GREAT PLAINS OF SABETHA INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- GREAT PLAINS OF SABETHA INC (EIN 48-1236156)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-13
- IRS object ID
- 201303179349305505
- Schema version
- 2012v2.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-13T15:38:25-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1551 N WATERFRONT PKWY STE 300 | AddressLine1 |
| City | WICHITA | City |
| State | KS | State |
| ZIP Code | 672066601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 481236156 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREAT PLAINS OF SABETHA INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % MIKE HAND | InCareOfName |
| Name Control | GREA | NameControl |
| Phone | 7855432111 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 625 THIRD STREET | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | PHILLIPSBURG | City |
| State | KS | State |
| ZIP Code | 676612138 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MIKE HAND | Name |
| Title | CFO AND SENIOR VICE PRESIDENT | Title |
| Phone | 7855432111 | Phone |
| Date Signed | 2013-11-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ELIZABETH S HOGAN | Name |
| Phone | 3162652811 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | ROGER JOHN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 625 THIRD STREET | AddressLine1 |
| City | PHILLIPSBURG | City |
| State | KS | State |
| ZIP Code | 676612138 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 11021473 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.SABETHAHOSPITAL.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2000 | YearFormation |
| State Legal Domicile | KS | StateLegalDomicile |
| Activity Or Mission Description | ACUTE CARE HOSPITAL THAT PROVIDES MEDICAL CARE TO THE GENERAL PUBLIC IN SABETHA, KANSAS AND SURROUNDING RURAL COMMUNITIES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 155 | TotalNbrEmployees |
| Total Nbr Volunteers | 25 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 157603 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 184866 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 9685334 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 10557332 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 16149 | InvestmentIncomePriorYear |
| Investment Income Current Year | 16510 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 125853 | OtherRevenuePriorYear |
| Other Revenue Current Year | 257559 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 9984939 | TotalRevenuePriorYear |
| Total Revenue Current Year | 11016267 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 6004397 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 6314946 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4209778 | OtherExpensePriorYear |
| Other Expenses Current Year | 4555671 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 10214175 | TotalExpensesPriorYear |
| Total Expenses Current Year | 10870617 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -229236 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 145650 | RevenuesLessExpensesCY |
| Total Assets BOY | 7697249 | TotalAssetsBOY |
| Total Assets EOY | 7451753 | TotalAssetsEOY |
| Total Liabilities BOY | 1621837 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1374661 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 6075412 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 6077092 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 9338397 | Expense |
| Grants | 0 | Grants |
| Revenue | 10733384 | Revenue |
| Description | THE HOSPITAL'S 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. SEE SCHEDULE O FOR CONTINUATION. | Description |
| Total Program Service Expense | 9338397 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 20 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 155 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | true | QuidProQuoContributions |
| Quid Pro Quo Disclosure | true | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MIKE HAND | NamePerson |
| Telephone Number | 3166851523 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 N ROCK RD STE 160 | AddressLine1 |
| City | WICHITA | City |
| State | KS | State |
| ZIP Code | 67206 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (18 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| STEVE CARLSON | ||||||||
| CHAIRMAN/DIRECTOR | 0.25 | 2.25 | X | X | 0 | 0 | 0 | |
| ROGER JOHN | ||||||||
| PRESIDENT/CEO/DIRECTOR | 2.0 | 48.0 | X | X | 0 | 117047 | 27982 | |
| BETH MEYERES | ||||||||
| VICE PRESIDENT/DIRECTOR | 0.25 | 2.25 | X | X | 0 | 0 | 0 | |
| LOGAN SPRUNGER | ||||||||
| VICE PRESIDENT/DIRECTOR | 0.25 | 2.25 | X | X | 0 | 0 | 0 | |
| ROBERT HAMILTON | ||||||||
| SECRETARY/DIRECTOR | 0.25 | 2.25 | X | X | 0 | 0 | 0 | |
| THOMAS E KELLER DVM | ||||||||
| DIRECTOR | 0.25 | 2.25 | X | 0 | 0 | 0 | ||
| BILL NAVIS | ||||||||
| DIRECTOR | 0.25 | 2.25 | X | 0 | 0 | 0 | ||
| DR BARBARA BROWN OD | ||||||||
| DIRECTOR | 0.25 | 2.25 | X | 0 | 0 | 0 | ||
| CURTIS ERICKSON | ||||||||
| DIRECTOR | 0.25 | 2.25 | X | 0 | 0 | 0 | ||
| DAVE RANKIN | ||||||||
| DIRECTOR | 0.25 | 2.25 | X | 0 | 0 | 0 | ||
| JOHN TERRILL | ||||||||
| DIRECTOR | 0.25 | 2.25 | X | 0 | 0 | 0 | ||
| DAVE DELLASEGA | ||||||||
| CFO | 2.0 | 48.0 | X | 0 | 110698 | 22720 | ||
| LORA KEY | ||||||||
| ADMINISTRATOR | 40.0 | 0.0 | X | 85725 | 0 | 25487 | ||
| KEVIN KENNALLY | ||||||||
| PHYSICIAN | 40.0 | 0.0 | 298690 | 0 | 43013 | X | ||
| GREGG WENGER | ||||||||
| PHYSICIAN | 40.0 | 0.0 | 173282 | 0 | 26786 | X | ||
| JAMES LONGABAUGH | ||||||||
| PHYSICIAN | 40.0 | 0.0 | 210976 | 0 | 31727 | X | ||
| CHRISTIAN TRAMP | ||||||||
| PHYSICIAN | 40.0 | 0.0 | 190843 | 0 | 36458 | X | ||
| KERSTIN GLYNN | ||||||||
| PHYSICIAN | 40.0 | 0.0 | 239502 | 0 | 39174 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1199018 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 227745 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 253347 | TotalOtherCompensation |
| Number Individuals GT100 K | 5 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|
| MIDWEST HEALTH SYSTEMS | |
| COMPUTER SUPPORT | 150807 |
| STORMONT VAIL HEALTHCARE | |
| LAB SERVICES | 135279 |
| SHARED MEDICAL SERVICES | |
| MRI SERVICES | 116700 |
| GREAT PLAINS HEALTH ALLIANCE | |
| MANAGEMENT SERVICES | 115534 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Fundraising Events | 10759 | FundraisingEvents |
| Government Grants | 17525 | GovernmentGrants |
| All Other Contributions | 156582 | AllOtherContributions |
| Total Contributions | 184866 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE REVENUE | Description |
| Business Code | 621300 | BusinessCode |
| Total Revenue Column | 10557332 | TotalRevenueColumn |
| Related Or Exempt Function Income | 10557332 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 10557332 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 16510 | TotalRevenueColumn |
| Exclusion | $16,510 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 16500 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 16500 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 16500 | TotalRevenueColumn |
| Exclusion | $16,500 | ExclusionAmount |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 5906 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 10759 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 5206 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 700 | TotalRevenueColumn |
| Exclusion | $700 | ExclusionAmount |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| EMPLOYEE/GUEST MEALS | 722513 | 15331 | $15,331 | |
| OUTSIDE SERVICES | 621300 | 77052 | 77052 | |
| EHR INCENTIVE REVENUE | 900099 | 99000 | 99000 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 48976 | TotalRevenueColumn |
| Exclusion | $48,976 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 240359 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 11016267 | TotalRevenueColumn |
| Related Or Exempt Function Income | 10733384 | RelatedOrExemptFunctionIncome |
| Exclusion | $98,017 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 111212 | Total |
| Management And General | 111212 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4949816 | Total |
| Program Services | 4377643 | ProgramServices |
| Management And General | 572173 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 379572 | Total |
| Program Services | 333287 | ProgramServices |
| Management And General | 46285 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 540286 | Total |
| Program Services | 415814 | ProgramServices |
| Management And General | 124472 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 334060 | Total |
| Program Services | 288008 | ProgramServices |
| Management And General | 46052 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 97381 | Total |
| Management And General | 97381 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1306 | Total |
| Management And General | 1306 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34860 | Total |
| Management And General | 34860 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1182764 | Total |
| Program Services | 1027368 | ProgramServices |
| Management And General | 155396 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28501 | Total |
| Program Services | 11979 | ProgramServices |
| Management And General | 16522 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 208022 | Total |
| Program Services | 144471 | ProgramServices |
| Management And General | 63551 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9969 | Total |
| Program Services | 3446 | ProgramServices |
| Management And General | 6523 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 226938 | Total |
| Program Services | 214491 | ProgramServices |
| Management And General | 12447 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6568 | Total |
| Program Services | 5125 | ProgramServices |
| Management And General | 1443 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40294 | Total |
| Program Services | 30185 | ProgramServices |
| Management And General | 10109 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22054 | Total |
| Program Services | 20358 | ProgramServices |
| Management And General | 1696 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 676552 | Total |
| Program Services | 621038 | ProgramServices |
| Management And General | 55514 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 139182 | Total |
| Program Services | 41808 | ProgramServices |
| Management And General | 97374 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | 1161716 | 1161716 | |
| EQUIPMENT RENTAL & MAINT. | 393997 | 364291 | 29706 |
| BAD DEBT EXPENSE | 210791 | 210791 | |
| DUES & SUBSCRIPTIONS | 44171 | 18464 | 25707 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 70605 | Total |
| Program Services | 48114 | ProgramServices |
| Management And General | 22491 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10870617 | Total |
| Program Services | 9338397 | ProgramServices |
| Management And General | 1532220 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 220 | BOY |
| EOY | 220 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 975815 | BOY |
| EOY | 744257 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15025 | BOY |
| EOY | 6263 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1458752 | BOY |
| EOY | 1849496 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 228701 | BOY |
| EOY | 226409 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 116343 | BOY |
| EOY | 113140 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 12192735 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 7971648 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4633742 | BOY |
| EOY | 4221087 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 233651 | BOY |
| EOY | 220881 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35000 | BOY |
| EOY | 70000 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7697249 | BOY |
| EOY | 7451753 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1106564 | BOY |
| EOY | 985718 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 515273 | BOY |
| EOY | 388943 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1621837 | BOY |
| EOY | 1374661 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6060387 | BOY |
| EOY | 6070829 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15025 | BOY |
| EOY | 6263 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6075412 | BOY |
| EOY | 6077092 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7697249 | BOY |
| EOY | 7451753 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 145650 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -143970 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Both | X | FinancialStatementBoth |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Belongs To Affiliated Group | X | OrgBelongsToAffiliatedGroup |
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Form4720 Filed | true | Form4720Filed |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | true | GrantsOtherOrganizations |
| Grants Other Organizations | $2,595 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 2595 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
| Form4720 Filed4912 Tax | false | Form4720Filed4912Tax |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES | Identifier |
| Return Reference | SCHEDULE C, PART II-B, LINE 1F | ReturnReference |
| Explanation | APPROXIMATELY 20% OF KANSAS HOSPITAL ASSOCIATION (KHA) DUES ARE DEDICATED FOR LOBBYING PURPOSES AS DIRECTED BY THE KHA. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years | |
| Current Year Minus4 Years | CurrentYearMinus4Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 35244 | OtherCostOrOtherBasis |
| Book Value | 35244 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6405253 | OtherCostOrOtherBasis |
| Depreciation | 3480715 | Depreciation |
| Book Value | 2924538 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5569228 | OtherCostOrOtherBasis |
| Depreciation | 4337761 | Depreciation |
| Book Value | 1231467 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 183010 | OtherCostOrOtherBasis |
| Depreciation | 153172 | Depreciation |
| Book Value | 29838 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 4221087 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
| Total Of Amounts | 0 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 10825412 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | -190855 | OtherRevenues |
| Revenue Not Rptd F990 | -190855 | RevenueNotRptdF990 |
| Revenue Subtotal | 11016267 | RevenueSubtotal |
| Total Revenue Per Form990 | 11016267 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 10823732 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 163906 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 163906 | ExpensesNotRptdF990 |
| Expenses Subtotal | 10659826 | ExpensesSubtotal |
| Other Expenses Not Included | 210791 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 210791 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 10870617 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| UNCERTAIN TAX POSITIONS | 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. RECONCILIATION OF REVENUE SCHEDULE D, PART XI, LINE 2D EQUITY IN EARNINGS SABETHA HEALTHCARE, INC. 14,730 SPECIAL EVENT EXPENSES 5,206 PROVISION FOR UNCOLLECTIBLE ACCOUNTS (210,791) ---------- TOTAL $ (190,855) |
| RECONCILIATION OF EXPENSES | SCHEDULE D, PART XII, LINE 2D | TRANSFER TO CITY OF SABETHA 158,700 SPECIAL EVENT EXPENSES 5,206 ---------- TOTAL $ 163,906 |
| RECONCILIATION OF EXPENSES | SCHEDULE D, PART XII, LINE 4B | PROVISION FOR UNCOLLECTIBLE ACCOUNTS 210,791 |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF TOURNAMENT | NameOfEvent1 |
| Gross Receipts Event1 | 16665 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 10759 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 5906 | GrossRevenueEvent1 |
| Cash Prizes Event1 | 2340 | CashPrizesEvent1 |
| Food And Beverage Event1 | 1280 | FoodAndBeverageEvent1 |
| Other Direct Expenses Event1 | 1586 | OtherDirectExpensesEvent1 |
| Total Number Of Other Events | 0 | TotalNumberOfOtherEvents |
| Gross Receipts Total | 16665 | GrossReceiptsTotal |
| Charitable Contributions Total | 10759 | CharitableContributionsTotal |
| Gross Revenue Total Events | 5906 | GrossRevenueTotalEvents |
| Cash Prizes Total Events | 2340 | CashPrizesTotalEvents |
| Food And Beverage Total Events | 1280 | FoodAndBeverageTotalEvents |
| Other Direct Expenses Total Events | 1586 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 5206 | DirectExpenseSummaryEvents |
| Net Income Summary | 700 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | false | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 34021 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 34021 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00320 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 130402 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 130402 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01220 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 155759 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 155759 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01460 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 320182 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 320182 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03000 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 21 | NumberOfActivitiesOrPrograms |
| Persons Served | 4977 | PersonsServed |
| Total Community Benefit Expense | 300577 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 181604 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 118973 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01120 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 14 | PersonsServed |
| Total Community Benefit Expense | 38 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 38 | NetCommunityBenefitExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 228 | PersonsServed |
| Total Community Benefit Expense | 4105 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 4105 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 25 | NumberOfActivitiesOrPrograms |
| Persons Served | 5219 | PersonsServed |
| Total Community Benefit Expense | 304720 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 181604 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 123116 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01160 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 25 | NumberOfActivitiesOrPrograms |
| Persons Served | 5219 | PersonsServed |
| Total Community Benefit Expense | 624902 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 181604 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 443298 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04160 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $210,791 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 2584217 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 2584217 | CostOfCareReimbursedByMedicare |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SABETHA COMMUNITY HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14TH OREGON PO BOX 229 | AddressLine1 |
| City | SABETHA | City |
| State | KS | State |
| ZIP Code | 66534 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SABETHA COMMUNITY HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 100 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 300. | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Provided On Admission | X | ProvidedOnAdmission |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 1 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SABETHA FAMILY PRACTICE | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1115 MAIN STREET | AddressLine1 |
| City | SABETHA | City |
| State | KS | State |
| ZIP Code | 66534 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | FAMILY CLINIC | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| 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 $210,791. | |
| 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. | |
| BAD DEBT EXPENSE | HOSPITAL CHARGES THAT ARE NOT COLLECTED AND ARE NOT APPROVED FOR FINANCIAL ASSISTANCE ARE CLASSIFIED AS BAD DEBTS FROM PATIENTS WHO WILL NOT PAY. BAD DEBT EXPENSE 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 2A |
| COLLECTION PRACTICES | 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 III, LINE 9B |
| CHARGES FOR MEDICAL CARE | THE HOSPITAL DETERMINES THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE USING GROSS CHARGES. | SCHEDULE H, PART V, SECTION B, LINE 20 |
| NEEDS ASSESSMENT | IN OCTOBER OF 2012, SABETHA COMMUNITY HOSPITAL ALONG WITH NEMAHA VALLEY COMMUNITY HOSPITAL AND COMMUNITY AND COUNTY WIDE PARTNERS ALONG WITH CONSUMERS HELD THREE MEETINGS TO DEVELOP THE THREE YEAR 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 HAVE BEEN WORKING EXTENSIVELY ON ALL PRIORITIES IDENTIFIED. THE CHNA WAS PRESENTED TO THE BOARD OF DIRECTORS AND WAS APPROVED IN DECEMBER 2012 WITH PERIODIC UPDATES ON PROGRESS. THE HOSPITAL CONTINUES TO PARTICIPATE IN THE HCAPS SURVEY AND RESULTS ARE REVIEWED WITH STAFF ANNUALLY. SABETHA COMMUNITY HOSPITAL RECEIVED AN AWARD FROM THE NATIONAL RURAL HEALTH ASSOCIATION FOR BEING ONE OF THE TOP 20 CAHS IN THE NATION FOR PATIENT PERSPECTIVE. THE HOSPITAL IS PARTICIPATING IN THE KANSAS HEALTH ENGAGEMENT NETWORK AND IDENTIFIED 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. | SCHEDULE H, PART VI, LINE 2 |
| PATIENT EDUCATION OF ELIGIBILITY | 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. WE ALSO HAVE POSTED IN BOTH THE HOSPITAL AND CLINIC LOBBIES THAT FINANCIAL ASSISTANCE IS AVAILABLE AND TO APPLY YOU NEED TO VISIT WITH THE FINANCIAL COUNSELOR AT THE HOSPITAL. 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 3 |
| COMMUNITY INFORMATION | 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 WHITES MAKE UP 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 4 |
| PROMOTION OF COMMUNITY HEALTH | IN THE EARLY PART OF 2012, SABETHA COMMUNITY HOSPITAL ADDED SHERRI WESSEL, PA, TO OUR TEAM OF PROVIDERS ROUNDING OUT THE MEDICAL STAFF. THE ADDITION OF THIS PA PROVIDED ADDITIONAL COVERAGE FOR THE HOSPITALS 24/7 EMERGENCY ROOM DEPARTMENT. THE EMERGENCY ROOM/TRAUMA QUALITY ASSURANCE COMMITTEE WORKED ON CRITERIA TO BECOME A LEVEL IV TRAUMA CENTER AND WAS DESIGNATED BY THE KANSAS DEPARTMENT OF HEALTH AND ENVIRONMENT IN MARCH AS A LEVEL IV. THE QUALITY ASSURANCE COORDINATOR ALONG WITH THE DIRECTOR OF NURSING AND MEDICAL STAFF ALSO MET CRITERIA TO BECOME A STROKE READY FACILITY. SABETHA FAMILY PRACTICE COMPLETED THE SECOND PHASE OF THE MEDICAL HOME PILOT PROJECT AND WILL FINISH UP WITH THAT PROJECT IN JULY OF 2013. DURING 2012, THE STAFF AT THE FIVE PHYSICIANS FAMILY PRACTICE OFFICE WORKED DILIGENTLY THROUGHOUT THE YEAR TO REACH STAGE 1 OF MEANINGFUL USE FOR THE ELECTRONIC RECORD AND WAS NOTIFIED THAT THEY HAD REACHED THEIR GOAL. DURING THIS TIME, PATIENTS WITHIN THE COMMUNITY WERE KEPT INFORMED OF THE PROCESS CHANGE AND AT THE COMPLETION OF EACH PATIENTS VISIT ARE NOW ABLE TO RECEIVE A CLINICAL SUMMARY. THE HOSPITAL ALSO ADDED ADDITIONAL TECHNOLOGY TO ENHANCE THE PATIENT EXPERIENCE WITH A NEW LAB PROGRAM, MEDICATION DISPENSING SYSTEM AND A LEGAL ELECTRONIC MEDICAL RECORD. CONNECTION TO THE KANSAS HEALTH INFORMATION EXCHANGE WAS COMPLETED IN THE FALL AND PATIENTS WERE NOTIFIED OF THEIR RIGHTS UNDER KHIN. ONE GOAL OF THE HOSPITAL FOR 2012 WAS TO ADD A DIABETES COUNSELING AND EDUCATION CLASS FOR DIABETIC PATIENTS. A CERTIFIED DIABETIC NURSE EDUCATOR WAS ADDED TO STAFF AND ALONG WITH THE REGISTERED DIETICIAN BEGAN WORK ON ACCREDITATION SO THAT SABETHA COMMUNITY HOSPITAL WOULD BECOME A DIABETIC CERTIFIED FACILITY. A SUPPORT GROUP WAS FORMED FOR 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 AND THE WELLNESS COORDINATOR MAINTAINS A FITNESS CALENDAR FOR EMPLOYEES WHO CHOOSE TO JOIN THE WELLNESS PROGRAM. 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. IN 2012, THE PHYSICAL THERAPY AND OCCUPATIONAL THERAPY DEPARTMENT ADDED A BALANCE MASTER SYSTEM TO AID STROKE PATIENTS OR INJURED ATHLETES ALONG WITH OTHER DIAGNOSIS. 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 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 PART D SERVICES, OR OTHER INFORMATION REFERRAL ASSISTANCE. 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 BOARD OF KANSAS HEALTH SERVICE CORPORATION WORKERS COMPENSATION FUND, THE KANSAS HOSPITAL ASSOCIATIONS POLICY AND ADVOCACY COMMITTEE, THE HEALTH INNOVATIONS NETWORK OF KANSAS BOARD, AND THE KANSAS HEALTH CARE COLLABORATIVE BOARD. SABETHA COMMUNITY HOSPITAL TAKES ITS COMMITMENT TO THE COMMUNITY VERY SERIOUSLY AND PARTICIPATES IN EMERGENCY DRILLS, ALWAYS MONITORING PATIENT AND EMPLOYEE SAFETY, RISK MANAGEMENT, QUALITY ASSURANCE, 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 MEDICAL SCHOOL ARE ABLE TO FOLLOW THE FAMILY PHYSICIANS, PHYSICAL THERAPY STUDENTS THROUGH AFFILIATION WITH KANSAS CITY KANSAS COMMUNITY COLLEGE AND INDIAN HILLS COMMUNITY COLLEGE, AND OCCUPATIONAL THERAPY STUDENTS THROUGH WASHBURN UNIVERSITY AFFILIATION ALL DO CLINICAL ROTATIONS. 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. | SCHEDULE H, PART VI, LINE 5 |
| AFFILIATED HEALTH CARE SYSTEMS | 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 MANAGERS, 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 6 |
| COMMUNITY BENEFIT REPORT | N/A | SCHEDULE H, PART VI, LINE 7 |
| FACILITY REPORTING GROUP | N/A | SCHEDULE H, PART VI, LINE 8 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEVIN KENNALLY | ||||||||||||||
| PHYSICIAN | 298690 | 0 | 0 | 0 | 0 | 0 | 24200 | 0 | 18813 | 0 | 341703 | 0 | 0 | 0 |
| GREGG WENGER | ||||||||||||||
| PHYSICIAN | 173282 | 0 | 0 | 0 | 0 | 0 | 16528 | 0 | 10257 | 0 | 200067 | 0 | 0 | 0 |
| JAMES LONGABAUGH | ||||||||||||||
| PHYSICIAN | 210976 | 0 | 0 | 0 | 0 | 0 | 20298 | 0 | 11430 | 0 | 242704 | 0 | 0 | 0 |
| CHRISTIAN TRAMP | ||||||||||||||
| PHYSICIAN | 190843 | 0 | 0 | 0 | 0 | 0 | 18284 | 0 | 18174 | 0 | 227301 | 0 | 0 | 0 |
| KERSTIN GLYNN | ||||||||||||||
| PHYSICIAN | 239502 | 0 | 0 | 0 | 0 | 0 | 23150 | 0 | 16023 | 0 | 278675 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | COMPENSATION FROM A RELATED ORGANIZATION | Identifier |
| Return Reference | FORM 990, PART VII; SCHEDULE J, PART I, LINE 3 | ReturnReference |
| Explanation | COMPENSATION FOR ROGER JOHN 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 AND MR. DELLASEGA. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| PROGRAM SERVICE ACCOMPLISHMENTS | FORM 990, PART III, LINE 4 | THE HOSPITAL ADDED SEVERAL NEW COMPONENTS IN 2012 TO ENHANCE THE DELIVERY OF HEALTH CARE. SABETHA COMMUNITY HOSPITAL WAS DESIGNATED AS A LEVEL IV TRAUMA CENTER AND STROKE READY FACILITY. SCH WAS ALSO RECOGNIZED BY THE NATIONAL RURAL HEALTH ASSOCIATION AS BEING ONE OF THE TOP 20 CRITICAL ACCESS HOSPITALS IN THE NATION FOR PATIENT PERSPECTIVE. SEVERAL COMPONENTS OF THE ELECTRONIC MEDICAL RECORD WAS ADDED IN 2012 SUCH AS THE NEW LAB SYSTEM TO INTERFACE WITH THE LEGAL MEDICAL RECORD AND THE UPGRADE TO THE MEDICATION DISPENSING SYSTEM TO POSITION THE HOSPITAL FOR THE 2013 IMPLEMENTATION OF THE PHARMACY AND MEDICATION ADMINISTRATION MODULE. IN LATE 2012 THE HOSPITAL CONNECTED WITH KANSAS HEALTH INFORMATION NETWORK AND BEGAN TRANSMITTING PATIENT INFORMATION INTO THE NETWORK. KEEPING PATIENTS INFORMED OF THEIR RIGHTS UNDER KHIN WAS A HIGH PRIORITY. A DISCHARGE INSTRUCTION MODULE (EXIT CARE) WAS ADDED TO HELP PATIENTS WHEN THEY ARE DISMISSED FROM THE HOSPITAL. WRITTEN INSTRUCTIONS WILL HELP AS A GUIDE TO CARE AT HOME OR FOR THE PATIENT CAREGIVER. DIABETIC EDUCATION WAS ALSO A HIGH PRIORITY AND THE HOSPITAL HIRED A DIABETIC EDUCATOR AND BEGAN WORK ON APPLYING TO BECOME A CERTIFIED DIABETIC EDUCATION FACILITY. |
| MEMBERS | 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. |
| MEMBERS MAY ELECT GOVERNING BODY | 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. |
| GOVERNING BODY DECISIONS SUBJECT TO APPROVAL OF 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 REVIEW PROCESS | 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. |
| CONFLICT OF INTEREST POLICY | 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. |
| COMPENSATION REVIEW | FORM 990, PART VI, SECTION B, LINES 15A & B | THERE IS NO FORMAL REVIEW BY INDEPENDENT SOURCES, BUT THE ORGANIZATION'S BUDGET AND THE GPHA BUDGET IS APPROVED BY THE BOARD. AS A HISTORICAL PRACTICE, RAISES OF THE PRESIDENT/CEO AND CHIEF FINANCIAL OFFICER ARE LIMITED TO $3,000 ANNUALLY SINCE THESE INDIVIDUALS EACH EARN OVER $100,000 ANNUALLY. |
| AVAILABILITY OF DOCUMENTS | 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. |
| OTHER CHANGES IN NET ASSETS | FORM 990, PART XI, LINE 9 | EQUITY IN EARNINGS SABETHA HEALTHCARE, INC. 14,730 TRANSFER TO CITY OF SABETHA (158,700) ---------- TOTAL $ (143,970) |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| GREAT PLAINS HEALTH ALLIANCE INC | ||||||||||
| 625 THIRD STREET | PHILLIPSBURG | KS | 67661 | 480617739 | MANAGEMENT | KS | 501(C)(3) | 3 | NA | false |
| GREAT PLAINS HEALTH CARE FOUNDATION INC | ||||||||||
| 625 THIRD STREET | PHILLIPSBURG | KS | 67661 | 480955870 | SUPPORT | KS | 501(C)(3) | 9 | GPHA INC | false |
| GREAT PLAINS OF CHEYENE COUNTY INC | ||||||||||
| 625 THIRD STREET | PHILLIPSBURG | KS | 67661 | 481226831 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC | false |
| GREAT PLAINS OF ELLINWOOD INC | ||||||||||
| 625 THIRD STREET | PHILLIPSBURG | KS | 67661 | 481226976 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC | false |
| GREAT PLAINS OF KIOWA COUNTY INC | ||||||||||
| 625 THIRD STREET | PHILLIPSBURG | KS | 67661 | 481226833 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC | false |
| GREAT PLAINS OF OTTAWA COUNTY INC | ||||||||||
| 625 THIRD STREET | PHILLIPSBURG | KS | 67661 | 481226856 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC | false |
| GREAT PLAINS OF PHILLIPS COUNTY INC | ||||||||||
| 625 THIRD STREET | PHILLIPSBURG | KS | 67661 | 481226829 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC | false |
| GREAT PLAINS OF REPUBLIC COUNTY INC | ||||||||||
| 625 THIRD STREET | PHILLIPSBURG | KS | 67661 | 481226977 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC | false |
| GREAT PLAINS OF SMITH COUNTY INC | ||||||||||
| 625 THIRD STREET | PHILLIPSBURG | KS | 67661 | 481226830 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |