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        <ExplanationTxt>Part V, Section B, Line 5: The CHNA was conducted in collaboration with the Barton County Health Department. The Hospital reached out to members of the community with broad interests in the community served and special knowledge of or expertise in public health from groups such as local hospitals, public health community, free clinics, community based clinics, service providers, school leaders, and local government. A Town Hall meeting of 39 attendees was conducted. The Town Hall meeting reflected on the size and seriousness of any health concerns cited and discussed current community health strengths, as well as identifying and ranking top community health concerns. In addition to the Town Hall meeting, CHNA surveys were completed by Barton County residents. The survey was created to measure Barton County residents' views regarding health care perceptions of delivery, access, and health practices.</ExplanationTxt>
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        <ExplanationTxt>Part V, Section B, Line 6b: Barton County Health Department (located in Great Bend, KS - Barton County)</ExplanationTxt>
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        <ExplanationTxt>Part V, Section B, Line 11: The annual update below pertains to the CHNA and implementation strategy completed for the 2021 tax year, which is the second-annual update for the three-year cycle. The Hospital also partnered with various community organizations to help address these needs.1. Nutrition/Healthy FoodClara Barton Medical Center (CBMC) continues to offer a full range of inpatient and outpatient nutrition services designed to help our patients achieve optimal health and feel their best. Our goal is to provide evidence-based nutrition care for treatment of acute and chronic illnesses and to promote nutritional health for adults and children who are either referred by their physician or taking steps on their own to improve their health. Whether someone simply wants to learn to eat healthier, or if they have special dietary needs, our registered dietitian will conduct an individualized nutrition assessment and create an individualized plan just for that person. K-State Extension kicked off a Living Well Wednesday Series. This is a series of educational webinars that focused on women's health. Topics included navigating diets, supplements, sleep deprivation, poor eating habits, gut issues, increased stress, immune system and many other topics.CBMC held a Rethink your Drink Challenge to encourage all to opt for water instead of other beverages throughout the day. Water boosts energy, curbs cravings to snack or overeat, improves bodily functions, and helps with weight loss. The Walk Kansas program kicked off. This was an 8-week State challenge that focused on physical activity and healthy eating.Great Bend Summer Street Stroll Farmers Market was downtown on the east side of the Courthouse square on Thursdays 4-7 pm. They offered fresh veggies, fruits, jellies, jams, and various homemade items. The market also served as the designated market for the Kansas Senior Farmers Market Nutrition Program for Barton County where seniors were able to redeem checks for locally grown fresh fruits and veggies.Every third Saturday during the summer, starting in June, a farmers market was held in front of the thrift store on Main Street in Hoisington. The Summer Food Service Program funded by the United States Department of Agriculture allowed kids to eat free in Great Bend and Hoisington. A Hy-Vee dietitian offered free nutrition counseling for anyone 60+ at the Great Bend Senior Center.Tammy Tipton, BSN,RN from Blue Cross and Blue Shield of Kansas came to CBMC and presented a session on Nutrition. The session addressed diet and nutrition myths. CBMC held a Five to Thrive Challenge to encourage all participants to eat five or more veggies a day. A session called ServSafe Food was presented in Great Bend by Karissa Winkel - Cottonwood Extension District. The course allowed participants to learn about foodborne illness along with common behaviors that cause foodborne illness. She also discussed various hazards, cross-contamination, allergens, sanitation, and more. Kids Ag Day was held for Barton County 4th graders. Organized by the Ag-Business Committee of the Great Bend Chamber of Commerce. Held at the Diamond K Farm, owned by the Koelsch family. 360 Barton County students attended. Students learned about where food and other products they use on a daily basis come from. One of the stations visited by the students discussed nutrition and the dangers of vaping and tobacco use.The Great Bend Recreation Center hosted healthy cooking classes once a week for kids in grades 1 - 6.Heartland Farm hosted an organic compost tea workshop. They taught participants how to create and adjust compost teas. Wheatland Electric employees delivered 7,051 pounds of food to those in need during the month of October in Great Bend following a food collection competition.CBMC registered dietician Olinda Harbaugh held a healthy recipe challenge. Anyone who brought a healthy recipe in during the month of November was entered into a drawing for a Kitchen gadget from the Kitchen Vault in Russell.A cooking healthy for the holidays program was held at the Great Bend Activity Center. The program focused on how to maintain a healthy lifestyle during the holidays. Simple swaps for holiday recipes were shared that could make meals lighter without sacrificing the flavor. There was a deep need in our community for food assistance and as a result Housing Opportunities, Inc and COPE Lead for Barton County put together 150 boxes of food to be distributed to those in need across Barton County in Ellinwood, Hoisington, Pawnee Rock, and Great Bend.Wheatland Electric raised $90,785 in cash and food donations for one dozen local food banks during their 2023 Power the Pantry campaign. This included a $13,080 cash donation to the Community Food Bank of Barton County in Great Bend.Karissa Winkel - Cottonwood Extension District shared information with the community about gluten intolerance. The Great Bend Chamber held a local food drive for all local businesses. They accepted items until December 20th then distributed the items to the local food banks.CBMC offers free fruit for patients and employees in the cafeteria.2. TransportationAmy Ferguson Rise Up Coordinator announced a new program to connect people to resources. The new program promoted healthier lifestyles by removing the barrier of transportation to things like appointments and meetings. They realized how hard it is for some people to keep moving forward when they always have to find a way to get where they need to go. The program continues to help provide rides and is available to Barton County residents.The Great Bend Health Department was able to purchase a 2022 Chrysler Pacifica Van and a 2022 RAM Laramie 1500 crew cab 4x4 from Marmie Motors in Great Bend using funding received from KDHE. The pick-up will be used to pull their mobile trailer and the Van will be used for their outreach clinics.Sunflower Catch-a-Ride Public Transportation currently provides transportation anywhere within the Barton County area Monday - Friday 5 a.m. - 8:45 p.m. and weekends within Great Bend city limits only 8 a.m. - 3:45 p.m. Cost is $2.00 one way. CBMC offers financial assistance to cover transportation to and from CBMC for patients in need. Mini-Bus Services are provided, within Great Bend city limits. This is available Monday - Friday 8 a.m. - 5 p.m. no weekends. Cost is 1.50 one way. If riding for a meal, it is free.C.A.B Transportation is available in the city limits and surrounding edges of Great Bend. Available 6:30 a.m. - 6:30 p.m. Cost is $4 each way in city limits, outer edges $8.00.The Hoisington Trolley provides transportation in the city of Hoisington Monday - Friday 9 a.m. - 4 p.m.. They will go out of the city limits (one mile) during regular operating hours. Suggested donation is $1.00 for each time boarding the Trolley. A 20-ride pass can be purchased for $15. CBMC offers Trolley coupons for anyone in need at no cost.CBMC has two care team management nurses who assist patients as needed to arrange transportation rides.Cardinal Cruiser bikes are available in Hoisington as part of the bike sharing program. They are available for free checkout at one of four locations throughout Hoisington: the city billing office, the Hoisington Public Library, the Hoisington Rec Commission at the Activity Center and the Rodeway Inn &amp; Suites. Using a shared document at those locations, the city keeps an updated list of which bikes have been checked in or out and from which location. Most of the bikes are of the standard single-speed variety, the city did mix it up with a side-by-side trike and two tandem bicycles.3. Mental HealthCBMC continues to partner with the KU Alzheimer's Disease Center to improve assessment of Alzheimer patients and to provide care giver counceling on site once a month.For a second year, Hoisington High School yellowed-out its gymnasium at the high school basketball game. Students involved in the #Zero Reasons Why program lead the event. The campaign is meant to eliminate the stigma of talking about mental health issues. Hoisington High School students met with Gov. Laura Kelly at Mental Health Advocacy Day in Topeka. The students represented the #Zero Reasons Why suicide-prevention program.Dropping 22 hosted the Great Bend chamber coffee to share information on their non-profit organization. They talked about who they are and whom they serve in the mental health area. The Center for Counseling and Consultation in Great Bend announced a new service called Assertive Community Treatment (ACT). This is an evidence-based practice to help those with illnesses such as bipolar disorder and schizophrenia. The Center for Counseling and Consultation in Great Bend announced that they have a 988 Suicide &amp; Crisis Lifeline that is manned 24/7.</ExplanationTxt>
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        <ExplanationTxt>Part V, Section B, Line 11: The Center for Counseling &amp; Consultation held a Mental Health Awareness Day event at the courthouse square in Great Bend. Community Partners had informational booths set up. Food, drinks, yard games, drum circle and bounce house. 300 people gathered to learn about local mental health resources. #Zero Reasons Why sponsored a Color Run/Walk at Hoisington Bicentennial Park to help raise awareness for teen mental health and suicide prevention. Julie Belt was hired to offer mental-health services at the Heart of Kansas in Great Bend. She will see patients all day on Monday, Tuesday and Thursday's and from 8:00 a.m. - noon on Fridays. Leonard Kaiser, counselor at The Center for Counseling &amp; Consultation, announced that he is offering to visit with farmers and/or their loved ones, as well as businesses that interact with ag producers on a regular basis to suggest how they can recognize the symptoms of someone at risk for suicide. Teenagers struggling with mental-health issues now have an outlet to share their experiences and offer encouragement to their peers and others in the community. The local #ZeroReasonsWhy program is accepting stories from local and area teenagers. Those who want to share their story can visit the website for The Center for Counseling &amp; Consultation. They can let other people know they are not alone in their feelings, and they can help remove the stigma associated with mental-health issues. Training was held for Dropping 22 counselors. A nonprofit organization dedicated to helping veteran's, first responders, active military members and their families reduce their risk of suicide and improve their mental health so they can overcome trauma, depression, anxiety and other stressors.Monique Koerner - Family and Community Wellness Agent with K-State Research and Extension - Cottonwood District presented information to the community on Dementia and Brain Health.Alicia Boor - Cottonwood Extension District presented information to the community on suicide prevention.Passages of Hope Counseling Center, LLC, a new Counseling Center opened in Great Bend. Owned by Joanne and Steve Wondra. It aims to provide comprehensive therapeutic services and medical management to empower individuals and families on their journey towards growth and healing. Their services include child and teen therapy, couples counseling, family therapy, play therapy, and grief therapy. Barton County held the 11th annual "Golden Belt Glow 4 Life" 5K run/walk to help raise money to promote suicide awareness and prevention at Veteran's Park in Great Bend. The event was put on by The Central Kansas Partnership Suicide Prevention Task Force.Rise Up Central Kansas held its third annual Recovery Out Loud, Every Voice Matters event at Jack Kilby Square in Great Bend. This event was a platform for anyone wanting to share their stories about substance use disorders, or for anyone recovering from mental health issues or trauma to do so.The University of Kansas Health System and the Great Bend Recreation Commission partnered and held a one day Memories Matter Bereavement Camp for kids ages 5-12 who had experienced the death of a parent, grandparent, sibling or other loved one. The camp was designed to help children understand that grief and mourning are natural reactions that are not one-time events. The Central Kansas Partnership Suicide Prevention Task Force hosted a pedal for prevention event at the Brit Spaugh Park Bike ramps in Great Bend. The Center in Great Bend was awarded a Kansas Fights Addiction 2023 Treatment Grant in the amount of $177,375. The funds will be used for their medication-assisted treatment (MAT) program for substance-use disorders. It assists those battling addiction and provides another option towards recovery. Barton Community College &amp; CKP Suicide Prevention Task Force held an event at the college. How to Live Mentally Well and Crush it during difficult times. The speaker was Josh Rivedal, who expanded the conversations around mental health and wellness. Rise Up sponsored a Let's Kick it (Kickball Event) at Brit Spaugh park in Great Bend. Proceeds supported Rise Up. This is a task force dedicated to helping individuals and our community rise up against substance abuse disorders, mental health issues and poverty.The Great Bend Recreation Commission held a class on Managing the Strain of Stress. The session gave information about the biology of stress, stress management tools, and how to understand the emerging science between mood and food.4. Child CareA coming soon sign was placed at the corner of 10th street and K-96 Highway in Great Bend to announce the soon to come 4,500 square-foot daycare center. They announced that they were taking applications for the site director position and that the project would soon be sent out for bids. The Great Bend school district USD 428 purchased the property at 1809 24th street, to remodel into a new preschool for ages 3 and 4. The Little Panthers preschool will include 15 classrooms. Each classroom can hold 15 students with up to one teacher and two assistants - that's room for approximately 450 students in half-day sessions. Each classroom will be approximately 600 square feet, and the rooms will be grouped together with shared restrooms, teacher workrooms, and a breakout space. A playground will be built to the east of the building. Plans are to open the facility August of 2024.The Great Bend Economic Development broke ground for Advancing Barton County Childcare's (ABCC) new day care center at Farmers Plaza on the corner of 10th street and K-96. Governor Laura Kelly attended.Advancing Barton County Childcare (ABCC) announced the site of its second childcare Barton County facility in Hoisington with the cooperation of USD 431. The vision is to build a daycare center that will service upwards to 50 children. A building site close to Roosevelt Elementary School in Hoisington has been identified for the new construction build. If everything goes as planned a groundbreaking for the childcare center in Hoisington will be in May 2024. Information on how to become a licensed, daycare provider was provided by The Great Bend Tribune. To become licensed, providers must pass a background check, be CPR certified, and their homes must pass a fire inspection by the fire marshal's office. The licensing requirements can be found on the Barton County Health Department's website, or the Kansas Department of Health and Environment website.Kelsie Baxter has been hired to be the site director of the new childcare center in Great Bend, the Advancing Barton County Childcare (ABCC) committee is taking applications for 11 other positions. A wait list will be published by the end of the month for parents wanting to send their children there for daycare. Completion of The Bright Beginnings childcare center is expected to be March 2024. 5. Chronic Comorbidities (Obesity, Heart Disease, High Blood Pressure, Diabetes, Cancer)Clara Barton Medical Center (CBMC) offers a comprehensive Diabetes Education Program geared toward those living with diabetes. It's goals are to provide current evidence-based education on diabetes education from our diabetes educator in an open and conducive environment. For participants to take charge of their own care and diabetes management. To improve the lives of our participants through the diabetes education services. Program content includes healthy eating, being active, monitoring glucometers, continuous glucose meters, taking meds, insulin injection education, insulin pumps, reducing risks and complications, healthy coping, problem solving, stress, sick days, hypoglycemia and hyperglycemia. Participants will work closely with our registered dietician to develop an individualized wellness plan of strategies to achieve your diabetes related goals.CBMC registered dietician works closely with patients needing individual assistance for obesity, high cholesterol, high blood pressure, chronic kidney disease, cancer, gut health problems, food disorders, and practical lifestyle advice.CBMC offers cardiac rehabilitation. This service includes lifestyle modification, supervised exercise and education to help individuals learn healthy lifestyle techniques to prevent progression of coronary artery disease (CAD) and assist in recovery following a heart attack or cardiac surgery.CBMC offers respiratory therapy. This department provides diagnostic and therapeutic services to those who are dealing with acute or chronic health issues that include asthma, bronchitis, emphysema, pneumonia, cardiovascular disease and trauma. They care for individuals that range in age from infant to geriatrics by evaluating, treating and maintaining lung function.</ExplanationTxt>
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        <ExplanationTxt>Part V, Section B, Line 11: CBMC kicked off 2023 with an Eat Well Live Well program. 8 hours of PTO could be earned for those employees that participated and completed several wellness initiatives throughout the year. CBMC offered employees free lab draws if they signed up to participate in the Eat Well Live Well wellness program. Quarterly Lab fairs were offered to the public at a discounted rate the 3rd Saturday of the month at CBMC during 2023. Dates were 1/20/23, 4/21/23, 7/21/23 and 10/20/23.The City of Great Bend is now among one of the few towns in Kansas to have a single-track mountain bike and hiking trail within city limits. A group of area bicyclists who maintain the Lake Barton trail, north of town, have created a 1.8 mile path around Rotary Lake, formerly known as MacArthur Lake. The trail is accessible to people of all ages and makes use of an underutilized area. CBMC staff celebrated National Wear Red Day to bring greater attention to heart disease as a leading cause of death for Americans, especially women. It encourages women to know their blood pressure, HDL cholesterol, and total cholesterol levels, as well as their body mass index (BMI) to better understand their health risk for heart disease.Tammy Tipton, BSN,RN from Blue Cross and Blue Shield of Kansas came to CBMC and presented a session on Budgeting your Wellness. The Great Bend Recreation Commission held an 8-week program in Great Bend called Stay Strong Stay Healthy. The program was designed to increase an aging adult's access to a safe, structured, and effective strength training program. Participants were taught exercises to improve their strength, flexibility, and balance.CBMC received certification as a Patient-Centered Medical Home by the National Committee for Quality Assurance (NCQA). This certification establishes a model of care that is patient-focused, improving the quality of care, enhancing patient experience, building relationships between patients and providers, and providing additional clinic services to better serve patient needs. CBMC has a care management team who works with patients to manage their medications and works with them and their other care professionals to make sure they are receiving the continuation of care they need. K-State Research and Extension Cottonwood District opened registration for the Walk Kansas program. This is an annual eight-week activity challenge.The Kansas Legislature approved a bill elevating the age to purchase tobacco from 18 to 21.On Earth Day CBMC hosted a volunteer pick up trash event. Participants got their workouts in picking up trash and improving the environment.CBMC sponsored National Walk at Lunch Day. The walk was held at the Great Bend and Hoisington Clinic Locations. This event encouraged residents to get out and walk.The Great Bend Recreation Commission hosted a free Stop "N Learn Session titled "Healthy Body, Healthy Brain" over the lunch period at the Great Bend Rec Activity Center. Discussions were on how taking care of your heart and cardiovascular system is the best way to protect your brain. The MIND diet was shared. CBMC hosted a Hit your Stride challenge. The event encouraged participants to track the number of steps they take daily whether running, jogging or walking.Monique Koerner - Family and Community Wellness Agent with K-State Research and Extension - Cottonwood District shared information with the public regarding grilling. The American institute for Cancer Research reminded us that cooking meat and poultry on the grill with intense heat can lead to formation of potential carcinogens. Studies have linked HCAs to the development of cancer. She suggested modifying the grilling technique to reduce the chance of cancer risk by marinating meat. Free 60+ Health screenings (Blood Pressure, HBA1C, Omega 3, Vitamin D) offered at the Great Bend Senior Center. The Youth Crew partnered with the Health Occupation Student Association Club at Great Bend High School to present "Blow Bubbles Not Smoke" event. Information was shared with students about the health impacts of vaping or using tobacco and resources to quit over the High Schools lunch period. Games were played and prizes handed out. In recognition of National Wellness Month in August. CBMC kicked off a special event to celebrate. To encourage community members to adopt healthy habits, the community was invited to participate in a 12-week walking program. This program utilized the new walking trail located at the Great Bend Clinic. Anyone who walked on the trail and who posted a picture of themselves were placed in a drawing for a chance to win a weekly swag bag. Gifts were provided by surrounding businesses. CBMC reminded the public that October is National Breast Cancer Awareness month and that they offer state-of-the-art 3D Mammography. CBMC hosted a 2nd volunteer pick up trash event. Participants got their workouts in picking up trash and improving the environment.Diabetes: You are in Control. A lunch and learn was held by Karissa Winkel, Family and Community Wellness Agent for K-State and Extension. She shared information about diabetes risk, self-management, and self-care behaviors. She also provided some diabetes approved recipes.CBMC and several other businesses sponsored a Turkey Trot 5K fun run in Great Bend.The City Council gave the Ok to add new lights to Vets Park walking path on the north side of the park. This is one of the most popular projects to come out of the quality-of-life sales tax initiative approved by voters. Lights should be installed in the spring of 2024. This will make it safer for community members to walk and exercise.Karissa Winkel - Cottonwood Extension District shared information with the community about three small phrases that can sum up how to improve your health and quality of life. Build a better meal. Boost your physical activity and balance stress. The Heart of Kansas Family Health Care in Great Bend was recognized as one of only 3 community health centers in the state to earn a Quality Award for its care and treatment of patients with diabetes. Karissa Winkel - Cottonwood Extension District shared information with the community that social isolation can increase health risks. Social isolation increases the risk of premature death and increases the risk of dementia. Poor social relationships are associated with a 29% increased risk of heart disease and a 32% risk of stroke. Stressed the importance of keeping social connections alive.Throughout the year CBMC continues to post healthy recipes to their facebook to share with the community. Such as Chinese Chicken Salad, Ham and Cheese Quiche, Mojito Fruit Salad etcCBMC offers a full range of both inpatient and outpatient nutrition services designed to help patients achieve optimal health. 6. Educate Public on the Services Offered in the CommunityClara Barton Medical Center (CBMC) has a Social Determinants Resource List and a Community Resource List available to give to patients or community members needing assistance.The CBMC radio show airs the second Thursday of every month at 8:30 a.m. on 1590 KVGB &amp; 95.5 FM local. Educational topics are shared with the community by subject matter experts. Rise Up Central Kansas Shared 1-800-CHILDREN hotline which offers 24/7 no-judgement support for parents and caretakers. No question is too big or too small when it comes to parenting. Dr. Patrick Stang from the Center for Counseling and Consultation was on a local radio show where he discussed the effects of media/social and media/video game content on children. CBMC held its annual meeting. Dr. PJ Stiles and Dr. Roxanne Stiles surgeons presented sharing the services offered in the Surgical Clinic and answered any questions community members might have.Advance Healthcare Directive Education was provided to the community by CBMC at 6:00 pm. Making healthcare decisions for yourself or someone who can no longer do so can be overwhelming. That is why it's important to make those arrangements and choices in advance. Representatives from Watkins Calcara Law Firm spoke about the importance of honoring care decisions and preparing healthcare directives in advance.It was announced that the Great Bend school district would again be offering the summer REACH program. Recreation, Enrichment, Academic, Curriculum and Health. This is a 3-week enrichment summer school program. It is available to all K-5 students who are in Skyward.The Family Crisis Center, Child Advocacy Center and the Kansas Children's Service Leage held a Blue Alert event to help raise awareness for child abuse prevention.</ExplanationTxt>
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        <ExplanationTxt>Part V, Section B, Line 11: The Center for Counceling &amp; Consultation announced they were starting a new program to better accommodate families. They offer services to bridge the gap between the agency's intake process and a child receiving individual therapy services. Mindfulness activities are at the core of these groups, which are available for children ages 3 - 18. They meet at least twice a month.Central Kansas CASA sponsored a Life In Limbo event at the First Presbyterian Church in Great Bend. It was an interactive workshop that gives individuals the opportunity to role-play. Participants are able to step into the shoes of birth parents, foster parents, and displaced children. Learning what it feels like to live a day in their life. CBMC held a community open house at the Great Bend Clinic. Construction was completed so the community was invited to tour the newly renovated facility. Clara Barton Medical Center's Newsletter highlighted the recent expansion and renovation of our ER/outpatient services area. Specifically the infusion area, which can now comfortably accommodate more patients due to additional space and new chairs. CBMC presented at the Hoisington Chamber of Commerce Meeting. Michelle Moshier shared that a new Vitro Chemistry Analyzer XT7600 was purchased, and is now in use in the laboratory department. This machine performs additional testing such as Vitamin D and CEA turmor mark testing. It requires less blood to be drawn, has a quick turn time and has a stat lane which means high priority labs get pushed to the front of the line. A documentary about dementia highlighting Dr. Webb a CBMC provider was shown at the Golden Belt Cinema 6 in Great Bend to share information about dementia. It was free for the community. 100 people attended. The Barton County Health Department held a Community Baby Shower at the Barton County Courthouse. The free event showcased 23 vendors, including those from Clara Barton, Family Crisis Center, Unitied Healthcare Community Plan, Great Bend Public Library, United Way of Central Kansas and Sunflower Early Education all educating those attending. The event also provided education for Safe Sleep. CBMC partnered with the Hoisington Dairy Queen and the Hoisington Police Department to start a new program encouraging kids to be safe. Coupons for free ice cream cones where handed out to kids for using safety equipment when out on bikes, skateboards, or during other activities.CBMC started sending out reminders to the community to schedule their school/sports physical. Summer gets busy and you do not want to wait until the last minute. Stuff the Bus event. This was a school and food pantry supply drive sponsored by the United Way. The bus was parked at the Town &amp; Country Supermarket &amp; Dollar General in Hoisington.Barton County COPE and Kansas Legal Services presented an event for Drivers License Reinstatement and Criminal Record Expungement. The purpose is to help individuals who have a suspended driver's license reinstated. Or to help individuals who are eligible for expungement of their conviction or diversion. Dr. Christopher Miller announced that he is establishing his dental practice at Heart of Kansas Family Health Care in Great Bend to treat patients of all ages and all walks of life."Becoming a Mom" 6 sessions - 1 per week were held at the Barton County Health Department. The course included discussion on health pregnancy, labor and delivery, infant feeding, infant care, postpartum health for mothers and pregnancy nutrition.The Hoisington Police Department and the Pilot Club of Great Bend sponsored a bike rodeo at the West Parking lot at CBMC. Participants learned bike safety, bike traffic signals, participated in an obstacle course, received a free helmet and were able to be entered to win a free bike. The Barton County Health Department offered free Tdap vaccination to the public from 9 a.m. - 4 p.m.The Great Bend Health Department shared information on the 1590 KVGB radio program. Types of Emergency Service they provide. Tetanus and Rabie shots. School vaccinations. CBMC offered a lactation Class for expectant and nursing mothers. The class was given by two lactation consultants. They covered an array of topics providing all mothers or those expecting with the knowledge and tools they need for a successful breastfeeding journey. Classes will continue to be held quarterly.Great Bend Juvenile Services shared information on the 1590 KVGB radio program. Discussed the prevention work they are doing in Barton County. CBMC Speech Therapists offered free speech screenings for kids up to 18 years old throughout the month of August. Screenings only take around 10 minutes to complete and were done in the therapy department. No doctor order needed.The Alliance for a Healthy Kansas held a community meeting at the First United Methodist Church of Great Bend to educate the public about the expanding Medicaid and KanCare programs.Free school sports physicals for the 2023-2024 school year for area middle and high school students were provided by The University of Kansas Health System. Physicals were done from 7-11 a.m. at St Rose Medical Pavilion in Great Bend.Rise Up presented Creating Resilience Through Connections at the Great Bend Public Library. This was a family-based training that explored how families and caregivers have a big impact on a child's ability to grow, cope and thrive when things get tough.The Center for Counseling &amp; Consultation announced that it is taking their services to a higher level by expanding its Care Coordination Services (CCS) that zero in on the needs of the whole person.The Barton County Association of Churches sponsored Discount Laundry. They offered to do 5 loads of free laundry per household to get the school year started off right with clean clothes. Dropping 22 offered resilience &amp; wellness training for emergency workers. The event was held at 916 Williams St. in Great Bend.The Heart of Kansas Family Healthcare, Inc. sponsored a Parenting the Love and Logic way event. Six sessions designed to help parents equip kids with character, compassion, problem solving skills and more.Barton County's Communities Organizing to Promote Equity (COPE) group hosted a Life Planning Event at the Knights of Columbus Hall in Great Bend. Karissa Winkel - Cottonwood Extension District educated the public on Fall Prevention.October is Cybersecurity Awareness Month. CBMC shared the message to be careful in this regard.It was announced to the public that the Great Bend Children's Clinic would be joining The University of Kansas Health System in Great Bend.Karissa Winkel - Cottonwood Extension District shared information with the public on how to read food labels to determine if foods are healthy or not.KDOT shared information with the community in celebration of National Pedestrian Safety Month. They encouraged communities to identify and improve walking areas and promoted the health benefits of walking.CBMC is now offering walk-in flu vaccinations no need to make an appointment. CBMC sent a reminder out to the community of Hoisington reminding them that Walk-In appointments and Same-Day appointments are available.The Youth Crew partnered with the Barton County Health Department and Sherrif's Office for National Prescription Drug Take Back Day. They provided a safe, convenient, and responsible means of disposing of prescription drugs, while also educating the general public about the potential for abuse of medications.2023 Senior Health Insurance Counseling of Kansas conducted Medicare Part D meetings in the east conference room at CBMC for the community. Members were invited to make an appointment and attend.The United Way of Central Kansas held a poverty simulation program for the public so they could experience what it would be like to live in poverty for one month. Participants role-played as a person experiencing survival mode. CBMC hosted a Thanksgiving Food Drive to support the Hoisington Food Bank. A HIREWORKS event was set up to bring together employers, hiring managers, and business leaders from across Barton County at the Great Bend Events Center for afternoon of engaging discussions, invaluable networking opportunities, and the chance to establish meaningful connections. This event was designed to significantly impact businesses and organizations growth trajectories. CBMC presented at the Hoisington Chamber of Commerce Meeting. James Tusten the newly appointed CEO presented. The discussion centered on the health of Rural Hospitals and some of the most recent closings. Data showed that 59% of the decline in U.S. community hospitals has been rural hospitals. He stressed what a strong medical center the Hoisington community has and how grateful he is to have so much community support.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Clara Barton Hospital Association, Inc.</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 11: CBMC announced the addition of Morgan Feldkamp, PA-C. She joined the clinicians at CBMC as a Physician Assistant, specializing in Family Practice.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Clara Barton Hospital Association, Inc.</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 20e: CBH notified all uninsured patients about the Hospital's FAP by letter, orally, and on patient statements.</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>4</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>1 - Clara Barton Medical Clinic</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>252 W 9th Street</AddressLine1Txt>
            <CityNm>Hoisington</CityNm>
            <StateAbbreviationCd>KS</StateAbbreviationCd>
            <ZIPCd>67544</ZIPCd>
          </USAddress>
          <FacilityTxt>Rural health clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>2 - Clara Barton Surgical Clinic</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>252 W 9th Street Suite B</AddressLine1Txt>
            <CityNm>Hoisington</CityNm>
            <StateAbbreviationCd>KS</StateAbbreviationCd>
            <ZIPCd>67544</ZIPCd>
          </USAddress>
          <FacilityTxt>Physician clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>3 - Russell Family Medical Care</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>410 N Main Street Suite C</AddressLine1Txt>
            <CityNm>Russell</CityNm>
            <StateAbbreviationCd>KS</StateAbbreviationCd>
            <ZIPCd>67665</ZIPCd>
          </USAddress>
          <FacilityTxt>Rural health clinic</FacilityTxt>
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        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>4 - Clara Barton Medical Clinic</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>906 McKinley Street</AddressLine1Txt>
            <CityNm>Great Bend</CityNm>
            <StateAbbreviationCd>KS</StateAbbreviationCd>
            <ZIPCd>67530</ZIPCd>
          </USAddress>
          <FacilityTxt>Rural health clinic</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 7:</FormAndLineReferenceDesc>
        <ExplanationTxt>Financial assistance at cost was determined by utilizing departmental cost-to-charge ratios for financial assistance provided in areas that are reported as subsidized health services. An overall cost-to-charge ratio derived from Worksheet 2 was used to determine the cost of financial assistance provided for services not reported as subsidized health services.Unreimbursed Medicaid costs were also determined using a blend of cost-to-charge ratios for certain services and an overall cost-to-charge ratio derived from Worksheet 2 for all other services.The cost of providing subsidized health services was determined using a cost-to-charge ratio for each service.Actual costs and revenues were utilized for all other items reported on line 7.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 7g:</FormAndLineReferenceDesc>
        <ExplanationTxt>Subsidized health services are comprised of services that the Hospital provides despite a financial loss to the organization. These services include the operation of a 24-hour emergency room, physician clinics, diabetic and dietician services, and various therapy services. The amount of costs attributed to physician clinics amount to $6,653,022.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Hospital recognizes patient service revenue associated with services provided to patients who have third-party payor coverage on the basis of contractual rates for the services rendered. For uninsured patients that do not qualify for charity care, the Hospital recognizes revenue on the basis of its standard rates for services provided. On the basis of historical experience, a significant portion of the Hospital's uninsured patients will be unable or unwilling to pay for the services provided. Thus, the Hospital records a significant provision for bad debts related to uninsured patients in the period the services are provided.Part III, Line 2:Bad debt expense at cost was determined by utilizing departmental cost-to-charge ratios for financial assistance provided in areas that are reported as subsidized health services. An overall cost-to-charge ratio derived from Worksheet 2 was applied to the charges deemed uncollectible during the year for all other services.Part III, Line 3:Bad debt expense attributable to patients eligible under the organization's financial assistance policy was determined using an estimated 2% of total bad debts. The Hospital takes steps to assist individuals who are believed to qualify for financial assistance prior to writing accounts off as uncollectible.All non-reimbursed costs for treatment of patients in our community provides a community benefit since patients unwilling or unable to pay have received a valuable service at no cost or at a reduced cost to them. This improves the health of our community as a whole.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 8:</FormAndLineReferenceDesc>
        <ExplanationTxt>Medicare allowable costs were determined by using amounts from the Hospital's Medicare cost report as filed with the Medicare Administrative Contractor. The Medicare cost report apportions actual costs to the Medicare program using charges for ancillary services and patient days for nursing services. Caring for Medicare patients fulfills a community need and relieves a government burden as these patients typically have low or fixed income. Therefore, any shortfall should be included as a community benefit.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 9b:</FormAndLineReferenceDesc>
        <ExplanationTxt>The collection policy states that the patient must cooperate with the Hospital to provide the information and documentation necessary to apply for other existing financial resources that may be available to pay for health care services, such as Medicaid. Then the information is gathered and assessed in order to determine eligibility for charity care. Whenever possible, prior to admission, the Hospital will conduct a pre-admission interview with the patient, the guarantor, and/or the patient's legal representative. Those patients who may qualify for financial assistance from a governmental program will be referred to the appropriate program, prior to the consideration for charity care.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Hospital works closely with the Barton County Health Department and Kansas Department of Health and Environment to identify trends in the community. Education and information is provided to the public, including information on West Nile, chicken pox, and whooping cough, for example. The Hospital also trends data in the hospital and clinics to identify emerging issues. The Hospital has provided, a fall prevention program, "Stepping On", for interested elderly members of Hoisington and surrounding areas. The Hospital also trends trauma data in the emergency room and as a result provided literature to the public on fall prevention.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>There is signage posted at admissions desk. Patients are referred to a financial counselor at admission if they do not have insurance. The financial counselor also works with a Medicaid helper to try and get qualified patients registered for the Medicaid program. Effort is made during billing of deductible and co-payment to see if patient can qualify for charity care.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>The community being served is located in central Kansas and consists of approximately 2,675 residents. The average household income is $48,110. 15.7% of the community residents live below federal poverty level. Neighboring hospitals include facilities in Ellinwood and Great Bend. They are approximately 18 and 11 miles away respectively.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Hospital's Board of Directors is elected from the community at large. This allows independent individuals who reside in the primary service area to serve as a director. The Hospital also extends medical staff privileges to all qualified physicians in the community. Any surplus in funds is retained by the Hospital and aids in improving overall patient care and facility maintenance.</ExplanationTxt>
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    <IRS990ScheduleK documentId="RetDoc1053100001">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>Hoisington Public Building Commission</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>471454939</BondIssuerEIN>
        <CUSIPNum>43466QBA6</CUSIPNum>
        <BondIssuedDt>2020-10-15</BondIssuedDt>
        <IssuePriceAmt>12569466</IssuePriceAmt>
        <PurposeDesc>Renovate and expand the Hospital</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
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        <BondReferenceCd>A</BondReferenceCd>
        <TotalProceedsAmt>12582778</TotalProceedsAmt>
        <CapitalizedInterestAmt>565260</CapitalizedInterestAmt>
        <IssuanceCostsFromProceedsAmt>216638</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>11651896</CapitalExpendituresAmt>
        <OtherSpentProceedsAmt>148795</OtherSpentProceedsAmt>
        <UnspentAmt>197</UnspentAmt>
        <RefundingTaxExemptBondsInd>0</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>0</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>0</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>0</RebateNotDueYetInd>
        <ExceptionToRebateInd>1</ExceptionToRebateInd>
        <NoRebateDueInd>0</NoRebateDueInd>
        <VariableRateIssueInd>0</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>1</ProceduresCorrectiveActionInd>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K, Part II, Line 3, Total proceeds of issue</FormAndLineReferenceDesc>
        <ExplanationTxt>The difference between Part II, Line 3 and Part I, Column (e) represent year-to-date investment earnings on bond proceeds.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="RetDoc1042800001">
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>Anita Blackwell</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>Spouse of James G. Blackwell, former officer</RelationshipDescriptionTxt>
        <TransactionAmt>73823</TransactionAmt>
        <TransactionDesc>Employment arrangement</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>Members of Clara Barton Hospital Foundation, Inc. are automatically members of Clara Barton Hospital Association, Inc.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>Members of Clara Barton Hospital Association, Inc. elect members of the governing body.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Form 990 is provided to governing body and reviewed prior to filing.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>A conflict of interest disclosure form is provided to each Board Member and is reviewed annually.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization uses the KHA Salary Survey as a guide for determining CEO compensation with Board of Directors approval. The KHA Salary Survey is used by the CEO when determining compensation for other officers and key employees.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon written request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, line 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>Change in beneficial interest in Foundation net of transfers -21,780. Net assets released from restrictions used for operations -46,907.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Clara Barton Hospital Foundation Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 25</AddressLine1Txt>
          <CityNm>Hoisington</CityNm>
          <StateAbbreviationCd>KS</StateAbbreviationCd>
          <ZIPCd>67544</ZIPCd>
        </USAddress>
        <EIN>481077460</EIN>
        <PrimaryActivitiesTxt>Provide support to Clara Barton Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>KS</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 7</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>1</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>