COMMUNITY MEMORIAL HEALTHCARE INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY MEMORIAL HEALTHCARE INC (EIN 48-0630224)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-09
- IRS object ID
- 201613149349300811
- Schema version
- 2015v2.1
- 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 H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-09T13:58:50-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | 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 | 1201 Walnut Suite 1700 | AddressLine1Txt |
| City | Kansas City | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 641062246 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 480630224 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY MEMORIAL HEALTHCARE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % CURTIS R HAWKINSON | InCareOfNm |
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 7855622311 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 708 N 18TH STREET | AddressLine1Txt |
| City | MARYSVILLE | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 66508 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CURTIS R HAWKINSON | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 7855622311 | PhoneNum |
| Signature | 2016-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kevin Ensminger CPA | PreparerPersonNm |
| PTIN | P01310558 | PTIN |
| Phone | 8162216300 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CURTIS R HAWKINSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 708 N 18TH STREET | AddressLine1Txt |
| City | MARYSVILLE | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 66508 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $23,000,646 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CMHCARE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1955 | FormationYr |
| Legal Domicile State | KS | LegalDomicileStateCd |
| Activity Or Mission | CMH IS A NOT-FOR-PROFIT MEMBERSHIP CORPORATION THAT OWNS AND OPERATES A GENERAL ACUTE CARE HOSPITAL FOR PATIENTS IN MARYSVILLE, KANSAS AND SURROUNDING AREAS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 252 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $127,338 | PYContributionsGrantsAmt |
| CY Contributions Grants | $57,750 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $19,982,886 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $21,628,194 | CYProgramServiceRevenueAmt |
| PY Investment Income | $447,061 | PYInvestmentIncomeAmt |
| CY Investment Income | $160,652 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $20,557,285 | PYTotalRevenueAmt |
| CY Total Revenue | $21,846,596 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $2,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $11,112,606 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $11,454,335 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,534,366 | PYOtherExpensesAmt |
| CY Other Expenses | $10,125,143 | CYOtherExpensesAmt |
| PY Total Expenses | $20,648,972 | PYTotalExpensesAmt |
| CY Total Expenses | $21,581,478 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$91,687 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $265,118 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $26,730,501 | TotalAssetsBOYAmt |
| Total Assets EOY | $26,373,461 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $18,022,175 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $17,738,750 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $8,708,326 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,634,711 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION STATEMENT OF COMMUNITY MEMORIAL HEALTHCARE, INC. IS TO EXCEL AT CARING FOR YOU. THE VISION STATEMENT OF COMMUNITY MEMORIAL HEALTHCARE, INC. IS TO EXCEED EXPECTATIONS AS A TRUSTED AND VALUED HEALTH PROVIDER. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $5,431,760 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $4,325,639 | RevenueAmt |
| Desc | THREE RURAL HEALTH CLINICS WITH A TOTAL OF 24,639 OFFICE VISITS | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,810,587 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $2,162,819 | RevenueAmt |
| Desc | INPATIENT AND OUTPATIENT SURGERIES AND SCOPE PROCEDURES - 1,239 PROCEDURES | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,353,763 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,946,537 | RevenueAmt |
| Desc | 24 HR EMERGENCY ROOM SERVICES -3,348 VISITS, DURABLE MEDICAL EQUIPMENT SALES, AND HOME HEALTH SERVICES - 6,041 VISITS | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $8,509,756 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $2,000 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $13,193,199 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $18,105,866 | 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 | Yes (true) | 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 | false | 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 | false | 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 | Yes (true) | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | 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 | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 33 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 252 | 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 | false | QuidProQuoContributionsInd |
| 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | 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 | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | KS | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CURTIS R HAWKINSON | PersonNm |
| Phone | 7855622311 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 708 N 18TH ST | AddressLine1Txt |
| City | MARYSVILLE | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 66508 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 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 |
|---|---|---|---|---|---|---|---|---|
| DAVID HAMEL | ||||||||
| VICE-CHAIRPERSON/DIRECTOR | 2.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| AMOS ALSTROM | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| DAN CAFFREY | ||||||||
| CHAIRPERSON/DIRECTOR | 4.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MARGE SCHLABACH | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT VOET | ||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| TRENT MOSER | ||||||||
| CHAIRPERSON/DIRECTOR | 2.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| CHAD KRAMER | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| JERRY ZANKER | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| LUCY PAPES | ||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| BRYCE PORTER | ||||||||
| VICE-CHAIRPERSON/DIRECTOR | 2.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DELORES STUMP | ||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| GAIL GILKERSON | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| KEN LAMOREAUX | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| CANDACE WRIGHT | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| DENNIS CASHIER | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| JIM LADNER | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| RAY SCULTZ | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| DR RANDALL BROWN | ||||||||
| CHIEF OF STAFF/DIRECTOR | 40.0 | 0.0 | Yes (X) | $300,455 | $0 | $24,594 | ||
| CURTIS R HAWKINSON | ||||||||
| CEO | 40.0 | 1.0 | Yes (X) | $154,209 | $0 | $23,726 | ||
| BEVERLY FIFERLICK | ||||||||
| CFO | 40.0 | 0.0 | Yes (X) | $113,746 | $0 | $11,980 | ||
| DR KEN DUENSING | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $213,860 | $0 | $20,138 | Yes (X) | ||
| DR JOHN HAEFELE | ||||||||
| DIR OF RADIOLOGY, OT, ST, REF | 40.0 | 0.0 | $278,682 | $0 | $24,594 | Yes (X) | ||
| DR BEN BRUNA | ||||||||
| DIRECTOR OF QUALITY, HH, RT, S | 40.0 | 0.0 | $366,190 | $0 | $22,594 | Yes (X) | ||
| DR SHANE THORESON | ||||||||
| DIRECTOR OF DIETARY, PHARMACY | 40.0 | 0.0 | $353,548 | $0 | $24,594 | Yes (X) | ||
| DR JOHN M RYAN | ||||||||
| DIR OF TRAUMA, SB, ED, RM, HIM | 40.0 | 0.0 | $242,489 | $0 | $21,614 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,023,179 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $173,834 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 11 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| ServicesServicesDesc | CompensationCompensationAmt |
|---|---|
| CRIST AND PIESCHEL PT | |
| PT, OT, ST | $1,003,886 |
| MARYSVILLE ANESTHESIA | |
| ANESTHESIOLOGIST | $422,885 |
| CPSI | |
| COMPUTER SERVICES | $244,870 |
| NEBRASKA HEART INSTITUTE | |
| NUC MED SERVICES | $168,219 |
| SHARED MEDICAL SRVICES | |
| MRI | $125,370 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $44,680 | RelatedOrganizationsAmt |
| Government Grants | $5,860 | GovernmentGrantsAmt |
| All Other Contributions | $7,210 | AllOtherContributionsAmt |
| Total Contributions | $57,750 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net Patient Service Revenue | 621400 | $20,659,119 | $20,659,119 |
| Dietary Income | 624200 | $146,997 | $146,997 |
| Other Operating Revenue | 900099 | $822,078 | $822,078 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $21,628,194 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $161,745 | TotalRevenueColumnAmt |
| Exclusion | $161,745 | 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 |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,151,057 | SecuritiesAmt |
| Other | $1,900 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,145,977 | SecuritiesAmt |
| Other | $8,073 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,080 | SecuritiesAmt |
| Other | -$6,173 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,093 | TotalRevenueColumnAmt |
| Exclusion | -$1,093 | ExclusionAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,846,596 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,628,194 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $160,652 | 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 | $2,000 | TotalAmt |
| Program Services | $2,000 | ProgramServicesAmt |
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 | $628,710 | TotalAmt |
| Program Services | $501,967 | ProgramServicesAmt |
| Management And General | $126,743 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $144,138 | TotalAmt |
| Program Services | $113,777 | ProgramServicesAmt |
| Management And General | $30,361 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,626,136 | TotalAmt |
| Program Services | $6,809,154 | ProgramServicesAmt |
| Management And General | $1,816,982 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $282,285 | TotalAmt |
| Program Services | $208,383 | ProgramServicesAmt |
| Management And General | $73,902 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,153,344 | TotalAmt |
| Program Services | $1,060,226 | ProgramServicesAmt |
| Management And General | $93,118 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $619,722 | TotalAmt |
| Program Services | $560,505 | ProgramServicesAmt |
| Management And General | $59,217 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,460 | TotalAmt |
| Management And General | $6,460 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $153,141 | TotalAmt |
| Management And General | $153,141 | 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 | $2,433,483 | TotalAmt |
| Program Services | $2,325,537 | ProgramServicesAmt |
| Management And General | $107,946 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,626 | TotalAmt |
| Program Services | $47,047 | ProgramServicesAmt |
| Management And General | $1,579 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $274,246 | TotalAmt |
| Program Services | $175,812 | ProgramServicesAmt |
| Management And General | $98,434 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,092 | TotalAmt |
| Program Services | $2,092 | ProgramServicesAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $892,107 | TotalAmt |
| Program Services | $833,551 | ProgramServicesAmt |
| Management And General | $58,556 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $174,149 | TotalAmt |
| Program Services | $174,149 | ProgramServicesAmt |
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 | $6,013 | TotalAmt |
| Management And General | $6,013 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $622,143 | TotalAmt |
| Program Services | $8,768 | ProgramServicesAmt |
| Management And General | $613,375 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,711,796 | TotalAmt |
| Program Services | $1,657,492 | ProgramServicesAmt |
| Management And General | $54,304 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $223,823 | TotalAmt |
| Program Services | $114,566 | ProgramServicesAmt |
| Management And General | $109,257 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT EXPENSE | $760,686 | $760,686 | |
| MEDICAL SUPPLIES | $2,303,015 | $2,303,015 | |
| EQUIP RENTAL & MAINTENANCE | $373,994 | $361,342 | $12,652 |
| DUES & SUBSCRIPTIONS | $95,743 | $55,619 | $40,124 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,626 | TotalAmt |
| Program Services | $30,178 | ProgramServicesAmt |
| Management And General | $13,448 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,581,478 | TotalAmt |
| Program Services | $18,105,866 | ProgramServicesAmt |
| Management And General | $3,475,612 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,287 | BOYAmt |
| EOY | $12,387 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,202,308 | BOYAmt |
| EOY | $2,721,403 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,009 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,383,645 | BOYAmt |
| EOY | $2,541,470 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $124,448 | BOYAmt |
| EOY | $84,333 | 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 | $460,169 | BOYAmt |
| EOY | $461,563 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $283,879 | BOYAmt |
| EOY | $240,643 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $27,218,707 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $12,560,763 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,926,901 | BOYAmt |
| EOY | $14,657,944 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,161,532 | BOYAmt |
| EOY | $5,491,857 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | 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 | $169,323 | BOYAmt |
| EOY | $161,861 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,730,501 | BOYAmt |
| EOY | $26,373,461 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,820,206 | BOYAmt |
| EOY | $2,012,432 | 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 | $0 | BOYAmt |
| EOY | $0 | 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 | $16,201,969 | BOYAmt |
| EOY | $15,726,318 | 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 | $18,022,175 | BOYAmt |
| EOY | $17,738,750 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,620,523 | BOYAmt |
| EOY | $8,558,917 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,009 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,794 | BOYAmt |
| EOY | $75,794 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,708,326 | BOYAmt |
| EOY | $8,634,711 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,730,501 | BOYAmt |
| EOY | $26,373,461 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $265,118 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$234,208 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$104,525 | 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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) |
|---|---|---|
| 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 | false | 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 | $6,633 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Total Lobbying Expenditures | $6,633 | 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 | DUES PAID TO THE KANSAS HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION ALLOCATED TO LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,072,988 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $31,992 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $2,000 | GrantsOrScholarshipsAmt |
| Other Expenditures | $42,001 | OtherExpendituresAmt |
| End Year Balance | $1,060,979 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,059,062 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $178,439 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $2,000 | GrantsOrScholarshipsAmt |
| Other Expenditures | $162,513 | OtherExpendituresAmt |
| End Year Balance | $1,072,988 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,134,824 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $55,511 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $2,000 | GrantsOrScholarshipsAmt |
| Other Expenditures | $123,306 | OtherExpendituresAmt |
| Administrative Expenses | $5,967 | AdministrativeExpensesAmt |
| End Year Balance | $1,059,062 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,126,013 | BeginningYearBalanceAmt |
| Contributions | $9,249 | ContributionsAmt |
| Investment Earnings Or Losses | $68,612 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $1,000 | GrantsOrScholarshipsAmt |
| Other Expenditures | $2,066,944 | OtherExpendituresAmt |
| Administrative Expenses | $1,106 | AdministrativeExpensesAmt |
| End Year Balance | $1,134,824 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,859,086 | BeginningYearBalanceAmt |
| Contributions | $266,927 | ContributionsAmt |
| Investment Earnings Or Losses | $4,502 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $2,000 | GrantsOrScholarshipsAmt |
| Other Expenditures | $0 | OtherExpendituresAmt |
| Administrative Expenses | $2,502 | AdministrativeExpensesAmt |
| End Year Balance | $3,126,013 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.92856 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.07144 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $81,530 | OtherCostOrOtherBasisAmt |
| Book Value | $81,530 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,214,407 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,877,919 | DepreciationAmt |
| Book Value | $13,336,488 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,639,310 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,530,211 | DepreciationAmt |
| Book Value | $1,109,099 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $283,460 | OtherCostOrOtherBasisAmt |
| Depreciation | $152,633 | DepreciationAmt |
| Book Value | $130,827 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $14,657,944 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $20,906,449 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$234,208 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $54,747 | OtherRevenueAmt |
| Revenue Not Reported | -$179,461 | RevenueNotReportedAmt |
| Revenue Subtotal | $21,085,910 | RevenueSubtotalAmt |
| Other Revenues Not Included | $760,686 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $760,686 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $21,846,596 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $20,914,533 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $93,741 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $93,741 | ExpensesNotReportedAmt |
| Expenses Subtotal | $20,820,792 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $760,686 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $760,686 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $21,581,478 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART V, LINE 4 | BOARD-DESIGNATED ASSETS LIMITED TO USE OF $987,149 INCLUDE ASSETS SET ASIDE BY THE BOARD OF DIRECTORS FOR FUTURE CAPITAL IMPROVEMENTS AND OPERATIONS OVER WHICH THE BOARD RETAINS CONTROL AND MAY, AT ITS DISCRETION, SUBSEQUENTLY USE THE ASSETS FOR OTHER PURPOSES. PERMANENTLY RESTRICTED ASSETS OF $75,109 HAVE BEEN RESTRICTED BY DONORS TO BE MAINTAINED BY CMH IN PERPETUITY WITH THE INCOME TO BE USED FOR SCHOLARSHIPS. |
| 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 | RELATED ORGANIZATION REVENUES $ 54,747 |
| SCHEDULE D, PART XI, LINE 4B | BAD DEBT EXPENSE $ 760,686 |
| SCHEDULE D, PART XII, LINE 2D | RELATED ORGANIZATION EXPENSES $ 93,741 |
| SCHEDULE D, PART XII, LINE 4B | BAD DEBT EXPENSE $ 760,686 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $256,883 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $256,883 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01230 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,271,131 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $831,967 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $439,164 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02110 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,528,014 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $831,967 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $696,047 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03340 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,391 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,420 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,971 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,391 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,420 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,971 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,532,405 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $833,387 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $699,018 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03350 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $760,686 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $61,000 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $9,804,317 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $10,042,702 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$238,385 | MedicareSurplusOrShortfallAmt |
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 | COMMUNITY MEMORIAL HEALTHCARE INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 708 N 18TH STREET | AddressLine1Txt |
| City | MARYSVILLE | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 66508 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.CMHCARE.COM | WebsiteAddressTxt |
| State License | H058001 | StateLicenseNum |
| 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 | COMMUNITY MEMORIAL HEALTHCARE INC | 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 |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | 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 | WWW.CMHCARE.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 14 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.CMHCARE.COM | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| 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 | 150. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400. | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| 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 |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.CMHCARE.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 5 | INCLUDED MEMBERS OF THE LOCAL SCHOOL SYSTEM AND COMMUNITY COLLEGE, RELIGIOUS ORGANIZATIONS, LOCAL CITY AND COUNTY GOVERNMENT, PUBLIC HEALTH AGENCIES AND MEDICAL PROVIDERS. |
| SCHEDULE H, PART V, SECTION B, LINE 11 | CMH AND SEVERAL OTHER LOCAL AGENCIES CREATED A GROUP THAT IS WORKING TO REDUCE OBESITY BY INCREASING ACTIVITY AND PROMOTING BETTER FOOD CHOICES. THE THRIVE MARSHALL COUNTY PROJECT (A.K.A. THE OBESITY PROJECT) INCORPORATES SEVERAL OF THE ITEMS ON THE LIST. THIS IS A MULTI-ORGANIZATIONAL COMMITTEE THAT IS DEVELOPING WAYS FOR THE COMMUNITY TO BECOME MORE ACTIVE AND EAT HEALTHIER. THE THOUGHT IS ALSO THAT IF WE CAN GET PEOPLE PHYSICALLY HEALTHY THEIR MENTAL HEALTH WILL ALSO IMPROVE. ANOTHER ITEM THAT CAME OUT OF OUR CHNA WAS AN AFTER-HOURS/URGENT CARE CLINIC. THIS IS NOT SOMETHING WE HAVE BEEN ABLE TO ACCOMPLISH WITH OUR CURRENT MEDICAL STAFF. |
| SCHEDULE H, PART V, SECTION B, LINE 22D | WE USED THE AVERAGE RATE FOR ALL PAYORS (EXCLUDING SELF-PAY) BROKEN OUT BETWEEN IP, OP, AND CLINIC WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| Community Physicians Clinic | ||||
| 1902 MAY ST | MARYSVILLE | KS | 66508 | RURAL HEALTH CLINIC |
| Marysville Clinic | ||||
| 808 N 19TH ST | Marysville | KS | 66508 | RURAL HEALTH CLINIC |
| Blue Rapids Medical Clinic | ||||
| 607 Lincoln | BLUE RAPIDS | KS | 66411 | RURAL HEALTH CLINIC |
| Community Medical Equipment | ||||
| 805 Broadway | Marysville | KS | 66508 | Durable Medical Equipment |
| CMH Home Health | ||||
| 805 Broadway | Marysville | KS | 66508 | Home Health Agency |
| COMMUNITY PHYSICIANS CLINIC - WYMORE | ||||
| 100 NORTH 7TH | WYMORE | NE | 68466 | RURAL HEALTH CLINIC |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 3C | SEE PART VI, SECTION B, LINE 13 FOR THE LIST OF FACTORS USED IN THE ELIGIBILITY CRITERIA EXPLAINED IN THE FAP FOR PROVIDING FREE AND DISCOUNTED CARE. |
| SCHEDULE H, PART I, LINE 7 | THE COST-TO-CHARGE RATIO WAS USED AS THE COSTING METHODOLOGY TO REPORT CHARITY CARE AND OTHER COMMUNITY BENEFITS AT COST. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. |
| SCHEDULE H, PART I, LINE 7, COLUMN F | THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), SUBTRACTED FOR PURPOSES OF CALCULATING SCHEDULE H, PART I, LINE 7 IS $760,686. |
| SCHEDULE H, PART III, SECTION A, LINE 2 | WE TAKE A PORTION OF THE MEDICARE, MEDICAID, AND COMMERCIAL ACCOUNTS IN THE A/R WE FEEL WILL BE PATIENT RESPONSIBILITY AFTER INSURANCE PAYMENTS AND CONTRACTUAL ADJUSTMENTS HAVE BEEN APPLIED. WE ADD THIS AMOUNT TO THE UNINSURED ACCOUNTS. WE APPLY A PERCENTAGE TO EACH AGING CATEGORY BALANCE BASED ON EXPERIENCE, ECONOMIC OUTLOOK, AND OUR INDEPENDENT AUDITOR'S INPUT TO ARRIVE AT THE AMOUNT WE FEEL IS UNCOLLECTIBLE. THIS FIGURE IS ADJUSTED BY BALANCES SENT TO COLLECTION, BALANCES PAID THROUGH COLLECTION, AND BALANCES RETURNED FROM COLLECTION AS UNCOLLECTIBLE, WHICH ARE THEN DIRECTLY WRITTEN OFF TO BAD DEBT EXPENSE ALONG WITH BANKRUPTCIES. |
| SCHEDULE H, PART III, SECTION C, LINE 3 | WE HAVE SEEN APPROXIMATELY 8% OF THE ACCOUNTS SENT TO COLLECTIONS RETURNED FROM THE AGENCY WITH THE IDENTIFICATION THAT THE PATIENT HAS NO ASSETS. |
| SCHEDULE H, PART III, SECTION A, LINE 4 | SEE NOTE 1 ON PAGE 8 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. |
| SCHEDULE H, PART III, SECTION B, LINE 8 | THE MEDICARE SHORTFALL IS DUE TO SEQUESTRATION. THE COSTING METHODOLOGY USED TO DETERMINE THESE AMOUNTS CAME FROM THE ORGANIZATION'S MEDICARE COST REPORT. THE SHORTFALL FROM LINE SEVEN REPRESENTS LEGITIMATE EXPENSES/COSTS INCURRED BY THE HOSPITAL TO SERVE MEDICARE PATIENTS. THESE ARE COSTS SIMILAR TO CHARITY CARE IN THAT THE HOSPITAL DID NOT COLLECT THESE FUNDS. AS SUCH THERE IS A DIRECT BENEFIT DERIVED FOR THE COMMUNITY IN THAT THE HOSPITAL WAS ABLE TO PROVIDE CARE FOR THESE PATIENTS. THEREFORE THE ENTIRE SHORTFALL SHOULD BE COUNTED AS A COMMUNITY BENEFIT. |
| SCHEDULE H, PART III, SECTION C, LINE 9B | PATIENTS ARE INFORMED OF OUR FINANCIAL ASSISTANCE POLICY AT THE TIME OF SERVICES. IF REQUESTED, THEY ARE GIVEN THE APPLICATION AT TIME OF SERVICE OR PRIOR TO DISMISSAL. FINANCIAL ASSISTANCE IS OFFERED AT TIME LETTERS ARE SENT OUT REQUESTING PAYMENT AGREEMENTS AND AGAIN BEFORE ACCOUNTS ARE SENT TO COLLECTION. |
| SCHEDULE H, PART VI, LINE 2 | IN ADDITION TO CONDUCTING ITS OWN RESEARCH, CMH COLLABORATES THROUGH THE INTERAGENCY COOPERATIVE COUNCIL (A COLLECTION OF COUNTY WIDE NOT-FOR-PROFIT AGENCIES) TO ASSESS THE NEEDS OF MARSHALL COUNTY. |
| SCHEDULE H, PART VI, LINE 3 | THE INSURANCE OFFICE PERSONNEL EXPLAIN ELIGIBILITY TO PATIENTS AND WILL ASSIST WITH PAPERWORK. THE AVAILABILITY OF FINANCIAL ASSISTANCE IS POSTED THROUGHOUT THE BUILDING (I.E. THE BUSINESS OFFICE, THE CLINICS, EMERGENCY DEPARTMENT). PATIENTS WHO ARE IDENTIFIED EITHER BEFORE SERVICES ARE RENDERED OR PRIOR TO DISCHARGE ARE CONTACTED BY THE BUSINESS OFFICE PERSONNEL TO ASSESS QUALIFICATION FOR MEDICAID OR FINANCIAL ASSISTANCE. BUSINESS OFFICE PERSONNEL ATTEMPT TO CONTACT PATIENTS VIA PHONE AND MAIL REGARDING THEIR BILL. PART OF THE CHARITY CARE PROGRAM IS TO ATTEMPT ENROLLMENT INTO THE MEDICAID PROGRAM. |
| SCHEDULE H, PART VI, LINE 4 | COMMUNITY MEMORIAL HEALTHCARE, INC. IS A NOT-FOR-PROFIT MEMBERSHIP CORPORATION THAT OWNS AND OPERATES A GENERAL ACUTE CARE HOSPITAL. CMH PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT, EMERGENCY, CLINIC AND HOME HEALTH SERVICES TO MARYSVILLE, BLUE RAPIDS, BEATTIE, HANOVER, WATERVILLE, WASHINGTON, FRANKFORT, AXTELL AND HOME KANSAS. THESE AREAS ARE ALSO SERVED BY HANOVER HOSPITAL (HANOVER, KS), NEMAHA VALLEY COMMUNITY HOSPITAL (SENECA, KS), MERCY REGIONAL HEALTH CENTER (MANHATTAN, KS), BRYAN LGH HEALTH SYSTEM (LINCOLN, NE), SAINT ELIZABETH REGIONAL MEDICAL CENTER (LINCOLN, NE), SAINT FRANCIS HEALTH CENTER (TOPEKA, KS), STORMONT-VAIL HEALTHCARE (TOPEKA, KS). AS OF THE 2010 CENSUS, THE CITY OF MARYSVILLE HAD A TOTAL POPULATION OF 3,294, WHILE MARSHALL COUNTY POPULATION WAS 10,117. BELOW ARE ADDITIONAL MARSHALL COUNTY DEMOGRAPHICS: 22% OF THE POPULATION IS OVER 65 YEARS OF AGE. 29% OF THE POPULATION IS BETWEEN 45-64 YEARS OF AGE. 27% OF THE POPULATION IS BETWEEN THE AGES OF 18-44. MEDIAN HOUSEHOLD INCOME FOR MARSHALL COUNTY WAS $44,615 FOR 2014. UNEMPLOYMENT IN MARSHALL COUNTY IS 5.2%. 12.87% OF THE POPULATION ARE LIVING BELOW THE POVERTY LEVEL. THE HOSPITAL IS THE THIRD LARGEST EMPLOYER IN THE COUNTY. |
| SCHEDULE H, PART VI, LINE 5 | COMMUNITY MEMORIAL HEALTHCARE SPONSORS AN ANNUAL HEALTH FAIR FOR THE GENERAL PUBLIC, DRAWING BLOOD AND RUNNING DIAGNOSTIC TESTS. THE HOSPITAL PUBLISHES A MONTHLY ARTICLE IN A LOCAL PAPER ADDRESSING CURRENT HEALTH TOPICS, PARTICIPATES IN THE COMMUNITY BABY BOOMER EXPO PROVIDING HEALTH EDUCATION, AND HOSTS A MONTHLY LUNCHEON FOR THE OVER-55 POPULATION WITH SPEAKERS ON CURRENT HEALTH TOPICS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CURTIS R HAWKINSON | ||||||||||||||
| CEO | $149,459 | $0 | $0 | $0 | $4,750 | $0 | $7,344 | $0 | $16,382 | $0 | $177,935 | $0 | $0 | $0 |
| DR KEN DUENSING | ||||||||||||||
| PHYSICIAN | $211,484 | $0 | $0 | $0 | $2,376 | $0 | $11,447 | $0 | $8,691 | $0 | $233,998 | $0 | $0 | $0 |
| DR JOHN HAEFELE | ||||||||||||||
| DIR OF RADIOLOGY, OT, ST, REF | $265,122 | $0 | $0 | $0 | $13,560 | $0 | $14,403 | $0 | $10,191 | $0 | $303,276 | $0 | $0 | $0 |
| DR RANDALL BROWN | ||||||||||||||
| CHIEF OF STAFF/DIRECTOR | $280,079 | $0 | $0 | $0 | $20,376 | $0 | $14,403 | $0 | $10,191 | $0 | $325,049 | $0 | $0 | $0 |
| DR BEN BRUNA | ||||||||||||||
| DIRECTOR OF QUALITY, HH, RT, S | $333,042 | $0 | $0 | $0 | $33,148 | $0 | $14,403 | $0 | $8,191 | $0 | $388,784 | $0 | $0 | $0 |
| DR SHANE THORESON | ||||||||||||||
| DIRECTOR OF DIETARY, PHARMACY | $337,660 | $0 | $0 | $0 | $15,888 | $0 | $14,403 | $0 | $10,191 | $0 | $378,142 | $0 | $0 | $0 |
| DR JOHN M RYAN | ||||||||||||||
| DIR OF TRAUMA, SB, ED, RM, HIM | $239,784 | $0 | $0 | $0 | $2,705 | $0 | $13,423 | $0 | $8,191 | $0 | $264,103 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (3 entries)
| Relationship With OrgRelationshipWithOrgTxt | Loan PurposeLoanPurposeTxt | Loan From OrganizationLoanFromOrganizationInd | Original PrincipalOriginalPrincipalAmt | Balance DueBalanceDueAmt | DefaultDefaultInd | Board Or Committee ApprovalBoardOrCommitteeApprovalInd | Written AgreementWrittenAgreementInd |
|---|---|---|---|---|---|---|---|
| DR BEN BRUNA | |||||||
| HCE/PHYSICIAN | MD - TUITION | Yes (X) | $66,000 | $36,362 | false | Yes (true) | Yes (true) |
| DR JOSEPH HAWKINS | |||||||
| HCE/PHYSICIAN | MD - TUITION | Yes (X) | $64,702 | $9,798 | false | Yes (true) | Yes (true) |
| DR SHANE THORESON | |||||||
| HCE/PHYSICIAN | MD - TUITION | Yes (X) | $69,284 | $38,172 | false | Yes (true) | Yes (true) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $84,332 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SEE SCHEDULE L PART V | PersonNm |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART IV | FormAndLineReferenceDesc |
| Explanation | TRANSACTION 1 (A) KELLY MOSER (B) KELLY MOSER IS THE SPOUSE OF TRENT MOSER, A DIRECTOR AND OFFICER OF COMMUNITY MEMORIAL HEALTHCARE, INC. (C) $19,020 (D) KELLY MOSER IS AN EMPLOYEE OF COMMUNITY MEMORIAL HEALTHCARE, INC. (E) NO TRANSACTION 2 (A) CYNTHIA VOET (B) CYNTHIA VOET IS THE SPOUSE OF ROBERT VOET, A DIRECTOR OF COMMUNITY MEMORIAL HEALTHCARE, INC. (C) $57,489 (D) CYNTHIA VOET IS AN EMPLOYEE OF COMMUNITY MEMORIAL HEALTHCARE, INC. (E) NO TRANSACTION 3 (A) SHANNON BRUNA (B) SHANNON BRUNA IS THE DAUGHTER OF ROBERT VOET, A DIRECTOR OF COMMUNITY MEMORIAL HEALTHCARE, INC. (C) $42,569 (D) SHANNON BRUNA IS AN EMPLOYEE OF COMMUNITY MEMORIAL HEALTHCARE, INC. (E) NO TRANSACTION 4 (A) ALISON VOET (B) ALISON VOET IS THE DAUGHTER OF ROBERT VOET, A DIRECTOR OF COMMUNITY MEMORIAL HEALTHCARE, INC. (C) $25,060 (D) ALLISON VOET IS AN EMPLOYEE OF COMMUNITY MEMORIAL HEALTHCARE, INC. (E) NO | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4D | INPATIENT & OUTPATIENT CARDIO PULMONARY - 7,435 SERVICES RADIOLOGICAL SERVICES - 9,221 EXAMS LAB - 244,860 TESTS PT, OT, ST SERVICES - 46,931 MODALITIES REFERRAL VISITS - 4,583 VISITS CENTRAL SUPPLY, DIETARY SERVICES |
| FORM 990, PART VI, SECTION A, LINE 6 | ANY PERSON, FIRM, ASSOCIATION, CORPORATION, OR BODY POLITIC OR SUBDIVISION THEREOF, MAY BECOME A MEMBER OF THE COMMUNITY MEMORIAL HEALTHCARE, INC. BY: (A) PAYING A MEMBERSHIP FEE OF $100.00; AND (B) AGREEING TO COMPLY WITH AND BE BOUND BY THE ARTICLES OF INCORPORATION AND BYLAWS AND ANY RULES AND REGULATIONS ADOPTED BY THE BOARD OF DIRECTORS OF THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | A CERTIFICATE OF MEMBERSHIP SHALL ENTITLE THE LEGAL HOLDER TO ONE VOTE UPON MATTERS SUBMITTED TO A VOTE AT A MEETING OF THE MEMBERS. WHERE THE LEGAL HOLDER OF THE CERTIFICATE IS A FIRM, ASSOCIATION, CORPORATION, OR A BODY POLITIC, OR A SUBDIVISION THEREOF, THE PRESIDENT, CHIEF EXECUTIVE OFFICER OR HIS DESIGNEE SHALL CAST THE VOTE. ALL QUESTIONS REQUIRING A VOTE OF THE MEMBERS SHALL BE DECIDED BY A VOTE OF A MAJORITY OF THE MEMBERS PRESENT EXCEPT AS OTHERWISE PROVIDED BY LAW, THE ARTICLES OF INCORPORATION OR THE BYLAWS. |
| FORM 990, PART VI, SECTION A, LINE 7B | 1. ANY SALE, LEASE, OR EXCHANGE OF ALL OR SUBSTANTIALLY ALL OF CORPORATE PROPERTY AND ASSETS OR ANY DISSOLUTION OF THE CORPORATION SHALL BE GOVERNED BY K.S.A. 17-6801 ET SEQ., REQUIRING A MAJORITY VOTE OF THE MEMBERS ENTITLED TO VOTE THEREON AT A DULY CALLED MEETING OF THE MEMBERS. 2. THE BYLAWS MAY NOT BE AMENDED, REVISED, OR REPEALED WITHOUT VOTE BY THE MEMBERSHIP. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE CFO GATHERS INFORMATION TO PREPARE THE FORM 990 TAX RETURN. THIS INFORMATION IS THEN GIVEN TO AN INDEPENDENT ACCOUNTING FIRM WHO PREPARES AND REVIEWS THE FORM 990. THE INDEPENDENT ACCOUNTING FIRM THEN PROVIDES THE CFO AND FINANCE COMMITTEE A DRAFT OF THE FORM 990 FOR COMMENTS AND APPROVAL. ONCE THE CFO, FINANCE COMMITTEE, AND THE CPA FIRM APPROVE THE FORM 990, A COPY OF THE FORM 990 IS GIVEN TO THE GOVERNING BOARD MEMBERS ALONG WITH A RESPONSE TIME FOR QUESTIONS AND COMMENTS. ALL ISSUES ARE RESOLVED, A FINAL COPY OF THE FORM 990 IS SENT TO THE ENTIRE BOARD, AND THE 990 IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD OF DIRECTORS, OFFICERS, AND COMMITTEE MEMBERS WILL COMPLETE A DISCLOSURE STATEMENT AT THE BEGINNING OF EACH CMH FISCAL YEAR AND PROVIDE SUCH STATEMENT TO THE CMH COMPLIANCE OFFICER. THE DISCLOSURE STATEMENT SHALL INCLUDE ANY INVESTMENT IN, OR ANY MANAGERIAL, CONSULTING, OR EMPLOYMENT RELATIONSHIP WITH, ANY OUTSIDE ENTITY THAT PROVIDES OR SEEKS TO PROVIDE GOODS OR SERVICES TO CMH, COMPETES WITH, OR INCLUDES CMH AS A JOINT VENTURE OR EQUITY INVESTOR. THE INTERESTED DIRECTOR SHOULD ABSTAIN FROM DISCUSSION AND VOTING ON THE MATTER BY TEMPORARILY LEAVING THE BOARD MEETING WHILE THE DISINTERESTED DIRECTORS DISCUSS AND VOTE. THE DISCLOSURE AND ABSTENTION SHALL BE RECORDED IN THE MINUTES OF THE BOARD MEETING. |
| FORM 990, PART VI, SECTION B, LINES 15A & 15B | THE COMPENSATION COMMITTEE EXISTS TO DESIGN, IMPLEMENT, AND EVALUATE BONUS CRITERIA FOR THE CEO'S COMPENSATION. FURTHERMORE, THE COMPENSATION COMMITTEE COMPLETES MEDICAL STAFF CONTRACT NEGOTIATIONS, EVALUATES AND COMPARES PERSONNEL WAGES TO INDUSTRY BENCHMARKS, AND PERFORMS THE CEO AND BOARD EVALUATIONS. THE COMPENSATION COMMITTEE CONSISTS OF FOUR MEMBERS OF THE BOARD AND THE COMMITTEE MEETS AT LEAST SEMI-ANNUALLY OR MORE FREQUENTLY AS NECESSARY. THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS LAST MET AND REVIEWED THE CEO COMPENSATION 10/21/14. THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS LAST MET AND REVIEWED THE PHYSICIAN COMPENSATION IN OCTOBER 2015. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. |
| FORM 990, PART XI, LINE 9 | NET ASSET TRANSFER TO CMH FOUNDATION $ ( 104,525) |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACT SVC-PHYSICAL THERAPY TOTAL FEES:929038 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACT SVC-ANESTHESIOLOGY TOTAL FEES:497891 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACT SVC-NUC MED TOTAL FEES:165798 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER FEES FOR SERVICES TOTAL FEES:840756 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CMH FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 708 N 18TH STREET | AddressLine1Txt |
| City | MARYSVILLE | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 66508 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 320297285 | EIN |
| Primary Activities | SUPPORT | PrimaryActivitiesTxt |
| Legal Domicile State | KS | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 11A | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CMH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (true) | ControlledOrganizationInd |
| 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 | Yes (true) | 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 | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | 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 |