STRATEGY STUDIO / PUBLIC DATA EXPLORER

DECATUR HEALTH SYSTEMS INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
DECATUR HEALTH SYSTEMS INC (EIN 80-0025964)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-14
IRS object ID
201143189349300344
Schema version
2010v3.4
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-11-14T09:09:03-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11551 N WATERFRONT PKWY STE 300AddressLine1
CityWICHITACity
StateKSState
ZIP Code672066601ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN800025964EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1DECATUR HEALTH SYSTEMS INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlDECANameControl
Phone7854752208Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1810 WEST COLUMBIA STREETAddressLine1
CityOBERLINCity
StateKSState
ZIP Code67749ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLYNN DOEDENName
TitleCEOTitle
Phone7854752208Phone
Date Signed2011-11-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameSTEVEN L WEBBName
Phone3162652811Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonLYNN DOEDENNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1810 WEST COLUMBIA STREETAddressLine1
CityOBERLINCity
StateKSState
ZIP Code67749ZIPCode
FieldValueIRS element (for citing)
Gross Receipts6915813GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.DECATURHEALTHSYSTEMS.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2002YearFormation
State Legal DomicileKSStateLegalDomicile
Activity Or Mission DescriptionTHE MISSION OF DECATUR HEALTH SYSTEMS IS TO PROVIDE HIGH QUALITY CARE FOR RURAL AMERICA BY CARING AND SHARING FROM THE HEART.ActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members5NbrIndependentVotingMembers
Total Nbr Employees145TotalNbrEmployees
Total Nbr Volunteers5TotalNbrVolunteers
Total Gross UBI54077TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year239647ContributionsGrantsPriorYear
Contributions Grants Current Year64913ContributionsGrantsCurrentYear
Program Service Revenue Prior Year6219175ProgramServiceRevenuePriorYear
Program Service Revenue CY6751898ProgramServiceRevenueCY
Investment Income Prior Year8097InvestmentIncomePriorYear
Investment Income Current Year5994InvestmentIncomeCurrentYear
Other Revenue Prior Year83225OtherRevenuePriorYear
Other Revenue Current Year74765OtherRevenueCurrentYear
Total Revenue Prior Year6550144TotalRevenuePriorYear
Total Revenue Current Year6897570TotalRevenueCurrentYear
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 Year4525946SalariesEtcPriorYear
Salaries Etc Current Year4314061SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2414243OtherExpensePriorYear
Other Expenses Current Year2538115OtherExpensesCurrentYear
Total Expenses Prior Year6940189TotalExpensesPriorYear
Total Expenses Current Year6852176TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-390045RevenuesLessExpensesPriorYear
Revenues Less Expenses CY45394RevenuesLessExpensesCY
Total Assets BOY1808410TotalAssetsBOY
Total Assets EOY2183654TotalAssetsEOY
Total Liabilities BOY1808410TotalLiabilitiesBOY
Total Liabilities EOY2183654TotalLiabilitiesEOY
Net Assets Or Fund Balances EOY0NetAssetsOrFundBalancesEOY
Mission DescriptionTHE MISSION OF DECATUR HEALTH SYSTEMS IS TO PROVIDE HIGH QUALITY CARE FOR RURAL AMERICA BY CARING AND SHARING FROM THE HEART.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense5977687Expense
Grants0Grants
Revenue6751898Revenue
DescriptionTHE ORGANIZATION OPERATED AN ACUTE CARE HOSPITAL TO PATIENTS IN THE CITY OF OBERLIN, KANSAS AND THE COMMUNITY OF DECATUR COUNTY. THE ORGANIZATION PROVIDED INPATIENT AND OUTPATIENT HEALTH SERVICES AS WELL AS LONG-TERM CARE SERVICES TO THE ELDERLY FOR A TOTAL OF 14,305 PATIENT DAYS DURING 2010.Description
Total Program Service Expense5977687TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedfalseFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109621NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees145NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members5NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonLYNN DOEDENNamePerson
Telephone Number7854752208TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 268AddressLine1
CityOBERLINCity
StateKSState
ZIP Code67749ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
RON JANSONIUS
CHAIRMAN/BOARD MEMBER2.5XX000
GARY WALTER
SECRETARY/BOARD MEMBER1.0XX000
PAM WILSON
TREASURER/BOARD MEMBER1.0XX000
CONNIE M GRAFEL
BOARD MEMBER0.5X000
KATHY NAUER
BOARD MEMBER0.5X000
LYNN DOEDEN
CEO40.0X11636007291
AMANDA FORTIN
CFO40.0X5247205569
FieldValueIRS element (for citing)
Total Reportable Comp From Org168832TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation12860TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Fundraising Events5130FundraisingEvents
Government Grants59783GovernmentGrants
Total Contributions64913TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICE REVENUEDescription
Business Code621300BusinessCode
Total Revenue Column6751898TotalRevenueColumn
Related Or Exempt Function Income6751898RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue6751898TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column5994TotalRevenueColumn
Exclusion$5,994ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Income Fundraising Events14655GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events5130CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses18243FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-3588TotalRevenueColumn
Exclusion-$3,588ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
MEALS72221012132$12,132
WHEAT RIDGE MANAGEMENT FEE5610005345853458
MISCELLANEOUS90009912763$12,144619
FieldValueIRS element (for citing)
Total Other Revenue78353TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column6897570TotalRevenueColumn
Related Or Exempt Function Income6751898RelatedOrExemptFunctionIncome
Unrelated Business Revenue54077UnrelatedBusinessRevenue
Exclusion$26,682ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total181692Total
Management And General181692ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total3388875Total
Program Services3021082ProgramServices
Management And General367793ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total92667Total
Program Services90385ProgramServices
Management And General2282ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total403956Total
Program Services394007ProgramServices
Management And General9949ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total246871Total
Program Services240791ProgramServices
Management And General6080ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total16946Total
Management And General16946ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total69210Total
Management And General69210ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total459765Total
Program Services343274ProgramServices
Management And General116491ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total9882Total
Program Services330ProgramServices
Management And General9552ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total929594Total
Program Services907405ProgramServices
Management And General22189ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total263633Total
Program Services257140ProgramServices
Management And General6493ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total21072Total
Program Services13433ProgramServices
Management And General7639ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total5944Total
Program Services4133ProgramServices
Management And General1811ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total4617Total
Program Services4503ProgramServices
Management And General114ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total62308Total
Program Services60773ProgramServices
Management And General1535ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total48930Total
Program Services47725ProgramServices
Management And General1205ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT EXPENSE214592214592
DUES & SUBSCRIPTIONS33377230436829404
REPAIRS & MAINTENANCE54237530201217
MINOR EQUIPMENT350381414920889
MISCELLANEOUS857565771998

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total6852176Total
Program Services5977687ProgramServices
Management And General874489ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY83011BOY
EOY87985EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY7389BOY
EOY224469EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY862711BOY
EOY1268570EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY17191EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY89511BOY
EOY104962EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY30578BOY
EOY47974EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis1057453LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec874950LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY235210BOY
EOY182503EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY500000BOY
EOY250000EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1808410BOY
EOY2183654EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY562408BOY
EOY897735EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY2200BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1243802BOY
EOY1285919EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1808410BOY
EOY2183654EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1808410BOY
EOY2183654EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses45394ReconcilationRevenueExpenses
Reconcilation Other Changes-45394ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$1,540GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB1540TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1057453OtherCostOrOtherBasis
Depreciation874950Depreciation
Book Value182503BookValue
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildings
Total Of Book Value Land Buildings182503TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM MEDICARE0
INVESTMENT IN WHEAT RIDGE250000
FieldValueIRS element (for citing)
Total Book Value Other Assets250000TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO DECATUR COUNTY HOSPITALDescription
Amount$1,285,919Amount
FieldValueIRS element (for citing)
Total Of Amounts1285919TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierUNCERTAIN TAX POSITIONSIdentifier
Return ReferenceSCHEDULE D, PART X, LINE 2ReturnReference
ExplanationManagement 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.Explanation

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLF BENEFITNameOfEvent1
Gross Receipts Event119785GrossReceiptsEvent1
Charitable Contributions Event15130CharitableContributionsEvent1
Gross Revenue Event114655GrossRevenueEvent1
Cash Prizes Event115400CashPrizesEvent1
Non Cash Prizes Event11359NonCashPrizesEvent1
Rent Facility Costs Event11080RentFacilityCostsEvent1
Food And Beverage Event10FoodAndBeverageEvent1
Entertainment Event10EntertainmentEvent1
Other Direct Expenses Event1404OtherDirectExpensesEvent1
Total Number Of Other Events0TotalNumberOfOtherEvents
Gross Receipts Total19785GrossReceiptsTotal
Charitable Contributions Total5130CharitableContributionsTotal
Gross Revenue Total Events14655GrossRevenueTotalEvents
Cash Prizes Total Events15400CashPrizesTotalEvents
Non Cash Prizes Total Events1359NonCashPrizesTotalEvents
Rent Facility Costs Total Events1080RentFacilityCostsTotalEvents
Food And Beverage Total Events0FoodAndBeverageTotalEvents
Entertainment Total Events0EntertainmentTotalEvents
Other Direct Expenses Total Events404OtherDirectExpensesTotalEvents
Direct Expense Summary Events18243DirectExpenseSummaryEvents
Net Income Summary-3588NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense6601TotalCommunityBenefitExpense
Net Community Benefit Expense6601NetCommunityBenefitExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense499628TotalCommunityBenefitExpense
Direct Offsetting Revenue539909DirectOffsettingRevenue

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense506229TotalCommunityBenefitExpense
Direct Offsetting Revenue539909DirectOffsettingRevenue
Net Community Benefit Expense6601NetCommunityBenefitExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense8492TotalCommunityBenefitExpense
Direct Offsetting Revenue7939DirectOffsettingRevenue
Net Community Benefit Expense613NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense8492TotalCommunityBenefitExpense
Direct Offsetting Revenue7939DirectOffsettingRevenue
Net Community Benefit Expense613NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense514721TotalCommunityBenefitExpense
Direct Offsetting Revenue547848DirectOffsettingRevenue
Net Community Benefit Expense7214NetCommunityBenefitExpense
Percent Of Total Expense0.00110PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$165,901BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare5234323AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare6071455CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-837132MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1DECATUR HEALTH SYSTEMS INCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1810 W COLUMBIAAddressLine1
CityOBERLINCity
StateKSState
ZIP Code67749ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1DECATUR HEALTH SYSTEMS INCBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
AMOUNT OF BAD DEBT REMOVED FROM PART I, LINE 7, CALCULATIONSCHEDULE H, PART I, LINE 7THE AMOUNT OF BAD DEBT REMOVED FROM PART I, COLUMN F, CALCULATIONS $214,592.
METHOD USED TO DETERMINE THE COST-TO-CHARGE RATIOPART I, LINE 7THE COST-TO-CHARGE RATIO WAS USED AS THE COSTING METHODOLOGY TO REPORT CHARITY CARE AND OTHER COMMUNITY BENEFITS AT COST. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES.
METHOD USED TO DETERMINE BAD DEBT EXPENSEPART III, LINE 4THE COST METHODOLOGY TO REPORT THE ORGANIZATION'S BAD DEBT EXPENSE ON LINE 2 IS ACTUAL COST. PATIENTS HAVE 30 DAYS TO MAKE A PAYMENT ON THEIR ACCOUNT. AFTER THAT 30 DAYS IF NO PAYMENT IS MADE THEN A REMINDER IS SENT REQUESTING A PAYMENT IN THE NEXT TWO WEEKS. IF NO PAYMENT IS RECEIVED THEN A FINAL NOTICE IS SENT STATING THAT A PAYMENT MUST BE MADE WITHIN TWO MORE WEEKS. AT THAT TIME IF NO PAYMENT IS RECEIVED THE ACCOUNT IS MOVED TO BAD DEBT.
MEDICARE SHORTFALLPART III, LINE 8SSERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY.
COLLECTION PRACTICESPART III, LINE 9BIF THE PATIENT QUALIFIES FOR CHARITY CARE PER WRITTEN HOSPITAL CRITERIA, THE QUALIFYING BALANCE IS WRITTEN OFF TO CHARITY CARE AND NO FURTHER COLLECTION EFFORTS ARE MADE.
NEEDS ASSESSMENTTHE ORGANIZATION SENDS OUT SATISFACTION SURVEYS AND ASKS FOR FEEDBACK ON WHAT THE COMMUNITY FEELS IT WOULD BENEFIT FROM.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCETHE FACILITY INFORMS AND EDUCATES PATIENTS BY HAVING THE SOCIAL SERVICES MANAGER SPEAK WITH PATIENTS AND GIVE THEM ALL OF THE INFORMATION NECESSARY TO EDUCATE THEM ON THE DIFFERENT ASSISTANCE PROGRAMS AVAILABLE TO THEM.
COMMUNITY LIMITATIONTHE ORGANIZATION SERVES A SMALL RURAL AREA IN NORTHWEST KANSAS. THE TOWN HAS A POPULATION OF APPROXIMATELY 1200 PEOPLE. THE MAIN ECONOMY IS AGRICULTURE.
PROMOTION OF COMMUNITY HEALTHDECATUR HEALTH SYSTEMS, INC. HAS A COMMUNITY BOARD AND AN OPEN MEDICAL STAFF.
COMMUNITY BENEFIT REPORT STATE FILINGSKANSAS

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
FORM 990 REIVEW PROCESSFORM 990, PART VI, SECTION B, LINE 11BAN INDEPENDENT ACCOUNTING FIRM PREPARES THE FORM 990. THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S CFO. ANY QUESTIONS OR CONCERNS ARE ADDRESSED AND ANY CHANGES ARE MADE IF NECESSARY. COPIES OF THE FORM 990 ARE THEN PROVIDED TO THE ORGANIZATION'S ENTIRE GOVERNING BODY PRIOR TO FILING WITH THE IRS.
CONFLICT OF INTEREST POLICYFORM 990, PART VI, SECTION B, LINE 12CAN ANNUAL REVIEW OF THE CONFLICT OF INTEREST POLICY IS COMPLETED BY BOARD MEMBERS, OFFICERS, AND EMPLOYEES. IF A POTENTIAL CONFLICT IS PRESENT THE BOARD MEMBERS WILL DELIBERATE TO DETERMINE WHETHER AN ACTUAL CONFLICT EXIST. A CONFLICTED BOARD MEMBER ABSTAINS FROM VOTING ON THE MATTER.
CEO COMPENSATION REVIEWFORM 990, PART VI, SECTION B, LINE 15ATHE BOARD OF DIRECTORS PERFORM AN ANNUAL EVALUATION OF THE CEO TO DETERMINE COMPENSATION AND RAISES. A COMPENSATION COMMITTEE REVIEWS THE KHA COMPENSATION DATA ANNUALLY TO DETERMINE WHETHER COMPENSATION IS APPROPRIATE GIVEN THE GEOGRAPHICAL LOCATION AND THE ORGANIZATION'S SIZE. USING THE EVALUATION AND THE KHA COMPENSATION DATA, THE BOARD DELIBERATES ANY COMPENSATION ADJUSTMENTS. THE DELIBERATION AND DECISION ARE DOCUMENTED IN THE BOARD MINUTES.
OTHER OFFICERS COMPENSATION REVIEWFORM 990, PART VI, SECTION B, LINE 15BTHE CEO PERFORM AN ANNUAL EVALUATION OF THE CFO AND ALL DEPARTMENT HEADS TO DETERMINE COMPENSATION AND RAISES. THE ANNUAL KHA COMPENSATION DATA IS UTILIZED AS A GUIDE FOR DETERMINING APPROPRIATE COMPENSATION. EVALUATION RECORDS AND COMPENSATION ADJUSTMENTS ARE DOCUMENTED AND FILED IN THE EMPLOYEE'S FILE.
AVAILABILITY OF DOCUMENTSFORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
CHANGE IN NET ASSETS RECONCILIATIONFORM 990, PART XI, LINE 5CHANGE IN AMOUNT DUE TO LESSOR $(45,394)
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:RON JANSONIUS TITLE:CHAIRMAN/BOARD MEMBER HOURS:3
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:GARY WALTER TITLE:SECRETARY/BOARD MEMBER HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:PAM WILSON TITLE:TREASURER/BOARD MEMBER HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:CONNIE M. GRAFEL TITLE:BOARD MEMBER HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:KATHY NAUER TITLE:BOARD MEMBER HOURS:1

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1DECATUR COUNTY HOSPITALBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1810 W COLUMBIAAddressLine1
CityOBERLINCity
StateKSState
ZIP Code67749ZIPCode
FieldValueIRS element (for citing)
EIN486110898EIN
Primary ActivitiesHOSPITALPrimaryActivities
Legal Domicile StateKSLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status115PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg