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SALINA REGIONAL HEALTH CENTER INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
SALINA REGIONAL HEALTH CENTER INC (EIN 48-1169103)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-14
IRS object ID
201402269349304230
Schema version
2012v2.1
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-08-14T16:11:55-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN481026809EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Wendling Noe Nelson & Johnson LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1534 S Kansas Ave Suite 1500AddressLine1
CityTopekaCity
StateKSState
ZIP Code666033491ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN481169103EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Salina Regional Health Center IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSALINameControl
Phone7854527145Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 South Santa FeAddressLine1
CitySalinaCity
StateKSState
ZIP Code67401ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJoel PhelpsName
TitleVP Operations/COOTitle
Phone7854527145Phone
Date Signed2014-08-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameHeather R EichemName
PTINP01515553PTIN
Phone7852334226Phone
Date Prepared2014-08-14DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJoel PhelpsNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1400 South Santa FeAddressLine1
CitySalinaCity
StateKSState
ZIP Code67401ZIPCode
FieldValueIRS element (for citing)
Gross Receipts178273187GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.srhc.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1995YearFormation
State Legal DomicileKSStateLegalDomicile
Activity Or Mission DescriptionTo provide high quality acute medical careActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees1607TotalNbrEmployees
Total Nbr Volunteers200TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income-107589NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1026616ContributionsGrantsPriorYear
Contributions Grants Current Year1118213ContributionsGrantsCurrentYear
Program Service Revenue Prior Year179755461ProgramServiceRevenuePriorYear
Program Service Revenue CY168331001ProgramServiceRevenueCY
Investment Income Prior Year2397122InvestmentIncomePriorYear
Investment Income Current Year5590796InvestmentIncomeCurrentYear
Other Revenue Prior Year2149921OtherRevenuePriorYear
Other Revenue Current Year2734694OtherRevenueCurrentYear
Total Revenue Prior Year185329120TotalRevenuePriorYear
Total Revenue Current Year177774704TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1766083GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1019472GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year72754883SalariesEtcPriorYear
Salaries Etc Current Year83392417SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year91423281OtherExpensePriorYear
Other Expenses Current Year77304765OtherExpensesCurrentYear
Total Expenses Prior Year165944247TotalExpensesPriorYear
Total Expenses Current Year161716654TotalExpensesCurrentYear
Revenues Less Expenses Prior Year19384873RevenuesLessExpensesPriorYear
Revenues Less Expenses CY16058050RevenuesLessExpensesCY
Total Assets BOY376263070TotalAssetsBOY
Total Assets EOY408504999TotalAssetsEOY
Total Liabilities BOY81569017TotalLiabilitiesBOY
Total Liabilities EOY77761152TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY294694053NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY330743847NetAssetsOrFundBalancesEOY
Mission DescriptionTo provide quality health care services in a healing and spiritual environment.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense129691304Expense
Grants250000Grants
Revenue168776299Revenue
DescriptionSalina Regional Health Center, Inc., is an IRS Section 501(c)(3) hospital which provides quality medical care regardless of race, creed, sex, national origin, handicap, or ability to pay. During the fiscal year, Salina Regional Health Center, Inc., discharged 8,651 inpatients resulting in 40,730 patient days, treated outpatients in 148,731 visits, and generated $164,806,514 in net patient service revenue. The amount of uncompensated care amounted to $31,567,959 of which $9,425,835 were charity care deductions and $22,142,124 were bad debt write offs.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense96662Expense
Grants96662Grants
DescriptionSalina Regional Health Center, Inc., provides scholarships to students attending nursing school.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense672810Expense
Grants672810Grants
DescriptionSalina Regional Health Center, Inc., provides grants to further the activities of the Community Health Improvement Program (CHIP).Description
FieldValueIRS element (for citing)
Total Program Service Expense130460776TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org1TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109687NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1607NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure0WrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Joe Tallon VP FinanceCFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7854527145TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1400 South Santa FeAddressLine1
CitySalinaCity
StateKSState
ZIP Code67401ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Larry Britegam
Chairman2.00XX000
Kent Buer
Vice Chairman2.00XX000
Robert Freelove MD
Secretary2.00XX000
David Hadley
Trustee2.00X000
Sean Herrington MD
Trustee40.00X377058025418
Rex Romeiser MD
Trustee2.00X000
Morrie Soderberg
Treasurer2.00XX000
Betsy Wearing
Trustee2.00X000
Lee Young
Trustee2.00X000
Micheal Terry
President/CEO40.00XX478966065612
Brian Smith MD
Trustee/Chief of Staff4.00X2000000
Jim Maes
Trustee2.00X000
Katie Platten
Trustee2.00X000
Chuck Oleen
Trustee2.00X000
Joe Tallon
VP Finance/CFO40.00X241591024952
Larry Barnes
VP Information Technology40.00257408059472X
Charles Grimwood
VP Regional Development40.00226161025386X
Jack Hinnenkamp
VP Facilities Management40.00193978017715X
David Moody
VP Human Resources40.00201353023100X
Joel Phelps
COO40.00304241043516X
John Kelemen
Physician40.00672953029017X
Jacob Breeding
Physician40.00404167018498X
Ali Manguoglu
Physician40.00372234026584X
Keir Swisher
Physician40.00408885025258X
Jeremiah Ostmeyer
Physician40.00445758016803X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4604753TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation401331TotalOtherCompensation
Number Individuals GT100 K69NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Hutton Construction
2229 S West StWichitaKS67213Construction3238404
CPT Enterprises Inc
2121 Crawford PlSalinaKS67401Management Services1465406
Anesthesia Associates of Central KS PA
PO Box 1607SalinaKS674021607Anesthesia Services980891
DMS Imaging
26273 Network PlChicagoIL606731262Imaging Services476953
Fresenius Medical Care
PO Box 749959Los AngelesCA900749959Medical Care465675
FieldValueIRS element (for citing)
Number Of Contractors GT100 K25NumberOfContractorsGT100K
Related Organizations169694RelatedOrganizations
Government Grants817664GovernmentGrants
All Other Contributions130855AllOtherContributions
Total Contributions1118213TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Patient service621990164806514164806514
EHR incentive payments62199019258921925892
Other operating62199015985951598595
FieldValueIRS element (for citing)
Total Program Service Revenue168331001TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column5006662TotalRevenueColumn
Exclusion$5,006,662ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real233542Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real372378Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-138836Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-138836TotalRevenueColumn
Related Or Exempt Function Income-138836RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities390049Securities
Other309884Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities
Other115799Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities390049Securities
Other194085Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column584134TotalRevenueColumn
Related Or Exempt Function Income584134RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Gross Income Fundraising Events31048GrossIncomeFundraisingEvents
Fundraising Direct Expenses10306FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column20742TotalRevenueColumn
Exclusion$20,742ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
Income from subsidiaries9000992776792$2,776,792
Other revenues90009975996$75,996
FieldValueIRS element (for citing)
Total Other Revenue2852788TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column177774704TotalRevenueColumn
Related Or Exempt Function Income168776299RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$7,880,192ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total922810Total
Program Services922810ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total96662Total
Program Services96662ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2646512Total
Program Services413871ProgramServices
Management And General2232641ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total66115518Total
Program Services59660430ProgramServices
Management And General6455088ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2473856Total
Program Services2236663ProgramServices
Management And General237193ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total7524029Total
Program Services6660788ProgramServices
Management And General863241ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4632502Total
Program Services4056635ProgramServices
Management And General575867ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total707341Total
Management And General707341ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total793966Total
Program Services60478ProgramServices
Management And General733488ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1080764Total
Program Services516746ProgramServices
Management And General564018ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total3942984Total
Program Services1370662ProgramServices
Management And General2572322ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2994049Total
Program Services1550319ProgramServices
Management And General1443730ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total370835Total
Program Services129038ProgramServices
Management And General241797ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total226377Total
Program Services70260ProgramServices
Management And General156117ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2782967Total
Program Services1441020ProgramServices
Management And General1341947ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total11636421Total
Program Services7440480ProgramServices
Management And General4195941ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1585771Total
Program Services450216ProgramServices
Management And General1135555ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Medical supplies1788555917885559
Pharmaceuticals1021059110210591
Professional fees other579348444557411337743
Outside services435297029579821394988

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total12940686Total
Program Services7873825ProgramServices
Management And General5066861ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total161716654Total
Program Services130460776ProgramServices
Management And General31255878ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY5331BOY
EOY7578EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY34554099BOY
EOY13062462EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY27232538BOY
EOY29157189EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1186762BOY
EOY1334375EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3951820BOY
EOY2737793EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis254619822LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec140589829LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY98973018BOY
EOY114029993EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY189179913BOY
EOY214421381EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY6377375BOY
EOY7117662EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY2681250BOY
EOY9681674EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY12120964BOY
EOY16954892EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY376263070BOY
EOY408504999EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY20535427BOY
EOY18502340EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY61022385BOY
EOY55184878EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY11205BOY
EOY883EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY4073051EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY81569017BOY
EOY77761152EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY285539705BOY
EOY320306956EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2682844BOY
EOY3487136EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY6471504BOY
EOY6949755EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY294694053BOY
EOY330743847EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY376263070BOY
EOY408504999EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses16058050ReconcilationRevenueExpenses
Reconciliation Unrealized Invest18538324ReconciliationUnrealizedInvest
Reconcilation Other Changes1453420ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$25,137OtherActivitiesAmount
Total Lobbying Expenditures IIB25137TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierExplanation of Lobbying Activities:Identifier
Return ReferencePart II-B, Line 1:ReturnReference
ExplanationA portion of annual dues paid by Salina Regional Health Center, Inc., to various health care organizations has been identified as association lobbying activities by those organizations. The amount reported as direct contact with legislators, their staff, government officials, or a legislative body represents the portion of dues identified as association lobbying activities by these organizations. Salina Regional Health Center, Inc., does not participate in activities supporting a political candidate.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1068232BeginningOfYearBalance
Investment Earnings Or Losses67038InvestmentEarningsOrLosses
Other Expenditures19636OtherExpenditures
End Of Year Balance1115634EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance938600BeginningOfYearBalance
Investment Earnings Or Losses145738InvestmentEarningsOrLosses
Other Expenditures16106OtherExpenditures
End Of Year Balance1068232EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance959381BeginningOfYearBalance
Contributions100Contributions
Investment Earnings Or Losses-20881InvestmentEarningsOrLosses
End Of Year Balance938600EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance900186BeginningOfYearBalance
Contributions80Contributions
Investment Earnings Or Losses75389InvestmentEarningsOrLosses
Other Expenditures16274OtherExpenditures
End Of Year Balance959381EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance899440BeginningOfYearBalance
Contributions8285Contributions
Investment Earnings Or Losses-7038InvestmentEarningsOrLosses
Other Expenditures501OtherExpenditures
End Of Year Balance900186EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.65400PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.34600TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs1EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis6979691OtherCostOrOtherBasis
Book Value6979691BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis150470690OtherCostOrOtherBasis
Depreciation78238647Depreciation
Book Value72232043BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis84129155OtherCostOrOtherBasis
Depreciation59602556Depreciation
Book Value24526599BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis13040286OtherCostOrOtherBasis
Depreciation2748626Depreciation
Book Value10291660BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings114029993TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionEstimated reimbursements payableDescription
Amount$4,073,051Amount
FieldValueIRS element (for citing)
Total Of Amounts4073051TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt196649180TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments18538324NetUnrealizedGainsInvestments
Other Revenues356894OtherRevenues
Revenue Not Rptd F99018895218RevenueNotRptdF990
Revenue Subtotal177753962RevenueSubtotal
Other Revenues Not Included20742OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt20742RevenueNotRptdOnFinStmt
Total Revenue Per Form990177774704TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt160773102TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal160773102ExpensesSubtotal
Other Expenses Not Included943552OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt943552ExpensesNotRptdOnFinStmt
Total Expenses Per Form990161716654TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Intended Use of Endowment Funds:Part V, Line 4:The endowment funds are to benefit the Cardiology, Rehabilitation, and Oncology departments of Salina Regional Health Center.
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:Community Health Improvement Program (CHIP) donation -672,810. KU Endowment donation -250,000. Change in beneficial interest in net assets of Foundation 801,453. Change in fair value of assets held in trust 478,251.
Part XI, Line 4b - Other Adjustments:Net fundraising events revenue 20,742.
Part XII, Line 4b - Other Adjustments:KU Endowment donation 250,000. Community Health Improvement Program (CHIP) donation 672,810. Net fundraising events revenue 20,742.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Rummage SalesNameOfEvent1
Gross Receipts Event116265GrossReceiptsEvent1
Gross Revenue Event116265GrossRevenueEvent1
Other Direct Expenses Event14920OtherDirectExpensesEvent1
Name Of Event2Holly DaysNameOfEvent2
Gross Receipts Event28266GrossReceiptsEvent2
Gross Revenue Event28266GrossRevenueEvent2
Other Direct Expenses Event24847OtherDirectExpensesEvent2
Total Number Of Other Events2TotalNumberOfOtherEvents
Gross Receipts Other Events6517GrossReceiptsOtherEvents
Gross Revenue Other Events6517GrossRevenueOtherEvents
Other Direct Expenses Other Events539OtherDirectExpensesOtherEvents
Gross Receipts Total31048GrossReceiptsTotal
Gross Revenue Total Events31048GrossRevenueTotalEvents
Other Direct Expenses Total Events10306OtherDirectExpensesTotalEvents
Direct Expense Summary Events10306DirectExpenseSummaryEvents
Net Income Summary20742NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Persons Served3910PersonsServed
Total Community Benefit Expense3105541TotalCommunityBenefitExpense
Net Community Benefit Expense3105541NetCommunityBenefitExpense
Percent Of Total Expense0.01920PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Persons Served11879PersonsServed
Total Community Benefit Expense17236844TotalCommunityBenefitExpense
Direct Offsetting Revenue7881225DirectOffsettingRevenue
Net Community Benefit Expense9355619NetCommunityBenefitExpense
Percent Of Total Expense0.05790PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Persons Served15789PersonsServed
Total Community Benefit Expense20342385TotalCommunityBenefitExpense
Direct Offsetting Revenue7881225DirectOffsettingRevenue
Net Community Benefit Expense12461160NetCommunityBenefitExpense
Percent Of Total Expense0.07710PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs20NumberOfActivitiesOrPrograms
Persons Served2242PersonsServed
Total Community Benefit Expense159087TotalCommunityBenefitExpense
Net Community Benefit Expense159087NetCommunityBenefitExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs11NumberOfActivitiesOrPrograms
Persons Served100PersonsServed
Total Community Benefit Expense2062249TotalCommunityBenefitExpense
Net Community Benefit Expense2062249NetCommunityBenefitExpense
Percent Of Total Expense0.01280PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs22NumberOfActivitiesOrPrograms
Persons Served9181PersonsServed
Total Community Benefit Expense29638152TotalCommunityBenefitExpense
Direct Offsetting Revenue17796440DirectOffsettingRevenue
Net Community Benefit Expense11841712NetCommunityBenefitExpense
Percent Of Total Expense0.07320PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Total Community Benefit Expense2671TotalCommunityBenefitExpense
Net Community Benefit Expense2671NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs14NumberOfActivitiesOrPrograms
Total Community Benefit Expense718169TotalCommunityBenefitExpense
Net Community Benefit Expense718169NetCommunityBenefitExpense
Percent Of Total Expense0.00440PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs69NumberOfActivitiesOrPrograms
Persons Served11523PersonsServed
Total Community Benefit Expense32580328TotalCommunityBenefitExpense
Direct Offsetting Revenue17796440DirectOffsettingRevenue
Net Community Benefit Expense14783888NetCommunityBenefitExpense
Percent Of Total Expense0.09140PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs69NumberOfActivitiesOrPrograms
Persons Served27312PersonsServed
Total Community Benefit Expense52922713TotalCommunityBenefitExpense
Direct Offsetting Revenue25677665DirectOffsettingRevenue
Net Community Benefit Expense27245048NetCommunityBenefitExpense
Percent Of Total Expense0.16850PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Total Community Building Expense14568TotalCommunityBuildingExpense
Net Community Building Expense14568NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Total Community Building Expense70090TotalCommunityBuildingExpense
Net Community Building Expense70090NetCommunityBuildingExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense686TotalCommunityBuildingExpense
Net Community Building Expense686NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Number Of Activities Or Programs5NumberOfActivitiesOrPrograms
Total Community Building Expense52514TotalCommunityBuildingExpense
Net Community Building Expense52514NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Persons Served53PersonsServed
Total Community Building Expense329069TotalCommunityBuildingExpense
Net Community Building Expense329069NetCommunityBuildingExpense
Percent Of Total Expense0.00200PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs16NumberOfActivitiesOrPrograms
Persons Served53PersonsServed
Total Community Building Expense466927TotalCommunityBuildingExpense
Net Community Building Expense466927NetCommunityBuildingExpense
Percent Of Total Expense0.00280PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$5,677,241BadDebtExpenseAmount
Amount Attributable To691336AmountAttributableTo
Amount Reimbursed By Medicare52102828AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare53926886CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-1824058MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost Accounting SystemXCostAccountingSystem
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities2NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalTeaching HospitalTeachingHospitalEr24 HoursEr24Hours
Salina Regional Health Center Inc
1400 South Santa FeSalinaKS67401XXXX
Salina Surgical Center LLC
2401 South Santa FeSalinaKS67401XX

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (2 entries)

Hospital Facility NumberHospitalFacilityNumberCHNA ConductedCHNAConductedCommunity DefinitionCommunityDefinitionCommunity DemographicsCommunityDemographicsExisting ResourcesExistingResourcesHow Data ObtainedHowDataObtainedCommunity Health NeedsCommunityHealthNeedsOther Health IssuesOtherHealthIssuesIdentifying ProcessIdentifyingProcessConsulting ProcessConsultingProcessInformation GapsInformationGapsNeeds Assessment ConductedNeedsAssessmentConductedTake Into AccountTakeIntoAccountOther FacilitiesOtherFacilitiesCHNA Widely AvailableCHNAWidelyAvailableOwn WebsiteOwnWebsiteOn RequestOnRequestOther MethodOtherMethodDevelop Community PlanDevelopCommunityPlanParticipate Community PlanParticipateCommunityPlanInclude Operational PlansIncludeOperationalPlansAdopt BudgetAdoptBudgetPrioritize Health NeedsPrioritizeHealthNeedsPrioritize ServicesPrioritizeServicesOther Needs AddressedOtherNeedsAddressedAll Needs AddressedAllNeedsAddressedOrganization Incur Excise TaxOrganizationIncurExciseTaxEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedFPG Discount PercentFPGDiscountPercentExplains BasisExplainsBasisIncome LevelIncomeLevelAsset LevelAssetLevelMedical IndigencyMedicalIndigencyInsurance StatusInsuranceStatusUninsured DiscountUninsuredDiscountExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresPosted On WebsitePostedOnWebsiteAttached To InvoicesAttachedToInvoicesAvailable On RequestAvailableOnRequestActions On NonpaymentActionsOnNonpaymentPermit Report To Credit AgencyPermitReportToCreditAgencyPermit LawsuitPermitLawsuitPermit Lien On ResidencePermitLienOnResidencePermit Other ActionsPermitOtherActionsCollection ActivitiesCollectionActivitiesNotify Upon AdmissionNotifyUponAdmissionNotify Before DischargeNotifyBeforeDischargeNotified All PatientsNotifiedAllPatientsDocumented DeterminationDocumentedDeterminationNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyUsed Other MethodUsedOtherMethodAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossChargesOther Actions TakenOtherActionsTaken
Salina Regional Health Center Inc
11XXXXXXXXX12101XXXXXXXXXX0011200.0000000000001300.0000000000001XXXXX11XXX1XXXX0XXXX1X00
Salina Surgical Center LLC
2011100.0000000000001100.0000000000001X11X101X00X

Form990 Schedule H Part VI Form990ScheduleHPartVI (18 entries)

ExplanationExplanationReturn ReferenceReturnReferenceIdentifierIdentifier
Part I, Line 7: Costing methodology used to determine ratio of patient care cost to charges is total operating expenses less bad debt, Medicaid provider taxes, total community benefit, and building expenses divided by total charges less community benefit charges.
Part II: Advancing Communities Together (ACT) analyzed data and discussed with multiple agencies in July 2012 resulting in the following high-level list of community health improvement priorities (descending order of priority): teen sexual behavior, obesity (children, adult) and the outcomes of obesity (heart disease, stroke), domestic violence, serious injuries requiring hospital care, chronic lower respiratory disease, adult flu vaccination, and cancer. These priorities have since been further researched. A report is being made available to the general public in early 2013 and through community forums, on-line surveys and paper surveys; input from the broader community is being obtained. Salina Regional Health Center is collaborating with Salina-Saline County Health Department and Central Kansas Foundation to conduct a community health assessment and develop a community health improvement plan. Across the early months of 2012, data was gathered, analyzed, and discussed by this collaborative group. Poster board presentations of the group's findings were prepared for presentation to a July 9, 2012 forum of representatives from a broader group of agencies that are involved in community development and health improvement. Participants included representatives of Salina Area United Way, Salina Family Healthcare, ComCare PA, Occupational Center of Central Kansas, Greater Salina Community Foundation, Salina Public Schools, Veridian Behavioral Health, Central Kansas Mental Health Center, Saline County Commission on Aging, Kansas State University Extension, City of Salina Parks and Recreation, Heartland Programs, North Central Kansas Regional Trauma Council, Salina Regional Health Center, The Volunteer Connection, Salina-Saline County Health Department, Central Kansas Foundation, and faith-based programs. The outcome of the meeting was buy-in to a process of getting broad community input into health improvement priorities, commitment to partner in the process, understanding of community health status data, and initial identification of priority issues to be addressed.
Part III, Line 4: See note A5 (page 9) of the audited financial statements regarding the allowance for uncollectible accounts. Part III, Line 3: A review of bad debt accounts was conducted to find accounts that were eligible for charity care. Eligibility was determined by whether the patient had received financial assistance for a portion of their responsibility toward the account. Any remaining charges written off after the financial assistance was granted was included as bad debt expense attributable to patients eligible for financial assistance.
Part III, Line 8: Amounts were obtained from the cost report filed with Medicare for the period ending September 30, 2013, less subsidized health services revenue and expenses included in Schedule H, Part I, Item 7(g). The total amount of the shortfall is considered a community benefit.
Part III, Line 9b: If a patient qualifies for financial assistance, the account is adjusted according to our policy. Any remaining balance after adjustment is collected under the billing and collection policies. Our billing and collection policies are the same for all patients. Patients who have qualified for financial assistance are considered approved for a period of six months from the date of approval. After six months, patients need to reapply for financial assistance.
Ratio of patient care cost to charges (see calculation for Part I, Line 7) multiplied by provision for bad debts.Part III, Line 2:
Part V, Section B, Line 3: Salina Regional Health Center collaborated with Salina-Saline County Health Department and Central Kansas Foundation to conduct a community health assessment and develop a community health improvement plan. Data was gathered, analyzed, and discussed by this collaborative group. Results were presented at a forum of representatives from a broader group of agencies involved in community development and health improvement. Broad community input was obtained through public forums and surveys. To assess public perception of the health issues identified by community partner organizations as most concerning, a survey and background information was developed and distributed in March 2013. Saline County residents were invited to review the information and participate in the survey via social media, the local newspaper, email, and notices posted throughout the community. A summary of the issues was presented at two public meetings that included opportunity for discussion with CHA Core Group representatives. A written summary of issues and the survey were placed at community locations that were easily accessible. Electronic versions of materials and the link to an internet survey were distributed via social media, the local newspaper, and email. Three hundred four individual surveys were completed during the 30 days it was available.Salina Regional Health Center, Inc.
Part V, Section B, Line 5c: The initial data report was provided on websites and in paper form at the Salina Regional Health Center information desk, public library, county health department, and other locations. The final report is posted on the Salina Regional Health Center website. A professional publication for broad distribution is under development for spring 2014 distribution (newspaper, direct mail, personal distribution to agencies, and other public locations). Results will also be presented by a SRHC representative at civic clubs and other settings.Salina Regional Health Center, Inc.
Part V, Section B, Line 7: Childhood obesity, teen pregnancy, adult obesity, domestic violence, and sexually-transmitted infections were needs identified in the CHNA which are not being addressed by Salina Regional Health Center as they are outside the scope of our operations.Salina Regional Health Center, Inc.
Part V, Section B, Line 16e: File against estatesSalina Regional Health Center, Inc.
Part V, Section B, Line 18e: No such effortsSalina Surgical Center, LLC
Part V, Section B, Line 20d: Deduction of 30%.Salina Regional Health Center, Inc.
Part V, Section B, Line 20d: Usual and customary net charges for services rendered.Salina Surgical Center, LLC
A community health needs assessment for Salina Surgical Center, LLC, a hospital facility of the hospital organization Salina Regional Health Center, was not conducted by the end of Salina Regional Health Center's taxable year. In late November 2013 our consultant began researching the requirements of 501(r) in relationship to our ownership percentage of Salina Surgical Center. In January 2014, we received a letter from our consultant indicating that Salina Surgical Center met the definition of a hospital facility under the proposed regulations. After reviewing the research and consulting legal counsel, we concluded in May 2014 that Salina Surgical Center, LLC is a hospital facility of Salina Regional Health Center; therefore, all requirements of 501(r) are applicable to Salina Surgical Center. We are currently in the process of making sure all requirements under 501(r) are met including the adoption of the CHNA and implementation strategy for Salina Surgical Center. We anticipate starting the joint CHNA by the end of the fiscal year ended 9/30/2014 and meeting the requirements for conducting the CHNA and adopting an implementation strategy by fiscal year ended 9/30/2015. To minimize future failures, we will communicate with Salina Surgical Center regarding the 501(r) requirements on an ongoing basis and work together with them to meet the requirements. On August 6, 2014, the board of directors of Salina Surgical Center reviewed and endorsed the findings of the Saline County 2013 Community Needs Assessment Survey.Part V, Section B, Line 1:Notice 2014-3 Proposed Revenue Procedure Disclosure:
Part VI, Line 2: In addition to the community health needs assessment, SRHC analyzes hospital discharge data for all counties in the region. The Kansas Hospital Association inpatient discharge database includes data for all reporting hospitals. From this we determine usage trends that help us plan needed services. For example, a significant number of residents of north central Kansas have had to travel far out of the region to access neurosurgical services because SRHC only had one neurosurgeon. This assessment and other information led to SRHC's employment of two additional neurosurgeons. One began practice in 2012 and the other in 2013.
Part VI, Line 3: At registration, the patient is informed of their rights for financial assistance if unable to produce valid insurance coverage. The patient is referred to a third-party vendor to determine eligibility for governmental programs and if it is determined they do not qualify, they are screened under our financial assistance guidelines. We post our guidelines on our website as well.
Part VI, Line 4: Salina Regional Health Center, Inc., is a rural sole community hospital serving a primary service area of Saline County, three immediately adjacent counties are its secondary service area, and has a 14-county referral area although certain specialties draw statewide. For purposes of community health needs assessment, the principal community of SRHC is Saline County because the other three counties each have a local Critical Access Hospital within the county. The primary service area (Saline County) has a population of 55,740. When compared to the national population, this area is represented by an older population with a lower educational level and lower median income. The area population grew 0.2% between 2010 and 2013. The primary service area population is expected to increase by 1.3% by 2018, which is lower than the rate of growth expected for Kansas (2.2%) and the U.S. (3.3%) for the same time period.The service area is less ethnically diverse compared to the U.S. overall. The majority of residents are Caucasian (81.4%) followed by Hispanic (10.3%), and Black (3.5%). Spanish patient education materials are available at SRHC and the hospital has developed a team of Spanish translators. Recognizing the relatively lower educational level in the community, the hospital writes patient information at a 6th to 8th grade reading level.Median household income in the primary service area in 2013 was $47,339, compared to a Kansas median of $51,273, and national median of $53,046. A lack of available resources to the indigent is a challenge in this environment, so in addition to providing charity care, the hospital has and continues to support the Salina Family Healthcare Center, which provides care to the indigent. Our patient population is composed of 50% Medicare, 11% Medicaid, 31% Commercial, 3% Tricare Workers Compensation, and 5% uninsured.
Part VI, Line 5: The governing board of Salina Regional Health Center, Inc., is comprised of volunteers intentionally selected to promote the betterment of the region we serve. Demonstrating its commitment to community benefit, this board has for nearly 20 years donated an average of 10% of the hospital's end-of-year operating margin to the Community Health Invest Program (CHIP) of the Salina Regional Health Foundation. Salina Regional Health Center, Inc., administrators and governing board members assist the Foundation by participating in the CHIP Committee.The Salina Regional Health Foundation's Community Health Investment Program (CHIP) awarded 12 grants in fiscal year 2013 for a total of $315,750. Funding for CHIP primarily comes from Salina Regional Health Center, which tithes a percentage of its operating margin each year to the Salina Regional Health Foundation. Additional funding for CHIP has come from the Salina Regional Service Auxiliary.Since the program was established in 1994, more than $8 million has been awarded through CHIP. Funding priorities for CHIP have primarily focused on youth development with emphasis on healthy lifestyles, dental access, and early childhood care and education. Grants in 2013 included:- $50,000 to the Coronado Area Council, Boy Scouts of America, for its Second Century Scouting Campaign to make capital improvements to Camp Brown and Scout Strong programming.- $50,000 to Noon Network AMBUCS for a handicapped accessible playground at Coronado Elementary School.- $50,000 to Kansas Wesleyan University for nursing scholarships.- $35,850 to the Salina Family Healthcare Center for a nitrous oxide delivery system at the clinic and pediatric surgical dental equipment for patients needing to undergo general anesthesia surgical procedures at the hospital.- $35,000 to the Salina-Saline County Health Department for the Maternal Child Health Program for prenatal education programming.- $25,000 to the Good Neighbor Fund for grants up to $1,000 to area charitable organizations to be awarded upon request at the discretion of the Foundation's executive director.- $20,000 in matching funds for the 2013 Salina Area United Way Campaign. The grant matched 50 cents for each dollar raised by Salina Regional Health Center's employee and volunteer led campaign. Employees raised $47,261.46 for a total contribution of $67,261.46.- $19,400 to the Salina Education Foundation to support the Power of One/Healthy Lifestyles Project, Sudden Opportunity Grants, The Heart Project, Early Childhood Parent Involvement Project, Heartland Programs, Opportunity Now/Social Meals Project, Kansas Kids Fitness Project, Central Kansas Cooperative in Education Ropes Project, and School Nurse Emergency Funds.- $12,000 to the Stiefel Theatre to provide complimentary tickets to area music students who complete specialized course work.- $10,000 to Big Brothers Big Sisters of Salina for the Big Heart Program, which pairs Bigs with children who have a parent or guardian facing a serious illness or injury.- $5,000 to Rolling Hills Zoo for Dream Night a special night at the zoo for children with terminal or chronic illness or disability and their immediate families.- $3,500 to Salina Community Theatre to allow special needs children and their families to attend performances free of charge.Salina Regional Health Center, Inc., is a member of the Sunflower Health Network (SHN), an organization of Salina Regional Health Center, Inc., and 14 Critical Access Hospitals (CAHs) distributed across 14 counties. A Salina Regional administrator led SHN strategic planning that resulted in regional health priorities, including improving access to specialist physician care, optimizing timeliness and safety of patient transfers, and sustaining the number of quality nurses in the region. As a result of this process, Salina Regional Health Center, Inc., invested in hiring physician recruiters for both the Salina community and the larger region. In 2012 Salina Regional Health Center, Inc., was verified by the American College of Surgeons as a Level III trauma center, the only designated Level III trauma center in the north central Kansas region. Salina Regional also provides access to computerized patient simulators and other nursing education modalities to strengthen the quality of nurses in regional communities.Salina Regional Health Center began a partnership with The University of Kansas School Of Medicine in 2010 to open a medical school campus in Salina. The intent is to develop students who will live and practice medicine in smaller-town Kansas to help alleviate the rural physician shortage. The eight students in the inaugural class completed their first year of medical school in 2012. Salina Regional Health Center is investing $1 million over a four-year period to help defray faculty and operating costs. The hospital also invested several hundred thousand dollars to renovate a building on the hospital campus. The building is provided to KU rent-free for as long as the medical school campus exists.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
Salina Regional Health Foundation Inc
400 South Santa FeSalinaKS67401480949407501(c)(3)672810To further the activities of the Community Health Improvement Program (CHIP)
KU Endowment
3901 Rainbow BlvdKansas CityKS661607804480547734501(c)(3)250000Support KU School of Medicine - Salina campus
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantSalina Regional Health Center, Inc., provides scholarships to students attending nursing school.TypeOfGrant
Number Of Recipients23NumberOfRecipients
Amount Of Cash Grant96662AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: All donee information is kept as part of the organization's books and records. For all nursing scholarships recipients are selected based on set criteria.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Sean Herrington MD
Trustee30294307376903460125000129180402476000
Micheal Terry
President/CEO3445660134400000508170147950544578000
Joe Tallon
VP Finance/CFO206991034600000125000124520266543000
Larry Barnes
VP Information Technology22185303555500051111083610316880000
Charles Grimwood
VP Regional Development19382003199503460122780131080251547000
Jack Hinnenkamp
VP Facilities Management16728302669500010229074860211693000
David Moody
VP Human Resources17258502842203460109090121910224453000
Joel Phelps
COO244336059905000307540127620347757000
John Kelemen
Physician642184025000057690125000165170701970000
Jacob Breeding
Physician3438210600000346050000134980422665000
Ali Manguoglu
Physician3676040450001300125000140840398818000
Keir Swisher
Physician34053906800003460125000127580434143000
Jeremiah Ostmeyer
Physician37225807350000050000118030462561000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePart I, Line 6ReturnReference
ExplanationThe compensation committee of the board determines bonus and incentive payments based on a balanced scorecard which includes financial, patient satisfaction, and quality data. In addition, a compensation review is performed by an independent outside consultant.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1City of Salina KansasBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN486017228IssuerEIN
CUSIP Number794770DP9CUSIPNumber
Date Issued2006-04-07DateIssued
Issue Price65053116IssuePrice
Description Of PurposeExtinguish Series 1999 Revenue Bonds and to construct a new patient towerDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Retired9978116AmountRetired
Total Proceeds65053116TotalProceeds
Amount In Reserve Fund4432787AmountInReserveFund
Issuance Costs From Proceeds570534IssuanceCostsFromProceeds
Capital Expenditures37121199CapitalExpenditures
Other Spent Proceeds23036195OtherSpentProceeds
Year Of Subst Completion2010YearOfSubstCompletion
Current Refunding0CurrentRefunding
Advance Refunding1AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Bond Iss Meet Prvt Security Pay Test0BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop0ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs0NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiled
Rebate Not Due Yet0RebateNotDueYet
Exception To Rebate0ExceptionToRebate
No Rebate Due0NoRebateDue
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Written Proc To Monitor Reqs0WrittenProcToMonitorReqs

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Stacie Maes
Family member of Jim Maes, Trustee53919Employment0
Salina Surgical Center
4 Board of directors are employees and/or trustees of SRHC164781Provide employees and supplies0
Patricia Grimwood
Spouse of Charles Grimwood, Key Employee of SRHC28170Employment0
Linda Hinnenkamp
Spouse of John Hinnenkamp, Key Employee of SRHC62467Employment0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 6Salina Regional Health Center has two corporate members: Salina Regional Health Foundation, Inc., and Via Christi Health, Inc.
Form 990, Part VI, Section A, line 7aThe corporate members have the power to approve appointment of members to and removal of members from the Board of Trustees.
Form 990, Part VI, Section B, line 11The Form 990 is provided to the Board of Trustees for review prior to filing.
Form 990, Part VI, Section B, line 12cA conflict of interest questionnaire is required to be completed upon election and annually. The questionnaire is reviewed by legal counsel.
Form 990, Part VI, Section B, line 15An independent compensation firm is obtained to complete an annual review and analysis of all the administrative staff members. The compiled report is forwarded to the Compensation Committee of the Board that reviews the analysis and approves the report.
Form 990, Part VI, Section C, line 19The Organization makes its governing documents, conflict of interest policy, and audited financial statements available to the public upon written request.
Form 990, Part XI, line 9:Intercompany transfers 173,716. Change in fair value of assets held in trust 478,251. Change in beneficial interest in net assets of Foundation 801,453.Changes in Net Assets or Fund Balances:
Form 990, Part XII, Line 2C:The audit committee assumes the responsibility for the oversight of the audited financial statements, review of the Form 990 and Form 990-T, and selection of the independent accounting firm.Audit Committee

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Salina Regional Health Foundation Inc
400 South Santa FeSalinaKS67401480949407Advancement of healthcare, health & medical education, research, & welfareKS501(c)(3)170(b)(1)(A)(vi)0
Salina Regional Health Properties Inc
400 South Santa FeSalinaKS67401481154675Own and operate medical office buildings for section 501(c)(3) organizationsKS501(c)(2)1Salina Regional Health Center Inc
Hospice of Salina Inc
730 Holly LaneSalinaKS67402481131570Provide hospice care and support services to the terminally ill and theirKS501(c)(3)509(a)1Salina Regional Health Center Inc
Via Christi Health Inc
8200 E Thorn Drive Suite 300WichitaKS67226481172107Hospital supportKS501(c)(3)509(a)0

Form990 Schedule R Part III Form990ScheduleRPartIII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStatePredominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnershipBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Salina Surgery Properties LLC
401 South Santa FeSalinaKS67401481200039Construct & own surgical facilityKSRelated2293351746696000.50000
Salina Surgical Center LLC
401 South Santa FeSalinaKS67401481199515Medical services, ambulatory surgeryKSRelated29334694388513000.50000
Salina Regional Home Medical Services LLC
520 South Santa Fe Suite 140SalinaKS67401481221623Home medical servicesKSRelated150882548772000.51000Salina Regional Health Center Inc

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Salina Regional Health Enterprises IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1400 South Santa FeAddressLine1
CitySalinaCity
StateKSState
ZIP Code67402ZIPCode
FieldValueIRS element (for citing)
EIN481056225EIN
Primary ActivityProvide mgmt services to hospitals in N. Central KS areaPrimaryActivity
Legal Domicile StateKSLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Salina Regional Health Center IncBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCTypeOfEntity
Share Of Total Income4389ShareOfTotalIncome
Share Of EOY Assets74283ShareOfEOYAssets
Percentage Ownership1.00000PercentageOwnership
Controlled Org1ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets1ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (8 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Salina Regional Health Properties Inc
I190280Cash received
Salina Regional Health Properties Inc
K770734Cash paid
Salina Regional Health Properties Inc
O109611Actual cost
Salina Regional Health Properties Inc
Q135660Actual cost
Hospice of Salina Inc
O284174Cash paid
Hospice of Salina Inc
Q240960Actual cost
Hospice of Salina Inc
B880000Actual cost
Salina Surgical Center LLC
Q299624Markup of cost