2015-08-17T08:52:13-05:00 2014-09-30 481026809 Wendling Noe Nelson & Johnson LLC 534 S Kansas Ave Suite 1500 Topeka KS 666033491 990 2013-10-01 480545183 Lindsborg Community Hospital Association LIND 7852273308 605 West Lincoln Lindsborg KS 674562328 Larry Van Der Wege CEO 7852273308 2015-07-30 1 Heather R Eichem P01515553 7852334226 2015-07-30 2013 2016-03-07 17:11:31Z Larry Van Der Wege 605 West Lincoln Lindsborg KS 674562328 9492093 0 X www.lindsborghospital.org X 1944 KS Operation of a critical access hospital for the care of individuals suffering from mental or physical illness, injury or deformity in an acute care, skilled nursing care, outpatient, or emergency setting. 9 9 0 53 0 0 132609 136852 7370982 9259935 3230 -1981 85761 93648 7592582 9488454 4713 2050 0 0 4447333 5197149 0 0 0 3229790 2810580 7681836 8009779 -89254 1478675 5694018 5088407 4033542 1929901 1660476 3158506 X Operation of a critical access hospital in a community qualifying for such designation under federal law, for the provision of facilities for the diagnosis, treatment of care of individuals suffering from mental or physical illness, disease, injury or deformity in an acute care, skilled nursing care, outpatient, or emergency room setting. 0 0 6911551 2050 9349944 Lindsborg Community Hospital (LCH) operates a critical access hospital in a community qualifying for such designation under federal law. The facilities are adequate for treatment or care of individuals suffering from mental or physical illness, disease, injury or deformity in an acute care, skilled nursing care, outpatient or emergency room setting. LCH cares for residents of the Smoky Valley with the operation of a 24/7 emergency room. 1,767 patients were seen in the 2014 fiscal year. 599 urgent care visits, 821 privately paid home health visits were made, and 418 cardiac rehab visits improved the health of community members. 1,548 meals on wheels were supplied to community members. Education was provided to Marquette and Lindsborg residents on breast cancer, colon cancer, smoking cessation, and the effects of sun exposure. Employees of the LCH partner with various community groups to provide assistance to the Midsummer's Committee, Hyllningsfest Committee, Chamber of Commerce, and Leadership Lindsborg to name a few. Staff also provide leadership with the Sunflower Health Network, KHA council, and the Sunflower (Kansas) HFMA chapter. 6911551 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X Laraine Gengler 7852273308 605 West Lincoln Lindsborg KS 674562328 Chuck Oleen President 1.00 X X 0 0 0 Denise Peterson Director 1.00 X 0 0 0 Judy Neuschafer Secretary 1.00 X X 0 0 0 Joel Woodard Vice-President 1.00 X X 0 0 0 Judy Murphy Director 1.00 X 0 0 0 Tom Buffington Treasurer 1.00 X X 0 0 0 Robyn Johnson Director 1.00 X 0 0 0 Ben Dolezal Director 1.00 X 0 0 0 Erika Lysell Director 1.00 X 0 0 0 Larry Van Der Wege CEO 40.00 X 94890 0 4865 Laraine Gengler CFO 40.00 X 87485 0 5245 182375 0 10110 0 0 0 0 National Therapeutic Association Inc D 11623 Arbor Street Omaha NE 68144 PT, OT and ST services 343666 1 80620 56232 7574 136852 Net patient service re 621400 9259935 9259935 9259935 1658 1658 12000 0 12000 12000 12000 3639 -3639 -3639 -3639 Employee/guest meals 900099 24147 24147 Medical record abstact 900099 13420 13420 Ambulance 621910 1049 1049 43032 43032 81648 9488454 9349944 0 1658 450 450 1600 1600 214043 214043 4138291 3798627 339664 134145 125941 8204 428836 378282 50554 281834 260090 21744 2443 2443 32042 32042 315662 243258 72404 95337 37570 57767 156101 63103 92998 96560 82607 13953 26828 16795 10033 2205 1635 570 20068 17168 2900 495561 423952 71609 44817 20479 24338 Professional fees - oth 361165 361165 Medical supplies 294503 294503 Pharmaceuticals 266221 266221 Repairs 164582 158685 5897 436485 356977 79508 8009779 6911551 1098228 0 105743 109331 854279 995357 1062545 1417696 119626 173714 57461 34605 5725899 3698872 2056337 2027027 306266 330677 1131761 0 5694018 5088407 182025 323162 599165 476568 3234435 483836 17917 646335 4033542 1929901 X 1383933 2736562 276543 421944 1660476 3158506 5694018 5088407 X 1478675 26929 -7574 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 2055 0 0 0 2055 0 Part II-B, Line 1: The portion of annual dues paid to hospital and medical associations attributed to lobbying activities by the associations. 10442 10442 2481721 1424930 1056791 2976480 2022704 953776 257256 251238 6018 2027027 Estimated reimbursements payable 646335 646335 X Part X, Line 2: Management is not aware of any uncertainties in income tax positions. 1 1 1 X 1 X 1 1 1 0 0 102096 102096 0.01270 259767 126814 132953 0.01660 361863 126814 235049 0.02930 23 54019 119008 44297 74711 0.00930 5 354 8412 8412 0.00110 8 576 3229 3229 0.00040 36 54949 130649 44297 86352 0.01080 36 54949 492512 171111 321401 0.04010 3 1570 2828 2828 0.00040 3 1570 2828 2828 0.00040 1 176445 4383132 4416236 -33104 X 1 1 1 1 Lindsborg Community Hospital 605 West Lincoln Lindsborg KS 674562328 X X X Lindsborg Community Hospital 1 1 X X X X X X X 12 1 1 1 X X X X X X 0 0 1 1 200.000000000000 1 300.000000000000 1 X X X 1 1 X X X X X 1 0 X X X X 1 X 0 0 Lindsborg Community Hospital Part V, Section B, Line 3: The McPherson County Health Needs Assessment process included gathering opinions from local sources and quantitative from secondary sources. The steering committee was represented by local organizations: McPherson County Health Department, McPherson Hospital, Lindsborg Community Hospital, and Mercy Hospital, Moundridge. A survey instrument was developed by the local steering committee. In early April 2013, the survey was distributed to individuals throughout the county, representing a broad spectrum of the population and their interests and professional and community endeavors. Representatives from the following areas received surveys: private college, public education administrators, special education advocacy, United Way, senior care administrators, senior care advocacy, child advocacy, family advocacy, chiropractic care, churches and church ministry groups, Chamber of Commerce, city government, county government, hospital administration, retail, mental health, county foundations, health care workers, physicians, law enforcement, EMS, pharmacists, college research and extension, recreation commission, dental care, disability care and advocacy, thrift stores, and low income housing. A total of 158 surveys were distributed with 106 returned, or a 67% return rate. The survey sought opinions and perspectives on several key areas including specific health issues; specific populations; barriers to health care; perceived weaknesses in areas ranging from emergency care to quality of housing; promotion of health and wellness; and key improvements needed to provide better health for residents. Responses to survey items were tallied and results calculated to determine which items received the most responses, providing a list of the most important health issues based on perception. A comprehensive list of identified community needs from the survey, in order of perceived importance, was developed. After the data was analyzed, a workgroup was formed to explore the results and begin to prioritize identified needs. The workgroup included county-wide representatives from the following: physicians and health care; mental health; law enforcement; city government; senior advocacy; public health; Chamber of Commerce; community foundations; research and extension; United Way; poverty; public education; and hospitals from the county. Lindsborg Community Hospital Part V, Section B, Line 4: Lindsborg Community Hospital Association collaborated with McPherson Hospital in McPherson, Kansas, and Mercy Hospital in Moundridge, Kansas, in creating a Community Health Needs Assessment. Lindsborg Community Hospital Part V, Section B, Line 7: Child care options will not be addressed as they are beyond the scope and abilities of LCH. Transportation will not be addressed by LCH as it is beyond the finances and abilities to provide transportation to community members. Also, it would conflict with transportation services provided to community members by the Lindsborg Senior Center and Marquette nursing homes. Annual description of the actions taken by the Hospital during the fiscal year to address the significant health needs identified through the most recently conducted CHNA:Health Issues In 2014, the emphasis of Lindsborg Community Hospital (LCH) was to begin to extract data from the hospital and clinic electronic medical records (EMR) to better understand the number of patients with these different health issues. Then, issue-specific action plans can be developed and tracked for the specific populations. We have developed reports to monitor which Medicare patients are in need of an Annual Wellness Visit or an Initial Medicare Visit. This enables us to provide preventative medicine screenings to these individuals which will assist in maintenance of any chronic conditions. Clinic EMR tools are also being used to monitor and maintain appropriate screening examinations and vaccinations. This will be continued and expanded in 2015.One health issue that was to be addressed in 2014 was to be substance abuse. With two new physicians to LCH, other practice development priorities took center stage to improve overall access to care. Assessment and referral strategies to Central Kansas Foundation in Salina were not further developed, although referral has been and will continue to be used.Education on many of these health issues has been performed since the inception of our action plan. Betty Nelson, Director of Marketing and Development, has organized and performed education for people in our service area. Forums addressed the role of genetics in disease, risk factors for each disease, strategies for prevention, how and when to visit with your medical provider, and the value of self-examination and screening tests. Interactive, educational stations were available on the topics of osteoporosis, exercise "at any age," and safe sun exposure. Participants may choose to take on-line health assessments to evaluate heart attack and stroke risk, and compare chronological age to "real age". Free blood pressure checks and blood sugar testing, as well as height, weight, and BMI (body mass indexing) were available.To address obesity, the Hospital sponsored a weight challenge in January 2014. Forty-three participants successfully completed the 12-week "Pound Plunge."In February 2014, LCH provided women's heart-health information in a local beauty salon, and provided free BP checks and on-line risk assessments.Summer 2014, approximately 70 people received a free skin cancer screening in three different sessions by two of our providers. Assessments were given and information distributed, along with samples of spf 30 sunscreen. One event was in Marquette, Kansas, and two here in Lindsborg.Specific Populations with Inadequate Access to CareEach of the specific populations with inadequate access to care has been better served by LCH in 2014 and beyond with the addition of two physicians. Dr. Jody Bieker started providing care in the Family Health Care Clinic on October 1st of 2013 and Dr. Andrea Eden began providing services in February of 2014. These two joined Dr. Ben Dolezal, Miranda Brown APRN, and Kelsey Swisher PA-C in providing a full range of family medicine services to patients across the specific populations. Schedule limitations have been reduced with the addition of the new physicians at LCH, allowing LCH to accept new patients.Barriers to CareCaring for those with low incomes and specifically those without insurance is something we will continue to do. Enhancement of our financial assistance policy, in accordance with 501(r) regulations, enabled us to provide care to those less financially able to afford care. An automatic deduction of 30% from total charges has been adopted for those individuals without insurance. LCH has also made an increased effort to identify and inform individuals about our Financial Assistance Policy, to encourage completion of application paperwork. For the fiscal year 2014 (Oct 1 - Sept 30), LCH provided $170,814 in charity care through the financial assistance policy to those without insurance. This is a 64% increase over the previous year. Also, $295,206 was the amount of care considered bad debt. Several years ago, LCH started the Pink Fund with a purpose to provide funding to pay for cancer screening services for those in our service area without insurance. In September of 2014, the purpose was expanded to provide grants of up to $500 for those in our service area with a diagnosis of cancer. Up to $3,000 per year will be granted.In the Family Health Care Clinic (FHCC), LCH has developed the process for school-aged children to have their activity health assessment forms completed. One option is a $35 cash option. It provides just the health assessment and form completion (no medications, labs, etc.) but is an economical option for families. This practice started in 2014 and will continue.In September of 2014, the FHCC began providing childhood immunizations. This service, along with our ability to accept new patients, was specifically marketed to Medicaid patients in our service area.LCH has continued to provide Urgent Care on Saturday and Sunday afternoons. This service provides an avenue for treatment of urgent situations when one's primary care provider is unavailable. It is also at a cost much less than in an Emergency Department. In fiscal year 2014, 599 visits were provided in the LCH Urgent Care clinic.Perceived Weaknesses in General AreasThe Wellness Center eliminated membership fees beginning September 1, 2013, providing free fitness options to adults and teens in the community. The Wellness Center also expanded their hours to 5:30 a.m. to 10 p.m. Monday - Friday and 8 a.m. to 10 p.m. on weekends and holidays. A second recumbent stepper was purchased in the spring of 2015 to provide additional equipment and reduce wait times. Dietary education will be covered in the educational services provided as discussed earlier. Access to specialists will be enhanced through the affiliation between LCH and SRHC. Lindsborg Community Hospital Part V, Section B, Line 20d: Anyone qualifying for free care under the financial assitance policy (FAP) is not charged for services. Anyone qualifying for discounted care under the FAP will not be charged more than the lowest negotiated commercial rate. 1 Family Health Care Clinic 605 W Lincoln St Lindsborg KS 67456 Physicians clinic Part III, Line 4: See Note A5 (page 9) of the Salina Regional Health Center, Inc. and Subsidiaries audited financial statements regarding the allowance for uncollectible accounts. Part III, Line 2: The Hospital's bad debt at cost was determined by applying an overall cost to charge ratio. Part III, Line 3: Lindsborg Community Hospital is unable to determine the amount of bad debt expense attributable to patients under its financial assistance policy. Suggested methods of estimation were not in place. For example, the number of financial assistance applications distibuted but not returned was not tracked. Rather than provide an estimate that cannot be substantiated, Lindsborg Community Hospital has chosen to report zero dollars as bad debt expense attributable to charity care patients. Part III, Line 8: Amounts were obtained from the cost report filed with Medicare for the period endend September 30, 2014. The total amount of the shortfall is considered a community benefit, representing our cost of providing services to the Smoky Valley communities. Part III, Line 9b: Patients who have qualified for financial assistance are considered qualified for one year. Updated information must be provided for any subsequent account balances. Patients who have qualified for partial financial assistance are to make payment arrangements for any remaining balance according to the policies that apply to other patients. Part VI, Line 2: A needs assessment has been completed. We are guided by our providers, our partners in nursing home care, Bethany Home and Riverview Estates, our partners in education of youth, USD 400 and Bethany College, and our patients in the Smoky Valley. Part VI, Line 3: The Hospital's charity care policy is posted in patient waiting rooms in a three-ring notebook. The contact information is not posted, but the employees of the Hospital have been instructed to direct anyone with questions regarding assistance to the Hospital's business office. Patients are educated by financial services staff and social services staff who are able to provide assistance upon request and through our policies being posted to our website. Part VI, Line 4: The Organization serves the Smoky Valley Area including Lindsborg, Marquette, Falun, Roxbury, Gypsum, Assaria and other areas including McPherson, Salina, Smolan, Canton, and Galva. Approximately 8% of the Hospital's patients are uninsured or Medicare patients. The community served by the Hospital is also served by two other hospitals, plus a FQHC in Salina. A City of Lindsborg Kansas 486019638 535596FH8 2009-10-15 545000 Refunding of 2000 series bonds. 0 0 0 A 215000 545000 545000 0 1 0 1 A 0 0 1 0 0 0 0 0 0 Kalli Weibert Daughter of Laraine Gengler, CFO 45932 Employment 0 Form 990, Part VI, Section A, line 3 The Hospital entered into a management and operating agreement with Salina Regional Health Center (SRHC) effective October 1, 2012. Under the agreement, SRHC is responsible for the daily management and operation of the Hospital, including the employment of all staff needed to manage and operate Lindsborg Community Hospital. For the calendar year of 2013, SRHC paid $99,755 for Larry Van Der Wege, the Hospital CEO's salary and benefits, and $92,730 for Laraine Gengler, the Hospital CFO's salary and benefits. These amounts are included on Form 990, Part VII, Columns D and F. Form 990, Part VI, Section A, line 6 Lindsborg Community Health Care Foundation, Inc., a not-for-profit, 501(c)(3) organization, is the sole member of Lindsborg Community Hospital. Form 990, Part VI, Section A, line 7a Lindsborg Community Health Care Foundation, Inc., being the sole member of Lindsborg Community Hospital, has the right to elect all board members. Form 990, Part VI, Section A, line 7b Lindsborg Community Health Care Foundation, Inc., is the sole member, and has the right to approve Lindsborg Community Hospital's by laws, articles of incorporation, and Board of Directors. Form 990, Part VI, Section B, line 11 An independent accounting firm prepares and reviews the Form 990. The Form 990 is then reviewed by the Organization's CEO and CFO. Any questions or concerns of the Organization's CEO and CFO are addressed and any corrections or clarifications that need to be made are made. The Form 990 is then provided to the Board of Directors for their review prior to filing the Form 990. Any questions or concerns of the Board of Directors are addressed and any corrections or clarifications that need to be made are made. The final Form 990 with all required schedules is then provided to all voting members of the board prior to filing the Form 990. Form 990, Part VI, Section B, line 12c At the time of hire or election (in the case of directors) and annually thereafter, the officers, directors, and key employees provide the applicable conflict of interest disclosures which are completed to identify any relationships, positions, or circumstances in which it is believed a conflict may arise. If a conflict arises, the officer, director, or key employee abstains from the vote of the conflicted position. The annual monitoring and review is part of the Organization's compliance plan. A report is submitted to the executive board concerning any interest disclosed. Form 990, Part VI, Section B, line 15a The Organization's process for determining Administrator's compensation begins with an initiative lead by the Executive Compensation Committee (ECC) of Salina Regional Health Center (SRHC). The ECC compares compensation and salary data provided by Integrated Health Strategies (HIS) for overall reasonableness of base compensation and total compensation for all SRHC executive staff. The ECC reviews the data and makes a recommendation to the SRHC board of trustees in a closed executive meeting where the compensation for the President/CEO of SRHC is then voted upon by all independent members of the board. This process was last completed in 2013. Lindsborg Community Hospital CEO's salary is then set by the President/CEO of SRHC. The Lindsborg Community Hospital CFO's salary is set by Lindsborg Community Hospital CEO using an annual salary survey and is increased using the same percentage as all other employees. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy, and financial statements are available to the public upon request. Form 990, Part XI, line 9: Fair market value of non-cash contribution not recognized on financials -7,574. Form 990, Part XI, Line 2C: The selection of an independent accountant for the audit of Salina Regional Health Center, Inc. and Subsidiaries is determined by Salina Regional Health Center's audit committee. Lindsborg Community Hospital is part of the consolidated financial statements of Salina Regional Health Center. Lindsborg Community Hospital did not have a separate financial statement audit in the current fiscal year. A decision to have a separate audit in any future year will be made by Salina Regional Health Center's audit committee or Lindsborg Community Hospital's Board of Directors. Lindsborg Community Health Care Foundation Inc 605 W Lincoln Lindsborg KS 67456 480947732 To support the hospital. KS 501(c)(3) Line 7 N/A 0 0 0 1 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0