COMMUNITY HEALTHCARE SYSTEM INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: COMMUNITY HEALTHCARE SYSTEM INC (EIN 48-1020227)
Tax period: 2012-04-01 to 2013-03-31
Filed: 2014-02-14
IRS object ID: 201410459349301121
Schema version: 2012v2.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule C
Schedule D
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-02-14T13:49:41-08:00	Timestamp
Tax Period End Date	2013-03-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	GEORGE BOWERMAN & NOEL PA	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	301 N MAIN SUITE 1350	AddressLine1
City	WICHITA	City
State	KS	State
ZIP Code	67202	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-04-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	481020227	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	COMMUNITY HEALTHCARE SYSTEM INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	COMM	NameControl
Phone	7858894657	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	120 WEST 8TH STREET	AddressLine1
City	ONAGA	City
State	KS	State
ZIP Code	66521	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	MONICA HOLTHAUS	Name
Title	CHIEF FINANCIAL OFFICER	Title
Phone	7858894657	Phone
Date Signed	2014-02-14	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	PAUL R BOWERMAN	Name
Phone	3162626277	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	MONICA HOLTHAUS	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	120 WEST 8TH ST	AddressLine1
City	ONAGA	City
State	KS	State
ZIP Code	66521	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	27702731	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	N/A	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1986	YearFormation
State Legal Domicile	KS	StateLegalDomicile
Activity Or Mission Description	Community HealthCare System,in partnership with our medical staff, has a long standing tradition in providing quality and compassionate health care to rural commmunities of NE Kansas and all our patients. Ourmission is to enrich the health and lives of the people we serve.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	7	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	7	NbrIndependentVotingMembers
Total Nbr Employees	536	TotalNbrEmployees
Total Nbr Volunteers	0	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	58588	ContributionsGrantsPriorYear
Contributions Grants Current Year	71265	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	26144381	ProgramServiceRevenuePriorYear
Program Service Revenue CY	27469821	ProgramServiceRevenueCY
Investment Income Prior Year	26118	InvestmentIncomePriorYear
Investment Income Current Year	32463	InvestmentIncomeCurrentYear
Other Revenue Prior Year	165683	OtherRevenuePriorYear
Other Revenue Current Year	129182	OtherRevenueCurrentYear
Total Revenue Prior Year	26394770	TotalRevenuePriorYear
Total Revenue Current Year	27702731	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	17613372	SalariesEtcPriorYear
Salaries Etc Current Year	19010380	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	7824574	OtherExpensePriorYear
Other Expenses Current Year	8903063	OtherExpensesCurrentYear
Total Expenses Prior Year	25437946	TotalExpensesPriorYear
Total Expenses Current Year	27913443	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	956824	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-210712	RevenuesLessExpensesCY
Total Assets BOY	10116983	TotalAssetsBOY
Total Assets EOY	11543879	TotalAssetsEOY
Total Liabilities BOY	5668796	TotalLiabilitiesBOY
Total Liabilities EOY	7404159	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	4448187	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	4139720	NetAssetsOrFundBalancesEOY
Mission Description	Community HealthCare System,in partnership	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	21461233	Expense
Revenue	27469821	Revenue
Description	RURAL HOSPITAL PROVIDING MEDICAL CARE ON BOTH AN INPATIENT AND OUTPATIENT BASIS TO AREA RESIDENTS. SERVICES PROVIDED INCLUDE EMERGENCY, OBSTETRICS, SURGICAL, RADIOLOGY, REHABILITATION, RURAL HEALTH CLINIC, HOME HEALTH CARE, AND LONG TERM CARE	Description
Total Program Service Expense	21461233	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	true	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	true	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	true	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	true	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	29	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	536	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Form8899 Filed	false	Form8899Filed
Form1098 C Filed	false	Form1098CFiled
Excess Business Holdings	false	ExcessBusinessHoldings
Taxable Distributions	false	TaxableDistributions
Distribution To Donor	false	DistributionToDonor
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	7	NbrVotingGoverningBodyMembers
Number Independent Voting Members	7	NumberIndependentVotingMembers
Family Or Business Relationship	true	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	MONICA HOLTHAUS	NamePerson
Telephone Number	7858894657	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	120 W 8TH STREET	AddressLine1
City	ONAGA	City
State	KS	State
ZIP Code	66521	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Highest Compensated EmployeeHighestCompensatedEmployee
JUSTIN BOSWELL
CHAIRMAN	2.00	X	2893	0	0
VIRGINIA REZAC
VICE CHAIRMAN	2.00	X	1568	0	0
ALAN FISCHER
SECRETARY	2.00	X	1500	0	0
MELVIN HANDLEY
DIRECTOR	2.00	X	950	0	0
MARK BOUTON
DIRECTOR	2.00	X	1806	0	0
KAREN HARDER
DIRECTOR	2.00	X	1559	0	0
ROBERT LADNER
DIRECTOR	2.00	X	1502	0	0
GREG UNRUH
CEO	40.00		208001	0	22903	X
MARCIA WALSH
COO	40.00		146768	0	12779	X
MONICA HOLTHAUS
CFO	40.00		101524	0	1729	X
ROSALIND LEWIS
CNO	40.00		117126	0	1996	X
DR DAVID
ALLEN	40.00		386251	0	11776		X
DR THOMAS WALSH
PHYSICIAN	40.00		331956	0	9613		X
DR DAGOBERTO HEREDIA
PHYSICIAN	40.00		300771	0	3309		X
DR JOHN KELLEY
PHYSICIAN	40		251795		7929		X
DR CHANCE WILLIAMS
PHYSICIAN	40		244741		9997		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	2100711	TotalReportableCompFromOrg
Total Other Compensation	82031	TotalOtherCompensation
Number Individuals GT100 K	21	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
ANESTHESIA PROFESSIONALS
2017 W HARBORLIGHT C	WICHITA	KS	67204	ANESTHESIA SERVICES	416000
STORMONT-VAIL HLTH CARE
1500 SW 10TH STREET	TOPEKA	KS	66604	MEDICAL SERVICES	237163
BENEFIT MANAGEMENT INC
2015 16TH STREET	GREAT BEND	KS	67530	THIRD PARTY ADMINISTRATOR FOR HEALTH INSURANCE	175643
HEALTHLAND
625 S LAKESHORE DR	GLEENWOOD	MN	56334	COMPUTER SYSTEM MAINTENANCE	215978
SHARED MEDICAL SERVICES INC
209 LIMESTONE PASS	COTTAGE GROVE	WI	53527	MRI SERVICES	160400

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	11	NumberOfContractorsGT100K
All Other Contributions	71265	AllOtherContributions
Noncash Contributions	8700	NoncashContributions
Total Contributions	71265	TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn
NET PATIENT SERVICE REVENUE	622110	26401390
TAX SUBSIDY	622110	1068431

Field	Value	IRS element (for citing)
Total Program Service Revenue	27469821	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	32463	TotalRevenueColumn
Exclusion	$32,463	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	19000	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	19000	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	19000	TotalRevenueColumn
Exclusion	$19,000	ExclusionAmount

Other Revenue Misc OtherRevenueMisc

Field	Value	IRS element (for citing)
Description	Other	Description
Business Code	900099	BusinessCode
Total Revenue Column	110182	TotalRevenueColumn
Exclusion	$110,182	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	110182	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	27702731	TotalRevenueColumn
Related Or Exempt Function Income	27469821	RelatedOrExemptFunctionIncome
Exclusion	$161,645	ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	585198	Total
Program Services	444222	ProgramServices
Management And General	140976	ManagementAndGeneral
Fundraising	0	Fundraising

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	15739214	Total
Program Services	12423571	ProgramServices
Management And General	3315643	ManagementAndGeneral
Fundraising	0	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	111213	Total
Program Services	81693	ProgramServices
Management And General	29520	ManagementAndGeneral
Fundraising	0	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	1456245	Total
Program Services	935981	ProgramServices
Management And General	520264	ManagementAndGeneral
Fundraising	0	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	1118510	Total
Program Services	881754	ProgramServices
Management And General	236756	ManagementAndGeneral
Fundraising	0	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	110326	Total
Program Services	102470	ProgramServices
Management And General	7856	ManagementAndGeneral
Fundraising	0	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	120247	Total
Program Services	75294	ProgramServices
Management And General	44953	ManagementAndGeneral
Fundraising	0	Fundraising

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	1222394	Total
Program Services	772830	ProgramServices
Management And General	449564	ManagementAndGeneral
Fundraising	0	Fundraising

Travel Travel

Field	Value	IRS element (for citing)
Total	150085	Total
Program Services	116783	ProgramServices
Management And General	33302	ManagementAndGeneral
Fundraising	0	Fundraising

Interest Interest

Field	Value	IRS element (for citing)
Total	160021	Total
Program Services	137694	ProgramServices
Management And General	22327	ManagementAndGeneral
Fundraising	0	Fundraising

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	677237	Total
Program Services	501155	ProgramServices
Management And General	176082	ManagementAndGeneral
Fundraising	0	Fundraising

Insurance Insurance

Field	Value	IRS element (for citing)
Total	243560	Total
Program Services	140078	ProgramServices
Management And General	103482	ManagementAndGeneral
Fundraising	0	Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
LEASED EQUIPMENT	120715	98417	22298
MISCELLANEOUS	190418	38469	151949
DUES AND SUBSCRIPTIONS	175982	73827	102155
EDUCATION	202577	168398	34179

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	5529501	Total
Program Services	4468597	ProgramServices
Management And General	1060904	ManagementAndGeneral
Fundraising	0	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	27913443	Total
Program Services	21461233	ProgramServices
Management And General	6452210	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	1739334	BOY
EOY	397549	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	3004715	BOY
EOY	2919619	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	880269	BOY
EOY	827350	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	194423	BOY
EOY	160687	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	15455581	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	9374638	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	3741497	BOY
EOY	6080943	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	182184	BOY
EOY	40169	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	74555	BOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	300006	BOY
EOY	1117562	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	10116983	BOY
EOY	11543879	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	2782348	BOY
EOY	2898253	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	2105000	BOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	687806	BOY
EOY	4412264	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	93642	BOY
EOY	93642	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	5668796	BOY
EOY	7404159	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	4317661	BOY
EOY	4129675	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	130526	BOY
EOY	10045	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	4448187	BOY
EOY	4139720	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	10116983	BOY
EOY	11543879	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	-210712	ReconcilationRevenueExpenses
Reconcilation Prior Adjustment	-97755	ReconcilationPriorAdjustment
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Separate	X	FinancialStatementSeparate

Field	Value	IRS element (for citing)
Audit Committee	false	AuditCommittee
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii
Public Support Total170	0	PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

Field	Value	IRS element (for citing)
Total	0	Total

Field	Value	IRS element (for citing)
Public Support Pertcentage170	0	PublicSupportPertcentage170
Public Support Total509	0	PublicSupportTotal509
Public Support Percentage509	0	PublicSupportPercentage509
Investment Income Percentage	0	InvestmentIncomePercentage

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	Volunteers
Paid Staff Or Management	false	PaidStaffOrManagement
Media Advertisements	false	MediaAdvertisements
Mailings Members	false	MailingsMembers
Publications Or Broadcast	false	PublicationsOrBroadcast
Grants Other Organizations	false	GrantsOtherOrganizations
Direct Contact Legislators	false	DirectContactLegislators
Rallies Demonstrations	false	RalliesDemonstrations
Other Activities	true	OtherActivities
Other Activities	$4,692	OtherActivitiesAmount
Total Lobbying Expenditures IIB	4692	TotalLobbyingExpendituresIIB

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	Pt II-B Line 1i	Identifier
Explanation	LOBBYING PORTION OF KANSAS HOSPITAL ASSOCIATION DUES	Explanation

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	370866	OtherCostOrOtherBasis
Book Value	370866	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	6224208	OtherCostOrOtherBasis
Depreciation	4036886	Depreciation
Book Value	2187322	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	6605435	OtherCostOrOtherBasis
Depreciation	5337752	Depreciation
Book Value	1267683	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	2255072	OtherCostOrOtherBasis
Book Value	2255072	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	6080943	TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescription	Method Of ValuationMethodOfValuation	Book ValueBookValue
FUNDS HELD BY TRUSTEE UNDER INDENTURE AGREEMENT	F
ASSETS WHOSE USE IS LIMITED-CD	C	40169

Field	Value	IRS element (for citing)
Total Of Book Value Securities	40169	TotalOfBookValueSecurities

Other Assets OtherAssets (3 entries)

DescriptionDescription	Book ValueBookValue
DUE FROM THIRD PARTY PAYER	1062149
DEFERRED FINANCING COSTS
OTHER	55413

Field	Value	IRS element (for citing)
Total Book Value Other Assets	1117562	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	DUE TO COMMUNITY HOSPITAL DISTRICT	Description
Amount	$93,642	Amount

Field	Value	IRS element (for citing)
Total Of Amounts	93642	TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt	27702731	TotRevenueEtcAuditedFinclStmt
Revenue Subtotal	27702731	RevenueSubtotal
Total Revenue Per Form990	27702731	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	27913443	TotExpensesEtcAuditedFinclStmt
Expenses Subtotal	27913443	ExpensesSubtotal
Total Expenses Per Form990	27913443	TotalExpensesPerForm990

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
FPG Reference Free Care	true	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	true	FPGReferenceDiscountedCare
Pcent200 D	X	Pcent200D
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	true	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	false	ExpensesExceededBudget
Annual Community Benefit Report	false	AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	168708	TotalCommunityBenefitExpense
Net Community Benefit Expense	168708	NetCommunityBenefitExpense
Percent Of Total Expense	0.00600	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1089784	TotalCommunityBenefitExpense
Direct Offsetting Revenue	862514	DirectOffsettingRevenue
Net Community Benefit Expense	227270	NetCommunityBenefitExpense
Percent Of Total Expense	0.00810	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1258492	TotalCommunityBenefitExpense
Direct Offsetting Revenue	862514	DirectOffsettingRevenue
Net Community Benefit Expense	395978	NetCommunityBenefitExpense
Percent Of Total Expense	0.01410	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	389166	TotalCommunityBenefitExpense
Direct Offsetting Revenue	197818	DirectOffsettingRevenue
Net Community Benefit Expense	191348	NetCommunityBenefitExpense
Percent Of Total Expense	0.00690	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	11526729	TotalCommunityBenefitExpense
Direct Offsetting Revenue	10096273	DirectOffsettingRevenue
Net Community Benefit Expense	1430456	NetCommunityBenefitExpense
Percent Of Total Expense	0.05120	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	11915895	TotalCommunityBenefitExpense
Direct Offsetting Revenue	10294091	DirectOffsettingRevenue
Net Community Benefit Expense	1621804	NetCommunityBenefitExpense
Percent Of Total Expense	0.05810	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	13174387	TotalCommunityBenefitExpense
Direct Offsetting Revenue	11156605	DirectOffsettingRevenue
Net Community Benefit Expense	2017782	NetCommunityBenefitExpense
Percent Of Total Expense	0.07220	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense	$394,058	BadDebtExpenseAmount
Amount Attributable To	295544	AmountAttributableTo
Amount Reimbursed By Medicare	5305326	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	5332936	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-27610	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	COMMUNITY HOSPITAL ONAGA	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	120 WEST 8TH	AddressLine1
City	ONAGA	City
State	KS	State
ZIP Code	66521	ZIPCode

Field	Value	IRS element (for citing)
Critical Access Hospital	X	CriticalAccessHospital

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	COMMUNITY HOSPITAL ONAGA	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	true	CHNAConducted
Community Definition	X	CommunityDefinition
Community Demographics	X	CommunityDemographics
Existing Resources	X	ExistingResources
How Data Obtained	X	HowDataObtained
Community Health Needs	X	CommunityHealthNeeds
Other Health Issues	X	OtherHealthIssues
Identifying Process	X	IdentifyingProcess
Consulting Process	X	ConsultingProcess
Needs Assessment Conducted	13	NeedsAssessmentConducted
Take Into Account	true	TakeIntoAccount
Other Facilities	false	OtherFacilities
CHNA Widely Available	true	CHNAWidelyAvailable
Own Website	X	OwnWebsite
Develop Community Plan	X	DevelopCommunityPlan
Participate Community Plan	X	ParticipateCommunityPlan
Prioritize Health Needs	X	PrioritizeHealthNeeds
Prioritize Services	X	PrioritizeServices
All Needs Addressed	false	AllNeedsAddressed
Organization Incur Excise Tax	false	OrganizationIncurExciseTax
Eligibility Criteria Explained	true	EligibilityCriteriaExplained
Uses FPG Free	true	UsesFPGFree
FPG Free Percent	200	FPGFreePercent
Uses FPG Discounted	true	UsesFPGDiscounted
FPG Discount Percent	200	FPGDiscountPercent
Explains Basis	true	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Uninsured Discount	X	UninsuredDiscount
Explains Application Method	true	ExplainsApplicationMethod
Includes Publicity Measures	true	IncludesPublicityMeasures
Available On Request	X	AvailableOnRequest
Actions On Nonpayment	true	ActionsOnNonpayment
Permit Other Actions	X	PermitOtherActions
Collection Activities	false	CollectionActivities
Nondiscrim Emergency Care Policy	true	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	false	AmountsGenerallyBilled
Gross Charges	false	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	5	NumberOfOtherFacilities

Other Facilities OtherFacilities (5 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
EASTRIDGE NURSING FACILITY
600 1ST STREET	CENTRALIA	KS	66415	Long-term Care
DOWNTOWN MEDICAL CLINIC
112 EAST 2ND STREET	FRANKFORT	KS	66427	Rural Health Clinic
HOLTON FAMILY HEALTH CLINIC
1603 WEST 4TH STREET	HOLTON	KS	66536	Rural Health Clinic
WESTMORELAND MEDICAL CLINIC
208 NORTH 1ST STREET	WESTMORELAND	KS	66549	Medical Clinic
FAMILY PRACTICE MEDICAL CLINIC
6221 5TH STREET	CORNING	KS	66417	Medical Clinic

Form990 Schedule H Part VI Form990ScheduleHPartVI (94 entries)

IdentifierIdentifier	ExplanationExplanation
Pt I Line 7	The total cost to charge ratio derived from the
	Medicare cost report was applied to gross charges to compute
	the community benefit expense for charity care and
	unreimbursed Medicaid. The community benefit expense
Pt VI Line 3	for community health improvement services and
	subsidized health services was obtained from the total
	costs per Worksheet B on the Medicare cost report
	with adjustments made to exclude amounts otherwise
	included as charity care, bad debts or unreimbursed
	Medicaid.
Pt I Line 7g	Subsidized health services include the cost attributable
	to physician clinics operated in rural communities
	and designated as Rural Health Clinics - $1,107,806
Pt III Line 4	The total cost to charge ratio derived from the
	Medicare cost report was applied to the gross charges
	written off (net of collections) to compute the
	community benefit expense for bad debts. The cost of
	providing services to those with the inability to pay
	or where collection efforts are not successful are
	included as community benefit expense to represent
	the full costs of providing services to the community.
	Financial statement footnote-If the patient is
	unable to pay the full amount at the time the patient is billed,
	the System negotiates a payment plan whereby monthly
	payments are made by the patient on the account. Accounts
	are considered delinquent and subsequently written off as bad debts
	based on individual credit evaluation and specific circumstances
	of the account. If future actual default rates on accounts receivable
	differ from those currently anticipated, the System may have to adjust its
	allowance for doubtful accounts, which would affect earnings
	in the period the adjustments are made.
Pt III Line 8	Medicare allowable cost per the Medicare cost report.
	Costs are apportioned to the Medicare program based on
	departmental cost to charge ratios for ancillary services
	and patient days for inpatient and swing bed services.
Pt III Line 9b	If collection efforts determine that a patient may
	qualify for finacial assistance, the financial assistance
	process is initiated including attempts to obtain the
	documentation required under the policy. Collection
	and financial assistance policies are consistently applied to all
	patients. Indigent patients balances adjusted according to Medicare bad debt policies
Pt VI Line 2	Informal needs assessment performed on an ongoing basis.
	Hospital personnel identify needs based on admissions
	and discharge data. Needs are also identified by
	requests from surrounding rural communities. Formal
	needs assessment is in process.
Pt VI Line 3	The availability of financial assistance is stated in
	collection letters sent to patients. Collections staff
	also inform uninsured patients of financial assistance
	available and policies are addressed verbally at admission with
	clinic patients.
Pt VI Line 5	All of the organization's governing body is comprised
	of individuals who reside in the organizaton's primary
	service area.
	Community HealthCare System, Inc. (the System) is a
	non-profit organization created by the Board of
	Directors of, and is considered a component unit of
	Community Hospital District No. 1 of
	Pottawatomie, Jackson and Nemaha Counties, Kansas
	to operate, control, and manage all matters concerning
	healthcare services in its service area pursuant to a lease agreement
	between the Hospital District and the System.
	The Hospital District Board appoints the members of the Board of Directors
	of the System. The Hospital District board is elected.
	The System's responsiveness to the community is demonstrated
	by the operation of Rural Health/Physician clinics in
	surrounding rural communities to provide access to care
	at the request from the surrounding communities or as a
	result of identified needs. The system participates
	in all government sponsored health care programs (Medicare,
	Medicaid, CHAMPUS, Tricare)and serves all persons
	regardless of ability to pay. The System operates
	LifeCare fitness centers in an effort to enhance
	community health thereby reducing total health care
	cost. The System extends medical staff privileges to
	qualified physicians in the community.
Pt VI Line 4	Critical Access Hospital serving primarly as sole provider
	to rural areas in Pottawatomie, Jackson and Nemaha Counties.
Pt V Sec B 19d	The Hospital assists those patients who are uninsured
	or have non-covered services by providing a 20% discount
	for hospital, emergency room, anesthesia, clinic home
	health and for medically needed DME. Further discounts
	are also available under the Hospital's financial
	assistance policy.
Pt V Sec B 16e	If the patient is able to pay a portion of their bill as
	determined by the financial assistance policy, a payment
	arrangement is made with the patient. Normal collection
	procedures (statements & letters) followed for remaining
	patient balance, if any.
Pt V Sec B 7	CHCS identified the highest priorities and focused its
	attention on those issues impacting the largest number of
	community members. Priorities focused on included mental health
	services and wellness, both nutritional and physical
	activity.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	false	SeverancePayment
Supplemental Nonqual Retire Plan	false	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	true	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	false	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	false	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	false	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Deferred Comp Filing OrgDeferredCompFilingOrg	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Total Compensation Filing OrgTotalCompensationFilingOrg	Bonus Filing OrgBonusFilingOrg
GREG UNRUH
208001	15562	7341	230904
MARCIA WALSH
146768	7200	5579	159547
DR DAVID
64142	3863	7913	398027	322109
DR THOMAS WALSH
84610	3320	6293	341569	247346
DR DAGOBERTO HEREDIA
300771			300771
DR JOHN KELLEY
251795			251795
DR CHANCE WILLIAMS
244741			244741

Form990 Schedule J Part III Form990ScheduleJPartIII

Field	Value	IRS element (for citing)
Identifier	Pt I Line 5a	Identifier
Explanation	PHYSICIAN COMPENSATION BASED, IN PART, ON PATIENT CLINIC CHARGES	Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

IdentifierIdentifier	ExplanationExplanation
Pt VI, Line 11b	Reviewed by the Chairman of the Board prior to filing
	and available to other Board members upon request.
Pt VI, Line 12c	Required to disclose conflict of interest upon hire/appointment
	to board and also update and report changes thereafter
Pt VI, Line 15a	CEO compensation is reviewed annually by the board of
	directors.
Pt VI, Line 15b	Other officer and key employee compensation is
	reviewed by CEO utilizing information obtained from
	sources such as the Kansas Hospital Association,
	Bureau of Labor and Kansas Department of Labor
Pt VI, Line 2	Dr. Tom Walsh/Marcia Walsh, COO - Spouse
Pt VI, Line 19	Reference documents not available to the public
Form 990, Part IX, Line 24f	CONTRACT LABOR 1792967. 1549571. 243396. 0. PROFESSIONAL FEES 228085. 0. 228085. 0. SUPPLIES 2569137. 2327414. 241723. 0. REPAIR AND MAINTENANCE 774933. 488032. 286901. 0. MINOR EQUIPMENT 159342. 100163. 59179. 0. PROPERTY TAXES 5037. 3417. 1620. 0.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	COMMUNITY HOSPITAL DISTRICT NO 1 OF POTTAWATOMIE JACKSON AND NEMAHA COUNTIE	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	120 WEST 8TH STREET	AddressLine1
City	ONAGA	City
State	KS	State
ZIP Code	66521	ZIPCode

Field	Value	IRS element (for citing)
EIN	486089515	EIN
Primary Activities	HOSPITAL DISTIRCT	PrimaryActivities
Legal Domicile State	KS	LegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	false	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	false	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	false	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	false	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	false	DividendsRelatedOrganization
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	false	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	true	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	false	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	false	PerformOfServicesByOtherOrgs
Sharing Of Facilities	false	SharingOfFacilities
Sharing Of Paid Employees	false	SharingOfPaidEmployees
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	false	OtherTransferToOtherOrg
Other Transfer From Other Org	false	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

Field	Value	IRS element (for citing)
Business Name Line1	COMMUNITY HOSPITAL DISTRICT NO 1 OF POTTAWATOMIE JACKSON AND NEMAHA COUNTIE	BusinessNameLine1

Field	Value	IRS element (for citing)
Transaction Type	k	TransactionType
Amount Involved	594095	AmountInvolved
Method Of Amt Determination	ACTUAL	MethodOfAmtDetermination