COMMUNITY HEALTHCARE SYSTEM INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization: COMMUNITY HEALTHCARE SYSTEM INC (EIN 48-1020227)
Tax period: 2009-04-01 to 2010-03-31
Filed: 2011-02-18
IRS object ID: 201100499349300410
Schema version: 2009v1.3
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
Form 990
Schedule A
Schedule C
Schedule D
Schedule H
Schedule J
Schedule K
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2011-02-18T14:22:40-08:00	Timestamp
Tax Period End Date	2010-03-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	GEORGE BOWERMAN & NOEL PA	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	301 N MAIN SUITE 1350	AddressLine1
City	WICHITA	City
State	KS	State
ZIP Code	67202	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2009-04-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	481020227	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	COMMUNITY HEALTHCARE SYSTEM INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	COMM	NameControl
Phone	7858894657	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	120 WEST 8TH STREET	AddressLine1
City	ONAGA	City
State	KS	State
ZIP Code	66521	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	MONICA HOLTHAUS	Name
Title	CFO	Title
Phone	7858894657	Phone
Date Signed	2011-02-14	DateSigned

Preparer Preparer

Field	Value	IRS element (for citing)
Name	ERIC MEYER	Name
Phone	3162626277	Phone

Field	Value	IRS element (for citing)
Tax Year	2009	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	MONICA HOLTHAUS	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	120 WEST 8TH ST	AddressLine1
City	ONAGA	City
State	KS	State
ZIP Code	66521	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	26181573	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c	X	Organization501c
Web Site	N/A	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1986	YearFormation
State Legal Domicile	KS	StateLegalDomicile
Activity Or Mission Description	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.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	7	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	7	NbrIndependentVotingMembers
Total Nbr Employees	516	TotalNbrEmployees
Total Nbr Volunteers	0	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	131809	ContributionsGrantsPriorYear
Contributions Grants Current Year	87188	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	25490410	ProgramServiceRevenuePriorYear
Program Service Revenue CY	25921707	ProgramServiceRevenueCY
Investment Income Prior Year	42368	InvestmentIncomePriorYear
Investment Income Current Year	24099	InvestmentIncomeCurrentYear
Other Revenue Prior Year	119530	OtherRevenuePriorYear
Other Revenue Current Year	148579	OtherRevenueCurrentYear
Total Revenue Prior Year	25784117	TotalRevenuePriorYear
Total Revenue Current Year	26181573	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	16710060	SalariesEtcPriorYear
Salaries Etc Current Year	17034746	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	9143971	OtherExpensePriorYear
Other Expenses Current Year	8389561	OtherExpensesCurrentYear
Total Expenses Prior Year	25854031	TotalExpensesPriorYear
Total Expenses Current Year	25424307	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-69914	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	757266	RevenuesLessExpensesCY
Total Assets BOY	10426315	TotalAssetsBOY
Total Assets EOY	9325001	TotalAssetsEOY
Total Liabilities BOY	8720201	TotalLiabilitiesBOY
Total Liabilities EOY	6858038	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	1706114	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	2466963	NetAssetsOrFundBalancesEOY
Mission Description	Community HealthCare System, in partnership with our medical staff, has a	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	19876978	Expense
Revenue	25921707	Revenue
Description	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	Description
Total Program Service Expense	19876978	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	true	LobbyingActivities
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Balance Sheet Amounts Reported	true	BalanceSheetAmountsReported
Independent Audit Financial Stmt	true	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	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
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	true	TaxExemptBonds
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
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
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	573	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	516	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
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
Form8899 Filed	true	Form8899Filed
Form1098 C Filed	true	Form1098CFiled
Excess Business Holdings	false	ExcessBusinessHoldings
Taxable Distributions	false	TaxableDistributions
Distribution To Donor	false	DistributionToDonor
Nbr Voting Governing Body Members	7	NbrVotingGoverningBodyMembers
Number Independent Voting Members	7	NumberIndependentVotingMembers
Family Or Business Relationship	true	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	true	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	true	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	MONICA HOLTHAUS	NamePerson
Telephone Number	7858894657	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	120 W 8TH STREET	AddressLine1
City	ONAGA	City
State	KS	State
ZIP Code	66521	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Highest Compensated EmployeeHighestCompensatedEmployee
MELVIN HANDLEY
CHAIRMAN	10.00	X	3863	0	0
VIRGINIA REZAC
VICE CHAIRMAN	10.00	X	3298	0	0
DEAN MYERS
SECRETARY	10.00	X	3291	0	0
JUSTIN BOSWELL
DIRECTOR	10.00	X	4063	0	0
OWEN DUER
DIRECTOR	10.00	X	3865	0	0
PHIL SPRINGER
DIRECTOR	10.00	X	3765	0	0
LONNIE KUFAHL
DIRECTOR	10.00	X	642	0	0
GREG UNRUH
CEO	40.00		178434	0	20304	X
MARCIA WALSH
COO	40.00		153905	0	12113	X
ROSALIND LEWIS
CNO	40.00		99124	0	3026	X
MONICA HOLTHAUS
CFO	40.00		97406	0	1335	X
ALAN FISCHER
DIRECTOR	40.00	X	745	0	0
DR DAVID ALLEN
PHYSICIAN	40.00		474464	0	9945		X
DR TOM WALSH
PHYSICIAN	40.00		292234	0	7269		X
DR ROY DANKS
PHYSICIAN	40.00		242306	0	2757		X
DR NANCY ZIDEK
PHYSICIAN	40.00		205565	0	5043		X
DR DAGOBERTO HEREDIA
PHYSICIAN	40.00		287960	0	8476		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	2054930	TotalReportableCompFromOrg
Total Other Compensation	70268	TotalOtherCompensation
Number Individuals GT100 K	7	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
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	232442
BENEFIT MANAGEMENT INC
2015 16TH STREET	GREAT BEND	KS	67530	THIRD PARTY ADMINISTRATOR FOR HEALTH INSURANCE	185080
HEALTHLAND
625 S LAKESHORE DR	GLEENWOOD	MN	56334	COMPUTER SYSTEM MAINTENANCE	173104
TECHFORCE3 INC
31 EAST BUTLER AVE	AMBLER	PA	19002	CONTRACT LABOR FOR LAB	153600

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	13	NumberOfContractorsGT100K
Government Grants	20424	GovernmentGrants
All Other Contributions	66764	AllOtherContributions
Total Contributions	87188	TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REVENUE	622110	24300625	24300625
TAX SUBSIDY	622110	1621082	1621082

Field	Value	IRS element (for citing)
Total Program Service Revenue	25921707	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	24099	TotalRevenueColumn
Exclusion	$24,099	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	17327	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	17327	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	17327	TotalRevenueColumn
Exclusion	$17,327	ExclusionAmount

Other Revenue Misc OtherRevenueMisc

Field	Value	IRS element (for citing)
Description	Other	Description
Business Code	900099	BusinessCode
Total Revenue Column	131252	TotalRevenueColumn
Exclusion	$131,252	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	131252	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	26181573	TotalRevenueColumn
Related Or Exempt Function Income	25921707	RelatedOrExemptFunctionIncome
Exclusion	$172,678	ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	552402	Total
Program Services	419327	ProgramServices
Management And General	133075	ManagementAndGeneral
Fundraising	0	Fundraising

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	13934383	Total
Program Services	11257315	ProgramServices
Management And General	2677068	ManagementAndGeneral
Fundraising	0	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	76136	Total
Program Services	55919	ProgramServices
Management And General	20217	ManagementAndGeneral
Fundraising	0	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	1480499	Total
Program Services	1097029	ProgramServices
Management And General	383470	ManagementAndGeneral
Fundraising	0	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	991326	Total
Program Services	796035	ProgramServices
Management And General	195291	ManagementAndGeneral
Fundraising	0	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	63710	Total
Program Services	61785	ProgramServices
Management And General	1925	ManagementAndGeneral
Fundraising	0	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	119169	Total
Program Services	80524	ProgramServices
Management And General	38645	ManagementAndGeneral
Fundraising	0	Fundraising

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	1297831	Total
Program Services	854052	ProgramServices
Management And General	443779	ManagementAndGeneral
Fundraising	0	Fundraising

Travel Travel

Field	Value	IRS element (for citing)
Total	144403	Total
Program Services	122091	ProgramServices
Management And General	22312	ManagementAndGeneral
Fundraising	0	Fundraising

Interest Interest

Field	Value	IRS element (for citing)
Total	312259	Total
Program Services	224957	ProgramServices
Management And General	87302	ManagementAndGeneral
Fundraising	0	Fundraising

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	931972	Total
Program Services	689659	ProgramServices
Management And General	242313	ManagementAndGeneral
Fundraising	0	Fundraising

Insurance Insurance

Field	Value	IRS element (for citing)
Total	237973	Total
Program Services	136865	ProgramServices
Management And General	101108	ManagementAndGeneral
Fundraising	0	Fundraising

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
LEASED EQUIPMENT	124074	105338	18736
MISCELLANEOUS	95281	30491	64790
DUES AND SUBSCRIPTIONS	113165	54972	58193
EDUCATION	63587	46107	17480
MINOR EQUIPMENT	123773	109928	13845

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	4762364	Total
Program Services	3734584	ProgramServices
Management And General	1027780	ManagementAndGeneral
Fundraising	0	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	25424307	Total
Program Services	19876978	ProgramServices
Management And General	5547329	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	102000	BOY
EOY	375358	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	2936179	BOY
EOY	3101364	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	840447	BOY
EOY	784381	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	218343	BOY
EOY	167055	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	12115670	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	7979173	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	4996857	BOY
EOY	4136497	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	240668	BOY
EOY	240275	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	9723	BOY
EOY	143375	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	1082098	BOY
EOY	376696	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	10426315	BOY
EOY	9325001	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	2976791	BOY
EOY	2865494	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	2850000	BOY
EOY	2610000	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	2799768	BOY
EOY	1288902	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	93642	BOY
EOY	93642	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	8720201	BOY
EOY	6858038	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1523550	BOY
EOY	2282934	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	182564	BOY
EOY	184029	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	1706114	BOY
EOY	2466963	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	10426315	BOY
EOY	9325001	EOY

Field	Value	IRS element (for citing)
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	false	AuditCommittee
Financial Statement Separate	X	FinancialStatementSeparate
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii
Public Support Total170	0	PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

Field	Value	IRS element (for citing)
Total	0	Total

Field	Value	IRS element (for citing)
Public Support Pertcentage170	0	PublicSupportPertcentage170
Public Support Total509	0	PublicSupportTotal509
Public Support Percentage509	0	PublicSupportPercentage509
Investment Income Percentage	0	InvestmentIncomePercentage

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
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	$4,157	GrantsOtherOrganizationsAmount
Direct Contact Legislators	false	DirectContactLegislators
Rallies Demonstrations	false	RalliesDemonstrations
Other Activities	false	OtherActivities
Total Lobbying Expenditures IIB	4157	TotalLobbyingExpendituresIIB

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	Pt II-B Line 1i	Identifier
Explanation	LOBBYING PORTION OF KANSAS HOSPITAL ASSOCIATION DUES	Explanation

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	370866	OtherCostOrOtherBasis
Book Value	370866	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	5773423	OtherCostOrOtherBasis
Depreciation	3321638	Depreciation
Book Value	2451785	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	5971381	OtherCostOrOtherBasis
Depreciation	4657535	Depreciation
Book Value	1313846	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	4136497	TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescription	Book ValueBookValue	Method Of ValuationMethodOfValuation
FUNDS HELD BY TRUSTEE UNDER INDENTURE AGREEMENT	200686	F
ASSETS WHOSE USE IS LIMITED-CD	39589	C

Field	Value	IRS element (for citing)
Total Of Book Value Securities	240275	TotalOfBookValueSecurities

Other Assets OtherAssets (3 entries)

DescriptionDescription	Book ValueBookValue
DUE FROM THIRD PARTY PAYER	128888
DEFERRED FINANCING COSTS	121029
OTHER	126779

Field	Value	IRS element (for citing)
Total Book Value Other Assets	376696	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	DUE TO COMMUNITY HOSPITAL DISTRICT	Description
Amount	$93,642	Amount

Field	Value	IRS element (for citing)
Total Of Amounts	93642	TotalOfAmounts
Total Revenue	26181573	TotalRevenue
Total Expenses	25424307	TotalExpenses
Excess Or Deficit For Year	757266	ExcessOrDeficitForYear
Excess Or Deficit Per FS	757266	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	26181573	TotRevenueEtcAuditedFinclStmt
Revenue Subtotal	26181573	RevenueSubtotal
Total Revenue Per Form990	26181573	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	25424307	TotExpensesEtcAuditedFinclStmt
Expenses Subtotal	25424307	ExpensesSubtotal
Total Expenses Per Form990	25424307	TotalExpensesPerForm990

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
Pcent200	X	Pcent200
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	false	AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	176405	TotalCommunityBenefitExpense
Net Community Benefit Expense	176405	NetCommunityBenefitExpense
Percent Of Total Expense	0.00690	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1181567	TotalCommunityBenefitExpense
Direct Offsetting Revenue	902521	DirectOffsettingRevenue
Net Community Benefit Expense	279046	NetCommunityBenefitExpense
Percent Of Total Expense	0.01100	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1357972	TotalCommunityBenefitExpense
Direct Offsetting Revenue	902521	DirectOffsettingRevenue
Net Community Benefit Expense	455451	NetCommunityBenefitExpense
Percent Of Total Expense	0.01790	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	382175	TotalCommunityBenefitExpense
Direct Offsetting Revenue	186897	DirectOffsettingRevenue
Net Community Benefit Expense	195278	NetCommunityBenefitExpense
Percent Of Total Expense	0.00770	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	11349876	TotalCommunityBenefitExpense
Direct Offsetting Revenue	9340471	DirectOffsettingRevenue
Net Community Benefit Expense	2009405	NetCommunityBenefitExpense
Percent Of Total Expense	0.07900	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	11732051	TotalCommunityBenefitExpense
Direct Offsetting Revenue	9527368	DirectOffsettingRevenue
Net Community Benefit Expense	2204683	NetCommunityBenefitExpense
Percent Of Total Expense	0.08670	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	13090023	TotalCommunityBenefitExpense
Direct Offsetting Revenue	10429889	DirectOffsettingRevenue
Net Community Benefit Expense	2660134	NetCommunityBenefitExpense
Percent Of Total Expense	0.10460	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense	$331,966	BadDebtExpenseAmount
Amount Attributable To	248975	AmountAttributableTo
Amount Reimbursed By Medicare	4874149	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	4880422	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-6273	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

Form990 Schedule H Part V Form990ScheduleHPartV (5 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Critical Access HospitalCriticalAccessHospital	OtherOther
COMMUNITY HOSPITAL ONAGA
120 WEST 8TH	ONAGA	KS	66521	X
ST MARYS HEALTH CENTER
206 GRAND AVENUE	ST MARYS	KS	66536	X
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		RUAL HEALTH CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI

Field	Value	IRS element (for citing)
Costing Method Used	THE TOTAL COST TO CHARGE RATIO DERIVED FROM THE	CostingMethodUsed
Subsidized Health Services Expln	SUBSIDIZED HEATH SERVICES INCLUDE THE COST ATTRIBUTABLE	SubsidizedHealthServicesExpln
Bad Debt Footnote	THE TOTAL COST TO CHARGE RATIO DERIVED FROM THE	BadDebtFootnote
Shortfall As Community Benefit	MEDICARE ALLOWABLE COST PER THE MEDICARE COST REPORT.	ShortfallAsCommunityBenefit
Debt Collection Policy	IF COLLECTION EFFORTS DETERMINE THAT A PATIENT MAY	DebtCollectionPolicy
Number Of Facility Type Expln	ONE SKILLED NURSING FACILITY	NumberOfFacilityTypeExpln
Needs Assessment	INFORMAL NEEDS ASSESSMENT PERFORMED ON AN ONGOING BASIS.	NeedsAssessment
Patient Education Assistance	THE AVAILABILITY OF FINANCIAL ASSISTANCE IS STATED IN	PatientEducationAssistance
Community Information	CRITICAL ACCESS HOSPITAL SERVING PRIMARLY AS SOLE PROVIDER	CommunityInformation
Other Information	ALL OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED	OtherInformation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Written Employment Contract	X	WrittenEmploymentContract
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	false	SeverancePayment
Supplemental Nonqual Retire Plan	false	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	true	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	false	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	false	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	false	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Total Compensation Filing OrgTotalCompensationFilingOrg	Bonus Filing OrgBonusFilingOrg
GREG UNRUH
178434	20304	198738
MARCIA WALSH
153905	12113	166018
DR DAVID ALLEN
11550	9945	484409	462914
DR TOM WALSH
45115	7269	299503	247119
DR ROY DANKS
242306	2757	245063
DR NANCY ZIDEK
11100	5043	210608	194465
DR DAGOBERTO HEREDIA
287960	8476	296436

Form990 Schedule J Part III Form990ScheduleJPartIII

Field	Value	IRS element (for citing)
Identifier	Pt I Line 5a	Identifier
Explanation	PHYSICIAN COMPENSATION BASED, IN PART, ON PATIENT CHARGES	Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEIN	CUSIP NumberCUSIPNumber	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer
CITY OF HOLTON KANSAS
486030368	436578BE7	2003-03-31	1325000	HEALTHCARE FACILITIES	false	false
CITY OF ST MARYS
486024500	792607AK9	2003-07-15	2000000	HEALTHCARE FACILITIES	false	false

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifier	ExplanationExplanation
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

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	COMMUNITY HOSPITAL DISTRICT NO 1 OF POTTAWATOMIE JACKSON AND NEMAHA COUNTIE	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	120 WEST 8TH STREET	AddressLine1
City	ONAGA	City
State	KS	State
ZIP Code	66521	ZIPCode

Field	Value	IRS element (for citing)
EIN	486089515	EIN
Primary Activities	HOSPITAL DISTIRCT	PrimaryActivities
Legal Domicile State	KS	LegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1

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	false	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	false	OtherTransferToOtherOrg
Other Transfer From Other Org	false	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

Field	Value	IRS element (for citing)
Business Name Line1	COMMUNITY HOSPITAL DISTRICT NO 1 OF POTTAWATOMIE JACKSON AND NEMAH COUNTIES	BusinessNameLine1

Field	Value	IRS element (for citing)
Transaction Type	j	TransactionType
Amount Involved	683961	AmountInvolved