SOUTHWEST MEDICAL CENTER: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- SOUTHWEST MEDICAL CENTER (EIN 48-0684878)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-12
- IRS object ID
- 201343169349302634
- 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 B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-12T08:08:53-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 481026809 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Wendling Noe Nelson & Johnson LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 534 S Kansas Ave Suite 1500 | AddressLine1 |
| City | Topeka | City |
| State | KS | State |
| ZIP Code | 666033491 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 480684878 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Southwest Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SOUT | NameControl |
| Phone | 6206241651 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1340 | AddressLine1 |
| City | Liberal | City |
| State | KS | State |
| ZIP Code | 679011340 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Lori Smith | Name |
| Title | CFO | Title |
| Phone | 6206241651 | Phone |
| Date Signed | 2013-11-11 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | John R Helms | Name |
| PTIN | P00203953 | PTIN |
| Phone | 7852334226 | Phone |
| Date Prepared | 2013-11-11 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Lori Smith | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1340 | AddressLine1 |
| City | Liberal | City |
| State | KS | State |
| ZIP Code | 679011340 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 41840169 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.swmedcenter.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1963 | YearFormation |
| State Legal Domicile | KS | StateLegalDomicile |
| Activity Or Mission Description | The Medical Center is a county hospital dedicated to the provision of personalized and quality care of the sick and injured at a reasonable cost. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 463 | TotalNbrEmployees |
| Total Nbr Volunteers | 144 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 285714 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 280310 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 43645696 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 40651431 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -43103 | InvestmentIncomePriorYear |
| Investment Income Current Year | 109653 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 672901 | OtherRevenuePriorYear |
| Other Revenue Current Year | 798775 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 44561208 | TotalRevenuePriorYear |
| Total Revenue Current Year | 41840169 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 21005656 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 21512010 | 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 | 22834424 | OtherExpensePriorYear |
| Other Expenses Current Year | 19179337 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 43840080 | TotalExpensesPriorYear |
| Total Expenses Current Year | 40691347 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 721128 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1148822 | RevenuesLessExpensesCY |
| Total Assets BOY | 55655149 | TotalAssetsBOY |
| Total Assets EOY | 56210435 | TotalAssetsEOY |
| Total Liabilities BOY | 21799136 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 21205600 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 33856013 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 35004835 | NetAssetsOrFundBalancesEOY |
| Mission Description | The Medical Center is a county hospital dedicated to the provision of personalized and quality care of the sick and injured at a reasonable cost. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 34996655 | Expense |
| Revenue | 41256746 | Revenue |
| Description | Southwest Medical Center provides necessary medical care to the community. It is the only facility in the area providing certain medical equipment and services. | Description |
| Total Program Service Expense | 34996655 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | 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 | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 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 | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | 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 | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 43 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 463 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | 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 | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lori Smith | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6206296680 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1340 | AddressLine1 |
| City | Liberal | City |
| State | KS | State |
| ZIP Code | 679011340 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| Joe Sealey | ||||||||
| Chairman | 1.00 | X | X | 0 | 0 | 0 | ||
| Ray E Allen MD | ||||||||
| Vice-Chairman | 1.00 | X | X | 0 | 0 | 0 | ||
| Gary Andrews | ||||||||
| Secretary | 1.00 | X | X | 0 | 0 | 0 | ||
| Jay Hay | ||||||||
| Treasurer | 1.00 | X | X | 0 | 0 | 0 | ||
| Mark Schepers | ||||||||
| Asst. Secretary/Treasurer | 1.00 | X | X | 0 | 0 | 0 | ||
| Kim Yount DDS | ||||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |||
| Thomas Willis | ||||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |||
| William Ermann | ||||||||
| CEO | 40.00 | X | 151344 | 0 | 21623 | |||
| Michelle M Gillespie | ||||||||
| VP of Operations | 40.00 | X | 145160 | 0 | 16155 | |||
| Jo Harrison | ||||||||
| VP of Nursing | 40.00 | X | 128227 | 0 | 20643 | |||
| Robert Trivett | ||||||||
| VP of Physician Services | 40.00 | X | 72389 | 0 | 10735 | |||
| William R Valdez MD | ||||||||
| Physician | 40.00 | 488377 | 0 | 29403 | X | |||
| Lawrence P Shank | ||||||||
| Physician | 40.00 | 481973 | 0 | 29330 | X | |||
| Eve C Shank | ||||||||
| Physician | 40.00 | 345693 | 0 | 19927 | X | |||
| Rory Howard | ||||||||
| Physician | 40.00 | 333412 | 0 | 26178 | X | |||
| Francisco Chacon | ||||||||
| Physician | 40.00 | 177494 | 0 | 15347 | X | |||
| Norman Lambert | ||||||||
| Former CEO | 40.00 | 251389 | 0 | 9826 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2575458 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 199167 | TotalOtherCompensation |
| Number Individuals GT100 K | 13 | NumberIndividualsGT100K |
| Formers Listed | 1 | 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 |
|---|---|---|---|---|---|
| Comphealth | |||||
| PO Box 972651 | Dallas | TX | 75397 | Locum tenens | 1227975 |
| Nabholz Construction Services | |||||
| 1120 East Reno Avnue | Oklahoma City | OK | 73117 | Construction contractor | 706243 |
| Account Recovery Specialist Inc | |||||
| 200 W Wyatt Earp Blvd | Dodge City | KS | 67801 | Collection services | 590422 |
| Medical Information Technology | |||||
| Meditech Circle | Westwood | MA | 02090 | IT services | 530600 |
| Kansas Emergency Room Services PA | |||||
| 7032 Collection Center Drive | Chicago | IL | 60693 | ER services | 467661 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 16 | NumberOfContractorsGT100K |
| Related Organizations | 236034 | RelatedOrganizations |
| Government Grants | 9935 | GovernmentGrants |
| All Other Contributions | 34341 | AllOtherContributions |
| Noncash Contributions | 61034 | NoncashContributions |
| Total Contributions | 280310 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Net patient service revenue | Description |
| Business Code | 621990 | BusinessCode |
| Total Revenue Column | 40651431 | TotalRevenueColumn |
| Related Or Exempt Function Income | 40651431 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 40651431 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 109653 | TotalRevenueColumn |
| Exclusion | $109,653 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| Electronic health records incenti | 900099 | 431443 | 431443 | |
| Cafeteria & dietary | 722210 | 193460 | $193,460 | |
| Home medical equipment | 900099 | 123760 | 123760 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 50112 | TotalRevenueColumn |
| Related Or Exempt Function Income | 50112 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 798775 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 41840169 | TotalRevenueColumn |
| Related Or Exempt Function Income | 41256746 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $303,113 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 585743 | Total |
| Management And General | 585743 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16314045 | Total |
| Program Services | 14589623 | ProgramServices |
| Management And General | 1724422 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1195346 | Total |
| Program Services | 1070867 | ProgramServices |
| Management And General | 124479 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1737086 | Total |
| Program Services | 1531538 | ProgramServices |
| Management And General | 205548 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1679790 | Total |
| Program Services | 1456166 | ProgramServices |
| Management And General | 223624 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 151672 | Total |
| Management And General | 151672 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2100 | Total |
| Management And General | 2100 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 464092 | Total |
| Program Services | 143373 | ProgramServices |
| Management And General | 320719 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 326424 | Total |
| Program Services | 120241 | ProgramServices |
| Management And General | 206183 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1178915 | Total |
| Program Services | 1124248 | ProgramServices |
| Management And General | 54667 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20337 | Total |
| Management And General | 20337 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1134132 | Total |
| Program Services | 1053706 | ProgramServices |
| Management And General | 80426 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 58911 | Total |
| Program Services | 46038 | ProgramServices |
| Management And General | 12873 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49096 | Total |
| Program Services | 43679 | ProgramServices |
| Management And General | 5417 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 281755 | Total |
| Program Services | 281755 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2367166 | Total |
| Program Services | 2367166 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 384145 | Total |
| Program Services | 220322 | ProgramServices |
| Management And General | 163823 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Purchased services | 4820903 | 4307107 | 513796 |
| Medical supplies | 3556178 | 3541459 | 14719 |
| Repair & maintenance | 1425719 | 976023 | 449696 |
| Pharmacy drugs and supp | 1172996 | 1172996 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1784796 | Total |
| Program Services | 950348 | ProgramServices |
| Management And General | 834448 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40691347 | Total |
| Program Services | 34996655 | ProgramServices |
| Management And General | 5694692 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 430943 | BOY |
| EOY | 3074 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12880823 | BOY |
| EOY | 12071168 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5819462 | BOY |
| EOY | 6491131 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1322661 | BOY |
| EOY | 1286607 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1280934 | BOY |
| EOY | 1231296 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 79540085 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 48945372 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27080742 | BOY |
| EOY | 30594713 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6408046 | BOY |
| EOY | 3272644 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 431538 | BOY |
| EOY | 1259802 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 55655149 | BOY |
| EOY | 56210435 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4713195 | BOY |
| EOY | 4320221 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16630000 | BOY |
| EOY | 16455000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 455941 | BOY |
| EOY | 430379 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21799136 | BOY |
| EOY | 21205600 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32581179 | BOY |
| EOY | 33731671 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1274834 | BOY |
| EOY | 1273164 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33856013 | BOY |
| EOY | 35004835 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 55655149 | BOY |
| EOY | 56210435 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 1148822 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | 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 D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 104046 | OtherCostOrOtherBasis |
| Book Value | 104046 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 41623326 | OtherCostOrOtherBasis |
| Depreciation | 21047842 | Depreciation |
| Book Value | 20575484 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 32978823 | OtherCostOrOtherBasis |
| Depreciation | 27014333 | Depreciation |
| Book Value | 5964490 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4833890 | OtherCostOrOtherBasis |
| Depreciation | 883197 | Depreciation |
| Book Value | 3950693 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 30594713 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Unamortized premium | Description |
| Amount | $430,379 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 430379 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 41840169 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 41840169 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 41840169 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 40691347 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 40691347 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 40691347 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Description of Uncertain Tax Positions Under FIN 48: | Identifier |
| Return Reference | Part X, Line 2: | ReturnReference |
| Explanation | Management is not aware of any uncertainties in income tax positions. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 100.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 707540 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 433733 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 273807 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00670 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5597173 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4591666 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1005507 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02470 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6304713 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5025399 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1279314 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03140 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 34721 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 19820 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 14901 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7636784 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2329781 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5307003 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.13040 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 17903 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 17903 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7689408 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2349601 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5339807 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.13120 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13994121 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7375000 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6619121 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.16260 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $2,710,683 | BadDebtExpenseAmount |
| Amount Attributable To | 272010 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 6823904 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 10831323 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -4007419 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Southwest Medical Center | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 315 W 15th Street | AddressLine1 |
| City | Liberal | City |
| State | KS | State |
| ZIP Code | 679011304 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
| Other | Skilled nursing facility | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Southwest Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 100.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Insurance Status | X | InsuranceStatus |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Permit Lien On Residence | X | PermitLienOnResidence |
| Permit Body Attachment | X | PermitBodyAttachment |
| Permit Other Actions | X | PermitOtherActions |
| Collection Activities | 0 | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Other Actions Taken | X | OtherActionsTaken |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 6 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (6 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| Dr Gerald Lane DO | ||||
| 2381 N Kansas Ave | Liberal | KS | 67901 | Ophthalmologist |
| Southwest Professional Physicians Clinic | ||||
| 555 W 15th Street | Liberal | KS | 67901 | Ortho & ENT |
| Sleep Disorders Laboratory | ||||
| 101 E 11th Street | Liberal | KS | 67901 | Sleep Studies |
| North Clinic | ||||
| 2330 N Kansas Ave Suite 1 | Liberal | KS | 67901 | Family practice |
| Dr William Valdez MD | ||||
| 2 Plaza Drive | Liberal | KS | 67901 | Internal medicine |
| Advanced Surgery | ||||
| 1411 W 15th Street Suite 302 | Liberal | KS | 67901 | General Surgeons |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| Part I, Line 7: Amounts for Financial Assistance and Certain Other Community Benefits programs were obtained using known related charges and several cost to charge ratios. The cost to charge ratios used include the overall cost to charge ratio derived from Worksheet 2 as well as individual department cost to charge ratios identified for the calculation of subsidized health services information. | |
| Part I, Line 7g: Subsidized Health Services are made up of services that the Hospital provides despite a financial loss to the organization. These services include skilled nursing services, physical therapy, and physician clinics. | |
| Part II: N/A | |
| Part III, Line 4: The Medical Center provides for accounts receivable that could become uncollectible in the future by establishing an allowance to reduce the carrying value of such receivables to their estimated net realizable value. The Medical Center estimates this allowance based on the aging of its accounts receivable and its historical collection experience for each type of payor.Part III, Line 2Provisions for bad debts are related to accounts that have been deemed uncollectible during the year. The uncollectible amount is then written off pursuant with Hospital policy. The cost of the bad debts reported was determined using the cost to charge ratio and total bad debt expense.Part III, Line 3The estimate of provisions for bad debts attributable to patients eligible under the organization's financial assistance policy was determined using the number of incomplete charity care applications multiplied by the average amount of each account written off pursuant to the organizations financial assistance policy. | |
| Part III, Line 8: Amounts were obtained from the cost report filed with Medicare for the period ending December 31, 2012. | |
| Part III, Line 9b: The Hospital's collection policy does not contain a provision on the collection practices for patients who are known to qualify for charity care or financial assistance. To be considered for charity care, however, the charity care policy states that the patient must cooperate with the Hospital to provide the information and documentation necessary to apply for other existing financial resources that may be available to pay for health care services, such as Medicaid. Then the information is gathered and assessed in order to determine eligibility for charity care. Whenever possible, prior to admission, the Hospital will conduct a pre-admission interview with the patient, the guarantor, and or legal representative. Those patients who may qualify for financial assistance from a governmental program will be referred to the appropriate program, prior to the consideration for charity care. | |
| Part V, Section B, Line 14g: Forms of communicating the uncompensated care policy include, but are not limited to:1. Providing information about uncompensated care in patient financial brochures and guest guides in patient rooms.2. Designating Patient Financial Services staff members to explain the uncompensated care policy to the patient.3. Making available to the public a copy of our uncompensated policy, application and eligibility criteria, upon request. | Southwest Medical Center |
| Part V, Section B, Line 16e: Garnishments (wage or non-wage) and Writ of Execution | Southwest Medical Center |
| Part V, Section B, Line 18e: If patients are denied, the reason is documented in the account notes. | Southwest Medical Center |
| Part V, Section B, Line 20d: Southwest Medical Center bills all patients the gross charge amount for the services provided based on a set pricing structure regardless of the patient's payor type. | Southwest Medical Center |
| Part VI, Line 2: SWMC conducts a community needs assessment approximately each 3 years. The analysis includes community focus group meetings to hear directly from citizens what they believe are the needs. Additionally, SWMC monitors Kansas Hospital Association patient origin and destination data to look for patterns of migration for services that might be made available locally as a new service. | |
| Part VI, Line 3: PFS refers self pay patients to Midland Professionals and Midland assists them in seeing if they are eligible for any federal, state, or local programs. The collectors send out charity care paperwork to patients as they are calling and collecting or if a patient calls for the packet. | |
| Part VI, Line 4: SWMC's total service area is rural and is made up of southwest Kansas and the neighboring areas of Oklahoma, Colorado and New Mexico. SWMC's primary service area, however, is Seward County, KS, which has a population of approximately 23,500. According to the U.S. Census Bureau this population is 58% Hispanic with a median household income of $44,550, 16.2% of which are below the Federal poverty level. Seward County, while not designated as a Medically Underserved Area, is designated as a Health Professional Shortage Area based on income. SWMC takes an active role in recruiting needed primary care physicians and specialists to the community that are deemed necessary to provide for the community's needs. SWMC is a County owned hospital and is the only hospital in the county. It therefore provides care to all patients regardless of their ability to pay. 8.5% of services provided by SWMC are provided to Uninsured patients while an additional 15.2% is provided to Medicaid patients. | |
| Part VI, Line 5: SWMC's seven Board of Trustees members are appointed by the Seward County Board of County Commissioners. Trustees are required to reside in Seward County, KS, and cannot be employeed by the Hospital nor provide contract services to the Hospital. SWMC extends medical staff privileges to all qualified physicians in the community who so desire to have such privileges.All surplus funds are reinvested back into the Hospital to fund capital needs and additional services that are identified as needed to continue to provide high quality services to the community. SWMC works with other community agencies, including the Seward County Health Department, to provide educational programs to the public throughout the year and an annual Health Fair that provides laboratory testing and health screening to over 589 participants. SWMC provides clinical training facilities for many area educational institutions' nursing, respiratory therapy, and radiology students. This includes Seward County Community College, Fort Hays State University, the University of Kansas, Oklahoma State University, Texas Tech University and others, all without any financial compensation. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| William Ermann | ||||||||||||||
| CEO | 150097 | 0 | 1247 | 0 | 0 | 0 | 11797 | 0 | 9826 | 0 | 172967 | 0 | 0 | 0 |
| Michelle M Gillespie | ||||||||||||||
| VP of Operations | 143913 | 0 | 1247 | 0 | 0 | 0 | 11918 | 0 | 4237 | 0 | 161315 | 0 | 0 | 0 |
| William R Valdez MD | ||||||||||||||
| Physician | 296628 | 0 | 191749 | 0 | 0 | 0 | 19577 | 0 | 9826 | 0 | 517780 | 0 | 0 | 0 |
| Lawrence P Shank | ||||||||||||||
| Physician | 481973 | 0 | 0 | 0 | 0 | 0 | 19504 | 0 | 9826 | 0 | 511303 | 0 | 0 | 0 |
| Eve C Shank | ||||||||||||||
| Physician | 345693 | 0 | 0 | 0 | 0 | 0 | 19927 | 0 | 0 | 0 | 365620 | 0 | 0 | 0 |
| Rory Howard | ||||||||||||||
| Physician | 283412 | 0 | 50000 | 0 | 0 | 0 | 19754 | 0 | 6424 | 0 | 359590 | 0 | 0 | 0 |
| Francisco Chacon | ||||||||||||||
| Physician | 177494 | 0 | 0 | 0 | 0 | 0 | 10056 | 0 | 5291 | 0 | 192841 | 0 | 0 | 0 |
| Norman Lambert | ||||||||||||||
| Former CEO | 251389 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 9826 | 0 | 261215 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | Part I, Line 4a | ReturnReference |
| Explanation | Norman Lambert, CEO until 12/15/11, recevied $214,914 in gross severance payments in 2012. | Explanation |
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 | Seward County Kansas | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 486009370 | IssuerEIN |
| CUSIP Number | 818427ER3 | CUSIPNumber |
| Date Issued | 2010-05-27 | DateIssued |
| Issue Price | 18167463 | IssuePrice |
| Description Of Purpose | Expand and renovate facilities, purchase equipment, and fund debt. | 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 | 1215000 | AmountRetired |
| Total Proceeds | 18178316 | TotalProceeds |
| Capitalized Interest | 2602 | CapitalizedInterest |
| Issuance Costs From Proceeds | 213246 | IssuanceCostsFromProceeds |
| Credit Enhancement | 148667 | CreditEnhancement |
| Working Capital Expenditures | 15063361 | WorkingCapitalExpenditures |
| Other Spent Proceeds | 1005550 | OtherSpentProceeds |
| Amount Unspent | 1744619 | AmountUnspent |
| Year Of Subst Completion | 2012 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 1 | AdvanceRefunding |
| Final Allocation Made | 1 | 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 |
| 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 VI Form990ScheduleKPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Schedule K, Part II | Identifier |
| Explanation | The difference between Part I, column (e) and Part II, line 3 is due to the accumulation of investment income. | Explanation |
Schedule M IRS990ScheduleM
Real Estate Residential RealEstateResidential
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 61034 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | Book value | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section B, line 11 | The Form 990 is reviewed by the CFO and the Accounting Manager. | |
| Form 990, Part VI, Section B, line 12c | A conflict of interest policy disclosure form is provided with a copy of the current conflict of interest policy. This disclosure is completed by each Trustee upon election and annually thereafter. | |
| Form 990, Part VI, Section B, line 15 | The Board of Trustees is responsible for deteriming the job performance standards for the Administrator/CEO and determining compensation according to the organizations policies. | |
| Form 990, Part VI, Section C, line 19 | The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. | |
| Form 990, Part XI, Line 2C | The organization has an audit committee that is responsible for the oversight of the financial statement audit and selection of the independent accountant. | Financial Statement Reporting |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Southwest Medical Center Foundation | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1340 | AddressLine1 |
| City | Liberal | City |
| State | KS | State |
| ZIP Code | 67901 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 480908781 | EIN |
| Primary Activities | Fundraising for the benefit of Southwest Medical Center | PrimaryActivities |
| Legal Domicile State | KS | LegalDomicileState |
| Exempt Code Section | 501(c)(3) | ExemptCodeSection |
| Public Charity Status | 170(b)(1) | PublicCharityStatus |
| Controlled Org | 0 | ControlledOrg |
| 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 | 1 | 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 | 0 | 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 | Southwest Medical Center Foundation | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionType |
| Amount Involved | 236034 | AmountInvolved |