2012-04-30T11:46:19-05:00 2011-09-30 BKD LLP 1551 N WATERFRONT PKWY STE 300 WICHITA KS 672066601 990 2010-10-01 481058737 PRATT REGIONAL MEDICAL CENTER COMPANY INC PRAT 6206727451 200 COMMODORE PRATT KS 67124 HILLARY DOLBEE 6204501437 2012-04-27 true ELIZABETH S HOGAN 3162652811 2010 2016-02-24 21:20:13Z HILARY DOLBEE CFO 200 COMMODORE PRATT KS 67124 51716046 false X WWW.PRMC.ORG X 1988 KS TO 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. 11 9 511 105 0 0 490076 168501 36529761 43460206 135549 401949 493997 1713581 37649383 45744237 4057 9014 0 0 19343836 21674021 0 0 0 17470663 19879475 36818556 41562510 830827 4181727 24978604 29415166 10691050 11427742 14287554 17987424 X SEE SCHEDULE O false false 35216314 9014 44758938 Acute care hospital that provides medical care to the general public. See Schedule O for continuation. 35216314 true true false true false false false false true true false false true false true true false false false false false false false false false true true false true true true false false false false false false false true false true false false false false false true false false false false true 51 0 true 511 true false false false false false false false false false false X 11 9 true false true false true true true true true false false true true true true true true true false false X HILARY DOLBEE 6204501437 200 COMMODORE PRATT KS 67124 X WILLIAM WOJCIECHOWSKI ED D 1.0 X X 0 0 0 DON PETERS 1.0 X X 0 0 0 BILL KELLER 1.0 X 0 0 0 BARBARA CUDNEY MD 1.0 X 0 0 0 JEANETTE SIMENS 1.0 X 0 0 0 IAN KOVACH MD 40.0 X 991825 0 10536 GARY BARKER 1.0 X 0 0 0 SUE SCHREPEL 1.0 X 0 0 0 DAN SUITER MD 1.0 X 0 0 0 BECCA FLOWERS 1.0 X 0 0 0 DENNIS MCKINNEY 1.0 X 0 0 0 SUSAN PAGE 40.0 X 117986 0 37996 KEN BROWN 40.0 X 109376 0 16076 HILARY DOLBEE 39.5 X 77477 0 15778 NANCY BAILEY 39.5 X 37860 0 3580 ALEXANDER NEEL MD 40.0 X 372449 0 13626 JON MORGAN DPM 40.0 X 260144 0 20353 JACOB BREEDING MD 40.0 X 253951 0 2224 FREDRICK FARMER MD 40.0 X 194552 0 36377 JOHN VRTISKA MD 40.0 X 197452 0 20171 2613072 0 176717 16 false true false PRATT OPEN MRI MEDICAL SERVICES 565994 KEY REHABILITATION REHAB SERVICES 265041 LAB CORP OF AMERICA LAB SERVICES 228999 CENTRAL STATES RECOVERY COLLECTION SERVICES 109615 PROMISE REGIONAL MEDICAL CENTER LAUNDRY SERVICES 104206 5 72695 95806 168501 NET PATIENT SERVICE REVENUE 621300 43460206 43460206 43460206 203800 203800 0 0 304314 69962 234352 234352 234352 6087996 12000 5880104 21743 207892 -9743 198149 198149 0 0 0 ELECTRONIC HEALTH RECORD INCENTIVE 1187941 1187941 CAFETERIA/VENDING 722210 127040 127040 MEDICAL RECORDS 518210 10921 10921 153327 110791 42536 1479229 45744237 44758938 0 816798 0 9014 9014 0 0 1370789 902377 468412 0 17833951 16005021 1828930 295725 198454 97271 937936 533754 404182 1235620 723625 511995 0 103077 103077 75880 75880 0 0 0 3193080 2431836 761244 163736 102282 61454 8046789 7756531 290258 0 0 1157714 901159 256555 144762 111406 33356 0 73941 52549 21392 309750 295891 13859 0 1559310 913190 646120 506556 75458 431098 BAD DEBT EXPENSE 3325168 3325168 RECRUITING 242857 170309 72548 LICENSES/DUES/SUBSCRIPTIONS 142533 83201 59332 REPAIRS/MAINTENANCE 436325 315774 120551 PROG-RELATED TAX ASSESSMENTS 282300 282300 115697 27015 88682 41562510 35216314 6346196 0 557770 1188382 309495 419910 4144297 5884148 1947042 1581429 492441 456554 38928557 28642026 10627321 10286531 3877986 5640520 374055 445092 53075 35208 2595122 3477392 24978604 29415166 4160442 5645153 6010000 5450000 390449 230322 130159 102267 10691050 11427742 X 14192327 17886845 6604 11956 88623 88623 14287554 17987424 24978604 29415166 X 4181727 -481857 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 6920 false false false 6920 false 88623 5367 5367 88623 88623 88623 88623 88623 1.00000 false true true 12625 12625 20789656 14035199 6754457 15562460 12892529 2669931 2563816 1714298 849518 10286531 FUNDS HELD BY FISCAL AGENT 421907 INV IN PRATT HEALTH FOUNDATION 1760091 UNAMORTIZED BOND COSTS 107453 DUE FROM MEDICARE 1187941 3477392 0 0 45744237 41562510 4181727 -598864 0 -598864 3582863 45215335 -598864 69962 -528902 45744237 45744237 41632472 69962 69962 41562510 41562510 INTENDED USES OF ENDOWMENT FUNDS SCHEDULE D, PART V, LINE 4 ENDOWMENT 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 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 XII, LINE 2D RENTAL EXPENSES $ 69,962 RECONCILIATION OF EXPENSES SCHEDULE D, PART XIII, LINE 2D RENTAL EXPENSES $ 69,962 true true true X true X true true true false true true 214 224273 123193 101080 0.00240 5529 1712089 967393 744696 0.01790 592646 269773 322873 0.00780 5743 2529008 1360359 1168649 0.02810 1017 18691 0 18691 0.00040 68 144367 0 144367 0.00350 945 11865 0 11865 0.00030 6930 0 6930 0.00020 2030 181853 0 181853 0.00440 7773 2710861 1360359 1350502 0.03250 198 48167 0 48167 0.00100 198 48167 0 48167 0.00100 false 1826515 0 14763194 14812533 -49339 true true 1 1 PRATT REGIONAL MEDICAL CENTER

200 COMMODORE PRATT KS 67124

X X X PRATT REGIONAL MEDICAL CENTER 1 SCHEDULE H, PART I, LINE 7G THE 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 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 $3,325,168. SCHEDULE H, PART I, LINE 7 THE 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 EXPENSE SCHEDULE H, PART III, LINE 4 THE 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. MEDICARE SCHEDULE H, PART III, LINE 8 Government 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. COLLECTION PRACTICES SCHEDULE H, PART III, LINE 9B WHEN 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. NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2 Meeting 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. PATIENT EDUCATION ON ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI, LINE 3 PRMC 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. COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4 OUR 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. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 5 Providing 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. true X X X X X false false false false false false false false false IAN KOVACH MD 991825 0 0 0 0 0 0 0 10536 0 1002361 0 0 0 SUSAN PAGE 114823 0 0 0 3163 0 25099 0 12897 0 155982 0 0 0 ALEXANDER NEEL MD 372449 0 0 0 0 0 0 0 13626 0 386075 0 0 0 JON MORGAN DPM 260144 0 0 0 0 0 20098 0 255 0 280497 0 0 0 JACOB BREEDING MD 253951 0 0 0 0 0 0 0 2224 0 256175 0 0 0 FREDRICK FARMER MD 194552 0 0 0 0 0 26672 0 9705 0 230929 0 0 0 JOHN VRTISKA MD 197452 0 0 0 0 0 12783 0 7388 0 217623 0 0 0 PRATT COUNTY KANSAS PUBLIC BUILDING COMMISSION 480606708 739762AAO 2007-09-15 2960000 BUILDING PURCHASE false false false PRATT COUNTY KANSAS PUBLIC BUILDING COMMISSION 480606708 739762AK8 2007-09-15 4380000 BUILDING PURCHASE false false false 0 0 2960000 204126 0 0 0 0 0 2696674 0 0 2000 true false true true 0 0 4380000 295874 0 0 0 0 0 3908654 0 0 2000 true false true true false false false false false 0.00000 0.00000 0.00000 true false false false false false 0.00000 0.00000 0.00000 true false false false false false false false false false false SEE SCHEDULE L PART V BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS SCHEDULE L, PART IV A) 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. ORGANIZATION'S MISSION FORM 990, PART III, LINE 1 To 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 ACCOMPLISHMENTS FORM 990, PART III, LINE 4A Pratt 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 RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 2 IAN KOVACH AND DAN SUITER, BOARD MEMBERS, HAVE A BUSINESS RELATIONSHIP. MEMBERS FORM 990, PART VI, SECTION A, LINE 6 PRATT 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 BODY FORM 990, PART VI, SECTION A, LINE 7A THE 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 MEMBERS FORM 990, PART VI, SECTION A, LINE 7B THE 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 PROCESS FORM 990, PART VI, SECTION B, LINE 11A AN 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 POLICY FORM 990, PART VI, SECTION B, LINE 12C AT 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 REVIEW FORM 990, PART VI, SECTION B, LINES 15A & B CONSISTENT 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 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. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 5 CHANGE 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 ORGANIZATION FORM 990 PART VII NAME:HILARY DOLBEE TITLE:TREASURER/CFO HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:NANCY BAILEY TITLE:SECRETARY HOURS:1 PRATT HEALTH FOUNDATION 200 COMMODORE PRATT KS 67124 481088881 SUPPORT KS 501(C)(3) 7 NA false false true false false false false false false false false true false false false false false false