FURP.ORG / PUBLIC DATA EXPLORER

GREAT PLAINS OF SABETHA INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
GREAT PLAINS OF SABETHA INC (EIN 48-1236156)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-11-12
IRS object ID
201413169349303816
Schema version
2013v3.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2014-11-12T14:08:21-06:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11551 N WATERFRONT PKWY STE 300AddressLine1
CityWICHITACity
StateKSState
ZIP Code672066601ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN481236156EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GREAT PLAINS OF SABETHA INCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of% MIKE HANDInCareOfNm
Business Name ControlGREABusinessNameControlTxt
Phone7855432111PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1250 NORTH ROCK ROADAddressLine1
Address Line2Suite 160AddressLine2
CityWICHITACity
StateKSState
ZIP Code67206ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMIKE HANDPersonNm
Person TitleCFO AND SENIOR VICE PRESIDENTPersonTitleTxt
Phone7855432111PhoneNum
Signature2014-11-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonELIZABETH S HOGANPreparerPersonNm
PTINP00273248PTIN
Phone7855432111PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd
Principal OfficerMIKE HANDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1250 NORTH ROCK ROADAddressLine1
CityWICHITACity
StateKSState
ZIP Code67206ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$11,003,698GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.SABETHAHOSPITAL.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2000FormationYr
Legal Domicile StateKSLegalDomicileStateCd
Activity Or MissionACUTE CARE HOSPITAL THAT PROVIDES MEDICAL CARE TO THE GENERAL PUBLIC IN SABETHA, KANSAS AND SURROUNDING RURAL COMMUNITIES.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee167TotalEmployeeCnt
Total Volunteers47TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$184,866PYContributionsGrantsAmt
CY Contributions Grants$466,057CYContributionsGrantsAmt
PY Program Service Revenue$10,557,332PYProgramServiceRevenueAmt
CY Program Service Revenue$10,308,408CYProgramServiceRevenueAmt
PY Investment Income$16,510PYInvestmentIncomeAmt
CY Investment Income$16,736CYInvestmentIncomeAmt
PY Other Revenue$257,559PYOtherRevenueAmt
CY Other Revenue$206,954CYOtherRevenueAmt
PY Total Revenue$11,016,267PYTotalRevenueAmt
CY Total Revenue$10,998,155CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$6,314,946PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$6,485,258CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$4,555,671PYOtherExpensesAmt
CY Other Expenses$4,547,291CYOtherExpensesAmt
PY Total Expenses$10,870,617PYTotalExpensesAmt
CY Total Expenses$11,032,549CYTotalExpensesAmt
PY Revenues Less Expenses$145,650PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$34,394CYRevenuesLessExpensesAmt
Total Assets BOY$7,451,753TotalAssetsBOYAmt
Total Assets EOY$7,533,531TotalAssetsEOYAmt
Total Liabilities BOY$1,374,661TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,607,258TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$6,077,092NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$5,926,273NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO 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.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$9,462,368ExpenseAmt
Grant$0GrantAmt
Revenue$10,440,964RevenueAmt
DescSEE SCHEDULE O.Desc
Total Program Service Expenses$9,462,368TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document19IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee167EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMIKE HANDPersonNm
Phone3166851523PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1250 NORTH ROCK ROAD STE 160AddressLine1
CityWICHITACity
StateKSState
ZIP Code67206ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
STEVE CARLSON
CHAIRMAN/DIRECTOR0.252.25Yes (X)Yes (X)$0$0$0
ROGER JOHN
PRESIDENT/CEO/DIRECTOR2.040.0Yes (X)Yes (X)$41,627$7,627
BETH MEYERES
VICE PRESIDENT/DIRECTOR0.252.25Yes (X)Yes (X)
LOGAN SPRUNGER
VICE PRESIDENT/DIRECTOR0.252.25Yes (X)Yes (X)
ROBERT HAMILTON
SECRETARY/DIRECTOR0.252.25Yes (X)Yes (X)
THOMAS E KELLER DVM
TREASURER/DIRECTOR0.252.25Yes (X)
BILL NAVIS
DIRECTOR0.252.25Yes (X)
DR BARBARA BROWN OD
DIRECTOR0.252.25Yes (X)
CURTIS ERICKSON
DIRECTOR0.250.25Yes (X)
DAVE RANKIN
DIRECTOR0.252.25Yes (X)
JOHN TERRILL
DIRECTOR0.252.25Yes (X)
DAVE DELLASEGA
PRESIDENT/CEO/DIRECTOR2.040.0Yes (X)Yes (X)$166,304$27,342
LORA KEY
ADMINISTRATOR40.00.0Yes (X)$88,625$26,029
MIKE HAND
CFO2.040.0Yes (X)$116,220$25,391
KEVIN KENNALLY
PHYSICIAN40.00.0$277,887$43,776Yes (X)
GREGG WENGER
PHYSICIAN40.00.0$172,920$27,045Yes (X)
JAMES LONGABAUGH
PHYSICIAN40.00.0$208,736$31,570Yes (X)
CHRISTIAN TRAMP
PHYSICIAN40.00.0$190,400$36,583Yes (X)
KERSTIN GLYNN
PHYSICIAN40.00.0$250,018$40,060Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,188,586TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$324,151TotReportableCompRltdOrgAmt
Total Other Compensation$265,423TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K5IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

ServicesServicesDescCompensationCompensationAmt
MIDWEST HEALTH SYSTEMS
COMPUTER SUPPORT$178,772
STORMONT VAIL HEALTHCARE
LAB SERVICES$118,836
GREAT PLAINS HEALTH ALLIANCE
MANAGEMENT SERVICES$118,190
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
Fundraising$12,704FundraisingAmt
Government Grants$17,198GovernmentGrantsAmt
All Other Contributions$436,155AllOtherContributionsAmt
Total Contributions$466,057TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT SERVICE REVENUEDesc
Business621300BusinessCd
Total Revenue Column$10,308,408TotalRevenueColumnAmt
Related Or Exempt Func Income$10,308,408RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$10,308,408TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$14,265TotalRevenueColumnAmt
Exclusion$14,265ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$16,500RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$16,500RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,500TotalRevenueColumnAmt
Exclusion$16,500ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$2,471OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$2,471OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,471TotalRevenueColumnAmt
Exclusion$2,471ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$3,553FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$12,704ContriRptFundraisingEventAmt
Fundraising Direct Expenses$5,543FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$1,990TotalRevenueColumnAmt
Exclusion-$1,990ExclusionAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EMPLOYEE/GUEST MEALS722513$14,585$14,585
OUTSIDE SERVICES621300$66,556$66,556
EHR INCENTIVE REVENUE900099$66,000$66,000

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$45,303TotalRevenueColumnAmt
Exclusion$45,303ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$192,444OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$10,998,155TotalRevenueColumnAmt
Related Or Exempt Func Income$10,440,964RelatedOrExemptFuncIncomeAmt
Exclusion$91,134ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$114,654TotalAmt
Management And General$114,654ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,136,523TotalAmt
Program Services$4,510,798ProgramServicesAmt
Management And General$625,725ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$387,657TotalAmt
Program Services$332,616ProgramServicesAmt
Management And General$55,041ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$495,585TotalAmt
Program Services$382,798ProgramServicesAmt
Management And General$112,787ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$350,839TotalAmt
Program Services$299,812ProgramServicesAmt
Management And General$51,027ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$101,276TotalAmt
Management And General$101,276ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$6,621TotalAmt
Management And General$6,621ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$29,599TotalAmt
Management And General$29,599ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,167,772TotalAmt
Program Services$1,013,138ProgramServicesAmt
Management And General$154,634ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$21,576TotalAmt
Program Services$9,992ProgramServicesAmt
Management And General$11,584ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$210,738TotalAmt
Program Services$146,369ProgramServicesAmt
Management And General$64,369ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$7,014TotalAmt
Program Services$3,675ProgramServicesAmt
Management And General$3,339ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$247,487TotalAmt
Program Services$234,569ProgramServicesAmt
Management And General$12,918ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$15,952TotalAmt
Program Services$4,829ProgramServicesAmt
Management And General$11,123ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$46,630TotalAmt
Program Services$37,477ProgramServicesAmt
Management And General$9,153ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$22,149TotalAmt
Program Services$20,445ProgramServicesAmt
Management And General$1,704ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$611,214TotalAmt
Program Services$556,939ProgramServicesAmt
Management And General$54,275ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$132,757TotalAmt
Program Services$37,654ProgramServicesAmt
Management And General$95,103ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & DRUGS$1,204,878$1,204,878
RENTAL EQUIPMENT & REPAIRS$370,538$358,926$11,612
BAD DEBT EXPENSE$260,012$257,533$2,479
DUES & SUBSCRIPTIONS$42,793$17,349$25,444

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$48,286TotalAmt
Program Services$32,571ProgramServicesAmt
Management And General$15,714ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$11,032,549TotalAmt
Program Services$9,462,368ProgramServicesAmt
Management And General$1,570,181ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$220BOYAmt
EOY$220EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$744,257BOYAmt
EOY$909,276EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$6,263BOYAmt
EOY$13,243EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,849,496BOYAmt
EOY$1,396,966EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$226,409BOYAmt
EOY$193,606EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$113,140BOYAmt
EOY$104,132EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$12,071,956LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$7,899,424LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$4,221,087BOYAmt
EOY$4,172,532EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$220,881BOYAmt
EOY$233,556EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$70,000BOYAmt
EOY$510,000EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$7,451,753BOYAmt
EOY$7,533,531EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$985,718BOYAmt
EOY$1,052,361EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$388,943BOYAmt
EOY$554,897EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,374,661BOYAmt
EOY$1,607,258EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$6,070,829BOYAmt
EOY$5,913,030EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$6,263BOYAmt
EOY$13,243EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,077,092BOYAmt
EOY$5,926,273EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$7,451,753BOYAmt
EOY$7,533,531EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$34,394ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$116,425OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Organization Belongs Afflt GrpYes (X)OrganizationBelongsAffltGrpInd
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
Form4720 FiledYes (true)Form4720FiledInd
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsYes (true)GrantsOtherOrganizationsInd
Grants Other Organizations$2,593GrantsOtherOrganizationsAmt
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesfalseOtherActivitiesInd
Total Lobbying Expenditures$2,593TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1FFormAndLineReferenceDesc
ExplanationA PORTION OF THE ANNUAL DUES PAID TO KHA AND AHA ARE USED FOR LOBBYING.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$35,244OtherCostOrOtherBasisAmt
Book Value$35,244BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,405,253OtherCostOrOtherBasisAmt
Depreciation$3,745,069DepreciationAmt
Book Value$2,660,184BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,448,449OtherCostOrOtherBasisAmt
Depreciation$3,993,909DepreciationAmt
Book Value$1,454,540BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$183,010OtherCostOrOtherBasisAmt
Depreciation$160,446DepreciationAmt
Book Value$22,564BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$4,172,532TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescTHIRD PARTY RECEIVABLEDesc
Book Value$510,000BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$510,000TotalBookValueOtherAssetsAmt
Total Rev Etc Audited Fincl Stmt$10,783,861TotalRevEtcAuditedFinclStmtAmt
Other Revenue-$214,294OtherRevenueAmt
Revenue Not Reported-$214,294RevenueNotReportedAmt
Revenue Subtotal$10,998,155RevenueSubtotalAmt
Total Revenue Per Form990$10,998,155TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$10,934,680TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$162,143OtherExpensesIncludedAmt
Expenses Not Reported$162,143ExpensesNotReportedAmt
Expenses Subtotal$10,772,537ExpensesSubtotalAmt
Other Expenses Not Included$260,012OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$260,012ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$11,032,549TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART X, LINE 2MANAGEMENT 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. 40,175 SPECIAL EVENT EXPENSES 5,543 PROVISION FOR UNCOLLECTIBLE ACCOUNTS (260,012) ---------- TOTAL $ (214,294)
SCHEDULE D, PART XII, LINE 2DTRANSFER TO CITY OF SABETHA 156,600 SPECIAL EVENT EXPENSES 5,543 ---------- TOTAL $ 162,143
SCHEDULE D, PART XII, LINE 4BPROVISION FOR UNCOLLECTIBLE ACCOUNTS 260,012

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Name Of Event1GOLF TOURNAMENTNameOfEvent1Amt
Gross Receipts Event1$16,257GrossReceiptsEvent1Amt
Charitable Contri Event1$12,704CharitableContriEvent1Amt
Gross Revenue Event1$3,553GrossRevenueEvent1Amt
Cash Prizes Event1$2,160CashPrizesEvent1Amt
Rent Facility Costs Event1$700RentFacilityCostsEvent1Amt
Food And Beverage Event1$1,181FoodAndBeverageEvent1Amt
Other Direct Expenses Event1$1,502OtherDirectExpensesEvent1Amt
Other Events Total0OtherEventsTotalCnt
Gross Receipts Total$16,257GrossReceiptsTotalAmt
Charitable Contributions Tot$12,704CharitableContributionsTotAmt
Gross Revenue Total Events$3,553GrossRevenueTotalEventsAmt
Cash Prizes Total Events$2,160CashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$700RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$1,181FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events$1,502OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$5,543DirectExpenseSummaryEventsAmt
Net Income Summary-$1,990NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$374,409TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$192,433DirectOffsettingRevenueAmt
Net Community Benefit Expns$181,976NetCommunityBenefitExpnsAmt
Total Expense0.01660TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$374,409TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$192,433DirectOffsettingRevenueAmt
Net Community Benefit Expns$181,976NetCommunityBenefitExpnsAmt
Total Expense0.01660TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs16ActivitiesOrProgramsCnt
Persons Served4788PersonsServedCnt
Total Community Benefit Expns$292,591TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$175,171DirectOffsettingRevenueAmt
Net Community Benefit Expns$117,420NetCommunityBenefitExpnsAmt
Total Expense0.01070TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served18PersonsServedCnt
Total Community Benefit Expns$59TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$59NetCommunityBenefitExpnsAmt

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs4ActivitiesOrProgramsCnt
Persons Served300PersonsServedCnt
Total Community Benefit Expns$3,338TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,338NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs21ActivitiesOrProgramsCnt
Persons Served5106PersonsServedCnt
Total Community Benefit Expns$295,988TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$175,171DirectOffsettingRevenueAmt
Net Community Benefit Expns$120,817NetCommunityBenefitExpnsAmt
Total Expense0.01100TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs21ActivitiesOrProgramsCnt
Persons Served5106PersonsServedCnt
Total Community Benefit Expns$670,397TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$367,604DirectOffsettingRevenueAmt
Net Community Benefit Expns$302,793NetCommunityBenefitExpnsAmt
Total Expense0.02760TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$260,012BadDebtExpenseAmt
Reimbursed By Medicare$3,718,385ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$3,718,385CostOfCareReimbursedByMedcrAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SABETHA COMMUNITY HOSPITALBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line114TH OREGON PO BOX 229AddressLine1
CitySABETHACity
StateKSState
ZIP Code66534ZIPCode
FieldValueIRS element (for citing)
Website AddressWWW.SABETHAHOSPITAL.ORGWebsiteAddressTxt
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1SABETHA COMMUNITY HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Facility1FacilityNum
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.SABETHAHOSPITAL.COMOwnWebsiteURLTxt
Adopt Implementation StrategyYes (X)AdoptImplementationStrategyInd
Develop Community Wide PlanYes (X)DevelopCommunityWidePlanInd
Prioritize Health NeedsYes (X)PrioritizeHealthNeedsInd
Prioritize ServicesYes (X)PrioritizeServicesInd
All Needs AddressedYes (true)AllNeedsAddressedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Used Deter Elig Free CareYes (true)FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care100FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt CareYes (true)FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care300.FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (true)ExplainedBasisInd
Income LevelYes (X)IncomeLevelInd
Asset LevelYes (X)AssetLevelInd
Medical IndigencyYes (X)MedicalIndigencyInd
Insurance StatusYes (X)InsuranceStatusInd
Medicaid MedicareYes (X)MedicaidMedicareInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
Posted On WebsiteYes (X)PostedOnWebsiteInd
Attached To InvoiceYes (X)AttachedToInvoiceInd
Posted In Emergency RoomYes (X)PostedInEmergencyRoomInd
Posted In Admission OfficeYes (X)PostedInAdmissionOfficeInd
Provided On AdmissionYes (X)ProvidedOnAdmissionInd
Available On RequestYes (X)AvailableOnRequestInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Collection ActivitiesfalseCollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Lowest Negotiated RatesYes (X)LowestNegotiatedRatesInd
Medicare RatesYes (X)MedicareRatesInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SABETHA FAMILY PRACTICEBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line11115 MAIN STREETAddressLine1
CitySABETHACity
StateKSState
ZIP Code66534ZIPCode
FieldValueIRS element (for citing)
FacilityFAMILY CLINICFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART I, LINE 7, COLUMN FTHE 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 $260,012.
SCHEDULE H, PART I, LINE 7THE 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 2AHOSPITAL 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 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 9BALL 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 V, SECTION B, LINE 3 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 4 NEMAHA VALLEY COMMUNITY HOSPITAL
SCHEDULE H, PART VI, LINE 2SABETHA 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. AS A RESULT OF THE CHNA, THREE COMMITTEES WERE FORMED AND THROUGHOUT 2013 HAVE WORKED ON INITIATIVES FOR EACH PRIORITY IDENTIFIED. THE CHNA WAS POSTED ON THE SABETHA COMMUNITY HOSPITALS WEBSITE FOR EASY ACCESS BY THE COMMUNITIES. THE HOSPITAL PROVIDES EDUCATIONAL INFORMATION THROUGH ITS MONTHLY OUTPATIENT CALENDARS AND EDUCATIONAL EVENTS IN THE COMMUNITY. IN 2013 A WOMENS HEALTH FAIR WAS CONDUCTED; THE PHYSICIANS PARTICIPATED IN CONCUSSION TRAINING FOR STUDENT ATHLETES, DIABETES EDUCATION TRAINING AND A MONITORING PROGRAM BY THE CERTIFIED DIABETIC EDUCATOR WAS ESTABLISHED. 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 AN AFFORDABLE CARE ACT INFORMATIONAL MEETING WAS HELD FOR LOCAL EMPLOYERS. 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 SUCH AS THE CAUTI PROJECT REDUCING CATHETER ASSOCIATED URINARY TRACT INFECTIONS AND THE REDUCTION OF EARLY ELECTIVE DELIVERIES. SEVERAL OPTIONS WERE EXPLORED FOR BETTER ACCESS TO MENTAL HEALTH INCLUDING TELEMEDICINE PSYCHIATRY. DISCUSSIONS WERE HELD WITH THE COMMUNITY MENTAL HEALTH CENTER AND EXPLORATION INTO CRISIS TELEPSYCH IS BEING PURSUED.
SCHEDULE H, PART VI, LINE 3THE 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 PATIENTS HOUSEHOLD INCOME AND QUALIFYING ASSETS. THE FINANCIAL COUNSELOR CONSULTS WITH PRIVATE PAY PATIENTS TO SEE IF THEY QUALIFY FOR THE HOSPITALS 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 4SABETHA 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. ACCORDING TO DATA COLLECTED DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT, THE PRIMARY SERVICE AREA FOR SABETHA COMMUNITY HOSPITAL INCLUDES PORTIONS OF NEMAHA, BROWN AND JACKSON COUNTIES WITH NEMAHA COUNTY PROVIDING 78.6%, BROWN 6.6%, JACKSON 1.4%, AND OTHER AREAS WHICH WOULD INCLUDE NEBRASKA AND OTHER COUNTIES 6.0% OF INPATIENT DISCHARGES FOR 2011. IN 2010, AN ESTIMATED 10,083 PEOPLE LIVE IN NEMAHA COUNTY. PEOPLE AGE 35 TO 54 YEARS MAKE UP THE LARGEST PORTION OF THE POPULATION WITH 26.7% AND OF THAT GROUP 51.5 % WERE MALE AND 48.5% WERE FEMALE. 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. MEDICARE USERS MAKE UP 21% OF THE COUNTYS TOTAL POPULATION.
SCHEDULE H, PART VI, LINE 5SABETHA COMMUNITY HOSPITALS EMERGENCY ROOM/TRAUMA QUALITY ASSURANCE COMMITTEE MEETS MONTHLY TO MAINTAIN THE LEVEL IV TRAUMA CENTER DESIGNATION AND WORKED WITH THE LOCAL FIREARM SAFETY GROUP IN PROMOTING GUN SAFETY AND GUN LOCKS. THE HOSPITAL ALSO HELPED SPONSOR FIRE PREVENTION BOOKLETS TO THE ELEMENTARY STUDENTS TO PROMOTE FIRE SAFETY. ALL CRITERIA WERE MET IN 2013 TO MAINTAIN THE DESIGNATION AS A STROKE READY FACILITY. SABETHA FAMILY PRACTICE FINISHED THE MEDICAL HOME PILOT PROJECT AND BEGAN TO PURSUE THE NCQA DESIGNATION. FOR THE ENTIRE YEAR OF 2013, SFP MET THE CRITERIA FOR STAGE I MEANINGFUL USE OF THE ELECTRONIC RECORD. THE HOSPITAL ALSO ADDED ADDITIONAL TECHNOLOGY AT THE HOSPITAL TO AID THE PHYSICIANS IN ENTERING ELECTRONIC ORDERS. PHARMACY AND MEDICATION RECONCILIATION ADMINISTRATION SOFTWARE WAS ADDED AS WELL AND IS UTILIZED NOT ONLY IN THE INPATIENT SETTING BUT THE EMERGENCY ROOM AS WELL. IN 2013 THE HOSPITAL BECAME A MEDICARE CERTIFIED DIABETIC EDUCATION FACILITY, AND THE CERTIFIED DIABETIC NURSE EDUCATOR ALONG WITH THE REGISTERED DIETICIAN PROVIDES A SUPPORT GROUP TO DIABETIC PATIENTS PROMOTING LIFE STYLE CHANGES AND ACCOUNTABILITY IN THEIR DIABETIC JOURNEY. 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. 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. AN ADDITIONAL FEATURE WAS ADDED IN 2013 TO PROMOTE WELLNESS WITHIN LOCAL BUSINESSES, STAFF WILL CONDUCT MINI HEALTH FAIRS WITH MANUFACTURING FACILITIES TO PROMOTE WELLNESS. 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 AT THE HOSPITAL, AND HOSPITAL STAFF 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. THE HOSPITAL ALSO PROVIDES LIFELINE TO THE SENIOR POPULATION IN THE REGION. ONE OF THE HOSPITAL PHYSICIANS SITS AS THE MEDICAL DIRECTOR FOR THE CITY OWNED AMBULANCE SERVICE AND ALSO SERVES AS THE MEDICAL DIRECTOR FOR A LOCAL NURSING HOME. ANOTHER PHYSICIAN SERVES AS A MEDICAL DIRECTOR FOR A NURSING HOME AS WELL AS THE LOCAL 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, THE GOVERNORS KANCARE ADVISORY GROUP, AND THE KANSAS DEPARTMENT OF HEALTH AND ENVIRONMENT PROVIDER AND OPERATIONAL ISSUES WORKGROUP FOR KANCARE. 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 THROUGH THE HOSPITAL 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 FOLLOW 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. 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. EVERY YEAR MIDDLE SCHOOL STUDENTS AND HIGH SCHOOL STUDENTS JOB SHADOW AT THE HOSPITAL TO ENCOURAGE CAREERS IN HEALTHCARE.
SCHEDULE H, PART VI, LINE 6ORGANIZATION 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 7N/A

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmtBase Compensation Filing OrgBaseCompensationFilingOrgAmt
DAVE DELLASEGA
PRESIDENT/CEO/DIRECTOR$166,304$0$16,120$0$11,222$0$193,646$0$0
KEVIN KENNALLY
PHYSICIAN$25,177$0$18,599$0$321,663$0$0$0$277,887
GREGG WENGER
PHYSICIAN$16,793$0$10,252$0$199,965$0$0$0$172,920
JAMES LONGABAUGH
PHYSICIAN$20,426$0$11,144$0$240,306$0$0$0$208,736
CHRISTIAN TRAMP
PHYSICIAN$19,238$0$17,345$0$226,983$0$0$0$190,400
KERSTIN GLYNN
PHYSICIAN$24,700$0$15,360$0$290,078$0$0$0$250,018

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFORM 990, PART VII; SCHEDULE J, PART I, LINE 3FormAndLineReferenceDesc
ExplanationCOMPENSATION FOR ROGER JOHN, 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. JOHN, MR. HAND, AND MR. DELLASEGA.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 4THE 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 2013, 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. PART VI, SECTION A, LINE 2 ROGER JOHN, DAVE DELLASEGA, AND MIKE HAND HAVE A BUSINESS RELATIONSHIP. THEY ARE ALL EMPLOYED BY, AND ALSO OFFICERS OF, A RELATED 501(C)(3) ORGANIZATION, GREAT PLAINS HEALTH ALLIANCE.
FORM 990, PART VI, SECTION A, LINE 6GREAT 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 7AGREAT 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 7BGREAT 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 11BTHE 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 12CTHE 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 & BTHE 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 19THE 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 9EQUITY IN EARNINGS SABETHA HEALTHCARE, INC. 40,175 TRANSFER TO CITY OF SABETHA (156,600) ---------- TOTAL $ (116,425)
FORM 990 PART IX LINE 11GDESCRIPTION:CONTRACTED MEDICAL STAFF TOTAL FEES:923317
FORM 990 PART IX LINE 11GDESCRIPTION:BILLING/COLLECTIONS TOTAL FEES:114619
FORM 990 PART IX LINE 11GDESCRIPTION:LAB SERVICES TOTAL FEES:44464
FORM 990 PART IX LINE 11GDESCRIPTION:PHARMACY SERVICES TOTAL FEES:43557
FORM 990 PART IX LINE 11GDESCRIPTION:ADMINISTRATION/HUMAN RESOURCES TOTAL FEES:40015
FORM 990 PART IX LINE 11GDESCRIPTION:MAINTENANCE/HOUSEKEEPING TOTAL FEES:1800

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrganizationControlledOrganizationInd
GREAT PLAINS HEALTH ALLIANCE INC
250 NORTH ROCK ROAD STE 160WICHITAKS67206480617739MANAGEMENTKS501(C)(3)3NAfalse
GREAT PLAINS HEALTH CARE FOUNDATION INC
250 NORTH ROCK ROAD STE 160WICHITAKS67206480955870SUPPORTKS501(C)(3)9GPHA INCYes (true)
GREAT PLAINS OF CHEYENE COUNTY INC
250 NORTH ROCK ROAD STE 160WICHITAKS67206481226831HOSPITALKS501(C)(3)3GPHA INCYes (true)
GREAT PLAINS OF ELLINWOOD INC
250 NORTH ROCK ROAD STE 160WICHITAKS67206481226976HOSPITALKS501(C)(3)3GPHA INCYes (true)
GREAT PLAINS OF KIOWA COUNTY INC
250 NORTH ROCK ROAD STE 160WICHITAKS67206481226833HOSPITALKS501(C)(3)3GPHA INCYes (true)
GREAT PLAINS OF OTTAWA COUNTY INC
250 NORTH ROCK ROAD STE 160WICHITAKS67206481226856HOSPITALKS501(C)(3)3GPHA INCYes (true)
GREAT PLAINS OF PHILLIPS COUNTY INC
250 NORTH ROCK ROAD STE 160WICHITAKS67206481226829HOSPITALKS501(C)(3)3GPHA INCYes (true)
GREAT PLAINS OF REPUBLIC COUNTY INC
250 NORTH ROCK ROAD STE 160WICHITAKS67206481226977HOSPITALKS501(C)(3)3GPHA INCYes (true)
GREAT PLAINS OF SMITH COUNTY INC
250 NORTH ROCK ROAD STE 160WICHITAKS67206481226830HOSPITALKS501(C)(3)3GPHA INCYes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd