DECATUR HEALTH SYSTEMS INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- DECATUR HEALTH SYSTEMS INC (EIN 80-0025964)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-14
- IRS object ID
- 201233199349301958
- 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 | 2012-11-14T12:38:11-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | 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 | 1551 N WATERFRONT PKWY STE 300 | AddressLine1 |
| City | WICHITA | City |
| State | KS | State |
| ZIP Code | 672066601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 800025964 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DECATUR HEALTH SYSTEMS INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % DERICK LORENTZ | InCareOfName |
| Name Control | DECA | NameControl |
| Phone | 7854752208 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 810 WEST COLUMBIA STREET | AddressLine1 |
| City | OBERLIN | City |
| State | KS | State |
| ZIP Code | 67749 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DERICK LORENTZ | Name |
| Title | CFO | Title |
| Date Signed | 2012-11-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ELIZABETH S HOGAN | Name |
| Phone | 3162652811 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DERICK LORENTZ | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 810 WEST COLUMBIA STREET | AddressLine1 |
| City | OBERLIN | City |
| State | KS | State |
| ZIP Code | 67749 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 7224850 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.DECATURHEALTHSYSTEMS.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2002 | YearFormation |
| State Legal Domicile | KS | StateLegalDomicile |
| Activity Or Mission Description | THE MISSION OF DECATUR HEALTH SYSTEMS IS TO PROVIDE HIGH QUALITY CARE FOR RURAL AMERICA BY CARING AND SHARING FROM THE HEART. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 3 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 3 | NbrIndependentVotingMembers |
| Total Nbr Employees | 165 | TotalNbrEmployees |
| Total Nbr Volunteers | 5 | TotalNbrVolunteers |
| Total Gross UBI | 50922 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 64913 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 766606 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 6751898 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 6350052 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 5994 | InvestmentIncomePriorYear |
| Investment Income Current Year | 7439 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 74765 | OtherRevenuePriorYear |
| Other Revenue Current Year | 89942 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 6897570 | TotalRevenuePriorYear |
| Total Revenue Current Year | 7214039 | 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 | 4314061 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 4477767 | 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 | 2538115 | OtherExpensePriorYear |
| Other Expenses Current Year | 2563503 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 6852176 | TotalExpensesPriorYear |
| Total Expenses Current Year | 7041270 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 45394 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 172769 | RevenuesLessExpensesCY |
| Total Assets BOY | 2183654 | TotalAssetsBOY |
| Total Assets EOY | 1934950 | TotalAssetsEOY |
| Total Liabilities BOY | 2183654 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1934950 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 0 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 0 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE MISSION OF DECATUR HEALTH SYSTEMS IS TO PROVIDE HIGH QUALITY CARE FOR RURAL AMERICA BY CARING AND SHARING FROM THE HEART. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 6027379 | Expense |
| Grants | 0 | Grants |
| Revenue | 6350052 | Revenue |
| Description | THE ORGANIZATION OPERATED AN ACUTE CARE HOSPITAL TO PATIENTS IN THE CITY OF OBERLIN, KANSAS AND THE COMMUNITY OF DECATUR COUNTY. THE ORGANIZATION PROVIDED INPATIENT AND OUTPATIENT HEALTH SERVICES AS WELL AS LONG-TERM CARE SERVICES TO THE ELDERLY FOR A TOTAL OF 10,461 PATIENT DAYS DURING 2011. | Description |
| Total Program Service Expense | 6027379 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| 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 | true | ReportOtherAssets |
| Report Other Liabilities | true | 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 | 20 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 165 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| 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 | 3 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 3 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | 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 | false | 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 |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DERICK LORENTZ | NamePerson |
| Telephone Number | 7854752208 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 810 W COLUMBIA STREET | AddressLine1 |
| City | OBERLIN | City |
| State | KS | State |
| ZIP Code | 67749 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (7 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| RON JANSONIUS | ||||||
| CHAIRMAN/DIRECTOR | 2.5 | X | X | 0 | 0 | 0 |
| GARY WALTER | ||||||
| CHAIRMAN/SECRETARY/DIRECTOR | 1.0 | X | X | 0 | 0 | 0 |
| PAM WILSON | ||||||
| TREASURER/DIRECTOR | 1.0 | X | X | 0 | 0 | 0 |
| CONNIE M GRAFEL | ||||||
| DIRECTOR | 0.5 | X | 0 | 0 | 0 | |
| KATHY NAUER | ||||||
| SECRETARY/DIRECTOR | 0.5 | X | X | 0 | 0 | 0 |
| LYNN DOEDEN | ||||||
| CEO | 40.0 | X | 121652 | 0 | 13005 | |
| AMANDA FORTIN | ||||||
| CFO | 40.0 | X | 59208 | 0 | 4918 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 180860 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 17923 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DOCS WHO CARE | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Of Contractor | AddressOfContractor | |
| Description Of Services | PHYSICIANS | DescriptionOfServices |
| Compensation | 307617 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| Fundraising Events | 2000 | FundraisingEvents |
| Government Grants | 707588 | GovernmentGrants |
| All Other Contributions | 57018 | AllOtherContributions |
| Total Contributions | 766606 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE REVENUE | Description |
| Business Code | 621300 | BusinessCode |
| Total Revenue Column | 6350052 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6350052 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 6350052 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7439 | TotalRevenueColumn |
| Exclusion | $7,439 | 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 9724 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 2000 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 10811 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -1087 | TotalRevenueColumn |
| Exclusion | -$1,087 | ExclusionAmount |
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 (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| EMPLOYEE/GUEST MEALS | 722210 | 9946 | $9,946 | |
| WHEAT RIDGE MANAGEMENT FEE | 561000 | 50895 | 50895 | |
| MISCELLANEOUS | 900099 | 30188 | $30,161 | 27 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 30188 | TotalRevenueColumn |
| Unrelated Business Revenue | 27 | UnrelatedBusinessRevenue |
| Exclusion | $30,161 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 91029 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7214039 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6350052 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 50922 | UnrelatedBusinessRevenue |
| Exclusion | $46,459 | 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 | 0 | Total |
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 | 198783 | Total |
| Management And General | 198783 | 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 | 3407067 | Total |
| Program Services | 3029094 | ProgramServices |
| Management And General | 377973 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 64901 | Total |
| Program Services | 60100 | ProgramServices |
| Management And General | 4801 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 537347 | Total |
| Program Services | 497597 | ProgramServices |
| Management And General | 39750 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 269669 | Total |
| Program Services | 249720 | ProgramServices |
| Management And General | 19949 | 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 | 45897 | Total |
| Management And General | 45897 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 56610 | Total |
| Management And General | 56610 | 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 | 460810 | Total |
| Program Services | 326112 | ProgramServices |
| Management And General | 134698 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16258 | Total |
| Program Services | 1389 | ProgramServices |
| Management And General | 14869 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 219819 | Total |
| Program Services | 194335 | ProgramServices |
| Management And General | 25484 | 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 | 287317 | Total |
| Program Services | 263977 | ProgramServices |
| Management And General | 23340 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 29204 | Total |
| Program Services | 22246 | ProgramServices |
| Management And General | 6958 | 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 | 5755 | Total |
| Program Services | 4459 | ProgramServices |
| Management And General | 1296 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 95760 | Total |
| Program Services | 88676 | ProgramServices |
| Management And General | 7084 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 58261 | Total |
| Program Services | 53951 | ProgramServices |
| Management And General | 4310 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT EXPENSE | 153547 | 153547 | |
| DUES & SUBSCRIPTIONS | 524139 | 498760 | 25379 |
| REPAIRS & MAINTENANCE | 55251 | 51341 | 3910 |
| MINOR EQUIPMENT | 37454 | 17787 | 19667 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 517421 | Total |
| Program Services | 514288 | ProgramServices |
| Management And General | 3133 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7041270 | Total |
| Program Services | 6027379 | ProgramServices |
| Management And General | 1013891 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 87985 | BOY |
| EOY | 95508 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 224469 | BOY |
| EOY | 34872 | 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 | 1268570 | BOY |
| EOY | 675669 | 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 | 17191 | BOY |
| EOY | 3010 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 104962 | BOY |
| EOY | 106005 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 47974 | BOY |
| EOY | 79745 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1118083 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 903442 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 182503 | BOY |
| EOY | 214641 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | 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 | 250000 | BOY |
| EOY | 725500 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2183654 | BOY |
| EOY | 1934950 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 897735 | BOY |
| EOY | 549170 | 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 | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1285919 | BOY |
| EOY | 1385780 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2183654 | BOY |
| EOY | 1934950 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | 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 | 0 | BOY |
| EOY | 0 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2183654 | BOY |
| EOY | 1934950 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 172769 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -172769 | 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 | $1,602 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 1602 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES | Identifier |
| Return Reference | FORM 990, SCHEDULE C, PART II-B, LINE 1F | ReturnReference |
| Explanation | APPROXIMATELY 15% OF KHA DUES ARE USED FOR DIRECT LOBBYING AND ADVOCACY ACTIVITIES. | Explanation |
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 | |
| Buildings | Buildings | |
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1118083 | OtherCostOrOtherBasis |
| Depreciation | 903442 | Depreciation |
| Book Value | 214641 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildings | |
| Total Of Book Value Land Buildings | 214641 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DUE FROM MEDICARE | 393000 |
| INVESTMENT IN WHEAT RIDGE | 250000 |
| INVESTMENT-RURAL HEALTH CLINIC | 82500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 725500 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO DECATUR COUNTY HOSPITAL | Description |
| Amount | $1,385,780 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1385780 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | UNCERTAIN TAX POSITIONS | Identifier |
| Return Reference | SCHEDULE D, PART X, LINE 2 | ReturnReference |
| Explanation | 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. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| 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 | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 577692 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 708243 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 577692 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 708243 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 577692 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 708243 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $153,547 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 3176257 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 3144809 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 31448 | 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 | DECATUR HEALTH SYSTEMS INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 810 W COLUMBIA | AddressLine1 |
| City | OBERLIN | City |
| State | KS | State |
| ZIP Code | 67749 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DECATUR HEALTH SYSTEMS INC | 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 | 100 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 200. | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Lowest Negotiated Rates | X | LowestNegotiatedRates |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 3 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (3 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| CEDAR LIVING CENTER | ||||
| 810 W COLUMBIA | OBERLIN | KS | 67749 | LONG-TERM CARE |
| FAMILY PRACTICE CLINIC | ||||
| 810 W COLUMBIA | OBERLIN | KS | 67749 | CLINIC |
| COTTONWOOD HOME HEALTH | ||||
| 810 W COLUMBIA | OBERLIN | KS | 67749 | HOME HEALTH |
Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| AMOUNT OF BAD DEBT REMOVED FROM PART I, LINE 7, CALCULATION | SCHEDULE H, PART I, LINE 7 | THE AMOUNT OF BAD DEBT REMOVED FROM PART I, COLUMN F, CALCULATIONS $153,547. |
| METHOD USED TO DETERMINE THE COST-TO-CHARGE RATIO | PART I, LINE 7 | THE COST-TO-CHARGE RATIO WAS USED AS THE COSTING METHODOLOGY TO REPORT CHARITY CARE AND OTHER COMMUNITY BENEFITS AT COST. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. |
| METHOD USED TO DETERMINE BAD DEBT EXPENSE | PART III, LINE 4 | THE COST METHODOLOGY TO REPORT THE ORGANIZATION'S BAD DEBT EXPENSE ON LINE 2 IS ACTUAL COST. PATIENTS HAVE 30 DAYS TO MAKE A PAYMENT ON THEIR ACCOUNT. AFTER THAT 30 DAYS IF NO PAYMENT IS MADE THEN A REMINDER IS SENT REQUESTING A PAYMENT IN THE NEXT TWO WEEKS. IF NO PAYMENT IS RECEIVED THEN A FINAL NOTICE IS SENT STATING THAT A PAYMENT MUST BE MADE WITHIN TWO MORE WEEKS. AT THAT TIME IF NO PAYMENT IS RECEIVED THE ACCOUNT IS MOVED TO BAD DEBT. |
| MEDICARE SHORTFALL | PART III, LINE 8 | SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. |
| COLLECTION PRACTICES | PART III, LINE 9B | IF THE PATIENT QUALIFIES FOR CHARITY CARE PER WRITTEN HOSPITAL CRITERIA, THE QUALIFYING BALANCE IS WRITTEN OFF TO CHARITY CARE AND NO FURTHER COLLECTION EFFORTS ARE MADE. |
| NEEDS ASSESSMENT | THE ORGANIZATION SENDS OUT SATISFACTION SURVEYS AND ASKS FOR FEEDBACK ON WHAT THE COMMUNITY FEELS IT WOULD BENEFIT FROM. | |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | THE FACILITY INFORMS AND EDUCATES PATIENTS BY HAVING THE SOCIAL SERVICES MANAGER SPEAK WITH PATIENTS AND GIVE THEM ALL OF THE INFORMATION NECESSARY TO EDUCATE THEM ON THE DIFFERENT ASSISTANCE PROGRAMS AVAILABLE TO THEM. | |
| COMMUNITY LIMITATION | THE ORGANIZATION SERVES A SMALL RURAL AREA IN NORTHWEST KANSAS. THE TOWN HAS A POPULATION OF APPROXIMATELY 1200 PEOPLE. THE MAIN ECONOMY IS AGRICULTURE. | |
| PROMOTION OF COMMUNITY HEALTH | DECATUR HEALTH SYSTEMS, INC. HAS A COMMUNITY BOARD AND AN OPEN MEDICAL STAFF. | |
| COMMUNITY BENEFIT REPORT STATE FILINGS | KANSAS |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| FORM 990 REIVEW PROCESS | FORM 990, PART VI, SECTION B, LINE 11B | AN INDEPENDENT ACCOUNTING FIRM PREPARES THE FORM 990. THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S CFO. ANY QUESTIONS OR CONCERNS ARE ADDRESSED AND ANY CHANGES ARE MADE IF NECESSARY. THE NORMAL PROCEDURE IS TO PROVIDE COPIES OF THE FORM 990 WITH ALL REQUIRED SCHEDULES TO THE ORGANIZATION'S ENTIRE GOVERNING BODY PRIOR TO FILING WITH THE IRS. HOWEVER, DUE TO TIME CONSTRAINTS IT WAS NOT POSSIBLE TO PROVIDE THE ENTIRE GOVERNING BODY A COPY OF THE 2011 FORM 990 PRIOR TO FILING WITH THE IRS. |
| CONFLICT OF INTEREST POLICY | FORM 990, PART VI, SECTION B, LINE 12C | AN ANNUAL REVIEW OF THE CONFLICT OF INTEREST POLICY IS COMPLETED BY BOARD MEMBERS, OFFICERS, AND EMPLOYEES. IF A POTENTIAL CONFLICT IS PRESENT THE BOARD MEMBERS WILL DELIBERATE TO DETERMINE WHETHER AN ACTUAL CONFLICT EXIST. A CONFLICTED BOARD MEMBER ABSTAINS FROM VOTING ON THE MATTER. |
| CEO COMPENSATION REVIEW | FORM 990, PART VI, SECTION B, LINE 15A | THE BOARD OF DIRECTORS PERFORM AN ANNUAL EVALUATION OF THE CEO TO DETERMINE COMPENSATION AND RAISES. A COMPENSATION COMMITTEE REVIEWS THE KHA COMPENSATION DATA ANNUALLY TO DETERMINE WHETHER COMPENSATION IS APPROPRIATE GIVEN THE GEOGRAPHICAL LOCATION AND THE ORGANIZATION'S SIZE. USING THE EVALUATION AND THE KHA COMPENSATION DATA, THE BOARD DELIBERATES ANY COMPENSATION ADJUSTMENTS. THE DELIBERATION AND DECISION ARE DOCUMENTED IN THE BOARD MINUTES. |
| OTHER OFFICERS COMPENSATION REVIEW | FORM 990, PART VI, SECTION B, LINE 15B | THE CEO PERFORM AN ANNUAL EVALUATION OF THE CFO AND ALL DEPARTMENT HEADS TO DETERMINE COMPENSATION AND RAISES. THE ANNUAL KHA COMPENSATION DATA IS UTILIZED AS A GUIDE FOR DETERMINING APPROPRIATE COMPENSATION. EVALUATION RECORDS AND COMPENSATION ADJUSTMENTS ARE DOCUMENTED AND FILED IN THE EMPLOYEE'S FILE. |
| AVAILABILITY OF 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. |
| CHANGE IN NET ASSETS RECONCILIATION | FORM 990, PART XI, LINE 5 | CHANGE IN AMOUNT DUE TO LESSOR $(172,769) |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:RON JANSONIUS TITLE:CHAIRMAN/DIRECTOR HOURS:3 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:GARY WALTER TITLE:CHAIRMAN/SECRETARY/DIRECTOR HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:PAM WILSON TITLE:TREASURER/DIRECTOR HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:CONNIE M. GRAFEL TITLE:DIRECTOR HOURS:1 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:KATHY NAUER TITLE:SECRETARY/DIRECTOR HOURS:1 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DECATUR COUNTY HOSPITAL | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 810 W COLUMBIA | AddressLine1 |
| City | OBERLIN | City |
| State | KS | State |
| ZIP Code | 67749 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 486110898 | EIN |
| Primary Activities | HOSPITAL | PrimaryActivities |
| Legal Domicile State | KS | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | 115 | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | false | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | 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 | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |