2015-11-16T10:03:22-06:00 2014-12-31 BKD LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2014-01-01 480577658 HIAWATHA HOSPITAL ASSOCIATION INC % JENNY KNUDSON HIAW 7857422131 300 UTAH STREET HIAWATHA KS 66434 JOHN MOORE CEO 7857422131 2015-11-16 true Kevin Ensminger CPA P01310558 8162216300 2014 2016-02-25 16:41:14Z HIAWATHA COMMUNITY HOSPITAL JOHN MOORE 300 UTAH STREET HIAWATHA KS 66434 24408257 false X WWW.HCH-KS.ORG X 1945 KS AS A RURAL COMMUNITY HOSPITAL, HIAWATHA HOSPITAL'S PRIMARY GOAL IS TO PROVIDE MODERN, RELIABLE, AND AFFORDABLE HEALTH SERVICES THAT BEST MEET THE NEEDS OF OUR COMMUNITY RESIDENTS. 10 8 299 8 0 0 105241 354300 26132212 23893926 16735 16147 111655 121925 26365843 24386298 17861 15854 0 0 13907775 13837833 0 0 3650 11607099 11958117 25532735 25811804 833108 -1425506 26745965 22104767 11791941 8831757 14954024 13273010 THE BOARD APPROVED MISSION STATEMENT PROMOTES A REGIONAL MODERN HEALTHCARE FACILITY THAT IS BASED ON SOUND FINANCIAL AND STRATEGIC PLANNING WHICH IS GUIDED BY A COMMITMENT TO THE WELL BEING OF ITS COMMUNITY AND EMPLOYEES. false false 21834846 15854 23874140 HIAWATHA COMMUNITY HOSPITAL'S PRIMARY GOAL IS TO PROVIDE QUALITY, MODERN, AFFORDABLE HEALTHCARE TO OUR COMMUNITY. IN 2014, WE PROVIDED SERVICE FOR 3,619 INPATIENT DAYS. WE PREFORMED 138 INPATIENT SURGERIES AND 1,150 OUTPATIENT SURGERIES. WE DELIVERED 84 BABIES. WE PROVIDED OUTPATIENT SERVICES TO 27,328 PATIENTS. BY PROVIDING SERVICES LIKE OBSTETRICS AND 24 HOUR EMERGENCY SERVICES THAT NOT ALL SMALL RURAL HOSPITALS PROVIDE, EVEN THOUGH THE PROGRAMS ARE NOT ALWAYS PROFITABLE FOR THE HOSPITAL, WE FEEL STRONGLY THAT THESE SERVICES PROVIDE NECESSARY CARE TO ADDRESS OUR COMMUNITY'S OVERALL HEALTH WHILE PROMOTING OUR MISSION AS A CHARITABLE ORGANIZATION. 21834846 true true false true false false false false false false true false false false false false true false false false false false false false false false true true false true true true false false false false false false false false false false false false false false false true true false false false true 25 0 true 299 true false false false false false false false false false false X 10 8 false false false false false false false true true false false true true true true true true true false false KS X JENNY KNUDSON 7857426210 300 UTAH STREET HIAWATHA KS 66434 DR STEFFEN SHAMBURG PHYSICIAN/CHIEF OF STAFF 40.0 0.0 X 413811 0 33418 HILLARY BOYE TRUSTEE 0.25 0.0 X 0 0 0 LORI ELLIOT TRUSTEE 0.25 0.0 X 0 0 0 FONDA LAFRENZ APRN SECRETARY/BOARD TREASURER 3.0 0.0 X X 5053 0 0 CHERYL RASMUSSEN TRUSTEE 0.25 0.0 X 0 0 0 ERIK MADSEN TRUSTEE 0.25 0.0 X 0 0 0 ERIC MCPEAK BOARD PRESIDENT/TRUSTEE 0.5 0.0 X X 0 0 0 GALEN MEYER TRUSTEE 0.25 0.0 X 0 0 0 NICK HRENCHER VICE PRESIDENT/TRUSTEE 0.3 0.0 X X 0 0 0 ANDY DELANEY TRUSTEE 0.25 0.0 X 0 0 0 JOHN MOORE CEO 40.0 0.0 X 156341 0 27987 DUSTIN WILLIAMS PHYSICIAN ASSISTANT 40.0 0.0 X 154596 0 9387 DR BRYON BIGHAM PHYSICIAN 40.0 0.0 X 268896 0 33480 DR PETER ROSA PHYSICIAN 40.0 0.0 X 267772 0 31888 DR CROSBY GERNON RADIOLOGIST 40.0 0.0 X 457072 0 36004 DR JULIE ROSA PHYSICIAN 22.0 0.0 X 129773 0 261 JEAN ABEITA PHARMACIST 40.0 0.0 X 128320 0 25337 1981634 0 197762 8 false true false STEVEN H GUNNELS CRNA 598320 STARS THERAPY SERVICES 552304 ROCK PORT TELEPHONE COMPANY IT CONTRACT SERVICES 266821 SHARED MEDICAL SERVICES MRI 211900 ICE TECHNOLOGIES EMR SUPPORT HOSTING 210638 8 69155 4099 281046 354300 PATIENT SERVICE REVENUE 621110 21989421 21989421 OTHER PATIENT REVENUE 621110 59334 59334 340B PHARMACY 446110 1519909 1519909 EMR INCENTIVE REVENUE 621110 325262 325262 23893926 7675 7675 0 0 50136 15256 34880 0 34880 34880 10948 6703 4245 8472 8472 0 0 0 CAFETERIA INCOME 722514 87045 87045 87045 24386298 23893926 138072 4797 4797 11057 11057 0 0 1895705 1669821 225884 0 9202125 7982557 1219568 362916 316714 46202 1668020 1324596 343424 709067 623153 85914 0 5523 10 5513 127453 328 127125 0 0 0 3005676 2452949 549077 3650 59496 40954 18542 567142 428439 138703 26789 18673 8116 0 502771 371272 131499 40637 34578 6059 0 180 180 454260 352069 102191 0 1838603 1217154 621449 160026 90755 69271 BAD DEBT EXPENSE 1238786 1238786 REPAIRS & MAINTENANCE 706859 648994 57865 DUES & SUBSCRIPTIONS 202297 146100 56197 MEDICAL SUPPLIES 2807804 2807804 213815 53286 160529 25811804 21834846 3973308 3650 286 286 3992590 3895701 49607 50522 4083209 3440130 0 0 0 0 0 0 486471 432611 215682 221831 30641852 17072819 14617871 13569033 0 0 0 0 0 0 0 0 3300249 494653 26745965 22104767 2558255 2149650 0 0 0 0 4145000 6440000 0 0 0 0 4588686 242107 0 0 500000 0 11791941 8831757 X 14889433 12754632 64591 518378 0 0 14954024 13273010 26745965 22104767 X -1425506 -255508 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6184 6184 25805620 25811804 1000000 250000 1000000 1000000 1000000 1000000 4000000 6000000 4401 4425 5509 6184 20519 250000 250000 250000 250000 1000000 1500000 4401 4425 5509 6184 20519 769309 769309 17213501 8153568 9059933 10961417 8247400 2714017 1697625 671851 1025774 13569033 23153381 15256 15256 23138125 1248173 1248173 24386298 24579802 15256 15256 24564546 1247258 1247258 25811804 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 RENTAL EXPENSES $ 15,256 SCHEDULE D, PART XI, LINE 4B GAIN(LOSS) ON DISPOSITIONS OF FIXED ASSETS $ 8,472 CHANGE IN ESTATE RECEIVABLE 915 BAD DEBT EXPENSE 1,238,786 ------------ $ 1,248,173 SCHEDULE D, PART XII, LINE 2D RENTAL EXPENSES $ 15,256 SCHEDULE D, PART XII, LINE 4B GAIN(LOSS) ON DISPOSITIONS OF FIXED ASSETS $ 8,472 BAD DEBT EXPENSE 1,238,786 ------------ $ 1,247,258 true true true X true X true false false 303187 792 302395 0.01200 2727820 1143945 1583875 0.06400 68112 29936 38177 0.00200 3099119 1174673 1924447 0.07800 36320 17000 19320 0.00100 37526 0 37526 0.00200 400 0 400 0.00010 74246 17000 57246 0.00310 3173365 1191673 1981693 0.08110 1 3847 3847 0.00020 1 7589 7589 0.00030 2 11436 11436 0.00050 false 1238786 60000 20862967 21053737 -190770 X true true 1 1 HIAWATHA HOSPITAL ASSOCIATION 300 UTAH STREET HIAWATHA KS 66434 www.hch-ks.org X X X X HIAWATHA HOSPITAL ASSOCIATION false false true X X X X X X X X X 13 true false false true X www.hch-ks.org X true 13 true www.hch-ks.org false false true X 150. 250. X X true true X X true X X X X X X X X X X true false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 WE CHOSE INDIVIDUALS WHO WOULD HAVE UNIQUE UNDERSTANDING OF THE DIFFERENT POPULATIONS IN OUR COMMUNITY TO BE ON THE COMMITTEE. THE COMMITTEE HELPED FORMULATE THE SURVEY TO TAKE TO OUR COMMUNITY AND GAVE SIGNIFICANT FEEDBACK AND DIRECTION ABOUT WHAT SPECIFIC POPULATION NEEDS WERE. INCLUDED ON THE COMMITTEE: KARLA HARTER, NURSING DIRECTOR FOR BROWN COUNTY HEALTH DEPARTMENT; DR. PETE ROSA IS NOT ONLY THE DIRECTOR OF THE MED STAFF WHEN WE DID THE SURVEY BUT ALSO SERVED ON THE LOCAL SCHOOL BOARD; SHERI WESSEL, PA IS THE DIRECTOR OF THE WEIGHT LOSS CLINIC AND WOULD ALSO REPRESENT THE NEMAHA COUNTY POPULATION; DR. CROSBY GERNON WAS THE MAYOR OF HIAWATHA; LYNN DIERKING, RN IS THE DIRECTOR OF OUR HOME HEALTH AGENCY; KAREN WILSON WAS THE DIRECTOR OF THE AREA AGENCY ON AGING; LYNNE LADNER WAS CITY ADMINISTRATOR AND MEMBER OF LOCAL ECONOMIC DEVELOPMENT GROUP; KRISTIN BOLTZ, NURSE PRACTIONER AT WHITE CLOUD HEALTH STATION THAT SERVES IOWA SAC & FOX INDIAN TRIBE; MICHELLE SHAMBURG, PA IS A HEALTH CARE PROVIDER FOR THE KICKAPOO INDIAN NATION; WENDY SHOEMAKER EMT WORKED IN THE WEIGHT LOSS CLINIC. SCHEDULE H, PART V, SECTION B, LINE 11 OUR INITIAL PUSH WAS TO MAKE OUR WEIGHT LOSS CLINIC A SIGNIFICANT FACTOR IN REDUCING COMMUNITY OBESITY. HOWEVER, CHANGEOVER IN PERSONNEL HAS SHIFTED OUR FOCUS TO PROVIDING TRANSPORTATION TO POPULATIONS WITH CHALLENGES AT NO COST. SCHEDULE H, PART V, SECTION B, LINE 13H BECAUSE WE HAVE A GENEROUS FAP, SOME OTHER LOCAL HOSPITALS WERE DIRECTING PATIENTS THAT MAY NOT BE ABLE TO PAY THEIR BILLS TO OUR FACILITY. TO PREVENT PATIENT SHUFFLING, WE DID INCLUDE A CLAUSE STATING THAT TO BE ELIGIBLE FOR OUR FAP, THE APPLICANTS PRIMARY CARE PROVIDER MUST BE PART OF OUR ACTIVE MED STAFF. SCHEDULE H, PART V, SECTION B, LINE 15E THE POLICY STATES PLACES THAT THE APPLICATION IS AVAILABLE, WHAT SUPPORT WILL NEED TO BE INCLUDED, AND TO WHOM THE APPLICATION NEEDS TO BE RETURNED TO. 3 HIAWATHA COMMUNITY HOSPITAL HOME HEALTH 300 UTAH STREET HIAWATHA KS 66434 HOME HEALTH AGENCY HIAWATHA COMM HOSP FAM PRACTICE CLINIC 300 OREGON STREET 2ND FLOOR HIAWATHA KS 66434 RURAL HEALTH CLINIC HIAWATHA COMM HOSPITAL HIGHLAND CLINIC 415 S MAIN STREET HIAWATHA KS 66434 RURAL HEALTH CLINIC SCHEDULE H, PART I, LINE 7 THE HOSPITAL USES THE COST-TO-CHARGE RATIO. THIS METHOD WAS USED TO CALCULATE THE FIGURES IN THE TABLE AND WAS DETERMINED BY COMPARING PATIENT CARE COST TO PATIENT CARE CHARGES. SCHEDULE H, PART I, LINE 7, COLUMN F THE AMOUNT OF BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES FOR CALCULATING THE NET COMMUNITY BENEFIT EXPENSE PERCENTAGE WAS $1,238,786. SCHEDULE H, PART II, LINES 1 - 10 LITTLE HANDS DAYCARE IS A NOT FOR PROFIT DAYCARE THAT PROVIDES LICENSED, RELIABLE, QUALITY DAYCARE AND EDUCATION TO CHILDREN IN THE COMMUNITY. ONE OF THE ISSUES CITED BY LOCAL EMPLOYERS WHEN RECRUITING WORKERS WAS A LACK OF OPENINGS WITH LOCAL DAYCARE PROVIDERS. LITTLE HANDS WAS STARTED TO ADDRESS THAT NEED. HIAWATHA HOSPITAL'S CONTRIBUTIONS IN TIME AND SUPPLIES HAS HELPED THEM TO BE ABLE TO PROVIDE QUALITY SERVICES WHILE OPERATING ON MINIMAL MARGINS. HIAWATHA COMMUNITY HOSPITAL LEARNED THROUGH OUR COMMUNITY BENEFIT STUDY THAT TRANSPORTATION IS A BARRIER FOR MANY CITIZENS TO OBTAINING HEALTHCARE. SO WE BEGAN OPERATING A FREE MEDICAL TRANSPORT VAN THAT CAN BE USED WITHOUT COST TO GET PEOPLE TO MEDICAL APPOINTMENTS OR BACK FROM STAYS AT HOSPITALS IN LARGER COMMUNITIES. SCHEDULE H, PART III, SECTION A, LINE 2 ALL APPLICABLE INSURANCE CONTRACT DISCOUNTS, SELF-PAY CONTRACT DISCOUNTS, AND CHARITY CARE SLIDING SCALE DISCOUNTS ARE APPLIED PRIOR TO BALANCE BEING ELIGIBLE TO BE WRITTEN OFF AS BAD DEBT. ONCE THE ACCOUNT IS ELIGIBLE, THE ACCOUNT IS FORWARDED TO THE BOARD OF TRUSTEES FOR CONSIDERATION. ONLY AFTER BOARD APPROVAL IS GRANTED IS THE ACCOUNT IS WRITTEN OFF TO BAD DEBT. SCHEDULE H, PART III, SECTION A, LINE 3 BEFORE MAKING ACCOUNTS ELIGIBLE FOR BAD DEBT, WE RUN ALL ACCOUNTS THROUGH A COMPANY TO CHECK TO SEE IF THEY WOULD LIKELY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. THOSE WHO COME BACK AS PROBABLE ARE CONTACTED AND ASKED AGAIN TO COMPLETE A FAP APPLICATION. MANY INDIVIDUALS ARE NOT WILLING TO COMPLETE THE APPLICATION. AT THAT POINT THEY ARE GRANTED PRESUMPTIVE FINANCIAL ASSISTANCE STATUS AND THEIR BALANCES ARE WRITTEN OFF TO CHARITY CARE INSTEAD OF BAD DEBT. WHILE WE FEEL THAT WE WORK VERY DILIGENTLY TO PROVIDE FINANCIAL ASSISTANCE TO THOSE WHO QUALIFY, WE CANNOT GUARANTEE A PERFECT SYSTEM. SO THE ABOVE FIGURE IS AN ESTIMATION OF THE BALANCES THAT MAY HAVE NOT BEEN CAUGHT BY OUR SYSTEM. SCHEDULE H, PART III, SECTION A, LINE 4 PAGE 8 OF THE AUDITED FINANCIAL REPORT SCHEDULE H, PART III, SECTION A, LINE 8 MEDICARE WITHHELD 2% FROM OUR SETTLEMENT THAT REPRESENTS THE SEQUESTRATION AMOUNT. THIS YEAR THAT AMOUNT WAS $190,300. THAT 2% TAKES OUR REIMBURSEMENT BACK TO 99% OF COSTS. WE CONSIDER THE FULL SEQUESTRATION AMOUNT COMMUNITY BENEFIT AS THE HOSPITAL IS PROVIDING SERVICES NOT JUST BELOW THE AGREED UPON RATE WITH MEDICARE, BUT A LOSS AS WE ARE BEING REIMBURSED 99% OF OUR COSTS. SCHEDULE H, PART III, SECTION B, LINE 9B CHARITY CARE APPLICATIONS ARE MADE AVAILABLE TO ALL PATIENTS AT TIME OF REGISTRATION, ON STATEMENTS, AND ON THE WEBSITE. 120 DAYS AFTER THE FIRST POST DISCHARGE STATEMENT IS MADE ON AN ACCOUNT, IF PAYMENT ISN'T MADE AND A CHARITY CARE APPLICATION ISN'T COMPLETED THE PATIENT'S NAME IS RUN THROUGH A COMPANY TO CHECK FOR PRESUMPTIVE CHARITY CARE. IF THEY QUALIFY, THEY ARE OFFERED AN APPLICATION AGAIN. IF THEY FAIL TO COMPLETE THE APPLICATION, THEY ARE WRITTEN OFF TO CHARITY CARE UNDER OUR PRESUMPTIVE CHARITY CARE PROGRAM. IF THEY DO NOT QUALIFY FOR CHARITY CARE, AND HAVE NOT RESPONDED TO OUR REQUESTS FOR PAYMENTS FOR 120 DAYS, THEN THE ACCOUNT IS PUT ON A LIST FOR APPROVAL BY THE BOARD OF TRUSTEES. ONCE AN ACCOUNT IS GRANTED APPROVAL BY THE BOARD, IT IS SENT TO THE COLLECTION AGENCY. WE GIVE THE COLLECTION AGENCY SEVERAL MONTHS TO COLLECT THE DEBT. IF THEY ARE UNSUCCESSFUL, THE ACCOUNT IS RETURNED TO THE HOSPITAL AND WRITTEN OFF. SCHEDULE H, PART VI, LINE 2 NOT ONLY DID WE SEEK FEEDBACK FROM COMMITTEE MEMBERS REPRESENTING LESSER HEARD VOICES FROM OUR COMMUNITY, BUT WE MADE AN ONLINE SURVEY AVAILABLE, WE PUT HARD COPIES OF THE SURVEY IN MULTIPLE PLACES INCLUDING ALL OF THE TOWNS IN OUR SERVICE AREA. WE COMBINED THAT FEEDBACK WITH STATISTICAL INFORMATION FROM RELIABLE SOURCES TO IDENTIFY PRIORITIES. SCHEDULE H, PART VI, LINE 3 WE POST INFORMATION ABOUT OUR FAPS EXISTENCE IN PROMINENT LOCATIONS. WE MAKE COPIES OF THE FAP AVAILABLE DURING REGISTRATION, IN INPATIENT ROOMS, ONLINE, AND ON OUR BILLING CORRESPONDENCE. SCHEDULE H, PART VI, LINE 4 THE HOSPITAL SERVES A GEOGRAPHIC AREA THAT ENCOMPASSES ATCHISON, BROWN, DONIPHAN, JACKSON AND NEMAHA COUNTIES IN KANSAS, AND RICHARDSON COUNTY IN NEBRASKA. OF THOSE PATIENTS, 85% ARE FROM BROWN AND DONIPHAN COUNTIES. THESE ARE MOSTLY RURAL COMMUNITIES. 88% OF THE POPULATION OF THE BROWN AND DONIPHAN COUNTIES THAT IS 25 YEARS OR OLDER HAS A MINIMUM OF A HIGH SCHOOL DIPLOMA, 16% HAS A BACHELORS DEGREE OR HIGHER. THE AVERAGE MEDIAN HOUSEHOLD INCOME IS $41,300 COMPARED TO THE STATE WIDE MEDIAN HOUSEHOLD INCOME OF $50,594. 16% OF THE POPULATION LIVES IN POVERTY; 19% FOR BROWN COUNTY ALONE. 16% OF THE POPULATION IN BROWN AND DONIPHAN COUNTIES DOES NOT HAVE HEALTH INSURANCE. SCHEDULE H, PART VI, LINE 5 WE SUPPORT A WIDE ARRAY OF PROGRAMS AND PROJECTS IN OUR COMMUNITY. MANY OF OUR KEY EMPLOYEES SERVE ON MULTIPLE BOARDS THAT HAVE A POSITIVE IMPACT ON VARIOUS ASPECTS OF THE COMMUNITY. WE PROVIDE DONATIONS OF BOTH TIME AND MONEY TO VARIOUS SERVICE ORGANIZATIONS. SCHEDULE H, PART VI, LINE 6 N/A SCHEDULE H, PART VI, LINE 7 KANSAS true SCHOLARSHIPS 6 11057 SCHEDULE I, PART 1, LINE 2 COMMUNITY SCHOLARSHIP - HCH HAS GIVEN SCHOLARSHIPS TO COMMUNITY MEMBERS PURSUING A DEGREE IN THE MEDICAL FIELD. AFTER THE SCHOLARSHIP IS APPROVED BY HOSPITAL CEO, THE TUITION IS PAID TO THE SCHOOL, THE STUDENT OR THE STUDENT LOAN HOLDER. X X false true false false false true false false false DR STEFFEN SHAMBURG PHYSICIAN/CHIEF OF STAFF 358559 0 55252 0 0 0 13552 0 19866 0 447229 0 30151 0 JOHN MOORE CEO 150281 0 431 0 5629 0 6722 0 21265 0 184328 0 0 0 DUSTIN WILLIAMS PHYSICIAN ASSISTANT 144979 0 9617 0 0 0 6207 0 3180 0 163983 0 0 0 DR BRYON BIGHAM PHYSICIAN 254205 0 10749 0 3942 0 11114 0 22366 0 302376 0 0 0 DR PETER ROSA PHYSICIAN 236922 0 30850 0 0 0 10184 0 21704 0 299660 0 4126 0 DR CROSBY GERNON RADIOLOGIST 397454 0 42118 0 17500 0 15923 0 20081 0 493076 0 16000 0 JEAN ABEITA PHARMACIST 127860 0 460 0 0 0 5471 0 19866 0 153657 0 0 0 SCHEDULE J, PART I, LINE 4B DR CROSBY GERNON RECEIVED 457(F) SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS TOTALING $17,500. SCHEDULE J, PART I, LINE 6A DOCTORS ARE PAID A PERFORMANCE BONUS BASED ON PRODUCTIVITY AND REVENUES AND EXPENSES. A CITY OF HIAWATHA KANSAS 483025665 428545CN5 2014-09-29 6440000 SEE PART VI false false false A 0 0 6440000 300003 0 0 115920 0 0 0 6324080 0 2011 true false true true A false false true true false 0.00000 0.00000 0.00000 false false 0.00000 false true A false false true false false false 0 false 0 false true A true PART I, LINE A, COLUMN F THE SERIES 2014 BONDS WERE ISSUED TO REFUND THE SERIES 2007 BONDS (ISSUED 03/29/2007) AND REFUND TWO TAXABLE BANK LOANS. FORM 990, PART VI, SECTION B, LINE 11B AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE 990. THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S OFFICERS AND ACCOUNTING PERSONNEL. ANY QUESTIONS OR CONCERNS THE ORGANIZATION'S OFFICERS AND ACCOUNTING PERSONNEL HAVE ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEED TO BE MADE ARE MADE. THE FINAL FORM 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE 990. FORM 990, PART VI, SECTION B, LINE 12C ALL EMPLOYEES AND DECISION MAKERS FOR THE HOSPITAL ARE COVERED UNDER THIS POLICY. CONFLICTS ARE EITHER REVIEWED BY THE CORPORATE COMPLIANCE OFFICER OR THE BOARD PRESIDENT. AT BOARD MEETINGS, THE BOARD CHAIR IS APPRAISED OF ALL CONFLICTS OF INTEREST AND THEN ASKS THE MEMBER TO ABSTAIN FROM DISCUSSING AND VOTING ON TOPICS OF CONFLICT. FORM 990, PART VI, SECTION B, LINE 15A THE DIRECTOR OF HUMAN RESOURCES PERIODICALLY PROVIDES THE PRESIDENT OF THE BOARD OF DIRECTORS WITH A COMPENSATION SURVEY COMPILED BY THE KANSAS HOSPITAL ASSOCIATION. THE SURVEY DELINEATES COMPENSATION PACKAGES FOR ADMINISTRATORS AT HOSPITALS THAT ARE SIMILAR TO HIAWATHA. BASED ON THAT SURVEY, THE ADMINISTRATOR'S PERFORMANCE, AND THE PERFORMANCE OF THE HOSPITAL, THE BOARD SETS THE ADMINISTRATOR'S SALARY. THE LAST EVALUATION WAS GIVEN IN 2012. 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 REQUEST. FORM 990, PART XI, LINE 9 CHANGE IN FOUNDATION ASSETS $(255,508) FORM 990 PART IX LINE 11G DESCRIPTION:ANESTHESIOLOGY SERVICES TOTAL FEES:607200 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICAL THERAPY SERVICES TOTAL FEES:378194 FORM 990 PART IX LINE 11G DESCRIPTION:EMR SERVICES TOTAL FEES:292009 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER FEES FOR SERVICES TOTAL FEES:1728273 HIAWATHA HOSPITAL ASSOCIATION FOUNDATION 300 UTAH STREET HIAWATHA KS 66434 481223766 FUNDRAISING KS 501(C)(3) 11D HHA false CHARITABLE REMAINDER TRUST (1) TRUST KS NA false false false true false false false false false false false false false false true true false false false true