2024-05-15T08:01:41-05:00 2023-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2022-07-01 730579295 Farmers Union Hospital Association FARM 5802252511 PO Box 2339 Elk City OK 73648 Monica R Scott CFO 5802252511 2024-05-14 1 Monica Scott 999009999 1 Kim Hunwardsen CPA P00484560 6122536500 2024-05-14 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Great Plains Regional Medical Center Corey Lively PO Box 2339 Elk City OK 73648 53267532 0 X www.gprmc-ok.com X 1938 OK To provide comprehensive, cost-effective, high quality healthcare to our communities. 10 7 528 23 14904 0 8199394 485118 55228648 51314975 1901608 500135 599028 584979 65928678 52885207 22577 27859 0 0 27035778 26777683 0 0 0 33526846 32627148 60585201 59432690 5343477 -6547483 75879737 63686130 45080180 37258427 30799557 26427703 X Great Plains Regional Medical Center will distinguish itself as the leader in Western Oklahoma and the Eastern Texas Panhandle for comprehensive, cost effective, high quality healthcare. We will meet the healthcare needs of patients in our service area while achieving cost effective quality outcomes. We will maintain and enhance collaborative relationships with physicians to better serve the healthcare needs of our service area. We will maintain and continually enhance health promotion, patient education and disease prevention for patients in our service area. 1 0 45356441 27859 51314975 Farmers Union Hospital Association, DBA Great Plains Regional Medical Center in Elk City, Oklahoma (hereinafter referred to as GPRMC) is a 62-bed hospital that provides quality health care regardless of race, religion, creed, sex, national origin, handicap, age, or ability to pay. Reimbursement for services rendered is critical to the operation and stability of GPRMC, it is recognized that not all individuals possess the ability to purchase essential medical services. In keeping with the Hospital's commitment to serve all members of its community, free care and/or subsidized care, care provided to persons covered by government programs at below cost, and health care activities and programs to support the community will be considered whether the need and/or individual's inability to pay exists. Continued on Schedule O.GPRMC served over 1,887 Inpatients that include, Medical, Intensive Care, Inpatient Rehabilitation, Newborns, Swing Bed and Senior Care. These services produced more than 9,207 Inpatient days. During the year we treated 13,131 patients in the Emergency Department. Our Surgical teams performed 3,186 surgeries. GPRMC provides care to persons covered by governmental and other programs as part of its mission to the community. These programs may not pay full charges to the extent reimbursement is below full charges. GPRMC recognized these amounts as contractual adjustments in meeting its mission to the entire community. Also, in recognizing its mission to the community, GPRMC provides services for those unable to pay. Additionally, GPRMC has provided services to others who are either unwilling or unable to qualify for charity care guidelines but who are still unable to pay. Community benefit is also provided by GPRMC by providing reduced price services, free programs offered throughout the year which GPRMC believes will serve a bona fide community health need. See Schedule H for more information regarding these activities.The Hospital provides health care services to patients who meet certain criteria under its charity policy without charge or amounts less than established rates. GPRMC does not pursue collection amounts determined to qualify as charity care, they are not recorded as revenue. The amount of charges foregone for services provided under the Hospital's charity care policy were approximately $78,000 in 2023. Total direct and indirect cost related to these foregone charges were $24,000, based on an average ratio of cost to gross charges. 45356441 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 113 0 1 528 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 1 1 OK X Monica Scott 5808215500 1801 W 3rd Street Elk City OK 73544 J Coffey MD-Chair until Oct '22 then Member 1.00 1.00 X X 0 0 0 Kyle Zybach - Secretary until Oct '22/Chair as of Nov '22 1.00 1.00 X X 0 0 0 Jeff Jackson - Member until Oct '22/Secretary as of Nov '22 1.00 1.00 X X 0 0 0 Joe Allen - Member until Oct '22/Vice Chair as of Nov '22 1.00 1.00 X X 0 0 0 Erick DeRocher DO Member/Chief of Staff 10.00 1.00 X 14300 0 0 Edward Albert Member 1.00 1.00 X 0 0 0 Paul Kumpf Member 1.00 1.00 X 0 0 0 Jack Morrison DDS Member until Sept '22 1.00 1.00 X 0 0 0 Danny Sprowls Member 1.00 1.00 X 0 0 0 Roy Greenway MD-Vice Chief of Staff/Member until Aug '22 40.00 1.00 X 518937 0 14475 Tyson Fisher MD - Medical Staff/Member as of Sept '22 40.00 1.00 X 670984 0 41416 Daniel Garbarino Member as of Jan '23 1.00 1.00 X 0 0 0 Corey Lively CEO 40.00 1.00 X 317220 0 21212 Monica R Scott CFO 40.00 1.00 X 142817 0 17099 Steven Winham MD Surgery 40.00 0.00 X 874378 0 39602 Michael Grossman MD Gastroenterologist 40.00 0.00 X 301667 0 14179 Misty Carter Chief Human Resources 40.00 0.00 X 141652 0 17097 James Bass MD Family Practice 40.00 0.00 X 218867 0 41091 Tiffany Dupree DO Obstetrics & Gynecology 40.00 0.00 X 322312 0 26105 3523134 0 232276 28 0 1 0 Premier Physician Staffing 20 E 5th St Suite 620 Tulsa OK 74103 Physician ER coverage 2979254 Prime Physician Staffing PLLC 20 E 5th St Suite 620 Tulsa OK 74103 Hospitalist physician coverage 1327125 Lifepoint Rehabilitation PO Box 502096 St Louis MO 63150 Rehab Management 820240 Qualivis LLC PO Box 123847 Dallas TX 75312 Contract Labor Staffing 681311 Western Oklahoma Anesthesia Consults 2221 Lakeside Dr Suite 600 Richardson TX 75082 Contract Anesthesiology 605641 17 479966 5152 485118 Net patient service 621990 49241753 49241753 Cafeteria 722514 416097 401193 14904 Daycare center 624410 112031 112031 Plains Diag Imaging 900099 104682 104682 1440412 1440412 51314975 882460 882460 55782 55782 529197 0 529197 529197 529197 382325 -382325 -382325 -382325 52885207 51300071 14904 1085114 X 14751 14751 13108 13108 1504939 958641 546298 152729 152729 18949282 14509221 4440061 56107 43054 13053 4737993 3582843 1155150 1376633 1045062 331571 12575416 9339966 3235450 90551 274 90277 1474631 888117 586514 395750 180732 215018 1185083 316130 868953 92278 79845 12433 14918 5299 9619 1380506 1286936 93570 3479466 3230543 248923 868352 194116 674236 Medical supplies 9218840 9177357 41483 Food 692155 3108 689047 Repairs and maintenance 509429 149801 359628 Dues and Subscriptions 252565 31591 220974 397208 153217 243991 59432690 45356441 14076249 0 2765 2765 6097784 392811 12124377 9196961 1909566 1819543 967315 643822 94417795 67838773 29570569 26579022 21565139 20688225 2533418 3045318 1021237 1132737 84000 84000 3567 100926 75879737 63686130 11359636 9944042 5498042 28222502 27314385 45080180 37258427 X 30799557 26427703 30799557 26427703 75879737 63686130 -6547483 2175629 0 X 0 1 X 1 0 X 861828 861828 60808185 39039886 21768299 107083 8924 98159 30954784 27293988 3660796 1685915 1495975 189940 26579022 Payable to related party 26317627 Estimated third-party payor settlements 191326 Operating Lease Liabilities 91657 Finance Lease Liabilities 713775 27314385 X Part X, Line 2: The Hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. 1 1 X 1 X 1 X 1 1 0 0 24000 24000 0.00040 24000 24000 0.00040 3790692 2145969 1644723 0.02770 3790692 2145969 1644723 0.02770 3814692 2145969 1668723 0.02810 1 4593656 886576 12945295 15132126 -2186831 X 1 1 1 Plains Diagnostic Imaging LLC Radiology services 0.71870 0.00000 0.28130 1 1 Great Plains Regional Medical Center 1801 W 3rd Street Elk City OK 73644 www.gprmc-ok.com 2210 X X X 2 Provider Based Rural Health Clinics Great Plains Regional Medical Center 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X www.gprmc-ok.com/about/chna X https://osururalhealth.blogspot.com/p/chna.html X 1 21 1 www.gprmc-ok.com/about/chna 0 1 X 100.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X https://gprmc-ok.com/patient/financial-assistance/ X https://gprmc-ok.com/patient/financial-assistance/ X https://gprmc-ok.com/patient/financial-assistance/ X X X X X X 1 X 0 X X X X 1 X 0 0 Great Plains Regional Medical Center Part V, Section B, Line 5: Due to the unprecedented Covid-19 pandemic, Great Plains Regional Medical Center was not able to host three community meetings as they have in the past to seek feedback from key stakeholders. In an effort to promote social distancing and following recommendations outlined the CDC's website, the hospital hosted one single community meeting to gather community feedback. The meeting was held on March 23, 2022. All stakeholders received primary and secondary data prior to the meeting.Community members invited to the community meeting included representatives from Great Plains Regional Medical Center, City of Elk City, Elk City Fire Department, Elk City Chamber of Commerce, Area Agency on Aging, Hospital Foundation, Elk City Public Schools and Vocational Technology Schools. Community members received a phone invitation and/or an email invitation from the hospital. Specific representatives included: board members, foundation members, Elk City and Western Oklahoma Wellness Initiatives coordinator, AirEvac, City of Elk City Farmers Union Hospital Association officials, Beckham County Health Department, and GPRMC department directors. The director of Western Oklahoma Family Care Center was invited because of the low-income population served. Therefore, a significant effort was placed on including representatives from the public health sector and those who serve the underserved, low-income or racially diverse populations to gain their perspective of needs in the community. Great Plains Regional Medical Center Part V, Section B, Line 11: The community health needs assessment (CHNA) was completed in fiscal year 2022. The following needs were identified and the actions taken in fiscal year 2023 to address those needs.Mental Health including services for youth and adolescents Drug, alcohol, and tobacco abuse Lack of OBGYN care Limited outdoor youth activities Mental Health including services for youth and adolescents Great Plains Regional Medical Center currently offers a Geropsychiatry program. The Hospital grew the program through greater marketing of services and care availability. The Medical Center continues to screen each outpatient and emergency room patient for the need for mental health services (e.g. depression, suicide). When a patient screens as needing additional services, resources are then identified for the patient. The Medical Center plans to continue these screenings and continue to search for additional services and resources.Drug, alcohol, and tobacco abuseThe Hospital addressed the increase in drug, alcohol, and tobacco abuse. Counselors are present in Elk City and Red Rock. Lack of OB/GYN careGreat Plains Regional Medical Center in collaboration and support of local providers continue to recruit for a new OB/GYN. The facility strives to maintain patient access to current inpatient and outpatient resources. GPRMC will ensure increased access for the Medicaid population for Obstetrics and Gynecology services. Limited outdoor youth activitiesThe Hospital provided input on the need for additional health related services for the community. A new activity center was built and opened in 2022. A new outdoor aquatic park also opened in 2023. Great Plains Regional Medical Center Part V, Section B, Line 13h: Great Plains Regional Medical Center (GPRMC) provides 100% financial assistance for non-elective services under the presumptive guidelines if the patient/responsible party meets any of the below listed criteria:a. Is uninsured and has an estimated family income of less than 200% FPL, and a Health Care Credit score of less than 620 as determined by externally available data sources such as credit agenciesb. Is homeless or received care from a homeless clinicc. Is deceased with no known estate or living spouse Part I, Line 3c: Great Plains Regional Medical Center (GPRMC) provides 100% financial assistance for non-elective services under the presumptive guidelines if the patient/responsible party meets any of the below listed criteria:a. Is uninsured and has an estimated family income of less than 200% FPL, and a Health Care Credit score of less than 620 as determined by externally available data sources such as credit agenciesb. Is Homeless or received care from a homeless clinicc. Is deceased with no known estate or living spouse Part I, Line 7: Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report. Part III, Line 2: The amount reported on line 2 represents implicit price concessions. The Hospital determines its estimate of implicit price concessions based on its historical collection experience with this class of patients. Part III, Line 3: An estimated 19.3% of implicit price concession in 2022 are attributable to patients potentially eligible for financial assistance. This is based on the percentage of individuals in the county under the federal poverty level. Part III, Line 4: The footnote to the Organization's financial statements that describes implicit price concession is located in the audited financial statement report on pages 11 and 12. Part III, Line 8: Great Plains Regional Medical Center provides services to Medicare patients understanding there will be write-offs and knowing the Organization will not recover the costs of the services provided. Providing these services is essential to the community and therefore increases access to healthcare services, which is a community benefit. Both the total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by the Centers for Medicare and Medicaid Services. Part III, Line 9b: GPRMC patients who qualify for charity care and who are cooperating in good faith to resolve their discounted hospital bills, are offered extended payment plans. During this time GPRMC will not send unpaid bills to outside collection agencies, and will cease all collection efforts. Great Plains Regional Medical Center will not impose extraordinary collections actions such as wage garnishments; liens on primary residences, or other legal actions for any patient without first making reasonable efforts to determine whether that patient is eligible for charity care under the financial assistance policy. Patients have 120-days from their first statement to apply for charity care with no extraordinary collection actions.Patients are pre-screened for charitable services before receiving tests and a determination is made as to the financial ability to pay. If patients are pre-qualified for services, the collection process is ceased. Part VI, Line 2: GPRMC relies on input from physicians, other healthcare providers, community leaders, the Board of Directors and citizens in the community to assess the needs of the community. We look at out-migration studies to determine what services individuals from the community are seeking and receiving from outside locations. We also consider comparisons of the volume of physician specialties in our area to nationally recognized data. The factors are all considered in addition to feedback from patients in the community to determine shortages of care areas. Part VI, Line 3: Assistance is discussed with patients as part of the intake process. Patients are screened at registration to determine need for financial assistance and then are given copies of the financial assistance policy. Upon request, we try to assist patients with paperwork for medical assistance such as Medicare, Medicaid, disability, or financial assistance.Notification about financial assistance is disseminated from Great Plains Regional Medical Center through various means. This includes notice in patient bills and the Conditions of Admissions form. In addition, information is posted in emergency rooms, the admitting and registration departments and the hospital business offices. A request for financial assistance may be made by the patient, patient family member, close friend, or any associate of the patient, subject to applicable privacy laws. Part VI, Line 4: Great Plains Regional Medical Center is a 62-bed acute care facility located in Beckham County. The hospital provides 24-hour emergency department, acute inpatient services, hospitalist services, laboratory, diagnostic radiology (CT, ultrasound, MRI, nuclear medicine, echocardiograms, mammography, and cardiac catheterization), intensive care, and cancer treatment center (prostate, breast, and head and neck cancers).The primary medical service area of Great Plains Regional Medical Center includes the zip code areas of Elk City, Sayre, Erick, Hammon, Cheyenne, Cordell, Canute, Mangum, Sentinel and Clinton. The primary medical service area experienced a population decrease of 1.0 percent from the 2010 Census to the latest available, 2016-2020, American Community Survey. The secondary medical services area is comprised of the zip code areas of Burns Flat, Carter, Weatherford, Sweetwater, Reydon, Arnett, Lone Wolf, Durham, Butler, Leedey, Foss, Dill City, Hobart, Granite, Hollis, and Altus. The secondary medical service area experienced a population decrease of 4 percent from 2010 to the 2016-2020 American Community Survey.The 2023 annual unemployment rate for Beckham County was 2.8%. This rate is lower than the state average of 3.2%. The rates were not seasonally adjusted. The most recent monthly estimates show Beckham County to be lower than 2020. The share of individual captured below the poverty threshold for income and household size is calculated by the U.S. Census Bureau.In 2022, the poverty rate for all ages in Beckham County was 19.3 percent. This is higher than the state rate of 15.7%. Part VI, Line 5: Our Board of Directors is comprised of citizens from the community, from business owners to retired individuals. This broadly based group provides us with a broad perspective on the needs of the community. GPRMC extends medical privileges to local and area physicians. They must apply for privileges and be approved by the medical staff and Board of Directors. Surplus funds are reinvested into facility and equipment upgrades and free programs throughout the year.GPRMC publishes notices in the area newspapers reaching 8,000 to 10,000 homes. The notices provide information on new physicians and medical services.GPRMC provides education to the community on CPR, pre-natal education and Heart Disease Prevention. The Medical Center is one of two designated donor locations for the community wide blood drive held several times per year.Great Plains Regional Medical Center sponsors healthcare initiatives for the community. Some of these include diabetes self-management classes for patients with new or uncontrolled diabetes and education to local nursing home staff regarding care of patients with dementia and other types of behavioral disorders. Due to the shortage of nurses in the area, scholarships are awarded to students wishing to pursue degrees in the medical field. Education programs are presented at the local adult learning center discussing education needed to fulfill the requirements for employment in a hospital setting. We also participate in several career fairs for different schools in our area. GPRMC works in cooperation with educators by providing a clinical rotation training environment for students of various fields including physician, nursing, pharmacy, lab, radiology and medical records. We participate with area high schools in the job shadow program. Students interested in health careers may observe our staff in the work setting and obtain a first-hand experience. The Medical Center developed a collaboration with Western Oklahoma State College to provide distance learning classes for those in the community wishing to pursue nursing degrees. GPRMC provides a classroom in the local community. Additionally, in-kind services are provided to Western Oklahoma State College. This is vital to prospective students pursuing nursing degrees that would not have been able to drive the long distance to the College.In-kind services are also provided to Southwestern Oklahoma State University for college classes. The Hospital provides a room, Monday - Friday for teaching general education classes in both fall and spring semesters. 1 High school health care scholarships 10 13108 Part I, Line 2: The Hospital provides scholarships for high school seniors who will pursue health related fields and nursing scholarships. Students complete an application and essay. Administration reviews the applications and chooses the recipients. X X X X 0 0 0 0 0 0 0 0 0 Steven Winham MD Surgery 733607 0 140123 0 648 0 0 0 39602 0 913980 0 0 0 Tyson Fisher MD - Medical Staff/Member as of Sept '22 580381 0 89982 0 621 0 1525 0 39891 0 712400 0 0 0 Roy Greenway MD-Vice Chief of Staff/Member until Aug '22 511309 0 6935 0 693 0 1525 0 12950 0 533412 0 0 0 Tiffany Dupree DO Obstetrics & Gynecology 292946 0 27686 0 1680 0 1327 0 24778 0 348417 0 0 0 Corey Lively CEO 315361 0 1200 0 659 0 0 0 21212 0 338432 0 0 0 Michael Grossman MD Gastroenterologist 300560 0 909 0 198 0 1500 0 12679 0 315846 0 0 0 James Bass MD Family Practice 110274 0 104317 0 4276 0 1200 0 39891 0 259958 0 0 0 Monica R Scott CFO 141313 0 66 0 1438 0 730 0 17873 0 161420 0 0 0 Misty Carter Chief Human Resources 136847 0 0 0 4805 0 720 0 17630 0 160002 0 0 0 Jacob Jackson Family relation to Jeff Jackson, Board Member 152729 Compensation as employee 0 Form 990, Part III, line 2 The Hospital opened a provider based clinic in fiscal year 2023. Form 990, Part VI, Section A, line 1a The Executive Committee is composed of the officers of the Board; President, Vice President, Secretary and Treasurer. The Hospital's Board President serves as the Chair of the Executive Committee. Other members may be added if advisable. The Executive Committee directly represents the Board and possesses the power to act for the Board within limits set for it by the Board, on matters needing immediate attention, prior to regular board meetings, and such other powers as delegated to it by the Board. The Executive Committee reports to the Board of Directors at the next regular or at the next special meeting called for that purpose. Form 990, Part VI, Section A, line 6 Members are individuals who have voting shares in Great Plains Regional Medical Center. Membership is obtained through transfers of existing memberships. Transfers normally result either through voluntary surrender of a membership from a current member who is no longer interested in retaining their membership or through the death of a member who has no immediate family interested in retaining the membership. Each individual is allowed only one membership and there is only one vote allowed per membership. Form 990, Part VI, Section A, line 7a Governing Board members are appointed through nomination and a majority vote election by the membership at annual meetings. Form 990, Part VI, Section A, line 7b Any amendments to the Governing Board Bylaws and Rules & Regulations have to be approved by a majority vote of the membership. Per the Organization's Bylaws, the members are the supreme authority of the Association in all its affairs. Form 990, Part VI, Section B, line 11b The Form 990 is presented and reviewed at the governing Board's monthly meeting. The 990 is also posted on the governing Board's website prior to the meeting. Form 990, Part VI, Section B, line 12c All members of the governing board, officers and key employees receive a copy of the Conflict of Interest Policy on an annual basis. The individuals are required to review the policy and complete and sign the questionnaire attesting to their understanding of the policy and that their answers are true and accurate. The board as a whole reviews the conflict of interest statements. Any potential conflicts are discussed and depending on the conflict the board decides the appropriate action to take. Form 990, Part VI, Section B, line 15a When determining the CEO's compensation, Human Resources conducts a comparative analysis of compensation by position using state, multi-state, regional and national compensation data. Data is selected from hospitals with similar bed size, revenue and other similar area comparatives. Human Resources then submits a report to the Executive Committee. This is completed on an annual basis. The Executive Committee reviews the data, confirms the data with an independent auditor and recommends appropriate CEO compensation to the Board of Directors. All other positions within the Hospital are reviewed annually by Human Resources and approved by the CEO. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Form 990, Part IX, line 11g Consulting: Program service expenses 5,142,790. Management and general expenses 1,842,090. Fundraising expenses 0. Total expenses 6,984,880. Service contracts: Program service expenses 654,577. Management and general expenses 618,826. Fundraising expenses 0. Total expenses 1,273,403. Contract labor: Program service expenses 3,538,766. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,538,766. Purchased services: Program service expenses 3,833. Management and general expenses 774,534. Fundraising expenses 0. Total expenses 778,367. GPRMC Holdings Inc PO Box 2339 Elk City OK 73648 824447018 Own property and lease to hospital to operate charitably OK 501(c)(3) Line 12b, II Great Plains Regional Medical Center 1 Plains Diagnostic Imaging LLC 1705 W 2nd St Elk City OK 73644 261530951 Radiology services and equipment rental OK Great Plains Regional Medical Center Related 104682 1019661 0 1 0.71870 1 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 1 1 Plains Diagnostic Imaging LLC K 685200 General ledger Plains Diagnostic Imaging LLC S 104682 Amount from K-1 Plains Diagnostic Imaging LLC A 1289 Amount from K-1 GPRMC Holdings Inc R 1327153 General ledger