STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

FARMERS UNION HOSPITAL ASSOCIATION: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
FARMERS UNION HOSPITAL ASSOCIATION (EIN 73-0579295)
Tax period
2014-07-01 to 2015-06-30
Filed
2016-05-10
IRS object ID
201641319349301019
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 ReturnHeader

FieldValueIRS element (for citing)
Return2016-05-10T09:52:20-05:00ReturnTs
Tax Period End2015-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11601 NW EXPRESSWAY SUITE 1900AddressLine1Txt
CityOKLAHOMA CITYCityNm
State AbbreviationOKStateAbbreviationCd
ZIP73118ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN730579295EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Farmers Union Hospital AssociationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlFARMBusinessNameControlTxt
Phone5802252511PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11801 W 3rd StreetAddressLine1Txt
CityElk CityCityNm
State AbbreviationOKStateAbbreviationCd
ZIP73648ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCorey LivelyPersonNm
Person TitleCEOPersonTitleTxt
Phone5802252511PhoneNum
Signature2016-05-04SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKim Hunwardsen CPAPreparerPersonNm
PTINP00484560PTIN
Phone4054783334PhoneNum
Preparation2016-05-04PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-08-17 19:52:53ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Great Plains Regional Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerCorey LivelyPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11801 W 3rd StreetAddressLine1Txt
CityElk CityCityNm
State AbbreviationOKStateAbbreviationCd
ZIP73648ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$65,286,778GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.gprmc-ok.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1938FormationYr
Legal Domicile StateOKLegalDomicileStateCd
Activity Or MissionTo provide comprehensive, cost-effective, high quality healthcare to our communities.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee509TotalEmployeeCnt
Total Volunteers39TotalVolunteersCnt
Total Gross UBI$77,072TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$1,765NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$87,134PYContributionsGrantsAmt
CY Contributions Grants$48,965CYContributionsGrantsAmt
PY Program Service Revenue$46,946,279PYProgramServiceRevenueAmt
CY Program Service Revenue$51,498,824CYProgramServiceRevenueAmt
PY Investment Income$670,031PYInvestmentIncomeAmt
CY Investment Income$562,658CYInvestmentIncomeAmt
PY Other Revenue$1,245,542PYOtherRevenueAmt
CY Other Revenue$479,808CYOtherRevenueAmt
PY Total Revenue$48,948,986PYTotalRevenueAmt
CY Total Revenue$52,590,255CYTotalRevenueAmt
PY Grants And Similar Paid$4,342PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$3,100CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$20,271,705PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$21,208,812CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$31,366,434PYOtherExpensesAmt
CY Other Expenses$33,083,682CYOtherExpensesAmt
PY Total Expenses$51,642,481PYTotalExpensesAmt
CY Total Expenses$54,295,594CYTotalExpensesAmt
PY Revenues Less Expenses-$2,693,495PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,705,339CYRevenuesLessExpensesAmt
Total Assets BOY$85,483,381TotalAssetsBOYAmt
Total Assets EOY$83,283,661TotalAssetsEOYAmt
Total Liabilities BOY$39,049,687TotalLiabilitiesBOYAmt
Total Liabilities EOY$38,868,711TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$46,433,694NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$44,414,950NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionGreat Plains Regional Medical Center will distinguish itself as the leader in Western Oklahoma and the Eastern Texas Panhandle for comprehensive, cost effective, high quality healthcare. We will meet the healthcare needs of patients in our service area while achieving cost effective quality outcomes. We will maintain and enhance collaborative relationships with physicians to better serve the healthcare needs of our service area. We will maintain and continually enhance health promotion, patient education and disease prevention for patients in our service area.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$47,272,457ExpenseAmt
Grant$3,100GrantAmt
Revenue$51,421,752RevenueAmt
DescFarmers Union Hospital Association, DBA Great Plains Regional Medical Center in Elk City, Oklahoma (hereinafter referred to as GPRMC) provides quality health care regardless of race, religion, creed, sex, national origin, handicap, age or ability to pay. Reimbursement for services rendered is critical to the operation and stability of GPRMC, it is recognized that not all individuals possess the ability to purchase essential medical services. In keeping with the Hospital's commitment to serve all members of its community, free care and/or subsidized care, care provided to persons covered by government programs at below cost, and health care activities and programs to support the community will be considered whether the need and/or individual's inability to pay exists. GPRMC served over 1,895 patients with more than 6.978 patient days on an inpatient basis. We also had 56,023 outpatient encounters. During the year we treated 13,260 patients in the Emergency Department. Our Surgical teams performed 2,750 outpatient surgeries. GPRMC provides care to persons covered by governmental and other programs as part of its mission to the community. These programs may not pay full charges to the extent reimbursement is below full charges. GPRMC recognized these amounts as contractual adjustments in meeting its mission to the entire community. Also, in recognizing its mission to the community, GPRMC provides services for those unable to pay. Additionally, GPRMC has provided services to others who are either unwilling or unable to qualify for charity care guidelines but who are still unable to pay. Community benefit is also provided by GPRMC by providing reduced price services, free programs offered throughout the year which GPRMC believes will serve a bona fide community health need. See Schedule H for more information regarding these activities.Desc
Total Program Service Expenses$47,272,457TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document81IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee509EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldOKStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJanet MillerPersonNm
Phone5808215302PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11801 W 3rd StreetAddressLine1Txt
CityElk CityCityNm
State AbbreviationOKStateAbbreviationCd
ZIP73648ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Paul Kumpf
Chairman1.00Yes (X)Yes (X)$0$0$0
Edward Albert
Vice Chairman1.00Yes (X)Yes (X)$0$0$0
Jack Morrison DDS
Secretary1.00Yes (X)Yes (X)$0$0$0
Jean Forsberg MD
Chief of Staff - Through Feb. 20151.00Yes (X)Yes (X)$0$0$0
Joe Coker MD
Chief of Staff - Commenced Feb. 20151.00Yes (X)Yes (X)$12,115$0$0
Francis Abraham MD
Vice Chief of Staff1.00Yes (X)Yes (X)$378,624$0$4,414
J Coffey MD
Member1.00Yes (X)$0$0$0
Emory Thomas
Member1.00Yes (X)$0$0$0
Gene Smith
Member1.00Yes (X)$0$0$0
Bill Gwartney
Member1.00Yes (X)$0$0$0
Danny Sprowls
Member1.00Yes (X)$0$0$0
Corey Lively
CEO40.00Yes (X)$265,383$0$0
Monica Scott
CFO40.00Yes (X)$134,901$0$4,810
Laura Kurzendoerfer
CNO - Through 3/20/201540.00$198,282$0$791Yes (X)
Lindsey Pena
Physician40.00$365,290$0$0Yes (X)
Tiffany Dupree
Physician40.00$299,421$0$791Yes (X)
Jeffrey Lester
Physician40.00$234,230$0$0Yes (X)
Janice Witt
Physician40.00$149,998$0$0Yes (X)
Misty Carter
COO40.00$129,015$0$2,048Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,167,259TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$12,854TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K14IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Premier Physician Staffing
19992 W Woodhaven RoadOwassoOK74055Physician ER coverage$1,725,893
Nightrays PA
PO Box 204367DallasTX75230Radiologist services$920,308
EM Care Physician Services Inc
13737 Noel Road Suite 1600DallasTX75240Physician ER coverage$797,727
Hospital Care Consultants Inc
17304 Preston Road Suite 510DallasTX75252Hospitalist$588,000
Cronin Enterprises
8270 College Parkway Suite 101Fort MyersFL33919Outside coding services$183,362
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt
Government Grants$7,956GovernmentGrantsAmt
All Other Contributions$41,009AllOtherContributionsAmt
Total Contributions$48,965TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Net Patient Service621990$49,703,605$49,703,605
Cafeteria722210$550,853$473,781$77,072
EHR Incentives900099$540,978$540,978
Income from Plains Diagnostic Ima900099$410,656$410,656
Daycare Center Revenue624410$111,438$111,438

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$181,294TotalRevenueColumnAmt
Related Or Exempt Func Income$181,294RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$51,498,824TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$540,188TotalRevenueColumnAmt
Exclusion$540,188ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$217,213TotalRevenueColumnAmt
Exclusion$217,213ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$262,595RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$262,595RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$262,595TotalRevenueColumnAmt
Exclusion$262,595ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$12,718,993SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$12,696,523SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$22,470SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$22,470TotalRevenueColumnAmt
Exclusion$22,470ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$52,590,255TotalRevenueColumnAmt
Related Or Exempt Func Income$51,421,752RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$77,072UnrelatedBusinessRevenueAmt
Exclusion$1,042,466ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$3,100TotalAmt
Program Services$3,100ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$919,454TotalAmt
Program Services$479,451ProgramServicesAmt
Management And General$440,003ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$15,172,726TotalAmt
Program Services$13,156,417ProgramServicesAmt
Management And General$2,016,309ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,005,764TotalAmt
Program Services$3,394,324ProgramServicesAmt
Management And General$611,440ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,110,868TotalAmt
Program Services$941,305ProgramServicesAmt
Management And General$169,563ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$460,676TotalAmt
Management And General$460,676ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$43,624TotalAmt
Management And General$43,624ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$9,338,628TotalAmt
Program Services$7,730,325ProgramServicesAmt
Management And General$1,608,303ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$86,129TotalAmt
Program Services$2,864ProgramServicesAmt
Management And General$83,265ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,518,165TotalAmt
Program Services$5,378,531ProgramServicesAmt
Management And General$139,634ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$207,492TotalAmt
Program Services$51,304ProgramServicesAmt
Management And General$156,188ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$775,437TotalAmt
Program Services$775,437ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$100,462TotalAmt
Program Services$84,032ProgramServicesAmt
Management And General$16,430ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$48,058TotalAmt
Program Services$37,822ProgramServicesAmt
Management And General$10,236ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,779,337TotalAmt
Program Services$1,506,945ProgramServicesAmt
Management And General$272,392ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,100,234TotalAmt
Program Services$3,869,830ProgramServicesAmt
Management And General$230,404ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$712,503TotalAmt
Program Services$139,790ProgramServicesAmt
Management And General$572,713ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Bad Debt Expense$5,819,307$5,819,307
Medical Supplies/Food$2,356,853$2,339,601$17,252
Lease and Rental$1,337,495$1,328,821$8,674
Dues & Subscriptions$223,298$173,779$49,519

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$175,984TotalAmt
Program Services$59,472ProgramServicesAmt
Management And General$116,512ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$54,295,594TotalAmt
Program Services$47,272,457ProgramServicesAmt
Management And General$7,023,137ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,918,932BOYAmt
EOY$2,825EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$18,161,825BOYAmt
EOY$8,328,116EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$5,749,921BOYAmt
EOY$6,271,464EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,284,175BOYAmt
EOY$1,433,641EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$603,957BOYAmt
EOY$1,121,362EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$85,928,681LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$39,575,709LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$49,134,242BOYAmt
EOY$46,352,972EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$4,592,913BOYAmt
EOY$17,069,320EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$1,257,900BOYAmt
EOY$1,397,738EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$44,362EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$779,516BOYAmt
EOY$1,261,861EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$85,483,381BOYAmt
EOY$83,283,661EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,550,186BOYAmt
EOY$4,482,697EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$35,505,000BOYAmt
EOY$34,306,547EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$399,501BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$595,000BOYAmt
EOY$79,467EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$39,049,687BOYAmt
EOY$38,868,711EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$46,433,694BOYAmt
EOY$44,414,950EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$46,433,694BOYAmt
EOY$44,414,950EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$85,483,381BOYAmt
EOY$83,283,661EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$1,705,339ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$313,405NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$748,759OtherCostOrOtherBasisAmt
Book Value$748,759BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$59,310,836OtherCostOrOtherBasisAmt
Depreciation$19,223,193DepreciationAmt
Book Value$40,087,643BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$24,211,416OtherCostOrOtherBasisAmt
Depreciation$19,474,084DepreciationAmt
Book Value$4,737,332BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,657,670OtherCostOrOtherBasisAmt
Depreciation$878,432DepreciationAmt
Book Value$779,238BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$46,352,972TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Payable to Related Party$67,000
Estimated third-party payor settlements$12,467
FieldValueIRS element (for citing)
Total Liability$79,467TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X, Line 2:FormAndLineReferenceDesc
ExplanationThe Hospital is organized as an Oklahoma nonprofit 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). The Hospital is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Hospital is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Hospital has determined it is not subject to unrelated business income tax and has not filed an Exempt Organization Business Income Tax Return (Form 990T) with the IRS. The Hospital 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 consolidated financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other135.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$564,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$564,000NetCommunityBenefitExpnsAmt
Total Expense0.01160TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$564,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$564,000NetCommunityBenefitExpnsAmt
Total Expense0.01160TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,443TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$11,443NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,696,788TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,945,885DirectOffsettingRevenueAmt
Net Community Benefit Expns$750,903NetCommunityBenefitExpnsAmt
Total Expense0.01550TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,708,231TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,945,885DirectOffsettingRevenueAmt
Net Community Benefit Expns$762,346NetCommunityBenefitExpnsAmt
Total Expense0.01570TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,272,231TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,945,885DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,326,346NetCommunityBenefitExpnsAmt
Total Expense0.02730TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,126TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,126NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,126TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,126NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$5,819,307BadDebtExpenseAmt
Bad Debt Expense Attributable$931,089BadDebtExpenseAttributableAmt
Reimbursed By Medicare$10,928,166ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$15,288,805CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$4,360,639MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

FieldValueIRS element (for citing)
Business Name Line11 Plains Diagnostic Imaging LLCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Primary ActivitiesRadiology servicesPrimaryActivitiesTxt
Org Profit Or Ownership0.80170OrgProfitOrOwnershipPct
Ofcr Etc Profit Or Ownership0.00000OfcrEtcProfitOrOwnershipPct
Physicians Profit Or Ownership0.19830PhysiciansProfitOrOwnershipPct
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Great Plains Regional Medical CenterBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11801 W 3rd StreetAddressLine1Txt
CityElk CityCityNm
State AbbreviationOKStateAbbreviationCd
ZIP73644ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.gprmc-ok.comWebsiteAddressTxt
State License2210StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Great Plains Regional Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted12CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLwww.gprmc-ok.com/about/OwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLwww.okruralhealthworks.orgOtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt12ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLwww.gprmc-ok.com/about/StrategyWebsiteURLTxt
Strategy Attached0StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care135.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Medicare RatesYes (X)MedicareRatesInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross ChargesYes (1)GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Great Plains Regional Medical CenterPart V, Section B, Line 5: Great Plains Regional Medical Center hosted five community meetings between July 27, 2011 and March 13, 2013. Average attendance at the community meetings was 20-25 community members consisting of retired individuals, local business owners, city government, local bank employees/officers, local volunteer organizations, Great Plains Regional Medical Center representatives and individuals from the County Cooperative Extension office.
Great Plains Regional Medical CenterPart V, Section B, Line 11: Mental HealthAfter examining the availability and access of mental health services, community members present noted the lack or strict definition of services available. However, these services are very specific and accessible via inpatient services. The hospital is currently exploring available options.Temporary Assistance for Needy Families (TANF) casesCommunity members present noted the high number of local TANF cases and the large number of students at school that receive backpacks of food/supplies.This health concern is beyond the scope of services the hospital provides.
Great Plains Regional Medical CenterPart V, Section B, Line 13b: If the patients' medical expenses are 30% of their income then they can also qualify for assistance.There are instances when a patient may appear eligible for charity care discounts, but there is no financial assistance form on file due to a lack of supporting documentation. Often there is adequate information provided by the patient or through other sources, which could provide sufficient evidence to provide the patient with charity care assistance. In the event there is no evidence to support a patient's eligibility for charity care, Great Plains Regional Medical Center could use outside agencies in determining estimate income amounts for the basis of determining charity care eligibility and potential discount amounts.
Great Plains Regional Medical CenterPart V, Section B, Line 24: Great Plains Regional Medical Center provides financial assistance to qualifying patients for medically necessary services, non-elective services provided in response to life-threatening circumstances in a non-emergency room setting and services for a condition in which, if not promptly treated, would lead to an adverse change in the health status of the patient. Elective services are not eligible for financial assistance, therefore some financial assistance eligible patients may have been billed gross charges for elective services.

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c:If the patients' medical expenses are 30% of their income then they can also qualify for assistance.There are instances when a patient may appear eligible for charity care discounts, but there is no financial assistance form on file due to a lack of supporting documentation. Often there is adequate information provided by the patient or through other sources, which could provide sufficient evidence to provide the patient with charity care assistance. In the event there is no evidence to support a patient's eligibility for charity care, Great Plains Regional Medical Center could use outside agencies in determining estimate income amounts for the basis of determining charity care eligibility and potential discount amounts.
Part I, Line 6a:The Organization's community benefit report can be found on its website at http://www.gprmc-ok.com/about/chna.
Part I, Line 7:Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Community health improvement services, line 7e, was compiled using actual costs recorded in the general ledger. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report.
Part I, Ln 7 Col(f):The amount of bad debt expense removed from total expenses to determine the community benefit percentage was $5,819,307.
Part II, Community Building Activities:Great Plains Regional Medical Center's involvement in community building activities extends through programs such as Meals on Wheels, which delivers meals to the homebound. The Medical Center has a taxi service for patients that need to be transported to their home after a visit at the hospital or one of the physician clinics. The taxi service is free to patients.
Part III, Line 2:All forms of payment, including self-pay, insurance, contractual allowances, and discounts, are applied to the patient's account before the account is classified as bad debt. A payment received on an account previously written off as bad debt reduces bad debt expense. Great Plains Regional Medical Center does not refuse services to patients that generate bad debt.Bad debt expense on line 2 is reported at charges as presented on the financial statements.
Part III, Line 3:A reasonable estimate of the Organization's bad debt expense attributable to patients under the Organization's financial assistance policy is 16% of bad debt expense. This is based on the percentage of individuals in the county under the federal poverty level.
Part III, Line 4:The footnote to the Organization's financial statements can be found on page 8 and 9 of the attached audited financial statements.
Part III, Line 8:Great Plains Regional Medical Center provides services to Medicare patients understaning there will be write-offs and knowing the Organization will not recover the costs of the services provided. Providing these services is essential to the community and therefore increases access to healthcare services, which is a community benefit. Both the total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by the Centers for Medicare and Medicaid Services.
Part III, Line 9b:Patients are pre-screened for charitable services before receiving tests and a determination is made as to the financial ability to pay. If patients are pre-qualified for services, the collection process is ceased.For patients who qualify for charity care and who are cooperating in good faith to resolve their discounted hospital bills, Great Plains Regional Medical Center may offer extended payment plans, will not send unpaid bills to outside collection agencies, and will cease all collection efforts. Great Plains Regional Medical Center will not impose extraordinary collections actions such as wage garnishments; liens on primary residences, or other legal actions for any patient without first making reasonable efforts to determine whether that patient is eligible for charity care under this financial assistance policy. Reasonable efforts shall include:1. Validating that the patient owes the unpaid bills and that all sources of third-party payments have been identified and billed by the hospital; 2. Documentation that Great Plains Regional Medical Center has or has attempted to offer the patient the opportunity to apply for charity care pursuant to this policy and that the patient has not complied with the hospital's application requirements; 3. Documentation that the patient has been offered a payment plan but has not honored the terms of that plan
Part VI, Line 2:The Organization relies on input from physicians, other healthcare providers, community leaders, the Board of Directors and citizens in the community. We look at out-migration studies to determine what services individuals from the community are seeking and receiving from outside locations. We also consider comparisons of the volume of physician specialties in our area to nationally recognized data. The factors are all considered in addition to feedback from patients in the community to determine shortages of care areas.
Part VI, Line 3:Assistance is discussed with patients as part of the intake process. Patients are screened at registration to determine need for financial assistance and then are given copies of the financial assistance policy. Upon request, we try to assist patients with paperwork for medical assistance such as Medicare, Medicaid, disability or financial assistance.
Part VI, Line 4:Great Plains Regional Medical Center is an acute care hospital located in Elk City, Oklahoma in Beckham County. The Medical Center provides a comprehensive range of general, acute and specialized care, as well as outpatient and ancillary services to residents in its primary and secondary service areas covering ten counties. The estimated primary and secondary service area population exceeds 100,000. The median household income in Beckham County is $43,642 and 16% of the county is below poverty level.
Part VI, Line 5:Our Board of Directors is comprised of citizens from the community, from business owners to retired individuals. This broadly based group provides us with a broad perspective on the needs of the community. GPRMC extends medical privileges to area physicians. Physicians must apply for privileges and be approved by the medical staff and Board of Directors. Surplus funds are reinvested into facility and equipment upgrades and free programs throughout the year.GPRMC publishes notices in the area newspapers reaching 8,000 to 10,000 homes. The notices provide information on new physicians and medical services.GPRMC provides breast self-exam, CPR and pre-natal education to community members. The Medical Center is one of two designated donor locations for the communitywide blood drive held five times per year.Great Plains Regional Medical Center sponsors healthcare initiatives for the community. Some of these include diabetes self-management classes for patients with new or uncontrolled diabetes and education to local nursing home staff regarding care of patients with dementia and other types of behavioral disorders. Due to the shortage of nurses in the area, scholarships are awarded to students wishing to pursue degrees in the medical field. Education programs are presented at the local adult learning center discussing education needed to fulfill the requirements for employment in a hospital setting. We also participate in several career fairs for different schools in our area. GPRMC works in cooperation with educators by providing a clinical rotation training environment for students of various fields including physician, nursing, pharmacy, lab, radiology and medical records. We participate with area high schools in the job shadow program. Students interested in health careers may observe our staff in the work setting and obtain a first-hand experience. The Medical Center developed a collaboration with Western Oklahoma State College to provide distance learning classes for those in the community wishing to pursue nursing degrees. GPRMC provides a classroom in the local community. Additionally, in-kind services are provided to Western Oklahoma State College. This is vital to prospective students pursuing nursing degrees that would not have been able to drive the long distance to the College.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Francis Abraham MD
Vice Chief of Staff$370,590$0$0$0$8,034$0$0$0$4,414$0$383,038$0$0$0
Corey Lively
CEO$265,383$0$0$0$0$0$0$0$0$0$265,383$0$0$0
Laura Kurzendoerfer
CNO - Through 3/20/2015$190,290$0$6,923$0$1,069$0$0$0$791$0$199,073$0$0$0
Lindsey Pena
Physician$365,002$0$0$0$288$0$0$0$0$0$365,290$0$0$0
Tiffany Dupree
Physician$274,206$0$25,000$0$215$0$0$0$791$0$300,212$0$0$0
Jeffrey Lester
Physician$234,230$0$0$0$0$0$0$0$0$0$234,230$0$0$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1The Oklahoma Development Finance CommitteeBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN731083741BondIssuerEIN
CUSIP678910DB3CUSIPNum
Bond Issued2007-06-01BondIssuedDt
Issue Price$39,448,937IssuePriceAmt
PurposeConstruct and furnish a 62-bed hospitalPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$5,142,390RetiredAmt
Total Proceeds$39,448,937TotalProceedsAmt
In Reserve Fund$2,653,544InReserveFundAmt
Issuance Costs From Proceeds$562,777IssuanceCostsFromProceedsAmt
Other Spent Proceeds$36,232,616OtherSpentProceedsAmt
Substantial Completion2008SubstantialCompletionYr
Current Refunding0CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Use By Others0.00000PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00000PrivateBusConcerningUBIPct
Total Private Business Use0.00000TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate DueYes (1)NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Date Rebate Computation PerformedIssuer Name: The Oklahoma Development Finance Committee Date the Rebate Computation was Performed: 09/04/2012
Form 990, Schedule K, Part II, Line 3:The total issue price of $40,000,000 reported on Part I, Line A, Column (e) less the Original Issue Discount of $551,063 is the amount reported on Part II, Line 3.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 1The Executive Committee is composed of the officers of the Board; President, Vice President, Secretary and Treasurer. The Hospital's Board President serves as the Chair of the Executive Committee. Other members may be added if advisable. The Executive Committee directly represents the Board and possesses the power to act for the Board within limits set for it by the Board, on matters needing immediate attention, prior to regular board meetings, and such other powers as delegated to it by the Board. The Executive Committee reports to the Board of Directors at the next regular or at the next special meeting called for that purpose.
Form 990, Part VI, Section A, line 6Members are individuals who have voting shares in Great Plains Regional Medical Center. Membership is obtained through transfers of existing memberships. Transfers normally result either through voluntary surrender of a membership from a current member who is no longer interested in retaining their membership or through the death of a member who has no immediate family interested in retaining the membership. Each individual is allowed only one membership and there is only one vote allowed per membership.
Form 990, Part VI, Section A, line 7aGoverning Board members are appointed through nomination and a majority vote election by the membership at annual meetings.
Form 990, Part VI, Section A, line 7bAny amendments to the Governing Board Bylaws and Rules & Regulations have to be approved by a majority vote of the membership. Per the Organization's Bylaws, the members are the supreme authority of the Association in all its affairs.
Form 990, Part VI, Section B, line 11The Form 990 is presented and reviewed at the governing Board's monthly meeting. The 990 is also posted on the governing Board's website prior to the meeting.
Form 990, Part VI, Section B, line 12cAll members of the governing board, officers and key employees receive a copy of the Conflict of Interest Policy on an annual basis. The individuals are required to review the policy and complete and sign the questionnaire attesting to their understanding of the policy and that their answers are true and accurate. The board as a whole reviews the conflict of interest statements. Any potential conflicts are discussed and depending on the conflict the board decides the appropriate action to take.
Form 990, Part VI, Section B, line 15aHuman Resources conducts a comparative analysis using state, multi-state, regional, and national compensation (by position). Data is culled into bed-size, revenue, and similar area comparatives. Human Resources submits a report to the Executive Committee of the Board of Directors annually. The Executive Committee reviews the data, confirms the data with an out-of-house auditor, and recommends appropriate CEO compensation to the Board of Directors as a whole. All other positions are reviewed annually by Human Resources and approved by the CEO.
Form 990, Part VI, Section C, line 19GPRMC makes its Forms 1023, 990, and 990-T available to the public upon request. A copy of the requested document is provided when practical. Otherwise, an appointment for an on-site review of the requested document is made, with the day and time of the appointment determined by the person(s) who has made the request, according to their schedule and convenience.
Form 990, Part IX, line 11gRepairs: Program service expenses 196,660. Management and general expenses 6,503. Fundraising expenses 0. Total expenses 203,163. Consulting: Program service expenses 1,850,719. Management and general expenses 1,376,241. Fundraising expenses 0. Total expenses 3,226,960. Service Contracts: Program service expenses 897,412. Management and general expenses 225,559. Fundraising expenses 0. Total expenses 1,122,971. Contract Labor: Program service expenses 4,515,988. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,515,988. Purchased Services: Program service expenses 269,546. Management and general expenses 0. Fundraising expenses 0. Total expenses 269,546.

Schedule R IRS990ScheduleR

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Plains Diagnostic Imaging LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11705 W 2nd StAddressLine1Txt
CityElk CityCityNm
State AbbreviationOKStateAbbreviationCd
ZIP73644ZIPCd
FieldValueIRS element (for citing)
EIN261530951EIN
Primary ActivitiesRadiology services and equipment rentalPrimaryActivitiesTxt
Legal Domicile StateOKLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Great Plains Regional Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeRelatedPredominantIncomeTypeTxt
Share Of Total Income$412,398ShareOfTotalIncomeAmt
Share Of EOY Assets$569,688ShareOfEOYAssetsAmt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing PartnerYes (1)GeneralOrManagingPartnerInd
Ownership0.82300OwnershipPct
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Plains Diagnostic Imaging LLC
K$804,000General Ledger
Plains Diagnostic Imaging LLC
S$410,656General Ledger