2015-11-11T13:33:39-06:00 2014-12-31 BKD LLP 1551 N WATERFRONT PKWY STE 300 WICHITA KS 672066601 990 2014-01-01 481236156 GREAT PLAINS OF SABETHA INC % MIKE HAND GREA 3166851523 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 MIKE HAND CFO AND SENIOR VICE PRESIDENT 7855432111 2015-11-15 true ELIZABETH S HOGAN P00273248 3162652811 2014 2016-03-07 17:11:31Z MIKE HAND 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 11540412 false X WWW.SABETHAHOSPITAL.COM X 2000 KS ACUTE CARE HOSPITAL THAT PROVIDES MEDICAL CARE TO THE GENERAL PUBLIC IN SABETHA, KANSAS AND SURROUNDING RURAL COMMUNITIES. 10 9 167 69 0 466057 212800 10308408 10889871 16736 -53 206954 388423 10998155 11491041 0 0 0 0 6485258 6705988 0 0 0 4547291 4593740 11032549 11299728 -34394 191313 7533531 7892337 1607258 1897732 5926273 5994605 X TO OPERATE HOSPITAL FACILITIES FOR THE DELIVERY OF HOSPITAL AND RELATED HEALTH CARE SERVICES, HEALTH RELATED EDUCATION, AS WELL AS THE PROMOTION OF HEALTH AND WELLNESS, WITHOUT REGARD TO RACE, CREED, COLOR, SEX, OR FINANCIAL CIRCUMSTANCES. false false 9599651 0 11160547 SEE SCHEDULE O. 9599651 true true false true false false false false false false true false false false false false true true false false false false false false false false true true false false true false false false false false false false false true false false false false true true false false false true 25 0 true 167 true false false false false false true true false false false false X 10 9 true false false false true true true true true false false true true true true true true false false false X MIKE HAND 3166851523 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 THOMAS E KELLER DVM CHAIRMAN/DIRECTOR 0.25 2.25 X X 0 0 0 DAVE DELLASEGA PRESIDENT/CEO/DIRECTOR 2.0 40.0 X X 0 184141 29272 BILL NAVIS VICE PRESIDENT/DIRECTOR 0.25 2.25 X X 0 0 0 JOHN TERRILL VICE PRESIDENT/DIRECTOR 0.25 2.25 X X 0 0 0 ROBERT HAMILTON SECRETARY/DIRECTOR 0.25 2.25 X X 0 0 0 STEVE CARLSON TREASURER/DIRECTOR 0.25 2.25 X X 0 0 0 DAVE RANKIN DIRECTOR 0.25 2.25 X 0 0 0 DR BARBARA BROWN APPLEGATE DIRECTOR 0.25 2.25 X 0 0 0 TERRY DESCHAINE DIRECTOR 0.25 2.25 X 0 0 0 LOGAN SPRUNGER VICE PRESIDENT/DIRECTOR 0.25 2.25 X X 0 0 0 BETH MEYERES VICE PRESIDENT/DIRECTOR 0.25 2.25 X X 0 0 0 MIKE HAND CFO 2.0 40.0 X 0 136809 33148 LORA KEY ADMINISTRATOR 40.0 0.0 X 92940 0 27973 KEVIN KENNALLY PHYSICIAN 40.0 0.0 X 276982 0 45032 GREGG WENGER PHYSICIAN 40.0 0.0 X 187822 0 29108 JAMES LONGABAUGH PHYSICIAN 40.0 0.0 X 225714 0 34225 CHRISTIAN TRAMP PHYSICIAN 40.0 0.0 X 217340 0 40880 KERSTIN GLYNN PHYSICIAN 40.0 0.0 X 250627 0 41954 1251425 320950 281592 5 false true false EXEC PARTNERS IN ANESTHESIA ANESTHESIA SERVICES 350000 MHS DATA CENTER COMPUTER SUPPORT 239965 STORMONT VAIL HEALTHCARE LAB SERVICES 124106 GPHA MANAGEMENT 123303 SHARED MEDICAL SERVICES INC MRI SERVICES 107100 5 14394 8790 189616 72778 212800 NET PATIENT SERVICE REVENUE 621300 10889871 10889871 10889871 17708 17708 0 0 16500 16500 0 16500 16500 28386 46147 -17761 -17761 -17761 14394 3224 -3224 -3224 0 0 EHR INCENTIVE REVENUE 900099 218208 218208 OUTSIDE SERVICES 621300 47468 47468 EMPLOYEE/GUEST MEALS 722513 15648 15648 93823 5000 88823 375147 11491041 11160547 117694 0 0 0 0 120913 120913 0 5289522 4607763 681759 418798 358139 60659 516864 398386 118478 359891 307700 52191 105327 105327 6357 6357 37940 37940 0 0 0 1298140 1093867 204273 26223 12943 13280 221924 152243 69681 12634 5882 6752 0 232492 221233 11259 16315 5226 11089 0 48138 36868 11270 17284 15953 1331 0 650254 604502 45752 120802 37839 82963 MEDICAL SUPPLIES & DRUGS 1261976 1261960 16 RENTAL EQUIPMENT & REPAIRS 335376 320070 15306 BAD DEBT EXPENSE 101590 101590 DUES & SUBSCRIPTIONS 45705 17158 28547 55263 40329 14934 11299728 9599651 1700077 0 220 220 909276 1672426 13243 5603 1396966 1913395 0 0 0 0 0 0 193606 176867 104132 112692 12139139 8353931 4172532 3785208 0 0 233556 225926 0 0 0 0 510000 0 7533531 7892337 1052361 1443802 0 0 0 0 0 0 0 0 0 0 554897 453930 0 0 0 0 1607258 1897732 X 5913030 5989002 13243 5603 0 0 5926273 5994605 7533531 7892337 X 191313 -122981 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X true false false false false false true 2892 false false false 2892 false SCHEDULE C, PART II-B, LINE 1F A PORTION OF THE ANNUAL DUES PAID TO KHA AND AHA ARE USED FOR LOBBYING. 0 44744 44744 0 6468530 3990123 2478407 0 5421846 4197255 1224591 0 204019 166553 37466 3785208 11426294 -64747 -64747 11491041 11491041 11357962 159824 159824 11198138 101590 101590 11299728 SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D EQUITY IN EARNINGS SABETHA HEALTHCARE, INC. 33,619 SPECIAL EVENT EXPENSES 3,224 PROVISION FOR UNCOLLECTIBLE ACCOUNTS (101,590) ---------- TOTAL $ (64,747) SCHEDULE D, PART XII, LINE 2D TRANSFER TO CITY OF SABETHA 156,600 SPECIAL EVENT EXPENSES 3,224 ---------- TOTAL $ 159,824 SCHEDULE D, PART XII, LINE 4B PROVISION FOR UNCOLLECTIBLE ACCOUNTS 101,590 true true false true X true true false true true 46648 46648 0.00400 426418 198518 227900 0.02000 473066 198518 274548 0.02400 17 284568 189634 94934 0.00800 1 238 238 3 11 3821 3821 21 11 288627 189634 98993 0.00800 21 11 761693 388152 373541 0.03200 false 101591 4257566 4257566 X true true 1 1 SABETHA COMMUNITY HOSPITAL 14TH OREGON PO BOX 229 SABETHA KS 66534 WWW.SABETHAHOSPITAL.ORG H066002 X X X X SABETHA COMMUNITY HOSPITAL 1 false false true X X X X X X X X X 13 true true false true X WWW.SABETHAHOSPITAL.COM true 13 true WWW.SABETHAHOSPITAL.COM false false true X 0. 300. X X X true true X X true X X X X X X X X true X false X X X X true X X false false SCHEDULE H, PART V, SECTION B, LINE 5 A PRIORITY OF THE PROGRAM IS TO SOLICIT INPUT FROM A BROAD CROSS SECTION OF THE COMMUNITY, NOT SIMPLY MEMBERS OF THE LOCAL HEALTHCARE SECTOR. THE MEETING PARTICIPANTS INCLUDED COMMUNITY RESIDENTS AND GOVERNMENTAL AND BUSINESS LEADERS WITHIN THE COMMUNITY. SCHEDULE H, PART V, SECTION B, LINE 6A NEMAHA VALLEY COMMUNITY HOSPITAL SCHEDULE H, PART V, SECTION B, LINE 11 SABETHA COMMUNITY HOSPITAL INTENDS TO PROMOTE HEALTH AND WELLNESS THROUGH MONTHLY EDUCATIONAL CALENDARS, NEWS ARTICLES IN THE LOCAL NEWSPAPER, AND HOSTING EDUCATIONAL CLASSES AND EVENTS. ANOTHER PRIORITY IDENTIFIED BY THE CHNA WAS TO IMPROVE ACCESS TO MENTAL HEALTH ASSISTANCE. THE HOSPITAL HAS MET WITH KANZA MENTAL HEALTH TO WORK ON CREATING A BETTER RELATIONSHIP. THE SCREENING PROCESS IS NOW THROUGH VIDEO RATHER THAN IN PERSON, WHICH CREATES A SHORTER WAIT TIME FOR THE PATIENT. IMPROVING ACCESS TO INFORMATION AND ASSISTANCE WAS ALSO AN IDENTIFIED NEED OF THE COMMUNITY. THE COMMITTEE, AFTER MUCH RESEARCH, DECIDED TO TABLE THE COUNTY-WIDE APP DEVELOPMENT UNTIL WEBSITE IMPROVEMENTS WERE MADE, FUNDING OPTIONS WERE FOUND, AND AN ENTITY TO BE RESPONSIBLE FOR THE MAINTENANCE OF THE DATABASE COULD BE FOUND. SCHEDULE H, PART V, SECTION B, LINE 13H THE ORGANIZATION EMPLOYS A SLIDING SCALE DISCOUNT THAT TAKES INTO CONSIDERATION A PATIENT'S HOUSEHOLD INCOME AND QUALIFYING ASSETS. TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, A PATIENT'S HOUSEHOLD INCOME MUST BE BELOW 300% OF THE MOST RECENT FEDERAL POVERTY LEVEL AT THE DATE OF SERVICE. TO DETERMINE THE AMOUNT OF THE DISCOUNT, AN ASSET TEST IS ALSO UTILIZED. 1 SABETHA FAMILY PRACTICE 1115 MAIN STREET SABETHA KS 66534 FAMILY CLINIC SCHEDULE H, PART I, LINE 3C THE ORGANIZATION EMPLOYS A SLIDING SCALE DISCOUNT THAT TAKES INTO CONSIDERATION A PATIENT'S HOUSEHOLD INCOME AND QUALIFYING ASSETS. TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, A PATIENT'S HOUSEHOLD INCOME MUST BE BELOW 300% OF THE MOST RECENT FEDERAL POVERTY LEVEL AT THE DATE OF SERVICE. TO DETERMINE THE AMOUNT OF THE DISCOUNT, AN ASSET TEST IS ALSO UTILIZED. SCHEDULE H, PART I, LINE 7, COLUMN F THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $101,591. SCHEDULE H, PART I, LINE 7 THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART I, LINE 7, OF SCHEDULE H, IS A COST TO CHARGE RATIO. SCHEDULE H, PART III, LINE 2 HOSPITAL CHARGES THAT ARE NOT COLLECTED AND ARE NOT APPROVED FOR FINANCIAL ASSISTANCE ARE CLASSIFIED AS BAD DEBTS FROM PATIENTS WHO WILL NOT PAY. SCHEDULE H, PART III, LINE 3 THE COSTING METHODOLOGY IS BASED ON THE ORGANIZATION'S MEDICARE COST-TO-CHARGE RATIO. WHILE WE RECOGNIZE THAT THERE WOULD BE SOME BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY, WE HAVE NO REASONABLE BASIS FOR ESTIMATING THIS FIGURE. IF ELIGIBILITY IS KNOWN, THE AMOUNT WOULD FALL UNDER CHARITY CARE AND NOT BAD DEBT. SCHEDULE H, PART III, LINE 4 NO SEPARATE BAD DEBT EXPENSE DISCLOSURE. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. DISCLOSURES ON PROVISION FOR DOUBTFUL ACCOUNT ARE RELATED TO DISCLOSURES REGARDING THE ALLOWANCE FOR DOUBTFUL ACCOUNTS WHICH IS SET FOR ALL NON-MEDICARE ACCOUNTS RECEIVABLE OVER 150 DAYS OLD. THE PROVISION FOR DOUBTFUL ACCOUNTS IS A SEPARATE EXPENSE ON THE STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS. SCHEDULE H, PART III, LINE 8 THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNT ON LINE 6 IS A COST TO CHARGE RATIO. SCHEDULE H, PART III, LINE 9B ALL CHARITY CARE CHARGES AND CHARGES NOT TO BE COLLECTED DUE TO FINANCIAL ASSISTANCE COMPUTATIONS ARE EXEMPTED FROM COLLECTION POLICIES AND PRACTICES. THOSE ACCOUNTS ARE REMOVED FROM THE COLLECTION CYCLE. SCHEDULE H, PART VI, LINE 2 SABETHA COMMUNITY HOSPITAL AND NEMAHA VALLEY COMMUNITY HOSPITAL PARTNERED IN OCTOBER OF 2012 AND CONDUCTED A COMMUNITY HEALTH CARE NEEDS ASSESSMENT. NUMEROUS OBJECTIVES WERE IDENTIFIED BUT THE MAIN PRIORITIES TO BE ADDRESSED ARE 1) PROMOTE HEALTH, WELLNESS, AND CHRONIC DISEASE PREVENTION; 2) IMPROVE ACCESS TO MENTAL HEALTH ASSISTANCE; 3) IMPROVE ACCESS TO INFORMATION AND ASSISTANCE ACROSS MULTIPLE NEEDS AND POPULATIONS. THE CHNA IS POSTED ON THE SABETHA COMMUNITY HOSPITALS WEBSITE FOR EASY ACCESS BY THE COMMUNITIES. IN 2014, SCH COMMITTED TO FURTHERING THOSE PRIORITIES IN THE COMMUNITY THROUGH INVOLVEMENT OF THE MEDICAL STAFF, BOARD OF DIRECTORS, AND OTHER IDENTIFIED STAFF MEMBERS. DURING 2014, THE HOSPITAL UPDATED ITS WEBSITE AND THE HOME HEALTH AND HOSPICE AGENCY ADDED A SOCIAL MEDIA PAGE. TO ADDRESS PRIORITY #1; THE HOSPITAL PROVIDED EDUCATIONAL INFORMATION THROUGH ITS MONTHLY OUTPATIENT CALENDARS AND THROUGH THE MULTIPLE CLINICS PROVIDED TO THE COMMUNITY - A DERMATOLOGY AND BREASTFEEDING CLINIC WAS ADDED IN 2014. DIABETIC EDUCATION CONTINUES TO BE A PRIORITY AND THE DIABETIC EDUCATOR AND DIETICIAN PARTNERED WITH BCBS OF KANSAS TO PRESENT, "DIABETES AND YOU" TO THE COMMUNITY. THROUGH THE HOSPICE PROGRAM, BEREAVEMENT SUPPORT AND EDUCATION MATERIALS ARE PROVIDED FOR THOSE IN THE COMMUNITY WHO HAVE LOST LOVED ONES. IN NOVEMBER, MEDICARE PART D INFORMATIONAL MEETINGS WERE CONDUCTED FOR MEDICARE ELIGIBLE PATIENTS, AND THROUGHOUT THE YEAR THE HOSPITAL SOCIAL WORKER CONTINUES TO PROVIDE ENROLLMENT ASSISTANCE SUCH AS MEDICAID, MEDICARE AND THIRD PARTY PAYERS TO LOCAL COMMUNITY MEMBERS. THE HOSPITAL TRAUMA PROGRAM PROVIDED SAFETY EDUCATION AND ITEMS TO THE LOCAL GUN SAFETY EDUCATION CLASS. THE HOSPITAL CONTINUES TO PARTICIPATE IN THE HCAPS SURVEY AND RESULTS ARE REVIEWED WITH STAFF ANNUALLY. THE HOSPITAL IS PARTICIPATING IN THE KANSAS HEALTH ENGAGEMENT NETWORK AND HAS SUCCESSFULLY COMPLETED SEVERAL QUALITY PROJECTS. PRIORITY #2; SCH AND NVCH EXPLORED SEVERAL OPTIONS FOR BETTER ACCESS TO MENTAL HEALTH. DISCUSSIONS WERE HELD WITH THE COMMUNITY MENTAL HEALTH CENTER AND THE OUTCOME WAS A CRISIS MENTAL HEALTH SCREENING TOOL USED WITHIN THE ED. FURTHER OPTIONS WERE EXPLORED BUT FINANCIAL FEASIBILITY WAS A CONSTRAINT. AS MENTIONED EARLIER PRIORITY #3; TO IMPROVE ACCESS TO INFORMATION AND ASSISTANCE RESOURCES - THE HOSPITAL DID UPDATE ITS WEBSITE AND POSTED THE DIRECTORY FROM THE 2012 CHNA ON THE WEBSITE. THE HOME HEALTH AND HOSPICE SOCIAL MEDIA PAGE IS USED ALSO TO UPDATE THE COMMUNITY ON RESOURCES. THE SOCIAL WORKER WORKS WITH A LOCAL GROUP THROUGH THE LIBRARY, DAYCARE, PARENTS AS TEACHERS, AND OTHER ORGANIZATIONS TO REMAIN UPDATED ON COMMUNITY RESOURCES AND NEEDS, AND TO SHARE HOSPITAL RESOURCES BACK TO THE COMMUNITY. SCHEDULE H, PART VI, LINE 3 THE FOLLOWING MEASURES ARE USED TO PUBLICIZE THE PROGRAM TO THE COMMUNITY AND PATIENTS: 1. POSTING THE FINANCIAL ASSISTANCE PROGRAM, FINANCIAL ASSISTANCE APPLICATION AND A SUMMARY OF THE POLICY ON THE SABETHA COMMUNITY HOSPITAL WEBSITE AT THE FOLLOWING LOCATION: WWW.SABETHAHOSPITAL.COM 2. PROVIDING PAPER COPIES OF THE PROGRAM, APPLICATION AND SUMMARY OF THE PROGRAM UPON REQUEST IN ADMISSIONS AND PATIENT FINANCIAL SERVICES AT SABETHA COMMUNITY HOSPITAL. 3. POSTING NOTICES ABOUT THE PROGRAM IN THE EMERGENCY DEPARTMENT, ADMITTING AREAS, CLINIC LOBBY AND BUSINESS OFFICE OF SABETHA COMMUNITY HOSPITAL. 4. DISTRIBUTING A PLAIN LANGUAGE SUMMARY OF THE PROGRAM AND OFFERING A FINANCIAL ASSISTANCE APPLICATION TO PATIENTS BEFORE DISCHARGE FROM THE HOSPITAL. 5. INFORMING PATIENTS ABOUT THE PROGRAM IN PERSON OR DURING BILLING AND CUSTOMER SERVICE PHONE CONTACTS. 6. PROVIDING A SUMMARY OF THE PROGRAM IN THE PATIENTS' MONTHLY BILLING STATEMENT. THE FINANCIAL ASSISTANCE PROGRAM EMPLOYS A SLIDING SCALE DISCOUNT THAT TAKES INTO CONSIDERATION A PATIENT'S HOUSEHOLD INCOME AND QUALIFYING ASSETS. THE FINANCIAL COUNSELOR CONSULTS WITH PRIVATE PAY PATIENTS TO SEE IF THEY QUALIFY FOR THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. IF DISCOVERED DURING THE ACCOUNTS RECEIVABLE COLLECTION PROCESS THAT A PATIENT IS HAVING TROUBLE PAYING BILLS, BOTH THE HOSPITAL AND THE CLINIC WILL INFORM THE PATIENT THAT FINANCIAL ASSISTANCE IS AVAILABLE. AS PART OF THE FINANCIAL ASSISTANCE PROGRAM ALL APPLICANTS MUST APPLY FOR MEDICAID. TO DETERMINE IF THE PATIENT MAY QUALIFY FOR FINANCIAL ASSISTANCE, THE FINANCIAL COUNSELOR GIVES PATIENT FORMS TO COMPLETE AND ASKS TO SEE BANK STATEMENTS, TAX RETURNS, ETC. COMPUTATIONS BASED ON CURRENT FEDERAL POVERTY LEVEL GUIDELINES ARE COMPLETED TO SEE IF QUALIFICATIONS IS APPROPRIATE AND THE PERCENTAGE OF CHARGES TO BE WRITTEN OFF IS DETERMINED, BASED ON FAMILY SIZE AND HOUSEHOLD INCOME. ALL INSTANCES OF FINANCIAL ASSISTANCE ARE APPROVED BY UPPER MANAGEMENT OF THE HOSPITAL. INFORMATION ABOUT FINANCIAL ASSISTANCE IS POSTED ON THE HOSPITAL WEBSITE AND THE FINANCIAL ASSISTANCE FORM CAN BE DOWNLOADED FROM WWW.SABETHAHOSPITAL.COM SCHEDULE H, PART VI, LINE 4 SABETHA COMMUNITY HOSPITAL IS A 25 BED CRITICAL ACCESS HOSPITAL LOCATED IN THE CITY OF SABETHA, NEMAHA COUNTY KANSAS. CURRENTLY THE POPULATION IS ESTIMATED AT 2800. THE PRIMARY SERVICE AREA FOR SABETHA COMMUNITY HOSPITAL INCLUDES PORTIONS OF NEMAHA, BROWN AND JACKSON COUNTY, KANSAS AND SEVERAL COUNTIES IN NEBRASKA. NEMAHA COUNTY PROVIDED 78.5% OF INPATIENT DISCHARGES FOR 2014. ESTIMATED POPULATION FOR NEMAHA COUNTY IS 10,161 ACCORDING TO THE KANSAS STATE RESEARCH AND EXTENSION ECONOMIC IMPACT STUDY. PEOPLE AGE 65 AND OVER MAKE UP 20.2% OF THE COUNTYS TOTAL POPULATION. THE RACIAL AND ETHNIC COMPOSITION OF NEMAHA COUNTY IS MOSTLY WHITE WHICH IS AT 97.1%, NATIVE AMERICAN .6%, AFRICAN AMERICANS .7%, ASIANS .2% AND HISPANICS WERE 1.4% OF THE POPULATION. SCHEDULE H, PART VI, LINE 5 SABETHA COMMUNITY HOSPITALS EMERGENCY ROOM/TRAUMA QUALITY ASSURANCE COMMITTEE MEETS MONTHLY TO MAINTAIN THE LEVEL IV TRAUMA CENTER DESIGNATION. THE COMMITTEE PROVIDED GUN LOCKS TO THE LOCAL FIREARMS GROUP DURING THEIR SAFETY EDUCATION CLASS AND FIRE PREVENTION BOOKLETS TO THE ELEMENTARY STUDENTS TO PROMOTE FIRE SAFETY. ALL CRITERIA WAS MET IN 2014 TO MAINTAIN THE DESIGNATION AS A STROKE READY FACILITY. SABETHA FAMILY PRACTICE CONTINUED TO PURSUE THE NCQA DESIGNATION. SFP IMPLEMENTED A PATIENT PORTAL TO TRY AND MEET CRITERIA FOR STAGE 2 MEANINGFUL USE OF THE ELECTRONIC RECORD. THE HOSPITAL ADDED A PATIENT PORTAL AS WELL AS MAINTAINING THE CURRENT MODULES FOR THE SIEMENS MEDSERIES 4 ELECTRONIC HEALTH RECORD. THROUGHOUT 2014, THE HOSPITAL MAINTAINED ITS CERTIFICATION AS A MEDICARE CERTIFIED DIABETIC EDUCATION FACILITY, AND THE CERTIFIED DIABETIC NURSE EDUCATOR ALONG WITH THE REGISTERED DIETICIAN PROVIDED A SUPPORT GROUP TO DIABETIC PATIENTS PROMOTING LIFE STYLE CHANGES AND ACCOUNTABILITY IN THEIR DIABETIC JOURNEY. SCH ALSO PARTNERED WITH BCBS OF KANSAS FOR A COMMUNITY DIABETIC EDUCATION EVENT. THE WELLNESS COORDINATOR OF THE HOSPITAL SITS ON THE WELLNESS COUNCIL FOR THE LOCAL SCHOOL DISTRICT. THE HOSPITAL ALSO PROMOTES WELLNESS AMONG EMPLOYEES BY PROVIDING A CORPORATE MEMBERSHIP TO THE COMMUNITY FITNESS ROOM. IN MARCH, EMPLOYEES AND THE COMMUNITY WERE ENCOURAGED TO PARTICIPATE IN THE ANNUAL WALK ACROSS KANSAS PROGRAM PROMOTED BY THE MEADOWLARK COUNTY EXTENSION OFFICE. MONTHLY OUTPATIENT CALENDARS FOCUSING ON HEALTH ISSUES ARE PUBLISHED AND SENT OUT TO THE COMMUNITY AND SURROUNDING AREAS. SABETHA COMMUNITY HOSPITAL GUILD MEMBERS VOLUNTEER TO COORDINATE EFFORTS TO HOLD BLOODMOBILE CLINICS AND THE HOSPITAL VOLUNTEER CORE CONTINUES TO REMAIN STRONG WITH COMMUNITY MEMBERS BEING UTILIZED IN MANY AREAS OF THE HOSPITAL. ANOTHER SERVICE TO THE COMMUNITY IS THE PROVISION OF OCCUPATIONAL ASSESSMENT TESTING ALONG WITH HEARING SCREENS. CERTIFIED STAFF IS AVAILABLE IN HOUSE TO PROVIDE THOSE SERVICES. STAFF WILL ALSO CONDUCT ERGONOMIC CHECKS AND BLOOD PRESSURE CHECKS WHEN REQUESTED AT THE LOCAL BUSINESSES AS WELL AS MINI HEALTH FAIRS AND WELLNESS EDUCATION. FIRST GRADE STUDENTS ARE INVITED TO ATTEND AN ANNUAL HOSPITAL TOUR GUIDING THEM THROUGH VARIOUS DEPARTMENTS OF THE HOSPITAL. DURING THE FLU SEASON, FLU CLINICS ARE OFFERED TO THE COMMUNITY AT THE HOSPITAL, AND HOSPITAL STAFF ALSO CONDUCTS FLU CLINICS AT THE LOCAL GROCERY STORE AS WELL AS ONSITE FLU VACCINATIONS FOR SEVERAL LOCAL BUSINESSES. HOSPITAL STAFF PROVIDES CPR TRAINING FOR PROFESSIONALS IN THE AREA. THE HOSPITAL PROVIDES PRENATAL CLASSES INCLUDING CPR TRAINING, BREASTFEEDING AND CARE OF A NEWBORN INFANT ON A QUARTERLY BASIS FOR EXPECTANT PARENTS. CARDIAC REHAB PHASE III IS OPEN TO THE COMMUNITY TO OFFER SUPPORT IN AN EXERCISE PROGRAM, ESPECIALLY FOR THOSE PATIENTS WHO HAVE GRADUATED FROM THE CARDIAC REHAB PHASE II PROGRAM. SOCIAL SERVICES AIDS THOSE IN THE COMMUNITY WHO ARE IN NEED OF ENROLLMENT ASSISTANCE, WHETHER IT BE FOR MEDICAID, MEDICARE, MEDICARE PART D SERVICES, OR OTHER INFORMATION REFERRAL ASSISTANCE. SOCIAL SERVICE AND SWINGBED DIRECTOR COORDINATE TRANSFER OF PATIENTS TO THE LOCAL DIALYSIS CENTER. ONE OF THE HOSPITAL PHYSICIANS SITS AS THE MEDICAL DIRECTOR FOR THE CITY OWNED AMBULANCE SERVICE AND THE HOSPITAL PROVIDES RNS AS NEEDED FOR EMERGENCY INDICATED TRANSFERS TO THE LOCAL TERTIARY CENTER. THE FIVE FAMILY PRACTICE PHYSICIANS SERVE AS MEDICAL DIRECTORS FOR THE HOME HEALTH AND HOSPICE AGENCY. THE CHIEF EXECUTIVE OFFICER OF SABETHA COMMUNITY HOSPITAL SERVES ON THE KANSAS HOSPITAL ASSOCIATIONS POLICY AND ADVOCACY COMMITTEE, THE HEALTH INNOVATIONS NETWORK OF KANSAS BOARD, THE KANSAS HEALTH CARE COLLABORATIVE BOARD, THE KANSAS HOSPITAL ASSOCIATION KANCARE TECHNICAL ADVISORY GROUP, AND THE GOVERNORS KANCARE ADVISORY GROUP. SABETHA COMMUNITY HOSPITAL TAKES ITS COMMITMENT TO THE COMMUNITY VERY SERIOUSLY AND PARTICIPATES IN EMERGENCY DRILLS, ALWAYS MONITORING PATIENT AND EMPLOYEE SAFETY, EDUCATING STAFF ON RISK MANAGEMENT, QUALITY ASSURANCE, INFECTION CONTROL ISSUES, BLOOD BORN PATHOGENS, HIPAA AND CORPORATE COMPLIANCE. THE HOSPITAL PROVIDES AN AVENUE FOR NURSING STUDENTS TO DO ROTATIONS THROUGH THE HOSPITAL WITH ITS AFFILIATION WITH HIGHLAND COMMUNITY COLLEGE AND SOUTHEAST COMMUNITY COLLEGE, BEATRICE, NEBRASKA. MEDICAL STUDENTS IN THE RURAL RESIDENCY PROGRAM AT KANSAS UNIVERSITY SCHOOL OF MEDICINE ARE ABLE TO DO CLINICAL ROTATIONS WITH THE FAMILY PHYSICIANS. PHYSICAL THERAPY STUDENTS THROUGH AFFILIATION WITH KANSAS CITY KANSAS COMMUNITY COLLEGE AND INDIAN HILLS COMMUNITY COLLEGE, OCCUPATIONAL THERAPY STUDENTS THROUGH WASHBURN UNIVERSITY AFFILIATION AND SOCIAL SERVICE STUDENTS FROM KANSAS STATE UNIVERSITY ALL DO CLINICAL ROTATIONS AT THE HOSPITAL AS WELL. HOSPITAL ADMINISTRATION WORKS CLOSELY WITH THE HIGH SCHOOL COUNSELOR IN THE ADMINISTRATION OF LOCAL SCHOLARSHIPS TO NURSING STUDENTS AND TO THOSE WHO ARE GOING INTO A HEALTHCARE CAREER. HOSPITAL STAFF PARTICIPATE IN SENIOR CAREER DAY AT THE LOCAL HIGH SCHOOL AND EVERY YEAR MIDDLE SCHOOL AND HIGH SCHOOL STUDENTS JOB SHADOW AT THE HOSPITAL TO ENCOURAGE CAREERS IN HEALTHCARE. SCHEDULE H, PART VI, LINE 6 THE ORGANIZATION IS AFFILIATED WITH GREAT PLAINS HEALTH ALLIANCE, INC. (GPHA), A NON-PROFIT 501C3 ORGANIZATION WHICH PROVIDES MANAGEMENT SERVICES AND OPERATIONAL, FINANCE AND ACCOUNTING SUPPORT TO THE HOSPITAL. GPHA DOES NOT PROVIDE SERVICES DIRECTLY TO PATIENTS, BUT DOES PROVIDE ACCESS TO PROFESSIONALS THAT MAY NOT BE AFFORDABLE TO THE NORMAL CRITICAL ACCESS HOSPITAL. GPHA PROVIDES EDUCATION AND ASSISTANCE IN AREAS SUCH AS HIPAA, MEDICARE REIMBURSEMENT, MEANINGFUL USE REQUIREMENTS FOR COMPUTER SYSTEMS, ETC. GPHA IS AN AFFILIATION OF CRITICAL ACCESS HOSPITALS IN KANSAS AND NEBRASKA THAT PROVIDES NETWORKING OPPORTUNITIES WITH OTHER RURAL HOSPITAL, COMMUNITIES AND LEADERS. GPHA PROVIDES POLICIES AND GUIDANCE TO ITS CRITICAL ACCESS FACILITIES REGARDING FINANCIAL ASSISTANCE, CONFLICTS OF INTEREST, CORPORATE COMPLIANCE, HIPAA PRIVACY AND SECURITY AND MANY OTHER AREAS. GPHA ALSO PROVIDES EDUCATIONAL SESSIONS FOR BOARD MEMBERS, BUSINESS OFFICE MANGERS, BILLERS, MEDICAL RECORDS PERSONNEL, DIRECTOR OF NURSING AND ADMINISTRATORS. GPHA IS A VITAL LINK IN ALLOWING CAH HOSPITALS TO OPERATE AT A HIGH QUALITY WITHIN THE CASH CONSTRAINTS IMPOSED BY THE CRITICAL ACCESS PROGRAM. SCHEDULE H, PART VI, LINE 7 N/A false false false false false false false false false DAVE DELLASEGA PRESIDENT/CEO/DIRECTOR 0 184141 0 17850 0 11422 0 213413 0 0 MIKE HAND CFO 0 136809 0 13165 0 19983 0 169957 0 0 KEVIN KENNALLY PHYSICIAN 276982 0 25200 0 19832 0 322014 0 0 0 GREGG WENGER PHYSICIAN 187822 0 18296 0 10812 0 216930 0 0 0 JAMES LONGABAUGH PHYSICIAN 225714 0 22175 0 12050 0 259939 0 0 0 CHRISTIAN TRAMP PHYSICIAN 217340 0 22033 0 18847 0 258220 0 0 0 KERSTIN GLYNN PHYSICIAN 250627 0 25104 0 16850 0 292581 0 0 0 FORM 990, PART VII; SCHEDULE J, PART I, LINE 3 COMPENSATION FOR MIKE HAND AND DAVE DELLASEGA IS PROVIDED BY GREAT PLAINS HEALTH ALLIANCE, A RELATED ORGANIZATION. GREAT PLAINS HEALTH ALLIANCE'S BOARD OF DIRECTORS ANNUALLY APPROVE THE COMPENSATION FOR MR. HAND AND MR. DELLASEGA. X 1 72778 FMV 0 false false false SCHEDULE M, PART I, LINE 19 THE NUMBER REPORTED IN COLUMN (B) FOR REAL ESTATE - RESIDENTIAL (LINE 15) IS THE NUMBER OF CONTRIBUTIONS. FORM 990, PART III, LINE 4 THE HOSPITALS PRIMARY FUNCTION IS THE DELIVERY OF HEALTHCARE AND WELLNESS SERVICES TO INPATIENTS AND OUTPATIENTS IN NEMAHA COUNTY, SPECIFICALLY SABETHA AND OTHER SURROUNDING COMMUNITIES. INPATIENT CARE INCLUDES ACUTE CARE, SWING BED AND INTERMEDIATE SWING BED. OUTPATIENT SERVICES ARE ALSO AN IMPORTANT COMPONENT IN MEETING THE COMMUNITYS NEEDS AS WELL. DURING 2014, THE IMAGING DEPARTMENT OF THE HOSPITAL UPDATED THE CT SCANNER ENHANCING DIAGNOSTIC PROCEDURES FOR THE PHYSICIANS, AND THE HOSPITAL ADDED COMPUTERIZED PHYSICIAN ORDER ENTRY AND PHARMACY/MEDICATION RECONCILIATION ADMINISTRATION MODULES TO THE ELECTRONIC HEALTH RECORD. AN IMPORTANT FOCUS FOR SCH IS TO CONTINUE TO BUILD A STRONG ELECTRONIC MEDICAL RECORD TO BETTER SERVE OUR PATIENT POPULATION ENHANCING PROVISION OF CARE TO THE YOUNG AS WELL AS THE OLD WITHIN OUR COMMUNITY AND SURROUNDING AREAS THAT WE SERVE. SABETHA COMMUNITY HOSPITAL CONTINUES TO MAINTAIN ITS LEVEL IV TRAUMA CENTER DESIGNATION AS WELL AS BEING A STROKE READY FACILITY. THE HOSPITAL PARTNERED WITH A TERTIARY CENTER ON A TELEMEDICINE PILOT PROJECT FOR THE EMERGENCY ROOM. SABETHA COMMUNITY HOSPITAL ALSO PARTICIPATED IN THE KANSAS HEALTH CARE COLLABORATIVE HEALTH ENGAGEMENT NETWORK QUALITY PROJECTS. WITH THE COOPERATION OF THE MEDICAL STAFF AND SURGEONS ALONG WITH SCH STAFF, THE HOSPITAL WAS ABLE TO REDUCE EARLY ELECTIVE DELIVERIES BY 100%. THE HOSPITAL ALSO ACHIEVED A REDUCTION IN URINARY CATHETER DAYS BY PARTICIPATING IN THE CAUTI PROJECT THROUGH THE KANSAS HEN. THE HOSPITAL PARTICIPATES IN CMS HCAHPS AND USES THOSE SCORES TO KEEP STAFF INFORMED OF PROVISION OF CARE TO OUR PATIENTS. FORM 990, PART VI, SECTION A, LINE 2 DAVE DELLASEGA AND MIKE HAND HAVE A BUSINESS RELATIONSHIP. THEY ARE BOTH EMPLOYED BY, AND ALSO OFFICERS OF, A RELATED 501(C)(3) ORGANIZATION, GREAT PLAINS HEALTH ALLIANCE. FORM 990, PART VI, SECTION A, LINE 6 GREAT PLAINS HEALTH ALLIANCE, INC., A NOT-FOR-PROFIT, 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF GREAT PLAINS OF SABETHA, INC. FORM 990, PART VI, SECTION A, LINE 7A GREAT PLAINS HEALTH ALLIANCE, INC., BEING THE SOLE MEMBER, HAS THE RIGHT TO ELECT AND APPROVE ALL THE BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B GREAT PLAINS HEALTH ALLIANCE, INC. (GPHA) IS THE SOLE MEMBER AND HAS THE AUTHORITY TO APPROVE THE ARTICLES OF INCORPORATION, BYLAWS, ELECTION TO OR REMOVAL FROM THE BOARD OF DIRECTORS, THE ANNUAL OPERATING AND CAPITAL BUDGETS, AND THE LONG RANGE OR STRATEGIC PLANS. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE 990 IS THEN PROVIDED TO THE CHIEF FINANCIAL OFFICER FOR REVIEW AND APPROVAL. AN ELECTRONIC DRAFT OF THE 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO THE FULL BOARD FOR REIVEW PRIOR TO FILING THE 990 WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION IS REQUIRED TO ADOPT GPHA'S CONFLICT OF INTEREST POLICY. ALL BOARD MEMBERS, OFFICERS AND EMPLOYEES ARE SUBJECT TO THE CONFLICT OF INTEREST POLICY AND SIGN AN ANNUAL ACKNOWLEDGEMENT THAT THEY HAVE READ, UNDERSTAND AND COMPLIED WITH THE GPHA CONFLICT OF INTEREST POLICY. UNDER THE POLICY, ANY MEMBER WHO HAS A DIRECT OR INDIRECT (VIA FAMILY) FINANCIAL INTEREST IS CHARACTERIZED AS AN INTERESTED PERSON. INTERESTED PERSONS ARE REQUIRED TO DISCLOSE FINANCIAL INTERESTS WITH COMPANIES DOING BUSINESS WITH GPHA. THE INTERESTED PERSON MUST RECUSE THEMSELVES FROM FURTHER DISCUSSIONS OF THE TRANSACTION AND LEAVE THE ROOM. THE REMAINING NON-INTERESTED MEMBERS DECIDE IF A CONFLICT OF INTEREST EXISTS. THE BOARD CHAIR MAY APPOINT ANOTHER DISINTERESTED PARTY TO DISCUSS THE TRANSACTION OR THE REMAINING BOARD MEMBERS MAY VOTE TO ENTER INTO OR ABSTAIN FROM THE SUSPECT TRANSACTION. FAILURE TO DISCLOSE FINANCIAL INTERESTS BY INTERESTED BOARD MEMBERS WILL RESULT IN DISCIPLINARY ACTION, INCLUDING SANCTIONING BY BOARD. ALL CONFLICTS OF INTEREST AND THEIR ULTIMATE RESOLUTION ARE DOCUMENTED IN THE BOARD MINUTES. THE BOARD CONDUCTS PERIODIC REVIEWS TO DETERMINE THAT CONFLICTS ARE BEING IDENTIFIED AND RESOLVED ACCORDING TO POLICY DOCUMENTATION. REVIEWS BY OUTSIDE EXPERTS ARE PERMITTED, BUT NOT REQUIRED. FORM 990, PART VI, SECTION B, LINES 15A & B THE CEO AND CFO ARE COMPENSATED BY GREAT PLAINS HEALTH ALLIANCE, A RELATED ORGANIZATION. GPHA'S BOARD USES COMPARABILITY DATA IN SETTING THEIR SALARIES, AND DOCUMENTATION IS RETAINED OF THE BOARD'S DELIBERATIONS AND DECISIONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE COMPANY'S KANSAS ANNUAL REPORT IS ALSO AVAILABLE UPON REQUEST FROM THE KANSAS SECRETARY OF STATE. FORM 990, PART XI, LINE 9 EQUITY IN EARNINGS SABETHA HEALTHCARE, INC. 33,619 TRANSFER TO CITY OF SABETHA (156,600) ---------- TOTAL $ (122,981) FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED MEDICAL STAFF TOTAL FEES:969841 FORM 990 PART IX LINE 11G DESCRIPTION:BILLING/COLLECTIONS TOTAL FEES:123057 FORM 990 PART IX LINE 11G DESCRIPTION:LAB SERVICES TOTAL FEES:46426 FORM 990 PART IX LINE 11G DESCRIPTION:PHARMACY SERVICES TOTAL FEES:76514 FORM 990 PART IX LINE 11G DESCRIPTION:ADMINISTRATION/HUMAN RESOURCES TOTAL FEES:81216 FORM 990 PART IX LINE 11G DESCRIPTION:MAINTENANCE/HOUSEKEEPING TOTAL FEES:1086 GREAT PLAINS HEALTH ALLIANCE INC 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 480617739 MANAGEMENT KS 501 (C)(3) 3 NA false GREAT PLAINS HEALTH CARE FOUNDATION INC 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 480955870 SUPPORT KS 501 (C)(3) 9 GPHA INC true GREAT PLAINS OF CHEYENNE CO INC 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 481226831 HOSPITAL KS 501 (C)(3) 3 GPHA INC true GREAT PLAINS OF ELLINWOOD INC 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 481226976 HOSPITAL KS 501 (C)(3) 3 GPHA INC true GREAT PLAINS OF KIOWA CO INC 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 481226833 HOSPITAL KS 501 (C)(3) 3 GPHA INC true GREAT PLAINS OF OTTAWA CO INC 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 481226856 HOSPITAL KS 501 (C)(3) 3 GPHA INC true GREAT PLAINS OF PHILLIPS CO INC 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 481226829 HOSPITAL KS 501 (C)(3) 3 GPHA INC true GREAT PLAINS OF REPUBLIC CO INC 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 481226977 HOSPITAL KS 501 (C)(3) 3 GPHA INC true GREAT PLAINS OF SMITH CO INC 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 481226830 HOSPITAL KS 501 (C)(3) 3 GPHA INC true false false false false false false false false false false false false true false false false false false false