2014-05-15T08:56:59-05:00 2013-06-30 481026809 Wendling Noe Nelson & Johnson LLC 534 S Kansas Ave Suite 1500 Topeka KS 666033491 990 2012-07-01 480559088 Hays Medical Center Inc HAYS 7856235000 2220 Canterbury Drive Hays KS 67601 John Jeter MD 7856235000 2014-05-14 1 Derek H Hart P01054116 7852334226 2014-05-14 2012 2015-11-30 17:44:51Z John Jeter MD 2220 Canterbury Drive Hays KS 67601 193585425 0 X www.haysmed.com X 1944 KS Hays Medical Center is a tax-exempt charitable organization under Section 501(c)(3) of the Internal Revenue Code and is licensed by the State of Kansas Department of Health and Environment. The purpose of the Organization is to provide healthcare facilities and services for the care and treatment of inpatients and outpatients who are acutely ill or who otherwise require medical care and related services. The core purpose of the Organization is to help people be healthy. The Organization is striving to become the best tertiary care center in rural America. 15 10 1684 226 4075 0 554519 130706 209765102 188373548 3283281 4636554 0 259211 213602902 193400019 0 0 0 0 97368988 97190789 0 0 0 104049045 87289896 201418033 184480685 12184869 8919334 250657314 262721462 102200013 99540527 148457301 163180935 X Hays Medical Center is a tax-exempt charitable organization under Section 501(c)(3) of the Internal Revenue Code and is licensed by the State of Kansas Department of Health and Environment. The purpose of the Organization is to provide healthcare facilities and services for the care and treatment of inpatients and outpatients who are acutely ill or who otherwise require medical care and related services. The core purpose of the Organization is to help people be healthy. The Organization is striving to become the best tertiary care center in rural America. 0 0 152446317 188373548 Patient Care Program services consist of routine and ancillary department healthcare services provided by a healthcare organization as defined in Section 501(c)(3) of the IRS code. Admissions: Acute-5,499, Newborn ICU-40, Newborn-680, Senior Focused Care-206, Rehabilitation-132, Total admissions-6,557. Patient days: ICU/CPCU-6,804, Medical/Surgical-13,700, Oncology-1,672, Obstetrics-1,619, Pediatrics-277, Senior Focused Care-2,110, Rehabilitation-1,494, Newborn ICU-336, Newborn-1,234, Total patient days-29,246. Other statistical information: Surgical procedures-8,291, Cardiac caths-1,384, Emergency room visits-13,871, Outpatient procedures-134,363, Medical oncology service visits-7,046, Clinic visits-154,070. 152446317 1 0 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 1 0 0 1 148 0 1 1684 1 1 1 0 0 0 0 0 0 0 0 0 X 15 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X John Jeter MD CEO 7856235000 2220 Canterbury Drive Hays KS 67601 Nancy Curtis 0.50 X 0 0 0 Dennis Bieker 0.50 X X 0 0 0 Kenneth Beran 0.50 X X 0 0 0 Darrell Werth MD 40.00 X 680133 0 33348 Daniel Schippers 0.50 X X 0 0 0 Tom McDonald MD 0.50 X 0 0 0 Jim Black DO 0.50 X 0 0 0 Ross Buckles DO 40.00 X 345325 0 38481 Jayne Clarke 0.50 X 0 0 0 Sharon Dreher 0.50 X 0 0 0 Alan Moore 0.50 X 0 0 0 DG Bickle 0.50 X 0 0 0 John Jeter MD 40.00 X X 589737 0 142673 Mary Martin 0.50 X 0 0 0 Lee Hodny MD 40.00 X 654987 0 41713 Gary Shorman 0.50 X 0 0 0 Kurt Rider 40.00 X 249495 0 41028 William Overbey 40.00 X 304265 0 82350 Dale Montgomery 40.00 X 185231 0 63609 Shae Veach 40.00 X 171034 0 58831 D Bruce Whittington 40.00 X 189035 0 64781 Bryce Young 40.00 X 294000 0 85301 Terry Siek 40.00 X 163242 0 43473 Christine Fisher 40.00 X 955185 0 38713 Richard Markiewicz 40.00 X 944351 0 26848 Alex De Carvalho 40.00 X 855774 0 29166 Kirk Potter 40.00 X 818432 0 37978 Elizabeth Ashworth 40.00 X 756760 0 26116 Jodi Schmidt 0.00 X 269175 0 0 8426161 0 854409 118 1 1 0 Quest Diagnostics Inc PO Box 14730 St Louis MO 631504730 Lab Services 4698033 Huron Consulting Services LLC 3005 Momentum Place Chicago IL 606895330 Consulting 2159647 Sovereign Medical Corporation 1582 Charlton Road San Marino CA 91108 Pulmonology Services 2118521 Inpatient Management Inc 16000 N Dallas Parkway Ste 450 Dallas TX 75248 Hospitalist Program 1581870 Health Facilities Group 142 N Mosley St Ste 300 Wichita KS 67202 Architect Fees 890020 32 130706 130706 Net patient service revenue 621990 177081006 177081006 Services to CAH network and afill 900099 3390192 3390192 Fitness center 900099 1572293 1572293 EHR incentive payments 900099 1429610 1429610 Retail pharmacy 900099 1341087 1341087 3559360 3559360 188373548 4800327 4800327 21633 185406 -163773 -163773 -163773 Rental income 900099 255136 255136 Nursing mother's resources 446199 4075 4075 259211 193400019 188373548 4075 4891690 X 4813340 2031493 2781847 74483705 64127765 10355940 3093138 2952173 140965 10046580 8580979 1465601 4754026 3995723 758303 2052483 2052483 1197629 1197629 231935 231935 19436043 15719036 3717007 356152 8833 347319 525586 376484 149102 1951600 1203523 748077 2057939 1605783 452156 315189 216212 98977 883759 608414 275345 2913301 2913301 10566217 7906700 2659517 1156280 938283 217997 Medical Supplies 19119875 19119875 Pharmaceuticals 12661172 12661172 Repairs and maintenance 4167185 3629982 537203 Taxes and assessments 1552376 394 1551982 6145175 3850192 2294983 184480685 152446317 32034368 0 6285 5765 7283364 4262222 30875563 30002457 4450389 4345938 3757425 3700959 197421181 115238274 70308415 82182907 87193639 80389289 16322244 25696304 538200 538200 29921790 31597421 250657314 262721462 23112767 22682371 97346 115499 78169536 76045689 820364 696968 102200013 99540527 X 142082350 155618659 6374951 7562276 148457301 163180935 250657314 262721462 8919334 5804300 0 X X 0 1 X 1 0 X 0 0 0 0 0 1 14792 0 0 0 14792 0 Explanation of Lobbying Activities: Part II-B, Line 1: Hays Medical Center, 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. 9480780 106926 388512 42988 9933230 8947679 167515 427208 61622 9480780 8608848 119796 287574 68539 8947679 8099830 332063 234201 57246 8608848 7649441 249859 226379 25849 8099830 0.60000 0.33000 0.07000 0 1 1 350356 350356 70412923 33824353 36588570 111665445 75910373 35755072 14992457 5503548 9488909 82182907 Hedge funds 16350749 F Private equity funds 4493930 F Real estate limited partnership 4851625 F 25696304 Cash whose use is limited by Board or indenture agreement 11924868 Interest receivable whose use is limited by Board or indenture agreement 75189 Interest in net assets of Hadley Foundation 7562276 Other receivables 2449969 Debt issue costs 893903 Other long-term assets 5843009 Third party payor settlements 948819 Intercompany receivables 1899388 31597421 Estimated third-party payor settlements 696968 696968 X 199368092 5804300 163773 5968073 193400019 0 193400019 184644458 163773 163773 184480685 0 184480685 Description of Intended Use of Endowment Funds: Part V, Line 4: The endowed funds held by the Hays Medical Center Foundation are used to help meet both the immediate and long range health care needs of patients of Hays Medical Center, Inc. The Hays Medical Center Foundation provides grants and assistance to Hays Medical Center, Inc., for property and equipment acquisitions, education, and community health issues. Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: Management is not aware of any uncertainties in income tax positions. Part XI, Line 2d - Other Adjustments: Loss on disposal of equipment included as a revenue deduction in Part VIII 1 1 X 1 X 125.000000000000 1 X 1 1 0 1 1 1879620 1879620 0.01020 9503816 6128364 3375452 0.01830 11383436 6128364 5255072 0.02850 1934108 1580987 353121 0.00190 732282 100841 631441 0.00340 53124837 47604894 5519943 0.02990 42267 42267 0.00020 55833494 49286722 6546772 0.03540 67216930 55415086 11801844 0.06390 82500 82500 0.00040 82500 82500 0.00040 1 4207951 294557 58833423 68050750 -9217327 X 1 1 2 1 Hays Medical Center Inc

2220 Canterbury Hays KS 67601

X X X 2 Pawnee Valley Community Hospital Inc

923 Carroll Ave Larned KS 67550

X X X X Hays Medical Center Inc 1 1 X X X X X X X X X 12 1 0 1 X X X X X X X X X X 1 0 1 1 125.000000000000 1 400.000000000000 1 X X X X X X 1 1 X X X X X X 1 0 X X X 1 X 0 0 Pawnee Valley Community Hospital Inc 2 1 X X X X X X X X X 12 1 0 1 X X X X X 1 0 1 1 125.000000000000 1 400.000000000000 1 X X X X X X 1 1 X X X X X 1 0 X X X 1 X 0 0 5 Hays Family Medicine

2509 Canterbury Hays KS 67601

Family Medicine Pawnee Valley Medical Associates

713 W 11th St Larned KS 67550

Family Medicine Central Kansas Urology

3520 Lakin Great Bend KS 67530

Urology Services HaysMed Psychiatric Associates

205 E 7th St Hays KS 67601

Psychiatric Services Breast Care Center

2501 E 13th St Hays KS 67601

Breast Care Services Part I, Line 7: Hays Medical Center, Inc.'s, cost accounting system was used to calculate community health improvement services, health professions education, and subsidized health services costs. A cost-to-charge ratio derived from Worksheet 2 was used to calculate financial assistance at cost and the community benefit expense attributable to serving Medicaid beneficiaries. Part I, Line 7g: Subsidized health services community benefit expenses include $48,226,931 of expenses attributable to physician clinics that have net operating losses. Part II: Hays Medical Center, Inc., helps to support the First Care Clinic in Hays, Kansas. This clinic was established to help lower income individuals receive health care at a reduced cost. Our support helps to increase the number of individuals in Hays, Kansas, who receive quality primary health care. Part III, Line 4: Text of the footnote that describes bad debt expense:Accounts receivable are reduced by an allowance for uncollectible accounts. In evaluating the collectability of accounts receivable, the HaysMed Group analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for uncollectible accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for uncollectible accounts. For receivables associated with services provided to patients who have third-party coverage, the HaysMed Group analyzes contractually due amounts and provides an allowance for uncollectible accounts and a provision for bad debts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payor has not yet paid, or for payors who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the HaysMed Group records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for uncollectible accounts.Costing methodology: A cost-to-charge ratio derived from Worksheet 2 was used to calculate bad debt expense at cost.Methodology for bad debt cost for financial assistance eligible: This amount was estimated based on historical information from our collection agency on the percentage of accounts referred to collection whose guarantor was indigent. Part III, Line 8: The Medicare cost report was the costing methodology used to determine Medicare allowable costs. Allowable costs of care reported on line 6 were determined using amounts from Worksheet D, Part V and Worksheet D-1 in the Hays Medical Center, Inc., Medicare cost report for the fiscal year ended June 30, 2013. Part III, Line 9b: Whenever possible, the customer service representatives (CSR's) of Hays Medical Center, Inc., try to determine the estimated self-pay balance prior to the patient receiving services. FAP eligibility is first considered at this point in time. In addition, if full payment is not received or if payment is not made within 30 days, the CSR contacts the patient. If it is determined that at least a 2-year payment plan cannot be established with the patient, the CSR will screen for charity care and request that the charity care application be completed by the patient. Hays Medical Center, Inc. Part V, Section B, Line 3: The CHNA was conducted in collaboration with the Ellis County Health Department. Two Town Hall Meetings were organized to provide an objective consensus building method of reviewing and prioritizing county health issues. During the Town Hall meetings, the group reflected on the size and seriousness of any health concerns cited and discussed current community health strengths. The group identified and ranked top community health concerns, and all Town Hall attendees were encouraged to continue to contribute ideas by going online and taking a feedback survey that addresses any additional thoughts related to the CHNA. All Town Hall priority-setting and scoring processes involved the input of a diverse group with knowledge and/or expertise in public health as well as persons who represent the broad interests of the community served by the hospital. Key stakeholders in attendance included representatives from: Ellis County, Turning Point Professional Counseling, First Care Clinic, KaMMCO/KMC, Heartland Community Foundation, Regional Prevention Center, Community Assistance Center, Ellis County Health Department, representatives of USD 489 and representatives of Hays Medical Center. The CHNA was coordinated and produced by VVV Research & Development, Inc. from Olathe, Kansas. Pawnee Valley Community Hospital, Inc. Part V, Section B, Line 3: The CHNA was conducted in collaboration with the Pawnee County Health Department. A Town Hall Meeting was organized to provide an objective consensus building method of reviewing and prioritizing county health issues. During the Town Hall meeting, the group reflected on the size and seriousness of any health concerns cited and discussed current community health strengths. The group identified and ranked top community health concerns, and all Town Hall attendees were encouraged to continue to contribute ideas by going online and taking a feedback survey that addresses any additional thoughts related to the CHNA. All Town Hall priority-setting and scoring processes involved the input of a diverse group with knowledge and/or expertise in public health as well as persons who represent the broad interests of the community served by the hospital. Key stakeholders in attendance included representatives from: United Way, Welcome Inn Senior Center, Center for Counseling, Elder Care, Inc., Smith Dental Clinic, Pawnee County Sherriff's Office, Larned Police Department, Pawnee County Health Department, County Commissioners, members of the Chamber of Commerce, members of the USD 495 School Board, school nurses of USD 495, local members of the media, local religious organizations, city council members, and representatives of Pawnee Valley Community Hospital. The CHNA was coordinated and produced by VVV Research & Development, Inc. from Olathe, Kansas. Hays Medical Center, Inc. Part V, Section B, Line 14g: Hays Medical Center will proactively seek out applicants who may be in need of financial assistance. Hays Medical Center will post notice of this policy to all patients/guarantors through its registration, pre-registration, and financial counseling process. This policy will also be posted in prominent areas of the Hospital and on the Hospital's website. Pawnee Valley Community Hospital, Inc. Part V, Section B, Line 14g: Pawnee Valley Community Hospital, Inc. (PVCH) will proactively seek out applicants who may be in need of financial assistance. PVCH will post notice of this policy to all patients/guarantors through its registration, pre-registration, and financial counseling process. This policy will also be posted in prominent areas of the Hospital and on the Hospital's website. Hays Medical Center, Inc. Part V, Section B, Line 20d: The hospital used the look-back method based on actual paid claims by Medicare and all other private health insurers paying claims to the hospital. Pawnee Valley Community Hospital, Inc. Part V, Section B, Line 20d: The hospital used the look-back method based on actual paid claims by Medicare and all other private health insurers paying claims to the hospital. Part VI, Line 3: Information regarding the Hays Medical Center, Inc., charity care program is located on the Hays Medical Center, Inc., website for patients and community members to view, and the financial assistance application is also on the website to print off and complete. In addition, if a customer service representative of Hays Medical Center, Inc. contacts a patient about a bill and in visiting with them they determine that the patient could possibly qualify for the Hospital's charity care policy, they will send the application to the patient as well. Part VI, Line 4: Hays Medical Center, Inc. is located in Hays, Kansas, which has a population of approximately 20,000 people, as of the 2010 census. One of the State of Kansas Regents universities is also located in Hays, Kansas, so the population includes many college-aged students. The median household income of Hays, Kansas, is $44,227. Approximately 5.7% of families and 15.6% of the population were below the poverty line. Almost 6% of the Hospital's revenue is from services provided to patients eligible for Medicaid. Hays Medical Center, Inc., is the only hospital in the city of Hays. In addition, since this is a rural area and because it is the only hospital providing tertiary level care in the region, Hays Medical Center, Inc., provides certain services to the whole western half of the State of Kansas. Part VI, Line 5: Hays Medical Center, Inc., promotes the health of the community by extending medical privileges to most qualified, local physicians. In addition, the majority of the Board of Directors live and work in the city of Hays, but they are not employed by Hays Medical Center. Inc. Part VI, Line 6: Hays Medical Center, Inc., is not a part of an affiliated health care system. X X 1 1 X X X X 0 1 0 0 0 1 0 0 0 Darrell Werth MD 598500 0 81633 0 0 0 13750 0 19598 0 713481 0 0 0 Ross Buckles DO 211539 0 127786 0 6000 0 13750 0 24731 0 383806 0 0 0 John Jeter MD 437483 0 142252 0 10002 0 117710 0 24963 0 732410 0 0 0 Lee Hodny MD 347000 0 301987 0 6000 0 13750 0 27963 0 696700 0 0 0 Kurt Rider 227000 0 0 0 22495 0 13065 0 27963 0 290523 0 0 0 William Overbey 237941 0 54516 0 11808 0 57619 0 24731 0 386615 0 0 0 Dale Montgomery 142961 0 27274 0 14996 0 36400 0 27209 0 248840 0 0 0 Shae Veach 142127 0 25970 0 2937 0 34622 0 24209 0 229865 0 0 0 D Bruce Whittington 161110 0 27668 0 257 0 39072 0 25709 0 253816 0 0 0 Bryce Young 233847 0 55284 0 4869 0 57570 0 27731 0 379301 0 0 0 Terry Siek 144367 0 18854 0 21 0 33460 0 10013 0 206715 0 0 0 Christine Fisher 600000 0 302110 0 53075 0 13750 0 24963 0 993898 0 0 0 Richard Markiewicz 600000 0 277276 0 67075 0 8750 0 18098 0 971199 0 0 0 Alex De Carvalho 500000 0 355774 0 0 0 13750 0 15416 0 884940 0 0 0 Kirk Potter 450000 0 340555 0 27877 0 13015 0 24963 0 856410 0 0 0 Elizabeth Ashworth 538050 0 90022 0 128688 0 8750 0 17366 0 782876 0 0 0 Jodi Schmidt 0 0 0 0 269175 0 0 0 0 0 269175 0 269175 0 Part I, Line 1a Benefits identified include tax indemnification on health claims and health club dues. Both benefits are available to the CEO and are included in taxable income. Part I, Line 4b John Jeter, M.D. - $86,960 William Overbey - $43,869 Bryce Young - $43,820 Dale Montgomery - $25,985 D. Bruce Whittington - $28,542 Shae Veach - $25,215 Terry Siek - $24,483 Part I, Line 6 A portion of incentive compensation for officers and key employees is determined by net earnings exceeding budget for the fiscal year. A Kansas Development Finance Authority 481066589 48543BGR3 2003-11-12 16008878 Construction 0 0 0 B Kansas Development Finance Authority 481066589 48543BJD1 2005-11-22 23635944 Construction 0 0 0 C Kansas Development Finance Authority 481066589 48543BLY2 2010-11-02 46930167 Refinancing of previous bond and equipment 0 0 0 A 16008878 320017 15680861 2005 0 0 1 1 B 7260000 23635944 2037125 316000 23319944 2006 0 1 1 1 C 2675000 46930167 667574 26993022 16300000 2969571 2012 1 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 Schedule K Part IV, Arbitrage, Line 2c Date Rebate Computation Performed Issuer Name: Kansas Development Finance Authority Date the Rebate Computation was Performed: 11/12/2008 Issuer Name: Kansas Development Finance Authority Date the Rebate Computation was Performed: 11/01/2010 Blue Cross and Blue Shield of Kansas Entity of which Gary Shorman, current director, is a director 58760000 Payment for health care services provided to benenficiaries of Blue Cross and Blue Shield's insurance plans. These payments represent less than 3% of Blue Cross and Blue Shield of Kansas' annual disbursements. 0 Eagle Communications Entity of which Gary Shorman, current director, is an officer 128281 Payments for advertising, cable, and internet services 0 Jeter Law Firm Partnership more than 5% owned by family member of John Jeter, MD, CEO 5345 Payments for legal services 0 Lynette Pfannenstiel Family member of D.G. Bickle, current director 66871 Employment arrangement 0 John T Jeter Family member of John Jeter, MD, CEO 21824 Employment arrangement 0 Arlene Werth Family member of Darrell Werth, MD, current director 44405 Employment arrangement 0 Heather Harris Family member of Ross Buckles, D.O., current director 170196 Employment arrangement 0 Form 990, Part VI, Section B, line 11 Form 990 was reviewed with the officers and Board Finance committee. Form 990, Part VI, Section B, line 12c Officers, directors, and key employees, along with all associates, are required to complete a conflict of interest statement annually. The statements are used to monitor and enforce compliance with the policy. Form 990, Part VI, Section B, line 15 The CEO's, officers', and key employees' salaries are reviewed annually by an independent consulting group and the Compensation Committee, which is made up of members of the Board. Form 990, Part VI, Section C, line 19 These documents are not made available to the public. Financial statements are released to bond holders on a quarterly basis. Other Fees Form 990, Part IX, line 11g Contract labor: Program service expenses 733,961. Management and general expenses 27,418. Fundraising expenses 0. Total expenses 761,379. Medical professional fees: Program service expenses 7,763,867. Management and general expenses 233,525. Fundraising expenses 0. Total expenses 7,997,392. Laboratory services: Program service expenses 4,983,039. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,983,039. Consulting services: Program service expenses 77,504. Management and general expenses 82,816. Fundraising expenses 0. Total expenses 160,320. Recruiting fees: Program service expenses 0. Management and general expenses 55,938. Fundraising expenses 0. Total expenses 55,938. Non-medical professional fees: Program service expenses 864,872. Management and general expenses 1,184,288. Fundraising expenses 0. Total expenses 2,049,160. Collection and billing fees: Program service expenses 26,696. Management and general expenses 408,887. Fundraising expenses 0. Total expenses 435,583. Other purchased services: Program service expenses 1,269,097. Management and general expenses 1,724,135. Fundraising expenses 0. Total expenses 2,993,232. Financial Statements and Reporting Form 990, Part XII, Line 2C Hays Medical Center, Inc., has an audit committee that is responsible for the oversight of the financial statement audit and the selection process of an independent accountant. Hays Medical Center Foundation 2220 Canterbury Hays KS 67601 481179684 Provide grants and allocations to Hays Medical Center, Inc. KS 501(c)(3) Line 11a, I Hays Medical Center Inc 1 HaysMed Partners Inc 2220 Canterbury Hays KS 67601 270877152 Owns management contract for Pawnee Valley Community Hospital, Inc. KS 501(c)(3) Line 3 Hays Medical Center Inc 1 Pawnee Valley Community Hospital Inc 923 Carroll Ave Larned KS 67550 481253246 Hospital operated by Hays Medical Center, Inc. KS 501(c)(3) Line 3 HaysMed Partners Inc 1 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 0 1 0 0 Hays Medical Center Foundation Q 222833 Actual cost Pawnee Valley Community Hospital Inc D 123318 Cash advanced Pawnee Valley Community Hospital Inc L 504817 Actual cost Pawnee Valley Community Hospital Inc O 349606 Actual cost Pawnee Valley Community Hospital Inc J 8234 Rent agreement Pawnee Valley Community Hospital Inc K 68655 Rent agreement Pawnee Valley Community Hospital Inc Q 1719983 Contractual formula