2014-02-07T11:20:40-06:00 2013-03-31 BKD LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2012-04-01 742826278 Rural Health Resources of Jackson County Inc % MARLENE KRANZ RURA 7853642116 1110 Columbine Drive Suite Holton KS 66436 CARRIE SAIA 7853649636 2014-02-15 true Michael J Engle 8162216300 2012 2015-11-30 17:44:51Z HOLTON COMMUNITY HOSPITAL CARRIE SAIA 1110 COLUMBINE DRIVE HOLTON KS 66436 12188335 false X HTTP://WWW.HOLTONHOSPITAL.COM X 1997 KS TO PROVIDE HIGH QUALITY HEALTHCARE SERVICES TO ALL OF JACKSON COUNTY AND SURROUNDING COMMUNITIES WHILE CONSISTENTLY DEMONSTRATING PROFESSIONALISM WITH THE HOMETOWN TOUCH. 7 5 158 23 0 0 95320 29113 11238479 11933653 43577 32498 325666 193071 11703042 12188335 100 0 0 0 5908159 6417031 0 0 0 5094514 5428160 11002773 11845191 700269 343144 7888598 7852939 4537153 4158350 3351445 3694589 X TO PROVIDE PROFESSIONALISM, COMPASSION AND EXCELLENCE IN HEALTHCARE FOR A HEALTHIER COMMUNITY. false false 7590915 9336408 SEE SCHEDULE O 2359973 0 2597245 THERE ARE 3 RURAL HEALTH CLINICS: 1 RURAL HEALTH CLINIC WITHIN THE SAME COMMUNITY WHERE THE HOSPITAL RESIDES, AND 2 RURAL HEALTH CLINICS LOCATED IN 2 SMALLER NEARBY COMMUNITIES. THE RURAL HEALTH CLINICS REPORTED 14,548 VISITS FROM 4/1/12 THROUGH 3/31/13. PROVIDERS FOR THE RURAL HEALTH CLINICS LIVE AND WORK IN THE SAME COMMUNITY AND ARE ACTIVELY INVOLVED IN COMMUNITY ACTIVITIES; OFFERING A LARGE VARIETY OF EDUCATIONAL SERVICES AS WELL AS CLINICAL SERVICES SUCH AS PROVIDING 2 LOCAL HIGH SCHOOLS A SPORTS MEDICINE CLINIC AND COVERAGE BY PROVIDERS AT HOME SPORTING EVENTS. 9950888 true true false true false false false false false true true false false true false true true false false false false false false false false false true true false false true false false false false false false true false false false false false false false false false false true 22 0 true 158 true false false false false false false false false false false X 7 5 false true false false false false false true true false false true true true true true true true false false KS X MARLENE KRANZ 7853649636 1110 COLUMBINE DRIVE HOLTON KS 66436 CATHERINE E REED 1.0 X X RICHARD LAKE 1.0 X X MARGARET PAGEL 1.0 X X ALEX GILLILAND 1.0 X X BOBBI MCGRATH 1.0 X IRVIN SANDERSON 1.0 X JANET ZWONITZER 1.0 X RONALD MARSHALL 40.0 X 168064 0 18175 CARRIE SAIA 40.0 X 124691 0 27403 CLINT M COLBERG 40.0 X 185339 0 24240 LEE R SCHNEE 40.0 X 189937 0 19236 MALIA S WARNER 40.0 X 175850 0 24801 VANCE R LASSEY 40.0 X 197084 0 19433 JOEL R HUTCHINS 40.0 X 184155 0 9328 1225120 0 142616 8 false true false ST FRANCIS HEALTH CENTER MANAGEMENT SERVICES 607170 GLENDAVNIC ANESTHESIA PLLC ANESTHESIA SERVICES 323183 SHARED MEDICAL SERVICES MRI SERVICES 144850 HEALTHCARE MANAGEMENT SERVICES SOFTWARE SUPPORT 317599 4 13415 15698 29113 NET PATIENT SERVICE REVENUE 621110 11933653 11933653 11933653 32498 32498 0 0 0 0 0 0 0 0 0 CAFETERIA 623000 27323 27323 MEDICAL RECORDS 623000 8126 8126 ALL OTHER MISC REVENUE 623000 157622 157622 157622 157622 193071 12188335 11933653 225569 0 0 0 0 172100 124576 47524 111605 111605 5271144 4713369 557775 82512 70764 11748 367612 280097 87515 412058 371580 40478 0 24548 24548 93163 93163 0 0 0 1595253 1173455 421798 33243 25 33218 562945 500356 62589 123096 1500 121596 0 331760 240148 91612 55806 37174 18632 0 0 177539 128514 49025 0 366022 264949 101073 238317 211586 26731 BAD DEBT EXPENSE 773074 773074 REPAIRS & MAINTENANCE 231193 200248 30945 DUES & SUBSCRIPTIONS 39601 20033 19568 MEDICAL SUPPLIES 681574 681574 101026 46261 54765 11845191 9950888 1894303 0 460 660 2629092 1973102 0 0 1345611 1389804 0 0 0 0 0 0 114910 119636 103053 136371 8298984 4666959 3599632 3632025 0 0 0 0 0 0 0 0 95840 601341 7888598 7852939 811728 697256 0 0 0 0 3245000 3110000 0 0 0 0 343425 351094 0 0 137000 0 4537153 4158350 X 3293599 3636743 0 0 57846 57846 3351445 3694589 7888598 7852939 343144 X false true X false false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 1982 false false false 1982 false 57846 521 521 57846 57846 1180 1180 57846 58600 1391 2145 57846 58600 2277 2277 58600 58600 1747 1747 58600 1.00000 false false 4258753 1588708 2670045 222167 45162 177005 3347602 2788819 558783 470462 244270 226192 3632025 OTHER ASSETS 86887 DUE FROM THIRD PARTY 514454 601341 0 0 12188335 12188335 12188335 11845191 11845191 11845191 INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS SCHEDULE D, PART V, LINE 4 THE PERMANENTLY DONOR RESTRICTED ENDOWMENT ONLY ALLOWS THE ORGANIZATION TO USE INTEREST INCOME FOR OPERATIONS. UNCERTAIN TAX POSITIONS DISCLOSURE SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. true true true X true X true false true true 44320 44320 0.00410 978878 616613 362266 0.03300 1023198 616613 406586 0.03710 50464 18855 31609 0.00290 47393 47393 0.00440 1610 1610 0.00010 99467 18855 80612 0.00740 1122665 635468 487198 0.04450 338 338 338 338 false 439879 20830 5389448 5339520 49928 X true true 1 1 HOLTON COMMUNITY HOSPITAL

1110 COLUMBINE DRIVE HOLTON KS 66436

X X X HOLTON COMMUNITY HOSPITAL 1 true X X X X X X X X X 12 true false true X X X X X X X X false false true true 200. true 200. true X true true X X X X X true false true X false false 3 FAMILY PRACTICE ASSOCIATES - HOLTON

1100 COLUMBINE DRIVE HOLTON KS 66436

RURAL HEALTH CLINIC FAMILY PRACTICE ASSOCIATES - HOYT

207 HIGHLAND AVENUE HOYT KS 66440

RURAL HEALTH CLINIC FAMILY PRACTICE ASSOCIATES - WETMORE

323 SECOND STREET WETMORE KS 66550

RURAL HEALTH CLINIC SCHEDULE H, PART I, LINE 7, COLUMN F THE AMOUNT OF BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES FOR CALCULATING THE NET COMMUNITY BENEFIT EXPENSE PERCENTAGE WAS $773,074. SCHEDULE H, PART I, LINE 7 THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART I, LINE 7, OF SCHEDULE H, IS A COST-TO-CHARGE RATIO. COMMUNITY BUILDING ACTIVITIES SCHEDULE H, PART II THE HOSPITAL IS A COMMITTED PARTNER IN PROMOTING COMMUNITY HEALTH EDUCATION. THE REHABILITATION DEPT HAS 7 - CERTIFIED ARTHRITIS FOUNDATION EXERCISE INSTRUCTORS OFFERING WEEKLY CLASSES AT SEVERAL COMMUNITY LOCATIONS. SOCIAL SERVICES DIRECTOR SPONSORS MONTHLY GRIEF SUPPORT GROUP FOR THOSE SADDENED BY A LOSS OF A LOVED ONE OR FRIEND AS WELL AS A MONTHLY ALZHEIMER'S SUPPORT GROUP. SPORTS PHYSICALS ARE OFFERED AT LOCAL SCHOOLS TO MAKE SURE THE SPORTS ORIENTATED YOUNG PEOPLE ARE HEALTHY. THE HOSPITAL OFFERS HEALTH SERVICES EDUCATION IN WEEKLY LOCAL NEWSPAPERS. PROVIDERS AND OTHER ALLIED HEALTH PROFESSIONALS ARE ACTIVE IN SPONSORING INTERNS AND STUDENT JOB SHADOWS TO ENCOURAGE AND EMPHASIZE HEALTH CARE PROVIDERS IN SMALL RURAL COMMUNITIES. BAD DEBT EXPENSE SCHEDULE H, PART III, LINE 4 The Hospital reports patient accounts receivable for services rendered at net realizable amounts from third-party payers, patients and others. The Hospital provides an allowance for doubtful accounts based upon a review of outstanding receivables, historical collection information and existing economic conditions. As a service to the patient, the Hospital bills third-party payers directly and bills the patient when the patient's liability is determined. Patient accounts receivable are due in accordance with a predetermined payment plan based on the value of the patient's balance. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluation and specific circumstances of the account. Patients are also given the option to finance the self-pay balance due with a local financial institution, in which the Hospital guarantees 100% of the debt. BAD DEBT EXPENSE (AT COST) IDENTIFIED THE PROVISION FOR UNCOLLECTIBLES FROM 3/31/13 AUDITED STATEMENT OF OPERATIONS. MULTIPLIED THAT AMOUNT BY THE COST-TO-CHARGE RATIO. CHARITY CARE (AT COST): LOGS MAINTAINED BY CASH COLLECTOR. LOG CONTAINS DATA OF THE DOLLAR AMOUNT TURNED TO BAD DEBT WHERE A CHARITY CARE APPLICATION WAS SENT BUT NOT RETURNED AND WHEN CHARITY CARE APPLICATION WAS RETURNED BUT PATIENT DID NOT FULFILL FINANCIAL OBLIGATION. SUBSEQUENTLY, MULTIPLIED THAT AMOUNT BY THE COST-TO-CHARGE RATIO IDENTIFIED IN SCHEDULE H, PART I. COLLECTION PRACTICES SCHEDULE H, PART III, LINE 9B WHEN A RESPONSIBLE PARTY IS UNABLE TO MEET THE FINANCIAL OBLIGATION GUIDELINES AS DESCRIBED IN THE HOSPITAL'S FINANCIAL POLICY, THE PARTY IS ADVISED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. CLARIFICATION IS MADE AS TO WHETHER THE PATIENT HAS PRIMARY INSURANCE. IF NO PRIMARY INSURANCE IS AVAILABLE IT IS EXPLAINED THAT PER THE POLICY AN APPLICATION TO MEDICAID IS REQUIRED BEFORE FINANCIAL ASSISTANCE CAN BE CONSIDERED. IF MEDICAID DENIES ELIGIBILITY, A WRITTEN STATEMENT FROM MEDICAID IS REQUIRED. ONCE A MEDICAID ELIGIBILITY DENIAL IS RECEIVED A FINANCIAL ASSISTANCE APPLICATION IS OFFERED. THE RESPONSIBLE PARTY IS REQUIRED TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION AND SUBMIT ALL DOCUMENTATION INDICATED (AS OUTLINED ON APPLICATION) IN ORDER FOR THE HOSPITAL TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY. IF AN APPLICATION IS NOT RETURNED AFTER 15-DAYS, A COURTESY EXTENSION OF 5 ADDITIONAL DAYS IS AUTHORIZED. AFTER THE 5-DAY EXTENSION AND THE FINANCIAL ASSISTANCE APPLICATION ALONG WITH REQUIRED DOCUMENTATION IS NOT RECEIVED, FURTHER COLLECTION ACTION IS TAKEN. THE COLLECTION PROCESS CONTINUES UNTIL THE RESPONSIBLE PARTY CONTACTS A PATIENT FINANCIAL COUNSELOR OR RETURNS THE APPLICATION WITH REQUIRED DOCUMENTATION. ONCE A FINANCIAL ASSISTANCE APPLICATION IS RECEIVED, NOT ALL THE REQUIRED FINANCIAL DOCUMENTATION (AS OUTLINED ON THE APPLICATION) IS SUBMITTED, A COURTESY LETTER IS SENT TO THE RESPONSIBLE PARTY. THIS LETTER REQUESTS THE INFORMATION BE RETURNED WITHIN 15-DAYS IN ORDER TO BE CONSIDERED. IF THE REQUIRED DOCUMENTATION IS THEN SUBSEQUENTLY NOT RECEIVED WITHIN THOSE 15-DAYS AND NO CONTACT WITH THE PATIENT FINANCIAL COUNSELOR IS MADE, THE FINANCIAL ASSISTANCE APPLICATION IS DENIED AND FURTHER COLLECTION ACTION IS TAKEN. PERSONS WHO REPRESENT THE COMMUNITY SCHEDULE H, PART V, SECTION B, LINE 3 The planning committee for the Jackson County CHNA developed a list of entities within Jackson County that would connect with the majority of our population. Once the target audience was identified a survey was created in order to solicit community input. The steering committee selected the top eleven indicators to include in the survey. The survey was published both online and in hard copy and distributed widely throughout the county. Steering committee members as well as the larger stakeholders group members were asked to complete the survey. Additionally, surveys were made available at each healthcare facility in the county for a random sampling of clients. The survey asked participants to rank their top priorities in order to assist the steering committee to identify the community's top ten health priorities. Following the identification of the top priorities by survey participants a group of community public health experts was convened for a focus group meeting to discuss the health indicators and to narrow the choices to one or two high priorities around which to build a community action plan. During the town hall meeting participants were asked to narrow the eleven indicators to the top five. By a nominal group voting technique, five indicators were selected from the eleven presented. Five groups were created in order to analyze each of the five top priorities; participants were asked to join whichever group most met their concern/interest. A steering committee member facilitated each small group discussion. The purpose of the group discussion was to discover root causes of each of the health issues. The method used for analysis was Dispersion Analysis or the "Five Why's" technique (Source: Public Health Foundation) where the first question, "Why is (e.g.) overweight/obesity a problem in Jackson County," leads to succeeding in depth questions to discover the root "Why" answer. Each small group reported their "Five Why" results out to the larger group, which then voted using the Nominal Voting Technique to narrow to the top one or two priority issues. SCHEDULE H, PART V, SECTION B, LINE 5A http://www.holtonhospital.com/docs/Jackson_County_CHA_-_Final_Copy.pdf SCHEDULE H, PART V, SECTION B, LINE 5C COPIES ARE AVAILABLE AT ALL HEALTHCARE PROVIDERS IN THE COUNTY. NEEDS IDENTIFIED SCHEDULE H, PART V, SECTION B, LINE 7 RURAL HEALTH RESOURCES IS IN THE PROCESS OF INDENTIFYING THE NEEDS THAT HAVE NOT BEEN ADDRESSED BY THE DATE REQUIRED. MAXIMUM AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS SCHEDULE H, PART V, SECTION B, LINE 20D THE LOOK-BACK METHOD IS USED IN CALCULATING THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2 Our current 12-bed hospital is located within the outer region of the Holton city limits. Our expanded facilities allow us to provide a broad range of healthcare services to all members of our community without regard to age, race, sex or financial constraints. Our Rehabilitation Services department provides a full-compliment of occupational and physical therapies, including a lymphedema management program and speech therapy. Our Cardiovascular Services department provides cardiac rehab, as well as performs pulmonary function procedures and stress tests, and provides one-on-one CERTIFIED diabetes education and tobacco cessation counseling. Our Surgery department provides 24/7 surgical services. We have a large variety of specialty physicians who treat patients in the facility as well as perform NUMEROUS surgical procedures. Our Radiology department, in collaboration with St. Francis Hospital, provides mobile Nuclear Medicine testing on site. The facility also contracts with Shared Medical Services, Inc. to provide on-site mobile MRI testing. The Radiology department is also very proud to have a 32-slice CT scanner which provides high resolution images. A CT scanner with this capability is a rarity in a hospital of our size. Our hospital offers a full-service, 24-7 emergency department with a physician available at all times. We have transfer agreements with surrounding hospitals for those patients who present to the hospital Emergency Department and require care beyond our capabilities. Our 12-bed in-patient unit provides care to medical-surgical patients, sub-acute patients, pediatrics and geriatrics. We provide obstetrical and newborn care patient services which is becoming increasingly rare among rural hospitals. We are also licensed to provide Swingbed services. THIS ALLOW PATIENTS TO RECEIVE TRANSITIONAL INPATIENT REHABILIATION AND RECOVERY SERVICES. Holton Community Hospital has a full-service home health and hospice program. Our award-winning hospice delivers end of life care to patients of providers throughout northeast Kansas. Our Rural Health Clinic (Family Practice Associates) has THREE locations in Holton, Hoyt AND WETMORE, Kansas. Our mix of five physicians, one Physician Assistant and THREE Advanced Registered Nurse Practitioners allows our community members to find a provider that best serves their health care needs. Seeing a need for sports medicine services within our local community, a contractual agreement was reached with A local school system. Our Physician's Assistant, also a registered physical therapist, offers sports medicine services 2 afternoons per week at Holton High School. He also attends all home games, and away games as needed, to assist with possible injuries that might occur. We have been distributing Patient Satisfaction Surveys throughout our surgical, inpatient, outpatient, rural health clinic, emergency room and rehabilitation services for approximately 4 years. The results of these surveys are compiled monthly and are used to better our patient services. We have also established a surgical oversight committee that meets monthly on how to improve services and processes in the surgery department. WE ARE COMMITTED TO PROVIDING QUALITY HEALTHCARE TO ALL MEMBERS OF OUR COMMUNITY. BECAUSE WE ARE A SMALL TOWN HOSPITAL, A MAJORITY OF OUR PATIENTS HAVE A STRONG BOND WITH OUR STAFF. THIS ALLOWS US TO PROVIDE CARE THAT EXTENDS BEYOND JUST MEDICAL NEEDS. THE COST AND DIFFICULTY IN SEEKING CARE IN OTHER AREAS FOR OUR ELDERLY AND POOR POPULATION REINFORCES THE NEED FOR A STRONG COMMUNITY HOSPITAL. WE STRIVE TO MEET THIS NEED BY PROVIDING ALL SERVICES POSSIBLE. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI, LINE 3 HOLTON COMMUNITY HOSPITAL POSTS SIGNS AT ITS REGISTRATION LOCATIONS REGARDING THE AVAILABILITY OF OUR FINANCIAL ASSISTANCE PROGRAM. THE AVAILABILITY OF A FINANCIAL ASSISTANCE PROGRAM IS ALSO IDENTIFIED ON ALL HOSPITAL PATIENT SERVICE RELATED LETTERS AND GUARANTOR STATEMENTS. ONCE A PATIENT CALLS TO INQUIRE ABOUT THE FINANCIAL ASSISTANCE PROGRAM THE PATIENT FINANCIAL COUNSELOR WORKS ONE-ON-ONE WITH THE PATIENTS OUTLINING THE REQUIREMENTS, DOCUMENTS NEEDED AND EXPLAINS OUR FINANCIAL ASSISTANCE PROGRAM IN DETAIL. COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4 HOLTON COMMUNITY HOSPITAL AND FAMILY PRACTICE ASSOCIATES PHYSICIAN'S CLINIC ARE THE PREMIERE HEALTHCARE PROVIDERS IN OUR COUNTY. LIKE OTHER RURAL HOSPITALS, HCH SERVES A HIGHER PERCENTAGE OF ELDERLY AND CHILDREN LIVING IN POVERTY WHILE THE COUNTY EXPERIENCES HIGHER LEVELS OF UNEMPLOYMENT AND LOWER INCOMES. ACCORDING TO A REPORT GENERATED BY THE KANSAS RURAL HEALTH OPTIONS PROJECT, RURAL INDIVIDUALS REPORT POORER OVERALL HEALTH AND MORE CHRONIC HEALTH CONDITIONS. ADDITIONALLY, RURAL COUNTIES SEE A HIGHER RATE OF UNINSURED INDIVIDUALS AND HAVE FEWER HEALTH CARE SERVICES AVAILABLE TO THEM. FINALLY, PEOPLE IN RURAL COMMUNITIES ARE MORE LIKELY TO DERIVE PART OF THEIR INCOME FROM THE HEALTHCARE INDUSTRY (EITHER DIRECTLY OR INDIRECTLY). JACKSON COUNTY HOLDS THE DESIGNATION OF BEING A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA). THIS DESIGNATION COMES FROM THE KANSAS DEPARTMENT OF HEALTH AND ENVIRONMENT (KDHE) AND IDENTIFIES AREAS OF THE STATE THAT ARE MEDICALLY UNDERSERVED. ACCORDING TO THE WEBSITE, KANSASHEALTHMATTERS.ORG, EACH PHYSICIAN IN JACKSON COUNTY HAS A POTENTIAL 1,745 INDIVIDUALS TO PROVIDE CARE TO. ADDITIONALLY, THIS SAME WEBSITE NOTED THAT IN 2009 MORE THAN 15.9% OF OUR COUNTY HAS NO HEALTH INSURANCE. KANSASHEALTHMATTERS.ORG ALSO REPORTS THAT 12.5% OF JACKSON COUNTY, KANSAS CHILDREN UNDER THE AGE OF 18 WERE LIVING AT OR BELOW THE POVERTY LINE (REPORTING PERIOD: 2006-2010). IN COMPARISON, ACCORDING TO THE US CENSUS BUREAU, AMERICAN COMMUNITY SURVEY REPORT FOR THE PERIOD 2007-2011, 9.5% OF JACKSON COUNTY RESIDENTS LIVED BELOW THE POVERTY LEVEL. THE SAME REPORT NOTED THE PER CAPITA PERSONAL INCOME OF JACKSON COUNTY RESIDENTS FROM 2006-2011 WAS APPROXIMATELY $24,200.00, COMPARED TO THE STATE'S PER CAPITA PERSONAL INCOME OF $26,425.00. ADDITIONALLY, IN A RECENT SURVEY COMPLETED BY THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE AND THE ROBERT WOOD JOHNSON FOUNDATION, JACKSON COUNTY RANKED 44TH IN THE STATE ON THE HEALTH OF OUR COUNTY. JACKSON COUNTY SCORES BELOW STATE BENCHMARKS IN HEALTH CARE, HEALTHY BEHAVIORS AND SOCIAL AND ECONOMIC FACTORS. THERE IS NO CONTRADICTORY INFORMATION TO CHALLENGE THAT THERE ARE STILL 81 PRIMARY CARE PROVIDERS PER 100,000 RESIDENTS IN THE COUNTY (ACTUAL NUMBER: 11 PROVIDERS), BELOW THE STATE'S AVERAGES OF 115 AND THE TARGET RATE OF 151. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 5 HOSPITAL EMPLOYEES ARE ENCOURAGED TO PARTICIPATE IN LOCAL COMMUNITY ACTIVITIES. EMPLOYEES ARE MEMBERS OF THE LOCAL CHAMBER OF COMMERCE, SERVE AS BOARD MEMBERS WITH SEVERAL LOCAL ORGANIZATIONS, AND ARE BOARD MEMBERS OF A STATE ORGANIZATION PROMOTING THE PATIENT FINANCIAL SERVICES SEGMENT OF HEALTHCARE. EMPLOYEES ARE INVOLVED ON SEVERAL LEVELS WITH YOUTH PROGRAMS. EMPLOYEES PROVIDE INSERVICE TRAINING TO VARIOUS LOCAL AGENCIES ON HEALTH ORIENTED SUBJECTS SUCH AS MEDICAL ADMINISTRATION. false false false false false false false false false RONALD MARSHALL 165729 0 0 0 2335 0 4028 0 14147 0 186239 0 0 0 CLINT M COLBERG 183611 0 0 0 1728 0 5059 0 19181 0 209579 0 0 0 LEE R SCHNEE 188225 0 0 0 1712 0 5055 0 14181 0 209173 0 0 0 MALIA S WARNER 175754 0 0 0 96 0 4620 0 20181 0 200651 0 0 0 VANCE R LASSEY 196976 0 0 0 108 0 5252 0 14181 0 216517 0 0 0 JOEL R HUTCHINS 183363 0 0 0 792 0 4859 0 4469 0 193483 0 0 0 CARRIE SAIA 123965 0 0 0 726 0 7585 0 19818 0 152094 0 0 0 RON MARSHALL AND CARRIE SAIA COMPENSATION FORM 990, PART VII, SECTION A, LINE 1A AND SCHEDULE J, PART II THE COMPENSATION BEING REPORTED FOR RON MARSHALL AND CARRIE SAIA ARE PAID BY ST. FRANCIS HEALTH CENTER WHICH IS PART OF THE MANAGEMENT CONTRACT. SEE SCHEDULE L PART V BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS SCHEDULE L, PART IV (A) CODY UTZ (B) CODY UTZ IS THE DAUGHTER OF CATHERINE REED WHO IS A BOARD MEMBER. (C) $ 80,223 (D) CODY UTZ IS AN EMPLOYEE OF RURAL HEALTH RESOURCES OF JACKSON COUNTY. (E) NO (A) KAY RASH (B) KAY RASH IS THE SISTER OF MARGARET PAGEL WHO IS A BOARD MEMBER. (C) $ 31,382 (D) KAY RASH IS AN EMPLOYEE OF RURAL HEALTH RESOURCES OF JACKSON COUNTY. (E) NO PROGRAM SERVICE ACCOMPLISHMENT FORM 990, PART III, LINE 4A HOLTON COMMUNITY HOSPITAL (HCH) IS A 12-BED CRITICAL ACCESS HOSPITAL IN A SMALL RURAL COMMUNITY. HCH OFFERS A WIDE RANGE OF SERVICES INCLUDING PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, REGISTERED DIETICIAN SERVICES, MRI, MRA, NUCLEAR MEDICINE, CT SCAN ALONG WITH OTHER RADIOLOGY SERVICES, SURGERY, LABORATORY, A CERTIFIED DIABETIC EDUCATION PROGRAM, CARDIOVASCULAR SERVICES, CERTIFIED LYMPHEDEMA PROGRAM, AND WOUND CARE SERVICES AS WELL AS A VARIETY OF SPECIALTY PROVIDER SERVICES. THE HOSPITAL STAFF IS CERTIFIED TO TEACH OUTREACH SERVICES UNDER THE NATIONAL ARTHRITIS FOUNDATION EXERCISE PROGRAM. THE HOSPITAL ALSO OFFERS HOME HEALTH AND HOSPICE SERVICES. THE HOSPITAL PROVIDED 24/7 EMERGENCY ROOM SERVICES WITH 2,464 EMERGENCY ROOM VISITS RECORDED FROM 4/1/12 THROUGH 3/31/13. EMERGENCY ROOM SERVICES ARE SUPPORTED BY STAFF TRAINED IN ADVANCED CARDIAC LIFE SUPPORT, CPR, EMERGENCY NURSING PEDIATRICS, TRAUMA NURSING CORE CURRICULUM, AND PEDIATRIC ADVANCED LIFE SUPPORT. HOSPITAL IDENTIFIED 14,997 INPATIENT HOURS AND 2,418 OBSERVATION HOURS AND 237 EXTENDED RECOVERY HOURS OF CARE FROM 4/1/12 THROUGH 3/31/13. MANAGEMENT DUTIES FORM 990, PART VI, SECTION A, LINE 3 RURAL HEALTH RESOURCES OF JACKSON COUNTY HOLDS A MANAGEMENT CONTRACT WITH SISTERS OF CHARITY OF LEAVENWORTH/ST. FRANCIS HEALTH CENTER, TOPEKA, KS. SISTERS OF CHARITY OF LEAVENWORTH APPOINTS A CHIEF EXECUTIVE OFFICER TO MANAGE DAY-TO-DAY OPERATIONS. FORM 990 REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11B AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE FORM 990. THE 990 IS THEN REVIEWED BY THE CEO AND CONTROLLER OF RURAL HEALTH RESOURCES OF JACKSON COUNTY (RHRJC). ANY QUESTIONS OR CONCERNS THAT ARISE ARE ADDRESSED WITH THE ACCOUNTING FIRM AND CORRECTIONS, CLARIFICATIONS OR REVISIONS ARE MADE AS NECESSARY. THE FINAL 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD OF RHRJC PRIOR TO THE FILING OF THE 990. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C UPON HIRE (OR IN THE CASE OF ELECTION OF BOARD MEMBERS) AND ANNUALLY THEREAFTER, THE CEO OR DESIGNEE(S) SHALL PROVIDE TO THE BOARD, STAFF AND EMPLOYED PROVIDERS OF RURAL HEALTH RESOURCES OF JACKSON COUNTY (RHRJC) A COPY OF THE CONFLICT OF INTEREST POLICY AND THE APPLICABLE CONFLICT OF INTEREST DISCLOSURE FORM. THESE DOCUMENTS WILL BE COMPLETED TO IDENTIFY ANY RELATIONSHIPS, POSITIONS, OR CIRCUMSTANCES IN WHICH IT IS BELIEVED A CONFLICT MAY ARISE. THE ANNUAL MONITORING AND REVIEW PROCESS WILL BE PART OF RHRJC'S CORPORATE COMPLIANCE PLAN. ANY POTENTIAL CONFLICT OF INTEREST CONCERNS THAT ARISE SHALL BE REPORTED BY THE CEO TO THE BOARD CHAIR. SHOULD THE CONCERN INVOLVE THE BOARD CHAIR, THE BOARD VICE-CHAIR WILL BE INFORMED INSTEAD. EACH BOARD MEMBER, STAFF MEMBER OR EMPLOYED PROVIDER SHALL FULLY DISCLOSE ANY AND ALL ACTUAL OR POTENTIAL CONFLICTS, DUALITY OF INTEREST OR RESPONSIBILITY INVOLVING INDIVIDUAL, PERSONAL, OR BUSINESS ISSUES WHICH MAY EXIST. IF THERE IS A CONFLICT, THE CONFLICTED INDIVIDUALS ABSTAIN FROM VOTING. COMPENSATION REVIEW FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF DIRECTORS OF RURAL HEALTH RESOURCES OF JACKSON COUNTY, D.B.A. HOLTON COMMUNITY HOSPITAL, APPROVED IN MAY 2008 A MANAGEMENT CONTRACT WITH ST. FRANCIS HEALTH CENTER IN TOPEKA, KANSAS. AS PART OF THIS MANAGEMENT CONTRACT, THE CHIEF EXECUTIVE OFFICER OF HOLTON COMMUNITY HOSPITAL IS PROVIDED BY ST. FRANCIS. AS PART OF THE APPROVAL PROCESS THE BOARD DETERMINED THE CONTRACT PROVIDED SERVICES AND MANAGEMENT AT THE EQUIVALENT OF FAIR MARKET VALUE. AVAILABILITY OF DOCUMENTS FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:NURSING TOTAL FEES:323183 OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:MRI TOTAL FEES:159151 OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:ER PROVIDERS ON CALL FEES TOTAL FEES:204242 OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:MISC. MEDICAL SERVICES TOTAL FEES:486879 OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTION COMPANY FEES TOTAL FEES:79569 OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:ST. FRANCIS MANAGEMENT FEES TOTAL FEES:252306 OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:MISC. MANAGEMENT SERVICES TOTAL FEES:89923