LINDSBORG COMMUNITY HOSPITAL ASSOCIATION: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- LINDSBORG COMMUNITY HOSPITAL ASSOCIATION (EIN 48-0545183)
- Tax period
- 2015-10-01 to 2016-09-30
- Filed
- 2017-07-18
- IRS object ID
- 201721999349300702
- Schema version
- 2015v3.0
- 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 L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-07-18T07:15:19-05:00 | ReturnTs |
| Tax Period End | 2016-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Nicollet Mall Ste 1300 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554027033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 480545183 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lindsborg Community Hospital Association | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LIND | BusinessNameControlTxt |
| Phone | 7852273308 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 605 West Lincoln | AddressLine1Txt |
| City | Lindsborg | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 674562328 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Larry Van Der Wege | PersonNm |
| Person Title | Administrator | PersonTitleTxt |
| Phone | 7852273308 | PhoneNum |
| Signature | 2017-07-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2017-07-13 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Larry Van Der Wege | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 605 West Lincoln | AddressLine1Txt |
| City | Lindsborg | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 674562328 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $8,821,203 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.lindsborghospital.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1944 | FormationYr |
| Legal Domicile State | KS | LegalDomicileStateCd |
| Activity Or Mission | Operation of critical access hospital. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 39 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $206,470 | PYContributionsGrantsAmt |
| CY Contributions Grants | $90,362 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $9,413,661 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,712,242 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$5,584 | PYInvestmentIncomeAmt |
| CY Investment Income | -$38,430 | CYInvestmentIncomeAmt |
| PY Other Revenue | $140,622 | PYOtherRevenueAmt |
| CY Other Revenue | $12,000 | CYOtherRevenueAmt |
| PY Total Revenue | $9,755,169 | PYTotalRevenueAmt |
| CY Total Revenue | $8,776,174 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,633 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $5,512,184 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,940,221 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $2,581 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,181,790 | PYOtherExpensesAmt |
| CY Other Expenses | $4,982,136 | CYOtherExpensesAmt |
| PY Total Expenses | $8,695,607 | PYTotalExpensesAmt |
| CY Total Expenses | $10,922,357 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,059,562 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,146,183 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,971,923 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,451,209 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,754,086 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,036,600 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,217,837 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,414,609 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Partners caring for the health of the Smoky Valley communities. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $9,953,317 | ExpenseAmt |
| Revenue | $8,712,242 | RevenueAmt |
| Desc | 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; 1,850 patients were seen in the 2016 fiscal year. 620 urgent care visits, 621 privately paid home health visits were made, and 314 cardiac rehab visits improved the health of community members. 4,250 meals on wheels were supplied to community members. Education was provided to Marquette and Lindsborg residents on breast cancer, colon cancer, smoking cessation, and the effects of sun exposure. Employees of the LCH partner with various community groups to provide assistance to the Midsummer's Committee, Hyllningsfest Committee, Chamber of Commerce, and Leadership Lindsborg to name a few. Staff also provide leadership with the Sunflower Health Network, KHA council, and the Sunflower (Kansas) HFMA Chapter. | Desc |
| Total Program Service Expenses | $9,953,317 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Laraine Gengler | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7852273308 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 605 West Lincoln | AddressLine1Txt |
| City | Lindsborg | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 674562328 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| Chuck Oleen | ||||||
| President | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Robyn Johnson | ||||||
| Vice President | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Judy Neuschafer | ||||||
| Secretary | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Tom Buffington | ||||||
| Treasurer | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Denise Peterson | ||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Ryan Biegert | ||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Dr Ben Dolezal | ||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Mike Rose | ||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Mary Ann Carlson | ||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Larry Van Der Wege | ||||||
| Administrator | 40.00 | Yes (X) | $0 | $0 | $0 | |
| Laraine Gengler | ||||||
| CFO | 40.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Salina Regional Health Center | |||||
| 400 S Santa Fe | Salina | KS | 67401 | Payment for payroll and other reimbursem | $10,575,000 |
| Rehabvisions | |||||
| 11623 Arbor St | Omaha | NE | 68144 | PT, OT and ST services | $432,254 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $90,362 | AllOtherContributionsAmt |
| Total Contributions | $90,362 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net patient revenue | 621400 | $8,047,773 | $8,047,773 |
| Sales Tax Revenue | 900099 | $307,218 | $307,218 |
| EHR Payments | 900099 | $103,163 | $103,163 |
| Cafeteria | 900099 | $5,275 | $5,275 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $248,813 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $248,813 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,712,242 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,599 | TotalRevenueColumnAmt |
| Exclusion | $6,599 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $12,000 | 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 | $12,000 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,000 | TotalRevenueColumnAmt |
| Exclusion | $12,000 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $45,029 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$45,029 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$45,029 | TotalRevenueColumnAmt |
| Exclusion | -$45,029 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,776,174 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,712,242 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$26,430 | 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 | $220,838 | TotalAmt |
| Management And General | $220,838 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,687,580 | TotalAmt |
| Program Services | $4,439,142 | ProgramServicesAmt |
| Management And General | $248,438 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $138,311 | TotalAmt |
| Program Services | $128,703 | ProgramServicesAmt |
| Management And General | $9,608 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $589,329 | TotalAmt |
| Program Services | $554,013 | ProgramServicesAmt |
| Management And General | $35,316 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $304,163 | TotalAmt |
| Program Services | $270,843 | ProgramServicesAmt |
| Management And General | $33,320 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,024 | TotalAmt |
| Program Services | $56,024 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,355 | TotalAmt |
| Program Services | $8,355 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,441 | TotalAmt |
| Management And General | $25,441 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,903,067 | TotalAmt |
| Program Services | $1,903,067 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,782 | TotalAmt |
| Management And General | $28,782 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $368,777 | TotalAmt |
| Program Services | $295,925 | ProgramServicesAmt |
| Management And General | $72,852 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $193,051 | TotalAmt |
| Program Services | $81,965 | ProgramServicesAmt |
| Management And General | $111,086 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,687 | TotalAmt |
| Program Services | $71,687 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,106 | TotalAmt |
| Program Services | $11,164 | ProgramServicesAmt |
| Management And General | $6,942 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,806 | TotalAmt |
| Program Services | $12,594 | ProgramServicesAmt |
| Management And General | $4,212 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $759 | TotalAmt |
| Program Services | $759 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $583,111 | TotalAmt |
| Program Services | $478,743 | ProgramServicesAmt |
| Management And General | $104,368 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,566 | TotalAmt |
| Program Services | $14,984 | ProgramServicesAmt |
| Management And General | $22,582 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical and Patient Sup | $867,795 | $867,718 | $77 |
| Bad Debts | $209,759 | $209,759 | |
| Food Costs | $68,052 | $66,101 | $1,951 |
| Dues, Licenses and Taxe | $37,269 | $24,338 | $12,931 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $487,729 | TotalAmt |
| Program Services | $457,433 | ProgramServicesAmt |
| Management And General | $27,715 | ManagementAndGeneralAmt |
| Fundraising | $2,581 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,922,357 | TotalAmt |
| Program Services | $9,953,317 | ProgramServicesAmt |
| Management And General | $966,459 | ManagementAndGeneralAmt |
| Fundraising | $2,581 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $114,656 | BOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,120,932 | BOYAmt |
| EOY | $520,358 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,993,940 | BOYAmt |
| EOY | $1,679,280 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $179,819 | BOYAmt |
| EOY | $179,694 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,557 | BOYAmt |
| EOY | $83,287 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,994,080 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,136,831 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,003,704 | BOYAmt |
| EOY | $1,857,249 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $329,042 | BOYAmt |
| EOY | $1,131,290 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $156,273 | BOYAmt |
| EOY | $51 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,971,923 | BOYAmt |
| EOY | $5,451,209 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $323,867 | BOYAmt |
| EOY | $304,369 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $353,839 | BOYAmt |
| EOY | $230,000 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,076,380 | BOYAmt |
| EOY | $1,502,231 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,754,086 | BOYAmt |
| EOY | $2,036,600 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,774,059 | BOYAmt |
| EOY | $3,154,055 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $443,778 | BOYAmt |
| EOY | $260,554 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,217,837 | BOYAmt |
| EOY | $3,414,609 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,971,923 | BOYAmt |
| EOY | $5,451,209 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$2,146,183 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $1,342,955 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | 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 | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $2,576 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,576 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | The portion of annual dues paid to hospital and medical associations attributed to lobbying activities by the associations. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,442 | OtherCostOrOtherBasisAmt |
| Book Value | $10,442 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,626,795 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,598,873 | DepreciationAmt |
| Book Value | $1,027,922 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,099,587 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,286,015 | DepreciationAmt |
| Book Value | $813,572 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $257,256 | OtherCostOrOtherBasisAmt |
| Depreciation | $251,943 | DepreciationAmt |
| Book Value | $5,313 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,857,249 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Estimated third party payor settlements | $826,739 |
| Due to related parties | $675,492 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,502,231 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $9,886,965 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $1,342,284 | OtherRevenueAmt |
| Revenue Not Reported | $1,342,284 | RevenueNotReportedAmt |
| Revenue Subtotal | $8,544,681 | RevenueSubtotalAmt |
| Other Revenues Not Included | $231,493 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $231,493 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $8,776,174 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $10,690,192 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $10,690,192 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $232,165 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $232,165 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $10,922,357 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 2d - Other Adjustments: | Intercompany transfer 1,342,284. |
| Part XI, Line 4b - Other Adjustments: | Bad Debts 209,759. Reclassification of revenue/expense accounts, net 19,824. Auxiliary revenue 1,910. |
| Part XII, Line 4b - Other Adjustments: | Bad Debts 209,759. Reclassification of revenue/expense accounts, net 19,824. Auxiliary expense 2,582. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $26,237 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $26,237 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $299,316 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $126,899 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $172,417 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01580 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $325,553 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $126,899 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $198,654 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01820 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 556 | PersonsServedCnt |
| Total Community Benefit Expns | $906 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $906 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 6 | PersonsServedCnt |
| Total Community Benefit Expns | $33,115 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $27,329 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,786 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,134,562 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $817,685 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,316,877 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.21210 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,247 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,247 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 562 | PersonsServedCnt |
| Total Community Benefit Expns | $3,170,830 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $845,014 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,325,816 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.21290 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 562 | PersonsServedCnt |
| Total Community Benefit Expns | $3,496,383 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $971,913 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,524,470 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.23110 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,560 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,560 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,560 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,560 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $209,759 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $9,229 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $4,620,527 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $4,653,444 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$32,917 | 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 (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | 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 | Lindsborg Community Hospital Association | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 605 W Lincoln St | AddressLine1Txt |
| City | Lindsborg | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67456 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.lindsborghospital.org | WebsiteAddressTxt |
| State License | H059001 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| 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 | Lindsborg Community Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | 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 |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Part V, Page 7 | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Part V, Page 7 | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | www.lindsborghospital.org/patients/financial_assistance.html | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | www.lindsborghospital.org/patients/financial_assistance.html | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | www.lindsborghospital.org/patients/financial_assistance.html | 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 |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Lindsborg Community Hospital | Part V, Section B, Line 6a: McPherson Hospital, McPherson, Kansas Mercy Hosptial, 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 being addressed is from July 2016. Health Issues - The CHNA identified a need for services that target obesity, heart disease, cancer, diabetes, substance abuse, and daily life stressors. Further development of work flows and order sets to improve performance in these areas continues. Screening questions have been added to clinic wellness exams and emergency department examinations for all age groups to identify individuals who may suffer from substance abuse. Education on many of these health issues has been performed since the inception of our implementation plan.Specific Populations with Inadequate Access to Care and Barriers to Care - The CHNA identified low income, elderly, young adults, disabled persons and children as having inadequate access to care. Identified barriers to care include the ability to pay, lack of insurance, transportation, lack of providers, and schedule limitations. LCH is working to address many of these needs through enhancement of our financial assistance policy. An automatic deduction of 30% of total charges has been adopted for those individuals without insurance. This discount is provided regardless of the completion of the financial assistance application. LCH has made an increased effort to identify and inform individuals about our Financial Assistance Policy, to encourage completion of application paperwork to provide for greater discounts. A fund has been established to pay for cancer screening services for those in our area without insurance. LCH has developed a process for school-aged children to have their activity health assessment forms completed. Provider staffing at the Family Health Care Clinic has been challenging, but needs have been met through temporary physicians and physician assistants. LCH is working with Salina Regional Health Center Emergency Department to staff the emergency department. Recruitment of physicians will continue until the open positions are filled. Perceived weaknesses in general areas - The CHNA identified the need for free fitness options, child care options, dietary education services and access to specialists. The Wellness Center is open to the public at no charge. Access to specialists will be enhanced through the affiliation between LCH and SRHC. Dietary consultations are available three days per week for inpatients and outpatients. Needs identified but not addressed - Child care options will not be addressed as it is beyond the scope and abilities of LCH. |
| 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 16i: 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 22d: The facility uses the Lookback method in calculating Amounts Generally Billed. |
| Lindsborg Community Hospital | Part V, Section B, Line 24: The policy applies to medically necessary services only. |
| PART V, Section B, LINE 7A: | www.lindsborghospital.org/about/message_from_ceo.html |
| Part V, Section B, Line 10a: | www.lindsborghospital.org/about/message_from_ceo.html |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - Family Health Care Clinic | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 605 W Lincoln St | AddressLine1Txt |
| City | Lindsborg | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67456 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | Physicians clinic | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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: | The amount reported on Lines 7a is from the organization's cost accounting system taking all patient segments into account. The amounts reported on line 7b were determined using Worksheets 2 and 3. Amounts on lines 7e, 7f, and 7i are from the actual general ledger. Subsidized health services on line 7g were calculated utilizing the Medicare cost report. |
| 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 $209,759. |
| Part II, Community Building Activities: | We provided health and education through the Lindsborg News-Record and the Marquette Tribune. |
| Part III, Line 3: | The estimated amount of charity care expense included in bad debt is based on the percentage of charity care to revenue times bad debt expense. |
| 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: | The needs assessment has been completed. We are guided by our providers, our partners in nursing home care, Bethany Home and Riverview Estates, our partners in education of youth, USD 400 and Bethany College, and our patients in the Smoky Valley. |
| Part VI, Line 3: | The Hospital's charity care policy is posted in patient waiting rooms in a three-ring note book. The contact information is not posted, but the employees of the Hospital 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 our policies being 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 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 777 CNA students over the last 15 years through a partnership with Bethany Home. The students receive the training at no cost to themselves. The organization makes available to the surrounding area a wellness center open seven days a week without fees. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Kalli Weibert | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Daughter of Laraine Gengler, CFO | RelationshipDescriptionTxt |
| Transaction | $51,918 | TransactionAmt |
| Transaction | Employment | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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: | Lindsborg Community Hospital Association has its own employees, however, Salina Regional Health Center, the management company, pays all compensation and employee benefits. The actual compensation of each employee is directly charged to their assigned entity. Salaries are reported 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 2015, SRHC paid $116,000 for Larry Van Der Wege, the Hospital Administrator's salary and benefits, and $104,838 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 11 | 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 2016. 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 1,884,445. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,884,445. Service Contracts: Program service expenses 18,622. Management and general expenses 0. Fundraising expenses 0. Total expenses 18,622. |
| Form 990, Part XI, line 9: | Intercompany Transfers 1,342,284. Change in auxiliary 671. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lindsborg Community Health Care Foundation Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 605 W Lincoln | AddressLine1Txt |
| City | Lindsborg | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67456 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 480947732 | EIN |
| Primary Activities | Hospital support | PrimaryActivitiesTxt |
| Legal Domicile State | KS | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | Line 7 | PublicCharityStatusTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |