SUSAN B ALLEN MEMORIAL HOSPITAL: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization: SUSAN B ALLEN MEMORIAL HOSPITAL (EIN 48-0581968)
Tax period: 2018-01-01 to 2018-12-31
Filed: 2019-11-15
IRS object ID: 201943199349312539
Schema version: 2018v3.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule F
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2019-11-15T14:02:26-06:00	ReturnTs
Tax Period End	2018-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BKD LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	1201 Walnut Suite 1700	AddressLine1Txt
City	Kansas City	CityNm
State Abbreviation	MO	StateAbbreviationCd
ZIP	641062246	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2018-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	480581968	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SUSAN B ALLEN MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% EMILY DOYON	InCareOfNm
Business Name Control	SUSA	BusinessNameControlTxt
Phone	3163213300	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	720 WEST CENTRAL	AddressLine1Txt
City	EL DORADO	CityNm
State Abbreviation	KS	StateAbbreviationCd
ZIP	67042	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DIANE DEBLON	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	3163224559	PhoneNum
Signature	2019-11-15	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	April Arnold CPA	PreparerPersonNm
PTIN	P01559426	PTIN
Phone	8162216300	PhoneNum
Preparation	2019-11-15	PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	167.68.126.162	IPv4AddressTxt

Field	Value	IRS element (for citing)
Federal Original Submission Id	43372220193195000009	FederalOriginalSubmissionId
Federal Original Submission Id	2019-11-15	FederalOriginalSubmissionIdDt
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	3F90BF00E5791F99736B2C534E02CD665B75897F	AtSubmissionCreationDeviceId
At Submission Filing Device Id	B63AEF58A3948584CFC9994E7E12F4E53EEB27F2	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2018	TaxYr
Build TS	2020-03-31 21:24:44Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	JIM KIRKBRIDE	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	720 WEST CENTRAL	AddressLine1Txt
City	EL DORADO	CityNm
State Abbreviation	KS	StateAbbreviationCd
ZIP	67042	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$50,049,540	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.SBAMH.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1930	FormationYr
Legal Domicile State	KS	LegalDomicileStateCd
Activity Or Mission	THE MISSION OF SUSAN B. ALLEN MEMORIAL HOSPITAL IS TO PROVIDE COMPASSIONATE, PROFESSSIONAL HEALTH CARE TO THE PEOPLE WE SERVE.	ActivityOrMissionDesc
Voting Members Governing Body	11	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	491	TotalEmployeeCnt
Total Volunteers	120	TotalVolunteersCnt
Total Gross UBI	-$11,272	TotalGrossUBIAmt
PY Contributions Grants	$234,758	PYContributionsGrantsAmt
CY Contributions Grants	$188,996	CYContributionsGrantsAmt
PY Program Service Revenue	$44,662,711	PYProgramServiceRevenueAmt
CY Program Service Revenue	$48,521,808	CYProgramServiceRevenueAmt
PY Investment Income	$1,673,975	PYInvestmentIncomeAmt
CY Investment Income	$1,463,115	CYInvestmentIncomeAmt
PY Other Revenue	$606,979	PYOtherRevenueAmt
CY Other Revenue	$649,411	CYOtherRevenueAmt
PY Total Revenue	$47,178,423	PYTotalRevenueAmt
CY Total Revenue	$50,823,330	CYTotalRevenueAmt
PY Grants And Similar Paid	$25,363	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$22,356	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$28,731,671	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$27,443,599	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$30,086,755	PYOtherExpensesAmt
CY Other Expenses	$28,223,175	CYOtherExpensesAmt
PY Total Expenses	$58,843,789	PYTotalExpensesAmt
CY Total Expenses	$55,689,130	CYTotalExpensesAmt
PY Revenues Less Expenses	-$11,665,366	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$4,865,800	CYRevenuesLessExpensesAmt
Total Assets BOY	$74,741,897	TotalAssetsBOYAmt
Total Assets EOY	$64,575,356	TotalAssetsEOYAmt
Total Liabilities BOY	$20,266,116	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$16,927,228	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$54,475,781	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$47,648,128	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	TO PROVIDE COMPASSIONATE, PROFESSIONAL HEALTH CARE TO THE PEOPLE WE SERVE.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$46,064,500	ExpenseAmt
Grant	$22,356	GrantAmt
Revenue	$48,510,536	RevenueAmt
Desc	SEE SCHEDULE O	Desc
Total Program Service Expenses	$46,064,500	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	Yes (true)	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	Yes (true)	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	Yes (true)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	92	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	491	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	11	GoverningBodyVotingMembersCnt
Independent Voting Member	10	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	false	MembersOrStockholdersInd
Election Of Board Members	false	ElectionOfBoardMembersInd
Decisions Subject To Approva	false	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	KS	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	EMILY DOYON	PersonNm
Phone	3163224559	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	720 WEST CENTRAL	AddressLine1Txt
City	EL DORADO	CityNm
State Abbreviation	KS	StateAbbreviationCd
ZIP	67042	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd
CAMI BAKER
CHAIR	1.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
MICHAEL CLIFTON
SECRETARY/TREASURER	1.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
ED GARD
FORMER CHAIR	1.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
VINCE HAINES
TRUSTEE	1.0	0.0	Yes (X)		$0	$0	$0
BRANDI LANE
TRUSTEE	1.0	0.0	Yes (X)		$0	$0	$0
SUZIE LOCKE
TRUSTEE	1.0	0.0	Yes (X)		$0	$0	$0
AMY SEEBER MD
TRUSTEE	1.0	0.0	Yes (X)		$5,346	$0	$0
GREG JOYCE
TRUSTEE	1.0	0.0	Yes (X)		$0	$0	$0
JACE GIANNETTI
TRUSTEE	1.0	0.0	Yes (X)		$0	$0	$0
JEREMY SUNDGREN
TRUSTEE	1.0	0.0	Yes (X)		$0	$0	$0
GLENN BUCHHOLZ
TRUSTEE	1.0	0.0	Yes (X)		$0	$0	$0
RYAN MURRY
TRUSTEE	1.0	0.0	Yes (X)		$0	$0	$0
JIM KIRKBRIDE
PRESIDENT AND CEO	40.0	1.0		Yes (X)	$258,387	$0	$30,200
CECILIA GOEBEL
CHIEF NURSING OFFICER	40.0	0.0		Yes (X)	$140,898	$0	$30,810
GAY KIMBLE
CHIEF HR OFFICER	40.0	0.0		Yes (X)	$141,530	$0	$27,852
FRANCIA BIRD
CHIEF QUALITY OFFICER	40.0	0.0		Yes (X)	$103,229	$0	$26,624
MARK ROOKER
CIO AND COO	40.0	0.0		Yes (X)	$131,372	$0	$26,457
JENNI GERKEN
CFO	40.0	0.0		Yes (X)	$86,462	$0	$3,531
JONATHAN IMMORDINO
CFO	40.0	1.0		Yes (X)	$0	$0	$0
VIKRANT AZAD
PHYSICIAN	40.0	0.0			$483,049	$0	$20,709	Yes (X)
JENNFIER PHARRIS
PHYSICIAN	40.0	0.0			$267,231	$0	$20,665	Yes (X)
JASON BRUNTON
HOSPITALIST	40.0	0.0			$264,228	$0	$20,389	Yes (X)
STEPHEN GRILLOT
HOSPITALIST	40.0	0.0			$258,185	$0	$31,729	Yes (X)
CHARLES STAFFORD
MEDICAL PHYSICIST	40.0	0.0			$192,686	$0	$22,159	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,332,603	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$261,125	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	23	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
TRUBRIDGE
3725 AIRPORT BLVD	MOBILE	AL	36608	REV CYCLE BILLING	$422,907
PEOPLE 20 GLOBAL LLC
PO BOX 677905	DALLAS	TX	752677905	CONTRACT LABOR	$397,852
CASCADE HEALTH SERVICES
1045 SWIFT	NORTH KANSAS CITY	MO	64116	CONTRACT LABOR	$311,807
FRESENIUS KIDNEY CARE
920 WINTER STREET	WALTHAM	MA	024511457	DIALYSIS PROVIDER	$297,618
MID AMERICA ANESTHESIA PROFESSIONAL
720 W CENTRAL AVE	EL DORADO	KS	67042	ANESTHESIA PROVIDERS	$243,900

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	11	CntrctRcvdGreaterThan100KCnt
Related Organizations	$125,570	RelatedOrganizationsAmt
All Other Contributions	$63,426	AllOtherContributionsAmt
Total Contributions	$188,996	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient Service Revenue	621110	$48,397,226	$48,397,226
Meals on Wheels	624200	$122,824	$122,824
Screening Program	623990	$1,758	$1,758

Field	Value	IRS element (for citing)
Total Program Service Revenue	$48,521,808	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$234,442	TotalRevenueColumnAmt
Exclusion	$234,442	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$489	TotalRevenueColumnAmt
Exclusion	$489	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$558,129	RealAmt
Personal	$74,088	PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$358,936	RealAmt
Personal	$95,947	PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$199,193	RealAmt
Personal	-$21,859	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$177,334	TotalRevenueColumnAmt
Unrelated Business Revenue	-$21,859	UnrelatedBusinessRevenueAmt
Exclusion	$199,193	ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	-$1,275,450	SecuritiesAmt
Other	$46,777	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$1,275,450	SecuritiesAmt
Other	-$46,777	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,228,673	TotalRevenueColumnAmt
Exclusion	$1,228,673	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
Cafeteria	722210	$280,379	$280,379
PARTNERSHIP INCOME	900099	$10,587		$10,587
MISCELLANEOUS		$180,622	$180,622

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$180,622	TotalRevenueColumnAmt
Exclusion	$180,622	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$471,588	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$50,823,330	TotalRevenueColumnAmt
Related Or Exempt Func Income	$48,521,808	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	-$11,272	UnrelatedBusinessRevenueAmt
Exclusion	$2,123,798	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$22,356	TotalAmt
Program Services	$22,356	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,012,698	TotalAmt
Management And General	$1,012,698	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$164,542	TotalAmt
Program Services	$164,542	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$20,311,387	TotalAmt
Program Services	$16,045,996	ProgramServicesAmt
Management And General	$4,265,391	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$945,083	TotalAmt
Program Services	$746,616	ProgramServicesAmt
Management And General	$198,467	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$3,503,354	TotalAmt
Program Services	$2,767,650	ProgramServicesAmt
Management And General	$735,704	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,506,535	TotalAmt
Program Services	$1,190,163	ProgramServicesAmt
Management And General	$316,372	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$8,217,941	TotalAmt
Program Services	$6,492,173	ProgramServicesAmt
Management And General	$1,725,768	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$85,645	TotalAmt
Program Services	$67,660	ProgramServicesAmt
Management And General	$17,985	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$817,795	TotalAmt
Program Services	$646,058	ProgramServicesAmt
Management And General	$171,737	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$770,132	TotalAmt
Program Services	$608,404	ProgramServicesAmt
Management And General	$161,728	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$268,824	TotalAmt
Program Services	$212,371	ProgramServicesAmt
Management And General	$56,453	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$136,579	TotalAmt
Program Services	$102,434	ProgramServicesAmt
Management And General	$34,145	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$3,607,125	TotalAmt
Program Services	$2,849,629	ProgramServicesAmt
Management And General	$757,496	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$210,758	TotalAmt
Program Services	$166,499	ProgramServicesAmt
Management And General	$44,259	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Bad Debt	$4,402,286	$4,402,286
Medical Supplies	$8,877,482	$8,877,482
Repairs & Maint.	$102,662	$81,103	$21,559
Recruiting & Retention	$284,428	$224,698	$59,730

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$441,518	TotalAmt
Program Services	$396,380	ProgramServicesAmt
Management And General	$45,138	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$55,689,130	TotalAmt
Program Services	$46,064,500	ProgramServicesAmt
Management And General	$9,624,630	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$74,733	BOYAmt
EOY	$163,590	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$10,538,857	BOYAmt
EOY	$10,601,741	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,322,523	BOYAmt
EOY	$1,303,202	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$685,429	BOYAmt
EOY	$734,860	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$90,176,560	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$54,068,678	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$39,276,388	BOYAmt
EOY	$36,107,882	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$19,901,612	BOYAmt
EOY	$12,333,201	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$2,363,798	BOYAmt
EOY	$2,487,005	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$369,960	BOYAmt
EOY	$669,531	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$208,597	BOYAmt
EOY	$174,344	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$74,741,897	BOYAmt
EOY	$64,575,356	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$6,709,338	BOYAmt
EOY	$5,508,981	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$9,746,778	BOYAmt
EOY	$7,143,247	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$3,810,000	BOYAmt
EOY	$4,275,000	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$20,266,116	BOYAmt
EOY	$16,927,228	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$50,472,045	BOYAmt
EOY	$44,043,258	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$403,967	BOYAmt
EOY	$430,184	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,599,769	BOYAmt
EOY	$3,174,686	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$54,475,781	BOYAmt
EOY	$47,648,128	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$74,741,897	BOYAmt
EOY	$64,575,356	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$4,865,800	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$1,602,422	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$359,431	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	Yes (true)	GrantsOtherOrganizationsInd
Grants Other Organizations	$8,418	GrantsOtherOrganizationsAmt
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	false	OtherActivitiesInd
Total Lobbying Expenditures	$8,418	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1F	FormAndLineReferenceDesc
Explanation	A PORTION OF THE KANSAS HOSPITAL ASSOCIATION AND AMERICAN HEALTH ASSOCIATION DUES ARE ATTRIBUTED TO LOBBYING EXPENSES.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,141,962	BeginningYearBalanceAmt
Contributions	$9,966	ContributionsAmt
Investment Earnings Or Losses	-$178,045	InvestmentEarningsOrLossesAmt
Administrative Expenses	$10,304	AdministrativeExpensesAmt
End Year Balance	$1,963,579	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,887,242	BeginningYearBalanceAmt
Contributions	$20,087	ContributionsAmt
Investment Earnings Or Losses	$243,725	InvestmentEarningsOrLossesAmt
Administrative Expenses	$9,092	AdministrativeExpensesAmt
End Year Balance	$2,141,962	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,568,899	BeginningYearBalanceAmt
Contributions	$220,239	ContributionsAmt
Investment Earnings Or Losses	$105,714	InvestmentEarningsOrLossesAmt
Administrative Expenses	$7,610	AdministrativeExpensesAmt
End Year Balance	$1,887,242	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,570,557	BeginningYearBalanceAmt
Contributions	$94,805	ContributionsAmt
Investment Earnings Or Losses	-$15,692	InvestmentEarningsOrLossesAmt
Other Expenditures	$73,371	OtherExpendituresAmt
Administrative Expenses	$7,400	AdministrativeExpensesAmt
End Year Balance	$1,568,899	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,479,284	BeginningYearBalanceAmt
Contributions	$46,819	ContributionsAmt
Investment Earnings Or Losses	$108,550	InvestmentEarningsOrLossesAmt
Other Expenditures	$56,867	OtherExpendituresAmt
Administrative Expenses	$7,229	AdministrativeExpensesAmt
End Year Balance	$1,570,557	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.75160	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.20520	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.04320	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (true)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (true)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,104,215	OtherCostOrOtherBasisAmt
Book Value	$4,104,215	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$46,626,024	OtherCostOrOtherBasisAmt
Depreciation	$22,786,928	DepreciationAmt
Book Value	$23,839,096	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$0	OtherCostOrOtherBasisAmt
Depreciation	$0	DepreciationAmt
Book Value	$0	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$37,949,195	OtherCostOrOtherBasisAmt
Depreciation	$30,140,976	DepreciationAmt
Book Value	$7,808,219	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,497,126	OtherCostOrOtherBasisAmt
Depreciation	$1,140,774	DepreciationAmt
Book Value	$356,352	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$36,107,882	TotalBookValueLandBuildingsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	LINE OF CREDIT	Desc
Amt	$4,275,000	Amt

Field	Value	IRS element (for citing)
Total Liability	$4,275,000	TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt	$45,325,134	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	-$1,602,422	NetUnrealizedGainsInvstAmt
Other Revenue	$506,512	OtherRevenueAmt
Revenue Not Reported	-$1,095,910	RevenueNotReportedAmt
Revenue Subtotal	$46,421,044	RevenueSubtotalAmt
Other Revenues Not Included	$4,402,286	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$4,402,286	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$50,823,330	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$51,827,704	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$540,860	OtherExpensesIncludedAmt
Expenses Not Reported	$540,860	ExpensesNotReportedAmt
Expenses Subtotal	$51,286,844	ExpensesSubtotalAmt
Other Expenses Not Included	$4,402,286	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$4,402,286	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$55,689,130	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4	THE ENDOWNMENT FUNDS ARE HELD BY SUSAN B. ALLEN MEMORIAL HOSPITAL FOUNDATION, A RELATED TAX EXEMPT ORGANIZATION. THE EARNINGS FROM THE ENDWOMENT FUNDS ARE USED TO FUND THE PURCHASE OF EQUIPMENT AND PROGRAM SUPPORT FOR SUSAN B. ALLEN MEMORIAL HOSPITAL.
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	RELATED ORGANIZATION REVENUE $ 322,186 ELIMINATIONS $ (259,970) RECLASS OF RENTAL EXPENSES $ 454,883 PARTNERSHIP INCOME $ ( 10,587) ---------- $ 506,512
SCHEDULE D, PART XI, LINE 4B	BAD DEBT EXPENSE $ 4,402,286
SCHEDULE D, PART XII, LINE 2D	RELATED ORGANIZATION EXPENSE $ 211,547 ELIMINATIONS $ (125,570) RECLASS OF RENTAL EXPENSES $ 454,883 ---------- $ 540,860
SCHEDULE D, PART XII, LINE 4B	BAD DEBT EXPENSE $ 4,402,286

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

Field	Value	IRS element (for citing)
Region	Central America and the Caribbean	RegionTxt
Type Of Activities Conducted	Investments	TypeOfActivitiesConductedTxt
Region Total Expenditures	$792,498	RegionTotalExpendituresAmt

Field	Value	IRS element (for citing)
Subtotal Spent	$792,498	SubtotalSpentAmt
Total Spent	$792,498	TotalSpentAmt
Transfer To Foreign Corp	false	TransferToForeignCorpInd
Interest In Foreign Trust	false	InterestInForeignTrustInd
Foreign Corp Ownership	Yes (true)	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	Yes (true)	PassiveForeignInvestmestCoInd
Foreign Partnership	false	ForeignPartnershipInd
Boycott Countries	false	BoycottCountriesInd

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	false	FPGReferenceDiscountedCareInd
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$976,923	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$113,211	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$863,712	NetCommunityBenefitExpnsAmt
Total Expense	0.01670	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,339,552	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,023,927	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,315,624	NetCommunityBenefitExpnsAmt
Total Expense	0.02540	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,316,475	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,137,138	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,179,336	NetCommunityBenefitExpnsAmt
Total Expense	0.04210	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$52,820	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$42,478	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,342	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$52,820	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$42,478	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,342	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,369,295	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,179,616	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,189,678	NetCommunityBenefitExpnsAmt
Total Expense	0.04230	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$6,906,762	BadDebtExpenseAmt
Bad Debt Expense Attributable	$880,806	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$14,023,665	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$19,009,399	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$4,985,734	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SUSAN B ALLEN MEMORIAL HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	720 WEST CENTRAL	AddressLine1Txt
City	EL DORADO	CityNm
State Abbreviation	KS	StateAbbreviationCd
ZIP	67042	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.SBAMH.ORG	WebsiteAddressTxt
State License	H-008-002	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	SUSAN B ALLEN MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	16	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V, SECTION C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	16	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V, SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	0.	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SECTION C	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Prospective Medicare Medicaid	Yes (X)	ProspectiveMedicareMedicaidInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5	BASED ON DATA ACQUIRED FROM THE 2013 CHNA, HEALTH AND WELLNESS COMMUNITY PARTNERS WERE INVITED TO GIVE INPUT DURING THE 2016 CHNA DATA COLLECTION PROCESS AND PARTICIPATED IN THE TOWN HALL MEETING THAT FOLLOWED WHERE GAPS IN SIGNIFICANT NEEDS WERE IDENTIFIED AND PRIORITIZED. THESE PARTNERS INCLUDED BUT WERE NOT LIMITED TO: BUTLER COUNTY HEALTH DEPT, SOUTH CENTRAL KANSAS MENTAL HEALTH, LOCAL SCHOOL DISTRICTS, DEPARTMENT OF AGING, MEMBERS OF SBA MEDICAL STAFF, ALLIED HEALTH, BUTLER COMMUNITY COLLEGE SCHOOL OF NURSING, UNITED WAY, YMCA, LARGE BUSINESS OWNERS, CLERGY, DEPARTMENT OF HUMAN SERVICES, ETC.
SCHEDULE H, PART V, SECTION B, LINE 7A & 10A	WWW.SBAMH.ORG/ABOUT_US/COMMUNITY_HEALTH_NEEDS_ASSESSMENT
SCHEDULE H, PART V, SECTION B, LINE 11	SBA has adopted a "Population Health" philosophy where Health & Wellness services are developed and delivered to all citizens in our service area. The 2016 CHNA identified three (3) major underserved areas of significant need; mental health/allied health, community awareness/education and child/adult obesity management. SBA has filled vacant Board of Trustee positions based on these gaps and recently hired a community advocate to coordinate with local partners to develop strategies to best deliver the results of the 2016 CHNA to the community. SBA has discussed the need to improve access to dental care with several local dentists. Thus far, the discussion have focused on a hospital based dental clinic where dental hygienists and dentists could practice preventative and routine dental care for the underserved in partnership with the hospital. Initially, there was a dental room planned in the Cancer Center hallway construction project but after further review, it was determined to be too small to accommodate all the needed equipment. Current discussion include offering space in the ENT office that is underutilized and more than adequate for this service.
SCHEDULE H, PART V, SECTION B, LINE 16	www.sbamh.org/patients_info/billing_information

Field	Value	IRS element (for citing)
Facility	7	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
SBA MEMORIAL HOSPITAL HOME HEALTH
720 W CENTRAL	EL DORADO	KS	67042	HOME HEALTH AGENCY
SUSAN B ALLEN MEMORIAL HOSPITAL DME
720 W CENTRAL	EL DORADO	KS	67042	DURABLE MEDICAL EQUIPMENT PROVIDER
SBA MEMORIAL HOSPITAL DIALYSIS
720 W CENTRAL	EL DORADO	KS	67042	HEMODIALYSIS
SBA MEMORIAL HOSPITAL MEDICAL CLINIC
720 W CENTRAL	EL DORADO	KS	67042	MEDICAL OFFICE BUILDING
AUGUSTA FAMILY CLINIC
401 W 7TH AVE	AUGUSTA	KS	67010	FAMILY PRACTICE CLINIC
AGUSTA IMMEDIATE CARE
401 W 7TH AVE	AUGUSTA	KS	67010	IMMEDIATE CARE CLINIC
EL DORADO URGENT CARE
2710 W CENTRAL AVE SUITE A	EL DORADO	KS	67042	URENT CARE CLINIC

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART I, LINE 3C	THE HOSPITAL ALSO USES MEDICAL INDIGENCY, ASSET LEVEL, AND RESIDENCY AS FACTORS TO DETERMINE ELIGIBILITY.
Schedule H, Part I, Line 7, Column F	THE AMOUNT OF BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES FOR CALDULATING THE NET COMMUNITY BENEFIT EXPENSE PERCENTAGE WAS $4,402,286.
Schedule H, Part I, Line 7	THE HOSPITAL USES THE COST-TO-CHARGE RATIO. THIS METHOD WAS USED TO CALCULATE THE FIGURES IN THE TABLE AND WAS DETERMINED BY COMPARING PATIENT CARE COST TO PATIENT CARE CHARGES.
SCHEDULE H, PART III, SECTION A, LINE 2	NON-MEDICARE/MEDICAID ACCOUNT AGING OVER 180 DAY RESERVES AT 100%. MEDICARE/MEDICAID ACCOUNT AGING OVER 365 DAY RESERVED AT 100%.
SCHEDULE H, PART III, SECTION A, LINE 3	ESTIMATED BASED ON US CENSUS BUREAU INDIVIDUALS BELOW POVERTY LEVEL OF 15.4%.
SCHEDULE H, PART III, SECTION A, LINE 4	THE BAD DEBT FOOTNOTE IS ON PAGE 9 OF THE AUDITED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, SECTION B, LINE 8	SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY.
SCHEDULE H, PART III, SECTION C, LINE 9B	THE FINANCIAL ASSISTANCE POLICY IS OFFERED AT TIME OF REGISTRATION. NOTIFICATION OF THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN MULTIPLE FORMS.
SCHEDULE H, PART VI, LINE 2	IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT THAT WAS COMPLETED IN 2016 AS REQUIRED BY 501(R) THE ORGANIZATION HAS A STRATEGIC PLANNING COMMITTEE OF THE BOARD WHO THROUGH A CONSULTANT CONDUCTS A NEEDS SURVEY OF OUR SERVICE AREA.
SCHEDULE H, PART VI, LINE 3	ON ADMISSION, PATIENTS ARE GIVEN A BROCHURE DESCRIBING INFORMATION ABOUT THE KANSAS HEALTHWAVE PROGRAM. IT ALSO INCLUDES INFORMATION ABOUT COVENTRY ONE HEALTH INSURANCE AND VALUE BLUE, BOTH ARE LOW COST OR NO COST INSURANCE PLANS. THE BROCHURE GIVES INFORMATION ABOUT OUR CHARITY CARE PROGRAM. OUR CHARITY CARE PROGRAM INFORMATION IS GIVEN TO OUR MEDICAL STAFF PHYSICIANS FOR DISTRIBUTION TO PATIENTS IN THEIR OFFICES. ALL OF THE BILLING STATEMENTS LIST THAT WE HAVE A CHARITY CARE PROGRAM AND THE WEBSITE URL. THE CHARITY CARE APPLICATION WITH COVER LETTER IS MAILED ALONG WITH THE FIRST STATEMENT SENT TO SELFPAY PATIENTS. THE GUIDELINES ARE INCLUDED WITH THE SECOND STATEMENT AFTER A REVIEW OF THE ACCOUNT INDICATES A NEED FOR FINANCIAL ASSISTANCE. PATIENT ACCOUNT REPRESENTATIVES REVIEW OUR CHARITY CARE PROGRAM WITH PATIENTS WHEN MAKING CALLS. WE ALSO REFER PATIENTS TO THE MIDLAND GROUP TO DETERMINE ELIGIBILITY FOR MEDICAID, OTHER ASSISTANCE PROGRAMS AND OUR CHARITY CARE PROGRAM. THE MIDLAND GROUP ASSISTS PATIENTS IN THE APPLICATION PROCESS TO SEE IF THEY ARE ELIGIBLE FOR STATE ASSISTANCE PROGRAMS. KANSAS MEDICAL ASSISTANCE PROGRAM (KMAP) HEALTHWAVE BROCHURES AND APPLICATIONS ARE PROVIDED TO PATIENTS WHO MAY MEET THE FINANCIAL GUIDELINES OF THE KMAP.
SCHEDULE H, PART VI, LINE 4	THE HOSPITAL'S PRIMARY SERVICE AREA CONSISTS OF 6 COMMUNITIES WITHIN BUTLER COUNTY WHICH LIE WITHIN A 15 MILE RADIUS OF THE HOSPITAL. THE POPULATION OF THESE COMMUNITIES IS APPROXIMATELY 37,500 OF WHICH 26% ARE AGE 55 OR OLDER. THE HOSPITAL'S SECONDARY SERVICE AREA CONSISTS OF 13 SMALLER COMMUNITIES LOCATED IN BUTLER, GREENWOOD, ELK, MARION AND COWLEY COUNTIES WITH A COMBINED POPULATION OF JUST OVER 15,000 RESIDENTS OF WHICH 32% ARE AGE 55 OR OLDER. WHILE PART OF THE SERVICE AREA IS IN THE WICHITA METROPOLITAN STATISTICAL AREA, MUCH OF THE SERVICE AREA IS RURAL.
SCHEDULE H, PART VI, LINE 5	WE PARTICIPATE IN THE BUTLER COUNTY SENIOR FAIR PROVIDING HEALTH INFORMATION ON VARIOUS HEALTH ISSUES. WE PARTICIPATE IN THE FRONTIER REFINING EMPLOYEE HEALTH FAIR PROVIDING INFORMATION ABOUT VARIOUS HEALTH ISSUES AND OFFER HEALTH TESTING AND SCREENINGS. WE PARTICIPATE IN THE BUTLER COMMUNITY COLLEGE WOMEN'S FAIR AND THE BUTLER COMMUNITY COLLEGE-ANDOVER/SHERWIN WILLIAMS WELLNESS FAIR PROVIDING INFORMATION ABOUT VARIOUS HEALTH ISSUES AND OFFER HEALTH TESTING AND SCREENINGS. WE ARE A SPONSOR OF THE AMERICAN CANCER SOCIETY'S RELAY FOR LIFE IN EL DORADO, KANSAS AND IN EUREKA, KANSAS. WE PROVIDED A PHARMACIST FOR POISON PREVENTION AND SAFETY TO EL DORADO KINDERGARTEN AND 1ST GRADERS. WE PROVIDED MEETING SPACE FOR SEVERAL COMMUNITY HEALTH GROUPS INCLUDING BUTLER COUNTY DIABETES SUPPORT GROUP, THE AMERICAN CANCER SOCIETY, AND THE BUTLER COUNTY MULTIPLE SCLEROSIS SUPPORT GROUP. WE PROVIDE LOW COST SCREENING PROGRAMS FOR CARDIAC HEALTH, OSTEOPOROSIS, HYPERTENSION AND DIABETES. WE PROVIDE FREE INFLUENZA VACCINATIONS TO MEMBERS OF THE COMMUNITY. WE HAVE A VOLUNTEER BOARD OF 12 MEMBERS THAT COME FROM THROUGHOUT OUR SERVICE AREA.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

Field	Value	IRS element (for citing)
Grant Type	PUBLIC INFLUENZA VACCINATIONS	GrantTypeTxt
Recipient	987	RecipientCnt
Non Cash Assistance	$22,356	NonCashAssistanceAmt
Valuation Method Used	BOOK	ValuationMethodUsedDesc
Non Cash Assistance	VACCINATIONS	NonCashAssistanceDesc

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE I, PART I, LINE 2	FormAndLineReferenceDesc
Explanation	THE PUBLIC INFLUENZA VACCINATIONS ARE GIVEN TO ALL WHO SHOW UP AT THE TWO CLINICS.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	false	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	Yes (true)	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JIM KIRKBRIDE
PRESIDENT AND CEO	$254,372	$0	$0	$0	$4,015	$0	$10,213	$0	$19,987	$0	$288,587	$0	$0	$0
CECILIA GOEBEL
CHIEF NURSING OFFICER	$139,013	$0	$0	$0	$1,885	$0	$8,765	$0	$22,045	$0	$171,708	$0	$0	$0
GAY KIMBLE
CHIEF HR OFFICER	$139,611	$0	$400	$0	$1,519	$0	$8,742	$0	$19,110	$0	$169,382	$0	$0	$0
MARK ROOKER
CIO AND COO	$130,965	$0	$0	$0	$407	$0	$7,906	$0	$18,551	$0	$157,829	$0	$0	$0
VIKRANT AZAD
PHYSICIAN	$482,913	$0	$0	$0	$136	$0	$11,200	$0	$9,509	$0	$503,758	$0	$0	$0
JENNFIER PHARRIS
PHYSICIAN	$264,711	$0	$2,520	$0	$0	$0	$10,792	$0	$9,873	$0	$287,896	$0	$0	$0
JASON BRUNTON
HOSPITALIST	$263,214	$0	$0	$0	$1,014	$0	$10,199	$0	$10,190	$0	$284,617	$0	$0	$0
STEPHEN GRILLOT
HOSPITALIST	$258,049	$0	$0	$0	$136	$0	$10,343	$0	$21,386	$0	$289,914	$0	$0	$0
CHARLES STAFFORD
MEDICAL PHYSICIST	$191,390	$0	$0	$0	$1,296	$0	$11,527	$0	$10,632	$0	$214,845	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE J, PART I, LINE 1A	JIM KIRKBRIDE'S COMPENSATION INCLUDES SOCIAL CLUB DUES THAT ARE TREATED AS TAXABLE INCOME.
SCHEDULE J, PART I, LINE 6A	MANAGEMENT INCENTIVE PLAN BASED ON CRITERIA OF CONTRIBUTION MARGIN PERCENTAGE AFTER MEETING ACCREDITATION STANDARDS AND QUALITY STANDARDS.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
BUTLER COUNTY KANSAS
A	486035405	12343PAA3	2012-04-30	$14,500,000	SEE PART VI	false	false	false
Butler County Kansas
B	486035405		2014-12-16	$6,500,000	SEE PART VI	false	false	false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	UnspentUnspentAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$11,416,631	$0	$14,500,655	$0	$24	$0	$0	$0	$0	$3,607,315	$10,983,316	$0	2013	Yes (true)	Yes (true)	Yes (true)	Yes (true)
B	$2,440,122	$0	$6,503,000	$0	$0	$0	$110,354	$0	$0	$6,392,646	$0	$0	2017	false	false	Yes (true)	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Any Research AgreementsAnyResearchAgreementsInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Remedial Action TakenRemedialActionTakenInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	false	false	Yes (true)	Yes (true)	false	0	false	false	false	Yes (true)
B	false	false	false		false	0	false	false	false	Yes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Business Name Line1GICProviderName/BusinessNameLine1Txt	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
0
A	false	Yes (true)	false	false	false	0	false	Yes (true)
0
B	false	Yes (true)	false	false	false	0	false	Yes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (true)
B	Yes (true)

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Line A, Column (F)	Improve and equip hospital facilities; Refund Series 1998Z Bonds (issued 12/22/1998); Refund Series 2002Q Bonds (issued 12/17/2002).
Part I, Line B, Column (F)	Renovations to and equipment for hospital facilities.
Part II, Line 3, Column A	Amount does not equal issue price due to investment earnings earned in the project fund during the project period.
Part II, Line 3, Column B	Amount does not equal issue price due to investment earnings earned in the project fund during the project period.
Part II, Line 11, Column A	This amount was expended to redeem the refunded bonds on May 1, 2012 and December 15, 2012.
Part II, Line 15, Column A	The bond issue constitutes an "advance refunding issue" under U.S. Treasury Regs 1.150-1(d), but no bond that is part of the bond issue is an "advance refunding bond" under I.R.C. 149(d). The bonds were issued as a "draw-down loan" within meaning of U.S. Treasury Regs 1.150(1)(c)(4)(i). The first draw/advance on the bonds was made April 30, 2012 (i.e., the issue date of the bond issue), in part, to refund and redeem a prior series of 1998Z bonds on May 1, 2012; the second draw/advance on the Bonds was made December 14, 2012, in part, to refund and redeem a prior series of 2002Q bonds on December 15, 2012. Therefore, there are no advance refunding bonds, because no bond proceeds were used to pay debt service on a prior series of bonds more than 90 days after the issue date of that bond.
Part III, Column A	Part III has been completed for the projects originally financed after January 1, 2003.
Part IV, Line 2c, Column A	Arbitrage Computation completed as of 1/1/2014.
Part IV, Line 2c, Column B	Arbitrage Computation completed as of 8/1/2017.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)

SEE SCHEDULE L PART V
SEE SCHEDULE L PART V
SEE SCHEDULE L PART V

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE L, PART IV, LINE 1	(A) GENE KIMBLE (B) SPOUSE OF GAY KIMBLE, CHIEF HR OFFICER OF SUSAN B. ALLEN MEMORIAL HOSPITAL. (C) $12,389 (D) GENE KIMBLE IS AN EMPLOYEE AT SUSAN B. ALLEN MEMORIAL HOSPITAL. (E) NO
SCHEDULE L, PART IV, LINE 2	(A) CHASE LOCKE (B) BROTHER IN LAW OF SUZIE LOCKE, TRUSTEE OF SUSAN B. ALLEN MEMORIAL HOSPITAL. (C) $100,062 (D) CHASE LOCKE IS AN EMPLOYEE AT SUSAN B. ALLEN MEMORIAL HOSPITAL. (E) NO
SCHEDULE L, PART IV, LINE 3	(A) ASHLEY GREER (B) DAUGHTER IN LAW OF GAY KIMBLE, CHIEF HR OFFICER OF SUSAN B. ALLEN MEMORIAL HOSPITAL. (C) $52,091 (D) ASHLEY GREER IS AN EMPLOYEE AT SUSAN B. ALLEN MEMORIAL HOSPITAL. (E) NO

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III, LINE 4A	COMMUNITY SERVICES - SUSAN B. ALLEN MEMORIAL HOSPITAL OFFERS A NUMBER OF PROGRAMS AND SERVICES IN OUR COMMUNITY AT MINIMAL OR NO COST IN ORDER TO PROMOTE HEALTH AND WELLNESS. ACTUAL COSTS FOR THESE SERVICES ARE NOT SEPARATELY IDENTIFIABLE, AND ARE INCLUDED AS PART OF THE PATIENT SERVICES COST. 1. PARTICIPATED IN THE BUTLER COUNTY SENIOR FAIR, HELD IN EL DORADO, DISPLAYING AND PROVIDING INFORMATION REGARDING OUR DIABETES EDUCATION PROGRAM, HOME HEALTH SERVICES (INCLUDING BLOOD PRESSURE TESTING), HOME MEDICAL EQUIPMENT SERVICES, NUTRITION SERVICES, AND PHYSICAL REHABILITATION AT NO CHARGE. 2. PARTICIPATED IN THE FRONTIER REFINING EMPLOYEE HEALTH FAIR PROVIDING INFORMATION ON DIABETIC FOOT CARE, CARDIAC HEALTH, DIETARY EDUCATION, ORTHOPAEDIC ISSUES, PHYSICAL THERAPY ISSUES, SKIN CANCER CHECKS, BONE DENSITY TESTING AND BLOOD WORK (INCLUDING LIPID, PSA AND HEMOGLOBIN A1C TESTING). 3. SERVED AS A PROJECT SEARCH HOST SITE. PROJECT SEARCH IS A HIGH SCHOOL TO WORK TRANSITION PROGRAM SERVING STUDENTS WITH DISABILITIES BETWEEN THE AGES OF 18-21. 4. SUPPORTED MANY AREA SCHOOL EVENTS THROUGH SPONSORSHIPS AND PARTICIPATION, INCLUDING PARTICIPATED IN THE AUGUSTA SCHOOL DISTRICT WELLNESS FAIR, EHS DRAMA BOOSTER SPONSORSHIP, BUTLER COMMUNITY COLLEGE CAREER FAIR SPONSORSHIPS, BUTLER COMMUNITY COLLEGE SCHOLARSHIP SPONSORSHIP, AND EHS AFTER PROM DONATION. 5. PARTICIPATED IN THE EL DORADO SCHOOL DISTRICT KIDZFEST EVENT WHERE PARENTS AND CHILDREN OF THE SCHOOL DISTRICT WERE INVITED TO LEARN OF SERVICES AVAILABLE TO CHILDREN. STAFF ATTENDED AND SPOKE WITH CHILDREN AND THEIR PARENTS ABOUT THE POSITIVE EFFECTS OF EXERCISE AND GOOD NUTRITION ON HEART HEALTH. 6. PROVIDED A REGISTERED PHARMACIST TO THE EL DORADO SCHOOL DISTRICT FOR POISON PREVENTION AND SAFETY TALKS FOR ALL KINDERGARTEN AND FIRST GRADE STUDENTS AT THE ELEMENTARY SCHOOLS IN TOWN (APPROXIMATELY 300 STUDENTS). 7. PROVIDED A NUMBER OF DIRECTORS AND STAFF TO SPEAK AT LOCAL SCHOOL DISTRICT CAREER FAIR EVENTS INCLUDING PHYSICAL REHABILITATION, DIAGNOSTIC IMAGING, ATHLETIC TRAINING, FAMILY PRACITICE, ALLERGY/IMMUNOLOGY AND ORTHOPEDIC SURGERY. 8. PROVIDED SPONSORSHIPS FOR THE WOMEN IN BUSINESS LUNCHEON, EL DORADO HALF MARATHON/SBA ONE-MILE, AND PROVIDED A TABLE AT NATIONAL NIGHT OUT. 9. PROVIDED NURSING STATION AT LOCAL EVENTS, INCLUDING DAM MUSIC FESTIVAL AND LANTERN FEST. 10. ADMINISTRATIVE PERSONNEL ARE SUPPORTING THE EL DORADO VISION 2020 PROGRAM, PROVIDING MENTORING AT A LOCAL SCHOOL ONE HOUR PER WEEK. 11. PROVIDED DARI (MOTION ANALYSIS) SCREENINGS FOR HIGH SCHOOL ATHLETES. 12. MADE AVAILABLE A "SPEAKERS BUREAU" TO OUR COMMUNITY. HOSPITAL PERSONNEL SPOKE TO VARIOUS CIVIC GROUPS AND ORGANIZATIONS ON NUMEROUS OCCASIONS. 13. HOSPITAL EMPLOYEES DONATED OVER $15,000 IN SUPPORT OF THE EL DORADO UNITED WAY PROGRAM. 14. PROVIDED MEETING ROOM SPACE FOR OTHER ORGANIZATIONS SERVING THE COMMUNITY, SUCH AS THE BUTLER COUNTY DIABETES SUPPORT GROUP, THE AMERICAN CANCER SOCIETY, THE ARC OF BUTLER (SPECIAL NEEDS AND DISABILITIES), BUTLER COUNTY ALZHEIMER'S SUPPORT GROUP, AND THE BUTLER COUNTY MULTIPLE SCLEROSIS SUPPORT GROUP. 15. STAFF MEMBERS FROM THE EMERGENCY AND PHYSICAL REHABILITATION DEPARTMENTS TOOK PART IN THE BUTLER COUNTY EMS KIDS CAMP, WHERE KIDS LEARNED ABOUT SAFETY AND HEALTH RELATED TOPICS. 16. PROVIDE PERSONNEL AND FACILITIES FOR LOCAL EMERGENCY PLANNING COMMITTEE MEETINGS. 17. PROVIDE ONCE-A-MONTH FREE CHILDBIRTH EDUCATION CLASSES FOR NEW MOMS AND SIGNIFICANT OTHERS, REGARDLESS OF WHERE THEY WILL BE DELIVERING. OBSTETRICS STAFF PROVIDE EDUCATION AND INFORMATION ABOUT LABOR AND DELIVERY, COMFORT MEASURES, PAIN MANAGEMENT, NEWBORN CARE, RECOVERY AND DISCHARGE. 18. PROVIDE ONCE-A-MONTH FREE BREASTFEEDING EDUCATION CLASSES FOR NEW MOMS, REGARDLESS OF WHERE THEY WILL BE DELIVERING. 19. PROVIDED INFORMATION TO NEW MOMS AT THE FIRST BABY JUBILEE. FAMILY BIRTH CENTER STAFF TALKED ABOUT THE FACILITIES, AS WELL AS PROGRAMS OFFERED AT SBA. 20. PROVIDED A LOW-COST SCREENING PROGRAM FOR CARDIAC HEALTH, OSTEOPOROSIS, HYPERTENSION, AND DIABETES TWO TIMES DURING THE YEAR IN FOR THE COMMUNITY HERE AT SUSAN B. ALLEN. 21. PROVIDE FREE HEARING SCREENINGS IN THE EL DORADO EAR, NOSE AND THROAT OFFICES ONE-HALF DAY EACH WEEK. 22. ANOTHER WELLNESS INITIATIVE THAT WE HAVE IS EWOW (EL DORADO WORKING ON WELLNESS). IN THIS PROGRAM WE ENGAGE WITH A GROUP OF TEACHERS OR SCHOOL EMPLOYEES AND WORK ON IMPLEMENTING HEALTHIER LIFESTYLE CHOICES THROUGH NUTRITIONAL EDUCATION, GROUP FITNESS TRAINING AND HEALTH SCREENINGS. WE ARE INVESTING IN OUR TEACHERS, SO THAT THEY CAN TAKE THE HEALTHY LIFESTYLE CHOICES BACK INTO THEIR CLASSROOMS AND SCHOOLS AND SHARE WHAT THEY HAVE LEARNED. WE ALSO SUPPORT THE SCHOOLS BY PROVIDING ATHLETIC TRAINERS FOR LOCAL AREA SCHOOLS AND SUMMER TRIPPLE A BASEBALL TEAMS. IN ADDITION, SBA PROVIDED ATHLETIC TRAINERS FOR THE SHRINE BOWL. 23. PROVIDED A FREE INFLUENZA VACCINATION PROGRAM FOR MEMBERS OF OUR COMMUNITY. LARGE CLINICS WERE HELD FOR THE GENERAL PUBLIC - 1 IN EL DORADO AND 1 IN AUGUSTA. IN TOTAL, 955 DOSES WERE GIVEN TO COMMUNITY MEMBERS AT NO COST. 24. ADMINISTRATIVE AND MANAGEMENT STAFF SERVE ON A VARIETY OF BOARDS AND COMMITTEES, INCLUDING THE RESPIRATORY CARE COUNCIL AT THE BOARD OF HEALING ARTS IN TOPEKA, ADVISORY COUNCIL FOR BCC NURSING, PROJECT SEARCH ADVISORY BOARD, KHHRA, UNITED WAY OF EL DORADO, El DORADO YMCA, THRIVE!BUTLER, ADVISORY BOARD WSU MEDICAL LABORATORY SCIENTIST PROGRAM, ADVISORY BOARD MANHATTEN TECHNICAL SCHOOL MEDICAL LABORATORY TECHNICIAN PROGRAM, ADVISORY BOARD BARTON COMMUNITY COLLEGE MEDICAL LABORATORY TECHNICIAN PROGRAM, ADVISORY BOARD SEWARD COUNTY COMMUNITY COLLEGE LABORATORY TECHNICIAN PROGRAM, ASCLS, CLMA, STATE OF KANSAS LABORATORY COMMITTEE, PRESIDENT ELECT FOR KHELSA, EMPAC, TRINITY HEIGHTS RESPITE CARE IN NEWTON, DIRECTOR BOARD OF EDUCATION FOR ANNOOR ISLAMIC SCHOOL IN WICHITA AND COMMUNITY EDUCATION/OUTREACH COMMITTEE MEMBER FOR ISLAMIC SOCIETY OF WICHITA, PARTNERS IN EDUCATION BOARD MEMBER, SOROPTIMIST INTERNATIONAL OF EL DORADO, RELAY FOR LIFE BUTLER COUNTY BOARD MEMBER, CELEBRATION OF FREEDOM COMMITTEE, KANSAS OIL MUSEUM BOARD, OB/PEDS COMMITTEE AND TV CHANNEL COMMITTEE, AND SUNSET PTO. 25. IS A MEMBER OF THE EL DORADO AND AUGUSTA CHAMBERS OF COMMERCE, REPRESENTING THE HOSPITAL IN COMMUNITY DISCUSSIONS AND EVENTS. 26. OFFERED COMMUNITY HEALTH PRESENTATIONS AT AREA SENIOR CENTERS AND NURSING/RETIREMENT HOMES, WITH TOPICS INCLUDING FALL PREVENTION, TIPS TO A HEALTHY HEART, DIABETES PREVENTION, ALZHEIMERS AWARENESS, FOOT HEALTH, LIVING WILLS, STROKE PREVENTION, ARTHRITIS, STRESS PREVENTION, DEHYDRATION, HEAT STROKE AND MORE. 27. ACT AS A CLINICAL SITE FOR TRAINING OF HEALTHCARE PROFESSIONALS INCLUDING MEDICAL STUDENTS, NURSING STUDENTS, RADIOLOGY, LAB, MEDICAL TECHNOLOGISTS, RESPIRATORY THERAPISTS, DIETITIANS, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPISTS, ATHLETIC TRAINING STUDENTS, CRNA STUDENTS, PHYSICIAN ASSISTANT STUDENTS, APRN STUDENTS, AND PHARMACY STUDENTS. 28. MADE AVAILABLE SCHOLARSHIP MONEY FOR PATIENTS TO GO THROUGH THE SBA ADULT DIABETES EDUCATION PROGRAM. IN ADDITION TO THE ACTUAL CLASS COSTS, ADDITIONAL LAB WORK WAS ALSO WRITTEN OFF FOR THESE PATIENTS. 29. SPOSORED THE EL DORADO YMCA "STRONG KIDS" CAMPAIGN WITH A $1,000 DONATION.
FORM 990, PART VI, SECTION B, LINE 11B	AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE 990. THE 990 IS THEN REVIEWED BY THE HOSPITAL'S OFFICERS AND THE ACCOUNTING DIRECTOR. ANY QUESTIONS OR CONCERNS THE HOSPITAL'S OFFICERS OR ACCOUNTING DIRECTOR HAVE ARE ADDRESSED AND ANY CLARIFICATION OR CORRECTIONS THAT NEED TO BE MADE ARE MADE. THE 990 IS THEN PRESENTED TO THE BOARD OF TRUSTEES FOR THEIR REVIEW AND COMMENT. ANY QUESTIONS OR CONCERNS THE BOARD OF TRUSTEES HAVE ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT ARE NEEDED ARE MADE. THE FINAL 990 WITH ALL REQUIRED SCHEDULES ARE APPROVED BY THE BOARD OF TRUSTEES AND FILED. IF THE 990 IS FILED PRIOR TO BOARD APPROVAL AND CHANGES ARE NEEDED AN AMENDED RETURN IS FILED.
FORM 990, PART VI, SECTION B, LINE 12C	AT THE TIME OF HIRE OR ELECTION IN THE CASE OF BOARD MEMBERS, AND ANNUALLY THEREAFTER, THE PRESIDENT AND CEO OR THEIR DESIGNEE SHALL PROVIDE TO THE BOARD, EXECUTIVE OFFICERS AND DEPARTMENT DIRECTORS, A COPY OF THE CONFLICT OF INTEREST POLICY AND THE CONFLICT OF INTEREST DISCLOSURE STATEMENT WHICH WILL BE COMPLETED TO IDENTIFY ANY RELATIONSHIPS, POSITIONS OR CIRCUMSTANCES WITH RESPECT IT IS BELIEVED A CONFLICT MAY ARISE. THE ANNUAL REVIEW AND MONITORING IS A PART OF THE HOSPITAL'S CORPORATE COMPLIANCE PLAN. A REPORT SHALL BE MADE TO THE BOARD OF TRUSTEES OF ITEMS DISCLOSED. EACH MEMBER OF THE BOARD OF TRUSTEES OR MANAGEMENT SHALL DISCLOSE FULLY AND FRANKLY ANY AND ALL POTENTIAL CONFLICTS OF INTEREST WHICH MAY EXIST OR APPEAR TO EXIST.
FORM 990, PART VI, SECTION B, LINE 15A & 15B	THE HOSPITAL PARTICIPATES IN AN EXTERNAL SALARY SURVEY FOR ALL EXECUTIVE POSITIONS. THE PRESIDENT AND CEO AND CHIEF HUMAN RESOURCES OFFICER REVIEWS THE SURVEY RESULTS, AND PRESENTS THEM TO THE COMPENSATION COMMITTEE OF THE BOARD WITH RECOMMENDATIONS FOR THE EXECUTIVE AND VICE PRESIDENT POSITIONS. THE COMPENSATION COMMITTEE OF THE BOARD MAKES RECOMMENDATIONS TO THE FULL BOARD FOR APPROVAL. IN ADDITION, THE COMPENSATION COMMITTEE MAKES A RECOMMENDATION FOR THE PRESIDENT AND CEO SALARY TO THE FULL BOARD FOR APPROVAL. THE REVIEW IS DONE ANNUALLY BY THE COMPENSATION COMMITTEE AND THE BOARD.
FORM 990, PART VI, SECTION C, LINE 19	THE GOVERING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC.
FORM 990, PART VII	AMY SEEBER IS COMPENSATED BY THE HOSPITAL FOR HER SERVICES PROVIDING A PHYSICIAN INTERPRETATION OF ELECTROCARDIOGRAMS.
FORM 990, PART XI, LINE 9	CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUSTS $ 425,085 CHANGE IN INTEREST IN THE NET ASSETS OF SBAMHF $ (123,204) Contributed personnel services from affiliate $ 146,969 Partnership Income $ 10,587 CONTRIBUTIONS $ (100,000) ---------- $ 359,431

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	SUSAN B ALLEN MEMORIAL HOSPITAL FDN	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	720 WEST CENTRAL	AddressLine1Txt
City	EL DORADO	CityNm
State Abbreviation	KS	StateAbbreviationCd
ZIP	67042	ZIPCd

Field	Value	IRS element (for citing)
EIN	480862732	EIN
Primary Activities	SUPPORT ORG	PrimaryActivitiesTxt
Legal Domicile State	KS	LegalDomicileStateCd
Exempt Code Section	501(C)(3)	ExemptCodeSectionTxt
Public Charity Status	12A	PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	SBA HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Controlled Organization	Yes (true)	ControlledOrganizationInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	FS ALLEN	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	720 WEST CENTRAL	AddressLine1Txt
City	EL DORADO	CityNm
State Abbreviation	KS	StateAbbreviationCd
ZIP	67042	ZIPCd

Field	Value	IRS element (for citing)
EIN	486103710	EIN
Primary Activities	GRANTOR TRUST	PrimaryActivitiesTxt
Legal Domicile State	KS	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Entity Type	TRUST	EntityTypeTxt
Share Of Total Income	-$414,399	ShareOfTotalIncomeAmt
Share Of EOY Assets	$2,698,837	ShareOfEOYAssetsAmt
Ownership	1.00000	OwnershipPct
Controlled Organization	Yes (true)	ControlledOrganizationInd

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (true)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
SUSAN B ALLEN MEMORIAL HOSPITAL FDN
C	$125,570	cash
SUSAN B ALLEN MEMORIAL HOSPITAL FDN
L	$146,969	FMV