2026-05-08T11:45:17-05:00 2025-06-30 481026809 Wendling Noe Nelson & Johnson LLC 623 SW 10th Ave Suite 300 Topeka KS 66612 990 2024-07-01 481253246 Pawnee Valley Community Hospital Inc PAWN 6202853161 923 Carroll Ave Larned KS 67550 Shae Veach President 6202853161 2026-05-07 1 0 Eric L Otting P00298454 7852334226 2026-05-07 2024 2025-03-06 01:10:19Z Shae Veach 923 Carroll Ave Larned KS 67550 22224026 0 X www.pawneevalleyhospital.com X 2001 KS Pawnee Valley Community Hospital, Inc. is a tax-exempt charitable organization under Section 501(c)(3) of the Internal Revenue Code and is licensed by the State of Kansas Department of Health and Environment. The purpose of the Organization is to improve the quality of life for the communities we serve through exceptional healthcare and service excellence. The Organization is striving to be the best Critical Access Hospital in rural America. 6 2 163 104 0 0 46479 162630 19767423 21733650 54684 145147 172045 182599 20040631 22224026 12402 4369 0 0 9974477 10172789 0 0 86241 9650333 9822209 19637212 19999367 403419 2224659 13833734 14200279 11222055 11925527 2611679 2274752 X Pawnee Valley Community Hospital, Inc. is a tax-exempt charitable organization under Section 501(c)(3) of the Internal Revenue Code and is licensed by the State of Kansas Department of Health and Environment. The purpose of the Organization is to provide healthcare facilities and services for the care and treatment of inpatients and outpatients who are acutely ill or who otherwise require medical care and related services. The core purpose of the Corporation is to improve the quality of life for the communities we serve through exceptional healthcare and service excellence. 0 0 17797607 4369 21743550 Patient care: Program services consist of routine and ancillary department healthcare services provided by a healthcare organization as described in 501(c)(3) of the IRS code. 17797607 1 1 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 1 163 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 2 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Michelle Beckner 7856232350 2220 Canterbury Drive Hays KS 67601 Shae Veach President 4.00 36.00 X X 0 277582 89309 John Haas Vice President 0.50 X X 0 0 0 Michelle Beckner Treasurer 4.00 36.00 X X 0 366538 103465 Sarah Johnson Director 0.50 X 0 0 0 Edward Herrman Secretary 4.00 36.00 X X 0 815354 178177 Terry Siek Director thru. 09/24 4.00 36.00 X 0 270074 50056 Joben Rieth Director Eff. 03/25 4.00 36.00 X 0 0 0 Melanie Urban Administrator 40.00 X 0 161871 42312 Angela Beck APRN 40.00 X 151703 0 18395 Susan Aistrup APRN 40.00 X 135753 0 16395 Arlo Reimer Chief of Staff 40.00 X 297706 0 47354 Dusty Atterbury APRN 40.00 X 157519 0 9523 Calvin Kruger Physician Assistant 40.00 X 156478 0 8959 George Harms Former Treasurer 0.00 X 0 593894 0 899159 2485313 563945 11 1 1 0 Hays Medical Center 2220 Canterbury Drive Hays KS 67601 Contract Services 3019336 Qualivis LLC PO Box 123847 Dallas TX 752674913 Contract Labor 437826 G E Precision Healthcare LLC PO Box 96483 Chicago IL 60693 Website Services 249608 Quest Diagnostics PO Box 772976 Chicago IL 606770276 Lab Fees 158770 Luminare Health Benefits 6133 N River Road Rosemont IL 60018 TPA Fees 131148 7 150000 12630 162630 Patient service revenue 622000 20890033 20890033 340b drug program 456110 769254 769254 Lab fairs 900099 29391 29391 44972 44972 21733650 138497 138497 9900 0 9900 9900 9900 6650 0 6650 6650 6650 Meals sold to employees and guest 722513 172699 172699 172699 22224026 21743550 0 317846 X 4369 4369 205358 205358 7942333 7469438 416172 56723 340718 321601 16706 2411 1094695 1029330 57649 7716 589685 542805 42811 4069 2000000 1841000 145200 13800 10530 10530 80302 80302 5564 5564 2477451 2108650 368801 154051 154051 118071 22415 95655 1 594712 445538 149174 389105 292334 95681 1090 22060 14917 7137 6 51582 43252 8329 1 128220 114302 13918 Pharmaceuticals 1892245 1892245 0 0 Medical supplies 704723 704723 0 0 Repairs & Maintenance 586783 528992 57427 364 Food & Dietary Supplies 218624 174858 43766 0 388186 246838 141288 60 19999367 17797607 2115519 86241 1319613 1154546 6353675 7011300 2752373 2555754 475819 488488 164987 306264 2767267 2683927 13833734 14200279 1534032 1475287 150000 0 9538023 10450240 11222055 11925527 X 2611679 2274752 2611679 2274752 13833734 14200279 X 2224659 -2561586 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 5564 0 0 0 5564 0 Part II-B, Line 1: Pawnee Valley Community Hospital is a member of the Kansas Hospital Association and the American Hospital Association. Both of these organizations engage in lobbying activities for hospitals and health care as part of the services provided to members. 1808292 -360606 1447686 2030752 -222460 1808292 1827260 203492 2030752 1624536 202724 1827260 1450099 174437 1624536 0.69480 0.30520 0 1 1 0 Beneficial interest in net assets of foundation 2274752 Receivable from related party 494 Other receivables 163681 Estimated third-party payor settlements 245000 2683927 Due to Pawnee County 9777913 Due to Hays Medical Center, Inc. 672327 10450240 X 22037099 -186927 -186927 22224026 0 22224026 19999367 0 19999367 0 19999367 Part V, Line 4: Donations are requested for specific items or improvements to the Hospital. When a donation is received for a purpose, it is restricted for that use by the Board until the specific purpose has been met. Part X, Line 2: Management is not aware of any uncertain tax positions. Part XI, Line 2d - Other Adjustments: Change in beneficial interest in net assets of Foundation 1 1 X 1 X 130.000000000000 1 X 1 1 0 0 23438 23438 0.00120 1235964 850408 385556 0.01930 1259402 850408 408994 0.02050 183 183 0.00000 2902734 2409721 493013 0.02470 4369 4369 0.00020 2907286 2409721 497565 0.02490 4166688 3260129 906559 0.04540 1 664882 10392703 10608225 -215522 X 1 1 1 1 Pawnee Valley Community Hospital Inc 923 Carroll Avenue Larned KS 67550 X X X X Pawnee Valley Community Hospital Inc 1 0 0 1 X X X X X X X X X 23 1 0 1 1 X https://pawneevalleyhospital.com/wp-content/uploads/2024/06/CHNA_2024_Pawne X http://www.pawneecountykansas.com/ X 1 23 1 https://pawneevalleyhospital.com/wp-content/uploads/2024/07/CHNA2024_ImpDet 0 1 X 130.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X https://pawneevalleyhospital.com/billing/#financial-assistance-policy X https://pawneevalleyhospital.com/billing/#financial-assistance-policy X X X X 1 X 0 X X X X 1 X 0 0 Pawnee Valley Community Hospital, Inc. Part V, Section B, Line 5: The CHNA was conducted in collaboration with the Pawnee County Health Department. A Town Hall meeting was conducted in February 2024 to provide an objective consensus building method of reviewing and prioritizing county health issues. During the Town Hall meeting, the group reflected on the size and seriousness of any health concerns cited and discussed current community health strengths. The group identified and ranked top community health concerns, and all Town Hall attendees were encouraged to continue to contribute ideas by going online and taking a feedback survey that addresses any additional thoughts related to the CHNA. All Town Hall priority-setting and score processes involved the input of a diverse group with knowledge and/or expertise in public health as well as persons who represent the broad interests of the community served by the hospital. Key stakeholders in attendance included Larned State Hospital, Country Living of Larned, The Center for Counseling & Consulation, Heart of Kansas Family Health Care, Larned Police Department, Pawnee County Sheriff's office, Pawnee County Health Department, County Commissioners, members of the Chamber of Commerce, members of the USD 495 School Board, local members of the media, local religious organizations, local business owners, and representatives of Pawnee Valley Community Hospital. The CHNA was coordinated and produced by VVV Research & Development, Inc. from Olathe, Kansas. Pawnee Valley Community Hospital, Inc. Part V, Section B, Line 6b: Pawnee County, KS Pawnee Valley Community Hospital, Inc. Part V, Section B, Line 11: Pawnee Valley Community Hospital, Inc. (PVCH) conducted its fifth Community Health Needs Assessment (CHNA) along with the Pawnee County Health Department in 2024. The Hospital and County Health Department will work with others in the community to address the needs that were identified in the survey. The needs that received the most votes are listed below.Substance Abuse (Drugs & Alcohol) - 16.3%Mental Health (Diagnosis, Placement, Aftercare, Access to Providers) - 14.0%Childcare (Accessible & Affordable) - 11.6%Provide Youth Activities - 8.5%Physician Recruitment (Primary Care-MD's, DO's) - 7.8%Health Education (Chronic/Prevention) - 6.2%Obesity (Exercise & Nutrition) - 5.4%Physical Activities for Adults - 5.4%Visiting Specialists (Onc, Ortho, CV, OBGYN, ENT, NEP, DERM) - 5.4%The Town Hall meeting also noted the Community's Health Strengths, which are listed below.Three family medicine clinicsEMT, Fire Dept and Hospital have strong collaborationThriving hospitalAccess to recreation and exerciseOpioids dispense is minimalQuality Health DepartmentBi-annual health fairQuality and affordable long-term careChildcare committee - improving childcareSeveral internet providers/strong connectionAvailable mental health/crisis servicesSchool programs for parent involvement and educationCommunity involvementState Hospital offers continuing educationOn the 2024 CHNA Implementation Plan, it is noted that several areas are not part of hospital mission critical operations and that PVCH will be a partner with others to address these needs. These needs and the lead partner are listed below.Substance Abuse (Drugs & Alcohol) - Center for Counseling and Pawnee County Health DepartmentMental Health (Diagnosis, Placement, Aftercare, Access to Providers) - Center for Counseling and Pawnee County Health DepartmentChildcare (Accessible & Affordable) - Pawnee County Childcare CoalitionProvide Youth Activities - Pawnee Co Youth Initiative Foundation/Larned Rec CenterPhysical Activities for Adults - Pawnee Co Youth Initiative Foundation/Larned Rec CenterThe remaining CHNA Health Areas of Need will be addressed with PVCH as the lead partner. Updates to the progress are outlined below.Physician Recruitment (Primary Care-MD's, DO's) and Visiting Specialists (Oncology, Ortho, Cardiovascular, OBGYN, ENT, Nephrology, Dermatology) - Heart of Kansas recruited a family medicine physician to work at the Larned, KS clinic.Pawnee Valley Community Hospital recruited a Board-Certified Emergency Medicine Physician to replace the resigning Emergency Department Medical Director.The Pawnee Valley Community Family Medicine Clinic family medicine physician is engaged with the Kansas Osteopathic Medicine School to receive a medical student for rotation during 2025-2026 school year.Family medicine physician at Healthy Choice Clinic engaged with the Kansas Osteopathic Medicine School and received a medical student during the 2024-2025 school year. Rotation included Pawnee Valley Community Hospital.Added additional Specialty Care Clinic days for Cardiology Nurse Practitioner from HaysMed DeBakey Heart Institute.Pawnee Valley Community hospital is actively engaged in conversations and work to add the following additional specialty care services: Psychiatric Mental Health Nurse Practitioner Rheumatology Telehealth ServicesThe Pawnee Valley Community Family Medicine Clinic family medicine physician is partnered with the HaysMed Center Women's Health to provide an obstetrical shared care model. Health Education (Chronic/Prevention) - Pawnee Valley Community Hospital Family Medicine clinic implemented and is growing a Chronic Care Management Program with ChartSpan.Pawnee Valley Community Hospital engaged and trained a Pawnee Valley Community Hospital Family Medicine clinic family medicine nurse practitioner to teach Chronic Care Management classes quarterly.Pawnee Valley Community Hospital provided education on occupational therapy services and benefits via newspaper and social media to the community in addition to the Occupational Therapist attending civic group meetings to provide the education.Pawnee Valley Community Hospital initiated a vaccine campaign educating the community on vaccines and the important role they play in health prevention and public health.Pawnee Valley Community Hospital Family Medicine clinic initiated a women's health campaign which included obesity/weight loss services for women (education, medication treatment, exercise regimens, etc.)Pawnee County Health Department provides: One-on-one teaching in the office as needed Educated clients on chronic disease issues Health information via: Facebook, Digital sign, Bulletin boards, Pamphlets (inside and outside office), County resource list (posted on webpage) Bulletin board topics included: Breast Cancer Awareness, Diabetes Awareness, World Breastfeeding Week, Dental Health, Mental Health Preparedness education is offered multiple times per yearObesity (Exercise & Nutrition) Pawnee Valley Community Hospital Family Medicine clinic initiated a women's health campaign, which included obesity/weight loss services for women (education, medication treatment, exercise regimens, etc.) Pawnee Valley Community Hospital sponsors an annual 6th Grade Health Fair.Visiting Specialists Added additional Specialty Care Clinic days for Pulmonology Nurse Practitioner from HaysMed Pulmonology Clinic. Added additional Specialty Care Clinic days for Cardiology Nurse Practitioner from HaysMed DeBakey Heart Institute. Pawnee Valley Community Hospital is actively engaged in conversations and works to add the following additional specialty care services: Psychiatric Mental Health Nurse Practitioner Rheumatology Telehealth Services The Pawnee Valley Community Family Medicine Clinic family medicine physician is partnered with the HaysMed Center Women's Health to provide an obstetrical shared care model. The following CHNA Health Areas of Need in which PVCH assisted. Updates to the progress are outlined below.Childcare (Accessible & Affordable) Pawnee Valley Community Hospital Administrator partnered with the Pawnee County Chamber and Economic Development to form a Pawnee County Childcare Coalition. Pawnee Valley Community Hospital Administrator chaired the committee. Grants were received to offset supplies for current day care providers and assist new providers. Pawnee Valley Church opened a new day care facility. Organized a Child Care Provider Appreciation Day (May) and delivered thank-you gifts to current providers. Provide Youth ActivitiesPawnee Co Youth Initiative Foundation was created and ran with this project. Pawnee Valley Community Hospital Administrator is a member of this Foundation. Activities include: Cops and Bobbers (June), Free Movie Night, Touch-a-Truck education booth, Root Beer Float socials at Pawnee Heights (twice), Secured grant funding for spring programming, Task force includes multiple youth stakeholdersPhysical Activities for AdultsPawnee Valley Community Hospital supports and partners with the Pawnee County Health Department.Pawnee County Health Department provides: Promotion of exercise opportunities in Pawnee County through: Health fairs, County Fair, One-on-one Counseling Incorporation of physical activity education into HD, WIC, FP, KBH programs Presentations at Pawnee Valley Community Hospital 6th Grade Health Fair and Ag DaySubstance AbusePawnee Valley Community Hospital partnered with local school districts to provide Narcan. Includes policy, education, and a coordinated plan.Mental HealthPawnee Valley Community Hospital is in discussions with the Center for Counseling and Consultation to build mental health services at Pawnee Valley Community Hospital. Pawnee Valley Community Hospital Administrator is an active member of the Larned State Hospital Advisory Committee. Pawnee Valley Community Hospital is actively recruiting for a mental health provider. Pawnee Valley Community Hospital, Inc. Part V, Section B, Line 13h: The balance of the patient account is also considered. 1 1 - Pawnee Valley Hospital Family Medicine 713 W 11th St Larned KS 67550 Family Medicine Part I, Line 7: A cost-to-charge ratio derived from Worksheet 2 was used to determine financial assistance at cost and the cost of subsidized health services. A cost-to-charge ratio derived from Worksheet 2 was used to determine the costs of serving Medicaid beneficiaries.Part I, Line 7g:Subsidized health services community benefit expenses include $1,855,758 of expenses attributable to physician clinics that have net operating losses. Part III, Line 4: See Note B (pages 8-11) of the hospital's financial statements for a description of how the hospital calculated bad debt expensePart III Line 2:Costing methodology: A cost-to-charge ratio derived from Worksheet 2 was used to calculate bad debt expense at cost. Part III, Line 8: The Medicare cost report was the costing methodology used to determine the allowable Medicare costs pertaining to Medicare net revenue. Allowable costs of care reported on line 6 were determined using amounts from Worksheet D, Part V and Worksheet D-1 in the Pawnee Valley Community Hospital, Inc., Medicare cost report for fiscal year ended June 30, 2025. Part III, Line 9b: Whenever possible, the customer service representatives (CSR's) of Pawnee Valley Community Hospital try to determine the estimated self-pay balance prior to the patient receiving services. Charity care eligibility may be considered at this point in time. The patient will receive statements that include instructions on how to obtain a FAP application. If the patient contacts the CSR, the CSR will mail a FAP application upon request or direct the patient to the website to print one and request that the charity care application be completed by the patient. Part VI, Line 3: Information regarding the Pawnee Valley Community Hospital, Inc. charity care program is located on the Pawnee Valley Community Hospital and Hays Medical Center, Inc. website for patients and community members to view, and the financial assistance application is also on the HMC website to print off and complete. In addition, if a customer service representative contacts a patient about a bill and in visiting with them they determine that patient could possibly qualify for the hospital's charity care policy, the CSR will send the application to the patient as well. Part VI, Line 4: Pawnee Valley Community Hospital, Inc. is located in Larned, Kansas, a town in Pawnee County, Kansas, which has a population of approximately 6,300 people, as of the 2020 census. The median household income of Pawnee County was $63,625. Approximately 12.8% of the total population was below the poverty line. Approximately 6.5% of the hospital's revenue is from services provided to patients eligible for Medicaid. Pawnee Valley Community Hospital, Inc. is the only hospital in Larned, Kansas. It mainly serves the communities in Pawnee County, Kansas. Part VI, Line 5: Pawnee Valley Community Hospital, Inc. promotes the health of the community by extending medical privileges to most qualified, local physicians. Part VI, Line 6: Pawnee Valley Community Hospital, Inc. is not part of an affiliated health care system. 1 1 0 0 0 0 0 0 0 Edward Herrman Secretary 0 687816 0 124775 0 2763 0 140966 0 37211 0 993531 0 0 George Harms Former Treasurer 0 0 0 0 0 593894 0 0 0 0 0 593894 0 373414 Michelle Beckner Treasurer 0 319655 0 46345 0 538 0 67038 0 36427 0 470003 0 0 Shae Veach President 0 241144 0 35544 0 894 0 56961 0 32348 0 366891 0 0 Arlo Reimer Chief of Staff 262291 0 19250 0 16165 0 14969 0 32385 0 345060 0 0 0 Terry Siek Director thru. 09/24 0 166407 0 33470 0 70197 0 41179 0 8877 0 320130 0 0 Melanie Urban Administrator 0 161307 0 0 0 564 0 8535 0 33777 0 204183 0 0 Angela Beck APRN 144965 0 0 0 6738 0 7691 0 10704 0 170098 0 0 0 Dusty Atterbury APRN 152927 0 0 0 4592 0 7878 0 1645 0 167042 0 0 0 Calvin Kruger Physician Assistant 153156 0 0 0 3322 0 7801 0 1158 0 165437 0 0 0 Susan Aistrup APRN 133005 0 0 0 2748 0 6749 0 9646 0 152148 0 0 0 Part I, Line 3 A related organization uses a compensation committee, independent compensation consultant, written employment contract, and approval by the board or compensation committee to establish the compensation of the Hospital's Administrator. Part I, Lines 4a-b Severance payments received: Terry Siek - $50,880 Contributions to the plan: Edward Herrman - $123,716 Michelle Beckner - $49,788 Shae Veach - $42,721 Terry Siek - $30,207 Distributions from the plan: George Harms - $593,894 Form 990, Part VI, Section A, line 6 The organization has one member, HaysMed Partners, Inc., which became the sole member as of March 1, 2010. HaysMed Partners, Inc., is a wholly-owned subsidiary of Hays Medical Center, Inc. Form 990, Part VI, Section A, line 7a The Board members of HaysMed Partners, Inc., the sole member of Pawnee Valley Community Hospital, appoint the Board members of Pawnee Valley Community Hospital, Inc. Form 990, Part VI, Section A, line 7b HaysMed Partners, Inc., the sole member of Pawnee Valley Community Hospital, elects the Board members of Pawnee Valley Community Hospital. Form 990, Part VI, Section B, line 11b The Form 990 is prepared and reviewed by an independent accounting firm. It is then reviewed by the organization's officers and accounting personnel. Their questions and concerns are addressed and either corrected or clarified in the Form 990. The final Form 990 is then provided to the board for review prior to filing. Form 990, Part VI, Section B, line 12c Officers, directors and key employees, along with all associates, are required to complete a conflict of interest statement annually. The statements are reviewed by the Board, the Compliance Officer and Governance Director as well. When conflict of interest issues arise during a Board meeting, the board members with the conflict are asked to remove themselves from discussion or from the room entirely. They are not allowed to vote on that particular issue. Form 990, Part VI, Section B, line 15 The hospital administrator and officers' salaries are reviewed annually by an independent consulting group and the Board members. They base the review on salary comparisons obtained by the consulting group from peer hospitals in similiar geographic regions. The last review was conducted in February 2025. Form 990, Part VI, Section C, line 19 These documents are not made available to the public. Form 990, Part IX, line 11g Contract labor: Program service expenses 639,743. Management and general expenses 0. Fundraising expenses 0. Total expenses 639,743. Medical provider fees: Program service expenses 229,830. Management and general expenses 0. Fundraising expenses 0. Total expenses 229,830. Laboratory services: Program service expenses 151,667. Management and general expenses 5,871. Fundraising expenses 0. Total expenses 157,538. Recruiting fees: Program service expenses 0. Management and general expenses 4,805. Fundraising expenses 0. Total expenses 4,805. Other non-provider medical professional fees: Program service expenses 335,221. Management and general expenses 12. Fundraising expenses 0. Total expenses 335,233. Collection and billing fees: Program service expenses 3,940. Management and general expenses 110,571. Fundraising expenses 0. Total expenses 114,511. Other purchased services: Program service expenses 748,249. Management and general expenses 247,542. Fundraising expenses 0. Total expenses 995,791. Form 990, Part XI, line 9: Change in beneficial interest in net assets of foundation -186,927. Transfers to Pawnee County -2,374,659. Form 990. Part XII, Line 2c Hays Medical Center, Inc. has a Compliance committee that is responsible for the oversight of Pawnee Valley Community Hospital, Inc.'s financial statement audit and the selection process of an independent auditor. HaysMed Partners Inc (HMed) 2220 Canterbury Dr Hays KS 67601 270877152 Management contract for Pawnee Valley Community Hospital KS 501(c)(3) Line 3 Hays Medical Center Inc 1 Hays Medical Center Inc 2220 Canterbury Dr Hays KS 67601 480559088 Hospital KS 501(c)(3) Line 3 0 Pawnee Valley Community Hospital Foundation 923 Carroll Ave Larned KS 67550 455333776 Support the activities and mission of the Hospital KS 501(c)(3) Line 12a Pawnee Valley Community Hospital 1 0 0 1 0 1 0 0 0 0 0 1 0 1 0 1 1 1 0 0 Pawnee Valley Community Hospital Foundation O 73295 FMV Pawnee Valley Community Hospital Foundation O 150000 Amount Paid