RURAL HEALTH RESOURCES OF JACKSON CO INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- RURAL HEALTH RESOURCES OF JACKSON CO INC (EIN 74-2826278)
- Tax period
- 2014-04-01 to 2015-03-31
- Filed
- 2016-02-12
- IRS object ID
- 201630439349300528
- Schema version
- 2014v6.0
- 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 J
- Schedule K
- Schedule L
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-02-12T08:32:10-06:00 | ReturnTs |
| Tax Period End | 2015-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1201 Walnut Suite 1700 | AddressLine1Txt |
| City | Kansas City | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 641062246 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 742826278 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RURAL HEALTH RESOURCES OF JACKSON CO INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % BART KENTON | InCareOfNm |
| Business Name Control | RURA | BusinessNameControlTxt |
| Phone | 7853642116 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1110 COLUMBINE DRIVE | AddressLine1Txt |
| City | HOLTON | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 66436 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CARRIE SAIA | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 7853642116 | PhoneNum |
| Signature | 2016-02-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Michael J Engle | PreparerPersonNm |
| PTIN | P00482834 | PTIN |
| Phone | 8162216300 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLTON COMMUNITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CARRIE SAIA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1110 COLUMBINE DRIVE | AddressLine1Txt |
| City | HOLTON | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 66436 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $15,081,015 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP://WWW.HOLTONHOSPITAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1997 | FormationYr |
| Legal Domicile State | KS | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HIGH QUALITY HEALTHCARE SERVICES TO ALL OF JACKSON COUNTY AND SURROUNDING COMMUNITIES WHILE CONSISTENTLY DEMONSTRATING PROFESSIONALISM WITH THE HOMETOWN TOUCH. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 186 | TotalEmployeeCnt |
| Total Volunteers | 21 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $35,769 | PYContributionsGrantsAmt |
| CY Contributions Grants | $159,336 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $13,573,179 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $14,620,000 | CYProgramServiceRevenueAmt |
| PY Investment Income | $27,551 | PYInvestmentIncomeAmt |
| CY Investment Income | $48,779 | CYInvestmentIncomeAmt |
| PY Other Revenue | $237,847 | PYOtherRevenueAmt |
| CY Other Revenue | $252,900 | CYOtherRevenueAmt |
| PY Total Revenue | $13,874,346 | PYTotalRevenueAmt |
| CY Total Revenue | $15,081,015 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | 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 | $6,918,332 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,668,239 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,047,772 | PYOtherExpensesAmt |
| CY Other Expenses | $6,437,468 | CYOtherExpensesAmt |
| PY Total Expenses | $12,966,104 | PYTotalExpensesAmt |
| CY Total Expenses | $14,105,707 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $908,242 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $975,308 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $8,426,565 | TotalAssetsBOYAmt |
| Total Assets EOY | $10,723,329 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,823,734 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,145,190 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,602,831 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,578,139 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE PROFESSIONALISM, COMPASSION AND EXCELLENCE IN HEALTHCARE FOR A HEALTHIER COMMUNITY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $8,517,068 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $11,636,576 | RevenueAmt |
| Desc | SEE SCHEDULE O | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,905,020 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $2,983,424 | RevenueAmt |
| Desc | THERE ARE 3 RURAL HEALTH CLINICS: 1 RURAL HEALTH CLINIC WITHIN THE SAME COMMUNITY WHERE THE HOSPITAL RESIDES, AND 2 RURAL HEALTH CLINICS LOCATED IN 2 SMALLER NEARBY COMMUNITIES. THE RURAL HEALTH CLINICS REPORTED 17,350 VISITS FROM 4/1/14 THROUGH 3/31/15. PROVIDERS FOR THE RURAL HEALTH CLINICS LIVE AND WORK IN THE SAME COMMUNITY AND ARE ACTIVELY INVOLVED IN COMMUNITY ACTIVITIES; OFFERING A LARGE VARIETY OF EDUCATIONAL SERVICES AS WELL AS CLINICAL SERVICES SUCH AS PROVIDING 2 LOCAL HIGH SCHOOLS A SPORTS MEDICINE CLINIC AND COVERAGE BY PROVIDERS AT HOME SPORTING EVENTS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $0 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $0 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $11,422,088 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | 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 | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| 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 | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 21 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 186 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | KS | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BART KENTON | PersonNm |
| Phone | 7853649636 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1110 COLUMBINE DRIVE | AddressLine1Txt |
| City | HOLTON | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 66436 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| CATHERINE E REED | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| J RICHARD LAKE | ||||||||
| BOARD CHAIR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MARGARET PAGEL | ||||||||
| BOARD SECRETARY | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| ALEX GILLILAND | ||||||||
| BOARD TREASURER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| BOBBI MCGRATH | ||||||||
| BOARD VICE CHAIR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| IRVIN SANDERSON | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| DAN BRENNER | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| CARRIE SAIA | ||||||||
| CEO | 40.0 | 0.0 | $146,818 | $0 | $30,910 | Yes (X) | ||
| BART KENTON | ||||||||
| CFO, HIRED 11/2014 | 40.0 | 0.0 | $14,838 | $0 | $2,180 | Yes (X) | ||
| CLINT M COLBERG | ||||||||
| MEDICAL PROVIDER | 40.0 | 0.0 | $242,503 | $0 | $24,330 | Yes (X) | ||
| LEE R SCHNEE | ||||||||
| MEDICAL PROVIDER | 40.0 | 0.0 | $237,238 | $0 | $21,601 | Yes (X) | ||
| MALIA S WARNER | ||||||||
| MEDICAL PROVIDER | 40.0 | 0.0 | $191,716 | $0 | $27,853 | Yes (X) | ||
| VANCE R LASSEY | ||||||||
| MEDICAL PROVIDER | 40.0 | 0.0 | $229,089 | $0 | $21,352 | Yes (X) | ||
| JOEL R HUTCHINS | ||||||||
| MEDICAL PROVIDER | 40.0 | 0.0 | $192,015 | $0 | $8,533 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,254,217 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $136,759 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | 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)
| ServicesServicesDesc | CompensationCompensationAmt |
|---|---|
| ST FRANCIS HEALTH CENTER | |
| MGMT/LAB SERVICES | $514,199 |
| GLENDAVNIC ANESTHESIA PLLC | |
| ANESTHESIA SERVICES | $351,398 |
| MEDHOST OF TENNESSEE INC | |
| SUPPORT/SOFTWARE | $252,387 |
| SHARED MEDICAL SERVICES | |
| MRI SERVICES | $130,000 |
| ARSI INC | |
| COLLECTION SERVICES | $102,906 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $12,957 | GovernmentGrantsAmt |
| All Other Contributions | $146,379 | AllOtherContributionsAmt |
| Total Contributions | $159,336 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $14,620,000 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14,620,000 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $14,620,000 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $48,779 | TotalRevenueColumnAmt |
| Exclusion | $48,779 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA | 623000 | $22,636 | $22,636 |
| MEDICAL RECORDS | 623000 | $4,115 | $4,115 |
| ALL OTHER MISC REVENUE | 623000 | $226,149 | $226,149 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $226,149 | TotalRevenueColumnAmt |
| Exclusion | $226,149 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $252,900 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,081,015 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14,620,000 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $301,679 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $223,889 | TotalAmt |
| Program Services | $161,200 | ProgramServicesAmt |
| Management And General | $62,689 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,665 | TotalAmt |
| Program Services | $118,665 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,182,430 | TotalAmt |
| Program Services | $5,275,657 | ProgramServicesAmt |
| Management And General | $906,773 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,696 | TotalAmt |
| Program Services | $78,663 | ProgramServicesAmt |
| Management And General | $15,033 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $553,826 | TotalAmt |
| Program Services | $412,959 | ProgramServicesAmt |
| Management And General | $140,867 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $495,733 | TotalAmt |
| Program Services | $439,426 | ProgramServicesAmt |
| Management And General | $56,307 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,225 | TotalAmt |
| Management And General | $5,225 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,284 | TotalAmt |
| Management And General | $77,284 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,838,150 | TotalAmt |
| Program Services | $1,309,397 | ProgramServicesAmt |
| Management And General | $528,753 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,678 | TotalAmt |
| Program Services | $129 | ProgramServicesAmt |
| Management And General | $43,549 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $625,430 | TotalAmt |
| Program Services | $542,144 | ProgramServicesAmt |
| Management And General | $83,286 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $249,174 | TotalAmt |
| Program Services | $2,181 | ProgramServicesAmt |
| Management And General | $246,993 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $334,390 | TotalAmt |
| Program Services | $242,052 | ProgramServicesAmt |
| Management And General | $92,338 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,377 | TotalAmt |
| Program Services | $51,897 | ProgramServicesAmt |
| Management And General | $25,480 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,689 | TotalAmt |
| Program Services | $122,107 | ProgramServicesAmt |
| Management And General | $46,582 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $527,529 | TotalAmt |
| Program Services | $362,284 | ProgramServicesAmt |
| Management And General | $165,245 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $271,472 | TotalAmt |
| Program Services | $248,158 | ProgramServicesAmt |
| Management And General | $23,314 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT EXPENSE | $833,959 | $833,959 | |
| REPAIRS & MAINTENANCE | $223,467 | $184,709 | $38,758 |
| LOSS ON EXT OF DEBT | $70,882 | $70,882 | $0 |
| MEDICAL SUPPLIES | $896,062 | $896,062 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $194,700 | TotalAmt |
| Program Services | $69,557 | ProgramServicesAmt |
| Management And General | $125,143 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,105,707 | TotalAmt |
| Program Services | $11,422,088 | ProgramServicesAmt |
| Management And General | $2,683,619 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $660 | BOYAmt |
| EOY | $830 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,094,073 | BOYAmt |
| EOY | $3,933,796 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,925,184 | BOYAmt |
| EOY | $1,868,093 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,756 | BOYAmt |
| EOY | $146,688 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $124,125 | BOYAmt |
| EOY | $121,756 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $8,504,048 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,584,941 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,737,601 | BOYAmt |
| EOY | $3,919,107 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $419,166 | BOYAmt |
| EOY | $733,059 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,426,565 | BOYAmt |
| EOY | $10,723,329 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $694,123 | BOYAmt |
| EOY | $964,476 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,970,000 | BOYAmt |
| EOY | $3,535,580 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $159,611 | BOYAmt |
| EOY | $645,134 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,823,734 | BOYAmt |
| EOY | $5,145,190 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,544,985 | BOYAmt |
| EOY | $5,520,293 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,846 | BOYAmt |
| EOY | $57,846 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,602,831 | BOYAmt |
| EOY | $5,578,139 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,426,565 | BOYAmt |
| EOY | $10,723,329 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $975,308 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
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) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (true) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $3,398 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Total Lobbying Expenditures | $3,398 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1F | FormAndLineReferenceDesc |
| Explanation | THIS AMOUNT REPRESENTS THE PORTION OF THE DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND THE KANSAS HOSPITAL ASSOCIATION THAT ARE FOR LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $57,846 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $289 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $289 | OtherExpendituresAmt |
| End Year Balance | $57,846 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $57,846 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $359 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $359 | OtherExpendituresAmt |
| End Year Balance | $57,846 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $57,846 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $521 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $521 | OtherExpendituresAmt |
| End Year Balance | $57,846 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $57,846 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,180 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,180 | OtherExpendituresAmt |
| End Year Balance | $57,846 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $58,600 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,391 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $2,145 | OtherExpendituresAmt |
| End Year Balance | $57,846 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,983 | OtherCostOrOtherBasisAmt |
| Book Value | $9,983 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,258,753 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,837,764 | DepreciationAmt |
| Book Value | $2,420,989 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $301,631 | OtherCostOrOtherBasisAmt |
| Depreciation | $69,170 | DepreciationAmt |
| Book Value | $232,461 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,966,118 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,114,343 | DepreciationAmt |
| Book Value | $851,775 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $967,563 | OtherCostOrOtherBasisAmt |
| Depreciation | $563,664 | DepreciationAmt |
| Book Value | $403,899 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,919,107 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DEFERRED FINANCING COSTS | $150,699 |
| DUE FROM THIRD PARTY | $582,360 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $733,059 | TotalBookValueOtherAssetsAmt |
| Total Rev Etc Audited Fincl Stmt | $14,247,056 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $14,247,056 | RevenueSubtotalAmt |
| Other Revenues Not Included | $833,959 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $833,959 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $15,081,015 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $13,271,748 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $13,271,748 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $833,959 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $833,959 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $14,105,707 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART V, LINE 4 | THE PERMANENTLY DONOR RESTRICTED ENDOWMENT ONLY ALLOWS THE ORGANIZATION TO USE INTEREST INCOME FOR OPERATIONS. |
| SCHEDULE D, PART X, LINE 2 | 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. |
| SCHEDULE D, PART XI AND PART XII, LINE 4B | PROVISION FOR UNCOLLECTIBLE ACCOUNTS $ 833,959 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | false | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,372 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $25,372 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $998,737 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $953,121 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $45,616 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00340 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,024,109 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $953,121 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $70,988 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00530 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $66,034 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $18,699 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $47,335 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00360 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $213,195 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $213,195 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01610 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,477 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,477 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $283,706 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $18,699 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $265,007 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02000 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,307,815 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $971,820 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $335,995 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02530 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,277 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,277 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,277 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,277 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $833,959 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $6,775,154 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $6,696,762 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $78,392 | 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 | HOLTON COMMUNITY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1110 COLUMBINE DRIVE | AddressLine1Txt |
| City | HOLTON | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 66436 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.HOLTONCOMMUNITYHOSPITAL.COM | WebsiteAddressTxt |
| State License | H043001 | 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 | HOLTON COMMUNITY HOSPITAL | 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 |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | 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 | http://holtonhospital.com | 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 | 12 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | http://holtonhospital.com | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| 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 | 100 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200. | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTP://HOLTONHOSPITAL.COM | FAPAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 5 | THE PLANNING COMMITTEE FOR THE JACKSON COUNTY CHNA DEVELOPED A LIST OF ENTITIES WITHIN JACKSON COUNTY THAT WOULD CONNECT WITH THE MAJORITY OF OUR POPULATION. ONCE THE TARGET AUDIENCE WAS IDENTIFIED A SURVEY WAS CREATED IN ORDER TO SOLICIT COMMUNITY INPUT. THE STEERING COMMITTEE SELECTED THE TOP ELEVEN INDICATORS TO INCLUDE IN THE SURVEY. THE SURVEY WAS PUBLISHED BOTH ONLINE AND IN HARD COPY AND DISTRIBUTED WIDELY THROUGHOUT THE COUNTY. STEERING COMMITTEE MEMBERS AS WELL AS THE LARGER STAKEHOLDERS GROUP MEMBERS WERE ASKED TO COMPLETE THE SURVEY. ADDITIONALLY, SURVEYS WERE MADE AVAILABLE AT EACH HEALTHCARE FACILITY IN THE COUNTY FOR A RANDOM SAMPLING OF CLIENTS. THE SURVEY ASKED PARTICIPANTS TO RANK THEIR TOP PRIORITIES IN ORDER TO ASSIST THE STEERING COMMITTEE TO IDENTIFY THE COMMUNITY'S TOP TEN HEALTH PRIORITIES. FOLLOWING THE IDENTIFICATION OF THE TOP PRIORITIES BY SURVEY PARTICIPANTS, A GROUP OF COMMUNITY PUBLIC HEALTH EXPERTS WAS CONVENED FOR A FOCUS GROUP MEETING TO DISCUSS THE HEALTH INDICATORS AND TO NARROW THE CHOICES TO ONE OR TWO HIGH PRIORITIES AROUND WHICH TO BUILD A COMMUNITY ACTION PLAN. DURING THE TOWN HALL MEETING PARTICIPANTS WERE ASKED TO NARROW THE ELEVEN INDICATORS TO THE TOP FIVE. BY A NOMINAL GROUP VOTING TECHNIQUE, FIVE INDICATORS WERE SELECTED FROM THE ELEVEN PRESENTED. FIVE GROUPS WERE CREATED IN ORDER TO ANALYZE EACH OF THE FIVE TOP PRIORITIES; PARTICIPANTS WERE ASKED TO JOIN WHICHEVER GROUP MOST MET THEIR CONCERN/INTEREST. A STEERING COMMITTEE MEMBER FACILITATED EACH SMALL GROUP DISCUSSION. THE PURPOSE OF THE GROUP DISCUSSION WAS TO DISCOVER ROOT CAUSES OF EACH OF THE HEALTH ISSUES. THE METHOD USED FOR ANALYSIS WAS DISPERSION ANALYSIS OR THE "FIVE WHY'S" TECHNIQUE (SOURCE: PUBLIC HEALTH FOUNDATION) WHERE THE QUESTION, "WHY IS (E.G.) OVERWEIGHT/OBESITY A PROBLEM IN JACKSON COUNTY," LEADS TO SUCCEEDING IN DEPTH QUESTIONS TO DISCOVER THE ROOT "WHY" ANSWER. EACH SMALL GROUP REPORTED THEIR "FIVE WHY" RESULTS TO THE LARGER GROUP, WHICH THEN VOTED USING THE NOMINAL VOTING TECHNIQUE TO NARROW TO THE TOP ONE OR TWO PRIORITY ISSUES. |
| SCHEDULE H, PART V, SECTION B, LINE 6B | Prairie Band Pottawatomie Health Services Jackson County Head Start City of Holton Police Department Kanza Mental Health Services Jackson County Public Health Department NEKCAP- Northeast Kansas Community Action Program NEK Multi County Health Agencies KSU Research and Extension Holton Family Health (Community HealthCare System) |
| SCHEDULE H, PART V, SECTION B, LINE 7D | COPIES ARE AVILABLE AT ALL HEALTHCARE PROVIDERS IN THE COUNTY. |
| SCHEDULE H, PART V, SECTION B, LINE 11 | During the CHNA, the top 5 items identified were: 1. Obesity/Overweight 2. Cancer 3. Heart Disease 4. Diabetes 5. Mental Health The top two issues as voted upon by the public health experts were Overweight/Obesity and Mental Health. Because Heart Disease, Diabetes, and to a lesser extent Cancer are potentially co-morbidities of Obesity/Overweight, the committee decided to address those issues through the Obesity/Overweight implementation strategies. In order to effect the most change within Jackson County, the steering committee voted to focus its' energies upon the topics of Overweight and Obesity for Year 1, keeping Mental Health issues in focus for future implementation. Once progress has been made in implementing strategies to combat Obesity and Overweight issues within our community, the issue of Mental Health will be raised. Improving mental health is imperative to the citizens of our county and outlying service areas. Since adoption of the CHNA, Holton Community Hospital has conducted or participated in the following to implement strategies to combat Obesity in Jackson County residents: - Participates in Healthy Living Taskforce meetings every other month. Community partners are invited to discuss events, needs, and options for further community education or intervention. Taskforce began in 2013 and continues today. - Holton Community Hospital joined the Healthy Kansas Hospital initiative and has developed a wellness committee, developed quarterly challenges for employees, improved options for the vending machines and cafeteria menus. - Holton Community Hospital has provided ongoing diabetic education training (individual and group) by a diabetic educator at Holton Community Hospital. - Participated in PSAs on healthy choices done via radio by KSU Research and Education - CME on Obesity offered to medical professionals in Jackson, Brown, Shawnee and Nemaha counties through KU Med. Holton Community Hospital has had a less active role in Mental Health. HCH provides limited Mental Health care but has promoted and/or participated in the following since the adoption of the CHNA: - Quarterly mental health updates on community bulletin boards or electronic bulletin boards at 8 different locations in the county. - Mental Health First Aid training held in Holton. Approximately 20 participants completed this 8 hour course. - Kanza Mental Health created a telehealth option for screening of individuals with behavioral health issues in Brown and Jackson Counties. It is to be used in law enforcement and healthcare situations. - Holton Community Hospital is currently exploring options to partner with an external agency that would provide Behavioral Health services on its facility grounds to meet an identified community need. - Holton Community Hospital collaborated with a local nursing school, behavioral health agency, and larger healthcare organization in applying for a HRSA grant that would assist nurse practitioner students in being better prepared to immediately care for patient populations better in rural and behavioral health settings upon graduation. If successful in being awarded this grant application, our organization would be involved with a 3 year commitment in providing an educational track for these advanced practice nurse practitioner students. During the 2016 Community Health Needs Assessment, the most recent CHNA will be reviewed. Additionally, demographic data for the areas of concern (obesity and mental health) will be reviewed. If there have been no positive changes to either category, they will remain a focus area of the Healthy Living Taskforce and programming will be created to meet those needs. If there has been positive change in the demographic data, the Steering Committee and Healthy Living Taskforce will review the needs identified in the 2016 CHNA and develop programming that would address those needs. |
| SCHEDULE H, PART V, SECTION B, LINE 22D | THE LOOK-BACK METHOD IS USED IN CALCULATING THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| FAMILY PRACTICE ASSOCIATES - HOLTON | ||||
| 1100 COLUMBINE DRIVE | HOLTON | KS | 66436 | RURAL HEALTH CLINIC |
| FAMILY PRACTICE ASSOCIATES - HOYT | ||||
| 207 HIGHLAND AVENUE | HOYT | KS | 66440 | RURAL HEALTH CLINIC |
| FAMILY PRACTICE ASSOCIATES - WETMORE | ||||
| 323 SECOND STREET | WETMORE | KS | 66550 | RURAL HEALTH CLINIC |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 7, COLUMN F | THE AMOUNT OF BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES FOR CALCULATING THE NET COMMUNITY BENEFIT EXPENSE PERCENTAGE WAS $833,959. |
| SCHEDULE H, PART I, LINE 7 | THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNT CONTAINED IN THE TABLE OF SCHEDULE H, PART I, LINE 7 IS THE A COST-TO-CHARGE RATIO. |
| SCHEDULE H, PART II | THE HOSPITAL IS A COMMITTED PARTNER IN PROMOTING COMMUNITY HEALTH EDUCATION. THE REHABILITATION DEPT HAS 7 - CERTIFIED ARTHRITIS FOUNDATION EXERCISE INSTRUCTORS OFFERING WEEKLY CLASSES AT SEVERAL COMMUNITY LOCATIONS. SOCIAL SERVICES DIRECTOR SPONSORS MONTHLY GRIEF SUPPORT GROUP FOR THOSE SADDENED BY A LOSS OF A LOVED ONE OR FRIEND AS WELL AS A MONTHLY ALZHEIMER'S SUPPORT GROUP. SPORTS PHYSICALS ARE OFFERED AT LOCAL SCHOOLS TO MAKE SURE THE SPORTS ORIENTED YOUNG PEOPLE ARE HEALTHY. THE HOSPITAL OFFERS HEALTH SERVICES EDUCATION IN WEEKLY LOCAL NEWSPAPERS. PROVIDERS AND OTHER ALLIED HEALTH PROFESSIONALS ARE ACTIVE IN SPONSORING INTERNS AND STUDENT JOB SHADOWS TO ENCOURAGE AND EMPHASIZE HEALTH CARE PROVIDERS IN SMALL RURAL COMMUNITIES. |
| SCHEDULE H, PART III, SECTION A, LINE 2 | THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HOSPITAL BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN ACCORDANCE WITH A PREDETERMINED PAYMENT PLAN BASED ON THE VALUE OF THE PATIENT'S BALANCE. ACCOUNTS ARE COSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBT BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. |
| SCHEDULE H, PART III, SECTION A, LINE 3 | BAD DEBT EXPENSE (AT COST) IDENTIFIED THE PROVISION FOR UNCOLLECTIBLES FROM 3/31/15 AUDITED STATEMENT OF OPERATIONS. MULTIPLIED THAT AMOUNT BY THE COST TO CHARGE RATIO. CHARITY CARE (AT COST): LOGS MAINTAINED BY CASH COLLECTOR. LOG CONTAINS DATA OF THE DOLLAR AMOUNT TURNED TO BAD DEBT WHERE A CHARITY CARE APPLICATION WAS SENT BUT NOT RETURNED AND WHEN CHARITY CARE APPLICATION WAS RETURNED BUT PATIENT DID NOT FULFILL FINANCIAL OBLIGATION. SUBSEQUENTLY, MULTIPLIED THAT AMOUNT BY THE COST-TO-CHARGE RATIO IDENTIFIED IN SCHEDULE H, PART I. |
| SCHEDULE H, PART III, SECTION A, LINE 4 | SEE PAGE 8 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. |
| SCHEDULE H, PART III, SECTION C, LINE 9B | WHEN A RESPONSIBLE PARTY IS UNABLE TO MEET THE FINANCIAL OBLIGATION GUIDELINES AS DESCRIBED IN THE HOSPITAL'S FINANCIAL POLICY, THE PARTY IS ADVISED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. CLARIFICATION IS MADE AS TO WHETHER THE PATIENT HAS PRIMARY INSURANCE. IF NO PRIMARY INSURANCE IS AVAILABLE IT IS EXPLAINED THAT PER THE POLICY AN APPLICATION TO MEDICAID IS REQUIRED BEFORE FINANCIAL ASSISTANCE CAN BE CONSIDERED. IF MEDICAID DENIES ELIGIBILITY, A WRITTEN STATEMENT FROM MEDICAID IS REQUIRED. ONCE A MEDICAID ELIGIBILITY DENIAL IS RECEIVED A FINANCIAL ASSISTANCE APPLICATION IS OFFERED. THE RESPONSIBLE PARTY IS REQUIRED TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION AND SUBMIT ALL DOCUMENTATION INDICATED (AS OUTLINED ON THE APPLICATION) IN ORDER FOR THE HOSPITAL TO DETERMINE FINANCIAL ASSISTANCE ELGIBILITY. IF AN APPLICATION IS NOT RETURNED AFTER 15 DAYS, A COURTESY EXTENSION OF 5 ADDITIONAL DAYS IS AUTHORIZED. AFTER THE 5 DAY EXTENSION AND THE FINANCIAL ASSISTANCE APPLICATION ALONG WITH REQUIRED DOCUMENTATION IS NOT RECEIVED, FURTHER COLLECTION ACTION IS TAKEN. THE COLLECTION PROCESS CONTINUES UNTIL THE RESPONSIBLE PARTY CONTACTS A PATIENT FINANCIAL COUNSELOR OR RETURNS THE APPLICATION WITH REQUIRED DOCUMENTATION . ONCE A FINANCIAL ASSISTANCE APPLICATION IS RECEIVED, NOT ALL THE REQUIRED FINANCIAL DOCUMENTATION (AS OUTLINED ON THE APPLICATION) IS SUBMITTED, A COURTESY LETTER IS SENT TO THE RESPONSIBLE PARTY. THIS LETTER REQUESTS THE INFORMATION BE RETURNED WITH 15 DAYS IN ORDER TO BE CONSIDERED. IF THE REQUIRED DOCUMENTATION IS THEN SUBSEQUENTLY NOT RECEIVED WITHIN THOSE 15 DAYS AND NO CONTACT WITH THE PATIENT FINANCIAL FINANCIAL COUNSELOR IS MADE, THE FINANCIAL ASSISTANCE APPLICATION IS DENIED AND FURTHER COLLECTION ACTION IS TAKEN. |
| SCHEDULE H, PART VI, LINE 2 | OUR CURRENT 12-BED HOSPITAL IS LOCATED WITHIN THE OUTER REGION OF THE HOLTON CITY LIMITS. OUR EXPANDED FACILITIES ALLOW US TO PROVIDE A BROAD RANGE OF HEALTHCARE SERVICES TO ALL MEMBERS OF OUR COMMUNITY WITHOUT REGARD TO AGE, RACE, SEX OR FINANCIAL CONSTRAINTS. HOLTON COMMUNITY HOSPITAL IS PROUD TO BE A CERTIFIED 'STROKE READY' FACILITY. OUR REHABILITATION SERVICES DEPARTMENT PROVIDES A FULL-COMPLIMENT OF OCCUPATIONAL AND PHYSICAL THERAPIES, INCLUDING A LYMPHEDEMA MANAGEMENT PROGRAM AND SPEECH THERAPY. OUR CARDIOVASCULAR SERVICES DEPARTMENT PROVIDES CARDIAC REHAB, AS WELL AS PERFORMS PULMONARY FUNCTION PROCEDURES AND STRESS TESTS, AND PROVIDES ONE-ON-ONE CERTIFIED DIABETES EDUCATION AND TOBACCO CESSATION COUNSELING. THE SURGERY DEPARTMENT PROVIDES 24/7 SURGICAL SERVICES. WE HAVE A LARGE VARIETY OF SPECIALTY PHYSICIANS WHO TREAT PATIENTS IN THE FACILITY AS WELL AS PERFORM NUMEROUS SURGICAL PROCEDURES. THE RADIOLOGY DEPARTMENT, IN COLLABORATION WITH ST. FRANCIS HOSPITAL, PROVIDES MOBILE NUCLEAR MEDICINE TESTING ON SITE. THE FACILITY ALSO CONTRACTS WITH SHARED MEDICAL SERVICES, INC. TO PROVIDE ON-SITE MOBILE MRI TESTING. THE RADIOLOGY DEPARTMENT IS ALSO VERY PROUD TO HAVE A 32-SLICE CT SCANNER WHICH PROVIDES HIGH RESOLUTION IMAGES. A CT SCANNER WITH THIS CAPABILITY IS A RARITY IN A HOSPITAL OF OUR SIZE. OUR HOSPITAL OFFERS A FULL-SERVICE, 24-7 EMERGENCY DEPARTMENT WITH A PHYSICIAN AVAILABLE AT ALL TIMES. WE HAVE TRANSFER AGREEMENTS WITH SURROUNDING HOSPITALS FOR THOSE PATIENTS WHO PRESENT TO THE HOSPITAL EMERGENCY DEPARTMENT AND REQUIRE CARE BEYOND OUR CAPABILITIES. OUR 12-BED IN-PATIENT UNIT PROVIDES CARE TO MEDICAL-SURGICAL PATIENTS, SUB-ACUTE PATIENTS, PEDIATRICS AND GERIATRICS. WE PROVIDE OBSTETRICAL AND NEWBORN CARE PATIENT SERVICES WHICH IS BECOMING INCREASINGLY RARE AMONG RURAL HOSPITALS. WE ARE ALSO LICENSED TO PROVIDE SWINGBED SERVICES. THIS ALLOWS PATIENTS TO RECEIVE TRANSITIONAL INPATIENT REHABILIATION AND RECOVERY SERVICES. HOLTON COMMUNITY HOSPITAL HAS A FULL-SERVICE HOME HEALTH AND HOSPICE PROGRAM. OUR AWARD-WINNING HOSPICE DELIVERS END OF LIFE CARE TO PATIENTS OF PROVIDERS THROUGHOUT NORTHEAST KANSAS. OUR RURAL HEALTH CLINIC (FAMILY PRACTICE ASSOCIATES) HAS THREE LOCATIONS IN HOLTON, HOYT AND WETMORE, KANSAS. OUR MIX OF FIVE PHYSICIANS, ONE PHYSICIAN ASSISTANT AND THREE ADVANCED REGISTERED NURSE PRACTITIONERS ALLOWS OUR COMMUNITY MEMBERS TO FIND A PROVIDER THAT BEST SERVES THEIR HEALTH CARE NEEDS. SEEING A NEED FOR SPORTS MEDICINE SERVICES WITHIN OUR LOCAL COMMUNITY, A CONTRACTUAL AGREEMENT WAS REACHED WITH A LOCAL SCHOOL SYSTEM. OUR PHYSICIAN'S ASSISTANT, ALSO A REGISTERED PHYSICAL THERAPIST, OFFERS SPORTS MEDICINE SERVICES 2 AFTERNOONS PER WEEK AT HOLTON HIGH SCHOOL. HE ALSO ATTENDS ALL HOME GAMES, AND AWAY GAMES AS NEEDED, TO ASSIST WITH POSSIBLE INJURIES THAT MIGHT OCCUR. WE HAVE BEEN DISTRIBUTING PATIENT SATISFACTION SURVEYS THROUGHOUT OUR SURGICAL, INPATIENT, OUTPATIENT, RURAL HEALTH CLINIC, EMERGENCY ROOM AND REHABILITATION SERVICES FOR APPROXIMATELY 5 YEARS. THE RESULTS OF THESE SURVEYS ARE COMPILED MONTHLY AND ARE USED TO BETTER OUR PATIENT SERVICES. WE HAVE ALSO ESTABLISHED A SURGICAL OVERSIGHT COMMITTEE THAT MEETS MONTHLY ON HOW TO IMPROVE SERVICES AND PROCESSES IN THE SURGERY DEPARTMENT. WE ARE COMMITTED TO PROVIDING QUALITY HEALTHCARE TO ALL MEMBERS OF OUR COMMUNITY. BECAUSE WE ARE A SMALL TOWN HOSPITAL, A MAJORITY OF OUR PATIENTS HAVE A STRONG BOND WITH OUR STAFF. THIS ALLOWS US TO PROVIDE CARE THAT EXTENDS BEYOND JUST MEDICAL NEEDS. THE COST AND DIFFICULTY IN SEEKING CARE IN OTHER AREAS FOR OUR ELDERLY AND POOR POPULATION REINFORCES THE NEED FOR A STRONG COMMUNITY HOSPITAL. WE STRIVE TO MEET THIS NEED BY PROVIDING ALL SERVICES POSSIBLE. |
| SCHEDULE H, PART VI, LINE 3 | HOLTON COMMUNITY HOSPITAL POSTS SIGNS AT ITS REGISTRATION LOCATIONS REGARDING THE AVAILABILITY OF OUR FINANCIAL ASSISTANCE PROGRAM. THE AVAILABILITY OF A FINANCIAL ASSISTANCE PROGRAM IS ALSO IDENTIFIED ON ALL HOSPITAL PATIENT SERVICE RELATED LETTERS AND GUARANTOR STATEMENTS. ONCE A PATIENT CALLS TO INQUIRE ABOUT THE FINANCIAL ASSISTANCE PROGRAM THE PATIENT FINANCIAL COUNSELOR WORKS ONE-ON-ONE WITH THE PATIENTS OUTLINING THE REQUIREMENTS, DOCUMENTS NEEDED AND EXPLAINS OUR FINANCIAL ASSISTANCE PROGRAM IN DETAIL. |
| SCHEDULE H, PART VI, LINE 4 | HOLTON COMMUNITY HOSPITAL AND FAMILY PRACTICE ASSOCIATES PHYSICIAN'S CLINIC ARE THE PREMIERE HEALTHCARE PROVIDERS IN OUR COUNTY. LIKE OTHER RURAL HOSPITALS, HCH SERVES A HIGHER PERCENTAGE OF ELDERLY AND CHILDREN LIVING IN POVERTY WHILE THE COUNTY EXPERIENCES HIGHER LEVELS OF UNEMPLOYMENT AND LOWER INCOMES. ACCORDING TO A REPORT GENERATED BY THE KANSAS RURAL HEALTH OPTIONS PROJECT, RURAL INDIVIDUALS REPORT POORER OVERALL HEALTH AND MORE CHRONIC HEALTH CONDITIONS. ADDITIONALLY, RURAL COUNTIES SEE A HIGHER RATE OF UNINSURED INDIVIDUALS AND HAVE FEWER HEALTH CARE SERVICES AVAILABLE TO THEM. FINALLY, PEOPLE IN RURAL COMMUNITIES ARE MORE LIKELY TO DERIVE PART OF THEIR INCOME FROM THE HEALTHCARE INDUSTRY (EITHER DIRECTLY OR INDIRECTLY). JACKSON COUNTY HOLDS THE DESIGNATION OF BEING A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA). THIS DESIGNATION COMES FROM THE KANSAS DEPARTMENT OF HEALTH AND ENVIRONMENT (KDHE) AND IDENTIFIES AREAS OF THE STATE THAT ARE MEDICALLY UNDERSERVED. ACCORDING TO THE WEBSITE, KANSASHEALTHMATTERS.ORG, EACH PHYSICIAN IN JACKSON COUNTY HAS A POTENTIAL 1,745 INDIVIDUALS TO PROVIDE CARE TO. ADDITIONALLY, THIS SAME WEBSITE NOTED THAT IN 2009 MORE THAN 15.9% OF OUR COUNTY HAS NO HEALTH INSURANCE. KANSASHEALTHMATTERS.ORG ALSO REPORTS THAT 12.5% OF JACKSON COUNTY, KANSAS CHILDREN UNDER THE AGE OF 18 WERE LIVING AT OR BELOW THE POVERTY LINE (REPORTING PERIOD: 2006-2010). IN COMPARISON, ACCORDING TO THE US CENSUS BUREAU, AMERICAN COMMUNITY SURVEY REPORT FOR THE PERIOD 2007-2011, 9.5% OF JACKSON COUNTY RESIDENTS LIVED BELOW THE POVERTY LEVEL. THE SAME REPORT NOTED THE PER CAPITA PERSONAL INCOME OF JACKSON COUNTY RESIDENTS FROM 2006-2011 WAS APPROXIMATELY $24,200.00, COMPARED TO THE STATE'S PER CAPITA PERSONAL INCOME OF $26,425.00. ADDITIONALLY, IN A RECENT SURVEY COMPLETED BY THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE AND THE ROBERT WOOD JOHNSON FOUNDATION, JACKSON COUNTY RANKED 44TH IN THE STATE ON THE HEALTH OF OUR COUNTY. JACKSON COUNTY SCORES BELOW STATE BENCHMARKS IN HEALTH CARE, HEALTHY BEHAVIORS AND SOCIAL AND ECONOMIC FACTORS. THERE IS NO CONTRADICTORY INFORMATION TO CHALLENGE THAT THERE ARE STILL 81 PRIMARY CARE PROVIDERS PER 100,000 RESIDENTS IN THE COUNTY (ACTUAL NUMBER: 11 PROVIDERS), BELOW THE STATE'S AVERAGES OF 115 AND THE TARGET RATE OF 151. |
| SCHEDULE H, PART VI, LINE 5 | HOSPITAL EMPLOYEES ARE ENCOURAGED TO PARTICIPATE IN LOCAL COMMUNITY ACTIVITIES. EMPLOYEES ARE MEMBERS OF THE LOCAL CHAMBER OF COMMERCE, SERVE AS BOARD MEMBERS WITH SEVERAL LOCAL ORGANIZATIONS, AND ARE BOARD MEMBERS OF A STATE ORGANIZATION PROMOTING THE PATIENT FINANCIAL SERVICES SEGMENT OF HEALTHCARE. EMPLOYEES ARE INVOLVED ON SEVERAL LEVELS WITH YOUTH PROGRAMS. EMPLOYEES PROVIDE INSERVICE TRAINING TO VARIOUS LOCAL AGENCIES ON HEALTH ORIENTED SUBJECTS SUCH AS MEDICAL ADMINISTRATION. |
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 (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CARRIE SAIA | ||||||||||||||
| CEO | $146,139 | $0 | $0 | $0 | $679 | $0 | $8,234 | $0 | $22,676 | $0 | $177,728 | $0 | $0 | $0 |
| CLINT M COLBERG | ||||||||||||||
| MEDICAL PROVIDER | $240,691 | $0 | $0 | $0 | $1,812 | $0 | $7,347 | $0 | $16,983 | $0 | $266,833 | $0 | $0 | $0 |
| LEE R SCHNEE | ||||||||||||||
| MEDICAL PROVIDER | $237,126 | $0 | $0 | $0 | $112 | $0 | $7,118 | $0 | $14,483 | $0 | $258,839 | $0 | $0 | $0 |
| MALIA S WARNER | ||||||||||||||
| MEDICAL PROVIDER | $191,604 | $0 | $0 | $0 | $112 | $0 | $5,970 | $0 | $21,883 | $0 | $219,569 | $0 | $0 | $0 |
| VANCE R LASSEY | ||||||||||||||
| MEDICAL PROVIDER | $228,977 | $0 | $0 | $0 | $112 | $0 | $6,869 | $0 | $14,483 | $0 | $250,441 | $0 | $0 | $0 |
| JOEL R HUTCHINS | ||||||||||||||
| MEDICAL PROVIDER | $190,460 | $0 | $0 | $0 | $1,555 | $0 | $4,023 | $0 | $4,510 | $0 | $200,548 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, PART VII, SECTION A, LINE 1A AND SCHEDULE J, PART II | FormAndLineReferenceDesc |
| Explanation | THE COMPENSATION BEING REPORTED FOR CARRIE SAIA IS PAID BY ST. FRANCIS HEALTH CENTER WHICH IS PART OF THE MANAGEMENT CONTRACT. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF HOLTON KANSAS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 486030368 | BondIssuerEIN |
| Bond Issued | 2015-03-04 | BondIssuedDt |
| Issue Price | $3,535,579 | IssuePriceAmt |
| Purpose | SEE PART VI | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $0 | RetiredAmt |
| Bond Defeased | $0 | BondDefeasedAmt |
| Total Proceeds | $3,535,579 | TotalProceedsAmt |
| In Reserve Fund | $0 | InReserveFundAmt |
| Capitalized Interest | $0 | CapitalizedInterestAmt |
| Refunding Escrow | $0 | RefundingEscrowAmt |
| Issuance Costs From Proceeds | $63,992 | IssuanceCostsFromProceedsAmt |
| Credit Enhancement | $0 | CreditEnhancementAmt |
| Working Capital Expenditures | $0 | WorkingCapitalExpendituresAmt |
| Capital Expenditures | $0 | CapitalExpendituresAmt |
| Other Spent Proceeds | $2,514,928 | OtherSpentProceedsAmt |
| Unspent | $956,659 | UnspentAmt |
| Current Refunding | Yes (true) | CurrentRefundingInd |
| Advance Refunding | false | AdvanceRefundingInd |
| Final Allocation Made | false | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Change In Use Bond Financed Prop | 0.00000 | ChangeInUseBondFinancedPropPct |
| Procs Nonqualified Bond Remdtd | Yes (true) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (true) | RebateNotDueYetInd |
| Variable Rate Issue | Yes (true) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
GIC Provider Name GICProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (true) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (true) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE A, COLUMN F | Construct, furnish and equip additions to the hospital facility and a rural health clinic and refund Series 1997L Bonds. The Series 1997L Bonds were originally issued on 9/15/1997. |
| PART II, LINE 11, COLUMN A | Amount of bond proceeds used to redeem the Series 1997L Bonds on 3/13/2015. |
| PART II, LINE 12, COLUMN A | The project is not complete. This amount represents Bond proceeds on deposit in the Project Fund as of 3/31/2015. |
| PART II, LINE 13, COLUMN A | The project is not complete. |
| PART II, LINE 16, COLUMN A | The project is not complete. |
| PART III | Part III was not completed because (1) the project financed by the refunding portion was originally financed prior to January 1, 2003, and (2) the project financed by the new money portion has not been completed. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SEE SCHEDULE L PART V | PersonNm |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, SCHEDULE L, PART IV | FormAndLineReferenceDesc |
| Explanation | (A) CODY UTZ (B) CODY UTZ IS THE DAUGHTER OF CATHERINE REED WHO IS A BOARD MEMBER. (C) $ 84,704 (D) CODY UTZ IS AN EMPLOYEE OF RURAL HEALTH RESOURCES OF JACKSON COUNTY. (E) NO (A) KAY RASH (B) KAY RASH IS THE SISTER OF MARGARET PAGEL WHO IS A BOARD MEMBER. (C) $ 33,961 (D) KAY RASH IS AN EMPLOYEE OF RURAL HEALTH RESOURCES OF JACKSON COUNTY. (E) NO | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4A | HOLTON COMMUNITY HOSPITAL (HCH) IS A 12-BED CRITICAL ACCESS HOSPITAL IN A SMALL RURAL COMMUNITY. HCH OFFERS A WIDE RANGE OF SERVICES INCLUDING PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, REGISTERED DIETICIAN SERVICES, MRI, MRA, NUCLEAR MEDICINE, CT SCAN ALONG WITH OTHER RADIOLOGY SERVICES, SURGERY, LABORATORY, A CERTIFIED DIABETIC EDUCATION PROGRAM, CARDIOVASCULAR SERVICES, CERTIFIED LYMPHEDEMA PROGRAM, AND WOUND CARE SERVICES AS WELL AS A VARIETY OF SPECIALTY PROVIDER SERVICES. THE HOSPITAL STAFF IS A CERTIFIED 'STROKE READY' FACILITY AND TRAINED TO TEACH OUTREACH SERVICES UNDER THE NATIONAL ARTHRITIS FOUNDATION EXERCISE PROGRAM. THE HOSPITAL ALSO OFFERS HOME HEALTH AND HOSPICE SERVICES. THE HOSPITAL PROVIDED 24/7 EMERGENCY ROOM SERVICES WITH 2,725 EMERGENCY ROOM VISITS RECORDED FROM 4/1/14 THROUGH 3/31/15. EMERGENCY ROOM SERVICES ARE SUPPORTED BY STAFF TRAINED IN ADVANCED CARDIAC LIFE SUPPORT, CPR, EMERGENCY NURSING PEDIATRICS, TRAUMA NURSING CORE CURRICULUM, AND PEDIATRIC ADVANCED LIFE SUPPORT. THE HOSPITAL IDENTIFIED 13,258 INPATIENT HOURS AND 2,927 OBSERVATION HOURS FROM 4/1/14 THROUGH 3/31/15. |
| FORM 990, PART VI, SECTION A, LINE 3 | RURAL HEALTH RESOURCES OF JACKSON COUNTY HOLDS A MANAGEMENT CONTRACT WITH SISTERS OF CHARITY OF LEAVENWORTH/ST. FRANCIS HEALTH CENTER, TOPEKA, KS. SISTERS OF CHARITY OF LEAVENWORTH APPOINTS A CHIEF EXECUTIVE OFFICER TO MANAGE DAY-TO-DAY OPERATIONS. |
| FORM 990, PART VI, SECTION B, LINE 11B | AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE FORM 990. THE 990 IS THEN REVIEWED BY THE CEO AND CFO OF RURAL HEALTH RESOURCES OF JACKSON COUNTY (RHRJC). ANY QUESTIONS OR CONCERNS THAT ARISE ARE ADDRESSED WITH THE ACCOUNTING FIRM AND CORRECTIONS, CLARIFICATIONS OR REVISIONS ARE MADE AS NECESSARY. THE FINAL 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD OF RHRJC PRIOR TO THE FILING OF THE 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | UPON HIRE (OR IN THE CASE OF ELECTION OF BOARD MEMBERS) AND ANNUALLY THEREAFTER, THE CEO OR DESIGNEE(S) SHALL PROVIDE TO THE BOARD, STAFF AND EMPLOYED PROVIDERS OF RURAL HEALTH RESOURCES OF JACKSON COUNTY (RHRJC) A COPY OF THE CONFLICT OF INTEREST POLICY AND THE APPLICABLE CONFLICT OF INTEREST DISCLOSURE FORM. THESE DOCUMENTS WILL BE COMPLETED TO IDENTIFY ANY RELATIONSHIPS, POSITIONS, OR CIRCUMSTANCES IN WHICH IT IS BELIEVED A CONFLICT MAY ARISE. THE ANNUAL MONITORING AND REVIEW PROCESS WILL BE PART OF RHRJC'S CORPORATE COMPLIANCE PLAN. ANY POTENTIAL CONFLICT OF INTEREST CONCERNS THAT ARISE SHALL BE REPORTED BY THE CEO TO THE BOARD CHAIR. SHOULD THE CONCERN INVOLVE THE BOARD CHAIR, THE BOARD VICE-CHAIR WILL BE INFORMED INSTEAD. EACH BOARD MEMBER, STAFF MEMBER OR EMPLOYED PROVIDER SHALL FULLY DISCLOSE ANY AND ALL ACTUAL OR POTENTIAL CONFLICTS, DUALITY OF INTEREST OR RESPONSIBILITY INVOLVING INDIVIDUAL, PERSONAL, OR BUSINESS ISSUES WHICH MAY EXIST. IF THERE IS A CONFLICT, THE CONFLICTED INDIVIDUALS ABSTAIN FROM VOTING. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE BOARD OF DIRECTORS OF RURAL HEALTH RESOURCES OF JACKSON COUNTY, D.B.A. HOLTON COMMUNITY HOSPITAL, APPROVED IN MAY 2008 A MANAGEMENT CONTRACT WITH ST. FRANCIS HEALTH CENTER IN TOPEKA, KANSAS. AS PART OF THIS MANAGEMENT CONTRACT, THE CHIEF EXECUTIVE OFFICER OF HOLTON COMMUNITY HOSPITAL IS PROVIDED BY ST. FRANCIS. AS PART OF THE APPROVAL PROCESS THE BOARD DETERMINED THE CONTRACT PROVIDED SERVICES AND MANAGEMENT AT THE EQUIVALENT OF FAIR MARKET VALUE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:NURSING TOTAL FEES:350004 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:MRI TOTAL FEES:144781 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:ER PROVIDERS ON CALL FEES TOTAL FEES:264837 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:MISC. MEDICAL SERVICES TOTAL FEES:549775 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:COLLECTION COMPANY FEES TOTAL FEES:108161 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:ST. FRANCIS MANAGEMENT FEES TOTAL FEES:277079 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:MISC. MANAGEMENT SERVICES TOTAL FEES:143513 |