GREAT PLAINS OF OTTAWA CO INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- GREAT PLAINS OF OTTAWA CO INC (EIN 48-1226856)
- Tax period
- 2021-10-01 to 2022-09-30
- Filed
- 2023-08-09
- IRS object ID
- 202302219349301960
- Schema version
- 2021v4.2
- 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 | 2023-08-09T16:30:08-05:00 | ReturnTs |
| Tax Period End | 2022-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FORVIS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1551 N WATERFRONT PKWY STE 300 | AddressLine1Txt |
| City | WICHITA | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 672066601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 481226856 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREAT PLAINS OF OTTAWA CO INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % JASON BARB | InCareOfNm |
| Business Name Control | GREA | BusinessNameControlTxt |
| Phone | 3166851523 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 NORTH ROCK ROAD STE 160 | AddressLine1Txt |
| City | WICHITA | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67206 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JASON BARB | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3166851523 | PhoneNum |
| Signature | 2023-06-01 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JASON | PersonFirstNm |
| Person Last | BARB | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SHAWNELL LINOT | PreparerPersonNm |
| PTIN | P01663908 | PTIN |
| Phone | 3162652811 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JASON BARB | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 NORTH ROCK ROAD STE 160 | AddressLine1Txt |
| City | WICHITA | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67206 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $9,046,004 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.OTTAWACOUNTYHEALTHCENTER.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1999 | FormationYr |
| Legal Domicile State | KS | LegalDomicileStateCd |
| Activity Or Mission | TO OPERATE HOSPITAL FACILITIES FOR THE DELIVERY OF HOSPITAL AND RELATED HEALTH-CARE SERVICES AND PROMOTE THE HEALTH AND WELLNESS OF THE MINNEAPOLIS AND OTTAWA COUNTY KANSAS AREA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 107 | TotalEmployeeCnt |
| Total Volunteers | 5 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $3,238,745 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,460,437 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,936,108 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $7,508,448 | CYProgramServiceRevenueAmt |
| PY Investment Income | $19,345 | PYInvestmentIncomeAmt |
| CY Investment Income | $33,193 | CYInvestmentIncomeAmt |
| PY Other Revenue | $17,783 | PYOtherRevenueAmt |
| CY Other Revenue | $43,926 | CYOtherRevenueAmt |
| PY Total Revenue | $10,211,981 | PYTotalRevenueAmt |
| CY Total Revenue | $9,046,004 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,309,972 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,202,316 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,061,431 | PYOtherExpensesAmt |
| CY Other Expenses | $3,914,456 | CYOtherExpensesAmt |
| PY Total Expenses | $7,371,403 | PYTotalExpensesAmt |
| CY Total Expenses | $8,116,772 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,840,578 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $929,232 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $12,881,385 | TotalAssetsBOYAmt |
| Total Assets EOY | $12,909,045 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,696,032 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $794,460 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,185,353 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $12,114,585 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO OPERATE HOSPITAL FACILITIES FOR THE DELIVERY OF HOSPITAL AND RELATED HEALTH-CARE PURPOSES AND TO PROMOTE THE HEALTH AND WELLNESS OF THE MINNEAPOLIS AND OTTAWA COUNTY KANSAS AREA. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $6,424,440 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $7,524,425 | RevenueAmt |
| Desc | THE HOSPITAL'S PRIMARY PROGRAM IS THE DELIVERY OF HEALTHCARE AND RELATED SERVICES TO RESIDENTS OF OTTAWA COUNTY, KANSAS. PRIMARY SERVICES INCLUDE INPATIENT CARE (ACUTE AND SWING-BED); OUTPATIENT AND ANCILLARY SERVICES (ER, OBSERVATION, LAB, RADIOLOGY, REHABILITATION THERAPIES, ETC.); INTERMEDIATE SWING-BEDS AND LONG-TERM CARE, AND A COMMUNITY WELLNESS/FITNESS CENTER. SEE SCHEDULE O FOR CONTINUATION. | Desc |
| Total Program Service Expenses | $6,424,440 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (true) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 41 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 107 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JASON BARB | PersonNm |
| Phone | 3166851523 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 NORTH ROCK ROAD STE 160 | AddressLine1Txt |
| City | WICHITA | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67206 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 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 |
|---|---|---|---|---|---|---|---|---|
| DAVE DELLASEGA | ||||||||
| PRESIDENT/DIRECTOR/SECRETARY | 0.25 | 40.0 | Yes (X) | Yes (X) | $0 | $209,142 | $59,769 | |
| JODY PARKS | ||||||||
| ADMINISTRATOR | 40.0 | 0.0 | Yes (X) | $163,548 | $0 | $43,402 | ||
| CHERYL LANOUE | ||||||||
| BUSINESS OFFICE MANAGER/CFO | 40.0 | 0.0 | Yes (X) | $130,539 | $0 | $38,135 | ||
| MARLENE GAWITH | ||||||||
| DON | 40.0 | 0.0 | $131,244 | $0 | $27,765 | Yes (X) | ||
| DURREL KELLEY | ||||||||
| SENIOR VP OF OPERATIONS | 2.0 | 40.0 | Yes (X) | $0 | $127,901 | $30,947 | ||
| JASON BARB | ||||||||
| CFO | 0.25 | 40.0 | Yes (X) | $0 | $46,160 | $5,528 | ||
| DAVE RANKIN | ||||||||
| DIRECTOR/CHAIRMAN | 0.25 | 2.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JOHN TERRILL | ||||||||
| VICE PRESIDENT/DIRECTOR | 0.25 | 2.25 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| STEVE CARLSON | ||||||||
| TREASURER/DIRECTOR | 0.25 | 2.25 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DR BARBARA BROWN APPLEGATE | ||||||||
| DIRECTOR | 0.25 | 2.25 | Yes (X) | $0 | $0 | $0 | ||
| ARTHUR HENDRICKSON | ||||||||
| DIRECTOR | 0.25 | 2.25 | Yes (X) | $0 | $0 | $0 | ||
| CHARLES WESTIN | ||||||||
| DIRECTOR/CHAIRMAN | 0.25 | 2.25 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ROGER JOHN | ||||||||
| DIRECTOR | 0.25 | 2.25 | Yes (X) | $0 | $0 | $0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $425,331 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $383,203 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $205,546 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| GPHA | |||||
| 250 N ROCK RD STE 160 | WICHITA | KS | 67206 | MANAGEMENT AND CBO | $581,205 |
| LABES BRUCE MD | |||||
| 1135 WINDMILL RD | DELPHOS | KS | 67436 | CONTRACT SERVICES | $116,050 |
| CASCADE HEALTH SERVICES | |||||
| 1001 NW BARRY ROAD | KANSAS CITY | MO | 64155 | CONTRACT SERVICES | $211,271 |
| SUPERIOR CONTRACT MANUFACTURING S | |||||
| 1655-B WALL STREET | SALINA | KS | 67401 | CONSTRUCTION SERVICE | $132,660 |
| AYA HEALTH CARE INC | |||||
| PO BOX 123519 | DALLAS | TX | 753123519 | CONTRACT SERVICES | $152,764 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,460,437 | GovernmentGrantsAmt |
| Total Contributions | $1,460,437 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621300 | $7,465,106 | $7,465,106 |
| WELLNESS CENTER | 621400 | $43,342 | $43,342 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $7,508,448 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $33,193 | TotalRevenueColumnAmt |
| Exclusion | $33,193 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| EMPLOYEE/GUEST MEALS | 722320 | $4,217 | $4,217 |
| VENDOR REBATES/PURCHASE DISCOUNTS | 900099 | $23,725 | $23,725 |
| All Other Misc Revenue | $15,984 | $15,984 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,984 | TotalRevenueColumnAmt |
| Exclusion | $15,984 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $43,926 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,046,004 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,508,448 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $77,119 | 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 | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $372,137 | TotalAmt |
| Management And General | $372,137 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,828,149 | TotalAmt |
| Program Services | $2,431,385 | ProgramServicesAmt |
| Management And General | $396,764 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $211,233 | TotalAmt |
| Program Services | $173,859 | ProgramServicesAmt |
| Management And General | $37,374 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $562,257 | TotalAmt |
| Program Services | $441,672 | ProgramServicesAmt |
| Management And General | $120,585 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $228,540 | TotalAmt |
| Program Services | $180,212 | ProgramServicesAmt |
| Management And General | $48,328 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,144 | TotalAmt |
| Management And General | $100,144 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,542 | TotalAmt |
| Management And General | $43,542 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $995 | TotalAmt |
| Management And General | $995 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,129,145 | TotalAmt |
| Program Services | $1,922,252 | ProgramServicesAmt |
| Management And General | $206,893 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,611 | TotalAmt |
| Program Services | $1,306 | ProgramServicesAmt |
| Management And General | $305 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $280,359 | TotalAmt |
| Program Services | $244,291 | ProgramServicesAmt |
| Management And General | $36,068 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $191,747 | TotalAmt |
| Program Services | $120,166 | ProgramServicesAmt |
| Management And General | $71,581 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,775 | TotalAmt |
| Program Services | $1,733 | ProgramServicesAmt |
| Management And General | $42 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,341 | TotalAmt |
| Program Services | $1,501 | ProgramServicesAmt |
| Management And General | $2,840 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $749,311 | TotalAmt |
| Program Services | $548,504 | ProgramServicesAmt |
| Management And General | $200,807 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,201 | TotalAmt |
| Program Services | $53,544 | ProgramServicesAmt |
| Management And General | $26,657 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $232,734 | $232,667 | $67 |
| EQUIPMENT RENTAL & REPAIRS | $78,998 | $66,301 | $12,697 |
| DUES & SUBSCRIPTIONS | $14,436 | $1,113 | $13,323 |
| _ | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,117 | TotalAmt |
| Program Services | $3,934 | ProgramServicesAmt |
| Management And General | $1,183 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,116,772 | TotalAmt |
| Program Services | $6,424,440 | ProgramServicesAmt |
| Management And General | $1,692,332 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,009,829 | BOYAmt |
| EOY | $413,490 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,368,545 | BOYAmt |
| EOY | $6,291,176 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,605,288 | BOYAmt |
| EOY | $651,395 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $106,333 | BOYAmt |
| EOY | $101,968 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $95,981 | BOYAmt |
| EOY | $87,868 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $12,298,023 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,062,096 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,598,897 | BOYAmt |
| EOY | $5,235,927 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $96,512 | BOYAmt |
| EOY | $127,221 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,881,385 | BOYAmt |
| EOY | $12,909,045 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $633,135 | BOYAmt |
| EOY | $703,460 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $850 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,062,047 | BOYAmt |
| EOY | $91,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,696,032 | BOYAmt |
| EOY | $794,460 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,185,353 | BOYAmt |
| EOY | $12,114,585 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,185,353 | BOYAmt |
| EOY | $12,114,585 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,881,385 | BOYAmt |
| EOY | $12,909,045 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $929,232 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
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) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (true) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $995 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Total Lobbying Expenditures | $995 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1F | FormAndLineReferenceDesc |
| Explanation | A PORTION OF THE ANNUAL DUES PAID TO KHA AND AHA ARE USED FOR LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $19,000 | OtherCostOrOtherBasisAmt |
| Book Value | $19,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,303,072 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,768,799 | DepreciationAmt |
| Book Value | $3,534,273 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,410,802 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,883,264 | DepreciationAmt |
| Book Value | $1,527,538 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $565,149 | OtherCostOrOtherBasisAmt |
| Depreciation | $410,033 | DepreciationAmt |
| Book Value | $155,116 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,235,927 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | THIRD PARTY PAYABLE | Desc |
| Amt | $91,000 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $91,000 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $9,046,004 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $9,046,004 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $9,046,004 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $8,116,772 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $8,116,772 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $8,116,772 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART X, LINE 2 | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,080 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $9,080 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $281,847 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $78,358 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $203,489 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02510 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $290,927 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $78,358 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $212,569 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02620 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $290,927 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $78,358 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $212,569 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02620 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $74,721 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $5,109,596 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $5,109,596 | CostOfCareReimbursedByMedcrAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | 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 | OTTAWA COUNTY HEALTH CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 215 E 8TH STREET | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67467 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.OTTAWACOUNTYHEALTHCENTER.COM | WebsiteAddressTxt |
| State License | A072002 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Facility Reporting Group | 1 | FacilityReportingGroupCd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OTTAWA COUNTY HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | 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 | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SCHEDULE H, PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SCHEDULE H, PART V, SECTION C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 0. | 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 |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE SCHEDULE H, PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE SCHEDULE H, PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE SCH H, PART V, SECTION C | 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 |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | 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 (true) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, LINE 5 | THE ASSESSMENT PROCESS WAS INITIATED AND CHAIRED JOINTLY BY OTTAWA COUNTY HEALTH CENTER, OTTAWA COUNTY HEALTH DEPARTMENT, OTTAWA COUNTY HEALTH PLANNING COMMISSION AND OTTAWA COUNTY ECONOMIC DEVELOPMENT. A BROAD-BASED GROUP OF COMMUNITY LEADERS AND COUNTY RESIDENTS WERE INVITED TO PARTICIPATE. |
| SCHEDULE H, PART V, LINE 6B | OTTAWA COUNTY HEALTH DEPARTMENT, OTTAWA COUNTY HEALTH PLANNING COMMISSION AND OTTAWA COUNTY ECONOMIC DEVELOPMENT |
| SCHEDULE H, PART V, LINE 7A | HTTP://WWW.OTTAWACOUNTYHEALTHCENTER.COM |
| SCHEDULE H, PART V, LINE 10A | HTTP://WWW.OTTAWACOUNTYHEALTHCENTER.COM |
| SCHEDULE H, PART V, LINE 11 | 2022 CHNA PRIORITIES: The below priorities and goals were established following our September 2022 Community Health Needs Assessment. OCHC will take steps and create initiatives to address these priorities over the next three years, 2022-2025. PRIORITY 1: OBESITY/PHYSICAL INACTIVITY/LACK OF HEALTHY BEHAVIORS Goal 1: Improve Access to/Increase interest in the Wellness Center Goal 2: Community Health Education PRIORITY 2: LACK OF AWARENESS REGARDING AVAILABLE HEALTH SERVICE IN THE COMMUNITY Goal 1: Promote Ottawa County Health Center's Services Offered Goal 2: Provide Educational Opportunities to Surrounding Area Residents THE HOSPITAL WILL WORK WITH COMMUNITY PARTNERS AND/OR HEALTH ISSUE EXPERTS ON THE FOLLOWING FOR EACH OF THE APPROACHES TO ADDRESSING THE IDENTIFIED HEALTH NEEDS: DEVELOP WORK PLANS TO SUPPORT EFFECTIVE IMPLEMENTATION, CREATE MECHANISMS TO MONITOR AND MEASURE OUTCOMES. AND PROVIDE ON-GOING STATUS AND RESULTS OF THESE EFFORTS TO IMPROVE COMMUNITY HEALTH. WHILE SOME OF THE NEEDS WERE COMBINED IN IDENTIFYING THE ABOVE PRIORITIES, OTHER NEEDS WERE NOT ADDRESSED DUE TO A LACK OF FINANCIAL AND OTHER RESOURCES. |
| SCHEDULE H, PART V, LINE 16A, B, & C | HTTP://WWW.OTTAWACOUNTYHEALTHCENTER.COM/PATIENT-INFORMATION.HTML |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 HOSPITAL HAS SEVERAL AVENUES TO ASSESS THE NEEDS OF THE COMMUNITY: (1) THE COUNTY COMMISSIONERS APPOINT A 5-PERSON GOVERNING BOARD, THE OTTAWA COUNTY HEALTH CENTER BOARD OF TRUSTEES, MADE UP OF LOCAL COUNTY RESIDENTS. THESE BOARD MEMBERS, WHO RESIDE IN VARIOUS AREAS OF THE COUNTY, ARE A VITAL LINK IN COMMUNICATION TO THE COMMUNITY. (2) THE OTTAWA COUNTY HEALTH CENTER BOARD OF TRUSTEES OWNS THE LOCAL PHYSICIAN'S CLINIC BUILDING TO ENSURE THAT HEALTHCARE PROVIDERS HAVE THE SPACE AND OFFICES FROM WHICH TO BASE THEIR PRACTICES AND PROVIDE NECESSARY SERVICES TO THE COMMUNITY. (3) THE HOSPITAL WORKS CLOSELY AND PARTNERS WITH THE COUNTY PUBLIC HEALTH DEPARTMENT TO IDENTIFY PATIENTS WHO REQUIRE SPECIALIZED OR ADDITIONAL CARE AND TO COORDINATE PROGRAMS TO IMPROVE OVERALL COUNTY HEALTH. (4) THE HOSPITAL CONDUCTED A FORMAL NEEDS ANALYSIS IN 2013, 2016, 2019, AND MOST RECENTLY IN SEPTEMBER 2022. THE FINDINGS HAVE BEEN MUCH THE SAME IN EACH ASSESSMENT. BELOW IS INFORMATION ON THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND HOW THE HOSPITAL HAS ADDRESSED THE KEY FINDINGS OVER THE PAST YEAR. THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT PRIORITIES ARE ALSO NOTED. THESE PRIORITIES WILL BE ADDRESSED IN 2023-2025. OTTAWA COUNTY HEALTH CENTER WORKED WITH FORVIS TO CONDUCT A COMPREHENSIVE COMMUNITY HEALTH ASSESSMENT OF OTTAWA COUNTY. THE ASSESSMENT NOT ONLY MET THE NEW IRS REQUIREMENTS, BUT IT ALSO IDENTIFIED OPPORTUNITIES FOR IMPROVEMENT OF HEALTH AND WELLNESS AND SUPPORTED OTTAWA COUNTY'S STRATEGIC PRIORITY OF LOCALIZING HEALTH CARE FOR THE COMMUNITY. FORVIS RESEARCHED AND ANALYZED COMMUNITY HEALTH DATA, CONDUCTED SURVEYS OF LOCAL KEY STAKEHOLDERS TO DETERMINE RELEVANT ISSUES, AND PROPOSED NECESSARY ACTION PLANS AND IMPLEMENTATION STRATEGIES TO ADDRESS THESE ISSUES. WITH THESE FINDINGS, OTTAWA COUNTY HEALTH CENTER IDENTIFIED TWO GENERAL HEALTH PRIORITIES ON WHICH TO FOCUS AS STRATEGIC INITIATIVES IN OTTAWA COUNTY. THE IMPLEMENTATION STRATEGY IS LISTED BELOW WITH THE GOALS AND STRATEGIES TO ADDRESS EACH INITIATIVE OVER THE NEXT THREE YEARS. 2019 CHNA PRIORITIES: PRIORITY 1: OBESITY/UNHEALTHY EATING/PHYSICAL INACTIVITY GOAL 1: ENCOURAGE USAGE OF AND INTEREST IN THE LOCAL WELLNESS CENTER GOAL 2: SPONSOR ANNUAL 5K RUN TO SUPPORT HEART HEALTH AND WELLNESS GOAL 3: SUPPORT HEALTHY EATING IN THE COMMUNITY PRIORITY 2: INFORMATION ON/ACCESS TO LOCAL MEDICAL SERVICES GOAL 1: PROVIDE GENERAL HEALTH EDUCATION TO THE COMMUNITY GOAL 2: SUPPORT COMMUNITY INITIATIVES RELATED TO HEALTH INFORMATION AND EDUCATION TO ADDRESS THESE GOALS, OTTAWA COUNTY HEALTH CENTER IMPLEMENTED THE IDENTIFIED STRATEGIES AS FOLLOWS: - OCHC recently completed a significant renovation to the Wellness Center, a fitness center and lap pool available to the community. The renovation addressed safety issues, functionality improvements, and general cosmetic updates. The renovation was well received by the community, and we have seen drastic increases in facility usage and membership. The Wellness Center Director is offering additional classes and weight room instruction to help encourage community members to continue an active lifestyle. Members have numerous opportunities to participate in these free group exercise classes and services that include: HIIT class, Water HIIT, water aerobics, group exercises; Beachbody; Blood Pressure and Heart Rate Assessments, etc. In addition, we now offer discounted rates to high school students to help encourage fitness and activity to those individuals. Membership rates are reviewed annually, and the facility is available to the community at reasonable monthly rates. The Wellness Center requires significant funding by the hospital beyond membership dues that are collected. The overall health improvement from having a fitness center available in our small community is a great benefit to area residents. While the Wellness Center does not generate income for Ottawa County Health Center, we recognize its importance and benefit to the community to promote healthier living to county residents. - To help promote wellness in our community and increase the options for physical activity, the hospital sponsored a 5k run/walk in conjunction with our annual county fair. Our plan is to continue this event in coming years and encourage the community to participate to support a healthy lifestyle. - The hospital supports the local Food Pantry as they utilize the hospital as pick-up location/meeting area for local residents needing assistance. In addition, OCHC donated funds to the local Summer Caf initiative that provides healthy meals to local children throughout the summer to ensure they have balanced meals while not in school. - Local healthcare services provided by Ottawa County Health Center are regularly advertised in the county newspaper along with informational articles related to new services. Additionally, the hospital assists local support and educational groups by offering hospital conference rooms to hold meetings for community members. OCHC is looking to expand and improve educational materials regarding available healthcare services. - Ottawa County Health Center leadership maintains regular communication/meetings with local physicians to assess community needs, patient or service issues, and ER coverage needs. We will continue outreach clinics and look for other opportunities to allow our community members to have services available locally so that they don't have to travel outside of the county. - Ottawa County Health Center's Charity Care program continues to be offered to those who qualify. In FY2022, the hospital provided approximately $8,000 in Charity Care and community benefit to area residents. Additionally, the hospital's Social Worker and Patient Financial Coordinator work closely with patients and their families to assist with insurance questions, Medicaid applications, etc. at no cost. Last year, we provided information on Medicare Advantage Plans to the local newspaper and presented to senior centers - Ottawa County Health Center Office Staff, with guidance from Great Plains Health Alliance, reviews hospital charges on at least an annual basis to ensure that charges and fees are accurate, justifiable, and appropriate. Based on these reviews, fees will be revised as needed in an effort to provide quality medical services at reasonable costs to our community. OCHC has compiled a list of all hospital charges for any item or service provided at the hospital; this information has been posted on the hospital website to allow our patrons the opportunity to review potential charges and understand the application of their specific insurance prior to their service. In addition to the Community Health Needs Assessment initiatives, Ottawa County Health Center continues to promote the local fitness center (Wellness Center) through advertising and programs to improve community health. Wellness and fitness tips/information are also posted around the hospital and Wellness Center for hospital staff and community members' education. The hospital has also taken steps to help improve the overall awareness of the local health care services and add new services based on community need. The goal is to ensure that community members know those services that can be offered closer to home. The hospital advertises in the local newspaper whose readership closely matches are primary patient demographic. A listing of services and contact information has been posted in the newspaper frequently. When new hospital services and/or personnel are added, this is an opportunity for the hospital to market those services with articles and information in the newspaper. Participation in local health fairs and senior center presentations has also been a positive way to educate the community on local healthcare services. In addition to the Community Benefit items, the hospital also offers staff assistance to the local ambulance service. When necessary, hospital nurses ride in the ambulance to assist local EMS personnel in transporting patients requiring higher a higher level of care. 2022 CHNA PRIORITIES: The below priorities and goals were established following our September 2022 Community Health Needs Assessment. OCHC will take steps and create initiatives to address these priorities over the next three years, 2022-2025. PRIORITY 1: OBESITY/PHYSICAL INACTIVITY/LACK OF HEALTHY BEHAVIORS Goal 1: Improve Access to/Increase interest in the Wellness Center Goal 2: Community Health Education PRIORITY 2: LACK OF AWARENESS REGARDING AVAILABLE HEALTH SERVICE IN THE COMMUNITY Goal 1: Promote Ottawa County Health Center's Services Offered Goal 2: Provide Educational Opportunities to Surrounding Area Residents |
| SCHEDULE H, PART VI, LINE 3 | The Hospital's Patient Financial Coordinator and/or CFO consults with all patients to see if they qualify for the Hospital's financial assistance policy. The Hospital has billing/collection brochures outlining the financial assistance policy that are provided to the public. This brochure is given to all patients upon admission and is also available in Hospital waiting rooms and the Emergency Room. The hospital's Social Worker will also discuss the potential for assistance from Medicaid, if that option is available. Notices of the availability of financial assistance are also included in billing mailings to all patients owing deductibles or coinsurance on their Hospital bills. An 800 bi-lingual telephone service is utilized for those patients that do not speak English. The Hospital's website also references the availability of financial assistance. The Patient Financial Coordinator provides and helps the patients with the financial assistance paperwork as the patients are required to provide bank statements, tax returns, etc.to verify income. Computations based on current Federal Poverty Level Guidelines are completed to see if qualifications are 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. Alternatively, the Social Worker will also work with the patient to file the appropriate forms with Medicaid if the patient qualifies. From 10-1-2021 to 9-30-22, the Hospital provided $7,868.13 in Financial Assistance (Charity Care) and other community benefits. |
| SCHEDULE H, PART VI, LINE 4 | The Hospital, located in Minneapolis, Kansas, has a population of approximately 1,950, and primarily serves the residents of Ottawa County. The total population of the County is approximately 5,800 people, which equates to a population density of 8.0 people per square mile - an obviously rural county. Ottawa County is divided into twenty townships. There are 2,686 occupied households with an average size of 2.41 persons residing in Ottawa County. The racial makeup of the County is 95.9% White, 1.4% African American, .6% Native American, 0.4% Asian, 3.2% Hispanic or Latino, and 1.6% Multiracial. The population spread of Ottawa County is 28.3% under the age of 18, 51.1% from age 18 to 65, and 20.6% at or over the age of 65. The median annual income for a household in Ottawa County is $57,455. Approximately 10.7% of the people living in Ottawa County were below the poverty line. The County has a history of stable population. Although the Hospital primarily serves residents of Ottawa County, the Hospital does see some patients from the neighboring counties. The Hospital patient mix is heavily weighted towards Medicare beneficiaries, especially for acute inpatient and swing-bed utilization. |
| SCHEDULE H, PART VI, LINE 5 | The Hospital utilizes individual Hospital services and partnerships with other local organizations to promote the health of citizens of Ottawa County. (1) The Hospital partners with the Ottawa County Public Health to offer health fairs for community members. Additionally, the hospital provides space to house the local health department at no cost. (2) The Hospital partners with local health agencies to educate high school seniors prior to graduation on texting while driving, sun damage, and the importance of staying active. (3) The Hospital physical and occupational therapists conduct in-home safety assessments for County residents to prevent trips and falls. (4) The Hospital maintains biohazard equipment that can be used in the case of toxic spills or biohazard events in the County. The equipment would include isolation rooms and decontamination showers. Equipment for airborne pathogens is also available. (5) The Hospital annually participates with Emergency Preparedness Trainings with local police and firefighting units from within the County to prepare for any future emergency situations. (6) The Hospital operates a wellness center catering to single, family, and corporate members. It is the only fitness facility in Minneapolis. (7) The Hospital promotes a healthy lifestyle, educates on heart disease through organizations and sponsorship of a 5K run/walk. (8) The Hospital has open board meetings that allow community members to offer ideas, suggestions, and input on community health needs. (9) The Hospital board authorizes the use of donated monies or surplus funds to specific health initiatives (room remodels, new equipment, etc.). Please note that while some of these initiatives were changed or eliminated in 2020 due to COVID-19, we intend to resume all health promotional activities when we can safely do so. |
| SCHEDULE H, PART VI, LINE 6 | THE HOSPITAL PARTICIPATES IN HEALTHCARE PROGRAMS FOR MEDICARE AND MEDICAID AMONG OTHERS. THE HOSPITAL HAS RECEIVED DESIGNATION FROM THE MEDICARE PROGRAM AS A CRITICAL ACCESS HOSPITAL AND IS THE ONLY HOSPITAL IN THE OTTAWA COUNTY. SALINA REGIONAL HOSPITAL IS THE TERTIARY HOSPITAL THAT PARTNERS WITH THE HOSPITAL IN THE CRITICAL ACCESS PROGRAM. THE HOSPITAL'S SERVICES ARE VITAL TO THE HEALTH OF OTTAWA COUNTY RESIDENTS. EDUCATIONAL SESSIONS PROMOTED BY THE HOSPITAL PROVIDE RESIDENTS OF THE COUNTY WITH VITAL TRAINING ON HOW TO MINIMIZE THEIR AFFLICTIONS AND MAXIMIZE THEIR QUALITY OF LIFE. SUCH TRAINING WOULD INCLUDE DIABETIC TRAINING CLASSES FOCUSING ON DIET TO CONTROL SYMPTOMS, SMOKING CESSATION CLASSES, HEART-HEALTH CLASSES AND CPR/ACLS TRAINING. THE HOSPITAL ALSO WORKS CLOSELY WITH THE COUNTY DEPARTMENT OF MENTAL HEALTH TO REFER RESIDENTS TO AN APPROPRIATE MENTAL HEALTH PROFESSIONAL. THE HOSPITAL MAKES AN ANNUAL PRESENTATION TO THE OTTAWA COUNTY BOARD OF COMMISSIONERS ON THE STATUS OF THE HOSPITALS, AND THE SERVICES IT PROVIDES TO THE RESIDENTS OF THE COUNTY. THE HOSPITAL ADMINISTRATOR ALSO ATTENDS MEETINGS OF THE COUNTY COMMISSIONERS, IF NECESSARY OR REQUESTED, TO DISCUSS NEW PROJECTS, BUDGETS, ETC. THE HOSPITAL IS AFFILIATED WITH GREAT PLAINS HEALTH ALLIANCE, INC. (GPHA), A NON-PROFIT 501C3 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 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 MANAGERS, BILLERS, DIRECTOR OF NURSING, MEDICAL RECORDS PERSONNEL AND ADMINISTRATORS. GPHA IS A VITAL LINK IN ALLOWING HOSPITALS TO OPERATE AT A HIGH QUALITY WITHIN THE CASH CONSTRAINTS IMPOSED BY THE CRITICAL ACCESS PROGRAM. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVE DELLASEGA | ||||||||||||||
| PRESIDENT/DIRECTOR/SECRETARY | $0 | $206,439 | $0 | $0 | $0 | $2,703 | $0 | $20,695 | $0 | $39,074 | $0 | $268,911 | $0 | $0 |
| JODY PARKS | ||||||||||||||
| ADMINISTRATOR | $161,898 | $0 | $0 | $0 | $1,650 | $0 | $15,555 | $0 | $27,847 | $0 | $206,950 | $0 | $0 | $0 |
| DURREL KELLEY | ||||||||||||||
| SENIOR VP OF OPERATIONS | $0 | $126,271 | $0 | $0 | $0 | $1,630 | $0 | $12,293 | $0 | $18,654 | $0 | $158,848 | $0 | $0 |
| MARLENE GAWITH | ||||||||||||||
| DON | $129,870 | $0 | $0 | $0 | $1,374 | $0 | $12,324 | $0 | $15,441 | $0 | $159,009 | $0 | $0 | $0 |
| CHERYL LANOUE | ||||||||||||||
| BUSINESS OFFICE MANAGER/CFO | $129,254 | $0 | $0 | $0 | $1,285 | $0 | $12,254 | $0 | $25,881 | $0 | $168,674 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, PART VII; SCHEDULE J, PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4A | Our goal is to ensure that the community and surrounding area have necessary and needed healthcare services available to them locally. During our 2022 fiscal year, the Hospital completed several projects and initiatives to increase the quality of care, safety, and services offered to our patients and residents as well as managed the ongoing impacts COVID-19 pandemic to staff, patients, and the community. Approximately $8,000 in charity care was provided to area residents in FY2022. In 2022, OCHC's focus continued to be on the COVID-19 pandemic and the actions OCHC had to take to respond to the pandemic for the benefit of the community. OCHC provided COVID19 articles, information, and updates during the year via the local newspaper to keep the community informed and aware of the status of COVID19 in the community and throughout the state. Hospital staff met regularly to manage the pandemic for our community. In response to COVID 19 and to improve the air quality throughout the facility, OCHC is in the process of installing new, improved HVAC in some areas of the hospital. This project will be completed in FY2023. In 2022, we purchased new endoscopes for the hospital. Our goal is to provide as many services locally as possible, and this is an example of that. With outreach physicians coming to our facility twice a month, we can offer our community colonoscopy and endoscopy services in Minneapolis. Keeping up to date equipment is key to the success of these outreach programs. To assist patients with COVID19 or other respiratory illnesses, OCHC purchased a V30 machine in FY2021 to assist with breathing. Since OCHC does not have ventilators, this allowed us to keep COVID patients here and safely care for them without having to send them to larger hospitals who had limited bed space. While this equipment was purchased in FY2021, it is worth noting that this machine was used several times over the last year by COVID and other patients. Medical staff has indicated that this machine has been key in the successful outcomes of our patients. Throughout the year, OCHC continued to improve security to the facility by adding automated door controls in the facility. This allows us to improve safety and security and ensure that all patients and visitors are entering through designated and monitored entry points. The Wellness Center (fitness center and lap pool) is available to the community at reasonable monthly rates. The Wellness Center requires significant funding by the hospital beyond membership dues that are collected. The overall health improvement that is possible from having a fitness center available in our small community is a great benefit to area residents. To encourage continued lifestyle fitness in our community, the OCHC board approved a significant renovation/remodel of the Wellness Center that was completed in fiscal year 2021. The renovation addressed safety issues, functionality improvements, and general cosmetic updates. This has proved to be another means to help increase and encourage fitness and activity for our community. Over the last year, we have seen a drastic increase in Wellness Center usage and memberships because of our renovation. The increase in physical activity is a great benefit to our community. OCHC takes pride in the physical building and appearance of our facility as a crucial part of the economy and sustainability of Ottawa County. Investments in our building and infrastructure were made throughout 2022 to maintain our facility. Additionally, OCHC continues to discuss quality initiatives and improvements throughout the facility and research new opportunities and services to offer to the members of our community. |
| FORM 990, PART VI, SECTION A, LINE 2 | DAVE DELLASEGA, DURREL KELLEY, AND JASON BARB HAVE A BUSINESS RELATIONSHIP. THEY ARE ALL 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 OTTAWA 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:1661033 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:BILLING/COLLECTIONS TOTAL FEES:42329 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:LAB SERVICES TOTAL FEES:168851 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PHARMACY SERVICES TOTAL FEES:92368 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:ADMIN/HUMAN RESOURCES TOTAL FEES:164564 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| GREAT PLAINS HEALTH ALLIANCE | ||||||||||
| 1601 E WOODBROOK LN | DERBY | KS | 67037 | 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 | Yes (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 | Yes (true) |
| GREAT PLAINS OF ELLINWOOD INC | ||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 481226976 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC | Yes (true) |
| GREAT PLAINS OF REPUBLIC COUNTY INC | ||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 481226977 | HOSPITAL | KS | 501(3)(3) | 3 | GPHA INC | Yes (true) |
| GREAT PLAINS OF CHEYENNE COUNTY | ||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 481226831 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC | Yes (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 | Yes (true) |
| GPHA EMPLOYEE BENEFITS TRUST | ||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 476918582 | HEALTH PLAN | KS | 501(C)(9) | GPHA INC | Yes (true) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GPHA EMPLOYEE BENEFITS TRUST | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | R | TransactionTypeTxt |
| Involved | $520,402 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |
Comments