2020-11-16T15:39:36-06:00 2019-12-31 481026809 Wendling Noe Nelson & Johnson LLC 623 SW 10th Ave Suite 300 Topeka KS 66612 990 2019-01-01 486099245 Labette County Medical Center LABE 6204214880 1902 S US Highway 59 Parsons KS 67357 Thomas Macaronas CFO 6204214880 2020-11-13 1 Heather R Eichem P01515553 7852334226 2020-11-13 98.172.114.81 2020-11-13 15:44:24 CS P 45974FB016872293A466C5C5F79D67D5933FD26A 15FE72F34CF0D489E1799E32E014D49C8FB57FE7 2019 2021-01-29 14:40:06Z Labette Health Thomas Macaronas 1902 S US Highway 59 Parsons KS 67357 82108716 0 X www.labettehealth.com X Government 1961 KS Medical care for the southeast Kansas region 9 6 865 69 0 0 1422106 1904883 74380711 78704224 109735 325179 2370349 928070 78282901 81862356 104000 258736 0 0 37738887 40884830 0 0 130540 35539239 37863145 73382126 79006711 4900775 2855645 70937596 75085223 30722893 32014875 40214703 43070348 Focusing on the patient and providing exceptional healthcare through effective clinical and financial management. 0 0 68798077 258736 78704224 Labette County Medical Center operates physician clinics and provides inpatient and outpatient services to the residents of the southeastern Kansas area. 68798077 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 1 1 1 0 0 1 99 0 1 865 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 6 0 0 0 0 0 1 0 1 0 0 0 0 1 1 1 1 1 1 1 0 X Thomas Macaronas 6204214880 1902 S US Highway 59 Parsons KS 67357 Perry Sorrell President 1.00 X X 0 0 0 Dee Bohnenblust Vice President 1.00 X X 0 0 0 Melissa Morris Treasurer 1.00 X X 0 0 0 Marna George Secretary 1.00 X X 0 0 0 Wayne Gilmore OD Trustee 1.00 X 0 0 0 Jill Thomas Trustee 1.00 X 0 0 0 Ned Wall Trustee 1.00 X 0 0 0 Manish Dixit MD Trustee 1.00 X 9577 0 0 Robert Gibbs MD Trustee 1.00 X 12000 0 0 Thomas Macaronas CFO/COO 40.00 X 181019 0 17952 Brian Williams President/CEO 40.00 X 314322 0 45001 Douglas Stacy CIO 40.00 X 168845 0 21780 Kathi McKinney CNO 40.00 X 165661 0 16673 Michael Bolt Physician 40.00 X 433745 0 24459 Robert Legler Physician 40.00 X 396598 0 25204 Philip Gorman Anesthesiologist 40.00 X 405032 0 25275 Logan Wineland Physician 40.00 X 455098 0 16847 Shawn Zimbrunes Physician 40.00 X 404283 0 24459 2946180 0 217650 56 0 1 0 SilverCreek Medical 2400 N Broadway Pittsburg KS 66762 Billing services 689223 CPSI 6600 Wall Street Mobile AL 36695 Computer support services 662755 Spencer Fane Britt and Browne LLP PO Box 872037 Kansas City MO 64187 Legal services 544110 Jerry C Bouman DO PC 21004 Ness Road Parsons KS 67357 Physician services 508744 Melinda Allen Cullins 1361 Country Road 1600 Caney KS 67333 Physician services 416838 30 706617 1198266 1904883 Patient service revenue 621110 69884359 69884359 340b pharmacy revenue 621990 8665161 8665161 Fitness center 713940 100204 100204 54500 54500 78704224 431359 431359 261572 0 261572 261572 261572 140180 246360 -106180 -106180 -106180 Cafeteria meals 722210 263975 263975 Leased employees 900099 87591 87591 314932 314932 666498 81862356 78704224 0 1253249 254736 254736 4000 4000 965227 19527 945700 34522750 31426387 3037510 58853 848091 817258 29303 1530 2208442 1991067 213647 3728 2340320 2079694 256731 3895 495702 495702 7158097 6163339 994748 10 586553 56562 524868 5123 283769 32424 246517 4828 283587 283587 2482950 2208257 272213 2480 247202 202608 44284 310 927859 762607 164695 557 4631883 3708286 915260 8337 535974 334415 201536 23 Drugs and medical suppl 13156607 13156607 Collection fees 2758129 2429247 328882 Repairs and maintenance 2043383 1618753 424113 517 Food and paper goods 536646 536646 1734804 995657 698798 40349 79006711 68798077 10078094 130540 62206 246272 29891845 34627791 9270593 8684395 50000 50000 384143 646521 1476135 1671078 451437 545869 91754982 65186908 27157727 26568074 2193510 2045223 70937596 75085223 5874131 7226650 329186 327070 23159000 22541000 1103201 1687703 257375 232452 30722893 32014875 X 39124559 41518170 1090144 1552178 40214703 43070348 70937596 75085223 2855645 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 10868 10868 0 Part II-B, Line 1: A portion of the annual dues paid by Labette County Medical Center to various healthcare associations has been identified as lobbying activities by those associations. Labette County Medical Center does not participate in activities supporting a political candidate. 854786 854786 56971118 39752643 17218475 33546990 25434265 8112725 382088 382088 26568074 Estimated third-party payor settlements 232452 232452 X 81862356 0 81862356 0 81862356 79006711 0 79006711 0 79006711 Part X, Line 2: Labette Health is exempt from federal income taxes pursuant to Sections 115 and 501(a) of the Internal Revenue Code. 1 1 1 X 1 X 1 1 0 0 577401 81998 495403 0.00630 9377761 6417392 2960369 0.03750 9955162 6499390 3455772 0.04380 77064 12922 64142 0.00080 4000 4000 0.00010 17906400 14771466 3134934 0.03970 256636 256636 0.00320 18244100 14784388 3459712 0.04380 28199262 21283778 6915484 0.08760 1 3030758 303076 19501847 17415934 2085913 X 1 1 1 1 Labette County Medical Center 1902 S US Highway 59 Parsons KS 67657 X X X Labette County Medical Center 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X http://www.labettehealth.com/about-community-health-needs.html X 1 18 1 http://www.labettehealth.com/about-community-health-needs.html 0 1 X 150.000000000000 250.000000000000 X X X X X 1 1 X X X 1 X http://www.labettehealth.com/ X http://www.labettehealth.com/ X http://www.labettehealth.com/ X X X X X X 1 X 0 X X 1 X 0 0 Labette County Medical Center Part V, Section B, Line 5: Labette County Medical Center evaluated the Community Health Needs Assessment by surveying its constituents through personal feedback, surveys, and organization and community town hall meetings. Those involved in the feedback process were Clancie Sorrell, Marketing Intern, Kerri Beardmore, Marking Director, Brian Williams, President/CEO, Krista Postai with Community Health Center of Southeast Kansas, Matt Atteberry with Labette Center for Mental Health, and Kelly Bradford with Four County Mental Health, and Lisa Hoppock with Labette Health Department. The Labette Health Department was unable to attend therefore was invited to participate in online survey to address and suggest the needs of the community. In addition, we involved students, employees, community leaders, and organization leadership from key local organizations. Labette County Medical Center Part V, Section B, Line 11: Part V, Section B, Line 11:The following is a desciption of actions taken during 2019 to address the needs identified in the most recently conducted CHNA.We continue to strengthen our community involvement by offering community based screenings as well as work site screenings. During the planning phase for each of these, our staff received health improvement ideas for implementation.Through our food and nutrition resources, we collaborate with local agencies to insure that the citizens of the communities that we serve have access to food goods.We have developed a relationship with Southeast Kansas Community Health Center (a FQHC) to enhance recruiting efforts for primary care providers to make medical services more readily available.Our education department offers public awareness education on key healthcare concerns within our communities. Our EMS department coordinates a multi-disciplinary and multi-agency safety education program designed for kids. The focal points include helmet use, fire precaution, and water safety.We continue to provide financial assistance to our patients who are un-insured or under-insured by assisting with the application for Medicaid based on personal data provided and by offering validated discounted rates.Based on the demonstrated community needs, we have assisted medical professionals to expand their education to meet such needs. 10 1 - Independence Health Center 510 N Peter Pan Road Independence KS 67301 Emergency, outpatient services and rural health clinic 2 - Labette Health Physicians Group 1902 S Hwy 59 Bldg E Parsons KS 67357 Physician and rural health clinic 3 - Cherryvale Clinic 209 E Main Street Cherryvale KS 67335 Rural health clinic 4 - St Paul Clinic 200 Carroll St Paul KS 66771 Rural health clinic 5 - Altamont Clinic 607 E 4th Street Altamont KS 67330 Rural health clinic 6 - Chanute Clinic and Express Care 2613 South Santa Fe Avenue Chanute KS 66720 Rural health clinic 7 - Erie Clinic 324 S Main Street Erie KS 66733 Rural health clinic 8 - Women's and Children's Clinic 209 N 6th Street Suite 103 Independence KS 67301 Rural health clinic 9 - Oswego Clinic and Express Care 608 Commercial Oswego KS 67356 Physician and rural health clinic 10 - Chetopa Clinic 613 Maple Street Chetopa KS 67336 Physician and rural health clinic Part I, Line 7: Financial assistance at cost was determined by utilizing departmental cost-to-charge ratios for financial assistance provided in areas that are reported as subsidized health services. An overall cost-to-charge ratio derived from Worksheet 2 was used to determine the cost of financial assistance provided for services not reported as subsidized health services.Unreimbursed Medicaid costs were also determined using a blend of cost-to-charge ratios for certain services and an overall cost-to-charge ratio derived from Worksheet 2 for all other services.The cost of providing subsidized health services was determined using a cost-to-charge ratio for each service.Actual costs and revenues were utilized for all other items reported on line 7. Part I, Line 7g: Subsidized health services are comprised of services that Labette Health provides despite a financial loss to the organization. These services include outpatient physician clinics. The cost of outpatient physician clinics amounts to $14,818,526. Part II, Community Building Activities: N/A Part III, Line 4: Labette Health 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. Labette Health estimates this allowance based on the aging of its accounts receivable and its historical collection experience for each type of payor.Part III, Line 2:The provision for bad debts is related to accounts that have been deemed uncollectible during the year. The uncollectible amount is then written off pursuant to Labette Health's policy. The cost of bad debt expense was determined using the overall cost-to-charge ratio derived from Worksheet 2 applied to all charges that were deemed uncollectible during the year.Part III, Line 3:Bad debt expense attributable to patients eligible under Labette Health's financial assistance policy was determined using an estimated 10% of total bad debts. Labette Health takes steps to assist individuals who are believed to qualify for financial assistance prior to writing accounts off as uncollectible.All non-reimbursed costs for treatment of patients in our community provides a community benefit since patients unwilling or unable to pay have received a valuable service at no cost or at a reduced cost to them. This improves the health of our community as a whole. Part III, Line 8: Medicare allowable costs were determined by using amounts from Labette Health's Medicare cost report as filed with the Medicare Administrative Contractor. The Medicare cost report apportions actual costs to the Medicare program using charges for ancillary services and patient days for nursing services. Any shortfalls are considered a community benefit.Revenue included in Medicare Cost Report $19,501,847Fee schedule revenue excluded from Medicare Cost Report 1,209,602Total Medicare revenue 20,711,449Expenses included in Medicare Cost Report $17,415,934Fee schedule expense excluded from Medicare Cost Report 2,223,773Total Medicare expense 19,639,707Total net Medicare income 1,071,742 Part III, Line 9b: Labette Health's collection policy contains provisions on the collection practices for patients who are known to qualify for charity care or financial assistance. The charity care policy states that the patient must cooperate with Labette Health 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, Labette Health 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: N/A Part VI, Line 3: All uninsured individuals are asked if they have any desire to complete a financial assistance application and/or are advised of the process to apply for Medicaid. When a patient has the desire or need to apply for Medicaid, Labette Health refers them to the Social Security Department to begin the application process. When a patient applies for Medicaid, they are asked to let Labette Health know of their decision and then their financial assistance application can be completed and processed after all information has been received. If an application is found to be incomplete, a letter is sent to the applicant advising them of the incomplete status and addressing the needed items for completion. During the social service intake/discharge planning process a social worker assists the uninsured in applying for any appropriate governmental program or Labette Health's financial assistance program. Part VI, Line 4: Based on the Stark II definition (the area composed of the lowest number of contiguous zip codes from which we draw at least 90% of our inpatients) the primary service area (PSA) has an approximate population of 28,000 people and the secondary service area (SSA) has an approximate population of 28,000 people. Our total service area has a population in excess of 65,000 people. Our service area impacts largely three counties: (1) Labette County has a population of 19,618, in the city of Parsons (population 9,500) Labette Health operates a general acute hospital and provider clinics; (2) Montgomery County, Labette Health operates an emergency room/critical decision unit facility and provider clinics in the city of Independence (population 8,500); (3) Neosho County beginning in 2018 Labette Health operates a provider clinic and urgent care clinic in the city of Chanute (population 9,000). The median household income for this area is approximately $45,700. Within these three counties 16% live in poverty, which is higher than the State of Kansas average of 12%. Unemployment by county is as follows: Labette 7.1%; Montgomery 9.0%, Noesho 9.1%. Multicultural composition reflects that as of 2018, approximately 15% of the population is non-white. Population within our PSA fall significantly lower than Kansas averages when considering people with a Bachelor's degree or higher.Other hospitals in our area are in the following cities within our PSA: Chanute (CAH-37 miles), Coffeyville (PPS-48 miles) and contiguous to our PSA: Neodesha(CAH-32 miles), Fredonia (CAH-47 miles), Girard (CAH-39 miles), and Pittsburgh (PPS-41 miles). Part VI, Line 5: The Board of Trustees is appointed by the County Commissioners and is comprised of 9 members, all of whom live in the county and are not employed by the Hospital. All employees sign a conflict of interest statement. Labette Health's medical staff is open with the exception of Radiology and Anesthesiology. Any profit margin, whether operational or in total, that Labette Health may experience is reinvested into operations. No one individual or one organization benefits from the profit margin but rather the institution and our patients are the beneficiaries. Part VI, Line 6: N/A 1 Labette Health Foundation 1902 South US Highway 59 Parsons KS 67357 481009259 501(c)(3) 254736 Capital campaign donation to reimburse prior years capital campaign expenses and other assistance 1 Part I, Line 2: The Medical Center monitors the use of grant funds by requiring receipts and other supporting documentation before disbursing any requested funds. X X X 0 1 0 0 0 0 0 1 0 Thomas Macaronas CFO/COO 180879 0 140 0 0 0 10821 0 7131 0 198971 0 0 0 Brian Williams President/CEO 302000 0 10000 0 2322 0 45000 0 1 0 359323 0 0 0 Douglas Stacy CIO 152397 0 15140 0 1308 0 6221 0 15559 0 190625 0 0 0 Kathi McKinney CNO 160521 0 5140 0 0 0 9542 0 7131 0 182334 0 0 0 Michael Bolt Physician 426254 0 141 0 7350 0 8000 0 16459 0 458204 0 0 0 Robert Legler Physician 206762 0 178078 0 11758 0 8000 0 17204 0 421802 0 0 0 Philip Gorman Anesthesiologist 403097 0 141 0 1794 0 8000 0 17275 0 430307 0 0 0 Logan Wineland Physician 378476 0 67304 0 9318 0 8000 0 8847 0 471945 0 0 0 Shawn Zimbrunes Physician 260060 0 85742 0 58481 0 8000 0 16459 0 428742 0 0 0 Part I, Line 4b Brian Williams, current CEO, is eligible to receive IRC section 457(f) retirement plan contributions of up to $30,000 annually at the discretion of the Board of Trustees. $30,000 was contributed to Brian's IRC section 457(f) plan during 2019. Part I, Line 7 Physicians and anesthesiologists are eligible for incentive bonuses based on their production. A Labette County Kansas 486040264 NoneAvail 2016-12-29 9021000 Partial refund of Series A, 2007 bonds issued 0 0 0 B Labette County Kansas 486040264 NoneAvail 2017-01-26 15000000 Partial refund of Series A and B, 2007 bonds issued 0 0 0 A 530000 9021000 180649 8840351 2010 0 1 1 1 B 950000 15000000 240000 14760000 2010 0 1 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 Robert Gibbs Trustee Recruiting assitance loan X 50000 50000 0 1 1 50000 Emily Brown Family member of Ned Wall, Trustee 75500 Employment 0 Tracy Gilmore Family member of Wayne Gilmore, Trustee 140823 Employment 0 Form 990, Part VI, Section A, line 7a Members of the Board of Trustees are appointed by the Commissioners of Labette County, Kansas Form 990, Part VI, Section A, line 8b There are no committees with the authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b Form 990 is reviewed by the CEO, CFO, and Controller and is provided to the Board prior to filing. Form 990, Part VI, Section B, line 12c A conflict of interest disclosure form is provided with a copy of the current conflict of interest policy. This disclosure is completed by each member of the Board of Trustees 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 CEO and fixing 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 XII, Line 2c The Medical Center has made no changes to the oversight process or selection process during the tax year. Labette Health Regional Partnerships Inc 9401 Indian Creek Parkway Building Overland Park KS 66210 464050502 Operating a medical office building utilized for health care services KS 501(c)(3) Line 12b, II Labette County Medical Center 1 Southeast Kansas Regional Health Inc 1902 S US Highway 59 Parsons KS 67357 813739559 Provide healthcare facilities and services KS 501(c)(3) Line 12b, II Labette County Medical Center 1 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 Labette Health Regional Partnerships Inc D 296634 Actual amount owed