION OR THE REMAINING BOARD MEMBERS MAY VOTE TO ENTER INTO OR ABSTAIN FROM THE SUSPECT TRANSACTION. FAILURE TO DISCLOSE FINANCIAL INTERESTS BY INTERESTED BOARD MEMBERS WILL RESULT IN DISCIPLINARY ACTION, INCLUDING SANCTIONING BY BOARD. ALL CONFLICTS OF INTEREST AND THEIR ULTIMATE RESOLUTION ARE DOCUMENTED IN THE BOARD MINUTES. THE BOARD CONDUCTS PERIODIC REVIEWS TO DETERMINE THAT CONFLICTS ARE BEING IDENTIFIED AND RESOLVED ACCORDING TO POLICY DOCUMENTATION. REVIEWS BY OUTSIDE EXPERTS ARE PERMITTED, BUT NOT REQUIRED. |
| Form 990, Part VI, Line 19 Required documents available to the public | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE COMPANY'S KANSAS ANNUAL REPORT IS ALSO AVAILABLE UPON REQUEST FROM THE KANSAS SECRETARY OF STATE. |
| Form 990, Part VIII, Line 11d Other Miscellaneous Revenue | MISCELLANEOUS REVENUE - Total Revenue: 417834, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 417834; |
| Form 990, Part IX, Line 11g Other Fees | CONTRACTED MEDICAL STAFF - Total Expense: 4827152, Program Service Expense: 4827152, Management and General Expenses: , Fundraising Expenses: ; BILLING/COLLECTIONS - Total Expense: 492310, Program Service Expense: , Management and General Expenses: 492310, Fundraising Expenses: ; LAB SERVICES - Total Expense: 215377, Program Service Expense: 215377, Management and General Expenses: , Fundraising Expenses: ; PHARMACY SERVICES - Total Expense: 194203, Program Service Expense: 194203, Management and General Expenses: , Fundraising Expenses: ; ADMINISTRATION/HUMAN RESOURCES - Total Expense: 215070, Program Service Expense: 42022, Management and General Expenses: 173048, Fundraising Expenses: ; PLANT OPERATIONS - Total Expense: 19811, Program Service Expense: 19811, Management and General Expenses: , Fundraising Expenses: ; DIETARY SERVICES - Total Expense: 9821, Program Service Expense: 9821, Management and General Expenses: , Fundraising Expenses: ; |
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 |
|---|---|---|---|---|---|---|---|---|---|---|
| GREAT PLAINS HEALTH CARE FOUNDATION INC | ||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 480955870 | SUPPORT | KS | 501(c)(3) | 10 | GPHA INC | Yes (true) |
| GREAT PLAINS OF SABETHA COUNTY INC | ||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 481236156 | HOSPITAL | KS | 501(c)(3) | 3 | GPHA INC | Yes (true) |
| GREAT PLAINS OF ELLINWOOD INC | ||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 481226976 | HOSPITAL | KS | 501(c)(3) | 3 | GPHA INC | Yes (true) |
| GREAT PLAINS HEALTH ALLIANCE | ||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67037 | 480617739 | MANAGEMENT | KS | 501(c)(3) | 3 | false | |
| GREAT PLAINS OF OTTAWA COUNTY INC | ||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 481226856 | HOSPITAL | KS | 501(c)(3) | 3 | GPHA INC | Yes (true) |
| GREAT PLAINS OF REPUBLIC COUNTY INC | ||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67037 | 481226977 | HOSPITAL | KS | 501(c)(3) | 3 | GPHA INC | Yes (true) |
| GREAT PLAINS OF SMITH COUNTY INC | ||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 481226820 | HOSPITAL | KS | 501(c)(3) | 3 | GPHA INC | Yes (true) |
| GPHA EMPLOYEE BENEFITS TRUST | ||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67037 | 476918582 | HEALTH PLAN | KS | 501(c)(9) | GPHA INC | 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 | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | 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 | false | 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 | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GPHA Employee Benefit Plan | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | R | TransactionTypeTxt |
| Involved | $732,701 | InvolvedAmt |
| Method Of Amount Determination | ACTUAL | MethodOfAmountDeterminationTxt |