2023-09-13T19:16:31-05:00 2022-09-30 FORVIS LLP 14241 DALLAS PARKWAY SUITE 1100 DALLAS TX 75254 990 2021-10-01 237169376 Pawhuska Hospital Inc % JASON MCBRIDE PAWH 9182873232 1101 East 15th Street Pawhuska OK 74056 JASON MCBRIDE ADMINISTRATOR 9182873232 2023-08-15 true JASON MCBRIDE 999009999 Jeanette Verrelli P00742631 9727028262 3 2021 2023-04-26 12:10:37Z JASON MCBRIDE 1101 EAST 15TH STREET PAWHUSKA OK 740561920 28200680 false X WWW.PAWHUSKAHOSPITAL.COM X 1959 OK PAWHUSKA HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH AND LIVES IN THE COMMUNITIES WE SERVE. 5 4 163 4 0 0 5681229 2513668 15857174 25682550 1000 115 10198 4347 21549601 28200680 5160 8283 0 0 6822425 8287690 0 0 0 11373627 20049497 18201212 28345470 3348389 -144790 8271887 7258692 12673560 11806117 -4401673 -4547425 X WE, THE PHYSICIANS, STAFF, AND GOVERNING BOARD OF PAWHUSKA HOSPITAL, INC. ARE COMMITTED TO PROVIDING THE HIGHEST LEVEL OF HEALTHCARE POSSIBLE FOR OUR FACILITY. RECOGNIZING THE HEALTH NEEDS OF OUR COMMUNITY AND SURROUNDING AREA, WE PLEDGE TO PROVIDE, IN A COST-EFFECTIVE MANNER, THE SERVICES NECESSARY TO ENHANCE THE QUALITY OF LIFE. UNDERSTANDING THE CONSTANT AND DRAMATIC CHANGES IN THE HEALTHCARE INDUSTRY, WE WILL STRIVE TO ACHIEVE EXCELLENCE AND CONTINUE OUR SUPPORT OF THE COMMUNITY. false false 23624689 8283 25686877 PAWHUSKA HOSPITAL, INC. IS A 25-BED CRITICAL ACCESS HOSPITAL AND RURAL HEALTH CLINIC LOCATED IN PAWHUSKA, OKLAHOMA, AND PROVIDES MEDICAL SERVICES TO PAWHUSKA AND SURROUNDING AREA. THE HOSPITAL AND CLINIC IS MANAGED THROUGH AN AGREEMENT WITH COHESIVE HEALTHCARE MANAGEMENT AND CONSULTING. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. 23624689 true true false true false false false false false false true false false false true true false false false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true 24 0 true 163 true false false false false false false false false false false false false X 5 4 false true false false false true false true true false false true true true true true true true true false OK X JASON MCBRIDE 9182875123 1101 EAST 15TH STREET PAWHUSKA OK 740561920 X MATTHEW C RUMSEY CHIEF MEDICAL OFFICER 40.0 0.0 X X 399533 0 21338 RON DUNKLE APRN 40.0 0.0 X 334272 0 16113 HEATHER ARRINGTON PHYSICIAN 40.0 0.0 X 166701 0 7457 JOHN CHIAFFITELLI PHYSICIAN 40.0 0.0 X 141635 0 21338 DALTON SMITH PHYSICAL THERAPIST 40.0 0.0 X 152058 0 1056 Adam Helm APRN 40.0 0.0 X 149028 0 1824 AMANDA BRAY COMPLIANCE & RISK OFFICER 40.0 0.0 X 125541 0 0 BEN WEST SECRETARY 2.0 0.0 X X 0 0 0 BEVERLY TOLSON TRUSTEE 2.0 0.0 X 0 0 0 ELIZABETH REED CHAIRWOMAN 4.0 0.0 X X 0 0 0 PAM CARPENTER TRUSTEE 2.0 0.0 X 0 0 0 JASON MCBRIDE ADMINISTRATOR 40.0 0.0 X 0 0 0 JILL GRAY CCO 40.0 0.0 X 0 0 0 WHITNEY SMITH FINANCE DIRECTOR END: 12/21 40.0 0.0 X 0 0 0 Tina Steele Finance Director, START: 01/22 40.0 0.0 X 0 0 0 1468768 0 69126 12 false true false Cohesive Healthcare Management 2510 Independence St Suite 100 SHAWNEE OK 74804 MANAGEMENT SERVICES 2701889 COHESIVE REVOPS Integration PO BOX 679227 DALLAS TX 75267 REVENUE CYCLE SVCS 963676 COHESIVE STAFFING Solutions 2510 INDEPENDENCE ST SUITE 100 SHAWNEE OK 74804 CONTRACT LABOR STAFF 2232646 AMERISOURCE BERGEN Drug Co PO BOX 978526 DALLAS TX 75297 PHARMACEUTICAL DISTB 416581 Equalizercm Revops 5910 Courtyard Dr Ste 350 AUSTIN TX 78731 Employee Insurance 173220 12 X 2509639 4029 2513668 patient service revenue 621110 25682550 25682550 25682550 115 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 MISCELLANEOUS REVENUE 900099 4327 4327 Cafeteria Revenue 722514 20 20 4347 28200680 25686877 135 X 8283 8283 0 0 0 546412 464450 81962 0 6891939 6838170 53769 0 332240 262201 70039 517099 503517 13582 2700000 167965 2532035 0 45159 45159 0 0 0 4452764 3135944 1316820 6206 226 5980 675507 467863 207644 139650 63241 76409 0 431256 384044 47212 2203 2034 169 0 10400 10350 50 42520 33712 8808 0 374367 296821 77546 132674 132674 bad debt expense 9903722 9903722 medical supplies 889330 889330 Equipment 77381 64469 12912 food 122836 122822 14 43522 5525 37997 28345470 23624689 4720781 0 0 103773 3305465 2432688 0 0 1764738 1862005 0 0 0 0 0 0 364340 370096 46624 50567 7978210 5538647 2790720 2439563 0 0 0 0 0 0 0 0 0 0 8271887 7258692 5134742 4848083 0 0 0 0 0 0 0 0 0 0 7188542 6653740 0 0 350276 304294 12673560 11806117 X -4401673 -4547425 0 0 -4401673 -4547425 8271887 7258692 X -144790 -962 X X false false true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 1026 1026 false SCHEDULE C, PART II-B, LINE 1I OTHER ACTIVITIES: THE HOSPITAL PAID DUES TO THE OKLAHOMA HOSPITAL ASSOCIATION, A PORTION OF WHICH IS DESIGNATED FOR LOBBYING EXPENSES. 46940 46940 2894793 1618930 1275863 41179 39592 1587 4882867 3880125 1002742 112431 112431 2439563 0 Est 3rd Party Payor Settlement 304294 304294 X SCHEDULE D, PART X, LINE 2 ASC 740 FOOTNOTE: THE HOSPITAL IS ORGANIZED AS AN OKLAHOMA NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE HOSPITAL IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE HOSPITAL IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. THE HOSPITAL HAS DETERMINED IT IS NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAS NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990T) WITH THE IRS. THE HOSPITAL BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE HOSPITAL WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. true true X true X true X true false false 94864 94864 0.00510 1644144 747389 896755 0.04860 1739008 747389 991619 0.05370 156699 156699 0.00850 156699 156699 0.00850 1895707 747389 1148318 0.06220 false 9903722 11522983 9565462 1957521 X true true 1 1 PAWHUSKA HOSPITAL INC 1101 E 15TH STREET PAWHUSKA OK 74056 WWW.PAWHUSKAHOSPITAL.COM 2271 X X X X PAWHUSKA HOSPITAL INC false false true X X X X X X X X X 21 true false true true X WWW.PAWHUSKAHOSPITAL.COM X true 21 true WWW.PAWHUSKAHOSPITAL.COM false true X 200. 300. X X X X true true X X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 PERSONS WHO REPRESENT THE COMMUNITY: A NEW CHNA WAS PERFORMED FOR THE 2022 FISCAL YEAR. THE HOSPITAL HOSTED A COMMUNITY MEETING ON JULY 13, 2022 WITH THE ASSISTANCE OF THE OKLAHOMA OFFICE OF RURAL HEALTH. THE INDIVIDUALS ATTENDING THESE MEETINGS INCLUDED, BUT WERE NOT LIMITED TO, INDIVIDUALS FROM THE FOLLOWING ORGANIZATIONS: PAWHUSKA HOSPITAL BOARD MEMBERS, Pawhuska Family Medical Clinic, AND Cohesive Healthcare. ADDITIONAL INPUT CAME FROM targeted interviews RESPONSES FROM VARIOUS key stakeholders OF THE COMMUNITY. THE targeted interviews WERE DISTRIBUTED through email to included participants from the Osage County Health Department and Osage County Department of Human Services. SCHEDULE H, PART V, SECTION B, LINE 11 NEEDS ADDRESSED AND NOT ADDRESSED IN CHNA: PAWHUSKA HOSPITAL PARTNERED WITH THE OKLAHOMA OFFICE OF RURAL HEALTH TO COMPLETE A CHNA DURING THE 2022 FISCAL YEAR. THROUGH THIS PROCESS, SECONDARY DATA WAS GATHERED, target interviews Were COMPLETED, AND KEY COMMUNITY PARTNERS INCLUDING PUBLIC HEALTH WERE SOLICITED FOR INPUT. THE FOLLOWING IDENTIFIES EACH PRIORITY, IMPLEMENTATION TAKEN, AND AN EVALUATION OR IMPACT OF THE IMPLEMENTATION. Priority: Expansion of services The hospital is currently working to expand space to provide outpatient physical therapy and exploring the option to also include speech therapy. This is in the early stages of exploration. Priority: Life skills The hospital is working to partner with the Osage Nation's TANF program to provide an employment pipeline for beneficiaries to gain skills for employment at the hospital. The hospital will also be working with some of their tribal members enrolled in the physical therapy program to host some of their clinical rotations. PRIORITY: SUBSTANCE ABUSE The hospital and clinic will continue to expand the chronic care management program and continue to look for partners and resources in this area. SCHEDULE H, PART V, SECTION B, LINE 6B CHNA CONDUCTED WITH OTHER ORGANIZATIONS: THE HOSPITAL COMPLETED THE CHNA IN PARTNERSHIP WITH THE OKLAHOMA OFFICE OF RURAL HEALTH. THE OFFICE OF RURAL HEALTH ASSISTED WITH GATHERING DATA AND ANALYZING THE LOCAL HEALTH DATA, AS WELL AS ASSISTED WITH DEVELOPING THE IMPLEMENTATION STRATEGY. SCHEDULE H, PART V, SECTION B, LINES 16A, 16B & 16C FINANCIAL ASSISTANCE POLICY AVAILABILITY: THE FINANCIAL ASSISTANCE POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE UPON REQUEST AND AT THE FOLLOWING WEBSITE: https://pawhuskahospital.com/financial-services/ 1 PAWHUSKA FAMILY MEDICAL CLINIC 1101 E 15TH STREET PAWHUSKA OK 74056 RURAL HEALTH CLINIC SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE: PATIENTS ACCOUNTS ARE WRITTEN OFF TO BAD DEBT AFTER EVERY EFFORT IS MADE TO COLLECT THE BALANCE AND PATIENTS ARE GIVEN OPPORTUNITIES TO COMPLETE CHARITY CARE APPLICATIONS OR SET UP PAYMENT PLANS. ALL DISCOUNTS AND CONTRACTUAL ADJUSTMENTS ARE APPLIED TO ACCOUNTS BEFORE THEY ARE WRITTEN OFF TO BAD DEBT. CURRENT PAYMENTS ON ACCOUNTS PREVIOUSLY WRITTEN OFF AS BAD DEBT REDUCES BAD DEBT EXPENSE. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY: THE ORGANIZATION IS UNABLE TO ESTIMATE THE AMOUNT FOR LINE 3 AND HAS ELECTED TO LEAVE IT BLANK. SCHEDULE H, PART III, SECTION B, LINE 8 COSTING METHODOLOGY: THE HOSPITAL USES COST REPORT METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS BASED ON MEDICARE OR MEDICAID DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARY COSTS BASED ON PROGRAM CHARGES TO TOTAL CHARGES. SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION POLICY: ALL COLLECTION EFFORTS CEASE WHEN A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE. NORMAL COLLECTIONS EFFORTS CONTINUE ON ANY PERSONAL AMOUNT OWED BY THE PATIENT. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: ADMINISTRATION, MEDICAL STAFF AND THE GOVERNING BOARD REGULARLY DISCUSS THE HEALTH CARE NEEDS OF THE LOCAL COMMUNITY DURING GOVERNING BOARD MEETINGS AS WELL AS IN THE BIMONTHLY MEETINGS OF THE MEDICAL STAFF. THE OKLAHOMA OFFICE OF RURAL HEALTH AND PAWHUSKA HOSPITAL DEVELOPED A COMMUNITY NEEDS ASSESSMENT DURING FISCAL YEAR 2022. PAWHUSKA HOSPITAL IMPLEMENTED STRATEGIES FOR EACH HEALTH PRIORITY IDENTIFIED THROUGH THE NEEDS ASSESSMENT. IN ADDITION, WHEN LOOKING AT THE POTENTIAL OF ADDING NEW SERVICES, THE HOSPITAL RESEARCHES HOW SUCH SERVICES WILL MEET AND ADDRESS THE NEEDS OF THE COMMUNITY. THE HOSPITAL IS PLANNING ON DEVELOPING FUTURE PROGRAMS THAT ALLOW OPPORTUNITIES TO GATHER A LARGER COMMUNITY AUDIENCE THAT CAN EXPRESS THE ISSUES THAT ARE IMPORTANT TO THE COMMUNITY. FOCUS GROUPS WILL ENABLE THE HOSPITAL TO FURTHER EDUCATE TO MEET THE NEEDS OF THE COMMUNITY. THE NEXT CHNA WILL BE COMPLETED IN FY2025. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: PAWHUSKA HOSPITAL, INC PROVIDES A LETTER TO PATIENTS UPON ADMISSION THAT STATES THE HOSPITAL PROVIDES ASSISTANCE TO THOSE PATIENTS WITH LIMITED INCOME TO HELP PAY FOR HOSPITAL EXPENSES. THE LETTER INDICATES THAT CHARITY CARE APPLICATIONS ARE AVAILABLE TO ALL PATIENTS AND CAN BE PICKED UP AT THE TIME OF SERVICE OR AT A LATER DATE. THE CHARITY CARE APPLICATION GIVES AN OVERVIEW OF THE CHARITY CARE POLICY AND NOTES THAT MEDICARE AND OTHER STATE PROGRAMS ARE ALSO AVAILABLE TO PATIENTS THAT MEET INCOME REQUIREMENTS. THE HOSPITAL STAFF IS AVAILABLE TO OFFER PATIENTS ASSISTANCE IN COMPLETING THE CHARITY CARE AND MEDICAID APPLICATIONS IF NEEDED. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: PAWHUSKA HOSPITAL, INC. PRIMARILY SERVES THE CITIZENS OF THE COMMUNITY OF PAWHUSKA, OKLAHOMA AND THE SURROUNDING AREA. PAWHUSKA SERVES AS THE COUNTY SEAT OF OSAGE COUNTY, OKLAHOMA AND IS ALSO THE CAPITAL OF THE OSAGE NATION. THE HOSPITAL IS ONE OF TWO FACILITIES LOCATED IN OSAGE COUNTY. OSAGE COUNTY IS A RURAL AREA WITH A POPULATION OF 45,839 FROM THE 2022 U.S. CENSUS. THE PER CAPITA INCOME FOR THE COUNTY WAS $27,562. ABOUT 12.3% OF THE POPULATION WERE BELOW THE POVERTY LINE, WITH A 5.5% UNEMPLOYMENT RATE. THE HOSPITAL IS A FEDERALLY DESIGNATED UNDERSERVED AREA FOR PRIMARY CARE HEALTH PROFESSIONALS, MENTAL HEALTH PROFESSIONALS AND DENTAL CARE HEALTH PROFESSIONALS. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: PAWHUSKA HOSPITAL'S GOVERNING BODY IS COMPRISED OF VOLUNTEER MEMBERS WHO RESIDE IN THE COMMUNITY. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. SURPLUS FUNDS ARE REINVESTED IN FACILITIES TO IMPROVE PATIENT CARE. THE HOSPITAL OPERATES AN EMERGENCY ROOM THAT IS AVAILABLE TO ALL REGARDLESS OF A PATIENT'S ABILITY TO PAY. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: N/A SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: not applicable for 2022 fISCAL YEAR SCHEDULE H, PART I, LINE 3C FACTORS OTHER THAN FPG DETERMINING FREE OR DISCOUNTED CARE: THE HOSPITAL USES THE FOLLOWING CRITERIA TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE: -ASSET LEVEL -MEDICAL INDIGENCY -INSURANCE STATUS -UNDERINSURANCE STATUS SCHEDULE H, PART I, line 7, col (f) PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25, OF THE FORM 990 WAS REDUCED BY BAD DEBT EXPENSE, TOTALING $9,903,722. Schedule H, Part III, Section A, Line 4 BAD DEBT EXPENSE FOOTNOTE: THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS CAN BE FOUND ON PAGE 10 & PAGE 11 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY FOR COMMUNITY BENEFIT COSTS: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1 AND 3. THE RATIO WAS COMPUTED FROM THE MEDICARE COST REPORT. THE COST COMPUTED ON WORKSHEET 8 WERE FROM THE HOSPITAL'S INCOME STATEMENT AND GRANT SCHEDULE. X X false false false false false false false false false MATTHEW C RUMSEY CHIEF MEDICAL OFFICER 398533 1000 0 0 21338 420871 0 DALTON SMITH PHYSICAL THERAPIST 151058 1000 0 0 1056 153114 0 HEATHER ARRINGTON PHYSICIAN 165701 1000 0 0 7457 174158 0 JOHN CHIAFFITELLI PHYSICIAN 140635 1000 0 0 21338 162973 0 RON DUNKLE APRN 333272 1000 0 0 16113 350385 0 Adam Helm APRN 148028 1000 0 0 1824 150852 0 FORM 990, PART VI, SECTION A, LINE 3 DELEGATION OF CONTROL OVER MANAGEMENT DUTIES: COHESIVE HEALTHCARE MANAGEMENT AND CONSULTING PROVIDED ADMINISTRATIVE OVERSIGHT FOR DAY-TO-DAY OPERATIONS, ACCOUNTING SERVICES, AND OPERATIONAL CONSULTING SERVICES. JASON MCBRIDE IS THE ADMINISTRATOR AND DENNIS BOYD IS THE CFO ON BEHALF OF COHESIVE HEALTHCARE MANAGEMENT AND CONSULTING. PER IRS GUIDANCE, THE COMPENSATION PAID BY THE MANAGEMENT COMPANY IS NOT SHOWN ON FORM 990, PART VII, FOR THE 2021 CALENDAR YEAR FOR THESE INDIVIDUALS: JILL GRAY $107,425 JASON MCBRIDE $98,986 Tina Steele $17,000 WHITNEY SMITH $67,869 FORM 990, PART VI, SECTION A, LINE 7A PERSONS WITH POWER TO ELECT OR APPOINT GOVERNING BODY: THERE ARE A TOTAL OF FIVE TRUSTEES. ALL ARE APPOINTED BY THE CITY COUNCIL OF PAWHUSKA BOARD OF INCORPORATORS. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW FORM 990: THE FORM 990 IS PRESENTED TO THE ADMINISTRATOR FOR REVIEW AND THEN PRESENTED TO THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C PROCESS TO MONITOR COMPLIANCE WITH CONFLICT OF INTEREST POLICY: ALL EMPLOYEES, BOARD MEMBERS, AND CONTRACT EMPLOYEES ARE COVERED IN OUR POLICIES. THE EMPLOYEE AND CONTRACT EMPLOYEE DETERMINATIONS ARE MADE BY ADMINISTRATION AND ANY BOARD DETERMINATIONS ARE MADE BY THE GOVERNING BOARD. THE EMPLOYEE WILL BE ASKED TO REMEDY THE SITUATION AND THE BOARD MEMBER WILL BE ASKED TO LEAVE AFTER PRESENTING THEIR CONFLICT AND THE REMAINDER OF THE GOVERNING BOARD WILL DISCUSS AND THEN VOTE. COPIES OF BOTH POLICIES CAN BE PROVIDED UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 15A & 15B COMPENSATION REVIEW: PAWHUSKA HOSPITAL, INC. FOLLOWS THE PAY GUIDELINES OF COHESIVE HEALTHCARE. SALARY DATA IS REVIEWED AGAINST SURVEY DATA FROM THE OKLAHOMA HOSPITAL ASSOCIATION. INCREASES ARE TIED TO AN ANNUAL PERFORMANCE EVALUATION AND APPROVAL FROM THE BOARD OF DIRECTORS. THE PROCESS AND DETERMINATION IS DOCUMENTED IN THE PERSONNEL FILES AND BOARD MINUTES. THE OTHER OFFICERS' COMPENSATION REVIEW IS PERFORMED EVERY YEAR BY THE HR DIRECTOR AND THEN REVIEWED BY THE COHESIVE CFO AND ADMINISTRATOR. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF DOCUMENTS: THE HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IV, LINE 12 & PART XII, LINE 2 AUDITED FINANCIAL STATEMENTS: THE ORGANIZATION HAS ANSWERED "NO" TO THE QUESTIONS REGARDING AN AUDIT IN PART IV, LINE 12a AND PART XII. THE ORGANIZATION IS IN THE PROCESS OF AN AUDIT OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED SEPTEMBER 30, 2022. HOWEVER, AT THE TIME OF FILING THIS RETURN, THE AUDIT IS NOT YET COMPLETE. THE ORGANIZATION HAS ATTACHED A COPY OF ITS MOST RECENT AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED SEPTEMBER 30, 2020 AND SEPTEMBER 30, 2019 TO THE 990 AND ANSWERED YES TO PART IV, LINE 20B. FORM 990, PART XII, LINE 3B SINGLE AUDIT: THE ORGANIZATION DID UNDERGO THE REQUIRED SINGLE AUDIT, BUT IT WAS STILL IN PROCESS AT THE TIME OF FILING THE FORM 990. FORM 990, PART XI, LINE 8 PRIOR PERIOD ADJUSTMENT: AFTER THE SEPTEMBER 30, 2021 FISCAL YEAR END, THE HOSPITAL MADE SOME MINOR ADJUSTING ENTRIES TO CORRECT THE ENDING CASH BALANCE AND EXPENSES RESULTING IN A PRIR PERIOD ADJUSTMENT OF $962. FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:1875795 FORM 990 PART IX LINE 11G DESCRIPTION:LAUNDRY TOTAL FEES:86242 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT STAFF TOTAL FEES:2490727 CITY OF PAWHUSKA 118 W MAIN STREET PAWHUSKA OK 74056 736005371 COMMUNITY SVC OK GOVT N/A NA false false false false false false false false false false false false false false false false false false false false