GREAT PLAINS OF SABETHA INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: GREAT PLAINS OF SABETHA INC (EIN 48-1236156)
Tax period: 2016-01-01 to 2016-12-31
Filed: 2017-09-20
IRS object ID: 201712639349300811
Schema version: 2016v3.1
Source: Download XML · Original 990 at ProPublica

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

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule G
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-09-20T09:04:10-05:00	ReturnTs
Tax Period End	2016-12-31	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	2016-01-01	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	2014-05-15	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
Preparation	2017-08-15	PreparationDt

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2022-09-23 18:48:47Z	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	$11,480,150	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	9	VotingMembersGoverningBodyCnt
Voting Members Independent	8	VotingMembersIndependentCnt
Total Employee	157	TotalEmployeeCnt
Total Volunteers	16	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
PY Contributions Grants	$239,347	PYContributionsGrantsAmt
CY Contributions Grants	$444,837	CYContributionsGrantsAmt
PY Program Service Revenue	$11,733,327	PYProgramServiceRevenueAmt
CY Program Service Revenue	$10,900,423	CYProgramServiceRevenueAmt
PY Investment Income	$17,104	PYInvestmentIncomeAmt
CY Investment Income	$15,728	CYInvestmentIncomeAmt
PY Other Revenue	$231,809	PYOtherRevenueAmt
CY Other Revenue	$113,536	CYOtherRevenueAmt
PY Total Revenue	$12,221,587	PYTotalRevenueAmt
CY Total Revenue	$11,474,524	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	$7,159,088	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$7,217,280	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$5,246,648	PYOtherExpensesAmt
CY Other Expenses	$4,862,473	CYOtherExpensesAmt
PY Total Expenses	$12,405,736	PYTotalExpensesAmt
CY Total Expenses	$12,079,753	CYTotalExpensesAmt
PY Revenues Less Expenses	-$184,149	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$605,229	CYRevenuesLessExpensesAmt
Total Assets BOY	$7,481,760	TotalAssetsBOYAmt
Total Assets EOY	$6,586,438	TotalAssetsEOYAmt
Total Liabilities BOY	$1,805,547	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,641,560	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$5,676,213	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$4,944,878	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	$10,271,545	ExpenseAmt
Revenue	$10,886,871	RevenueAmt
Desc	SEE SCHEDULE O.	Desc
Total Program Service Expenses	$10,271,545	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	false	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	false	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	157	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	9	GoverningBodyVotingMembersCnt
Independent Voting Member	8	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	$201,990	$29,280
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	0.25	2.25	Yes (X)		$0	$0	$0
DR BARBARA BROWN APPLEGATE
DIRECTOR	0.25	2.25	Yes (X)		$0	$0	$0
TERRY DESCHAINE
DIRECTOR	0.25	2.25	Yes (X)		$0	$0	$0
MIKE HAND
CFO	2.0	40.0		Yes (X)	$0	$163,659	$30,575
LORA KEY
ADMINISTRATOR	40.0	0.0		Yes (X)	$112,407	$0	$28,933
KEVIN KENNALLY
PHYSICIAN	40.0	0.0			$308,786	$0	$45,582	Yes (X)
GREGG WENGER
PHYSICIAN	40.0	0.0			$208,943	$0	$38,439	Yes (X)
JAMES LONGABAUGH
PHYSICIAN	40.0	0.0			$241,609	$0	$33,804	Yes (X)
CHRISTIAN TRAMP
PHYSICIAN	40.0	0.0			$223,793	$0	$42,632	Yes (X)
KERSTIN GLYNN
PHYSICIAN	40.0	0.0			$264,835	$0	$46,768	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,360,373	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$365,649	TotReportableCompRltdOrgAmt
Total Other Compensation	$296,013	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 (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
MHS DATA CENTER
103 E 27TH SUITE A	HAYS	KS	67601	COMPUTER SUPPORT	$389,870
STORMONT VAIL HEALTHCARE
1500 SW 10TH STREET	TOPEKA	KS	66604	LAB SERVICES	$115,668
GREAT PLAINS HEALTH ALLIANCE
PO BOX 366	PHILLIPSBURG	KS	67661	MANAGEMENT	$130,259
SHARED MEDICAL SERVICES INC
209 LIMESTONE PASS	COTTAGE GROVE	WI	53527	MRI SERVICES	$110,055

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	4	CntrctRcvdGreaterThan100KCnt
Fundraising	$15,173	FundraisingAmt
Government Grants	$396,161	GovernmentGrantsAmt
All Other Contributions	$33,503	AllOtherContributionsAmt
Noncash Contributions	$1,446	NoncashContributionsAmt
Total Contributions	$444,837	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE	621300	$10,857,450	$10,857,450
340(B) PHARMACY REVENUE	621300	$42,973	$42,973

Field	Value	IRS element (for citing)
Total Program Service Revenue	$10,900,423	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$15,728	TotalRevenueColumnAmt
Exclusion	$15,728	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	$16,025	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$16,025	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$16,025	TotalRevenueColumnAmt
Exclusion	$16,025	ExclusionAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

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

Field	Value	IRS element (for citing)
Fundraising Gross Income	$3,175	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$15,173	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$5,626	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$2,451	TotalRevenueColumnAmt
Exclusion	-$2,451	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	900099	$14,994	$14,994
OUTSIDE SERVICES	621300	$29,421	$29,421
VENDOR REBATES	900099	$12,390	$12,390

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$43,157	TotalRevenueColumnAmt
Exclusion	$43,157	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$99,962	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$11,474,524	TotalRevenueColumnAmt
Related Or Exempt Func Income	$10,900,423	RelatedOrExemptFuncIncomeAmt
Exclusion	$129,264	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	$141,340	TotalAmt
Management And General	$141,340	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	$5,592,375	TotalAmt
Program Services	$4,919,458	ProgramServicesAmt
Management And General	$672,917	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$429,788	TotalAmt
Program Services	$391,832	ProgramServicesAmt
Management And General	$37,956	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$674,759	TotalAmt
Program Services	$492,427	ProgramServicesAmt
Management And General	$182,332	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$379,018	TotalAmt
Program Services	$323,678	ProgramServicesAmt
Management And General	$55,340	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$113,922	TotalAmt
Management And General	$113,922	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$4,348	TotalAmt
Management And General	$4,348	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$35,758	TotalAmt
Management And General	$35,758	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

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

Fees For Services Prof Fundraising FeesForServicesProfFundraising

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

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

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

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$1,434,375	TotalAmt
Program Services	$1,194,136	ProgramServicesAmt
Management And General	$240,239	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$27,320	TotalAmt
Program Services	$12,018	ProgramServicesAmt
Management And General	$15,302	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$204,684	TotalAmt
Program Services	$134,610	ProgramServicesAmt
Management And General	$70,074	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	$194,212	TotalAmt
Program Services	$183,502	ProgramServicesAmt
Management And General	$10,710	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$16,225	TotalAmt
Program Services	$5,530	ProgramServicesAmt
Management And General	$10,695	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	$47,365	TotalAmt
Program Services	$40,074	ProgramServicesAmt
Management And General	$7,291	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$14,391	TotalAmt
Program Services	$13,146	ProgramServicesAmt
Management And General	$1,245	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

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

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$562,937	TotalAmt
Program Services	$517,571	ProgramServicesAmt
Management And General	$45,366	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$130,298	TotalAmt
Program Services	$38,219	ProgramServicesAmt
Management And General	$92,079	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & DRUGS	$1,373,900	$1,373,900
RENTAL EQUIPMENT & REPAIRS	$372,044	$357,036	$15,008
BAD DEBT EXPENSE	$178,524	$178,524
DUES & SUBSCRIPTIONS	$49,088	$17,841	$31,247

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$101,487	TotalAmt
Program Services	$78,043	ProgramServicesAmt
Management And General	$23,444	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$12,079,753	TotalAmt
Program Services	$10,271,545	ProgramServicesAmt
Management And General	$1,808,208	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$220	BOYAmt
EOY	$23,177	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$1,148,584	BOYAmt
EOY	$1,338,225	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$72,113	BOYAmt
EOY	$100,547	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,987,837	BOYAmt
EOY	$1,490,100	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	$156,401	BOYAmt
EOY	$169,189	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$113,580	BOYAmt
EOY	$105,396	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$12,224,231	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$9,391,924	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$3,365,742	BOYAmt
EOY	$2,832,307	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	$237,283	BOYAmt
EOY	$245,777	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	$400,000	BOYAmt
EOY	$281,720	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$7,481,760	BOYAmt
EOY	$6,586,438	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$1,319,730	BOYAmt
EOY	$1,289,784	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	$72,113	BOYAmt
EOY	$63,872	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	$413,704	BOYAmt
EOY	$287,904	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	$1,805,547	BOYAmt
EOY	$1,641,560	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$5,676,213	BOYAmt
EOY	$4,940,737	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$4,141	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	$5,676,213	BOYAmt
EOY	$4,944,878	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$7,481,760	BOYAmt
EOY	$6,586,438	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$605,229	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	-$126,106	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

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

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

Contributor US Address ContributorUSAddress

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

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

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
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	$3,865	GrantsOtherOrganizationsAmt
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	false	OtherActivitiesInd
Total Lobbying Expenditures	$3,865	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	$4,454,779	DepreciationAmt
Book Value	$2,058,510	BookValueAmt

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovementsGrp

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$5,471,679	OtherCostOrOtherBasisAmt
Depreciation	$4,759,835	DepreciationAmt
Book Value	$711,844	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$204,019	OtherCostOrOtherBasisAmt
Depreciation	$177,310	DepreciationAmt
Book Value	$26,709	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$2,832,307	TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt	$11,332,120	TotalRevEtcAuditedFinclStmtAmt
Other Revenue	-$142,404	OtherRevenueAmt
Revenue Not Reported	-$142,404	RevenueNotReportedAmt
Revenue Subtotal	$11,474,524	RevenueSubtotalAmt
Total Revenue Per Form990	$11,474,524	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$12,063,455	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$162,226	OtherExpensesIncludedAmt
Expenses Not Reported	$162,226	ExpensesNotReportedAmt
Expenses Subtotal	$11,901,229	ExpensesSubtotalAmt
Other Expenses Not Included	$178,524	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$178,524	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$12,079,753	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. 30,494 SPECIAL EVENT EXPENSES 5,626 PROVISION FOR UNCOLLECTIBLE ACCOUNTS (178,524) --------- TOTAL (142,404)
SCHEDULE D, PART XII, LINE 2D	TRANSFER TO CITY OF SABETHA 156,600 SPECIAL EVENT EXPENSES 5,626 -------- TOTAL 162,226
SCHEDULE D, PART XII, LINE 4B	PROVISION FOR UNCOLLECTIBLE ACCOUNTS 178,524

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	GOLF TOURNAMENT	Event1Nm
Gross Receipts Event1	$18,348	GrossReceiptsEvent1Amt
Charitable Contri Event1	$15,173	CharitableContriEvent1Amt
Gross Revenue Event1	$3,175	GrossRevenueEvent1Amt
Cash Prizes Event1	$2,500	CashPrizesEvent1Amt
Non Cash Prizes Event1	$535	NonCashPrizesEvent1Amt
Rent Facility Costs Event1	$0	RentFacilityCostsEvent1Amt
Food And Beverage Event1	$951	FoodAndBeverageEvent1Amt
Entertainment Event1	$0	EntertainmentEvent1Amt
Other Direct Expenses Event1	$1,640	OtherDirectExpensesEvent1Amt
Other Events Total	0	OtherEventsTotalCnt
Gross Receipts Total	$18,348	GrossReceiptsTotalAmt
Charitable Contributions Tot	$15,173	CharitableContributionsTotAmt
Gross Revenue Total Events	$3,175	GrossRevenueTotalEventsAmt
Cash Prizes Total Events	$2,500	CashPrizesTotalEventsAmt
Non Cash Prizes Total Events	$535	NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$0	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$951	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$0	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$1,640	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$5,626	DirectExpenseSummaryEventsAmt
Net Income Summary	-$2,451	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	false	FPGReferenceFreeCareInd
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
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	$47,406	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$47,406	NetCommunityBenefitExpnsAmt
Total Expense	0.00400	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$360,329	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$210,061	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$150,268	NetCommunityBenefitExpnsAmt
Total Expense	0.01260	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$407,735	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$210,061	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$197,674	NetCommunityBenefitExpnsAmt
Total Expense	0.01660	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$65,732	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$17,376	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$48,356	NetCommunityBenefitExpnsAmt
Total Expense	0.00410	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,506	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,506	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$69,238	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$17,376	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$51,862	NetCommunityBenefitExpnsAmt
Total Expense	0.00440	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$476,973	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$227,437	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$249,536	NetCommunityBenefitExpnsAmt
Total Expense	0.02100	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$178,524	BadDebtExpenseAmt
Reimbursed By Medicare	$4,775,191	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$4,775,191	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	0.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
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
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (9 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://nemvch.com/uploads/documents/Community%20Needs%20Assessment%202015. 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 NUMBER THREE; 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 2016, 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 2016, 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 2016, 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 2016, 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 13H	THE ORGANIZATION EMPLOYS A SLIDING SCALE DISCOUNT THAT TAKES INTO CONSIDERATION A PATIENT'S HOUSEHOLD INCOME AND QUALIFYING ASSETS. TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, A PATIENT'S HOUSEHOLD INCOME MUST BE BELOW 300% OF THE MOST RECENT FEDERAL POVERTY LEVEL AT THE DATE OF SERVICE. TO DETERMINE THE AMOUNT OF THE DISCOUNT, AN ASSET TEST IS ALSO UTILIZED.
SCHEDULE H, PART V, LINE 16A	http://www.sabethahospital.com/getpage.php?name=finassist&sub=Sabetha%20Ho spital
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/getpage.php?name=finassist&sub=Sabetha%20Ho spital

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 (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART I, LINE 3C	THE ORGANIZATION EMPLOYS A SLIDING SCALE DISCOUNT THAT TAKES INTO CONSIDERATION A PATIENT'S HOUSEHOLD INCOME AND QUALIFYING ASSETS. TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, A PATIENT'S HOUSEHOLD INCOME MUST BE BELOW 300% OF THE MOST RECENT FEDERAL POVERTY LEVEL AT THE DATE OF SERVICE. TO DETERMINE THE AMOUNT OF THE DISCOUNT, AN ASSET TEST IS ALSO UTILIZED.
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 $178,524.
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	SCH IS COMMITTED TO PROVIDING ACCESS TO CARE FOR OUR PATIENTS BY PROVIDING MONTHLY OUTPATIENT SPECIALTY CLINICS SO THAT LOCAL PATIENTS DO NOT NEED TO TRAVEL 70 PLUS MILES TO SEE A SPECIALIST BUT CAN STAY WITHIN THEIR LOCAL COMMUNITY HEALTHCARE SYSTEM. INFORMATION REGARDING THE OUTPATIENT SPECIALTY CLINICS ALONG WITH MONTHLY EDUCATIONAL INFORMATION IS PUBLISHED WITHIN LOCAL COMMUNITY PAPERS, AND IT IS ALSO POSTED ON THE HOSPITAL WEBSITE. THE FIRST YEAR OF A COLLABORATIVE AGREEMENT WITH KU MED FOR THE RE-POWER PROGRAM PROVED TO BE VERY PRODUCTIVE. PATIENTS WERE IDENTIFIED AND ADMITTED TO THE PROGRAM WITH AN OVERALL HEALTH ASSESSMENT BEING CONDUCTED TO SERVE AS A BASELINE FOR THE WEIGHT LOSS PROGRAM. 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 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. IN 2016, THE HOSPITAL CONDUCTED A BABYSITTING CLASS WITH 19 PARTICIPANTS. EDUCATION WAS PROVIDED FOR THEM ON NUTRITION, APPROPRIATE ACTIVITIES FOR INFANTS AND TODDLERS, AND EMERGENCY FIRST AID. THE LEVEL IV TRAUMA COMMITTEE GAVE SCHOLARSHIPS SO THAT 4 COMMUNITY CHILDREN COULD TAKE SWIMMING LESSONS OFFERED AT THE PUBLIC POOL. BEREAVEMENT SUPPORT GROUPS ARE CONDUCTED YEARLY, AND EDUCATION MATERIALS ARE PROVIDED FOR THOSE IN THE COMMUNITY WHO HAVE LOST LOVED ONES. THE HOSPITAL HAS A TRAINED CAR SEAT SPECIALIST WHO CONDUCTS CAR SEAT SAFETY CHECKS BEFORE INFANTS LEAVE THE HOSPITAL. THE HOSPITAL CONTINUES TO PARTICIPATE IN THE HCAPS SURVEY AND RESULTS ARE REVIEWED WITH STAFF ANNUALLY. THE HOSPITAL PARTICIPATED IN THE KANSAS HEALTH ENGAGEMENT NETWORK 2.0 UNTIL THE COMPLETION OF THAT PROJECT AND NOW PARTICIPATES IN KHIIN QUALITY PROJECT. THE HOSPITAL PARTNERS WITH THE COMMUNITY MENTAL HEALTH CENTER HELPING TO PROVIDE ACCESS TO MENTAL HEALTH SERVICES. FURTHER OPTIONS TO EXPAND MENTAL HEALTH ARE BEING RESEARCHED BUT RESOURCES AND THE AVAILABILITY OF MENTAL HEALTH PROFESSIONALS ARE LIMITED. HOSPITAL STAFF MEMBERS PROVIDE HELP TO COMMUNITY MEMBERS DURING THE MEDICARE PART D OPEN ENROLLMENT PERIOD. AND, 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 A SUMMARY OF THE PROGRAM IN THE PATIENTS' MONTHLY BILLING STATEMENT. THE FINANCIAL ASSISTANCE PROGRAM EMPLOYS A SLIDING SCALE DISCOUNT THAT 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 IS ESTIMATED AT 2800. THE PRIMARY SERVICE AREA FOR SABETHA COMMUNITY HOSPITAL INCLUDES PORTIONS OF NEMAHA, BROWN AND JACKSON COUNTY, KANSAS AND SEVERAL COUNTIES IN NEBRASKA. NEMAHA COUNTY PROVIDED 83% OF INPATIENT DISCHARGES FOR 2016. ESTIMATED POPULATION FOR NEMAHA COUNTY IS 10,277 ACCORDING TO THE UNITED STATES CENSUS BUREAU. PEOPLE AGE 65 AND OVER MAKE UP 20.1% OF THE COUNTYS TOTAL POPULATION. THE RACIAL AND ETHNIC COMPOSITION OF NEMAHA COUNTY IS MOSTLY WHITE WHICH IS AT 96.9%, NATIVE AMERICAN .7%, AFRICAN AMERICANS .7%, ASIANS .2% AND HISPANICS WERE 1.7% OF THE POPULATION.
SCHEDULE H, PART VI, LINE 5	THE HOSPITAL CEO PARTICIPATED IN AN ECONOMIC DEVELOPMENT COMMITTEE PROVIDING A HEALTHCARE ASPECT TO THE GROUP WANTING TO GROW THE COMMUNITY. THE HOSPITAL PARTNERED WITH OTHER COMMUNITY PROVIDERS IN SPONSORING FIRE PREVENTION BOOKLETS TO THE ELEMENTARY STUDENTS TO PROMOTE FIRE SAFETY. IN 2016, THE HOSPITAL BEGAN TRAINING PHYSICIANS AND STAFF MEMBERS ON CERNER COMMUNITY WORKS AND EDUCATING THE COMMUNITY ON HOW THE TRANSITION WOULD AFFECT PATIENTS ELECTRONIC MEDICAL RECORDS AND THE PATIENT PORTAL. THE CERTIFIED DIABETIC NURSE EDUCATOR ALONG WITH THE REGISTERED DIETICIAN PROVIDE A SUPPORT GROUP TO DIABETIC PATIENTS PROMOTING LIFE STYLE CHANGES AND ACCOUNTABILITY IN THEIR DIABETIC JOURNEY. THE HOSPITAL PROVIDES WELLNESS CHECKS FOR LOCAL, AREA BUSINESSES ALONG WITH EDUCATION SESSIONS. 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. THE HOSPITAL VOLUNTEER CORE CONTINUES TO REMAIN STRONG WITH COMMUNITY MEMBERS BEING UTILIZED IN MANY AREAS OF THE HOSPITAL. ANOTHER SERVICE TO THE COMMUNITY IS THE PROVISION OF OCCUPATIONAL ASSESSMENT TESTING ALONG WITH HEARING SCREENS. CERTIFIED STAFF IS AVAILABLE IN HOUSE TO PROVIDE THOSE SERVICES. STAFF WILL ALSO CONDUCT BLOOD PRESSURE CHECKS AND BLOOD WORK WHEN REQUESTED AT THE LOCAL BUSINESSES AS WELL AS WELLNESS EDUCATION LUNCH AND LEARN. FIRST GRADE STUDENTS ARE INVITED TO ATTEND AN ANNUAL HOSPITAL TOUR GUIDING THEM THROUGH VARIOUS DEPARTMENTS OF THE HOSPITAL. DURING THE FLU SEASON, FLU CLINICS ARE OFFERED TO THE COMMUNITY AT THE HOSPITAL, AND HOSPITAL STAFF ALSO CONDUCTS FLU CLINICS AT THE LOCAL GROCERY STORE AS WELL AS ONSITE FLU VACCINATIONS FOR SEVERAL LOCAL BUSINESSES. 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 KANSAS HOSPITAL ASSOCIATIONS POLICY AND ADVOCACY COMMITTEE, THE HEALTH INNOVATIONS NETWORK OF KANSAS BOARD, THE KANSAS HEALTH CARE COLLABORATIVE BOARD, THE KANSAS HOSPITAL ASSOCIATION KANCARE TECHNICAL ADVISORY GROUP, AND THE GOVERNORS KANCARE ADVISORY GROUP. 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 501C3 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 MANAGERS, 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 (7 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	$199,666	$0	$0	$0	$2,324	$0	$19,610	$0	$9,670	$0	$231,270	$0	$0
MIKE HAND
CFO	$0	$161,885	$0	$0	$0	$1,774	$0	$15,599	$0	$14,976	$0	$194,234	$0	$0
KEVIN KENNALLY
PHYSICIAN	$305,398	$0	$0	$0	$3,388	$0	$25,700	$0	$19,882	$0	$354,368	$0	$0	$0
GREGG WENGER
PHYSICIAN	$206,729	$0	$0	$0	$2,214	$0	$21,203	$0	$17,236	$0	$247,382	$0	$0	$0
JAMES LONGABAUGH
PHYSICIAN	$239,160	$0	$0	$0	$2,449	$0	$23,735	$0	$10,069	$0	$275,413	$0	$0	$0
CHRISTIAN TRAMP
PHYSICIAN	$221,236	$0	$0	$0	$2,557	$0	$22,618	$0	$20,014	$0	$266,425	$0	$0	$0
KERSTIN GLYNN
PHYSICIAN	$262,009	$0	$0	$0	$2,826	$0	$25,700	$0	$21,068	$0	$311,603	$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 (18 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III, LINE 4	SABETHA COMMUNITY HOSPITAL CONTINUES ITS MISSION TO DELIVER CARE TO OUR PATIENTS AT THE RIGHT TIME, RIGHT PLACE, AND WITHIN THE STANDARD OF CARE. AS EVIDENCED BY THE ACA, ESSENTIAL HEALTH BENEFITS ARE A PRIORITY IN THE HEALTHCARE INDUSTRY. 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 AND FOR REDUCED SESSION FEES ARE ABLE TO UTILIZE 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. ALONG THE LINES OF THE SOCIAL ASPECT, ADDRESSING THE NEEDS OF MENTAL HEALTH AMONG THE ELDERLY POPULATION AS WELL AS YOUTH CONTINUES TO BE A PRIORITY. THE HOSPITAL PARTNERS WITH THE COMMUNITY MENTAL HEALTH CENTER TO PROVIDE ACCESS TO MENTAL HEALTH SERVICES WHICH IS ANOTHER KEY IN PROMOTING OVERALL HEALTH. THE PROVISION OF MENTAL HEALTH SERVICES IS A CHALLENGE BUT CONTINUES TO REMAIN A PRIORITY. ANOTHER LARGE PROGRAM WHICH THE HOSPITAL PROVIDES IS A BREASTFEEDING CLINIC. THIS CLINIC PROVIDES SUPPORT TO 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. ALONG WITH THE BREASTFEEDING PROGRAM, THE HOSPITAL ALSO PARTICIPATES IN 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 A BABY. ANOTHER IMPORTANT FACTOR IN BABES CARE IS ALSO A PROPERLY FITTED CAR SEAT, THE HOSPITAL PROVIDES A CA SEAT SPECIALIST TO MAKE SURE THE BABY IS SAFE WHEN LEAVING THE HOSPITAL. PROGRAMS IDENTIFIED THROUGH COMMUNITY HEALTH NEEDS ASSESSMENT ARE CONTINUALLY BEING ENHANCED AND ADDED TO AS WELL. THE IMPORTANCE OF DIABETIC EDUCATION AND SUPPORT FOR OUR PATIENTS CONTINUE TO BE A PRIMARY FOCUS FOR SCH. THE HOSPITAL CONDUCTS A SMART PROGRAM BRINGING ACCOUNTABILITY TO THE DIABETIC PATIENT. KU MED AND SCH PARTNERED TOGETHER TO CONDUCT A PILOT PROJECT TO PROMOTE WEIGHT LOSS IN A TARGETED GROUP OF PATIENTS. THIS PROGRAM CONTINUES FOR THREE YEARS BUT THIS FIRST YEAR HAS PROVEN TO BE SUCCESSFUL. CONTINUATION TO PROMOTE HEALTH, WELLNESS AND CHRONIC DISEASE PREVENTION REMAINS A PRIORITY. THROUGH 2016, SCH FOCUSED ON BUILDING A STRONG ELECTRONIC MEDICAL RECORD TO BETTER SERVE OUR PATIENT POPULATION ENHANCING PROVISION OF CARE TO THE YOUNG AS WELL AS THE OLD WITHIN OUR COMMUNITY AND SURROUNDING AREAS THAT WE SERVE. THE CURRENT EHR SYSTEM WAS BOUGHT OUT BY CERNER AND SO TRAINING BEGAN IN THE FALL TO TRANSITION TO CERNER COMMUNITY WORKS. SABETHA COMMUNITY HOSPITAL CONTINUED TO PARTICIPATE IN THE KANSAS HEALTH CARE COLLABORATIVE HEN 2.0 QUALITY PROJECTS UNTIL THE COMPLETION OF THAT PROJECT AND THEN JOINED KHC HIIN QUALITY PROJECT. THE HCAHPS SCORES ARE USED TO KEEP STAFF INFORMED OF PATIENT SATISFACTION AND AREAS OF IMPROVEMENT ENHANCING SCHS MISSION IS 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 ALSO 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 A 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 FINANCIAL 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 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 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. 30,494 TRANSFER TO CITY OF SABETHA (156,600) ---------- TOTAL $ (126,106)
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACTED MEDICAL STAFF TOTAL FEES:939275
FORM 990 PART IX LINE 11G	DESCRIPTION:BILLING/COLLECTIONS TOTAL FEES:126742
FORM 990 PART IX LINE 11G	DESCRIPTION:LAB SERVICES TOTAL FEES:129534
FORM 990 PART IX LINE 11G	DESCRIPTION:PHARMACY SERVICES TOTAL FEES:116942
FORM 990 PART IX LINE 11G	DESCRIPTION:ADMINISTRATION/HUMAN RESOURCES TOTAL FEES:111625
FORM 990 PART IX LINE 11G	DESCRIPTION:MAINTENANCE/HOUSEKEEPING TOTAL FEES:8385
FORM 990 PART IX LINE 11G	DESCRIPTION:PLANT OPERATIONS TOTAL FEES:1872

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 ROAD	WICHITA	KS	67206	480617739	MANAGEMENT	KS	501(C)(3)	3	NA	false
GREAT PLAINS HEALTH CARE FOUNDATION INC
250 NORTH ROCK ROAD STE 160	WICHITA	KS	67206	480955870	SUPPORT	KS	501 (C)(3)	9	GPHA INC	Yes (true)
GREAT PLAINS OF CHEYENNE COUNTY INC
250 NORTH ROCK ROAD STE 160	WICHITA	KS	67206	481226831	HOSPITAL	KS	501 (C)(3)	3	GPHA INC	Yes (true)
GREAT PLAINS OF ELLINWOOD INC
250 NORTH ROCK ROAD 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 ROAD 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 ROAD STE 160	WICHITA	KS	67206	481226977	HOSPITAL	KS	501(C)(3)	3	GPHA INC	Yes (true)
GREAT PLAINS OF SABETHA COUNTY INC
250 NORTH ROCK ROAD STE 160	WICHITA	KS	67206	481236156	HOSPITAL	KS	501(C)(3)	3	GPHA INC	Yes (true)
GREAT PLAINS OF SMITH COUNTY INC
250 NORTH ROCK ROAD STE 160	WICHITA	KS	67206	481226830	HOSPITAL	KS	501(C)(3)	3	GPHA INC	Yes (true)
GREAT PLAINS OF SMITH COUNTY INC
250 NORTH ROCK ROAD STE 160	WICHITA	KS	67206	481226830	HOSPITAL	KS	501 (C) (3)	3	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	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd