PAWNEE VALLEY COMMUNITY HOSPITAL INC: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- PAWNEE VALLEY COMMUNITY HOSPITAL INC (EIN 48-1253246)
- Tax period
- 2024-07-01 to 2025-06-30
- Filed
- 2026-05-08
- IRS object ID
- 202631289349302533
- Schema version
- 2024v5.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2026-05-08T11:45:17-05:00 | ReturnTs |
| Tax Period End | 2025-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 481026809 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Wendling Noe Nelson & Johnson LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 623 SW 10th Ave Suite 300 | AddressLine1Txt |
| City | Topeka | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 66612 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 481253246 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pawnee Valley Community Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PAWN | BusinessNameControlTxt |
| Phone | 6202853161 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 923 Carroll Ave | AddressLine1Txt |
| City | Larned | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67550 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Shae Veach | PersonNm |
| Person Title | President | PersonTitleTxt |
| Phone | 6202853161 | PhoneNum |
| Signature | 2026-05-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Eric L Otting | PreparerPersonNm |
| PTIN | P00298454 | PTIN |
| Phone | 7852334226 | PhoneNum |
| Preparation | 2026-05-07 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Shae Veach | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 923 Carroll Ave | AddressLine1Txt |
| City | Larned | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67550 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $22,224,026 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.pawneevalleyhospital.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2001 | FormationYr |
| Legal Domicile State | KS | LegalDomicileStateCd |
| Activity Or Mission | Pawnee Valley Community Hospital, Inc. 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 Organization is to improve the quality of life for the communities we serve through exceptional healthcare and service excellence. The Organization is striving to be the best Critical Access Hospital in rural America. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 2 | VotingMembersIndependentCnt |
| Total Employee | 163 | TotalEmployeeCnt |
| Total Volunteers | 104 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $46,479 | PYContributionsGrantsAmt |
| CY Contributions Grants | $162,630 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $19,767,423 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $21,733,650 | CYProgramServiceRevenueAmt |
| PY Investment Income | $54,684 | PYInvestmentIncomeAmt |
| CY Investment Income | $145,147 | CYInvestmentIncomeAmt |
| PY Other Revenue | $172,045 | PYOtherRevenueAmt |
| CY Other Revenue | $182,599 | CYOtherRevenueAmt |
| PY Total Revenue | $20,040,631 | PYTotalRevenueAmt |
| CY Total Revenue | $22,224,026 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $12,402 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $4,369 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,974,477 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,172,789 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $86,241 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,650,333 | PYOtherExpensesAmt |
| CY Other Expenses | $9,822,209 | CYOtherExpensesAmt |
| PY Total Expenses | $19,637,212 | PYTotalExpensesAmt |
| CY Total Expenses | $19,999,367 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $403,419 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,224,659 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $13,833,734 | TotalAssetsBOYAmt |
| Total Assets EOY | $14,200,279 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $11,222,055 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,925,527 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,611,679 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,274,752 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Pawnee Valley Community Hospital, Inc. 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 Organization is to provide healthcare 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 improve the quality of life for the communities we serve through exceptional healthcare and service excellence. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $17,797,607 | ExpenseAmt |
| Grant | $4,369 | GrantAmt |
| Revenue | $21,743,550 | RevenueAmt |
| Desc | Patient care: Program services consist of routine and ancillary department healthcare services provided by a healthcare organization as described in 501(c)(3) of the IRS code. | Desc |
| Total Program Service Expenses | $17,797,607 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 163 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 2 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Michelle Beckner | PersonNm |
| Phone | 7856232350 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2220 Canterbury Drive | AddressLine1Txt |
| City | Hays | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67601 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| Shae Veach | |||||||||
| President | 4.00 | 36.00 | Yes (X) | Yes (X) | $0 | $277,582 | $89,309 | ||
| John Haas | |||||||||
| Vice President | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Michelle Beckner | |||||||||
| Treasurer | 4.00 | 36.00 | Yes (X) | Yes (X) | $0 | $366,538 | $103,465 | ||
| Sarah Johnson | |||||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | ||||
| Edward Herrman | |||||||||
| Secretary | 4.00 | 36.00 | Yes (X) | Yes (X) | $0 | $815,354 | $178,177 | ||
| Terry Siek | |||||||||
| Director thru. 09/24 | 4.00 | 36.00 | Yes (X) | $0 | $270,074 | $50,056 | |||
| Joben Rieth | |||||||||
| Director Eff. 03/25 | 4.00 | 36.00 | Yes (X) | $0 | $0 | $0 | |||
| Melanie Urban | |||||||||
| Administrator | 40.00 | Yes (X) | $0 | $161,871 | $42,312 | ||||
| Angela Beck | |||||||||
| APRN | 40.00 | $151,703 | $0 | $18,395 | Yes (X) | ||||
| Susan Aistrup | |||||||||
| APRN | 40.00 | $135,753 | $0 | $16,395 | Yes (X) | ||||
| Arlo Reimer | |||||||||
| Chief of Staff | 40.00 | $297,706 | $0 | $47,354 | Yes (X) | ||||
| Dusty Atterbury | |||||||||
| APRN | 40.00 | $157,519 | $0 | $9,523 | Yes (X) | ||||
| Calvin Kruger | |||||||||
| Physician Assistant | 40.00 | $156,478 | $0 | $8,959 | Yes (X) | ||||
| George Harms | |||||||||
| Former Treasurer | 0.00 | $0 | $593,894 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $899,159 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,485,313 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $563,945 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 11 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Hays Medical Center | |||||
| 2220 Canterbury Drive | Hays | KS | 67601 | Contract Services | $3,019,336 |
| Qualivis LLC | |||||
| PO Box 123847 | Dallas | TX | 752674913 | Contract Labor | $437,826 |
| G E Precision Healthcare LLC | |||||
| PO Box 96483 | Chicago | IL | 60693 | Website Services | $249,608 |
| Quest Diagnostics | |||||
| PO Box 772976 | Chicago | IL | 606770276 | Lab Fees | $158,770 |
| Luminare Health Benefits | |||||
| 6133 N River Road | Rosemont | IL | 60018 | TPA Fees | $131,148 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $150,000 | RelatedOrganizationsAmt |
| All Other Contributions | $12,630 | AllOtherContributionsAmt |
| Total Contributions | $162,630 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient service revenue | 622000 | $20,890,033 | $20,890,033 |
| 340b drug program | 456110 | $769,254 | $769,254 |
| Lab fairs | 900099 | $29,391 | $29,391 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $44,972 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $44,972 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $21,733,650 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $138,497 | TotalRevenueColumnAmt |
| Exclusion | $138,497 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $9,900 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $9,900 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,900 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,900 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $6,650 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $6,650 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,650 | TotalRevenueColumnAmt |
| Exclusion | $6,650 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Meals sold to employees and guest | Desc |
| Business | 722513 | BusinessCd |
| Total Revenue Column | $172,699 | TotalRevenueColumnAmt |
| Exclusion | $172,699 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $172,699 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $22,224,026 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,743,550 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $317,846 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,369 | TotalAmt |
| Program Services | $4,369 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $205,358 | TotalAmt |
| Management And General | $205,358 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,942,333 | TotalAmt |
| Program Services | $7,469,438 | ProgramServicesAmt |
| Management And General | $416,172 | ManagementAndGeneralAmt |
| Fundraising | $56,723 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $340,718 | TotalAmt |
| Program Services | $321,601 | ProgramServicesAmt |
| Management And General | $16,706 | ManagementAndGeneralAmt |
| Fundraising | $2,411 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,094,695 | TotalAmt |
| Program Services | $1,029,330 | ProgramServicesAmt |
| Management And General | $57,649 | ManagementAndGeneralAmt |
| Fundraising | $7,716 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $589,685 | TotalAmt |
| Program Services | $542,805 | ProgramServicesAmt |
| Management And General | $42,811 | ManagementAndGeneralAmt |
| Fundraising | $4,069 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,000,000 | TotalAmt |
| Program Services | $1,841,000 | ProgramServicesAmt |
| Management And General | $145,200 | ManagementAndGeneralAmt |
| Fundraising | $13,800 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,530 | TotalAmt |
| Management And General | $10,530 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,302 | TotalAmt |
| Management And General | $80,302 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,564 | TotalAmt |
| Management And General | $5,564 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,477,451 | TotalAmt |
| Program Services | $2,108,650 | ProgramServicesAmt |
| Management And General | $368,801 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $154,051 | TotalAmt |
| Management And General | $154,051 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,071 | TotalAmt |
| Program Services | $22,415 | ProgramServicesAmt |
| Management And General | $95,655 | ManagementAndGeneralAmt |
| Fundraising | $1 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $594,712 | TotalAmt |
| Program Services | $445,538 | ProgramServicesAmt |
| Management And General | $149,174 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $389,105 | TotalAmt |
| Program Services | $292,334 | ProgramServicesAmt |
| Management And General | $95,681 | ManagementAndGeneralAmt |
| Fundraising | $1,090 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,060 | TotalAmt |
| Program Services | $14,917 | ProgramServicesAmt |
| Management And General | $7,137 | ManagementAndGeneralAmt |
| Fundraising | $6 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,582 | TotalAmt |
| Program Services | $43,252 | ProgramServicesAmt |
| Management And General | $8,329 | ManagementAndGeneralAmt |
| Fundraising | $1 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $128,220 | TotalAmt |
| Program Services | $114,302 | ProgramServicesAmt |
| Management And General | $13,918 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Pharmaceuticals | $1,892,245 | $1,892,245 | $0 | $0 |
| Medical supplies | $704,723 | $704,723 | $0 | $0 |
| Repairs & Maintenance | $586,783 | $528,992 | $57,427 | $364 |
| Food & Dietary Supplies | $218,624 | $174,858 | $43,766 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $388,186 | TotalAmt |
| Program Services | $246,838 | ProgramServicesAmt |
| Management And General | $141,288 | ManagementAndGeneralAmt |
| Fundraising | $60 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,999,367 | TotalAmt |
| Program Services | $17,797,607 | ProgramServicesAmt |
| Management And General | $2,115,519 | ManagementAndGeneralAmt |
| Fundraising | $86,241 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,319,613 | BOYAmt |
| EOY | $1,154,546 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,353,675 | BOYAmt |
| EOY | $7,011,300 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,752,373 | BOYAmt |
| EOY | $2,555,754 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $475,819 | BOYAmt |
| EOY | $488,488 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $164,987 | BOYAmt |
| EOY | $306,264 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,767,267 | BOYAmt |
| EOY | $2,683,927 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,833,734 | BOYAmt |
| EOY | $14,200,279 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,534,032 | BOYAmt |
| EOY | $1,475,287 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $150,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,538,023 | BOYAmt |
| EOY | $10,450,240 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,222,055 | BOYAmt |
| EOY | $11,925,527 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,611,679 | BOYAmt |
| EOY | $2,274,752 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,611,679 | BOYAmt |
| EOY | $2,274,752 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,833,734 | BOYAmt |
| EOY | $14,200,279 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $2,224,659 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$2,561,586 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $5,564 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $5,564 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | Pawnee Valley Community Hospital is a member of the Kansas Hospital Association and the American Hospital Association. Both of these organizations engage in lobbying activities for hospitals and health care as part of the services provided to members. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,808,292 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$360,606 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,447,686 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,030,752 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$222,460 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,808,292 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,827,260 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $203,492 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $2,030,752 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,624,536 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $202,724 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,827,260 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,450,099 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $174,437 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,624,536 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.69480 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.30520 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Beneficial interest in net assets of foundation | $2,274,752 |
| Receivable from related party | $494 |
| Other receivables | $163,681 |
| Estimated third-party payor settlements | $245,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,683,927 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to Pawnee County | $9,777,913 |
| Due to Hays Medical Center, Inc. | $672,327 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $10,450,240 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $22,037,099 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$186,927 | OtherRevenueAmt |
| Revenue Not Reported | -$186,927 | RevenueNotReportedAmt |
| Revenue Subtotal | $22,224,026 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $22,224,026 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $19,999,367 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $19,999,367 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $19,999,367 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | Donations are requested for specific items or improvements to the Hospital. When a donation is received for a purpose, it is restricted for that use by the Board until the specific purpose has been met. |
| Part X, Line 2: | Management is not aware of any uncertain tax positions. |
| Part XI, Line 2d - Other Adjustments: | Change in beneficial interest in net assets of Foundation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 130.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,438 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $23,438 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,235,964 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $850,408 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $385,556 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01930 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,259,402 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $850,408 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $408,994 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02050 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $183 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $183 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,902,734 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,409,721 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $493,013 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02470 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,369 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,369 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,907,286 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,409,721 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $497,565 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02490 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,166,688 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,260,129 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $906,559 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04540 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $664,882 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $10,392,703 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $10,608,225 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$215,522 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pawnee Valley Community Hospital Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 923 Carroll Avenue | AddressLine1Txt |
| City | Larned | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67550 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Pawnee Valley Community Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 23 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https://pawneevalleyhospital.com/wp-content/uploads/2024/06/CHNA_2024_Pawne | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | http://www.pawneecountykansas.com/ | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 23 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://pawneevalleyhospital.com/wp-content/uploads/2024/07/CHNA2024_ImpDet | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 130.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://pawneevalleyhospital.com/billing/#financial-assistance-policy | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://pawneevalleyhospital.com/billing/#financial-assistance-policy | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pawnee Valley Community Hospital, Inc. | Part V, Section B, Line 5: The CHNA was conducted in collaboration with the Pawnee County Health Department. A Town Hall meeting was conducted in February 2024 to provide an objective consensus building method of reviewing and prioritizing county health issues. During the Town Hall meeting, the group reflected on the size and seriousness of any health concerns cited and discussed current community health strengths. The group identified and ranked top community health concerns, and all Town Hall attendees were encouraged to continue to contribute ideas by going online and taking a feedback survey that addresses any additional thoughts related to the CHNA. All Town Hall priority-setting and score processes involved the input of a diverse group with knowledge and/or expertise in public health as well as persons who represent the broad interests of the community served by the hospital. Key stakeholders in attendance included Larned State Hospital, Country Living of Larned, The Center for Counseling & Consulation, Heart of Kansas Family Health Care, Larned Police Department, Pawnee County Sheriff's office, Pawnee County Health Department, County Commissioners, members of the Chamber of Commerce, members of the USD 495 School Board, local members of the media, local religious organizations, local business owners, and representatives of Pawnee Valley Community Hospital. The CHNA was coordinated and produced by VVV Research & Development, Inc. from Olathe, Kansas. |
| Pawnee Valley Community Hospital, Inc. | Part V, Section B, Line 6b: Pawnee County, KS |
| Pawnee Valley Community Hospital, Inc. | Part V, Section B, Line 11: Pawnee Valley Community Hospital, Inc. (PVCH) conducted its fifth Community Health Needs Assessment (CHNA) along with the Pawnee County Health Department in 2024. The Hospital and County Health Department will work with others in the community to address the needs that were identified in the survey. The needs that received the most votes are listed below.Substance Abuse (Drugs & Alcohol) - 16.3%Mental Health (Diagnosis, Placement, Aftercare, Access to Providers) - 14.0%Childcare (Accessible & Affordable) - 11.6%Provide Youth Activities - 8.5%Physician Recruitment (Primary Care-MD's, DO's) - 7.8%Health Education (Chronic/Prevention) - 6.2%Obesity (Exercise & Nutrition) - 5.4%Physical Activities for Adults - 5.4%Visiting Specialists (Onc, Ortho, CV, OBGYN, ENT, NEP, DERM) - 5.4%The Town Hall meeting also noted the Community's Health Strengths, which are listed below.Three family medicine clinicsEMT, Fire Dept and Hospital have strong collaborationThriving hospitalAccess to recreation and exerciseOpioids dispense is minimalQuality Health DepartmentBi-annual health fairQuality and affordable long-term careChildcare committee - improving childcareSeveral internet providers/strong connectionAvailable mental health/crisis servicesSchool programs for parent involvement and educationCommunity involvementState Hospital offers continuing educationOn the 2024 CHNA Implementation Plan, it is noted that several areas are not part of hospital mission critical operations and that PVCH will be a partner with others to address these needs. These needs and the lead partner are listed below.Substance Abuse (Drugs & Alcohol) - Center for Counseling and Pawnee County Health DepartmentMental Health (Diagnosis, Placement, Aftercare, Access to Providers) - Center for Counseling and Pawnee County Health DepartmentChildcare (Accessible & Affordable) - Pawnee County Childcare CoalitionProvide Youth Activities - Pawnee Co Youth Initiative Foundation/Larned Rec CenterPhysical Activities for Adults - Pawnee Co Youth Initiative Foundation/Larned Rec CenterThe remaining CHNA Health Areas of Need will be addressed with PVCH as the lead partner. Updates to the progress are outlined below.Physician Recruitment (Primary Care-MD's, DO's) and Visiting Specialists (Oncology, Ortho, Cardiovascular, OBGYN, ENT, Nephrology, Dermatology) - Heart of Kansas recruited a family medicine physician to work at the Larned, KS clinic.Pawnee Valley Community Hospital recruited a Board-Certified Emergency Medicine Physician to replace the resigning Emergency Department Medical Director.The Pawnee Valley Community Family Medicine Clinic family medicine physician is engaged with the Kansas Osteopathic Medicine School to receive a medical student for rotation during 2025-2026 school year.Family medicine physician at Healthy Choice Clinic engaged with the Kansas Osteopathic Medicine School and received a medical student during the 2024-2025 school year. Rotation included Pawnee Valley Community Hospital.Added additional Specialty Care Clinic days for Cardiology Nurse Practitioner from HaysMed DeBakey Heart Institute.Pawnee Valley Community hospital is actively engaged in conversations and work to add the following additional specialty care services: Psychiatric Mental Health Nurse Practitioner Rheumatology Telehealth ServicesThe Pawnee Valley Community Family Medicine Clinic family medicine physician is partnered with the HaysMed Center Women's Health to provide an obstetrical shared care model. Health Education (Chronic/Prevention) - Pawnee Valley Community Hospital Family Medicine clinic implemented and is growing a Chronic Care Management Program with ChartSpan.Pawnee Valley Community Hospital engaged and trained a Pawnee Valley Community Hospital Family Medicine clinic family medicine nurse practitioner to teach Chronic Care Management classes quarterly.Pawnee Valley Community Hospital provided education on occupational therapy services and benefits via newspaper and social media to the community in addition to the Occupational Therapist attending civic group meetings to provide the education.Pawnee Valley Community Hospital initiated a vaccine campaign educating the community on vaccines and the important role they play in health prevention and public health.Pawnee Valley Community Hospital Family Medicine clinic initiated a women's health campaign which included obesity/weight loss services for women (education, medication treatment, exercise regimens, etc.)Pawnee County Health Department provides: One-on-one teaching in the office as needed Educated clients on chronic disease issues Health information via: Facebook, Digital sign, Bulletin boards, Pamphlets (inside and outside office), County resource list (posted on webpage) Bulletin board topics included: Breast Cancer Awareness, Diabetes Awareness, World Breastfeeding Week, Dental Health, Mental Health Preparedness education is offered multiple times per yearObesity (Exercise & Nutrition) Pawnee Valley Community Hospital Family Medicine clinic initiated a women's health campaign, which included obesity/weight loss services for women (education, medication treatment, exercise regimens, etc.) Pawnee Valley Community Hospital sponsors an annual 6th Grade Health Fair.Visiting Specialists Added additional Specialty Care Clinic days for Pulmonology Nurse Practitioner from HaysMed Pulmonology Clinic. Added additional Specialty Care Clinic days for Cardiology Nurse Practitioner from HaysMed DeBakey Heart Institute. Pawnee Valley Community Hospital is actively engaged in conversations and works to add the following additional specialty care services: Psychiatric Mental Health Nurse Practitioner Rheumatology Telehealth Services The Pawnee Valley Community Family Medicine Clinic family medicine physician is partnered with the HaysMed Center Women's Health to provide an obstetrical shared care model. The following CHNA Health Areas of Need in which PVCH assisted. Updates to the progress are outlined below.Childcare (Accessible & Affordable) Pawnee Valley Community Hospital Administrator partnered with the Pawnee County Chamber and Economic Development to form a Pawnee County Childcare Coalition. Pawnee Valley Community Hospital Administrator chaired the committee. Grants were received to offset supplies for current day care providers and assist new providers. Pawnee Valley Church opened a new day care facility. Organized a Child Care Provider Appreciation Day (May) and delivered thank-you gifts to current providers. Provide Youth ActivitiesPawnee Co Youth Initiative Foundation was created and ran with this project. Pawnee Valley Community Hospital Administrator is a member of this Foundation. Activities include: Cops and Bobbers (June), Free Movie Night, Touch-a-Truck education booth, Root Beer Float socials at Pawnee Heights (twice), Secured grant funding for spring programming, Task force includes multiple youth stakeholdersPhysical Activities for AdultsPawnee Valley Community Hospital supports and partners with the Pawnee County Health Department.Pawnee County Health Department provides: Promotion of exercise opportunities in Pawnee County through: Health fairs, County Fair, One-on-one Counseling Incorporation of physical activity education into HD, WIC, FP, KBH programs Presentations at Pawnee Valley Community Hospital 6th Grade Health Fair and Ag DaySubstance AbusePawnee Valley Community Hospital partnered with local school districts to provide Narcan. Includes policy, education, and a coordinated plan.Mental HealthPawnee Valley Community Hospital is in discussions with the Center for Counseling and Consultation to build mental health services at Pawnee Valley Community Hospital. Pawnee Valley Community Hospital Administrator is an active member of the Larned State Hospital Advisory Committee. Pawnee Valley Community Hospital is actively recruiting for a mental health provider. |
| Pawnee Valley Community Hospital, Inc. | Part V, Section B, Line 13h: The balance of the patient account is also considered. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - Pawnee Valley Hospital Family Medicine | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 713 W 11th St | AddressLine1Txt |
| City | Larned | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67550 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | Family Medicine | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | A cost-to-charge ratio derived from Worksheet 2 was used to determine financial assistance at cost and the cost of subsidized health services. A cost-to-charge ratio derived from Worksheet 2 was used to determine the costs of serving Medicaid beneficiaries.Part I, Line 7g:Subsidized health services community benefit expenses include $1,855,758 of expenses attributable to physician clinics that have net operating losses. |
| Part III, Line 4: | See Note B (pages 8-11) of the hospital's financial statements for a description of how the hospital calculated bad debt expensePart III Line 2:Costing methodology: A cost-to-charge ratio derived from Worksheet 2 was used to calculate bad debt expense at cost. |
| Part III, Line 8: | The Medicare cost report was the costing methodology used to determine the allowable Medicare costs pertaining to Medicare net revenue. Allowable costs of care reported on line 6 were determined using amounts from Worksheet D, Part V and Worksheet D-1 in the Pawnee Valley Community Hospital, Inc., Medicare cost report for fiscal year ended June 30, 2025. |
| Part III, Line 9b: | Whenever possible, the customer service representatives (CSR's) of Pawnee Valley Community Hospital try to determine the estimated self-pay balance prior to the patient receiving services. Charity care eligibility may be considered at this point in time. The patient will receive statements that include instructions on how to obtain a FAP application. If the patient contacts the CSR, the CSR will mail a FAP application upon request or direct the patient to the website to print one and request that the charity care application be completed by the patient. |
| Part VI, Line 3: | Information regarding the Pawnee Valley Community Hospital, Inc. charity care program is located on the Pawnee Valley Community Hospital and Hays Medical Center, Inc. website for patients and community members to view, and the financial assistance application is also on the HMC website to print off and complete. In addition, if a customer service representative 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, the CSR will send the application to the patient as well. |
| Part VI, Line 4: | Pawnee Valley Community Hospital, Inc. is located in Larned, Kansas, a town in Pawnee County, Kansas, which has a population of approximately 6,300 people, as of the 2020 census. The median household income of Pawnee County was $63,625. Approximately 12.8% of the total population was below the poverty line. Approximately 6.5% of the hospital's revenue is from services provided to patients eligible for Medicaid. Pawnee Valley Community Hospital, Inc. is the only hospital in Larned, Kansas. It mainly serves the communities in Pawnee County, Kansas. |
| Part VI, Line 5: | Pawnee Valley Community Hospital, Inc. promotes the health of the community by extending medical privileges to most qualified, local physicians. |
| Part VI, Line 6: | Pawnee Valley Community Hospital, Inc. is not part of an affiliated health care system. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Edward Herrman | ||||||||||||||
| Secretary | $0 | $687,816 | $0 | $124,775 | $0 | $2,763 | $0 | $140,966 | $0 | $37,211 | $0 | $993,531 | $0 | $0 |
| George Harms | ||||||||||||||
| Former Treasurer | $0 | $0 | $0 | $0 | $0 | $593,894 | $0 | $0 | $0 | $0 | $0 | $593,894 | $0 | $373,414 |
| Michelle Beckner | ||||||||||||||
| Treasurer | $0 | $319,655 | $0 | $46,345 | $0 | $538 | $0 | $67,038 | $0 | $36,427 | $0 | $470,003 | $0 | $0 |
| Shae Veach | ||||||||||||||
| President | $0 | $241,144 | $0 | $35,544 | $0 | $894 | $0 | $56,961 | $0 | $32,348 | $0 | $366,891 | $0 | $0 |
| Arlo Reimer | ||||||||||||||
| Chief of Staff | $262,291 | $0 | $19,250 | $0 | $16,165 | $0 | $14,969 | $0 | $32,385 | $0 | $345,060 | $0 | $0 | $0 |
| Terry Siek | ||||||||||||||
| Director thru. 09/24 | $0 | $166,407 | $0 | $33,470 | $0 | $70,197 | $0 | $41,179 | $0 | $8,877 | $0 | $320,130 | $0 | $0 |
| Melanie Urban | ||||||||||||||
| Administrator | $0 | $161,307 | $0 | $0 | $0 | $564 | $0 | $8,535 | $0 | $33,777 | $0 | $204,183 | $0 | $0 |
| Angela Beck | ||||||||||||||
| APRN | $144,965 | $0 | $0 | $0 | $6,738 | $0 | $7,691 | $0 | $10,704 | $0 | $170,098 | $0 | $0 | $0 |
| Dusty Atterbury | ||||||||||||||
| APRN | $152,927 | $0 | $0 | $0 | $4,592 | $0 | $7,878 | $0 | $1,645 | $0 | $167,042 | $0 | $0 | $0 |
| Calvin Kruger | ||||||||||||||
| Physician Assistant | $153,156 | $0 | $0 | $0 | $3,322 | $0 | $7,801 | $0 | $1,158 | $0 | $165,437 | $0 | $0 | $0 |
| Susan Aistrup | ||||||||||||||
| APRN | $133,005 | $0 | $0 | $0 | $2,748 | $0 | $6,749 | $0 | $9,646 | $0 | $152,148 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | A related organization uses a compensation committee, independent compensation consultant, written employment contract, and approval by the board or compensation committee to establish the compensation of the Hospital's Administrator. |
| Part I, Lines 4a-b | Severance payments received: Terry Siek - $50,880 Contributions to the plan: Edward Herrman - $123,716 Michelle Beckner - $49,788 Shae Veach - $42,721 Terry Siek - $30,207 Distributions from the plan: George Harms - $593,894 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | The organization has one member, HaysMed Partners, Inc., which became the sole member as of March 1, 2010. HaysMed Partners, Inc., is a wholly-owned subsidiary of Hays Medical Center, Inc. |
| Form 990, Part VI, Section A, line 7a | The Board members of HaysMed Partners, Inc., the sole member of Pawnee Valley Community Hospital, appoint the Board members of Pawnee Valley Community Hospital, Inc. |
| Form 990, Part VI, Section A, line 7b | HaysMed Partners, Inc., the sole member of Pawnee Valley Community Hospital, elects the Board members of Pawnee Valley Community Hospital. |
| Form 990, Part VI, Section B, line 11b | The Form 990 is prepared and reviewed by an independent accounting firm. It is then reviewed by the organization's officers and accounting personnel. Their questions and concerns are addressed and either corrected or clarified in the Form 990. The final Form 990 is then provided to the board for review prior to filing. |
| Form 990, Part VI, Section B, line 12c | Officers, directors and key employees, along with all associates, are required to complete a conflict of interest statement annually. The statements are reviewed by the Board, the Compliance Officer and Governance Director as well. When conflict of interest issues arise during a Board meeting, the board members with the conflict are asked to remove themselves from discussion or from the room entirely. They are not allowed to vote on that particular issue. |
| Form 990, Part VI, Section B, line 15 | The hospital administrator and officers' salaries are reviewed annually by an independent consulting group and the Board members. They base the review on salary comparisons obtained by the consulting group from peer hospitals in similiar geographic regions. The last review was conducted in February 2025. |
| Form 990, Part VI, Section C, line 19 | These documents are not made available to the public. |
| Form 990, Part IX, line 11g | Contract labor: Program service expenses 639,743. Management and general expenses 0. Fundraising expenses 0. Total expenses 639,743. Medical provider fees: Program service expenses 229,830. Management and general expenses 0. Fundraising expenses 0. Total expenses 229,830. Laboratory services: Program service expenses 151,667. Management and general expenses 5,871. Fundraising expenses 0. Total expenses 157,538. Recruiting fees: Program service expenses 0. Management and general expenses 4,805. Fundraising expenses 0. Total expenses 4,805. Other non-provider medical professional fees: Program service expenses 335,221. Management and general expenses 12. Fundraising expenses 0. Total expenses 335,233. Collection and billing fees: Program service expenses 3,940. Management and general expenses 110,571. Fundraising expenses 0. Total expenses 114,511. Other purchased services: Program service expenses 748,249. Management and general expenses 247,542. Fundraising expenses 0. Total expenses 995,791. |
| Form 990, Part XI, line 9: | Change in beneficial interest in net assets of foundation -186,927. Transfers to Pawnee County -2,374,659. |
| Form 990. Part XII, Line 2c | Hays Medical Center, Inc. has a Compliance committee that is responsible for the oversight of Pawnee Valley Community Hospital, Inc.'s financial statement audit and the selection process of an independent auditor. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| HaysMed Partners Inc (HMed) | ||||||||||
| 2220 Canterbury Dr | Hays | KS | 67601 | 270877152 | Management contract for Pawnee Valley Community Hospital | KS | 501(c)(3) | Line 3 | Hays Medical Center Inc | Yes (1) |
| Hays Medical Center Inc | ||||||||||
| 2220 Canterbury Dr | Hays | KS | 67601 | 480559088 | Hospital | KS | 501(c)(3) | Line 3 | 0 | |
| Pawnee Valley Community Hospital Foundation | ||||||||||
| 923 Carroll Ave | Larned | KS | 67550 | 455333776 | Support the activities and mission of the Hospital | KS | 501(c)(3) | Line 12a | Pawnee Valley Community Hospital | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Pawnee Valley Community Hospital Foundation | ||
| O | $73,295 | FMV |
| Pawnee Valley Community Hospital Foundation | ||
| O | $150,000 | Amount Paid |