2015-07-09T13:13:27-05:00 2014-09-30 BKD LLP 1551 N WATERFRONT PKWY STE 300 WICHITA KS 672066601 990 2013-10-01 480608913 SALEM HOSPITAL INC % ALLEN EDIGER SALE 6209472272 704 SOUTH ASH Suite HILLSBORO KS 67063 ALLEN EDIGER CHIEF FINANCIAL OFFICER 6209471498 2015-08-15 true ELIZABETH S HOGAN P00273248 6209471498 2013 2016-02-25 16:41:14Z SALEM HOME ALLEN EDIGER 704 SOUTH ASH HILLSBORO KS 67063 2815857 false X WWW.SALEMHOMEKS.ORG X 1953 KS SALEM HOME WILL MASTER PERSON-CENTERED CARE TO BENEFIT RESIDENTS, FAMILIES, STAFF, AND THE COMMUNITY. 7 7 93 25 36232 -2414 2732 4391 2732733 2703172 332 319 119181 105427 2854978 2813309 0 0 0 0 1834440 1906753 0 0 3120 1051670 983297 2886110 2890050 -31132 -76741 1188761 1154240 210763 188085 977998 966155 SALEM HOME WILL MASTER PERSON-CENTERED CARE TO BENEFIT RESIDENTS, FAMILIES, STAFF, AND THE COMMUNITY. false false 2596789 0 2703172 PROVIDED LONG-TERM CARE VIA A SKILLED NURSING FACILITY AND INDEPENDENT LIVING APARTMENTS. CARE WAS PROVIDED FOR A TOTAL OF 72 NURSING FACILITY RESIDENTS AND 8 APARTMENT RESIDENTS. THERE WERE A TOTAL OF 15,393 CENSUS DAYS FOR NURSING FACILITY RESIDENTS. 2596789 true false false true false false false false false false true false false false false false true false false false false false false false false false false false false false false false false false false false false false false false false false false false false false false true 5 0 true 93 true true true false false false false false false false false false X 7 7 false false false false false false false true true false false true true true true false false true false false X ALLEN EDIGER 6209471498 704 SOUTH ASH HILLSBORO KS 67063 JARED JOST CHAIRMAN/DIRECTOR 1.0 0.0 X X 0 0 0 JON WIEBE VICE CHAIR/DIRECTOR 1.0 0.0 X X 0 0 0 JOANN KNAK SECRETARY/DIRECTOR 1.0 0.0 X X 0 0 0 CARRIE KOONS DIRECTOR 1.0 0.0 X 0 0 0 JAMES THOMAS DIRECTOR 1.0 0.0 X 0 0 0 MARTIN RHODES DIRECTOR 1.0 0.0 X 0 0 0 EILEEN UNRUH DIRECTOR 1.0 0.0 X 0 0 0 KRIS ERICKSON CEO/ADMINISTRATOR 40.0 0.0 X 64956 0 9149 ALLEN EDIGER CHIEF FINANCIAL OFFICER 40.0 0.0 X 52072 0 1328 MARLIN JOHNSON INTERIM CEO/ADMINISTRATOR 40.0 0.0 X 0 0 0 117028 0 10477 0 false false false AEGIS THERAPIES INC PHYSICAL THERAPY 124020 1 4391 4391 NET RESIDENT SERVICE REVENUE 623000 2703172 2703172 2703172 319 319 0 0 46555 2548 44007 0 44007 -1348 45355 0 0 0 0 NONPATIENT MEALS 722513 50358 28405 21953 LAUNDRY SERVICE 812300 9063 9063 VENDOR REBATES 900099 570 570 1429 112 1317 61420 2813309 2703172 36232 69514 0 0 0 0 131879 131879 0 1347666 1316631 31035 4696 4588 108 304804 297785 7019 117708 104747 12961 0 1780 1780 38541 38541 0 0 218674 195862 22812 0 8312 5192 3120 313916 302427 11489 0 0 70220 65930 4290 1548 664 884 0 9033 6104 2929 25 23 2 0 39398 36991 2407 37505 35214 2291 EQUIPMENT RENTAL & MAINT. 140138 133484 6654 MEDICAL SUPPLIES 68282 68282 BED ASSESSMENT 13782 13782 DUES & SUBSCRIPTIONS 6122 3922 2200 16021 10353 5668 2890050 2596789 290141 3120 29707 70804 315708 300741 0 0 360613 296905 0 0 0 0 0 0 21530 22530 53298 48282 1228126 813148 407905 414978 0 0 0 0 0 0 0 0 0 0 1188761 1154240 203006 188085 0 0 0 0 0 0 0 0 0 0 7757 0 0 0 0 0 210763 188085 X 977998 966155 0 0 0 0 977998 966155 1188761 1154240 -76741 64898 X false true X true false X false false false false false true 325 false false false 325 false SCHEDULE C, PART II-B, LINE 1F A PORTION OF THE LEADINGAGE KANSAS ANNUAL DUES WERE FOR LOBBYING ACTIVITIES. 106042 62292 43750 1122084 750856 371228 414978 2880678 64898 -77 64821 2815857 -2548 -2548 2813309 2892521 2548 2548 2889973 77 77 2890050 SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D BAD DEBT EXPENSE (77) SCHEDULE D, PART XI, LINE 4B RENTAL EXPENSE (2,548) SCHEDULE D, PART XII, LINE 2D RENTAL EXPENSE 2,548 SCHEDULE D, PART XII, LINE 4B BAD DEBT EXPENSE 77 FORM 990, PART VI, SECTION B, LINE 11B AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE FORM 990. THE RETURN IS THEN REVIEWED BY THE CHIEF FINANCIAL OFFICER. ANY QUESTIONS OR CONCERNS THE CHIEF FINANCIAL OFFICER HAS ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS ARE MADE. THE FINAL FORM 990, WITH ALL REQUIRED SCHEDULES, IS PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE 990. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS DIRECTORS, OFFICERS, AND ALL EMPLOYEES WHO CAN INFLUENCE THE ACTIONS OF SALEM HOME. THESE INDIVIDUALS ARE REQUIRED TO ANNUALLY SIGN A STATEMENT CONFIRMING THAT THEY HAVE RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAVE READ AND UNDERSTAND THE POLICY, AND HAVE AGREED TO COMPLY WITH THE POLICY. ANY POTENTIAL CONFLICTS OF INTEREST MUST BE DISCLOSED TO THE CHIEF EXECUTIVE OFFICER (OR TO THE BOARD CHAIR IF IT IS THE CEO WHO HAS THE POTENTIAL CONFLICT). THE POTENTIAL CONFLICT WILL THEN BE BROUGHT TO THE BOARD OF DIRECTORS WHO SHALL DETERMINE IF AN ACTUAL CONFLICT EXISTS. IF AN ACTUAL CONFLICT EXISTS, THE INDIVIDUAL WITH THE CONFLICT MUST RECUSE THEMSELF FROM THE BOARD MEETING UNTIL THE DISCUSSION AND APPROVAL OF THE TRANSACTION IS COMPLETED. FORM 990, PART VI, SECTION B, LINE 15A THE HR DIRECTOR USED PAYSCALE, AN ONLINE COMPENSATION DATABASE, TO PERFORM A SEARCH OF COMPARABLE POSITIONS IN THE AREA AND PROVIDED THE INFORMATION TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS AGREED UPON A WAGE RANGE WHICH WAS DOCUMENTED IN THE BOARD MINUTES. THE ACTUAL COMPENSATION WAS INCLUDED ON AN INTERNAL FORM AS PART OF THE HIRING PACKET. THIS FORM WAS SIGNED OFF ON BY THE CHAIRMAN OF THE BOARD. THIS PROCESS WAS COMPLETED IN 2010 WITH THE HIRING OF A NEW CEO. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.