2015-08-13T09:22:38-05:00 2014-09-30 481026809 Wendling Noe Nelson & Johnson LLC 534 S Kansas Ave Suite 1500 Topeka KS 666033491 990 2013-10-01 481169103 Salina Regional Health Center Inc SALI 7854527145 400 South Santa Fe Salina KS 67401 Joe Tallon VP Finance/CFO 7854527145 2015-08-12 1 Heather R Eichem P01515553 7852334226 2015-08-12 2013 2016-03-07 17:11:31Z Joe Tallon 400 South Santa Fe Salina KS 67401 213872910 0 X www.srhc.com X 1995 KS To provide high quality acute medical care 14 12 1894 200 0 -135017 1118213 907399 168331001 202457634 5590796 7051433 2734694 2958313 177774704 213374779 1019472 1494546 0 0 83392417 100025634 0 0 0 77304765 90651627 161716654 192171807 16058050 21202972 408504999 443880353 77761152 80624439 330743847 363255914 To provide quality health care services in a healing and spiritual environment. 0 0 157411963 64774 203494911 Salina Regional Health Center, Inc., is an IRS Section 501(c)(3) hospital which provides quality medical care regardless of race, creed, sex, national origin, handicap, or ability to pay. During the fiscal year, Salina Regional Health Center, Inc., discharged 8,828 inpatients resulting in 41,702 patient days, treated outpatients in 164,410 visits, and generated $199,075,905 in net patient service revenue. The amount of uncompensated care amounted to $31,782,092 of which $8,640,945 were charity care deductions and $23,141,147 were bad debt write offs. 360600 360600 Salina Regional Health Center, Inc., provides scholarships to students attending nursing school and provides a donation to the KU endowment to offset the cost of establishing a medical school on the Salina Regional Health Center campus. 1069172 1069172 Salina Regional Health Center, Inc., provides grants to further the activities of the Community Health Improvement Program (CHIP). 158841735 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 1 1 0 1 94 0 1 1894 1 1 1 0 0 0 0 0 0 0 0 0 X 14 12 0 0 1 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 X Joe Tallon VP FinanceCFO 7854527145 400 South Santa Fe Salina KS 67401 Larry Britegam Trustee 2.00 X 0 0 0 Kent Buer Chairman 2.00 X X 0 0 0 Robert Freelove MD Secretary 2.00 X X 0 0 0 Robert Heath Trustee 2.00 X 0 0 0 Sean Herrington MD Trustee 40.00 X 377880 0 26842 Rex Romeiser MD Trustee 2.00 X 0 0 0 Morrie Soderberg Treasurer 2.00 X X 0 0 0 Betsy Wearing Trustee 2.00 X 0 0 0 Lee Young Trustee 2.00 X 0 0 0 Micheal Terry President/CEO 40.00 X X 535189 0 72044 Ryan Payne MD Trustee/Chief of Staff 4.00 X 0 0 0 Jim Maes Trustee 2.00 X 0 0 0 Katie Platten Trustee 2.00 X 0 0 0 Chuck Oleen Trustee 2.00 X 0 0 0 Joe Tallon VP Finance/CFO 40.00 X 261927 0 26357 Larry Barnes VP Information Technology 40.00 X 276322 0 63107 Charles Grimwood VP Regional Development 40.00 X 242684 0 27250 Jack Hinnenkamp VP Facilities Management 40.00 X 208200 0 21342 David Moody VP Human Resources 40.00 X 214852 0 26516 Joel Phelps COO 40.00 X 312391 0 45489 Luanne Smith VP Patient Care/CNO 40.00 X 187965 0 25891 John Kelemen Physician 40.00 X 670910 0 30376 Keir Swisher Physician 40.00 X 408027 0 26303 Jeremiah Ostmeyer Physician 40.00 X 382359 0 26527 Justin Whitlow Physician 40.00 X 550739 0 28552 Merle Hodges Physician 40.00 X 442760 0 28124 5072205 0 474720 105 0 1 0 CPT Enterprises Inc 2121 Crawford Pl Salina KS 67401 Management Services 1358168 Anesthesia Associates of Central KS PA PO Box 1607 Salina KS 674021607 Anesthesia Services 1000013 Laboratory Corporation 358 S Main St Burlington NC 66210 Laboratory testing services 496075 Fresenius Medical Care PO Box 749959 Los Angeles CA 900749959 Medical Care 465675 Great Plains Imaging LLC 320 N Terrace Dr Wichita KS 67208 Imaging Services 447065 27 764342 143057 907399 Patient service 621990 199075905 199075905 EHR incentive payments 621990 1891723 1891723 Other operating 621990 1490006 1490006 202457634 5805171 5805171 114839 323824 -208985 -208985 -208985 1406837 5500 0 166075 1406837 -160575 1246262 1246262 20885 8232 12653 12653 Income from subsidiaries 900099 3079551 3079551 Other revenues 900099 75094 75094 3154645 213374779 203494911 0 8972469 1383946 1383946 110600 110600 3146304 434381 2711923 79917852 72894434 7023418 3083850 2818442 265408 8636517 7735849 900668 5241111 4638317 602794 418518 418518 926307 116588 809719 1437773 768413 669360 4511702 1845285 2666417 3961410 2052010 1909400 443206 161511 281695 151005 51886 99119 2636245 1365575 1270670 13418826 8658937 4759889 2159131 558377 1600754 Medical supplies 20725661 20725661 Pharmaceuticals 14972037 14972037 Professional fees other 5451385 4144554 1306831 Professional fees physi 5085015 5085015 14353406 8319917 6033489 192171807 158841735 33330072 0 7578 7878 13062462 23471356 29157189 30789094 1334375 1462964 2737793 4187023 261775971 152090196 114029993 109685775 214421381 242431965 7117662 7444213 9681674 9751388 16954892 14648697 408504999 443880353 18502340 22384804 55184878 54377466 883 4073051 3862169 77761152 80624439 X 320306956 352217400 3487136 3596681 6949755 7441833 330743847 363255914 408504999 443880353 X 21202972 10522774 786321 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 27560 27560 0 Part II-B, Line 1: A portion of annual dues paid by Salina Regional Health Center, Inc., to various health care organizations has been identified as association lobbying activities by those organizations. The amount reported as direct contact with legislators, their staff, government officials, or a legislative body represents the portion of dues identified as association lobbying activities by these organizations. Salina Regional Health Center, Inc., does not participate in activities supporting a political candidate. 0 1115634 167724 129862 19191 1394029 1068232 67038 19636 1115634 938600 145738 16106 1068232 959381 100 -20881 938600 900186 80 75389 16274 959381 0.64000 0.36000 1 1 1 6864891 6864891 155257459 83379907 71877552 95158079 66074136 29083943 4495542 2636153 1859389 109685775 Estimated reimbursements payable 3862169 3862169 X 223081375 10522774 -803525 9719249 213362126 12653 12653 213374779 190782782 0 190782782 1389025 1389025 192171807 Part V, Line 4: The endowment funds are to benefit the Cardiology, Rehabilitation, and Oncology departments of Salina Regional Health Center. Part X, Line 2: Management is not aware of any uncertainties in income tax positions. Part XI, Line 2d - Other Adjustments: Community Health Improvement Program (CHIP) donation -1,069,172. KU Endowment donation -250,000. Ashby house donation -57,200. Change in beneficial interest in net assets of Foundation 240,385. Change in fair value of assets held in trust 332,462. Part XI, Line 4b - Other Adjustments: Net fundraising events revenue 12,653. Part XII, Line 4b - Other Adjustments: Ashby house donation 57,200. KU Endowment donation 250,000. Community Health Improvement Program (CHIP) donation 1,069,172. Net fundraising events revenue 12,653. Rummage Sales 15738 15738 5161 Holly Days 5147 5147 3071 20885 20885 8232 8232 12653 1 1 1 X 1 X 1 1 0 1 1 3845 2674855 2674855 0.01390 12693 14350223 9011638 5338585 0.02780 16538 17025078 9011638 8013440 0.04170 24 1570 186481 186481 0.00100 25 2425389 693052 1732337 0.00900 19 11133 67711710 46920617 20791093 0.10820 2 2232 2232 0.00000 7 1075775 1075775 0.00560 77 12703 71401587 47613669 23787918 0.12380 77 29241 88426665 56625307 31801358 0.16550 1 7371 7371 0.00000 1 14075 12695 1380 0.00000 3 2908 2908 0.00000 5 24354 12695 11659 1 4605088 678191 60488403 57164390 3324013 X 1 1 2 1 Salina Regional Health Center Inc 400 South Santa Fe Salina KS 67401 X X X X 2 Salina Surgical Center LLC 401 South Santa Fe Salina KS 67401 X X Salina Regional Health Center Inc 1 1 X X X X X X X X X 12 1 0 1 X www.srhc.com/about/documents/ X X X X X X X X X X X 0 0 1 1 200.000000000000 1 300.000000000000 1 X X X X X 1 1 X X X 1 X X X X 0 X X X X 1 X 0 0 Salina Surgical Center LLC 2 0 1 1 100.000000000000 1 100.000000000000 1 X 1 1 X 1 0 1 X 0 0 Salina Regional Health Center, Inc. Part V, Section B, Line 3: Salina Regional Health Center collaborated with Salina-Saline County Health Department and Central Kansas Foundation to conduct a community health assessment and develop a community health improvement plan. Data was gathered, analyzed, and discussed by this collaborative group. Results were presented at a forum of representatives from a broader group of agencies involved in community development and health improvement. Broad community input was obtained through public forums and surveys. To assess public perception of the health issues identified by community partner organizations as most concerning, a survey and background information was developed and distributed in March 2013. Saline County residents were invited to review the information and participate in the survey via social media, the local newspaper, email, and notices posted throughout the community. A summary of the issues was presented at two public meetings that included opportunity for discussion with CHA Core Group representatives. A written summary of issues and the survey were placed at community locations that were easily accessible. Electronic versions of materials and the link to an internet survey were distributed via social media, the local newspaper, and email. Three hundred four individual surveys were completed during the 30 days it was available. The CHNA was retroactively endorsed by Salina Surgical Center. Salina Regional Health Center, Inc. Part V, Section B, Line 5d: The initial data report was provided on websites and in paper form at the Salina Regional Health Center information desk, public library, county health department, and other locations. The final report is posted on the Salina Regional Health Center website. In the spring of 2014, a professional publication was distributed (newspaper, direct mail, personal distribution to agencies, and other public locations). Results were also presented by a SRHC representative at civic clubs and other settings.Annual update of implementation strategy:The 2013 Community Health Needs Assessment recognized the following items childhold obesity, teenage pregancy, adult obesity, domestic violence, falls among elderly, medication misuse, and sexually transmitted infections for prioritization. SRHC chose two items (falls among elderly and medication misuse) to concentrate on as they fit within the framework of our mission and had less attention from other Saline County agencies. Falls among elderly and medication misuse:In 2014 the North Central-Flint Hills Area Agency on Aging received a $100,000 grant from Salina Regional to start a fall prevention program in the Salina area the program was rolled out in July 2014. The program is called "Be Well! Stay Well! Right at Home" and is aimed at helping prevent falls. It includes going into a person's home and identifying often small changes that can make the home safer. The first steps included placing articles about fall prevention in "Keynotes," the agency's newspaper, and providing information about fall prevention at venues such as the annual Sunflower Fair in Salina. There's also an eight-session class called "A Matter of Balance," that follows a curriculum written at Boston University and addresses fear of falling, recognizing that falls are preventable and increasing physical activity. The program also includes an assessment to identify situations that can cause falls and finding ways to fix them. During an in-home assessment they look at issues such as the person's vision, what medications they're taking and items around the home that represent fall dangers. The agency has contact with several other agencies that can help with specific issues that can help a person stay out of the hospital again.Medication misuse:As part of a project to limit readmissions to hospital and disease complications due to medication misuse the SRHC pharmacy department implemented a new process for follow up on heart failure patients to assure proper medication compliance. In October 2012, a 90 day pilot project began, in which heart failure patients were educated by pharmacists prior to discharge and with a follow-up phone call 48-72 hours after discharge. The pilot project indicated HCAP scores increased for medication-related measures and no CMS failures for discharge instructions occurred on patients with pharmacist intervention. Beginning in May 2013, quality auditors identify patients with possible primary diagnosis of heart failure and notify pharmacists. For these patients, pharmacists add discharge instructions for heart failure to the patient's chart, pharmacist visit patients prior to discharge and schedule a follow-up phone call appointment with patient. During visit, the pharmacists give patient a Zone Chart and answer medication questions. Nurses also complete a discharge assessment and document if the patient has heart failure and has received discharge instructions to identify patients for follow-up phone call. The follow-up phone call is completed by the pharmacist 48-72 post discharge for patients returning to home setting to reinforce education and medication adherence.Pharmacy interventions: October 2013-December 2014 1. Patient scales: - October 2013-July 2014: 5 patients reported on phone call they still had not purchased scales - August 2014: pharmacy obtained a grant to purchase scales for patients, six given out August to December 2014 - 6 Additional scales purchased and dispensed in 2015 2. Discharge instructions: - 403 patients targeted with intervention - Improved measure from 84.5% in fiscal year 2012 to 91% from October - December 2013 3. Patient visit prior to discharge: - From October to December 2014, 7 out of 28 patients had pharmacist visit prior to discharge 4. Follow-up phone call interventions: - 253 patients targeted for follow-up phone call - Corrections to discharge medication instructions - Reinforce obtaining new prescriptions - Discuss new prescriptions and effects/side effects - Reinforce making follow-up appointment with physician - Contact physician's office with concerns - Coordinate with SFHC ambulatory care pharmacist for clinic follow-up - Discuss fluid and salt restrictionsThe 30-day all cause readmission rate for patients who received a phone call from a pharmacists was 14%. The readmission rate for patients who did not receive a phone call was 41%. Interventions by pharmacists ranged from reinforcement of discharge instructions to taking action like calling physician office or retail pharamcy to correct medication discrepancies.Salina Regional Health Center's Pharmacy Residency Program welcomed its second class of residents in July. The program was initiated in 2012 to increase post-graduate training opportunities in the State to attract and retain pharmacists who might one day enter practice here. Today, many pharmacy graduates pursue post-graduate training to gain specialized skills. Many jobs even require additional training. "One year of residency is often considered equivalent to three-to-five years of practice experience," said Steven Blanner, Salina Regional's pharmacy residency director. While interest in post-graduate training has increased in recent years, the number of training opportunities available hasn't been able to keep pace. This year 31.5 percent of applicants for pharmacy residency positions nationwide were unable to match with a program because not enough positions were available. Salina is one of nine Kansas hospitals to offer a post-graduate pharmacy training program. Salina Regional Health Center's Pharmacy Residency Program recently received a full, three-year accreditation from the American Society of HealthSystem Pharmacists. Salina Regional Health Center, Inc. Part V, Section B, Line 7: Childhood obesity, teen pregnancy, adult obesity, domestic violence, and sexually-transmitted infections were needs identified in the CHNA which are not being addressed by Salina Regional Health Center as they are outside the scope of our operations. Salina Regional Health Center, Inc. Part V, Section B, Line 16e: File against estates Salina Regional Health Center, Inc. Part V, Section B, Line 20d: Deduction of 30%. Salina Surgical Center, LLC Part V, Section B, Line 20d: Usual and customary net charges for services rendered. Salina Surgical Center, LLC: Part V, Section B, Line 1:A community health needs assessment for Salina Surgical Center, LLC, a hospital facility of the hospital organization Salina Regional Health Center, was not conducted by the end of Salina Regional Health Center's taxable year. In late November 2013 our consultant began researching the requirements of 501(r) in relationship to our ownership percentage of Salina Surgical Center. In January 2014, we received a letter from our consultant indicating that Salina Surgical Center met the definition of a hospital facility under the proposed regulations. After reviewing the research and consulting legal counsel, we concluded in May 2014 that Salina Surgical Center, LLC is a hospital facility of Salina Regional Health Center; therefore, all requirements of 501(r) are applicable to Salina Surgical Center. We are currently in the process of making sure all requirements under 501(r) are met including the adoption of the CHNA and implementation strategy for Salina Surgical Center. We anticipate starting the joint CHNA by the end of the fiscal year ended 9/30/2014 and meeting the requirements for conducting the CHNA and adopting an implementation strategy by fiscal year ended 9/30/2015. To minimize future failures, we will communicate with Salina Surgical Center regarding the 501(r) requirements on an ongoing basis and work together with them to meet the requirements. On August 6, 2014, the board of directors of Salina Surgical Center reviewed and endorsed the findings of the Saline County 2013 Community Needs Assessment Survey. 20 Salina Regional Outpatient Imaging 520 S Santa Fe Lower Level Salina KS 67401 Outpatient imaging clinic Salina Regional Oncology 511 S Santa Fe Salina KS 67401 Physician clinic Comcare - Santa Fe Clinic 520 S Santa Fe Suite 300 Salina KS 67401 Physician clinic, lab & x-ray services Comcare - Elm Clinic 617 E Elm Street Salina KS 67401 Physician clinic, imaging center,& lab services Salina Regional Neurosurgery 501 S Santa Fe Suite 300 Salina KS 67401 Physician clinic Salina Pediatric Care 501 S Santa Fe Suite 100 Salina KS 67401 Physician clinic Comcare - Statcare Clinic 1001 S Ohio St Salina KS 67401 Minor emergency and illness clinic, lab & x-ray services Salina Regional Surgical Associates 501 S Santa Fe Suite 200 Salina KS 67401 Physician clinic Salina Women's Clinic 501 S Santa Fe Suite 140 Salina KS 67401 Physician clinic Salina Regional Cardo Thoracic 501 S Santa Fe Suite 200 Salina KS 67401 Physician clinic Salina Regional Outpatient PT 520 S Santa Fe Salina KS 67401 Outpatient physical therapy Comcare - Minneapolis Clinic 311 N Mill St Minneapolis KS 67456 Physician clinic, lab & x-ray services Comcare - Occupational Health Partners 1101 E Republic St Salina KS 67401 Therapy, lab and x-ray services Hospice of Salina 730 Holly Lane Salina KS 67401 Hospice care Salina Regional Pulmonary 520 S Santa Fe Lower Level Salina KS 67401 Physician clinic Salina Regional Veridian 730 Holly Lane Salina KS 67401 Outpatient psych clinic Salina Regional Neurosciences 501 S Santa Fe Suite 210 Salina KS 67401 Physician clinic Salina Regional Infant Child Development 155 N Oakdale Salina KS 67401 Outpatient child development services Salina Regional Podiatry 501 S Santa Fe Suite 200 Salina KS 67401 Physician clinic Salina Regional New Options 1375 W Ash St Junction City KS 66441 Outpatient psych clinic Part I, Line 7: Costing methodology used to determine ratio of patient care cost to charges is total operating expenses less bad debt, Medicaid provider taxes, total community benefit, and building expenses divided by total charges less community benefit charges. Part II, Community Building Activities: Advancing Communities Together (ACT) analyzed data and discussed with multiple agencies in July 2012 resulting in the following high-level list of community health improvement priorities (descending order of priority): teen sexual behavior, obesity (children, adult) and the outcomes of obesity (heart disease, stroke), domestic violence, serious injuries requiring hospital care, chronic lower respiratory disease, adult flu vaccination, and cancer. These priorities have since been further researched. A report is being made available to the general public in early 2013 and through community forums, on-line surveys and paper surveys; input from the broader community is being obtained. Salina Regional Health Center is collaborating with Salina-Saline County Health Department and Central Kansas Foundation to conduct a community health assessment and develop a community health improvement plan. Across the early months of 2012, data was gathered, analyzed, and discussed by this collaborative group. Poster board presentations of the group's findings were prepared for presentation to a July 9, 2012 forum of representatives from a broader group of agencies that are involved in community development and health improvement. Participants included representatives of Salina Area United Way, Salina Family Healthcare, ComCare PA, Occupational Center of Central Kansas, Greater Salina Community Foundation, Salina Public Schools, Veridian Behavioral Health, Central Kansas Mental Health Center, Saline County Commission on Aging, Kansas State University Extension, City of Salina Parks and Recreation, Heartland Programs, North Central Kansas Regional Trauma Council, Salina Regional Health Center, The Volunteer Connection, Salina-Saline County Health Department, Central Kansas Foundation, and faith-based programs. The outcome of the meeting was buy-in to a process of getting broad community input into health improvement priorities, commitment to partner in the process, understanding of community health status data, and initial identification of priority issues to be addressed. Part III, Line 4: See note A5 (page 9) of the audited financial statements regarding the allowance for uncollectible accounts. Part III, Line 3: A review of bad debt accounts was conducted to find accounts that were eligible for charity care. Eligibility was determined by whether the patient had received financial assistance for a portion of their responsibility toward the account. Any remaining charges written off after the financial assistance was granted was included as bad debt expense attributable to patients eligible for financial assistance. Part III, Line 8: Amounts were obtained from the cost report filed with Medicare for the period ending September 30, 2014, less subsidized health services revenue and expenses included in Schedule H, Part I, Item 7(g). The total amount of the shortfall is considered a community benefit. Part III, Line 9b: If a patient qualifies for financial assistance, the account is adjusted according to our policy. Any remaining balance after adjustment is collected under the billing and collection policies. Our billing and collection policies are the same for all patients. Patients who have qualified for financial assistance are considered approved for a period of six months from the date of approval. After six months, patients need to reapply for financial assistance. Part III, Line 2: Ratio of patient care cost to charges (see calculation for Part I, Line 7) multiplied by provision for bad debts. Part VI, Line 2: In addition to the community health needs assessment, SRHC analyzes hospital discharge data for all counties in the region. The Kansas Hospital Association inpatient discharge database includes data for all reporting hospitals. From this we determine usage trends that help us plan needed services. For example, a significant number of residents of north central Kansas have had to travel far out of the region to access neurosurgical services because SRHC only had one neurosurgeon. This assessment and other information led to SRHC's employment of two additional neurosurgeons. One began practice in 2012 and the other in 2013. Part VI, Line 3: At registration, the patient is informed of their rights for financial assistance if unable to produce valid insurance coverage. The patient is referred to a third-party vendor to determine eligibility for governmental programs and if it is determined they do not qualify, they are screened under our financial assistance guidelines. We post our guidelines on our website as well. Part VI, Line 4: Salina Regional Health Center, Inc., is a rural sole community hospital serving a primary service area of Saline County, three immediately adjacent counties are its secondary service area, and has a 14-county referral area although certain specialties draw statewide. For purposes of community health needs assessment, the principal community of SRHC is Saline County because the other three counties each have a local Critical Access Hospital within the county. The primary service area (Saline County) has a population of 55,740. When compared to the national population, this area is represented by an older population with a lower educational level and lower median income. The area population grew 0.2% between 2010 and 2013. The primary service area population is expected to increase by 1.3% by 2018, which is lower than the rate of growth expected for Kansas (2.2%) and the U.S. (3.3%) for the same time period.The service area is less ethnically diverse compared to the U.S. overall. The majority of residents are Caucasian (81.4%) followed by Hispanic (10.3%), and Black (3.5%). Spanish patient education materials are available at SRHC and the hospital has developed a team of Spanish translators. Recognizing the relatively lower educational level in the community, the hospital writes patient information at a 6th to 8th grade reading level.Median household income in the primary service area in 2013 was $47,339, compared to a Kansas median of $51,273, and national median of $53,046. A lack of available resources to the indigent is a challenge in this environment, so in addition to providing charity care, the hospital has and continues to support the Salina Family Healthcare Center, which provides care to the indigent. Our patient population is composed of 50% Medicare, 11% Medicaid, 31% Commercial, 3% Tricare Workers Compensation, and 5% uninsured. Part VI, Line 5: The governing board of Salina Regional Health Center, Inc., is comprised of volunteers intentionally selected to promote the betterment of the region we serve. Demonstrating its commitment to community benefit, this board has for nearly 20 years donated an average of 10% of the hospital's end-of-year operating margin to the Community Health Invest Program (CHIP) of the Salina Regional Health Foundation. Salina Regional Health Center, Inc., administrators and governing board members assist the Foundation by participating in the CHIP Committee.Salina Regional Health Center, Inc., is a member of the Sunflower Health Network (SHN), an organization of Salina Regional Health Center, Inc., and 14 Critical Access Hospitals (CAHs) distributed across 14 counties. A Salina Regional administrator led SHN strategic planning that resulted in regional health priorities, including improving access to specialist physician care, optimizing timeliness and safety of patient transfers, and sustaining the number of quality nurses in the region. As a result of this process, Salina Regional Health Center, Inc., invested in hiring physician recruiters for both the Salina community and the larger region. In 2012 Salina Regional Health Center, Inc., was verified by the American College of Surgeons as a Level III trauma center, the only designated Level III trauma center in the north central Kansas region. Salina Regional also provides access to computerized patient simulators and other nursing education modalities to strengthen the quality of nurses in regional communities.Salina Regional Health Center began a partnership with The University of Kansas School Of Medicine in 2010 to open a medical school campus in Salina. The intent is to develop students who will live and practice medicine in smaller-town Kansas to help alleviate the rural physician shortage. The eight students in the inaugural class completed their first year of medical school in 2012. Salina Regional Health Center is investing $1 million over a four-year period to help defray faculty and operating costs. The hospital also invested several hundred thousand dollars to renovate a building on the hospital campus. The building is provided to KU rent-free for as long as the medical school campus exists. 1 Salina Regional Health Foundation Inc 400 South Santa Fe Salina KS 67401 480949407 501(c)(3) 1069172 To further the activities of the Community Health Improvement Program (CHIP) KU Endowment 3901 Rainbow Blvd Kansas City KS 661607804 480547734 501(c)(3) 250000 Support KU School of Medicine - Salina campus Ashby House LTD PO Box 3482 Salina KS 67402 481099925 501(c)(3) 57200 Book Real estate To provide shelter for homeless families and single women Lindbsborg Community Hospital Association 605 West Lincoln Lindsborg KS 674562328 480545183 501(c)(3) 7574 FMV Equipment To provide medical equipment Scholarships to students attending nursing school. 19 110600 Part I, Line 2: All donee information is kept as part of the organization's books and records. All nursing scholarships recipients are selected based on set criteria. X X X X X 0 0 0 0 0 1 0 0 0 Sean Herrington MD Trustee 291789 0 86091 0 0 0 12500 0 14342 0 404722 0 0 0 Micheal Terry President/CEO 390939 0 144250 0 0 0 55315 0 16729 0 607233 0 0 0 Joe Tallon VP Finance/CFO 219650 0 42277 0 0 0 12500 0 13857 0 288284 0 0 0 Larry Barnes VP Information Technology 232881 0 43441 0 0 0 53948 0 9159 0 339429 0 0 0 Charles Grimwood VP Regional Development 203593 0 39091 0 0 0 13125 0 14125 0 269934 0 0 0 Jack Hinnenkamp VP Facilities Management 175584 0 32616 0 0 0 13125 0 8217 0 229542 0 0 0 David Moody VP Human Resources 180126 0 34726 0 0 0 13125 0 13391 0 241368 0 0 0 Joel Phelps COO 254721 0 57670 0 0 0 31243 0 14246 0 357880 0 0 0 Luanne Smith VP Patient Care/CNO 157666 0 30299 0 0 0 13125 0 12766 0 213856 0 0 0 John Kelemen Physician 552218 0 28692 0 90000 0 12500 0 17876 0 701286 0 0 0 Keir Swisher Physician 328782 0 79245 0 0 0 12500 0 13803 0 434330 0 0 0 Jeremiah Ostmeyer Physician 346526 0 35833 0 0 0 12500 0 14027 0 408886 0 0 0 Justin Whitlow Physician 543239 0 7500 0 0 0 12500 0 16052 0 579291 0 0 0 Merle Hodges Physician 390730 0 52030 0 0 0 12500 0 15624 0 470884 0 0 0 Part I, Line 6 The compensation committee of the board determines bonus and incentive payments based on a balanced scorecard which includes financial, patient satisfaction, and quality data. In addition, a compensation review is performed by an independent outside consultant. A City of Salina Kansas 486017228 794770DP9 2006-04-07 65053116 Extinguish Series 1999 Revenue Bonds and to construct a new patient tower 0 0 0 A 10778116 65053116 4540402 570534 37121199 23036195 2010 0 1 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 A 0 Stacie Maes Family member of Jim Maes, Trustee 70385 Employment 0 Salina Surgical Center 4 Board of directors are employees and/or trustees of SRHC 222174 Provide employees and supplies 0 Patricia Grimwood Spouse of Charles Grimwood, Key Employee of SRHC 17479 Employment 0 Linda Hinnenkamp Spouse of John Hinnenkamp, Key Employee of SRHC 69630 Employment 0 Form 990, Part VI, Section A, line 4 Articles of incorporation and bylaws were amended to reflect Ascension Health's acquisition of Via Christi Health, Inc, a corporate member of Salina Regional Health Center, Inc. Form 990, Part VI, Section A, line 6 Salina Regional Health Center has two corporate members: Salina Regional Health Foundation, Inc., and Via Christi Health, Inc. Form 990, Part VI, Section A, line 7a The corporate members have the power to approve appointment of members to and removal of members from the Board of Trustees. Form 990, Part VI, Section B, line 11 The Form 990 is provided to the Board of Trustees for review prior to filing. Due to current year timing, the approval by the audit committee will not occur until after the filing date. Form 990, Part VI, Section B, line 12c A conflict of interest questionnaire is required to be completed upon election and annually. The questionnaire is reviewed by legal counsel. Form 990, Part VI, Section B, line 15 An independent compensation firm is obtained to complete an annual review and analysis of all the administrative staff members. The compiled report is forwarded to the Compensation Committee of the Board that reviews the analysis and approves the report. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy, and audited financial statements available to the public upon written request. Form 990, Part XI, line 9: Intercompany transfers 213,474. Change in fair value of assets held in trust 332,462. Change in beneficial interest in net assets of Foundation 240,385. Form 990, Part XII, Line 2C: The audit committee assumes the responsibility for the oversight of the audited financial statements, review of the Form 990 and Form 990-T, and selection of the independent accounting firm. Salina Regional Health Foundation Inc 400 South Santa Fe Salina KS 67401 480949407 Advancement of healthcare, health & medical education, research, & welfare KS 501(c)(3) 170(b)(1)(A)(vi) 0 Salina Regional Health Properties Inc 400 South Santa Fe Salina KS 67401 481154675 Own and operate medical office buildings for section 501(c)(3) organizations KS 501(c)(2) Salina Regional Health Center Inc 1 Hospice of Salina Inc 730 Holly Lane Salina KS 67402 481131570 Provide hospice care and support services to the terminally ill and their KS 501(c)(3) 509(a) Salina Regional Health Center Inc 1 Via Christi Health Inc 8200 E Thorn Drive Suite 300 Wichita KS 67226 481172107 Hospital support KS 501(c)(3) 509(a) 0 Salina Surgery Properties LLC 401 South Santa Fe Salina KS 67401 481200039 Construct & own surgical facility KS Related 234688 1664113 0 0 0.50000 Salina Surgical Center LLC 401 South Santa Fe Salina KS 67401 481199515 Medical services, ambulatory surgery KS Related 3646576 5763869 0 0 0.50000 Salina Regional Home Medical Services LLC 520 South Santa Fe Suite 140 Salina KS 67401 481221623 Home medical services KS Salina Regional Health Center Inc Related 222653 618425 0 0 0.51000 Salina Regional Health Enterprises Inc 400 South Santa Fe Salina KS 67402 481056225 Provide mgmt services to hospitals in N. Central KS area KS Salina Regional Health Center Inc C 1.00000 1 0 1 1 0 0 0 0 0 1 0 1 0 0 0 1 0 1 0 0 Salina Regional Health Properties Inc I 173716 Cash received Salina Regional Health Properties Inc K 1061087 Cash paid Salina Regional Health Properties Inc O 86158 Actual cost Salina Regional Health Properties Inc Q 89671 Actual cost Hospice of Salina Inc O 257809 Actual cost Hospice of Salina Inc Q 273023 Actual cost Hospice of Salina Inc B 675000 Actual cost Salina Surgical Center LLC Q 332458 Markup of cost