2021-11-12T11:14:21-06:00 2020-12-31 481026809 Wendling Noe Nelson & Johnson LLC 623 SW 10th Ave Suite 300 Topeka KS 66612 990 2020-01-01 480684878 Southwest Medical Center SOUT 6206241651 PO Box 1340 Liberal KS 679011340 Amber Williams CFO 6206241651 2021-11-12 1 Amber Williams XXX-XX-XXXX Heather R Eichem P01515553 7852334226 2021-11-12 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z Amber Williams PO Box 1340 Liberal KS 679011340 81495610 0 X www.swmedcenter.com X 1963 KS The Medical Center is a county hospital dedicated to the provision of personalized and quality care of the sick and injured at a reasonable cost. 7 7 681 130 0 0 523261 619407 72524480 80124310 405926 228731 631864 554099 74085531 81526547 0 0 0 0 36972938 43957475 0 0 0 29951103 34536002 66924041 78493477 7161490 3033070 86151476 108538515 39090836 58444805 47060640 50093710 The Medical Center is a county hospital dedicated to the provision of personalized and quality care of the sick and injured at a reasonable cost. 0 0 71835897 80308876 Southwest Medical Center provides necessary medical care to the community. It is the only facility in the area providing certain medical equipment and services. 71835897 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 114 0 1 681 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 1 1 0 X Amber Williams CFO 6206296680 PO Box 1340 Liberal KS 679011340 Mark Schepers Chairman 1.00 X X 0 0 0 Ray E Allen MD Trustee 1.00 X 0 0 0 Ivanhoe Love Jr Trustee 1.00 X 0 0 0 Frederick Miller Treasurer 1.00 X X 0 0 0 Tammy Lenear Asst. Secretary/Treasurer 1.00 X X 0 0 0 Thomas Willis Secretary 1.00 X 0 0 0 Dennis Sander Vice-Chairman 1.00 X X 0 0 0 William Ermann CEO (Through March 2020) 40.00 X 58371 0 10153 Robert Whitaker CEO (Beginning March 2020) 40.00 X 242307 0 43643 Amber Williams CFO 40.00 X 196202 0 32359 Rama Chanda Physician 40.00 X 736984 0 61206 Fadi Darwiche Physician 40.00 X 640463 0 60204 Pingal Desai Physician 40.00 X 667290 0 60490 Andrey Ilyasov Physician 40.00 X 888676 0 62685 Akshath Kamath Physician 40.00 X 742117 0 61240 4172410 0 391980 55 0 1 0 Avant Healthcare Professionals LLC PO Box 744554 Atlanta GA 30374 Contract Services 2371312 Kansas Emergency Room Services PA 7032 Collection Center Drive Chicago IL 60693 ER Services 841537 Guymon Physical Therapy and Wellness 211 NW 5th Street Guymon OK 73942 Therapy Services 646985 Account Recovery Specialists Inc 200 W Wyatt Earp Boulevard Dodge City KS 67801 Collection Fees 609760 OneStaff Medical LLC PO Box 3544 Omaha NE 68103 Contract Services 532435 29 350675 150000 118732 19499 619407 Net patient service revenue 622110 80124310 80124310 80124310 197794 197794 114239 0 114239 114239 114239 -30937 30937 30937 30937 Cafeteria & dietary 722210 255294 255294 Miscellenous revenue 900099 184566 184566 439860 81526547 80308876 0 598264 572533 572533 34080420 31553450 2526970 4069022 3807746 261276 2870277 2637128 233149 2365223 2188458 176765 42397 42397 2120 2120 629793 248916 380877 51263 22782 28481 621954 507119 114835 97921 50422 47499 1359421 1341192 18229 63484 59818 3666 74600 71592 3008 568062 568062 2963012 2833551 129461 564728 490122 74606 Purchased services 11378739 10591189 787550 Medical supplies 7026276 7026276 Pharmacy drugs and supp 4981714 4981714 Repair & maintenance 2117780 1401643 716137 1992738 1454717 538021 78493477 71835897 6657580 0 4524 4824 37528356 49746349 13540148 19494085 1487489 2180455 2569410 2524820 49617957 25417485 23962740 24200472 1664994 1645779 5393815 8741731 86151476 108538515 5324013 5292898 10407466 14870000 14375000 4729400 18896823 23640041 39090836 58444805 X 45724384 48440922 1336256 1652788 47060640 50093710 86151476 108538515 3033070 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 4338 0 0 0 4338 0 Part II-B, Line 1: Southwest Medical Center is a member of the Kansas Hospital Association. This organization engages in lobbying activities for hospital and general health care interests as part of the services provided to members. 1115081 19318 70000 1064399 1298500 81081 264500 1115081 1230394 79295 11189 1298500 1130458 109686 9750 1230394 1158096 -16388 11250 1130458 0.62760 0.37240 0 1 1 104046 104046 27479905 12929608 14550297 17448987 11617009 5831978 4585019 870868 3714151 24200472 Interest receivable 2392 Other receivables 54959 Deferred outflows of resources - pension 7842350 Deferred outflow on advance refunding 819068 Estimated third-party payor settlements 22962 8741731 Unamortized premium 421603 Deferred inflows of resources - Pension 294713 Net pension liability 22923725 23640041 X 81526547 0 81526547 0 81526547 78493477 0 78493477 0 78493477 Part V, Line 4: Southwest Medical Center Foundation, Inc.'s endowment consists of approximately six individual funds established for scholarships and general support of Southwest Medical Center. Part X, Line 2: Management is not aware of any uncertainties in income tax positions. 1 1 0 1 X 1 1 0 1 1 663526 152948 510578 0.00650 9650525 4110773 5539752 0.07060 10314051 4263721 6050330 0.07710 15179834 6385619 8794215 0.11200 250 250 0.00000 15180084 6385619 8794465 0.11200 25494135 10649340 14844795 0.18910 1 4952338 147252 16168823 17490508 -1321685 X 1 1 1 1 Southwest Medical Center 315 W 15th Street Liberal KS 679011304 X X X Skilled nursing facility (Closed 09/20) Southwest Medical Center 1 0 0 1 X X X X X X X X X 19 1 0 0 1 X www.swmedcenter.com X 1 19 1 www.swmedcenter.com 0 1 X 350.000000000000 X X X X X 1 1 X X X X 1 X www.swmedcenter.com X www.swmedcenter.com X www.swmedcenter.com X X X X X X 1 X 0 X X X X 1 X 0 0 Southwest Medical Center Part V, Section B, Line 5: SWMC contacted community leaders via email and requested that these individuals complete an online survey with questions addressing the various health issues of the community.Persons who completed this survey included physicians, public health representatives, other health professionals, social service providers and a variety of other community leaders. Southwest Medical Center Part V, Section B, Line 11: Access to Primary Care and Primary Care Specialists:SWMC continued to collaborate with regional primary care providers and share best practice delivery methods in order to increase access to primary care. SWMC worked to strengthen relationships with Wichita State University, University of Kansas, and Rocky Vista by offering medical student rotations and helping recruit medical professionals to the area. Furthermore, SWMC has worked to expand orientation programs for prospective new providers and increase new provider retention. SWMC has continued efforts to educate the community about when patients should go to their primary care clinic and when patients should go to the ER.Access to Healthcare SpecialistsSWMC held meetings with providers to gather their thoughts on the medical needs in the community in order to determine the number of providers needed to serve the population. SWMC expanded access to specialists via telehealth and made this method a primary function of care during the COVID-19 pandemic. SWMC continued to work with area medical schools in order to establish medical student placement relations and help with the recruiting of medical professionals to the area.Chronic Health: DiabetesSWMC continued to provide and distribute CDC educational resources at community events. However, the events were limited due to the COVID-19 pandemic. SWMC did not work with community organizations to explore the Diabetes Prevention Recognition Program for Organizations due to COVID-19 being the main focus of SWMC during the year.Mental Health and Substance Abuse:SWMC continued programs to educate staff and the community on mental health issues, symptoms, and treatments. However, these educational efforts were limited due to COVID-19 being the main focus of SWMC during the year.The following needs identified in the CHNA were not addressed either because they were deemed not part of mission critical operations or because COVID-19 was the primary focus of SWMC during the year: Access to Dental Care, Chronic Health Conditions, Teen Births, Sexually Transmitted Diseases, Suicide, Substance Abuse, Sexual Assault, Motor Vehicle Accidents, and Child Care Access. Southwest Medical Center Part V, Section B, Line 15e: A presumptive eligibility determination in unusual or extenuating circumstances when a patient is unable to submit a complete application. Presumptive eligibility may be determined on the basis of individual life circumstances which may include, but is not limited to:-Homelessness or receipt of care from a homeless shelter;-Eligibility for out of state or out of area medical assistance programs;-Patient is deceased with no known estate;-Patient who has filed bankruptcy and whose bill has been fully discharged by the court. 9 1 - 15th Street Family Care Center 555 W 15th Street Liberal KS 67901 Family practice 2 - General Surgery Care Center 305 W 15th Street Suite 204 Liberal KS 67901 General Surgery 3 - Women's Specialty Center of Liberal 305 W 15th Street Suite 104 Liberal KS 67901 OB/GYN Services 4 - Orthopedic & Sports Medicine 305 W 15th Street Suite 101 Liberal KS 67901 Orthopedics 5 - Sleep Disorders Laboratory 101 E 11th Street Liberal KS 67901 Sleep Studies 6 - Women's Specialty Center of Guymon 421 Medical Drive Guymon OK 73942 OB/GYN Services 7 - McMurry Family Center 123 Medical Drive Guymon OK 73942 Family practice 8 - Urology Care Center 305 W 15th Street Suite 102 Liberal KS 67901 Urology 9 - Dermatology Care Center 15 E 11th Street Liberal KS 67901 Dermatology Part I, Line 7: Amounts for Financial Assistance and Certain Other Community Benefits programs were obtained using known related charges and several cost to charge ratios. The cost to charge ratios used include the overall cost to charge ratio derived from Worksheet 2 as well as individual department cost to charge ratios identified for the calculation of subsidized health services information. Part I, Line 7g: Subsidized Health Services are made up of services that the Medical Center provides despite a financial loss to the organization. These services include skilled nursing services and physician clinics. Of the $18,179,834 in total costs associated with subsidized health services, $13,380,732 were due to physician clinics. Part III, Line 4: The Medical Center provides for accounts receivable that could become uncollectible in the future by establishing an allowance to reduce the carrying value of such receivables to their estimated net realizable value. The Medical Center estimates this allowance based on the aging of its accounts receivable and its historical collection experience for each type of payor.Part III, Line 2Provisions for bad debts are related to accounts that have been deemed uncollectible during the year. The uncollectible amount is then written off pursuant with Medical Center policy. The cost of the bad debts reported was determined using the cost to charge ratio and total bad debt expense.Part III, Line 3The estimate of provisions for bad debts attributable to patients eligible under the organization's financial assistance policy was determined using the amount of charges included in incomplete charity care applications multiplied by the Medical Center's cost to charge ratio. It is our belief that the portion of the Medical Center's bad debt expense attributable to patients eligible under the Medical Center's financial assistance policy should be included as community benefit. As a not-for-profit, patient care is provided to all, regardless of ability to pay for that care. Making quality patient care available to all in our community, regardless of their economic means, qualifies bad debts as a community benefit. Part III, Line 8: Amounts were obtained from the cost report filed with Medicare for the period ending December 31, 2020. The Medicare shortfall should be considered a community benefit because our mission is to promote health in the community and we do not limit the care available to any patients, including those covered by Medicare. We are relieving a government burden by providing care to Medicare patients. Tax-exempt hospitals are expected to participate in the Medicare program. Part III, Line 9b: The Medical Center's collection policy does not contain a provision on the collection practices for patients who are known to qualify for charity care or financial assistance. To be considered for charity care, however, the charity care policy states that the patient must cooperate with the Medical Center to provide the information and documentation necessary to apply for other existing financial resources that may be available to pay for health care services, such as Medicaid. Then the information is gathered and assessed in order to determine eligibility for charity care. Whenever possible, prior to admission, the Medical Center will conduct a pre-admission interview with the patient, the guarantor, and/or legal representative. Those patients who may qualify for financial assistance from a governmental program will be referred to the appropriate program, prior to the consideration for charity care. Part VI, Line 2: SWMC conducts a community needs assessment approximately every 3 years. The assessment includes conducting community focus group meetings to hear what the citizens believe are the community's most critical needs. Additionally, SWMC monitors Kansas Hospital Association patient origin and destination data to look for patterns of migration for services that might be made available locally as a new service. Part VI, Line 3: PFS refers self pay patients to Midland Professionals and Midland assists them in seeing if they are eligible for any federal, state, or local programs. The collectors send out charity care paperwork to patients as they are calling and collecting or if a patient calls for the packet. Part VI, Line 4: SWMC's total service area is rural and is made up of southwest Kansas and the neighboring areas of Oklahoma, Colorado and New Mexico. SWMC's primary service area, however, is Seward County, KS, which has a population of approximately 21,428. According to the U.S. Census Bureau this population is approximately 63.2% Hispanic, has a median household income of $49,291, and 14.2% of all people in Seward County are below the Federal poverty level.SWMC is a County owned hospital and is the only hospital in the county. It therefore provides care to all patients regardless of their ability to pay. 8.3% of services provided by SWMC are provided to Uninsured patients while an additional 12.2% is provided to Medicaid patients. Part VI, Line 5: SWMC's seven Board of Trustees members are appointed by the Seward County Board of County Commissioners. Trustees are required to reside in Seward County, KS, and cannot be employed by the Hospital. SWMC extends medical staff privileges to all qualified physicians in the community who so desire to have such privileges.All surplus funds are reinvested back into the Hospital to fund capital needs and additional services that are identified as needed to continue to provide high quality services to the community. SWMC works with other community agencies, including the Seward County Health Department, to provide educational programs to the public throughout the year. SWMC provides clinical training facilities for many area educational institutions' nursing, respiratory therapy, and radiology students. This includes Seward County Community College, Fort Hays State University, the University of Kansas, Oklahoma State University, Texas Tech University and others, all without any financial compensation. X X X 0 0 0 0 0 0 0 0 0 Andrey Ilyasov Physician 413437 0 475239 0 0 0 27389 0 35296 0 951361 0 0 0 Akshath Kamath Physician 363592 0 378525 0 0 0 27389 0 33851 0 803357 0 0 0 Rama Chanda Physician 356813 0 380171 0 0 0 27389 0 33817 0 798190 0 0 0 Pingal Desai Physician 510645 0 156645 0 0 0 27388 0 33102 0 727780 0 0 0 Fadi Darwiche Physician 411980 0 228483 0 0 0 27388 0 32816 0 700667 0 0 0 Robert Whitaker CEO (Beginning March 2020) 242307 0 0 0 0 0 23579 0 20064 0 285950 0 0 0 Amber Williams CFO 176684 0 19518 0 0 0 17440 0 14919 0 228561 0 0 0 A Seward County Kansas 486009370 818427ER3 2010-05-27 18167463 Expand and renovate facilities, purchase equipment, and fund debt. 0 0 0 B Seward County Kansas 486009370 818427FR2 2016-03-30 9921376 Partially refund 2010 bond issue 0 0 0 A 12420000 18182121 1085835 213247 148667 16727638 1005550 87211 2012 0 1 1 1 B 355000 9921376 149800 10210375 15000 2016 0 1 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 1 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 Schedule K, Part II The difference between Part I, column (e) and Part II, line 3 is due to the accumulation of investment income. Kathlene Ermann Sister of William Ermann, CEO through March 2020 57170 Employment 0 Caleb Whitaker Son of Robert Whitaker, CEO beginning March 2020 31408 Employment 0 Form 990, Part VI, Section B, line 11b The Form 990 is reviewed by the CFO and Controller. Form 990, Part VI, Section B, line 12c A conflict of interest policy disclosure form is provided with a copy of the current conflict of interest policy. This disclosure is completed by each Trustee upon election and annually thereafter. Form 990, Part VI, Section B, line 15 The Board of Trustees is responsible for determining the job performance standards for the Administrator/CEO and determining compensation according to the organization's policies. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Form 990, Part XI, Line 2C The organization has an audit committee that is responsible for the oversight of the financial statement audit and selection of the independent accountant. Southwest Medical Center Foundation PO Box 1340 Liberal KS 67901 480908781 Fundraising for the benefit of Southwest Medical Center KS 501(c)(3) Line 12d, III-O 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0