2011-11-15T17:36:24-06:00 2010-12-31 BKD LLP 1551 N WATERFRONT PKWY STE 300 WICHITA KS 672066601 990 2010-01-01 300078435 GREELEY COUNTY HEALTH SERVICES GREE 6203764221 506 THIRD STREET TRIBUNE KS 67879 JAMES L SMITH 6203764221 2011-11-15 true STEVEN L WEBB 3162652811 2010 2016-03-07 17:11:31Z JAMES L SMITH 506 THIRD STREET TRIBUNE KS 67879 9494673 false X WWW.GCHSNET.COM X 2006 KS ADDRESS HEALTHCARE NEEDS THROUGH THE EFFECTIVE PARTNERING OF A COMPASSIONATE STAFF WITH QUALITY CARE. 5 5 169 5 0 0 598011 638973 8257427 8204297 2609 2523 974760 648880 9832807 9494673 0 0 0 0 6774685 6493409 0 0 0 3681496 3598419 10456181 10091828 -623374 -597155 5580148 5072991 1817896 1907894 3762252 3165097 X SEE SCHEDULE O false false 2488558 0 2583987 A CRITICAL ACCESS HOSPITAL WITH 333 TOTAL ACUTE ADMISSIONS IN 2010 4597278 0 5044381 PROVIDING RURAL HEALTH CLINIC/OUTPATIENT SERVICES 1663557 0 1171845 PROVIDING LONG TERM CARE SERVICES FOR 9,090 RESIDENT PATIENT DAYS IN 2010 8749393 true true false true false false false false false true false false false false true true false false false false false false false false false true false false false true false false false false false false false false false false false false true false false false false false true 20 0 true 169 true false false false false false false false false false false X 5 5 false true false false false false false true true false false false true true false true true true true false X JAMES L SMITH CFO 6203764221 506 THIRD STREET TRIBUNE KS 67879 JAN EPP 1.0 X X 0 0 0 BETH AESCHLIMAN 1.0 X X 0 0 0 KENNETH ZERR 1.0 X 0 0 0 DON SMITH 1.0 X 0 0 0 STEVE MANGAN 1.0 X X 0 0 0 TODD BURCH 40.0 X 68197 0 13268 CHRIS EKROM 40.0 X 43459 0 6860 NEIL WILSON 40.0 X 89768 0 9994 JAMES SMITH 40.0 X 27865 0 7189 NELSON TOEBBE 40.0 X 63530 0 16229 LISA JARNIGAN 40.0 X 24744 0 6384 WILLIAM HARTLEY 40.0 X 16833 0 3376 SHEILA SCHEFFE MD 40.0 X 170508 0 17759 WENDEL ELLIS DO 40.0 X 294754 0 37362 RANDALL FAHRENHOLTZMD 40.0 X 208399 0 27861 ROBERT MOSER MD 40.0 X 118039 0 20106 ROBIN LIU MD 40.0 X 171653 0 30690 1297749 0 197078 5 false true false ANESTHESIA ASSOCIATES ANESTHESIA SERVICES 224400 QUORUM HEALTH RESOURCES MANAGEMENT SERVICES 143994 2 490186 148787 638973 NET PATIENT SERVICE REVENUE 621110 8204297 8204297 8204297 2523 2523 0 0 2745 0 2745 2745 2745 0 0 0 0 OUTSIDE SERVICES 611420 532094 532094 NONPATIENT MEALS 624200 63822 63822 MISCELLANEOUS INCOME 900099 50219 50219 646135 9494673 8800213 0 55487 0 0 0 0 397696 397696 0 4830819 4492662 338157 262584 244468 18116 666254 620289 45965 336056 312872 23184 143994 143994 20003 20003 90289 90289 0 0 0 767109 714186 52923 51420 8723 42697 1080380 1005845 74535 0 0 256040 238376 17664 58091 54083 4008 0 49851 46412 3439 50333 46861 3472 0 347004 323064 23940 97679 80552 17127 BAD DEBT EXPENSE 220572 220572 REPAIRS & MAINTENANCE 116477 108441 8036 DUES & SUBSCRIPTIONS 29139 27129 2010 EQUIPMENT RENTAL 74312 69185 5127 MINOR EQUIPMENT 37036 34481 2555 108690 101192 7498 10091828 8749393 1342435 0 239731 243213 43955 73858 1026575 1223799 105973 106133 142038 153907 4958068 1695987 3535557 3262081 36319 0 450000 10000 5580148 5072991 1317681 1410558 37464 15000 462751 482336 1817896 1907894 X 689446 235352 3072806 2929745 3762252 3165097 5580148 5072991 -597155 0 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 461 461 false false SCHEDULE C, PART II-B, LINE 1I LOBBYING EXPENSES A PORTION OF DUES PAID TO THE KHA AND AHA WAS FOR LOBBYING AND ADVOCACY. 49851 49851 3600737 846210 2754527 1295895 845014 450881 11585 4763 6822 3262081 0 0 9494673 10091828 -597155 -597155 9274101 9274101 220572 220572 9494673 9871256 9871256 220572 220572 10091828 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. RECONCILIATION OF REVENUE SCHEDULE D, PART XII, LINE 4B BAD DEBT EXPENSE $220,572 RECONCILIATION OF EXPENSES SCHEDULE D, PART XIII, LINE 4B BAD DEBT EXPENSE $220,572 true true true X true X true true true false false 117875 0 117875 0.01170 902823 725591 177232 0.01760 1020698 725591 295107 0.02930 1020698 725591 295107 0.02930 false 220572 0 2855659 3909003 -1053344 X true true 1 1 GREELEY COUNTY HEALTH SERVICES

506 THIRD STREET TRIBUNE KS 67879

X X X X GREELEY COUNTY HEALTH SERVICES 1 SCHEDULE H, 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 $220,572. SCHEDULE H, PART I, LINE 7 THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART I, LINE 7, OF SCHEDULE H, IS A COST TO CHARGE RATIO. BAD DEBT EXPENSE SCHEDULE H, PART III, LINE 4 THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. THE HOSPITAL HAS AGREEMENTS WITH THIRD-PARTY PAYERS THAT PROVIDE FOR PAYMENTS TO THE HOSPITAL AT AMOUNTS DIFFERENT FROM ITS ESTABLISHED RATES. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYERS AND OTHERS FOR SERVICES RENDERED AND INCLUDES ESTIMATED RETROACTIVE REVENUE ADJUSTMENTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS. RETROACTIVE ADJUSTMENTS ARE CONSIDERED IN THE RECOGNITION OF REVENUE ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND SUCH ESTIMATED AMOUNTS ARE REVISED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN. MEDICARE SCHEDULE H, PART III, LINE 8 100% OF THE OVERALL SHORTFALL INCLUDED IN SCHEDULE H, PART II, LINE 7 SHOULD BE CONSIDERED AS COMMUNITY BENEFIT. DUE TO THE FACT THAT THE FACILITY IS A CRITICAL ACCESS HOSPITAL, GREELEY COUNTY HEALTH SERVICES HAS NO OTHER REVENUE SOURCES TO MAKE UP FOR THIS SHORTFALL. THE ANNUAL MEDICARE COST REPORT IS THE SOURCE FOR THE COSTING METHODOLOGY FOR SCHEDULE H, LINE 6. COLLECTION PRACTICES SCHEDULE H, PART III, LINE 9B THE ACCOUNTS OF UNINSURED OR UNDERINSURED PATIENTS WHO HAVE APPLIED FOR MEDICAL ASSISTANCE OR FINANCIAL ASSISTANCE ARE HELD WITHOUT FURTHER COLLECTION ACTION, UNTIL THE APPLICATION PROCESS HAS BEEN COMPLETED. NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2 GREELEY COUNTY HEALTH SERVICES USES LOCAL AND STATE BASED DATA TO ASSIST ITS MEDICAL STAFF IN ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES AND PROVIDES BASIC FAMILY BASED PRIMARY CARE. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI, LINE 3 ALL PATIENTS PRESENTING TO OUR FACILITY WHO ARE UNINSURED/UNDERINSURED ARE PRESENTED WITH THE OPPORTUNITY FOR FINANCIAL ASSISTANCE. A PATIENT FINANCIAL ASSISTANCE COUNSELOR IS AVAILABLE FULL TIME FOR INQUIRIES & CONSULTING REGARDING ALL AVAILABLE FINANCIAL AID PROGRAMS. COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4 THE COMMUNITY IS A FRONTIER, RURAL COMMUNITY IN WESTERN KANSAS. THE RURAL POPULATION AMONG THE THREE COUNTIES SERVED BY THE FACILITY IS APPROXIMATELY 3,000 PEOPLE. THE SERVICE AREA COVERS 8,000 SQUARE MILES. THE AREA IS PREDOMINANTLY AGRICULTURAL BASED. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 5 THE FACILITY DOES HAVE AN OPEN MEDICAL STAFF WITH SUPPORTING MID-LEVEL PRACTICIONERS, A COUNTY GOVERNMENT APPOINTED COMMUNITY BOARD THAT RECEIVES APPROXIMATELY 3% SUPPORT FROM LOCAL TAX APPROPRIATIONS, AND HOLDS NUMEROUS COMMUNITY ACTIVITIES SUCH AS HEALTH FAIRS, FREE FLU SHOT CLINICS, AND NUMEROUS HEALTH AND WELLNESS ACTIVITIES TO PROMOTE COMMUNITY HEALTH. X X false false false false false false false false false SHEILA SCHEFFE MD 170508 0 0 0 0 0 11967 0 5792 0 188267 0 0 0 WENDEL ELLIS DO 294754 0 0 0 0 0 19893 0 17469 0 332116 0 0 0 RANDALL FAHRENHOLTZMD 208399 0 0 0 0 0 15420 0 12441 0 236260 0 0 0 ROBIN LIU MD 171653 0 0 0 0 0 13221 0 17469 0 202343 0 0 0 ORGANIZATION'S MISSION FORM 990, PART III, LINE 1 GREELEY COUNTY HEALTH SERVICES STRIVES TO ADDRESS THE HEALTHCARE NEEDS OF THE REGION THROUGH THE EFFECTIVE PARTNERING OF A COMPASSIONATE STAFF WITH QUALITY CARE ROOTED IN THE CONTINUOUS PURSUIT OF BEST PRACTICES. WE UTILIZE APPROPRIATE TECHNOLOGY TO MINIMIZE THE EFFECTS OF CHRONIC DISEASE, FOCUS ON PROVIDING PREVENTIVE MEDICINE AND TREAT EACH PATIENT'S MIND, BODY AND SOUL WITHIN THE FAMILY MEDICINE SPECTRUM OF CARE. ATTACHMENT OF AUDITED FINANCIAL STATEMENTS FORM 990, PART IV, LINE 20B PER THE IRS' FORM 990 INSTRUCTIONS, AN ORGANIZATION OPERATING ONE OR MORE HOSPITALS AT ANY TIME DURING THE YEAR MUST ATTACH A COPY OF ITS AUDITED FINANCIAL STATEMENTS TO THE TAX RETURN IF ITS TAX YEAR BEGAN AFTER MARCH 23, 2010. GREELEY COUNTY HEALTH SERVICES' AUDITED FINANCIAL STATEMENTS ARE NOT ATTACHED BECAUSE ITS TAX YEAR BEGAN ON JANUARY 1, 2010. MANAGEMENT DUTIES FORM 990, PART VI, SECTION A, LINE 13 GREELEY COUNTY HEALTH SERVICES HOLDS A MANAGEMENT CONTRACT WITH QUORUM HEALTH RESOURCES OF BRENTWOOD, TENNESSEE. QUORUM HEALTH RESOURCES APPOINTS A CHIEF EXECUTIVE OFFICER AND A CHIEF FINANCIAL OFFICER TO MANAGE DAY-TO-DAY OPERATIONS AND FINANCIAL RESPONSIBILITIES. FORM 990 REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11B AN INDEPENDENT ACCOUNTING FIRM PREPARES THE FORM 990. THE CFO THEN REVIEWS THE COMPLETE FORM 990 AND ALL REQUIRED SCHEDULES. ANY QUESTIONS OR CONCERNS ARE ADDRESSED AND ANY NECESSARY CHANGES ARE MADE PRIOR TO FILING. COMPENSATION REVIEW FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF DIRECTORS AND QUORUM HEALTH RESOURCES REVIEW BOTH THE CEO'S AND CFO'S COMPENSATION ANNUALLY. COMPARISON DATA FROM SIMILAR ORGANIZATIONS IS USED TO DETERMINE ANY PAY INCREASES. ALL DELIBERATIONS AND DECISIONS ARE DOCUMENTED. AVAILABILITY OF DOCUMENTS FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FILING STATUS FORM 990 THE FORM 990 AND REQUIRED SCHEDULES FOR GREELEY COUNTY HEALTH SERVICES ARE BEING FILED WITH THE AVAILABLE INFORMATION. IF IT IS DETERMINED THAT THE INFORMATION PROVIDED ON THE FORM 990 AND REQUIRED SCHEDULES HAS CHANGED, AN AMENDED FORM 990 AND REQUIRED SCHEDULES WILL BE FILED. SOUTHWIND HEALTH RESOURCES 514 BROADWAY TRIBUNE KS 67879 262767444 HEALTHCARE KS 0 0 false false false false false false false false false false false false false false false false false false