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        <ServicesDesc>NURSING AND LAB CONTRACT SERVICES</ServicesDesc>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
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        <ServicesDesc>PROFESSIONAL SERVICES</ServicesDesc>
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      <NetGainOrLossInvestmentsGrp>
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        <ExclusionAmt>37194</ExclusionAmt>
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        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
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      <OtherExpensesGrp>
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        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 5 Facility 1, 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility 1, 1 - ELLINWOOD DISTRICT HOSPITAL. THE ASSESSMENT PROCESS WAS INITIATED BY ELLINWOOD DISTRICT HOSPITAL AND COMPLETED IN COLLABORATION WITH BARTON COUNTY HEALTH DEPARTMENT. ALL OF THE EDUCATIONAL, GOVERNMENTAL, CIVIC AND HEALTH RELATED ORGANIZATIONS WITHIN THE COMMUNITY WERE INVITED TO PARTICIPATE. TO ENSURE INPUT FROM PERSONS WITH A BROAD KNOWLEDGE OF THE COMMUNITY, NOTICES OF ALL MEETINGS WERE ANNOUNCED BY MAILED LETTERS, EMAILS, AND ADVERTISEMENTS. REPRESENTATIVES AND INDIVIDUALS FROM THE COMMUNITY AND HEALTH ORGANIZATIONS ATTENDED THE TOWN HALL, FROM ELLINWOOD AND SURROUNDING AREAS INCLUDING HOISINGTON, GREAT BEND, CLAFLIN, AND BEAMER.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 6b Facility 1, 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility 1, 1 - ELLINWOOD DISTRICT HOSPITAL. BARTON COUNTY HEALTH DEPARTMENT</ExplanationTxt>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 11 Facility 1, 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility 1, 1 - ELLINWOOD DISTRICT HOSPITAL. The hospital provides and promotes the health of the citizens of the Ellinwood district by constantly looking for opportunities to educate area residents about healthy activities and habits and offering opportunities for education about health care topics. Some of the activities to further the health of the area include: 1. Mental Health (Diagnosis, Placement, Aftercare, Access to Providers) a. Collaborate with community elementary, middle, and high schools to educate students on mental health (de-stigmatize mental health conditions, bullying, suicide prevention and social media bullying). b. Continue Depression Screening initiatives at hospital (ER) and DOH. Provide intervention guidelines / handouts / adequate education c. Continue and enhance and promote 24-hour 988 crisis hotline. Promote and enhance The Center Hotline: 620-792-2544 or 800-275-7544 d. Expand Primary Care and ER staff training; share quality mental health service delivery. Create updated brochures on mental health service options. Continue ER tele psych service delivery.. e. Continue to build and expand Tele Psych through the Center for Counseling &amp; Consultation (Pad) service offerings that are approved by area providers. Explore reimbursement options. f. Develop a Suicide Prevention Public service announcements, literature, resources to contact (Availability). Providers identifying and promoting services, education, etc. g. Enhance and expand Mobile Crisis Services. Promote services. h. Continue to develop MH referral relationships with key community partners for collective impact. i. Continue to support "Youth Group "Zero Reasons Why" j. Continue Outpatient community-based programs. Promote existing mental health services, facilities, and providers. Educate community on placement process and options thru hospital physicians, clinics, and E.R. k. Continue to build and promote community activities, tools, and resources for Mental Health. l. Engage a well known Guest Speaker to come to community to share on de-stigmatize mental health treatment. (Secure a speaker and continue it) 2. Childcare (Safe &amp; Affordable) a. Continue to conduct Child Care Support education i.e., teen babysitting classes etc. Continue to provide support for licensure i.e., CPR classes. b. Expand free or low-cost activities and educational programs at local libraries and community centers to provide additional care and enrichment opportunities. c. Explore the development of part-time, drop-in, and extended-hour childcare options to accommodate parents with non-traditional work schedules. d. Continue to work with local schools and community organizations to increase the availability of preschool programs that combine care with early education, particularly in areas with high demand. e. Continue to evaluate access to child care needs and confirm number of child care providers needed. f. Continue to encourage unlicensed or informal childcare providers to become licensed by offering support and resources, ensuring they meet state standards and can serve more families. g. Continue EMS Child fittings for car seats. 3. Senior Care a. Continue and enhance "End of Life" Suite of services at Ellinwood District Hospital. b. Organize regular social events, such as book clubs, gardening clubs, or arts and crafts sessions, to keep seniors engaged and reduce feelings of isolation. c. Explore a volunteer program where younger community members or other seniors regularly check in on those who live alone. d. Create support groups for family members who are caregivers, providing them with resources, training, and emotional support. e. Explore Tele-Health program for home bound patients. Explore Tele-Health opportunities for home health. f. Continue offering senior transportation services while looking into expansion of services for Healthcare and Mental Health outside of PSA. g. Develop a "Adopt a Senior" Program in Ellinwood. Continue senior center activities for senior checks, yoga classes, and lab fairs. h. Continue and enhance meal delivery services that cater to seniors' dietary needs. i. Continue to partner with local pharmacies to deliver medications to seniors who may have difficulty picking them up themselves. j. Explore a feasibility study to document need of SR services and staffing/development. k. Explore a county wide Healthy Seniors Club. Establish programs, housing and services to allow older adults to "age in place". Coordinate with senior center. l. Re-Launch training for seniors on how to use smartphones, tablets, and computers to stay connected with family, access telehealth services, and remain informed. Partner with Rec and Senior Center. 4. Social Emotional Learning (Expand School Program) a. Work with local schools to incorporate Social Emotional Learning into the standard curriculum through lessons that focus on emotional literacy, empathy, conflict resolution, and decision-making skills. b. Expand workshops that teach parents and caregivers how to foster social-emotional skills at home, including effective communication, empathy, and emotional regulation. c. Continue to encourage and require community service hours for students. Continue partnership with Ellinwood Ministerial Alliance. d. Continue "Second Step" program through School District. e. Continue collaboration with St. John's Child Development Center and the School District. f. Grow programs where older students or young adults mentor younger children, fostering relationships built on trust, empathy, and support. Create peer support groups for different age ranges, where participants can share experiences, discuss emotions, and learn coping strategies in a safe, supportive environment. (STEM Buddies) g. Continue to provide mindfulness and yoga classes that help community members of all ages learn stress management, emotional regulation, and self-awareness. h. Continue to conduct regular assessments and surveys to evaluate the effectiveness of SEL programs and initiatives, gathering feedback from participants, educators, and community members. Use data from assessments to adjust strategies and programs, ensuring they continue to meet the evolving needs of the community. i. Explore community art projects like murals or collaborative installations that focus on themes of kindness, empathy, and community. 5. Access to Specialists (URL, ENDO, ENT) a. Conduct community education programs to inform residents about available specialist services, how to access them, and the benefits of early specialist intervention. b. Continue to offer attractive incentive packages, including competitive salaries, signing bonuses, relocation assistance, and student loan repayment options, to recruit specialists to the community. c. Develop a streamlined referral system that facilitates quick and efficient referrals from primary care providers to specialists, reducing wait times. d. Explore demand / adjust clinic hours to meet market need. Conduct further research on the desire/need for afterhours care. e. Retain existing Barton Co providers. Conduct a physician manpower assessment to identify number of providers needed per specialty for PH primary service area draw. f. Conduct additional research (PSA focus group) to further determine ideas to recruit qualified providers to EDH. g. Explore grants from government programs, non-profits, and private foundations to fund specialist services or telemedicine infrastructure. h. Partner with local non-profits, community organizations, and other healthcare providers to maximize the use of existing resources and expand specialist services. i. Provide ongoing professional development and training opportunities to keep specialists engaged and up-to-date with the latest medical advancements. 6. Substance Abuse (Drug &amp; Alcohol) a. Continue to offer Guidance Counselors and group sessions at schools (on prevention and community education). b. Continue discarding "Old prescriptions-off program at local police departments with focus on prescribed opioids. c. Continue and expand to offer / create meaningful community youth activities to keep youth engaged and active. Research prevalent issues leading to drug abuse by adolescents. d. Continue clinic education on pain management. Consider and explore the development of an opioid treatment program. e. Build Recovery support system partners. Create programs to help addicts and their families. Continue to provide counseling and support for drug abusers and their families. Support local substance abuse counseling. Educate public on signs of drug abuse and how to approach those needing guidance. f. Conduct a Community Inventory Survey and maintain the directory to document scope of substance abuse services and hours of service. Publish via count/city website</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 11 Facility 1, 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Facility 1, 2 - ELLINWOOD DISTRICT HOSPITAL. g. Continue local advertisement / social media campaign to combat drug and alcohol abuse and educate on the ramifications. 7. Suicide Prevention a. Continue to educate all medical staff including EMS and Police officers regarding suicide prevalence in the area and how to address them. Provide continuing education courses to staff, lunch and learn presentations, etc. to keep them current in terms of treating mental health issues. b. Continue to educate Community to build awareness of mental health. Suicide prevention services. Update &amp; distribute overview brochures detailing mental health services and crisis information. c. Start a "It's OK" screening program. Encourage &amp; increase suicide/depression screenings through primary care physicians, Health Dept, schools, and clinics. Provide appropriate depression intervention / referrals / education during Annual Physicals. d. Establish a community inventory of services to document the availability of mental health resources, including hours of service. e. Continue to investigate grant writing to suicide prevention and depression. Use grant funding to support mental health care and mental health prevention. f. Partner (with Health Dept.) to offer mental health service "first aid" training for law enforcement, schools, and other first responders in the community. g. Explore hosting Suicide Prevention Public service announcements, literature, resources to contact (Availability). Providers identifying and promoting services, education, etc. h. Develop a flowsheet with key individuals on what steps look like after it is determined a member of the community needs help. Share and educate all local partners and entities the flow sheet and resources available. 8. Transportation (All) a. Continue to educate community on transportation offerings for healthcare and city offerings. b. Explore transportation services specifically for seniors and people with disabilities. This can include accessible vans, specialized shuttles, or partnerships with agencies that provide transport for these populations. c. Educate provider schedulers the importance to consolidate appointments with different providers on same day in order to minimize travel needed. d. Explore and apply for additional grants for transportation opportunities in order to meet needs. e. Explore Hospital Transportation for patients. f. Explore research to document demand. Expand current transportation resources and report progress / options. g. Explore expanding to community rides or separate initiative for community outside of just healthcare visits.</ExplanationTxt>
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            <BusinessNameLine1Txt>ELLINWOOD RURAL HEALTH CLINIC</BusinessNameLine1Txt>
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            <AddressLine1Txt>611 N MAIN</AddressLine1Txt>
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          <FacilityTxt>MEDICAL CLINIC</FacilityTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION USED THE FOLLOWING CRITERIA TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE: ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, AND UNDERINSURANCE STATUS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation</FormAndLineReferenceDesc>
        <ExplanationTxt>328593</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART I, LINE 7 OF SCHEDULE H, IS A COST TO CHARGE RATIO.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount</FormAndLineReferenceDesc>
        <ExplanationTxt>HOSPITAL CHARGES THAT ARE NOT COLLECTED AND ARE NOT APPROVED FOR FINANCIAL ASSISTANCE ARE CLASSIFIED AS BAD DEBTS FROM PATIENTS WHO WILL NOT PAY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 3 Bad Debt Expense Methodology</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COSTING METHODOLOGY IS BASED ON THE ORGANIZATION'S MEDICARE COST-TO-CHARGE RATIO. WHILE WE RECOGNIZE THAT THERE WOULD BE SOME BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY, WE HAVE NO REASONABLE BASIS FOR ESTIMATING THIS FIGURE. IF ELIGIBILITY IS KNOWN, THE AMOUNT WOULD FALL UNDER CHARITY CARE AND NOT BAD DEBT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote</FormAndLineReferenceDesc>
        <ExplanationTxt>NOT APPLICABLE DUE TO ADOPTION OF ASC 606 REVENUE CONTRACTS WITH CUSTOMERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 8 Community benefit &amp; methodology for determining medicare costs</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNT ON LINE 6 IS COST TO CHARGE RATIO.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL CHARITY CARE CHARGES AND CHARGES NOT TO BE COLLECTED DUE TO FINANCIAL ASSISTANCE COMPUTATIONS ARE EXEMPT FROM COLLECTION POLICIES AND PRACTICES. THESE ACCOUNTS ARE REMOVED FROM THE COLLECTION CYCLE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16a FAP website</FormAndLineReferenceDesc>
        <ExplanationTxt>1 - ELLINWOOD DISTRICT HOSPITAL: Line 16a URL: https://www.ellinwooddistricthospital.org/financial-assistance;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16b FAP Application website</FormAndLineReferenceDesc>
        <ExplanationTxt>1 - ELLINWOOD DISTRICT HOSPITAL: Line 16b URL: https://www.ellinwooddistricthospital.org/financial-assistance;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part V, Section B, Line 16c FAP plain language summary website</FormAndLineReferenceDesc>
        <ExplanationTxt>1 - ELLINWOOD DISTRICT HOSPITAL: Line 16c URL: https://www.ellinwooddistricthospital.org/financial-assistance;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 2 Needs assessment</FormAndLineReferenceDesc>
        <ExplanationTxt>In 2024, the hospital has continued to work to address the health needs identified by the 2021 Community Health Needs Assessment of our service area. The top item was a new or updated facility and we moved into our new facility July 2024. Another community need was to recruit new providers and in 2024 we hired a New MD and had 2 nurses in the last stages of their APRN program.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 3 Patient education of eligibility for assistance</FormAndLineReferenceDesc>
        <ExplanationTxt>The Financial Assistance Program employs a sliding scale discount that takes into consideration a patient's household income and qualifying assets. The Financial Counselor consults with private pay patients to see if they qualify for the Hospital's financial assistance policy. We also have posted online and in both the hospital and clinic lobbies that financial assistance is available and to apply with the Financial Counselor at the Hospital. If discovered during the accounts receivable collection process that a patient is having trouble paying bills, both the hospital and the centralized billing office will inform the patient that financial assistance is available. As part of the financial assistance program all applicants must apply for Medicaid. If after the initial interview there is a consensus that the patient may qualify for financial assistance, the financial counselor gives patient forms to complete and asks to see bank statements, tax returns, etc. Computations based on current Federal Poverty Level Guidelines are completed to see if qualification is appropriate and the percentage of charges to be written off is determined, based on family size and household income. All instances of financial assistance are approved by upper management of the Hospital.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 4 Community information</FormAndLineReferenceDesc>
        <ExplanationTxt>The Ellinwood Hospital District consists of all of Lakin township (including the City of Ellinwood) and all of Comanche township (with the exception of the two tiers of sections along the western edge described as Sections 5,6,7,8,17,18,19,20,29,30,31, and 32, in West 20-12. This area is known as the Ellinwood Trade Area. The hospital is located in Ellinwood, Kansas which has a population of 2,063 as of the 2019 5-year estimates of the American Community Survey, by the U.S. Census Bureau, and serves the eastern part of Barton County. Total population of Barton County is 26,453 as of the same census. The median age of an Ellinwood resident is 39.9 years. Total households in Ellinwood are 834 plus the rural households from the district. The racial makeup of the community is 90% white, 7% Hispanic, and the remaining 3% are other races or multiple races. The median income per household in Ellinwood was $47,500, as compared to the state of Kansas which is $59,597. 40% of Ellinwood citizens are 50 or older. The percentage of people at the poverty level or below in Ellinwood is 12%, the same as compared to the state poverty rate of 12%. Poverty level of those under 18 is 11% and for those over the age of 65 it is 10%. The patient population also includes patients from Russell, Rice, and Stafford Counties. The patient mix is heavily weighted toward Medicare and Medicaid beneficiaries, especially acute, ER, and swing bed care. Citation: U.S. Census Bureau (2019). American Community Survey 5-year estimates. Retrieved from Census Reporter Profile page for Ellinwood, KS &lt;https://censusreporter.org/profiles/16000US2020425-ellinwood-ks/&gt;</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 5 Promotion of community health</FormAndLineReferenceDesc>
        <ExplanationTxt>The hospital provides and promotes the health of the citizens of the Ellinwood district by constantly looking for opportunities to educate area residents about healthy activities and habits and offering opportunities for education about health care topics. Some of the activities to further the health of the area include: 1. Educational classes are offered throughout the year, including classes to clubs and organizations in the community. Educational presentations are also made at local schools. (Two classes held in 2024) 2. We offer support to other healthcare related organizations, such as the local food bank, United Way, and Relay for Life, to raise awareness about health-related issues, such as cancer, and to ensure that their missions can be carried out, impacting the health and wellness of us all. 3. In conjunction with the community ambulance service, the hospital sponsors ACLS, PALS and CPR for professionals in Barton County. 4. TNCC classes for nurses are sponsored by the hospital for area health care professionals. 5. The hospital and its staff took the lead for the county medical organizations in emergency preparedness, especially concerning the new requirements faced by all other provider types. We host and participate in disaster/bioterrorism drills with other area health care facilities on a regular basis to encourage preparedness and awareness within our communities. 6. We support medical education in all forms, but especially by giving support to our local community colleges: top management serves on advisory boards for nursing program and medical assistant/coding programs at Barton Community College (BCC). The hospital is a practice site for phlebotomists/MLT, medical assistant program and nursing program from BCC. We are also a practice site for the physical therapy assistant program at Hutchinson Community College. We also have a job shadowing program with our local high school. This allows students to shadow a professional in the medical field they might be interesting in pursuing in college. 7. EDH continues to dedicate itself and any surplus funds to improving the healthcare available to area residents and patients by updating equipment and ensuring that the hospital's technology is current and able to meet the patients' needs.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule H, Part VI, Line 6 Affiliated health care system</FormAndLineReferenceDesc>
        <ExplanationTxt>Ellinwood District Hospital and Clinic are affiliated with Great Plains Health Alliance, Inc. (GPHA), a non-profit 501(c)3 organization which provides management services and operational, finance, and accounting support. GPHA does not provide services directly to patients, but does provide access to professionals that may not be affordable to the normal critical access hospital. GPHA provides education and assistance in areas such as HIPAA, Medicare reimbursement, meaningful use requirements for computer systems, etc. GPHA is an affiliation of Critical Access Hospitals in Kansas and Nebraska that provides networking opportunities with other rural hospitals, communities, and leaders. GPHA provides policies and guidance to its Critical Access facilities regarding financial assistance, conflicts of interest, corporate compliance, and many other areas. GPHA also provides educational sessions for Board Members, Business Office Mangers, Billers, Medical Records personnel, Directors of Nursing, and Administrators. GPHA is a vital link in allowing CAH hospitals to operate at a high quality within the cash constraints imposed by the Critical Access program.</ExplanationTxt>
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        <ExplanationTxt>KS</ExplanationTxt>
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        <PersonNm>KILE MAGNER</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JASON BARB</PersonNm>
        <TitleTxt>CFO</TitleTxt>
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        <PersonNm>CHRISTOPHER BROWN</PersonNm>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CHARLIE JOSLIN</PersonNm>
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        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
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      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TROY MOORE</PersonNm>
        <TitleTxt>DEPT HEAD PT</TitleTxt>
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        <FormAndLineReferenceDesc>Schedule J, Part I, Line 3 Form 990, Part VII</FormAndLineReferenceDesc>
        <ExplanationTxt>ANNUAL COMPENSATION REVIEWS ARE COMPLETED BY THE CEO AND CHIEF FINANCIAL OFFICER USING RECOMMENDATIONS PROVIDED BY DEPARTMENT MANAGERS AND CURRENT MARKET CONDITIONS. ALL EXECUTIVE EMPLOYEE SALARIES, INCLUDING THE PRESIDENT/CEO, ARE APPROVED BY THE GPHA BOARD OF DIRECTORS. THE AMERICAN COLLEGE HEALTHCARE EXECUTIVES AND THE KANSAS HOSPITAL ASSOCIATION ALSO HAS COMPARABLE COMPENSATION DATA THAT CAN BE USED BY THE BOARD. THE CEO RETAINS DOCUMENTATION IN ADDITION TO THAT IN THE BOARD MINUTES.</ExplanationTxt>
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        <BondIssuedDt>2023-01-24</BondIssuedDt>
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        <PurposeDesc>NEW HOSPITAL CONSTRUCTION</PurposeDesc>
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      <TaxExemptBondsPrivateBusUseGrp>
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        <OwningBondFinancedPropertyInd>false</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>false</AnyLeaseArrangementsInd>
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        <EngageBondCounselContractsInd>true</EngageBondCounselContractsInd>
        <AnyResearchAgreementsInd>false</AnyResearchAgreementsInd>
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        <RebateNotDueYetInd>true</RebateNotDueYetInd>
        <ExceptionToRebateInd>false</ExceptionToRebateInd>
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        <GrossProceedsInvestedInd>false</GrossProceedsInvestedInd>
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        <ProceduresCorrectiveActionInd>true</ProceduresCorrectiveActionInd>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part I, Column (f) DESCRIPTION OF PURPOSE</FormAndLineReferenceDesc>
        <ExplanationTxt>The Series 2023 Bonds were issued to construct, equip and furnish an approximately 46,195 square feet new hospital facility to replace the existing hospital building.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IV, Line 20b AUDITED FINANCIAL STATEMENTS</FormAndLineReferenceDesc>
        <ExplanationTxt>THE AUDIT FOR THE CURRENT FISCAL YEAR (SEPTEMBER 30, 2024) IS STILL IN THE PROCESS OF BEING FINALIZED BUT NOT COMPLETED. THE FY 2023 AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THIS FILING WHILE THE CURRENT FISCAL YEAR AUDIT IS BEING CONDUCTED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS</FormAndLineReferenceDesc>
        <ExplanationTxt>JASON BARB AND CURT COLSON HAVE A BUSINESS RELATIONSHIP. THEY ARE BOTH EMPLOYED BY, AND ALSO AN OFFICER OF, A RELATED 501(C)(3) ORGANIZATION, GREAT PLAINS HEALTH ALLIANCE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15a &amp; 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CEO AND CFO ARE COMPENSATED BY GREAT PLAINS HEALTH ALLIANCE, A RELATED ORGANIZATION. GPHA'S BOARD USES COMPARABILITY DATA IN SETTING THEIR SALARIES, AND DOCUMENTATION IS RETAINED OF THE BOARD'S DELIBERATIONS AND DECISIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 6 Classes of members or stockholders</FormAndLineReferenceDesc>
        <ExplanationTxt>GREAT PLAINS HEALTH ALLIANCE, INC., A NOT-FOR-PROFIT 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF GREAT PLAINS OF ELLINWOOD, INC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7a Members or stockholders electing members of governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>GREAT PLAINS HEALTH ALLIANCE, INC., BEING THE SOLE MEMBER, HAS THE RIGHT TO ELECT AND APPROVE ALL THE BOARD MEMBERS.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders</FormAndLineReferenceDesc>
        <ExplanationTxt>GREAT PLAINS HEALTH ALLIANCE, INC (GPHA) IS THE SOLE MEMBER AND HAS THE AUTHORITY TO APPROVE THE ARTICLES OF INCORPORATION, BYLAWS, ELECTION TO OR REMOVAL FROM THE BOARD OF DIRECTORS, THE ANNUAL OPERATING AND CAPITAL BUDGETS, AND THE LONG RANGE OR STRATEGIC PLANS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b Review of form 990 by governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>THE 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE 990 IS THEN PROVIDED TO THE CHIEF EXECUTIVE OFFICER FOR REVIEW AND APPROVAL. AN ELECTRONIC DRAFT OF THE 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO THE FULL BOARD FOR REVIEW PRIOR TO FILING THE 990 WITH THE IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c Conflict of interest policy</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION IS REQUIRED TO ADOPT GPHA'S CONFLICT OF INTEREST POLICY. ALL BOARD MEMBERS, OFFICERS, AND EMPLOYEES ARE SUBJECT TO THE CONFLICT OF INTEREST POLICY AND SIGN AN ANNUAL ACKNOWLEDGEMENT THAT THEY HAVE READ, UNDERSTAND AND COMPLIED WITH THE GPHA CONFLICT OF INTEREST POLICY. UNDER THE POLICY, ANY MEMBER WHO HAS A DIRECT OR INDIRECT (VIA FAMILY) FINANCIAL INTEREST IS CHARACTERIZED AS AN INTERESTED PERSON. INTERESTED PERSONS ARE REQUIRED TO DISCLOSE FINANCIAL INTERESTS WITH COMPANIES DOING BUSINESS WITH GPHA. THE INTERESTED PERSON MUST RECUSE THEMSELVES FROM FURTHER DISCUSSIONS OF THE TRANSACTION AND LEAVE THE ROOM. THE REMAINING NON-INTERESTED MEMBERS DECIDE IF A CONFLICT OF INTEREST EXISTS. THE BOARD CHAIR MAY APPOINT ANOTHER DISINTERESTED PARTY TO DISCUSS THE TRANSACTION OR THE REMAINING BOARD MEMBERS MAY VOTE TO ENTER INTO OR ABSTAIN FROM THE SUSPECT TRANSACTION. FAILURE TO DISCLOSE FINANCIAL INTERESTS BY INTERESTED BOARD MEMBERS WILL RESULT IN DISCIPLINARY ACTION, INCLUDING SANCTIONING BY BOARD. ALL CONFLICTS OF INTEREST AND THEIR ULTIMATE RESOLUTION ARE DOCUMENTED IN THE BOARD MINUTES. THE BOARD CONDUCTS PERIODIC REVIEWS TO DETERMINE THAT CONFLICTS ARE BEING IDENTIFIED AND RESOLVED ACCORDING TO POLICY DOCUMENTATION. REVIEWS BY OUTSIDE EXPERTS ARE PERMITTED, BUT NOT REQUIRED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19 Required documents available to the public</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE COMPANY'S KANSAS ANNUAL REPORT IS ALSO AVAILABLE UPON REQUEST FROM THE KANSAS SECRETARY OF STATE.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VIII, Line 11d Other Miscellaneous Revenue</FormAndLineReferenceDesc>
        <ExplanationTxt>MISCELLANEOUS REVENUE - Total Revenue: 34983, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 34983;</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g Other Fees</FormAndLineReferenceDesc>
        <ExplanationTxt>CONTRACTED MEDICAL STAFF - Total Expense: 595416, Program Service Expense: 595416, Management and General Expenses: , Fundraising Expenses: ; BILLING/COLLECTIONS - Total Expense: 321924, Program Service Expense: , Management and General Expenses: 321924, Fundraising Expenses: ; LAB SERVICES - Total Expense: 115822, Program Service Expense: 115822, Management and General Expenses: , Fundraising Expenses: ; MAINTENANCE/HOUSEKEEPING - Total Expense: 133737, Program Service Expense: 133737, Management and General Expenses: , Fundraising Expenses: ; PHARMACY SERVICES - Total Expense: 587486, Program Service Expense: 587486, Management and General Expenses: , Fundraising Expenses: ; ADMINISTRATION/HUMAN RESOURCES - Total Expense: 138448, Program Service Expense: , Management and General Expenses: 138448, Fundraising Expenses: ; DIETARY SERVICES - Total Expense: 1847, Program Service Expense: 1847, Management and General Expenses: , Fundraising Expenses: ;</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XII, Line 3b Reason organization did not undergo required audit</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FY 2024 FINANCIALS STATEMENTS ARE UNDERGOING AUDIT AT THE DATE OF THIS FILING.</ExplanationTxt>
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          <AddressLine1Txt>250 N ROCK ROAD STE 160</AddressLine1Txt>
          <CityNm>WICHITA</CityNm>
          <StateAbbreviationCd>KS</StateAbbreviationCd>
          <ZIPCd>67206</ZIPCd>
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          <CityNm>WICHITA</CityNm>
          <StateAbbreviationCd>KS</StateAbbreviationCd>
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        <EIN>480955870</EIN>
        <PrimaryActivitiesTxt>SUPPORT</PrimaryActivitiesTxt>
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        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>GREAT PLAINS OF SABETHA COUNTY INC</BusinessNameLine1Txt>
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          <AddressLine1Txt>250 N ROCK ROAD STE 160</AddressLine1Txt>
          <CityNm>WICHITA</CityNm>
          <StateAbbreviationCd>KS</StateAbbreviationCd>
          <ZIPCd>67206</ZIPCd>
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        <EIN>481236156</EIN>
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          <AddressLine1Txt>250 N ROCK ROAD STE 160</AddressLine1Txt>
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          <StateAbbreviationCd>KS</StateAbbreviationCd>
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          <BusinessNameLine1Txt>GPHA INC</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>GREAT PLAINS OF CHEYENNE COUNTY</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>250 N ROCK ROAD STE 160</AddressLine1Txt>
          <CityNm>WICHITA</CityNm>
          <StateAbbreviationCd>KS</StateAbbreviationCd>
          <ZIPCd>67206</ZIPCd>
        </USAddress>
        <EIN>481226831</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>KS</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>GPHA INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>GREAT PLAINS OF OTTAWA COUNTY INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>250 N ROCK ROAD STE 160</AddressLine1Txt>
          <CityNm>WICHITA</CityNm>
          <StateAbbreviationCd>KS</StateAbbreviationCd>
          <ZIPCd>67206</ZIPCd>
        </USAddress>
        <EIN>481226856</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>KS</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>GPHA INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>GREAT PLAINS EMPLOYEE BENEFITS TRUST</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>250 N ROCK ROAD STE 160</AddressLine1Txt>
          <CityNm>WICHITA</CityNm>
          <StateAbbreviationCd>KS</StateAbbreviationCd>
          <ZIPCd>67206</ZIPCd>
        </USAddress>
        <EIN>476918582</EIN>
        <PrimaryActivitiesTxt>HEALTH PLAN</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>KS</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(9)</ExemptCodeSectionTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>GPHA INC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>true</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>true</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>true</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>true</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>true</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>GPHA Employee Benefit Plan</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>R</TransactionTypeTxt>
        <InvolvedAmt>654203</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>FMV</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>