FURP.ORG / PUBLIC DATA EXPLORER

CLOUD COUNTY HEALTH CENTER INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
CLOUD COUNTY HEALTH CENTER INC (EIN 48-0545923)
Tax period
2021-10-01 to 2022-09-30
Filed
2023-08-11
IRS object ID
202342239349300629
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 ReturnHeader

FieldValueIRS element (for citing)
Return2023-08-11T11:26:21-05:00ReturnTs
Tax Period End2022-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Eide Bailly LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1800 Nicollet Mall Ste 1300AddressLine1Txt
CityMinneapolisCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554027033ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN480545923EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Cloud County Health Center IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCLOUBusinessNameControlTxt
Phone7852431234PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1155 W College DrAddressLine1Txt
CityConcordiaCityNm
State AbbreviationKSStateAbbreviationCd
ZIP66901ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRon HarringtonPersonNm
Person TitleChief Financial OfficerPersonTitleTxt
Phone7852431234PhoneNum
Signature2023-08-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstRonPersonFirstNm
Person LastHarringtonPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKim Hunwardsen CPAPreparerPersonNm
PTINP00484560PTIN
Phone6122536500PhoneNum
Preparation2023-08-11PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1North Central Kansas Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerRon HarringtonPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1155 W College DrAddressLine1Txt
CityConcordiaCityNm
State AbbreviationKSStateAbbreviationCd
ZIP66901ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$20,058,770GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.nckmed.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1970FormationYr
Legal Domicile StateKSLegalDomicileStateCd
Activity Or MissionOperation of critical access hospitalActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers50TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,069,633PYContributionsGrantsAmt
CY Contributions Grants$1,223,487CYContributionsGrantsAmt
PY Program Service Revenue$18,661,904PYProgramServiceRevenueAmt
CY Program Service Revenue$18,821,707CYProgramServiceRevenueAmt
PY Investment Income-$2,149PYInvestmentIncomeAmt
CY Investment Income$6,683CYInvestmentIncomeAmt
PY Other Revenue$11,398PYOtherRevenueAmt
CY Other Revenue$6,893CYOtherRevenueAmt
PY Total Revenue$19,740,786PYTotalRevenueAmt
CY Total Revenue$20,058,770CYTotalRevenueAmt
PY Grants And Similar Paid$8,565PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$2,500CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$11,301,531PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$11,815,503CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$6,447,316PYOtherExpensesAmt
CY Other Expenses$6,501,625CYOtherExpensesAmt
PY Total Expenses$17,757,412PYTotalExpensesAmt
CY Total Expenses$18,319,628CYTotalExpensesAmt
PY Revenues Less Expenses$1,983,374PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,739,142CYRevenuesLessExpensesAmt
Total Assets BOY$19,458,806TotalAssetsBOYAmt
Total Assets EOY$46,728,571TotalAssetsEOYAmt
Total Liabilities BOY$9,332,652TotalLiabilitiesBOYAmt
Total Liabilities EOY$34,564,275TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$10,126,154NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$12,164,296NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionCloud County Health Center is committed to providing quality health care services delivered in a caring and respectful manner through teamwork and professional excellence.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$14,278,930ExpenseAmt
Grant$2,500GrantAmt
Revenue$18,821,707RevenueAmt
DescCloud County Health Center (Health Center) is a nonprofit acute care hospital located in Concordia Kansas. The Health Center provides inpatient, outpatient, rural healht clinic and emergency care services to residents of Cloud County and the surrounding area. Health Center had a total of 253 discharges and 1,613 patient days. The hospital had a total of 275 surgeries, 2,639 ED visits and 22,190 OP visits and the Family Care Center had 15,121 visits. In addition to providing Inpatient and Outpatient services, the hospital provides the following ancillary services; Lab, Imaging, Pharmacy, Respiratory Therapy, Rehab services and Sleep Lab services. Imaging services include all of the following areas; General X-ray, CT Scan, Nuclear Medicine, Ultrasound, Bone Density and Mammography services. MRI services are provided on Sundays with a Mobile Unit.Desc
Total Program Service Expenses$14,278,930TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Ron HarringtonBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7852431234PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1155 W College DriveAddressLine1Txt
CityConcordiaCityNm
State AbbreviationKSStateAbbreviationCd
ZIP66901ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Philip Gilliland
Chairperson1.000.00Yes (X)Yes (X)$0$0$0
Kurt Kocher
Vice Chair1.001.00Yes (X)Yes (X)$0$0$0
Charles Lambertz
Secretary1.000.00Yes (X)Yes (X)$0$0$0
Amy Lange
Treasurer1.000.00Yes (X)Yes (X)$0$0$0
Joanne Balthazor
Director1.001.00Yes (X)$0$0$0
Amber Knoettgen
Director (Beg Feb 2022)1.000.00Yes (X)$0$0$0
Ashley Hutchinson
Director (Until Jan 2022)1.000.00Yes (X)$0$0$0
Robb Rosenbaum
Director1.000.00Yes (X)$0$0$0
Darrel Hosie
Director1.000.00Yes (X)$0$0$0
Kent Otott
Director1.000.00Yes (X)$0$0$0
Quentin Breese
Director1.000.00Yes (X)$0$0$0
Sister Jean Rosemarynoski
Director1.000.00Yes (X)$0$0$0
Darrell Gallegos
Director1.000.00Yes (X)$0$0$0
Justin Poore
Chief of Staff/Physician40.000.00Yes (X)$0$0$0
David Garnas
Adminstrator/CEO40.001.00Yes (X)$0$0$0
Ronald Harrington
CFO40.001.00Yes (X)$0$0$0
Tiffany Naccarato
Advanced Practice Provider40.000.00$179,600$0$9,709Yes (X)
Shawna Huggans
Advanced Practice Provider40.000.00$187,051$0$33,750Yes (X)
Daniel Garlow
Physician40.000.00$259,224$0$37,720Yes (X)
Dorothy Breault
Physician40.000.00$238,776$0$39,034Yes (X)
Jeff McCroskey
Advanced Practice Provider40.000.00$143,479$0$4,937Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,008,130TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$125,150TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K5IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other SrcsYes (1)CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
SALINA REGIONAL HEALTH CENTER
400 S SANTA FESALINAKS67401PAYROLL AND OTHER REIMBURSEMENT$18,993,000
TREANORL
1040 VERMONT STREETLAWRENCEKS660442920ARCHITECTURE SERVICE$374,921
CPSI
PO BOX 11407BIRMINGHAMAL352466448COMPUTER SERVICES$127,891
GEARY ANESTHESIA ASSOCIATES
819 CRESTVIEW DRJUNCTION CITYKS66441ANESTHESIA SERVICES$121,235
MEDICAL INFORMATION TECHNOLOGY INC
PO BOX 74569CHICAGOIL60696COMPUTER SERVICES$113,848
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
Related Organizations$11,007RelatedOrganizationsAmt
Government Grants$1,211,741GovernmentGrantsAmt
All Other Contributions$739AllOtherContributionsAmt
Total Contributions$1,223,487TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient Revenue621400$17,886,568$17,886,568
Pharmacy Revenue900099$824,707$824,707
Cafeteria900099$58,363$58,363

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$52,069TotalRevenueColumnAmt
Related Or Exempt Func Income$52,069RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$18,821,707TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,683TotalRevenueColumnAmt
Exclusion$6,683ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMisc. revenueDesc
Business900099BusinessCd
Total Revenue Column$6,893TotalRevenueColumnAmt
Exclusion$6,893ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$6,893OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$20,058,770TotalRevenueColumnAmt
Related Or Exempt Func Income$18,821,707RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$13,576ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$2,500TotalAmt
Program Services$2,500ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$837,433TotalAmt
Program Services$374,995ProgramServicesAmt
Management And General$462,438ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$9,160,422TotalAmt
Program Services$7,376,591ProgramServicesAmt
Management And General$1,783,831ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$350,206TotalAmt
Program Services$290,665ProgramServicesAmt
Management And General$59,541ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$784,643TotalAmt
Program Services$582,935ProgramServicesAmt
Management And General$201,708ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$682,799TotalAmt
Program Services$533,625ProgramServicesAmt
Management And General$149,174ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$2,103TotalAmt
Management And General$2,103ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$2,307TotalAmt
Management And General$2,307ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$2,056TotalAmt
Program Services$2,056ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,004,276TotalAmt
Program Services$1,671,818ProgramServicesAmt
Management And General$332,458ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$75,537TotalAmt
Program Services$70ProgramServicesAmt
Management And General$75,467ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$377,728TotalAmt
Program Services$197,006ProgramServicesAmt
Management And General$180,722ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$329,120TotalAmt
Program Services$213,993ProgramServicesAmt
Management And General$115,127ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$318,678TotalAmt
Program Services$5,472ProgramServicesAmt
Management And General$313,206ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$50,181TotalAmt
Program Services$30,193ProgramServicesAmt
Management And General$19,988ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,709TotalAmt
Management And General$1,709ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$21TotalAmt
Management And General$21ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$452,737TotalAmt
Program Services$292,059ProgramServicesAmt
Management And General$160,678ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$63,454TotalAmt
Program Services$17,112ProgramServicesAmt
Management And General$46,342ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical and Patient Sup$2,360,441$2,289,134$71,307
Food Costs$102,792$85,050$17,742
Dues, Licenses, and Tax$64,921$20,092$44,829

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$293,564TotalAmt
Program Services$293,564ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$18,319,628TotalAmt
Program Services$14,278,930ProgramServicesAmt
Management And General$4,040,698ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$44,469BOYAmt
EOY$617,164EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,364,400BOYAmt
EOY$2,272,138EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$156,928BOYAmt
EOY$289,348EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$111,535BOYAmt
EOY$227,600EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$55,300,178LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$14,821,757LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$13,297,754BOYAmt
EOY$40,478,421EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$842,682BOYAmt
EOY$1,146,075EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,641,038BOYAmt
EOY$1,697,825EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$19,458,806BOYAmt
EOY$46,728,571EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,835,855BOYAmt
EOY$6,654,387EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$6,496,797BOYAmt
EOY$27,551,431EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$358,457EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,332,652BOYAmt
EOY$34,564,275EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$9,283,702BOYAmt
EOY$11,018,451EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$842,452BOYAmt
EOY$1,145,845EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$10,126,154BOYAmt
EOY$12,164,296EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$19,458,806BOYAmt
EOY$46,728,571EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$1,739,142ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$299,000OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$2,056OtherActivitiesAmt
Total Lobbying Expenditures$2,056TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationA portion of annual dues paid by Cloud County Health Center to the Kansas Hospital Association (KHA) has been identified as association lobbying activities by KHA. Cloud County Health Center does not directly participate in lobbying activities.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$741,702OtherCostOrOtherBasisAmt
Book Value$741,702BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,539,464OtherCostOrOtherBasisAmt
Depreciation$2,524,938DepreciationAmt
Book Value$14,526BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,308,199OtherCostOrOtherBasisAmt
Depreciation$12,276,058DepreciationAmt
Book Value$1,032,141BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$38,710,813OtherCostOrOtherBasisAmt
Depreciation$20,761DepreciationAmt
Book Value$38,690,052BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$40,478,421TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescEstimated third party payor settlemetDesc
Amt$358,457Amt
FieldValueIRS element (for citing)
Total Liability$358,457TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$22,467,752TotalRevEtcAuditedFinclStmtAmt
Donated Services And Use Fclts$2,415,875DonatedServicesAndUseFcltsAmt
Revenue Not Reported$2,415,875RevenueNotReportedAmt
Revenue Subtotal$20,051,877RevenueSubtotalAmt
Other Revenues Not Included$6,893OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$6,893RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$20,058,770TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$20,733,003TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$2,415,875DonatedServicesUseFcltsAmt
Expenses Not Reported$2,415,875ExpensesNotReportedAmt
Expenses Subtotal$18,317,128ExpensesSubtotalAmt
Other Expenses Not Included$2,500OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$2,500ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$18,319,628TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part X, Line 2:The Health Center believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Health Center would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred.
Part XI, Line 4b - Other Adjustments:Net Auxiliary Income 6,893.
Part XII, Line 4b - Other Adjustments:Auxiliary expense 2,500.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent200 DYes (X)Percent200DInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$140,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$140,000NetCommunityBenefitExpnsAmt
Total Expense0.00760TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,621,439TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$469,699DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,151,740NetCommunityBenefitExpnsAmt
Total Expense0.06290TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,761,439TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$469,699DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,291,740NetCommunityBenefitExpnsAmt
Total Expense0.07050TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,914,725TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,975,315DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,939,410NetCommunityBenefitExpnsAmt
Total Expense0.16050TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,914,725TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,975,315DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,939,410NetCommunityBenefitExpnsAmt
Total Expense0.16050TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,676,164TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,445,014DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,231,150NetCommunityBenefitExpnsAmt
Total Expense0.23100TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$900,579BadDebtExpenseAmt
Reimbursed By Medicare$8,840,890ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$8,807,976CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$32,914MedicareSurplusOrShortfallAmt
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Cloud County Health CenterBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1155 W College DriveAddressLine1Txt
CityConcordiaCityNm
State AbbreviationKSStateAbbreviationCd
ZIP66901ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.nckmed.comWebsiteAddressTxt
State LicenseH015001StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Cloud County Health CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted21CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Section COwnWebsiteURLTxt
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt21ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSee Section CStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care200.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLnckmed.com/patient-and-visitors/financial-assistanceFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLnckmed.com/patient-and-visitors/financial-assistanceFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLnckmed.com/patient-and-visitors/financial-assistanceFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Prospective Medicare MedicaidYes (X)ProspectiveMedicareMedicaidInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Cloud County Health CenterPart V, Section B, Line 5: On April 28, 2022, the Community Health Needs Assessment Committee met and discussed ways to involve the community in addressing the most important health needs of Cloud County. The group decided to survey the community, asking for their input on priority of the following areas:- Obesity- Depression/Mental Health- Diabetes- Heart Disease- Tobacco Use Including vaping and chewing- Stroke- Trauma/Falls- Hypertension (high blood pressure)- High cholesterol- Substance Abuse- Transportation to Medical ServicesThe survey was launched through all forms of media for a period of six weeks. 118 surveys were received and tabulated. The Community Health Needs Assessment Committee met in July to review the results and discuss an implementation plan. The Committee consists of 25 members from various organizations in the community.
Cloud County Health CenterPart V, Section B, Line 7d: Can contact the Hospital or Health Department to obtain a copy.
Cloud County Health CenterPart V, Section B, Line 11: The following community health priority areas were identified in the most recent CHNA.1) Obesity2) Depression/Mental Health3) Diabetes4) Heart Disease5) Tobacco Use6) Stroke7) Trauma/Falls8) Hypertension9) High Cholesterol10) Substance Abuse11) Transportation to Medical ServicesAlthough all of the above are important and will be addressed as part of our regular operations, the hospital will focus on Obesity (including trauma/falls), Depression/Mental Health, and Substance Abuse, including Tobacco Use during fiscal years ending in 2023-2025. With assistance from other organizations, we will address the issues through the following steps:#1 - Provide Opportunities to Stabilize Mental HealthA) Publicize a new hotline number for suicide prevention and provide information in schools, libraries, the hospital, major employers, and ag industry companies.B) Develop more access to telehealth#2 - Provide ways to decrease Obesity in the Community and include Education of Health issues leading to ObesityA) Start Weight Watchers program in the communityB) Offer Community classes on weight managementC) Stepping On Program Provide classes at the hospital to help prevent falls/trauma injuriesD) Community exercise activities - Develop bike trails/walking trails in the community#3 - Develop ways to decrease Substance abuse and Tobacco useA) Promote Great American Smokeout Day annuallyB) Utilize health fairs to publicize dangers of substance abuseDue to timing, the hospital focused on the needs identified in the prior CHNA during fiscal year ended 2022, as follows:#1 - Accessibility and Availability to Healthcare - A new state-of-the-art facility will open in November 2022. The Hospital received approval from USDA on funding for the new replacement facility and broke ground in March 2021. We continued to offer increased the hours in our Family Care Clinic and walk-in clinic hours until 6:00 p.m., Monday thru Friday. Each day we have a dedicated provider scheduled for walk-in patients. The clinic continued its relationship with the high school USD 333 and the community college to provide annual physicals for their student athletes. Tele-health services were also available and increased during the fiscal year for the Clinic.#2 - Promoting Healthier Lifestyles - We continued to promote awareness of heart disease through increased advertising in our community in the newspaper, on the radio and our website. We participated in Wear RED Day in February to help raise awareness of heart disease as the leading cause of death among Americans. We promoted increased community activity of the bike trails, walking trails in the city of Concordia and made our Physical Therapy equipment available after hours in the hospital.#3 - Received funding for a fixed MRI at our new facility when it opens in November 2022. The hospital will now have MRI services scheduled 5 days a week and emergency services on weekends instead of the mobile MRI truck one day per week on Sundays. We provided increased services in the community to treat patients with trauma, stroke, hypertension, high cholesterol, etc.
Cloud County Health CenterPart V, Section B, Line 24: The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy.
Part V, Section B, Line 7anckmed.com/about/community-health-needs
Part V, Section B, Line 10anckmed.com/about/community-health-needs
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line11 - Family Care Center ClinicBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1155 W College DriveAddressLine1Txt
CityConcordiaCityNm
State AbbreviationKSStateAbbreviationCd
ZIP66901ZIPCd
FieldValueIRS element (for citing)
FacilityRural health clinicFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c:The methodology used to determine eligibility for financial assistance takes into consideration income, net assets, family size, medical indigency, insurance and underinsurance status. Presumptive eligibility may be used if the other options are not available.
Part I, Line 7:Charity care expense was converted to cost on line 7A based on an overall cost-to-charge ratio addressing all patient segments. Line 7B, Medicaid, was determined based on the costing methods used to prepare the cost reports. Line 7G was obtained from the Medicare Cost Report.
Part I, Line 7g:Rural health clinic revenue of $1,727,645 and expense of $3,682,373 are included on line 7g. The net cost of rural health clinic subsidized services is $1,954,728.
Part III, Line 2:The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concession based on its historical collection experience with this class of patients.
Part III, Line 4:The footnote to the organization's financial statements that describes implicit price concession is located in the audited financial statement report on pages 11-12.
Part III, Line 8:The payments are compared to the actual cost of providing the service as arrived at through the Medicare cost reports. Medical services are provided to patients with Medicare coverage regardless of whether or not a surplus or deficit is realized. Providing Medicare services promotes access to healthcare services which are vitally needed by our community.
Part III, Line 9b:Collection practices do not apply to patients who have an approved payment plan in effect provided payments are kept current. Patients who have qualified for 100% financial assistance would not go to collection as their account balance would be reduced to zero prior to getting to the collection stage. Patients who qualify for less than 100% assistance may go to collection if their balance is not paid according to an agreed upon schedule. Accounts that are deemed to qualify for financial assistance while in collections will be removed from collections and returned to the business office.
Part VI, Line 2:The hospital has an 18 member CHNA committee that meets quarterly at the hospital to discuss the healthcare needs in the community. Members include staff from the hospital, health department representatives, city and county government officials, school leaders and city business leaders.
Part VI, Line 3:The hospital does the following to educate patients on the financial assistance offered at CCHC; (1) posts its financial assistance policy and financial assistance contact information on its website, in admissions areas, emergency rooms, and other areas of the organization's facilities in which eligible patients are likely to be present; (2) provides a copy of the policy, or a summary thereof, and financial assistance contact information to patients as part of the intake process; (3) includes the policy, or a summary thereof, along with financial assistance contact information, in patient bills; and/or (4) discusses with the patient the availability of various government benefits, such as Medicaid or state programs, and assists the patient with qualification for such programs, where applicable.
Part VI, Line 4:CCHC is located in Concordia, KS. Concordia is the county seat of Cloud County. It is a rural community with an estimated population of 5,111 per the 2020 Census data. Concordia is home to Cloud County Community College located just off highway 81 in Concordia. Concordia is surrounded by Healthcare facilities in all directions. To the north in Belleville, KS is Republic County Hospital located 18 miles from Concordia, KS. To the east is Clay County which has Clay County Medical Center approx. 45 miles from Concordia, KS. To the south is Ottawa County approx. 33 miles from Concordia, KS. Ottawa County has a facility in Minneapolis, KS. Then to the west is Mitchell County approx. 32 miles from Concordia, KS. Mitchell County has a facility in Beloit, KS. CCHC gets about 80% of its patients from Concordia, 6% from Clyde, 5% from Jamestown, 2% from Glasco and 1% from both Aurora and Miltonvale. Also, the hospital sees about 4% of its patients from Belleville and Beloit combined. The median income for a household is $44,185. The per capita income for the city is $22,715. About 13.6% of the population were below the poverty line.
Part VI, Line 5:The hospital has a Rural Health Clinic within the hospital and provides services Monday through Friday from 8:30 am. till 6:00 pm. Monday thru Friday. The Clinic has outreach locations in Clyde and Jamestown. The physicians see patients in Clyde on Wednesday and Thursday mornings and every other Tuesday morning in Jamestown. The hospital has a total of 7 providers of which 3 are physicians and 4 are mid-level providers. The hospital operates an emergency department 24 hours per day, 7 days per week.The hospital's Board of Trustees is made up of members from all parts of the county, including local business leaders and retired individuals from Concordia and the surrounding communities.The services offered at CCHC include the following:IP Acute servicesIP ICU servicesIP swing bed services - patients requiring Therapy services or IV antibiotic servicesED services FCC Family Care Clinic Specialty Clinic ServicesAncillary services including the following:Physical Therapy, Occupational Therapy and Speech Pathology services,Radiology services including ultrasound, nuclear medicine, CT scan and mobile MRI servicesLaboratoryRespiratory TherapyCardiac Rehab ServicesSleep Lab servicesOperating Room OP proceduresAnti Coag ClinicOutpatient Services Including IV Therapy and Blood Transfusions
Part VI, Line 6:CCHC has been part of an affiliation with Salina Regional Health Center (SRHC) since May 2016. CCHC staff are employees of SRHC and adhere to the same polices as SRHC staff. CCHC is on the same EMR system as SRHC which helps to provide a continuity of care for our patients in our communities. Contracts and purchasing agreements are beneficial for both organizations in the areas of pricing and terms of the agreements. SRHC helps support our community by sending specialists to our clinic monthly. They also provide subject matter experts that CCHC can call upon with questions.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Daniel Garlow
Physician$220,894$0$38,330$0$0$0$0$12,616$0$28,003$259,224$40,619$0$0
Dorothy Breault
Physician$206,874$0$31,902$0$0$0$0$12,347$0$29,592$238,776$41,939$0$0
Shawna Huggans
Advanced Practice Provider$184,051$0$3,000$0$0$0$0$9,630$0$24,493$187,051$34,123$0$0
Tiffany Naccarato
Advanced Practice Provider$176,600$0$3,000$0$0$0$0$8,919$0$789$179,600$9,708$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule J, Part IIIFormAndLineReferenceDesc
ExplanationDorothy Breault, Daniel Garlow Shawna Huggans, Jeff McCroskey, and Tiffany Naccarato were paid by an unrelated organization, Salina Regional Health Center, for medical services performed. See Schedule J, Part II and Form 990 Part VII for amounts paid for these services.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part V, Line 1a, Number reported in Box 3 of Form 1096:Cloud County Health Center, Inc. has independent contractors, however, Salina Regional Health Center, the management company, pays all the independent contractors directly. The actual expense of each independent contractor is directly charged to the assigned entity.
Form 990, Part V, Line 2a, Number of employees on W-3:Under a management agreement, Salina Regional Health Center (SRHC) is responsible for the daily management and operation of the hospital, including employment of all staff. All payroll and benefits are paid by SRHC and payroll reporting is done by SRHC. Allocable compensation by individual is charged to Cloud County Health Center, Inc. and is shown on line 7 of Part IX.
Form 990, Part VI, Section A, line 3The Hospital entered into a management and operating agreement with Salina Regional Health Center (SRHC) effective May 1, 2016. Under the agreement, SRHC is responsible for the daily management and operation of the Hospital, including the employment of all staff needed to manage and operate Cloud County Health Center. For calendar yearend 12/31/2021, SRHC paid the following in compensation and benefits for individuals listed in Part VII: Ronald Harrington $188,903 David Garnas $271,645 Justin Poore $329,088
Form 990, Part VI, Section A, line 6The Health Center's Board of Trustees is the sole member of the Health Center.
Form 990, Part VI, Section A, line 8bThe organization does not have committees with broad authority to act on behalf of the governing board.
Form 990, Part VI, Section B, line 11bForm 990 is reviewed by the President & CFO. A copy of the return is provided to board members prior to filing with the IRS.
Form 990, Part VI, Section B, line 12cThe Health Center requires the trustees and key employees to sign an annual conflict of interest form. On the form they designate if they have any conflicts. Potential conflicts of interest are presented to the Board of Directors. The Board determines whether a conflict exists. If a conflict exists, the effected person will be required to abstain from voting on the matter.
Form 990, Part VI, Section B, line 15aThe Organization's process for determining the President's compensation begins with an initiative led by the Executive Compensation Committee (ECC) of Salina Regional Health Center (SRHC). The ECC compares compensation and salary data provided by Integrated Health Strategies (IHS) for overall reasonableness of base compensation and total compensation for all SRHC executive staff. The ECC reviews the data and makes a recommendation to the SRHC board of trustees in a closed executive meeting. The process was last completed in 2020. Cloud County Health Center's President's salary is then set by the President/CEO of SRHC. The Cloud County Health Center CFO's salary is set by Salina Regional Hospital Vice President of Finance using an annual salary survey and is increased using the same percentage as all other employees.
Form 990, Part VI, Section C, line 19The organization's governing documents, conflict of interest policy, and financial statements are available to the public upon request.
Form 990, Part IX, line 11gContract Labor: Program service expenses 1,194,182. Management and general expenses 197,528. Fundraising expenses 0. Total expenses 1,391,710. Service Contracts: Program service expenses 477,636. Management and general expenses 134,892. Fundraising expenses 0. Total expenses 612,528. Credit Card Fees: Program service expenses 0. Management and general expenses 38. Fundraising expenses 0. Total expenses 38.
Form 990, Part XI, line 9:Net Income From Auxiliary -4,393. Change in Beneficial Interest in Net Assets of the Foundation 303,393.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1Cloud County Foundation for Health Care IncBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1155 W College DriveAddressLine1Txt
CityConcordiaCityNm
State AbbreviationKSStateAbbreviationCd
ZIP66901ZIPCd
FieldValueIRS element (for citing)
EIN480966856EIN
Primary Activitiessupport community health and welfarePrimaryActivitiesTxt
Legal Domicile StateKSLegalDomicileStateCd
Exempt Code Section501(c)(3)ExemptCodeSectionTxt
Public Charity StatusLine 7PublicCharityStatusTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd