CLARA BARTON HOSPITAL ASSOCIATION INC HOISINGTON KANSAS: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- CLARA BARTON HOSPITAL ASSOCIATION INC HOISINGTON KANSAS (EIN 48-0576039)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-10-27
- IRS object ID
- 201523009349301107
- Schema version
- 2014v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-10-27T12:58:17-05:00 | ReturnTs |
| Tax Period End | 2014-12-31 | 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 | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 534 S Kansas Ave Suite 1500 | AddressLine1Txt |
| City | Topeka | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 666033491 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 480576039 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Clara Barton Hospital Association Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CLAR | BusinessNameControlTxt |
| Phone | 6206532114 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 West 9th Street | AddressLine1Txt |
| City | Hoisington | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 675441799 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | James G Blackwell | PersonNm |
| Person Title | Chief Executive Officer | PersonTitleTxt |
| Phone | 6206532114 | PhoneNum |
| Signature | 2015-10-09 | 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 | 2015-10-09 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | James G Blackwell | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 West 9th Street | AddressLine1Txt |
| City | Hoisington | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 675441799 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $19,947,883 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.clarabartonhospital.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1946 | FormationYr |
| Legal Domicile State | KS | LegalDomicileStateCd |
| Activity Or Mission | Provision of inpatient and outpatient hospital services, primary care services, and surgical services to residents of our service area. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 224 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $140,112 | PYContributionsGrantsAmt |
| CY Contributions Grants | $629,560 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $16,864,249 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $17,915,629 | CYProgramServiceRevenueAmt |
| PY Investment Income | $136,642 | PYInvestmentIncomeAmt |
| CY Investment Income | $241,738 | CYInvestmentIncomeAmt |
| PY Other Revenue | $347,188 | PYOtherRevenueAmt |
| CY Other Revenue | $712,036 | CYOtherRevenueAmt |
| PY Total Revenue | $17,488,191 | PYTotalRevenueAmt |
| CY Total Revenue | $19,498,963 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,750,596 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,961,591 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $97,017 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,639,474 | PYOtherExpensesAmt |
| CY Other Expenses | $7,767,920 | CYOtherExpensesAmt |
| PY Total Expenses | $17,390,070 | PYTotalExpensesAmt |
| CY Total Expenses | $18,729,511 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $98,121 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $769,452 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $12,690,483 | TotalAssetsBOYAmt |
| Total Assets EOY | $12,484,332 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,339,164 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,551,108 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $7,351,319 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $7,933,224 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Clara Barton Hospital Association is dedicated to meeting the health care needs and improving the quality of life for the community we serve. We continually pursue clinical excellence in an atmosphere of caring and compassion. We are deeply committed to serving all in need within our resources. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $16,023,115 | ExpenseAmt |
| Revenue | $18,057,003 | RevenueAmt |
| Desc | Clara Barton Hospital Association provided a wide range of health care services to residents of its service area including 2,527 patient days of inpatient care, 20,364 outpatient hospital visits and 26,267 visits to our primary care and surgical clinics. | Desc |
| Total Program Service Expenses | $16,023,115 | 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 | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | 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 | 59 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 224 | 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | 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 | 0 | 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 | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | James G Blackwell | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6206532114 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 West 9th Street | AddressLine1Txt |
| City | Hoisington | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 675441799 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 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 |
|---|---|---|---|---|---|---|---|
| Curt J Colson | |||||||
| President/CEO | 40.00 | Yes (X) | Yes (X) | $142,653 | $0 | $34,496 | |
| Jon Radke | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Troy Bailey | |||||||
| Chairman | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Mike Aylward | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Nathaniel Knackstedt | |||||||
| Director/Chief of Staff | 40.00 | Yes (X) | $232,518 | $0 | $36,827 | ||
| Marla Mooney | |||||||
| Vice-Chairman | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Karla Crissman | |||||||
| Secretary | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Jim Carney | |||||||
| Treasurer | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Lisa Beran | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Doug Hubbard | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| James G Blackwell | |||||||
| Vice President/CFO | 40.00 | Yes (X) | $114,202 | $0 | $33,557 | ||
| Robin Durrett | |||||||
| Physician | 40.00 | $529,526 | $0 | $38,236 | Yes (X) | ||
| Timothy Webb | |||||||
| Physician | 40.00 | $343,014 | $0 | $28,247 | Yes (X) | ||
| Phillip Barnes | |||||||
| Physician Assistant | 40.00 | $121,720 | $0 | $29,952 | Yes (X) | ||
| Abelardo Sotelo | |||||||
| Physician | 40.00 | $378,554 | $0 | $20,055 | Yes (X) | ||
| Celeste M Meitner | |||||||
| Pharmacist | 40.00 | $112,171 | $0 | $17,361 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,974,358 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $238,731 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 11 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Hutton Construction | |||||
| 2229 S West St | Wichita | KS | 67213 | Construction services | $1,501,014 |
| Docs Who Care PA | |||||
| 1337 South Fountain Drive | Olathe | KS | 66061 | ER Physician coverage | $618,835 |
| Aramark Uniform Services | |||||
| 115 N First St | Burbank | CA | 91502 | Laundry services | $424,750 |
| Mobile Imaging Inc | |||||
| 3520 Lakin Ave | Great Bend | KS | 67530 | Sonography tech services | $183,199 |
| Hutchinson Clinic PA | |||||
| PO Box 1187 | Hutchinson | KS | 67504 | Surgery and respiratory therapy services | $173,997 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 11 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $606,341 | RelatedOrganizationsAmt |
| Government Grants | $13,590 | GovernmentGrantsAmt |
| All Other Contributions | $9,629 | AllOtherContributionsAmt |
| Total Contributions | $629,560 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient service revenue | 621990 | $17,537,076 | $17,537,076 |
| 340b drug program revenue | 621990 | $378,553 | $378,553 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $17,915,629 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $199,012 | TotalRevenueColumnAmt |
| Exclusion | $199,012 | ExclusionAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $484,622 | TotalRevenueColumnAmt |
| Exclusion | $484,622 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $13,715 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $13,715 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,715 | TotalRevenueColumnAmt |
| Exclusion | $13,715 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $480,646 | SecuritiesAmt |
| Other | $11,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $448,920 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $31,726 | SecuritiesAmt |
| Other | $11,000 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $42,726 | TotalRevenueColumnAmt |
| Exclusion | $42,726 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| Cafeteria | 722210 | $72,325 | $72,325 | |
| Purchase discounts and rebates | 621990 | $66,405 | $66,405 | |
| Patient account interest | 621990 | $25,911 | $25,911 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $49,058 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $49,058 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $213,699 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,498,963 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $18,057,003 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $812,400 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $594,253 | TotalAmt |
| Program Services | $269,345 | ProgramServicesAmt |
| Management And General | $324,908 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,496,844 | TotalAmt |
| Program Services | $7,374,343 | ProgramServicesAmt |
| Management And General | $1,052,338 | ManagementAndGeneralAmt |
| Fundraising | $70,163 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,066 | TotalAmt |
| Program Services | $148,710 | ProgramServicesAmt |
| Management And General | $18,926 | ManagementAndGeneralAmt |
| Fundraising | $1,430 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,071,298 | TotalAmt |
| Program Services | $953,216 | ProgramServicesAmt |
| Management And General | $109,009 | ManagementAndGeneralAmt |
| Fundraising | $9,073 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $630,130 | TotalAmt |
| Program Services | $533,407 | ProgramServicesAmt |
| Management And General | $91,803 | ManagementAndGeneralAmt |
| Fundraising | $4,920 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,273 | TotalAmt |
| Management And General | $42,273 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,825 | TotalAmt |
| Management And General | $1,825 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,671,822 | TotalAmt |
| Program Services | $2,436,722 | ProgramServicesAmt |
| Management And General | $234,932 | ManagementAndGeneralAmt |
| Fundraising | $168 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,084 | TotalAmt |
| Program Services | $22,416 | ProgramServicesAmt |
| Management And General | $23,668 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $742,789 | TotalAmt |
| Program Services | $634,802 | ProgramServicesAmt |
| Management And General | $102,278 | ManagementAndGeneralAmt |
| Fundraising | $5,709 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $131,166 | TotalAmt |
| Management And General | $131,166 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $315,767 | TotalAmt |
| Program Services | $270,982 | ProgramServicesAmt |
| Management And General | $43,572 | ManagementAndGeneralAmt |
| Fundraising | $1,213 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,640 | TotalAmt |
| Program Services | $36,514 | ProgramServicesAmt |
| Management And General | $6,125 | ManagementAndGeneralAmt |
| Fundraising | $1 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $194,435 | TotalAmt |
| Program Services | $194,435 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $743,518 | TotalAmt |
| Program Services | $622,771 | ProgramServicesAmt |
| Management And General | $117,476 | ManagementAndGeneralAmt |
| Fundraising | $3,271 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,818 | TotalAmt |
| Management And General | $119,818 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Medical supplies | $1,043,378 | $1,043,378 | ||
| Pharmacy supplies | $676,987 | $676,987 | ||
| Repairs and maintenance | $274,855 | $256,369 | $18,100 | $386 |
| Minor equipment | $212,781 | $139,643 | $73,131 | $7 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $507,782 | TotalAmt |
| Program Services | $409,075 | ProgramServicesAmt |
| Management And General | $98,031 | ManagementAndGeneralAmt |
| Fundraising | $676 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,729,511 | TotalAmt |
| Program Services | $16,023,115 | ProgramServicesAmt |
| Management And General | $2,609,379 | ManagementAndGeneralAmt |
| Fundraising | $97,017 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $987 | BOYAmt |
| EOY | $14,321 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,796,417 | BOYAmt |
| EOY | $791,942 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,723,828 | BOYAmt |
| EOY | $1,664,688 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,028 | BOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,500 | BOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $487,893 | BOYAmt |
| EOY | $581,001 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $220,392 | BOYAmt |
| EOY | $206,425 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $14,084,283 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $9,372,563 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,726,964 | BOYAmt |
| EOY | $4,711,720 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,111,883 | BOYAmt |
| EOY | $2,919,048 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,547 | BOYAmt |
| EOY | $5,547 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,512,044 | BOYAmt |
| EOY | $1,589,640 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,690,483 | BOYAmt |
| EOY | $12,484,332 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,963,536 | BOYAmt |
| EOY | $1,986,019 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,210,611 | BOYAmt |
| EOY | $2,479,782 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $165,017 | BOYAmt |
| EOY | $85,307 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,339,164 | BOYAmt |
| EOY | $4,551,108 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,473,147 | BOYAmt |
| EOY | $7,151,501 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $603,839 | BOYAmt |
| EOY | $503,419 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $274,333 | BOYAmt |
| EOY | $278,304 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,351,319 | BOYAmt |
| EOY | $7,933,224 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,690,483 | BOYAmt |
| EOY | $12,484,332 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $769,452 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$100,028 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$87,519 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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 | $5,957 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $5,957 | 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 | Clara Barton Hospital Association, Inc., is a member of the Kansas Hospital Association and the American Hospital Association. Both of these organizations engage in lobbying activities for hospital and general health care interests as part of the services provided to members. | ExplanationTxt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $554,300 | OtherCostOrOtherBasisAmt |
| Depreciation | $401,937 | DepreciationAmt |
| Book Value | $152,363 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,404,736 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,674,558 | DepreciationAmt |
| Book Value | $1,730,178 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,428,451 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,679,329 | DepreciationAmt |
| Book Value | $749,122 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,696,796 | OtherCostOrOtherBasisAmt |
| Depreciation | $616,739 | DepreciationAmt |
| Book Value | $2,080,057 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,711,720 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Beneficial interest in net assets of CBH Foundation | $761,723 |
| Deferred financing costs | $50,365 |
| Estimated third-party payor settlements | $591,935 |
| Other receivables | $108,673 |
| Advances to physicians | $76,944 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,589,640 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $19,311,416 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$100,028 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$100,028 | RevenueNotReportedAmt |
| Revenue Subtotal | $19,411,444 | RevenueSubtotalAmt |
| Other Revenues Not Included | $87,519 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $87,519 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $19,498,963 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $18,729,511 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $18,729,511 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $18,729,511 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part X, Line 2: | Management is not aware of any uncertainties in income tax positions. |
| Part XI, Line 4b - Other Adjustments: | Change in beneficial interest in net assets of Foundation, net of transfers 87,519. |
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 |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $277,704 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $277,704 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01480 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $973,943 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $467,456 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $506,487 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02700 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,251,647 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $467,456 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $784,191 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04180 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,527 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,527 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,527 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,527 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,565,475 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,010,555 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $554,920 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02960 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $950 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $950 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,576,479 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,010,555 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $565,924 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03020 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,828,126 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,478,011 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,350,115 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07200 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $339,425 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $33,943 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $7,557,390 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,628,127 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$70,737 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (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 | Clara Barton Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 West 9th Street | AddressLine1Txt |
| City | Hoisington | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 675441799 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | H005003 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | Physician clinics & rural health clinics | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Clara Barton Hospital Association Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| 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 | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.clarabartonhospital.org | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 12 | ImplementationStrategyAdptYr |
| Strategy Posted Website | 0 | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (1) | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| 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 (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Clara Barton Hospital Association, Inc. | Part V, Section B, Line 5: The CHNA was conducted in collaboration with Great Bend Regional, Ellinwood District Hospital, St. Rose's ASC, and the Barton County Health Department. The Hospital reached out to members of the community with broad interests in the community served and special knowledge of or expertise in public health from groups such as local hospitals, public health community, mental health community, free clinics, community based clinics, service providers, local residents, community leaders, opinion leaders, school leaders, business leaders, local government, faith-based organizations and persons (or organizations serving them), people with chronic conditions, uninsured community members, low income residents, and minority groups. A Town Hall meeting of 37 attendees was conducted. The Town Hall meeting reflected on the size and seriousness of any health concerns cited and discussed current community health strengths, as well as identifying and ranking top community health concerns. In addition to the Town Hall meeting, CHNA surveys were mailed to 2,000 randomly selected Barton County residents. 230 area households in the community completed the CHNA survey. The survey was created to measure Barton County residents' views regarding health care perceptions of delivery, access, and health practices. |
| Clara Barton Hospital Association, Inc. | Part V, Section B, Line 6a: Great Bend Regional (located in Great Bend, KS - Barton County), Ellinwood District Hospital (located in Ellinwood, KS - Barton County), and St. Rose's ASC (located in Great Bend, KS - Barton County) |
| Clara Barton Hospital Association, Inc. | Part V, Section B, Line 11: 1. Obesity / ExerciseCBH distributed educational materials regarding healthy food choices, nutrition, and ways to be active and increase exercise during an annual Hoisington Middle School Sixth Grade Health Fair.CBH contracted with a registered dietician who is available to meet with patients either in a one-on-one and/or group setting to provide nutritional consultation and education.CBH provided substantially discounted Lab Fairs on three occasions in 2014. During these lab fairs CBH also offered blood pressure checks. The lab tests that were offered are CMP, CBC, Lipid Profile, HgbA1C, TSH, PSA and Vitamin D.Clara Barton Medical Clinic (CBMC) offered the Virtual Lifestyle Management (VLM) program via the Kansas Department of Health and Environment (KDHE) for any patient 30 or more pounds overweight and with one or more of the following conditions: Type 2 diabetes or Pre-diabetes, Metabolic Syndrome, high cholesterol, obstructive sleep apnea, coronary artery disease. VLM is an online program with lessons on physical activity, nutrition, motivation and tracking tools. Personal coaching sand support was also available. CBMC had approximately 30 participants during 2014.2. Heart HealthCBH partnered with Cardiovascular Consultants of Kansas, P.A. and brought the cardiac services of Dr. Micheal Lloyd, DO to Hoisington's outreach specialty clinic twice each month.CBH partnered with Wichita Surgical Specialist bringing the cardio-thoracic services of Dr. Brett Grizzell, MD, to CBH's Surgical Services location in Great Bend Kansas once a month. CBH actively sought to provide affordable access to highly-specialized healthcare. Services included Nuclear Medicine Stress Testing, Cardiac Rehab , and Pulmonary Rehab.CBH provided substantially discounted Lab Fairs on three occasions in 2014. During these lab fairs CBH also offered blood pressure checks. The lab tests that were offered are CMP, CBC, Lipid Profile, HgbA1C, TSH, PSA and Vitamin D.CBH participated in the CMS Quality Core Measures monitoring cardiac services provided for in the Emergency Room Department.CBH in collaboration with Ellis County Extension Agent, and Barton County Extension Agent hosted an educational seminar entitled "Seafood at its Best". The seminar provided education on how seafood can be an important part of a healthy diet and has Omega-3 fats that help support a healthy heart, nervous system and reduce cancer risks. It included tip for selecting, preparing, and cooking seafood.3. Economic Development (Advocacy)CBH actively sought additional health care services in attempt to bring advanced medicine and specialized services to Hoisington and surrounding communities.CBH was the second largest employer in Hoisington in 2014 with 191 total employees. An average of about half of the total employee reside in Hoisington. When applying the economic multiplier of .34, the total employment impact in Barton County and surrounding communities are 255 jobs. CBH was an active member of and supported the ongoing efforts of City of Hoisington, Hoisington and Great Bend Chambers of Commerce.5. Teen Pregnancy RateCBH and clinics worked closely with Barton County Health Department and refers most patient inquiries to them for servicesCBMC providers offered birth control counseling to all patients seeking birth control, including teens.6. Access to Care (Underinsured)CBH operated Rural Health Clinics in Hoisington and Russell, Kansas. RHC's provide improved access to primary care in underserved rural areas.CBMC & Russell Family Medical Care (RFMC) offered a Sliding Fee Scale for patient with incomes equal to or less than 300% of the Federal Poverty Guideline.Prescription Assistance in the form of Medication Samples and Prescription Discount Cards were available on a non-emergent basis.CBH offered 24/7 emergency care services. Providers were on-call 24/7. CBH & Clinics pursued and integrated Electronic Medical Records. This allowed better coordination of care among providers and access to records. 7. Diabetic EducationConsultations with a Registered Dietician were available by appointment to the community.Consultations with Diabetic Educators providing education on diet, exercise were available to CBMC patients on a bi-monthly basis. CBMC participated in the Chronic Disease Electronic Management System (CDEMS) as part of the Kansas Quality of Care Project through the Kansas Department of Health and Environment (KDHE) in an effort to help track and monitor diabetes.8. Awareness of ServicesCBH used its limited resources to fund marketing efforts regarding our patient care services. 2014 Marketing/Advertising was ongoing in Television, Radio and Newspaper advertisements.Clara Barton Hospital's Board of Directors, Hospital Leadership, Physicians and staff participated in numerous Community Activities including:Health FairsLadies Night Out"Chamber Coffee'sUSD 431 Sports and Scholarship Activities9. Behavioral / Substance AbuseCBH & Clinics partnered with Hutchinson Clinic to bring Physical Medicine/Pain Management services to Hoisington for patients with chronic pain.CBH & Clinics partnered with Hays Medical Center's Psychiatric Associates Clinic where primary focus is on psychiatric evaluations, medication management, individual and family therapy.CBH collaborated relationships with The Center for Counseling & Consultation in Great Bend to identify ways to work together to provide better access for patients.CBH distributed educational materials on tobacco, drug, and alcohol abuse during an annual Hoisington Middle School Sixth Grade Health Fair.10. Health Care Transport (out of county)The need for health care transport was not addressed during 2014. Due to limited resources CBH did not have the ability to fund an additional transportation service, but continued to monitor and remain in collaboration with the community.There is a local transportation van accessible to the community for healthcare, shopping, and personal transportation needs. However, it did not provide out of county transportation in 2014. |
| Clara Barton Hospital Association, Inc. | Part V, Section B, Line 20e: Clara Barton Hospital Association, Inc., notified all uninsured patients about the Hospital's charity care program by letter. |
| Clara Barton Hospital Association, Inc. | Part V, Section B, Line 22d: Maximum amounts that can be charged were determined by calculating the amounts generally billed (AGB). AGB is calculated based on the look back method for Medicare and commercial payors. |
| Part V, Section B, Line 16 | Financial Assistance Policy Website Availability |
| Clara Barton Hospital Association, Inc. Part V, Section B, line 16a website: | www.clarabartonhospital.org |
| Clara Barton Hospital Association, Inc. Part V, Section B, line 16b website: | www.clarabartonhospital.org |
| Clara Barton Hospital Association, Inc. Part V, Section B, line 16c website: | www.clarabartonhospital.org |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| Clara Barton Medical Clinic | ||||
| 252 W 9th Street | Hoisington | KS | 67544 | Rural health clinic |
| Clara Barton Surgical & Specialty Clinic | ||||
| 351 W 10th Street | Hoisington | KS | 67544 | Physician clinic |
| Russell Family Medical Care | ||||
| 410 N Main Street Suite C | Russell | KS | 67665 | Rural health clinic |
| Clara Barton Orthopedic Clinic | ||||
| 352 W 10th Street | Hoisington | KS | 67544 | Physician clinic |
| Clara Barton Hospital Surgical Clinic | ||||
| 1301 Jackson Street | Great Bend | KS | 67530 | Physician clinic |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | Financial assistance at cost was determined by utilizing departmental cost-to-charge ratios for financial assistance provided in areas that are reported as subsidized health services. An overall cost-to-charge ratio derived from Worksheet 2 was used to determine the cost of financial assistance provided for services not reported as subsidized health services.Unreimbursed Medicaid costs were also determined using a blend of cost-to-charge ratios for certain services and an overall cost-to-charge ratio derived from Worksheet 2 for all other services.The cost of providing subsidized health services was determined using a cost-to-charge ratio for each service.Actual costs and revenues were utilized for all other items reported on line 7. |
| Part I, Line 7g: | Subsidized health services are comprised of services that the Hospital provides despite a financial loss to the organization. These services include the operation of a 24-hour emergency room. |
| Part III, Line 4: | The Hospital recognizes patient service revenue associated with services provided to patients who have third-party payor coverage on the basis of contractual rates for the services rendered. For uninsured patients that do not qualify for charity care, the Hospital recognizes revenue on the basis of its standard rates for services provided. On the basis of historical experience, a significant portion of the Hospital's uninsured patients will be unable or unwilling to pay for the services provided. Thus, the Hospital records a significant provision for bad debts related to uninsured patients in the period the services are provided.Part III, Line 2:Bad debt expense at cost was determined by utilizing departmental cost-to-charge ratios for financial assistance provided in areas that are reported as subsidized health services. An overall cost-to-charge ratio derived from Worksheet 2 was applied to the charges deemed uncollectible during the year for all other services.Part III, Line 3:Bad debt expense attributable to patients eligible under the organization's financial assistance policy was determined using an estimated 10% of total bad debts. The Hospital takes steps to assist individuals who are believed to qualify for financial assistance prior to writing accounts off as uncollectible.All non-reimbursed costs for treatment of patients in our community provides a community benefit since patients unwilling or unable to pay have received a valuable service at no cost or at a reduced cost to them. This improves the health of our community as a whole. |
| Part III, Line 8: | Medicare allowable costs were determined by using amounts from the Hospital's Medicare cost report as filed with the Medicare Administrative Contractor. The Medicare cost report apportions actual costs to the Medicare program using charges for ancillary services and patient days for nursing services. Caring for Medicare patients fulfills a community need and relieves a government burden as these patients typically have low or fixed income. Medicare does not provide sufficient reimbursement to cover the cost of providing care for these patients as a result any shortfall should be included as a community benefit. |
| Part III, Line 9b: | The collection policy states that the patient must cooperate with the Hospital to provide the information and documentation necessary to apply for other existing financial resources that may be available to pay for health care services, such as Medicaid. Then the information is gathered and assessed in order to determine eligibility for charity care. Whenever possible, prior to admission, the Hospital will conduct a pre-admission interview with the patient, the guarantor, and/or the patient's legal representative. Those patients who may qualify for financial assistance from a governmental program will be referred to the appropriate program, prior to the consideration for charity care. |
| Part VI, Line 2: | The Hospital works closely with the Barton County Health Department and Kansas Department of Health and Environment to identify trends in the community. Education and information is provided to the public. For example information on West Nile, chicken pox, and whooping cough. The Hospital also trends data in the hospital and clinics to identify emerging issues. The Hospital has provided, a fall prevention program, "Stepping "On," for interested elderly members of Hoisington and surrounding areas. The Hospital also trends trauma data in the emergency room and as a result provided literature to the public on fall prevention. "Lights Out" stroke education was provided to the public at football games in Hoisington and Claflin in the fall of 2014. |
| Part VI, Line 3: | There is signage posted at admissions desk. Patients are referred to a financial counselor at admission if they do not have insurance. The financial counselor also works with a Medicaid helper to try and get qualified patients register for the Medicaid program. Effort is made during billing of deductible and co-payment to see if patient can qualify for charity care. |
| Part VI, Line 4: | The community being served is located in central Kansas and consists of approximately 2,800 residents. The average household income is $32,993. 15.4% of the community residents live below federal poverty level, and 4.7% of the community residents live below 50% of the federal poverty level. Neighboring hospitals include facilities in Ellinwood and Great Bend. They are approximately 18 and 11 miles away respectively. |
| Part VI, Line 5: | The Hospital's Board of Directors is elected from the community at large. This allows independent individuals who reside in the primary service area to serve as a director. The Hospital also extends medical staff privileges to all qualified physicians in the community. Any surplus in funds is retained by the Hospital and aids in improving overall patient care and facility maintenance. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Curt J Colson | ||||||||||||||
| President/CEO | $142,653 | $0 | $0 | $0 | $0 | $0 | $4,281 | $0 | $30,215 | $0 | $177,149 | $0 | $0 | $0 |
| Nathaniel Knackstedt | ||||||||||||||
| Director/Chief of Staff | $213,090 | $0 | $19,428 | $0 | $0 | $0 | $6,376 | $0 | $30,451 | $0 | $269,345 | $0 | $0 | $0 |
| Robin Durrett | ||||||||||||||
| Physician | $498,323 | $0 | $31,203 | $0 | $0 | $0 | $7,800 | $0 | $30,436 | $0 | $567,762 | $0 | $0 | $0 |
| Timothy Webb | ||||||||||||||
| Physician | $308,951 | $0 | $34,063 | $0 | $0 | $0 | $7,800 | $0 | $20,447 | $0 | $371,261 | $0 | $0 | $0 |
| Phillip Barnes | ||||||||||||||
| Physician Assistant | $107,418 | $0 | $14,302 | $0 | $0 | $0 | $0 | $0 | $29,952 | $0 | $151,672 | $0 | $0 | $0 |
| Abelardo Sotelo | ||||||||||||||
| Physician | $378,554 | $0 | $0 | $0 | $0 | $0 | $6,936 | $0 | $13,119 | $0 | $398,609 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Hoisington Public Building Commission | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 471454939 | BondIssuerEIN |
| CUSIP | 43466QAG4 | CUSIPNum |
| Bond Issued | 2014-08-06 | BondIssuedDt |
| Issue Price | $2,487,003 | IssuePriceAmt |
| Purpose | Refund outstanding bonds issued on 12/19/2000, 2/27/2003 and 3/23/2006 | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $2,487,076 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $24,050 | IssuanceCostsFromProceedsAmt |
| Other Spent Proceeds | $2,462,953 | OtherSpentProceedsAmt |
| Substantial Completion | 2006 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | Yes (1) | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Date Rebate Computation Performed | Issuer Name: Hoisington Public Building Commission Date the Rebate Computation was Performed: 08/06/2014 |
| Schedule K, Part II, Line 3, Total proceeds of issue | The difference between Part II, Line 3 and Part I, Column (e) represent year-to-date investment earnings on bond proceeds. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Anita Blackwell | |||
| Spouse of James G. Blackwell, current officer | $51,233 | Employment arrangement | 0 |
| Cardinal Pharmacy | |||
| 100% owned by Marla Mooney, current officer | $169,880 | Dispensing fees remitted in accordance with 340B drug program agreement | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | Members of Clara Barton Hospital Foundation, Inc., are automatically members of Clara Barton Hospital Association, Inc. |
| Form 990, Part VI, Section A, line 7a | Members of Clara Barton Hospital Association, Inc., elect members of the governing body. |
| Form 990, Part VI, Section B, line 11 | Form 990 provided to governing body and reviewed prior to filing. |
| Form 990, Part VI, Section B, line 12c | A conflict of interest disclosure form is provided to each Board Member and is reviewed annually. |
| Form 990, Part VI, Section B, line 15a | The organization uses the KHA Salary Survey as a guide for determining CEO compensation with Board of Directors approval. The KHA Salary Survey is used by the CEO when determining compensation for other officers and key employees. |
| Form 990, Part VI, Section C, line 19 | The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon written request. |
| Form 990, Part XI, line 9: | Change in beneficial interest in Foundation net of transfers -87,519. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Clara Barton Hospital Foundation Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 25 | AddressLine1Txt |
| City | Hoisington | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67544 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 481077460 | EIN |
| Primary Activities | Provide support to Clara Barton Hospital | PrimaryActivitiesTxt |
| Legal Domicile State | KS | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | Line 7 | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | 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 | 0 | 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 | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |