2012-03-30T12:13:39-07:00 2011-03-31 GEORGE BOWERMAN & NOEL PA 301 N MAIN SUITE 1350 WICHITA KS 67202 990 2010-04-01 481020227 COMMUNITY HEALTHCARE SYSTEM INC COMM 7858894657 120 WEST 8TH STREET ONAGA KS 66521 MONICA HOLTHAUS 7858894657 2012-02-10 ERIC MEYER 3162626277 2010 2016-02-24 21:20:13Z MONICA HOLTHAUS 120 WEST 8TH ST ONAGA KS 66521 25069237 false X N/A X 1986 KS Community HealthCare System,in partnership with our medical staff, has a long standing tradition in providing quality and compassionate health care to rural commmunities of NE Kansas and all our patients. Ourmission is to enrich the health and lives of the people we serve. 7 7 502 0 0 87188 65124 25921707 24803620 24099 24925 148579 175568 26181573 25069237 0 0 17034746 16495481 0 0 8389561 7549356 25424307 24044837 757266 1024400 9325001 9477269 6858038 5985906 2466963 3491363 Community HealthCare System, in partnership with our medical staff, has a false false 19035982 24803620 RURAL HOSPITAL PROVIDING MEDICAL CARE ON BOTH AN INPATIENT AND OUTPATIENT BASIS TO AREA RESIDENTS. SERVICES PROVIDED INCLUDE EMERGENCY, OBSTETRICS, SURGICAL, RADIOLOGY, REHABILITATION, RURAL HEALTH CLINIC AND LONG TERM CARE 19035982 true false false true false false false false false true true false true true false true false false false false false false false false false true true false false true true false false false false false false false false false false false false false false false true false false false true 524 0 true 502 true false false false false false false false false false true true false false false false X 7 7 true false false false false false false true true false false true true true true true true true true false X MONICA HOLTHAUS 7858894657 120 W 8TH STREET ONAGA KS 66521 MELVIN HANDLEY 2.00 X 1500 0 0 VIRGINIA REZAC 2.00 X 1719 0 0 DEAN MYERS 2.00 X 339 0 0 JUSTIN BOSWELL 2.00 X 1934 0 0 OWEN DUER 2.00 X 1523 0 0 PHIL SPRINGER 2.00 X 1876 0 0 MARK BOUTON 2.00 X 1111 0 0 GREG UNRUH 40.00 X 173166 0 20232 MARCIA WALSH 40.00 X 145884 0 12057 ROSALIND LEWIS 40.00 X 107405 0 1479 MONICA HOLTHAUS 40.00 X 96238 0 1372 ALAN FISCHER 2.00 X 1435 0 0 DR DAVID ALLEN 40.00 X 408498 0 11780 DR TOM WALSH 40.00 X 305685 0 7269 DR DAGOBERTO HEREDIA 40.00 X 288090 0 9052 DR NANCY ZIDEK 40.00 X 206686 0 5043 DR C BRUCE CARROLL 40.00 X 199135 0 536 1942224 68820 17 false true false ANESTHESIA PROFESSIONALS 2017 W HARBORLIGHT C WICHITA KS 67204 ANESTHESIA SERVICES 384000 STORMONT-VAIL HLTH CARE 1500 SW 10TH STREET TOPEKA KS 66604 MEDICAL SERVICES 246150 BENEFIT MANAGEMENT INC 2015 16TH STREET GREAT BEND KS 67530 THIRD PARTY ADMINISTRATOR FOR HEALTH INSURANCE 166101 HEALTHLAND 625 S LAKESHORE DR GLEENWOOD MN 56334 COMPUTER SYSTEM MAINTENANCE 212526 SHARED MEDICAL SERVICES INC 209 LIMESTONE PASS COTTAGE GROVE WI 53527 MRI SERVICES 115600 6 12075 53049 65124 NET PATIENT SERVICE REVENUE 622110 23542391 TAX SUBSIDY 622110 1261229 24803620 24925 24925 16800 16800 16800 16800 Other 900099 158768 158768 158768 25069237 24803620 200493 534129 405456 128673 0 13841244 11264952 2576292 0 85305 62662 22643 0 1046274 749876 296398 0 988529 794769 193760 0 70822 63521 7301 0 110563 78215 32348 0 1240766 813688 427078 0 128629 104175 24454 0 218508 212043 6465 0 771636 571010 200626 0 244421 140573 103848 0 LEASED EQUIPMENT 127483 106716 20767 0 MISCELLANEOUS 86669 27131 59538 0 DUES AND SUBSCRIPTIONS 116662 52805 63857 0 EDUCATION 84995 50931 34064 0 MINOR EQUIPMENT 134815 104346 30469 0 4213387 3433113 780274 0 24044837 19035982 5008855 0 375358 1093221 3101364 2858730 784381 802088 167055 190833 12104635 8508140 4136497 3596495 240275 245348 143375 108965 376696 581589 9325001 9477269 2865494 2799722 2610000 2365000 1288902 727542 93642 93642 6858038 5985906 X 2282934 3300099 184029 191264 2466963 3491363 9325001 9477269 1024400 X false true false X false X 0 0 0 0 0 0 false false false false false false false false true 4638 4638 Pt II-B Line 1i LOBBYING PORTION OF KANSAS HOSPITAL ASSOCIATION DUES 370866 370866 5779494 3562350 2217144 5949849 4945790 1004059 4426 4426 3596495 FUNDS HELD BY TRUSTEE UNDER INDENTURE AGREEMENT 205501 F aSSETS WHOSE USE IS LIMITED-CD 39847 C 245348 DUE FROM THIRD PARTY PAYER 357726 DEFERRED FINANCING COSTS 109210 OTHER 114653 581589 DUE TO COMMUNITY HOSPITAL DISTRICT 93642 93642 25069237 24044837 1024400 1024400 25069237 25069237 25069237 24044837 24044837 24044837 true true true X true X true true false false 122275 122275 0.00510 1252291 1030209 222082 0.00920 1374566 1030209 344357 0.01430 359229 193806 165423 0.00690 10280208 8495759 1784449 0.07420 10639437 8689565 1949872 0.08110 12014003 9719774 2294229 0.09540 484573 363430 4747204 4734415 12789 X true true 1 1 COMMUNITY HOSPITAL ONAGA

120 WEST 8TH ONAGA KS 66521

X COMMUNITY HOSPITAL ONAGA 1 false true true 200 true 200 true X X X X true true X true X true X X X X X X true X false false 4 EASTRIDGE NURSING FACILITY

606 1ST STREET CENTRALIA KS 66415

LONG TERM CARE DOWNTOWN MEDICAL CLINIC

112 EAST 2ND STREET FRANKFORT KS 66427

RURAL HEALTH CLINIC HOLTON FAMILY HEALTH CLINIC

1603 WEST 4TH STREET HOLTON KS 66536

RURAL HEALTH CLINIC WESTMORELAND MEDICAL CLINIC

208 NORTH 1ST STREET WESTMORELAND KS 66549

CLINIC Pt I Line 7 The total cost to charge ratio derived from the Medicare cost report was applied to gross charges to compute the community benefit expense for charity care and unreimbursed Medicaid. The community benefit expense Pt VI Line 3 for community health improvement services and subsidized health services was obtained from the total costs per Worksheet B on the Medicare cost report with adjustments made to exclude amounts otherwise included as charity care, bad debts or unreimbursed Medicaid. Pt I Line 7g Subsidized heath services include the cost attributable to physician clinics operated in rural communities and designated as Rural Health Clinics - $1,286,866 Pt III Line 4 The total cost to charge ratio derived from the Medicare cost report was applied to the gross charges written off (net of collections) to compute the community benefit expense for bad debts. The cost of providing services to those with the inability to pay or where collection efforts are not successful are included as community benefit expense to represent the full costs of providing services to the community. Financial statement footnote-If the patient is unable to pay the full amount at the time the patient is billed, the System negotiates a payment plan whereby monthly payments are made by the patient on the account. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluation and specific circumstances of the account. If future actual default rates on accounts receivable differ from those currently anticipated, the System may have to adjust its allowance for doubtful accounts, which would affect earnings in the period the adjustments are made. Pt III Line 8 Medicare allowable cost per the Medicare cost report. Costs are apportioned to the Medicare program based on departmental cost to charge ratios for ancillary services and patient days for inpatient and swing bed services. Pt III Line 9b If collection efforts determine that a patient may qualify for finacial assistance, the financial assistance process is initiated including attempts to obtain the documentation required under the policy. Collection and financial assistance policies are consistently applied to all patients. Indigent patients balances adjusted according to Medicare bad debt policies Pt V One skilled nursing facility Pt VI Line 2 Informal needs assessment performed on an ongoing basis. Hospital personnel identify needs based on admissions and discharge data. Needs are also identified by requests from surrounding rural communities. Formal needs assessment is in process. Pt VI Line 3 The availability of financial assistance is stated in collection letters sent to patients. Collections staff also inform uninsured patients of financial assistance available and policies are addressed verbally at admission with clinic patients. Pt VI Line 5 All of the organization's governing body is comprised of individuals who reside in the organizaton's primary service area. Community HealthCare System, Inc. (the System) is a non-profit organization created by the Board of Directors of, and is considered a component unit of Community Hospital District No. 1 of Pottawatomie, Jackson and Nemaha Counties, Kansas to operate, control, and manage all matters concerning healthcare services in its service area pursuant to a lease agreement between the Hospital District and the System. The Hospital District Board appoints the members of the Board of Directors of the System. The Hospital District board is elected. The System's responsiveness to the community is demonstrated by the operation of Rural Health/Physician clinics in surrounding rural communities to provide access to care at the request from the surrounding communities or as a result of identified needs. The system participates in all government sponsored health care programs (Medicare, Medicaid, CHAMPUS, Tricare)and serves all persons regardless of ability to pay. The System operates LifeCare fitness centers in an effort to enhance community health thereby reducing total health care cost. The System extends medical staff privileges to qualified physicians in the community. Pt VI Line 4 Critical Access Hospital serving primarly as sole provider to rural areas in Pottawatomie, Jackson and Nemaha Counties. Pt V Sec B 19d The Hospital assists those patients who are uninsured or have non-covered services by providing a 20% discount for hospital, emergency room, anesthesia, clinic home health and for medically needed DME. Further discounts are also available under the Hospital's financial assistance policy. Pt V Sec B 15e If the patient is able to pay a portion of their bill as determined by the financial assistance policy, a payment arrangement is made with the patient. Normal collection procedures (statements & letters) followed for remaining patient balance, if any. Pt V Sec B 16e Court action for garnishment purposes false false false true false false false false false GREG UNRUH 173166 15280 4952 193398 198738 MARCIA WALSH 145884 7191 4866 157941 166018 DR DAVID ALLEN 10000 398498 4085 7695 420278 484409 DR TOM WALSH 58185 247500 2250 5019 312954 299503 DR DAGOBERTO HEREDIA 288090 1413 7639 297142 196436 DR NANCY ZIDEK 14870 191816 5043 211729 210608 DR C BRUCE CARROLL 13190 185945 536 199671 Pt I Line 5a PHYSICIAN COMPENSATION BASED, IN PART, ON PATIENT CHARGES CITY OF HOLTON KANSAS 486030368 436578BE7 2003-03-31 1325000 HEALTHCARE FACILITIES false false false CITY OF ST MARYS 486024500 792607AK9 2003-07-15 2000000 HEALTHCARE FACILITIES false false false Pt VI-B, Line 11a Reviewed by the Chairman of the Board prior to filing and available to other Board members upon request. Pt VI-B, Line 12c Required to disclose conflict of interest upon hire/appointment to board and also update and report changes thereafter Pt VI-B, Line 15 CEO compensation is reviewed annually by the board of directors: officer and key employee compensation is reviewed by CEO utilizing information obtained from sources such as the Kansas Hospital Association, Bureau of Labor and Kansas Department of Labor Pt VI-A, Line 2 Dr. Tom Walsh/Marcia Walsh, COO - Spouse Pt VI-C, Line 19 Reference documents not available to the public Form 990, Part IX, Line 24f CONTRACT LABOR 1249285. 1150475. 98810. 0. PROFESSIONAL FEES 190979. 0. 190979. 0. SUPPLIES 2179694. 1966234. 213460. 0. REPAIR AND MAINTENANCE 593429. 316404. 277025. 0. COMMUNITY HOSPITAL DISTRICT NO 1 OF POTTAWATOMIE JACKSON AND NEMAHA COUNTIE 120 WEST 8TH STREET ONAGA KS 66521 486089515 HOSPITAL DISTIRCT KS NA false false false false false false false false false true false false false false false false false false COMMUNITY HOSPITAL DISTRICT NO 1 OF POTTAWATOMIE JACKSON AND NEMAHA COUNTIE j 641311 ACTUAL