2018-11-09T11:42:00-06:00 2017-12-31 481026809 Wendling Noe Nelson & Johnson LLC 534 S Kansas Ave Suite 1500 Topeka KS 666033491 990 2017-01-01 486099245 Labette County Medical Center LABE 6204214880 1902 S US Highway 59 Parsons KS 67357 Thomas Macaronas CFO 6204214880 2018-11-02 1 Heather R Eichem P01515553 7852334226 2018-11-02 98.172.114.81 2018-11-02 15:27:08 CD P A2305A0D198B2FF4E8D11255ADD7E606F4830AA8 7131FAC72250B97EA8406F4A5067E840B7263ABE 2017 2018-06-14 16:35:46Z Labette Health Thomas Macaronas 1902 S US Highway 59 Parsons KS 67357 68316210 0 X www.labettehealth.com X Government 1961 KS Medical care for the southeast Kansas region 9 6 748 55 0 0 1203933 1715595 62813002 65801160 82758 45253 851524 745406 64951217 68307414 17979 238602 0 0 31543702 34163602 0 0 184972 31141499 32892710 62703180 67294914 2248037 1012500 69476651 66382188 35175223 31068260 34301428 35313928 Focusing on the patient and providing exceptional healthcare through effective clinical and financial management. 0 0 57775597 238602 65792364 Labette County Medical Center operates physician clinics and provides inpatient and outpatient services to the residents of the southeastern Kansas area. 57775597 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 1 0 0 0 1 44 0 1 748 1 0 0 0 0 0 0 0 0 0 0 X 9 6 0 0 0 0 0 1 0 1 0 0 0 1 1 1 1 1 1 1 1 0 X Thomas Macaronas 6204214880 1902 S US Highway 59 Parsons KS 67357 Perry Sorrell President 1.00 X X 0 0 0 Dee Bohnenblust Vice President 1.00 X X 0 0 0 Melissa Morris Treasurer 1.00 X X 0 0 0 Marna George Secretary 1.00 X X 0 0 0 Wayne Gilmore OD Trustee 1.00 X 0 0 0 Jill Thomas Trustee 1.00 X 0 0 0 Ned Wall Trustee 1.00 X 0 0 0 Ronald Leonard DO Trustee 1.00 X 0 0 0 Robert Gibbs MD Trustee 1.00 X 24000 0 420 Thomas Macaronas CFO/COO 40.00 X 177840 0 25342 Brian Williams President/CEO 40.00 X 297742 0 37441 Douglas Stacy CIO 40.00 X 152085 0 17631 Kathi McKinney CNO 40.00 X 154694 0 15332 Michael Bolt Physician 40.00 X 389601 0 23799 Trevor Bond Physician 40.00 X 433896 0 24484 Philip Gorman Anesthesiologist 40.00 X 417703 0 25275 Roxanne Olmstead Physician 40.00 X 396422 0 16872 Shawn Southwick Physician 40.00 X 376394 0 16593 2820377 0 203189 40 0 1 0 CPSI PO Box 850309 Mobile AL 36685 Computer support services 704985 Medical Consultants of Kansas LLC PO Box 21 Mulvane KS 67110 Physician services 499315 Jerry C Bouman DO 21004 Ness Road Parsons KS 67357 Physician services 479453 SilverCreek Medical 2400 N Broadway Pittsburg KS 66762 Billing services 450202 Melinda Allen Cullins 1361 Country Road Caney KS 67333 Physician services 411283 14 960576 681937 73082 1715595 Patient service revenue 621990 60023367 60023367 340b pharmacy revenue 621990 5634595 5634595 Fitness center 713940 100939 100939 EHR incentive payments 621990 -7699 -7699 49958 49958 65801160 54049 54049 233729 0 233729 233729 233729 8796 -8796 -8796 -8796 Cafeteria meals 722210 260391 260391 Leased employees 900099 65689 65689 185597 185597 511677 68307414 65792364 0 799455 234602 234602 4000 4000 916993 24420 892573 27862455 25062125 2691855 108475 706569 668540 35136 2893 2778153 2463750 303739 10664 1899432 1661098 231145 7189 366828 366828 6570424 5440225 1114459 15740 475048 68105 401790 5153 242687 52950 185882 3855 272317 272317 1663765 1413842 247283 2640 183848 145811 34550 3487 1236215 994658 240815 742 4670184 3697385 962525 10274 444954 223979 220918 57 Drugs and medical suppl 10798483 10798483 Collection fees 2182838 1918531 264307 Repairs and maintenance 1705073 1393393 310728 952 Food and paper goods 491039 491039 1589007 1018661 557495 12851 67294914 57775597 9334345 184972 75448 29819 23938821 23224414 9961036 9180288 50000 50000 466247 515822 1382647 1572768 313389 264150 88631765 59167228 30764986 29464537 1507536 1016541 2080390 69476651 66382188 5095802 5892036 101597 332621 25663001 23634000 4261496 1156276 53327 53327 35175223 31068260 X 32638430 34065387 1662998 1248541 34301428 35313928 69476651 66382188 1012500 0 X 0 0 0 X 0 0 0 0 0 0 0 0 1 9957 9957 0 Part II-B, Line 1: A portion of annual dues paid by Labette County Medical Center to various healthcare associations has been identified as lobbying activities by those associations. Labette County Medical Center does not participate in activities supporting a political candidate. 849026 849026 55890471 35958788 19931683 31736200 23208440 8527760 156068 156068 29464537 Estimated third-party payor settlements 53327 53327 68072812 0 68072812 234602 234602 68307414 67060312 0 67060312 234602 234602 67294914 Part XI, Line 4b - Other Adjustments: Contribution to Foundation 234,602. Part XII, Line 4b - Other Adjustments: Contribution to Foundation 234,602. 1 1 1 X 1 X 1 1 0 0 588978 84780 504198 0.00750 8155845 5096592 3059253 0.04550 8744823 5181372 3563451 0.05300 69988 16837 53151 0.00080 4000 4000 0.00010 9862383 7745597 2116786 0.03150 1808 1808 0.00000 9938179 7762434 2175745 0.03240 18683002 12943806 5739196 0.08540 1 3146339 314634 20174977 19727399 447578 X 1 1 1 1 Labette County Medical Center 1902 S U S Highway 59 Parsons KS 67657 X X X Labette County Medical Center 1 0 0 1 X X X X X X X X 15 1 1 1 1 X http://www.labettehealth.com/about-community-health-needs.html X 1 15 1 http://www.labettehealth.com/about-community-health-needs.html 0 1 X 150.000000000000 250.000000000000 X X X X X 1 1 X X X 1 X http://www.labettehealth.com/ X http://www.labettehealth.com/ X http://www.labettehealth.com/ X X X X X X 1 X 0 X X 1 X 0 0 Labette County Medical Center Part V, Section B, Line 5: The County Health rankings, along with a number of additional community health indicators from the Kansas Department of Health and Environment and other agencies, were reviewed to provide insight into the current situation of the community. Furthermore, the Medical Center asked for input from many key community members by way of community meetings, telephone interviews and e-mail correspondence. The individuals invited to these meetings included a Medical Center board member, local medical professionals, the City Manager, Chief of Police, members of the Chamber of Commerce, religious leaders, a County Commissioner, and the Recreation Commission. Labette County Medical Center Part V, Section B, Line 6a: Oswego Community Hospital Labette County Medical Center Part V, Section B, Line 6b: Labette County Public Health Department and Labette Center for Mental Health Labette County Medical Center Part V, Section B, Line 11: Throughout the year, administration, board members, providers, and staff of Labette County Medical Center d/b/a Labette Health continually seek feedback from community officials, organizations and citizens to whom we provide healthcare services. This objective is accomplished through community based meetings, impromptu conversation, surveys, and hospital/community committees. We continually encourage our providers and key staff to maintain active memberships in local organizations as another venue to assess the impact of our organization.From these interactions, our internal committees, staff, and board members become aware of solutions to improvement initiatives for county health rankings and social needs of the communities served.Our Quality Improvement initiatives continue to improve outcomes by reducing preventable readmissions, reducing preventable harm, increasing our patient safety through patient education, providing community education in the areas of diabetes and trauma injury, and increasing our involvement with Meals on Wheels (over 5,000 meals) and the Summer Food Program for the school age population (over 7,000 meals and snacks).In 2016, the Labette Health Board of Trustees established the Labette Health Patient and Family Advisory Council (PFAC) to advise Labette Health on how to improve the quality of service and safety, improve systems of care, and educate health care professionals and staff on the patients and families' perceptions. This Council was very active during 2017. The Council is comprised of 11 patients and/or family members, 1 Board of Trustee liaison and 5 staff members from Labette Health. A summary of activities completed during 2017 include: representation at the strategic planning meeting providing suggestions from PFAC, the development of a wayfinding map to guide patients around the hospital, the drafting of an educational pamphlets to help educate what nurse practitioners and physician assistants can do and their scope of practice, providing feedback on the redesign of the Medical Center's website, proposing suggestions regarding our educational pamphlet for Hospital and Clinical Patient portals as well as their functionality, providing feedback on process of third party vendors calling patients on behalf of Labette Health Billing department, and providing feedback on Antibiotic Stewardship posters and other avenues to educate public.In mid 2017, our plans culminated in the opening of our Emergency Care Facility in Independence to serve the citizens of Independence in response to the loss of their hospital. In addition, during 2017, we increased our catchment areas access to healthcare with the addition of primary care Rural Health Clinics in Altamont, Erie, and Independence and the recruiting of providers in OB/GYN, Family Practice and Emergency Medicine. 7 1 - Independence Health Center 510 N Peter Pan Road Independence KS 67301 Emergency, outpatient services and rural health clinic 2 - Labette Health Physicians Group 1902 S Hwy 59 Bldg E Parsons KS 67357 Physician and rural health clinic 3 - Cherryvale Clinic 209 E Main Cherryvale KS 67335 Rural health clinic 4 - St Paul Clinic 200 Carroll St Paul KS 66771 Rural health clinic 5 - Express Care Clinic 2100 Commerce Dr Parsons KS 67357 Physician clinic 6 - Altamont Clinic 607 E 4th St Altamont KS 67330 Rural health clinic 7 - Erie Clinic 324 S Main St Erie KS 66733 Rural health clinic Part I, Line 7: Financial assistance at cost was determined by utilizing departmental cost-to-charge ratios for financial assistance provided in areas that are reported as subsidized health services. An overall cost-to-charge ratio derived from Worksheet 2 was used to determine the cost of financial assistance provided for services not reported as subsidized health services.Unreimbursed Medicaid costs were also determined using a blend of cost-to-charge ratios for certain services and an overall cost-to-charge ratio derived from Worksheet 2 for all other services.The cost of providing subsidized health services was determined using a cost-to-charge ratio for each service.Actual costs and revenues were utilized for all other items reported on line 7. Part I, Line 7g: Subsidized health services are comprised of services that Labette Health provides despite a financial loss to the organization. These services include outpatient physician clinics. The cost of outpatient physician clinics amounts to $9,862,383. Part II, Community Building Activities: N/A Part III, Line 4: Labette Health provides for accounts receivable that could become uncollectible in the future by establishing an allowance to reduce the carrying value of such receivables to their estimated net realizable value. Labette Health estimates this allowance based on the aging of its accounts receivable and its historical collection experience for each type of payor.Part III, Line 2:The provision for bad debts is related to accounts that have been deemed uncollectible during the year. The uncollectible amount is then written off pursuant to Labette Health's policy. The cost of bad debt expense was determined using the overall cost-to-charge ratio derived from Worksheet 2 applied to all charges that were deemed uncollectible during the year.Part III, Line 3:Bad debt expense attributable to patients eligible under Labette Health's financial assistance policy was determined using an estimated 10% of total bad debts. Labette Health takes steps to assist individuals who are believed to qualify for financial assistance prior to writing accounts off as uncollectible.All non-reimbursed costs for treatment of patients in our community provides a community benefit since patients unwilling or unable to pay have received a valuable service at no cost or at a reduced cost to them. This improves the health of our community as a whole. Part III, Line 8: Medicare allowable costs were determined by using amounts from Labette Health's Medicare cost report as filed with the Medicare Administrative Contractor. The Medicare cost report apportions actual costs to the Medicare program using charges for ancillary services and patient days for nursing services. Any shortfalls are considered a community benefit. Part III, Line 9b: Labette Health's collection policy contains provisions on the collection practices for patients who are known to qualify for charity care or financial assistance. The charity care policy states that the patient must cooperate with Labette Health to provide the information and documentation necessary to apply for other existing financial resources that may be available to pay for health care services, such as Medicaid. Then the information is gathered and assessed in order to determine eligibility for charity care. Whenever possible, prior to admission, Labette Health will conduct a pre-admission interview with the patient, the guarantor, and or legal representative. Those patients who may qualify for financial assistance from a governmental program will be referred to the appropriate program, prior to the consideration for charity care. Part VI, Line 2: N/A Part VI, Line 3: All uninsured individuals are asked if they have any desire to complete a financial assistance application and/or are advised of the process to apply for Medicaid. When a patient has the desire or need to apply for Medicaid, Labette Health refers them to the Social Security Department to begin the application process. When a patient applies for Medicaid, they are asked to let Labette Health know of their decision and then their financial assistance application can be completed and processed after all information has been received. If an application is found to be incomplete, a letter is sent to the applicant advising them of the incomplete status and addressing the needed items for completion. During the social service intake/discharge planning process a social worker assists the uninsured in applying for any appropriate governmental program or Labette Health's financial assistance program. Part VI, Line 4: Based on the Stark II definition (the area composed of the lowest number of contiguous zip codes from which we draw at least 90% of our inpatients) the primary service area (PSA) has an approximate population of 34,000 people and the secondary service area (SSA) has an approximate population of 29,000 people. Our total service area has a population in excess of 70,000 people. Our service area impacts largely three counties: (1) Labette County has a population of 20,000, in the city of Parsons (population 10,000) Labette Health operates a general acute hospital and provider clinics; (2) Montgomery County, Labette Health operates an emergency room/critical decision unit facility and provider clinics in the city of Independence (population 9,000); (3) Neosho County beginning in 2018 Labette Health operates a provider clinic and urgent care clinic in the city of Chanute (population 9,000). The median household income for this area is approximately $42,800. Within these three counties 19% live in poverty, which is higher than the State of Kansas average of 12%. Unemployment by county reflects: Labette 4.1%; Montgomery 4.6%, Noesho 5.2%. Multicultural composition reflects that as of 2017 15% of the population is non-white. Population within our PSA fall significantly lower than Kansas averages when considering people with a Bachelor's degree or higher.Other hospitals in our area are in the following cities within our PSA: Oswego (CAH-19 miles), Chanute (CAH-37 miles), Coffeyville (PPS-48 miles) and contiguous to our PSA: Neodesha(CAH-32 miles), Fredonia (CAH-47 miles), Girard (CAH-39 miles), and Pittsburgh (PPS-41 miles). Part VI, Line 5: The Board of Trustees is appointed by the County Commissioners and is comprised of 9 members, all of whom live in the county and are not employed by the Hospital. All employees sign a conflict of interest statement. Labette Health's medical staff is open with the exception of Radiology and Anesthesiology. Any profit margin, whether operational or in total, that Labette Health may experience is reinvested into operations. No one individual or one organization benefits from the profit margin but rather the institution and our patients are the beneficiaries. Part VI, Line 6: N/A 1 Labette Health Foundation Inc 1902 South Highway 59 Parsons KS 67357 481009259 501(c)(3) 234602 Independence facility construction costs 1 0 Part I, Line 2: The Medical Center monitors the use of grant funds by requiring receipts and other supporting documenation before disbursing any requested funds. X X X 0 1 0 0 0 0 0 1 0 Thomas Macaronas CFO/COO 176040 0 1800 0 0 0 10789 0 14553 0 203182 0 0 0 Brian Williams President/CEO 291242 0 6500 0 0 0 35000 0 2441 0 335183 0 0 0 Douglas Stacy CIO 148277 0 2500 0 1308 0 3078 0 14553 0 169716 0 0 0 Kathi McKinney CNO 152194 0 2500 0 0 0 9026 0 6306 0 170026 0 0 0 Michael Bolt Physician 358673 0 0 0 30928 0 8000 0 15799 0 413400 0 0 0 Trevor Bond Physician 432642 0 0 0 1254 0 8000 0 16484 0 458380 0 0 0 Philip Gorman Anesthesiologist 406145 0 10250 0 1308 0 8000 0 17275 0 442978 0 0 0 Roxanne Olmstead Physician 374622 0 4800 0 17000 0 8000 0 8872 0 413294 0 0 0 Shawn Southwick Physician 375269 0 0 0 1125 0 8000 0 8593 0 392987 0 0 0 Part I, Line 4b Brian Williams, current CEO, is eligible to receive IRC section 457(f) pension plan contributions of up to $30,000 annually at the discretion of the Board of Trustees. $20,000 was contributed to Brian's IRC section 457(f) plan during 2017. Part I, Line 7 Physicians and anesthesiologists are eligible for incentive bonuses based on their production. A Labette County Kansas 486040264 NoneAvail 2016-12-29 9021000 Partial refund of Series A, 2007 bonds issued 0 0 0 B Labette County Kansas 486040264 NoneAvail 2017-01-26 15000000 Partial refund of Series A and B, 2007 bonds issued 0 0 0 A 144000 9021000 180649 8840351 2010 0 1 1 1 B 243000 15000000 240000 14760000 2010 0 1 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 A 1 B 1 Robert Gibbs Trustee Recruiting assitance loan X 50000 50000 0 1 1 50000 Emily Brown Family member of Ned Wall, Trustee 73579 Employment 0 Tracy Gilmore Family member of Wayne Gilmore, Trustee 105307 Employment 0 Form 990, Part VI, Section A, line 7a Members of the Board of Trustees are appointed by the Commissioners of Labette County, Kansas Form 990, Part VI, Section A, line 8b There are no committees with the authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b Form 990 is reviewed by the CEO and CFO and is provided to the governing body prior to filing. Form 990, Part VI, Section B, line 12c A conflict of interest disclosure form is provided with a copy of the current conflict of interest policy. This disclosure is completed by each member of the Board of Trustees upon election and annually thereafter. Form 990, Part VI, Section B, line 15 The Board of Trustees is responsible for determining the job performance standards for the CEO and fixing compensation according to the organization's policies. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Labette Health Regional Partnerships Inc 9401 Indian Creek Parkway Building Overland Park KS 66210 464050502 Operating a medical office building utilized for health care services KS 501(c)(3) Line 12b, II Labette County Medical Center 1 Southeast Kansas Regional Health Inc 1902 S US Highway 59 Parsons KS 67357 813739559 Provide healthcare facilities and services KS 501(c)(3) Line 12b, II Labette County Medical Center 1 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 Labette Health Regional Partnerships Inc D 327940 Actual amount owed