2019-06-14T08:12:42-05:00 2018-07-31 481026809 Wendling Noe Nelson & Johnson LLC 534 S Kansas Ave Suite 1500 Topeka KS 666033491 990 2017-08-01 742842747 West Central Kansas Association Inc WEST 7854833131 200 S Main Russell KS 67665 Sharon Collins CEO 7854833131 2019-06-13 1 Heather R Eichem P01515553 7852334226 2019-06-13 98.172.114.81 2019-06-13 17:22:58 CD P 5FE697FDAA7BE4B38BDC0BF4968DBFC464CC3817 E5A33FBA892307F7DB132BC3C67873B6922D10E4 2017 2019-02-21 02:37:17Z Russell Regional Hospital Sharon Collins 200 S Main Russell KS 67665 17026859 0 X www.russellhospital.org X 1997 KS Dedicating our lives to improving yours. 5 5 239 5 0 0 150893 151650 15713042 16556545 57656 49664 227831 269000 16149422 17026859 0 0 0 0 10755560 11025405 0 0 0 5784790 6237159 16540350 17262564 -390928 -235705 5066091 5422062 5028291 5384262 37800 37800 Dedicating our lives to improving yours. 0 0 15292430 16814317 Russell Regional Hospital provides a variety of health care services including acute inpatient care, swingbed inpatient care, outpatient care, rural health clinic, and long-term care services to patients in need of care. 15292430 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 9 0 1 239 1 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 1 1 1 0 X X Sharon Collins CEO 7854832323 200 S Main Russell KS 67665 Morris Krug President 1.00 X X 0 0 0 Vance Ruggels Secretary 1.00 X X 0 0 0 John O Farmer III Treasurer 1.00 X X 0 0 0 Michael Holland Director 1.00 X 0 0 0 Mallory Davis Vice Chair 1.00 X X 0 0 0 Sharon Collins Interim CEO through 11/1/2017 40.00 X 93306 0 31697 Kevin Kreutzer CFO 40.00 X 86831 0 11097 Robert Nahmensen CEO beginning 11/1/2017 40.00 X 19000 0 6509 Earl Merkel Physician 40.00 X 296401 0 22902 Tyrel Somers Physician 40.00 X 411316 0 39092 James Anderson Physician 40.00 X 336496 0 32554 Alicia Bean Physician 40.00 X 260316 0 46207 Sambhundh Panichabhongse Physician 40.00 X 230387 0 19866 1734053 0 209924 11 0 1 0 Sunflower Physician Services 1659 S Tamarisk Dr Wichita KS 67230 Physician services 504990 CPSI PO Box 850309 Mobile AL 366850309 Software and technical support 197574 Shared Medical Services Inc 4253 Arogosy Court Madison WI 53714 MRI Services 153220 Quest Diagnostics PO Box 14730 St Louis MO 631504730 Lab services 132992 New Wave Anesthesia LLC 3312 Thunderbird Drive Hays KS 67601 Anesthesia services 118380 5 132248 19402 151650 Net patient service revenue 622110 15096730 15096730 340b retail pharmacy 446110 1459815 1459815 16556545 49664 49664 11228 0 11228 11228 11228 Contracted rheumatology 622110 166525 166525 Cafeteria sales 722210 51580 51580 Purchase discounts 900099 32179 32179 7488 7488 257772 17026859 16814317 0 60892 252573 252573 8972944 8222568 750376 104099 95534 8565 1109882 1020921 88961 585907 524144 61763 16277 16277 1626090 1357642 268448 17257 14219 3038 169154 41764 127390 172404 137751 34653 3691 992 2699 34162 30896 3266 283504 226520 56984 146110 120732 25378 Pharmacy supplies 1170015 1170015 340b drug program expen 991538 991538 Repairs and maintenance 608615 430743 177872 Medical supplies 533811 533811 464531 372640 91891 17262564 15292430 1970134 0 2046411 1913405 1026 1393 1687003 1623021 284777 284659 123245 123600 4951621 3822620 808953 1129001 114676 346983 5066091 5422062 943410 1033311 517560 829474 3567321 3521477 5028291 5384262 X 37800 37800 37800 37800 5066091 5422062 X -235705 235705 X 0 1 X 0 0 X 0 0 0 0 0 1 3905 0 0 0 3905 0 Part II-B, Line 1: West Central Kansas Association, Inc. is a member of the Kansas Hospital Association and the American Hospital Association. Both of these organizations engage in lobbying activities for hospital and general health care interests as part of the services provided to members. 3722535 2722353 1000182 1229086 1100267 128819 1129001 Estimated third-party payor settlements 174735 Other receivables 172248 346983 Estimated third - party payor settlements 55259 Due to lessor 3465419 Accrued Interest 799 3521477 X 17026859 0 17026859 0 17026859 17262564 0 17262564 0 17262564 Part X, Line 2: Management is not aware of any uncertainties in income tax positions. 1 1 1 X 70.000000000000 1 X 1 1 0 1 0 143667 118159 25508 0.00150 1527615 1198336 329279 0.01910 1671282 1316495 354787 0.02060 7984 7984 0.00050 4066282 3225988 840294 0.04870 200 200 0.00000 4074466 3225988 848478 0.04920 5745748 4542483 1203265 0.06980 1 578758 6160204 6196756 -36552 X 1 1 1 1 Russell Regional Hospital 200 South Main Street Russell KS 67665 X X X X Russell Regional Hospital 1 0 0 1 X X X X X X X X X 17 1 0 1 1 X www.russellhospital.org X 1 17 1 www.russellhospital.org 0 1 X 70.000000000000 200.000000000000 X X X 1 1 X X X 1 X http://www.russellhospital.org X http://www.russellhospital.org X http://www.russellhospital.org X X X X 1 X 0 X X X 1 X 0 0 Russell Regional Hospital Part V, Section B, Line 5: A priority of the CHNA was to solicit input from a broad cross section of the community, not simply members of the local healthcare sector, in an effort to represent the community as a whole. Steering Committee participants include representatives from these local organizations: Russell County Area Community Foundation, Russell Regional Hospital, Russell County Hospital Board, Russell County Health Department, Russell County Economic Development/CVB, Russell County Emergency Preparedness, City of Russell, Russell County supervisor, and city law enforcement. Russell Regional Hospital Part V, Section B, Line 6b: Russell County Health Department Russell Regional Hospital Part V, Section B, Line 11: The annual update below pertains to the CHNA and implementation strategy completed for the 2014 tax year (fiscal year ended 07/31/2015), which completes the three year cycle for the prior assessment and strategy. The most recently completed CHNA and implementation strategy applies to the next three years moving forward.The Russell Regional Hospital Community Health Needs Assessment for 7/31/2015 (tax year 2014) showed seven issues the community wanted to address. The seven issues are (1) Improve Mental Health Screenings/Placement, (2) Improve Chronic Disease Management (Diabetes, Heart, Stroke), (3) Improve Drugs/Alcohol & Placement, (4) Increase Availability of Affordable Quality Housing, (5) Expand Healthcare Transportation Out of County, (6) Provide Dentist Services, (7) Expand Child Care Offerings.Number 1 Turning Point Professional Counseling Service out of Hays is seeing patients in our specialty clinic by appointment. We have discussed the need to provide mental health services 1 to 2 days per week. In addition, RRH is utilizing the Avera eEmergency system for acute mental health issues in the ER. We also continue to utilize ITV Services with High Plains Mental Health of Hays, KS. Number 2 RRH in partnership with The Heart and Stroke Collaborative hired a health coach to work with patients who have co-morbidities. This health coach serves as a liaison between the physician and patient while making home visits and educational phone calls to make sure the patients are keeping appointments, taking medication correctly and observing a healthy lifestyle. There are approximately 200 patients who have co-morbidities. RRH has engaged in a healthy hospital initiative that includes proper nutrition and exercise.Number 3 The Russell County Sheriff Department does provide education for middle school students on the risks of alcohol and drug abuse. Number 4 Six middle income town homes have been constructed in Russell. Four more town homes are in the construction phase.Number 5After investigation it was determined that providing transportation within the city was feasible, but transportation within the county or outside the county could not be accomplished at this time. The city of Russell has public transportation in place at this time.Number 6Russell County Economic Development continues to recruit dentists.Number 7 Russell Regional Hospital and USD 407 met to discuss a community preschool and daycare in the city of Russell. At this time there have been no decisions made on a community preschool or daycare. 2 1 - Russell Rgnl Hospital Physicians Clinin 200 South Main Street Russell KS 67665 Rural health clinic 2 - Russell Rgnl Hospital - Main Street Man 200 South Main Street Russell KS 67665 Long-term care facility Part I, Line 7g: The costs of subsidized health services include costs attributable to a physician clinic in the amount of $2,687,393. Part III, Line 4: See Note A-2 (page 7) of the audited financial statements regarding the allowance for uncollectible accounts.Part III, Line 2: The Hospital's bad debt at cost was determined by applying an overall ratio of cost to charges. Part III, Line 3: West Central Kansas Association, Inc. is unable to determine the amount of bad debt expense attributable to patients eligible under its charity care policy for the year covered by this return. Suggested methods for estimation were either not in place or proved to be unreliable. For example, the number of financial assistance applications distributed but not returned was not tracked. Using demographic data to estimate an amount did not provide reasonable results. Undoubtedly, there is bad debt expense attributed to patients who meet charity care guidelines. However, paperwork needed for approval of charity care was not returned or tracked. Rather than provide an estimate that can't be substantiated, West Central Kansas Association, Inc. has chosen to report zero dollars as bad debt expense attributable to charity care patients. Part III, Line 8: The amounts were obtained from the cost report filed with Medicare for the period ending 07/31/2018. The total amount of shortfall between Medicare revenue received and related allowable costs is considered community benefit. Part III, Line 9b: Patients who are known to qualify for financial assistance are qualified for up to three months. After three months, patients must reapply for financial assistance. A patient who has qualified for partial financial assistance payments are subject to our normal collection procedures. Part VI, Line 3: Patients receive information regarding federal, state and charity care programs upon request. Part VI, Line 4: The Hospital is located in Russell County, Kansas in the city of Russell and serves the surrounding area. The Russell community is a predominately agricultural one. The city of Russell and Russell County have an approximate population of 4,500 & 7,000 individuals respectively. The average Russell household annual income is approximately $48,000. Approximately 14.2% of the residents in Russell County have an annual income below the federal poverty level. Other hospitals in the area are located in Hays, Hoisington, and Great Bend. The distance between the Hospital and these facilities is approximately 26, 29, and 40 miles respectively. Part VI, Line 5: The Hospital's governing body is comprised solely of local community members. All local physicians have admitting privileges at the Hospital. X X 0 0 0 0 0 0 0 0 0 Earl Merkel Physician 195951 0 100450 0 0 0 0 0 22902 0 319303 0 0 0 Tyrel Somers Physician 311770 0 73500 0 26046 0 9801 0 29291 0 450408 0 0 0 James Anderson Physician 336275 0 0 0 221 0 21754 0 10800 0 369050 0 0 0 Alicia Bean Physician 193788 0 66500 0 28 0 12288 0 33919 0 306523 0 0 0 Sambhundh Panichabhongse Physician 174860 0 55500 0 27 0 0 0 19866 0 250253 0 0 0 Clarissa Schneider Daughter-in-law of Sharon Collins, officer 32661 Employment 0 Brian Schneider Son of Sharon Collins, officer 72121 Employment 0 Audrey Owens Daughter of Sharon Collins, officer 38284 Employment 0 Sarah Depiesse Daughter of Sharon Collins, officer 57755 Employment 0 Kelly Depiesse Son-in-law of Sharon Collins, officer 29773 Employment 0 Form 990, Part VI, Section B, line 11b The Form 990 is reviewed by the governing body prior to filing. It is distributed by email to all governing body Board Members for review. Any questions and/or comments are directed to management for further discussion. Form 990, Part VI, Section B, line 15 The compensation of the organization's officers is voted on and approved by the Board of Directors. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy, and audited financial statements available to the public upon written request. Form 990, Part XI, line 9: Transfer from lessor 225,276. Change in amount due to lessor 10,429.