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Nonprofiteer
← HIAWATHA HOSPITAL ASSOCIATION INC

Form 990 for tax year 2022

Filed by HIAWATHA HOSPITAL ASSOCIATION INC.

Totals

Total revenue
$30,810,336
Total expenses
$31,319,774
Contributions and grants received
$2,788,081
Grants paid
$10,834
Program service revenue
$27,953,607
Investment income
$16,004
Other revenue
$52,644
Total assets, end of year
$24,339,775
Total liabilities, end of year
$8,616,967
Net assets or fund balances, end of year
$15,722,808
Program services expenses (Part IX)
$27,080,293
Management and general expenses
$4,239,481
Fundraising expenses
$0
Program service expenses (Part III)
$27,080,293

Program services were 86.5% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1d · Related organizations

    $224,747

  • 1e · Government grants (contributions)

    $2,043,720

  • 1f · All other contributions, gifts and grants

    $519,614

  • 2a · Program service revenue: PATIENT SERVICE REVENUE

    total $27,323,818 · related or exempt $27,323,818

  • 2b · Program service revenue: PHARMACY REVENUE

    total $443,640 · related or exempt $443,640

  • 2f · All other program service revenue

    total $186,149 · related or exempt $186,149

  • 3 · Investment income

    total $16,004 · excluded $16,004

  • 6a · Gross rents

    real property $1,832

  • 6b · Less rental expenses

    real property $500

  • 6c · Rental income or loss

    real property $1,332

  • 6d · Net rental income or loss

    total $1,332 · excluded $1,332

  • 11a · Other revenue: CAFETERIA

    total $51,312 · related or exempt $51,312

  • 11e · Other revenue, total

    $51,312

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $10,834 · program services $10,834

  • 5 · Compensation of officers, directors and key employees

    total $720,230 · program services $445,795 · management and general $274,435

  • 7 · Other salaries and wages

    total $12,279,629 · program services $11,705,175 · management and general $574,454

  • 8 · Pension plan contributions

    total $349,546 · program services $339,295 · management and general $10,251

  • 9 · Other employee benefits

    total $1,584,674 · program services $1,470,783 · management and general $113,891

  • 10 · Payroll taxes

    total $870,811 · program services $829,856 · management and general $40,955

  • 11b · Fees: legal

    total $128,137 · program services $25,685 · management and general $102,452

  • 11c · Fees: accounting

    total $135,712 · management and general $135,712

  • 11d · Fees: lobbying

    total $4,017 · management and general $4,017

  • 11g · Fees: other

    total $5,664,389 · program services $5,460,752 · management and general $203,637

  • 12 · Advertising and promotion

    total $105,550 · program services $60,717 · management and general $44,833

  • 13 · Office expenses

    total $896,505 · program services $855,452 · management and general $41,053

  • 14 · Information technology

    total $393,300 · program services $104,684 · management and general $288,616

  • 16 · Occupancy

    total $484,792 · program services $153,761 · management and general $331,031

  • 17 · Travel

    total $127,004 · program services $123,874 · management and general $3,130

  • 20 · Interest

    total $236,611 · program services $53,364 · management and general $183,247

  • 22 · Depreciation, depletion and amortization

    total $1,402,068 · program services $219,690 · management and general $1,182,378

  • 23 · Insurance

    total $553,133 · program services $195,869 · management and general $357,264

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $3,972,630 · program services $3,737,375 · management and general $235,255

  • 24b · Other expenses: REPAIRS AND MAINTENANCE

    total $404,509 · program services $404,509

  • 24c · Other expenses: DUES & SUBSCRIPTIONS

    total $313,310 · program services $278,115 · management and general $35,195

  • 24e · All other expenses

    total $682,383 · program services $604,708 · management and general $77,675

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $366 · end of year $565

  • 2 · Savings and temporary cash investments

    beginning of year $13,540,608 · end of year $2,992,962

  • 4 · Accounts receivable

    beginning of year $4,737,443 · end of year $5,995,741

  • 8 · Inventories for sale or use

    beginning of year $813,797 · end of year $528,780

  • 9 · Prepaid expenses and deferred charges

    beginning of year $182,630 · end of year $233,271

  • 10a · Land, buildings and equipment: cost or other basis

    $36,413,177

  • 10b · Land, buildings and equipment: accumulated depreciation

    $24,157,314

  • 10c · Land, buildings and equipment, net

    beginning of year $10,489,649 · end of year $12,255,863

  • 11 · Investments: publicly traded securities

    end of year $679,120

  • 14 · Intangible assets

    beginning of year $0 · end of year $261,000

  • 15 · Other assets

    beginning of year $1,741,917 · end of year $1,392,473

  • 17 · Accounts payable and accrued expenses

    beginning of year $2,611,680 · end of year $2,857,358

  • 19 · Deferred revenue

    beginning of year $4,428,615 · end of year $0

  • 20 · Tax-exempt bond liabilities

    beginning of year $5,955,000 · end of year $5,447,525

  • 23 · Secured mortgages and notes payable

    beginning of year $124,709 · end of year $312,084

  • 24 · Unsecured notes and loans payable

    beginning of year $1,850,582 · end of year $0

  • 25 · Other liabilities

    beginning of year $156,229 · end of year $0

  • 27 · Net assets without donor restrictions

    beginning of year $15,735,573 · end of year $15,226,135

  • 28 · Net assets with donor restrictions

    beginning of year $644,022 · end of year $496,673

Mission and programs · 2022

Mission

AMBERWELL HIAWATHA PROVIDES COMPASSIONATE CARE WITH CLINICAL EXCELLENCE.

Activities or mission (Part I)

PROVIDE MODERN, RELIABLE, AFFORDABLE HEALTH CARE THAT BEST MEETS THE NEEDS OF OUR COMMUNITY.

  • HIAWATHA HOSPITAL ASSOCIATION, INC. DBA AMBERWELL HEALTH HIAWATHA IS A CRITICAL ACCESS HOSPITAL (CAH) THAT PROVIDES RELATED INPATIENT, OUTPATIENT, EMERGENCY CARE, AND PHYSICIAN SERVICES TO PATIENTS IN HIAWATHA, KANSAS AND SURROUNDING AREAS. HIAWATHA COMMUNITY HOSPITAL'S PRIMARY GOAL IS TO PROVIDE QUALITY, MODERN, AFFORDABLE HEALTHCARE TO OUR COMMUNITY. IN 2022, WE PROVIDED SERVICE FOR 2,864 INPATIENT DAYS, 66 INPATIENT SURGERIES AND 741 OUTPATIENT SURGERIES. WE DELIVERED 52 BABIES AND PROVIDED OUTPATIENT SERVICES TO 50,829 PATIENTS. (STATEMENT CONTINUED ON SCHEDULE O)BY PROVIDING SERVICES LIKE OBSTETRICS AND 24 HOUR EMERGENCY SERVICES THAT NOT ALL SMALL RURAL HOSPITALS PROVIDE, EVEN THOUGH THE PROGRAMS ARE NOT ALWAYS PROFITABLE FOR THE HOSPITAL, WE STRONGLY FEEL THAT THESE SERVICES PROVIDE NECESSARY CARE TO ADDRESS OUR COMMUNITY'S OVERALL HEALTH WHILE PROMOTING OUR MISSION AS A CHARITABLE ORGANIZATION.THE HOSPITAL MAINTAINS A FINANCIAL ASSISTANCE POLICY FOR PATIENTS WHO ARE FINANCIALLY UNABLE TO PAY FOR THE HEALTHCARE SERVICES THEY RECEIVE. IT IS THE POLICY OF THE HOSPITAL NOT TO PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS PATIENT FINANCIAL ASSISTANCE UNDER THE POLICY. ACCORDINGLY, THE HOSPITAL DOES NOT REPORT THESE AMOUNTS IN PATIENT SERVICE REVENUE. THE HOSPITAL DETERMINES THE COSTS ASSOCIATED WITH PROVIDING CHARITY CARE BY AGGREGATING THE DIRECT AND IN DIRECT COSTS, INCLUDING SALARIES, BENEFITS, SUPPLIES, AND OTHER OPERATING EXPENSES, BASED ON AN OVERALL COST TO CHARGE RATIO. THE COSTS OF CARING FOR THESE PATIENTS FOR THE YEAR ENDED DECEMBER 31, 2022 WAS APPROXIMATELY $275,000.

    Expenses $27,080,293 · Grants $10,834 · Revenue $28,004,919

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Greg Rodvelt

    PRESIDENT

    Total calculated
    $0
    Hours/week
    0.5

  • Del Elffner

    VICE PRESIDENT

    Total calculated
    $0
    Hours/week
    0.3 + 1 related

  • John Moore

    SECRETARY/TREASURER

    Total calculated
    $0
    Hours/week
    0.3

  • Eric Ingmire

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.3

  • Mandy Graham

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.3

  • Willie Geisendorf

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.3

  • Howard Elliott

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.3

  • Andrea Collins-Keller

    DIRECTOR THRU 06/22

    Total calculated
    $0
    Hours/week
    0.3

  • Sharese Moser

    DIRECTOR OF FINANCE

    Total calculated
    $103,831
    From this org
    $80,092
    From related orgs
    $0
    Other
    $23,739
    Hours/week
    40

  • Jeffery Perry

    CEO

    Total calculated
    $170,604
    From this org
    $169,189
    From related orgs
    $0
    Other
    $1,415
    Hours/week
    20

    Schedule J breakdown matched by us

    Base
    $169,189
    Bonus
    $0
    Other
    $0
    Deferred
    $1,415
    Nontaxable benefits
    $0
    Filer's total
    $170,604

  • Dr Jessica Jarvis

    PHYSICIAN

    Total calculated
    $445,795
    From this org
    $393,063
    From related orgs
    $0
    Other
    $52,732
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $352,732
    Bonus
    $40,331
    Other
    $0
    Deferred
    $13,494
    Nontaxable benefits
    $39,238
    Filer's total
    $445,795

  • Dr Crosby Gernon

    RADIOLOGIST

    Total calculated
    $447,035
    From this org
    $398,484
    From related orgs
    $0
    Other
    $48,551
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $398,484
    Bonus
    $0
    Other
    $0
    Deferred
    $14,525
    Nontaxable benefits
    $34,026
    Filer's total
    $447,035

  • Dr Bryon Bigham

    PHYSICIAN

    Total calculated
    $248,858
    From this org
    $216,502
    From related orgs
    $0
    Other
    $32,356
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $207,502
    Bonus
    $9,000
    Other
    $0
    Deferred
    $8,895
    Nontaxable benefits
    $23,461
    Filer's total
    $248,858

  • Dustin Williams

    APRN

    Total calculated
    $333,333
    From this org
    $286,373
    From related orgs
    $0
    Other
    $46,960
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $235,356
    Bonus
    $51,017
    Other
    $0
    Deferred
    $10,184
    Nontaxable benefits
    $36,776
    Filer's total
    $333,333

  • Dr Lowell Searight

    PHYSICIAN

    Total calculated
    $204,266
    From this org
    $184,743
    From related orgs
    $0
    Other
    $19,523
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $168,296
    Bonus
    $16,447
    Other
    $0
    Deferred
    $7,188
    Nontaxable benefits
    $12,335
    Filer's total
    $204,266

  • Dr Anna Cleland-Leighton

    PHYSICIAN

    Total calculated
    $318,479
    From this org
    $275,282
    From related orgs
    $0
    Other
    $43,197
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $275,282
    Bonus
    $0
    Other
    $0
    Deferred
    $3,293
    Nontaxable benefits
    $39,904
    Filer's total
    $318,479

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 5a · Pay contingent on this organization's revenues

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 5
THE PROVIDERS ARE PAID A PERFORMANCE BONUS BASED ON PRODUCTIVITY AND CONSIDERATION OF REVENUES.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • CHARITABLE REMAINDER TRUST (1)

    T · TRUST · KS · controlled entity

    Directly controlled by HHA

Provenance

Return type
form_990
Tax year
2022
Filed
15 November 2023
IRS schema version
2022v5.0
Source object
202313199349322736

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