2023-08-08T09:16:27-05:00 2022-09-30 FORVIS LLP 1551 N WATERFRONT PKWY STE 300 WICHITA KS 672066601 990 2021-10-01 481226977 GREAT PLAINS OF REPUBLIC CO INC % JASON BARB GREA 3166851523 250 NORTH ROCK ROAD SUITE 160 WICHITA KS 67206 JASON BARB CFO 3166851523 2023-06-01 true JASON BARB 999009999 SHAWNELL LINOT P01663908 3162652811 2 2021 2023-04-26 12:10:37Z JASON BARB 250 NORTH ROCK ROAD SUITE 160 WICHITA KS 67206 22553418 false X WWW.RPHOSPITAL.ORG X 1999 KS TO OPERATE AN ACUTE CARE HOSPITAL THAT PROVIDES MEDICAL CARE TO THE GENERAL PUBLIC IN BELLEVILLE, KANSAS AND THE SURROUNDING RURAL COMMUNITIES IN REPUBLIC COUNTY. 8 7 200 10 0 6913771 4927358 16520477 17405333 19092 -12231 160952 200657 23614292 22521117 0 0 0 0 9534382 10802949 0 0 0 8436715 8068018 17971097 18870967 5643195 3650150 16186685 18168964 5558894 3891023 10627791 14277941 X 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 15828671 0 17413913 REPUBLIC COUNTY HOSPITAL'S (RCH) PRIMARY PROGRAM IS THE DELIVERY OF HEALTHCARE AND RELATED SERVICES TO PATIENTS FROM REPUBLIC COUNTY AND CONTIGUOUS COUNTIES IN KANSAS OF CLOUD, JEWELL AND WASHINGTON. SERVICES INCLUDE INPATIENT ACUTE, SURGERY, OUTPATIENT, OBSTETRIC, EMERGENCY ROOM, INTERMEDIATE SWING BED (ISB) AND SKILLED NURSING CARE (SNF). REPUBLIC COUNTY HOSPITAL PROVIDES NEEDED HEALTH CARE SERVICES TO PATIENTS WHO COME TO OUR HOSPITAL FOR CARE, REGARDLESS OF THE PATIENT'S ABILITY TO PAY AND HAS A FINANCIAL ASSISTANCE PROGRAM FOR THOSE PATIENTS WITH LIMITED RESOURCES. SEE SCHEDULE O FOR CONTINUATION. 15828671 true true false true false false false false false false true false false false false false true true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true true false true 33 0 true 200 true false false false false false false false false false false false false X 8 7 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 X DAVE DELLASEGA PRESIDENT/SECRETARY/DIRECTOR 2.0 40.0 X X 0 209142 59769 BRENT MARTIN COO 40.0 0.0 X 164280 0 50656 DANIEL KELLY ADMINISTRATOR 40.0 0.0 X 185950 0 13631 DURREL KELLEY SENIOR VP OF OPERATIONS 2.0 40.0 X 0 127901 30947 REBECCA BROWN DON 40.0 0.0 X 122705 0 27806 BARRY BOTTGER CFO 40.0 0.0 X 122089 0 28367 TRISHA CHAMPLIN RN 40.0 0.0 X 112587 0 34895 KELSEY MUGLER LAB TECH 40.0 0.0 X 99262 0 35566 JASON BARB CFO 0.25 40.0 X 0 46160 5528 DAVE RANKIN CHAIRMAN/DIRECTOR 0.25 2.25 X X 0 0 0 JOHN TERRILL VICE PRESIDENT/DIRECTOR 0.25 2.25 X X 0 0 0 STEVE CARLSON TREASURER/DIRECTOR 0.25 2.25 X X 0 0 0 DR BARBARA BROWN APPLEGATE DIRECTOR 0.25 2.25 X 0 0 0 ARTHUR HENDRICKSON DIRECTOR 0.25 2.25 X 0 0 0 CHARLES WESTIN DIRECTOR/CHAIRMAN 0.25 2.25 X X 0 0 0 ROGER JOHN DIRECTOR 0.25 2.25 X 0 0 0 806873 383203 287165 5 false true false GPHA 250 N ROCK RD STE 160 WICHITA KS 67206 MANAGEMENT AND SERV 856120 PSYCHIATRIC MEDICAL CARE LLC PO BOX 734606 DALLAS TX 753734606 CONTRACT SERVICES 451165 LARRY TROSHYNSKI 630 W 101ST PLACE OVERLAND PARK KS 66212 CONTRACT SERVICES 169500 QUALIVIS PO BOX 1180 COLUMBIA SC 29201 CONTRACT NURSING 340982 GLMV ARCHITECTURE 1525 E DOUGLAS AVE WICHITA KS 67211 ARCHITECT SERVICES 391155 13 1559397 3367961 4927358 NET PATIENT SERVICE REVENUE 621300 17405333 17405333 17405333 10380 10380 0 0 9338 9338 0 9338 9338 9690 32301 -22611 -22611 -22611 0 0 0 0 0 0 0 0 0 EMPLOYEE/GUEST MEALS 722513 60525 60525 OUTSIDE SERVICES 621300 8580 8580 VENDING INCOME/REBATES 900099 56674 56674 65540 65540 191319 22521117 17413913 179846 X 0 0 0 0 373568 373568 0 8187181 7255980 931201 544979 467489 77490 1102933 853647 249286 594288 506709 87579 173287 173287 26859 26859 49925 49925 3093 3093 0 0 2943656 2327284 616372 0 49282 7798 41484 1296736 1191980 104756 0 0 432956 383674 49282 7189 7078 111 0 46711 36618 10093 18959 18323 636 0 783321 715786 67535 136354 120789 15565 MEDICAL SUPPLIES 1739801 1739801 0 EQUIPMENT RENTAL & REPAIRS 195820 179878 15942 DUES & SUBSCRIPTIONS 36606 3030 33576 LICENSES/TAXES 4368 4368 0 123095 8439 114656 18870967 15828671 3042296 0 7697820 4572154 371798 570458 0 0 3168339 3335610 0 0 0 0 3086 3687 211983 231808 132614 592026 21134052 12824193 4583022 8309859 0 0 0 0 0 0 0 0 18023 553362 16186685 18168964 5501884 3409597 0 0 0 49614 0 0 0 0 0 0 57010 431812 0 0 0 0 5558894 3891023 X 10439754 14277941 188037 0 10627791 14277941 16186685 18168964 3650150 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 3093 false false false 3093 false SCHEDULE C, PART II-B, LINE 1F A PORTION OF THE ANNUAL DUES PAID TO KHA AND AHA ARE USED FOR LOBBYING. 14107 14107 8166655 7250499 916156 9808039 5111008 4697031 3145251 462686 2682565 8309859 22521117 22521117 22521117 18870967 18870967 18870967 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. true true X true X false true true false true true 143179 143179 0.00760 1222559 454366 768193 0.04070 1365738 454366 911372 0.04830 8781 8781 0.00050 140 140 8921 8921 0.00050 1374659 454366 920293 0.04880 false 319801 9822498 9822498 X true true 1 1 REPULIC COUNTY HOSPITAL 2420 G STREET BELLEVILLE KS 66935 WWW.RPHOSPITAL.ORG H079001 X X X X 1 REPULIC COUNTY HOSPITAL 1 false false true X X X X X X X X X 21 true false true true X SEE SCHEDULE H, PART V, SECTION C X true 21 true SEE SCHEDULE H, PART V, SECTION C false true X 200. 0. X X X X true true X X X true X SEE SCHEDULE H, PART V, SECTION C X SEE SCHEDULE H, PART V, SECTION C X SEE SCH H, PART V, SECTION C 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 THE ASSESSMENT PROCESS WAS INITIATED AND CHAIRED JOINTLY BY REPUBLIC COUNTY HOSPITAL AND THE REPUBLIC COUNTY HEALTH DEPARTMENT. ALL OF THE EDUCATIONAL, GOVERNMENTAL, CIVIC AND HEALTH RELATED ORGANIZATIONS WITHIN THE COMMUNITY WERE INVITED TO PARTICIPATE. SCHEDULE H, PART V, LINE 6B REPUBLIC COUNTY HEALTH DEPARTMENT SCHEDULE H, PART V, SECTION B, LINE 7A https://www.rphospital.org/getpage.php?name=Community_Health_Needs_Assessm ent SCHEDULE H, PART V, SECTION B, LINE 10A https://www.rphospital.org/getpage.php?name=Community_Health_Needs_Assessm ent SCHEDULE H, PART V, SECTION B, LINE 11 THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED NINE (9) SPECIFIC COMMUNITY HEALTH NEEDS. TWO OF THOSE NINE NEEDS (HOUSING AND CHILDCARE) WERE NOT ADDRESSED DUE TO A LACK OF FINANCIAL RESOURCES AND/OR DEEMED OUTSIDE THE SCOPE OF HOSPITAL MISSION OF CRITICAL OPPERATIONS. REPUBLIC COUNTY HOSPITAL (RCH) IS PROMOTING PHYSICAL AND MENTAL HEALTH, WELLNESS, AND CHRONIC DISEASE PREVENTION. RCH IS COLLABORATING WITH OTHER PROVIDERS IN THE COUNTY TO PROVIDE EDUCATION RESOURCES AND SUPPORTING THE REPUBLIC COUNTY HEALTH DEPARTMENT, REPUBLIC COUNTY RESOURCE COUNCIL AND SCHOOL DISTRICTS USD 109 AND 426 IN REPUBLIC COUNTY. RCH IS IMPROVING ACCESS TO INFORMATION AND ASSISTANCE ACROSS MULTIPLE NEEDS AND POPULATIONS. THE HOSPITAL IS SUPPORTING THE REPUBLIC COUNTY RESOURCE COUNCIL IN KEEPING THE HEALTH SERVICES DIRECTORY CURRENT AND AVAILABLE TO THE PUBLIC. ADDITIONALLY, RCH IS WORKING WITH OTHER PROVIDERS TO ENHANCE AWARENESS FOR EXISTING PROGRAMS AND SERVICES WHILE ALSO WORKING TO ESTABLISH SUSTAINABLE ATTENTION IN PROMOTING HEALTHY LIVING THROUGH PROGRAMMING SPECIFIC TO PATIENT POPULATIONS AND NEEDS AS OUTLINE IN THE RCH CHNA IMPLEMENTATION PLAN. SCHEDULE H, PART V, SECTION B, LINE 16A, B & C HTTPS://WWW.RPHOSPITAL.ORG/GETPAGE.PHP?NAME=FINANCIAL_ASSISTANCE&SUB=PATIE NTS%20%26%20VISITORS 2 BELLEVILLE MEDICAL CLINIC PA 2337 G STREET BELLEVILLE KS 66935 MEDICAL CLINIC REPUBLIC COUNTY MEDICAL FAMILY PHYSICIAN 2337 G STREET BELLEVILLE KS 66935 MEDICAL CLINIC SCHEDULE H, PART I, LINE 3C 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, COLUMN F NOT APPLICABLE DUE TO ADOPTION OF ASC 606 REVENUE CONTRACTS WITH CUSTOMERS. SCHEDULE H, PART I, LINE 7 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 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 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 NOT APPLICABLE DUE TO ADOPTION OF ASC 606 REVENUE CONTRACTS WITH CUSTOMERS. SCHEDULE H, PART III, LINE 8 THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNT ON LINE 6 IS A COST TO CHARGE RATIO. SCHEDULE H, PART III, LINE 9B ALL CHARITY CARE 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 VI, LINE 2 The Republic County Hospital (RCH) assesses the health care needs of the community it serves in an ongoing fashion. RCH strives to provide services that meet patient needs, and that the needs of the population served guide decisions about which services will be provided directly or through referral, consultation, contractual arrangements, or other agreements. We determine these needs in a variety of ways. In 2022, a Community Health Needs Assessment (CHNA) was conducted by VVV Consultants LLC. This assessment involved an extensive on-line survey and a town-hall meeting with community stakeholders (plus other extensive data collection) that addressed access to primary care health services, health insurance, travel distance for services, hospital services, county health department services and other county health related services. The survey identified the top nine community concerns, in which seven of the nine were identified as the top health concerns in our County. The results of this survey were shared with the public, community stakeholders and providers, and were used to address the perceived health related need in the identified areas. A copy of the results the CHNA and Implementation Strategy Plan are available upon request and posted to our website, www.rphospital.org.) Using the Community Health Needs Assessment that was conducted by VVV Consultants LLC for FY ending September 30th, 2022, community and stakeholder input a Community Health Implementation Strategy for 2022-2023 was developed, approved by the Board of Trustees, and is posted on the Republic County Hospital website as noted. The 2022 Implementation Strategy Plan- Year 1 of 3 (starting 10/1/22-9/30/23) was reviewed and approved by the Governing Board September 26th, 2022, as required by Law, and is posted on the website as well. An important component of the Hospital Mission and Vision is that of being a health resource to the community by advocating healthy behaviors, working in concert with other health care providers, promoting health services through education, and by recruiting and retaining qualified health professionals. Services are also assessed through HCAHPS patient satisfaction survey processes. Board Meetings are open to the public and we have open communication with our patients and their physicians about the types and quality of services provided. Needs are also identified through community involvement and are brought to the hospital through the Patient and Family Advisory Council, which meets regularly. SCHEDULE H, PART VI, LINE 3 The Republic County Hospital has a written financial assistance/charity care policy and a credit policy that is included in the patient information brochure received by all inpatients and outpatient surgery patients. The credit policy is also posted on the Hospital's website, www.rphospital.org. In addition to other payment options the patient brochure, website and each billing statement sent to patients includes the statement "Republic County Hospital also offers a healthcare assistance program that provides medical care free, or at reduced rates, for patients who qualify based on income guidelines". The Hospital's Financial Counselor visits with private pay patients and patients with high deductibles to determine if they qualify for the Hospital charity care/financial assistance program. The hospital also employs a Social Services worker who consults and assists private pay or uninsured patients to determine if they qualify for assistance through the State Medicaid Program or other government programs. This employee is a member of the County Resource Council. The Social Services worker will assist in completing the applications for medical assistance and act as a resource for other health related services. SCHEDULE H, PART VI, LINE 4 Republic County Hospital is located in Belleville, Kansas and serves the residents of Republic County and surrounding area. The est. population of Republic County, by 2019 census, is 4,636 which is down 6.9% since 2010. The service area for the Hospital is Republic County and contiguous counties in Northcentral Kansas and Southcentral Nebraska. These Counties in Kansas are exclusively rural. Republic County has a population density of less than 8 people per square mile and 27.8% of the population is over the age of 65 years. The racial makeup of the county by 2019 census was 96.6% White, 2.6% Hispanic or Latin American and .8% Black or African American. 5.9% of the population was under 5 years of age and the per capita income in the past 12 months (in 2029 dollars) is $24,647. Specifically, 12.2% of Republic County households are living in poverty with 8.7% of the population experiencing severe housing problems. Approximately 60% of hospital services are delivered to patients 65 years of age or older. Complete demographics and other information are available on the Hospital Website in the CHNA section. SCHEDULE H, PART VI, LINE 5 Republic County Hospital participates in community building activities. The hospital is very active in community education on the benefits of immunizations for the prevention of influenza and pneumonia. We work with the County Health Department, Nursing Homes in the community and with local physicians and pharmacies to improve immunization rates. The hospital is very active in and is an integral part of our County Emergency Preparedness activities. The Hospital is an education provider for continuing education and in addition to other classes presents classes for CPR, ACLS, NRP and TNCC certifications. We work closely with the County EMS in the delivery of emergency services. The hospital is an educational site for nursing students from the Cloud County Community College and we frequently have Medical Students in our facility for clinical clerkships and Family Practice Residents here for month long rural residencies. We are also a clinical practice site for Medical Laboratory Technicians, Physician Assistant Students, various Allied Health Students and Advanced Practice Registered Nurse Students. We provide scholarships for students enrolled in health-related professional studies. Republic County Hospital also collaborate with and assists with leadership to the local North Central Kansas Health Care Foundation to support activities related to physician recruitment and supporting the healthcare infrastructure in Republic County. The Chief Executive Officer participates as a Board Member of the Republic County Economic Development Corporation. The hospital sponsors and holds an annual community health fair to educate the community on current and ongoing health issues. We have fully implemented an electronic health record that can be shared with other providers to improve care and reduce health care costs. The hospital also takes seriously its efforts at promoting the mental health for seniors in its community in partnership with the Senior Life Solutions program in Republic County. Republic County Hospital is a 25 bed Critical Access Hospital and Level 4 Trauma rated facility. The Hospital provides 24-hour Emergency Room Care and financially subsidizes this service. The Hospital contracts with the local physicians and since the cost of the coverage far exceeds the income generated through the ER, we consider this to be a heavily subsidized service. The hospital participates in all government health care plans and is the only hospital in Republic County. We have an open medical staff and have several specialist physicians holding outpatient clinics in our community preventing the need for persons in our community to travel long distances for these specialty medical services. We promote community health through health fairs, public service announcements, classes through collaboration and support of various health education opportunities across the community we serve. The hospital works closely with a regional hospice provider in the provision Hospice services. The hospital provides Childbirth Education Classes and Breastfeeding support to our patients and community. SCHEDULE H, PART VI, LINE 6 Organization is 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 to the Hospital. GPHA does not provide services directly to patients, but it 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 system, etc. GPHA is an affiliation of Critical Access Hospitals in Kansas and Nebraska that provides networking opportunities with other rural hospitals, communities and other health care organizations. 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 Managers, Billers, Medical Records personnel 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 VI, LINE 7 N/A false false false false false false false false false DAVE DELLASEGA PRESIDENT/SECRETARY/DIRECTOR 0 206439 0 0 0 2703 0 20695 0 39074 0 268911 0 0 DURREL KELLEY SENIOR VP OF OPERATIONS 0 126271 0 0 0 1630 0 12293 0 18654 0 158848 0 0 DANIEL KELLY ADMINISTRATOR 183787 0 0 0 2163 0 773 0 12858 0 199581 0 0 0 BRENT MARTIN COO 162433 0 0 0 1847 0 15628 0 35028 0 214936 0 0 0 REBECCA BROWN DON 121263 0 0 0 1442 0 11470 0 16336 0 150511 0 0 0 BARRY BOTTGER CFO 120653 0 0 0 1436 0 11409 0 16958 0 150456 0 0 0 FORM 990, PART VII; SCHEDULE J, PART I, LINE 3 COMPENSATION FOR DURREL KELLEY, DAVE DELLASEGA, AND JASON BARB IS PROVIDED BY GREAT PLAINS HEALTH ALLIANCE, A RELATED ORGANIZATION. GREAT PLAINS HEALTH ALLIANCE'S BOARD OF DIRECTORS ANNUALLY APPROVE THE COMPENSATION FOR MR. KELLEY, MR. DELLASEGA, AND MR. BARB. THE AMERICAN COLLEGE HEALTHCARE EXECUTIVES AND THE KANSAS HOSPITAL ASSOCIATION ALSO HAVE COMPARABLE COMPENSATION DATA THAT CAN BE USED BY THE BOARD. A COMPENSATION REVIEW WAS DONE WHEN DAVE DELLASEGA TOOK OVER AS CEO AND WAS CONDUCTED BY THE BOARD, BUT SINCE THAT TIME THERE HAS BEEN NO FORMAL COMPENSATION REVIEW. FORM 990, PART III, LINE 4A Republic County Hospital's (RCH) primary program is the delivery of healthcare and related services to patients from Republic County and contiguous counties in Northcentral Kansas and Southcentral Nebraska. Services include inpatient acute, surgery, outpatient, obstetric, emergency room and Intermediate Swing Bed (ISB). Republic County Hospital provides needed health care services to patients who come to our hospital for care, regardless of the patient's ability to pay and has a financial assistance program for those patients with limited resources. Major accomplishments in FY 2022 include the following: 1) RCH has and continues to support the citizens of Republic County through the federal Public Health Emergency for COVID- 19 (PHE) set to expire May 11th, 2023. Our involvement has been multifaceted from organizing and assisting with community planning to mitigation, testing, with administering the vaccine and other approved treatments. 2) The hospital attested to Meaningful Use Stage 3. 3) Hospital staff provides education to the community including smoking cessation and works closely with area schools on prevention of head injuries occurring during sports. 4) The hospital maintains the outpatient seniors group therapy program Senior Life Solutions. 5) Retained and recertified for our Level 4 Trauma certification. 6) Continues to update our website meeting the price transparency requirements for CMS and No Surprises Act requirements. 7) Continue Case Management services for our patients. 8) Hospital participates in open forum coffee for local chamber of commerce on a weekly basis. 9) Hospital also regularly serves as a clinical site for nursing students and Certified Nursing Assistant (CNA) students from a neighboring community college. 10) Continues to offer regular exercise programming for our community. 11) Continue to provide patient assistance with a certified diabetic educator. 12) RCH continues to provide a breastfeeding program for the community and provides education and patient support to breast feeding mothers in the community with an international board-certified lactation consultant. The hospital also provides Childbirth Education Classes. 13) Collaborates with the North Central Kansas Healthcare foundations through providing community education on the services we provide and offering a community health fair in conjunction with their annual radiothon fundraiser. 14) Supply appropriate patients discharging from our ED with flu kits. 15) The RCH BOT reviewed and approved our 2022 Community Health Needs Assessment and Implementation Strategy -for FY ending Sept. 2023. The CHNA and Implementation Strategy can be found on our hospital website. 16) Below please find the: A Year in Review - RCH 2022 that list changes in roles, major accomplishments with surveys, accreditations and equipment upgrades and additional services. FORM 990, PART VI, SECTION A, LINE 2 DAVE DELLASEGA, DURREL KELLEY, AND JASON BARB HAVE A BUSINESS RELATIONSHIP. THEY ARE BOTH EMPLOYED BY, AND ALSO OFFICERS OF, A RELATED 501(C)(3) ORGANIZATION, GREAT PLAINS HEALTH ALLIANCE. FORM 990, PART VI, SECTION A, LINE 6 GREAT PLAINS HEALTH ALLIANCE, INC., A NOT-FOR-PROFIT, 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF GREAT PLAINS OF REPUBLIC CO., INC. FORM 990, PART VI, SECTION A, LINE 7A GREAT PLAINS HEALTH ALLIANCE, INC., BEING THE SOLE MEMBER, HAS THE RIGHT TO ELECT AND APPROVE ALL THE BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B 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, SECTION B, LINE 11B 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, SECTION B, LINE 12C 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, SECTION B, LINES 15A & B THE CEO AND COO 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, SECTION C, LINE 19 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 IX LINE 11G DESCRIPTION:CONTRACTED MEDICAL STAFF TOTAL FEES:1837327 FORM 990 PART IX LINE 11G DESCRIPTION:BILLING/COLLECTIONS TOTAL FEES:150151 FORM 990 PART IX LINE 11G DESCRIPTION:LAB SERVICES TOTAL FEES:226803 FORM 990 PART IX LINE 11G DESCRIPTION:PHARMACY SERVICES TOTAL FEES:186293 FORM 990 PART IX LINE 11G DESCRIPTION:ADMINISTRATION/HUMAN RESOURCES TOTAL FEES:456474 FORM 990 PART IX LINE 11G DESCRIPTION:MAINTENANCE/HOUSEKEEPING TOTAL FEES:21347 FORM 990 PART IX LINE 11G DESCRIPTION:PLANT OPERATIONS TOTAL FEES:64042 FORM 990 PART IX LINE 11G DESCRIPTION:DIETARY SERVICES TOTAL FEES:1219 GREAT PLAINS HEALTH ALLIANCE 250 N ROCK ROAD STE 160 WICHITA KS 67206 480617739 MANAGEMENT KS 501(C)(3) 3 NA 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 OTTAWA COUNTY INC 250 N ROCK ROAD STE 160 WICHITA KS 67206 481226856 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 CHEYENNE COUNTY 250 N ROCK ROAD STE 160 WICHITA KS 67206 481226831 HOSPITAL KS 501(C)(3) 3 GPHA INC true GREAT PLAINS OF ELLINWOOD INC 250 N ROCK ROAD STE 160 WICHITA KS 67206 481226976 HOSPITAL KS 501(C)(3) 3 GPHA INC true GPHA 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 false true false false false false true false GPHA EMPLOYEE BENEFITS TRUST R 985781 FMV