WEST CENTRAL KANSAS ASSOCIATION INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
WEST CENTRAL KANSAS ASSOCIATION INC (EIN 74-2842747)
Tax period
2011-08-01 to 2012-07-31
Filed
2013-06-11
IRS object ID
201301629349300900
Schema version
2011v1.2
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)
Timestamp2013-06-11T11:19:42-05:00Timestamp
Tax Period End Date2012-07-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN481026809EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Wendling Noe Nelson & Johnson LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1534 S Kansas Ave Suite 1500AddressLine1
CityTopekaCity
StateKSState
ZIP Code666033491ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-08-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN742842747EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1West Central Kansas Association IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlWESTNameControl
Phone7854833131Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 S MainAddressLine1
CityRussellCity
StateKSState
ZIP Code67665ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSharon CollinsName
TitleInterim CEOTitle
Phone7854832323Phone
Date Signed2013-06-03DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJohn R HelmsName
PTINP00203953PTIN
Phone7852334226Phone
Date Prepared2013-06-03DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1Russell Regional HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonSharon CollinsNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1200 S MainAddressLine1
CityRussellCity
StateKSState
ZIP Code67665ZIPCode
FieldValueIRS element (for citing)
Gross Receipts12906264GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.russellhospital.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1997YearFormation
State Legal DomicileKSStateLegalDomicile
Activity Or Mission DescriptionTo provide a caring and compassionate team dedicated to the delivery of quality healthcare, and to meet the current and future healthcare needs of the community.ActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members5NbrIndependentVotingMembers
Total Nbr Employees213TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year9575ContributionsGrantsPriorYear
Contributions Grants Current Year309911ContributionsGrantsCurrentYear
Program Service Revenue Prior Year13303825ProgramServiceRevenuePriorYear
Program Service Revenue CY12485536ProgramServiceRevenueCY
Investment Income Prior Year3640InvestmentIncomePriorYear
Investment Income Current Year47438InvestmentIncomeCurrentYear
Other Revenue Prior Year363354OtherRevenuePriorYear
Other Revenue Current Year63379OtherRevenueCurrentYear
Total Revenue Prior Year13680394TotalRevenuePriorYear
Total Revenue Current Year12906264TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year9022477SalariesEtcPriorYear
Salaries Etc Current Year8685376SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4937934OtherExpensePriorYear
Other Expenses Current Year4228887OtherExpensesCurrentYear
Total Expenses Prior Year13960411TotalExpensesPriorYear
Total Expenses Current Year12914263TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-280017RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-7999RevenuesLessExpensesCY
Total Assets BOY3857845TotalAssetsBOY
Total Assets EOY3742583TotalAssetsEOY
Total Liabilities BOY3734278TotalLiabilitiesBOY
Total Liabilities EOY3710099TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY123567NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY32484NetAssetsOrFundBalancesEOY
Mission DescriptionTo care for our communities and their citizens with the caring, compassion, quality and commitment that validates their trust in us.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense11389119Expense
Revenue12548915Revenue
DescriptionRussell Regional Hospital provides a variety of health care services including acute inpatient care, swingbed inpatient care, outpatient care, rural health clinic, and long-term care services to patients in need of care.Description
Total Program Service Expense11389119TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109617NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees213NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members5NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons0AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement0RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Sharon Collins Interim CEOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7854832323TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1200 S MainAddressLine1
CityRussellCity
StateKSState
ZIP Code67665ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (14 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Morris Krug
President1.00XX000
Sylvia Newton
Secretary1.00XX000
John O Farmer III
Treasurer1.00XX000
Michael Holland
Director1.00X000
Richard L Shields
Vice-President1.00XX000
Shelley Boden
CEO40.00X98490026493
Mary Odom
CFO (thru June 2012 )40.00X585000158
Joy Bretz
CFO40.00X000
Clark Eddy
Physician40.00297581012375X
Alexander Chung
Physician40.0029852104486X
Earl Merkel
Physician40.0029190008813X
Jill Doerfler-Iniguez
Physician40.0021742208443X
Sambhundh Panichabhongse
Physician40.0018217908917X
Andrea Herrera
Former - Physician40.0015379406997X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1598387TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation76682TotalOtherCompensation
Number Individuals GT100 K9NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Dr John Whitehead
1659 Tamarisk DriveWichitaKS67230Physician ER & Clinic Coverage194055
Docs Who Care
1337 S Fountain DriveOlatheKS66061Physician ER & Clinic Coverage115500
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
Government Grants307161GovernmentGrants
All Other Contributions2750AllOtherContributions
Total Contributions309911TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNet patient service reDescription
Business Code900099BusinessCode
Total Revenue Column12485536TotalRevenueColumn
Related Or Exempt Function Income12485536RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue12485536TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column47438TotalRevenueColumn
Exclusion$47,438ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real8456Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real8456Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column8456TotalRevenueColumn
Related Or Exempt Function Income8456RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Cafeteria sales7222103769737697
Contracted physical th90009964146414
Meals on wheels61171035043504

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column7308TotalRevenueColumn
Related Or Exempt Function Income7308RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue54923TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column12906264TotalRevenueColumn
Related Or Exempt Function Income12548915RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$47,438ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total206687Total
Management And General206687ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total7163058Total
Program Services6566324ProgramServices
Management And General596734ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total60832Total
Program Services56207ProgramServices
Management And General4625ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total776545Total
Program Services716787ProgramServices
Management And General59758ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total478254Total
Program Services427684ProgramServices
Management And General50570ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2180Total
Management And General2180ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total204506Total
Program Services7147ProgramServices
Management And General197359ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total28144Total
Program Services26953ProgramServices
Management And General1191ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total130761Total
Program Services78822ProgramServices
Management And General51939ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total286058Total
Program Services257452ProgramServices
Management And General28606ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total19226Total
Program Services16925ProgramServices
Management And General2301ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total85994Total
Program Services70468ProgramServices
Management And General15526ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total430926Total
Program Services387833ProgramServices
Management And General43093ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total148437Total
Program Services148437ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Pharmacy supplies755595755595
Purchased services60937253673272640
Physician fees487823487823
Medical supplies39435133643557916

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total645514Total
Program Services511495ProgramServices
Management And General134019ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total12914263Total
Program Services11389119ProgramServices
Management And General1525144ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY558489BOY
EOY604899EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY710EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1431199BOY
EOY1331781EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY203699BOY
EOY198968EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY127510BOY
EOY121373EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis3306947LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2002559LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1408434BOY
EOY1304388EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY128514BOY
EOY180464EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY3857845BOY
EOY3742583EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1080997BOY
EOY1038759EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1480213BOY
EOY1053487EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1173068BOY
EOY1617853EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY3734278BOY
EOY3710099EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY123567BOY
EOY32484EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY123567BOY
EOY32484EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3857845BOY
EOY3742583EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-7999ReconcilationRevenueExpenses
Reconcilation Other Changes-83084ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee0AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule D IRS990ScheduleD

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2144021OtherCostOrOtherBasis
Depreciation1746296Depreciation
Book Value397725BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1162926OtherCostOrOtherBasis
Depreciation256263Depreciation
Book Value906663BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1304388TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDue to lessorDescription
Amount$1,617,853Amount
FieldValueIRS element (for citing)
Total Of Amounts1617853TotalOfAmounts
Total Revenue12906264TotalRevenue
Total Expenses12914263TotalExpenses
Excess Or Deficit For Year-7999ExcessOrDeficitForYear
Other-$83,084OtherAmount
Total Adjustments-83084TotalAdjustments
Excess Or Deficit Per FS-91083ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt12906264TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal12906264RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99012906264TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt12914263TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal12914263ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99012914263TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Uncertain Tax Positions Under FIN 48:Part X:Management is not aware of any uncertainties in income tax positions.
Part XI, Line 8 - Other Adjustments:Transfer from lessor 269,561. Change in amount due to lessor -452,644. Contributions temporarily restricted 99,999. Total to Schedule D, Part XI, Line 8: -83,084.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage130.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care0AmountsBudgetedForCharityCare
Annual Community Benefit Report0AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense101390TotalCommunityBenefitExpense
Direct Offsetting Revenue97798DirectOffsettingRevenue
Net Community Benefit Expense3592NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense1154180TotalCommunityBenefitExpense
Direct Offsetting Revenue1295276DirectOffsettingRevenue
Net Community Benefit Expense-141096NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense1255570TotalCommunityBenefitExpense
Direct Offsetting Revenue1393074DirectOffsettingRevenue
Net Community Benefit Expense-137504NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense3443369TotalCommunityBenefitExpense
Direct Offsetting Revenue2738018DirectOffsettingRevenue
Net Community Benefit Expense705351NetCommunityBenefitExpense
Percent Of Total Expense0.05460PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense3443369TotalCommunityBenefitExpense
Direct Offsetting Revenue2738018DirectOffsettingRevenue
Net Community Benefit Expense705351NetCommunityBenefitExpense
Percent Of Total Expense0.05460PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense4698939TotalCommunityBenefitExpense
Direct Offsetting Revenue4131092DirectOffsettingRevenue
Net Community Benefit Expense567847NetCommunityBenefitExpense
Percent Of Total Expense0.05490PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$380,202BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare6007902AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare6203111CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-195209MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care0ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Russell Regional HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1200 South Main StreetAddressLine1
CityRussellCity
StateKSState
ZIP Code67665ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours
OtherLong-term care facility, outpatient physician clinicOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Russell Regional HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent130.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent200.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Insurance StatusXInsuranceStatus
Medicaid MedicareXMedicaidMedicare
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (6 entries)

ExplanationExplanationIdentifierIdentifier
Part III, Line 4: The Hospital provides for accounts receivable that could become uncollectible in the future by establishing an allowance to reduce the carrying value of such receivables to their estimated net realizable value. The Hospital estimates this allowance based on the aging of its accounts receivable and its historical collection experience for each type of payor. Bad debt expense is included in net patient service revenue on Part VIII, Line 2a.The Hospital's bad debt at cost was determined by applying an overall ratio of cost to charges. Part III, Line 3West Central Kansas Association, Inc. is unable to determine the amount of bad debt expense attributable to patients eligible under its charity care policy for the year covered by this return. Suggested methods for estimation were either not in place or proved to be unreliable. For example, the number of financial assistance applications distributed but not returned was not tracked. Using demographic data to estimate an amount did not provide reasonable results. Undoubtedly, there is bad debt expense attributed to patients who meet charity care guidelines. However, paperwork needed for approval of charity care was not returned or tracked. Rather than provide an estimate that can't be substantiated, West Central Kansas Association, Inc. has chosen to report zero dollars as bad debt expense attributable to charity care patients.
Part III, Line 8: The amounts were obtained from the cost report filed with Medicare for the period ending 07/31/2012. The total amount of shortfall between Medicare revenue received and relating allowable costs is considered community benefit.
Part V, Section B, Line 19d: The Hospital utilizes a sliding scale to determine the level of financial assistance applicable for each individual. The FAP takes several factors into account such as the individuals income in comparison with published federal poverty guidelines. The patient liability is determined by reducing the gross charges of the services provided by the amount of financial assistance awarded.Russell Regional Hospital
Part VI, Line 3: Patients receive information regarding federal, state and charity care programs upon request.
Part VI, Line 4: The Hospital is located in Russell County, Kansas in the city of Russell and serves the surrounding area. The Russell community is a predominately agricultural one. The city of Russell and Russell County have an approximate population of 4,500 & 7,000 individuals respectively. The average Russell household annual income is approximately $38,168. Approximately 13.9% of the residents in Russell County have an annual income below the federal poverty level and approximately 7.0% of residents have an annual income below 50% of the federal poverty level. Other hospitals in the area are located in Hays, Hoisington, and Great Bend. The distance between the Hospital and these facilities is approximately 26, 29, and 40 miles respectively.
Part VI, Line 5: The Hospital's governing body is comprised solely of local community members. All local physicians have admitting privileges at the Hospital.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Clark Eddy
25595604162500000123750309956000
Alexander Chung
2592080393130000044860303007000
Earl Merkel
19382909800007100088130300713000
Jill Doerfler-Iniguez
18739503000002703826046170225865000
Sambhundh Panichabhongse
148054034000012500089170191096000
Andrea Herrera
9802105575901400069970160791000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section B, line 11The Form 990 is reviewed by the governing body prior to filing. It is distributed by email to all governing body Board Members for review. Any questions and/or comments are directed to management for further discussion.
Form 990, Part VI, Section B, line 15The compensation of the organization's officers is voted on and approved by the Board of Directors.
Form 990, Part VI, Section C, line 19The 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 5:Transfer from lessor 269,561. Change in amount due to lessor -452,644. Contributions temporarily restricted 99,999. Total to Form 990, Part XI, Line 5: -83,084.Changes in Net Assets or Fund Balances:

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