2015-02-12T10:40:39-06:00 2014-06-30 481026809 Wendling Noe Nelson & Johnson LLC 534 S Kansas Ave Suite 1500 Topeka KS 666033491 990 2013-07-01 480799105 McPherson Hospital Inc MCPH 6202412250 1000 Hospital Drive McPherson KS 674602326 Robert Monical CEO 6202412250 2015-02-10 1 Heather R Eichem P01515553 7852334226 2015-02-10 2013 2016-02-25 16:41:14Z Robert Monical 1000 Hospital Drive McPherson KS 674602326 22858853 0 X www.mcphersonmemorial.org X 1972 KS Provision of acute hospital care to patients regardless of ability to pay. 12 11 337 138 0 0 1201310 866095 21394702 21432493 250870 139044 420751 413301 23267633 22850933 16500 15980 0 0 12233959 11686614 0 0 0 11160253 12477196 23410712 24179790 -143079 -1328857 20333449 19501937 2665043 1988257 17668406 17513680 To meet our community's need by providing superior health care and exceptional service for each person, every time. 0 0 20707354 15980 21458249 Provision of inpatient and outpatient hospital services. 20707354 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 42 0 1 337 1 0 0 0 0 0 0 0 0 0 0 X 12 11 0 1 1 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Robert Monical President CEO 6202412250 1000 Hospital Drive McPherson KS 674602326 Dean Elliott Trustee 2.00 X 0 0 0 J David Ferrell Trustee 2.00 X 0 0 0 Bill Glazner Chairman 2.00 X X 0 0 0 Tim R Karstetter Trustee 2.00 X 0 0 0 Marsha Silver Secretary 2.00 X X 0 0 0 Paul Taliaferro Vice Chairman 2.00 X X 0 0 0 Brent Wall Trustee 2.00 X 0 0 0 Samuel Claassen Trustee/Physician 40.00 X 190203 0 18821 Craig Harms Trustee 2.00 X 0 0 0 Joan Reichenberger Trustee 2.00 X 0 0 0 Greg Thomas MD Trustee 2.00 X 0 0 0 Dan Lichty MD Trustee 2.00 X 0 0 0 Rob Monical CEO 40.00 X X 0 0 0 George Halama CFO 40.00 X 0 0 0 Tyler G Hughes MD Physician 40.00 X 278564 0 22951 John Worden Pharmacy Director 40.00 X 142215 0 17463 Mary Blankenship Pharmacist 40.00 X 110042 0 5743 Clayton Fetsch Physician 40.00 X 266460 0 24243 Andrea Herrera Physician 40.00 X 126103 0 11068 1113587 0 100289 7 0 1 0 Via Christi Health Inc 8200 E Thorn Wichita KS 67226 Management fees and CEO, CFO & CNO servi 1748890 EMSC LLC 3521 Bayview Ct Wichita KS 67204 ER physician coverage 1349040 Rehabvisions 11623 Arbor St Omaha NE 68144 Physical/occupational therapy 596953 Trimedx LLC PO Box 636129 Cincinnati OH 452636129 Clinical equipment servicer 387621 Shared Medical Services 209 Limestone Pass Cotton Grove WI 53527 Mobile MRI services 250160 10 40578 713939 111578 866095 Net patient service revenue 900099 20662694 20662694 EHR incentive payment 900099 769767 769767 Lab services 621500 32 32 21432493 121093 121093 78586 0 78586 78586 78586 25871 7920 17951 17951 17951 Nonpatient meals 722210 180855 180855 Auxiliary 900099 84102 84102 Fitness center 713940 44002 44002 25756 25756 334715 22850933 21458249 0 526589 15980 15980 241393 241393 9744030 8692586 1051444 231862 206244 25618 738524 659282 79242 730805 653674 77131 1087803 573700 514103 25216 25216 1130315 764760 365555 42293 1179 41114 190496 137184 53312 560988 420741 140247 483277 359993 123284 32410 24289 8121 7527 5244 2283 7518 5600 1918 1436540 1070079 366461 220943 61901 159042 Physician fees 3188033 3097482 90551 Medical supplies 1238068 1238068 Equipment rental & main 1068312 1030283 38029 Pharmacy supplies 873946 873946 883511 573746 309765 24179790 20707354 3472436 0 2154 2483 2787562 3386298 4529288 3274887 555742 480268 215549 184870 28612383 21846349 7974931 6766034 2440002 2720841 1828221 2686256 20333449 19501937 2102174 1844620 440000 122869 143637 2665043 1988257 X 16188012 15064772 574478 1510399 905916 938509 17668406 17513680 20333449 19501937 X -1328857 175497 998634 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 7881 0 0 0 7881 0 Part II-B, Line 1: McPherson Hospital, 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. 1065492 46956 162884 -73602 1190121 957909 41166 149077 -82660 1065492 1001082 12198 19182 -74239 -314 957909 853047 47383 125329 -24677 1001082 513503 300373 43365 -4194 853047 0.09310 0.69870 0.20820 1 1 1 16312 16312 14793524 11004985 3788539 12428895 9688007 2740888 1373652 1153357 220295 6766034 Other receivables 40967 Beneficial interest in net assets of the Foundation 2196673 Goodwill 25952 Estimated third-party payor settlements 422664 2686256 Estimated third-party payor settlements 143637 143637 X 24025064 175497 998634 1174131 22850933 0 22850933 24179790 0 24179790 0 24179790 Part V, Line 4: Donor restricted and board designated funds for special projects and operating purposes. Part X, Line 2: Management is not aware of any uncertainties in income tax positions. Part XI, Line 2d - Other Adjustments: Change in beneficial interest in net assets of the Foundation 998,634. 1 1 1 X 1 X 1 1 1 0 0 664553 151585 512968 0.02120 1584748 1067995 516753 0.02140 2249301 1219580 1029721 0.04260 91362 72487 18875 0.00080 90411 68676 21735 0.00090 4373081 2396442 1976639 0.08170 26034 26034 0.00110 4580888 2537605 2043283 0.08450 6830189 3757185 3073004 0.12710 1 1154775 0 5036637 4905545 131092 X 1 1 1 1 McPherson Hospital Inc 1000 Hospital Drive McPherson KS 67460 X X X McPherson Hospital Inc 1 1 X X X X X X X 12 1 1 1 X http://www.mcphersonhospital.org X X X X X X 0 0 1 1 200.000000000000 1 200.000000000000 1 X X X X 1 1 X X X X X X 1 0 X X X X 1 X 0 0 McPherson Hospital, Inc. Part V, Section B, Line 3: The assessment was achieved through the co-leadership of the director of the McPherson County Health Department. The McPherson County CHNA process included gathering opinions from local sources and quantitative data from secondary sources. A survey instrument was developed by the leadership of the participating hospitals and the public health department. The survey was distributed to individuals throughout the county, representing a broad spectrum of the population and their interests and professional and community endeavors. Included were individuals representing health care, law enforcement, family advocacy, United Way, civic leadership, education, religion, and seniors, among others. A total of 158 surveys were distributed with 106 returned for a 67% return rate. The identified weaknesses through the survey results were reviewed and prioritized by a workgroup comprised of a cross section of survey respondents from throughout the county. This group met to discuss survey results and explore relevant county secondary data from various sources. The workgroup was split into subgroups and asked to rank the top five health issues gleaned from the survey to arrive at a prioritized list. McPherson Hospital, Inc. Part V, Section B, Line 4: The leadership of McPherson Hospital in McPherson, Lindsborg Community Hospital in Lindsborg, Mercy Hospital in Moundridge, and the McPherson County Health Department chose to collaborate in creating the McPherson County CHNA. McPherson Hospital, Inc. Part V, Section B, Line 5d: The link for the CHNA on the Hospital's website is http://www.mcphersonhospital.org/gallery/images/communityhealthneeds.pdf McPherson Hospital, Inc. Part V, Section B, Line 7: The identified needs not addressed specifically were daily life stressors and substance abuse. It is felt that the broad scope of daily life stressors makes it difficult to target a specific area that would have significant impact. However, the strategies outlined in the CHNA implementation strategy could have a positive effect on daily life stress with proper diet and exercise. Substance abuse was not addressed specifically as it is addressed by other organizations in the community and is not within the scope of available resources to affect meaningfully.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:(a) Lunch and Learn Events: Because of the timing of the budget planning process prior to the implementation strategy's completion and due to budget constraints, the lunch and learn events were postponed until fiscal year 2015 with appropriate budget allocations.(b) Speaker's Bureau: This list is currently being compiled and will be available in October of 2014.(c) Radio show: A radio show has aired twice monthly with our pharmacy and lab director and a general surgeon as moderators covering a wide variety of health topics. The show continues in a different format of one show monthly for a half hour each so the time allotted remains the same.(d) "Commit to Get Fit": This local wellness initiative is held early each fall and is currently getting under way with McPherson Hospital as a co-sponsor. As a co-sponsor and through the encouragement of organized teams, it is stressed to the general public the importance of exercise and proper nutrition. Teams are engaged in activities and challenges for healthy eating and exercise.(d) Theraband Classes: These classes are held weekly for senior citizens at no charge, reaching approximately ten or more individuals aged 50 and over.(e) Activities with the Kansas State University Extension Office: The hospital participated in the Walk Kansas event held each spring, providing teams and helping to share information. The SNAP Ed program is operated within the school system and the hospital and the KSU Extension Office are still discussing ways in which the hospital can be an effective partner. A new initiative through a co-sponsorship is expected in the fall of 2014, providing information and activities to elementary school-aged children on health eating habits. The Dining with Diabetes event scheduled in the spring of 2014 was not held due to a lack of interest. Another attempt will be made in the fall of 2014 prior to the holidays.(f) Diabetes support group: The planned activities of the Diabetes Support Group was postponed due to lack of participation and interest. The leadership for this group will continue to assess needs and interest and implement additional activities as warranted in the coming months.(g) Health Risk Analyses: The Corporate Health Services department works regularly with local and area businesses providing information to employees on risk factors for health issues such as heart disease, cancer, obesity and diabetes. Staff members also regularly provide free blood pressure checks at the local YMCA.(h) Corporate Challenge: These activities have been postponed until the Corporate Health Services department is established in a permanent space off of the main hospital grounds. The department will partner with our local industrial development council in creating this initiative in the fall of 2014. (i) Disease Awareness: McPherson Hospital provides significant support locally through a variety of resources, specifically for breast cancer awareness by sponsoring events for area residents to raise awareness and encourage screenings. Also, the hospital is a platinum sponsor for the local Relay for Life event each year for the American Cancer Society, providing resources and leadership to raise awareness and encourage health lifestyles.(j) County health services resource directory: The hospital is currently finalizing with the McPherson County Public Health Department a comprehensive directory that will be made available to the public on websites and at appropriate care agencies throughout the county in the fall of 2014. 1 McPherson Medical & Surgical Associates 1000 Hospital Drive McPherson KS 67460 Physician clinic, family & internal medicine, surgery and hospitlists Part III, Line 4: See Note 3A (page 7) of the audited financial statements regarding the allowance for uncollectible accounts. Part III, Line 8: Amounts were obtained from the cost report filed with Medicare for the period ending June 30, 2014. The total amount of shortfall between Medicare revenue received and relating allowable costs is considered community benefit. Part III, Line 9b: Patients who have qualified for financial assistance are considered qualified for six months. 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 III, Line 3: McPherson Hospital, Inc. is unable to determine the amount of bad debt expense attributable to patients eligible under its charity care policy for the year covered by this return. Suggested methods for estimation were either not in place or proved to be unreliable. For example, the number of financial assistance applications distributed but not returned was not tracked. Using demographic data to estimate an amount did not provide reasonable results. Rather than provide an estimate that cannot be substantiated, McPherson Hospital Inc. has chosen to report zero dollars as bad debt expense attributable to charity care patients. Part III, Line 2: The Hospital's bad debt at cost was determined by applying an overall ratio of cost to charges. Part VI, Line 2: McPherson Hospital, Inc. does not have a formal community needs assessment process, with the exception of the process utilized for the CHNA. Part VI, Line 3: All self-pay patients are screened by a contractor for eligibility under federal, state, or local government programs. Notice of the Hospital's financial assistance program is posted in patient registration areas and on the Hospital's website. The availability of financial assistance is also communicated to patients with the first billing statement and at any time during the collection process if an inability to pay is expressed by the patient/guarantor. Part VI, Line 4: McPherson Hospital, Inc.'s primary service area is McPherson, Kansas, a rural community of approximately 13,000. According to the 2012 census, the per capita income for McPherson was $28,113. The percent of families below poverty level was 4.6. The percent of individuals below poverty level was 8.5. For the year ending June 30, 2014, 10 percent of the Hospital's inpatient admissions were Medicaid recipients and 5 percent were uninsured. Larger hospitals in Hutchinson, Salina, and Newton also provide services to the residents of McPherson. The distances between these facilities and McPherson Hospital, Inc. are approximately 23, 29, and 28 miles respectively. There are no federally-designated medically underserved areas or populations in McPherson. Part VI, Line 5: McPherson Hospital, Inc.'s governing body is comprised of individuals who reside in the primary service area. All Board members, with the exception of the CEO and one physician, are not employed by the Hospital. Annually, all trustees sign a conflict of interest statement and disclose any potential conflicts of interest. With limited exceptions for hospital-based services, the Hospital extends medical staff privileges to all qualified physicians in the community. Surplus funds are used by the Hospital to update facilities and equipment, recruit needed physicians and staff, and otherwise improve patient care. 1 Scholarship awards for local students pursuing education in the health care industry. 16 15980 Part I, Line 2: Scholarship checks are not provided to students until verification is received from the school that the student has begun classes. X X X 0 0 0 0 0 0 0 0 0 Samuel Claassen Trustee/Physician 183703 0 6500 0 0 0 9288 0 9533 0 209024 0 0 0 Tyler G Hughes MD Physician 278564 0 0 0 0 0 13026 0 9925 0 301515 0 0 0 John Worden Pharmacy Director 142215 0 0 0 0 0 6842 0 10621 0 159678 0 0 0 Clayton Fetsch Physician 265799 0 661 0 0 0 13026 0 11217 0 290703 0 0 0 Form 990, Part VI, Section A, line 3 The Hospital entered into a management agreement with Via Christi Health, Inc. (Via Christi) on January 1, 2011. Under the agreement, Via Christi is responsible for the daily management and administration of the Hospital, including the employment of the CEO, CFO, and CNO (effective April 2014). For the calendar year of 2013, McPherson Hospital reimbursed Via Christi $202,016 for Robert Monical, CEO's salary and benefits and $120,750 for George Halama, CFO's salary and benefits. Form 990, Part VI, Section A, line 4 The bylaws were amended May 5, 2014, which changed the board meetings from monthly to bimonthly. Form 990, Part VI, Section A, line 6 Organization's sole member is MACCO Healthcare, Inc. Form 990, Part VI, Section A, line 7a MACCO Healthcare, Inc. approves members of the governing body of McPherson Hospital, Inc. Form 990, Part VI, Section B, line 11 A copy of the Form 990 is provided to members of the organization's Finance Committee with an opportunity to comment or ask questions prior to filing. Form 990, Part VI, Section B, line 12c The conflict of interest policy is reviewed annually by the governing body. Updated individual disclosure forms are also required annually. Form 990, Part VI, Section B, line 15 Organization participates annually in salary surveys sponsored by the State Hospital Association and uses MGMA and other national references in establishing physician compensation. Terms of employment contracts are approved by the governing body. 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 net assets of Foundation 998,634. FORM 990 PART XI, LINE 2C: The Finance Committee reviews the audit prior to submitting to the Board. MACCO Healthcare Inc 1000 Hospital Drive McPherson KS 67460 481059194 Sole Member of McPherson Hopsital, Inc. and McPherson Healthcare Fdn, Inc. KS 501(c)(3) Line 7 0 McPherson Healthcare Foundation Inc 1016 N Main McPherson KS 67460 481043952 Raise funds to support the operation of McPherson Hopsital, Inc. KS 501(c)(3) Line 7 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 McPherson Healthcare Foundation Inc C 40578