2020-11-16T13:37:50-06:00 2019-12-31 BKD LLP 1551 N WATERFRONT PKWY STE 300 WICHITA KS 672066601 990 2019-01-01 480892178 CITIZENS MEDICAL CENTER INC % RYAN STOVER CITI 7854627511 100 E COLLEGE DRIVE COLBY KS 67701 GREG UNRUH CEO 7854627511 2020-11-15 true SHAWNELL LINOT P01663908 3162652811 167.68.126.162 48010220203215000031 2020-11-16 P 066B6432F8DC24BA6735E6E2B8FCFDB371380179 BA21A7A7DF03597CAA95FF5B57CCAA395E7C7A92 2019 2021-01-29 14:40:06Z GREG UNRUH 100 E COLLEGE DRIVE COLBY KS 67701 46320748 false X WWW.CMCIKS.COM X 1979 KS ENHANCING THE LIVES OF THOSE WE SERVE. 7 7 498 22 29550 -45908 104356 409636 41367004 45411893 37438 28430 397681 470135 41906479 46320094 4000 11041 0 0 22893276 24427326 0 0 99268 18292389 20738163 41189664 45176530 716815 1143564 23444534 23261586 10655796 9141373 12788738 14120213 ENHANCING THE LIVES OF THOSE WE SERVE. false false 36441895 11041 45433254 CMCI PROVIDED A WIDE RANGE OF HEALTHCARE SERVICES TO RESIDENTS OF ITS SERVICE AREA. 3,622 PATIENT DAYS OF INPATIENT CARE, 19,446 PATIENT DAYS OF NURSING FACILITY CARE, 3,368 EMERGENCY ROOM VISITS,AND 33,566 PHYSICIAN CLINIC VISITS WERE PROVIDED DURING THE FISCAL YEAR. 36441895 true true false true false false false false false false true false false true false false true false false false false false false false false false true true false true true false false false false false false false false false false false false false true true true true false true 63 0 true 498 true true true false false false false false false false false false false false X 7 7 false false false false true true false true true false false true true true true true true true true false X RYAN STOVER 7854627511 100 E COLLEGE DRIVE COLBY KS 67701 X KELLY GABEL PHYSICIAN 40.0 0.0 X 425835 0 54957 BRENDA KOPRIVA PHYSICIAN 40.0 0.0 X 401467 0 43620 BREWSTER KELLOGG PHYSICIAN 40.0 0.0 X 323334 0 51875 DARREN MATCHELL PHYSICIAN 40.0 0.0 X 305519 0 44660 DERECK TOTTEN PHYSICIAN 40.0 0.0 X 272448 0 37355 GREG UNRUH CHIEF EXECUTIVE OFFICER 40.0 1.0 X 213259 0 37143 JACEE DOBBS CHIEF INFORMATION OFFICER 40.0 0.0 X 80680 0 16468 RYAN STOVER CHIEF FINANCIAL OFFICER 40.0 1.0 X 79471 0 8575 BOB STANDAGE CHAIR 4.0 0.0 X X 0 0 0 LON FRAHM VICE CHAIR 4.0 0.0 X X 0 0 0 JANET SADDLER SECRETARY 4.0 0.0 X X 0 0 0 PAT ERICKSON TRUSTEE 4.0 0.0 X 0 0 0 MICHAEL HAMILTON TRUSTEE 4.0 0.0 X 0 0 0 LORI STANLEY TREASURER 4.0 0.0 X X 0 0 0 TERESA CRAMPTON TRUSTEE 4.0 0.0 X 0 0 0 2102013 0 294653 33 false true false MEDICAL RECOVERY SERVICES ASSOCIATE 901 W MAIN ST STE 100 BLUE SPRINGS MO 64015 BILLING SERVICES 520217 CPSI PO BOX 850309 MOBILE AL 36685 SOFTWARE 335399 KANYON ANESTHESIA PA 2306 GRANDVIEW DRIVE E GARDEN CITY KS 67846 MEDICAL - ANESTHESIA 307400 STEPHENS CONSTRUCTION INC PO BOX 605 COLBY KS 67701 CONSTRUCTION 288282 GRACETEAM LLC 6025 SW 39TH CT TOPEKA KS 66610 NURSING HOME MGMT 277760 16 13582 396054 409636 Net Patient Service Revenue 621990 42509360 42509360 340B DRUG PROGRAM 621990 2730233 2730233 Clinical Outreach 621400 172300 172300 45411893 16454 16454 0 0 14331 14331 0 14331 14331 12630 654 11976 11976 11976 0 0 0 0 0 0 0 0 0 CAFETERIA & VENDING 621990 123911 123911 CHILDCARE 624410 107996 29550 78446 PHARMACY SALES 446110 21361 21361 202536 202536 455804 46320094 45433254 29550 447654 0 11041 11041 0 0 435596 435596 0 20194384 18161562 2006180 26642 725235 366630 351198 7407 1689290 836198 836198 16894 1382821 685325 683684 13812 0 42919 42919 183744 183744 8125 8125 0 5191 5191 4670899 2790887 1880012 0 56610 5889 50721 430594 321540 107827 1227 0 0 471632 239246 228188 4198 125718 81016 44315 387 0 86907 72085 14806 16 329667 163185 163185 3297 0 1831133 906411 906411 18311 355378 168809 186569 Drugs 4540081 4540081 PROVISION FOR UNCOLLECTIBLE 2762519 2762519 MEDICAL SUPPLIES 2367165 2367165 REPAIRS AND MAINTENANCE 1285702 999476 280359 5867 1184179 962830 220139 1210 45176530 36441895 8635367 99268 583930 654580 0 0 0 0 6130604 4816161 0 0 0 0 105351 61574 841465 975415 522891 669232 41537039 30932593 10249182 10604446 0 0 0 0 0 0 0 0 5011111 5480178 23444534 23261586 5690163 3542018 0 0 0 0 0 0 0 0 0 0 4796552 5599355 0 0 169081 0 10655796 9141373 X 10856133 12097854 1932605 2022359 12788738 14120213 23444534 23261586 X 1143564 75613 112298 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 8125 false false false 8125 false false SCHEDULE C, PART II-B, LINE 1f CITIZENS MEDICAL CENTER, INC., IS A MEMBER OF THE KANSAS HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. THESE ORGANIZATIONS ENGAGE IN LOBBYING ACTIVITIES FOR HOSPITAL AND GENERAL HEALTH CARE iNTERESTS AS PART OF THE SERVICES PROVIDED TO MEMBERS. 15.5% OF KHA DUES AND 23.32% OF AHA DUES PAID WERE FOR LOBBYING ACTIVITIES. 235982 235982 20959810 14987183 5972627 2227215 1658088 569127 18018020 14287322 3730698 96012 96012 10604446 Interest Receivable -1205 INTEREST IN FOUNDATIONS 2022359 REINSURANCE RECOVERABLE 77000 Other Receivables 451513 DUE FROM MEDICARE 900000 Assets Limited As to Use 2030511 5480178 43740295 75613 -2655412 -2579799 46320094 46320094 42408820 42408820 2767710 2767710 45176530 SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATIONS NET OF TRANSFERS 112,298 INVESTMENT FEES INCLUDED IN INCOME (5,191) PROVISION FOR UNCOLLECTIBLE ACCOUNTS (2,762,519) ----------- (2,655,412) SCHEDULE D, PART XII, LINE 4B INVESTMENT FEES INCLUDED IN INCOME 5,191 PROVISION FOR UNCOLLECTIBLE ACCOUNTS 2,762,519 ------------ 2,767,710 true true X true X 130. true X true true false false 708788 708788 0.01670 2209887 1549079 660808 0.01560 2918675 1549079 1369596 0.03230 8 815 92790 30315 62475 0.00150 3 154 10629 0 10629 0.00030 0 0 0 0 0.00000 0 0 0 0 0.00000 6 75 4533 0 4533 0.00010 17 1044 107952 30315 77637 0.00190 17 1044 3026627 1579394 1447233 0.03420 true 2762519 33833811 33833811 X true true 1 1 CITIZENS MEDICAL CENTER 100 E COLLEGE DRIVE COLBY KS 67701 H097001 X X X X NURSING FACILITY AND RURAL HEALTH CLINIC. CITIZENS MEDICAL CENTER 1 false false true X X X X X X X X X 18 true false true true X WWW.CMCIKS.COM X true 18 true WWW.CMCIKS.COM false true X 130. 300. X X X true true X X X true X SEE SCH H, PART V, SECTION C X SEE SCH H, PART V, SECTION C X SEE SCH H, 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 EACH COMMUNITY HAS A WEALTH OF EXPERTISE TO BE TAPPED TO CONDUCT THE CHNA. FOR THIS PURPOSE, TOWN HALL MEETINGS ARE THE PERFECT FORUM TO GATHER COMMUNITY INSIGHT. TOWN HALL SESSIONS WERE ORGANIZED TO PROVIDE An OBJECTIVE CONSENSUS-BUILDING METHOD OF REVIEWING AND PRIORITIZING COUNTY HEALTH ISSUES. DURING THE MEETINGS, THE TOPICS OF ISSUE WERE ADDRESSED WITH ROUND TABLE DISCUSSIONS. THE INDIVIDUALS AND ORGANIZATIONS COMPRISING THE TOWN HALLS WERE CRITICALLY IMPORTANT TO THE SUCCESS OF THE chNA. THE FOLLOWING LIST OUTLINES PARTNERS INVITED TO EACH TOWN HALL MEETING: LOCAL HOSPITAL, PUBLIC HEALTH COMMUNITY, MENTAL HEALTH COMMUNITY, COMMUNITY-BASED CLINICS, SERVICE PROVIDERS, LOCAL RESIDENTS,cOMMUNITY LEADERS, OPINION LEADERS, SCHOOL LEADERS, BUSINESS LEADERS,LOCAL GOVERNMENT, FAITH-BASED ORGANIZATIONS AND PERSONS (OR ORGANIZATIONS) SERVING THEM, PEOPLE WITH CHRONIC CONDITIONS, UNINSURED coMMUNITY MEMBERS, LOW-INCOME RESIDENTS, AND MINORITY GRUOPS. SCHEDULE H, PART V, SECTION B, LINE 6B THOMAS COUNTY HEALTH DEPARTMENT AND THOMAS COUNTY COMMISSIONERS/REPRESENTATIVES. SCHEDULE H, PART V, SECTION B, LINE 11 1. INCREASE AVAILABILITY OF CHILDCARE: WE BEGAN THE PROCESS OF OPENING A CHILDCARE CENTER TO HELP ALLEVIATE THE LACK OF CHILDCARE IN THOMAS COUNTY BY HIRING A CHILD CARE DIRECTOR TO BEGIN THE DEVELOPMENT OF A FULL CHILDCARE CENTER. 2. EXPAND CANCER SERVICES: A) RENOVATIONS TOOK PLACE TO EXPAND THE CANCER CENTER. WE CONTINUED OUR PARTNERSHIP WITH HAYS MED TO OFFER ONCOLOGY SERVICES INCLUDING PROVIDING CHEMOTHERAPY. B) HELD A FREE PINK PLATOON BOOTCAMP FOR BREAST CANCER SURVIVORS AND OFFERED FREE EDUCATION AND SUPPORT. 3. PROVIDE NUTRITION & FITNESS EDUCATION: A) STARTED A "BURN WHILE YOU LEARN" PROGRAM THAT ALLOWED THE PUBLIC TO TAKE A WALK WITH THEIR PROVIDER AND LEARN ABOUT FITNESS & NUTRITION. B) CONTINUED TO OFFER FREE DIABETES CLASSES. 4. EXPAND PREVENTATIVE CARE: A) ADDED A PA WHICH ALLOWED OUR PATIENTS BETTER ACCESS TO CARE. B) FAMILY CENTER FOR HEALTH CARE BEGAN PROVIDING FLUORIDE TREATMENTS FOR SMALL CHILDREN AS PART OF THEIR WELL-CHILD VISITS. C) PROVIDED 430 WELL-CHILD PHYSICALS AND 156 GARDISIL VACCINES. 5. RECRUIT SPECIALISTS: A) BROUGHT IN SIX NEW SPECIALISTS TO THE SPECIALTY CLINIC INCLUDING: CARDIAC ELECTROPHYSIOLOGY, PULMONOLOGY, OTOLARYNGOLOGY, PODIATRY, OPHTHALMOLOGY, & CARDIOLOGY. B) BROUGHT IN A NEW SPEECH PATHOLOGIST AND OCCUPATIONAL THERAPIST TO THE REHAB DEPARTMENT. SCHEDULE H, PART V, SECTION B, LINES 16A, 16B, AND 16C HTTPS://CMCIKS.COM/CITIZENS-MEDICAL-CENTER/FINANCE-BILLING/ 2 PRAIRIE SENIOR LIVING COMPLEX 1625 S FRANKLIN AVE COLBY KS 67701 LONG-TERM CARE FACILITY FAMILY CENTER FOR HEALTH CARE 310 E COLLEGE DRIVE COLBY KS 67701 RURAL HEALTH CLINIC SCHEDULE H, 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 PROVIED FOR SERVICES NOT REPORTED AS SUBSIDIZED HEALTH SERVICES. UNREIMBURSED MEDICAL 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. SCHEDULE H, PART III, LINE 2 BAD DEBTS AT COST WERE DETERMINED BY UTILIZING DEPARTMENTAL COST-TO-CHARGE RATIOS FOR BAD DEBTS 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 BAD DEBTS IN ALL OTHER AREAS. SCHEDULE H, PART III, LINE 3 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. SCHEDULE H, PART III, LINE 4 SEE PAGE 16 OF THE AUDITED FINANCIAL STATEMENTS REGARDING THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SCHEDULE H, PART III, LINE 8 MEDICARE ALLOWABLE COSTS WERE DETERMINED USING AMOUNTS FROM THE MEDICAL CENTER'S MEDICARE COST REPORT. THE MEDICARE COST REPORT APPORTIONS ACTUAL COSTS TO THE MEDICARE PROGRAM USING CHARGES FOR ANCILLARY SERVICES AND PATIENT DAYS FOR NURSING SERVICES. THE MEDICAL CENTER BELIEVES THAT ALL OF THE MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THE MEDICAL CENTER PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. SCHEDULE H, PART III, LINE 9B THE FINANCIAL ASSISTANCE POLICY STATES THAT PATIENTS QUALIFYING FOR CHARITY CARE MUST COMPLETE A FINANCIAL ASSISTANCE QUESTIONNAIRE AND SUBMIT A COPY OF THE PATIENT'S OR RELATIVE'S MOST RECENTLY-FILED TAX RETURN. IF CHARITY CARE IS CONSIDERED APPROPRIATE BY A COMMITTEE, THE PATIENT'S LIABILITY WILL BE REDUCED BY THE APPROVED AMOUNT. ANY REMAINING BALANCE ON PATIENT ACCOUNTS IS SUBJECT TO THE DEBT COLLECTION PROCEDURES ARTICULATED IN THE WRITTEN POLICY. SCHEDULE H, PART VI, LINE 2 THE MEDICAL CENTER ASSESSES THE COMMUNITY HEALTH CARE NEEDS PRIMARILY FROM RESPONSES FROM PATIENTS, COMMUNITY MEMBERS, AND HEALTH pROFESSIONALS. THE MEDICAL CENTER WILL TAKE INTO ACCOUNT CONCERNS OR REQUESTS FOR SERVICES THAT ARE EXPRESSED BY ALL PATIENTS AND COMMUNITY MEMBERS. ALSO, THE MEDICAL CENTER CONSIDERS REQUESTS MADE BY HEALTH PROFESSIONALS WHO INCLUDE, BUT ARE NOT LIMIT TO, PHYSICIANS, MID-LEVEL PROVIDERS, SOCIAL WORKERS, NURSES, AND DIETICIANS. SCHEDULE H, PART VI, LINE 3 ALL UNINSURED AND UNDER-INSURED PATIENTS ARE IDENTIFIED AND SCREENED UPON ADMISSION BY THE PATIENT FINANCIAL ADVISOR. DURING THIS INTERVIEW PROCESS, PAYMENT TERMS ARE DISCUSSED. IF THE PATIENT APPEARS TO NOT HAVE THE ABILITY TO PAY, THEY ARE ASKED TO COMPLETE A FINANCIAL QUESTIONNAIRE AND PROVIDE A COPY OF THEIR MOST RECENTLY FILED TAX RETURN FOR DETERMINING THEIR ABILITY TO PAY UNDER THE MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY. IF DURING THIS INTERVIEW PROCESS, IT APPEARS THAT A PATIENT MAY QUALIFY FOR ASSISTANCE UNDER STATE OR FEDERAL ASSISTANCE PROGRAMS, THEY ARE REFERRED TO CMCI'S SOCIAL SERVICES DEPARTMENT FOR ASSISTANCE IN COMPLETING THE APPLICABLE APPLICATIONS. SCHEDULE H, PART VI, LINE 4 THE MEDICAL CENTER IS LOCATED IN COLBY, KS AND SERVES THE NINE-COUNTY REGION OF NORTHWEST KANSAS, SEVERAL OF WHICH ARE MEDICALLY UNDERSERVED. THERE ARE A TOTAL OF EIGHT SMALL HOSPITALS SERVING THIS NINE-COUNTY REGION, HOWEVER, CMCI PROVIDES MANY SERVCES THAT ARE UNAVAILABLE IN SMALLER HOSPITALS. THE CLOSEST HOSPITALS TO THE MEDICAL CENTER ARE LOCATED IN OAKLEY, ATWOOD, AND HOXIE. THESE HOSPITALS ARE APPROXIMATELY 23, 30, AND 36 MILES FROM COLBY, RESPECTIVELY. THE HIGHEST CONCENTRATION OF POPULATION FOR THE SERVICE AREA IS LOCATED IN COLBY, KS. COLBY HAS A POPULATION OF APPROXIMATELY 5,400 PEOPLE. THE MEDIAN HOUSEHOLD INCOME FOR THE CITY IS APPROXIMATELY $48,600. A MAJOR PORTION OF THE POPULATION THAT THE MEDICAL CENTER SERVES IS MEDICARE-ELIGIBLE CITIZENS WHO LIVE ON A FIXED INCOME. SCHEDULE H, PART VI, LINE 5 THE MEDICAL CENTER IS A GRANTEE OF THE KANSAS DEPARTMENT OF HEALTH & ENVIRONMENT, KANSAS QUALITY OF CARE PROJECT, AND PARTICIPATES IN PROGRAMS IDENTIFIED BY THE STATE AS NEEDED TO HELP IMPROVE THE HEALTH OF RESIDENTS OF OUR STATE AND LOCAL AREA. KANSAS PROMOTING HEALTH PROGRAM IS A CHONIC DISEASE SUPPORT GROUP AND IS A PROGRAM IN WHICH THE MEDICAL CENTER HAS TRAINED FACILITATORS AND OFFERS CLASSES. FORM 990 DISCLOSURE REQUIRED UNDER REV. PROC. 2015-21 Citizens Medical Center, Inc. discovered in August of 2020 that they did not fully comply with 501(r) during the year. The hospital believed they were in compliance until a review of the financial assistance policy and processes revealed inadvertent errors. CMCI corrected this issue and updated all locations of the FAP with the new policy. The new policy and updated processes and procedures will keep this from happening again. true SCHOLARSHIPS 13 11041 SCHEDULE I, PART I, LINE 2 CITIZENS MEDICAL CENTER AWARDS SCHOLARSHIPS ANNUALLY TO INDIVIDUALS WHO ARE STUDYING IN HEALTHCARE FIELDS INCLUDING, BUT NOT LIMITED TO: NURSING, LAB, RADIOLOGY, THERAPY, DIETETICS, MEDICAL RECORDS, TRANSCRIPTION, GERIATRICS, MD, DO, ARNP, PA, PHARMACY, SOCIAL SERVICES, OR HEALTHCARE ADMINISTRATION. CANDIDATES MUST COMPLETE AN APPLICATION AND ARE INTERVIEWED BY THE FOUNDATION EXECUTIVE DIRECTOR AND EDUCATION MANAGER. THE CITIZENS FOUNDATION BOARD AND CEO APPROVE THE FINAL SCHOLARSHIP RECIPIENTS. THE SCHOLARSHIP RECIPIENTS ARE RESPONSIBLE FOR TRACKING THE FUNDS AFTER AWARDS ARE MADE. X X false false false false false true false false false GREG UNRUH CHIEF EXECUTIVE OFFICER 209449 0 0 0 3810 0 11208 0 25935 0 250402 0 0 0 KELLY GABEL PHYSICIAN 421012 0 4553 0 270 0 22103 0 32854 0 480792 0 0 0 BREWSTER KELLOGG PHYSICIAN 321605 0 439 0 1290 0 16842 0 35033 0 375209 0 0 0 BRENDA KOPRIVA PHYSICIAN 401167 0 0 0 300 0 8230 0 35390 0 445087 0 0 0 DARREN MATCHELL PHYSICIAN 304829 0 0 0 690 0 9492 0 35168 0 350179 0 0 0 DERECK TOTTEN PHYSICIAN 267402 0 5046 0 0 0 13922 0 23433 0 309803 0 0 0 SCHEDULE J, PART I, LINE 6A THE CEO AND CFO HAVE A BONUS ARRANGMENT THAT IS TRIGGERED IF INCOME FROM OPERATIONS EXCEEDS 2% OF EXPENSES. NO BONUSES WERE PAID TO THE CEO OR CFO IN 2019. FORM 990, PART VI, SECTION A, LINE 6 THE MEDICAL CENTER IS A NOT-FOR-PROFIT CORPORATION WITH 33 MEMBERS AT DECEMBER 31, 2019. FORM 990, PART VI, SECTION A, LINE 7A THE MEDICAL CENTER'S CORPORATE MEMBERS ELECT THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE FORM 990. THE RETURN IS THEN REVIEWED BY THE ORGANIZATION'S CEO AND BOARD OF TRUSTEES. ANY QUESTIONS OR CONCERNS ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS ARE MADE. THE FINAL FORM 990, WITH ALL REQUIRED SCHEDULES, IS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING THE 990. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST DISCLOSURE FORM IS PROVIDED WITH A COPY TO THE CURRENT CONFLICT OF INTEREST POLICY. THIS DISCLOSURE IS COMPLETED BY EACH MEMBER OF THE BOARD OF TRUSTEES UPON ELECTION AND ANNUALLY THEREAFTER. IF A CONFLICT OF INTEREST IS DISCOVERED, THE MEMBER CONCERNED IS NOT ALLOWED TO VOTE ON THE RELATED MATTER. FORM 990, PART VI, SECTION B, LINE 15A & 15B THE BOARD OF TRUSTEES REVIEWS THE COMPENSATION OF THE CEO AND SENIOR MANAGEMENT. THE MEDICAL CENTER RELIES ON A JOINT WAGE SALARY REPORT PUBLISHED BY THE KANSAS HOSPITAL AND MISSOURI HOSPITAL ASSOCIATIONS, AS WELL AS ANY AND ALL AVAILABLE LOCAL DATA. FORM 990, PART VI, SECTION C, LINE 19 THE MEDICAL CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. FORM 990, PART XI, LINE 9 CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATIONS NET OF TRANSFERS 112,298. FORM 990 PART IX LINE 11G DESCRIPTION:ANESTHESIA TOTAL FEES:818485 FORM 990 PART IX LINE 11G DESCRIPTION:PHARMACY/340B DRUG TOTAL FEES:364567 FORM 990 PART IX LINE 11G DESCRIPTION:LAB TOTAL FEES:257236 FORM 990 PART IX LINE 11G DESCRIPTION:NUCLEAR MEDICINE TOTAL FEES:155655 FORM 990 PART IX LINE 11G DESCRIPTION:SPECIALTY CLINIC TOTAL FEES:340707 FORM 990 PART IX LINE 11G DESCRIPTION:FCHC CLINIC TOTAL FEES:327250 FORM 990 PART IX LINE 11G DESCRIPTION:NURSING TOTAL FEES:32005 FORM 990 PART IX LINE 11G DESCRIPTION:ROUTINE SERVICES TOTAL FEES:33116 FORM 990 PART IX LINE 11G DESCRIPTION:BUSINESS OFFICE TOTAL FEES:799551 FORM 990 PART IX LINE 11G DESCRIPTION:ADMINISTRATION TOTAL FEES:918681 FORM 990 PART IX LINE 11G DESCRIPTION:HEALTH INFORMATION TOTAL FEES:102967 FORM 990 PART IX LINE 11G DESCRIPTION:DATA PROCESSING TOTAL FEES:133053 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER TOTAL FEES:387626 CITIZENS MEDICAL CENTER EMPLOYEE BENEFIT 100 E COLLEGE DRIVE COLBY KS 67701 481158262 BENEFITS KS 501(C)(9) CMCI true MED-SERV INC 100 E COLLEGE DRIVE COLBY KS 67701 480994564 INACTIVE KS CMCI C 0 0 1.00000 true false false false false false false false false false false false false true false true false false false false CITIZENS MEDICAL CENTER EMPLOYEE BENEFIT PLAN M 1192015 COST