2014-11-12T14:08:21-06:00 2013-12-31 BKD LLP 1551 N WATERFRONT PKWY STE 300 WICHITA KS 672066601 990 2013-01-01 481236156 GREAT PLAINS OF SABETHA INC % MIKE HAND GREA 7855432111 250 NORTH ROCK ROAD Suite 160 WICHITA KS 67206 MIKE HAND CFO AND SENIOR VICE PRESIDENT 7855432111 2014-11-15 true ELIZABETH S HOGAN P00273248 7855432111 2013 2015-11-30 17:44:51Z X MIKE HAND 250 NORTH ROCK ROAD WICHITA KS 67206 11003698 false X WWW.SABETHAHOSPITAL.COM X 2000 KS ACUTE CARE HOSPITAL THAT PROVIDES MEDICAL CARE TO THE GENERAL PUBLIC IN SABETHA, KANSAS AND SURROUNDING RURAL COMMUNITIES. 11 10 167 47 0 184866 466057 10557332 10308408 16510 16736 257559 206954 11016267 10998155 0 0 0 0 6314946 6485258 0 0 0 4555671 4547291 10870617 11032549 145650 -34394 7451753 7533531 1374661 1607258 6077092 5926273 X TO OPERATE HOSPITAL FACILITIES FOR THE DELIVERY OF HOSPITAL AND RELATED HEALTH CARE SERVICES, HEALTH RELATED EDUCATION, AS WELL AS THE PROMOTION OF HEALTH AND WELLNESS, WITHOUT REGARD TO RACE, CREED, COLOR, SEX, OR FINANCIAL CIRCUMSTANCES. false false 9462368 0 10440964 SEE SCHEDULE O. 9462368 true true false true false false false false false false true false false true false false true true false false false false false false true false true true false false true false false false false false false false false false false false false false true true false false false true 19 0 true 167 true false false false false false true true false false false false X 11 10 true false false false true true true true true false false true true true true true true false false false X MIKE HAND 3166851523 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 STEVE CARLSON CHAIRMAN/DIRECTOR 0.25 2.25 X X 0 0 0 ROGER JOHN PRESIDENT/CEO/DIRECTOR 2.0 40.0 X X 41627 7627 BETH MEYERES VICE PRESIDENT/DIRECTOR 0.25 2.25 X X LOGAN SPRUNGER VICE PRESIDENT/DIRECTOR 0.25 2.25 X X ROBERT HAMILTON SECRETARY/DIRECTOR 0.25 2.25 X X THOMAS E KELLER DVM TREASURER/DIRECTOR 0.25 2.25 X BILL NAVIS DIRECTOR 0.25 2.25 X DR BARBARA BROWN OD DIRECTOR 0.25 2.25 X CURTIS ERICKSON DIRECTOR 0.25 0.25 X DAVE RANKIN DIRECTOR 0.25 2.25 X JOHN TERRILL DIRECTOR 0.25 2.25 X DAVE DELLASEGA PRESIDENT/CEO/DIRECTOR 2.0 40.0 X X 166304 27342 LORA KEY ADMINISTRATOR 40.0 0.0 X 88625 26029 MIKE HAND CFO 2.0 40.0 X 116220 25391 KEVIN KENNALLY PHYSICIAN 40.0 0.0 X 277887 43776 GREGG WENGER PHYSICIAN 40.0 0.0 X 172920 27045 JAMES LONGABAUGH PHYSICIAN 40.0 0.0 X 208736 31570 CHRISTIAN TRAMP PHYSICIAN 40.0 0.0 X 190400 36583 KERSTIN GLYNN PHYSICIAN 40.0 0.0 X 250018 40060 1188586 324151 265423 5 false true false MIDWEST HEALTH SYSTEMS COMPUTER SUPPORT 178772 STORMONT VAIL HEALTHCARE LAB SERVICES 118836 GREAT PLAINS HEALTH ALLIANCE MANAGEMENT SERVICES 118190 3 12704 17198 436155 466057 NET PATIENT SERVICE REVENUE 621300 10308408 10308408 10308408 14265 14265 0 0 16500 16500 0 16500 16500 2471 2471 2471 2471 3553 12704 5543 -1990 -1990 0 0 EMPLOYEE/GUEST MEALS 722513 14585 14585 OUTSIDE SERVICES 621300 66556 66556 EHR INCENTIVE REVENUE 900099 66000 66000 45303 45303 192444 10998155 10440964 91134 0 0 0 0 114654 114654 0 5136523 4510798 625725 387657 332616 55041 495585 382798 112787 350839 299812 51027 101276 101276 6621 6621 29599 29599 0 0 0 1167772 1013138 154634 21576 9992 11584 210738 146369 64369 7014 3675 3339 0 247487 234569 12918 15952 4829 11123 0 46630 37477 9153 22149 20445 1704 0 611214 556939 54275 132757 37654 95103 MEDICAL SUPPLIES & DRUGS 1204878 1204878 RENTAL EQUIPMENT & REPAIRS 370538 358926 11612 BAD DEBT EXPENSE 260012 257533 2479 DUES & SUBSCRIPTIONS 42793 17349 25444 48286 32571 15714 11032549 9462368 1570181 0 220 220 744257 909276 6263 13243 1849496 1396966 0 0 0 0 0 0 226409 193606 113140 104132 12071956 7899424 4221087 4172532 0 0 220881 233556 0 0 0 0 70000 510000 7451753 7533531 985718 1052361 0 0 0 0 0 0 0 0 0 0 388943 554897 0 0 0 0 1374661 1607258 X 6070829 5913030 6263 13243 0 0 6077092 5926273 7451753 7533531 X -34394 -116425 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X true false false false false false true 2593 false false false 2593 false SCHEDULE C, PART II-B, LINE 1F A PORTION OF THE ANNUAL DUES PAID TO KHA AND AHA ARE USED FOR LOBBYING. 35244 35244 6405253 3745069 2660184 5448449 3993909 1454540 183010 160446 22564 4172532 THIRD PARTY RECEIVABLE 510000 510000 10783861 -214294 -214294 10998155 10998155 10934680 162143 162143 10772537 260012 260012 11032549 SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D EQUITY IN EARNINGS SABETHA HEALTHCARE, INC. 40,175 SPECIAL EVENT EXPENSES 5,543 PROVISION FOR UNCOLLECTIBLE ACCOUNTS (260,012) ---------- TOTAL $ (214,294) SCHEDULE D, PART XII, LINE 2D TRANSFER TO CITY OF SABETHA 156,600 SPECIAL EVENT EXPENSES 5,543 ---------- TOTAL $ 162,143 SCHEDULE D, PART XII, LINE 4B PROVISION FOR UNCOLLECTIBLE ACCOUNTS 260,012 GOLF TOURNAMENT 16257 12704 3553 2160 700 1181 1502 0 16257 12704 3553 2160 700 1181 1502 5543 -1990 true true true X true X true true false true true 374409 192433 181976 0.01660 374409 192433 181976 0.01660 16 4788 292591 175171 117420 0.01070 1 18 59 59 4 300 3338 3338 0.00030 21 5106 295988 175171 120817 0.01100 21 5106 670397 367604 302793 0.02760 false 260012 3718385 3718385 X true true 1 1 SABETHA COMMUNITY HOSPITAL 14TH OREGON PO BOX 229 SABETHA KS 66534 WWW.SABETHAHOSPITAL.ORG X X X X SABETHA COMMUNITY HOSPITAL 1 true X X X X X X X X X 13 true true true X WWW.SABETHAHOSPITAL.COM X X X X true false true true 100 true 300. true X X X X X true true X X X X X X true false X X X X true X X false false 1 SABETHA FAMILY PRACTICE 1115 MAIN STREET SABETHA KS 66534 FAMILY CLINIC SCHEDULE H, PART I, LINE 7, COLUMN F THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $260,012. SCHEDULE H, PART I, LINE 7 THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART I, LINE 7, OF SCHEDULE H, IS A COST TO CHARGE RATIO. SCHEDULE H, PART III, LINE 2A HOSPITAL CHARGES THAT ARE NOT COLLECTED AND ARE NOT APPROVED FOR FINANCIAL ASSISTANCE ARE CLASSIFIED AS BAD DEBTS FROM PATIENTS WHO WILL NOT PAY. SCHEDULE H, PART III, LINE 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 9B ALL CHARITY CARE CHARGES AND CHARGES NOT TO BE COLLECTED DUE TO FINANCIAL ASSISTANCE COMPUTATIONS ARE EXEMPTED FROM COLLECTION POLICIES AND PRACTICES. THOSE ACCOUNTS ARE REMOVED FROM THE COLLECTION CYCLE. SCHEDULE H, PART 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 2 SABETHA COMMUNITY HOSPITAL AND NEMAHA VALLEY COMMUNITY HOSPITAL PARTNERED IN OCTOBER OF 2012 AND CONDUCTED A COMMUNITY HEALTH CARE NEEDS ASSESSMENT. NUMEROUS OBJECTIVES WERE IDENTIFIED BUT THE MAIN PRIORITIES TO BE ADDRESSED ARE 1) PROMOTE HEALTH, WELLNESS, AND CHRONIC DISEASE PREVENTION; 2) IMPROVE ACCESS TO MENTAL HEALTH ASSISTANCE; 3) IMPROVE ACCESS TO INFORMATION AND ASSISTANCE ACROSS MULTIPLE NEEDS AND POPULATIONS. 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 3 THE FOLLOWING MEASURES ARE USED TO PUBLICIZE THE PROGRAM TO THE COMMUNITY AND PATIENTS: 1. POSTING THE FINANCIAL ASSISTANCE PROGRAM, FINANCIAL ASSISTANCE APPLICATION AND A SUMMARY OF THE POLICY ON THE SABETHA COMMUNITY HOSPITAL WEBSITE AT THE FOLLOWING LOCATION: WWW.SABETHAHOSPITAL.COM 2. PROVIDING PAPER COPIES OF THE PROGRAM, APPLICATION AND SUMMARY OF THE PROGRAM UPON REQUEST IN ADMISSIONS AND PATIENT FINANCIAL SERVICES AT SABETHA COMMUNITY HOSPITAL. 3. POSTING NOTICES ABOUT THE PROGRAM IN THE EMERGENCY DEPARTMENT, ADMITTING AREAS, CLINIC LOBBY AND BUSINESS OFFICE OF SABETHA COMMUNITY HOSPITAL. 4. DISTRIBUTING A PLAIN LANGUAGE SUMMARY OF THE PROGRAM AND OFFERING A FINANCIAL ASSISTANCE APPLICATION TO PATIENTS BEFORE DISCHARGE FROM THE HOSPITAL. 5. INFORMING PATIENTS ABOUT THE PROGRAM IN PERSON OR DURING BILLING AND CUSTOMER SERVICE PHONE CONTACTS. 6. PROVIDING A SUMMARY OF THE PROGRAM IN THE PATIENTS' MONTHLY BILLING STATEMENT. THE FINANCIAL ASSISTANCE PROGRAM EMPLOYS A SLIDING SCALE DISCOUNT THAT TAKES INTO CONSIDERATION A 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 4 SABETHA COMMUNITY HOSPITAL IS A 25 BED CRITICAL ACCESS HOSPITAL LOCATED IN THE CITY OF SABETHA, NEMAHA COUNTY KANSAS. CURRENTLY THE POPULATION IS ESTIMATED AT 2800. 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 5 SABETHA 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 6 ORGANIZATION IS AFFILIATED WITH GREAT PLAINS HEALTH ALLIANCE, INC. (GPHA), A NON-PROFIT 501C3 ORGANIZATION WHICH PROVIDES MANAGEMENT SERVICES AND OPERATIONAL, FINANCE AND ACCOUNTING SUPPORT TO THE HOSPITAL. GPHA DOES NOT PROVIDE SERVICES DIRECTLY TO PATIENTS, BUT DOES PROVIDE ACCESS TO PROFESSIONALS THAT MAY NOT BE AFFORDABLE TO THE NORMAL CRITICAL ACCESS HOSPITAL. GPHA PROVIDES EDUCATION AND ASSISTANCE IN AREAS SUCH AS HIPAA, MEDICARE REIMBURSEMENT, MEANINGFUL USE REQUIREMENTS FOR COMPUTER SYSTEMS, ETC. GPHA IS AN AFFILIATION OF CRITICAL ACCESS HOSPITALS IN KANSAS AND NEBRASKA THAT PROVIDES NETWORKING OPPORTUNITIES WITH OTHER RURAL HOSPITAL, COMMUNITIES AND LEADERS. GPHA PROVIDES POLICIES AND GUIDANCE TO ITS CRITICAL ACCESS FACILITIES REGARDING FINANCIAL ASSISTANCE, CONFLICTS OF INTEREST, CORPORATE COMPLIANCE, HIPAA PRIVACY AND SECURITY AND MANY OTHER AREAS. GPHA ALSO PROVIDES EDUCATIONAL SESSIONS FOR BOARD MEMBERS, BUSINESS OFFICE MANGERS, BILLERS, MEDICAL RECORDS PERSONNEL, DIRECTOR OF NURSING AND ADMINISTRATORS. GPHA IS A VITAL LINK IN ALLOWING CAH HOSPITALS TO OPERATE AT A HIGH QUALITY WITHIN THE CASH CONSTRAINTS IMPOSED BY THE CRITICAL ACCESS PROGRAM. SCHEDULE H, PART VI, LINE 7 N/A false false false false false false false false false DAVE DELLASEGA PRESIDENT/CEO/DIRECTOR 166304 0 16120 0 11222 0 193646 0 0 KEVIN KENNALLY PHYSICIAN 277887 25177 0 18599 0 321663 0 0 0 GREGG WENGER PHYSICIAN 172920 16793 0 10252 0 199965 0 0 0 JAMES LONGABAUGH PHYSICIAN 208736 20426 0 11144 0 240306 0 0 0 CHRISTIAN TRAMP PHYSICIAN 190400 19238 0 17345 0 226983 0 0 0 KERSTIN GLYNN PHYSICIAN 250018 24700 0 15360 0 290078 0 0 0 FORM 990, PART VII; SCHEDULE J, PART I, LINE 3 COMPENSATION 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. FORM 990, PART III, LINE 4 THE HOSPITALS PRIMARY FUNCTION IS THE DELIVERY OF HEALTHCARE AND WELLNESS SERVICES TO INPATIENTS AND OUTPATIENTS IN NEMAHA COUNTY, SPECIFICALLY SABETHA AND OTHER SURROUNDING COMMUNITIES. INPATIENT CARE INCLUDES ACUTE CARE, SWING BED AND INTERMEDIATE SWING BED. OUTPATIENT SERVICES ARE ALSO AN IMPORTANT COMPONENT IN MEETING THE COMMUNITYS NEEDS AS WELL. DURING 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 6 GREAT PLAINS HEALTH ALLIANCE, INC., A NOT-FOR-PROFIT, 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF GREAT PLAINS OF SABETHA, INC. FORM 990, PART VI, SECTION A, LINE 7A GREAT PLAINS HEALTH ALLIANCE, INC., BEING THE SOLE MEMBER, HAS THE RIGHT TO ELECT AND APPROVE ALL THE BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B GREAT PLAINS HEALTH ALLIANCE, INC. (GPHA) IS THE SOLE MEMBER AND HAS THE AUTHORITY TO APPROVE THE ARTICLES OF INCORPORATION, BYLAWS, ELECTION TO OR REMOVAL FROM THE BOARD OF DIRECTORS, THE ANNUAL OPERATING AND CAPITAL BUDGETS, AND THE LONG RANGE OR STRATEGIC PLANS. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE 990 IS THEN PROVIDED TO THE CHIEF FINANCIAL OFFICER FOR REVIEW AND APPROVAL. AN ELECTRONIC DRAFT OF THE 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO THE FULL BOARD FOR REIVEW PRIOR TO FILING THE 990 WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION IS REQUIRED TO ADOPT GPHA'S CONFLICT OF INTEREST POLICY. ALL BOARD MEMBERS, OFFICERS AND EMPLOYEES ARE SUBJECT TO THE CONFLICT OF INTEREST POLICY AND SIGN AN ANNUAL ACKNOWLEDGEMENT THAT THEY HAVE READ, UNDERSTAND AND COMPLIED WITH THE GPHA CONFLICT OF INTEREST POLICY. UNDER THE POLICY, ANY MEMBER WHO HAS A DIRECT OR INDIRECT (VIA FAMILY) FINANCIAL INTEREST IS CHARACTERIZED AS AN INTERESTED PERSON. INTERESTED PERSONS ARE REQUIRED TO DISCLOSE FINANCIAL INTERESTS WITH COMPANIES DOING BUSINESS WITH GPHA. THE INTERESTED PERSON MUST RECUSE THEMSELVES FROM FURTHER DISCUSSIONS OF THE TRANSACTION AND LEAVE THE ROOM. THE REMAINING NON-INTERESTED MEMBERS DECIDE IF A CONFLICT OF INTEREST EXISTS. THE BOARD CHAIR MAY APPOINT ANOTHER DISINTERESTED PARTY TO DISCUSS THE TRANSACTION OR THE REMAINING BOARD MEMBERS MAY VOTE TO ENTER INTO OR ABSTAIN FROM THE SUSPECT TRANSACTION. FAILURE TO DISCLOSE FINANCIAL INTERESTS BY INTERESTED BOARD MEMBERS WILL RESULT IN DISCIPLINARY ACTION, INCLUDING SANCTIONING BY BOARD. ALL CONFLICTS OF INTEREST AND THEIR ULTIMATE RESOLUTION ARE DOCUMENTED IN THE BOARD MINUTES. THE BOARD CONDUCTS PERIODIC REVIEWS TO DETERMINE THAT CONFLICTS ARE BEING IDENTIFIED AND RESOLVED ACCORDING TO POLICY DOCUMENTATION. REVIEWS BY OUTSIDE EXPERTS ARE PERMITTED, BUT NOT REQUIRED. FORM 990, PART VI, SECTION B, LINES 15A & B THE CEO AND CFO ARE COMPENSATED BY GREAT PLAINS HEALTH ALLIANCE, A RELATED ORGANIZATION. GPHA'S BOARD USES COMPARABILITY DATA IN SETTING THEIR SALARIES, AND DOCUMENTATION IS RETAINED OF THE BOARD'S DELIBERATIONS AND DECISIONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE COMPANY'S KANSAS ANNUAL REPORT IS ALSO AVAILABLE UPON REQUEST FROM THE KANSAS SECRETARY OF STATE. FORM 990, PART XI, LINE 9 EQUITY IN EARNINGS SABETHA HEALTHCARE, INC. 40,175 TRANSFER TO CITY OF SABETHA (156,600) ---------- TOTAL $ (116,425) FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED MEDICAL STAFF TOTAL FEES:923317 FORM 990 PART IX LINE 11G DESCRIPTION:BILLING/COLLECTIONS TOTAL FEES:114619 FORM 990 PART IX LINE 11G DESCRIPTION:LAB SERVICES TOTAL FEES:44464 FORM 990 PART IX LINE 11G DESCRIPTION:PHARMACY SERVICES TOTAL FEES:43557 FORM 990 PART IX LINE 11G DESCRIPTION:ADMINISTRATION/HUMAN RESOURCES TOTAL FEES:40015 FORM 990 PART IX LINE 11G DESCRIPTION:MAINTENANCE/HOUSEKEEPING TOTAL FEES:1800 GREAT PLAINS HEALTH ALLIANCE INC 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 480617739 MANAGEMENT KS 501(C)(3) 3 NA false GREAT PLAINS HEALTH CARE FOUNDATION INC 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 480955870 SUPPORT KS 501(C)(3) 9 GPHA INC true GREAT PLAINS OF CHEYENE COUNTY INC 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 481226831 HOSPITAL KS 501(C)(3) 3 GPHA INC true GREAT PLAINS OF ELLINWOOD INC 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 481226976 HOSPITAL KS 501(C)(3) 3 GPHA INC true GREAT PLAINS OF KIOWA COUNTY INC 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 481226833 HOSPITAL KS 501(C)(3) 3 GPHA INC true GREAT PLAINS OF OTTAWA COUNTY INC 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 481226856 HOSPITAL KS 501(C)(3) 3 GPHA INC true GREAT PLAINS OF PHILLIPS COUNTY INC 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 481226829 HOSPITAL KS 501(C)(3) 3 GPHA INC true GREAT PLAINS OF REPUBLIC COUNTY INC 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 481226977 HOSPITAL KS 501(C)(3) 3 GPHA INC true GREAT PLAINS OF SMITH COUNTY INC 250 NORTH ROCK ROAD STE 160 WICHITA KS 67206 481226830 HOSPITAL KS 501(C)(3) 3 GPHA INC true false false false false false false false false false false false false true false false false false false false