GREAT PLAINS OF SABETHA INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- GREAT PLAINS OF SABETHA INC (EIN 48-1236156)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-15
- IRS object ID
- 201143199349301134
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-15T08:07:13-05:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1551 N WATERFRONT PKWY STE 300 | AddressLine1 |
| City | WICHITA | City |
| State | KS | State |
| ZIP Code | 672066601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 481236156 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREAT PLAINS OF SABETHA INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | GREA | NameControl |
| Phone | 7855432111 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 625 THIRD STREET | AddressLine1 |
| City | PHILLIPSBURG | City |
| State | KS | State |
| ZIP Code | 676612138 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DAVE DELLESAGE | Name |
| Title | CFO | Title |
| Phone | 3166851523 | Phone |
| Date Signed | 2011-11-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | STEVEN L WEBB | Name |
| Phone | 3162652811 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | ROGER JOHN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 625 THIRD STREET | AddressLine1 |
| City | PHILLIPSBURG | City |
| State | KS | State |
| ZIP Code | 67661 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 9565762 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.SABETHAHOSPITAL.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2000 | YearFormation |
| State Legal Domicile | KS | StateLegalDomicile |
| Activity Or Mission Description | ACUTE CARE HOSPITAL THAT PROVIDES MEDICAL CARE TO THE GENERAL PUBLIC IN SABETHA, KANSAS AND SURROUNDING RURAL COMMUNITIES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 139 | TotalNbrEmployees |
| Total Nbr Volunteers | 29 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 110872 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 122838 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 9098815 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 9292754 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 11539 | InvestmentIncomePriorYear |
| Investment Income Current Year | 10234 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 213360 | OtherRevenuePriorYear |
| Other Revenue Current Year | 122322 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 9434586 | TotalRevenuePriorYear |
| Total Revenue Current Year | 9548148 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 5659907 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5832855 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4244350 | OtherExpensePriorYear |
| Other Expenses Current Year | 4107919 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 9904257 | TotalExpensesPriorYear |
| Total Expenses Current Year | 9940774 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -469671 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -392626 | RevenuesLessExpensesCY |
| Total Assets BOY | 8285377 | TotalAssetsBOY |
| Total Assets EOY | 7779815 | TotalAssetsEOY |
| Total Liabilities BOY | 1331346 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1351904 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 6954031 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 6427911 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO OPERATE HOSPITAL FACILITIES FOR THE DELIVERY OF HOSPITAL AND RELATED HEALTH CARE SERVICES, HEALTH RELATED EDUCATION, AS WELL AS THE PROMOTION OF HEALTH AND WELLNESS, WITHOUT REGARD TO RACE, CREED, COLOR, SEX, OR FINANCIAL CIRCUMSTANCES. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 8525623 | Expense |
| Grants | 0 | Grants |
| Revenue | 9343322 | Revenue |
| Description | The hospital's primary function is the delivery of healthcare and wellness services to inpatients and outpatients in Nemaha County, specifically Sabetha and other surrounding communities. Inpatient care includes acute care, swing bed and intermediate swing bed. The hospital has had several major accomplishments during 2010. See Schedule O for continuation. | Description |
| Total Program Service Expense | 8525623 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | false | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 25 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 139 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | true | QuidProQuoContributions |
| Quid Pro Quo Disclosure | false | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DAVE DELLASEGA | NamePerson |
| Telephone Number | 3166851523 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 N ROCK RD STE 160 | AddressLine1 |
| City | WICHITA | City |
| State | KS | State |
| ZIP Code | 67206 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (18 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| STEVE CARLSON | |||||||
| CHAIRMAN/DIRECTOR | 0.25 | X | X | 0 | 0 | 0 | |
| ROGER JOHN | |||||||
| PRESIDENT/CEO/DIRECTOR | 2.0 | X | X | 0 | 111175 | 25792 | |
| BETH MEYERES | |||||||
| VICE PRESIDENT/DIRECTOR | 0.25 | X | X | 0 | 0 | 0 | |
| LOGAN SPRUNGER | |||||||
| VICE PRESIDENT/DIRECTOR | 0.25 | X | X | 0 | 0 | 0 | |
| ROBERT HAMILTON | |||||||
| SECREATRY/DIRECTOR | 0.25 | X | X | 0 | 0 | 0 | |
| THOMAS E KELLER DVM | |||||||
| TREASURER/DIRECTOR | 0.25 | X | X | 0 | 0 | 0 | |
| FERD DIETZ | |||||||
| DIRECTOR | 0.25 | X | 0 | 0 | 0 | ||
| HERBERT DOUBEK MD | |||||||
| DIRECTOR | 0.25 | X | 0 | 0 | 0 | ||
| DAVE RANKIN | |||||||
| DIRECTOR | 0.25 | X | 0 | 0 | 0 | ||
| CURTIS ERICKSON | |||||||
| DIRECTOR | 0.25 | X | 0 | 0 | 0 | ||
| JOHN TERRILL | |||||||
| DIRECTOR | 0.25 | X | 0 | 0 | 0 | ||
| DAVE DELLASEGA | |||||||
| CFO | 2.0 | X | 0 | 108220 | 17029 | ||
| LORA KEY | |||||||
| ADMINISTRATOR | 50.0 | X | 83419 | 0 | 22416 | ||
| KEVIN KENNALLY | |||||||
| PHYSICIAN | 40.0 | 259588 | 0 | 41286 | X | ||
| KERSTIN GLYNN | |||||||
| PHYSICIAN | 40.0 | 219204 | 0 | 35819 | X | ||
| JAMES LONGABAUGH | |||||||
| PHYSICIAN | 40.0 | 199570 | 0 | 27753 | X | ||
| CHRISTIAN TRAMP | |||||||
| PHYSICIAN | 40.0 | 163149 | 0 | 30899 | X | ||
| GREGG WENGER | |||||||
| PHYSICIAN | 40.0 | 162172 | 0 | 24710 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1087102 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 219395 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 225704 | TotalOtherCompensation |
| Number Individuals GT100 K | 5 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|
| STORMONT VAIL HEALTHCARE | |
| LAB SERVICES | 157523 |
| GREAT PLAINS HEALTH ALLIANCE | |
| MANAGEMENT SERVICES | 105430 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| Fundraising Events | 16752 | FundraisingEvents |
| Government Grants | 17075 | GovernmentGrants |
| All Other Contributions | 89011 | AllOtherContributions |
| Total Contributions | 122838 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE REVENUE | Description |
| Business Code | 621300 | BusinessCode |
| Total Revenue Column | 9292754 | TotalRevenueColumn |
| Related Or Exempt Function Income | 9292754 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 9292754 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 18886 | TotalRevenueColumn |
| Exclusion | $18,886 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 20700 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 20700 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 20700 | TotalRevenueColumn |
| Exclusion | $20,700 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 2649 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 11301 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -8652 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -8652 | TotalRevenueColumn |
| Exclusion | -$8,652 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 2175 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 16752 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 6313 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -4138 | TotalRevenueColumn |
| Exclusion | -$4,138 | ExclusionAmount |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| NONPATIENT MEALS | 722210 | 20270 | $20,270 | |
| OUTSIDE SERVICES | 621300 | 50568 | 50568 | |
| MISCELLANEOUS INCOME | 900099 | 34922 | $34,922 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 105760 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9548148 | TotalRevenueColumn |
| Related Or Exempt Function Income | 9343322 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $81,988 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 105835 | Total |
| Management And General | 105835 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4542780 | Total |
| Program Services | 4023675 | ProgramServices |
| Management And General | 519105 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 360037 | Total |
| Program Services | 310393 | ProgramServices |
| Management And General | 49644 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 517150 | Total |
| Program Services | 391317 | ProgramServices |
| Management And General | 125833 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 307053 | Total |
| Program Services | 263321 | ProgramServices |
| Management And General | 43732 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 90034 | Total |
| Management And General | 90034 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2195 | Total |
| Management And General | 2195 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27423 | Total |
| Management And General | 27423 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1176425 | Total |
| Program Services | 1030350 | ProgramServices |
| Management And General | 146075 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25863 | Total |
| Program Services | 11368 | ProgramServices |
| Management And General | 14495 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 948019 | Total |
| Program Services | 896630 | ProgramServices |
| Management And General | 51389 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 243818 | Total |
| Program Services | 230919 | ProgramServices |
| Management And General | 12899 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8812 | Total |
| Program Services | 5991 | ProgramServices |
| Management And General | 2821 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37612 | Total |
| Program Services | 28334 | ProgramServices |
| Management And General | 9278 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13663 | Total |
| Program Services | 12575 | ProgramServices |
| Management And General | 1088 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 562821 | Total |
| Program Services | 514916 | ProgramServices |
| Management And General | 47905 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 144974 | Total |
| Program Services | 39770 | ProgramServices |
| Management And General | 105204 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| RENTAL EQUIPMENT & REPAIRS | 471537 | 445109 | 26428 |
| BAD DEBT EXPENSE | 233777 | 233777 | |
| LICENSES & TAXES | 30566 | 24574 | 5992 |
| DUES & SUBSCRIPTIONS | 37987 | 19626 | 18361 |
| UNCOLLECTIBLE CONTRIBUTIONS | 24800 | 24800 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27593 | Total |
| Program Services | 18178 | ProgramServices |
| Management And General | 9415 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9940774 | Total |
| Program Services | 8525623 | ProgramServices |
| Management And General | 1415151 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 220 | BOY |
| EOY | 220 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1405712 | BOY |
| EOY | 931724 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40537 | BOY |
| EOY | 14208 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1233154 | BOY |
| EOY | 1278063 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 191886 | BOY |
| EOY | 211757 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 88280 | BOY |
| EOY | 128765 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 11857317 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 6946654 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5082929 | BOY |
| EOY | 4910663 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 242659 | BOY |
| EOY | 219415 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 85000 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8285377 | BOY |
| EOY | 7779815 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1207342 | BOY |
| EOY | 947266 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 124004 | BOY |
| EOY | 404638 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1331346 | BOY |
| EOY | 1351904 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6913494 | BOY |
| EOY | 6413703 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40537 | BOY |
| EOY | 14208 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6954031 | BOY |
| EOY | 6427911 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8285377 | BOY |
| EOY | 7779815 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -392626 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -133494 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
| Contrib By Controlling Individual | false | ContribByControllingIndividual |
| Contribution By Related Party | false | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | false | ContribBy35ControlledEntity |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | true | GrantsOtherOrganizations |
| Grants Other Organizations | $2,079 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 2079 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 35244 | OtherCostOrOtherBasis |
| Book Value | 35244 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6397928 | OtherCostOrOtherBasis |
| Depreciation | 2904313 | Depreciation |
| Book Value | 3493615 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5238026 | OtherCostOrOtherBasis |
| Depreciation | 3903354 | Depreciation |
| Book Value | 1334672 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 186119 | OtherCostOrOtherBasis |
| Depreciation | 138987 | Depreciation |
| Book Value | 47132 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 4910663 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
| Total Of Amounts | 0 | TotalOfAmounts |
| Total Revenue | 9548148 | TotalRevenue |
| Total Expenses | 9940774 | TotalExpenses |
| Excess Or Deficit For Year | -392626 | ExcessOrDeficitForYear |
| Other | -$133,494 | OtherAmount |
| Total Adjustments | -133494 | TotalAdjustments |
| Excess Or Deficit Per FS | -526120 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 9585967 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 37819 | OtherRevenues |
| Revenue Not Rptd F990 | 37819 | RevenueNotRptdF990 |
| Revenue Subtotal | 9548148 | RevenueSubtotal |
| Total Revenue Per Form990 | 9548148 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 10112087 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 171313 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 171313 | ExpensesNotRptdF990 |
| Expenses Subtotal | 9940774 | ExpensesSubtotal |
| Total Expenses Per Form990 | 9940774 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| UNCERTAIN TAX POSITIONS | SCHEDULE D, PART X, LINE 2 | MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| RECONCILIATION OF CHANGE IN NET ASSETS | SCHEDULE D, PART XI, LINE 8 | OTHER CHANGES IN NET ASSETS: EQUITY IN EARNINGS SABETHA HEALTHCARE, INC. 31,506 TRANSFER TO CITY OF SABETHA (165,000) ---------- $ (133,494) |
| RECONCILIATION OF REVENUE | SCHEDULE D, PART XII, LINE 2D | EQUITY IN EARNINGS SABETHA HEALTHCARE, INC. 31,506 SPECIAL EVENT EXPENSES 6,313 --------- $ 37,819 |
| RECONCILIATION OF EXPENSES | SCHEDULE D, PART XIII, LINE 2D | TRANSFER TO CITY OF SABETHA 165,000 SPECIAL EVENT EXPENSES 6,313 --------- $ 171,313 |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF TOURNAMENT | NameOfEvent1 |
| Gross Receipts Event1 | 18927 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 16752 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 2175 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 6313 | OtherDirectExpensesEvent1 |
| Total Number Of Other Events | 0 | TotalNumberOfOtherEvents |
| Gross Receipts Total | 18927 | GrossReceiptsTotal |
| Charitable Contributions Total | 16752 | CharitableContributionsTotal |
| Gross Revenue Total Events | 2175 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 6313 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 6313 | DirectExpenseSummaryEvents |
| Net Income Summary | -4138 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | false | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 47961 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 47961 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00480 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 143452 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 143452 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01450 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 191413 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 191413 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01930 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 272337 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 180034 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 92303 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00930 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7181 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 7181 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 279518 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 180034 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 99484 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01000 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 470931 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 180034 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 290897 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02930 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $183,679 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 2580217 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 2580217 | CostOfCareReimbursedByMedicare |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SABETHA COMMUNITY HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14TH OREGON PO BOX 229 | AddressLine1 |
| City | SABETHA | City |
| State | KS | State |
| ZIP Code | 66534 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SABETHA COMMUNITY HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part VI Form990ScheduleHPartVI (9 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| SCHEDULE H, PART I, LINE 7, COLUMN F | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $233,777. | |
| SCHEDULE H, PART I, LINE 7 | THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART I, LINE 7, OF SCHEDULE H, IS A COST TO CHARGE RATIO. | |
| BAD DEBT EXPENSE | No separate bad debt expense disclosure. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluation and specific circumstances of the account. Disclosures on provision for doubtful account are related to disclosures regarding the allowance for doubtful accounts which is set for all non-Medicare accounts receivable over 150 days old. The provision for doubtful accounts is a separate expense on the statement of operations and changes in net assets. Hospital charges that are not collected and are not approved for financial assistance as classified as bad debts from patients who will not pay. Bad debts are a service to the community because many people cannot pay, but will not submit a charity care application due to the negative implications within the community. | SCHEDULE H, PART III, LINE 4 |
| COLLECTION PRACTICES | ALL CHARITY CARE CHARGES AND CHARGES NOT TO BE COLLECTED DUE TO FINANCIAL ASSISTANCE COMPUTATIONS ARE EXEMPTED FROM COLLECTION POLICIES AND PRACTICES. THOSE ACCOUNTS ARE REMOVED FROM THE COLLECTION CYCLE. | SCHEDULE H, PART III, LINE 9B |
| NEEDS ASSESSMENT | In 2009, Sabetha Community Hospital developed a three year strategic plan. The goals established through the strategic plan process continue to be reviewed on a regular basis by the Hospital Board of Directors. Community perceptions of the hospital were determined based on two focus groups, interviews of community leaders, health care providers, Board members and the five family physicians located in Sabetha and hospital department directors. As a result of this strategic plan several nutritional sessions and obstetrical classes were provided to the community. The Board of Directors is kept informed of regulatory and industry changes as the Board meets monthly. Results from patient satisfaction surveys are reviewed on regular intervals in order that hospital staff can identify issues which need to be addressed. The Hospital plans on conducting a community needs assessment in 2012 bringing in community leaders from local industry, city officials, schools, local consumers, and community health. | SCHEDULE H, PART VI, LINE 2 |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | The Financial Assistance Program employs a sliding scale discount that takes into consideration a patients household income and qualifying assets. The Financial Counselor consults with private pay patients to see if they qualify for the Hospitals financial assistance policy. It is posted in both the hospital and clinic lobbies that financial assistance is available and directs patients to the Financial Counselor at the Hospital for information to apply. If discovered during the accounts receivable collection process that a patient is having trouble paying bills, both the hospital and the clinic will inform the patient that financial assistance is available. As part of the financial assistance program all applicants must apply for Medicaid. To determine if the patient may qualify for financial assistance, the financial counselor gives the patient forms to complete and requests bank statements, tax returns, etc. Computations based on current Federal Poverty Level Guidelines are completed to see if qualifications is appropriate and the percentage of charges to be written off is determined, based on family size and household income. All instances of financial assistance are approved by upper management of the Hospital. Information about Financial Assistance is posted on the hospital website and the Financial Assistance form can be downloaded from www.sabethahospital.com | SCHEDULE H, PART VI, LINE 3 |
| COMMUNITY INFORMATION | Sabetha Community Hospital is a 25 bed Critical Access Hospital located in the city of Sabetha, Nemaha County Kansas. Currently the population is estimated at 2800. According to data collected during the strategic planning process, the primary service area for Sabetha Community Hospital includes portions of Nemaha and Brown Counties with Nemaha County providing 79% of all inpatients and Sabetha zip code alone contributing 69%. Nebraska and a few other counties provide a growing portion of the hospitals patient base. Brown and Nemaha counties account for 20,269 persons according to the 2007 U.S. Census estimate. In 2007, 92.5% of the the two-county population was white, 4.2% Native American, 2.1% Hispanic and 1.2% African-American. The 65 and older age group accounted for 19.5% of the population in 2007. | SCHEDULE H, PART VI, LINE 4 |
| PROMOTION OF COMMUNITY HEALTH | The hospital provides and promotes the health of the citizens of Sabetha and the surrounding region by providing the following services. The hospital offers diabetic consultations with a registered dietician. First grade students are invited to attend an annual hospital tour guiding them through various departments of the hospital. The hospital Guild members volunteer to coordinate efforts to hold bloodmobile clinics. During the flu season flu clinics are offered at the hospital, and hospital staff conducts flu clinics at the local grocery store as well as onsite flu vaccinations for several local businesses. Hospital staff provides CPR training for professionals in the area. The hospital provides prenatal classes including CPR training on a quarterly basis. Hospital staff travels to surrounding communities to provide free blood pressure clinics. Sabetha Community Hospital implemented the Healthy U program, an educational class for the community to discuss healthy eating and exercise. Two of these courses were held in 2010. These sessions won the Community Connection award from the State Hospital Association. Cardiac Rehab Phase III is open to the community to offer support in an exercise program, especially for those patients who have graduated from the Cardiac Rehab program. Social Services aids those in the community who are in need of enrollment assistance, whether it be for Medicaid, Medicare Part D services, or other information referral assistance. The hospital also provides Lifeline to the senior population in the region. One of the hospital physicians sits as the Medical Director for the city owned ambulance service. The Chief Executive Officer of Sabetha Community Hospital serves on the board of Kansas Health Service Corporation Workers Compensation Fund, the Kansas Hospital Associations Policy and Advocacy committee and the Health Innovations Network of Kansas strategic planning committee. The Wellness Coordinator of the hospital sits on the Wellness Council for the local school district. Sabetha Community Hospital coordinated with community leaders to sponsor Twelve Minutes to Live. Twelve Minutes to Live, held on April 30, 2010 was a disaster preparedness drill which provided vital training not only for hospital staff in case of a mass casualty disaster but to those in the community who would be affected by such an event. Hot Drills are run which include members of the local EMS, Fire Department, County response system and Public Health Department. The hospital annually sponsors the Sabetha Firecracker 5k Run/Walk. A learning avenue for nursing students is provided through the hospital affiliation with Highland Community College, medical students in the rural residency program at Kansas University Medical School are able to follow the family physicians, physical therapy students through affiliation with Kansas City Kansas Community College and Indian Hills Community College, and occupational therapy students through Washburn University affiliation all do clinical rotations. Hospital Administration works closely with the High School counselor in the administration of local scholarships to nursing students and to those who are going into a healthcare career. | SCHEDULE H, PART VI, LINE 5 |
| AFFILIATED HEALTH CARE SYSTEM | The organization is affiliated with Great Plains Health Alliance, Inc. (GPHA), a non-profit 501(c)(3) organization, which provides management services and operational, financial and accounting support to the Hospital. GPHA does not provide services directly to patients, but does provide access to professionals that may not be affordable to the normal critical access hospital. GPHA provides education and assistance in areas such as HIPAA, Medicare reimbursement, meaningful use requirements for computer systems, etc. GPHA is an affiliation of Critical Access hospitals in Kansas and Nebraska that provides networking opportunities with other rural hospitals, communities and leaders. GPHA provides policies and guidance to its Critical Access facilities regarding financial assistance, conflicts of interest, corporate compliance and many other areas. GPHA also provides educational sessions for Board Members, Business Office Managers, Billers, Medical Records personnel, Director of Nursing and Administrators. GPHA is a vital link in allowing critical access hospitals to operate at a high quality within the cash constraints imposed by the Critical Access program. | SCHEDULE H, PART VI, LINE 6 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEVIN KENNALLY | |||||||||||||
| 259588 | 0 | 0 | 0 | 0 | 0 | 24561 | 0 | 16725 | 0 | 300874 | 0 | 0 | 0 |
| KERSTIN GLYNN | |||||||||||||
| 219204 | 0 | 0 | 0 | 0 | 0 | 21120 | 0 | 14699 | 0 | 255023 | 0 | 0 | 0 |
| JAMES LONGABAUGH | |||||||||||||
| 199570 | 0 | 0 | 0 | 0 | 0 | 19157 | 0 | 8596 | 0 | 227323 | 0 | 0 | 0 |
| CHRISTIAN TRAMP | |||||||||||||
| 163149 | 0 | 0 | 0 | 0 | 0 | 15427 | 0 | 15472 | 0 | 194048 | 0 | 0 | 0 |
| GREGG WENGER | |||||||||||||
| 162172 | 0 | 0 | 0 | 0 | 0 | 15340 | 0 | 9370 | 0 | 186882 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | COMPENSATION FROM A RELATED ORGANIZATION | Identifier |
| Return Reference | FORM 990, PART VII; SCHEDULE J, PART I, LINE 3 | ReturnReference |
| Explanation | COMPENSATION FOR ROGER JOHN AND DAVE DELLASEGA IS PROVIDED BY GREAT PLAINS HEALTH ALLIANCE, A RELATED ORGANIZATION. GREAT PLAINS HEALTH ALLIANCE'S BOARD OF DIRECTORS ANNUALLY APPROVE THE COMPENSATION FOR MR. JOHN AND MR. DELLASEGA. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (22 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| PROGRAM SERVICE ACCOMPLISHMENTS | FORM 990, PART III, LINE 4 | Hospital staff spent many hours training for disaster preparedness through the transition from its mass casualty plan to the Emergency Operations Plan. Recognizing the need to assist patients and their families facing advanced or end-of-life illnesses, August 1, 2010, Sabetha Community Hospital began to provide palliative care to our patients. In October, hospital staff had a dress down day to raise funds for Kansas Dialysis Services. Multiple pieces to the electronic medical record have been added throughout 2010 with the installation of order entry, nursing documentation and others. In an effort to provide a centralized location for staff to access policies which affect how they function, the hospital began to utilize PolicyTech software to maintain departmental policies. As information technology continues to be a vital part of the healthcare industry, the hospital looks to expand the avenues utilized to provide education to staff as well as patients. Sabetha Community Hospital was able to obtain ITV equipment. Carpet was replaced in the outpatient office as well as the entry way to the portion of the hospital which houses cardiac rehabilitation, Nemaha County Home Health and Hospice, outpatient clinics, Occupational Assessment Services, administration, human resources, and medical records. |
| ATTACHMENT OF AUDITED FINANCIAL STATEMENTS | FORM 990, PART IV, LINE 20B | PER THE IRS' FORM 990 INSTRUCTIONS, AN ORGANIZATION OPERATING ONE OR MORE HOSPITALS AT ANY TIME DURING THE YEAR MUST ATTACH A COPY OF ITS AUDITED FINANCIAL STATEMENTS TO THE TAX RETURN IF ITS TAX YEAR BEGAN AFTER MARCH 23, 2010. THE AUDITED FINANCIAL STATEMENTS OF GREAT PLAINS OF SABETHA, INC. ARE NOT ATTACHED BECAUSE ITS TAX YEAR BEGAN ON JANUARY 1, 2010. |
| MEMBERS | FORM 990, PART VI, SECTION A, LINE 6 | GREAT PLAINS HEALTH ALLIANCE, INC., A NOT-FOR-PROFIT, 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF GREAT PLAINS OF SABETHA, INC. |
| MEMBERS MAY ELECT GOVERNING BODY | FORM 990, PART VI, SECTION A, LINE 7A | GREAT PLAINS HEALTH ALLIANCE, INC., BEING THE SOLE MEMBER, HAS THE RIGHT TO ELECT AND APPROVE ALL THE BOARD MEMBERS. |
| GOVERNING BODY DECISIONS SUBJECT TO APPROVAL OF MEMBERS | FORM 990, PART VI, SECTION A, LINE 7B | GREAT PLAINS HEALTH ALLIANCE, INC. (GPHA) IS THE SOLE MEMBER AND HAS THE AUTHORITY TO APPROVE THE ARTICLES OF INCORPORATION, BYLAWS, ELECTION TO OR REMOVAL FROM THE BOARD OF DIRECTORS, THE ANNUAL OPERATING AND CAPITAL BUDGETS, AND THE LONG RANGE OR STRATEGIC PLANS. |
| FORM 990 REVIEW PROCESS | FORM 990, PART VI, SECTION B, LINE 11B | THE 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE 990 IS THEN PROVIDED TO THE CHIEF FINANCIAL OFFICER FOR REVIEW AND APPROVAL. AN ELECTRONIC DRAFT OF THE 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO THE FULL BOARD FOR REIVEW PRIOR TO FILING THE 990 WITH THE IRS. |
| CONFLICT OF INTEREST POLICY | FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION IS REQUIRED TO ADOPT GPHA'S CONFLICT OF INTEREST POLICY. ALL BOARD MEMBERS, OFFICERS AND EMPLOYEES ARE SUBJECT TO THE CONFLICT OF INTEREST POLICY AND SIGN AN ANNUAL ACKNOWLEDGEMENT THAT THEY HAVE READ, UNDERSTAND AND COMPLIED WITH THE GPHA CONFLICT OF INTEREST POLICY. UNDER THE POLICY, ANY MEMBER WHO HAS A DIRECT OR INDIRECT (VIA FAMILY) FINANCIAL INTEREST IS CHARACTERIZED AS AN INTERESTED PERSON. INTERSTED PERSONS ARE REQUIRED TO DISCLOSE FINANCIAL INTERESTS WITH COMPANIES DOING BUSINESS WITH GPHA. THE INTERESTED PERSON MUST RECUSE THEMSELVES FROM FURTHER DISCUSSIONS OF THE TRANSACTION AND LEAVE THE ROOM. THE REMAINING NON-INTERESTED MEMBERS DECIDE IF A CONFLICT OF INTEREST EXISTS. THE BOARD CHAIR MAY APPOINT ANOTHER DISINTERESTED PARTY TO DISCUSS THE TRANSACTION OR THE REMAINING BOARD MEMBERS MAY VOTE TO ENTER INTO OR ABSTAIN FROM THE SUSPECT TRANSACTION. FAILURE TO DISCLOSE FINANCIAL INTERESTS BY INTERESTED BOARD MEMBERS WILL RESULT IN DISCIPLIARY ACTION, INCLUDING SACTIONING BY BOARD. ALL CONFLICTS OF INTEREST AND THEIR ULTIMATE RESOLUTION ARE DOCUMENTED IN THE BOARD MINUTES. THE BOARD CONDUCTS PERIODIC REVIEWS TO DETERMINE THAT CONFLICTS ARE BEING IDENTIFIED AND RESOLVED ACCORDING TO POLICY DOCUMENTATION. REVIEWS BY OUTSIDE EXPERTS ARE PERMITTED, BUT NOT REQUIRED. |
| COMPENSATION REVIEW | FORM 990, PART VI, SECTION B, LINES 15A & B | THERE IS NO FORMAL REVIEW BY INDEPENDENT SOURCES, BUT THE ORGANIZATION'S BUDGET AND THE GPHA BUDGET IS APPROVED BY THE BOARD. AS A HISTORICAL PRACTICE, RAISES OF THE PRESIDENT/CEO AND CHIEF FINANCIAL OFFICER ARE LIMITED TO $3,000 ANNUALLY SINCE THESE INDIVIDUALS EACH EARN OVER $100,000 ANNUALLY. |
| AVAILABILITY OF DOCUMENTS | FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE COMPANY'S KANSAS ANNUAL REPORT IS ALSO AVAILABLE UPON REQUEST FROM THE KANSAS SECRETARY OF STATE. |
| OTHER CHANGES IN NET ASSETS | FORM 990, PART XI, LINE 5 | EQUITY IN EARNINGS SABETHA HEALTHCARE, INC. 31,506 TRANSFER TO CITY OF SABETHA (165,000) ---------- $ (133,494) |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:STEVE CARLSON TITLE:CHAIRMAN/DIRECTOR HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:ROGER JOHN TITLE:PRESIDENT/CEO/DIRECTOR HOURS:48 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:BETH MEYERES TITLE:VICE PRESIDENT/DIRECTOR HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:LOGAN SPRUNGER TITLE:VICE PRESIDENT/DIRECTOR HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:ROBERT HAMILTON TITLE:SECREATRY/DIRECTOR HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:THOMAS E. KELLER, D.V.M. TITLE:TREASURER/DIRECTOR HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:FERD DIETZ TITLE:DIRECTOR HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:HERBERT DOUBEK, M.D. TITLE:DIRECTOR HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:DAVE RANKIN TITLE:DIRECTOR HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:CURTIS ERICKSON TITLE:DIRECTOR HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JOHN TERRILL TITLE:DIRECTOR HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:DAVE DELLASEGA TITLE:CFO HOURS:44 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| GREAT PLAINS HEALTH ALLIANCE INC | |||||||||
| 625 THIRD STREET | PHILLIPSBURG | KS | 67661 | 480617739 | MANAGEMENT | KS | 501(C)(3) | 3 | NA |
| GREAT PLAINS HEALTH CARE FOUNDATION INC | |||||||||
| 625 THIRD STREET | PHILLIPSBURG | KS | 67661 | 480955870 | SUPPORT | KS | 501(C)(3) | 9 | GPHA INC |
| GREAT PLAINS OF ELLINWOOD INC | |||||||||
| 625 THIRD STREET | PHILLIPSBURG | KS | 67661 | 481226976 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC |
| GREAT PLAINS OF KIOWA COUNTY INC | |||||||||
| 625 THIRD STREET | PHILLIPSBURG | KS | 67661 | 481226833 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC |
| GREAT PLAINS OF OTTAWA COUNTY INC | |||||||||
| 625 THIRD STREET | PHILLIPSBURG | KS | 67661 | 481226856 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC |
| GREAT PLAINS OF PHILLIPS COUNTY INC | |||||||||
| 625 THIRD STREET | PHILLIPSBURG | KS | 67661 | 481226829 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC |
| GREAT PLAINS OF CHEYENNE COUNTY INC | |||||||||
| 625 THIRD STREET | PHILLIPSBURG | KS | 67661 | 481226831 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC |
| GREAT PLAINS OF REPUBLIC COUNTY INC | |||||||||
| 625 THIRD STREET | PHILLIPSBURG | KS | 67661 | 481226977 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC |
| GREAT PLAINS OF SMITH COUNTY INC | |||||||||
| 625 THIRD STREET | PHILLIPSBURG | KS | 67661 | 481226830 | HOSPITAL | KS | 501(C)(3) | 3 | GPHA INC |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |