WEST CENTRAL KANSAS ASSOCIATION INC: Form 990, tax year 2012
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- Organization
- WEST CENTRAL KANSAS ASSOCIATION INC (EIN 74-2842747)
- Tax period
- 2012-08-01 to 2013-07-31
- Filed
- 2014-04-08
- IRS object ID
- 201430989349300828
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-04-08T15:10:13-05:00 | Timestamp |
| Tax Period End Date | 2013-07-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 481026809 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Wendling Noe Nelson & Johnson LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 534 S Kansas Ave Suite 1500 | AddressLine1 |
| City | Topeka | City |
| State | KS | State |
| ZIP Code | 666033491 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-08-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 742842747 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | West Central Kansas Association Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | WEST | NameControl |
| Phone | 7854833131 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 S Main | AddressLine1 |
| City | Russell | City |
| State | KS | State |
| ZIP Code | 67665 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Harold Courtois | Name |
| Title | CEO | Title |
| Phone | 7854833131 | Phone |
| Date Signed | 2014-04-01 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Heather R Eichem | Name |
| PTIN | P01515553 | PTIN |
| Phone | 7852334226 | Phone |
| Date Prepared | 2014-04-01 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Russell Regional Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Harold Courtois | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 S Main | AddressLine1 |
| City | Russell | City |
| State | KS | State |
| ZIP Code | 67665 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 12089075 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.russellhospital.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1997 | YearFormation |
| State Legal Domicile | KS | StateLegalDomicile |
| Activity Or Mission Description | To provide a caring and compassionate team dedicated to the delivery of quality healthcare, and to meet the current and future healthcare needs of the community. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 6 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 207 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 309911 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 23267 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 12485536 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 11931380 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 47438 | InvestmentIncomePriorYear |
| Investment Income Current Year | 45595 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 63379 | OtherRevenuePriorYear |
| Other Revenue Current Year | 88833 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 12906264 | TotalRevenuePriorYear |
| Total Revenue Current Year | 12089075 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 1000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 8685376 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 7959138 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4228887 | OtherExpensePriorYear |
| Other Expenses Current Year | 4597450 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 12914263 | TotalExpensesPriorYear |
| Total Expenses Current Year | 12557588 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -7999 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -468513 | RevenuesLessExpensesCY |
| Total Assets BOY | 3742583 | TotalAssetsBOY |
| Total Assets EOY | 4234259 | TotalAssetsEOY |
| Total Liabilities BOY | 3710099 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 4234259 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 32484 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 0 | NetAssetsOrFundBalancesEOY |
| Mission Description | To care for our communities and their citizens with the caring, compassion, quality and commitment that validates their trust in us. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 11066505 | Expense |
| Grants | 1000 | Grants |
| Revenue | 12020213 | Revenue |
| Description | Russell Regional Hospital provides a variety of health care services including acute inpatient care, swingbed inpatient care, outpatient care, rural health clinic, and long-term care services to patients in need of care. | Description |
| Total Program Service Expense | 11066505 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 15 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 207 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 6 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 0 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 0 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Harold Courtois CEO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7854833131 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 S Main | AddressLine1 |
| City | Russell | City |
| State | KS | State |
| ZIP Code | 67665 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (16 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Morris Krug | |||||||
| President | 1.00 | X | X | 0 | 0 | 0 | |
| Sylvia Newton | |||||||
| Secretary | 1.00 | X | X | 0 | 0 | 0 | |
| John O Farmer III | |||||||
| Treasurer | 1.00 | X | X | 0 | 0 | 0 | |
| Michael Holland | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Richard L Shields | |||||||
| Vice-President | 1.00 | X | X | 0 | 0 | 0 | |
| Vance Ruggels | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Shelley Boden | |||||||
| CEO (thru 1/13) | 40.00 | X | 98497 | 0 | 19254 | ||
| Joy Bretz | |||||||
| CFO (thru 4/13) | 40.00 | X | 26963 | 0 | 0 | ||
| Sharon Collins | |||||||
| HR Dir/Interim CEO (thru 7/13) | 40.00 | X | 84487 | 0 | 14784 | ||
| Kevin Kreutzer | |||||||
| CFO | 40.00 | X | 0 | 0 | 0 | ||
| Harold Courtois | |||||||
| CEO | 40.00 | X | 0 | 0 | 0 | ||
| Alexander Chung | |||||||
| Physician | 40.00 | 319602 | 0 | 7025 | X | ||
| Earl Merkel | |||||||
| Physician | 40.00 | 291209 | 0 | 8713 | X | ||
| Jill Doerfler-Iniguez | |||||||
| Physician | 40.00 | 216498 | 0 | 8652 | X | ||
| Sambhundh Panichabhongse | |||||||
| Physician | 40.00 | 208200 | 0 | 7654 | X | ||
| Curtis Sohm | |||||||
| Physical Therapist | 40.00 | 133965 | 0 | 16476 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1379421 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 82558 | TotalOtherCompensation |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Dr John Whitehead | |||||
| 1659 Tamarisk Drive | Wichita | KS | 67230 | Physician ER & clinic coverage | 170850 |
| Docs Who Care | |||||
| 1337 S Fountain Drive | Olathe | KS | 66061 | Physician ER & clinic coverage | 155768 |
| Shared Medical Services Inc | |||||
| PO Box 330 | Cottage Grove | WI | 53527 | MRI services | 138400 |
| Aegis Therapies Inc | |||||
| PO Box 8103 | Fort Smith | AR | 72902 | Therapy services | 112722 |
| CPSI | |||||
| PO Box 850309 | Mobile | AL | 366850309 | Software and technical support | 109857 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 8 | NumberOfContractorsGT100K |
| Government Grants | 21848 | GovernmentGrants |
| All Other Contributions | 1419 | AllOtherContributions |
| Total Contributions | 23267 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Net patient service revenue | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 11931380 | TotalRevenueColumn |
| Related Or Exempt Function Income | 11931380 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 11931380 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 45595 | TotalRevenueColumn |
| Exclusion | $45,595 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 8554 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 8554 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 8554 | TotalRevenueColumn |
| Related Or Exempt Function Income | 8554 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Cafeteria sales | 722210 | 44204 | 44204 |
| Purchase discounts | 900099 | 20393 | 20393 |
| Meals on wheels | 611710 | 3693 | 3693 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 11989 | TotalRevenueColumn |
| Related Or Exempt Function Income | 11989 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 80279 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12089075 | TotalRevenueColumn |
| Related Or Exempt Function Income | 12020213 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $45,595 | ExclusionAmount |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1000 | Total |
| Program Services | 1000 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 239231 | Total |
| Management And General | 239231 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6526446 | Total |
| Program Services | 6041748 | ProgramServices |
| Management And General | 484698 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 61427 | Total |
| Program Services | 57411 | ProgramServices |
| Management And General | 4016 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 690913 | Total |
| Program Services | 643111 | ProgramServices |
| Management And General | 47802 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 441121 | Total |
| Program Services | 395604 | ProgramServices |
| Management And General | 45517 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2845 | Total |
| Management And General | 2845 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 199875 | Total |
| Program Services | 6287 | ProgramServices |
| Management And General | 193588 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18890 | Total |
| Program Services | 18890 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 143085 | Total |
| Program Services | 86919 | ProgramServices |
| Management And General | 56166 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 324851 | Total |
| Program Services | 259881 | ProgramServices |
| Management And General | 64970 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13620 | Total |
| Program Services | 11783 | ProgramServices |
| Management And General | 1837 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 52169 | Total |
| Program Services | 52169 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 404680 | Total |
| Program Services | 323744 | ProgramServices |
| Management And General | 80936 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 138984 | Total |
| Program Services | 126206 | ProgramServices |
| Management And General | 12778 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Pharmacy supplies | 818266 | 818266 | |
| Physician fees | 630558 | 630558 | |
| Purchased services | 599010 | 553977 | 45033 |
| Repairs and maintenance | 537120 | 448054 | 89066 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 713497 | Total |
| Program Services | 590897 | ProgramServices |
| Management And General | 122600 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12557588 | Total |
| Program Services | 11066505 | ProgramServices |
| Management And General | 1491083 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 604899 | BOY |
| EOY | 838783 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 710 | BOY |
| EOY | 708 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1331781 | BOY |
| EOY | 1198556 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 198968 | BOY |
| EOY | 237849 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 121373 | BOY |
| EOY | 106165 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 3826771 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 2407239 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1304388 | BOY |
| EOY | 1419532 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 180464 | BOY |
| EOY | 432666 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3742583 | BOY |
| EOY | 4234259 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1038759 | BOY |
| EOY | 1278450 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1053487 | BOY |
| EOY | 840591 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1617853 | BOY |
| EOY | 2115218 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3710099 | BOY |
| EOY | 4234259 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32484 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32484 | BOY |
| EOY | 0 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3742583 | BOY |
| EOY | 4234259 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -468513 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 436029 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 0 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2642291 | OtherCostOrOtherBasis |
| Depreciation | 1944010 | Depreciation |
| Book Value | 698281 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1184480 | OtherCostOrOtherBasis |
| Depreciation | 463229 | Depreciation |
| Book Value | 721251 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1419532 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Estimated third-party payor settlements | Description |
| Book Value | 432666 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 432666 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Due to lessor | Description |
| Amount | $2,115,218 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2115218 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 12089075 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 12089075 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 12089075 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 12557588 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 12557588 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 12557588 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Description of Uncertain Tax Positions Under FIN 48: | Identifier |
| Return Reference | Part X, Line 2: | ReturnReference |
| Explanation | Management is not aware of any uncertainties in income tax positions. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 70.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 79593 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 96204 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -16611 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 824223 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 900777 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -76554 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 903816 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 996981 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -93165 | NetCommunityBenefitExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1882 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1882 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1874261 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1441946 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 432315 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03440 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1876143 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1441946 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 434197 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03450 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2779959 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2438927 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 341032 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03450 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $416,737 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 6064370 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 6273612 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -209242 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | 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 | Russell Regional Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 South Main Street | AddressLine1 |
| City | Russell | City |
| State | KS | State |
| ZIP Code | 67665 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
| Other | Long-term care facility, outpatient physician clinic | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Russell Regional Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | 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 |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 0 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 1 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 70.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 200.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Insurance Status | X | InsuranceStatus |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (7 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| Part III, Line 4: See Note 2A (page 7) of the audited financial statements regarding the allowance for uncollectible accounts.Part III, Line 2: The Hospital's bad debt at cost was determined by applying an overall ratio of cost to charges. Part III, Line 3: West Central Kansas Association, Inc. is unable to determine the amount of bad debt expense attributable to patients eligible under its charity care policy for the year covered by this return. Suggested methods for estimation were either not in place or proved to be unreliable. For example, the number of financial assistance applications distributed but not returned was not tracked. Using demographic data to estimate an amount did not provide reasonable results. Undoubtedly, there is bad debt expense attributed to patients who meet charity care guidelines. However, paperwork needed for approval of charity care was not returned or tracked. Rather than provide an estimate that can't be substantiated, West Central Kansas Association, Inc. has chosen to report zero dollars as bad debt expense attributable to charity care patients. | |
| Part III, Line 8: The total amount of the shortfall between Medicare revenue received and relating allowable costs is considered community benefit. The amounts were obtained from the cost report filed with Medicare for the period ending 07/31/2013. | |
| Part V, Section B, Line 3: A priority of the CHNA was to solicit input from a broad cross section of the community, not simply members of the local healthcare sector, in an effort to represent the community as a whole. Steering Committee participants include representatives from these local organizations: Russell County Area Community Foundation, Russell Regional Hospital, Russell County EMS, Russell Rotary Club, Russell Area Chamber of Commerce, Russell County Health Dept, Angels Care Home Health, Hospice of Hays Medical Center, Russell County Economic Development/CVB, the office of Gary K. Crnic DDS, and Russell County Sheriff's Office. | Russell Regional Hospital |
| Part V, Section B, Line 20d: The Hospital utilizes a sliding scale to determine the level of financial assistance applicable for each individual. The FAP takes several factors into account such as the individuals income in comparison with published federal poverty guidelines. The patient liability is determined by reducing the gross charges of the services provided by the amount of financial assistance awarded. | Russell Regional Hospital |
| Part VI, Line 3: Patients receive information regarding federal, state and charity care programs upon request. | |
| Part VI, Line 4: The Hospital is located in Russell County, Kansas in the city of Russell and serves the surrounding area. The Russell community is a predominately agricultural one. The city of Russell and Russell County have an approximate population of 4,500 & 7,000 individuals respectively. The average Russell household annual income is approximately $38,168. Approximately 13.9% of the residents in Russell County have an annual income below the federal poverty level. Other hospitals in the area are located in Hays, Hoisington, and Great Bend. The distance between the Hospital and these facilities is approximately 26, 29, and 40 miles respectively. | |
| Part VI, Line 5: The Hospital's governing body is comprised solely of local community members. All local physicians have admitting privileges at the Hospital. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Alexander Chung | ||||||||||||||
| Physician | 257573 | 0 | 61975 | 0 | 54 | 0 | 900 | 0 | 6125 | 0 | 326627 | 0 | 0 | 0 |
| Earl Merkel | ||||||||||||||
| Physician | 193138 | 0 | 98000 | 0 | 71 | 0 | 0 | 0 | 8713 | 0 | 299922 | 0 | 0 | 0 |
| Jill Doerfler-Iniguez | ||||||||||||||
| Physician | 193971 | 0 | 22500 | 0 | 27 | 0 | 3769 | 0 | 4883 | 0 | 225150 | 0 | 0 | 0 |
| Sambhundh Panichabhongse | ||||||||||||||
| Physician | 161578 | 0 | 46500 | 0 | 122 | 0 | 0 | 0 | 7654 | 0 | 215854 | 0 | 0 | 0 |
| Curtis Sohm | ||||||||||||||
| Physical Therapist | 133950 | 0 | 0 | 0 | 15 | 0 | 2960 | 0 | 13516 | 0 | 150441 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Audrey Christian | |||
| Daughter of Sharon Collins, Interim CEO | 26350 | Employment | 0 |
| Sarah Depiesse | |||
| Daughter of Sharon Collins, Interim CEO | 33469 | Employment | 0 |
| Clarissa Schneider | |||
| Daughter-in-law of Sharon Collins, Interim CEO | 22862 | Employment | 0 |
| Kelly Depiesse | |||
| Son-in-law of Sharon Collins, Interim CEO | 10171 | Employment | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section B, line 11 | The Form 990 is distributed by email to all governing body Board Members for review prior to filing the Form 990. Any questions and/or comments are directed to management for further discussion. | |
| Form 990, Part VI, Section B, line 15 | The compensation of the organization's officers is voted on and approved by the Board of Directors. | |
| Form 990, Part VI, Section C, line 19 | The 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: | Transfer from lessor 933,394. Change in amount due to lessor -497,365. | Changes in Net Assets or Fund Balances: |