PRATT REGIONAL MEDICAL CENTER CORPORATION: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
PRATT REGIONAL MEDICAL CENTER CORPORATION (EIN 48-1058737)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-04-30
IRS object ID
201201219349300420
Schema version
2010v3.7
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)
Timestamp2012-04-30T11:46:19-05:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11551 N WATERFRONT PKWY STE 300AddressLine1
CityWICHITACity
StateKSState
ZIP Code672066601ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN481058737EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1PRATT REGIONAL MEDICAL CENTER COMPANY INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlPRATNameControl
Phone6206727451Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 COMMODOREAddressLine1
CityPRATTCity
StateKSState
ZIP Code67124ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameHILLARY DOLBEEName
TitleCFOTitle
Phone6204501437Phone
Date Signed2012-04-27DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameELIZABETH S HOGANName
Phone3162652811Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonHILARY DOLBEE CFONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1200 COMMODOREAddressLine1
CityPRATTCity
StateKSState
ZIP Code67124ZIPCode
FieldValueIRS element (for citing)
Gross Receipts51716046GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.PRMC.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1988YearFormation
State Legal DomicileKSStateLegalDomicile
Activity Or Mission DescriptionTO OPERATE A GENERAL HOSPITAL FOR THE PROVISION OF FACILITIES FOR THE DIAGNOSIS, TREATMENT, OR CARE OF INDIVIDUALS SUFFERING FROM PHYSICAL ILLNESS, DISEASE, INJURY, OR DEFORMITY IN PRATT CO AND ADJACENT AREAS.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees511TotalNbrEmployees
Total Nbr Volunteers105TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year490076ContributionsGrantsPriorYear
Contributions Grants Current Year168501ContributionsGrantsCurrentYear
Program Service Revenue Prior Year36529761ProgramServiceRevenuePriorYear
Program Service Revenue CY43460206ProgramServiceRevenueCY
Investment Income Prior Year135549InvestmentIncomePriorYear
Investment Income Current Year401949InvestmentIncomeCurrentYear
Other Revenue Prior Year493997OtherRevenuePriorYear
Other Revenue Current Year1713581OtherRevenueCurrentYear
Total Revenue Prior Year37649383TotalRevenuePriorYear
Total Revenue Current Year45744237TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year4057GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY9014GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year19343836SalariesEtcPriorYear
Salaries Etc Current Year21674021SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year17470663OtherExpensePriorYear
Other Expenses Current Year19879475OtherExpensesCurrentYear
Total Expenses Prior Year36818556TotalExpensesPriorYear
Total Expenses Current Year41562510TotalExpensesCurrentYear
Revenues Less Expenses Prior Year830827RevenuesLessExpensesPriorYear
Revenues Less Expenses CY4181727RevenuesLessExpensesCY
Total Assets BOY24978604TotalAssetsBOY
Total Assets EOY29415166TotalAssetsEOY
Total Liabilities BOY10691050TotalLiabilitiesBOY
Total Liabilities EOY11427742TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY14287554NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY17987424NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSEE SCHEDULE OMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense35216314Expense
Grants9014Grants
Revenue44758938Revenue
DescriptionAcute care hospital that provides medical care to the general public. See Schedule O for continuation.Description
Total Program Service Expense35216314TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109651NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees511NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocstrueChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonHILARY DOLBEENamePerson
Telephone Number6204501437TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1200 COMMODOREAddressLine1
CityPRATTCity
StateKSState
ZIP Code67124ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
WILLIAM WOJCIECHOWSKI ED D
CHAIRMAN/BOARD MEMBER1.0XX000
DON PETERS
VICE CHAIR/BOARD MEMBER1.0XX000
BILL KELLER
BOARD MEMBER1.0X000
BARBARA CUDNEY MD
BOARD MEMBER1.0X000
JEANETTE SIMENS
BOARD MEMBER1.0X000
IAN KOVACH MD
BOARD MEMBER40.0X991825010536
GARY BARKER
BOARD MEMBER1.0X000
SUE SCHREPEL
BOARD MEMBER1.0X000
DAN SUITER MD
BOARD MEMBER1.0X000
BECCA FLOWERS
BOARD MEMBER1.0X000
DENNIS MCKINNEY
BOARD MEMBER1.0X000
SUSAN PAGE
PRESIDENT40.0X117986037996
KEN BROWN
VICE PRESIDENT40.0X109376016076
HILARY DOLBEE
TREASURER/CFO39.5X77477015778
NANCY BAILEY
SECRETARY39.5X3786003580
ALEXANDER NEEL MD
PHYSICIAN40.0372449013626X
JON MORGAN DPM
PODIATRIST40.0260144020353X
JACOB BREEDING MD
SURGEON40.025395102224X
FREDRICK FARMER MD
PHYSICIAN40.0194552036377X
JOHN VRTISKA MD
PHYSICIAN40.0197452020171X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2613072TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation176717TotalOtherCompensation
Number Individuals GT100 K16NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Description Of ServicesDescriptionOfServicesCompensationCompensation
PRATT OPEN MRI
MEDICAL SERVICES565994
KEY REHABILITATION
REHAB SERVICES265041
LAB CORP OF AMERICA
LAB SERVICES228999
CENTRAL STATES RECOVERY
COLLECTION SERVICES109615
PROMISE REGIONAL MEDICAL CENTER
LAUNDRY SERVICES104206
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Related Organizations72695RelatedOrganizations
Government Grants95806GovernmentGrants
Total Contributions168501TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICE REVENUEDescription
Business Code621300BusinessCode
Total Revenue Column43460206TotalRevenueColumn
Related Or Exempt Function Income43460206RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue43460206TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column203800TotalRevenueColumn
Exclusion$203,800ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real304314Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real69962Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real234352Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column234352TotalRevenueColumn
Exclusion$234,352ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities6087996Securities
Other12000Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities5880104Securities
Other21743Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities207892Securities
Other-9743Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column198149TotalRevenueColumn
Exclusion$198,149ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeBusiness CodeBusinessCodeExclusionExclusionAmount
ELECTRONIC HEALTH RECORD INCENTIVE11879411187941
CAFETERIA/VENDING127040722210$127,040
MEDICAL RECORDS10921518210$10,921

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column153327TotalRevenueColumn
Related Or Exempt Function Income110791RelatedOrExemptFunctionIncome
Exclusion$42,536ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue1479229TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column45744237TotalRevenueColumn
Related Or Exempt Function Income44758938RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$816,798ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total9014Total
Program Services9014ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1370789Total
Program Services902377ProgramServices
Management And General468412ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total17833951Total
Program Services16005021ProgramServices
Management And General1828930ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total295725Total
Program Services198454ProgramServices
Management And General97271ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total937936Total
Program Services533754ProgramServices
Management And General404182ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1235620Total
Program Services723625ProgramServices
Management And General511995ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total103077Total
Management And General103077ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total75880Total
Management And General75880ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total3193080Total
Program Services2431836ProgramServices
Management And General761244ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total163736Total
Program Services102282ProgramServices
Management And General61454ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total8046789Total
Program Services7756531ProgramServices
Management And General290258ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1157714Total
Program Services901159ProgramServices
Management And General256555ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total144762Total
Program Services111406ProgramServices
Management And General33356ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total73941Total
Program Services52549ProgramServices
Management And General21392ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total309750Total
Program Services295891ProgramServices
Management And General13859ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1559310Total
Program Services913190ProgramServices
Management And General646120ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total506556Total
Program Services75458ProgramServices
Management And General431098ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT EXPENSE33251683325168
RECRUITING24285717030972548
LICENSES/DUES/SUBSCRIPTIONS1425338320159332
REPAIRS/MAINTENANCE436325315774120551
PROG-RELATED TAX ASSESSMENTS282300282300

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total115697Total
Program Services27015ProgramServices
Management And General88682ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total41562510Total
Program Services35216314ProgramServices
Management And General6346196ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY557770BOY
EOY1188382EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY309495BOY
EOY419910EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY4144297BOY
EOY5884148EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1947042BOY
EOY1581429EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY492441BOY
EOY456554EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis38928557LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec28642026LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY10627321BOY
EOY10286531EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY3877986BOY
EOY5640520EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY374055BOY
EOY445092EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY53075BOY
EOY35208EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2595122BOY
EOY3477392EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY24978604BOY
EOY29415166EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4160442BOY
EOY5645153EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY6010000BOY
EOY5450000EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY390449BOY
EOY230322EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY130159BOY
EOY102267EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY10691050BOY
EOY11427742EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY14192327BOY
EOY17886845EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY6604BOY
EOY11956EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY88623BOY
EOY88623EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY14287554BOY
EOY17987424EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY24978604BOY
EOY29415166EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses4181727ReconcilationRevenueExpenses
Reconcilation Other Changes-481857ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$6,920GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB6920TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance88623BeginningOfYearBalance
Investment Earnings Or Losses5367InvestmentEarningsOrLosses
Other Expenditures5367OtherExpenditures
End Of Year Balance88623EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance88623BeginningOfYearBalance
End Of Year Balance88623EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Contributions88623Contributions
End Of Year Balance88623EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgstrueEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RtrueAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis12625OtherCostOrOtherBasis
Book Value12625BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis20789656OtherCostOrOtherBasis
Depreciation14035199Depreciation
Book Value6754457BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis15562460OtherCostOrOtherBasis
Depreciation12892529Depreciation
Book Value2669931BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2563816OtherCostOrOtherBasis
Depreciation1714298Depreciation
Book Value849518BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings10286531TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
FUNDS HELD BY FISCAL AGENT421907
INV IN PRATT HEALTH FOUNDATION1760091
UNAMORTIZED BOND COSTS107453
DUE FROM MEDICARE1187941
FieldValueIRS element (for citing)
Total Book Value Other Assets3477392TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability
Total Of Amounts0TotalOfAmounts
Total Revenue45744237TotalRevenue
Total Expenses41562510TotalExpenses
Excess Or Deficit For Year4181727ExcessOrDeficitForYear
Net Unrealized GL On Investments-598864NetUnrealizedGLOnInvestments
Other$0OtherAmount
Total Adjustments-598864TotalAdjustments
Excess Or Deficit Per FS3582863ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt45215335TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-598864NetUnrealizedGainsInvestments
Other Revenues69962OtherRevenues
Revenue Not Rptd F990-528902RevenueNotRptdF990
Revenue Subtotal45744237RevenueSubtotal
Total Revenue Per Form99045744237TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt41632472TotExpensesEtcAuditedFinclStmt
Other Expenses Included69962OtherExpensesIncluded
Expenses Not Rptd F99069962ExpensesNotRptdF990
Expenses Subtotal41562510ExpensesSubtotal
Total Expenses Per Form99041562510TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
INTENDED USES OF ENDOWMENT FUNDSSCHEDULE D, PART V, LINE 4ENDOWMENT FUNDS ARE HELD BY PRATT HEALTH FOUNDATION, A RELATED TAX-EXEMPT ORGANIZATION. INCOME FROM THE ENDOWMENT IS TO BE USED 40% FOR PRATT REGIONAL LIVING CENTER AND 60% FOR THE SUPPORT AND PROGRAMS OF PRATT REGIONAL MEDICAL CENTER, INC.
UNCERTAIN TAX POSITIONSSCHEDULE D, PART X, LINE 2Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements.
RECONCILIATION OF REVENUESCHEDULE D, PART XII, LINE 2DRENTAL EXPENSES $ 69,962
RECONCILIATION OF EXPENSESSCHEDULE D, PART XIII, LINE 2DRENTAL EXPENSES $ 69,962

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Persons Served214PersonsServed
Total Community Benefit Expense224273TotalCommunityBenefitExpense
Direct Offsetting Revenue123193DirectOffsettingRevenue
Net Community Benefit Expense101080NetCommunityBenefitExpense
Percent Of Total Expense0.00240PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Persons Served5529PersonsServed
Total Community Benefit Expense1712089TotalCommunityBenefitExpense
Direct Offsetting Revenue967393DirectOffsettingRevenue
Net Community Benefit Expense744696NetCommunityBenefitExpense
Percent Of Total Expense0.01790PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense592646TotalCommunityBenefitExpense
Direct Offsetting Revenue269773DirectOffsettingRevenue
Net Community Benefit Expense322873NetCommunityBenefitExpense
Percent Of Total Expense0.00780PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Persons Served5743PersonsServed
Total Community Benefit Expense2529008TotalCommunityBenefitExpense
Direct Offsetting Revenue1360359DirectOffsettingRevenue
Net Community Benefit Expense1168649NetCommunityBenefitExpense
Percent Of Total Expense0.02810PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Persons Served1017PersonsServed
Total Community Benefit Expense18691TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense18691NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Persons Served68PersonsServed
Total Community Benefit Expense144367TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense144367NetCommunityBenefitExpense
Percent Of Total Expense0.00350PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Persons Served945PersonsServed
Total Community Benefit Expense11865TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense11865NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense6930TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense6930NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Persons Served2030PersonsServed
Total Community Benefit Expense181853TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense181853NetCommunityBenefitExpense
Percent Of Total Expense0.00440PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Persons Served7773PersonsServed
Total Community Benefit Expense2710861TotalCommunityBenefitExpense
Direct Offsetting Revenue1360359DirectOffsettingRevenue
Net Community Benefit Expense1350502NetCommunityBenefitExpense
Percent Of Total Expense0.03250PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Persons Served198PersonsServed
Total Community Building Expense48167TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense48167NetCommunityBuildingExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Persons Served198PersonsServed
Total Community Building Expense48167TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense48167NetCommunityBuildingExpense
Percent Of Total Expense0.00100PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$1,826,515BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare14763194AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare14812533CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-49339MedicareSurplusOrShortfall
Costing Methodology UsedCostingMethodologyUsed
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
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 Line1PRATT REGIONAL MEDICAL CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1200 COMMODOREAddressLine1
CityPRATTCity
StateKSState
ZIP Code67124ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1PRATT REGIONAL MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
SCHEDULE H, PART I, LINE 7GTHE SUBSIDIZED HEALTH SERVICES EXPENSE IN PART I, LINE 7, OF SCHEDULE H DOES NOT INCLUDE ANY COSTS ASSOCIATED WITH PHYSICIAN CLINICS.
SCHEDULE H, PART I, LINE 7, COLUMN FTHE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $3,325,168.
SCHEDULE H, PART I, LINE 7THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLES OF PART I, LINE 7, OF SCHEDULE H, IS A COST TO CHARGE RATIO.
BAD DEBT EXPENSETHE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HOSPITAL BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN ACCORDANCE WITH A PREDETERMINED PAYMENT PLAN. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON THE HOSPITAL'S STATED TIME POLICY. BAD DEBT EXPENSE (AT COST) INDENTIFIED THE PROVISION FOR UNCOLLECTIBLES FROM 9/30/11 AUDITED STATEMENT OF OPERATIONS. MULTIPLIED THAT AMOUNT X THE COST-TO-CHARGE RATIO.SCHEDULE H, PART III, LINE 4
MEDICAREGovernment programs such as Medicaid offer fixed reimbursements based on a patient's diagnosis. This often does not account for the cost of the latest technology and treatment options that are available to give patients the best chances for recovery from an illness. PRMC offers patients the best interventions available - no matter what reimbursement for the service might be. SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY.SCHEDULE H, PART III, LINE 8
COLLECTION PRACTICESWHEN A RESPONSIBLE PARTY IS UNABLE TO MEET THE FINANICAL OBLIGATION GUIDELINES AS DESCRIBED IN THE HOSPITAL'S FINANCIAL POLICY, THE PARTY IS ADVISED OF THE AVAILABILITY OF CHARITY CARE OR FINANCIAL ASSISTANCE. CLARIFICATION IS MADE AS TO WHETHER THE PATIENT HAS PRIMARY INSURANCE. THE RESPONSIBLE PARTY IS REQUIRED TO COMPLETE A CHARITY CARE APPLICATION AND SUBMIT ALL DOCUMENTATION INDICATED (AS OUTLINED ON APPLICATION) IN ORDER FOR THE HOSPITAL TO DETERMINE CHARITY CARE ELIGIBILITY. THE HOSPITAL WILL PURSUE COLLECTION UNTIL THE RESPONSIBLE PARTY CONTACTS A PATIENT FINANCIAL COUNSELOR OR RETURNS THE APPLICATION WITH REQUIRED DOCUMENTATION. ONCE A CHARITY CARE APPLICATION IS RECEIVED, IF NOT ALL THE REQUIRED FINANCIAL (AS OUTLINED ON THE APPLICATION) ARE SUBMITTED, A COURTESY LETTER IS SENT TO THE RESPONSIBLE PARTY REQUESTING THE INFORMATION BE RETURNED IN ORDER TO BE CONSIDERED. IF THE REQUIRED DOCUMENTATION IS SUBSEQUENTLY NOT RECEIVED AND NO CONTACT WITH THE PATIENT FINANCIAL COUSELOR IS MADE, THE CHARITY CARE APPLICATION IS DENIED AND FURTHER COLLECTION ACTION IS TAKEN.SCHEDULE H, PART III, LINE 9B
NEEDS ASSESSMENTMeeting the health care needs of our region cannot be achieved through any one employee, department, or facility. PRMC physicians, nurses, staff and volunteers work together so that we can better meet specific community needs and achieve our mission of providing excellent and compassionate healthcare services. As a rural hospital, in south central Kansas, Pratt Regional Medical Center considers itself a regional hospital, serving the residents of Pratt, Stafford, Barber, Edwards, Kiowa, Kingman, Clark, and Comanche counties. OUR EXPANDED FACILITIES ALLOW US TO PROVIDE A BROAD RANGE OF HEALTHCARE SERVICES TO ALL MEMBERS OF OUR COMMUNITY WITHOUT REGARD TO AGE, RACE, SEX OR FINANCIAL CONSTRAINTS. OUR REHABILIATION SERVICES DEPARTMENT PROVIDES A FULL-COMPLIMENT OF OCCUPATIONAL, PHYSICAL AND SPEECH THERAPIES. OUR SURGICAL DEPARTMENT PROVIDES 24/7 SURGICAL SERVICES. WE HAVE A LARGE VARIETY OF SPECIALTY PHYSICIANS WHO SEE AND TREAT PATIENTS IN OUR FACILITY AS WELL AS PERFORM MANY SURGICAL PROCEDURES. OUR RADIOLOGY DEPARTMENT PROVIDES NUCLEAR MEDICINE AND MRI TESTING ON SITE. WE ALSO HAVE A 32-SLICE CT SCANNER WHICH PROVIDES HIGH RESOLUTION IMAGES. OUR HOSPITAL OFFERS A FULL-SERVICE, 24-7 EMERGENCY DEPARTMENT. OUR IN-PATIENT PROVIDES CARE TO MEDICAL-SURGICAL PATIENTS, SUB-ACUTE PATIENTS, PEDIATRICS AND GERIATRICS. WE PROVIDE OBSTETRICAL AND NEWBORN CARE, PATIENT SERVICES THAT ARE BECOMING INCREASINGLY RARE AMONG RURAL HOSPITALS. PRMC OFFERS A FULL-SERVICE HOME HEALTH PROGRAM. WE ARE COMMITTED TO PROVIDING QUALITY HEALTHCARE TO ALL MEMBERS OF OUR COMMUNITY. BECAUSE WE ARE A SMALL TOWN HOSPITAL, A MAJORITY OF OUR PATIENTS HAVE A STRONG BOND WITH OUR STAFF. THIS ALLOWS US TO PROVIDE CARE THAT EXTENDS BEYOND JUST MEDICAL NEEDS. THE COST AND DEFFICULTY IN SEEKING CARE IN OTHER AREAS FOR OUR ELDERLY AND POOR POPULATION REINFORCES THE NEED FOR A STRONG COMMUNITY HOSPITAL. WE STRIVE TO MEET THIS NEED BY PROVIDING ALL SERVICES POSSIBLE.SCHEDULE H, PART VI, LINE 2
PATIENT EDUCATION ON ELIGIBILITY FOR ASSISTANCEPRMC POSTS SIGNS AT ITS REGISTRATION LOCATIONS AND OFFERS BROCHURES REGARDING THE AVAILABILITY OF CHARITY CARE. THE AVAILABILITY OF CHARITY CARE PROGRAM IS ALSO IDENTIFIED ON ALL HOSPITAL PATIENT SERVICE RELATED LETTERS AND GUARANTOR STATEMENTS. ONCE A PATIENT CALLS TO INQUIRE ABOUT THE CHARITY CARE PROGRAM THE PATIENT FINANCIAL COUSELOR OUTLINES THE REQUIREMENTS, DOCUMENTS NEEDED AND EXPLAINS THE CHARITY CARE POLICY IN DETAIL. IN ADDITION, THE HOSPITAL CONTRACTS WITH AN OUTSIDE COMPANY TO CONTACT AND REVIEW WITH EACH PRIVATE PAY PATIENT OUR CHARITY CARE POLICY AS WELL AS OTHER ASSISTANCE THAT MIGHT BE AVAILABLE.SCHEDULE H, PART VI, LINE 3
COMMUNITY INFORMATIONOUR CURRENT 48 BED HOSPITAL IS LOCATED IN SOUTH CENTRAL KANSAS. As a rural hospital, Pratt Regional Medical Center considers itself a regional hospital, serving the residents of Pratt, Stafford, Barber, Edwards, Kiowa, Kingman, Clark, and Comanche counties. Pratt Regional Medical Center also provides support for five Critical Access Hospitals in the Southern Plains Health Network, which include hospitals in Comanche County, Kiowa, Medicine Lodge, Ashland and Stafford. According to the 2010 census, in 2009, 11.2% of Pratt County residents were living below the poverty level. The uninsured adult population in Pratt County was 14.4 percent, and in 2009-2010, the percentage of Kansans without health insurance rose to 13%, the highest rate of the decade. Each year, hundreds of people seek medical help at Pratt Regional Medical Center. The programs and services we provide go beyond statistics and numbers, as we often serve those who do not have the means to pay for needed health care services. PRMC's community is becoming increasingly diverse. The health risks associated with chronic diseases like diabetes and obesity are particularly high among our growing medically underserved. The hospital has taken steps to reach out to the underserved by working together with local physicians, churches, organizations, and community members to begin the Agape Health Clinic, which is a free health clinic for the uninsured. Planning for the Agape clinic took place in FY11. The free clinic opened on the campus of Pratt Community College on the first Saturday in October. The goal is to help all residents access the health care they need, and to help patients learn to manage their health conditions and live healthier lives. PRMC has committed $10,000 per year for ancillary services for Agape Health Clinic patients, as well as support through usage of meeting rooms, and volunteer manpower for specialized health care support and information.SCHEDULE H, PART VI, LINE 4
PROMOTION OF COMMUNITY HEALTHProviding Advocacy for Our Patients: Pratt Regional Medical Center partners with The Medical Assistance Program. If patients are uninsured, the Medical Assistance Program is available to help them obtain benefits to pay for all or part of their services. This service is provided free of charge to Pratt Regional Medical Center patients. Patients may contact the Medical Assistance Program toll free, at (888) 843-5817. Meeting the Needs of Our Community, in the Community PRMC's mission is to provide excellent and compassionate health care services and it cannot be achieved solely through the care we provide within our facilities; it includes the people helped and the lives touched by our community programs. Prescription Assistance Program: The Pratt Regional Medical Center Prescription Assistance Program (PAP) is a service available to anyone who needs assistance with completing and following up on the paperwork required for prescription drug assistance application. Pratt's PAP program is unique in the fact PRMC supports this program by providing office space, supplies and oversight from the PRMC social service department, while hospital volunteers manage the program. The PAP program assisted 274 people with a total of 319 prescriptions creating a savings of $52,540.74. Bicycle Safety & Fitness Program: Pratt County students in third and fourth grade have the opportunity to participate in a Bicycle Safety & Fitness course sponsored by the Pratt Health Foundation every spring. This program was started in 1996 with a Kansas Health Foundation grant and the program has been offered ever since. This program teaches: the rules of the road, how to use hand signals, safe riding habits, the benefits of physical activity, and how to use a bicycle helmet. Students go on a bicycle ride for about 30 minutes for two days a week with DeWayne Bryan, who is the Executive Director of the Pratt Health Foundation. After the initial lessons are taught, the students go on a specially designed three-mile ride through Pratt. The bicyclers are followed by the staff of the Pratt County Health Department in case of emergency or mechanical breakdown. Community Service Coordinator Peggy Lee and selected helpers, watch the traffic when the group crosses busy intersections. Dental Screenings for Elementary Students Program: The Pratt Health Foundation (PHF) collaborates with Pratt dentists and schools to provide a dental screening program for Pratt elementary kids. Kansas statutes require an annual dental screening program for elementary students. The program was started with a United Methodist Health Ministry grant five years ago, and the grant money has since been depleted. The PHF now covers most of the costs associated with the screening activities. The Pratt Health Foundation helps coordinate the effort and supplies the dental screening equipment. Pratt Regional Medical Center employees volunteer to sterilize the screening utensils for the program. It is a great demonstration of what a community can do when everyone works together. Here is a glimpse at other PRMC community benefit programs and projects: - PRMC's Family Birth Suites nursing staff provides newborn babies and mothers with a Well-Mother Well-Baby check. During the visit, mothers are able to ask questions and nurses are able to provide education to new moms as well as evaluate the newborn and make sure they are doing well physically. In FY11 PRMC delivered 285 babies. Because PRMC is the only hospital where babies are delivered in our area, patients are traveling from surrounding counties to deliver their baby at PRMC. - PRMC Volunteers purchase books and present new parents with information about the importance of reading to children (Books for Babes) - PRMC staff and volunteers run the local Meals on Wheels program. Meals are prepared and delivered five days a week to residents who are not able to prepare a nutritious meal for themselves. PRMC's dietary staff prepared 2,557 meals in FY11. - Volunteers provide one-on-one education about options available to seniors through Medicare Part D opportunities; In FY11, PRMC Volunteers assisted 239 clients with the Medicare Plan D enrollment process. PRMC provides space and materials to run the program and volunteers provide the man power. PRMC's social service department works closely with the program volunteers to make sure they have the tools and support they need to provide services. - Job shadowing is popular among students interested in becoming healthcare professionals. There were approximately 103 students who job shadowed in various departments throughout the hospital in FY11. The program continues to grow and most students who shadow are very impressed with their experience. Tours are also popular among students. Several schools bring students to PRMC annually for a tour. Some of these schools include: Pratt elementary and High School, Macksville High School, Stafford High School, Fairfield elementary, Skyline elementary, Haskins elementary and Greensburg. - PRMC hosts a blood drive for the American Red Cross. PRMC employees lined up four times this year to donate blood. - PRMC employees and volunteers participate in the Pratt County Relay for Life every summer. Not only does the hospital raise money for the American Cancer Society, the hospital enjoys showing support to those who are fighting cancer and remember those lost. Education for a Healthy Future: PRMC considers education to be part of its mission. It is important to help prepare the next generation of health care professionals to meet new health care demands. To ensure a quality workforce in the future, PRMC is committed to the education of current and future caregivers, and has partnered with local high schools and area Community Colleges to provide instructors, classroom space, and practicum training. - In FY11 PRMC gave $1500 scholarships to four nursing students for a total of $6000. - Barton County Community College EMT students spent 36 hours training on PRMC's campus. - Two Medical Laboratory Technology students from Barton County Community College each spent 124 hours training in the PRMC laboratory. - Physician Assistant students from Wichita State University spent a total of 38 days at PRMC in the emergency department. - Pratt Community College nursing students perform clinical rotations at PRMC. This includes first and second year students. During the fall semester, 35 PCC nursing students spent a total of 10,080 hours at PRMC. In the spring, 18 PCC nursing students spent at total of 5,184 hours at PRMC. - PRMC's radiology department trains two students from Hutchinson Community College every year. Both students work 40 hour weeks. Students do get all the holidays off, 10 personal days, a week's vacation at spring break and a week's vacation over Christmas break. PRMC does not receive any compensation from HCC and the students also do not receive any compensation from PRMC. They learn through hands on experience with oversight from radiology technologists and HCC instructors who visit the students on PRMC's campus weekly. Opening Our Facilities for Local Meetings: Pratt Regional Medical Center is host, and has been host to an active, collaborative community groups such as the Pratt Community Health and Resource Council and the Pratt Ministerial Alliance. These groups have met monthly at PRMC for years to discuss, share and strategize for solutions to community health and resource related topics. All regular meetings take place at Pratt Regional Medical Center, and Pratt Regional Medical Center employees are active participants and leaders within these groups. On average, in FY11, PRMC hosted 22 monthly meetings, which took approximately 60 hours in our meeting rooms each month. Some meetings include: Ministerial Alliance, Agape clinic, Health and Resource Council, Rotary Board, and Kiwanis. Employees in the Community: Every year, Pratt Regional Medical Center employees unite to volunteer and participate in community activities. Some help in their churches or their children's school others volunteer to coach little league teams while some get involved in local clubs and organizations. In FY11, PRMC employees spent 6,813 hours volunteering in the community. All of these activities benefit the quality of life as residents of Pratt County. At Pratt Regional Medical Center, it's important to us to give back to our community.SCHEDULE H, PART VI, LINE 5

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained
No Grant More Than5000XNoGrantMoreThan5000

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 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
IAN KOVACH MD
99182500000001053601002361000
SUSAN PAGE
11482300031630250990128970155982000
ALEXANDER NEEL MD
3724490000000136260386075000
JON MORGAN DPM
260144000002009802550280497000
JACOB BREEDING MD
253951000000022240256175000
FREDRICK FARMER MD
1945520000026672097050230929000
JOHN VRTISKA MD
1974520000012783073880217623000

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
PRATT COUNTY KANSAS PUBLIC BUILDING COMMISSION
480606708739762AAO2007-09-152960000BUILDING PURCHASEfalsefalsefalse
PRATT COUNTY KANSAS PUBLIC BUILDING COMMISSION
480606708739762AK82007-09-154380000BUILDING PURCHASEfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Amount RetiredAmountRetiredAmount Bond DefeasedAmountBondDefeasedTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundCapitalized InterestCapitalizedInterestRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsAmount UnspentAmountUnspentYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
002960000204126000002696674002000truefalsetruetrue
004380000295874000003908654002000truefalsetruetrue

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsefalsefalsefalsefalse0.000000.000000.00000true
falsefalsefalsefalsefalse0.000000.000000.00000true

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
falsefalsefalsefalsefalse
falsefalsefalsefalsefalse

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonSEE SCHEDULE L PART VNamePerson

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierBUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONSIdentifier
Return ReferenceSCHEDULE L, PART IVReturnReference
ExplanationA) PRATT OPEN MRI, LLC (POMRI) B) IAN KOVACH, M.D. AND DAN SUITER, M.D. ARE BOARD MEMBERS OF PRATT REGIONAL MEDICAL CENTER COMPANY, INC. (PRMC) AND OWN GREATER THAN 35% INTEREST IN POMRI. C) $565,994 D) PRMC PURCHASED MEDICAL SERVICES FROM POMRI.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990, PART III, LINE 1To operat a general hospital for the provision of facilities for the diagnosis, treatment or care of individuals suffering from physical illness, disease, injury, or deformity within Pratt county and adjacent areas. Such diagnosis, care and treatment shall be provided to all persons, regardless of race, creed, color, sex, or ability to pay.
PROGRAM SERVICE ACCOMPLISHMENTSFORM 990, PART III, LINE 4APratt Regional Medical Center (PRMC) strives to provide excellent and compassionate healthcare services. As a community not-for-profit organization, we take seriously our responsibility to invest our resources and energies into understanding and meeting the diverse health care needs of all, and ensure that everyone, regardless of their ability to pay, receives the care they need. In 2011, PRMC provided $414,773 in charity care and contributed more than 6,813 hours of total employee volunteer time in the community. The hospital donated $6,930 to local charities and community events, as well as helped to educate and train future caregivers seeking degrees in the health care field. PRMC plays a vital economic role in the Pratt community. As the largest employer in the county, PRMC employs 440 people with full and part-time jobs. In FY11, PRMC paid $21,825,388 in salaries and benefits, and purchased over $2 million in local products and services and paid $964,754 for utilities. Thirty-seven million dollars came into Pratt County through insurance payments to PRMC in 2011. Well over half of that $37 million was paid out in salaries and benefits. PRMC brings value to the Pratt community through providing quality health care and jobs. The hospital proudly provides four family practice physicians, three internal medicine physicians (with a fourth one coming soon), a rural health clinic family physician, a gastroenterologist, a hematologist/oncologist, an interventional pain management specialist, a radiologist, a gynecological surgeon, a general surgeon, a podiatrist/foot and ankle surgeon and two orthopedic surgeons. With a successful medical staff, PRMC thrives. This past year, that was evident as the Hospital was able to increase surgery volumes by 75%. As a result of more surgeries, most ancillary volumes increased. PRMC ended the fiscal year with a positive net operating income, and was also able to make some rather large capital equipment purchases during the year, which included digital mammography. PRMC has been successful at meeting high quality health care needs for the past 60 years. It is PRMC's vision to continue to meet those expectations and become the health care provider of choice for south-central and western Kansas.
BUSINESS RELATIONSHIPFORM 990, PART VI, SECTION A, LINE 2IAN KOVACH AND DAN SUITER, BOARD MEMBERS, HAVE A BUSINESS RELATIONSHIP.
MEMBERSFORM 990, PART VI, SECTION A, LINE 6PRATT HEALTH FOUNDATION (THE FOUNDATION), A KANSAS NONPROFIT CORPORATION, IS THE SOLE MEMBER OF PRATT REGIONAL MEDICAL CENTER COMPANY, INC. (PRMC). THE FOUNDATION IS DESIGNATED AS THE SOLE MEMBER SO LONG AS IT SHALL CONTINUE TO QUALIFY AS A TAX EXEMPT, NON PROFIT ENTITY RECOGNIZED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE.
MEMBERS MAY ELECT GOVERNING BODYFORM 990, PART VI, SECTION A, LINE 7ATHE GOVERNING BODY OF PRATT REGIONAL MEDICAL CENTER COMPANY, INC. (PRMC) IS ABLE TO NOMINATE NEW MEMBERS TO ITS GOVERNING BODY. PRATT HEALTH FOUNDATION, BEING THE SOLE MEMBER OF PRMC, RETAINS THE RIGHT TO APPROVE SUCH NEW MEMBERS OF THE GOVERNING BODY OF PRMC.
GOVERNING BODY DECISIONS SUBJECT TO APPROVAL OF MEMBERSFORM 990, PART VI, SECTION A, LINE 7BTHE FOUNDATION, BEING THE SOLE MEMBER OF PRMC, HAS THE RIGHT TO APPROVE THE ARTICLES OF INCORPORATION, BYLAWS AND THE BOARD OF DIRECTORS.
FORM 990 REVIEW PROCESSFORM 990, PART VI, SECTION B, LINE 11AAN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE FORM 990. THE 990 IS THEN PROVIDED TO THE CFO AND ACCOUNTING PERSONNEL FOR REVIEW. ANY QUESTIONS OR CONCERNS THE CFO AND ACCOUNTING PERSONNEL HAVE ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS ARE MADE, IF NEEDED. THE FINAL FORM 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE 990 WITH THE IRS.
CONFLICT OF INTEREST POLICYFORM 990, PART VI, SECTION B, LINE 12CAT THE TIME OF HIRE (OR ELECTION IN THE CASE OF BOARD MEMBERS) AND ANNUALLY THEREAFTER, THE CFO OR HIS/HER DESIGNEE SHALL PROVIDE TO THE BOARD AND TO ALL EXECUTIVE OFFICERS A COPY OF THE CONFLICT OF INTEREST POLICY AND THE APPLICABLE CONFLICT DISCLOSURE FORM AND QUESTIONNAIRE, WHICH SHALL BE COMPLETED TO IDENTIFY ANY RELATIONSHIPS, POSITIONS OR CIRCUMSTANCES WITH RESPECT TO WHICH IT IS BELIEVED A CONFLICT MAY ARISE. EACH MEMBER SHALL DISCLOSE FULLY AND FRANKLY ANY AND ALL ACTUAL OR POTENTIAL CONFLICTS OF DUALITY OR INTEREST OR RESPONSIBILITY, WHETHER INDIVIDUAL, PERSONAL OR BUSINESS, WHICH MAY EXIST OR APPEAR AS TO THE ORGANIZATION OR ANY SYSTEM ENTITY OR ANY MATTER OF BUSINESS WHICH MAY COME BEFORE THE BOARD. THE BOARD CHAIRMAN REVIEWS ANY POTENTIAL CONFLICTS, AND DETERMINES WHETHER A CONFLICT IS PRESENT. A CONFLICTED INDIVIDUAL MUST ABSTAIN FROM VOTING IN THE MATTER OF WHICH A CONFLICT HAS BEEN IDENTIFIED BY THE BOARD CHAIRMAN.
COMPENSATION REVIEWFORM 990, PART VI, SECTION B, LINES 15A & BCONSISTENT WITH THE POLICY AND COMPENSATION PRACTICE WITHIN PRATT REGIONAL MEDICAL CENTER (PRMC), THE PRESIDENT AND CEO IS SUBJECT TO AN ANNUAL REVIEW BY THE PRMC BOARD OF DIRECTORS. REASONABLE COMPENSATION: IT IS THE OBLIGATION OF THE PRMC BOARD OF DIRECTORS TO SEE THAT ITS PRESIDENT AND CEO IS PAID A REASONABLE LEVEL OF COMPENSATION. THE FULL AMOUNT OF ALL DIRECT AND INDIRECT COMPENSATION IS CONSIDERED. COMPENSATION LEVELS ARE REVIEWED AND APPROVED EITHER BY THE BOARD OF DIRECTORS OF PRMC OR BY A COMPENSATION COMMITTEE MADE UP OF BOARD MEMBERS. APPROVAL PROCESS: A SPECIFIC COMPENSATION ARRANGEMENT MUST BE APPROVED EITHER BY THE BOARD OF DIRECTORS OR BY A COMPENSATION COMMITTEE TO WHICH COMPENSATION DECISION(S) HAVE BEEN DELEGATED BY ACTION OF THE BOARD OF DIRECTORS. IF A COMMITTEE IS USED IT IS TO BE COMPRISED OF DISINTERESTED BOARD MEMBERS. COMPARISONS: THE BOARD OR COMMITTEE USES "COMPARATIVE DATA" THAT LOOKS AT COMPARABLE SOURCES TO DETERMINE THE REASONABLENESS OF COMPENSATION. COMPARATIVE DATA INCLUDES: COMPENSATION PAID BY SIMILAR ORGANIZATIONS, AVAILABILITY OF SIMILAR SERVICES WITHIN THE GEOGRAPHIC AREA, ACTUAL WRITTEN OFFERS FROM SIMILAR INSTITUTIONS COMPETING FOR THE SERVICES OF THE PRESIDENT AND CEO. DOCUMENTATION: THE BOARD OR COMMITTEE ADEQUATELY DOCUMENTS THE BASIS FOR ITS DETERMINATION THAT THE COMPENSATION ARRANGEMENT IS REASONABLE AT THE TIME THE DECISION IS MADE. RECORDS INCLUDE THE TERMS OF THE ARRANGEMENT THAT WAS APPROVED AND THE DATE IT WAS APPROVED, THE BOARD OR COMMITTEE MEMBERS PRESENT DURING THE DECISION OF THE ARRANGEMENT AND THOSE WHO VOTED IN FAVOR OF IT, COMPARABILITY DATA RELIED UPON AND HOW IT WAS OBTAINED, THE ACTIONS TAKEN WITH RESPECT TO CONSIDERATION OF THE TRANSACTION OR ARRANGEMENT BY ANY MEMBER OF THE BOARD OR COMMITTEE THAT HAD A CONFLICT OF INTEREST. IT IS THE RESPONSIBILITY OF THE PRESIDENT AND CEO TO ASSURE THE BOARD THIS SAME PROCESS IS FOLLOWED AND DOCUMENTED REGARDING COMPENSATION OF THE CFO AND VICE PRESIDENTS OF THE MEDICAL CENTER.
AVAILABILITY OF DOCUMENTSFORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
OTHER CHANGES IN NET ASSETSFORM 990, PART XI, LINE 5CHANGE IN DEFINED BENEFIT PENSION PLAN (87,544) TRANSFERS TO PRATT COUNTY, KANSAS (3,750) CHANGE IN TEMPORARILY RESTRICTED NET ASSETS 5,352 CHANGE IN INTEREST IN NET ASSETS OF PHF 202,949 NET UNREALIZED LOSSES ON INVESTMENTS (598,864) --------- TOTAL (481,857)
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:HILARY DOLBEE TITLE:TREASURER/CFO HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:NANCY BAILEY TITLE:SECRETARY HOURS:1

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1PRATT HEALTH FOUNDATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1200 COMMODOREAddressLine1
CityPRATTCity
StateKSState
ZIP Code67124ZIPCode
FieldValueIRS element (for citing)
EIN481088881EIN
Primary ActivitiesSUPPORTPrimaryActivities
Legal Domicile StateKSLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status7PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

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