2023-10-24T08:56:36-05:00 2022-12-31 481026809 Wendling Noe Nelson & Johnson LLC 623 SW 10th Ave Suite 300 Topeka KS 66612 990 2022-01-01 481178846 Coffeyville Regional Medical Center Inc COFF 6202511200 1400 W 4th Street Coffeyville KS 67337 BRIAN LAWRENCE CEO 6202511200 2023-10-20 1 BRIAN LAWRENCE 999009999 0 Eric L Otting P00298454 7852334226 2023-10-20 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Brian Lawrence 1400 W 4th Street Coffeyville KS 67337 43800038 0 X http://crmcinc.org/ X 1996 KS Medical care and services by an acute care hospital. 7 6 435 37 0 0 10718546 3534886 44488393 39903766 120482 155140 1512209 206246 56839630 43800038 6649 7727 0 0 27880718 29423941 0 0 58493 24692920 23509103 52580287 52940771 4259343 -9140733 34899870 25595451 8459469 8741922 26440401 16853529 To promote general health and well being through the development, promotion, improvement, and support of all forms of health care services in Coffeyville, Kansas and the surrounding area. 0 0 47958052 7727 39903766 Coffeyville Regional Medical Center operates an acute care hospital located in southeast Kansas. We provide inpatient, outpatient, urgent and emergent care, and physician services to all patients regardless of race, creed, sex, national origin, sexual preference, or ability to pay. 47958052 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 1 0 0 0 1 46 0 1 435 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 6 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 0 0 X Jeffrey Morris 6202511200 1400 W 4th Coffeyville KS 67337 Neal Barkley Director 2.00 X 0 0 0 Monte Coffman Chairman 2.00 X X 0 0 0 Debbie Carter Secretary/Treasurer 2.00 X X 0 0 0 Jeff Morris Director 2.00 X 0 0 0 Craig Correll Director 2.00 X 0 0 0 Mike Ewy Vice-Chair 2.00 X X 0 0 0 Dr Garrick Rettele Director 2.00 X 0 0 0 Brian Lawrence CEO 40.00 X 266762 0 51519 Dale Guffey CFO 40.00 X 164743 0 29384 Michelle McGuirk Physician 40.00 X 463232 0 34942 Sunil Menon Physician 40.00 X 518086 0 38487 William Tinker Physician 40.00 X 380402 0 31221 Baba Abudu Anesthesiologist 40.00 X 442139 0 42084 Perry Yung Ping Lin Physician 40.00 X 386625 0 54993 2621989 0 282630 37 0 1 0 Green Country Emergency Physician 1145 S Utica 365 Tulsa OK 74104 ER Coverage 1418346 Regional Medical Laboratory 4142 South Mingo Road Tulsa OK 74146 Lab services 634458 Spinal Neurosurgical Associates 6921 E 109th St S Tulsa OK 74133 Physician services 527468 Nathan W Uy MD 7624 South Kingston Place Tulsa OK 74136 Physician services 383911 Quality Care LLC 16074 US Highway 59 Altamont KS 67330 Physician services 328930 15 392606 3136680 5600 245318 3534886 Net patient service revenue 621110 39271019 39271019 340b Pharmacy 456110 265183 265183 Ambulance services 621910 225318 225318 Education, wellness, and miscella 900099 132748 132748 Other patient related services 621110 9498 9498 39903766 155140 155140 39825 0 39825 39825 39825 Cafeteria and dietary income 722310 166421 166421 166421 43800038 39903766 0 361386 X 7727 7727 545749 545749 21889850 20618877 1243530 27443 1907963 1804128 101885 1950 3537958 3298077 235996 3885 1542421 1427048 113831 1542 83929 83929 118154 118154 125857 125857 9511929 8183784 1318238 9907 103496 103496 154988 72319 81914 755 25245 21842 3221 182 714915 576794 136763 1358 87021 80040 6981 7053 4948 2105 40158 40158 3015115 2645669 365391 4055 599951 519077 76554 4320 Pharmacy drugs 3963893 3963893 Medical supplies 3469610 3467705 0 1905 Medicaid provider asses 651698 651698 Miscellaneous 284380 90644 192835 901 551711 483624 67797 290 52940771 47958052 4924226 58493 3883727 718338 6057162 2824992 4848419 3664285 1424827 1595048 744280 448152 60713273 47479655 15212889 13233618 2728566 3111018 34899870 25595451 5376141 7968028 1904882 985083 321680 193363 452214 8459469 8741922 X 23756666 14598447 2683735 2255082 26440401 16853529 34899870 25595451 X -9140733 -446139 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 2726 0 0 0 2726 0 Part II-B, Line 1: Coffeyville Regional Medical Center, Inc. is a member of the Kansas Hospital Association and American Hospital Association. These organizations engage in lobbying activities for hospital and general health care interests as part of the services provided to members. 400668 10883 10883 400668 400668 62314 62314 400668 370668 30000 17809 17809 400668 370668 22011 22011 370668 370668 28901 28901 370668 1.00000 0 1 1 137016 137016 24483122 18162449 6320673 24158647 18855943 5302704 11934488 10461263 1473225 13233618 Other receivables 177554 Beneficial interest in net assets of foundation 1866505 Sales tax receivable 267902 Estimated third-party payor settlements 799057 3111018 Liability for receivables sold with recourse 15000 Estimated third-party payor settlements 437214 452214 X 43353899 -446139 -446139 43800038 0 43800038 52940771 0 52940771 0 52940771 Part V, Line 4: The Coffeyville Regional Medical Center Foundation's endowment consists of a fund established for dietary scholarships. Part X, Line 2: The Medical Center is a not-for-profit corporation as described in Section 501(c)(3) of the Internal Revenue Code and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Part XI, Line 2d - Other Adjustments: Increase in beneficial interests in net assets of Foundation -446,139. 1 1 1 X 250.000000000000 1 X 1 1 0 1 0 1043530 173157 870373 0.01640 8656654 4187656 4468998 0.08440 9700184 4360813 5339371 0.10080 9959626 5175721 4783905 0.09040 9959626 5175721 4783905 0.09040 19659810 9536534 10123276 0.19120 1 1173607 152884 9739184 11789691 -2050507 X 1 1 1 1 Coffeyville Regional Medical Center 1400 W 4th Street Coffeyville KS 67337 H063102 X X X Coffeyville Regional Medical Center Inc 1 0 0 1 X X X X X X X X X 22 0 0 1 1 X http://crmcinc.org/about/publications-reports/ X 1 22 1 http://crmcinc.org/about/publications-reports/ 0 1 X 250.000000000000 400.000000000000 X X X X X 1 1 X X X 1 X http://crmcinc.org/patients-visitors/billing-insurance/financial-assistance X http://crmcinc.org/patients-visitors/billing-insurance/financial-assistance X http://crmcinc.org/patients-visitors/billing-insurance/financial-assistance X X X X X 1 X 0 X X X X 1 X 0 0 Coffeyville Regional Medical Center, Inc Part V, Section B, Line 5: In August 2022, Coffeyville Regional Medical Center in conjunction with the Montgomery County Health Department began the process of updating the 2019 CHNA. The process included requesting various stakeholders in completing an on-line survey which was followed by a Town Hall Discussion in August 2022. The process included a wide variety of stake holders including business owners, civic leaders, law enforcement, hospital personnel, and other local health care professionals. Coffeyville Regional Medical Center, Inc Part V, Section B, Line 6b: Montgomery County Health Department Coffeyville Regional Medical Center, Inc Part V, Section B, Line 11: Area of need: Lack of Community Communication-CRMC continued to promote health and wellness on social media. CRMC created and promoted "Health Hub" nutrition videos and educational materials on a quarterly basis. CRMC also offers childbirth education and breastfeeding programs. The Medical Center continued to promote the services through physical mailings distributed homes within a 35 mile radius.-Telehealth hospital services were discontinued in June 2022. However, virtual visits are available through the primary care clinics.-Live Health Montgomery County works to maintain CHNA health resource directory, which provides primary contact information.-CRMC continues to educate the community with Alliance of Ministries and its resources. Area of need: Primary Care Providers-CRMC hosted several regional meetings with primary providers and visiting specialists to increase collaboration among healthcare providers.-CRMC participated in the Farm and Home Show and other community events to promote services and service providers at CRMC.-CRMC completed Physician Manpower Assessment to document specific service area need by specialty. -CRMC established a High School Mentor Program that established a on-the-job training opportunities for local high school students.-CRMC continued to hold 6-9 and 12 month orientation meetings with new providers.Area of need: Lack of Individual Health Ownership (Apathy)-The Medical Center published a Health Partners Magazine quarterly and makes it available on social media. The Medical Center also offered a women's health programs like Childbirth and Breast Feeding and participated in a community baby shower in November.-CRMC reopened a walking track after being closed due to Covid-19. The Medical Center announced that the indoor walking track is opened to the entire community and offers a climate controlled and safe environment.CRMC did not address the following needs identified in its most recently conducted community health needs assessment: Poverty, Obesity, Transportation, Drug Use, Tobacco, and Lack of Parental/Family Skills Education. CRMC did not address these needs because they are not part of CRMC's mission of health operations. CRMC will partner with other individuals and organizations to help address these needs as appropriate. 4 1 - CRMC Medical Group 1400 W 4th Street Coffeyville KS 67337 Surgery and Speciality Clinic 2 - CRMC Medical Group - Coffeyville 1400 W 4th Street Coffeyville KS 67337 Primary Care Physician Clinic 3 - CRMC Medical Group 1717 W 8th Street Coffeyville KS 67337 Women's Health, Obstetrics, and Gynocology 4 - CRMC Medical Group - Independence 122 W Myrtle St Independence KS 67301 Primary Care Physician Clinic Part I, Line 7: Amounts for financial assistance and certain other community benefit programs were obtained using known related charges and cost to charge ratios. The cost to charge ratios used include the overall cost to charge ratio derived from Worksheet 2 as well as individual department cost to charge ratios identified for the calculation of subsidized health services information. Part I, Line 7g: Subsidized health services are made up of services that the Medical Center provides despite a financial loss to the organization. These services include ambulance, respiratory therapy, physical therapy, occupational therapy, speech therapy, and physician clinics. Total reported costs for physician clinics amount to $6,285,922. Part III, Line 4: The Medical Center provides for accounts receivable that could become uncollectible in the future by establishing an allowance to reduce the carrying value of such receivables to their estimated net realizable value. The Medical Center estimates this allowance based on the aging of its accounts receivable and its historical collection experience.Part III, Line 2Provisions for bad debts are related to accounts that have been deemed uncollectible during the year. The uncollectible amount is then written off pursuant with Hospital policy. The cost of the bad debts reported was determined based upon the cost to charge ratio multiplied by the total charges written off to bad debt expense.Part III, Line 3The estimate of bad debt expense attributable to patients who we believe would be eligible under the organization's financial assistance policy was estimated at 15%. The gross charge amount was then adjusted to cost using the overall cost to charge ratio obtained from worksheet 2. It is our belief that much more of the amount written off to bad debts relates to patients that would qualify for charity; however, do not take the time to complete the application process due to their individual circumstances. We believe that this amount should be considered a community benefit because we are legally required to provide medical services to patients regardless of the ability to pay. Part III, Line 8: The 2022 Medicare Cost Report was used to determine the Medicare revenue and related cost. The shortfall is a benefit to the Medical Center's community since it represents health care provided at less than cost to elderly and needy residents of the Medical Center's service area. Part III, Line 9b: Admission representatives review accounts during the admissions process to identify patients with possible financial need. To be considered for charity care, the financial policy states that financial advisors will determine if the patient is eligible to apply for Medicaid or other financial assistance programs. The advisors will then assist the patient through the process of applying for financial assistance programs within and outside of the Medical Center. Whenever possible, prior to admission, the Hospital will conduct a pre-admission interview with the patient, the guarantor, and or legal representative. Patients who may qualify for financial assistance from a governmental program will be referred to the appropriate program prior to being considered for charity care. Part VI, Line 2: The Medical Center periodically engages a consulting firm to assist with developing a strategic plan. Part of that process is to interview people in the community for their opinion on what the Medical Center can do to meet the community needs. Interviews include physicians, board members, auxiliary personnel, and business leaders in the community to help get a feel for what they see as most important for our community. Part VI, Line 3: The hospital has signs posted in each admission window and other locations in the hospital encouraging patients to ask about the available payment options and how to apply for financial assistance. The financial assitance policy and application form is also made available on the hospitals website. The patient may be referred to meet with one of the hospital's Financial Advisors, who will determine the patients' eligibility for benefits and help them through the process of applying for assistance. Part VI, Line 4: Coffeyville is located in the southeastern part of Montgomery County, located in Southeast Kansas. It is located 64 miles north of Tulsa, Oklahoma. The US Census Bureau estimates the 2022 population of Montgomery County, Kansas to be 31,486. 20.8% of the population is 65 years of age or older, the median household income is $47,697, and 15.9% of individuals are below poverty level. Part VI, Line 5: Health fairs, fundraising for relay for life, public education, and resources on Coffeyville Regional Medical Center's website are some examples of activities the Medical Center does to support health in the community. X X X 0 0 0 0 0 0 0 0 0 Sunil Menon Physician 488086 0 30000 0 0 0 25732 0 12755 0 556573 0 0 0 Michelle McGuirk Physician 423132 0 40100 0 0 0 25732 0 9210 0 498174 0 0 0 Baba Abudu Anesthesiologist 442139 0 0 0 0 0 25732 0 16352 0 484223 0 0 0 Perry Yung Ping Lin Physician 333088 0 53537 0 0 0 26880 0 28113 0 441618 0 0 0 William Tinker Physician 380402 0 0 0 0 0 26147 0 5074 0 411623 0 0 0 Brian Lawrence CEO 258404 0 8358 0 0 0 23464 0 28055 0 318281 0 0 0 Dale Guffey CFO 158589 0 6154 0 0 0 14315 0 15069 0 194127 0 0 0 Mark Slavin Son-in-law of Board Member 111463 Employee Compensation 0 X 1 245318 Property appraisal 0 0 1 1 Part I, Line 32b: The Medical Center uses the appropriate third party to process and sell any non-cash contribution received. Form 990, Part VI, Section B, line 11b The Form 990 is reviewed by management prior to filing. Form 990, Part VI, Section B, line 12c The organization reviews concerns when identified. Members are required to remove themselves from any discussion which may involve a conflict of interest. Form 990, Part VI, Section B, line 15a The salary for the CEO is determined by the Board of Directors and is based upon performance and comparative information obtained from the Kansas Hospital Association wage survey. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon written request. Form 990, Part IX, line 11g Professional fees: Program service expenses 2,793,697. Management and general expenses 83,929. Fundraising expenses 0. Total expenses 2,877,626. Contract labor: Program service expenses 951,485. Management and general expenses 32,860. Fundraising expenses 0. Total expenses 984,345. Outside services: Program service expenses 3,108,845. Management and general expenses 652,599. Fundraising expenses 13. Total expenses 3,761,457. Other services: Program service expenses 1,329,757. Management and general expenses 548,850. Fundraising expenses 9,894. Total expenses 1,888,501. Form 990, Part XI, line 9: Increase in beneficial interest in net assets of CRMC Foundation -446,139. Form 990 Part XI, Line 2c: The Finance Committee reviews the audit prior to the presentation to the Board by the auditor. Form 990, Part XXII, Line 3b The Medical Center is currently in the process of completing its Single Audit. Coffeyville Regional Medical Center Foundation Inc 1400 W 4th Street Coffeyville KS 67337 480981990 To provide philanthropic assistance to Coffeyville Regional Medical Center KS 501(c)(3) Line 7 0 0 0 1 0 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0