2015-11-16T11:48:07-06:00 2014-12-31 BKD LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2014-01-01 481155548 MIAMI COUNTY MEDICAL CENTER INC % TIERNEY L GRASSER MIAM 9137914461 2100 BAPTISTE DRIVE PAOLA KS 66071 TIERNEY L GRASSER SENIOR VP/FINANCE 9137914461 2015-11-15 true Michael J Engle P00482834 8162216300 2014 2016-04-25 22:37:26Z TIERNEY L GRASSER 20333 W 151ST STREET OLATHE KS 66061 26803571 false X WWW.OLATHEHEALTH.ORG X 1994 KS TO IMPROVE THE HEALTH OF ALL INDIVIDUALS IN THE COMMUNITIES WE SERVE BY PROVIDING COMPASSIONATE, QUALITY HEALTHCARE IN AN ENVIRONMENT OF TRUST AND COLLABORATION. 5 5 176 25 0 0 12681 19912 19722005 20948491 1047538 3156005 35184 31205 20817408 24155613 50874 84915 0 0 9399234 9714353 0 0 0 9822944 10389041 19273052 20188309 1544356 3967304 54395788 58431306 6263791 6603556 48131997 51827750 X MIAMI COUNTY MEDICAL CENTER, INC. IS FOCUSED ON IMPROVING THE HEALTH OF ALL INDIVIDUALS IN THE COMMUNITIES WE SERVE BY PROVIDING COMPASSIONATE, QUALITY HEALTHCARE IN AN ENVIRONMENT OF TRUST AND COLLABORATION. false false 16344949 84915 20948491 SEE SCHEDULE O 16344949 true true false true false false false false false true true true false false true false false true false false false false false false false false true true true false true true false false false false false false false false true false false false false false false true true true false false true 22 0 true 176 true false false false false false false false false false false X 5 5 true false false false true true true true true false false true true true true true true true true false KS X X TIERNEY L GRASSER 9137914461 20333 W 151ST STREET OLATHE KS 66061 JACK TINNEL TRUSTEE/CHAIRPERSON 2.0 1.0 X X 0 0 0 DENISE GERMAN TRUSTEE/VICE CHAIRPERSON 1.0 0.0 X X 0 0 0 STEVE MILLER TRUSTEE/SECRETARY/TREASURER 1.0 0.0 X X 0 0 0 JOE MORELAND TRUSTEE 1.0 0.0 X 0 0 0 CHIP WOOD TRUSTEE 1.0 6.0 X 0 0 0 FRANK H DEVOCELLE PRESIDENT/CEO 7.0 43.0 X 0 933462 20521 TIERNEY L GRASSER SVP/CHIEF FINANCIAL OFFICER 9.0 41.0 X 0 437647 89768 CHERYL L ROSS ASSISTANT SECRETARY 2.0 43.0 X 0 122921 14804 PAUL W LUCE VP/CHIEF OPERATING OFFICER 45.0 0.0 X 151935 0 25769 STACEY GRAY PHARMACY DIRECTOR 45.0 0.0 X 125005 0 15430 TERESA LEVIN NURSE MANAGER- SURGERY 45.0 0.0 X 102076 0 9143 379016 1494030 175435 3 false true false SW KS EMERGENCY PHYSICIANS LLP ER PHYSICIAN SERVICE 1841654 MCCONNELL ASSOCIATES CONSTRUCTION 337724 DE MINT ANESTHESIA ANESTHESIA SERVICES 331327 SHARED MEDICAL SERVICES MRI SERVICES 292064 STRICKLAND CONSTRUCTION CO CONSTRUCTION 188751 8 19063 849 19912 Net Patient Service Revenue 900099 19983573 19983573 EMR Revenue 900099 964918 964918 20948491 1405677 1405677 0 0 84382 156851 -72469 0 -72469 -72469 4241435 2491107 1750328 1750328 1750328 0 0 0 Puchase Discounts 900099 13119 13119 Cafeteria 722210 22302 22302 ALL OTHER REVENUE 900099 68253 68253 68253 68253 103674 24155613 20948491 3187210 80165 80165 4750 4750 0 0 170298 131751 38547 43628 33753 9875 7761335 6004533 1756802 142800 110477 32323 1091895 844741 247154 504397 390225 114172 0 32296 32296 37010 37010 4910 4910 0 16424 16424 3684547 3276048 408499 0 91106 91106 785747 194129 591618 0 0 424756 363610 61146 14204 5571 8633 0 0 189517 162984 26533 0 957203 823189 134014 167037 143651 23386 Bad Debt Expense 1733198 1733198 Medical Supplies 1911357 1911283 74 Medicaid Assessment 71942 71942 Dues & Subscriptions 41728 14831 26897 226059 44118 181941 20188309 16344949 3843360 0 1411355 2118747 0 0 0 0 2726245 2720868 0 0 0 0 0 0 780833 770589 291513 221623 23977811 18666307 5401007 5311504 39198750 42959590 4078795 3890014 0 0 0 0 507290 438371 54395788 58431306 1626810 1690956 0 0 0 0 4343945 3925666 0 0 0 0 0 0 0 0 293036 986934 6263791 6603556 X 48112844 51820140 19153 7610 0 0 48131997 51827750 54395788 58431306 X 3967304 -266464 -5087 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 4910 false false 4910 false SCHEDULE C, PART II-B, LINE 1G THE LOBBYING EXPENDITURES ARE THE PORTION OF HOSPITAL ASSOCIATION DUES THAT RELATE TO LOBBYING. 42519913 700000 2867243 11542 46075614 34895600 681000 6961043 17730 42519913 29762822 670994 4469234 7450 34895600 29909183 401968 -522248 26081 29762822 24241897 2406369 3273465 12548 29909183 0.99990 0.00010 false false 1475439 1475439 10667018 9220843 1446175 11054121 9013155 2040966 781233 432309 348924 5311504 INVESTMENT IN SSGA 3890014 F 3890014 0 DUE TO AFFILIATES 986934 986934 316788654 -266464 294649127 294382663 22405991 16424 1733198 1749622 24155613 282592211 264153524 264153524 18438687 16424 1733198 1749622 20188309 SCHEDULE D, PART V, LINE 4 THE ENDOWMENT FUNDS ARE HELD FOR FUTURE CAPITAL AND EXPANSION NEEDS. IN ADDITION, THE FUNDS ALSO REPRESENT RESERVES FOR OPERATING NEEDS TO REMAIN FINANCIALLY STABLE. SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINES 2D & 4B LINE 2D: RELATED ORGANIZATIONS' REVENUE $294,492,276 RENTAL EXPENSES $ 156,851 ------------ TOTAL $294,649,127 LINE 4B: BAD DEBT EXPENSE $ 1,733,198 SCHEDULE D, PART XII, LINES 2D & 4B LINE 2D: RELATED ORGANIZATIONS' EXPENSES $263,996,673 RENTAL EXPENSES $ 156,851 ------------ TOTAL $264,513,524 LINE 4B: BAD DEBT EXPENSE $ 1,733,198 true true true X true X true true false true true 608559 608559 0.03300 2322845 735734 1587111 0.08600 2931404 735734 2195670 0.11900 7 279 17891 171 17720 0.00100 6 48 276843 276843 0.01500 75 17682 17682 0.00100 13 402 312416 171 312245 0.01700 13 402 3243820 735905 2507915 0.13600 2 493 493 2 4035 4035 0.00020 4 4528 4528 0.00020 true 642082 165000 5928925 8227690 -2298765 X true true 1 1 MIAMI COUNTY MEDICAL CENTER INC 2100 BAPTISTE DRIVE PAOLA KS 66071 WWW.OLATHEHEALTH.ORG H-061-001 X X X MIAMI COUNTY MEDICAL CENTER 1 false false true X X X X X X X X 13 true false false true X WWW.OLATHEHEALTH.ORG X true 14 true WWW.OLATHEHEALTH.ORG false false true X 200. 300. X X X X true true X X X true X X X X X X X X X X X true X false X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, MIAMI COUNTY MEDICAL CENTER CONDUCTED A TOWN HALL MEETING ON THURSDAY, NOVEMBER 1, 2012. THE COMMUNITY MEMBERS INVITED TO THIS TOWN HALL REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING INDIVIDUALS WITH SPECIAL KNOWLEDGE AND EXPERTISE IN PUBLIC HEALTH. THIS INCLUDES PEOPLE REPRESENTING THE FOLLOWING GROUPS: LOCAL HOSPITAL, PUBLIC HEALTH COMMUNITY, MENTAL HEALTH COMMUNITY, FREE CLINICS, COMMUNITY-BASED CLINICS, SERVICE PROVIDERS, LOCAL RESIDENTS, COMMUNITY LEADERS, OPINIONLEADERS, 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. SECTION V OF THE CHNA PROVIDES A LIST OF THE TOWN HALL ATTENDEES AND NOTES FROM THE MEETING. ALL PRIORITY-SETTING AND SCORING PROCESSES AT THE TOWN HALL MEETING INVOLVED THE INPUT OF KEY STAKEHOLDERS IN ATTENDANCE. THE MEETING INCLUDED A DISCUSSION OF COMMUNITY HEALTH DATA; REFLECTION ON SIZE AND SERIOUSNESS OF ANY HEALTH CONCERNS; AND DISCUSSION OF CURRENT COMMUNITY HEALTH STRENGTHS. PARTICIPANTS WERE THEN ASKED TO RANK THE COMMUNITY HEALTH CONCERNS CITED DURING THE MEETING AND FROM THE PRIMARY AND SECONDARY RESEARCH ALREADY COMPLETED. (PRIMARY RESEARCH SURVEY WAS CONDUCTED DURING SEPTEMBER-NOVEMBER 2012 BY ETC INSTITUTE ON BEHALF OF OLATHE HEALTH SYSTEM.) SCHEDULE H, PART V, SECTION B, LINE 11 In the fall of 2013, MCMCI developed a Community Health Improvement Plan to address the top health-need priorities that were identified through the assessment described above. It was approved by the MCMCI Board of Trustees in October 2013. This is a three-year plan, which began implementation in 2014. It speaks to each health need priority, outlining MCMCI's initiative(s) to address the need and the anticipated community impact. You can read the full Community Health Needs Assessment and Community Health Improvement Plan documents on our website at www.olathehealth.org/community. SCHEDULE H, PART V, SECTION B, LINE 13B WHEN ANNUAL HOUSEHOLD INCOME IS MORE THAN 300% OF THE FEDERAL POVERTY GUIDELINES, INDIVIDUALS WITH EXTRAORDINARY MEDICAL EXPENSES MAY BE ELIGIBLE, ON A CASE BY CASE BASIS, FOR A FINANCIAL ASSISTANCE DISCOUNT OR EXTENDED PAYMENT ARRANGEMENTS. SCHEDULE H, PART V, SECTION B, LINE 22D THE HOSPITAL UTILIZED THE LOOK BACK METHOD FOR ALL INSURANCE COMPANIES TO DETERMINE THE MAXIMUM AMOUNT THAT COULD BE CHARGED. 2 LOUISBURG REHAB OF MIAMI CTY MEDICAL CTR 102 W CRESTVIEW CIRCLE LOUISBURG KS 66053 OUTPATIENT REHABILITATION CLINIC OSAWATOMIE REHAB OF MIAMI CTY MED CENTER 539 MAIN STREET OSAWATOMIE KS 66064 OUTPATIENT REHABILITATION CLINIC SCHEDULE H, PART I, LINE 7, COLUMN F THE BAD DEBT EXPENSE IS NOT CONSIDERED A COMMUNITY BENEFIT EXPENSE AND IS NOT INCLUDED IN SCHEDULE H, PART I, LINE 7. THE AMOUNT EXCLUDED IS $1,733,198. SCHEDULE H, PART I, LINE 7 THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART I, LINE 7, OF SCHEDULE H, IS A COST ACCOUNTING SYSTEM. SCHEDULE H, PART II MIAMI COUNTY MEDICAL CENTER, INC. (MCMCI) IS COMMITTED TO IMPROVING THE COMMUNITY WE SERVE. OUR EMPLOYEES ARE INVOLVED IN A VARIETY OF ACTIVITIES IN OUR COMMUNITY THAT SUPPORT THE GENERAL ECONOMIC IMPROVEMENT OF OUR COMMUNITY; THE HEALTH, WELL BEING AND SAFETY OF OUR AREA'S RESIDENTS; AS WELL AS SUPPORTING PROGRAMS AND OTHER ORGANIZATIONS THAT REACH OUT TO OUR CITIZENS IN NEED. A FEW EXAMPLES OF MCMCI'S INVOLVEMENT IN 2014 INCLUDE: 1) INVOLVEMENT IN THE MIAMI COUNTY ECONOMIC DEVELOPMENT ADVISORY BOARD AND LOCAL CIVIC ORGANIZATIONS. 2) OUR SUPPORT OF JOHNSON COUNTY HEALTH PARTNERSHIPS, A CLINIC SERVING THE UNINSURED OF OUR COMMUNITY. 3) PARTICIPATION IN COMMUNITY ORGANIZATIONS AND EVENTS THROUGH DONATIONS AND BY PROVIDING HEALTH EDUCATION AND SERVICES. SOME OF THESE GROUPS INCLUDE BOYS SCOUTS OF AMERICA, MIAMI COUNTY CANCER FOUNDATION, MIAMI AND LINN COUNTY FAIRS, LOCAL CHAMBERS AND ROTARY CLUBS. 4) LEADERSHIP AND PARTICIPATION IN OUR AREA'S EMERGENCY PREPAREDNESS EFFORT BY COORDINATING EXTENSIVE DRILLS TO PRACTICE OUR RESPONSE TO POTENTIAL SITUATIONS. 5) PARTICIPATION IN THE PAOLA PATHWAYS ORGANIZATION, A GROUP WHO IS DEVELOPING WALKING/BICYCLING TRAILS IN AND AROUND PAOLA, AND THE MOUND CITY TRAIL PROJECT. SCHEDULE H, PART III, SECTION A, LINE 2 THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART III, LINE 2, OF SCHEDULE H, IS A COST ACCOUNTING SYSTEM. SCHEDULE H, PART III, SECTION A, LINE 4 SEE PAGE 9 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION B, LINE 8 MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST ACCOUNTING SYSTEM. SHORTFALLS ARISE FROM PAYMENTS THAT ARE LESS THAN THE COSTS TO PROVIDE THE SERVICES. WE ACCEPT ALL MEDICARE PATIENTS KNOWING THAT THE COST OF PROVIDING THE CARE MAY EXCEED THE PAYMENT WE RECEIVE FROM THE MEDICARE PROGRAM. THE SHORTFALL SHOULD BE CONSIDERED COMMUNITY BENEFIT AS MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. IT IS ALSO IMPLIED IN INTERNAL REVENUE SERVICE RULING 69-545 THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. REVENUE RULING 69-545 ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR TAX-EXEMPT HOSPITALS AND INDICATES THAT PARTICIPATION IN PUBLICLY-FINANCED PROGRAMS, SUCH AS MEDICARE, IS EVIDENCE THAT A HOSPITAL MEETS THE COMMUNITY BENEFIT STANDARD. SCHEDULE H, PART III, SECTION C, LINE 9B BEFORE PLACEMENT WITH COLLECTION AGENCIES, MCMCI PATIENT FINANCIAL SERVICES OFFERS VARIOUS OPTIONS FOR PATIENTS WITH FINANCIAL DIFFICULTIES. IN ADDITION TO OFFERING OUR OWN FINANCIAL ASSISTANCE TO QUALIFYING INDIVIDUALS, MCMCI CONTRACTS WITH AN AGENCY THAT SCREENS INDIVIDUALS FOR ELIGIBILITY FOR PROGRAMS LIKE MEDICAID, DISABILITY, AND CRIME VICTIM'S COMPENSATION AND THEN HELPS THEM THROUGH THE APPLICATION PROCESS. THE USE OF PROPENSITY TO PAY SOFTWARE ALSO HELPS MCMCI IDENTIFY INDIVIDUALS THAT MAY NEED ASSISTANCE THAT HAVE NOT COMPLETED AN APPLICATION. MCMCI HAS LANGUAGE WRITTEN IN THIR COLLECTION AGENCY CONTRACT THAT STATES, "IF THE COLLECTION AGENCY LEARNS A PATIENT/DEBTOR HAS NEITHER SUFFICIENT INCOME NOR ASSETS TO MEET HIS FINANCIAL OBLIGATION, THE AGENCY WILL NOT PURSUE COLLECTION ACTIVITIES AGAINST THE PATIENT/DEBTOR, UNLESS OR UNTIL THE AGENCY LEARNS THAT THE PATIENT/DEBTOR HAS INCOME OR ASSETS TO MEET THE OBLIGATION." IF THE COLLECTION AGENCY IS NOTIFIED BY THE PATIENT/DEBTOR THAT THIS CREATES AN UNDUE FINANCIAL HARDSHIP OR BURDEN DUE TO A CHANGE IN THEIR INCOME OR ASSETS, THE AGENCY WILL NOTIFY MCMCI AND AWAIT FURTHER DIRECTION FROM THE HOSPITAL. SCHEDULE H, PART VI, LINE 2 Miami County Medical Center, Inc. (MCMCI) is continually assessing the health needs of the communities it serves in a variety of ways. Informally, MCMCI is involved in multiple health fairs and other community outreach activities that involve screenings, questionnaires and general conversation that help us understand the needs of groups and individuals. The MCMCI community advisory group is represented by a diverse set of individuals who provide helpful input from the organizations and communities they represent. SCHEDULE H, PART VI, LINE 3 PATIENTS OF MIAMI COUNTY MEDICAL CENTER, INC. (MCMCI) ARE MADE AWARE OF ALL OPPORTUNITIES AVAILABLE FOR FINANCIAL ASSISTANCE IN A VARIETY OF WAYS. THERE ARE SIGNS IN THE REGISTRATION AREAS TO NOTIFY PATIENTS AND VISITORS OF THE AVAILABILITY OF ASSISTANCE PROGRAMS. EVERY BILLING STATEMENT CONTAINS A NOTICE OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AND HOW TO OBTAIN ADDITIONAL INFORMATION OR APPLY. APPLICATIONS AND INSTRUCTIONS ARE AVAILABLE ON THE MEDICAL CENTER'S WEBSITE, IN BOTH ENGLISH AND SPANISH. PATIENT ACCESS, PATIENT FINANCIAL SERVICES AND SOCIAL WORKERS ARE TRAINED TO PROVIDE APPLICATIONS TO PATIENTS IF THEY EXPRESS ANY CONCERN REGARDING ABILITY TO PAY FOR SERVICES, OR MAY BE REFERRED TO AN AGENCY THE MEDICAL CENTER CONTRACTS WITH TO HELP INDIVIDUALS THROUGH THE APPLICATION PROCESS FOR PROGRAMS LIKE MEDICAID AND DISABILITY. PATIENTS THAT CALL OUR PATIENT FINANCIAL SERVICES DEPARTMENT EXPRESSING CONCERNS ABOUT BEING ABLE TO PAY FOR THEIR SERVICES OR EXPRESS THAT THEY ARE EXPERIENCING A FINANCIAL HARDSHIP ARE ADVISED OF OUR ASSISTANCE POLICY AND ENCOURAGED TO APPLY. SCHEDULE H, PART VI, LINE 4 Miami County Medical Center, Inc. (MCMCI) serves the people of Miami and Linn Counties in Kansas. Miami and Linn Counties are both located in rural areas of the state of Kansas and are both federally designated medically underserved areas of Kansas. MCMC is the only hospital in these two counties. However, there are several other hospitals located in nearby metropolitan areas, including Olathe and Overland Park, Kansas, and Kansas City, Missouri. In addition to the general health care services provided by the hospital and its associated physicians, MCMCI serves a diverse population of mentally disabled patients. The Osawatomie State Hospital, Lake Mary Center, Medicalodge of Paola and the Tri-Ko are all organizations located in the service area. MCMCI supports each of these organizations by providing medical care to their residents. Below is a listing of economic levels for area residents. Time period: 2009 - 2013 Source: factfinder.census.gov People Living Below Poverty Level Miami 9.5% Linn County: 12.9% Young Children Living Below Poverty Level Miami County: 15.0% Linn County: 16.9% Uninsured Adult Population Rate (2013) Miami County: 13.4% Linn County: 19.6% SCHEDULE H, PART VI, LINE 5 In addition to the items listed above, Miami County Medical Center takes a very active role in support of local, regional and national not-for-profit organizations with a focus on improving health and supporting those in need. MCMCI provides support financially and through volunteering time and talents to multiple area organizations. MCMCI provides athletic trainers to area school sports programs. MCMCI staff members are involved in several health fairs and/or community screenings each year. The community health fairs are organized in conjunction with a variety of other area agencies, such as: Miami County Emergency Medical Services, local school districts, county agencies and several others. SCHEDULE H, PART VI, LINE 6 MIAMI COUNTY MEDICAL CENTER IS A PART OF OLATHE HEALTH SYSTEM, INC. (OHSI) THIS CONSISTS OF TWO HOSPITALS AND A NETWORK OF 38 CLINICS. OHSI AND ITS AFFILIATES, INCLUDING MIAMI COUNTY MEDICAL CENTER, TAKE A LEADERSHIP ROLE IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED. OHSI HOSPITALS AND CLINICS ARE VERY INVOLVED WITH COMMUNITY OUTREACH EDUCATION AND SCREENING PROGRAMS ACROSS THE ENTIRE SERVICE AREA. WE COLLABORATE WITH AREA COMPANIES AND OTHER HEALTH-RELATED SERVICE PROVIDERS TO PROVIDE EDUCATION AND SCREENINGS TO THE PUBLIC. OHSI POSITIONS ITSELF AS NOT ONLY A PROVIDER OF CARE, BUT A RESOURCE FOR EDUCATION AND PREVENTION. SCHEDULE H, PART VI, LINE 7 MCMCI IS NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT WITH THE STATE, BUT WE MAKE OUR REPORT AVAILABLE TO ANYONE INTERESTED AT WWW.OLATHEHEALTH.ORG. true PAOLA USD # 368 PO BOX 268 PAOLA KS 66071 480720746 GOVERNMENT 10662 BOOK SPORTS MEDICINE COMMUNITY WELLNESS SPRING HILL USD # 230 101 E SOUTH ST SPRING HILL KS 66083 480723504 GOVERNMENT 22778 BOOK SPORTS MEDICINE COMMUNITY WELLNESS OSAWATOMIE USD # 367 1200 TROJAN DRIVE OSAWATOMIE KS 66064 480723504 GOVERNMENT 10662 BOOK SPORTS MEDICINE COMMUNITY WELLNESS LAKEMARY CENTER 100 LAKEMARY DR PAOLA KS 66071 237423516 501(C)(3) 7500 COMMUNITY WELLNESS 4 SCHEDULE I, PART II MIAMI COUNTY MEDICAL CENTER, INC. PROVIDED SPORTS TRAINERS TO LOCAL HIGH SCHOOLS IN ADDITION TO PROVIDING FUNDS TO ALLOW THE PURCHASE OF DEFIBRILLATORS FOR EASY ACCESS AT SCHOOL SPORTING EVENTS. MIAMI COUNTY MEDICAL CENTER ALSO PROVIDED FUNDS FOR LAKEMARY CENTER, A NOT-FOR-PROFIT LOCATED IN PAOLA WHO PROVIDE CARE FOR DEVELOPMENTALLY DISABLED ADULTS TO BUILD A CLIMBING WALL TO PROVIDE EXERCISE FOR THEIR CLIENTS. SCHEDULE I, PART III FOR ALL SCHOLARSHIPS, THE ORGANIZATION CAREFULLY SELECTS THE RECIPIENTS OF THE FUNDS AND A CHECK IS WRITTEN DIRECTLY TO THE UNIVERSITY ON BEHALF OF THE INDIVIDUAL SELECTED. false true false false false false false false false FRANK H DEVOCELLE PRESIDENT/CEO 0 764417 0 132909 0 36136 0 0 0 20521 0 953983 0 0 TIERNEY L GRASSER SVP/CHIEF FINANCIAL OFFICER 0 362124 0 47215 0 28308 0 63214 0 26554 0 527415 0 16662 PAUL W LUCE VP/CHIEF OPERATING OFFICER 138154 0 10000 0 3781 0 2500 0 23269 0 177704 0 0 0 FORM 990, PART VII; SCHEDULE J, PART I, LINE 3 AND PART II THE COMPENSATION REPORTED FOR PAUL LUCE WAS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF OLATHE MEDICAL CENTER, INC. THE SOLE MEMBER OF MIAMI COUNTY MEDICAL CENTER INC. THE COMPENSATION COMMITTEE IS COMPRISED OF INDEPENDENT BOARD MEMBERS, WHICH INCLUDES A BOARD MEMBER FROM MIAMI COUNTY MEDICAL CENTER, INC. THE COMMITTEE UTILIZED AN INDEPENDENT COMPENSATION CONSULTANT AND THIRD PARTY SALARY SURVEYS IN THE ESTABLISHMENT OF MR. LUCE'S COMPENSATION. FORM 990, PART VII; SCHEDULE J, PART I, LINE 3 AND PART II THE COMPENSATION BEING REPORTED FOR FRANK H DEVOCELLE AND TIERNEY L GRASSER IS FROM OLATHE MEDICAL CENTER, INC., A RELATED TAX EXEMPT ORGANIZATION AND THE SOLE MEMBER OF MIAMI COUNTY MEDICAL CENTER, INC. OLATHE MEDICAL CENTER, INC. USES A COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT BOARD MEMBERS TO ESTABLISH AND APPROVE COMPENSATION AND BENEFITS FOR ALL OFFICERS OF OLATHE MEDICAL CENTER, INC. AND ITS AFFILIATED CORPORATIONS. THE COMMITTEE UTILIZED AN INDEPENDENT COMPENSATION CONSULTANT, A WRITTEN CONTRACT FOR THE CEO AND COMPENSATION SURVEYS TO ESTABLISH FAIR MARKET VALUE SALARIES AND BENEFITS FOR OLATHE MEDICAL CENTER, INC. AND ITS AFFILIATES' OFFICERS. SCHEDULE J, PART I, LINE 4B & PART II A SERP IS PROVIDED TO TIERNEY L GRASSER, SENIOR VICE PRESIDENT/FINANCE WHICH IS FUNDED OVER A SHORT TIME PERIOD BASED UPON THE IMPLEMENTATION DATE OF THE SERP IN 2005. MS. GRASSER'S CAREER SERVICE AT OLATHE MEDICAL CENTER, INC. AND ITS AFFILIATED ENTITIES IS CURRENTLY AT 26 YEARS, MOST OF WHICH DID NOT INCLUDE FUNDING FOR THE SERP BENEFIT. A MAJORITY OF THE DEFERRED COMPENSATION IS DUE TO FUNDING OF THE SERP BENEFIT FOR PRIOR YEARS OF SERVICE. IN 2014, THERE WAS A PAYOUT OF $20,716 AND AN ACCRUAL OF $63,214. A CITY OF OLATHE KANSAS 486034756 679390GX6 2008-02-27 5311403 SEE PART VI false false false A 1340000 0 5311403 0 0 0 22313 0 0 0 5289091 0 1996 true false true true A 0 A false true false false 0 false 0 false true A true SCHEDULE K, PART I, LINE A, COLUMN E THE ISSUE PRICE OF THE ENTIRE ISSUE IS $29,451,544. A PORTION OF THE ISSUE PRICE, EQUAL TO $24,140,141 IS ALLOCABLE TO OLATHE MEDICAL CENTER, INC. THE REMAINDER OF THE ISSUE PRICE, EQUAL TO $5,311,403, IS ALLOCABLE TO MIAMI COUNTY MEDICAL CENTER, INC., WHICH IS CONTROLLED BY OLATHE MEDICAL CENTER, INC., ITS SOLE MEMBER. SCHEDULE K, PART I, LINE A, COLUMN F REFUND SERIES 2004A BONDS ISSUED 07/29/2004 AND REFUND SERIES 2004B BONDS ISSUED 07/29/2004. SCHEDULE K, PART III THIS SECTION IS NOT COMPLETED FOR THE 2008B BONDS BECAUSE THE PORTION OF THE 2008B BONDS ALLOCABLE TO MIAMI COUNTY MEDICAL CENTER WAS USED TO REFINANCE PROJECTS ORIGINALLY FINANCED BY BONDS ISSUED PRIOR TO JANUARY 1, 2003. HEIDI HANSON DAUGHTER OF OFFICER 46128 SALARY false ROBIN LUCE SPOUSE OF OFFICER 13562 SALARY false SCHEDULE L, PART IV HEIDI HANSON IS THE DAUGHTER OF FRANK H DEVOCELLE, AN OFFICER OF MCMCI HEIDI HANSON IS AN EMPLOYEE OF MCMCI. ROBYN LUCE IS THE SPOUSE OF PAUL LUCE, AN OFFICER OF MCMCI. ROBYN LUCE IS AN EMPLOYEE OF MCMCI. FORM 990, PART III, LINE 4A MIAMI COUNTY MEDICAL CENTER, INC. OPERATES AN ACUTE CARE HOSPITAL IN Paola, Kansas. Miami County Medical Center, Inc. carries out its mission by providing quality and compassionate inpatient, outpatient, and emergency care services to residents in Miami County, Kansas and surrounding area. Miami County Medical Center, Inc. is a Joint Commission accredited hospital and is licensed for 39 beds and currently staffs 18 inpatient beds. Program services expenses are all related to the provision of healthcare services. In 2014, Miami County Medical Center, Inc. provided 1,201 days of inpatient care, provided 53,383 outpatient procedures, and 9,412 emergency visits to the community. Educational Support In addition to providing uncompensated care for patients in need, the Medical Center provides other health care related benefits to the communities it serves by providing 24-hour emergency rooms open every day to the public regardless of ability to pay. The Medical Center also provides education for a variety of medical professionals, health care screenings and education programs for the general public and support group sponsorships. Sports Net Miami County Medical Center provides Athletic Training staff for area high schools and junior high schools during the school year through its Sports Net program. In 2014, $44,102 of Athletic Trainer services was provided to the schools in the Medical Center's service area. Contributions Miami County Medical Center supports a variety of social, education, and civic healthcare related organizations within its service area. In 2014, $36,063 was contributed to various agencies and charitable organizations and $4,750 in scholarships. FORM 990, PART VI, SECTION A, LINE 2 FRANK H DEVOCELLE AND TIERNEY L GRASSER HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER. THEY SERVE AS AN OFFICER OR DIRECTOR FOR RELATED FOR PROFIT COMPANIES. CHIP WOOD, FRANK H DEVOCELLE, TIERNEY L GRASSER, AND CHERYL ROSS HAVE A BUSINESS RELATIONSHIP. THE BUSINESS RELATIONSHIP IS AN EMPLOYER/EMPLOYEE RELATIONSHIP, WHERE CHIP WOOD IS A BOARD MEMBER OF OLATHE MEDICAL CENTER, INC. AND FRANK DEVOCELLE, TIERNEY GRASSER, AND CHERYL ROSS ARE EMPLOYED BY OLATHE MEDICAL CENTER, INC. FORM 990, PART VI, SECTION A, LINE 6 OLATHE MEDICAL CENTER, INC., A NOT-FOR-PROFIT, 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF MIAMI COUNTY MEDICAL CENTER, INC. FORM 990, PART VI, SECTION A, LINE 7A OLATHE MEDICAL CENTER, INC. BEING THE SOLE MEMBER OF MIAMI COUNTY MEDICAL CENTER, INC. HAS THE RIGHT TO ELECT ALL THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 7B OLATHE MEDICAL CENTER, INC. IS THE SOLE MEMBER, AND HAS THE RIGHTS TO APPROVE MIAMI COUNTY MEDICAL CENTER, INC.'S BYLAWS AND ARTICLES OF INCORPORATION AND ALSO APPROVE MIAMI COUNTY MEDICAL CENTER'S BOARD MEMBERS AND CERTAIN CAPITAL EXPENDITURES. FORM 990, PART VI, SECTION B, LINE 11B The tax return form 990 is reviewed by the audit and compliaance committee of the Olathe Medical Center, Inc. (Miami County Medical Center's sole member) board on behalf of all of its affiliates prior to filing the return with the Internal Revenue Service. The Audit & Compliance Committee is comprised of independent Board members of Olathe Medical Center, Inc. The final form 990 with all required schedules is then provided to all board members for review prior to filing the form 990. FORM 990, PART VI, SECTION B, LINE 12c THE PURPOSE OF THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS TO PROTECT THE ORGANIZATION'S INTEREST WHEN IT IS CONTEMPLATING A DECISION OR ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF ANY PERSON IN A POSITION OF AUTHORITY OVER THE ORGANIZATION, OR MIGHT RESULT IN A POSSIBLE EXCESS BENEFIT TRANSACTION. CORPORATE OFFICERS AND MEMBERS OF THE BOARD OF TRUSTEES REVIEW THE CONFLICT OF INTEREST POLICY AND COMPLETE A DISCLOSURE OF INFORMATION FORM ANNUALLY. A SUMMARY OF THE ANNUAL DISCLOSURES OF INFORMATION IS PROVIDED TO THE FULL BOARD FOR REVIEW AT LEAST ONE TIME PER YEAR. THE CONFLICT OF INTEREST POLICY CALLS FOR ANY INTERESTED PERSON TO DISCLOSE THE EXISTENCE OF A FINANCIAL RELATIONSHIP OR COMPETITIVE INTEREST IN CONNECTION WITH ANY PENDING TRANSACTION OR ARRANGEMENT. THE INDIVIDUAL IS GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE TRUSTEES CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT THAT GAVE RISE TO THE DISCLOSURE. WHEN A TRANSACTION INVOLVES AN INTERESTED PARTY, THE FOLLOWING PROCEDURES ARE FOLLOWED: 1. THE INTERESTED PARTY LEAVES THE MEETING AFTER PROVIDING ANY MATERIAL FACTS OR DISCUSSION REGARDING THE MATTER THAT GIVES RISE TO THE INTEREST UNLESS REQUESTED TO STAY BY THE REMAINING BOARD OR COMMITTEE MEMBERS. 2. IF APPROPRIATE, THE BOARD MAY APPOINT A NON-INTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION; 3. THE INTERESTED TRUSTEE MAY NOT VOTE ON THE MATTER THAT GIVES RISE TO THE INTEREST. 4. IN ORDER TO APPROVE THE TRANSACTION, THE BOARD MUST FIRST FIND, BY A MAJORITY VOTE OF THE TRUSTEES THEN IN OFFICE, WITHOUT COUNTING THE VOTE OF THE INTERESTED TRUSTEE, a. THAT THE PROPOSED TRANSACTION IS IN THE ORGANIZATION'S BEST INTERESTS AND FOR ITS OWN BENEFIT, AND b. THAT, AFTER REASONABLE INVESTIGATION, THE BOARD HAS DETERMINED THAT THE ORGANIZATION CANNONT OBTAIN A MORE ADVANTAGEOUS TRANSACTION WITH EFFORTS UNDER THE CIRCUMSTANCES. FORM 990, PART VI, SECTION B, LINE 15a & b ANNUALLY, THE COMPENSATION COMMITTEE OF THE OLATHE MEDICAL CENTER, INC. BOARD, WHICH IS COMPRISED OF INDEPENDENT MEMBERS OF THE BOARD OF OLATHE MEDICAL CENTER, INC., REVIEWS AND APPROVES THE CEO AND OTHER OFFICERS AND KEY EMPLOYEES OF THE CORPORATION'S COMPENSATION IN ACCORDANCE WITH THEIR COMPENSATION POLICY. THE COMPENSATION COMMITTEE REVIEWS THIRD PARTY SALARY SURVEYS AND ALSO UTILIZES WRITTEN CONTRACTS FOR THE CEO TO DETERMINE THE FAIR MARKET VALUE OF THE CURRENT COMPENSATION SALARY RANGES AND BENEFITS. COMPENSATION FOR SUCH OFFICERS IS APPROVED BY THE COMMITTEE AND INFORMATION OF THEIR FINDINGS IS AVAILABLE TO ALL BOARD MEMBERS AT THEIR REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENT ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9 CHANGE IN TEMPORARILY RESTRICTED NET ASSETS ($5,087) FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL PROFESSIONAL FEES TOTAL FEES:2162115 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER CONTRACT SERVICES TOTAL FEES:1522432 OLATHE MEDICAL CENTER INC 20333 W 151ST ST OLATHE KS 66061 480577664 HOSPITAL KS 501(C)(3) 3 OHSI true OLATHE HEALTH SYSTEM INC 20333 W 151ST ST OLATHE KS 66061 480979845 SUPPORT ORG KS 501(C)(3) 11B NA false OLATHE MEDICAL SERVICES INC 20333 W 151ST ST OLATHE KS 66061 481088982 CLINICS KS 501(C)(3) 9 OMCI true OLATHE MEDICAL CENTER CHARITABLE FDN 20333 W 151ST ST OLATHE KS 66061 481136010 FUNDRAISING KS 501(C)(3) 7 OMCI true OMC DOCTOR'S BLDG CONDO OWNERS ASSOC 20333 W 151ST ST OLATHE KS 66061 481244766 REAL ESTATE KS OMCI C CORPORATION true OLATHE HEALTH DEVELOPMENT CORPORATION 20333 W 151ST ST OLATHE KS 66061 363445097 MEDICAL SERVICES KS OHSI C CORPORATION true false false false false false false false false false false false false true true true true true false false OLATHE MEDICAL SERVICES INC N 81626 COST OLATHE MEDICAL SERVICES INC P 84572 COST OLATHE MEDICAL CENTER INC N 446516 COST OLATHE MEDICAL CENTER INC O 2806996 COST OLATHE MEDICAL CENTER INC P 2604878 COST