2017-05-09T09:09:58-05:00 2016-06-30 481026809 Wendling Noe Nelson & Johnson LLC 534 S Kansas Ave Suite 1500 Topeka KS 666033491 990 2015-07-01 480799105 McPherson Hospital Inc MCPH 6202412250 1000 Hospital Drive McPherson KS 674602326 Robert Monical CEO 6202412250 2017-05-09 1 Heather R Eichem P01515553 7852334226 2017-05-09 2015 2021-01-29 14:40:06Z Robert Monical 1000 Hospital Drive McPherson KS 674602326 27523889 0 X http://www.mcphersonhospital.org/ X 1972 KS Provision of acute hospital care to patients regardless of ability to pay. 12 12 366 125 0 0 1469449 3102143 23252651 23731378 81575 174269 423878 513666 25227553 27521456 13732 232 0 0 12747380 14365463 0 0 0 14020559 14426845 26781671 28792540 -1554118 -1271084 21516079 20627872 4179025 4207553 17337054 16420319 To meet our community's need by providing superior health care and exceptional service for each person, every time. 0 0 24943518 232 23768012 Provision of inpatient and outpatient hospital services. 24943518 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 54 0 1 366 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Robert Monical President CEO 6202412250 1000 Hospital Drive McPherson KS 674602326 Brian Billings Trustee 2.00 X 0 0 0 Lenny Favara Trustee 2.00 X 0 0 0 Bill Glazner Trustee 2.00 X 0 0 0 Craig Harms Trustee 2.00 X 0 0 0 Andrea Herrera MD Trustee 2.00 X 0 0 0 Tim Karstetter Vice Chairman 2.00 X X 0 0 0 Chet Lang Trustee 2.00 X 0 0 0 Rob Monical CEO 40.00 X X 0 0 0 Joan Reichenberger Trustee 2.00 X 0 0 0 Marsha Silver Chairperson 2.00 X X 0 0 0 Paul Taliaferro Secretary 2.00 X X 0 0 0 Greg Thomas MD Trustee 2.00 X 0 0 0 Brent Wall Trustee 2.00 X 0 0 0 Dan Lichty MD Trustee through 12/31/2015 2.00 X 217969 0 23740 Michael Bloustine Physician 40.00 X 277467 0 24128 Clayton Fetsch Physician 40.00 X 325354 0 37721 Tyler Hughes Physician 40.00 X 289277 0 34550 Samuel Claassen Physician 40.00 X 159576 0 27210 Delane Vaughn Physician 40.00 X 195810 0 29071 1465453 0 176420 12 0 1 0 EMS LLC 920 Main Ste 300 Kansas City MO 64105 ER physician coverage 2054201 Via Christi Health Inc 8200 E Thorn Wichita KS 67226 Management fees and CEO, CFO & CNO servi 1824789 Rehabvisions 11623 Arbor St Omaha NE 68144 Physical/occupational therapy 814430 Trimedx LLC PO Box 636129 Cincinnati OH 45263 Clinical equipment servicer 390376 Shared Medical Serices 209 Limestone Pass Cottage Grove WI 53527 Scanning services 261330 15 282686 2717898 101559 3102143 Net patient service revenue 900099 23363781 23363781 EHR incentive payment 900099 367597 367597 23731378 176702 176702 172502 0 172502 172502 172502 2433 -2433 -2433 -2433 Nonpatient meals 722210 186793 186793 Auxiliary 900099 71649 71649 Fitness center 713940 46088 46088 36634 36634 341164 27521456 23768012 0 651301 X 232 232 236653 236653 11879609 10713054 1166555 317783 286558 31225 1098532 990569 107963 832886 752522 80364 1163462 622931 540531 17795 17795 5657132 5160101 497031 69813 1037 68776 218982 132895 86087 566710 425032 141678 471056 349288 121768 33074 22855 10219 31667 16777 14890 40387 29947 10440 1368355 1014635 353720 271131 85664 185467 Medical supplies 1397357 1397357 Equipment rental & main 1139063 1045245 93818 Pharmacy supplies 1068746 1068746 Dietary food & supplies 289850 270853 18997 622265 320567 301698 28792540 24943518 3849022 0 2802 379762 2051794 2930796 4645285 4044199 564777 581365 54409 69303 31722158 24263026 6553216 7459132 1426116 6217680 5163315 21516079 20627872 3690001 2255243 393580 1822640 95444 129670 4179025 4207553 X 13368766 12053246 3029779 2988571 938509 1378502 17337054 16420319 21516079 20627872 X -1271084 -51597 405946 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 8649 0 0 0 8649 0 Part II-B, Line 1: McPherson Hospital, Inc., is a member of the Kansas Hospital Association and the American Hospital Association. Both of these organizations engage in lobbying activities for hospital and general health care interests as part of the services provided to members. 2451101 1040269 -19295 267877 12870 3191328 1190121 1262657 80038 81715 2451101 1065492 46956 162884 -73602 1190121 957909 41166 149077 -82660 1065492 1001082 12198 19182 -74239 -314 957909 0.39840 0.60160 1 1 1 16312 16312 16558249 11918587 4639662 13466443 11075368 2391075 1681154 1269071 412083 7459132 Other receivables 550928 Beneficial interest in net assets of the Foundation 4089916 Goodwill 12700 Estimated third-party payor settlements 509771 5163315 Estimated third-party payor settlements 91450 Estimated liability for receivables sold with recourse 38220 129670 X 27875805 -51597 405946 354349 27521456 0 27521456 28792540 0 28792540 0 28792540 Part V, Line 4: Donor restricted and board designated funds for special projects and operating purposes. Part X, Line 2: Management is not aware of any uncertainties in income tax positions. Part XI, Line 2d - Other Adjustments: Change in beneficial interest in net assets of the Foundation 405,946. 1 1 1 X 1 X 1 1 0 1 1 567590 59987 507603 0.01760 2308980 1002276 1306704 0.04540 2876570 1062263 1814307 0.06300 12467 12467 0.00040 10460840 6851116 3609724 0.12540 24536 24536 0.00090 10497843 6851116 3646727 0.12670 13374413 7913379 5461034 0.18970 1 585630 0 4932015 5998811 -1066796 X 1 1 1 1 McPherson Hospital Inc 1000 Hospital Drive McPherson KS 67460 X X X Urgent care clinic McPherson Hospital Inc 1 0 0 1 X X X X X X X 15 1 1 1 1 X http://www.mcphersonhospital.org X http://www.lindsborgcommunityhospital.org X 1 15 1 http://www.mcphersonhospital.org 0 0 1 X 200.000000000000 200.000000000000 X X 1 1 X X X 1 X http://www.mcphersonhospital.org/patients-visitors/billing-financial-assist X X X X X X 1 X 0 X X 1 X 0 0 McPherson Hospital, Inc. Part V, Section B, Line 5: The assessment was achieved through the co-leadership of the director of the McPherson County Health Department along with input from other county hospitals, Lindsborg Community Hospital and Mercy Hospital in Moundridge. The McPherson County CHNA process included gathering opinions from the public and area sources through the use of a survey and quantitative data from secondary sources. A survey instrument comprised of 33 questions was developed by the leadership of the participating hospitals and the public health department. The electronic survey was made available throughout the county through various means including media, social media, hospital websites, and was publicized through said sources as well as newspaper and radio. A focus group was formed to provide input regarding the results of the survey. Included in the focus group were individuals representing health care, law enforcement, family advocacy, indigent populations, mental health, public health, civic leadership, education, religion, and senior services, fitness, and Chamber of Commerce, among others. A total of 322 survey responses were received with each community in the county represented in the respondent group. McPherson Hospital, Inc. Part V, Section B, Line 6a: Lindsborg Community Hospital in Lindsborg and Mercy Hospital in Moundridge McPherson Hospital, Inc. Part V, Section B, Line 6b: McPherson County Health Department McPherson Hospital, Inc. Part V, Section B, Line 11: The annual update below pertains to the prior CHNA and implementation strategy completed for the 2012 tax year (fiscal year ended 06/30/2013), which completes the three year cycle for the prior assessment and strategy. The most recently completed assessment and strategy applies to the next three years moving forward. Activities with the Kansas State University Extension Office: The hospital helped promote the Walk Kansas event held last spring, providing teams and resources to encourage participation from the community. The SNAP Ed program is operated within the school system through the Kansas State University (KSU) Extension Office. It has not yet been determined by these partners how the hospital can be an effective partner. The Dining with Diabetes event, also so-sponsored by the KSU Extension Office, was not held due to insufficient interest at the scheduled time.Diabetes support group: The planned activities of the Diabetes Support Group were postponed due to lack of participation and interest. The leadership for this group continues to assess needs and interest and implement additional activities as warranted.Lunch and Learn Events: A series of free monthly physician-led, lunch lectures were held in the Spring of 2016. Publicized widely in the community, topics ranged from the importance of health screenings to identifying certain types of cancers. A total of approximately 100 people attended these events.Speaker's Bureau: A list of clinical speakers was compiled in the Fall of 2015. There was limited usage indicating a need for targeted marketing strategies which still in development. Other providers have also been added to the bureau to increase outreach opportunities.Radio show: A radio show airs twice monthly with the pharmacy and lab director, a general surgeon and others covering a wide variety of health topics. The half-hour show receives positive feedback from listenership, though actual numbers are unquantifiable at this time."Commit to Get Fit": This initiative was a joint effort with the City of McPherson and other entities. The program was discontinued in 2015 due to lack of support from other leading organizations.Theraband Classes: These classes are held weekly for senior citizens at no charge, reaching approximately ten or more individuals each week, aged 50 and over.Health Risk Analyses: The Corporate Health Services department works regularly with local and area businesses providing information to employees on risk factors for health issues such as heart disease, cancer, obesity and diabetes. Staff members also regularly provide free blood pressure checks at the local YMCA.Corporate Challenge: A change in leadership and direction in the partnering organization in our community has postponed this initiative indefinitely. We will hopefully be able to realize this goal in the coming years.Disease Awareness: McPherson Hospital provides significant support locally through a variety of resources, specifically for breast cancer, by sponsoring events for area residents to provide education and encourage screenings. National health awareness dates are communicated through the hospital-produced newsletter which is available to patients, families and guests. Also, the hospital is a platinum sponsor for the local Relay for Life event each year for the American Cancer Society, providing resources and leadership to raise awareness and encourage healthy lifestyles.County health services resource directory: Due to the existence of other community-based resources, it was determined that such a directory would be repetitive. The hospital will seek to provide input and support for its ongoing availability.The identified needs not addressed specifically were daily life stressors and substance abuse. It is felt that the broad scope of daily life stressors makes it difficult to target a specific area that would have significant impact. However, the strategies outlined in the CHNA implementation strategy could have a positive effect on daily life stress with proper diet and exercise. Substance abuse was not addressed specifically as it is addressed by other organizations in the community and is not within the scope of available resources to affect meaningfully. McPherson Hospital, Inc. Part V, Section B, Line 16i: We assist applicants fill out the form. 1 1 - McPherson Medical & Surgical Associates 1000 Hospital Drive McPherson KS 67460 Physician clinic, family & internal medicine, surgery and hospitalists Part I, Line 7g: Subsidized health services community benefit expenses include $4,934,053 of expenses attributable to a physician clinic that has net operating losses. Part III, Line 4: See Note 3A (page 7) of the audited financial statements regarding the allowance for uncollectible accounts. Part III, Line 8: Amounts were obtained from the cost report filed with Medicare for the period ending June 30, 2016. The total amount of shortfall between Medicare revenue received and relating allowable costs is considered community benefit. Part III, Line 9b: Patients who have qualified for financial assistance are considered qualified for six months. Updated information must be provided for any subsequent account balances. Patients who have qualified for partial financial assistance are to make payment arrangements for any remaining balance according to the policies that apply to other patients. Part III, Line 3: McPherson Hospital, Inc. is unable to determine the amount of bad debt expense attributable to patients eligible under its charity care policy for the year covered by this return. Suggested methods for estimation were either not in place or proved to be unreliable. For example, the number of financial assistance applications distributed but not returned was not tracked. Using demographic data to estimate an amount did not provide reasonable results. Rather than provide an estimate that cannot be substantiated, McPherson Hospital Inc. has chosen to report zero dollars as bad debt expense attributable to charity care patients. Part III, Line 2: The Hospital's bad debt at cost was determined by applying an overall ratio of cost to charges. Part VI, Line 2: McPherson Hospital, Inc. does not have a formal community needs assessment process, with the exception of the process utilized for the CHNA. Part VI, Line 3: All self-pay patients are screened by a contractor for eligibility under federal, state, or local government programs. Notice of the Hospital's financial assistance program is posted in patient registration areas and on the Hospital's website. The availability of financial assistance is also communicated to patients with the first billing statement and at any time during the collection process if an inability to pay is expressed by the patient/guarantor. Part VI, Line 4: McPherson Hospital, Inc.'s primary service area is McPherson, Kansas, a rural community of approximately 13,000. According to 2015 census information, the per capita income for McPherson was $29,068. The percent of individuals below poverty level was 6.2. For the year ending June 30, 2016, 11 percent of the Hospital's inpatient admissions were Medicaid recipients and 5 percent were uninsured. Larger hospitals in Hutchinson, Salina, and Newton also provide services to the residents of McPherson. The distances between these facilities and McPherson Hospital, Inc. are approximately 23, 29, and 28 miles respectively. There are no federally-designated medically underserved areas or populations in McPherson. Part VI, Line 5: McPherson Hospital, Inc.'s governing body is comprised of individuals who reside in the primary service area. All Board members, with the exception of the CEO, are not employed by the Hospital. Annually, all trustees sign a conflict of interest statement and disclose any potential conflicts of interest. With limited exceptions for hospital-based services, the Hospital extends medical staff privileges to all qualified physicians in the community. Surplus funds are used by the Hospital to update facilities and equipment, recruit needed physicians and staff, and otherwise improve patient care. X X X 0 0 0 0 0 0 0 0 0 Dan Lichty MD Trustee through 12/31/2015 202076 0 0 0 15893 0 2914 0 20826 0 241709 0 0 0 Michael Bloustine Physician 273432 0 0 0 4035 0 14278 0 9850 0 301595 0 0 0 Clayton Fetsch Physician 273462 0 0 0 51892 0 13530 0 24191 0 363075 0 0 0 Tyler Hughes Physician 211538 0 0 0 77739 0 13530 0 21020 0 323827 0 0 0 Samuel Claassen Physician 132112 0 0 0 27464 0 7300 0 19910 0 186786 0 0 0 Delane Vaughn Physician 187992 0 0 0 7818 0 5570 0 23501 0 224881 0 0 0 Form 990, Part VI, Section A, line 3 The Hospital entered into a management agreement with Via Christi Health, Inc. (Via Christi) on January 1, 2011. Under the agreement, Via Christi is responsible for the daily management and administration of the Hospital, including the employment of the CEO, CFO, and CNO (effective April 2014). For the calendar year of 2015, McPherson Hospital reimbursed Via Christi $219,798 for Robert Monical, CEO's salary and benefits, $141,343 for George Halama, CFO's salary and benefits, and $115,370 for Beth Worden, DON's salary and benefits. Form 990, Part VI, Section A, line 6 Organization's sole member is MACCO Healthcare, Inc. Form 990, Part VI, Section A, line 7a MACCO Healthcare, Inc. approves members of the governing body of McPherson Hospital, Inc. Form 990, Part VI, Section B, line 11 A copy of the Form 990 is provided to members of the organization's Finance Committee with an opportunity to comment or ask questions prior to filing. Form 990, Part VI, Section B, line 12c The conflict of interest policy is reviewed annually by the governing body. Updated individual disclosure forms are also required annually. Form 990, Part VI, Section B, line 15 Organization participates annually in salary surveys sponsored by the State Hospital Association and uses MGMA and other national references in establishing physician compensation. Terms of employment contracts are approved by the governing body. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon written request. Form 990, Part IX, line 11g Physician professional fees: Program service expenses 2,630,214. Management and general expenses 24,367. Fundraising expenses 0. Total expenses 2,654,581. Other medical personnel professional fees: Program service expenses 1,518,841. Management and general expenses 75,290. Fundraising expenses 0. Total expenses 1,594,131. Non physician professional services: Program service expenses 1,011,046. Management and general expenses 397,374. Fundraising expenses 0. Total expenses 1,408,420. Form 990, Part XI, line 9: Change in beneficial interest in net assets of Foundation 405,946. FORM 990 PART XI, LINE 2C: The Finance Committee reviews the audit prior to submitting to the Board. MACCO Healthcare Inc 1000 Hospital Drive McPherson KS 67460 481059194 Sole Member of McPherson Hopsital, Inc. and McPherson Healthcare Fdn, Inc. KS 501(c)(3) Line 7 0 McPherson Healthcare Foundation Inc 1016 N Main McPherson KS 67460 481043952 Raise funds to support the operation of McPherson Hopsital, Inc. KS 501(c)(3) Line 7 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0