GREAT PLAINS OF SABETHA INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- GREAT PLAINS OF SABETHA INC (EIN 48-1236156)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-10-18
- IRS object ID
- 201842919349300309
- Schema version
- 2017v2.3
- 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 G
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-10-18T09:10:31-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | 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 | 1551 N WATERFRONT PKWY STE 300 | AddressLine1Txt |
| City | WICHITA | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 672066601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 481236156 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREAT PLAINS OF SABETHA INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % DAVE DELLASEGA | InCareOfNm |
| Business Name Control | GREA | BusinessNameControlTxt |
| Phone | 3166851523 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 NORTH ROCK ROAD STE 160 | AddressLine1Txt |
| City | WICHITA | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67206 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVE DELLASEGA | PersonNm |
| Person Title | CEO AND PRESIDENT | PersonTitleTxt |
| Phone | 3166851523 | PhoneNum |
| Signature | 2018-10-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | STEVEN L WEBB | PreparerPersonNm |
| PTIN | P00235405 | PTIN |
| Phone | 3162652811 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 4.53.77.173 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 48010220182915000001 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2018-10-18 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 305047111E71B1EF7CF07F45C8273AFE2A22C5B3 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 8E791C5199A669DB93BD25988D8F907149AF4FD6 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2018-06-14 16:35:46Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DAVE DELLASEGA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 NORTH ROCK ROAD STE 160 | AddressLine1Txt |
| City | WICHITA | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67206 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $12,156,973 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SABETHAHOSPITAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2000 | FormationYr |
| Legal Domicile State | KS | LegalDomicileStateCd |
| Activity Or Mission | ACUTE CARE HOSPITAL THAT PROVIDES MEDICAL CARE TO THE GENERAL PUBLIC IN SABETHA, KANSAS AND SURROUNDING RURAL COMMUNITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 153 | TotalEmployeeCnt |
| Total Volunteers | 23 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $444,837 | PYContributionsGrantsAmt |
| CY Contributions Grants | $442,968 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,900,423 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $11,535,377 | CYProgramServiceRevenueAmt |
| PY Investment Income | $15,728 | PYInvestmentIncomeAmt |
| CY Investment Income | $22,384 | CYInvestmentIncomeAmt |
| PY Other Revenue | $113,536 | PYOtherRevenueAmt |
| CY Other Revenue | $150,358 | CYOtherRevenueAmt |
| PY Total Revenue | $11,474,524 | PYTotalRevenueAmt |
| CY Total Revenue | $12,151,087 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $7,217,280 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,182,268 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,862,473 | PYOtherExpensesAmt |
| CY Other Expenses | $4,969,745 | CYOtherExpensesAmt |
| PY Total Expenses | $12,079,753 | PYTotalExpensesAmt |
| CY Total Expenses | $12,152,013 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$605,229 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$926 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,586,438 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,272,904 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,641,560 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,456,647 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,944,878 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,816,257 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO OPERATE HOSPITAL FACILITIES FOR THE DELIVERY OF HOSPITAL AND RELATED HEALTH CARE SERVICES, HEALTH RELATED EDUCATION, AS WELL AS THE PROMOTION OF HEALTH AND WELLNESS, WITHOUT REGARD TO RACE, CREED, COLOR, SEX, OR FINANCIAL CIRCUMSTANCES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $10,326,478 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $11,535,377 | RevenueAmt |
| Desc | SEE SCHEDULE O. | Desc |
| Total Program Service Expenses | $10,326,478 | 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 | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | 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 | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| 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 | false | 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 | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (true) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 25 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 153 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | 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 | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVE DELLASEGA | PersonNm |
| Phone | 3166851523 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 NORTH ROCK ROAD STE 160 | AddressLine1Txt |
| City | WICHITA | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67206 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 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 |
|---|---|---|---|---|---|---|---|---|
| THOMAS E KELLER DVM | ||||||||
| CHAIRMAN/DIRECTOR | 0.25 | 2.25 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DAVE DELLASEGA | ||||||||
| PRESIDENT/CEO/DIRECTOR | 2.0 | 40.0 | Yes (X) | Yes (X) | $0 | $211,212 | $30,675 | |
| BILL NAVIS | ||||||||
| VICE PRESIDENT/DIRECTOR | 0.25 | 2.25 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JOHN TERRILL | ||||||||
| VICE PRESIDENT/DIRECTOR | 0.25 | 2.25 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ROBERT HAMILTON | ||||||||
| SECRETARY/DIRECTOR | 0.25 | 2.25 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| STEVE CARLSON | ||||||||
| TREASURER/DIRECTOR | 0.25 | 2.25 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DAVE RANKIN | ||||||||
| DIRECTOR/CHAIRMAN | 0.25 | 2.25 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DR BARBARA BROWN APPLEGATE | ||||||||
| DIRECTOR | 0.25 | 2.25 | Yes (X) | $0 | $0 | $0 | ||
| ART HENRICKSON | ||||||||
| DIRECTOR | 0.25 | 2.25 | Yes (X) | $0 | $0 | $0 | ||
| LORA KEY | ||||||||
| ADMINISTRATOR | 40.0 | 0.0 | Yes (X) | $101,610 | $0 | $21,476 | ||
| MIKE HAND | ||||||||
| CFO | 2.0 | 40.0 | Yes (X) | $0 | $28,635 | $3,907 | ||
| KEVIN KENNALLY | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $300,841 | $0 | $47,252 | Yes (X) | ||
| GREGG WENGER | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $190,067 | $0 | $38,064 | Yes (X) | ||
| JAMES LONGABAUGH | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $220,666 | $0 | $33,595 | Yes (X) | ||
| CHRISTIAN TRAMP | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $217,419 | $0 | $48,147 | Yes (X) | ||
| KERSTIN GLYNN | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $260,745 | $0 | $45,408 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,291,348 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $239,847 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $268,524 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | 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 |
|---|---|---|---|---|---|
| MHS DATA CENTER INC | |||||
| 103 E 27TH SUITE A | HAYS | KS | 67601 | COMPUTER SUPPORT | $442,234 |
| STORMONT VAIL HEALTHCARE | |||||
| 1500 SW 10TH STREET | TOPEKA | KS | 66604 | LAB SERVICES | $111,354 |
| GREAT PLAINS HEALTH ALLIANCE | |||||
| PO BOX 366 | PHILLIPSBURG | KS | 67661 | MANAGEMENT | $143,348 |
| SHARED MEDICAL SERVICES INC | |||||
| 209 LIMESTONE PASS | COTTAGE GROVE | WI | 53527 | MRI SERVICES | $104,190 |
| STARS INC | |||||
| 201 S 4TH ST | HIAWATHA | KS | 66434 | PHYSCIAL THERAPY | $100,649 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $14,041 | FundraisingAmt |
| Government Grants | $378,670 | GovernmentGrantsAmt |
| All Other Contributions | $50,257 | AllOtherContributionsAmt |
| Noncash Contributions | $1,699 | NoncashContributionsAmt |
| Total Contributions | $442,968 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621300 | $11,138,006 | $11,138,006 |
| 340(b) Pharmacy Revenue | 621300 | $397,371 | $397,371 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $11,535,377 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,884 | TotalRevenueColumnAmt |
| Exclusion | $21,884 | 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 | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $15,150 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $15,150 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,150 | TotalRevenueColumnAmt |
| Exclusion | $15,150 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $500 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $500 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $500 | TotalRevenueColumnAmt |
| Exclusion | $500 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $3,280 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $14,041 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $5,886 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$2,606 | TotalRevenueColumnAmt |
| Exclusion | -$2,606 | ExclusionAmt |
| 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 |
|---|---|---|---|
| EMPLOYEE/GUEST MEALS | 722513 | $14,309 | $14,309 |
| OUTSIDE SERVICES | 621300 | $27,303 | $27,303 |
| VENDOR REBATES | 900099 | $11,160 | $11,160 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $85,042 | TotalRevenueColumnAmt |
| Exclusion | $85,042 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $137,814 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,151,087 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,535,377 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $172,742 | 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 | $0 | TotalAmt |
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 | $123,086 | TotalAmt |
| Management And General | $123,086 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,521,353 | TotalAmt |
| Program Services | $4,874,639 | ProgramServicesAmt |
| Management And General | $646,714 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $434,856 | TotalAmt |
| Program Services | $377,608 | ProgramServicesAmt |
| Management And General | $57,248 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $728,774 | TotalAmt |
| Program Services | $576,236 | ProgramServicesAmt |
| Management And General | $152,538 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $374,199 | TotalAmt |
| Program Services | $318,973 | ProgramServicesAmt |
| Management And General | $55,226 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,478 | TotalAmt |
| Management And General | $118,478 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $502 | TotalAmt |
| Management And General | $502 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,661 | TotalAmt |
| Management And General | $35,661 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,746 | TotalAmt |
| Management And General | $2,746 | ManagementAndGeneralAmt |
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 | $1,551,060 | TotalAmt |
| Program Services | $1,281,293 | ProgramServicesAmt |
| Management And General | $269,767 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,563 | TotalAmt |
| Program Services | $13,394 | ProgramServicesAmt |
| Management And General | $16,169 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $212,330 | TotalAmt |
| Program Services | $133,342 | ProgramServicesAmt |
| Management And General | $78,988 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,595 | TotalAmt |
| Management And General | $1,595 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $176,204 | TotalAmt |
| Program Services | $163,930 | ProgramServicesAmt |
| Management And General | $12,274 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,433 | TotalAmt |
| Program Services | $4,808 | ProgramServicesAmt |
| Management And General | $10,625 | 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 | $41,641 | TotalAmt |
| Program Services | $34,696 | ProgramServicesAmt |
| Management And General | $6,945 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,870 | TotalAmt |
| Program Services | $8,722 | ProgramServicesAmt |
| Management And General | $1,148 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $523,785 | TotalAmt |
| Program Services | $474,078 | ProgramServicesAmt |
| Management And General | $49,707 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $138,760 | TotalAmt |
| Program Services | $37,112 | ProgramServicesAmt |
| Management And General | $101,648 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | $1,444,861 | $1,444,861 | |
| RENTAL EQUIPMENT & REPAIRS | $337,978 | $324,565 | $13,413 |
| BAD DEBT EXPENSE | $203,253 | $203,253 | |
| DUES & SUBSCRIPTIONS | $47,250 | $12,714 | $34,536 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,775 | TotalAmt |
| Program Services | $42,254 | ProgramServicesAmt |
| Management And General | $36,521 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,152,013 | TotalAmt |
| Program Services | $10,326,478 | ProgramServicesAmt |
| Management And General | $1,825,535 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,177 | BOYAmt |
| EOY | $220 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,338,225 | BOYAmt |
| EOY | $1,354,825 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,547 | BOYAmt |
| EOY | $98,447 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,490,100 | BOYAmt |
| EOY | $1,515,267 | 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 | $169,189 | BOYAmt |
| EOY | $182,346 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $105,396 | BOYAmt |
| EOY | $120,151 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $12,273,406 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $9,909,689 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,832,307 | BOYAmt |
| EOY | $2,363,717 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $245,777 | BOYAmt |
| EOY | $249,932 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | 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 | $281,720 | BOYAmt |
| EOY | $387,999 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,586,438 | BOYAmt |
| EOY | $6,272,904 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,289,784 | BOYAmt |
| EOY | $1,291,072 | 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 | $63,872 | BOYAmt |
| EOY | $8,002 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | 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 | $287,904 | BOYAmt |
| EOY | $157,573 | 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 | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,641,560 | BOYAmt |
| EOY | $1,456,647 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,940,737 | BOYAmt |
| EOY | $4,816,257 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,141 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,944,878 | BOYAmt |
| EOY | $4,816,257 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,586,438 | BOYAmt |
| EOY | $6,272,904 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$926 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$127,695 | 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) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| 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
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Belongs Afflt Grp | Yes (X) | OrganizationBelongsAffltGrpInd |
| 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 | |
| Form4720 Filed | Yes (true) | Form4720FiledInd |
| 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 | $2,746 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Total Lobbying Expenditures | $2,746 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1F | FormAndLineReferenceDesc |
| Explanation | A PORTION OF THE ANNUAL DUES PAID TO KHA AND AHA ARE USED FOR LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $35,244 | OtherCostOrOtherBasisAmt |
| Book Value | $35,244 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,513,289 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,685,553 | DepreciationAmt |
| Book Value | $1,827,736 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,520,854 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,042,540 | DepreciationAmt |
| Book Value | $478,314 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $204,019 | OtherCostOrOtherBasisAmt |
| Depreciation | $181,596 | DepreciationAmt |
| Book Value | $22,423 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,363,717 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| THIRD PARTY RECEIVABLE | $274,364 |
| OTHER CURRENT ASSETS | $113,635 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $387,999 | TotalBookValueOtherAssetsAmt |
| Total Rev Etc Audited Fincl Stmt | $11,982,625 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$168,462 | OtherRevenueAmt |
| Revenue Not Reported | -$168,462 | RevenueNotReportedAmt |
| Revenue Subtotal | $12,151,087 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $12,151,087 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $12,111,246 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $162,486 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $162,486 | ExpensesNotReportedAmt |
| Expenses Subtotal | $11,948,760 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $203,253 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $203,253 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $12,152,013 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 | EQUITY IN EARNINGS SABETHA HEALTHCARE, INC. 28,905 SPECIAL EVENT EXPENSES 5,886 PROVISION FOR UNCOLLECTIBLE ACCOUNTS (203,253) ------------ TOTAL (168,462) |
| SCHEDULE D, PART XII, LINE 2D | TRANSFER TO CITY OF SABETHA 156,600 SPECIAL EVENT EXPENSES 5,886 ------------ TOTAL 162,486 |
| SCHEDULE D, PART XII, LINE 4B | PROVISION FOR UNCOLLECTIBLE ACCOUNTS 203,253 |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF TOURNAMENT | Event1Nm |
| Gross Receipts Event1 | $17,321 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $14,041 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $3,280 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $1,760 | CashPrizesEvent1Amt |
| Non Cash Prizes Event1 | $1,699 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $0 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $940 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $0 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $1,487 | OtherDirectExpensesEvent1Amt |
| Other Events Total | 0 | OtherEventsTotalCnt |
| Gross Receipts Total | $17,321 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $14,041 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $3,280 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $1,760 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $1,699 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $0 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $940 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $0 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $1,487 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $5,886 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$2,606 | NetIncomeSummaryAmt |
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 | false | ExpensesExceedBudgetInd |
| 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 | $15,929 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $15,929 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $364,317 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $206,895 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $157,422 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01320 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $380,246 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $206,895 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $173,351 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01450 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $56,450 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $16,720 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $39,730 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00330 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,772 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,772 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $60,222 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $16,720 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $43,502 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00360 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $440,468 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $223,615 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $216,853 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01810 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $203,253 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $4,924,622 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $4,924,622 | CostOfCareReimbursedByMedcrAmt |
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 | SABETHA COMMUNITY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14TH OREGON PO BOX 229 | AddressLine1Txt |
| City | SABETHA | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 66534 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.SABETHAHOSPITAL.ORG | WebsiteAddressTxt |
| State License | H066002 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SABETHA COMMUNITY 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 | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | 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 SCHEDULE H, PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SCHEDULE H, 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 |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| 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 |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE SCHEDULE H, PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE SCHEDULE H, PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE SCH H, 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 (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 5 | A PRIORITY OF THE PROGRAM IS TO SOLICIT INPUT FROM A BROAD CROSS SECTION OF THE COMMUNITY, NOT SIMPLY MEMBERS OF THE LOCAL HEALTHCARE SECTOR. THE MEETING PARTICIPANTS INCLUDED COMMUNITY RESIDENTS AND GOVERNMENTAL AND BUSINESS LEADERS WITHIN THE COMMUNITY. |
| SCHEDULE H, PART V, SECTION B, LINE 6A | NEMAHA VALLEY COMMUNITY HOSPITAL |
| SCHEDULE H, PART V, LINE 7A | http://www.sabethahospital.com/docs/Community_Needs_Assessment_2015_%281%2 9.pdf |
| SCHEDULE H, PART V, LINE 10A | http://www.sabethahospital.com/docs/CHN_Merged.pdf |
| SCHEDULE H, PART V, LINE 11 | SABETHA COMMUNITY HOSPITAL AND NEMAHA VALLEY COMMUNITY HOSPITAL PARTNERED IN JULY OF 2015 AND CONDUCTED A COMMUNITY HEALTH CARE NEEDS ASSESSMENT. A REVIEW OF THE 2012 CHNA PRIORITIES WAS CONDUCTED AND TWO OF THE MAIN PRIORITIES IDENTIFIED CONTINUE TO BE ADDRESSED AND ENHANCED; PRIORITY 1) PROMOTE HEALTH, WELLNESS, AND CHRONIC DISEASE PREVENTION; PRIORITY 2) IMPROVE ACCESS TO MENTAL HEALTH ASSISTANCE. PRIORITY 3) IMPROVE ACCESS TO INFORMATION AND ASSISTANCE ACROSS MULTIPLE NEEDS AND POPULATIONS, WAS CONSIDERED TOO BROAD AND UNMANAGEABLE. THE 2015 CHNA AS WELL AS THE 2012 CHNA IS POSTED ON THE SABETHA COMMUNITY HOSPITALS WEBSITE FOR EASY ACCESS BY THE COMMUNITIES. IN 2017, SCH COMMITTED TO FURTHERING THOSE PRIORITIES IN THE COMMUNITY THROUGH INVOLVEMENT OF THE MEDICAL STAFF, BOARD OF DIRECTORS, AND OTHER IDENTIFIED STAFF AND COMMUNITY MEMBERS. DURING 2017, THE HOSPITAL ADDRESSED PRIORITY #1 THROUGH ITS HOSPITAL WEBSITE AS WELL AS PROVIDING EDUCATIONAL INFORMATION THROUGH ITS MONTHLY OUTPATIENT CALENDARS AND THROUGH THE MULTIPLE CLINICS PROVIDED TO THE COMMUNITY. DURING 2017, THE PHYSICIAN CLINIC STARTED THE COLLABORATIVE AGREEMENT WITH KU MED FOR THE RE-POWER PROGRAM TO WORK WITH OBESE PATIENTS OVER A THREE YEAR PROJECT PERIOD SIGNED IN 2015. DIABETIC EDUCATION AS WELL AS BREASTFEEDING EDUCATION CONTINUES TO BE A PRIORITY. SCH PARTNERED WITH NEMAHA VALLEY COMMUNITY HOSPITAL TO PROVIDE NEWBORN SUPPLIES TO MOM AND BABE UPON BIRTH. IN 2017, THE HOSPITAL CONDUCTED TWO MINI HEALTH FAIRS FOR MEN AND WOMEN. BOTH FOCUSED ON BLOOD PRESSURE, BLOOD SUGARS, NUTRITION, SKIN CANCER CHECKS, AND PHYSICIANS SPOKE AT BOTH EVENTS EMPHASIZING THE IMPORTANCE OF OVERALL GENERAL HEALTH. THROUGH THE HOSPICE PROGRAM, BEREAVEMENT SUPPORT GROUP MET DURING THE FALL, AND EDUCATION MATERIALS ARE PROVIDED FOR THOSE IN THE COMMUNITY WHO HAVE LOST LOVED ONES. THE HOSPITAL SOCIAL WORKER TAKES APPOINTMENTS DURING THE OPEN ENROLLMENT PERIOD TO HELP COMMUNITY MEMBERS WITH MEDICARE PART D ENROLLMENT, AND THROUGHOUT THE YEAR CONTINUES TO PROVIDE ENROLLMENT ASSISTANCE FOR MEDICAID, MEDICARE AND THIRD PARTY PAYERS TO LOCAL COMMUNITY MEMBERS. THE HOSPITAL TRAUMA PROGRAM CONDUCTED A CAR SEAT SAFETY CHECK IN DECEMBER TO AID IN THE SAFE TRANSPORTATION OF BABES AND TODDLERS. THE HOSPITAL CONTINUES TO PARTICIPATE IN THE HCAPS SURVEY AND RESULTS ARE REVIEWED WITH STAFF ANNUALLY. THE HOSPITAL IS PARTICIPATING IN THE KANSAS HEALTH ENGAGEMENT NETWORK 2.0. PRIORITY #2; IMPROVING ACCESS TO MENTAL HEALTH CONTINUES TO BE A CHALLENGE AS THERE IS SUCH A CRISIS IN THE NATION. THE HOSPITAL CONTINUES TO PARTNER WITH THE COMMUNITY MENTAL HEALTH CENTER UTILIZING THE CRISIS MENTAL HEALTH SCREENING TOOL USED WITHIN THE ED SETTING. FURTHER OPTIONS ARE BEING RESEARCHED BUT LIMITED RESOURCES AND SPACE ARE CONSTRAINTS. AS MENTIONED EARLIER PRIORITY #3; TO IMPROVE ACCESS TO INFORMATION AND ASSISTANCE RESOURCES - THE HOSPITAL DID UPDATE ITS WEBSITE AND POSTED THE DIRECTORY FROM THE 2012 CHNA WHICH REMAINS ON THE WEBSITE. THE HOME HEALTH AND HOSPICE SOCIAL MEDIA PAGE IS USED ALSO TO UPDATE THE COMMUNITY ON RESOURCES. THE SOCIAL WORKER AND PUBLIC RELATIONS DIRECTOR WORKS WITH A LOCAL GROUP THROUGH THE LIBRARY, DAYCARE, PARENTS AS TEACHERS, AND OTHER ORGANIZATIONS TO REMAIN UPDATED ON COMMUNITY RESOURCES AND NEEDS, AND TO SHARE HOSPITAL RESOURCES BACK TO THE COMMUNITY. |
| SCHEDULE H, PART V, LINE 16A | http://www.sabethahospital.com/docs/Financial_Assistance_Program_and_Colle ction_Policy_8-6-18.output.pdf |
| SCHEDULE H, PART V, LINE 16B | http://www.sabethahospital.com/docs/Payment_Assistance_Document.pdf |
| SCHEDULE H, PART V, LINE 16C | http://www.sabethahospital.com/docs/Plain_Language_Summary_Updated_8-6-18. pdf |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SABETHA FAMILY PRACTICE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1115 MAIN STREET | AddressLine1Txt |
| City | SABETHA | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 66534 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | FAMILY CLINIC | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 3C | THE ORGANIZATION USED THE FOLLOWING CRITERIA TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE: ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, AND UNDERINSURANCE STATUS. SCHEDULE H, PART I, LINE 7 THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART I, LINE 7, OF SCHEDULE H, IS A COST TO CHARGE RATIO. SCHEDULE H, PART I, LINE 7, COLUMN F THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $203,253. |
| SCHEDULE H, PART III, LINE 2 | HOSPITAL CHARGES THAT ARE NOT COLLECTED AND ARE NOT APPROVED FOR FINANCIAL ASSISTANCE ARE CLASSIFIED AS BAD DEBTS FROM PATIENTS WHO WILL NOT PAY. |
| SCHEDULE H, PART III, LINE 3 | THE COSTING METHODOLOGY IS BASED ON THE ORGANIZATION'S MEDICARE COST-TO-CHARGE RATIO. WHILE WE RECOGNIZE THAT THERE WOULD BE SOME BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY, WE HAVE NO REASONABLE BASIS FOR ESTIMATING THIS FIGURE. IF ELIGIBILITY IS KNOWN, THE AMOUNT WOULD FALL UNDER CHARITY CARE AND NOT BAD DEBT. |
| SCHEDULE H, PART III, LINE 4 | SEE PAGE 7 OF THE AUDITED FINANCIALS UNDER NOTE 1. |
| SCHEDULE H, PART III, LINE 8 | THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNT ON LINE 6 IS A COST TO CHARGE RATIO. |
| SCHEDULE H, PART III, LINE 9B | ALL CHARITY CARE CHARGES AND CHARGES NOT TO BE COLLECTED DUE TO FINANCIAL ASSISTANCE COMPUTATIONS ARE EXEMPTED FROM COLLECTION POLICIES AND PRACTICES. THOSE ACCOUNTS ARE REMOVED FROM THE COLLECTION CYCLE. |
| SCHEDULE H, PART VI, LINE 2 | Sabetha Community Hospital and Nemaha Valley Community Hospital continue to work on the Community Health Needs Assessment which identified three focused areas. In late 2017, SCH also began collecting data to update the current strategic plan using information from the current CHNA. Priority #1 was to promote health, wellness, and chronic disease prevention especially in the areas of hypertension, diabetes, smoking cessation and increased seatbelt usage. The hospital is working toward accomplishing this goal by partnering with the City of Sabetha on a health and wellness center. The plan is to provide education on diet and exercise to address obesity, diabetes, and hypertension. To further address weight loss and the effect of obesity on hypertension and diabetes, a weight loss program, RE-Power, through KU Med is in its second year and has been very successful in educating and helping patients with weight reduction. Sabetha Community Hospital is a Certified Diabetic Education Facility which was re-accredited in 2017. SCH also employs a Certified Diabetic educator who works with the current diabetes patients. The diabetic educator not only conducts education classes but has a SMART program which holds the diabetic accountable for their own care. In 2017, the hospital also implemented the low dose CT for lung cancer screening and partnered with the local Community Health agency to direct patients to a smoking cessation class. The hospital also employs a certified seatbelt technician who does car seat safety checks for newborn babes leaving the hospital but car seat safety checks in the community as well. The hospital continues to publish monthly information regarding the outpatient specialty clinics held at the hospital along with an article on a specified health topic. This information is published within local community papers, and also posted on the hospital website. SCH continues to offer pre-natal classes quarterly throughout the year. Breastfeeding education for mothers became an apparent need in the community and SCH was able to offer this support through a certified lactation consultant. SCH collaborated with Nemaha County Health Department to provide this service. SCH also continues to partner with Nemaha Valley Community Hospital to provide newborn supplies to mom and babe upon birth. This program helps those moms and babes who are in need of extra help at the start of the newborns life. The Level IV Trauma committee gave scholarships so that 6 community children could take swimming lessons offered at the public pool. Priority #2 identified improving access to mental health services. The hospital partners with the community mental health center helping to provide access to mental health services through a clinic setting and telehealth. Discussions have been initiated with a tertiary care center for tele psychiatry. Further options to expand mental health are being researched but resources and the availability of mental health professionals are limited. The hospital social worker throughout the year continues to provide enrollment assistance for patients who are seeking help enrolling with Medicaid, Medicare and third party payers. The social worker and public relations director works with a local group through the library, daycare, parents as teachers, and other organizations to remain updated on community resources and needs, and to share hospital resources back to the community. In addition, a resource directory is attached to the community health needs assessment on the SCH website. |
| SCHEDULE H, PART VI, LINE 3 | The following measures are used to publicize the program to the community and patients: 1. Posting the Financial Assistance Program, Financial Assistance Application and a summary of the Policy on the Sabetha Community Hospital website at the following location: www.sabethahospital.com 2. Providing paper copies of the Program, application and summary of the Program upon request in admissions and patient financial services at Sabetha Community Hospital. 3. Posting notices about the Program in the emergency department, admitting areas, Clinic lobby and business office of Sabetha Community Hospital. 4. Distributing a plain language summary of the Program and offering a Financial Assistance application to patients before discharge from the hospital. 5. Informing patients about the Program in person or during billing and customer service phone contacts. 6. Providing notification of the Program in the patients' monthly billing statement which provides information and resources on how to apply for financial assistance. The Financial Assistance Program takes into consideration a patients household income and qualifying assets. The Financial Counselor consults with private pay patients to see if they qualify for the Hospitals financial assistance policy. If discovered during the accounts receivable collection process that a patient is having trouble paying bills, both the hospital and the clinic will inform the patient that financial assistance is available. As part of the financial assistance program all applicants must apply for Medicaid. To determine if the patient may qualify for financial assistance, the financial counselor gives patient forms to complete and asks to see bank statements, tax returns, etc. Computations based on current Federal Poverty Level Guidelines are completed to see if qualifications is appropriate and the percentage of charges to be written off is determined, based on family size and household income. All instances of financial assistance are approved by upper management of the Hospital. Information about Financial Assistance is posted on the hospital website and the Financial Assistance form can be downloaded from www.sabethahospital.com. |
| SCHEDULE H, PART VI, LINE 4 | Sabetha Community Hospital is a 25 bed Critical Access Hospital located in the city of Sabetha, Nemaha County Kansas. Currently, the population of the City of Sabetha is estimated at 2584. The primary service area for Sabetha Community Hospital includes portions of Nemaha, Brown and Jackson County, Kansas and several counties in Nebraska. For Nemaha County in 2017 there were 599 of inpatient discharges. Estimated population for Nemaha County is 10,241 according to the United States Census Bureau. People age 65 and over make up 27% of the countys total population. The racial and ethnic composition of Nemaha County is mostly white which is at 96.9%, Native American .6%, African Americans .8%, Asians .3% and Hispanics were 1.7% of the population. |
| SCHEDULE H, PART VI, LINE 5 | The hospital CEO continues to participate in an economic development committee providing a healthcare aspect to the group wanting to grow the community. In 2017, the hospital transitioned to Cerner Community Works and the community was educated on how patients electronic health records would be one record flowing from the physician office into the hospital setting. Also, patients would only have one patient portal to access with the Cerner record. The hospital provides wellness checks which include blood pressure checks, BMI, and blood work, if requested, for local area businesses along with educational sessions as requested. Another service to the local businesses is the provision of occupational assessment testing along with hearing screens. The OAS testing and hearing screens are done by certified hospital staff. During flu season, the hospital offers public flu immunization clinics at the local grocery store as well as providing immunization clinics at the local industries. The Wellness Coordinator of the hospital sits on the Wellness Council for the local school district. The hospital also promotes wellness among employees by providing a corporate membership to the community fitness room. Hospital staff is also encouraged to donate blood during the quarterly blood drives. Hospital staff provides CPR training for professionals in the area. The hospital provides prenatal classes including CPR training, breastfeeding and care of a newborn infant on a quarterly basis for expectant parents. Cardiac Rehab Phase III is open to the community to offer support in an exercise program, especially for those patients who have graduated from the Cardiac Rehab Phase II program. Social Services aids those in the community who are in need of enrollment assistance, whether it be for Medicaid, Medicare, Medicare Part D services, or other information referral assistance. Social Service and swingbed director coordinate transfer of patients to the local dialysis center. One of the hospital physicians sits as the Medical Director for the city owned ambulance service and the hospital provides RNs as needed for emergency indicated transfers to the local tertiary center. The five family practice physicians serve as medical directors for the Home Health and Hospice Agency. The Chief Executive Officer of Sabetha Community Hospital serves on the Health Innovations Network of Kansas Board, the Kansas Hospital Association KanCare Technical Advisory Group, and the Governors KanCare Advisory Group. Various staff serves on the local civic groups. Sabetha Community Hospital takes its commitment to the community very seriously and participates in emergency drills, always monitoring patient and employee safety, educating staff on risk management, quality assurance, infection control issues, blood born pathogens, HIPAA and Corporate Compliance. The hospital provides an avenue for nursing students to do rotations through the hospital with its affiliation with Highland Community College and Southeast Community College, Beatrice, Nebraska. Medical students in the rural residency program at Kansas University School of Medicine are able to do clinical rotations with the family physicians. Physical therapy students through affiliation with Kansas City Kansas Community College and Indian Hills Community College, occupational therapy students through Washburn University affiliation, and social service students from Kansas State University all do clinical rotations at the hospital as well. Hospital Administration works closely with the High School counselor in the administration of local scholarships to nursing students and to those who are going into a healthcare career. Hospital staff participate in Senior Career Day at the local high school and every year middle school and high school students job shadow at the hospital to encourage careers in healthcare. |
| SCHEDULE H, PART VI, LINE 6 | Organization is affiliated with Great Plains Health Alliance, Inc. (GPHA), a non-profit 501(c)(3) organization which provides management services and operational, finance and accounting support to the Hospital. GPHA does not provide services directly to patients, but does provide access to professionals that may not be affordable to the normal critical access hospital. GPHA provides education and assistance in areas such as HIPAA, Medicare reimbursement, meaningful use requirements for computer systems, etc. GPHA is an affiliation of Critical Access hospitals in Kansas and Nebraska that provides networking opportunities with other rural hospital, communities and leaders. GPHA provides policies and guidance to its Critical Access facilities regarding financial assistance, conflicts of interest, corporate compliance, HIPAA Privacy and Security and many other areas. GPHA also provides educational sessions for Board Members, Business Office Mangers, Billers, Medical Records personnel, Director of Nursing and Administrators. GPHA is a vital link in allowing CAH hospitals to operate at a high quality within the cash constraints imposed by the Critical Access program. |
| SCHEDULE H, PART VI, LINE 7 | N/A |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | false | 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 (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVE DELLASEGA | ||||||||||||||
| PRESIDENT/CEO/DIRECTOR | $0 | $208,212 | $0 | $0 | $0 | $3,000 | $0 | $20,484 | $0 | $10,191 | $0 | $241,887 | $0 | $0 |
| KEVIN KENNALLY | ||||||||||||||
| PHYSICIAN | $297,321 | $0 | $0 | $0 | $3,520 | $0 | $26,200 | $0 | $21,052 | $0 | $348,093 | $0 | $0 | $0 |
| GREGG WENGER | ||||||||||||||
| PHYSICIAN | $187,619 | $0 | $0 | $0 | $2,448 | $0 | $19,391 | $0 | $18,673 | $0 | $228,131 | $0 | $0 | $0 |
| JAMES LONGABAUGH | ||||||||||||||
| PHYSICIAN | $217,940 | $0 | $0 | $0 | $2,726 | $0 | $21,734 | $0 | $11,861 | $0 | $254,261 | $0 | $0 | $0 |
| CHRISTIAN TRAMP | ||||||||||||||
| PHYSICIAN | $214,810 | $0 | $0 | $0 | $2,609 | $0 | $22,133 | $0 | $26,014 | $0 | $265,566 | $0 | $0 | $0 |
| KERSTIN GLYNN | ||||||||||||||
| PHYSICIAN | $257,704 | $0 | $0 | $0 | $3,041 | $0 | $20,294 | $0 | $25,114 | $0 | $306,153 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, PART VII; SCHEDULE J, PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | COMPENSATION FOR MIKE HAND AND DAVE DELLASEGA IS PROVIDED BY GREAT PLAINS HEALTH ALLIANCE, A RELATED ORGANIZATION. GREAT PLAINS HEALTH ALLIANCE'S BOARD OF DIRECTORS ANNUALLY APPROVE THE COMPENSATION FOR MR. HAND AND MR. DELLASEGA. THE AMERICAN COLLEGE HEALTHCARE EXECUTIVES AND THE KANSAS HOSPITAL ASSOCIATION ALSO HAVE COMPARABLE COMPENSATION DATA THAT CAN BE USED BY THE BOARD. A COMPENSATION REVIEW WAS DONE WHEN DAVE DELLASEGA TOOK OVER AS CEO AND WAS CONDUCTED BY THE BOARD, BUT SINCE THAT TIME THERE HAS BEEN NO FORMAL COMPENSATION REVIEW. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4A | One of the largest programs Sabetha Community Hospital provides to patients is the Cardiac Rehab Phase III program in which members of the community are able to come to the hospital and for reduced session fees utilizing cardio pulmonary exercise equipment. Not only does this program address the importance of continual exercise and the health benefits associated, but also brings with it a social aspect to those who participate providing social interaction much needed within the elderly population. Addressing the needs of mental health among the elderly population as well as youth continues to be a priority but problematic. This is not new because it is a problem nationwide. The hospital partners with the Community Mental Health Center to provide access to mental health services within the community whether it be in a clinic setting or through telehealth services. Again, this is another key in promoting overall health in our community. Another large program which the hospital provides is a breastfeeding clinic. In 2017 the hospital partnered with Community Health to provide breastfeeding support for moms and babes. Some may be first time mothers or have multiple children already, but a certified lactation consultant provides support to mothers who are having problems breastfeeding their infant. The goal driving this program is to enhance the bonding between mother and infant and to give that infant the best start in life as possible. The High Five program is used as guideline to help provide standard of care. The hospital has also partnered with a neighboring facility to provide Babies Best Start which is a program that helps those mothers who are not able to afford diapers, clothing, or the needed necessities to care for baby. Another important factor in babes care is also a properly fitted car seat. The hospital provides a certified car seat specialist to make sure the baby is safe when leaving the hospital. The importance of diabetic education and support for our patients continue to be a primary focus for SCH. The hospital is a Certified Diabetic Education facility, and during 2017 that program was reaccredited. The hospital conducts a SMART Program by the certified diabetic educator which brings accountability to the diabetic patient. KU Med and SCH partnered together to conduct weight loss program, RE-Power, to a targeted group of patients. This program has proven to be very successful and will continue for another year. Continuation of promoting health, wellness and chronic disease prevention remains a priority. Discussions began with the City of Sabetha for the hospital to manage the new health and wellness center being built hoping to bring a health and wellness aspect to exercising. In 2017, the hospital implemented the low dose CT lung scan for those screening for lung cancer, and partnered with Community Health for resources to smoking cessation classes. In 2017, SCH transitioned to the Cerner electronic medical record which also encompasses the physician clinic making a strong continuity of care for the patient from the doctors office to the hospital setting whether it be inpatient or outpatient care. Transitioning to Cerner also created one patient portal for the hospital and physician clinic making it much easier for the patient to access their own personal health information. Building a strong electronic medical record to better serve our patient population focuses on the goal of enhancing provision of care to the young as well as the old within our community and surrounding areas that we serve. Sabetha Community Hospital continues to participate in the Kansas Health Care Collaborative HIIN as well as reporting for MBQIP. The HCAHPS scores are monitored and used to keep staff informed of patient satisfaction. The Hospital was awarded through the National Offices of Rural Health a Performance Leadership Award. And, SCHs mission remains to provide quality of health and care given in our communities. FORM 990, PART VI, SECTION A, LINE 2 DAVE DELLASEGA AND MIKE HAND HAVE A BUSINESS RELATIONSHIP. THEY ARE BOTH EMPLOYED BY, AND OFFICERS OF, A RELATED 501(C)(3) ORGANIZATION, GREAT PLAINS HEALTH ALLIANCE. |
| FORM 990, PART VI, SECTION A, LINE 6 | GREAT PLAINS HEALTH ALLIANCE, INC., A NOT-FOR-PROFIT, 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF GREAT PLAINS OF SABETHA, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | GREAT PLAINS HEALTH ALLIANCE, INC., BEING THE SOLE MEMBER, HAS THE RIGHT TO ELECT AND APPROVE ALL THE BOARD MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 7B | GREAT PLAINS HEALTH ALLIANCE, INC. (GPHA) IS THE SOLE MEMBER AND HAS THE AUTHORITY TO APPROVE THE ARTICLES OF INCORPORATION, BYLAWS, ELECTION TO OR REMOVAL FROM THE BOARD OF DIRECTORS, THE ANNUAL OPERATING AND CAPITAL BUDGETS, AND THE LONG RANGE OR STRATEGIC PLANS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE 990 IS THEN PROVIDED TO THE CHIEF EXECUTIVE OFFICER FOR REVIEW AND APPROVAL. AN ELECTRONIC DRAFT OF THE 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO THE FULL BOARD FOR REVIEW PRIOR TO FILING THE 990 WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION IS REQUIRED TO ADOPT GPHA'S CONFLICT OF INTEREST POLICY. ALL BOARD MEMBERS, OFFICERS AND EMPLOYEES ARE SUBJECT TO THE CONFLICT OF INTEREST POLICY AND SIGN AN ANNUAL ACKNOWLEDGEMENT THAT THEY HAVE READ, UNDERSTAND AND COMPLIED WITH THE GPHA CONFLICT OF INTEREST POLICY. UNDER THE POLICY, ANY MEMBER WHO HAS A DIRECT OR INDIRECT (VIA FAMILY) FINANCIAL INTEREST IS CHARACTERIZED AS AN INTERESTED PERSON. INTERESTED PERSONS ARE REQUIRED TO DISCLOSE FINANCIAL INTERESTS WITH COMPANIES DOING BUSINESS WITH GPHA. THE INTERESTED PERSON MUST RECUSE THEMSELVES FROM FURTHER DISCUSSIONS OF THE TRANSACTION AND LEAVE THE ROOM. THE REMAINING NON-INTERESTED MEMBERS DECIDE IF A CONFLICT OF INTEREST EXISTS. THE BOARD CHAIR MAY APPOINT ANOTHER DISINTERESTED PARTY TO DISCUSS THE TRANSACTION OR THE REMAINING BOARD MEMBERS MAY VOTE TO ENTER INTO OR ABSTAIN FROM THE SUSPECT TRANSACTION. FAILURE TO DISCLOSE FINANCIAL INTERESTS BY INTERESTED BOARD MEMBERS WILL RESULT IN DISCIPLINARY ACTION, INCLUDING SANCTIONING BY BOARD. ALL CONFLICTS OF INTEREST AND THEIR ULTIMATE RESOLUTION ARE DOCUMENTED IN THE BOARD MINUTES. THE BOARD CONDUCTS PERIODIC REVIEWS TO DETERMINE THAT CONFLICTS ARE BEING IDENTIFIED AND RESOLVED ACCORDING TO POLICY DOCUMENTATION. REVIEWS BY OUTSIDE EXPERTS ARE PERMITTED, BUT NOT REQUIRED. |
| FORM 990, PART VI, SECTION B, LINES 15A & B | THE CEO AND CFO ARE COMPENSATED BY GREAT PLAINS HEALTH ALLIANCE, A RELATED ORGANIZATION. GPHA'S BOARD USES COMPARABILITY DATA IN SETTING THEIR SALARIES, AND DOCUMENTATION IS RETAINED OF THE BOARD'S DELIBERATIONS AND DECISIONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE COMPANY'S KANSAS ANNUAL REPORT IS ALSO AVAILABLE UPON REQUEST FROM THE KANSAS SECRETARY OF STATE. |
| FORM 990, PART XI, LINE 9 | EQUITY IN EARNINGS SABETHA HEALTHCARE, INC. 28,905 TRANSFER TO CITY OF SABETHA (156,600) ---------- TOTAL $ (127,695) |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACTED MEDICAL STAFF TOTAL FEES:997609 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:BILLING/COLLECTIONS TOTAL FEES:119820 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:LAB SERVICES TOTAL FEES:160977 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PHARMACY SERVICES TOTAL FEES:115956 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:ADMINISTRATION/HUMAN RESOURCES TOTAL FEES:148267 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:MAINTENANCE/HOUSEKEEPING TOTAL FEES:8431 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| GREAT PLAINS HEALTH ALLIANCE INC | ||||||||||
| 250 N ROCK RD STE 160 | WICHITA | KS | 67206 | 480617739 | MANAGEMENT | KS | 501(C)(3) | 3 | NA | false |
| GREAT PLAINS HEALTH CARE FOUNDATION INC | ||||||||||
| 250 NORTH ROCK RD STE 160 | WICHITA | KS | 67206 | 480955870 | SUPPORT | KS | 501(C)(3) | 10 | GPHA INC | Yes (true) |
| GREAT PLAINS OF CHEYENNE COUNTY INC | ||||||||||
| 250 NORTH ROCK RD STE 160 | WICHITA | KS | 67206 | 481226831 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC | Yes (true) |
| GREAT PLAINS OF ELLINWOOD INC | ||||||||||
| 250 NORTH ROCK RD STE 160 | WICHITA | KS | 67206 | 481226976 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC | Yes (true) |
| GREAT PLAINS OF OTTAWA COUNTY INC | ||||||||||
| 250 NORTH ROCK RD STE 160 | WICHITA | KS | 67206 | 481226856 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC | Yes (true) |
| GREAT PLAINS OF REPUBLIC COUNTY INC | ||||||||||
| 250 NORTH ROCK RD STE 160 | WICHITA | KS | 67206 | 481226977 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC | Yes (true) |
| GREAT PLAINS OF SMITH COUNTY INC | ||||||||||
| 250 NORTH ROCK RD STE 160 | WICHITA | KS | 67206 | 481226830 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC | Yes (true) |
| GREAT PLAINS OF KIOWA COUNTY INC | ||||||||||
| 250 NORTH ROCK ROAD STE 160 | WICHITA | KS | 67206 | 481226833 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC | Yes (true) |
| GPHA EMPLOYEE BENEFITS TRUST | ||||||||||
| 250 N ROCK ROAD STE 160 | WICHITA | KS | 67206 | 476918582 | HEALTH PLAN | KS | 501(C)(9) | GPHA INC | Yes (true) | |
| 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 | false | 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 | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GPHA EMPLOYEE BENEFITS TRUST | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | R | TransactionTypeTxt |
| Involved | $632,363 | InvolvedAmt |
| Method Of Amount Determination | ACTUAL | MethodOfAmountDeterminationTxt |