2017-05-15T14:08:50-05:00 2016-06-30 990 2015-07-01 721526400 Wamego Hospital Association Inc WAME 7854587201 711 Genn Drive Wamego KS 66547 MICHAEL MCCULLOUGH CFO 2017-05-15 2015 2021-01-29 14:40:06Z Wamego Health Center Wamego Family Center STEVE LAND 711 Genn Drive Wamego KS 66547 11661539 false X www.wamegohealthcenter.org X 2002 KS Serves as a healing presence with special concern for our neighbors who are vulnerable. 8 5 0 3 0 0 75000 8580 12047485 11579131 107476 45268 31593 28560 12261554 11661539 12612 0 0 0 0 11176852 11372937 11176852 11385549 1084702 275990 9816480 11002681 2027346 3055614 7789134 7947067 Wamego Hospital Association, Inc. is part of Via Christi Health, Inc., a Catholic Health System. We share this mission, "Inspired by the Gospel and our Catholic tradition, we serve as a healing presence with special concern for our neighbors who are vulnerable". false false 8425991 12612 11581253 PROVIDING HEALTH CARE SERVICES AND CHARITY CARE: THE HOSPITAL PROVIDES CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES TO PATIENTS MEETING CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY. THE HOSPITAL PROVIDES THE FOLLOWING SERVICES TO THE RESIDENTS OF WAMEGO AND SURROUNDING COMMUNITIES: INPATIENT HOSPITALIZATION, EMERGENCY ROOM, SWING BED, OUTPATIENT IV THERAPIES, DIABETES EDUCATION, SPECIALTY CLINICS, LABORATORY, IMAGING SERVICES, HERITAGE PROGRAMS FOR SENIOR ADULTS, AND DIETARY CONSULTATION. THE SPECIALTY CLINICS INCLUDE THE FOLLOWING: PODIATRY, SURGERY, ORTHOPEDICS, GASTROENTEROLOGY, OTOLARYNGOLOGY, OPHTHAMOLOGY, UROLOGY, AND DIABETES. AS A FULL SERVICE HOSPITAL CENTRALLY LOCATED TO SUPPORT POTTAWATOMIE, WABAUNSEE AND SURROUNDING COUNTIES, WAMEGO HOSPITAL ASSOCIATION, INC. (WHA) OFFERS A COMBINATION OF TECHNOLOGY AND CARING TO PROVIDE ALL THE SPECIALTIES AND SERVICES NEEDED TO SUPPORT THE COMMUNITY'S HEALTH CARE NEEDS, FROM OUTPATIENT THERAPIES AND PREVENTATIVE CARE TO LONG-TERM INPATIENT CARE AND EMERGENCY SERVICES. AS A PART OF VIA CHRISTI HEALTH, INC., A CATHOLIC HEALTH SYSTEM, WE SHARE THIS MISSION: "INSPIRED BY THE GOSPEL AND OUR CATHOLIC TRADITION, WE SERVE AS A HEALING PRESENCE WITH SPECIAL CONCERN FOR OUR NEIGHBORS WHO ARE VULNERABLE". VIA CHRISTI HEALTH SYSTEM'S HISTORY EXTENDS BACK OVER 100 YEARS AND TODAY, ALONG WITH OUR SPONSORING ORGANIZATION, ASCENSION HEALTH, WE CONTINUE TO RESPOND TO COMMUNITY NEEDS IN KANSAS AND NORTHEASTERN OKLAHOMA. 8425991 true false false true false false false false false false true false false true true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true false false false true 17 0 true 0 false false false false false false false false false false X 8 5 false false false false true true true true true false false true true true true true true false false false X WILLIAM FISCHER 3167193224 8200 E THORN DRIVE WICHITA KS 67226 DWIGHT FAULKNER CHAIR 1.0 1.0 X X 0 0 0 MICHAEL LEITCH VICE CHAIR 1.0 0 X X 0 0 0 JOHN R BROBERG SECRETARY 1.0 49.0 X X 0 329415 62281 JACOB PUGH TREASURER 1.0 0 X X 0 0 0 WILLIAM E DITTO TRUSTEE 1.0 0 X 0 0 0 MARK KNACKENDOFFEL TRUSTEE 1.0 2.0 X 0 0 0 SISTER LOIS O'MALLEY CSJ TRUSTEE 1.0 1.0 X 0 0 0 CASEY POELL MD TRUSTEE 1.0 50.0 X 0 370279 36801 DAVID A GAMBINO TRUSTEE 1.0 54.0 X 0 544747 74387 SHANNAN FLACH ADMINISTRATOR 50.0 0.0 X 0 128049 34944 JAMES FRASER ADMINISTRATOR FINANCE 1.0 51.0 X 0 181887 18187 ROBERTA JOHNSON ASSISTANT SECRETARY 1.0 41.0 X 0 284651 66689 CAROL KARP ASSISTANT TREASURER (START 10/14)/CFO 1.0 55.0 X 0 417633 52960 CURTIS WOLFE CHIEF OF STAFF 50.0 0.0 X 0 202178 35534 ROLAND M DAREY JR MD PHYSICIAN 50.0 0.0 X 0 265585 38668 DANE DITTO MD PHYSICIAN 50.0 0.0 X 0 258341 28181 KATHY A DOUGLAS NURSE PRACTICIONER 50.0 0.0 X 0 118191 26274 TIMOTHY MINGES MD PHYSICIAN 50.0 0.0 X 0 218544 30542 JEFF SEIRER ASSISTANT TREASURER (END 9/14) 0.0 49.0 X 0 321492 71175 0 3640992 576623 0 true true false DIAMOND HEALTHCARE 701 E BYRD STREET 15TH FLOOR RICHMOND VA 23219 CONSULTING 278100 FREEMAN WHITE INC 8845 RED OAD BOULEVARD CHARLOTTE NC 28217 CONSULTING 229984 TELEQUALITY COMMUNICATIONS 21232 GATHERING OAKS 107 SAN ANTONIO TX 78260 SERVICES 159821 CASCADE HEALTH SERVICES 1045 SWIFT AVE NORTH KANSAS CITY MO 64116 CONTRACT LABOR 107524 4 8580 8580 NET PATIENT SERVICE REVENUE 621990 11523282 11523282 MEANINGFUL USE REVENUE 621990 55849 55849 0 0 0 0 11579131 45268 45268 6113 6113 0 6113 6113 0 0 EMPLOYEE MEALS & VENDING INCOME 722514 20055 20055 MEDICAL RECORD FEES INCOME 621990 2122 2122 Unclaimed Property 900099 270 270 0 0 0 0 22447 11661539 11581253 0 71706 X 12612 12612 1691668 1480992 210676 0 22139 401 21738 961115 854158 106957 33978 19285 14693 227129 226311 818 28467 22271 6196 26643 7794 18849 248040 256784 -8744 89888 24015 65873 Purchased Services- Affiliate 6511244 5130403 1380841 MANAGEMENT FEES 1028479 1028479 payroll taxes 379082 325799 53283 i/c lab services 53330 53330 71735 11836 59899 0 11385549 8425991 2959558 0 2651121 1613537 871046 0 1402269 1318236 0 0 27969 28700 0 749 4436189 3101816 1306540 1334373 0 0 62450 37430 3495085 6669656 9816480 11002681 1316825 718707 710521 2336907 2027346 3055614 X 7789134 7947067 7789134 7947067 9816480 11002681 275990 -118057 0 X false true X true false X false false false false false false false false true 3369 3369 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. Wamego Hospital Association, Inc. does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. Wamego Hospital Association, Inc. does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. 46127 23341 22786 176529 102409 74120 3778433 2976066 802367 435100 435100 1334373 LONG TERM INVESTMENTS 6453531 CSI RECEIVABLE 34136 DEPOSITS 37251 GRANTS DUE FROM RESTRICTED WAMEGO CITY HOSPITAL RECEIVABLE 24790 OTHER RECEIVABLES 28606 INTERCOMPANY RECEIVABLES 91342 6669656 MEDICARE SETTLEMENT 559566 INTERCOMPANY PAYABLES 1777341 2336907 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote From the consolidated audited financial statements of Ascension Health Alliance and its member organizations ("The System") which include the activity of Wamego Hospital Association, Inc.: The System accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. The System has determined that no material unrecognized tax benefits or liabilities exist as of June 30, 2016. true true X true X true X true true false true true 92206 92206 0.0081 566225 301347 264878 0.0233 0 0.0 0 0 658431 301347 357084 0.0314 30416 0 30416 0.0027 3321 0 3321 0.0003 0 0 0 0.0 0 0 0 0.0 15045 0 15045 0.0013 0 0 48782 0 48782 0.0043 0 0 707213 301347 405866 0.0356 0 0.0 10998 0 10998 0.0010 679 0 679 0.0001 471 0 471 0.0000 0 0.0 0 0.0 0 0.0 1119 0 1119 0.0001 0 0.0 0 0 13267 0 13267 0.0012 775404 0 6303125 6097656 205469 X true true 1 1 WAMEGO HOSPITAL ASSOCIATION INC 711 GENN DRIVE WAMEGO KS 66547 HTTPS://WWW.VIACHRISTI.ORG KANSAS H-075-002 X X X WAMEGO HOSPITAL ASSOCIATION INC 1 false false true X X X X X X X X X 14 true true true true X https://www.wamegohealthcenter.org/about-us/community-needs-assessment/ X http://www.pottawatomiecountycommunityneedsassessment.org/ X true 15 false true false true X 200.0 400.0 X X true true X X X X true X https://www.viachristi.org/patients-and-visitors/billing-and-finance/financial-assistance X https://www.viachristi.org/PATIENTS-AND-VISITORS/BILLING-AND-FINANCE/FINANCIAL-ASSISTANCE X https://www.viachristi.org/patients-and-visitors/billing-and-finance/financial-assistance X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Wamego Hospital Association, Inc.. The assessment was conducted by Wichita State University's Center for Community Support and Research (CCSR). The Riley County Seniors' Service Center provided leadership and coordination of this CHNA effort and it encompassed nearly 100 not-for-profit organizations or government agencies through survey research and/or focus group participation and feedback on initial CHNA draft. The organizations included area health care providers including health and mental health departments, unified school districts, government offices, low-income housing, senior living facilities, colleges, faith-based groups, homeless shelters and many others. Specific organizations participating included in addition to the two already name included: Caroline Peine Charitable Foundation (Manhattan Fund), Konza United Way, Via Christi Hospital - Manhattan (formerly called Mercy Regional Health Center), Riley County Council on Aging, Wamego Health Center, Riley County Health Department, 1350KMAN, Angel 95FM, Bethel AME Church, Big Brothers/Big Sisters of Riley County, Big Lakes Development Center, Boys & Girls Club of Manhattan, Catholic Charities of Northern Kansas, Center on Aging - KS State University, Child Development Center - KS State University, City of Leonardvile, City of Manhattan, City of Manhattan Parks & Recreation, City of Manhattan Social Services Advisory Board, City of Ogden, City of Randolph, City of Riley, Colorado Plaza Apartments, Community Health Ministries - Manhattan, Community Health Ministries - Wamego, Department of Sociology, Anthropology and Social Work - KS State University, Douglass Community Center, Downtown Manhattan, Inc., Family Connections of Riley County, First Presbyterian Church, First United Methodist Church, Flint Hills Area Transportation Agency, Flint Hills Breadbasket, Flint Hills Community Clinic, Flint Hills Human Rights Project, Flint Hills Volunteer Center (formerly RSVP of the Flint Hills, Inc.), Friendship Meals Program, Garden Grove Apartments, Greater Manhattan Community Foundation, Hands On Kansas State, Homecare & Hospice, Homestead Assisted Living, Housing & Credit Counseling Inc. - Manhattan, Kansas Legal Services, Konza Prairie Community Health Clinic, Konza United Way, KSNT News, League of Women Voters of Manhattan/Riley County, LGBT Resource Center - KS State University, Lion's Club, Manhattan Area Chamber of Commerce, Manhattan Area Habitat for Humanity, Manhattan Area Housing Partnership, Manhattan Area Technical College, Manhattan Arts Center, Manhattan Broadcasting, Manhattan Emergency Shelter, Inc., Manhattan Housing Authority, Manhattan Public Library, Manhattan/Riley County Preservation Alliance, Manhattan-Ogden USD 383 Head Start/Early Head Start, Meadowlark Hills Retirement Community, National Church Residences, North Central Flint Hills Area Agency on Aging, Ogden Friendship House, Pawnee Mental Health Services, Pilgrim Baptist Church, Pottawatomie County Health Department, Riley County, Riley County Community Corrections, Riley County Council on Aging, Riley County Extension, Riley County Health Department, Riley County Police Department, Saint Luke's Episcopal Church - Wamego, Salvation Army, School of Leadership Studies - KS State University, Seven Dolors Catholic Church, Shepherd's Crossing, South Manhattan Neighborhood Association, Stoneybrook Retirement Community, Sunflower CASA Project, Inc., Sunny 102.5, The Crisis Center, The KS State Collegian, The Manhattan Free Press, The Manhattan Mercury, Three Rivers, Inc., UFM Community Learning Center, USD 320 Wamego, USD 323 Rock Creek, USD 378 Riley, USD 383 Manhattan/Ogden, USD 383 Open Door, USD 384 Blue Valley, Via Christi Retirement Village, Wamego Chamber of Commerce, Wamego Smoke Signal, WIBW News and Wonder Workshop. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - Wamego Hospital Association, Inc.. Wamego Hospital Association, Inc. conducted its CHNA with Via Christi Hospital in Manhattan. Via Christi Hospital in Manhattan is a healthcare leader in northeastern Kansas, with 150 physicians, 800 employees and 350 volunteers serving the people of Manhattan and the surrounding areas with a wide range of quality health and wellness services. Services offered in Manhattan include: Outpatient behavioral health, A full-service emergency room, Heart care and cardiac rehabilitation, Physical rehabilitation, Orthopedics, Pain management, Labor and delivery, Sleep medicine, Weight loss services (Via Christi LIGHT), and more. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - Wamego Hospital Association, Inc.. Riley County Seniors' Service Center (RCSSC) The Riley County Seniors' Service Center provides services and activities for persons age 60 years of age and older living in Manhattan and Riley County. Services and activities provided include information and referral services. Cooperative efforts with service providers to address older adult needs, educational programs, volunteer service opportunities and recreational and social activities. KONZA UNITED WAY (KUW) SERVING CLAY, MARSHALL, POTTAWATOMIE, RILEY, WABAUNSEE AND WASHINGTON COUNTIES IN KANSAS, THE KUW FOCUSES ON THREE-SPECIFIC INITIATIVES: EDUCATION, HEALTH AND INCOME. THEIR PRIMARY GOAL IS TO ADVANCE EDUCATION, FINANCIAL STABILITY AND HEALTH FOR THOSE LIVING IN THEIR SIX COUNTY REGION WHO ARE FACING POVERTY. RILEY COUNTY COUNCIL ON AGING (RCCOA) THE PURPOSE OF RCCOA IS TO REPRESENT THE OLDER POPULATION IN RILEY COUNTY IN FUNDING REQUESTS, SUPPORTING PROPOSALS AND PROJECTS IMPORTANT TO AGING, DETERMINING AND COMMUNICATING THE NEEDS AND SERVICES FOR THE AGING WHILE ENCOURAGING AND FACILITATING ACTIVITIES THAT BENEFIT OLDER PERSONS BY COORDINATING WITH AGENCIES AND ORGANIZATIONS THAT WORK WITH OLDER PERSONS. RILEY COUNTY HEALTH DEPARTMENT (RCHD) THE RCHD HAS BEEN SERVING RILEY COUNTY FOR WELL OVER 50 YEARS. THEIR WORKFORCE INCLUDES NURSES, SOCIAL WORKERS, DIETITIANS, SUPPORT STAFF AND ADMINISTRATION. THE HEALTH DEPARTMENT OFFERS A WIDE VARIETY OF PROGRAMS AND SERVICES AND THEY VARY BY ELIGIBILITY BY COST. SOME SERVICES ARE AVAILABLE TO ANYONE WHILE SOME ARE RESTRICTED GEOGRAPHICALLY OR HAVE INCOME OR OTHER ELIGIBILITY REQUIREMENTS. SOME SERVICES ARE FREE, SOME HAVE SLIDING SCALES, SOME HAVE INSURANCE COVERAGE AND A FEW SPECIALTY SERVICES HAVE MANDATORY CHARGES. SERVICES PROVIDED INCLUDE BREAST CANCER AWARENESS, CHILD CARE LICENSING, CLINIC FORMS, COMMUNICABLE DISEASES, COMMUNITY CLINICS, COMMUNITY HEALTH PROMOTIONS AND WELLNESS, EMERGENCY PREPAREDNESS IMMUNIZATIONS AND INTERNATIONAL TRAVEL VACCINATIONS, MATERNAL AND CHILD HEALTH, RAISING RILEY, REPRODUCTIVE HEALTH SERVICE, RYAN WHITE PART B (HIV/AIDS PROGRAM), SCHOOL INSPECTIONS, SEXUALLY TRANSMITTED DISEASES (STDS), SHARPS DISPOSAL, TUBERCULOSIS (TB) CONTROL AND WOMEN INFANTS & CHILDREN (WIC) NUTRITION. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Wamego Hospital Association (WHA). Some of the ways WHA has contributed to Wamego and/or Pottawatomie County include: 1) Provide the support of Family Clinic physicians to Community Health Ministries' Clinic on a regular basis in seeing their patients who are not able to afford medical care but who are in need. 2) Donations of medical supplies to Community Health Ministries' Clinic when they have a need and may have limited resources to purchase their own supplies. 3) Provide free sport concussion screenings for Wamego High School athletes, many who would not be able to afford them or regularly access health care providers. Services provided that addresses the CHNA include: 1) Secondary data showed that Pottawatomie County residents are slightly less likely to consume enough fruits and vegetables than the state average; even though, the majority of survey respondents indicate that they eat healthy in general. Responses were mixed on the CHNA survey regarding whether the community has adequate access to healthy food. WHA gardeners worked together with the community to procure a grant to build their own community vegetable garden. Land was donated by the church, across from the hospital, and staff, as well as volunteers from the community, work together to grow produce and any extra produce realized is picked by WHA staff and others and donated to the local food pantry, WIC program participants, and nearby low-income housing communities. 2) Secondary data from the 2013 BRFSS showed that the percentage of Pottawatomie County residents who have experienced poor mental health is higher than the state average (12.0% for Pottawatomie, 9.7% for Kansas). The same is true for those who have experienced a depressive disorder (26.6% for County versus 18.1% for Kansas). The CHNA also found that 7.6% of respondents had been diagnosed with mental illness of some type, with depression being the most common diagnosis. The top need related to mental health were focused on affordability and access to quality services, including more providers of mental health services, affordable mental health services and insurance, high quality services and increased education and prevention regarding mental health. In order to address this need, WHA has made its licensed therapists available to work in partnership with the Community Health Ministries' Clinic through the Heritage Program. This program serves as a mental health clinic for senior adults in the City of Wamego and allows a person access to mental health care without driving to Manhattan or Topeka in order to gain access. 3) Concern was raised about the availability and affordability of child care, activities for children and youth and employment opportunities for teens. Because achieving educational goals is important to the overall economic and health status of every resident living in and around Wamego, WHA is a proud partner in the mentoring program with the school district. Every year, all students entering into the Wamego High School, are assigned a mentor who will stay with that student for their four years of high school. That adult volunteer helps the student to realize their goal of academic success, and many times steers their career aspirations, into areas the student never thought about prior to their mentoring encounter. 4) Although Pottawatomie County has a lower percentage of adults age 65 or older than is average for Kansas, concern was still voiced about their access to healthy food. WHA associates regularly assist in delivering Meals on Wheels to low income and/or home-bound elderly who are no longer able to afford or prepare healthy meals. Needs Not Being Addressed include: 1) Both secondary and survey data paint a fairly positive picture of Pottawatomie County regarding common social issues (e.g. crime, poverty, drop-out rates). Rates of poverty, youth substance abuse, and crime are lower than state averages, but secondary data show a possible issue with adult binge drinking. Survey responses note concerns about substance abuse for youth and adults, manufacturing and selling of drugs, inattentive driving and poverty. Given the resources the hospital currently has to address this need, becoming a primary player is limited except through community partnerships. WHA is willing to partner with other groups, including law enforcement, on combating these issues when adequate resources are available. 2) Education - secondary data shows that Pottawatomie County fares well regarding education except when comparing the number of Early Head Start slots and schools offering all-day/everyday Kindergarten to the state average. The primary needs as identified by respondents were recruiting and keeping good teachers, increased expectations for students and parental involvement, equality in funding among districts and more arts activities for students. Given the high ranking of the school, and the continued and growing partnership between the district and WHA, future programming was not seen to be a priority need at the present time. 3) Housing values are well above average for the state as a result over 60% of CHNA respondents agreed that there is a lack of affordable housing in the community. Housing costs are beyond the scope and financial resources of WHA. While, active in the Chamber, WHA keeps an eye on housing costs but there is relatively little WHA can do to influence the prices to become more affordable when the demand for housing continues to grow in the area. 4) Secondary data show Pottawatomie County to be relatively prosperous with higher than average median household income, median housing value and per capita sales; however, CHNA respondents indicated a lack of well-paying job opportunities. The primary needs identified by CHNA respondents are related to job availability, small business development, assistance to families for basic needs, and assistance with personal financial management. WHA reviews its own wages to ensure they are competitive for their own employees, participates on the Chamber to assist where possible on bringing in new businesses and volunteers with agencies which provide families with basic needs through Meals on Wheels, Wamego Community Garden and other projects. 5) Transportation was not identified by CHNA respondents as a major problem beyond desiring an increase of transportation options and routes (e.g. for bikes and pedestrians) and maintenance and improvements of road conditions. Transportation for medical appointments, when doctors are located outside of Wamego can be challenging for elderly drivers, So WHA works with its neighboring hospital (VCH-Manhattan) in providing access to specialists when needed. 1 WAMEGO FAMILY HEALTH CARE 711 GENN DRIVE WAMEGO KS 66547 FAMILY PRACTICE Schedule H, Part VI, Line 7 Kansas does not require hospitals to file community benefit reports, but Via Christi Health, Inc., which includes the activity of Wamego Hospital Association, Inc., distributes their community benefit totals and activities annually in press releases as well as in our annual report. Schedule H, Part III, Line 1 BAD DEBT IN ACCORDANCE WITH STATEMENT NO. 15 Wamego Hospital Association, Inc. (WHA) reports bad debt in accordance with generally accepted accounting principles (GAAP). Healthcare Financial Management Statement No. 15 is followed to the extent that it aligns with the guidelines set forth by GAAP. Schedule H, Part I, Line 6a Community benefit report prepared by related organization Via Christi Health Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data, and is calculated in compliance with the Catholic Health Association (CHA) guidelines. The best available data was used to calculate the amounts reported in the table, a cost-to-charge ratio was calculated and applied. Schedule H, Part II Community Building Activities One of Wamego Health Center's employees serves on the board of directors for the Wamego Community Foundation which helps to fund various projects in the Wamego community including health profession scholarships. Through these scholarships, high school graduates from around the area are given an opportunity to pursue health care careers and upon graduation from these programs encouraged to stay in the area to promote better health for their neighbors. In addition, high school students are mentored by Wamego Health Center employees and allowed to visit the health facility and shadow health professionals on-the-job to assist them in their discernment on establishing a health care career post high school graduation. Wamego Health Center employees are also very concerned about the environment and how waste in parks, highways and sidewalks put unsuspecting visitors, residents and children at risk. Our health center staff regularly participate in an area cleanup by removing unsafe debris/waste on Highway 24 thus reducing dangers caused by hazardous materials, unsafe fluids and unsanitary conditions for all. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Bad debt expense at cost is determined using the same cost-to-charge ratio that is used for charity care and Medicaid shortfall. WHA follows the guidance from CHA and does not consider bad debt as a community benefit. Schedule H, Part III, Line 3 Bad Debt Expense Methodology Wamego Hospital Association, Inc. has a very robust financial assistance program; therefore, no estimate is made for bad debt attributed to financial assistance eligible patients. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote From the audited financial statements of Ascension Health Alliance (which include the activity of Wamego Hospital Association, Inc.): The provision for doubtful accounts is based upon management's assessment of expected net collections considering historical experience, economic conditions, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the System follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by the System. Accounts receivable are written off after collection efforts have been followed in accordance with the System's policies. The methodology for determining the allowance for doubtful accounts and related write-offs on uninsured patient accounts has remained consistent with the prior year. WHA's bad debt deduction was $775,404 at charges and $381,434 at cost (after the cost to charge ratio was applied to the amount of charges). Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs Ascension Health and related health ministries follow the Catholic Health Association (CHA) guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance It is the policy of Wamego Hospital Association, Inc. (WHA) to promote socially just practices for billing and collections for all patients receiving care. The policy is intended to further the WHA mission by requiring ethical conduct in billing and collecting self-pay balances from the patient/guarantor regardless of ability to pay. The policy ensures that prior to turning an account to a Third Party Collection Agent (Agent) for collection activity, WHA will perform a reasonable review of each account to verify that the patient/guarantor is not potentially eligible for any government assistance programs (e.g. Medicaid, Medicare, etc.) and would likely not qualify for charity care. WHA will direct its staff and agents to periodically assess each patient/guarantor's ability to pay or to determine eligibility for charity care, The review and assessment should include but may not be limited to the following: a. Ensure the patient/guarantor has been notified of WHA's financial assistance policy; b. Ensure the patient/guarantor was offered a financial assistance application; c. Ensure documentation of any known extraordinary financial circumstances of the patient/guarantor or if they are medically indigent. Schedule H, Part V, Section B, Line 16a FAP website - WAMEGO HOSPITAL ASSOCIATION, INC.: Line 16a URL: https://www.viachristi.org/patients-and-visitors/billing-and-finance/financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website - WAMEGO HOSPITAL ASSOCIATION, INC.: Line 16b URL: https://www.viachristi.org/PATIENTS-AND-VISITORS/BILLING-AND-FINANCE/FINANCIAL-ASSISTANCE; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - WAMEGO HOSPITAL ASSOCIATION, INC.: Line 16c URL: https://www.viachristi.org/patients-and-visitors/billing-and-finance/financial-assistance; Schedule H, Part VI, Line 2 Needs assessment In addition to partnering with many organizations to conduct the CHNA, staff and Board members of the Wamego Hospital Association, Inc's (WHA) serve on community not-for-profit, service and faith-based boards and/or committees and are kept apprised of needs being presented. In addition, regular participation in community coalition meetings and Rotary where issues are raised are also a way that WHA stays engaged with community issues. Involvement with the schools to teach coaching staff and students the best way to prevent or recognize symptoms of injury also helps to build networks where problems can be shared and followed-up on. Keeping up with secondary data analysis conducted in behalf of Pottawatomie also helps to paint a picture on demographics so that changes can be monitored and addresses which may impact community needs. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Wamego Hospital Association, Inc.'s (WHA) financial assistance staff is trained on how to qualify patients for Medicaid, SCHIP and other such income-based programs. During the patient's registration, admissions and discharge processes, WHA attempts to identify patients who may be eligible for charity or discounted care through the charity care policy. In addition, WHA uses a percentage of the Federal Poverty Guidelines (FPG) to determine free and discounted care. Schedule H, Part VI, Line 4 Community information The primary Kansas County for Wamego Hospital Association, Inc. (WHA) is Pottawatomie. Pottawatomie County has a land area of 841 square miles with a 2015 estimated population of 23,298. The demographic breakout for Pottawatomie County includes: 94.0% white, 1.5% Black, 0.9% American Indian, 1.0% Asian persons, and 5.4% persons of Hispanic or Latino origin. Approximately 5.0% of Pottawatomie County residents report that a language other than English is spoken at home. When it comes to education, 95.7% completed high school and 32.2% of the adults 25 years of age or older had a bachelor's degree or higher. Median household income for Pottawatomie County residents between 2011 and 2015 was $60,216. During this same time period, the median value of owner-occupied housing units was $160,700 in Pottawatomie. Pottawatomie County reports 8.1% of its residents are below poverty level compared to the Statewide poverty level of 13.0%. Pottawatomie County has fewer residents age 65 years and older compared to the State of Kansas. Kansas reported in 2015 that 14.6% of all residents were persons 65 years of age and older. This compares to 13.4% for Pottawatomie. WHA is the only hospital in the City of Wamego and services are available to all persons regardless of their ability to pay. Schedule H, Part VI, Line 5 Promotion of community health Wamego Hospital Association, Inc. (WHA) enriches the area in which they operate, as well as the broader community, by increasing access to health care by providing care and support to people in need. WHA further supports this mission with a community board, open medical staff, and an emergency room available to patients regardless of ability to pay. Open Medical Staff - The medical staff of WHA is open and is composed of physicians licensed to practice medicine in the State of Kansas. WHA staff also participate in the community on boards/committees of other not-for-profit organizations. During FY2015, WHA staff served on the following area not-for-profit organizations: Wamego Housing Authority Board, Three Rivers Board, Konza United Way Board and Kansas Hospital Associations committees. In addition, WHA staff participated in projects sponsored by the Kansas Department of Transportation Highway Clean-Up Project, Wamego Community Garden, American Red Cross Blood Drive, Wamego High School Senior Interview Day, Wamego Flu Shot Clinic, etc. Community representation of the Governing body - The Board of Directors is the governing body of WHA. The majority of its members are external members comprised of persons who reside in or around Pottawatomie County and has responsibility for the charitable mission of the organization as set forth in its Articles of Incorporation and Bylaws. These directors are selected based on their expertise, experience, and other criteria established by the nominating committee of the Board of Directors. Areas of expertise and experience include areas such as healthcare, finance, education, and local government. The Board actively debates and sets policy and strategic direction for the ministry but does not get involved in issues related to daily operations. The Board takes a balanced approach when addressing community and business/financial concerns. The Board is also the primary group for determining the use of surplus funds generated by the organization which are reinvested in the ministry in order to allow the ministry to sustain its mission and prepare for the future. Annually, WHA provides diagnostic and lab services for Community Health Ministries Clinic. WHA staff participate in periodic Red Cross blood drives due to our mission of caring for those who are vulnerable and in need of life-saving blood. WHA staff have assisted in fundraising activities for other not-for-profits in the community (e.g. Community Garden and Konza United Way). WHA's conference room is shared with the outside community not-for-profits so they can use more of their resources in carrying out their missions. WHA's clinicians regularly spend time at the Community Health Ministries Clinic to assist with patients who have multiple chronic diseases and who are in need of advanced medical management. WHA's counselor provides mental health services for patients accessing medical care at the Community Health Ministries Clinic on an as needed basis. WHA's staff is actively involved in delivering Meals on Wheels to homebound elderly residents living in the Pottawatomie County area. In partnership with the Wamego School District, WHA gave free concussion screenings to student athletes as well as held sports clinics for those injured. In partnership with Wamego High School, WHA staff participate in the student mentoring project, where students are matched as freshmen and the program concludes once the student graduates. WHA sponsors diabetes support groups for patients as well as their caregivers. WHA provided a series of educational presentations (e.g. mental health and clergy and presentations to seniors at the Center). In addition, when needed, clinical staff has assisted the Coroner's Office. Schedule H, Part VI, Line 6 Affiliated health care system WHA is an affiliate of Via Christi Health, Inc. (VCH). VCH's affiliates are multi-faceted, integrated, not-for-profit ministries including hospital and non-hospital ministries (Physician Group Practices, Hospital organizations, Research, Home Health, and Durable Medical Equipment). These ministries work together to care for patients, joined by common systems and a philosophy of serving as a healing presence with special concern for our neighbors especially those who are vulnerable. This community benefit happens through its focus on patient care, education and research. The organizations work together to serve their communities at the local, regional, state and national level. Ascension Health Alliance, d/b/a Ascension (Ascension), is a Missouri nonprofit corporation formed on September 13, 2011. Ascension is the sole corporate member and parent organization of Ascension Health, a Catholic national health system consisting primarily of nonprofit corporations that own and operate local healthcare facilities, or Health Ministries, located in 23 of the United States and the District of Columbia. Ascension is sponsored by Ascension Sponsor, a Public Juridic Person. The Participating Entities of Ascension Sponsor are the Daughters of Charity of St. Vincent de Paul, St. Louise Province; the Congregation of St. Joseph; the Congregation of the Sisters of St. Joseph of Carondelet; the Congregation of Alexian Brothers of the Immaculate Conception Province, Inc. - American Province; and the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi - US/Caribbean Province. Mission: The System directs its governance and management activities toward strong, vibrant Catholic Health Ministries united in service and healing, and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with the System's mission of service to those persons living in poverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources utilized for the care of persons living in poverty and community benefit programs: - Traditional charity care includes the cost of services provided to persons who cannot afford healthcare because of inadequate resources and/or who are uninsured or underinsured. - Unpaid cost of public programs, excluding Medicare, represents the unpaid cost of services provided to persons covered by public programs for persons living in poverty and other vulnerable persons. - Cost of other programs for persons living in poverty and other vulnerable persons includes unreimbursed costs of programs intentionally designed to serve the persons living in poverty and other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiency syndrome. - Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the persons living in poverty, including health promotion and education, health clinics and screenings, and medical research. Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons living in poverty and other community benefit programs. The cost of providing care to persons living in poverty and other community benefit programs is estimated by reducing charges forgone by a factor derived from the ratio of each entity's total operating expenses to the entity's billed charges for patient care. Certain costs such as graduate medical education and certain other activities are excluded from total operating expenses for purposes of this computation. true Pottawatomie County Economic Development 1004 Lincoln P O Box 288 Wamego KS 66547 481059912 501(C)(3) 10000 Advance Pottawatomie County 1 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. ORGANIZATIONS REQUESTING DONATIONS ARE ASKED TO SUBMIT A REQUEST IN WRITING WHICH IDENTIFIES THE NEED THE DONATION WILL BE ADDRESSING, ALONG WITH GOALS AND OBJECTIVES. REQUESTS ARE REVIEWED BY ADMINISTRATION AT A WEEKLY MEETING. false true false false false false false false false JOHN R BROBERG SECRETARY 0 288916 0 36151 0 4348 0 51381 0 10900 0 391696 0 0 CASEY POELL MD TRUSTEE 0 319156 0 50702 0 421 0 22525 0 14276 0 407080 0 0 DAVID A GAMBINO TRUSTEE 0 444439 0 92278 0 8029 0 49950 0 24437 0 619133 0 0 JEFF SEIRER ASSISTANT TREASURER (END 9/14) 0 269148 0 49628 0 2716 0 50408 0 20767 0 392667 0 0 SHANNAN FLACH ADMINISTRATOR 0 115581 0 12060 0 409 0 15186 0 19758 0 162994 0 0 JAMES FRASER ADMINISTRATOR FINANCE 0 163080 0 16429 0 2378 0 4165 0 14022 0 200074 0 0 ROBERTA JOHNSON ASSISTANT SECRETARY 0 244281 0 33055 0 7315 0 58855 0 7834 0 351340 0 0 CAROL KARP ASSISTANT TREASURER (START 10/14)/CFO 0 352689 0 61150 0 3794 0 31950 0 21010 0 470593 0 0 CURTIS WOLFE CHIEF OF STAFF 0 201548 0 0 0 630 0 15486 0 20048 0 237712 0 0 ROLAND M DAREY JR MD PHYSICIAN 0 264558 0 0 0 1027 0 17225 0 21443 0 304253 0 0 DANE DITTO MD PHYSICIAN 0 244623 0 12611 0 1107 0 8910 0 19271 0 286522 0 0 TIMOTHY MINGES MD PHYSICIAN 0 215493 0 160 0 2891 0 15820 0 14722 0 249086 0 0 Schedule J, Part I, Line 3 The organization does not compensate the top management official for their role as President of the organization. However, if a President was employed, this person's salary would be set using the following policies established by Via Christi Health, Inc., a related organization: - Compensation Committee - Independent Compensation Consultant - Compensation Survey or Study - Approval by the Board or Compensation Committee Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are funded annually based on participation and are not vested until the 5 year service requirement is reached. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. The amount funded annually under the program to the executives is reported as compensation on Form 990 Schedule J, Part II, Column B in the year funded. The amount ultimately paid under the program to executives is reported on Form 990 Schedule J, Part II, Column F. There were no distributions from a supplemental nonqualified retirement plan during the year. Keysop plan-frozen: Eligible executives participated in a frozen supplemental option benefit program that provides for supplemental retirement benefits that was limited to Via Christi Hospital St. Francis, Preferred Medical Associates Physicians, Mount Carmel Regional Medical Center and Via Christi Health system executives. The payment of benefits under the program, if any, was linked to the exercise date for the options or to earned dividends on the options. Executives were vested in full when the options were granted. The amount ultimately paid under the program to executives receiving net option value is reported on Form 990 Schedule J, Part II, Column F. The following individual received a distribution from the Keysop plan in the amount listed below: Roberta Johnson - 16271 Form 990, Part VI, Line 6 Classes of members or stockholders Wamego Hospital Association, Inc. has two corporate members, Via Christi Hospital Manhattan, Inc. and City of Wamego. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body Wamego Hospital Association, Inc. has two corporate members, Via Christi Hospital Manhattan, Inc. and City of Wamego, who have the ability to elect members to the governing body of Wamego Hospital Association, Inc. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders All decisions that have a material impact to Wamego Hospital Association, Inc. financial information or corporation as a whole are subject to approval by its two corporate members, Via Christi Hospital Manhattan, Inc. and Wamego City Hospital. Form 990, Part VI, Line 11b Review of form 990 by governing body The finance committee reviews Wamego Hospital Association, Inc.'s Form 990. The finance committee reviews and approves the Form 990 prior to the date of filing. The finance committee reports on the review to the board of trustees and assures that the board has the opportunity to review the final Form 990 as filed. A copy of Form 990 is provided to the board of trustees via a secure email prior to filing with the IRS. Form 990, Part VI, Line 12c Conflict of interest policy The conflict of interest policy is monitored/enforced as part of the system-wide procedures and is not handled at the organizational level. The policy is monitored and enforced as follows: 1 - At time of appointment and annually thereafter, all interested persons, including board and committee members, complete a disclosure statement which addresses actual or potential conflicts of interest; 2 - The disclosure statement is done electronically and the return of the completed statement is a condition of continued appointment, employment, or participation with the organization; 3 - All actual or potential conflicts are reviewed, investigated, and resolved by the chief governance officer and the corporate responsibility officer, with the results shared with the chief executive of the organization; and 4 - Periodic reviews are conducted by governance, compliance, and internal audit to ensure the organization is operating consistent with the policy and enforcing the policy's terms. Form 990, Part VI, Line 19 Required documents available to the public Wamego Hospital Association, Inc.'s governing documents and conflict of interest policy are available to the public upon request. Form 990, Part IX, Line 11g Other Fees CONTRACT LABOR - Total Expense: 284672, Program Service Expense: 281454, Management and General Expenses: 3218, Fundraising Expenses: ; PURCHASED SERVICES - Total Expense: 834372, Program Service Expense: 766670, Management and General Expenses: 67702, Fundraising Expenses: ; PROFESSIONAL FEES - Total Expense: 572624, Program Service Expense: 432868, Management and General Expenses: 139756, Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; Form 990, Part XII, Line 2c oversight of audit or selection of independent accountant The activity of Wamego Hospital Association, Inc. is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of Wamego Hospital Association, Inc. is completed. Ascension Health Alliance's audit committee assumes responsibility for oversight of the audit of the financial statements. The audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of Wamego Hospital Association, Inc. Form 990, Part IV, Line 20B Explanation of Financial Statements The activity of Wamego Hospital Association, Inc. ("Wamego") is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of Wamego is completed. Therefore, the attached audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of Wamego. Form 990, Part VI, Line 15 Process for Determining Compensation Wamego Hospital Association, Inc. uses the policies established by Via Christi Health, Inc. (VCH). VCH has established a common philosophy, strategy, and process for executive compensation. Through the oversight of the VCH Executive Compensation Committee, executive compensation is competitively positioned at its stated market position when compared to the compensation paid by relevant organizations (comparably-sized health systems, hospitals, and long-term care providers). VCH recognizes its responsibility to ensure that its executive compensation program is appropriate in view of its mission and tax-exempt status and that its compensation levels and expenditures are reasonable and not excessive. To ensure these ends, the VCH Executive Compensation Committee has established and approved the executive compensation philosophy for VCH and all related entities. It will also approve all changes in the compensation package for VCH executives in advance. On an annual basis, the Committee conducts a comprehensive review of total compensation for all executives. It also reviews and approves "off-cycle" compensation transactions as needed. In their review, the Committee considers the following factors: - Market data from independent compensation surveys and sources that reflect comparable positions in organizations of similar size and scope; - Difficulties in recruiting and retaining executives; - Skills, experience and performance history of individual executives; - Critical business or strategic issues that the organization may face; and - Market position for total compensation. The adequacy, competitiveness, and cost of the VCH total executive compensation program are reviewed on an ongoing basis and changes are made as the Committee determines appropriate. The executive compensation program will be maintained such that it will fall within the safe harbor guidelines established by the intermediate sanctions regulations. The Committee also employs the services of an independent compensation consultant to prepare market analysis to aid and support the Committee's actions, provide documentation of market trends for budget setting purposes, review annual compensation changes to ensure "reasonableness" and provide attestation and consultation on all executive compensation issues. The Committee also relies on third-party validation of performance measures used in the determination of compensation. 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