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WEST CENTRAL KANSAS ASSOCIATION INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
WEST CENTRAL KANSAS ASSOCIATION INC (EIN 74-2842747)
Tax period
2010-08-01 to 2011-07-31
Filed
2012-05-29
IRS object ID
201241509349300119
Schema version
2010v3.4
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

FieldValueIRS element (for citing)
Timestamp2012-05-29T11:05:29-05:00Timestamp
Tax Period End Date2011-07-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Wendling Noe Nelson & Johnson LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1534 S Kansas Ave Suite 1500AddressLine1
CityTopekaCity
StateKSState
ZIP Code666033491ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-08-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN742842747EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1West Central Kansas Association IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlWESTNameControl
Phone7854833131Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 S MainAddressLine1
CityRussellCity
StateKSState
ZIP Code67665ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameShelley BodenName
TitleCEOTitle
Phone7854832323Phone
Date Signed2012-05-23DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJohn R HelmsName
Phone7852334226Phone
Date Prepared2012-05-23DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1Russell Regional HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonShelley BodenNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1200 S MainAddressLine1
CityRussellCity
StateKSState
ZIP Code67665ZIPCode
FieldValueIRS element (for citing)
Gross Receipts13716895GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.russellhospital.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1997YearFormation
State Legal DomicileKSStateLegalDomicile
Activity Or Mission DescriptionTo provide a caring and compassionate team dedicated to the delivery of quality healthcare, and to meet the current and future healthcare needs of the community.ActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members5NbrIndependentVotingMembers
Total Nbr Employees142TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1844ContributionsGrantsPriorYear
Contributions Grants Current Year9575ContributionsGrantsCurrentYear
Program Service Revenue Prior Year12685907ProgramServiceRevenuePriorYear
Program Service Revenue CY13303825ProgramServiceRevenueCY
Investment Income Prior Year51169InvestmentIncomePriorYear
Investment Income Current Year3640InvestmentIncomeCurrentYear
Other Revenue Prior Year295933OtherRevenuePriorYear
Other Revenue Current Year363354OtherRevenueCurrentYear
Total Revenue Prior Year13034853TotalRevenuePriorYear
Total Revenue Current Year13680394TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year9210714SalariesEtcPriorYear
Salaries Etc Current Year9022477SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4868121OtherExpensePriorYear
Other Expenses Current Year4937934OtherExpensesCurrentYear
Total Expenses Prior Year14078835TotalExpensesPriorYear
Total Expenses Current Year13960411TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1043982RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-280017RevenuesLessExpensesCY
Total Assets BOY3455961TotalAssetsBOY
Total Assets EOY3857845TotalAssetsEOY
Total Liabilities BOY3230961TotalLiabilitiesBOY
Total Liabilities EOY3734278TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY225000NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY123567NetAssetsOrFundBalancesEOY
Mission DescriptionTo care for our communities and their citizens with the caring, compassion, quality and commitment that validates their trust in us.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense12536428Expense
Revenue13667179Revenue
DescriptionRussell Regional Hospital provides a variety of health care services including acute inpatient care, swingbed inpatient care, outpatient care, rural health clinic, and long-term care services to patients in need of care.Description
Total Program Service Expense12536428TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109618NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees142NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members5NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons0AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement0RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Shelley Boden CEOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7854832323TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1200 S MainAddressLine1
CityRussellCity
StateKSState
ZIP Code67665ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (14 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Morris Krug
President1.00XX000
Sylvia Newton
Secretary1.00XX000
John O Farmer III
Treasurer1.00XX000
Michael Holland
Director1.00X000
Richard L Shields
Vice-President1.00XX000
Shelley Boden
CEO40.00X95517018031
Mary Odom
CFOX000
Janel Burch
CFO (thru January 2011 )40.00X3818508734
Sambhundh Panichabhongse
Physician40.0015046607844X
Earl Merkel
Physician40.0029681908914X
Aaron Rowland
Physician40.0018302107623X
Andrea Herrera
Physician40.00220562012744X
Jill Doerfler-Iniguez
Physician40.0021252408719X
Alexander Chung
Physician40.0023783302605X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1434927TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation75214TotalOtherCompensation
Number Individuals GT100 K8NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Docs Who Care
1337 S Fountain DriveOlatheKS66061Physician ER & Clinic Coverage153226
Shared Medical Services
PO Box 330Cottage GroveWI53527MRI services123832
Dr John Whitehead
1659 Tamarisk DriveWichitaKS67230Physician ER & Clinic Coverage117385
Etrans
2525 Perimeter Place DrNashvilleTN37214Medical record transcribing103577
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
Government Grants7075GovernmentGrants
All Other Contributions2500AllOtherContributions
Total Contributions9575TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNet patient service reDescription
Business Code900099BusinessCode
Total Revenue Column13303825TotalRevenueColumn
Related Or Exempt Function Income13303825RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue13303825TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column40141TotalRevenueColumn
Exclusion$40,141ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real7126Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real7126Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column7126TotalRevenueColumn
Related Or Exempt Function Income7126RelatedOrExemptFunctionIncome

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other36501Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-36501Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-36501TotalRevenueColumn
Exclusion-$36,501ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Ambulance services621910315000315000
Cafeteria sales7222103118131181
Meals on wheels62421053765376

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column4671TotalRevenueColumn
Related Or Exempt Function Income4671RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue356228TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column13680394TotalRevenueColumn
Related Or Exempt Function Income13667179RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$3,640ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total203528Total
Management And General203528ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total7432700Total
Program Services6874429ProgramServices
Management And General558271ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total62942Total
Program Services58715ProgramServices
Management And General4227ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total836802Total
Program Services786067ProgramServices
Management And General50735ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total486505Total
Program Services439955ProgramServices
Management And General46550ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total685Total
Management And General685ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total185680Total
Program Services13362ProgramServices
Management And General172318ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total18977Total
Program Services17227ProgramServices
Management And General1750ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total112363Total
Program Services19839ProgramServices
Management And General92524ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total352264Total
Program Services341534ProgramServices
Management And General10730ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total18913Total
Program Services18703ProgramServices
Management And General210ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total74805Total
Program Services39454ProgramServices
Management And General35351ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total444548Total
Program Services444548ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total189776Total
Program Services189776ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Bad debt provision755676755676
Pharmacy supplies732995732995
Purchased services50268545385048835
Repairs and maintenance47243738003792400
Medical supplies42742540344423981

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total648705Total
Program Services566817ProgramServices
Management And General81888ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total13960411Total
Program Services12536428ProgramServices
Management And General1423983ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY275870BOY
EOY558489EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY52BOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1689167BOY
EOY1431199EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY169221BOY
EOY203699EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY111049BOY
EOY127510EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis2980068LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1571634LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY984845BOY
EOY1408434EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY225757BOY
EOY128514EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY3455961BOY
EOY3857845EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1179475BOY
EOY1080997EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1096977BOY
EOY1480213EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY954509BOY
EOY1173068EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY3230961BOY
EOY3734278EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY225000BOY
EOY123567EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY225000BOY
EOY123567EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3455961BOY
EOY3857845EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-280017ReconcilationRevenueExpenses
Reconcilation Other Changes178584ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee0AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis59741OtherCostOrOtherBasis
Depreciation2902Depreciation
Book Value56839BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2036451OtherCostOrOtherBasis
Depreciation1501779Depreciation
Book Value534672BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis883876OtherCostOrOtherBasis
Depreciation66953Depreciation
Book Value816923BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1408434TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Due to lessor$1,165,209
Estimated third-party payor settlements$7,859
FieldValueIRS element (for citing)
Total Of Amounts1173068TotalOfAmounts
Total Revenue13680394TotalRevenue
Total Expenses13960411TotalExpenses
Excess Or Deficit For Year-280017ExcessOrDeficitForYear
Other$178,584OtherAmount
Total Adjustments178584TotalAdjustments
Excess Or Deficit Per FS-101433ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt13716895TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal13716895RevenueSubtotal
Other Revenues Not Included-36501OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-36501RevenueNotRptdOnFinStmt
Total Revenue Per Form99013680394TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt13960411TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal13960411ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99013960411TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierExplanationExplanation
Part XI, Line 8 - Other Adjustments:Transfer from lessor 389,363. Change in amount due to lessor -210,779.
Part XII, Line 4b - Other Adjustments:Loss on disposal of assets -36,501.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage130.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care0AmountsBudgetedForCharityCare
Annual Community Benefit Report0AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense109560TotalCommunityBenefitExpense
Direct Offsetting Revenue109551DirectOffsettingRevenue
Net Community Benefit Expense9NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense763378TotalCommunityBenefitExpense
Direct Offsetting Revenue823582DirectOffsettingRevenue
Net Community Benefit Expense-60204NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense872938TotalCommunityBenefitExpense
Direct Offsetting Revenue933133DirectOffsettingRevenue
Net Community Benefit Expense-60195NetCommunityBenefitExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense2988151TotalCommunityBenefitExpense
Direct Offsetting Revenue2339172DirectOffsettingRevenue
Net Community Benefit Expense648979NetCommunityBenefitExpense
Percent Of Total Expense0.04910PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense2988151TotalCommunityBenefitExpense
Direct Offsetting Revenue2339172DirectOffsettingRevenue
Net Community Benefit Expense648979NetCommunityBenefitExpense
Percent Of Total Expense0.04910PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense3861089TotalCommunityBenefitExpense
Direct Offsetting Revenue3272305DirectOffsettingRevenue
Net Community Benefit Expense588784NetCommunityBenefitExpense
Percent Of Total Expense0.04910PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$419,778BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare6383261AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare6400651CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-17390MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care0ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Russell Regional HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1200 South Main StreetAddressLine1
CityRussellCity
StateKSState
ZIP Code67665ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours
OtherLong-term care facility, outpatient physician clinicOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Not requiredBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part VI Form990ScheduleHPartVI (7 entries)

ExplanationExplanation
Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 755676.
Part III, Line 4: The Hospital 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 Hospital estimates this allowance based on the aging of its accounts receivable and its historical collection experience for each type of payor.The Hospital's bad debt at cost was determined by applying an overall ratio of cost to charges. Part III, Line 3West Central Kansas Association, Inc. is unable to determine the amount of bad debt expense attributable to patients eligible under its charity care policy for the year covered by this return. Suggested methods for estimation were either not in place or proved to be unreliable. For example, the number of financial assistance applications distributed but not returned was not tracked. Using demographic data to estimate an amount did not provide reasonable results. Undoubtedly, there is bad debt expense attributed to patients who meet charity care guidelines. However, paperwork needed for approval of charity care was not returned or tracked. Rather than provide an estimate that can't be substantiated, West Central Kansas Association, Inc. has chosen to report zero dollars as bad debt expense attributable to charity care patients.
Part III, Line 8: The amount was obtained from the cost report filed with Medicare for the period ending 07/31/2011.
Part VI, Line 2:
Part VI, Line 3: Patients receive information regarding federal, state and charity care programs upon request.
Part VI, Line 4: The Hospital is located in Russell County, Kansas in the city of Russell and serves the surrounding area. The Russell community is a predominately agricultural one. The city of Russell and Russell County have an approximate population of 4,500 & 7,000 individuals respectively. The average Russell household annual income is approximately $36,135. Approximately 16.9% of the residents in Russell County have an annual income below the federal poverty level and approximately 7.0% of residents have an annual income below 50% of the federal poverty level. Other hospitals in the area are located in Hays, Hoisington, and Great Bend. The distance between the Hospital and these facilities is approximately 26, 29, and 40 miles respectively.
Part VI, Line 6: The Hospital's governing body is comprised solely of local community members. All local physicians have admitting privileges at the Hospital.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Sambhundh Panichabhongse
1504660000000784401583100642030
Earl Merkel
29681900000008914030573301118820
Aaron Rowland
1830210000000762301906440560200
Andrea Herrera
22056200000001274402333060767760
Jill Doerfler-Iniguez
2125240000039070481202212430902070
Alexander Chung
23783300000002605024043801422690

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section B, line 11The Form 990 is reviewed by the governing body prior to filing. It is distributed by email to all governing body Board Members for review. Any questions and/or comments are directed to management for further discussion.
The compensation of the organization's officers is voted on and approved by the Board of Directors.Form 990, Part VI, Section B, line 15
The organization makes its governing documents, conflict of interest policy, and audited financial statements available to the public upon written request.Form 990, Part VI, Section C, line 19
Changes in Net Assets or Fund Balances:Transfer from lessor 389,363. Change in amount due to lessor -210,779. Total to Form 990, Part XI, Line 5: 178,584.Form 990, Part XI, line 5: