2012-11-14T12:38:11-06:00 2011-12-31 BKD LLP 1551 N WATERFRONT PKWY STE 300 WICHITA KS 672066601 990 2011-01-01 800025964 DECATUR HEALTH SYSTEMS INC % DERICK LORENTZ DECA 7854752208 810 WEST COLUMBIA STREET OBERLIN KS 67749 DERICK LORENTZ 2012-11-15 true ELIZABETH S HOGAN 3162652811 2011 2016-02-24 21:20:13Z DERICK LORENTZ 810 WEST COLUMBIA STREET OBERLIN KS 67749 7224850 false X WWW.DECATURHEALTHSYSTEMS.ORG X 2002 KS THE MISSION OF DECATUR HEALTH SYSTEMS IS TO PROVIDE HIGH QUALITY CARE FOR RURAL AMERICA BY CARING AND SHARING FROM THE HEART. 3 3 165 5 50922 0 64913 766606 6751898 6350052 5994 7439 74765 89942 6897570 7214039 0 0 0 0 4314061 4477767 0 0 0 2538115 2563503 6852176 7041270 45394 172769 2183654 1934950 2183654 1934950 0 0 THE MISSION OF DECATUR HEALTH SYSTEMS IS TO PROVIDE HIGH QUALITY CARE FOR RURAL AMERICA BY CARING AND SHARING FROM THE HEART. false false 6027379 0 6350052 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. 6027379 true true false true false false false false false false true false false true true true false true false false false false false false false false true true false false false false false false false false false false false false false false false false true false false false false true 20 0 true 165 true true true false false false false false false false false false X 3 3 false false false false false false false true true false false false true true true true true true false false X DERICK LORENTZ 7854752208 810 W COLUMBIA STREET OBERLIN KS 67749 X RON JANSONIUS 2.5 X X 0 0 0 GARY WALTER 1.0 X X 0 0 0 PAM WILSON 1.0 X X 0 0 0 CONNIE M GRAFEL 0.5 X 0 0 0 KATHY NAUER 0.5 X X 0 0 0 LYNN DOEDEN 40.0 X 121652 0 13005 AMANDA FORTIN 40.0 X 59208 0 4918 180860 0 17923 1 false false false DOCS WHO CARE PHYSICIANS 307617 1 2000 707588 57018 766606 NET PATIENT SERVICE REVENUE 621300 6350052 6350052 6350052 7439 7439 0 0 0 9724 2000 10811 -1087 -1087 0 0 EMPLOYEE/GUEST MEALS 722210 9946 9946 WHEAT RIDGE MANAGEMENT FEE 561000 50895 50895 MISCELLANEOUS 900099 30188 27 30161 30188 27 30161 91029 7214039 6350052 50922 46459 0 0 0 0 198783 198783 0 3407067 3029094 377973 64901 60100 4801 537347 497597 39750 269669 249720 19949 0 45897 45897 56610 56610 0 0 0 460810 326112 134698 16258 1389 14869 219819 194335 25484 0 0 287317 263977 23340 29204 22246 6958 0 5755 4459 1296 0 0 95760 88676 7084 58261 53951 4310 BAD DEBT EXPENSE 153547 153547 DUES & SUBSCRIPTIONS 524139 498760 25379 REPAIRS & MAINTENANCE 55251 51341 3910 MINOR EQUIPMENT 37454 17787 19667 517421 514288 3133 7041270 6027379 1013891 0 87985 95508 224469 34872 0 0 1268570 675669 0 0 0 0 17191 3010 104962 106005 47974 79745 1118083 903442 182503 214641 0 0 0 0 0 0 0 0 250000 725500 2183654 1934950 897735 549170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1285919 1385780 2183654 1934950 X 0 0 0 0 0 0 0 0 2183654 1934950 X 172769 -172769 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 1602 false false false 1602 false GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES FORM 990, SCHEDULE C, PART II-B, LINE 1F APPROXIMATELY 15% OF KHA DUES ARE USED FOR DIRECT LOBBYING AND ADVOCACY ACTIVITIES. 1118083 903442 214641 214641 DUE FROM MEDICARE 393000 INVESTMENT IN WHEAT RIDGE 250000 INVESTMENT-RURAL HEALTH CLINIC 82500 725500 0 DUE TO DECATUR COUNTY HOSPITAL 1385780 1385780 UNCERTAIN TAX POSITIONS SCHEDULE D, PART X, LINE 2 Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements. true true true X true X true true false true true 0 0 0 577692 708243 0 0 0 0 0.00000 577692 708243 0 0.00000 577692 708243 0 0.00000 false 153547 0 3176257 3144809 31448 X true true 1 1 DECATUR HEALTH SYSTEMS INC

810 W COLUMBIA OBERLIN KS 67749

X X X X DECATUR HEALTH SYSTEMS INC 1 true true 100 true 200. true X X true true X X true false X X true X false false 3 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 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 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 DECATUR COUNTY HOSPITAL 810 W COLUMBIA OBERLIN KS 67749 486110898 HOSPITAL KS 501(C)(3) 115 NA false false false false false false false false false false true false false false false false true false false