PAWNEE VALLEY COMMUNITY HOSPITAL INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- PAWNEE VALLEY COMMUNITY HOSPITAL INC (EIN 48-1253246)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-05-13
- IRS object ID
- 201501339349304865
- Schema version
- 2013v4.0
- 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 I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-05-13T15:18:45-05:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 481026809 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Wendling Noe Nelson & Johnson LLC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 534 S Kansas Ave Suite 1500 | AddressLine1 |
| City | Topeka | City |
| State | KS | State |
| ZIP Code | 666033491 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 481253246 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pawnee Valley Community Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PAWN | BusinessNameControlTxt |
| Phone | 6202853161 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 923 Carroll Ave | AddressLine1 |
| City | Larned | City |
| State | KS | State |
| ZIP Code | 67550 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Shea Veach | PersonNm |
| Person Title | President | PersonTitleTxt |
| Phone | 7856235000 | PhoneNum |
| Signature | 2015-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Heather R Eichem | PreparerPersonNm |
| PTIN | P01515553 | PTIN |
| Phone | 7852334226 | PhoneNum |
| Preparation | 2015-05-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Shea Veach | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 923 Carroll Ave | AddressLine1 |
| City | Larned | City |
| State | KS | State |
| ZIP Code | 67550 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $15,379,619 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.pawneevalleyhospital.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2001 | FormationYr |
| Legal Domicile State | KS | LegalDomicileStateCd |
| Activity Or Mission | Pawnee Valley Community Hospital, Inc. is a tax-exempt charitable organization under Section 501(c)(3) of the Internal Revenue Code and is licensed by the State of Kansas Department of Health and Environment. The purpose of the Organization is to improve the quality of life for the communities we serve through exceptional healthcare and service excellence. The Organization is striving to be the best Critical Access Hospital in rural America. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 133 | TotalEmployeeCnt |
| Total Volunteers | 88 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $9,589 | PYContributionsGrantsAmt |
| CY Contributions Grants | $190,261 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $13,157,124 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $15,182,064 | CYProgramServiceRevenueAmt |
| PY Investment Income | $6,060 | PYInvestmentIncomeAmt |
| CY Investment Income | $7,294 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $13,172,773 | PYTotalRevenueAmt |
| CY Total Revenue | $15,379,619 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $179,198 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $5,575,159 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,961,003 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,881,353 | PYOtherExpensesAmt |
| CY Other Expenses | $6,339,813 | CYOtherExpensesAmt |
| PY Total Expenses | $11,456,512 | PYTotalExpensesAmt |
| CY Total Expenses | $12,480,014 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,716,261 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,899,605 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,634,463 | TotalAssetsBOYAmt |
| Total Assets EOY | $8,019,575 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,634,463 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,610,192 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $0 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $409,383 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Pawnee Valley Community Hospital, Inc. is a tax-exempt charitable organization under Section 501(c)(3) of the Internal Revenue Code and is licensed by the State of Kansas Department of Health and Environment. The purpose of the Organization is to provide healthcare facitities and services for the care and treatment of inpatients and outpatients who are acutely ill or who otherwise require medical care and related services. The core purpose of the Corporation is to improve the quality of life for the communities we serve through exceptional healthcare and service excellence. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $8,845,068 | ExpenseAmt |
| Grant | $179,198 | GrantAmt |
| Revenue | $15,094,134 | RevenueAmt |
| Desc | Patient care: Program services consist of routine and ancillary department healthcare services provided by a healthcare organization as described in 501(c)(3) of the IRS code. | Desc |
| Total Program Service Expenses | $8,845,068 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 133 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Shea Veach President | PersonNm |
| Phone | 7856235000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2220 Canterbury | AddressLine1 |
| City | Hays | City |
| State | KS | State |
| ZIP Code | 67601 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| Shae Veach | |||||||
| President | 4.00 | Yes (X) | Yes (X) | $0 | $153,744 | $56,341 | |
| Bryce Young | |||||||
| Vice President | 4.00 | Yes (X) | Yes (X) | $0 | $255,193 | $79,252 | |
| Bill Overbey | |||||||
| Secretary/Treasurer (thru January 2014) | 4.00 | Yes (X) | Yes (X) | $0 | $256,963 | $79,858 | |
| John Jeter MD | |||||||
| Director | 4.00 | Yes (X) | $0 | $495,981 | $129,311 | ||
| Matt Heyn | |||||||
| Hospital Administrator | 40.00 | Yes (X) | Yes (X) | $0 | $145,842 | $33,725 | |
| George Harms | |||||||
| Secretary/Treasurer | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Larry Watts | |||||||
| Director | 4.00 | Yes (X) | $0 | $289,255 | $67,094 | ||
| Amanda Bickle | |||||||
| APRN | 40.00 | $119,530 | $0 | $30,545 | Yes (X) | ||
| Stacy Trout | |||||||
| PA | 40.00 | $112,074 | $0 | $3,235 | Yes (X) | ||
| Cynthia Carter | |||||||
| RN | 40.00 | $110,503 | $0 | $17,195 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $342,107 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,596,978 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $496,556 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Hays Medical Center | |||||
| 2220 Canterbury Drive | Hays | KS | 67601 | Contract Services | $3,232,781 |
| Quest Diagnostics | |||||
| PO Box 14730 | St Louis | MO | 63150 | Lab Services | $184,334 |
| Shared Medical Services Inc | |||||
| PO Box 330 | Cottage Grove | WI | 53527 | MRI services | $110,885 |
| Delta Healthcare Providers | |||||
| PO BOX 202940 | Dallas | TX | 75320 | Contract therapy | $106,618 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $179,198 | RelatedOrganizationsAmt |
| Government Grants | $8,198 | GovernmentGrantsAmt |
| All Other Contributions | $2,865 | AllOtherContributionsAmt |
| Total Contributions | $190,261 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| Net patient service revenue | 622000 | $14,886,827 | $14,886,827 | |
| Meals sold to non-patients | 722210 | $135,383 | $135,383 | |
| Rental income | 900099 | $87,930 | $87,930 | |
| Outreach therapy services | 900099 | $31,574 | $31,574 | |
| Lab fairs | 900099 | $29,006 | $29,006 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,344 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,344 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $15,182,064 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,148 | TotalRevenueColumnAmt |
| Exclusion | $6,148 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,146 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,146 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,146 | TotalRevenueColumnAmt |
| Exclusion | $1,146 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,379,619 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,094,134 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $95,224 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $179,198 | TotalAmt |
| Program Services | $179,198 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $174,888 | TotalAmt |
| Management And General | $174,888 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,613,647 | TotalAmt |
| Program Services | $4,050,490 | ProgramServicesAmt |
| Management And General | $563,157 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $165,404 | TotalAmt |
| Program Services | $147,307 | ProgramServicesAmt |
| Management And General | $18,097 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $670,369 | TotalAmt |
| Program Services | $592,296 | ProgramServicesAmt |
| Management And General | $78,073 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $336,695 | TotalAmt |
| Program Services | $286,755 | ProgramServicesAmt |
| Management And General | $49,940 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,107,950 | TotalAmt |
| Management And General | $2,107,950 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,671 | TotalAmt |
| Management And General | $27,671 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,594 | TotalAmt |
| Management And General | $2,594 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,661,363 | TotalAmt |
| Program Services | $1,448,798 | ProgramServicesAmt |
| Management And General | $212,565 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,774 | TotalAmt |
| Program Services | $2,550 | ProgramServicesAmt |
| Management And General | $86,224 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,328 | TotalAmt |
| Program Services | $24,414 | ProgramServicesAmt |
| Management And General | $8,914 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,607 | TotalAmt |
| Program Services | $44,164 | ProgramServicesAmt |
| Management And General | $29,443 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $288,961 | TotalAmt |
| Program Services | $241,398 | ProgramServicesAmt |
| Management And General | $47,563 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,749 | TotalAmt |
| Program Services | $14,040 | ProgramServicesAmt |
| Management And General | $3,709 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,613 | TotalAmt |
| Program Services | $4,613 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,383 | TotalAmt |
| Program Services | $44,030 | ProgramServicesAmt |
| Management And General | $29,353 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Pharmaceuticals | $599,047 | $599,047 | |
| Medical supplies | $442,890 | $442,886 | $4 |
| Minor equipment & suppl | $173,399 | $141,668 | $31,731 |
| Dietary | $154,154 | $154,154 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $590,330 | TotalAmt |
| Program Services | $427,260 | ProgramServicesAmt |
| Management And General | $163,070 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,480,014 | TotalAmt |
| Program Services | $8,845,068 | ProgramServicesAmt |
| Management And General | $3,634,946 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $630 | BOYAmt |
| EOY | $246,579 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,958,801 | BOYAmt |
| EOY | $4,529,204 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,012,785 | BOYAmt |
| EOY | $2,330,522 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $242,175 | BOYAmt |
| EOY | $265,762 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $110,847 | BOYAmt |
| EOY | $113,774 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $309,225 | BOYAmt |
| EOY | $533,734 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,634,463 | BOYAmt |
| EOY | $8,019,575 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $862,199 | BOYAmt |
| EOY | $908,936 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,772,264 | BOYAmt |
| EOY | $6,701,256 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,634,463 | BOYAmt |
| EOY | $7,610,192 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $409,383 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $409,383 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,634,463 | BOYAmt |
| EOY | $8,019,575 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $2,899,605 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$2,490,222 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $2,167 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $2,167 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | Pawnee Valley Community Hospital is a member of the Kansas Hospital Association and the American Hospital Association. Both of these organizations engage in lobbying activities for hospitals and health care as part of the services provided to members. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $142,777 | BeginningYearBalanceAmt |
| Contributions | $408,437 | ContributionsAmt |
| Other Expenditures | $179,198 | OtherExpendituresAmt |
| End Year Balance | $372,016 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributions | $1,026,228 | ContributionsAmt |
| Other Expenditures | $883,451 | OtherExpendituresAmt |
| End Year Balance | $142,777 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment Balance EOY | 1.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Estimated third-party payor settlements | $99,867 |
| Other receivables | $14,278 |
| Reinsurance proceeds recoverable | $7,565 |
| Receivable from Pawnee Valley Foundation | $2,641 |
| Beneficial interest in net assets of foundation | $409,383 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $533,734 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to Pawnee County | $4,195,896 |
| Due to Hays Medical Center, Inc. | $2,340,360 |
| Estimated third-party payor settlements | $165,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $6,701,256 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $15,609,804 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $230,185 | OtherRevenueAmt |
| Revenue Not Reported | $230,185 | RevenueNotReportedAmt |
| Revenue Subtotal | $15,379,619 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $15,379,619 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $12,300,816 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $12,300,816 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $179,198 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $179,198 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $12,480,014 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | Donations are requested for specific items or improvements to the Hospital. When a donation is received for that specific item, it is restricted for that use by the Board until the specific item or improvement is purchased. At any one time, one or more such projects can be in progress. |
| Part X, Line 2: | Management is not aware of any uncertainties in income tax positions. |
| Part XI, Line 2d - Other Adjustments: | Change in beneficial interest in net assets of Foundation 230,185. |
| Part XII, Line 4b - Other Adjustments: | Transfer of equipment to Pawnee County 179,198. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 130.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $160,497 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $160,497 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01290 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $853,335 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $258,527 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $594,808 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04770 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,013,832 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $258,527 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $755,305 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06060 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $925,288 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $585,700 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $339,588 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02720 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,107 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,107 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $932,395 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $585,700 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $346,695 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02780 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,946,227 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $844,227 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,102,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08840 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $506,306 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $35,441 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $8,435,456 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $8,487,723 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$52,267 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pawnee Valley Community Hospital Inc | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 923 Carroll Avenue | AddressLine1 |
| City | Larned | City |
| State | KS | State |
| ZIP Code | 67550 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pawnee Valley Community Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | http://www.pawneevalleyhospital.com/ | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | http://www.pawneecountykansas.com/ | OtherWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | Yes (1) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 130.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| Residency | Yes (X) | ResidencyInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Attached To Invoice | Yes (X) | AttachedToInvoiceInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Provided On Admission | Yes (X) | ProvidedOnAdmissionInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | 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 (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pawnee Valley Community Hospital, Inc. | Part V, Section B, Line 3: The CHNA was conducted in collaboration with the Pawnee County Health Department. A Town Hall meeting was organized to provide an objective consensus building method of reviewing and prioritizing county health issues. During the Town Hall meeting, the group reflected on the size and seriousness of any health concerns cited and discussed current community health strengths. The group identified and ranked top community health concerns, and all Town Hall attendees were encouraged to continue to contribute ideas by going online and taking a feedback survey that addresses any additional thoughts related to the CHNA. All Town Hall priority-setting and scoring processes involved the input of a diverse group with knowledge and/or expertise in public health as well as persons who represent the broad interests of the community served by the hospital. Key stakeholders in attendance included representatives from: United Way, Welcome Inn Senior Center, Center for Counseling, Elder Care, Inc., Smith Dental Clinic, Pawnee County Sherriff's Office, Larned Police Department, Pawnee County Health Department, County Commissioners, members of the Chamber of Commerce, members of the USD 495 School Board, school nurses of USD 495, local members of the media, local religious organizations, city council members, and representatives of Pawnee Valley Community Hospital. The CHNA was coordinated and produced by VVV Research & Development, Inc. from Olathe, Kansas. |
| Pawnee Valley Community Hospital, Inc. | Part V, Section B, Line 7: Annual description of the actions taken by the Hospital during the fiscal year to address the significant health needs identified throught the most recently conducted CHNA:Community Wellness - Community Wellness was #1 on the health needs - areas of future focus survey with 50 votes, 22.7%. Comments from the Town Hall meeting included, "Community is desperately in need of a wellness facility." and "Community needs nutritional education." Being overweight/obese, smoking, drinking in excess, not exercising etc. can lead to poor health. Pawnee County's ranking in adult obesity is at 34% compared to Kansas' county average of 30%. Physical inactivity ranked 30% compared to Kansas' average of 28%. Heart disease and diabetes rank high in Pawnee County.According to the Town Hall meeting, developing a community wellness program and facility was the highest ranked request. In lieu of this, PVCH leadership and county officials believe that this is not something that the hospital and county should be solely involved in orchestrating. Rather, the development and on-going maintenance of a wellness program and facility should be collaborative with other agencies and entities. We identified a key list of organizations that were considered to be part of the wellness coalition to identify and develop a plan. The following is a list of candidates for the coalition: PRIDE, PVCH, PVCH Foundation, USD 495, USD 495 Foundation, Recreation Commission, Pawnee County Health Department, City of Larned, Chamber of Commerce, CHO, Pawnee County Extension Office and Pawnee County Economic Development Commission.The Wellness Coalition has reached out to several different entities (i.e. YMCA) to come to Larned/Pawnee County to develop a wellness center in the community. Although several entities looked at Larned as a potential site for a wellness facility, no serious proposals from these inquiries.Medical Oncology Services - Medical Oncology Services was #5 on the health needs - areas of future focus survey with 25 votes, 11.4%. Comments included, "We have a lot of people in Pawnee County with cancer. A cancer treatment center would be really helpful." ; "There is a need for more specialized service appropriate for the size of town that Larned is." ; and "Specialty services are lacking including OB, Cancer, and Mental Health." The age adjusted cancer mortality rate per 100,000 population is significantly higher than the NW KS 10 counties and Kansas: Pawnee County 195.9, NW KS 10 169.8 and Kansas 188.In order to implement an effective oncology service line, many factors must come together. The following information outlined the plans for implementation of the PVCH oncology service line. We have had the great fortune of being able to partner with the Dreiling/Schmidt Cancer Institute at HMC. In lieu of this partnership, we were able to establish an outreach clinic with Dr. Abuerreish heading up the program. It is vitally important to maintain the relationship with both primary care medical staff as well as specialists. This will ensure consistent continuity for our patients as they move through the continuum of their cancer treatment course. There are many additional components that need to be implemented at PVCH prior to providing cancer treatment services. PVCH leadership had originally established that the program would start once we were in the new facility - spring of 2013. A task force committee was established with members from both PVCH and Dreiling/Schmidt Cancer Institute. The committee functioned as the backbone for developing all operational plans for the cancer therapy service line. This included, but was not limited to, a financial feasibility analysis, budget preparation, hiring experienced human resources, purchasing equipment, developing policies and procedures, advertising, and patient follow-up. It is important to note that if the financial proforma didn't show favorable profitability than we would not proceed with the program. The overall success of the program will be measured by community and patient feedback as well as volume growth. Additionally, the success is highly dependent on community and physician support. It will be important to advertise the oncology service line to regional primary care and medical oncologists. After further analysis by the committee and the hospital, it was shown that offering oncology services at PVCH was outside of the scope of services PVCH could offer to the community.Mental Health & Counseling - Mental Health & Counseling was #3 on the health needs - areas of future focus survey with 29 votes, 12.7%. Comments included, "Specialty services are lacking including mental health." ; "Local psycho-social/emotional counseling services - A lot of families that move into Larned seem to struggle with functioning at a productive level. The poor functioning of the adults is trickling down to produce children with low functioning mental capabilities, poor coping skills and increased emotional/behavioral issues. These children are then set up to repeat the cycle." ; "Yes, mental health needs are not met for those in the community. We as community members must travel for services." ; and "Difficult to acquire care for mental health."Research data showed:Alzheimer's disease - Pawnee county 33.6%; Kansas 28%. Inadequate social support - Pawnee county - 20%; Kansas 16%. Uninsured - Pawnee county 17%; Kansas 15%. Number of mental health persons served increasing over a three year period: 149 to 176 - an 18% increase. Pawnee County has at least 10 Foster Care Homes providing out of home care for children removed from homes. A multitude of organizations provide some type of mental health and counseling services. These services can be divided between primarily role such as the Center for Counseling and Consultation, secondary role such as school counselors, social workers employed in medical setting, and tertiary where clients are assisted with and referred to mental health services. At this time, most entities that provide any type of mental and behavioral services find themselves in a situation where any added services must also come with the funding to support them. Keeping this in mind, a work plan was developed that addressed goals to lay the ground work for improving and enhancing the capacity for mental health services using the current agencies' capabilities and resources. Based on this information, Pawnee County had several opportunities to work towards better mental health care. These included: 1) Enhancing mental health for Pawnee County infants and children birth through school age by increasing the number of infants and children screened using the Ages and Stages Social/Emotional Tool; 2) Enhancing the mental health of Pawnee County women who are pregnant or post-partum by increasing the number of pregnant and post-partum women screened using the Edenburg screening tool; and 3) Improving primary mental service access for Pawnee County residents by decreasing the barriers to mental health services in Pawnee County.The following are the outlined areas to be addressed and why the Hospital was not able to address those needs: OB Services - offering OB Services is outside of the scope of services that we can provide as a critical access hospital. We do, however, how have Dr. Goodwin offering pre-natal care for expecting mothers in the community. Nutrition Education - we were planning on addressing this area with the Wellness Facility. When we were unable to move forward with the Wellness Facility, we were not able to move this initiative forward.Home Health & Hospice - after further analysis it was determined that this initiative was outside of the hospital's scope and available manpower.Dental Services for the Uninsured - with a limited amount of dentists in the county, we were unable to provide this service to the community in the scope that the community was wanting it to happen.Increase Selection of Healthy Eating Options - we were planning on addressing this area with the Wellness Facility. When we were unable to move forward with the Wellness Facility, we were not able to move this initiative forward. |
| Pawnee Valley Community Hospital, Inc. | Part V, Section B, Line 14g: Pawnee Valley Community Hospital, Inc. (PVCH) will proactively seek out applicants who may be in need of financial assistance. PVCH will post notice of this policy to all patients/guarantors through its registration, pre-registration, and financial counseling process. This policy will also be posted in prominent areas of the hospital. |
| Pawnee Valley Community Hospital, Inc. | Part V, Section B, Line 20d: The hospital used the look-back method based on actual paid claims by Medicare and all other private health insurerspaying claims to the hospital. |
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | A cost-to-charge ratio derived from Worksheet 2 was used to determine financial assistance at cost and the cost of subsidized health services. A cost-to-charge ratio derived from Worksheet 2 was used to determine the costs of serving Medicaid beneficiaries. |
| Part III, Line 4: | The footnote from the hospital's financial statements follows:Accounts receivable are reduced by an allowance for uncollectible accounts. In evaluating the collectability of accounts receivable, the Hospital analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for uncollectible accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for uncollectible accounts. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for uncollectible accounts and a provision for bad debts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payor has not yet paid, or for payors who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for uncollectible accounts.Part III Line 2:Costing methodology: A cost-to-charge ratio derived from Worksheet 2 was used to calculate bad debt expense at cost.Part III Line 3:Methodology for bad debt cost for financial assistance eligible: The estimate for the amount of bad debt expense attributable to patients eligible under the FAP is based upon the experience of a related organization. |
| Part III, Line 8: | The Medicare cost report was the costing methodology used to determine the allowable Medicare costs pertaining to Medicare net revenue. Allowable costs of care reported on line 6 were determined using amounts from Worksheet D, Part V and Worksheet D-1 in the Pawnee Valley Community Hospital, Inc., Medicare cost report for fiscal year ended June 30, 2014. |
| Part III, Line 9b: | Whenever possible, the customer service representatives (CSR's) of Pawnee Valley Community Hospital try to determine the estimated self-pay balance prior to the patient receiving services. Charity care eligibility is first considered at this point in time. In addition, if full payment is not received or payment is not made with 30 days, the CSR contacts the patient. If it is determined that at least a two-year payment plan cannot be established with the patient, the CSR will screen for charity care and request that the charity care application be completed by the patient. |
| Part VI, Line 3: | Information regarding the Pawnee Valley Community Hospital, Inc. charity care program is located on the Pawnee Valley Community Hospital and Hays Medical Center, Inc. website for patients and community members to view, and the financial assistance application is also on the HMC website to print off and complete. In addition, if a customer service representative contacts a patient about a bill and in visiting with them they determine that patient could possibly qualify for the hospital's charity care policy, the CSR will send the application to the patient as well. |
| Part VI, Line 4: | Pawnee Valley Community Hospital, Inc. is located in Larned, Kansas, which has a population of approximately 4,050 people, as of the 2010 census. The median household income of Larned was $46,464. Approximately 5.9% of families were below the poverty line, and 7.4% of the total population was below the poverty line. Approximately 7.4% of the hospital's revenue is from services provided to patients eligible for Medicaid. Pawnee Valley Community Hospital, Inc. is the only hospital in Larned, Kansas. It mainly serves the community of Larned. |
| Part VI, Line 5: | Pawnee Valley Community Hospital, Inc. promotes the health of the community by extending medical privileges to most qualified, local physicians. |
| Part VI, Line 6: | Pawnee Valley Community Hospital, Inc. is not a part of an affiliated health care system. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pawnee County | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 715 Broadway | AddressLine1 |
| City | Larned | City |
| State | KS | State |
| ZIP Code | 67550 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 486007542 | RecipientEIN |
| Non Cash Assistance | $179,198 | NonCashAssistanceAmt |
| Valuation Method Used | Cash paid | ValuationMethodUsedDesc |
| Non Cash Assistance | Transfer of equipment | NonCashAssistanceDesc |
| Purpose Of Grant | Pawnee County owns all fixed assets (land, building, equipment) used by the Hospital. To expedite the purchase of equipment and obtain favorable purchasing terms, the Hospital purchased equipment on behalf of the County. The Pawnee Valley Community Hospital Foundation reimbursed the Hospital for the purchase. The Hospital then transferred ownership of the equipment to Pawnee County. | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Shae Veach | ||||||||||||||
| President | $0 | $150,223 | $0 | $0 | $0 | $3,521 | $0 | $31,235 | $0 | $25,106 | $0 | $210,085 | $0 | $0 |
| Bryce Young | ||||||||||||||
| Vice President | $0 | $252,835 | $0 | $0 | $0 | $2,358 | $0 | $52,325 | $0 | $26,927 | $0 | $334,445 | $0 | $0 |
| Bill Overbey | ||||||||||||||
| Secretary/Treasurer (thru January 20 | $0 | $256,872 | $0 | $0 | $0 | $91 | $0 | $52,931 | $0 | $26,927 | $0 | $336,821 | $0 | $0 |
| John Jeter MD | ||||||||||||||
| Director | $0 | $487,508 | $0 | $0 | $0 | $8,473 | $0 | $104,651 | $0 | $24,660 | $0 | $625,292 | $0 | $0 |
| Matt Heyn | ||||||||||||||
| Hospital Administrator | $0 | $131,605 | $0 | $14,237 | $0 | $0 | $0 | $8,076 | $0 | $25,649 | $0 | $179,567 | $0 | $0 |
| Larry Watts | ||||||||||||||
| Director | $0 | $284,616 | $0 | $0 | $0 | $4,639 | $0 | $49,440 | $0 | $17,654 | $0 | $356,349 | $0 | $0 |
| Amanda Bickle | ||||||||||||||
| APRN | $117,096 | $0 | $2,434 | $0 | $0 | $0 | $6,883 | $0 | $23,662 | $0 | $150,075 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | A related organization uses a compensation committee, independent compensation consultant, written employment contract, and approval by the board or compensation committee to establish the compensation of the Hospital's Administrator. |
| Part I, Line 4b | John Jeter, M.D. - $73,126 Bryce Young - $38,300 William Overbey - $38,906 Shae Veach - $22,713 Larry Watts - $42,692 |
| Part I, Line 6 | A portion of the Administrator's incentive compensation is determined by net earnings exceeding budget for the fiscal year. A portion of incentive compensation for officers and key employees of Hays Medical Center, Inc., a related organization, is determined by net earnings exceeding budget for the fiscal year. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | The organization has one member, HaysMed Partners, Inc., which became the sole member as of March 1, 2010. HaysMed Partners, Inc., is a wholly-owned subsidiary of Hays Medical Center, Inc. |
| Form 990, Part VI, Section A, line 7a | The Board members of HaysMed Partners, Inc., the sole member of Pawnee Valley Community Hospital, appoint the Board members of Pawnee Valley Community Hospital, Inc. |
| Form 990, Part VI, Section A, line 7b | HaysMed Partners, Inc., the sole member of Pawnee Valley Community Hospital, elects the Board members of Pawnee Valley Community Hospital. |
| Form 990, Part VI, Section B, line 11 | Form 990 was reviewed with the Board members prior to filing. |
| Form 990, Part VI, Section B, line 12c | Officers, directors & key employees, along with all associates, are required to complete a conflict of interest statement annually. The statements are used to monitor and enforce compliance with the policy. |
| Form 990, Part VI, Section B, line 15 | The hospital administrator and officers' salaries are reviewed annually by an independent consulting group and the Board members. |
| Form 990, Part VI, Section C, line 19 | These documents are not made available to the public. |
| Form 990, Part IX, line 11g | Medical professional fees: Program service expenses 857,551. Management and general expenses 521. Fundraising expenses 0. Total expenses 858,072. Laboratory professional fees: Program service expenses 247,922. Management and general expenses 0. Fundraising expenses 0. Total expenses 247,922. Other purchased services: Program service expenses 199,296. Management and general expenses 118,937. Fundraising expenses 0. Total expenses 318,233. Other professional fees: Program service expenses 144,029. Management and general expenses 50,864. Fundraising expenses 0. Total expenses 194,893. Collection agency services: Program service expenses 0. Management and general expenses 42,243. Fundraising expenses 0. Total expenses 42,243. |
| Form 990, Part XI, line 9: | Increase in amount due to Pawnee County -1,347,933. Transfers to Pawnee County -1,551,672. Change in beneficial interest in net assets of foundation 409,383. |
| Form 990. Part XII, Line 2c | Hays Medical Center, Inc., has an audit committee that is responsible for the oversight of Pawnee Valley Community Hospital, Inc's., financial statement audit and the selection process of an independent accountant. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| HaysMed Partners Inc | |||||||||
| 2220 Canterbury Dr | Hays | KS | 67601 | 270877152 | Owns management contract for Pawnee Valley Community Hospital | KS | 501(c)(3) | 170(b)(1)(A)(iii) | 0 |
| Hays Medical Center Inc | |||||||||
| 2220 Canterbury Dr | Hays | KS | 67601 | 480559088 | Hospital | KS | 501(c)(3) | 170(b)(1)(A)(iii) | 0 |
| Pawnee Valley Community Hospital Foundation | |||||||||
| 923 Carroll Ave | Larned | KS | 67550 | 455333776 | Support the activities and mission of the Hospital | KS | 501(c)(3) | 509(A)(3), Type I | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pawnee Valley Community Hospital Foundation | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionTypeTxt |
| Involved | $179,198 | InvolvedAmt |
| Method Of Amount Determination | Cash paid | MethodOfAmountDeterminationTxt |