FARMERS UNION HOSPITAL ASSOCIATION: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- FARMERS UNION HOSPITAL ASSOCIATION (EIN 73-0579295)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-04-29
- IRS object ID
- 201441199349301049
- 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
- Form 990
- Schedule A
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-04-29T17:07:35-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 752570395 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DURBIN & COMPANY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2950 50TH STREET | AddressLine1 |
| City | LUBBOCK | City |
| State | TX | State |
| ZIP Code | 79413 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 730579295 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FARMERS UNION HOSPITAL ASSOCIATION | BusinessNameLine1 |
| Business Name Line2 | D/B/A GREAT PLAINS REGIONAL MEDICAL CTR | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | FARM | NameControl |
| Phone | 5802252511 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1801 WEST THIRD LINCOLN BOX 2339 | AddressLine1 |
| City | ELK CITY | City |
| State | OK | State |
| ZIP Code | 73648 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | COREY LIVELY | Name |
| Title | CEO | Title |
| Phone | 5802252511 | Phone |
| Date Signed | 2014-04-29 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JONATHAN PHILLIPS | Name |
| PTIN | P01605460 | PTIN |
| Phone | 8067911591 | Phone |
| Date Prepared | 2014-04-29 | DatePrepared |
| 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 | COREY LIVELY | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1801 WEST THIRD LINCOLN BOX 2339 | AddressLine1 |
| City | ELK CITY | City |
| State | OK | State |
| ZIP Code | 73648 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 48919452 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.GPRMC-OK.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1929 | YearFormation |
| State Legal Domicile | OK | StateLegalDomicile |
| Activity Or Mission Description | GREAT PLAINS REGIONAL MEDICAL CENTER IS A NOT-FOR-PROFIT CORPORATION ORGANIZED UNDER THE STATE LAWS OF OKLAHOMA FOR THE SOLE PURPOSE OF PROVIDING COMPREHENSIVE, COST-EFFECTIVE, HIGH QUALITY HEALTHCARE TO OUR COMMUNITIES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 484 | TotalNbrEmployees |
| Total Nbr Volunteers | 40 | TotalNbrVolunteers |
| Total Gross UBI | 40261 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 2812 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 125685 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 24008 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 39896507 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 46544365 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 510321 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1016818 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 379718 | OtherRevenuePriorYear |
| Other Revenue Current Year | 882532 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 40912231 | TotalRevenuePriorYear |
| Total Revenue Current Year | 48467723 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 140 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 1550 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 20599036 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 20747406 | 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 | 23834528 | OtherExpensePriorYear |
| Other Expenses Current Year | 30609542 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 44433704 | TotalExpensesPriorYear |
| Total Expenses Current Year | 51358498 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -3521473 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -2890775 | RevenuesLessExpensesCY |
| Total Assets BOY | 94318349 | TotalAssetsBOY |
| Total Assets EOY | 88590448 | TotalAssetsEOY |
| Total Liabilities BOY | 40250385 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 39463259 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 54067964 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 49127189 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | GREAT PLAINS REGIONAL MEDICAL CENTER WILL DISTINGUISH ITSELF AS THE LEADER IN WESTERN OKLAHOMA & THE EASTERN TEXAS PANHANDLE FOR COMPREHENSIVE, COST EFFECTIVE, HIGH-QUALITY HELATHCARE. WE WILL MEET THE HEALTHCARE NEEDS OF PATIENTS IN OUR SERVICE AREA WHILE ACHIEVING COST EFFECTIVE QUALITY OUTCOMES. WE WILL MAINTAIN AND ENHANCE COLLABORATIVE RELATIONSHIPS WITH PHYSICIANS TO BETTER SERVE THE HEALTHCARE NEEDS OF OUR SERVICE AREA. WE WILL MAINTAIN AND CONTINUALLY ENHANCE HEALTH PROMOTION, PATIENT EDUCATION AND DISEASE PREVENTION FOR PATIENTS IN OUR SERVICE AREA. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 47297132 | Expense |
| Grants | 1550 | Grants |
| Revenue | 47370882 | Revenue |
| Description | FARMERS UNION HOSPITAL ASSOCIATION DBA. GREAT PLAINS REGIONAL MEDICAL CENTER IN ELK CITY, OKLAHOMA (HEREINAFTER REFERRED TO AS GPRMC) PROVIDES QUALITY HEALTH CARE REGARDLESS OF RACE, RELIGION, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF GPRMC, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES AND FURTHER THAT OUR MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTH CARE SERVICES AND HEALTH CARE EDUCATION. THEREFORE, IN KEEPING THIS HOSPITAL'S COMMITMENT TO SERVE ALL MEMBERS OF ITS COMMUNITY, FREE CARE AND/OR SUBSIDIZED CARE, CARE PROVIDED TO PERSONS COVERED BY GOVERNMENT PROGRAMS AT BELOW COST, AND HEALTH CARE ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY WILL BE CONSIDERED WHETHER THE NEED AND/OR INDIVIDUALS INABILITY TO PAY COEXISTS. THESE ACTIVITIES INCLUDED WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS,SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, & MEDICALLY UNDER-SERVED, AND OTHER BROAD COMMUNITY SUPPORT ACTIVITIES.GPRMC SERVED OVER 2,360 PATIENTS WITH MORE THAN 8,350 PATIENT DAYS ON AN INPATIENT BASIS. WE ALSO HAD 56,482 OUTPATIENT ENCOUNTERS WITH PATIENTS DURING THE YEAR. WE TREATED 13,733 PATIENTS IN THE EMERGENCY DEPARTMENT. OUR SURGICAL TEAMS PERFORMED 3,351 SURGERIES DURING THE YEAR.GPRMC PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL AND OTHER PROGRAMS AS PART OF ITS MISSION TO THE COMMUNITY. THESE PROGRAMS MAY NOT PAY FULL CHARGES. TO THE EXTENT REIMBURSEMENT IS BELOW FULL CHARGES, GPRMC RECOGNIZES THESE AMOUNTS AS CONTRACTUAL ADJUSTMENTS IN MEETING ITS MISSION TO THE ENTIRE COMMUNITY. ALSO, IN RECOGNIZING ITS MISSION TO THE COMMUNITY, GPRMC PROVIDES SERVICES FOR THOSE UNABLE TO PAY. ADDITIONALLY, GPRMC HAS PROVIDED SERVICES TO OTHERS WHO ARE EITHER UNWILLING OR UNABLE TO QUALIFY FOR CHARITY CARE GUIDELINES BUT WHO ARE STILL UNABLE TO PAY. COMMUNITY BENEFIT IS ALSO PROVIDED BY GPRMC BY ITS PROVIDING REDUCED PRICE SERVICES, FREE PROGRAMS OFFERED THROUGHOUT THE YEAR, AND INITIATIVES WHICH GPRMC BELIEVES WILL SERVE A BONA FIDE COMMUNITY HEALTH NEED. SEE SCHEDULE H FOR MORE INFORMATION REGARDING THESE ACTIVITIES. | Description |
| Total Program Service Expense | 47297132 | 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 | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | 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 | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| 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 | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 562 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 484 | NumberOfEmployees |
| Employment Tax Returns Filed | 0 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| 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 |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Form8899 Filed | 0 | Form8899Filed |
| Form1098 C Filed | 0 | Form1098CFiled |
| Excess Business Holdings | 0 | ExcessBusinessHoldings |
| Taxable Distributions | 0 | TaxableDistributions |
| Distribution To Donor | 0 | DistributionToDonor |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | 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 | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | 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 | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | OK | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
| Other Explain In Sch O | X | OtherExplainInSchO |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JANET MILLER EXECUTIVE ASSISTANT | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5808215302 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 2339 | AddressLine1 |
| City | ELK CITY | City |
| State | OK | State |
| ZIP Code | 73648 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 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 |
|---|---|---|---|---|---|---|---|
| DANNY SPROWLS | |||||||
| CHAIRMAN | 2.00 | X | 0 | 0 | 0 | ||
| PAUL KUMPF | |||||||
| VICE CHAIRMAN | 2.00 | X | 0 | 0 | 0 | ||
| EDWARD ALBERT | |||||||
| SECRETARY | 2.00 | X | 0 | 0 | 0 | ||
| CRAIG PHELPS MD | |||||||
| CHIEF OF STAFF (FORMER) | 2.00 | X | 47300 | 0 | 0 | ||
| SCOTT WILLIAMS DO | |||||||
| CHIEF OF STAFF | 2.00 | X | 9625 | 0 | 0 | ||
| J COFFEY MD | |||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| BILL GWARTNEY | |||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| JACK MORRISON DDS | |||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| GENE SMITH | |||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| EMORY THOMAS | |||||||
| BOARD MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| JEAN FORSBERG MD | |||||||
| VICE CHIEF OF STAFF | 2.00 | X | 83782 | 0 | 0 | ||
| ROY L IKNER | |||||||
| CEO | 40.00 | 330505 | 0 | 23586 | X | ||
| TRACY P BYERS | |||||||
| COO | 40.00 | 78875 | 0 | 2298 | X | ||
| STEVEN T STEWART | |||||||
| CFO | 40.00 | 76891 | 0 | 2489 | X | ||
| LINDSAY J PENA MD | |||||||
| PHYSICIAN | 40.00 | 364908 | 0 | 16827 | X | ||
| FRANCIS ABRAHAM MD | |||||||
| PHYSICIAN | 40.00 | 362969 | 0 | 49574 | X | ||
| LELAND W DENNIS MD | |||||||
| PHYSICIAN | 40.00 | 195959 | 0 | 3374 | X | ||
| LAURA L KURZENDOERFER | |||||||
| CNO | 40.00 | 193307 | 0 | 791 | X | ||
| HETLEVIA R VILAR-JENSEN MD | |||||||
| PHYSICIAN | 40.00 | 179751 | 0 | 4978 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1923872 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 103917 | TotalOtherCompensation |
| Number Individuals GT100 K | 9 | 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 |
|---|---|---|---|---|---|
| EM CARE PHYSICIAN SERVICES INC | |||||
| 13737 NOEL ROAD SUITE 1600 | DALLAS | TX | 75240 | PHYSICIAN ER COVERAGE | 1411215 |
| NIGHTRAYS PA | |||||
| PO BOX 204367 | DALLAS | TX | 75230 | RADIOLOGIST SERVICES | 929689 |
| HOSPITAL CARE CONSULTANTS INC | |||||
| 17304 PRESTON ROAD SUITE 510 | DALLAS | TX | 75252 | HOSPITALIST | 573600 |
| WATERSTONE BENEFIT ADMINISTRATORS | |||||
| 4013 NORTHWEST EXPRESSWAY SUITE 57 | OKLAHOMA CITY | OK | 73116 | INSURANCE MANAGEMENT | 440922 |
| HEALTHCARE CODING & CONSULTING SERVICES | |||||
| 8270 COLLEGE PARKWAY SUITE 101 | FORT MYERS | FL | 33919 | OUTSIDE CODING SERVICES | 235802 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 8 | NumberOfContractorsGT100K |
| Government Grants | 7817 | GovernmentGrants |
| All Other Contributions | 16191 | AllOtherContributions |
| Total Contributions | 24008 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SERVICE RE | 621990 | 46343017 | 46343017 |
| DAYCARE CENTER REVENUE | 900099 | 123867 | 123867 |
| OTHER SERVICE REVENUE | 900099 | 55359 | 55359 |
| MEDICAID INCENTIVE PAY | 900099 | 22122 | 22122 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 46544365 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 493716 | TotalRevenueColumn |
| Exclusion | $493,716 | ExclusionAmount |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 66431 | TotalRevenueColumn |
| Exclusion | $66,431 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 303415 | 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 | 303415 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 303415 | TotalRevenueColumn |
| Related Or Exempt Function Income | 303415 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 282688 | Securities |
| Other | 692143 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 355282 | Securities |
| Other | 96447 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -72594 | Securities |
| Other | 595696 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 523102 | TotalRevenueColumn |
| Related Or Exempt Function Income | 523102 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| CAFETERIA SALES | 722210 | 457484 | $457,484 | |
| CATERING SERVICES | 722320 | 40261 | 40261 | |
| VENDING MACHINES | 445100 | 14941 | $14,941 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 512686 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 48467723 | TotalRevenueColumn |
| Related Or Exempt Function Income | 47370882 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 40261 | UnrelatedBusinessRevenue |
| Exclusion | $1,032,572 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1550 | Total |
| Program Services | 1550 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 894213 | Total |
| Program Services | 397161 | ProgramServices |
| Management And General | 497052 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15643707 | Total |
| Program Services | 14698015 | ProgramServices |
| Management And General | 945692 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3059471 | Total |
| Program Services | 3059471 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1150015 | Total |
| Program Services | 1059568 | ProgramServices |
| Management And General | 90447 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 126798 | Total |
| Management And General | 126798 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 157560 | Total |
| Management And General | 157560 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 52028 | Total |
| Management And General | 52028 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6256116 | Total |
| Program Services | 6042364 | ProgramServices |
| Management And General | 213752 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 90218 | Total |
| Program Services | 86358 | ProgramServices |
| Management And General | 3860 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 99510 | Total |
| Program Services | 88369 | ProgramServices |
| Management And General | 11141 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 158024 | Total |
| Program Services | 158024 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1096912 | Total |
| Program Services | 1091979 | ProgramServices |
| Management And General | 4933 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 114031 | Total |
| Program Services | 109463 | ProgramServices |
| Management And General | 4568 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 75137 | Total |
| Program Services | 57273 | ProgramServices |
| Management And General | 17864 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1844909 | Total |
| Program Services | 10498 | ProgramServices |
| Management And General | 1834411 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5010975 | Total |
| Program Services | 5005612 | ProgramServices |
| Management And General | 5363 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 429694 | Total |
| Program Services | 429694 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBTS | 7121828 | 7121828 | |
| MEDICAL SUPPLIES | 6270899 | 6243275 | 27624 |
| EQUIPMENT LEASES | 1239130 | 1238930 | 200 |
| MISCELLANEOUS OTHER | 168602 | 155215 | 13387 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 297171 | Total |
| Program Services | 242485 | ProgramServices |
| Management And General | 54686 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51358498 | Total |
| Program Services | 47297132 | ProgramServices |
| Management And General | 4061366 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2045847 | BOY |
| EOY | 3985815 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15783589 | BOY |
| EOY | 17057769 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8665632 | BOY |
| EOY | 6374179 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1184656 | BOY |
| EOY | 1174501 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 537495 | BOY |
| EOY | 641371 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 83976105 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 30964832 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57511210 | BOY |
| EOY | 53011273 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5847996 | BOY |
| EOY | 4415492 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 844980 | BOY |
| EOY | 976905 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1896944 | BOY |
| EOY | 953143 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 94318349 | BOY |
| EOY | 88590448 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2318299 | BOY |
| EOY | 2597251 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37130000 | BOY |
| EOY | 36335000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 802086 | BOY |
| EOY | 531008 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40250385 | BOY |
| EOY | 39463259 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 54067964 | BOY |
| EOY | 49127189 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 54067964 | BOY |
| EOY | 49127189 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 94318349 | BOY |
| EOY | 88590448 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -2890775 | ReconcilationRevenueExpenses |
| Reconcilation Prior Adjustment | -2050000 | ReconcilationPriorAdjustment |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 1 | AccountantCompileOrReview |
Accountant Compile Or Review Basis AccountantCompileOrReviewBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 748759 | OtherCostOrOtherBasis |
| Book Value | 748759 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 59066990 | OtherCostOrOtherBasis |
| Depreciation | 13723927 | Depreciation |
| Book Value | 45343063 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1657670 | OtherCostOrOtherBasis |
| Depreciation | 643648 | Depreciation |
| Book Value | 1014022 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 22490886 | OtherCostOrOtherBasis |
| Depreciation | 16597257 | Depreciation |
| Book Value | 5893629 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 11800 | OtherCostOrOtherBasis |
| Book Value | 11800 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 53011273 | TotalOfBookValueLandBuildings |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 41345895 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 41345895 | RevenueSubtotal |
| Other Revenues Not Included | 7121828 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 7121828 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 48467723 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 44236670 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 44236670 | ExpensesSubtotal |
| Other Expenses Not Included | 7121828 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 7121828 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 51358498 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | THE HOSPITAL IS A NOT-FOR-PROFIT ORGANIZATION THAT IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPITAL EVALUATES AND ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES (FORMERLY FASB INTERPRETATION 48 (FIN 48) ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THIS STANDARD REQUIRES CERTAIN DISCLOSURES ABOUT UNCERTAIN INCOME TAX POSITIONS. THE HOSPITAL EVALUATES ANY UNCERTAIN TAX POSITIONS USING THE PROVISIONS OF ASC 450, CONTINGENCIES. AS A RESULT, MANAGEMENT DOES NOT BELIEVE THAT ANY UNCERTAIN TAX POSITIONS CURRENTLY EXIST AND NO LOSS CONTINGENCY HAS BEEN RECOGNIZED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL HAS FILED ALL APPLICABLE TAX RETURNS. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 7,121,828. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 7,121,828. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCare |
| 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 | 426302 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 80237 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 346065 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00780 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6844797 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4743554 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2101243 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04750 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7271099 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4823791 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2447308 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05530 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 44512 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 44512 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00100 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 130150 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 130150 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00290 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1550 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1550 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 176212 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 176212 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00390 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7447311 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4823791 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2623520 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05920 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 1438 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1438 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 2139 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2139 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 447469 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 447469 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.01010 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 451046 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 451046 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.01010 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $2,867,599 | BadDebtExpenseAmount |
| Amount Attributable To | 910257 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 7602843 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 7823256 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -220413 | 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 | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 PLAINS DIAGNOSTIC IMAGING LLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | RADIOLOGY SERVICES | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.79490 | OrganizationProfitOrOwnership |
| Officers Etc Profit Or Ownership | 0.00000 | OfficersEtcProfitOrOwnership |
| Physicans Profit Or Ownership | 0.20510 | PhysicansProfitOrOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | GREAT PLAINS REGIONAL MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 2339 | AddressLine1 |
| City | ELK CITY | City |
| State | OK | State |
| ZIP Code | 73648 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREAT PLAINS REGIONAL MEDICAL CENTER | 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 |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| 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 | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 0 | UsesFPGDiscounted |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| Other Factors | X | OtherFactors |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Other Actions | X | PermitOtherActions |
| Collection Activities | 1 | CollectionActivities |
| Other Actions | X | OtherActions |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| 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 (15 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| PART I, LINE 7: AMOUNTS ON LINE 7A AND 7B WERE CALCULATED USING THE COST TO CHARGE RATIO IN IRS WORKSHEET 2. AMOUNTS ON LINES 7E, F, AND I ARE BASED ON ACTUAL COST RECORDED IN THE GENERAL LEDGER AND HOURS AT AVERAGE RATES. | |
| PART I, L7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES TO DETERMINE THE COMMUNITY BENEFIT PERCENTAGE WAS $7,121,829. | |
| PART II: GPRMC PROVIDES COMMUNITY BUILDING ACTIVITIES WITHIN THE COMMUNITY, BUT HAS NOT TRACKED THE EXPENSES RELATED TO THESE ACTIVITIES. THE HOSPITAL PROVIDES SUPPORT TO THE COMMUNITY IN THE FOLLOWING WAYS:-GPRMC EMPLOYEES PROVIDE MANY HOURS OF VOLUNTEER SERVICE TO CIVIC AND OTHER COMMUNITY BENEFIT CLUBS IN THE AREA. WE PROVIDE VARIOUS DONATIONS TO THESE CLUBS, LOCAL SCHOOL SYSTEMS, AND VARIOUS NON-PROFIT FOUNDATIONS & ORGANIZATIONS.-AWARE OF THE SHORTAGE OF PHYSICIANS IN THE ELK CITY AREA, GPRMC HAS WORKED DILIGENTLY TO ATTRACT ADDITIONAL PHYSICIANS TO THE COMMUNITY. THESE PHYSICIANS RANGE FROM FAMILY PRACTICE TO A VARIETY OF SPECIALTY AREAS. PATIENTS WILL BE ABLE TO ACCESS THEIR HEALTHCARE NEEDS LOCALLY INSTEAD OF DRIVING GREAT DISTANCES TO SEE A SPECIALIST.-GPRMC INVOLVEMENT IN COMMUNITY BUILDING ACTIVITIES ALSO EXTENDS THROUGH OTHER PROGRAMS SUCH AS MEALS ON WHEELS WHICH DELIVERS MEALS TO THE HOMEBOUND; DONATING ATHLETIC TRAINER SERVICES TO LOCAL SCHOOLS; AND WORKING WITH THE LOCAL FOODBANK.-GPRMC HAS A SHUTTLE SERVICE FOR PATIENTS WITHOUT TRANSPORTATION TO THE PHYSICIANS OFFICES, CLINICS AND THE HOSPITAL. THE FREE SHUTTLE TRAVELS IN ELK CITY AND AREA COMMUNITIES.-GPRMC IS COMMITTED TO COALITION BUILDING THROUGH THE DREAM LEAGUE SPORTS PROGRAM. | |
| PART III, LINE 4: THE ORGANIZATION'S BAD DEBT EXPENSE AT COST WAS CALCULATED USING THE EXPENSE REPORTED ON THE FINANCIAL STATEMENTS AND APPLYING AN OVERALL COST-TO-CHARGE RATIO CALCULATED FROM WORKSHEET 2. BAD DEBT EXPENSE IS REPORTED NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS. ALL DISCOUNTS AND PAYMENTS ARE APPLIED BEFORE WRITTEN OFF TO BAD DEBT. A PAYMENT ON AN ACCOUNT THAT WAS PREVIOUSLY WRITTEN OFF REDUCES BAD DEBT EXPENSE IN THE CURRENT YEAR.THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE AT COST ATTRIBUTABLE TO PATIENTS UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY WAS CALCULATED BY APPLYING A PERCENTAGE OF THE POPULATION BELOW FEDERAL POVERTY GUIDELINES TO BAD DEBT AT COST.FINANCIAL STATEMENT FOOTNOTE: THE CARRYING AMOUNT OF PATIENT RECEIVABLES IS REDUCED BY A VALUATION ALLOWANCE THAT REFLECTS MANAGEMENT'S BEST ESTIMATE OF AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS AND THIRD-PARTY PAYORS. MANAGEMENT REVIEWS PATIENT RECEIVABLES BY PAYOR CLASS AND APPLIES PERCENTAGES TO DETERMINE ESTIMATED AMOUNTS THAT WILL NOT BE COLLECTED FROM THIRD PARTIES UNDER CONTRACTUAL AGREEMENTS AND AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS DUE TO BAD DEBTS. MANAGEMENT CONSIDERS HISTORICAL WRITE OFF AND RECOVERY INFORMATION IN DETERMINING THE ESTIMATED BAD DEBT PROVISION. | |
| PART III, LINE 8: GPRMC PROVIDES SERVICES TO MEDICARE PATIENTS UNDERSTANDING THERE WILL BE WRITE-OFFS AND KNOWING THE ORGANIZATION WILL NOT RECOVER THE COSTS OF THE SERVICES PROVIDED. PROVIDING THESE SERVICES IS ESSENTIAL TO THE COMMUNITY AND THEREFORE INCREASES ACCESS TO HEALTHCARE SERVICES, WHICH IS A COMMUNITY BENEFIT.TOTAL REVENUE RECEIVED FROM MEDICARE (INCLUDING DSH AND IME) IS THE GROSS REIMBURSEMENT PLUS SETTLEMENT (INCLUDING LSA). BOTH THE TOTAL REVENUE RECEIVED FROM MEDICARE AND THE MEDICARE ALLOWABLE COSTS ARE REPORTED FROM THE MEDICARE COST REPORT. | |
| PART III, LINE 9B: THE PATIENTS ARE PRE-SCREENED PRIOR TO TESTING FOR CHARITABLE SERVICES AND A DETERMINATION IS MADE AS TO THE FINANCIAL ABILITY TO PAY. IF PATIENTS ARE PRE-QUALIFIED FOR SERVICES, THE COLLECTION PROCESS IS CEASED. | |
| PART V, SECTION B, LINE 10: GREAT PLAINS REGIONAL MEDICAL CENTER (GPRMC) IS COMMITTED TO PROVIDING CARE BASED ON THE FOLLOWING PRINCIPLES:- TREAT ALL PATIENTS EQUITABLY, WITH DIGNITY, WITH RESPECT AND WITH COMPASSION.- SERVE THE EMERGENT HEALTH CARE NEEDS OF EVERYONE, REGARDLESS OF A PATIENTS ABILITY TO PAY FOR CARE.- ASSIST PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE.- CAREFUL BALANCE BETWEEN FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH THE NEED FOR FISCAL STEWARDSHIP TO THE COMMUNITY AT LARGE.GPRMC WILL BUDGET AND FUND A REASONABLE AMOUNT OF CHARITY CARE ON AN ANNUAL BASIS TO HELP SUPPORT THE COMMUNITY MEDICAL NEEDS OF THE INDIGENT.CRITERIA:AN APPLICANT MUST MEET EACH OF THE FOLLOWING CRITERIA TO BE ELIGIBLE FOR CHARITY CARE: A. HAVE INCURRED MEDICAL EXPENSES AT GREAT PLAINS REGIONAL MEDICAL CENTER AS A RESULT OF MEDICALLY EMERGENT NON-ELECTIVE SERVICES.B. HAVE NO HEALTH INSURANCE AND APPLY AND BE DENIED DUE TO PROGRAM ELIGIBILITY IN WHOLE OR PART BY MEDICAID AND ANY OTHER PROGRAM THE HOSPITAL CONSIDERS TO BE AN ALTERNATIVE SOURCE OF PAYMENT.DENIAL DUE TO NON COOPERATION WITH ANY POTENTIAL THIRD PARTY PAYER WILL CONSTITUTE A DENIAL OF CHARITY CARE.C. HAVE INCOME NOT TO EXCEED 200% OF THE CURRENT YEAR FEDERAL POVERTY GUIDELINES.ELIGIBILITY IS BASED UPON THE SIZE OF THE FAMILY UNIT OF THE PATIENT AND THE GROSS FAMILY INCOME FOR THE PRECEDING TWELVE (12) MONTHS. APPLICANTS WILL BE REQUIRED TO FURNISH PROOF OF INCOME FOR THE LAST TWELVE (12) MONTHS WHEN APPLICATION IS MADE. THE INCOME GUIDELINES AND DEFINITION OF FAMILY UNIT ARE DETERMINED BY THE MOST RECENTLY PUBLISHED FEDERAL POVERTY GUIDELINES. APPROVED APPLICANTS WILL RECEIVE A 100% DISCOUNT IN THE MONTH THE APPLICATION IS APPROVED.AN APPROVED APPLICATION WILL REMAIN IN EFFECT FOR TWELVE (12) MONTHS IF THE INDIVIDUAL DOCUMENTS THEY CONTINUE TO MEET THE INCOME GUIDELINES.D. HAVE RESOURCES NOT TO EXCEED $5,000. HOUSEHOLD RESOURCES WILL BE DETERMINED BY THE GUIDELINES SET FORTH BY THE DEPARTMENT OF HUMAN SERVICES. E. MAKE APPLICATION WITHIN SIXTY (60) DAYS AFTER BEING DENIED COVERAGE DUE TO PROGRAM ELIGIBILITY IN WHOLE OR PART BY MEDICAID OR ANY OTHER PROGRAM THE HOSPITAL CONSIDERS TO BE AN ALTERNATIVE SOURCE OF PAYMENT. | GREAT PLAINS REGIONAL MEDICAL CENTER |
| PART V, SECTION B, LINE 12H: PATIENTS, THEIR FAMILIES, OR THEIR REPRESENTATIVES MUST REQUEST CHARITY CARE AND COMPLETE THE APPLICATION WITHIN SIXTY (60) DAYS AFTER BEING DENIED COVERAGE DUE TO PROGRAM ELIGIBILITY IN WHOLE OR PART BY MEDICAID OR ANY OTHER PROGRAM THE HOSPITAL CONSIDERS TO BE AN ALTERNATIVE SOURCE OF PAYMENT. APPLICATIONS SUBMITTED MUST INCLUDE PROOF OF INCOME BY INCLUDING A PERSONAL FINANCIAL STATEMENT, PREVIOUS YEARS TAX RETURN, RELEASE OF INFORMATION FROM EMPLOYERS, AND CHECK STUBS FROM THE EMPLOYER. ADDITIONALLY, THE HOSPITAL PROVIDES A 35% DISCOUNT TO ALL SELF-PAY (NO INSURANCE) PATIENTS. THERE IS AN ASSET TEST TO QUALIFY FOR CHARITY CARE. HOUSEHOLD RESOURCES ARE DETERMINED BY THE GUIDELINES SET FORTH BY THE DEPARTMENT OF HUMAN SERVICES. | GREAT PLAINS REGIONAL MEDICAL CENTER |
| PART V, SECTION B, LINE 16E: THE ORGANIZATION HAS A 100% DISCOUNT FOR QUALIFIED CHARITY CARE PATIENTS. APPLICANTS HAVE 60 DAYS AFTER BEING DENIED COVERAGE DUE TO PROGRAM ELIGIBILITY IN WHOLE OR PART BY MEDICAID OR ANY OTHER PROGRAM THE HOSPITAL CONSIDERS TO BE AN ALTERNATIVE SOURCE OF PAYMENT TO SUBMIT THEIR APPLICATION FOR CHARITY CARE. DETERMINATION FOR APPLICATIONS REQUESTING CHARITY CARE IS TO BE MADE BY GPRMC WITHIN 30 DAYS AFTER A COMPLETE APPLICATION HAS BEEN SUBMITTED. NO AMOUNTS PAID PRIOR TO RECEIVING CHARITY CARE WILL BE REIMBURSED. | GREAT PLAINS REGIONAL MEDICAL CENTER |
| PART V, SECTION B, LINE 17E: THE ORGANIZATION HAS A 100% DISCOUNT FOR QUALIFIED CHARITY CARE PATIENTS. APPLICANTS HAVE 60 DAYS AFTER BEING DENIED COVERAGE DUE TO PROGRAM ELIGIBILITY IN WHOLE OR PART BY MEDICAID OR ANY OTHER PROGRAM THE HOSPITAL CONSIDERS TO BE AN ALTERNATIVE SOURCE OF PAYMENT TO SUBMIT THEIR APPLICATION FOR CHARITY CARE. DETERMINATION FOR APPLICATIONS REQUESTING CHARITY CARE IS TO BE MADE BY GPRMC WITHIN 30 DAYS AFTER A COMPLETE APPLICATION HAS BEEN SUBMITTED. NO AMOUNTS PAID PRIOR TO RECEIVING CHARITY CARE WILL BE REIMBURSED. | GREAT PLAINS REGIONAL MEDICAL CENTER |
| PART V, SECTION B, LINE 20D: GPRMC PROVIDES A 100% DISCOUNT TO QUALIFIED INDIVIDUALS UNDER THE CHARITY CARE POLICY. THE AMOUNT THAT IS CHARGED IS BASED OFF OF THE CHARGEMASTER AT THE FULL RATE AMOUNT. | GREAT PLAINS REGIONAL MEDICAL CENTER |
| PART VI, LINE 2: THE ORGANIZATION RELIES ON INPUT FROM PHYSICIANS, OTHER HEALTHCARE PROVIDERS, COMMUNITY LEADERS, THE BOARD OF DIRECTORS, CITIZENS, ETC. IN THE COMMUNITY. WE LOOK AT OUT-MIGRATION STUDIES TO DETERMINE WHAT SERVICES PEOPLE FROM OUR COMMUNITY ARE SEEKING AND RECEIVING FROM OUTSIDE LOCATIONS. WE ALSO CONSIDER COMPARISONS OF THE VOLUME OF PHYSICIAN SPECIALTIES IN OUR AREA TO NATIONALLY RECOGNIZED DATA. THESE FACTORS ARE ALL CONSIDERED IN ADDITION TO FEEDBACK FROM PATIENTS IN THE COMMUNITY TO DETERMINE SHORTAGE OF CARE AREAS. | |
| PART VI, LINE 3: ASSISTANCE IS DISCUSSED WITH PATIENTS AS PART OF THE INTAKE PROCESS. THEY ARE SCREENED AT REGISTRATION FOR NEED FOR FINANCIAL ASSISTANCE AND THEN ARE GIVEN COPIES OF CHARITY CARE POLICY/FINANCIAL POLICY UPON REQUEST. WE TRY TO ASSIST PEOPLE IN QUALIFYING FOR SOME TYPE OF MEDICAL ASSISTANCE WHETHER IT BE MEDICARE, MEDICAID, DISABILITY OR CHARITY CARE. | |
| PART VI, LINE 4: GREAT PLAINS REGIONAL MEDICAL CENTER IS A SIXTY-TWO LICENSED BED ACUTE CARE HOSPITAL LOCATED IN ELK CITY, OKLAHOMA IN BECKMAN COUNTY. THE CORPORATION PROVIDES A COMPREHENSIVE RANGE OF GENERAL, ACUTE AND SPECIALIZED CARE, AS WELL AS OUTPATIENT AND ANCILLARY SERVICES, TO RESIDENTS IN ITS PRIMARY AND SECONDARY SERVICE AREAS COVERING TEN COUNTIES. ESTIMATED PRIMARY AND SECONDARY SERVICE AREA POPULATION EXCEEDS 100,000 PEOPLE. THE MEDIAN HOUSEHOLD INCOME IN BECKAM COUNTY IS $43,642 AND 16% OF THE COUNTY IS BELOW POVERTY LEVEL. | |
| PART VI, LINE 5: OUR BOARD OF DIRECTORS IS MADE UP OF CITIZENS FROM THE COMMUNITY, FROM BUSINESS OWNERS TO RETIRED INDIVIDUALS. THIS BROADLY BASED GROUP PROVIDES US WITH A BROAD PERSPECTIVE ON THE NEEDS OF THE COMMUNITY.GPRMC EXTENDS MEDICAL PRIVILEGES TO AREA PHYSICIANS. THEY MUST APPLY FOR PRIVILEGES AND THEN BE APPROVED BY THE MEDICAL STAFF AND THEN BY THE BOARD OF DIRECTORS.IF GPRMC HAS A SURPLUS OF FUNDS, THEN THEY ARE USED BY THE ORGANIZATION TO FULFILL OUR MISSION, VISION, AND VALUES.AS QUANTIFIED IN PART II, QUESTION 7 E, F AND I COMMUNITY BENEFIT IS PROVIDED BY GPRMC THROUGH FREE PROGRAMS OFFERED THROUGHOUT THE YEAR AND INITIATIVES WHICH GPRMC BELIEVES SERVE A BONA FIDE COMMUNITY HEALTH NEED. SOME OF THESE ACTIVITIES ARE AS FOLLOWS: -NOTICES ARE PUBLISHED IN AREA NEWSPAPERS, REGARDING NEW PHYSICIANS OR MEDICAL SERVICES. ACCORDING TO ESTIMATED NEWSPAPER CIRCULATION, THESE ADS REACH FROM 8,000 TO 10,000 HOMES IN THE AREA.-GPRMC PROVIDED FLU SHOTS FOR THE OFFICE PERSONNEL OF THE PHYSICIANS IN THE COMMUNITY. -GPRMC PROVIDES BREAST SELF-EXAM, CPR AND PRE-NATAL EDUCATION TO COMMUNITY MEMBERS.-GPRMC IS ONE OF TWO DESIGNATED DONOR LOCATIONS FOR THE COMMUNITY-WIDE BLOOD DRIVE HELD FIVE TIMES PER YEAR.-GPRMC HAS A SHUTTLE SERVICE FOR PATIENTS WITHOUT TRANSPORTATION TO THE PHYSICIAN'S OFFICES, CLINICS AND THE HOSPITAL. THE FREE SHUTTLE TRAVELS IN ELK CITY AND AREA COMMUNITIES.-GPRMC SPONSORS HEALTHCARE EDUCATION INITIATIVES FOR THE COMMUNITY. SOME OF THESE INCLUDE DIABETES SELF-MANAGEMENT CLASSES FOR PATIENTS WITH NEW OR UNCONTROLLED DIABETES AND EDUCATION TO LOCAL NURSING HOME STAFF REGARDING CARE OF PATIENTS WITH DEMENTIA AND OTHER TYPES OF BEHAVIORAL DISORDERS.-DUE TO THE SHORTAGE OF NURSES, SCHOLARSHIPS ARE AWARDED TO STUDENTS WISHING TO PURSUE DEGREES IN THE MEDICAL FIELD. -REPRESENTATIVES FROM GPRMC PRESENT EDUCATION PROGRAMS AT THE LOCAL ADULT LEARNING CENTER RELATIVE TO EDUCATION NEEDED TO FULFILL THE REQUIREMENTS FOR EMPLOYMENT IN A HOSPITAL SETTING. WE ALSO PARTICIPATE IN SEVERAL CAREER FAIRS FOR DIFFERENT SCHOOLS IN OUR AREA.-GPRMC WORKS IN COOPERATION WITH EDUCATORS BY PROVIDING A CLINICAL ROTATION TRAINING ENVIRONMENT FOR STUDENTS OF VARIOUS FIELDS INCLUDING PHYSICIAN, NURSING, PHARMACY, LAB, RADIOLOGY AND MEDICAL RECORDS.-WE PARTICIPATE WITH AREA HIGH SCHOOLS IN THE 'JOB SHADOW PROGRAM'. STUDENTS INTERESTED IN HEALTH CAREERS MAY OBSERVE OUR STAFF IN THE WORK SETTING AND OBTAIN A FIRST-HAND EXPERIENCE.-GPRMC HAS DEVELOPED A COLLABORATION WITH WESTERN OKLAHOMA STATE COLLEGE TO PROVIDE DISTANCE LEARNING CLASSES FOR THOSE IN THE COMMUNITY WISHING TO PURSUE NURSING DEGREES. GPRMC'S PART OF THE COLLABORATIVE IS TO PROVIDE A CLASSROOM IN THE LOCAL COMMUNITY. ADDITIONALLY, IN-KIND SERVICES ARE PROVIDED TO WESTERN OKLAHOMA STATE COLLEGE. THIS IS VITAL TO THOSE PROSPECTIVE STUDENTS PURSUING NURSING DEGREES THAT WOULD NOT HAVE BEEN ABLE TO DRIVE THE LONG DISTANCE TO THE COLLEGE. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 1 | 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 (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROY L IKNER | ||||||||||||||
| CEO | 330505 | 0 | 0 | 0 | 0 | 0 | 22116 | 0 | 1470 | 0 | 354091 | 0 | 0 | 0 |
| LINDSAY J PENA MD | ||||||||||||||
| PHYSICIAN | 364908 | 0 | 0 | 0 | 0 | 0 | 16827 | 0 | 0 | 0 | 381735 | 0 | 0 | 0 |
| FRANCIS ABRAHAM MD | ||||||||||||||
| PHYSICIAN | 362969 | 0 | 0 | 0 | 0 | 0 | 41000 | 0 | 8574 | 0 | 412543 | 0 | 0 | 0 |
| LELAND W DENNIS MD | ||||||||||||||
| PHYSICIAN | 195959 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 3374 | 0 | 199333 | 0 | 0 | 0 |
| LAURA L KURZENDOERFER | ||||||||||||||
| CNO | 193307 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 791 | 0 | 194098 | 0 | 0 | 0 |
| HETLEVIA R VILAR-JENSEN MD | ||||||||||||||
| PHYSICIAN | 179751 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 4978 | 0 | 184729 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 3 | COMPENSATION FOR THE CEO IS ESTABLISHED BY GPRMC THROUGH A COMPENSATION COMMITTEE WHICH USES AN INDEPENDENT CONSULTATION CONSULTANT AND A COMPENSATION STUDY. THE BOARD THEN REVIEWS AND APPROVES THE CEO'S COMPENSATION AND SIGNS A WRITTEN EMPLOYMENT CONTRACT WITH THE CEO. |
| PART I, LINE 4C | FRANCIS ABRAHAM, MD IS A PARTNER IN PLAINS DIAGNOSTIC IMAGING, LLP (A RELATED ORGANIZATION AND JOINT VENTURE). DURING FISCAL YEAR 2013, DR. ABRAHAM RECEIVED $7,520 IN ORDINARY BUSINESS INCOME AND $62 IN INTEREST INCOME ON HIS K-1. (THIS AMOUNT WAS EXCLUDED FROM FORM 990 PART VII, SECTION A DUE TO THE $10,000 EXCEPTION FOR REPORTING COMPENSATION.) |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE OKLAHOMA DEVELOPMENT FINANCE COMMITTEE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 731083741 | IssuerEIN |
| CUSIP Number | 678910DB3 | CUSIPNumber |
| Date Issued | 2007-06-26 | DateIssued |
| Issue Price | 40000000 | IssuePrice |
| Description Of Purpose | CONSTRUCT & FURNISH 62-BED HOSPITAL | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Amount Retired | 3665000 | AmountRetired |
| Total Proceeds | 40000000 | TotalProceeds |
| Amount In Reserve Fund | 3461849 | AmountInReserveFund |
| Issuance Costs From Proceeds | 471185 | IssuanceCostsFromProceeds |
| Year Of Subst Completion | 2009 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 0 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Bond Iss Meet Prvt Security Pay Test | 0 | BondIssMeetPrvtSecurityPayTest |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedProp |
| Non Qualified Bond Remed Procdrs | 0 | NonQualifiedBondRemedProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiled |
| Rebate Not Due Yet | 0 | RebateNotDueYet |
| Exception To Rebate | 0 | ExceptionToRebate |
| No Rebate Due | 0 | NoRebateDue |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqs |
Form990 Schedule K Part V Form990ScheduleKPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Proc To Undertk Corrective Action | 1 | ProcToUndertkCorrectiveAction |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| JOHN MARK PHELPS | |||
| FAMILY MEMBER OF CRAIG PHELPS | 41557 | FAMILY MEMBER OF CRAIG PHELPS, BOARD MEMBER AND CHIEF OF STAFF (FORMER). | 0 |
| SARAH G PHELPS | |||
| FAMILY MEMBER OF CRAIG PHELPS | 70196 | FAMILY MEMBER OF CRAIG PHELPS, BOARD MEMBER AND CHIEF OF STAFF (FORMER). | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERS ARE INDIVIDUALS WHO HAVE VOTING SHARES IN THE ORGANIZATION. MEMBERSHIP IS OBTAINED THROUGH TRANSFERS OF EXISTING MEMBERSHIPS. TRANSFERS NORMALLY RESULT EITHER THROUGH VOLUNTARY SURRENDER OF A MEMBERSHIP OF THROUGH THE DEATH OF A MEMBER WHO HAS NO IMMEDIATE FAMILY INTERESTED IN RETAINING THE MEMBERSHIP. EACH INDIVIDUAL IS ALLOWED ONLY ONE MEMBERSHIP AND THERE IS ONLY ONE VOTE PER MEMBERSHIP. | |
| FORM 990, PART VI, SECTION A, LINE 7A | GOVERNING BOARD MEMBERS ARE APPOINTED THROUGH NOMINATION AND A MAJORITY VOTE ELECTION BY THE MEMBERSHIP AT ANNUAL MEETINGS. | |
| FORM 990, PART VI, SECTION A, LINE 7B | ANY EDITS TO THE GOVERNING BOARD BYLAWS, RULES, AND/OR REGULATIONS HAVE TO BE APPROVED BY A MAJORITY VOTE OF THE MEMBERSHIP. PER THE ORGANIZATION'S BYLAWS, THE MEMBERS ARE THE SUPREME AUTHORITY OF THE ORGANIZATION IN ALL ITS AFFAIRS. | |
| FORM 990, PART VI, SECTION B, LINE 11 | FORM 990 WILL BE PRESENTED AND REVIEWED AT ONE OF THE GOVERNING BOARD'S MONTHLY MEETINGS. THE FORM 990 WILL ALSO HAVE BEEN POSTED ON THE GOVERNING BOARD'S WEBSITE IN THE DAYS PRECEDING THE MONTHLY MEETING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | ON AN ANNUAL BASIS, ALL MEMBERS OF THE GOVERNING BODY AND KEY EMPLOYEES RECEIVE A COPY OF THE ORGANIZATIONS CONFLICT OF INTEREST POLICY. THEY ARE REQUIRED TO REVIEW THE POLICY, COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE, AND SIGN THE QUESTIONNAIRE; ATTESTING TO THEIR UNDERSTANDING OF THE POLICY AND THAT THEIR ANSWERS ON THE QUESTIONNAIRE ARE TRUE AND ACCURATE. | |
| FORM 990, PART VI, SECTION B, LINE 15 | HUMAN RESOURCES CONDUCTS A COMPARATIVE ANALYSIS USING STATE, MULTI-STATE, REGIONAL, AND NATIONAL COMPENSATION (BY POSITION) DATA. DATA IS CULLED INTO BEDSIZE, REVENUE, AND SIMILAR AREA COMPARATIVES. HUMAN RESOURCES THEN SUBMITS A REPORT TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS ANNUALLY. THE EXECUTIVE COMMITTEE REVIEWS THE DATA, CONFIRMS THE DATA WITH AN OUT-OF-HOUSE AUDITOR, AND RECOMMENDS APPROPRIATE CEO COMPENSATION TO THE BOARD OF DIRECTORS AS A WHOLE. ALL OTHER POSITIONS ARE REVIEWED ANNUALLY BY HUMAN RESOURCES AND APPROVED BY THE CEO. | |
| FORM 990, PART VI, SECTION C, LINE 18 | GPRMC MAKES ITS FORMS 1023, 990, AND 990-T AVAILABLE TO THE PUBLIC UPON REQUEST. A COPY OF THE REQUESTED DOCUMENT IS PROVIDED WHEN PRACTICAL. OTHERWISE, AN APPOINTMENT FOR AN ON-SITE REVIEW OF THE REQUESTED DOCUMENT IS MADE, WITH THE DAY AND TIME OF THE APPOINTMENT DETERMINED BY THE PERSON(S) WHO HAS MADE THE REQUEST, ACCORDING TO THEIR SCHEDULE AND CONVENIENCE. | |
| FORM 990, PART VI, SECTION C, LINE 19 | GPRMC MAKES ITS FORMS 1023, 990, AND 990-T AVAILABLE TO THE PUBLIC UPON REQUEST. A COPY OF THE REQUESTED DOCUMENT IS PROVIDED WHEN PRACTICAL. OTHERWISE, AN APPOINTMENT FOR AN ON-SITE REVIEW OF THE REQUESTED DOCUMENT IS MADE, WITH THE DAY AND TIME OF THE APPOINTMENT DETERMINED BY THE PERSON(S) WHO HAS MADE THE REQUEST, ACCORDING TO THEIR SCHEDULE AND CONVENIENCE. | |
| FORM 990, PART IX, LINE 11G | HEALTHCARE SERVICES: PROGRAM SERVICE EXPENSES 6,042,364. MANAGEMENT AND GENERAL EXPENSES 213,752. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,256,116. | OTHER FEES |
| THE BOARD OF DIRECTORS OF GPRMC ENGAGES AN INDEPENDENT THIRD-PARTY ACCOUNTING FIRM TO AUDIT THE ORGANIZATION'S FINANCIAL STATEMENTS ANNUALLY. THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR SELECTING AN INDEPENDENT ACCOUNTANT. MANAGEMENT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT, REVIEW, AND COMPILATION OF ITS FINANCIAL STATEMENTS. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FOUNDATION BOARD OF GREAT PLAINS REGIONAL MEDICAL CENTER | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 2339 | AddressLine1 |
| City | ELK CITY | City |
| State | OK | State |
| ZIP Code | 736482339 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 730479295 | EIN |
| Primary Activities | PROVIDING SUPPORT FOR HEALTHCARE | PrimaryActivities |
| Legal Domicile State | OK | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | LINE 3 | PublicCharityStatus |
| Controlled Org | 0 | ControlledOrg |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLAINS DIAGNOSTIC IMAGING LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 2339 | AddressLine1 |
| City | ELK CITY | City |
| State | OK | State |
| ZIP Code | 736482339 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 261530951 | EIN |
| Primary Activity | RADIOLOGY SERVICES - EQUIPMENT RENTAL | PrimaryActivity |
| Legal Domicile State | OK | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Predominant Income Type | RELATED | PredominantIncomeType |
| Share Of Total Income | 233116 | ShareOfTotalIncome |
| Share Of EOY Assets | 1090955 | ShareOfEOYAssets |
| Disproportionate Allocations | 0 | DisproportionateAllocations |
| General Or Managing Partner | 1 | GeneralOrManagingPartner |
| Percentage Ownership | 0.79490 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLAINS DIAGNOSTIC IMAGING | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | L | TransactionType |
| Amount Involved | 1089726 | AmountInvolved |
| Method Of Amt Determination | COST | MethodOfAmtDetermination |