FURP.ORG / PUBLIC DATA EXPLORER

WILLIAM NEWTON MEMORIAL HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
WILLIAM NEWTON MEMORIAL HOSPITAL (EIN 48-6005089)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-09-25
IRS object ID
201212699349300226
Schema version
2011v1.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-09-25T13:39:55-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN481026809EIN

Preparer Firm Business Name PreparerFirmBusinessName

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

Preparer Firm US Address PreparerFirmUSAddress

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

Filer Filer

FieldValueIRS element (for citing)
EIN486005089EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1William Newton Memorial HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlWILLNameControl
Phone6202212300Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11300 E 5th AvenueAddressLine1
CityWinfieldCity
StateKSState
ZIP Code67156ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDebbie HockenburyName
TitleChief Financial OfficerTitle
Phone6202212300Phone
Date Signed2012-09-19DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameEric L OttingName
PTINP00298454PTIN
Phone7852334226Phone
Date Prepared2012-09-19DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDebbie HockenburyNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11300 E 5th AvenueAddressLine1
CityWinfieldCity
StateKSState
ZIP Code67156ZIPCode
FieldValueIRS element (for citing)
Gross Receipts27242683GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.wnmh.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1927YearFormation
State Legal DomicileKSStateLegalDomicile
Activity Or Mission DescriptionProvide healthcare services to local area residentsActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members5NbrIndependentVotingMembers
Total Nbr Employees337TotalNbrEmployees
Total Nbr Volunteers88TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year511327ContributionsGrantsPriorYear
Contributions Grants Current Year378522ContributionsGrantsCurrentYear
Program Service Revenue Prior Year25022237ProgramServiceRevenuePriorYear
Program Service Revenue CY25936499ProgramServiceRevenueCY
Investment Income Prior Year34307InvestmentIncomePriorYear
Investment Income Current Year27801InvestmentIncomeCurrentYear
Other Revenue Prior Year427516OtherRevenuePriorYear
Other Revenue Current Year899861OtherRevenueCurrentYear
Total Revenue Prior Year25995387TotalRevenuePriorYear
Total Revenue Current Year27242683TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year13179630SalariesEtcPriorYear
Salaries Etc Current Year13706646SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year18535TotalFundrsngExpCurrentYear
Other Expense Prior Year11763958OtherExpensePriorYear
Other Expenses Current Year12478807OtherExpensesCurrentYear
Total Expenses Prior Year24943588TotalExpensesPriorYear
Total Expenses Current Year26185453TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1051799RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1057230RevenuesLessExpensesCY
Total Assets BOY24002971TotalAssetsBOY
Total Assets EOY23642692TotalAssetsEOY
Total Liabilities BOY9663800TotalLiabilitiesBOY
Total Liabilities EOY8246291TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY14339171NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY15396401NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionWilliam Newton Memorial Hospital is a team of skilled individuals dedicated to meeting the ever changing needs of the community through advances in leadership, education, technology and continuous improvement in the delivery of quality health care. We are committed to sound financial management and ethical practices. We care for those we serve with dignity, kindness and compassion.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense22271286Expense
Revenue26593058Revenue
DescriptionPatient services, full range of inpatient and outpatient services.Description
Total Program Service Expense22271286TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109660NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees337NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members5NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Debbie HockenburyBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6202212300TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11300 E 5th AvenueAddressLine1
CityWinfieldCity
StateKSState
ZIP Code67156ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
Don Drennan
Trustee1.00X000
Joan Cales
Trustee1.00X000
Brenda Butters
Trustee1.00X000
Thomas Herlocker
Vice Chairman1.00X000X
Steve McSpadden
Chairman1.00X000X
Richard Vaught
Administrator/CEO40.00149287014867X
Danny Huckvale
Assistant Administrator/CFO40.00102896016560X
Thomas Embers
Assistant Administrator/COO40.0010573907138X
James McDermott
Physician40.00254109026349X
Kelle Thompson
Pharmacy Director40.0010830707461X
Robert Matthews
Physician Assistant40.0010162100X
FieldValueIRS element (for citing)
Total Reportable Comp From Org821959TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation72375TotalOtherCompensation
Number Individuals GT100 K6NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Via Christi Financial Services
929 North St FrancisWichitaKS67214Radiation Contract799306
Acute Care Inc
1609 N Ankeny Blvd Suite 200AnkenyIA50023ER Physicians717828
CPSI
PO Box 850309MobileAL36685Computer Support Services416615
GE Medical Systems
PO Box 641419DallasTX75284Equipment Service Contract260010
Stockton Restoration Co
PO Box 3802WichitaKS67201Maintenance & Repair189900
FieldValueIRS element (for citing)
Number Of Contractors GT100 K8NumberOfContractorsGT100K
Related Organizations365352RelatedOrganizations
Government Grants13170GovernmentGrants
Total Contributions378522TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Patient services reven6219902552979225529792
Occupational Health900099328104328104
Pharmacy4461107860378603
FieldValueIRS element (for citing)
Total Program Service Revenue25936499TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column27074TotalRevenueColumn
Exclusion$27,074ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real165917Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real165917Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column165917TotalRevenueColumn
Exclusion$165,917ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other727Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other727Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column727TotalRevenueColumn
Exclusion$727ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
EHR incentive payments900099467029467029
Miscellaneous900099189530189530
Cafeteria and dietary72221051142$51,142

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column26243TotalRevenueColumn
Exclusion$26,243ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue733944TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column27242683TotalRevenueColumn
Related Or Exempt Function Income26593058RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$271,103ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total408450Total
Management And General408450ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total10746726Total
Program Services9129928ProgramServices
Management And General1602341ManagementAndGeneral
Fundraising14457Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total781393Total
Program Services662239ProgramServices
Management And General119154ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total888606Total
Program Services744453ProgramServices
Management And General141261ManagementAndGeneral
Fundraising2892Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total881471Total
Program Services748857ProgramServices
Management And General131428ManagementAndGeneral
Fundraising1186Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total37974Total
Management And General37974ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total258668Total
Program Services45396ProgramServices
Management And General213272ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total520990Total
Program Services520990ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total18738Total
Program Services18738ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total437838Total
Program Services437838ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1912819Total
Program Services1912819ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total147063Total
Management And General147063ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Purchased Services27242432502982221261
Medical Supplies228318722831870
Collection Fees and Bad14031301092899310231
Repairs and Maintenance1077197801925275272

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1656960Total
Program Services1369035ProgramServices
Management And General287925ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total26185453Total
Program Services22271286ProgramServices
Management And General3895632ManagementAndGeneral
Fundraising18535Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY110286BOY
EOY65478EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY4650015BOY
EOY6469299EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY4364179BOY
EOY4362572EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY311803BOY
EOY280680EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY230444BOY
EOY215820EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis32090888LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec20041059LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY13360720BOY
EOY12049829EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY975524BOY
EOY199014EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY24002971BOY
EOY23642692EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1592822BOY
EOY1782517EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY8070978BOY
EOY6463774EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY9663800BOY
EOY8246291EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY14339171BOY
EOY15396401EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY14339171BOY
EOY15396401EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY24002971BOY
EOY23642692EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses1057230ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

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 D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis101702OtherCostOrOtherBasis
Book Value101702BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis20081693OtherCostOrOtherBasis
Depreciation11276544Depreciation
Book Value8805149BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis11620080OtherCostOrOtherBasis
Depreciation8491999Depreciation
Book Value3128081BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis287413OtherCostOrOtherBasis
Depreciation272516Depreciation
Book Value14897BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings12049829TotalOfBookValueLandBuildings
Total Revenue27242683TotalRevenue
Total Expenses26185453TotalExpenses
Excess Or Deficit For Year1057230ExcessOrDeficitForYear
Excess Or Deficit Per FS1057230ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt26149784TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal26149784RevenueSubtotal
Other Revenues Not Included1092899OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt1092899RevenueNotRptdOnFinStmt
Total Revenue Per Form99027242683TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt25092554TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal25092554ExpensesSubtotal
Other Expenses Not Included1092899OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt1092899ExpensesNotRptdOnFinStmt
Total Expenses Per Form99026185453TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Uncertain Tax Positions Under FIN 48:Part X:The Hospital is exempt from federal income taxes pursuant to Section 115 of the Internal Revenue Code.
Part XII, Line 4b - Other Adjustments:Reclassification of bad debts 1,092,899.
Part XIII, Line 4b - Other Adjustments:Reclassification of bad debts 1,092,899.

Schedule H IRS990ScheduleH

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

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage120.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report0AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense278279TotalCommunityBenefitExpense
Direct Offsetting Revenue114983DirectOffsettingRevenue
Net Community Benefit Expense163296NetCommunityBenefitExpense
Percent Of Total Expense0.00650PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense2153362TotalCommunityBenefitExpense
Direct Offsetting Revenue2038472DirectOffsettingRevenue
Net Community Benefit Expense114890NetCommunityBenefitExpense
Percent Of Total Expense0.00460PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense2431641TotalCommunityBenefitExpense
Direct Offsetting Revenue2153455DirectOffsettingRevenue
Net Community Benefit Expense278186NetCommunityBenefitExpense
Percent Of Total Expense0.01110PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense29268TotalCommunityBenefitExpense
Net Community Benefit Expense29268NetCommunityBenefitExpense
Percent Of Total Expense0.00120PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense149866TotalCommunityBenefitExpense
Net Community Benefit Expense149866NetCommunityBenefitExpense
Percent Of Total Expense0.00600PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense2414028TotalCommunityBenefitExpense
Direct Offsetting Revenue982870DirectOffsettingRevenue
Net Community Benefit Expense1431158NetCommunityBenefitExpense
Percent Of Total Expense0.05700PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense800TotalCommunityBenefitExpense
Net Community Benefit Expense800NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense2593962TotalCommunityBenefitExpense
Direct Offsetting Revenue982870DirectOffsettingRevenue
Net Community Benefit Expense1611092NetCommunityBenefitExpense
Percent Of Total Expense0.06420PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense5025603TotalCommunityBenefitExpense
Direct Offsetting Revenue3136325DirectOffsettingRevenue
Net Community Benefit Expense1889278NetCommunityBenefitExpense
Percent Of Total Expense0.07530PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$434,085BadDebtExpenseAmount
Amount Attributable To65113AmountAttributableTo
Amount Reimbursed By Medicare9688367AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare9817931CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-129564MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1William Newton Memorial HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11300 E 5th AvenueAddressLine1
CityWinfieldCity
StateKSState
ZIP Code67156ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1William Newton Memorial HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent120.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent200.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Permit Other ActionsXPermitOtherActions
Collection Activities1CollectionActivities
Report To Credit AgencyXReportToCreditAgency
LawsuitXLawsuit
Other ActionsXOtherActions
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities5NumberOfOtherFacilities

Other Facilities OtherFacilities (5 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Cedar Vale Rural Health Clinic
508 WashingtonCedar ValeKS67024Rural Health Clinic
Tallgrass Rural Health Clinic
300 W North StSedanKS67361Rural Health Clinic
Moline Community Rural Health Clinic
200 N PlumMolineKS67353Rural Health Clinic
Dexter Community Rural Health Clinic
204 N Main StDexterKS67038Rural Health Clinic
Physician Pavillion
1230 East 6thWinfieldKS67156Outpatient Clinic

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

ExplanationExplanationIdentifierIdentifier
Part I, Line 6a: William Newton Memorial Hospital has not yet prepared a community benefit report.
Part I, Line 7: Amounts for financial assistance and certain other community benefit programs were obtained using known related charges and several cost to charge ratios. The cost to charge ratios used include the overall cost to charge ratio derived from Worksheet 2 as well as individual department cost to charge ratios identified for the calculation of subsidized health services information.
Part I, Line 7g: Subsidized health services are made up of services that the hospital provides despite a financial loss to the organization. These services include cardiac rehab, home health, and rural health clinics.
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 $ 1092899.
Part II: N/A
Part III, Line 4: The Hospital provides for accounts receivable that could become uncollectible in the future by establishing an allowance to reduce the carrying value of such receivables to their estimated net realizable value. The Hospital estimates this allowance based on the aging of its accounts receivable and its historical collection experience for each type of payor.Part III, Line 2The provision for bad debts are related to accounts that have been deemed uncollectible during the year. The uncollectible amount is then written off pursuant with Hospital policy. The cost of the bad debts reported was determined using an overall cost to charge ratio multiplied by total bad debt expense, net of payments recovered through the State.Part III, Line 3The provision for bad debts attributable to patients eligible under the organization's financial assistance policy were determined using an estimation of 15.0% of total bad debts. The US Census Bureau reports the persons below the federal poverty level in 2010 for Cowley County was 15.0%. William Newton Memorial Hospital takes steps to assist individuals who are believed to qualify for financial assistance prior to writing accounts off as uncollectible.
Part III, Line 8: The Hospital used the 2011 Medicare Cost Report to determine the Medicare revenue and related cost.
Part III, Line 9b: The Hospital's collection policy does not contain a provision on the collection practices for patients who are known to qualify for charity care or financial assistance. To be considered for charity care, however, the charity care policy states that the patient must cooperate with the Hospital to provide the information and documentation necessary to apply for other existing financial resources that may be available to pay for health care services, such as Medicaid. The information gathered is reviewed to determine eligibility for charity care. Whenever possible, prior to admission, the Hospital will conduct a pre-admission interview with the patient, the guarantor, and or legal representative. Those patients who may qualify for financial assistance from a governmental program will be referred to the appropriate program, prior to consideration for charity care.
Part V, Section B, Line 15e: William Newton Memorial Hospital may refer unpaid patient accounts to third party collection agencies and attorneys.William Newton Memorial Hospital
Part V, Section B, Line 16e: William Newton Memorial Hospital referred unpaid patient accounts to third party collection agencies and attorneys.William Newton Memorial Hospital
Part V, Section B, Line 19d: William Newton Memorial Hospital maintains a set pricing structure for all medical services. Patients that are determined to not meet the eligibility requirements for free or discounted care are billed for the gross charge amount.William Newton Memorial Hospital
Part VI, Line 2: The Hospital has not conducted a community needs assessment as it has not yet been required. The Hospital is making plans to complete an assessment when it is required by law.
Part VI, Line 3: William Newton Memorial Hospital educates patients about its charity care policies by signage at the registration desk and business office counter. When possible, the Hospital will conduct a pre-admission interview with the patient, the guarantor, and/or his/her legal representative to determine eligibility for charity care. If a pre-admission interview is not possible, the interview is conducted upon admission or as soon as possible thereafter. In the case of an emergency admission, the Hospital's evaluation of charity care qualification, or payment alternatives does not take place until the required medical care has been provided. Identification of potential eligible patients can take place at any time during the rendering of services or during the collection process. Patients who may qualify for financial assistance from a governmental program are referred to the appropriate program, such as Medicaid, prior to consideration for charity care. All patients who inquire about assistance are referred to the credit/collections manager for complete explanation of options.
Part VI, Line 4: The Hospital's primary service area is Cowley County, Kansas. Cowley County is a rural community located 135 miles west of the Missouri state line and touches the Oklahoma border. The US Census Bureau estimates the 2011 population of Cowley County, Kansas to be 36,272. 16.1% of the population is 65 years of age or older, median household income is $40,749, and 15.0% of the population is below poverty level compared to the State of Kansas average of 12.4%. There is one other acute care hospital located in Cowley County. William Newton has four rural health clinics in both Elk and Chautauque Counties. These counties neighbor Cowley County on the east and northeast side. According to the 2011 US Census Bureau, Elk County's population was 2,811. 25.3% of the population is 65 years of age or older, median household income is $33,455, and 18.4% of the population is below poverty level. According to the 2011 US Census Bureau, Chautauque County's population was 3,584. 23.8% of the population is 65 years of age or older, median household income is $35,848, and 10.1% of the population is below poverty level.
Part VI, Line 5: The administration of William Newton Hospital conducts extensive physician recruitment for the greater good of the broader community, and has been successful in recruiting physicians and physician assistants over the years. Ongoing recruitment is vital for the health of the community. Recruitment expense for 2011 was approximately $152,000. Community Health Fair, outreach programs, public education and newsletters are some examples of other activities the Hospital does to support health in the community. The hospital also operates four rural health clinics in Elk and Chautauqua Counties in Kansas. These clinics provide the only source of health care to these communities. The hospital provides access to health information to the community through the hospitals web page. The hospitals governing body is comprised of persons who reside in the primary service area who are neither employees nor contractors of the hospital, nor family members thereof.

Schedule J IRS990ScheduleJ

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

Form990 Schedule J Part II Form990ScheduleJPartII (2 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
Richard Vaught
1492870000010184046830164154000
James McDermott
2541090000017151091980280458000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 8bAll business takes place during board meetings, and due to the size of the organization, it is not necessary to establish standing committees.
Form 990, Part VI, Section B, line 11Form 990 is made available to the governing body for their review upon their request.
Form 990, Part VI, Section B, line 12cA conflict of interest disclosure form is provided with a copy of the current conflict of interest policy. This disclosure is completed by each Member upon election and annually thereafter.
Form 990, Part VI, Section B, line 15The Board of Trustees is responsible for deteriming the job performance standards for the Administrator/CEO and determining compensation according to the organizations policies.
Form 990, Part VI, Section C, line 19The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.
Form 990, Part XII, line 2CThe Hospital's Board of Trustees meets with the auditor and approves the audited financial statement.Financial Statement Reporting

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1William Newton Healthcare Foundation IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11300 E 5th StreetAddressLine1
CityWinfieldCity
StateKSState
ZIP Code67156ZIPCode
FieldValueIRS element (for citing)
EIN205069172EIN
Primary ActivitiesFundraising for the benefit of William Newton HospitalPrimaryActivities
Legal Domicile StateKSLegalDomicileState
Exempt Code Section501(c)(3)ExemptCodeSection
Public Charity Status170(b)(1)PublicCharityStatus
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
William Newton Healthcare Foundation Inc
C300000
William Newton Healthcare Foundation Inc
C31753