2016-05-05T15:57:23-05:00 2015-06-30 481026809 Wendling Noe Nelson & Johnson LLC 534 S Kansas Ave Suite 1500 Topeka KS 666033491 990 2014-07-01 480799105 McPherson Hospital Inc MCPH 6202412250 1000 Hospital Drive McPherson KS 674602326 Robert Monical CEO 6202412250 2016-05-03 1 Heather R Eichem P01515553 7852334226 2016-05-03 2014 2016-08-17 19:52:53Z Robert Monical 1000 Hospital Drive McPherson KS 674602326 25231644 0 X www.mcphersonmemorial.org X 1972 KS Provision of acute hospital care to patients regardless of ability to pay. 12 12 340 113 0 0 866095 1469449 21432493 23252651 139044 81575 413301 423878 22850933 25227553 15980 13732 0 0 11686614 12747380 0 0 0 12477196 14020559 24179790 26781671 -1328857 -1554118 19501937 21516079 1988257 4179025 17513680 17337054 To meet our community's need by providing superior health care and exceptional service for each person, every time. 0 0 23187069 13732 23292588 Provision of inpatient and outpatient hospital services. 23187069 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 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 68 0 1 340 1 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 Tim Karstetter Vice Chairperson 2.00 X X 0 0 0 Chet Lang Trustee 2.00 X 0 0 0 Dan Lichty MD 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 Samuel Claassen MD Trustee thru 12/31/15 / Physician 40.00 X 220128 0 20516 Dean Elliott Trustee thru 12/31/15 2.00 X 0 0 0 J David Ferrell Trustee thru 12/31/15 2.00 X 0 0 0 Clayton Fetsch MD Physician 40.00 X 280861 0 24477 Tyler G Hughes MD Physician 40.00 X 278564 0 23185 Michael Bloustine MD Physician 40.00 X 262479 0 7989 John Worden Lab and Pharmacy Director 40.00 X 142198 0 17397 Andrea Herrera MD Physician 40.00 X 137813 0 13171 1322043 0 106735 7 0 1 0 Via Christi Health Inc 8200 E Thorn Wichita KS 67226 Management fees and CEO, CFO & CNO servi 1936077 EMS LLC 920 Main Ste 300 Kansas City MO 64105 ER physician coverage 1128692 Rehabvisions 11623 Arbor St Omaha NE 68144 Physical/occupational therapy 737520 EMSC LLC 3521 Bayview Ct Wichita KS 67204 ER physician coverage 690998 Trimedx LLC 209 Limestone Pass Cotton Grove WI 53527 Clinical equipment servicer 388683 12 70508 1300542 98399 1469449 Net patient service revenue 900099 22285586 22285586 EHR incentive payment 900099 967065 967065 23252651 85666 85666 75576 0 75576 75576 75576 4091 -4091 -4091 -4091 Nonpatient meals 722210 177338 177338 Auxiliary 900099 84297 84297 Fitness center 713940 46730 46730 39937 39937 348302 25227553 23292588 0 465516 X 13732 13732 226389 226389 10575481 9523877 1051604 263900 237217 26683 912021 820997 91024 769589 694459 75130 1043414 539723 503691 14360 14360 5756655 5264428 492227 60416 3096 57320 192810 114834 77976 545419 409064 136355 522806 389438 133368 39980 28666 11314 10501 7250 3251 17728 13206 4522 1349933 1005565 344368 272853 106401 166452 Medical supplies 1346934 1346934 Equipment rental & main 1119881 1056940 62941 Pharmacy supplies 806268 806268 Dietary food & supplies 274917 254416 20501 645684 324169 321515 26781671 23187069 3594602 0 2483 2802 3386298 2051794 3274887 4645285 480268 564777 184870 54409 29494887 22941671 6766034 6553216 2720841 1426116 2686256 6217680 19501937 21516079 1844620 3690001 393580 143637 95444 1988257 4179025 X 15064772 13368766 1510399 3029779 938509 938509 17513680 17337054 19501937 21516079 X -1554118 -109803 1487295 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 11215 0 0 0 11215 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. 1190121 1262657 80038 81715 2451101 1065492 46956 162884 -73602 1190121 957909 41166 149077 -82660 1065492 1001082 12198 19182 -74239 -314 957909 853047 47383 125329 -24677 1001082 0.05000 0.34000 0.61000 1 1 1 16312 16312 15005143 11450021 3555122 13064997 10283312 2781685 1408435 1208338 200097 6553216 Other receivables 897937 Beneficial interest in net assets of the Foundation 3683969 Goodwill 19326 Estimated third-party payor settlements 250038 Building rights 1366410 6217680 Estimated third-party payor settlements 52467 Estimated liability for receivables sold with recourse 42977 95444 X 26605045 -109803 1487295 1377492 25227553 0 25227553 26781671 0 26781671 0 26781671 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 1,487,295. 1 1 1 X 1 X 1 1 1 0 0 949587 98293 851294 0.03180 2135886 724952 1410934 0.05270 3085473 823245 2262228 0.08450 4797 4797 0.00020 13000 13000 0.00050 9212496 6266193 2946303 0.11000 25409 25409 0.00090 9255702 6266193 2989509 0.11160 12341175 7089438 5251737 0.19610 1 129366 0 5094936 5350943 -256007 X 1 1 1 1 McPherson Hospital Inc 1000 Hospital Drive McPherson KS 67460 X X X McPherson Hospital Inc 1 0 0 1 X X X X X X X 12 1 1 1 1 X http://www.mcphersonhospital.org/about-us X 1 12 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. The McPherson County CHNA process included gathering opinions from local sources and quantitative data from secondary sources. A survey instrument was developed by the leadership of the participating hospitals and the public health department. The survey was distributed to individuals throughout the county, representing a broad spectrum of the population and their interests and professional and community endeavors. Included were individuals representing health care, law enforcement, family advocacy, United Way, civic leadership, education, religion, and seniors, among others. A total of 158 surveys were distributed with 106 returned for a 67% return rate. The identified weaknesses through the survey results were reviewed and prioritized by a workgroup comprised of a cross section of survey respondents from throughout the county. This group met to discuss survey results and explore relevant county secondary data from various sources. The workgroup was split into subgroups and asked to rank the top five health issues gleaned from the survey to arrive at a prioritized list. 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: Activities with the Kansas State University Extension Office: The hospital participated in the Walk Kansas event held last spring, providing teams and resources to encourage participation from the community. Over 370 individuals participated last spring, an increase over the previous year. 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: Other community-based efforts created an inability to sponsor these events this year. A series of monthly physician and other provider-led events are planned for the Spring of 2016.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 are currently 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, and a general surgeon as moderators 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": The hospital co-sponsors this local wellness initiative early each fall. Through organized teams, the importance of exercise and proper nutrition is communicated and encouraged. Teams are engaged in activities and challenges for healthy eating and exercise with individual and team results targeted and monitored. A total of 62 individuals participated during fiscal year ended 2015.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 soon.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, and is posted on the hospital website. 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 other community-based initiatives, this directory has been delayed but is currently being developed with the assistance of the McPherson County Health Department. It is targeted for a spring 2016 distribution to appropriate agencies and organizations in the community. McPherson Hospital, Inc. Part V, Section B, Line 16i: We assist applicants fill out the form. Part V, Section B, Line 16 Financial Assistance Policy Website Availability McPherson Hospital, Inc. Part V, Section B, line 16b website: http://www.mcphersonhospital.org/patients-visitors/billing-financial-assist 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 $3,970,954 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, 2015. 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 2014 census information, the per capita income for McPherson was $28,786. The percent of individuals below poverty level was 7.5. For the year ending June 30, 2015, 8 percent of the Hospital's inpatient admissions were Medicaid recipients and 6 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. 1 Scholarship awards for local students pursuing education in the health care industry. 13 13000 Part I, Line 2: Scholarship checks are not provided to students until verification is received from the school that the student has begun classes. X X X 0 0 0 0 0 0 0 0 0 Samuel Claassen MD Trustee thru 12/31/15 / Physician 184283 0 35845 0 0 0 10983 0 9533 0 240644 0 0 0 Clayton Fetsch MD Physician 280796 0 65 0 0 0 13260 0 11217 0 305338 0 0 0 Tyler G Hughes MD Physician 278564 0 0 0 0 0 13260 0 9925 0 301749 0 0 0 Michael Bloustine MD Physician 262479 0 0 0 0 0 3113 0 4876 0 270468 0 0 0 John Worden Lab and Pharmacy Director 142198 0 0 0 0 0 6776 0 10621 0 159595 0 0 0 Andrea Herrera MD Physician 120128 0 17685 0 0 0 5938 0 7233 0 150984 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 2014, McPherson Hospital reimbursed Via Christi $210,079 for Robert Monical, CEO's salary and benefits, $145,687 for George Halama, CFO's salary and benefits, and $88,721 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 2,612,571. Management and general expenses 23,336. Fundraising expenses 0. Total expenses 2,635,907. Other medical personnel professional fees: Program service expenses 1,524,269. Management and general expenses 84,660. Fundraising expenses 0. Total expenses 1,608,929. Non physician professional services: Program service expenses 505,785. Management and general expenses 0. Fundraising expenses 0. Total expenses 505,785. Other purchased services: Program service expenses 621,803. Management and general expenses 384,231. Fundraising expenses 0. Total expenses 1,006,034. Form 990, Part XI, line 9: Change in beneficial interest in net assets of Foundation 1,487,295. 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 0 0 0 0 0 0