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HAYS MEDICAL CENTER INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
HAYS MEDICAL CENTER INC (EIN 48-0559088)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-02-14
IRS object ID
201130469349300918
Schema version
2009v1.2
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)
Timestamp2011-02-14T14:57:05-07:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN480559088EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1HAYS MEDICAL CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHAYSNameControl
Phone7856235000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12220 Canterbury DriveAddressLine1
CityHaysCity
StateKSState
ZIP Code67601ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJohn JeterName
TitleCEOTitle
Phone7856235523Phone
Date Signed2011-02-09DateSigned
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJohn Jeter CEONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12220 Canterbury DrAddressLine1
CityHaysCity
StateKSState
ZIP Code67601ZIPCode
FieldValueIRS element (for citing)
Gross Receipts185319574GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.haysmed.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1944YearFormation
State Legal DomicileKSStateLegalDomicile
Activity Or Mission DescriptionHays Medical Center is a tax-exempt charitable organization under Section 501(c)(3) of the Internal Revenue Code and is licensed by the State of Kansas Department of Health and Environment. The purpose of the Corporation is to provide health care facilities and services for the care and treatment of inpatients and outpatients who are acutely ill or who otherwise require medical care and related services. The core purpose of the Corporation is to help people be healthy. The Corporation is striving to become the best tertiary care center in rural America.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees1543TotalNbrEmployees
Total Nbr Volunteers210TotalNbrVolunteers
Total Gross UBI4932TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year485029ContributionsGrantsPriorYear
Contributions Grants Current Year697482ContributionsGrantsCurrentYear
Program Service Revenue Prior Year169481806ProgramServiceRevenuePriorYear
Program Service Revenue CY181500860ProgramServiceRevenueCY
Investment Income Prior Year323936InvestmentIncomePriorYear
Investment Income Current Year2251997InvestmentIncomeCurrentYear
Other Revenue Prior Year-1016344OtherRevenuePriorYear
Other Revenue Current Year517536OtherRevenueCurrentYear
Total Revenue Prior Year169274427TotalRevenuePriorYear
Total Revenue Current Year184967875TotalRevenueCurrentYear
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 Year80061748SalariesEtcPriorYear
Salaries Etc Current Year87778078SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year83372507OtherExpensePriorYear
Other Expenses Current Year87812824OtherExpensesCurrentYear
Total Expenses Prior Year163434255TotalExpensesPriorYear
Total Expenses Current Year175590902TotalExpensesCurrentYear
Revenues Less Expenses Prior Year5840172RevenuesLessExpensesPriorYear
Revenues Less Expenses CY9376973RevenuesLessExpensesCY
Total Assets BOY177254743TotalAssetsBOY
Total Assets EOY192482750TotalAssetsEOY
Total Liabilities BOY70975372TotalLiabilitiesBOY
Total Liabilities EOY71594488TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY106279371NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY120888262NetAssetsOrFundBalancesEOY
Mission DescriptionHays Medical Center is a tax-exempt charitable organization under Section 501(c)(3) of the Internal Revenue Code and is licensed by the State of Kansas Department of Health and Environment. The purpose of the Corporation is to provide health care facilities and services for the care and treatment of inpatients and outpatients who are acutely ill or who otherwise require medical care and related services. The core purpose of the Corporation is to help people be healthy. The Corporation is striving to become the best tertiary care center in rural America.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense150115229Expense
Revenue181500860Revenue
DescriptionPatient Care: Program services consist of routine and ancillary department healthcare services provided by a healthcare organization as defined in Section 501(c)(3) of the IRS code. Admissions: Acute-5,761; Newborn ICU-32; Newborn-715; Rehabilitation-169; Total admissions-6,677. Patient days: ICU/CPCU-7,567; Medical/Surgical-12,849; Oncology-1,593; Obstetrics-1,854; Pediatrics-599; Rehabilitation-1,707; Newborn ICU-311; Newborn-1,406; Total patient days-27,886. Other statistical information: Surgical procedures-7,600; Cardiac caths-871; Emergency room visits-13,029; Outpatient procedures-125,173; Medical oncology service visits-8,883; Clinic visits-123,758.Description
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense150115229TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096125NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1543NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed0Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
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 Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonWilliam Overbey CFONamePerson
Telephone Number7856235000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12220 CanterburyAddressLine1
CityHaysCity
StateKSState
ZIP Code67601ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Nancy Curtis
Chair0X000
Dennis L Bieker
Secretary0X000
Kenneth L Beran
Treasurer0X000
January Fields-Meehan
Physician/Board Member40X528479034060
John Lloyd
Physician/Board Member40X391304028904
Ross Buckles DO
Physician/Board Member40X344406025904
Tom McDonald MD
Board Member0X000
Daniel F Schippers
Board Member0X000
Jim Black DO
Board Member0X000
Jayne Clark
Board Member0X000
Gene Argo
Board Member0X000
Gary Shorman
Board Member0X000
Darrell D Werth MD
Physician/Board Member40X642463028072
Sharon Dreher
Board Member0X000
John H Jeter MD
President & CEO404943620118254X
William Overbey
Chief Financial Officer40250691067568X
Dale Montgomery
VP Support Services40168646048606X
Jodi Schmidt
Chief Development Officer40180876044531X
Bryce Young
Chief Operating Officer40252344066660X
Kenneth Lindsey
Chief Medical Officer40322407068645X
Christine Fisher
Physician401050528026372X
Jeffery Curtis
Physician401048720029372X
Gary Benton
Physician401094775023529X
Abdul Ahad Haleem
Physician40868709021472X
Alex De Carvalho
Physician40866981023529X
Richard Rajewski
Physician/Board Member40186467025040X
Joel Fort
Physician/Board member40581384026091X
FieldValueIRS element (for citing)
Total Reportable Comp From Org9273542TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation706609TotalOtherCompensation
Number Individuals GT100 K90NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Quest Diagnostics Inc
PO Box 719HaysKS67601Lab Services3964661
Inpatient Management Inc
1 McBride and Son Center DrChesterfieldMO63005Hospitalists program1247800
Manmohan Biring MD
1582 Charlton RoadSan MarinoCA91108Pulmonology services762109
Anesthesiologist Assoc of Hays
PO Box 821HaysKS67601Anesthesiology Svcs585890
Comp Health
PO Box 972651DallasTX75397Physician coverage544152
FieldValueIRS element (for citing)
Number Of Contractors GT100 K23NumberOfContractorsGT100K
Federated Campaigns0FederatedCampaigns
Membership Dues0MembershipDues
Fundraising Events0FundraisingEvents
Related Organizations671601RelatedOrganizations
Government Grants25881GovernmentGrants
All Other Contributions0AllOtherContributions
Noncash Contributions0NoncashContributions
Total Contributions697482TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Net patient service revenue6220001718588751718588750$0
Shared services900099794322600$7,943,226
Other operating revenue900099169382700$1,693,827
Nursing mother's resource center452000493204932$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue181500860TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2246392TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$2,246,392ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities0Securities
Other357304Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities
Other351699Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities0Securities
Other5605Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column5605TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$5,605ExclusionAmount
FieldValueIRS element (for citing)
Cntrbtns Rprtd Fundraising Events0CntrbtnsRprtdFundraisingEvents

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Equity in gain of Hadley Foundation90009951759400$517,594
Benefit plan market adjustment900099-5800-$58

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue517536TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column184967875TotalRevenueColumn
Related Or Exempt Function Income171858875RelatedOrExemptFunctionIncome
Unrelated Business Revenue4932UnrelatedBusinessRevenue
Exclusion$12,406,586ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total4421048Total
Program Services0ProgramServices
Management And General4421048ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total67599130Total
Program Services60461374ProgramServices
Management And General7137756ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total3105149Total
Program Services2606791ProgramServices
Management And General498358ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total8287326Total
Program Services6617607ProgramServices
Management And General1669719ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4365425Total
Program Services3664801ProgramServices
Management And General700624ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total92068Total
Program Services0ProgramServices
Management And General92068ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total594191Total
Program Services0ProgramServices
Management And General594191ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total77165Total
Program Services0ProgramServices
Management And General77165ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total80140Total
Program Services0ProgramServices
Management And General80140ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total16158435Total
Program Services14415324ProgramServices
Management And General1743111ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1137707Total
Program Services682624ProgramServices
Management And General455083ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1883985Total
Program Services1472924ProgramServices
Management And General411061ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total239396Total
Program Services166819ProgramServices
Management And General72577ManagementAndGeneral
Fundraising0Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total650016Total
Program Services384059ProgramServices
Management And General265957ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total2441992Total
Program Services2441992ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total10450111Total
Program Services7577202ProgramServices
Management And General2872909ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total1250197Total
Program Services1001941ProgramServices
Management And General248256ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Supplies32407367318864875208800
Bad debts115226871152268700
Repairs & maintenance331052228963764141460
Rent203903316347024043310
Taxes & assessments99234709923470

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2485465Total
Program Services681519ProgramServices
Management And General1803946ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total175590902Total
Program Services150115229ProgramServices
Management And General25475673ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY5735BOY
EOY5885EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY9543410BOY
EOY9397817EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY27284566BOY
EOY27864083EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3648507BOY
EOY3910829EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2895849BOY
EOY3392473EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis169439884LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec105757101LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY65919616BOY
EOY63682783EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY67957060BOY
EOY84228880EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY177254743BOY
EOY192482750EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY17725372BOY
EOY19744488EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY53250000BOY
EOY51850000EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY70975372BOY
EOY71594488EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY101027650BOY
EOY115118946EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY5251721BOY
EOY5769316EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY106279371BOY
EOY120888262EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY177254743BOY
EOY192482750EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
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

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance8603284BeginningOfYearBalance
Contributions332063Contributions
Investment Earnings Or Losses234201InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures57246OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance9112302EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance8152895BeginningOfYearBalance
Contributions249859Contributions
Investment Earnings Or Losses226379InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures25849OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance8603284EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.65BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.35PermanentEndowmentEOYBalance
Term Endowment EOY Balance0TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis350356OtherCostOrOtherBasis
Book Value350356BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis55883852OtherCostOrOtherBasis
Depreciation26850438Depreciation
Book Value29033414BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value0BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis104352357OtherCostOrOtherBasis
Depreciation75381286Depreciation
Book Value28971071BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis8853319OtherCostOrOtherBasis
Depreciation3525377Depreciation
Book Value5327942BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings63682783TotalOfBookValueLandBuildings

Other Assets OtherAssets (7 entries)

DescriptionDescriptionBook ValueBookValue
Assets whose use is limited by Board for capital improvements67974150
Interest in net assets of Hadley Foundation5769316
Funds held by Trustee3223274
Other long-term assets3805340
Other receivables2430134
Debt Issue Costs951317
Unamortized bond premium & discount75349
FieldValueIRS element (for citing)
Total Book Value Other Assets84228880TotalBookValueOtherAssets
Total Revenue184967875TotalRevenue
Total Expenses175590902TotalExpenses
Excess Or Deficit For Year9376973ExcessOrDeficitForYear
Net Unrealized GL On Investments0NetUnrealizedGLOnInvestments
Donated Services And Facilities0DonatedServicesAndFacilities
Investment Expenses0InvestmentExpenses
Prior Period Adjustments0PriorPeriodAdjustments
Other$2OtherAmount
Total Adjustments2TotalAdjustments
Excess Or Deficit Per FS9376975ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt181594960TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments0NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities0DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants0RecoveriesOfPriorYearGrants
Other Revenues0OtherRevenues
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal181594960RevenueSubtotal
Investment Expenses Not Included0InvestmentExpensesNotIncluded
Other Revenues Not Included3372915OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt3372915RevenueNotRptdOnFinStmt
Total Revenue Per Form990184967875TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt175584896TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities0DonatedServicesUseOfFacilities
Prior Year Adjustments0PriorYearAdjustments
Losses Reported0LossesReported
Other Expenses Included0OtherExpensesIncluded
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal175584896ExpensesSubtotal
Investment Expenses Not Included20InvestmentExpensesNotIncluded2
Other Expenses Not Included6006OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt6006ExpensesNotRptdOnFinStmt
Total Expenses Per Form990175590902TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchD_P05_S00_L04Schedule D, Part V, Line 4The endowed funds held by the Hays Medical Center Foundation are used to help meet both the immediate and long range health care needs of patients of Hays Medical Center. The Hays Medical Center Foundation provides grants and assistance to Hays Medical Center for property and equipment acquisitions, education, and community health issues.
SchD_P11_S00_L08Schedule D, Part XI, Line 8Rounding
SchD_P12_S00_L04bSchedule D, Part XII, Line 4bGifts and bequests-680,601; investment income-2,243,251; Gain on disposal of assets-5,605; Interest in change in net assets of Hadley Foundation-517,595; Audit reclassifications-(74,137)
SchD_P13_S00_L04bSchedule D, Part XIII, Line 4bInvestment management fees-80,140; Audit reclassifications (74,134)

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 Percentage1.25FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense2715006TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense2715006NetCommunityBenefitExpense
Percent Of Total Expense0.0165PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense4511370TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense4511370NetCommunityBenefitExpense
Percent Of Total Expense0.0275PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense7226376TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense7226376NetCommunityBenefitExpense
Percent Of Total Expense0.0440PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense229630TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense229630NetCommunityBenefitExpense
Percent Of Total Expense0.0014PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense590403TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense590403NetCommunityBenefitExpense
Percent Of Total Expense0.0036PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense9282383TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense9282383NetCommunityBenefitExpense
Percent Of Total Expense0.0566PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense32474TotalCommunityBenefitExpense
Net Community Benefit Expense32474NetCommunityBenefitExpense
Percent Of Total Expense0.0002PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense10134890TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense10134890NetCommunityBenefitExpense
Percent Of Total Expense0.0618PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense17361266TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense17361266NetCommunityBenefitExpense
Percent Of Total Expense0.1058PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense116133TotalCommunityBuildingExpense
Net Community Building Expense116133NetCommunityBuildingExpense
Percent Of Total Expense0.0007PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense116133TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense116133NetCommunityBuildingExpense
Percent Of Total Expense0.0007PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$4,474,842BadDebtExpenseAmount
Amount Attributable To330158AmountAttributableTo
Amount Reimbursed By Medicare57428476AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare53703728CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall3724748MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV (2 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24HoursCritical Access HospitalCriticalAccessHospital
Hays Medical Center
2220 CanterburyHaysKS67601XXX
Pawnee Valley Community Hospital Inc
923 Carroll AveLarnedKS67550XXXX

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Costing Method UsedHays Medical Center's cost accounting system was used to calculate subsidized health services, health professions education, and community health improvement services. A cost-to-charge ratio was computed and used to calculate charity care and unreimbursed Medicaid reported on line 7.CostingMethodUsed
Subsidized Health Services ExplnPhysician clinic net costs included in subsidized health services totaled $7,235,705.SubsidizedHealthServicesExpln
Percent Of Total Expense ExplnBad debt expense of $11,522,687 is included in Part IX line 25. This amount was subtracted from total expenses when computing the denominator for the percentage calculated for line 7(f).PercentOfTotalExpenseExpln
Bad Debt FootnoteBad debt expense was calculated using the same cost-to-charge ratio computed for charity care and unreimbursed Medicaid. The estimate for the amount of bad debt expense attributable to patients that would qualify for charity care is based upon a report obtained from the collection agency showing indigent patients that have been referred to collection. The following is the information contained in the footnotes regarding patients accounts receivable in the audited consolidated financial statements of Hays Medical Center. Patient service revenue is recorded at HMC's established rates with contractual adjustments from third-party payors, charity allowances and other discounts deducted to arrive at net patient service revenue. Patient accounts receivable represent an estimate of net realizable amounts due from patients, third-party payors, and others for unpaid patient services, which is determined on historical payment experience. Retroactively calculated contractual adjustments arising under reimbursement agreements with Medicare and other third-party payors are accrued on an estimated basis in the periods the related services are rendered and adjusted in future periods as final settlements are determined. Medicare is HMC's most significant third-party payor.BadDebtFootnote
Shortfall As Community BenefitThe Medicare cost finding was the costing methodology used to determine the above costs. Allowable costs of care reported on line 6 were determined using amounts from Worksheets D and D-1 in the Hays Medical Center Medicare cost report for the fiscal year ended June 30, 2010.ShortfallAsCommunityBenefit
Debt Collection PolicyWhenever possible, the customer service representatives (CSR's) of Hays Medical Center try to determine the estimated self-pay balance prior to the patient receiving services. Charity care eligibility is first considered at this point in time. In addition, if full payment is not received or payment is not made within 30 days, the CSR contacts the patient. If it is determined that at least a 2 year payment plan cannot be established with the patient, the CSR will screen for charity care and request that the charity care application be completed by the patient.DebtCollectionPolicy
Needs AssessmentHays Medical Center is in the process of performing an assessment of the health care needs of the communities it serves; however, this is assessment is not yet completed.NeedsAssessment
Patient Education AssistanceInformation regarding the Hays Medical Center charity care program is located on the Hays Medical Center website for patients and community members to view, and the financial assistance application is also on the website to print off and complete. In addition, if a customer service representative of Hays Medical Center contacts a patient about a bill and in visiting with them they determine that patient could possibly qualify for the hospital's charity care policy, they will send the application to the patient as well.PatientEducationAssistance
Community InformationHays Medical Center is located in Hays, Kansas, which has a population of approximately 20,000 people, as of the last census. One of the State of Kansas' Regents universities is also located in Hays, so the population includes many college-aged students. The median household income of Hays was $31,501. The number of families below poverty level were 315 or 6.7%; however, the number of individuals below the poverty line were 2,817 or 14.9% of the population. Approximately 6% of the hospital's revenue is from services provided to patients eligible for Medicaid. Hays Medical Center is the only hospital in the city of Hays. In addition, since this is a rural area and because it is the only hospital providing tertiary level care in the region, Hays Medical Center provides certain services to the whole western half of the State of Kansas.CommunityInformation
Community Building ActivitiesHays Medical Center helps to support the First Care Clinic in Hays, KS. This clinic was established to help lower income individuals receive health care at a reduced cost. This support helps to increase the number of individuals in Hays, KS who receive quality health care.CommunityBuildingActivities
Other InformationHays Medical Center promotes the health of the community by extending medical privileges to most qualified, local physicians. In addition, the majority of the Board of Directors live and work in the city of Hays, but they are not employed by Hays Medical Center.OtherInformation
Affiliated Health Care SystemHays Medical Center is not a part of an affiliated health care system.AffiliatedHealthCareSystem

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (17 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
John H Jeter MD
367852010915001736001058980123560612616000
Kenneth Lindsey
2648000438510137560568200118250391052000
Bryce Young
200454046847050430520650145950319004000
William Overbey
200554046871032660520810154870318259000
Jodi Schmidt
1422020243370143370329320115990225407000
Dale Montgomery
1324020243360119080338750147310217252000
January Fields-Meehan
4420000685950178840134750205850562539000
John Lloyd
322000063627056770134750154290420208000
Ross Buckles DO
18384601448700156900134750124290370310000
Joel Fort
3500000228494028900134750126160607475000
Richard Rajewski
167769013630050680103730146670211507000
Darrell D Werth MD
5290700965130168800134750145970670535000
Gary Benton
54000005536600111501347501005401118304000
Christine Fisher
6000000449688084001347501289701076900000
Jeffery Curtis
60000004487200001347501589701078092000
Abdul Ahad Haleem
5000000341009027700085750128970890181000
Alex De Carvalho
5000000364981020000134750100540890510000

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchJ_P01_S00_L01aSchedule J, Part I, Line 1aBenefits identified include tax indemnification on health claims and health club dues. Both benefits are available to CEO and included in taxable income.
SchJ_P01_S00_L03Schedule J, Part I, Line 3The CEO, officers, and key employees' salaries are reviewed annually by an independent consulting group and the Compensation Committee, which is made up of members of the Board.
SchJ_P01_S00_L04Schedule J, Part I, Line 4Officers and key employees are eligible to participate in a non-qualified retirement plan. Contributions from employer are contributed to the plan on an annual basis. Contributions to the plan for listed persons are included on Schedule J as a component of deferred compensation. Contribution amounts for listed persons for FYE 6-30-10 were: Officers-$114,529 ; key employees-$136,719 .
SchJ_P01_S00_L06Schedule J, Part I, Line 6A portion of incentive compensation for officers and key employees is determined by net earnings exceeding budget for the fiscal year.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuer
Kansas Development Finance Authority
48106658948543BGR32003-11-1216000878Construction00
Kansas Development Finance Authority
48106658948543BJE92005-11-2217950000Construction and equipment00
Kansas Development Finance Authority
48106658948543BJD12005-11-2223635944Construction00

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Total ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundAmount DefeasedAmountDefeasedAmount UnspentAmountUnspentIssuance Costs From ProceedsIssuanceCostsFromProceedsWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
1666572812000240072648901593921520050011
1795000000082661601712493420060111
2363594420232500031600002331994420060111

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
000000001
000000001
000000000

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
000000
000001
000000

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Blue Cross Blue Shield of Kansas
Gary Shorman is a director on BCBS board53800000Insurance reimbursements on patient accounts0
Eagle Communications
Gary Shorman is CEO and employee/owner115539Payments for cable/internet services1
Jeter Law Firm LLP
Family member of John Jeter CEO5562Payment for legal services0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P04_S00_L20Form 990, Part IV, Line 20Beginning March 1, 2010, HaysMed Partners, Inc, a related organization to Hays Medical Center, signed an agreement with Pawnee County, KS commissioners to operate Pawnee Valley Community Hospital in Larned, KS. Hays Medical Center provides several services, such as accounting, information technology, etc, that it directly bills Pawnee Valley Community Hospital for; however, the ownership of the assets and the liability for any losses of Pawnee Valley Community Hospital remains with Pawnee County, KS. Due to this arrangement, Pawnee Valley Community Hospital is reported as a related organization, but its financial and other information is reported on its own, separate Form 990.
F990_P05_S00_L03bForm 990, Part V, Line 3bHays Medical Center received an extension to file the 2009 Form 990-T. The return will be filed by the extended due date of May 15, 2011.
F990_P06_S0B_L11Form 990, Part VI, Section B, Line 11Form 990 was reviewed with the officers and the Board Finance committee.
F990_P06_S0B_L12cForm 990, Part VI, Section B, Line 12cOfficers, directors, and key employees, along with all associates are required to complete a conflict of interest statement annually. The statements are used to monitor and enforce compliance with the policy.
F990_P06_S0B_L15Form 990, Part VI, Section B, Line 15The CEO, officers and key employees' salaries are reviewed annually by an independent consulting group and the Compensation Committee, which is made up of members of the Board.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19These documents are not made available to the public. Financial statements are released to bond holders on a quarterly basis.
SchB_P01_S00_L00Schedule B, Part IHays Medical Center is a pass-thru for several grants that are distributed to outreaching hospitals. Total grant monies received by Hays Medical Center during the fiscal year ended 6/30/10 for this purpose were $141,744.
SchL_P04_S00_L00Schedule L, Part IVThe insurance reimbursements received by Hays Medical Center Inc from Blue Cross Blue Shield of Kansas only represents approximately 2% of Blue Cross Blue Shield's annual disbursements.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNA
Hays Medical Center Foundation
2220 CanterburyHaysKS67601481179684Provide grants and allocations to Hays Medical Center Inc. for property, equip and community healthKS501(c)(3)509(a)(3) Type 1N/A
HaysMed Partners Inc
2220 CanterburyHaysKS67601270877152Owns management contract for Pawnee Valley Community HospitalKS501(c)(3)170(b)(1)(A)(iii)N/A
Pawnee Valley Community Hospital Inc
2220 CanterburyHaysKS67601481253246Hospital operated by Hays Medical CenterKS501(c)(3)170(b)(1)(A)(iii)N/A
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Hays Medical Center Foundation
c671601
Pawnee Valley Community Hospital Inc
k109361
Pawnee Valley Community Hospital Inc
n60556
Pawnee Valley Community Hospital Inc
d1543054
Hays Medical Center Foundation
p157957