LINDSBORG COMMUNITY HOSPITAL ASSOCIATION: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- LINDSBORG COMMUNITY HOSPITAL ASSOCIATION (EIN 48-0545183)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-01-31
- IRS object ID
- 201300319349300630
- Schema version
- 2011v1.3
- 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 | 2013-01-31T11:41:33-06:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1201 Walnut Suite 1700 | AddressLine1 |
| City | Kansas City | City |
| State | MO | State |
| ZIP Code | 641062246 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 480545183 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LINDSBORG COMMUNITY HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % LARAINE GENGLER | InCareOfName |
| Name Control | LIND | NameControl |
| Phone | 7852273308 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 605 WEST LINCOLN | AddressLine1 |
| City | LINDSBORG | City |
| State | KS | State |
| ZIP Code | 674562328 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LARRY VAN DER WEGE | Name |
| Title | ADMINISTRATOR | Title |
| Date Signed | 2013-02-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Michael J Engle | Name |
| Phone | 8162216300 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | LARRY VAN DER WEGE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 605 WEST LINCOLN | AddressLine1 |
| City | LINDSBORG | City |
| State | KS | State |
| ZIP Code | 674562328 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 6778723 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.LINDSBORGHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1944 | YearFormation |
| State Legal Domicile | KS | StateLegalDomicile |
| Activity Or Mission Description | OPERATION OF A CRITICAL ACCESS HOSPITAL FOR THE CARE OF INDIVIDUALS SUFFERING FROM MENTAL OR PHYSICAL ILLNESS, INJURY OR DEFORMITY IN AN ACUTE CARE, SKILLED NURSING CARE, OUTPATIENT, OR EMERGENCY SETTING. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 103 | TotalNbrEmployees |
| Total Nbr Volunteers | 7 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 127161 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 185745 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 5774736 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 6531961 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 30284 | InvestmentIncomePriorYear |
| Investment Income Current Year | 19812 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 29503 | OtherRevenuePriorYear |
| Other Revenue Current Year | 41205 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 5961684 | TotalRevenuePriorYear |
| Total Revenue Current Year | 6778723 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 775 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 3289569 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 3862872 | 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 | 2692590 | OtherExpensePriorYear |
| Other Expenses Current Year | 2931997 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 5982159 | TotalExpensesPriorYear |
| Total Expenses Current Year | 6795644 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -20475 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -16921 | RevenuesLessExpensesCY |
| Total Assets BOY | 3875592 | TotalAssetsBOY |
| Total Assets EOY | 4187233 | TotalAssetsEOY |
| Total Liabilities BOY | 1749534 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2437503 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2126058 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1749730 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | SEE SCHEDULE O | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 4498877 | Expense |
| Grants | 0 | Grants |
| Revenue | 6531961 | Revenue |
| Description | SEE SCHEDULE O | Description |
| Total Program Service Expense | 4498877 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | false | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 12 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 103 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | KS | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | LARAINE GENGLER | NamePerson |
| Telephone Number | 7852273308 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 605 WEST LINCOLN | AddressLine1 |
| City | LINDSBORG | City |
| State | KS | State |
| ZIP Code | 674562328 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (9 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| JUDY BURCH | ||||||
| PRESIDENT/TRUSTEE | 1.0 | X | X | |||
| JUDY MURPHY | ||||||
| SECRETARY/TRUSTEE | 1.0 | X | X | |||
| VIRGINIA SWISHER | ||||||
| VICE-PRESIDENT/TRUSTEE | 1.0 | X | X | |||
| DAVE SCHRAG | ||||||
| TRUSTEE | 1.0 | X | ||||
| JOEL WOODARD | ||||||
| TREASURER/TRUSTEE | 1.0 | X | X | |||
| CARLA SCOTT | ||||||
| TRUSTEE | 1.0 | X | ||||
| TOM BUFFINGTON | ||||||
| TRUSTEE | 1.0 | X | ||||
| LARAINE GENGLER | ||||||
| CFO | 36.0 | X | 83299 | 0 | 3391 | |
| LARRY VAN DER WEGE | ||||||
| CEO | 30.0 | X | 85790 | 0 | 3430 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 169089 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 6821 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Government Grants | 7161 | GovernmentGrants |
| All Other Contributions | 178584 | AllOtherContributions |
| Total Contributions | 185745 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE REVENUES | Description |
| Business Code | 621400 | BusinessCode |
| Total Revenue Column | 6531961 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6531961 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 6531961 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 19812 | TotalRevenueColumn |
| Exclusion | $19,812 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| EMPLOYEE/GUEST MEALS | 721000 | 35115 | $35,115 |
| WELLNESS CENTER | 900099 | 6090 | $6,090 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 41205 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6778723 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6531961 | RelatedOrExemptFunctionIncome |
| Exclusion | $61,017 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 775 | Total |
| Program Services | 775 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 181113 | Total |
| Program Services | 126779 | ProgramServices |
| Management And General | 54334 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3064531 | Total |
| Program Services | 1781264 | ProgramServices |
| Management And General | 1283267 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 114953 | Total |
| Program Services | 91809 | ProgramServices |
| Management And General | 23144 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 282611 | Total |
| Program Services | 225711 | ProgramServices |
| Management And General | 56900 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 219664 | Total |
| Program Services | 175437 | ProgramServices |
| Management And General | 44227 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35748 | Total |
| Management And General | 35748 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 61124 | Total |
| Management And General | 61124 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1100357 | Total |
| Program Services | 632440 | ProgramServices |
| Management And General | 467917 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 419 | Total |
| Program Services | 419 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 882290 | Total |
| Program Services | 769936 | ProgramServices |
| Management And General | 112354 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 112775 | Total |
| Program Services | 88609 | ProgramServices |
| Management And General | 24166 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14275 | Total |
| Program Services | 5816 | ProgramServices |
| Management And General | 8459 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50265 | Total |
| Program Services | 40145 | ProgramServices |
| Management And General | 10120 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 246506 | Total |
| Program Services | 196875 | ProgramServices |
| Management And General | 49631 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 45284 | Total |
| Program Services | 36494 | ProgramServices |
| Management And General | 8790 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| EQUIPMENT RENTAL & MAINT | 152267 | 130479 | 21788 |
| DUES & SUBSCRIPTIONS | 27864 | 10105 | 17759 |
| MINOR EQUIPMENT | 45337 | 28298 | 17039 |
| BAD DEBT EXPENSE | 157486 | 157486 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6795644 | Total |
| Program Services | 4498877 | ProgramServices |
| Management And General | 2296767 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 122919 | BOY |
| EOY | 76677 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 646049 | BOY |
| EOY | 560985 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 689747 | BOY |
| EOY | 819278 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 151717 | BOY |
| EOY | 153484 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37756 | BOY |
| EOY | 47311 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 7234501 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 5136615 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1307755 | BOY |
| EOY | 2097886 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 312068 | BOY |
| EOY | 225314 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 607581 | BOY |
| EOY | 206298 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3875592 | BOY |
| EOY | 4187233 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 555016 | BOY |
| EOY | 702534 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1194518 | BOY |
| EOY | 1084304 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 650665 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1749534 | BOY |
| EOY | 2437503 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1849515 | BOY |
| EOY | 1487778 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 276543 | BOY |
| EOY | 261952 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2126058 | BOY |
| EOY | 1749730 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3875592 | BOY |
| EOY | 4187233 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -16921 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -359407 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | true | GrantsOtherOrganizations |
| Grants Other Organizations | $1,685 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 1685 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10442 | OtherCostOrOtherBasis |
| Book Value | 10442 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2307063 | OtherCostOrOtherBasis |
| Depreciation | 1501273 | Depreciation |
| Book Value | 805790 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4009075 | OtherCostOrOtherBasis |
| Depreciation | 3384808 | Depreciation |
| Book Value | 624267 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 907921 | OtherCostOrOtherBasis |
| Depreciation | 250534 | Depreciation |
| Book Value | 657387 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2097886 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
| Total Of Amounts | 0 | TotalOfAmounts |
| Total Revenue | 6778723 | TotalRevenue |
| Total Expenses | 6795644 | TotalExpenses |
| Excess Or Deficit For Year | -16921 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 38438 | NetUnrealizedGLOnInvestments |
| Other | -$397,845 | OtherAmount |
| Total Adjustments | -359407 | TotalAdjustments |
| Excess Or Deficit Per FS | -376328 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 7479236 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 38438 | NetUnrealizedGainsInvestments |
| Other Revenues | 662075 | OtherRevenues |
| Revenue Not Rptd F990 | 700513 | RevenueNotRptdF990 |
| Revenue Subtotal | 6778723 | RevenueSubtotal |
| Total Revenue Per Form990 | 6778723 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 7675348 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 879704 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 879704 | ExpensesNotRptdF990 |
| Expenses Subtotal | 6795644 | ExpensesSubtotal |
| Total Expenses Per Form990 | 6795644 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| FIN 48 | SCHEDULE D, PART X, LINE 2 | MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| RECONCILIATION OF CHANGE IN NET ASSETS | SCHEDULE D, PART XI, LINE 8 | TRANSFER TO AFFILIATE $(397,845) |
| RECONCILIATION OF REVENUES | SCHEDULE D, PART XII, LINE 2D | REVENUE FROM RELATED ORGANIZATIONS $ 662,075 |
| RECONCILIATION OF EXPENSES | SCHEDULE D, PART XIII, LINE 2D | EXPENSES FROM RELATED ORGANIZATIONS $ 879,704 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 125. | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | false | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7143 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 7143 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00110 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 203509 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 91009 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 112500 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01690 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 210652 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 91009 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 119643 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01800 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 120300 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 44060 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 76240 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01150 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5998 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 5998 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8146 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 8146 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 775 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 775 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 135219 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 44060 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 91159 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01370 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 345871 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 135069 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 210802 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03170 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 214 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 214 | NetCommunityBuildingExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 214 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 214 | NetCommunityBuildingExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $343,934 | BadDebtExpenseAmount |
| Amount Attributable To | 227925 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 3701248 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 3687118 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 14130 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LINDSBORG COMMUNITY HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 605 WEST LINCOLN | AddressLine1 |
| City | LINDSBORG | City |
| State | KS | State |
| ZIP Code | 674562328 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Critical Access Hospital | X | CriticalAccessHospital |
| 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 | LINDSBORG COMMUNITY HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 125. | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 200. | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Insurance Status | X | InsuranceStatus |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| SCHEDULE H, PART I, LINE 7, COLUMN F | THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSE OF CALCULATING THE PERCENTAGE IS $157,486. | |
| SCHEDULE H, PART I, LINE 7 | THE COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2. | |
| SCHEDULE H, PART I, LINE 7G | NONE OF THE AMOUNT ON SCHEDULE H, PART I, LINE 7G IS APPLICABLE TO PHYSICIAN CLINICS. | |
| BAD DEBT EXPENSE | THE ORGANIZATION REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE ORGANIZATION PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE ORGANIZATION BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. IF THE PATIENT ACCOUNTS RECEIVABLE IS PAID WITHIN THIRTY DAYS OF THE FIRST PATIENT DUE STATEMENT A 25% DISCOUNT MAY BE TAKEN. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS WHEN THE PATIENT HAS RECEIVED FOUR STATEMENTS AND TWO COLLECTION LETTERS WITHOUT COMMUNICATION TO THE FACILITY. SPECIFIC CIRCUMSTANCES OF THE ACCOUNT MAY ALSO DETERMINE THE ACCOUNT TO BE DELINQUENT, I.E. AN ADDRESS THAT IS "MAIL RETURNED, ADDRESS NOT KNOWN." LINE 2: COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 LINE 3: ESTIMATED 35% | SCHEDULE H, PART III, LINE 4 |
| MEDICARE SHORTFALL | ALL OF A SHORTFALL WOULD BE TREATED AS A COMMUNITY BENEFIT. THIS IS OUR COST OF PROVIDING SERVICES TO THE SMOKY VALLEY COMMUNITIES WHICH ARE LARGELY MEDICARE BENEFICIARIES. THE SOURCE OF REPORTING FOR THE AMOUNT ON LINE 7 IS THE 2012 MEDICARE COST REPORT. | SCHEDULE H, PART III, LINE 8 |
| COLLECTION PRACTICES | A. SERVICES ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. FOR PURPOSES OF THIS POLICY, "FINANCIAL ASSISTANCE" REFERS TO HEALTHCARE SERVICES PROVIDED WITHOUT CHARGE OR AT A DISCOUNT TO QUALIFYING PATIENTS. THE FOLLOWING HEALTHCARE SERVICES ARE ELIGIBLE FOR FINANCIAL ASSISTANCE: 1. EMERGENCY MEDICAL SERVICES PROVIDED IN AN EMERGENCY ROOM SETTING; 2. SERVICES FOR A CONDITION WHICH, IF NOT PROMPTLY TREATED, WOULD LEAD TO AN ADVERSE CHANGE IN THE HEALTH STATUS OF AN INDIVIDUAL; 3. NON-ELECTIVE SERVICES PROVIDING IN RESPONSE TO LIFE-THREATENING CIRCUMSTANCES IN A NON-EMERGENCY ROOM SETTING; AND 4. MEDICALLY NECESSARY SERVICES, EVALUATED ON A CASE-BY-CASE BASIS AT LINDSBORG COMMUNITY HOSPITAL'S DISCRETION. B. ELIGIBILITY FOR FINANCIAL ASSISTANCE. ELIGIBILITY FOR FINANCIAL ASSISTANCE WILL BE CONSIDERED FOR THOSE INDIVIDUALS WHO ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR ANY GOVERNMENT HEALTH CARE BENEFIT PROGRAM, AND WHO ARE UNABLE TO PAY FOR THEIR CARE, BASED UPON A DETERMINATION OF FINANCIAL NEED IN ACCORDANCE WITH THIS POLICY. THE DETERMINATION OF FINANCIAL ASSISTANCE SHALL BE BASED ON AN INDIVIDUALIZED DETERMINATION OF FINANCIAL NEED, AND SHALL NOT TAKE INTO ACCOUNT AGE, GENDER, RACE, SOCIAL OR IMMIGRANT STATUS, SEXUAL ORIENTATION OR RELIGIOUS AFFILIATION. C. DETERMINATION OF FINANCIAL NEED 1. FINANCIAL NEED WILL BE DETERMINED IN ACCORDANCE WITH PROCEDURES THAT INVOLVE AN INDIVIDUAL ASSESSMENT OF FINANCIAL NEED; AND MAY A. INCLUDE AN APPLICATION PROCESS, IN WHICH THE PATIENT OR PATIENT'S GUARANTOR ARE REQUIRED TO COOPERATE AND SUPPLY PERSONAL, FINANCIAL AND OTHER INFORMATION AND DOCUMENTATION RELEVANT TO MAKING A DETERMINATION OF FINANCIAL NEED; B. INCLUDE REASONABLE EFFORTS BY LINDSBORG COMMUNITY HOSPITAL TO EXPLORE APPROPRIATE ALTERNATIVE SOURCES OF PAYMENT AND COVERAGE FROM PUBLIC AND PRIVATE PAYMENT PROGRAMS, AND TO ASSIST PATIENTS TO APPLY FOR SUCH PROGRAMS; C. TAKE INTO ACCOUNT THE PATIENT'S AVAILABLE ASSETS, AND ALL OTHER FINANCIAL RESOURCES AVAILABLE TO THE PATIENT; AND D. INCLUDE A REVIEW OF THE PATIENT'S OUTSTANDING ACCOUNTS RECEIVABLE FOR PRIOR SERVICES RENDERED AND THE PATIENT'S PAYMENT HISTORY. 2. IT IS PREFERRED BUT NOT REQUIRED THAT A REQUEST FOR FINANCIAL ASSISTANCE AND A DETERMINATION OF FINANCIAL NEED OCCUR PRIOR TO RENDERING OF SERVICES. HOWEVER, THE DETERMINATION MAY BE DONE AT ANY POINT IN THE COLLECTION CYCLE. THE NEED FOR PAYMENT ASSISTANCE SHALL BE RE-EVALUATED AT EACH SUBSEQUENT TIME OF SERVICES IF THE LAST FINANCIAL EVALUATION WAS COMPLETED MORE THAN A YEAR PRIOR, OR AT ANY TIME ADDITIONAL INFORMATION RELEVANT TO THE ELIGIBILITY OF THE PATIENT FOR FINANCIAL ASSISTANCE BECOMES KNOWN. 3. LINDSBORG COMMUNITY HOSPITAL'S VALUES OF HUMAN DIGNITY AND STEWARDSHIP SHALL BE REFLECTED IN THE APPLICATION PROCESS, FINANCIAL NEED DETERMINATION AND GRANTING OF FINANCIAL ASSISTANCE. REQUESTS FOR FINANCIAL ASSISTANCE SHALL BE PROCESSED PROMPTLY AND LINDSBORG COMMUNITY HOSPITAL SHALL NOTIFY THE PATIENT OR APPLICANT IN WRITING WITHIN 30 DAYS OF RECEIPT OF A COMPLETED APPLICATION. D. PRESUMPTIVE FINANCIAL ASSISTANCE ELIGIBILITY. THERE ARE INSTANCES WHEN A PATIENT MAY APPEAR ELIGIBLE FOR FINANCIAL ASSISTANCE BUT THERE IS NO FINANCIAL ASSISTANCE FORM ON FILE DUE TO A LACK OF SUPPORTING DOCUMENTATION. OFTEN THERE IS ADEQUATE INFORMATION PROVIDED BY THE PATIENT OR THROUGH OTHER SOURCES, WHICH COULD PROVIDE SUFFICIENT EVIDENCE TO PROVIDE THE PATIENT WITH FINANCIAL ASSISTANCE. IN THE EVENT THERE IS NO EVIDENCE TO SUPPORT A PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE, LINDSBORG COMMUNITY HOSPITAL COULD USE OUTSIDE AGENCIES IN DETERMINING ESTIMATE INCOME AMOUNTS FOR THE BASIS OF DETERMINING FINANCIAL ASSISTANCE ELIGIBILITY AND POTENTIAL DISCOUNT AMOUNTS. ONCE DETERMINED, DUE TO THE INHERENT NATURE OF THE PRESUMPTIVE CIRCUMSTANCES, THE ONLY DISCOUNT THAT CAN BE GRANTED IS A 100% WRITE OFF OF THE ACCOUNT BALANCE. PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: 1. STATE-FUNDED PRESCRIPTION PROGRAMS; 2. HOMELESS OR RECEIVED CARE FROM A HOMELESS CLINIC; 3. PARTICIPATION IN WOMEN, INFANTS, AND CHILDREN PROGRAMS (WIC); 4. FOOD STAMP ELIGIBILITY; 5. SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY; 6. ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED (E.G. MEDICAID SPEND-DOWN); 7. LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; 8. PATIENT IS DECEASED WITH NO KNOWN ESTATE. | SCHEDULE H, PART III, LINE 9B |
| MAXIMUM AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS | ANYONE QUALIFYING FOR FREE CARE UNDER THE FINANCIAL ASSISTANCE POLICY (FAP) IS NOT CHARGED FOR SERVICES. ANYONE QUALIFYING FOR DISCOUNTED CARE UNDER THE FAP WILL NOT BE CHARGED MORE THAN THE LOWEST NEGOTIATED COMMERICAL RATE. | SCHEDULE H, PART V, LINE 19 |
| NEEDS ASSESMENT | A NEEDS ASSESSMENT HAS NOT BEEN COMPLETED. WE ARE GUIDED BY OUR PROVIDERS; OUR PARTNERS IN NURSING HOME CARE, BETHANY HOME AND RIVERVIEW ESTATES; OUR PARTNERS IN EDUCATION OF YOUTH, USD 400 AND BETHANY COLLEGE; AND OUR PATIENTS IN THE SMOKY VALLEY. | SCHEDULE H, PART VI, LINE 2 |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | THE HOSPITAL'S CHARITY CARE POLICY IS POSTED IN PATIENT WAITING ROOMS IN A THREE-RING NOTEBOOK. THE CONTACT INFORMATION IS NOT POSTED, BUT THE EMPLOYEES OF THE HOSPITAL HAVE BEEN INSTRUCTED TO DIRECT ANYONE WITH QUESTIONS REGARDING ASSISTANCE TO THE HOSPITAL'S BUSINESS OFFICE. PATIENTS ARE EDUCATED BY FINANCIAL SERVICES STAFF AND SOCIAL SERVICES STAFF WHO ARE ABLE TO PROVIDE ASSISTANCE UPON REQUEST AND THROUGH OUR POLICIES BEING POSTED TO OUR WEBSITE. | SCHEDULE H, PART VI, LINE 3 |
| COMMUNITY INFORMATION | THE ORGANIZATION SERVES THE SMOKY VALLEY AREA INCLUDING LINDSBORG, MARQUETTE, FALUN, ROXBURY, GYPSUM, ASSARIA AND OTHER AREAS INCLUDING MCPHERSON, SALINA, SMOLAN, CANTON, AND GALVA. APPROXIMATELY 8% OF THE HOSPITAL'S PATIENTS ARE UNINSURED OR MEDICARE PATIENTS. THE COMMUNITY SERVED BY THE HOSPITAL IS ALSO SERVED BY TWO OTHER HOSPITALS, PLUS A FQHC IN SALINA. | SCHEDULE H, PART VI, LINE 4 |
| PROMOTION OF COMMUNITY HEALTH | ONE OF THE BENEFITS WE PROVIDE TO MEMBERS OF THE COMMUNITY IS OUR CAN PROGRAM. THE CAN PROGRAM EDUCATES COMMUNITY MEMBERS THAT ARE LOOKING TO BE MORE INVOLVED IN HEALTHCARE. THROUGH THE YEARS THAT WE HAVE PROVIDED THIS PROGRAM WE HAVE HAD CAN STUDENTS THAT WANTED TO BECOME A CNA AS AN OPTION FOR A NEW CAREER, TO BECOME MORE EDUCATED IN CARING FOR A LOVED ONE OR TO SEE IF HEALTHCARE IS THE RIGHT FIELD FOR THEM WHEN FURTHERING THEIR EDUCATION. THE MAJORITY OF THE HOSPITAL'S BOARD CONSISTS OF INDIVIDUALS RESIDING IN THE COMMUNITIES SERVED BY THE HOSPITAL. IF THE HOSPITAL HAS ANY SURPLUS FUNDS, THESE FUNDS ARE USED TO IMPROVE PATIENT CARE THROUGH INVESTING IN NEW TECHNOLOGIES. EMPLOYEES OF THE LCH/LRHC ARE ON A COMMUNITY WELLNESS CENTER COMMITTEE. THE PURPOSE OF THE COMMITTEE IS TO TRY AND CREATE A PARTNER WITH ANOTHER ORGANIZATION THAT WILL PROVIDE MEMBERS OF THE SMOKY VALLEY COMMUNITIES A PLACE TO DEVELOP A HEALTHY WAY OF LIFE. | SCHEDULE H, PART VI, LINE 5 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (13 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990, PART III, LINE 1 | OPERATION OF A CRITICAL ACCESS HOSPITAL IN A COMMUNITY QUALIFYING FOR SUCH DESIGNATION UNDER FEDERAL LAW, FOR THE PROVISION OF FACILITIES FOR THE DIAGNOSIS, TREATMENT OR CARE OF INDIVIDUALS SUFFERING FROM MENTAL OR PHYSICAL ILLNESS, DISEASE, INJURY OR DEFORMITY IN AN ACUTE CARE, SKILLED NURSING CARE, OUTPATIENT OR EMERGENCY ROOM SETTING. |
| PROGRAM SERVICE DESCRIPTION | FORM 990, PART III, LINE 4A | LINDSBORG COMMUNITY HOSPITAL (LCH) OPERATES A CRITICAL ACCESS HOSPITAL IN A COMMUNITY QUALIFYING FOR SUCH DESIGNATION UNDER FEDERAL LAW. THE FACILITIES ARE ADEQUATE FOR TREATMENT OR CARE OF INDIVIDUALS SUFFERING FROM MENTAL OR PHYSICAL ILLNESS, DISEASE, INJURY OR DEFORMITY IN AN ACUTE CARE, SKILLED NURSING CARE, OUTPATIENT OR EMERGENCY ROOM SETTING. LCH CARES FOR RESIDENTS OF THE SMOKY VALLEY WITH THE OPERATION OF A 24/7 EMERGENCY ROOM. 2,024 PATIENTS WERE SEEN IN THE 2012 FISCAL YEAR. 260 URGENT CARE VISITS, 669 PRIVATELY PAID HOME HEALTH VISITS WERE MADE, AND 332 CARDIAC REHAB VISITS IMPROVED THE HEALTH OF COMMUNITY MEMBERS. 1,351 MEALS ON WHEELS WERE SUPPLIED TO COMMUNITY MEMBERS. EDUCATION WAS PROVIDED TO MARQUETTE AND LINDSBORG RESIDENTS ON BREAST CANCER, COLON CANCER, SMOKING CESSATION, AND THE EFFECTS OF SUN EXPOSURE. EMPLOYEES OF THE LCH PARTNER WITH VARIOUS COMMUNITY GROUPS TO PROVIDE ASSISTANCE TO THE MIDSUMMER'S COMMITTEE, HYLLNINGSFEST COMMITTEE, CHAMBER OF COMMERCE, AND LEADERSHIP LINDSBORG TO NAME A FEW. STAFF ALSO PROVIDE LEADERSHIP WITH THE SUNFLOWER HEALTH NETWORK, KHA COUNCIL, AND THE SUNFLOWER (KANSAS) HFMA CHAPTER. |
| BUSINESS RELATIONSHIPS | FORM 990, PART VI, SECTION A, LINE 2 | DAVE SCHRAG AND VIRGINIA SWISHER HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER. |
| MEMBERS | FORM 990, PART VI, SECTION A, LINE 6 | LINDSBORG COMMUNITY HEALTH CARE FOUNDATION, A NOT-FOR-PROFIT, 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF LINDSBORG COMMUNITY HOPSITAL. |
| MEMBERS MAY ELECT GOVERNING BODY | FORM 990, PART VI, SECTION A, LINE 7A | LINDSBORG COMMUNITY HEALTH CARE FOUNDATION BEING THE SOLE MEMBER OF LINDSBORG COMMUNITY HOSPITAL HAS THE RIGHT TO ELECT ALL THE BOARD OF TRUSTEES. |
| GOVERNING BODY DECISIONS SUBJECT TO APPROVAL OF MEMBERS | FORM 990, PART VI, SECTION A, LINE 7B | LINDSBORG COMMUNITY HEALTH CARE FOUNDATION IS THE SOLE MEMBER, AND HAS THE RIGHT TO APPROVE LINDSBORG COMMUNITY HOSPITAL'S BYLAWS, ARTICLES OF INCORPORATION AND BOARD OF TRUSTEES. |
| FORM 990 REVIEW PROCESS | FORM 990, PART VI, SECTION B, LINE 11B | AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE 990. THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S CEO AND CFO. ANY QUESTIONS OR CONCERNS THE ORGANIZATION'S CEO AND CFO HAVE ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEED TO BE MADE ARE MADE. THE 990 IS THEN PROVIDED TO THE BOARD OF TRUSTEES FOR THEIR REVIEW PRIOR TO FILING THE 990. ANY QUESTIONS OR CONCERNS THE BOARD OF DIRECTORS MAY HAVE ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEED TO BE MADE ARE MADE. THE FINAL FORM 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE 990. |
| CONFLICT OF INTEREST POLICY | AT THE TIME OF HIRE OR ELECTION (IN THE CASE OF TRUSTEES) AND ANNUALLY THEREAFTER, THE OFFICERS, TRUSTEES, AND KEY EMPLOYEES SHALL PROVIDE THE APPLICABLE CONFLICT OF INTEREST DISCLOSURES WHICH SHALL BE COMPLETED TO IDENTIFY ANY RELATIONSHIPS, POSITIONS, OR CIRCUMSTANCES IN WHICH IT IS BELIEVED A CONFLICT MAY ARISE. IF A CONFLICT ARISES, THE OFFICER, TRUSTEE, OR KEY EMPLOYEE ABSTAINS FROM THE VOTE OF THE CONFLICTED POSITION. ANNUAL MONITORING AND REVIEW PROCEDURE SHALL BE PART OF THE ORGANIZATION'S COMPLIANCE PLAN. AN APPROPRIATE REPORT SHALL BE SUBMITTED TO THE EXECUTIVE BOARD CONCERNING ANY INTEREST DISCLOSED. | |
| COMPENSATION REVIEW | FORM 990, PART VI, SECTION B, LINES 15A & B | THE ORGANIZATION'S PROCESS FOR DETERMINING CEO COMPENSATION BEGINS WITH AN INITIATIVE LEAD BY THE PRESIDENT OF THE BOARD. THE PRESIDENT COMPARES COMPENSATION AND SALARY DATA PROVIDED BY THE KANSAS HOSPITAL ASSOCIATION. THE PRESIDENT REVIEWS THE DATA AND MAKES A RECOMMENDATION TO THE BOARD OF TRUSTEES IN A CLOSED EXECUTIVE MEETING WHERE THE COMPENSATION IS THEN VOTED UPON BY ALL INDEPENDENT MEMBERS OF THE BOARD. THIS PROCESS WAS LAST COMPLETED IN 2010. THE CFO'S SALARY IS SET BY THE CEO USING AN ANNUAL SALARY SURVEY. THE CFO'S SALARY IS INCREASED USING THE SAME PERCENTAGE AS ALL OTHER EMPLOYEES. |
| AVAILABILITY OF ORGANIZATION DOCUMENTS | FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| OTHER CHANGES IN NET ASSETS | FORM 990, PART XI, LINE 5 | UNREALIZED GAIN ON INVESTMENTS $ 38,438 TRANSFER TO AFFILIATE $ (397,845) ------------ $ (359,407) |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:LARAINE GENGLER TITLE:CFO HOURS:5 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:LARRY VAN DER WEGE TITLE:CEO HOURS:11 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| LINDSBORG COMMUNITY HEALTH CARE FDTN INC | ||||||||||
| 605 W LINCOLN | LINDSBORG | KS | 67456 | 480947732 | SUPPORT HOSP | KS | 501(C)(3) | 7 | NA | false |
| LINDSBORG COMMUNITY RURAL HEALTH CLINIC | ||||||||||
| 601 W LINCOLN | LINDSBORG | KS | 67456 | 481126826 | HEALTH CLINIC | KS | 501(C)(3) | 9 | LCHCF | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | true | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |