FURP.ORG / PUBLIC DATA EXPLORER

MIAMI COUNTY MEDICAL CENTER INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
MIAMI COUNTY MEDICAL CENTER INC (EIN 48-1155548)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-14
IRS object ID
201233199349306003
Schema version
2011v1.3
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)
Timestamp2012-11-14T15:25:30-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

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 Line11201 Walnut Suite 1700AddressLine1
CityKansas CityCity
StateMOState
ZIP Code641062246ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN481155548EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MIAMI COUNTY MEDICAL CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% TIERNEY L GRASSERInCareOfName
Name ControlMIAMNameControl
Phone9137914461Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12100 BAPTISTE DRIVEAddressLine1
CityPAOLACity
StateKSState
ZIP Code66071ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTIERNEY L GRASSERName
TitleSENIOR VP/FINANCETitle
Date Signed2012-11-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone8162216300Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTIERNEY L GRASSERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line120333 W 151ST STREETAddressLine1
CityOLATHECity
StateKSState
ZIP Code66061ZIPCode
FieldValueIRS element (for citing)
Gross Receipts29077509GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.OLATHEHEALTH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1994YearFormation
State Legal DomicileKSStateLegalDomicile
Activity Or Mission DescriptionTO IMPROVE THE HEALTH OF ALL INDIVIDUALS IN THE COMMUNITIES WE SERVE BY PROVIDING COMPASSIONATE, QUALITY HEALTHCARE IN AN ENVIRONMENT OF TRUST AND COLLABORATION.ActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members5NbrIndependentVotingMembers
Total Nbr Employees188TotalNbrEmployees
Total Nbr Volunteers33TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1332ContributionsGrantsPriorYear
Contributions Grants Current Year1105ContributionsGrantsCurrentYear
Program Service Revenue Prior Year22307375ProgramServiceRevenuePriorYear
Program Service Revenue CY21305362ProgramServiceRevenueCY
Investment Income Prior Year867610InvestmentIncomePriorYear
Investment Income Current Year292532InvestmentIncomeCurrentYear
Other Revenue Prior Year118059OtherRevenuePriorYear
Other Revenue Current Year58243OtherRevenueCurrentYear
Total Revenue Prior Year23294376TotalRevenuePriorYear
Total Revenue Current Year21657242TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year87994GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY100176GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year9461454SalariesEtcPriorYear
Salaries Etc Current Year9621685SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year10941209OtherExpensePriorYear
Other Expenses Current Year11425796OtherExpensesCurrentYear
Total Expenses Prior Year20490657TotalExpensesPriorYear
Total Expenses Current Year21147657TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2803719RevenuesLessExpensesPriorYear
Revenues Less Expenses CY509585RevenuesLessExpensesCY
Total Assets BOY42910451TotalAssetsBOY
Total Assets EOY42410654TotalAssetsEOY
Total Liabilities BOY8097661TotalLiabilitiesBOY
Total Liabilities EOY7306951TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY34812790NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY35103703NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE MISSION OF MIAMI COUNTY MEDICAL CENTER, INC. IS TO IMPROVE THE HEALTH OF ALL INDIVIDUALS IN THE COMMUNITIES WE SERVE BY PROVIDING COMPASSIONATE, QUALITY HEALTHCARE IN AN ENVIRONMENT OF TRUST AND COLLABORATION.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense15758310Expense
Grants100176Grants
Revenue21305362Revenue
DescriptionSEE SCHEDULE ODescription
Total Program Service Expense15758310TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
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 AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
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 OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
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 OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
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 With109629NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees188NumberOfEmployees
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 Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members5NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
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 OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledKSStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonTIERNEY L GRASSERNamePerson
Telephone Number9137914461TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line120333 W 151ST STREETAddressLine1
CityOLATHECity
StateKSState
ZIP Code66061ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
JACK TINNEL
TRUSTEE/CHAIRPERSON2.0XX
THOMAS J DAVIES
TRUSTEE RESIGNED 5/18/111.0XX
CHIP WOOD
TRUSTEE1.0X
STEVE MILLER
TRUSTEE/SECRETARY/TREASURER1.0XX
DENISE GERMAN
TRUSTEE/VICE CHAIRPERSON1.0XX
JOE MORLAND
TRUSTEE1.0X
FRANK H DEVOCELLE
PRESIDENT/CEO7.0X0761736305830
RODNEY D CORN
SR VP/OPS/RESIGNED 3/4/117.0X01522518513
TIERNEY L GRASSER
SENIOR VP/FINANCE9.0X0403879106123
GERALD WIESNER
VICE PRESIDENT/OPERATIONS40.0X165953015733
CHERYL L ROSS
ASSISTANT SECRETARY2.0X011284810887
PAUL W LUCE
PATIENT CARE DIRECTOR40.0120887020698X
STEVEN B MOON
PHARMACY DIRECTOR40.011543414133X
FieldValueIRS element (for citing)
Total Reportable Comp From Org402274TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1430714TotalReportableCompFrmRltdOrgs
Total Other Compensation481917TotalOtherCompensation
Number Individuals GT100 K3NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Description Of ServicesDescriptionOfServicesCompensationCompensation
EMERGENCY MEDICINE CARE PA
EMERGENCY SERVICES1666667
SHARED MEDICAL SYSTEMS INC
MRI SERVICES259877
P1 GROUP INC
HVAC MAINTENANCE144591
KRAMER FRANK
COLLECTION SERVICES113986
DE MINT ANESTHESIA SERVICE
ANESTHESIA SERVICES156197
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
All Other Contributions1105AllOtherContributions
Total Contributions1105TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNet Patient Service RevenueDescription
Business Code900099BusinessCode
Total Revenue Column21305362TotalRevenueColumn
Related Or Exempt Function Income21305362RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue21305362TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column799448TotalRevenueColumn
Exclusion$799,448ExclusionAmount

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)
Real99213Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real197681Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-98468Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-98468TotalRevenueColumn
Exclusion-$98,468ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities6715670Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities7222586Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-506916Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-506916TotalRevenueColumn
Exclusion-$506,916ExclusionAmount

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)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
Puchase Discounts90009922810$22,810
CAFETERIA72221028683$28,683
REFERENCE LAB INCOME62150028675$28,675

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column76543TotalRevenueColumn
Exclusion$76,543ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue156711TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column21657242TotalRevenueColumn
Related Or Exempt Function Income21305362RelatedOrExemptFunctionIncome
Exclusion$350,775ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total95176Total
Program Services95176ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total5000Total
Program Services5000ProgramServices

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)
Total181686Total
Program Services141687ProgramServices
Management And General39999ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total30671Total
Program Services30671ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total7732927Total
Program Services6030493ProgramServices
Management And General1702434ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total119378Total
Program Services93096ProgramServices
Management And General26282ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1021894Total
Program Services796920ProgramServices
Management And General224974ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total535129Total
Program Services417318ProgramServices
Management And General117811ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total72504Total
Management And General72504ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total29426Total
Management And General29426ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total3831Total
Management And General3831ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total12397Total
Management And General12397ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total3219899Total
Program Services1107179ProgramServices
Management And General2112720ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total83490Total
Management And General83490ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total741162Total
Program Services221900ProgramServices
Management And General519262ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total418600Total
Program Services373286ProgramServices
Management And General45314ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total19538Total
Management And General19538ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total225432Total
Program Services202148ProgramServices
Management And General23284ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1510900Total
Program Services1354845ProgramServices
Management And General156055ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total262435Total
Program Services235329ProgramServices
Management And General27106ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Bad Debt Expense13767691376769
MEDICAL SUPPLIES25347662534616150
Loss on Term of IR Swap556200556200
Medicaid Assessment8392183921

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total274526Total
Program Services101756ProgramServices
Management And General172770ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total21147657Total
Program Services15758310ProgramServices
Management And General5389347ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY363253BOY
EOY435287EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY4247760BOY
EOY3808380EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY801393BOY
EOY636865EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY168976BOY
EOY139391EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis21679955LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec15725159LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY6017101BOY
EOY5954796EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY31122444BOY
EOY31196508EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY189524BOY
EOY239427EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY42910451BOY
EOY42410654EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1834574BOY
EOY1960346EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY5216150BOY
EOY4934342EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1046937BOY
EOY412263EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY8097661BOY
EOY7306951EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY34785070BOY
EOY35077587EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY27720BOY
EOY26116EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY34812790BOY
EOY35103703EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY42910451BOY
EOY42410654EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses509585ReconcilationRevenueExpenses
Reconcilation Other Changes-218672ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

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$3,831GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB3831TotalLobbyingExpendituresIIB
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 Balance29909183BeginningOfYearBalance
Contributions401968Contributions
Investment Earnings Or Losses-522248InvestmentEarningsOrLosses
Other Expenditures26081OtherExpenditures
End Of Year Balance29762822EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance24241897BeginningOfYearBalance
Contributions2406369Contributions
Investment Earnings Or Losses3273465InvestmentEarningsOrLosses
Other Expenditures12548OtherExpenditures
End Of Year Balance29909183EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance15324746BeginningOfYearBalance
Contributions3571697Contributions
Investment Earnings Or Losses5368894InvestmentEarningsOrLosses
Other Expenditures23440OtherExpenditures
End Of Year Balance24241897EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance16823777BeginningOfYearBalance
Contributions1922937Contributions
Investment Earnings Or Losses-3411104InvestmentEarningsOrLosses
Other Expenditures10864OtherExpenditures
End Of Year Balance15324746EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.99910BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.00000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.00090TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1475439OtherCostOrOtherBasis
Book Value1475439BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis10057263OtherCostOrOtherBasis
Depreciation8586362Depreciation
Book Value1470901BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis9536639OtherCostOrOtherBasis
Depreciation6773788Depreciation
Book Value2762851BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis610614OtherCostOrOtherBasis
Depreciation365009Depreciation
Book Value245605BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings5954796TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO AFFILIATESDescription
Amount$412,263Amount
FieldValueIRS element (for citing)
Total Of Amounts412263TotalOfAmounts
Total Revenue21657242TotalRevenue
Total Expenses21147657TotalExpenses
Excess Or Deficit For Year509585ExcessOrDeficitForYear
Net Unrealized GL On Investments-840008NetUnrealizedGLOnInvestments
Other$622,940OtherAmount
Total Adjustments-217068TotalAdjustments
Excess Or Deficit Per FS292517ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt280513714TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-840008NetUnrealizedGainsInvestments
Other Revenues259708877OtherRevenues
Revenue Not Rptd F990258868869RevenueNotRptdF990
Revenue Subtotal21644845RevenueSubtotal
Investment Expenses Not Included12397InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt12397RevenueNotRptdOnFinStmt
Total Revenue Per Form99021657242TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt275251255TotExpensesEtcAuditedFinclStmt
Other Expenses Included254115995OtherExpensesIncluded
Expenses Not Rptd F990254115995ExpensesNotRptdF990
Expenses Subtotal21135260ExpensesSubtotal
Investment Expenses Not Included212397InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt12397ExpensesNotRptdOnFinStmt
Total Expenses Per Form99021147657TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIBE THE INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDSSCHEDULE D, PART V, LINE 4THE ENDOWMENT FUNDS ARE HELD FOR FUTURE CAPITAL AND EXPANSION NEEDS. IN ADDITION, THE FUNDS ALSO REPRESENT RESERVES FOR OPERATING NEEDS TO REMAIN FINANCIALLY STABLE.
UNCERTAIN TAX POSITIONS DISCLOSURESCHEDULE 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.
OTHER - RECONCILIATION OF REVENUE PER AUDITED F/S AND TAX RETURNCHANGE IN FAIR VALUE OF INTEREST RATE SWAP 613,175 NET ASSETS RELEASED- CAPITAL 9,765 -------- TOTAL $622,940
OTHER - REVENUE INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12SCHEDULE D, PART XII, LINE 2DRELATED ORGANIZATIONS' REVENUE 259,688,036 RENTAL EXPENSES 197,681 CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 379,360 LOSS ON TERMINATION OF INTEREST RATE SWAP (556,200) ------------- TOTAL $259,708,877
OTHER - EXPENSE INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25SCHEDULE D, PART XIII, LINE 2DRELATED ORGANIZATIONS' EXPENSES 254,474,514 RENTAL EXPENSES 197,681 LOSS ON TERMINATION OF INTEREST RATE SWAP (556,200) ------------- TOTAL $254,115,995

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CarefalseFPGReferenceFreeCare
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Number Of Activities Or Programs2307NumberOfActivitiesOrPrograms
Persons Served1143PersonsServed
Total Community Benefit Expense625475TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense625475NetCommunityBenefitExpense
Percent Of Total Expense0.02960PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Number Of Activities Or Programs5632NumberOfActivitiesOrPrograms
Persons Served1846PersonsServed
Total Community Benefit Expense2320105TotalCommunityBenefitExpense
Direct Offsetting Revenue685706DirectOffsettingRevenue
Net Community Benefit Expense1634399NetCommunityBenefitExpense
Percent Of Total Expense0.07730PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs7939NumberOfActivitiesOrPrograms
Persons Served2989PersonsServed
Total Community Benefit Expense2945580TotalCommunityBenefitExpense
Direct Offsetting Revenue685706DirectOffsettingRevenue
Net Community Benefit Expense2259874NetCommunityBenefitExpense
Percent Of Total Expense0.10690PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs5NumberOfActivitiesOrPrograms
Persons Served298PersonsServed
Total Community Benefit Expense7266TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense7266NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Persons Served15PersonsServed
Total Community Benefit Expense10387TotalCommunityBenefitExpense
Net Community Benefit Expense10387NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served75PersonsServed
Total Community Benefit Expense26526TotalCommunityBenefitExpense
Net Community Benefit Expense26526NetCommunityBenefitExpense
Percent Of Total Expense0.00130PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs11NumberOfActivitiesOrPrograms
Persons Served388PersonsServed
Total Community Benefit Expense44179TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense44179NetCommunityBenefitExpense
Percent Of Total Expense0.00210PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs7950NumberOfActivitiesOrPrograms
Persons Served3377PersonsServed
Total Community Benefit Expense2989759TotalCommunityBenefitExpense
Direct Offsetting Revenue685706DirectOffsettingRevenue
Net Community Benefit Expense2304053NetCommunityBenefitExpense
Percent Of Total Expense0.10900PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$453,271BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare5952880AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare8294429CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-2341549MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost Accounting SystemXCostAccountingSystem
FieldValueIRS element (for citing)
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 Line1MIAMI COUNTY MEDICAL CENTER INCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line12100 BAPTISTE DRIVEAddressLine1
CityPAOLACity
StateKSState
ZIP Code66071ZIPCode
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 Line1MIAMI COUNTY MEDICAL CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreefalseUsesFPGFree
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent250.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Other PublicityXOtherPublicity
Actions On NonpaymenttrueActionsOnNonpayment
Permit Other ActionsXPermitOtherActions
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities2NumberOfOtherFacilities

Other Facilities OtherFacilities (2 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
LOUISBURG REHAB OF MIAMI CTY MEDICAL CTR
102 W CRESTVIEW CIRCLELOUISBURGKS66053OUTPATIENT REHABILITATION CLINIC
OSAWATOMIE REHAB OF MIAMI CTY MED CENTER
539 MAIN STREETOSAWATOMIEKS66064OUTPATIENT REHABILITATION CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
FAMILY INCOME LIMIT FOR ELIGIBILITY FOR DISCOUNTED CARESCHEDULE H, PART I, LINE 3CMIAMI COUNTY MEDICAL CENTER, INC. (MCMCI) OFFERS DISCOUNTED CARE TO ALL INDIVIDUALS WITHOUT INSURANCE, SIMILAR TO MANAGED CARE DISCOUNTS. MCMCI'S UNINSURED DISCOUNT APPLIES TO ALL PATIENTS WITHOUT INSURANCE, REGARDLESS OF ABILITY TO PAY, INCLUDING ALL LOW INCOME INDIVIDUALS.
SCHEDULE H, PART I, LINE 7, COLUMN FTHE BAD DEBT EXPENSE IS NOT CONSIDERED A COMMUNITY BENEFIT EXPENSE AND IS NOT INCLUDED IN SCHEDULE H, PART I, LINE 7.
SCHEDULE H, PART I, LINE 7THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART I, LINE 7, OF SCHEDULE H, IS A COST ACCOUNTING SYSTEM.
BAD DEBT EXPENSESCHEDULE H, PART III, LINE 4THE SYSTEM REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. THE SYSTEM BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE SYSTEM RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. AN OVERALL COST TO CHARGE RATIO IS USED TO CALCULATE THE BAD DEBT EXPENSE.
COLLECTION PRACTICESSCHEDULE H, PART III, LINE 9BBEFORE PLACEMENT WITH COLLECTION AGENCIES, MCMCI PATIENT FINANCIAL SERVICES OFFERS VARIOUS OPTIONS FOR PATIENTS WITH FINANCIAL DIFFICULTIES. IN ADDITION TO OFFERING OUR OWN FINANCIAL ASSISTANCE TO QUALIFYING INDIVIDUALS, MCMCI CONTRACTS WITH AN AGENCY THAT SCREENS INDIVIDUALS FOR ELIGIBILITY FOR PROGRAMS LIKE MEDICAID, DISABILITY, AND CRIME VICTIM'S COMPENSATION AND THEN HELPS THEM THROUGH THE APPLICATION PROCESS. THE USE OF PROPENSITY TO PAY (LIKELIHOOD TO PAY) SOFTWARE ALSO HELPS MCMCI IDENTIFY INDIVIDUALS THAT MAY NEED ASSISTANCE THAT HAVE NOT COMPLETED AN APPLICATION. MCMCI HAS LANGUAGE WRITTEN IN THEIR COLLECTION AGENCY CONTRACT THAT STATES, "IF THE COLLECTION AGENCY LEARNS A PATIENT/DEBTOR HAS NEITHER SUFFICIENT INCOME NOR ASSETS TO MEET HIS FINANCIAL OBLIGATION, THE AGENCY WILL NOT PURSUE COLLECTION ACTIVITIES AGAINST THE PATIENT/DEBTOR, UNLESS OR UNTIL THE AGENCY LEARNS THAT THE PATIENT/DEBTOR HAS INCOME OR ASSETS TO MEET THE OBLIGATION." IF THE COLLECTION AGENCY IS NOTIFIED BY THE PATIENT/DEBTOR THAT THIS CREATES AN UNDUE FINANCIAL HARDSHIP OR BURDEN DUE TO A CHANGE IN THEIR INCOME OR ASSETS, THE AGENCY WILL NOTIFY MCMCI AND AWAIT FURTHER DIRECTION FROM THE HOSPITAL.
SCHEDULE H, PART V, SECTION B, LINE 9MIAMI COUNTY MEDICAL CENTER, INC. (MCMCI) DOES NOT OFFER FREE CARE EXCEPT IN THE CASE OF DEATH AND NO ASSETS OR INSURANCE ARE AVAILABLE. IN ALL OTHER CASES WE WILL DISCOUNT UP TO 99.9% OF TOTAL CHARGES FOR PATIENTS AT OR BELOW THE FEDERAL POVERTY GUIDELINES. ALL PATIENTS ARE EXPECTED TO CONTRIBUTE TO THEIR CARE IN ACCORDANCE WITH THEIR ABILITY.
SCHEDULE H, PART V, SECTION B, LINE 13GMIAMI COUNTY MEDICAL CENTER (MCMCI) PUBLICIZED THE FINANCIAL ASSISTANCE POLICY BY PUBLICIZING THE FINANCIAL ASSISTANCE PROGRAM IN THE FOLLOWING MANNER; THE FINANICAL ASSISTANCE PROGRAM WAS PUBLICIZED ON THE HOSPITAL'S WEBSITE, ON EACH PATIENT BILL AND WITH SIGNS IN REGISTRATION AREAS AND IN PATIENT FINANCIAL SERVICES. APPLICATIONS ARE GIVEN TO PATIENTS DURING REGISTRATION UPON REQUEST.
SCHEDULE H, PART V, SECTION B, LINE 15EMIAMI COUNTY MEDICAL CENTER (MCMCI) DOES NOT PERMIT ANY OF THE ACTIONS LISTED WITHOUT MAKING A REASONABLE EFFORT TO DETERMINE THE PATIENT'S ELIGIBILITY UNDER THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM.
SCHEDULE H, PART V, SECTION B, LINE 19DTHE HOSPITAL UTILIZED A DISCOUNT OF 50% FOR UNINSURED AND FINANCIAL ASSISTANCE ELIGIBLE INDIVIDUALS BASED ON AN OVERALL WRITE-OFF PERCENTAGE FOR COMMERCIAL PAYORS.
NEEDS ASSESSMENTSCHEDULE H, PART VI, LINE 2Miami County Medical Center, Inc. (MCMCI) is continually assessing the health needs of the communities it serves in a variety of ways. Informally, MCMCI is involved in multiple health fairs and other community outreach activities that involve screenings, questionnaires and general conversation that help us understand the needs of groups and individuals. The MCMCI community advisory group is represented by a diverse set of individuals who provide helpful input from the organizations and communities they represent. MCMCI has also been very involved with the Miami County Health Department and other area agencies in collaboration on health needs assessment and delivery of services. During 2011 MCMCI began to prepare a more formal process of assessment through a broad-based survey of residents of the service area, and town hall meetings open to the public planned for 2012. The results of these efforts will be available by year-end 2012. MCMCI will present a recommendation for a Community Health Improvement Process to its Board of Trustees by mid-2013.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCESCHEDULE H, PART VI, LINE 3PATIENTS OF MIAMI COUNTY MEDICAL CENTER, INC. (MCMCI) ARE MADE AWARE OF ALL OPPORTUNITIES AVAILABLE FOR FINANCIAL ASSISTANCE IN A VARIETY OF WAYS. THERE ARE SIGNS IN THE REGISTRATION AREAS TO NOTIFY PATIENTS AND VISITORS OF THE AVAILABILITY OF ASSISTANCE PROGRAMS. EVERY BILLING STATEMENT CONTAINS A NOTICE OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AND HOW TO OBTAIN ADDITIONAL INFORMATION OR APPLY. APPLICATIONS AND INSTRUCTIONS ARE AVAILABLE ON THE MEDICAL CENTER'S WEBSITE, IN BOTH ENGLISH AND SPANISH. PATIENT ACCESS, PATIENT FINANCIAL SERVICES AND SOCIAL WORKERS ARE TRAINED TO PROVIDE APPLICATIONS TO PATIENTS IF THEY EXPRESS ANY CONCERN REGARDING ABILITY TO PAY FOR SERVICES, OR MAY BE REFERRED TO AN AGENCY THE MEDICAL CENTER CONTRACTS WITH TO HELP INDIVIDUALS THROUGH THE APPLICATION PROCESS FOR PROGRAMS LIKE MEDICAID AND DISABILITY. PATIENTS THAT CALL OUR PATIENT FINANCIAL SERVICES DEPARTMENT EXPRESSING CONCERNS ABOUT BEING ABLE TO PAY FOR THEIR SERVICES OR EXPRESS THAT THEY ARE EXPERIENCING A FINANCIAL HARDSHIP ARE ADVISED OF OUR ASSISTANCE POLICY AND ENCOURAGED TO APPLY.
COMMUNITY INFORMATIONSCHEDULE H, PART VI, LINE 4Miami County Medical Center, Inc. (MCMCI) serves the people of Miami and Linn Counties in Kansas. Miami and Linn Counties are both located in rural areas of the state of Kansas and are both federally designated medically underserved areas of Kansas. MCMCI is the only hospital in these two counties. However, there are several other hospitals located in nearby metropolitan areas, including Olathe and Overland Park, Kansas, and Kansas City, Missouri. In addition to the general health care services provided by the hospital and its associated physicians, MCMCI serves a diverse population of mentally disabled patients. The Osawatomie State Hospital, Lake Mary Center, Medicalodge of Paola and the Tri-Ko are all organizations located in the service area. MCMCI supports each of these organizations by providing medical care to their residents. Below is a listing of economic levels for area residents. Time period: 2006 - 2010 Source: factfinder2.census.gov People Living Below Poverty Level Miami County: 5.7% Linn County: 10.3% Young Children Living Below Poverty Level Miami County: 10.6% Linn County: 12.1% Uninsured Adult Population Rate (2009) Miami County: 14.8% Linn County: 18.8%
PROMOTION OF COMMUNITY HEALTHSCHEDULE H, PART VI, LINE 5In addition to the items listed above, Miami County Medical Center takes a very active role in support of local, regional and national not-for-profit organizations with a focus on improving health and supporting those in need. MCMCI provides support financially and through volunteering time and talents to multiple area organizations. MCMCI provides athletic trainers to area school sports programs. MCMCI staff members are involved in several health fairs and/or community screenings each year. The community health fairs are organized in conjunction with a variety of other area agencies, such as: Miami County Emergency Medical Services, local school districts, county agencies.
AFFILIATED HEALTH CARE SYSTEMSCHEDULE H, PART VI, LINE 6MIAMI COUNTY MEDICAL CENTER IS A PART OF OLATHE HEALTH SYSTEM, INC. (OHSI) THIS CONSISTS OF TWO HOSPITALS AND A NETWORK OF 38 CLINICS. OHSI AND ITS AFFILIATES, INCLUDING MIAMI COUNTY MEDICAL CENTER, TAKE A LEADERSHIP ROLE IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED. OHSI HOSPITALS AND CLINICS ARE VERY INVOLVED WITH COMMUNITY OUTREACH EDUCATION AND SCREENING PROGRAMS ACROSS THE ENTIRE SERVICE AREA. WE COLLABORATE WITH AREA COMPANIES AND OTHER HEALTH-RELATED SERVICE PROVIDERS TO PROVIDE EDUCATION AND SCREENINGS TO THE PUBLIC. OHSI POSITIONS ITSELF AS NOT ONLY A PROVIDER OF CARE, BUT A RESOURCE FOR EDUCATION AND PREVENTION.
STATE FILING OF COMMUNITY BENEFIT REPORTSCHEDULE H, PART VI, LINE 7MCMCI IS NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT WITH THE STATE, BUT WE MAKE OUR REPORT AVAILABLE TO ANYONE INTERESTED AT WWW.OLATHEHEALTH.ORG.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistance
LAKEMARY ENDOWMENT
100 LAKEMARY DRIVEPAOLAKS66071237423516501(C)(3)7500CMTY WELLNESS
SCHOOL DISTRICT #368
PO BOX 268PAOLAKS66071480720746GOVERNMENTCMTY WELLNESS23024BOOKSPORTS MEDICINE
SCHOOL DISTRICT #230
101 E SOUTH STSPRING HILLKS66083480723504GOVERNMENTCMTY WELLNESS22702BOOKSPORTS MEDICINE
SCHOOL DISTRICT #367
1200 TROJAN DRIVEOSAWATOMIEKS66064GOVERNMENTCMTY WELLNESS23024BOOKSPORTS MEDICINE
YMCA OF GREATER KC
3100 BROADWAY SUITE 1020KCMO64111440546002501(C)(3)6000CMTY WELLNESS
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants5TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCESS FOR MONITORING THE USE OF GRANTS IN THE U.S.Identifier
Return ReferenceSCHEDULE I, PART I, LINE 2ReturnReference
ExplanationMIAMI COUNTY MEDICAL CENTER, INC. PROVIDED SPORTS TRAINERS TO LOCAL HIGH SCHOOLS. FOR ALL SCHOLARSHIPS, THE ORGANIZATION CAREFULLY SELECTS THE RECIPIENTS OF THE FUNDS AND A CHECK IS WRITTEN DIRECTLY TO THE ORGANIZATION OR INDIVIDUAL.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
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 (4 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
FRANK H DEVOCELLE
056003701494130522860289337016493010675660135830
RODNEY D CORN
08279103586403359606189023240160764035864
TIERNEY L GRASSER
03004990663870369930848880212350510002057728
GERALD WIESNER
1491880970207063020000137330181686097020

Form990 Schedule J Part III Form990ScheduleJPartIII (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SOCIAL CLUB DUES OR INITIATION FEESSCHEDULE J, PART I, LINE 1ASOCIAL CLUB DUES WERE PAID BY THE HOSPITAL FOR GERALD WIESNER AND WERE NOT INCLUDED IN HIS W-2 AS TAXABLE COMPENSATION BECAUSE IT WAS 100% BUSINESS USE.
ESTABLISHMENT OF OFFICER COMPENSATIONFORM 990, PART VII; SCHEDULE J, PART I, LINE 3 AND PART IITHE COMPENSATION BEING REPORTED FOR GERALD WIESNER WAS REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF OLATHE MEDICAL CENTER, INC. THE SOLE MEMBER OF MIAMI COUNTY MEDICAL CENTER INC. THE COMPENSATION COMMITTEE IS COMPRISED OF INDEPENDENT BOARD MEMBERS, WHICH INCLUDES A BOARD MEMBER FROM MIAMI COUNTY MEDICAL CENTER, INC. THE COMMITTEE UTILIZED AN INDEPENDENT COMPENSATION CONSULTANT AND THIRD PARTY SALARY SURVEYS IN THE ESTABLISHMENT OF MR. WIESNER'S COMPENSATION.
COMPENSATION FROM A RELATED ORGANIZATIONFORM 990, PART VII; SCHEDULE J, PART I, LINE 3 AND PART IITHE COMPENSATION BEING REPORTED FOR FRANK H DEVOCELLE, RODNEY D CORN AND TIERNEY L GRASSER BY A RELATED ORGANIZATION IS FROM OLATHE MEDICAL CENTER, INC. THE SOLE MEMBER OF MIAMI COUNTY MEDICAL CENTER, INC. OLATHE MEDICAL CENTER, INC. USES A COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT BOARD MEMBERS TO ESTABLISH COMPENSATION AND BENEFITS FOR ALL OFFICERS OF OLATHE MEDICAL CENTER, INC. AND ITS AFFILIATED CORPORATIONS. THE COMPENSATION COMMITTEE APPROVES AND ESTABLISHES ALL COMPENSATION AND BENEFITS FOR OFFICERS OF OLATHE MEDICAL CENTER, INC. AND ITS AFFILIATED COMPANIES. THEY UTILIZED AN INDEPENDENT COMPENSATION CONSULTANT, A WRITTEN CONTRACT FOR THE CEO AND COMPENSATION SURVEYS TO ESTABLISH FAIR MARKET VALUE SALARIES AND BENEFITS FOR OLATHE MEDICAL CENTER, INC. AND ITS AFFILIATES' OFFICERS.
SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANSCHEDULE J, PART I, LINE 4B & PART IIA SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IS PROVIDED TO FRANK H DEVOCELLE WHICH IS FUNDED OVER A SHORT TIME PERIOD BASED UPON THE IMPLEMENTATION DATE OF THE SERP IN 2005. MR. DEVOCELLE'S CAREER SERVICE AT OLATHE MEDICAL CENTER, INC. AND ITS AFFILIATED ENTITIES IS CURRENTLY AT 40 YEARS, MOST OF WHICH DID NOT INCLUDE FUNDING FOR THE SERP BENEFIT. A MAJORITY OF THE DEFERRED COMPENSATION IS DUE TO FUNDING OF THE SERP BENEFIT FOR PRIOR YEARS OF SERVICE. A SERP is also provided to Tierney L Grasser which is funded over a short time period based upon the implementation date of the SERP in 2005. Ms. Grasser's career service at Olathe Medical Center, Inc. and its affiliated entities is currently at 23 years, most of which did not include funding for the SERP benefit. A majority of the deferred compensation is due to funding of the SERP benefit for prior years of service. Certain physicians participate in a deferred compensation benefit plan. OFFICER SERP FRANK H DEVOCELLE $267,908 (AT LEAST 90% ATTRIBUTABLE TO UNDER FUNDING IN PRIOR YEARS) TIERNEY L GRASSER $ 68,226 (AT LEAST 85% ATTRIBUTABLE TO UNDER FUNDING IN PRIOR YEARS) RODNEY D CORN $ 4,134
COMPENSATION REPORTED IN PRIOR YEAR FORM 990SCHEDULE J, PART II, COLUMN FCOMPENSATION IS REPORTED ON THE FORM 990 IN THE YEAR THAT THE COMPENSATION IS EARNED BY OR AWARDED TO AN INDIVIDUAL, EVEN IF THE COMPENSATION IS NOT PAID TO THE INDIVIDUAL, IS NOT FULLY VESTED, OR IS SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. IF COMPENSATION IS EARNED OR AWARDED IN ONE YEAR BUT PAID IN A LATER YEAR, THEN THE COMPENSATION IS GENERALLY REPORTED A SECOND TIME ON THE FORM 990 IN THE YEAR THE COMPENSATION IS PAID TO THE INDIVIDUAL. AS A RESULT OF THE REPORTING REQUIREMENT, AN ORGANIZATION COULD BE REQUIRED TO REPORT THE SAME COMPENSATION AMOUNTS ON THE FORM 990 FOR TWO CONSECUTIVE YEARS. The amounts reported in column F: include incentive amounts and capital accumulation amounts which were reported in previous 990s as deferred compensation.
RETIREMENT AND OTHER DEFERRED COMPENSATIONSCHEDULE J, PART II, COLUMN CCOLUMN (C) REFLECTS SERP PAYMENTS (SEE ABOVE FOR FURTHER EXPLANATION) AND OTHER DEFERRED COMPENSATION. TOTAL SERP OTHER COLUMN C FRANK H DEVOCELLE $267,908 $ 21,429 $289,337 RODNEY D CORN 4,134 2,055 6,189 TIERNEY L GRASSER 68,226 16,662 84,888 GERALD WIESNER -0- 2,000 2,000

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1CITY OF OLATHE KANSASBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN486034756IssuerEIN
CUSIP Number679390GX6CUSIPNumber
Date Issued2008-02-27DateIssued
Issue Price5311403IssuePrice
Description Of PurposeSEE SCHEDULE ODescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired350000AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds5311403TotalProceeds
Amount In Reserve Fund0AmountInReserveFund
Capitalized Interest0CapitalizedInterest
Refunding Escrow0RefundingEscrow
Issuance Costs From Proceeds22312IssuanceCostsFromProceeds
Credit Enhancement0CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures0CapitalExpenditures
Other Spent Proceeds5289091OtherSpentProceeds
Amount Unspent0AmountUnspent
Year Of Subst Completion2008YearOfSubstCompletion
Current RefundingtrueCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Prcntge Prvt Business Use By Others0PrcntgePrvtBusinessUseByOthers
Post Issuance Compliance ProcdrstruePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuefalseVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatefalseExceptionToRebate
FieldValueIRS element (for citing)
Fed Tax Requirements ComplianceXFedTaxRequirementsCompliance

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 WITH INTERESTED PERSONSIdentifier
Return ReferenceSCHEDULE L, PART IVReturnReference
ExplanationTRANSACTION 1 (A) HEIDI HANSON (B) HEIDI HANSON IS THE DAUGHTER OF FRANK H DEVOCELLE, AN OFFICER OF MCMCI (C) $30,671 (D) HEIDI HANSON IS AN EMPLOYEE OF MCMCI (E) NOExplanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (19 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
PROGRAM SERVICE ACCOMPLISHMENTSFORM 990, PART III, LINE 4AMiami County Medical Center, Inc. operates an acute care hospital in Paola, Kansas. Miami County Medical Center, Inc. carries out its mission by providing quality and compassionate inpatient, outpatient, and emergency care services to residents in Miami County, Kansas and surrounding area. Miami County Medical Center, Inc. is a Joint Commission accredited hospital and is licensed for 39 beds and currently staffs 18 inpatient beds. Program services expenses are all related to the provision of healthcare services. In 2011, Miami County Medical Center, Inc. provided 1,213 days of inpatient care, provided 56,563 outpatient procedures, and 9,286 emergency visits to the community. Educational Support In addition to providing uncompensated care for patients in need, the Medical Center provides other health care related benefits to the communities it serves by providing 24-hour emergency rooms open every day to the public regardless of ability to pay. The Medical Center also provides education for a variety of medical professionals, health care screenings and education programs for the general public and support group sponsorships. Sports Net Miami County Medical Center provides Athletic Training staff for area high schools and junior high schools during the school year through its Sports Net program. In 2011, $68,750 of Athletic Trainer services was provided to the schools in the Medical Center's service area. Contributions Miami County Medical Center supports a variety of social, education, and civic healthcare related organizations within its service area. In 2011, $26,426 was contributed to various agencies and charitable organizations and $5,000 in scholarships.
BUSINESS RELATIONSHIPSFORM 990, PART VI, SECTION A, LINE 2FRANK H DEVOCELLE, RODNEY D CORN AND TIERNEY L GRASSER HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER. THEY SERVE AS AN OFFICER OR DIRECTOR FOR OLATHE HEALTH DEVELOPMENT CORPORATION, HEALTH ACCESS, INC. OR OLATHE MEDICAL CENTER DOCTOR'S BUILDING CONDOMINIUM OWNERS ASSOCIATION, WHICH ARE RELATED FOR PROFIT COMPANIES.
MEMBERFORM 990, PART VI, SECTION A, LINE 6OLATHE MEDICAL CENTER, INC., A NOT-FOR-PROFIT, 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF MIAMI COUNTY MEDICAL CENTER, INC.
MEMBER MAY ELECT GOVERNING BODYFORM 990, PART VI, SECTION A, LINE 7AOLATHE MEDICAL CENTER, INC. BEING THE SOLE MEMBER OF MIAMI COUNTY MEDICAL CENTER, INC. HAS THE RIGHT TO ELECT ALL THE BOARD OF TRUSTEES.
GOVERNING BODY DECISIONS SUBJECT TO APPROVAL OF MEMBERFORM 990, PART VI, SECTION A, LINE 7BOLATHE MEDICAL CENTER, INC. IS THE SOLE MEMBER, AND HAS THE RIGHTS TO APPROVE MIAMI COUNTY MEDICAL CENTER, INC.'S BYLAWS AND ARTICLES OF INCORPORATION AND ALSO APPROVE MIAMI COUNTY MEDICAL CENTER'S BOARD MEMBERS AND CERTAIN CAPITAL EXPENDITURES.
FORM 990 REVIEW PROCESSFORM 990, PART VI, SECTION B, LINE 11BThe tax return form 990 is reviewed by the Audit and compliance Committee of the Olathe Medical Center, Inc. (Miami County Medical Center's sole member) board on behalf of all of its affiliates prior to filing the return with the Internal Revenue Service. The Audit & Compliance Committee is comprised of independent Board members of Olathe Medical Center, Inc. The final form 990 with all required schedules is then provided to all board members for review prior to filing the form 990.
CONFLICT OF INTEREST POLICYFORM 990, PART VI, SECTION B, LINE 12CThe purpose of the Organization's Conflict of Interest Policy is to protect the organization's interest when it is contemplating a decision or entering into a transaction or arrangement that might benefit the private interest of any person in a position of authority over the organization, or might result in a possible excess benefit transaction. Corporate officers and members of the Board of Trustees review the Conflict of Interest Policy and complete a Disclosure of Information Form annually. A summary of the annual disclosures of information is provided to the full Board for review at least one time per year. The conflict of interest policy calls for any interested person to disclose the existence of a financial relationship or competitive interest in connection with any pending transaction or arrangement. The individual is given the opportunity to disclose all material facts to the Trustees considering the proposed transaction or arrangement that gave rise to the disclosure. When a transaction involves an interested party, the following procedures are followed: 1. The interested party leaves the meeting after providing any material facts or discussion regarding the matter that gives rise to the interest unless requested to stay by the remaining board or committee members. 2. If appropriate, the Board may appoint a non-interested person or committee to investigate alternatives to the proposed transaction; 3. The interested trustee may not vote in the matter that gives rise to the interest. 4. In order to approve the transaction, the Board must first find, by a majority vote of the trustees then in office, without counting the vote of the interested trustee, a. That the proposed transaction is in the Organization's best interests and for its own benefit, and b. That, after reasonable investigation, the board has determined that the organization cannot obtain a more advantageous transaction with reasonable efforts under the circumstances.
COMPENSATION REVIEWFORM 990, PART VI, SECTION B, LINES 15A & BThe compensation committee of the Olathe Medical Center, Inc. board, which is comprised of independent members of the board of Olathe Medical Center, Inc. and its affiliates, including a Miami County Medical Center, Inc. board member, reviews and approves the CEO and other officers and key employees of the corporation's compensation in accordance with their compensation policy. The compensation committee reviews third party salary surveys and also utilizes written contracts for the ceo to determine the fair market value of the current compensation, salary ranges and benefits. Compensation for such officers is approved by the committee and information of their findings is available to all board members at their request.
AVAILABILITY OF DOCUMENTSFORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC.
OTHER CHANGES IN NET ASSETSFORM 990, PART XI, LINE 5CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 613,175 NET ASSETS RELEASED- CAPITAL 9,765 UNREALIZED LOSS ON INVESTMENTS (840,008) CHANGE IN TEMPORARILY RESTRICTED NA (1,604) --------- TOTAL $(218,672)
BOND ISSUE PRICESCHEDULE K, PART I, LINE A, COLUMN ETHE ISSUE PRICE OF THE ENTIRE ISSUE IS $29,451,544. A PORTION OF THE ISSUE PRICE, EQUAL TO $24,140,141 IS ALLOCABLE TO OLATHE MEDICAL CENTER, INC. THE REMAINDER OF THE ISSUE PRICE, EQUAL TO $5,311,403, IS ALLOCABLE TO MIAMI COUNTY MEDICAL CENTER, INC., WHICH IS CONTROLLED BY OLATHE MEDICAL CENTER, INC., ITS SOLE MEMBER.
BOND DESCRIPTION OF PURPOSESCHEDULE K, PART I, LINE A, COLUMN FREFUND SERIES 2004A BONDS ISSUED 07/29/2004 AND REFUND SERIES 2004B BONDS ISSUED 07/29/2004.
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:JACK TINNEL TITLE:TRUSTEE/CHAIRPERSON HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:THOMAS J DAVIES TITLE:TRUSTEE RESIGNED 5/18/11 HOURS:4
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:CHIP WOOD TITLE:TRUSTEE HOURS:3
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:FRANK H DEVOCELLE TITLE:PRESIDENT/CEO HOURS:43
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:RODNEY D CORN TITLE:SR VP/OPS/RESIGNED 3/4/11 HOURS:43
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:TIERNEY L GRASSER TITLE:SENIOR VP/FINANCE HOURS:41
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:CHERYL L ROSS TITLE:ASSISTANT SECRETARY HOURS:43

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
OLATHE MEDICAL CENTER INC
20333 W 151ST STOLATHEKS66061480577664HOSPITALKS501(C)(3)3OHSIfalse
OLATHE HEALTH SYSTEM INC
20333 W 151ST STOLATHEKS66061480979845SUPPORT ORGKS501(C)(3)11BNAfalse
OLATHE MEDICAL SERVICES INC
20333 W 151ST STOLATHEKS66061481088982CLINICSKS501(C)(3)9OMCIfalse
OLATHE MEDICAL CENTER CHARITABLE FDN
20333 W 151ST STOLATHEKS66061481136010SUPPORT OMCIKS501(C)(3)7OMCIfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntity
HEALTH ACCESS INC
20333 W 151ST STOLATHEKS66061742855334HEALTH INSURANCEKSOMCIC CORPORATION
OMC DOCTOR'S BLDG CONDO OWNERS ASSOC INC
20333 W 151ST STOLATHEKS66061481244766REAL ESTATEKSOMCIC CORPORATION
OLATHE HEALTH DEVELOPMENT CORPORATION
20333 W 151ST STOLATHEKS66061363445097MEDICAL SERVICESKSOHSIC CORPORATION
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 AssetstrueExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg