Civic Intelligence

Great Plains of Kiowa Co Inc

EIN 48-1226833 • 501(c)3 • Wichita, KS

Profile

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 circumstance.

250 North Rock Road Ste 160Wichita, KS 67206

www.kcmh.net

Siviq Scores

Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.

Liabilities / Assets

Score unavailable

No value available

Liabilities-to-assets requires both liabilities and assets on the latest valid filing.

Source year 2020

Liabilities / Revenue

7th percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

501(c)3 • $10M-$25M nonprofits • Source year 2020

Net Margin

46th percentile

2.9%

Higher net margin than 46% of similar nonprofits.

501(c)3 • $10M-$25M nonprofits • Source year 2020

Top Officer Pay

89th percentile

$445,921

Higher top officer pay than 89% of similar nonprofits.

Top officer pay equals 4.4% of source-year revenue.

501(c)3 • $10M-$25M nonprofits • Source year 2020

Asset Growth

1st percentile

-100%

Faster asset growth than 1% of similar nonprofits.

501(c)3 • $10M-$25M nonprofits • Annualized from 2019 to 2020

Revenue Growth

73rd percentile

23%

Faster revenue growth than 73% of similar nonprofits.

501(c)3 • $10M-$25M nonprofits • Annualized from 2019 to 2020

Assets

Down

$0

Down $11,875,718 (-100%) from 2019

Liabilities

Down

$0

Down $2,293,850 (-100%) from 2019

Net Assets

Down

$0

Down $9,581,868 (-100%) from 2019

Revenue

Up

$10,050,366

Up $1,897,451 (+23%) from 2019

Expenses

Up

$9,757,450

Up $346,410 (+3.7%) from 2019

Net Income

Up

$292,916

Up $1,551,041 (+123%) from 2019

Trend Graphs

Balance Sheet Trend

Grouped bars show assets, liabilities, and net assets across loaded filings.

$30M$20M$10M$0Assets 2010: $24,492,665Liabilities 2010: $4,602,000Net Assets 2010: $19,890,6652010Assets 2011: $23,593,369Liabilities 2011: $4,510,385Net Assets 2011: $19,082,9842011Assets 2012: $21,814,986Liabilities 2012: $2,625,996Net Assets 2012: $19,188,9902012Assets 2013: $20,079,422Liabilities 2013: $2,646,377Net Assets 2013: $17,433,0452013Assets 2014: $18,512,930Liabilities 2014: $2,633,838Net Assets 2014: $15,879,0922014Assets 2015: $17,393,183Liabilities 2015: $2,725,688Net Assets 2015: $14,667,4952015Assets 2016: $15,934,010Liabilities 2016: $2,386,046Net Assets 2016: $13,547,9642016Assets 2017: $14,794,539Liabilities 2017: $2,525,283Net Assets 2017: $12,269,2562017Assets 2018: $13,165,742Liabilities 2018: $2,325,749Net Assets 2018: $10,839,9932018Assets 2019: $11,875,718Liabilities 2019: $2,293,850Net Assets 2019: $9,581,8682019Assets 2020: $0Liabilities 2020: $0Net Assets 2020: $02020

Highlighted filing

2020

Assets$0
Liabilities$0
Net Assets$0

Operations Trend

Revenue, expenses, and net income by year, with the latest filing highlighted.

$15M$10M$5.0M$0-$5.0MExpenses 2010: $7,243,0822010Expenses 2011: $8,079,8842011Expenses 2012: $7,847,8502012Revenue 2013: $6,162,529Expenses 2013: $7,918,474Net Income 2013: -$1,755,9452013Revenue 2014: $6,773,117Expenses 2014: $8,327,070Net Income 2014: -$1,553,9532014Revenue 2015: $7,051,956Expenses 2015: $8,263,553Net Income 2015: -$1,211,5972015Revenue 2016: $7,521,587Expenses 2016: $8,641,118Net Income 2016: -$1,119,5312016Revenue 2017: $7,901,882Expenses 2017: $9,180,590Net Income 2017: -$1,278,7082017Revenue 2018: $7,652,468Expenses 2018: $9,081,731Net Income 2018: -$1,429,2632018Revenue 2019: $8,152,915Expenses 2019: $9,411,040Net Income 2019: -$1,258,1252019Revenue 2020: $10,050,366Expenses 2020: $9,757,450Net Income 2020: $292,9162020

Highlighted filing

2020

Revenue$10,050,366
Expenses$9,757,450
Net Income$292,916

Filings

Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jan 1, 2020 to Dec 31, 2020
Signed
Nov 15, 2021
Return Version
2020v4.1
Gross Receipts
$10,050,366
Mission and Program Overview

Mission

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 circumstance.

SEE SCHEDULE O

Balance Sheet Detail
LineBeginningEndChange
Assets
Land, Buildings, and Equipment, Net$9,505,314$0▼ $9,505,314
Accounts Receivable$958,383$0▼ $958,383
Savings and Temporary Cash Investments$719,078$0▼ $719,078
Inventories for Sale or Use$188,326$0▼ $188,326
Prepaid Expenses and Deferred Charges$101,185$0▼ $101,185
Cash and Non-Interest-Bearing Accounts$11,115$0▼ $11,115
Other Notes and Loans Receivable, Net$0$0→ $0
Pledges and Grants Receivable$0$0→ $0
Receivable From Disqualified Prsn$0$0→ $0
Receivables From Officers Etc$0$0→ $0
Investments Other Securities$0$0→ $0
Investments Program Related$0$0→ $0
Investments in Publicly Traded Securities$0$0→ $0
Intangible Assets$0$0→ $0
Loans From Officers Directors$0$0→ $0
Total Assets$11,875,718$0▼ $11,875,718
Other Assets Total$392,317$0▼ $392,317
Liabilities
Tax Exempt Bond Liabilities$1,553,455$0▼ $1,553,455
Accounts Payable and Accrued Expenses$733,249$0▼ $733,249
Mortgage Notes Payable Secured by Investment Property$7,146$0▼ $7,146
Grants Payable$0$0→ $0
Unsecured Notes Loans Payable$0$0→ $0
Other Liabilities$0$0→ $0
Deferred Revenue$0$0→ $0
Escrow Account Liability$0$0→ $0
Total Liabilities$2,293,850$0▼ $2,293,850
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$9,581,868$0▼ $9,581,868
Net Assets With Donor Restrictions$0$0→ $0
Total Net Assets Fund Balance$9,581,868$0▼ $9,581,868
Total Liabilities and Net Assets / Fund Balance$11,875,718$0▼ $11,875,718
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseOtherTotal
Nizar KibarPhysicianFT$390,135$55,786$445,921
Richard MeadorPhysicianFT$321,101$33,356$354,457
Kelsey HottPhysician AssistantFT$234,394$32,366$266,760
Mary SweetAdministratorFT$170,828$20,694$191,522
Tanya YoderPhysical TherapistFT$121,022$38,487$159,509
Felecia MinyardDirector of NursingFT$103,751$9,184$112,935

Board Members and Trustees

NameTitle
Dave RankinChairman/director
Dave DellasegaPresident/CEO/secretary
John TerrillVice President/director
Arthur HenricksonDirector
Charles WestinDirector
Dr Barbara Brown ApplegateDirector
Robert HamiltonSecretary/director
Steve CarlsonTreasurer/director
Durrel KelleySenior VP of Operations

Highest Paid Contractors

ContractorServicesLocationCompensation
GphaManagement250 NORTH ROCK ROAD STE 160, Wichita, KS 67206$765,817
All StaffStaffing Agency1704 K96 HIGHWAY, Great Bend, KS 67530$384,721
Josh MoulinContract: Pa10265 WEST RIDGE RD, Holton, KS 66436$142,035
Revenue and Support

Revenue Composition

Contributions and Grants
$2,969,074
Program Service Revenue
$7,008,634
Investment Income
$8,703
Other Revenue
$63,955
All Other Contributions
$199,382
Change in Net Assets
$292,916

Audited Revenue Reconciliation

Revenue per Audited Statements
$9,876,872
Revenue Not Reported on Financial Statements
$173,494
Other Revenue Adjustments
$173,494
Total Revenue per Audited Statements
$9,876,872
Total Revenue per Form 990
$10,050,366
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$5,052,114
Other Expenses$4,705,336
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$2,912,814$968,966-$3,881,780
Fees for Services Other$1,220,428$294,453$0$1,514,881
Depreciation Depletion$927,074$183,219-$1,110,293
Other Employee Benefits$313,063$104,254-$417,317
Occupancy$283,676$70,248-$353,924
Office Expenses$249,015$58,746-$307,761
Pension Plan Contributions$256,274$37,906-$294,180
Payroll Taxes$224,095$43,220-$267,315
Current Officers, Directors, Trustees, and Key Employees-$191,522-$191,522
Fees for Services Management-$135,152-$135,152
Insurance$65,098$9,324-$74,422
All Other Expenses$19,730$43,135-$62,865
Interest$52,703$10,076-$62,779
Fees for Services Accounting-$59,323-$59,323
Other Expenses$8,954$14,959-$23,913
Conferences and Meetings$11,305$1,550-$12,855
Advertising$870$1,479-$2,349
Travel$904$773-$1,677
Fees for Services Lobbying-$1,299-$1,299
Fees for Services Legal-$1,013-$1,013
Total Functional Expenses$7,440,783$2,316,667$0$9,757,450

Audited Expense Reconciliation

Line ItemAmount
Total Expenses per Form 990$9,757,450
Expenses per Audited Statements$9,583,956
Total Expenses per Audited Statements$9,583,956
Expenses Not Reported on Financial Statements$173,494
Other Expense Adjustments$173,494
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Direct Expenses$0
Fundraising Gross Income$0
Gaming Direct Expenses$0
Gaming Gross Income$0
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
Yes
Subject to proxy tax
No
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Loans from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Receivables from Disqualified Persons$0$0→ $0
Receivables from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Debt and Bond Financing

Bond Issues

BondIssuerIssuedIssue PricePurpose
AKiowa County Kansas2010-01-15$2,130,200Construct, equip, & furnish hospit

Bond Proceeds

BondTotal ProceedsSpentRetiredIssuance Costs
A$2,133,553$0$626,036$2,993

Bond Financing Compliance

No rebate due
Yes
Form 8038-T filed
No
Gross proceeds invested
No
Gross proceeds invested in GIC
No
Corrective action procedures
Yes
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Backup withholding compliance
Yes
Business relationship with 35% controlled entity
No
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
No
Other officer compensation reviewed
No
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
Yes
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, Line 2

Dave dellasega and durrel kelley have a business relationship. They are both employed by, and also officers of, a related 501(c)(3) organization, great plains health alliance. 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 kiowa county, inc.

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.

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, 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 executive officer for review and approval. An electronic draft of the 990 with all required schedules is then provided to the full board for review prior to filing the 990 with the irs.

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. Interested 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 disciplinary action, including sanctioning 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.

Form 990, Part VI, Section B, Lines 15A & B

The ceo and coo are compensated by great plains health alliance, a related organization. Gpha's board uses comparability data in setting their salaries, and documentation is retained of the board's deliberations and decisions

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. Form 990, part xi, line 9 effective 12/31/2020, all of the assets, liabilities and activites of great plains of kiowa co., inc. Were transferred to kiowa county memorial hospital. The net amount of assets & liabilities transferred are $9,874,784

Filing and Contact Details

Filer

Filer Name
Great Plains of Kiowa Co Inc
EIN
48-1226833
In Care Of
% DAVE DELLASEGA
Phone
3166851523
Address
250 NORTH ROCK ROAD STE 160, WICHITA, KS 67206

Signing Officer

Name
Dave Dellasega
Title
CEO and President
Phone
3166851523
Signed
2021-11-15
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Dave Dellasega
Formed
1999
Legal Domicile
Ks
Voting Board Members
8
Independent Board Members
7
Employees
103
Volunteers
10

Preparer

Firm
Bkd Llp
Address
1551 N WATERFRONT PKWY STE 300, WICHITA, KS 67206-6601
Preparer
Shawnell Linot
Phone
3162652811
Supplemental Narrative

Additional Explanations

Form 990, Part I, Line 1

OPERATE HOSPITAL FACILITIES FOR THE DELIVERY OF HOSPITAL AND RELATED HEALTH CARE SERVICES, EDUATION, AND THE PROMOTION OF HEALTH AND WELLNESS TO THE CITIZENS OF GREENSBURG AND KIOWA COUNTY. FORM 990, PART III, LINE 3 EFFECTIVE 12/31/2020, ALL OF THE PROGRAM SERVICES FOR GREAT PLAINS OF KIOWA CO., INC. WILL BE TRANSFERRED TO KIOWA COUNTY MEMORIAL HOSPITAL (KCMH), UNDER A MANAGEMENT AGREEMENT WITH PRATT REGIONAL MEDICAL CENTER. THEREFORE, ALL PROGRAM SERVICES FOR GREAT PLAINS OF KIOWA CO., INC. WILL CEASE UPON TRANSFER. FORM 990, PART III, LINE 4A Care is provided in the areas of neurology, cardiac, dental and eye services. This specialty clinic offered services 155 days in 2020. We manage two rural health clinics and offer a sliding scale to those who cannot afford health care. We accept all Kansas Medicaid insurance. We manage the local ambulance service and manage staff and supplies to make that service affordable in a small rural community. Our hospital offers 24 hour Emergency Room, emergency X-ray, CT services and lab services, and inpatient care. We offer Physical Therapy Monday - Fri, 8:00 a.m. - 5:00 p.m. We offer mammography, MRIs, dexa and ultrasound exams on a scheduled basis. As requested by community members, we also became a provider of VA care and offer on-site DOT physicals. We also provided drug testing for companies that require it for their employees. We offered financial assistance for hospital and rural health clinic services in 2020 - write offs totaled $34,943.92. We participate in the 340B program with our local retail pharmacy. We implemented and began participating in a cost saving 340B program in 2015. With some of the funds from this program we started two community assist program - sponsoring employees up to 4 hours per month volunteering at a nonprofit of their choice and offering prescription financial assistance. In 2020, we had 96 hours of volunteer community hours for an estimated cost of $1,652.00. In addition to that we were able to offer a program at our local pharmacy where we can provide financial assistance for prescriptions. The total amount of that assistance was $456.80. Other than the County Health Department, we offer the only health care services in Kiowa County. The one assisted living entity in the County, closed and KCMH has begun to offer more Swing Bed intermediate beds to local residents on a short term basis so they can remain in their homes as long as possible. We work closely with Hospice agencies so that Hospice patients can remain in our community as well, for end of life services. Mental health has its own residential home in the community. Our Hospital employed Medical Staff director is also the medical director of the Kiowa County Health Department. He works as a consultant with them. We also assist in the Health Department's family planning, by offering their clients pap smears in conjunction with the family planning. We also work with the Health Department by helping to staffing their annual Health Fair with volunteers from our staff for both phlebotomy and clerical services. Due to the COVID-19 Pandemic, the Kiowa County Health Fair was cancelled, we will offer volunteer staff when the Health Fair is held next. The Kiowa County Health Department and Kiowa County Memorial Hospital do our Community Health Assessment jointly. The last one done was in 2018, and a new one will be done in 2021. We work closely with the Health Department and local Emergency Preparedness to make sure that our community is protected and safe. We participate in the local LEPC meetings, as well as in regional Emergency Preparedness meetings. KCMH worked with the local school and college to offer sports physicals at reduced costs to help ensure quality sports safety. KCMH also supports the local SHICK program volunteer. The SCHICK program allows many of our patients, access to needed medications and also information on insurance programs. We support the program by providing computers, printers,

Form 990 Part IX Line 11G

Description:contracted medical staff total fees:821128

Form 990 Part IX Line 11G

Description:billing/collections total fees:224140

Form 990 Part IX Line 11G

Description:lab services total fees:147341

Form 990 Part IX Line 11G

Description:pharmacy services total fees:166166

Form 990 Part IX Line 11G

Description:administration/human resources total fees:41199

Form 990 Part IX Line 11G

Description:maintenance/housekeeping total fees:316

Form 990 Part IX Line 11G

Description:plant operations total fees:112874

Form 990 Part IX Line 11G

Description:dietary services total fees:1717

Financial Statement Notes

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.

Schedule D, Part XI, Line 4B

BAD DEBT EXPENSE 173,494

Schedule D, Part XII, Line 4B

BAD DEBT EXPENSE 173,494

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IRS990/Desc0Kiowa County Memorial Hospital has the mission and primary function to deliver quality, compassionate health care to the population that we serve. When we cannot meet their needs - ie: cardiac, surgical, intensive care, OB needs, etc., we facilitate their entry into a health system that will meet those needs. Kiowa County Memorial Hospital manages the local county ambulance service via contract, to ensure that medical transfer is always available. To further their care, we also have a specialty clinic area, where specialists come to offer consulting and follow-up care. SEE SCHEDULE O FOR CONTINUATION.
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