2024-08-15T16:07:03+00:00 2023-09-30 440160260 Forvis Mazars LLP 1551 N Waterfront Pkwy Ste 300 Wichita KS 672066601 990 2022-10-01 481226976 Great Plains of Ellinwood Inc GREA 3166851523 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 JASON BARB CFO 3166851523 2024-08-15 true Michael Engle P00482834 3162652811 2022 2024-08-08 14:25:15Z JASON BARB 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 11209301 false X https://www.ellinwooddistricthospital.org/ X 1999 KS TO OPERATE AN ACUTE CARE HOSPITAL THAT PROVIDES MEDICAL CARE TO THE GENERAL PUBLIC IN ELLINWOOD, KANSAS AND THE SURROUNDING RURAL COMMUNITIES. 7 6 124 10 0 0 1930542 2036766 7656242 9068215 19480 30836 497271 73484 10103535 11209301 0 0 0 0 5960223 6006749 0 0 0 4026309 4619998 9986532 10626747 117003 582554 5223279 17291831 2439757 13925755 2783522 3366076 TO OPERATE HOSPITAL FACILITIES FOR THE DELIVERY OF HOSPITAL AND RELATED HEALTH CARE SERVICES, HEALTH RELATED EDUCATION, AS WELL AS THE PROMOTION OF HEALTH AND WELLNESS, WITHOUT REGARD TO RACE, CREED, COLOR, SEX OR FINANCIAL CIRCUMSTANCE. false false 9059733 0 9068215 Ellinwood District Hospital's (EDH) primary program is the delivery of healthcare and related services to patients from our district and the surrounding area. Services include inpatient acute, skilled swing-bed, and intermediate swing-bed care services along with outpatient services. During 2023, EDH completed several projects to increase the quality of service or safety to our patients and residents. 1) Ground was broken for our New Hospital that was on our 2021 Community Health Needs Assessment for an Improved Hospital Facility. The process entailed applying for a USDA Grant to make sure we didn't increase district taxes. During the process of designing the new facility, we also had to decide what equipment we would be able to replace and what equipment could move to the new facility with us. 2) EDH restructured our ER schedule so we can have more staff in the facility to cover the ER more hours out of the day. This added an additional position to our Nursing schedule, but in doing so we believe we can better serve our community. Now our inpatient nurse doesn't have to cover the ER during the night. This makes sure the ER patient gets the full attention they need while our inpatients still have a nurse available to them. 3) In 2023 we updated our inpatient communication boards. This allowed our patients to know the name of their physical therapist, medical doctor, nurse, state what their goals are and to make sure they let us know how they are feeling for the day. This simple tool helped all ancillary departments work with the patient and made patient care flow easier. 9059733 true true false true false false false false false true false false false true false true true false false false false false false false false true true false false true true false false false false false false false false false false false false false false false true true true true false true 34 0 true 124 true false false false false false false false false false false false false X 7 6 true false false false true true true true true false false true true true true true true false false false X JASON BARB 3166851523 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 CHARLES WESTIN DIRECTOR/CHAIRMAN 0.2 1.2 X X 0 0 0 CURT COLSON PRESIDENT/CEO/DIRECTOR 0.2 41.2 X X 0 216245 49307 JOHN TERRILL VICE PRESIDENT/DIRECTOR 0.2 1.2 X X 0 0 0 STEVE CARLSON TREASURER/DIRECTOR 0.2 1.2 X X 0 0 0 ARTHUR HENDRICKSON DIRECTOR 0.2 1.2 X 0 0 0 DR BARBARA BROWN APPLEGATE DIRECTOR 0.2 1.2 X 0 0 0 ROGER JOHN DIRECTOR 0.2 1.2 X 0 0 0 JASON BARB CFO 0.2 41.2 X 0 176924 31708 KILE MAGNER ADMINISTRATOR 40.0 0.0 X 124677 0 39760 CHARLIE JOSLIN PHYSICIAN 40.0 0.0 X 217408 0 52326 CHRISTOPHER BROWN PHYSICIAN 40.0 0.0 X 286652 0 48273 Kaylee Kaiser Physician 40.0 0.0 X 109889 0 27912 KELLI BROWN PHYSICIAN 40.0 0.0 X 110686 0 38440 TROY MOORE DEPT HEAD PT 40.0 0.0 X 136174 0 38623 985486 393169 326349 6 false true false HEALTH FACILITIES GROUP LLC 330 N MEAD ST WICHITA KS 67202 ARCHITECTURE SERVICES 1229688 GPHA 250 N ROCK RD STE 160 WICHITA KS 67206 MANAGEMENT AND SERV 781287 SIEMENS HEALTHCARE DIAGNOSTICS PO BOX 121102 DALLAS TX 753121102 PROFESSIONAL SERVICES 152934 AYA HEALTHCARE INC 5930 CORNERSTONE CT SUITE 300 SAN DIEGO CA 92121 NURSING AND LAB CONTRACT SERVICES 106465 4 1961671 75095 2036766 NET PATIENT SERVICE REVENUE 621300 8718082 8718082 340B REVENUE 621300 350133 350133 0 0 0 0 9068215 30836 30836 1760 0 1760 0 1760 1760 0 0 VENDOR REBATES 900099 36642 36642 EMPLOYEE/GUEST MEALS 722514 9800 9800 25282 0 0 25282 71724 11209301 9068215 0 104320 X 0 0 173470 173470 4518476 4038917 479559 322796 282837 39959 671552 565233 106319 320455 270347 50108 126237 126237 258 258 44514 44514 1492 1492 1815121 1502068 313053 0 18022 18022 445736 427185 18551 122268 110547 11721 12266 8571 3695 11315 9100 2215 34440 24488 9952 359794 243815 115979 77059 72243 4816 MEDICAL SUPPLIES 1034049 1034049 BAD DEBT EXPENSE 242494 242494 EQUIPMENT RENTAL & REPAIRS 156801 149479 7322 DUES & SUBSCRIPTIONS 35945 15989 19956 82187 62371 19816 0 10626747 9059733 1567014 0 1039037 217496 923353 983384 0 0 0 0 154315 161387 35887 41668 18517117 3007283 2795818 15509834 0 0 274869 378062 5223279 17291831 1950687 2055518 0 11558783 0 0 489070 188462 0 122992 2439757 13925755 X 2783522 3366076 2783522 3366076 5223279 17291831 582554 0 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 1492 false false false 1492 false Schedule C, Part II-B, Line 1f A PORTION OF THE ANNUAL DUES PAID TO KHA AND AHA ARE USED FOR LOBBYING. 255733 255733 1742035 1250883 491152 2293658 1665158 628500 14225691 91242 14134449 15509834 FINANCE LEASE LIABILITIES 122992 122992 10966807 0 0 10966807 242494 242494 11209301 10384253 0 0 10384253 242494 242494 10626747 Schedule D, Part X, Line 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements PROVISION FOR UNCOLLECTIBLE ACCOUNTS - 242494 Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statements PROVISION FOR UNCOLLECTIBLE ACCOUNTS - 242494 true true X true X false true true true false true true 24177 24177 0.0023 503263 314503 188760 0.0182 0 0.0 0 0 527440 314503 212937 0.0205 19950 19950 0.0019 0 0.0 0 0.0 0 0.0 1000 1000 0.0001 0 0 20950 0 20950 0.0020 0 0 548390 314503 233887 0.0225 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 false 242494 5083959 5083959 0 X true true 1 1 ELLINWOOD DISTRICT HOSPITAL 605 N MAIN ELLINWOOD KS 67526 WWW.ELLINWOODDISTRICTHOSPITAL.ORG H005001 X X X X 1 1 1 false false true X X X X X X X X X 21 true false true true X https://www.ellinwooddistricthospital.org/about X true 21 true https://www.ellinwooddistricthospital.org/about false true X 200.0 0.0 X X X X true true X X X true X https://www.ellinwooddistricthospital.org/ X https://www.ellinwooddistricthospital.org/ X https://www.ellinwooddistricthospital.org/ X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility 1, 1 Facility 1, 1 - ELLINWOOD DISTRICT HOSPITAL. THE ASSESSMENT PROCESS WAS INITIATED BY ELLINWOOD DISTRICT HOSPITAL AND COMPLETED IN COLLABORATION WITH BARTON COUNTY HEALTH DEPARTMENT. ALL OF THE EDUCATIONAL, GOVERNMENTAL, CIVIC AND HEALTH RELATED ORGANIZATIONS WITHIN THE COMMUNITY WERE INVITED TO PARTICIPATE. TO ENSURE INPUT FROM PERSONS WITH A BROAD KNOWLEDGE OF THE COMMUNITY, NOTICES OF ALL MEETINGS WERE ANNOUNCED BY MAILED LETTERS, EMAILS, AND ADVERTISEMENTS. REPRESENTATIVES AND INDIVIDUALS FROM THE COMMUNITY AND HEALTH ORGANIZATIONS ATTENDED THE TOWN HALL, FROM ELLINWOOD AND SURROUNDING AREAS INCLUDING HOISINGTON, GREAT BEND, CLAFLIN, AND BEAMER. Schedule H, Part V, Section B, Line 6b Facility 1, 1 Facility 1, 1 - ELLINWOOD DISTRICT HOSPITAL. BARTON COUNTY HEALTH DEPARTMENT Schedule H, Part V, Section B, Line 11 Facility 1, 1 Facility 1, 1 - ELLINWOOD DISTRICT HOSPITAL. The hospital provides and promotes the health of the citizens of the Ellinwood district by constantly looking for opportunities to educate area residents about healthy activities and habits and offering opportunities for education about health care topics. Some of the activities to further the health of the area include: 1. Due to the COVID-19 pandemic, activities in which participants gather together, indoors or out, have been put on indefinite hold. Many of the normal events that EDH participates in were cancelled during this time frame. The impacts/reductions are listed in parentheses with each statement. 2. Reduced cost lab fairs are provided semi-annually with Ellinwood Hospital Foundation support. (None were held in 2022 due to COVID-19 numbers in Barton county / City of Ellinwood) 3. Educational classes are offered throughout the year, including classes to clubs and organizations in the community. Educational presentations are also made at local schools. (Two classes held in 2020) 4. We offer support to other healthcare related organizations, such as the local food bank, United Way, and Relay for Life, to raise awareness about health-related issues, such as cancer, and to ensure that their missions can be carried out, impacting the health and wellness of us all. 5. In conjunction with the community ambulance service, the hospital sponsors ACLS, PALS and CPR for professionals in Barton County. 6. TNCC classes for nurses are sponsored by the hospital for area health care professionals. 7. The hospital and its staff took the lead for the county medical organizations in emergency preparedness, especially concerning the new requirements faced by all other provider types. We host and participate in disaster/bioterrorism drills with other area health care facilities on a regular basis to encourage preparedness and awareness within our communities. 8. We support medical education in all forms, but especially by giving support to our local community colleges: top management serves on advisory boards for nursing program and medical assistant/coding programs at Barton Community College (BCC). The hospital is a practice site for phlebotomists/MLT, medical assistant program and nursing program from BCC. We are also a practice site for the physical therapy assistant program at Hutchinson Community College. We also have a job shadowing program with our local high school. This allows students to shadow a professional in the medical field they might be interested in pursuing in college. 9. EDH continues to dedicate itself and any surplus funds to improving the healthcare available to area residents and patients by updating equipment and ensuring that the hospital's technology is current and able to meet the patients' needs. 1 ELLINWOOD RURAL HEALTH CLINIC 611 N MAIN ELLINWOOD KS 67526 MEDICAL CLINIC Schedule H, Part VI, Line 2 Needs Assessment In 2023, the hospital has continued to work to address the health needs identified by the 2021 Community Health Needs Assessment of our service area. The organization has surveyed district patrons on services currently provided at the hospital and what they see as future needs. Strategic planning and mission review is part of the annual advisory board's retreat. This year we reviewed the previous year's plan and planned for the next several years based on the needs assessment from survey and input received from the public. Two areas of focus were identified for the facility: 1. Develop a strategic plan going forward regarding the building of a new facility, including: funding opportunities and capital availability, public relations and community support, project management, budget, and timeline. 2. Develop and adopt a medical provider succession plan and build relationships to move forward with it. The current changes in health care at the federal, state, and community levels are communicated to the public via local media and town hall meetings as determined necessary. Advisory board meetings are considered open meetings and the public is encouraged to attend. The annual advisory board meeting informs the public of the hospital and clinic's most recent statistics and offered services. The hospital district supplies the clinic building for rural health clinic providers and for outside consulting physicians. Schedule H, Part VI, Line 3 Patient Education of Eligibility for Assistance The Financial Assistance Program employs a sliding scale discount that takes into consideration a patient's household income and qualifying assets. The Financial Counselor consults with private pay patients to see if they qualify for the Hospital's financial assistance policy. We also have posted online and in both the hospital and clinic lobbies that financial assistance is available and to apply with the Financial Counselor at the Hospital. If discovered during the accounts receivable collection process that a patient is having trouble paying bills, both the hospital and the centralized billing office will inform the patient that financial assistance is available. As part of the financial assistance program all applicants must apply for Medicaid. If after the initial interview there is a consensus that the patient may qualify for financial assistance, the financial counselor gives patient forms to complete and asks to see bank statements, tax returns, etc. Computations based on current Federal Poverty Level Guidelines are completed to see if qualification is appropriate and the percentage of charges to be written off is determined, based on family size and household income. All instances of financial assistance are approved by upper management of the Hospital. Schedule H, Part VI, Line 4 Community Information The Ellinwood Hospital District consists of all of Lakin township (including the City of Ellinwood) and all of Comanche township (with the exception of the two tiers of sections along the western edge described as Sections 5,6,7,8,17,18,19,20,29,30,31, and 32, in West 20-12. This area is known as the Ellinwood Trade Area. The hospital is located in Ellinwood, Kansas which has a population of 2,063 as of the 2019 5-year estimates of the American Community Survey, by the U.S. Census Bureau, and serves the eastern part of Barton County. Total population of Barton County is 26,453 as of the same census. The median age of an Ellinwood resident is 39.9 years. Total households in Ellinwood are 834 plus the rural households from the district. The racial makeup of the community is 90% white, 7% Hispanic, and the remaining 3% are other races or multiple races. The median income per household in Ellinwood was $47,500, as compared to the state of Kansas which is $59,597. 40% of Ellinwood citizens are 50 or older. The percentage of people at the poverty level or below in Ellinwood is 12%, the same as compared to the state poverty rate of 12%. Poverty level of those under 18 is 11% and for those over the age of 65 it is 10%. The patient population also includes patients from Russell, Rice, and Stafford Counties. The patient mix is heavily weighted toward Medicare and Medicaid beneficiaries, especially acute, ER, and swing bed care. Citation: U.S. Census Bureau (2019). American Community Survey 5-year estimates. Retrieved from Census Reporter Profile page for Ellinwood, KS <https://censusreporter.org/profiles/16000US2020425-ellinwood-ks/> Schedule H, Part VI, Line 5 Promotion of community health The hospital provides and promotes the health of the citizens of the Ellinwood district by constantly looking for opportunities to educate area residents about healthy activities and habits and offering opportunities for education about health care topics. Some of the activities to further the health of the area include: 1. Due to the COVID-19 pandemic, activities in which participants gather together, indoors or out, have been put on indefinite hold. Many of the normal events that EDH participates in were cancelled during this time frame. The impacts/reductions are listed in parentheses with each statement. 2. Reduced cost lab fairs are provided semi-annually with Ellinwood Hospital Foundation support. (None were held in 2022 due to COVID-19 numbers in Barton county / City of Ellinwood) 3. Educational classes are offered throughout the year, including classes to clubs and organizations in the community. Educational presentations are also made at local schools. (Two classes held in 2020) 4. We offer support to other healthcare related organizations, such as the local food bank, United Way, and Relay for Life, to raise awareness about health-related issues, such as cancer, and to ensure that their missions can be carried out, impacting the health and wellness of us all. 5. In conjunction with the community ambulance service, the hospital sponsors ACLS, PALS and CPR for professionals in Barton County. 6. TNCC classes for nurses are sponsored by the hospital for area health care professionals. 7. The hospital and its staff took the lead for the county medical organizations in emergency preparedness, especially concerning the new requirements faced by all other provider types. We host and participate in disaster/bioterrorism drills with other area health care facilities on a regular basis to encourage preparedness and awareness within our communities. 8. We support medical education in all forms, but especially by giving support to our local community colleges: top management serves on advisory boards for nursing program and medical assistant/coding programs at Barton Community College (BCC). The hospital is a practice site for phlebotomists/MLT, medical assistant program and nursing program from BCC. We are also a practice site for the physical therapy assistant program at Hutchinson Community College. We also have a job shadowing program with our local high school. This allows students to shadow a professional in the medical field they might be interested in pursuing in college. 9. EDH continues to dedicate itself and any surplus funds to improving the healthcare available to area residents and patients by updating equipment and ensuring that the hospital's technology is current and able to meet the patients' needs. Schedule H, Part VI, Line 6 Affiliated health care system Ellinwood District Hospital and Clinic are affiliated with Great Plains Health Alliance, Inc. (GPHA), a non-profit 501(c)(3) organization which provides management services and operational, finance, and accounting support. GPHA does not provide services directly to patients, but does provide access to professionals that may not be affordable to the normal critical access hospital. GPHA provides education and assistance in areas such as HIPAA, Medicare reimbursement, meaningful use requirements for computer systems, etc. GPHA is an affiliation of Critical Access Hospitals in Kansas and Nebraska that provides networking opportunities with other rural hospitals, communities, and leaders. GPHA provides policies and guidance to its Critical Access facilities regarding financial assistance, conflicts of interest, corporate compliance, and many other areas. GPHA also provides educational sessions for Board Members, Business Office Mangers, Billers, Medical Records personnel, Directors of Nursing, and Administrators. GPHA is a vital link in allowing CAH hospitals to operate at a high quality within the cash constraints imposed by the Critical Access program. Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care THE ORGANIZATION USED THE FOLLOWING CRITERIA TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE: ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, AND UNDERINSURANCE STATUS. Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 242494 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART I, LINE 7 OF SCHEDULE H, IS A COST TO CHARGE RATIO. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount HOSPITAL CHARGES THAT ARE NOT COLLECTED AND ARE NOT APPROVED FOR FINANCIAL ASSISTANCE ARE CLASSIFIED AS BAD DEBTS FROM PATIENTS WHO WILL NOT PAY. Schedule H, Part III, Line 3 Bad Debt Expense Methodology THE COSTING METHODOLOGY IS BASED ON THE ORGANIZATION'S MEDICARE COST-TO-CHARGE RATIO. WHILE WE RECOGNIZE THAT THERE WOULD BE SOME BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY, WE HAVE NO REASONABLE BASIS FOR ESTIMATING THIS FIGURE. IF ELIGIBILITY IS KNOWN, THE AMOUNT WOULD FALL UNDER CHARITY CARE AND NOT BAD DEBT. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote NOT APPLICABLE DUE TO ADOPTION OF ASC 606 REVENUE CONTRACTS WITH CUSTOMERS. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNT ON LINE 6 IS COST TO CHARGE RATIO. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance ALL CHARITY CARE CHARGES AND CHARGES NOT TO BE COLLECTED DUE TO FINANCIAL ASSISTANCE COMPUTATIONS ARE EXEMPT FROM COLLECTION POLICIES AND PRACTICES. THESE ACCOUNTS ARE REMOVED FROM THE COLLECTION CYCLE. Schedule H, Part V, Section B, Line 16a FAP website 1 - ELLINWOOD DISTRICT HOSPITAL: Line 16a URL: https://www.ellinwooddistricthospital.org/; Schedule H, Part V, Section B, Line 16b FAP Application website 1 - ELLINWOOD DISTRICT HOSPITAL: Line 16b URL: https://www.ellinwooddistricthospital.org/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website 1 - ELLINWOOD DISTRICT HOSPITAL: Line 16c URL: https://www.ellinwooddistricthospital.org/; Schedule H, Part VI, Line 7 State filing of community benefit report KS false false false false false false false false false CURT COLSON PRESIDENT/CEO/DIRECTOR 0 214367 0 0 0 1878 0 18997 0 30310 0 265552 0 0 KILE MAGNER ADMINISTRATOR 124490 0 0 0 187 0 12934 0 26826 0 164437 0 0 0 JASON BARB CFO 0 175716 0 0 0 1208 0 2692 0 29016 0 208632 0 0 CHRISTOPHER BROWN PHYSICIAN 278739 0 0 0 7913 0 20827 0 27446 0 334925 0 0 0 CHARLIE JOSLIN PHYSICIAN 215659 0 0 0 1749 0 22425 0 29901 0 269734 0 0 0 TROY MOORE DEPT HEAD PT 136174 0 0 0 0 0 13747 0 24876 0 174797 0 0 0 KELLI BROWN PHYSICIAN 110686 0 0 0 0 0 11552 0 26888 0 149126 0 0 0 Schedule J, Part I, Line 3 Form 990, Part VII ANNUAL COMPENSATION REVIEWS ARE COMPLETED BY THE CEO AND CHIEF FINANCIAL OFFICER USING RECOMMENDATIONS PROVIDED BY DEPARTMENT MANAGERS AND CURRENT MARKET CONDITIONS. ALL EXECUTIVE EMPLOYEE SALARIES, INCLUDING THE PRESIDENT/CEO, ARE APPROVED BY THE GPHA BOARD OF DIRECTORS. THE AMERICAN COLLEGE HEALTHCARE EXECUTIVES AND THE KANSAS HOSPITAL ASSOCIATION ALSO HAS COMPARABLE COMPENSATION DATA THAT CAN BE USED BY THE BOARD. THE CEO RETAINS DOCUMENTATION IN ADDITION TO THAT IN THE BOARD MINUTES. A ELLINWOOD HOSPITAL DISTRICT 480931413 000000000 2023-01-24 26000000 NEW HOSPITAL CONSTRUCTION false false false A 11843703 101396 440300 11301982 25 false false false true A false false true true false 0.0 0.0 0.0 false false true A false true false false false false false false true A true Schedule K, Part II, Line 3 PROCEEDS THE PROCEEDS OF THE BOND ARE FUNDED IN INSTALLMENTS. AS OF THE END OF THE YEAR, $11,824,963 OF THE TOTAL AVAILABLE $26,000,000 HAD BEEN DRAWN DOWN AND $18,740 OF INTEREST INCOME HAD BEEN EARNED, RESULTING IN $11,843,703 OF TOTAL PROCEEDS OF THE BOND ISSUE. Form 990, Part VI, Line 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS JASON BARB AND CURT COLSON HAVE A BUSINESS RELATIONSHIP. THEY ARE BOTH EMPLOYED BY, AND ALSO AN OFFICER OF, A RELATED 501(C)(3) ORGANIZATION, GREAT PLAINS HEALTH ALLIANCE. Form 990, Part VI, Line 15a & 15B THE CEO AND CFO ARE COMPENSATED BY GREAT PLAINS HEALTH ALLIANCE, A RELATED ORGANIZATION. GPHA'S BOARD USES COMPARABILITY DATA IN SETTING THEIR SALARIES, AND DOCUMENTATION IS RETAINED OF THE BOARD'S DELIBERATIONS AND DECISIONS. Form 990, Part VI, Line 6 Classes of members or stockholders GREAT PLAINS HEALTH ALLIANCE, INC., A NOT-FOR-PROFIT 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF GREAT PLAINS OF ELLINWOOD, INC. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body GREAT PLAINS HEALTH ALLIANCE, INC., BEING THE SOLE MEMBER, HAS THE RIGHT TO ELECT AND APPROVE ALL THE BOARD MEMBERS. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders GREAT PLAINS HEALTH ALLIANCE, INC (GPHA) IS THE SOLE MEMBER AND HAS THE AUTHORITY TO APPROVE THE ARTICLES OF INCORPORATION, BYLAWS, ELECTION TO OR REMOVAL FROM THE BOARD OF DIRECTORS, THE ANNUAL OPERATING AND CAPITAL BUDGETS, AND THE LONG RANGE OR STRATEGIC PLANS. Form 990, Part VI, Line 11b Review of form 990 by governing body THE 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE 990 IS THEN PROVIDED TO THE CHIEF EXECUTIVE OFFICER FOR REVIEW AND APPROVAL. AN ELECTRONIC DRAFT OF THE 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO THE FULL BOARD FOR REVIEW PRIOR TO FILING THE 990 WITH THE IRS. Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION IS REQUIRED TO ADOPT GPHA'S CONFLICT OF INTEREST POLICY. ALL BOARD MEMBERS, OFFICERS, AND EMPLOYEES ARE SUBJECT TO THE CONFLICT OF INTEREST POLICY AND SIGN AN ANNUAL ACKNOWLEDGEMENT THAT THEY HAVE READ, UNDERSTAND AND COMPLIED WITH THE GPHA CONFLICT OF INTEREST POLICY. UNDER THE POLICY, ANY MEMBER WHO HAS A DIRECT OR INDIRECT (VIA FAMILY) FINANCIAL INTEREST IS CHARACTERIZED AS AN INTERESTED PERSON. INTERESTED PERSONS ARE REQUIRED TO DISCLOSE FINANCIAL INTERESTS WITH COMPANIES DOING BUSINESS WITH GPHA. THE INTERESTED PERSON MUST RECUSE THEMSELVES FROM FURTHER DISCUSSIONS OF THE TRANSACTION AND LEAVE THE ROOM. THE REMAINING NON-INTERESTED MEMBERS DECIDE IF A CONFLICT OF INTEREST EXISTS. THE BOARD CHAIR MAY APPOINT ANOTHER DISINTERESTED PARTY TO DISCUSS THE TRANSACTION OR THE REMAINING BOARD MEMBERS MAY VOTE TO ENTER INTO OR ABSTAIN FROM THE SUSPECT TRANSACTION. FAILURE TO DISCLOSE FINANCIAL INTERESTS BY INTERESTED BOARD MEMBERS WILL RESULT IN DISCIPLINARY ACTION, INCLUDING SANCTIONING BY BOARD. ALL CONFLICTS OF INTEREST AND THEIR ULTIMATE RESOLUTION ARE DOCUMENTED IN THE BOARD MINUTES. THE BOARD CONDUCTS PERIODIC REVIEWS TO DETERMINE THAT CONFLICTS ARE BEING IDENTIFIED AND RESOLVED ACCORDING TO POLICY DOCUMENTATION. REVIEWS BY OUTSIDE EXPERTS ARE PERMITTED, BUT NOT REQUIRED. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE COMPANY'S KANSAS ANNUAL REPORT IS ALSO AVAILABLE UPON REQUEST FROM THE KANSAS SECRETARY OF STATE. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue MISCELLANEOUS REVENUE - Total Revenue: 25282, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 25282; Form 990, Part IX, Line 11g Other Fees CONTRACTED MEDICAL STAFF - Total Expense: 1128367, Program Service Expense: 1128367, Management and General Expenses: , Fundraising Expenses: ; BILLING/COLLECTIONS - Total Expense: 283616, Program Service Expense: , Management and General Expenses: 283616, Fundraising Expenses: ; LAB SERVICES - Total Expense: 209298, Program Service Expense: 209298, Management and General Expenses: , Fundraising Expenses: ; MAINTENANCE/HOUSEKEEPING - Total Expense: 98487, Program Service Expense: 98487, Management and General Expenses: , Fundraising Expenses: ; PHARMACY SERVICES - Total Expense: 62771, Program Service Expense: 62771, Management and General Expenses: , Fundraising Expenses: ; ADMINISTRATION/HUMAN RESOURCES - Total Expense: 29437, Program Service Expense: , Management and General Expenses: 29437, Fundraising Expenses: ; DIETARY SERVICES - Total Expense: 3145, Program Service Expense: 3145, Management and General Expenses: , Fundraising Expenses: ; GREAT PLAINS HEALTH ALLIANCE 250 N ROCK ROAD STE 160 WICHITA KS 67206 480617739 MANAGEMENT KS 501(c)(3) 3 N/A false GREAT PLAINS HEALTH CARE FOUNDATION INC 250 N ROCK ROAD STE 160 WICHITA KS 67206 480955870 SUPPORT KS 501(c)(3) 10 GPHA INC true GREAT PLAINS OF SABETHA COUNTY INC 250 N ROCK ROAD STE 160 WICHITA KS 67206 481236156 HOSPITAL KS 501(c)(3) 3 GPHA INC true GREAT PLAINS OF SMITH COUNTY INC 250 N ROCK ROAD STE 160 WICHITA KS 67206 481226830 HOSPITAL KS 501(c)(3) 3 GPHA INC true GREAT PLAINS OF REPUBLIC COUNTY IN 250 N ROCK ROAD STE 160 WICHITA KS 67037 481226977 HOSPITAL KS 501(c)(3) 3 GPHA INC true GREAT PLAINS OF CHEYENNE COUNTY 250 N ROCK ROAD STE 160 WICHITA KS 67206 481226831 HOSPITAL KS 501(c)(3) 3 GPHA INC true GREAT PLAINS OF OTTAWA COUNTY INC 250 N ROCK ROAD STE 160 WICHITA KS 67206 481226856 HOSPITAL KS 501(c)(3) 3 GPHA INC true GREAT PLAINS EMPLOYEE BENEFITS TRUST 250 N ROCK ROAD STE 160 WICHITA KS 67206 476918582 HEALTH PLAN KS 501(c)(9) GPHA INC true false false false false false false false false false false true true true false true false false true false GPHA Employee Benefit Plan R 627103 FMV