TY 2013 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) Larry Britegam........................................................................ Trustee	2.00 .......................	X			0	0
(2) Kent Buer........................................................................ Chairman	2.00 .......................	X	X		0	0
(3) Robert Freelove MD........................................................................ Secretary	2.00 .......................	X	X		0	0
(4) Robert Heath........................................................................ Trustee	2.00 .......................	X			0	0
(5) Sean Herrington MD........................................................................ Trustee	40.00 .......................	X			377,880	26,842
(6) Rex Romeiser MD........................................................................ Trustee	2.00 .......................	X			0	0
(7) Morrie Soderberg........................................................................ Treasurer	2.00 .......................	X	X		0	0
(8) Betsy Wearing........................................................................ Trustee	2.00 .......................	X			0	0
(9) Lee Young........................................................................ Trustee	2.00 .......................	X			0	0
(10) Micheal Terry........................................................................ President/CEO	40.00 .......................	X	X		535,189	72,044
(11) Ryan Payne MD........................................................................ Trustee/Chief of Staff	4.00 .......................	X			0	0
(12) Jim Maes........................................................................ Trustee	2.00 .......................	X			0	0
(13) Katie Platten........................................................................ Trustee	2.00 .......................	X			0	0
(14) Chuck Oleen........................................................................ Trustee	2.00 .......................	X			0	0
(15) Joe Tallon........................................................................ VP Finance/CFO	40.00 .......................		X		261,927	26,357
(16) Larry Barnes........................................................................ VP Information Technology	40.00 .......................			X	276,322	63,107
(17) Charles Grimwood........................................................................ VP Regional Development	40.00 .......................			X	242,684	27,250

(A) Name and business address	(B) Description of services	(C) Compensation
CPT Enterprises Inc2121 Crawford PlSalinaKS67401	Management Services	1,358,168
Anesthesia Associates of Central KS PAPO Box 1607SalinaKS674021607	Anesthesia Services	1,000,013
Laboratory Corporation358 S Main StBurlingtonNC66210	Laboratory testing services	496,075
Fresenius Medical CarePO Box 749959Los AngelesCA900749959	Medical Care	465,675
Great Plains Imaging LLC320 N Terrace DrWichitaKS67208	Imaging Services	447,065
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 27

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the United States. See Part IV, line 21	1,383,946	1,383,946
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	110,600	110,600
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	3,146,304	434,381	2,711,923
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	79,917,852	72,894,434	7,023,418
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	3,083,850	2,818,442	265,408
9	Other employee benefits .......	8,636,517	7,735,849	900,668
10	Payroll taxes ...........	5,241,111	4,638,317	602,794
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	418,518		418,518
c	Accounting ...........
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........
12	Advertising and promotion ....	926,307	116,588	809,719
13	Office expenses .......	1,437,773	768,413	669,360
14	Information technology ......	4,511,702	1,845,285	2,666,417
15	Royalties ..
16	Occupancy ...........	3,961,410	2,052,010	1,909,400
17	Travel ............	443,206	161,511	281,695
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	151,005	51,886	99,119
20	Interest ...........	2,636,245	1,365,575	1,270,670
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	13,418,826	8,658,937	4,759,889
23	Insurance ..............	2,159,131	558,377	1,600,754
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Medical supplies	20,725,661	20,725,661
b	Pharmaceuticals	14,972,037	14,972,037
c	Professional fees other	5,451,385	4,144,554	1,306,831
d	Professional fees physi	5,085,015	5,085,015
e	All other expenses	14,353,406	8,319,917	6,033,489
25	Total functional expenses. Add lines 1 through 24e	192,171,807	158,841,735	33,330,072	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	7,578	1	7,878
2	Savings and temporary cash investments .........	13,062,462	2	23,471,356
3	Pledges and grants receivable, net ...........		3
4	Accounts receivable, net .............	29,157,189	4	30,789,094
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
			5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
			6
7	Notes and loans receivable, net .............		7
8	Inventories for sale or use ..............	1,334,375	8	1,462,964
9	Prepaid expenses and deferred charges ..........	2,737,793	9	4,187,023
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	261,775,971
b	Less: accumulated depreciation .....	10b	152,090,196	114,029,993	10c	109,685,775
11	Investments—publicly traded securities ..........	214,421,381	11	242,431,965
12	Investments—other securities. See Part IV, line 11 .....	7,117,662	12	7,444,213
13	Investments—program-related. See Part IV, line 11 .....		13
14	Intangible assets ...............	9,681,674	14	9,751,388
15	Other assets. See Part IV, line 11 ...........	16,954,892	15	14,648,697
16	Total assets. Add lines 1 through 15 (must equal line 34)......	408,504,999	16	443,880,353
	17	Accounts payable and accrued expenses .........	18,502,340	17	22,384,804
18	Grants payable .................		18
19	Deferred revenue ................		19
20	Tax-exempt bond liabilities .............	55,184,878	20	54,377,466
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..	883	23
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	4,073,051	25	3,862,169
26	Total liabilities. Add lines 17 through 25.........	77,761,152	26	80,624,439
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	320,306,956	27	352,217,400
28	Temporarily restricted net assets ...........	3,487,136	28	3,596,681
29	Permanently restricted net assets ...........	6,949,755	29	7,441,833
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	330,743,847	33	363,255,914
34	Total liabilities and net assets/fund balances ........	408,504,999	34	443,880,353

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.
right arrow

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

Salina Regional Health Center Inc

Employer identification number

48-1169103

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Non-functionally integrated

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the supported organization? ................

11g(i)

(ii) A family member of a person described in (i) above? ......................

11g(ii)

(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of monetary support
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of monetary support


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2013

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here................................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2012 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2013. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2012. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2013. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2012. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2013

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2009	(b) 2010	(c) 2011	(d) 2012	(e) 2013	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2012 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2012 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2013. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ........ right arrow

33 1/3% support tests—2012. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2013

Page 4

Part IV

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Name of the organization

Salina Regional Health Center Inc

Employer identification number

48-1169103

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi) and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not total more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year ......................... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 2

Name of organization Salina Regional Health Center Inc

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTEDRESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 3

Name of organization Salina Regional Health Center Inc

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Page 4

Name of organization
Salina Regional Health Center Inc

Employer identification number

48-1169103

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

$
Use duplicate copies of Part III if additional space is needed.

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

See separate instructions. SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Salina Regional Health Center Inc

Employer identification number

48-1169103

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2013

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2013

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? ..........................

Yes

27,560

Total. Add lines 1c through 1i ...............................

27,560

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ............................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Part II-B, Line 1:	A portion of annual dues paid by Salina Regional Health Center, Inc., to various health care organizations has been identified as association lobbying activities by those organizations. The amount reported as direct contact with legislators, their staff, government officials, or a legislative body represents the portion of dues identified as association lobbying activities by these organizations. Salina Regional Health Center, Inc., does not participate in activities supporting a political candidate.

Return Reference

Explanation

Part II-B, Line 1:

A portion of annual dues paid by Salina Regional Health Center, Inc., to various health care organizations has been identified as association lobbying activities by those organizations. The amount reported as direct contact with legislators, their staff, government officials, or a legislative body represents the portion of dues identified as association lobbying activities by these organizations. Salina Regional Health Center, Inc., does not participate in activities supporting a political candidate.

Schedule C (Form 990 or 990EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions. SchDMd Bullet

Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

Salina Regional Health Center Inc

Employer identification number

48-1169103

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) .....
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2013

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIII and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....	1,115,634	1,068,232	938,600	959,381	900,186
b	Contributions ........	167,724			100	80
c	Net investment earnings, gains, and losses	129,862	67,038	145,738	-20,881	75,389
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........	19,191	19,636	16,106		16,274
f	Administrative expenses ....
g	End of year balance ......	1,394,029	1,115,634	1,068,232	938,600	959,381

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

64.000 %

Temporarily restricted endowment SchDMd Bullet

36.000 %

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

Yes

(ii) related organizations ........................

3a(ii)

Yes

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	6,864,891		6,864,891
b	Buildings ................	155,257,459	83,379,907	71,877,552
c	Leasehold improvements ............
d	Equipment ................	95,158,079	66,074,136	29,083,943
e	Other .................	4,495,542	2,636,153	1,859,389
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				109,685,775

Schedule D (Form 990) 2013

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes
Estimated reimbursements payable		3,862,169








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		3,862,169
2. Liability for uncertain tax positions In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII ..................................................

Schedule D (Form 990) 2013

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	223,081,375
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a	10,522,774
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	-803,525
e	Add lines 2a through 2d .....................			2e	9,719,249
3	Subtract line 2e from line 1.....................			3	213,362,126
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b	12,653
c	Add lines 4a and 4b.......................			4c	12,653
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	213,374,779

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	190,782,782
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d......................			2e	0
3	Subtract line 2e from line 1.....................			3	190,782,782
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b	1,389,025
c	Add lines 4a and 4b.......................			4c	1,389,025
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	192,171,807

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
Part V, Line 4:	The endowment funds are to benefit the Cardiology, Rehabilitation, and Oncology departments of Salina Regional Health Center.
Part X, Line 2:	Management is not aware of any uncertainties in income tax positions.
Part XI, Line 2d - Other Adjustments:	Community Health Improvement Program (CHIP) donation -1,069,172. KU Endowment donation -250,000. Ashby house donation -57,200. Change in beneficial interest in net assets of Foundation 240,385. Change in fair value of assets held in trust 332,462.
Part XI, Line 4b - Other Adjustments:	Net fundraising events revenue 12,653.
Part XII, Line 4b - Other Adjustments:	Ashby house donation 57,200. KU Endowment donation 250,000. Community Health Improvement Program (CHIP) donation 1,069,172. Net fundraising events revenue 12,653.

Schedule D (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.
right arrow

Information about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization
Salina Regional Health Center Inc

Employer identification number

48-1169103

Part I

Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

Yes

If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










Total .................

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

For Paperwork Reduction Act Notice, see the Instructions for Form 990or 990-EZ.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2013

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 Rummage Sales (event type)	(b) Event #2 Holly Days (event type)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . .	15,738	5,147	20,885
2	Less: Contributions . .
3	Gross income (line 1 minus line 2) . . .	15,738	5,147	20,885
4	Cash prizes . . .
5	Noncash prizes . .
6	Rent/facility costs . .
7	Food and beverages .
8	Entertainment . . .
9	Other direct expenses .	5,161	3,071	8,232
10	Direct expense summary. Add lines 4 through 9 in column (d) ...........			8,232
11	Net income summary. Subtract line 10 from line 3, column (d)...........			12,653

Part III

Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

(a) Bingo

(b) Pull tabs/Instant
bingo/progressive bingo

(c) Other gaming

(d) Total gaming (add col.(a) through col.(c))

Gross revenue . . . .

Cash prizes . . . .

Non-cash prizes . . .

Rent/facility costs . . .

Other direct expenses . .

Volunteer labor . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d) ......... right arrow

Enter the state(s) in which the organization operates gaming activities:

Is the organization licensed to operate gaming activities in each of these states? ............

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2013

Page 3

Does the organization operate gaming activities with nonmembers? .................

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? ..........................

YesNo

Indicate the percentage of gaming activity operated in:

The organization's facility ......................

13a

An outside facility ........................

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? ......................................

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? ............................

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).

Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

Salina Regional Health Center Inc

Employer identification number

48-1169103

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...

Yes

If "Yes," was it a written policy? .......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: .........

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............

Did the organization prepare a community benefit report during the tax year? ..........

Yes

If "Yes," did the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..		3,845	2,674,855		2,674,855	1.390 %
b	Medicaid (from Worksheet 3, column a) ....		12,693	14,350,223	9,011,638	5,338,585	2.780 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .
d	Total Financial Assistance and Means-Tested Government Programs .		16,538	17,025,078	9,011,638	8,013,440	4.170 %
Other Benefits		24	1,570	186,481		186,481	0.100 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	24	1,570	186,481		186,481	0.100 %
f	Health professions education (from Worksheet 5) ..	25		2,425,389	693,052	1,732,337	0.900 %
g	Subsidized health services (from Worksheet 6) ..	19	11,133	67,711,710	46,920,617	20,791,093	10.820 %
h	Research (from Worksheet 7)	2		2,232		2,232	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	7		1,075,775		1,075,775	0.560 %
j	Total. Other Benefits ..	77	12,703	71,401,587	47,613,669	23,787,918	12.380 %
k	Total. Add lines 7d and 7j .	77	29,241	88,426,665	56,625,307	31,801,358	16.550 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013

Schedule H (Form 990) 2013

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	1	7,371		7,371	0 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	1	14,075	12,695	1,380	0 %
8	Workforce development	3	2,908		2,908	0 %
9	Other
10	Total	5	24,354	12,695	11,659

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

4,605,088

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

678,191

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

60,488,403

Enter Medicare allowable costs of care relating to payments on line 5.....

57,164,390

Subtract line 6 from line 5. This is the surplus (or shortfall)........

3,324,013

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2013

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?2 Name, address, primary website address, and state license number
1	Salina Regional Health Center Inc 400 South Santa Fe Salina,KS67401	X	X	X	X
2	Salina Surgical Center LLC 401 South Santa Fe Salina,KS67401	X	X

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	Salina Regional Health Center Inc
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ....................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Did the hospital facility make its CHNA report widely available to the public? .............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): www.srhc.com/about/documents/

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 200.000000000000% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11	Yes
	If "Yes," indicate the FPG family income limit for eligibility for discounted care: 300.000000000000% If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	Yes
	If "Yes," indicate the factors used in determining such amounts (check all that apply):
a	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	Yes
	If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
17	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?..........	17		No
	If "Yes," check all actions in which the hospital facility or a third party engaged:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	Salina Surgical Center LLC
Name of hospital facility or facility reporting group

If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A)

Yes

Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9....................

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Part VI)

Indicate the tax year the hospital facility last conducted a CHNA: 20

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................

Did the hospital facility make its CHNA report widely available to the public? .............

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url):

Other website (list url):

Available upon request from the hospital facility

Other (describe in Part VI)

If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):

Adoption of an implementation strategy that addresses each of the community health needs identified through the CHNA

Execution of the implementation strategy

Participation in the development of a community-wide plan

Participation in the execution of a community-wide plan

Inclusion of a community benefit section in operational plans

Adoption of a budget for provision of services that address the needs identified in the CHNA

Prioritization of health needs in its community

Prioritization of services that the hospital facility will undertake to meet health needs in its community

Other (describe in Part VI)

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ......

If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Financial Assistance Policy			Yes	No
9	Did the hospital facility have in place during the tax year a written financial assistance policy that:
	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?	9	Yes
10	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........	10	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 100.000000000000% If "No," explain in Part VI the criteria the hospital facility used.
11	Used FPG to determine eligibility for providing discounted care?.................	11	Yes
	If "Yes," indicate the FPG family income limit for eligibility for discounted care: 100.000000000000% If "No," explain in Part VI the criteria the hospital facility used.
12	Explained the basis for calculating amounts charged to patients?.................	12	Yes
	If "Yes," indicate the factors used in determining such amounts (check all that apply):
a	Income level
b	Asset level
c	Medical indigency
d	Insurance status
e	Uninsured discount
f	Medicaid/Medicare
g	State regulation
h	Residency
i	Other (describe in Part VI)
13	Explained the method for applying for financial assistance?...................	13	Yes
14	Included measures to publicize the policy within the community served by the hospital facility?.......	14	Yes
	If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a	The policy was posted on the hospital facility’s website
b	The policy was attached to billing invoices
c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d	The policy was posted in the hospital facility’s admissions offices
e	The policy was provided, in writing, to patients on admission to the hospital facility
f	The policy was available upon request
g	Other (describe in Part VI)
Billing and Collections
15	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......	15	Yes
16	Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)
17	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?..........	17		No
	If "Yes," check all actions in which the hospital facility or a third party engaged:
a	Reporting to credit agency
b	Lawsuits
c	Liens on residences
d	Body attachments
e	Other similar actions (describe in Section C)

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)

Other (describe in Part VI)

Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Part VI)

If "Yes," explain in Part VI.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? .........................

If "Yes," explain in Part VI.

Schedule H (Form 990) 2013

Page

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference	Explanation
Salina Regional Health Center, Inc.	Part V, Section B, Line 3: Salina Regional Health Center collaborated with Salina-Saline County Health Department and Central Kansas Foundation to conduct a community health assessment and develop a community health improvement plan. Data was gathered, analyzed, and discussed by this collaborative group. Results were presented at a forum of representatives from a broader group of agencies involved in community development and health improvement. Broad community input was obtained through public forums and surveys. To assess public perception of the health issues identified by community partner organizations as most concerning, a survey and background information was developed and distributed in March 2013. Saline County residents were invited to review the information and participate in the survey via social media, the local newspaper, email, and notices posted throughout the community. A summary of the issues was presented at two public meetings that included opportunity for discussion with CHA Core Group representatives. A written summary of issues and the survey were placed at community locations that were easily accessible. Electronic versions of materials and the link to an internet survey were distributed via social media, the local newspaper, and email. Three hundred four individual surveys were completed during the 30 days it was available. The CHNA was retroactively endorsed by Salina Surgical Center.
Salina Regional Health Center, Inc.	Part V, Section B, Line 5d: The initial data report was provided on websites and in paper form at the Salina Regional Health Center information desk, public library, county health department, and other locations. The final report is posted on the Salina Regional Health Center website. In the spring of 2014, a professional publication was distributed (newspaper, direct mail, personal distribution to agencies, and other public locations). Results were also presented by a SRHC representative at civic clubs and other settings.Annual update of implementation strategy:The 2013 Community Health Needs Assessment recognized the following items childhold obesity, teenage pregancy, adult obesity, domestic violence, falls among elderly, medication misuse, and sexually transmitted infections for prioritization. SRHC chose two items (falls among elderly and medication misuse) to concentrate on as they fit within the framework of our mission and had less attention from other Saline County agencies. Falls among elderly and medication misuse:In 2014 the North Central-Flint Hills Area Agency on Aging received a $100,000 grant from Salina Regional to start a fall prevention program in the Salina area the program was rolled out in July 2014. The program is called "Be Well! Stay Well! Right at Home" and is aimed at helping prevent falls. It includes going into a person's home and identifying often small changes that can make the home safer. The first steps included placing articles about fall prevention in "Keynotes," the agency's newspaper, and providing information about fall prevention at venues such as the annual Sunflower Fair in Salina. There's also an eight-session class called "A Matter of Balance," that follows a curriculum written at Boston University and addresses fear of falling, recognizing that falls are preventable and increasing physical activity. The program also includes an assessment to identify situations that can cause falls and finding ways to fix them. During an in-home assessment they look at issues such as the person's vision, what medications they're taking and items around the home that represent fall dangers. The agency has contact with several other agencies that can help with specific issues that can help a person stay out of the hospital again.Medication misuse:As part of a project to limit readmissions to hospital and disease complications due to medication misuse the SRHC pharmacy department implemented a new process for follow up on heart failure patients to assure proper medication compliance. In October 2012, a 90 day pilot project began, in which heart failure patients were educated by pharmacists prior to discharge and with a follow-up phone call 48-72 hours after discharge. The pilot project indicated HCAP scores increased for medication-related measures and no CMS failures for discharge instructions occurred on patients with pharmacist intervention. Beginning in May 2013, quality auditors identify patients with possible primary diagnosis of heart failure and notify pharmacists. For these patients, pharmacists add discharge instructions for heart failure to the patient's chart, pharmacist visit patients prior to discharge and schedule a follow-up phone call appointment with patient. During visit, the pharmacists give patient a Zone Chart and answer medication questions. Nurses also complete a discharge assessment and document if the patient has heart failure and has received discharge instructions to identify patients for follow-up phone call. The follow-up phone call is completed by the pharmacist 48-72 post discharge for patients returning to home setting to reinforce education and medication adherence.Pharmacy interventions: October 2013-December 2014 1. Patient scales: - October 2013-July 2014: 5 patients reported on phone call they still had not purchased scales - August 2014: pharmacy obtained a grant to purchase scales for patients, six given out August to December 2014 - 6 Additional scales purchased and dispensed in 2015 2. Discharge instructions: - 403 patients targeted with intervention - Improved measure from 84.5% in fiscal year 2012 to 91% from October - December 2013 3. Patient visit prior to discharge: - From October to December 2014, 7 out of 28 patients had pharmacist visit prior to discharge 4. Follow-up phone call interventions: - 253 patients targeted for follow-up phone call - Corrections to discharge medication instructions - Reinforce obtaining new prescriptions - Discuss new prescriptions and effects/side effects - Reinforce making follow-up appointment with physician - Contact physician's office with concerns - Coordinate with SFHC ambulatory care pharmacist for clinic follow-up - Discuss fluid and salt restrictionsThe 30-day all cause readmission rate for patients who received a phone call from a pharmacists was 14%. The readmission rate for patients who did not receive a phone call was 41%. Interventions by pharmacists ranged from reinforcement of discharge instructions to taking action like calling physician office or retail pharamcy to correct medication discrepancies.Salina Regional Health Center's Pharmacy Residency Program welcomed its second class of residents in July. The program was initiated in 2012 to increase post-graduate training opportunities in the State to attract and retain pharmacists who might one day enter practice here. Today, many pharmacy graduates pursue post-graduate training to gain specialized skills. Many jobs even require additional training. "One year of residency is often considered equivalent to three-to-five years of practice experience," said Steven Blanner, Salina Regional's pharmacy residency director. While interest in post-graduate training has increased in recent years, the number of training opportunities available hasn't been able to keep pace. This year 31.5 percent of applicants for pharmacy residency positions nationwide were unable to match with a program because not enough positions were available. Salina is one of nine Kansas hospitals to offer a post-graduate pharmacy training program. Salina Regional Health Center's Pharmacy Residency Program recently received a full, three-year accreditation from the American Society of HealthSystem Pharmacists.
Salina Regional Health Center, Inc.	Part V, Section B, Line 7: Childhood obesity, teen pregnancy, adult obesity, domestic violence, and sexually-transmitted infections were needs identified in the CHNA which are not being addressed by Salina Regional Health Center as they are outside the scope of our operations.
Salina Regional Health Center, Inc.	Part V, Section B, Line 16e: File against estates
Salina Regional Health Center, Inc.	Part V, Section B, Line 20d: Deduction of 30%.
Salina Surgical Center, LLC	Part V, Section B, Line 20d: Usual and customary net charges for services rendered.
Salina Surgical Center, LLC:	Part V, Section B, Line 1:A community health needs assessment for Salina Surgical Center, LLC, a hospital facility of the hospital organization Salina Regional Health Center, was not conducted by the end of Salina Regional Health Center's taxable year. In late November 2013 our consultant began researching the requirements of 501(r) in relationship to our ownership percentage of Salina Surgical Center. In January 2014, we received a letter from our consultant indicating that Salina Surgical Center met the definition of a hospital facility under the proposed regulations. After reviewing the research and consulting legal counsel, we concluded in May 2014 that Salina Surgical Center, LLC is a hospital facility of Salina Regional Health Center; therefore, all requirements of 501(r) are applicable to Salina Surgical Center. We are currently in the process of making sure all requirements under 501(r) are met including the adoption of the CHNA and implementation strategy for Salina Surgical Center. We anticipate starting the joint CHNA by the end of the fiscal year ended 9/30/2014 and meeting the requirements for conducting the CHNA and adopting an implementation strategy by fiscal year ended 9/30/2015. To minimize future failures, we will communicate with Salina Surgical Center regarding the 501(r) requirements on an ongoing basis and work together with them to meet the requirements. On August 6, 2014, the board of directors of Salina Surgical Center reviewed and endorsed the findings of the Saline County 2013 Community Needs Assessment Survey.

Schedule H (Form 990) 2013

Page

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?20
Name and address		Type of Facility (describe)
1	Salina Regional Outpatient Imaging 520 S Santa Fe Lower Level Salina,KS67401	Outpatient imaging clinic
2	Salina Regional Oncology 511 S Santa Fe Salina,KS67401	Physician clinic
3	Comcare - Santa Fe Clinic 520 S Santa Fe Suite 300 Salina,KS67401	Physician clinic, lab & x-ray services
4	Comcare - Elm Clinic 617 E Elm Street Salina,KS67401	Physician clinic, imaging center,& lab services
5	Salina Regional Neurosurgery 501 S Santa Fe Suite 300 Salina,KS67401	Physician clinic
6	Salina Pediatric Care 501 S Santa Fe Suite 100 Salina,KS67401	Physician clinic
7	Comcare - Statcare Clinic 1001 S Ohio St Salina,KS67401	Minor emergency and illness clinic, lab & x-ray services
8	Salina Regional Surgical Associates 501 S Santa Fe Suite 200 Salina,KS67401	Physician clinic
9	Salina Women's Clinic 501 S Santa Fe Suite 140 Salina,KS67401	Physician clinic
10	Salina Regional Cardo Thoracic 501 S Santa Fe Suite 200 Salina,KS67401	Physician clinic
11	Salina Regional Outpatient PT 520 S Santa Fe Salina,KS67401	Outpatient physical therapy
12	Comcare - Minneapolis Clinic 311 N Mill St Minneapolis,KS67456	Physician clinic, lab & x-ray services
13	Comcare - Occupational Health Partners 1101 E Republic St Salina,KS67401	Therapy, lab and x-ray services
14	Hospice of Salina 730 Holly Lane Salina,KS67401	Hospice care
15	Salina Regional Pulmonary 520 S Santa Fe Lower Level Salina,KS67401	Physician clinic
16	Salina Regional Veridian 730 Holly Lane Salina,KS67401	Outpatient psych clinic
17	Salina Regional Neurosciences 501 S Santa Fe Suite 210 Salina,KS67401	Physician clinic
18	Salina Regional Infant Child Development 155 N Oakdale Salina,KS67401	Outpatient child development services
19	Salina Regional Podiatry 501 S Santa Fe Suite 200 Salina,KS67401	Physician clinic
20	Salina Regional New Options 1375 W Ash St Junction City,KS66441	Outpatient psych clinic

Schedule H (Form 990) 2013

Page

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Salina Regional Health Center, Inc.	Part V, Section B, Line 3: Salina Regional Health Center collaborated with Salina-Saline County Health Department and Central Kansas Foundation to conduct a community health assessment and develop a community health improvement plan. Data was gathered, analyzed, and discussed by this collaborative group. Results were presented at a forum of representatives from a broader group of agencies involved in community development and health improvement. Broad community input was obtained through public forums and surveys. To assess public perception of the health issues identified by community partner organizations as most concerning, a survey and background information was developed and distributed in March 2013. Saline County residents were invited to review the information and participate in the survey via social media, the local newspaper, email, and notices posted throughout the community. A summary of the issues was presented at two public meetings that included opportunity for discussion with CHA Core Group representatives. A written summary of issues and the survey were placed at community locations that were easily accessible. Electronic versions of materials and the link to an internet survey were distributed via social media, the local newspaper, and email. Three hundred four individual surveys were completed during the 30 days it was available. The CHNA was retroactively endorsed by Salina Surgical Center.
Salina Regional Health Center, Inc.	Part V, Section B, Line 5d: The initial data report was provided on websites and in paper form at the Salina Regional Health Center information desk, public library, county health department, and other locations. The final report is posted on the Salina Regional Health Center website. In the spring of 2014, a professional publication was distributed (newspaper, direct mail, personal distribution to agencies, and other public locations). Results were also presented by a SRHC representative at civic clubs and other settings.Annual update of implementation strategy:The 2013 Community Health Needs Assessment recognized the following items childhold obesity, teenage pregancy, adult obesity, domestic violence, falls among elderly, medication misuse, and sexually transmitted infections for prioritization. SRHC chose two items (falls among elderly and medication misuse) to concentrate on as they fit within the framework of our mission and had less attention from other Saline County agencies. Falls among elderly and medication misuse:In 2014 the North Central-Flint Hills Area Agency on Aging received a $100,000 grant from Salina Regional to start a fall prevention program in the Salina area the program was rolled out in July 2014. The program is called "Be Well! Stay Well! Right at Home" and is aimed at helping prevent falls. It includes going into a person's home and identifying often small changes that can make the home safer. The first steps included placing articles about fall prevention in "Keynotes," the agency's newspaper, and providing information about fall prevention at venues such as the annual Sunflower Fair in Salina. There's also an eight-session class called "A Matter of Balance," that follows a curriculum written at Boston University and addresses fear of falling, recognizing that falls are preventable and increasing physical activity. The program also includes an assessment to identify situations that can cause falls and finding ways to fix them. During an in-home assessment they look at issues such as the person's vision, what medications they're taking and items around the home that represent fall dangers. The agency has contact with several other agencies that can help with specific issues that can help a person stay out of the hospital again.Medication misuse:As part of a project to limit readmissions to hospital and disease complications due to medication misuse the SRHC pharmacy department implemented a new process for follow up on heart failure patients to assure proper medication compliance. In October 2012, a 90 day pilot project began, in which heart failure patients were educated by pharmacists prior to discharge and with a follow-up phone call 48-72 hours after discharge. The pilot project indicated HCAP scores increased for medication-related measures and no CMS failures for discharge instructions occurred on patients with pharmacist intervention. Beginning in May 2013, quality auditors identify patients with possible primary diagnosis of heart failure and notify pharmacists. For these patients, pharmacists add discharge instructions for heart failure to the patient's chart, pharmacist visit patients prior to discharge and schedule a follow-up phone call appointment with patient. During visit, the pharmacists give patient a Zone Chart and answer medication questions. Nurses also complete a discharge assessment and document if the patient has heart failure and has received discharge instructions to identify patients for follow-up phone call. The follow-up phone call is completed by the pharmacist 48-72 post discharge for patients returning to home setting to reinforce education and medication adherence.Pharmacy interventions: October 2013-December 2014 1. Patient scales: - October 2013-July 2014: 5 patients reported on phone call they still had not purchased scales - August 2014: pharmacy obtained a grant to purchase scales for patients, six given out August to December 2014 - 6 Additional scales purchased and dispensed in 2015 2. Discharge instructions: - 403 patients targeted with intervention - Improved measure from 84.5% in fiscal year 2012 to 91% from October - December 2013 3. Patient visit prior to discharge: - From October to December 2014, 7 out of 28 patients had pharmacist visit prior to discharge 4. Follow-up phone call interventions: - 253 patients targeted for follow-up phone call - Corrections to discharge medication instructions - Reinforce obtaining new prescriptions - Discuss new prescriptions and effects/side effects - Reinforce making follow-up appointment with physician - Contact physician's office with concerns - Coordinate with SFHC ambulatory care pharmacist for clinic follow-up - Discuss fluid and salt restrictionsThe 30-day all cause readmission rate for patients who received a phone call from a pharmacists was 14%. The readmission rate for patients who did not receive a phone call was 41%. Interventions by pharmacists ranged from reinforcement of discharge instructions to taking action like calling physician office or retail pharamcy to correct medication discrepancies.Salina Regional Health Center's Pharmacy Residency Program welcomed its second class of residents in July. The program was initiated in 2012 to increase post-graduate training opportunities in the State to attract and retain pharmacists who might one day enter practice here. Today, many pharmacy graduates pursue post-graduate training to gain specialized skills. Many jobs even require additional training. "One year of residency is often considered equivalent to three-to-five years of practice experience," said Steven Blanner, Salina Regional's pharmacy residency director. While interest in post-graduate training has increased in recent years, the number of training opportunities available hasn't been able to keep pace. This year 31.5 percent of applicants for pharmacy residency positions nationwide were unable to match with a program because not enough positions were available. Salina is one of nine Kansas hospitals to offer a post-graduate pharmacy training program. Salina Regional Health Center's Pharmacy Residency Program recently received a full, three-year accreditation from the American Society of HealthSystem Pharmacists.
Salina Regional Health Center, Inc.	Part V, Section B, Line 7: Childhood obesity, teen pregnancy, adult obesity, domestic violence, and sexually-transmitted infections were needs identified in the CHNA which are not being addressed by Salina Regional Health Center as they are outside the scope of our operations.
Salina Regional Health Center, Inc.	Part V, Section B, Line 16e: File against estates
Salina Regional Health Center, Inc.	Part V, Section B, Line 20d: Deduction of 30%.
Salina Surgical Center, LLC	Part V, Section B, Line 20d: Usual and customary net charges for services rendered.
Salina Surgical Center, LLC:	Part V, Section B, Line 1:A community health needs assessment for Salina Surgical Center, LLC, a hospital facility of the hospital organization Salina Regional Health Center, was not conducted by the end of Salina Regional Health Center's taxable year. In late November 2013 our consultant began researching the requirements of 501(r) in relationship to our ownership percentage of Salina Surgical Center. In January 2014, we received a letter from our consultant indicating that Salina Surgical Center met the definition of a hospital facility under the proposed regulations. After reviewing the research and consulting legal counsel, we concluded in May 2014 that Salina Surgical Center, LLC is a hospital facility of Salina Regional Health Center; therefore, all requirements of 501(r) are applicable to Salina Surgical Center. We are currently in the process of making sure all requirements under 501(r) are met including the adoption of the CHNA and implementation strategy for Salina Surgical Center. We anticipate starting the joint CHNA by the end of the fiscal year ended 9/30/2014 and meeting the requirements for conducting the CHNA and adopting an implementation strategy by fiscal year ended 9/30/2015. To minimize future failures, we will communicate with Salina Surgical Center regarding the 501(r) requirements on an ongoing basis and work together with them to meet the requirements. On August 6, 2014, the board of directors of Salina Surgical Center reviewed and endorsed the findings of the Saline County 2013 Community Needs Assessment Survey.

Schedule H (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990
lBullet

Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization
Salina Regional Health Center Inc

Employer identification number
48-1169103

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance
(1) Salina Regional Health Foundation Inc 400 South Santa Fe Salina,KS67401	48-0949407	501(c)(3)	1,069,172				To further the activities of the Community Health Improvement Program (CHIP)
(2) KU Endowment 3901 Rainbow Blvd Kansas City,KS661607804	48-0547734	501(c)(3)	250,000				Support KU School of Medicine - Salina campus
(3) Ashby House LTD PO Box 3482 Salina,KS67402	48-1099925	501(c)(3)		57,200	Book	Real estate	To provide shelter for homeless families and single women
(4) Lindbsborg Community Hospital Association 605 West Lincoln Lindsborg,KS674562328	48-0545183	501(c)(3)		7,574	FMV	Equipment	To provide medical equipment

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2013

Page 2

Part III

Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant
(1) Scholarships to students attending nursing school.	19	110,600

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference	Explanation
Part I, Line 2:	All donee information is kept as part of the organization's books and records. All nursing scholarships recipients are selected based on set criteria.

Schedule I (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

Salina Regional Health Center Inc

Employer identification number

48-1169103

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Yes

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2013

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1)Sean Herrington MDTrustee	(i) (ii)	291,789 0	86,091 0	0 0	12,500 0	14,342 0	404,722 0	0 0
(2)Micheal TerryPresident/CEO	(i) (ii)	390,939 0	144,250 0	0 0	55,315 0	16,729 0	607,233 0	0 0
(3)Joe TallonVP Finance/CFO	(i) (ii)	219,650 0	42,277 0	0 0	12,500 0	13,857 0	288,284 0	0 0
(4)Larry BarnesVP Information Technology	(i) (ii)	232,881 0	43,441 0	0 0	53,948 0	9,159 0	339,429 0	0 0
(5)Charles GrimwoodVP Regional Development	(i) (ii)	203,593 0	39,091 0	0 0	13,125 0	14,125 0	269,934 0	0 0
(6)Jack HinnenkampVP Facilities Management	(i) (ii)	175,584 0	32,616 0	0 0	13,125 0	8,217 0	229,542 0	0 0
(7)David MoodyVP Human Resources	(i) (ii)	180,126 0	34,726 0	0 0	13,125 0	13,391 0	241,368 0	0 0
(8)Joel PhelpsCOO	(i) (ii)	254,721 0	57,670 0	0 0	31,243 0	14,246 0	357,880 0	0 0
(9)Luanne SmithVP Patient Care/CNO	(i) (ii)	157,666 0	30,299 0	0 0	13,125 0	12,766 0	213,856 0	0 0
(10)John KelemenPhysician	(i) (ii)	552,218 0	28,692 0	90,000 0	12,500 0	17,876 0	701,286 0	0 0
(11)Keir SwisherPhysician	(i) (ii)	328,782 0	79,245 0	0 0	12,500 0	13,803 0	434,330 0	0 0
(12)Jeremiah OstmeyerPhysician	(i) (ii)	346,526 0	35,833 0	0 0	12,500 0	14,027 0	408,886 0	0 0
(13)Justin WhitlowPhysician	(i) (ii)	543,239 0	7,500 0	0 0	12,500 0	16,052 0	579,291 0	0 0
(14)Merle HodgesPhysician	(i) (ii)	390,730 0	52,030 0	0 0	12,500 0	15,624 0	470,884 0	0 0

Schedule J (Form 990) 2013

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.

Return Reference	Explanation
Part I, Line 6	The compensation committee of the board determines bonus and incentive payments based on a balanced scorecard which includes financial, patient satisfaction, and quality data. In addition, a compensation review is performed by an independent outside consultant.

Schedule J (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization
Salina Regional Health Center Inc

Employer identification number
48-1169103

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	City of Salina Kansas	48-6017228	794770DP9	04-07-2006	65,053,116	Extinguish Series 1999 Revenue Bonds and to construct a new patient tower		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	10,778,116
2 Amount of bonds legally defeased . . . . . . . . . . .
3 Total proceeds of issue . . . . . . . . . . . . . .	65,053,116
4 Gross proceeds in reserve funds . . . . . . . . . . . .	4,540,402
5 Capitalized interest from proceeds . . . . . . . . . . .
6 Proceeds in refunding escrows . . . . . . . . . . . .
7 Issuance costs from proceeds . . . . . . . . . . . .	570,534
8 Credit enhancement from proceeds . . . . . . . . . . .
9 Working capital expenditures from proceeds . . . . . . . . .
10 Capital expenditures from proceeds . . . . . . . . . . .	37,121,199
11 Other spent proceeds . . . . . . . . . . . . . .	23,036,195
12 Other unspent proceeds . . . . . . . . . . . . . .
13 Year of substantial completion . . . . . . . . . . . .	2010
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .		X
15 Were the bonds issued as part of an advance refunding issue? . . . . .	X
16 Has the final allocation of proceeds been made? . . . . . . . .	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2013

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .
6 Total of lines 4 and 5 . . . . . . . . . . . . .
7 Does the bond issue meet the private security or payment test? . . . . .		X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? . . . . . . .		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T? . . . . .		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X
b Exception to rebate? . . . . . . . .		X
c No rebate due? . . . . . . . .		X
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider . . . . . . . . .
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . .
e Was the hedge terminated? . . . . . .

Schedule K (Form 990) 2013

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X
b Name of provider . . . . . . . . .
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?		X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation

Schedule K (Form 990) 2013

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

Salina Regional Health Center Inc

Employer identification number

48-1169103

Part I

Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No






Total ...... $

Part III

Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2013

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) Stacie Maes	Family member of Jim Maes, Trustee	70,385	Employment		No
(2) Salina Surgical Center	4 Board of directors are employees and/or trustees of SRHC	222,174	Provide employees and supplies		No
(3) Patricia Grimwood	Spouse of Charles Grimwood, Key Employee of SRHC	17,479	Employment		No
(4) Linda Hinnenkamp	Spouse of John Hinnenkamp, Key Employee of SRHC	69,630	Employment		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

Salina Regional Health Center Inc

Employer identification number

48-1169103

Return Reference	Explanation
Form 990, Part VI, Section A, line 4	Articles of incorporation and bylaws were amended to reflect Ascension Health's acquisition of Via Christi Health, Inc, a corporate member of Salina Regional Health Center, Inc.
Form 990, Part VI, Section A, line 6	Salina Regional Health Center has two corporate members: Salina Regional Health Foundation, Inc., and Via Christi Health, Inc.
Form 990, Part VI, Section A, line 7a	The corporate members have the power to approve appointment of members to and removal of members from the Board of Trustees.
Form 990, Part VI, Section B, line 11	The Form 990 is provided to the Board of Trustees for review prior to filing. Due to current year timing, the approval by the audit committee will not occur until after the filing date.
Form 990, Part VI, Section B, line 12c	A conflict of interest questionnaire is required to be completed upon election and annually. The questionnaire is reviewed by legal counsel.
Form 990, Part VI, Section B, line 15	An independent compensation firm is obtained to complete an annual review and analysis of all the administrative staff members. The compiled report is forwarded to the Compensation Committee of the Board that reviews the analysis and approves the report.
Form 990, Part VI, Section C, line 19	The Organization makes its governing documents, conflict of interest policy, and audited financial statements available to the public upon written request.
Form 990, Part XI, line 9:	Intercompany transfers 213,474. Change in fair value of assets held in trust 332,462. Change in beneficial interest in net assets of Foundation 240,385.
Form 990, Part XII, Line 2C:	The audit committee assumes the responsibility for the oversight of the audited financial statements, review of the Form 990 and Form 990-T, and selection of the independent accounting firm.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2013

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public Inspection

Name of the organization

Salina Regional Health Center Inc

Employer identification number

48-1169103

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) Salina Regional Health Foundation Inc 400 South Santa Fe Salina,KS67401 48-0949407	Advancement of healthcare, health & medical education, research, & welfare	KS	501(c)(3)	170(b)(1)(A)(vi)			No
(2) Salina Regional Health Properties Inc 400 South Santa Fe Salina,KS67401 48-1154675	Own and operate medical office buildings for section 501(c)(3) organizations	KS	501(c)(2)		Salina Regional Health Center Inc	Yes
(3) Hospice of Salina Inc 730 Holly Lane Salina,KS67402 48-1131570	Provide hospice care and support services to the terminally ill and their	KS	501(c)(3)	509(a)	Salina Regional Health Center Inc	Yes
(4) Via Christi Health Inc 8200 E Thorn Drive Suite 300 Wichita,KS67226 48-1172107	Hospital support	KS	501(c)(3)	509(a)			No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2013

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) Salina Surgery Properties LLC 401 South Santa Fe Salina,KS67401 48-1200039	Construct & own surgical facility	KS		Related	234,688	1,664,113		No			No	50.000 %
(2) Salina Surgical Center LLC 401 South Santa Fe Salina,KS67401 48-1199515	Medical services, ambulatory surgery	KS		Related	3,646,576	5,763,869		No			No	50.000 %
(3) Salina Regional Home Medical Services LLC 520 South Santa Fe Suite 140 Salina,KS67401 48-1221623	Home medical services	KS	Salina Regional Health Center Inc	Related	222,653	618,425		No			No	51.000 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) Salina Regional Health Enterprises Inc 400 South Santa Fe Salina,KS67402 48-1056225	Provide mgmt services to hospitals in N. Central KS area	KS	Salina Regional Health Center Inc	C			100.000 %	Yes

Schedule R (Form 990) 2013

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) Salina Regional Health Properties Inc	I	173,716	Cash received
(2) Salina Regional Health Properties Inc	K	1,061,087	Cash paid
(3) Salina Regional Health Properties Inc	O	86,158	Actual cost
(4) Salina Regional Health Properties Inc	Q	89,671	Actual cost
(5) Hospice of Salina Inc	O	257,809	Actual cost
(6) Hospice of Salina Inc	Q	273,023	Actual cost
(7) Hospice of Salina Inc	B	675,000	Actual cost
(8) Salina Surgical Center LLC	Q	332,458	Markup of cost

Schedule R (Form 990) 2013

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V?UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V?UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2013

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2013

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: To provide high quality acute medical care
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	14
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	12
5	Total number of individuals employed in calendar year 2013 (Part V, line 2a) ......	5	1,894
6	Total number of volunteers (estimate if necessary) .............	6	200
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	-135,017

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,118,213	907,399
9	Program service revenue (Part VIII, line 2g) .........	168,331,001	202,457,634
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	5,590,796	7,051,433
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,734,694	2,958,313
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	177,774,704	213,374,779
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,019,472	1,494,546
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	83,392,417	100,025,634
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	77,304,765	90,651,627
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	161,716,654	192,171,807
19	Revenue less expenses. Subtract line 18 from line 12.......	16,058,050	21,202,972
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	408,504,999	443,880,353
21	Total liabilities (Part X, line 26).............	77,761,152	80,624,439
22	Net assets or fund balances. Subtract line 21 from line 20.....	330,743,847	363,255,914

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 157,411,963 including grants of $ 64,774 ) (Revenue $ 203,494,911 )
	Salina Regional Health Center, Inc., is an IRS Section 501(c)(3) hospital which provides quality medical care regardless of race, creed, sex, national origin, handicap, or ability to pay. During the fiscal year, Salina Regional Health Center, Inc., discharged 8,828 inpatients resulting in 41,702 patient days, treated outpatients in 164,410 visits, and generated $199,075,905 in net patient service revenue. The amount of uncompensated care amounted to $31,782,092 of which $8,640,945 were charity care deductions and $23,141,147 were bad debt write offs.

4b	(Code: ) (Expenses $ 360,600 including grants of $ 360,600 ) (Revenue $ )
	Salina Regional Health Center, Inc., provides scholarships to students attending nursing school and provides a donation to the KU endowment to offset the cost of establishing a medical school on the Salina Regional Health Center campus.

4c	(Code: ) (Expenses $ 1,069,172 including grants of $ 1,069,172 ) (Revenue $ )
	Salina Regional Health Center, Inc., provides grants to further the activities of the Community Health Improvement Program (CHIP).

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses158,841,735

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) Jack Hinnenkamp........................................................................ VP Facilities Management	40.00 .......................	X		208,200	0	21,342
(19) David Moody........................................................................ VP Human Resources	40.00 .......................	X		214,852	0	26,516
(20) Joel Phelps........................................................................ COO	40.00 .......................	X		312,391	0	45,489
(21) Luanne Smith........................................................................ VP Patient Care/CNO	40.00 .......................	X		187,965	0	25,891
(22) John Kelemen........................................................................ Physician	40.00 .......................		X	670,910	0	30,376
(23) Keir Swisher........................................................................ Physician	40.00 .......................		X	408,027	0	26,303
(24) Jeremiah Ostmeyer........................................................................ Physician	40.00 .......................		X	382,359	0	26,527
(25) Justin Whitlow........................................................................ Physician	40.00 .......................		X	550,739	0	28,552
(26) Merle Hodges........................................................................ Physician	40.00 .......................		X	442,760	0	28,124

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	5,072,205	0	474,720

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d
e	Government grants (contributions)1e		764,342

f	All other contributions, gifts, grants, and similar amounts not included above1f		143,057

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			907,399
			Business Code
2a	Patient service		621990	199,075,905	199,075,905
b	EHR incentive payments		621990	1,891,723	1,891,723
c	Other operating		621990	1,490,006	1,490,006
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			202,457,634
3	Investment income (including dividends, interest, and other similar amounts).......			5,805,171			5,805,171
4	Income from investment of tax-exempt bond proceeds..
5	Royalties...........
		(i) Real	(ii) Personal
6a	Gross rents	114,839
b	Less: rental expenses	323,824
c	Rental income or (loss)	-208,985
d	Net rental income or (loss).......			-208,985	-208,985
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	1,406,837	5,500
b	Less: cost or other basis and sales expenses	0	166,075
c	Gain or (loss)	1,406,837	-160,575
d	Net gain or (loss)..........			1,246,262	1,246,262
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a		20,885
b	Less: direct expenses ...b		8,232
c	Net income or (loss) from fundraising events..			12,653			12,653
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Miscellaneous Revenue			Business Code
11a	Income from subsidiaries		900099	3,079,551			3,079,551
b	Other revenues		900099	75,094			75,094
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			3,154,645
12	Total revenue. See Instructions......			213,374,779	203,494,911	0	8,972,469


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			7,578	1	7,878
2	Savings and temporary cash investments .........			13,062,462	2	23,471,356
3	Pledges and grants receivable, net ...........				3
4	Accounts receivable, net .............			29,157,189	4	30,789,094
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6
7	Notes and loans receivable, net .............				7
8	Inventories for sale or use ..............			1,334,375	8	1,462,964
9	Prepaid expenses and deferred charges ..........			2,737,793	9	4,187,023
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	261,775,971
b	Less: accumulated depreciation .....	10b	152,090,196	114,029,993	10c	109,685,775
11	Investments—publicly traded securities ..........			214,421,381	11	242,431,965
12	Investments—other securities. See Part IV, line 11 .....			7,117,662	12	7,444,213
13	Investments—program-related. See Part IV, line 11 .....				13
14	Intangible assets ...............			9,681,674	14	9,751,388
15	Other assets. See Part IV, line 11 ...........			16,954,892	15	14,648,697
16	Total assets. Add lines 1 through 15 (must equal line 34)......			408,504,999	16	443,880,353
17	Accounts payable and accrued expenses .........			18,502,340	17	22,384,804
18	Grants payable .................				18
19	Deferred revenue ................				19
20	Tax-exempt bond liabilities .............			55,184,878	20	54,377,466
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..			883	23
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			4,073,051	25	3,862,169
26	Total liabilities. Add lines 17 through 25.........			77,761,152	26	80,624,439
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			320,306,956	27	352,217,400
28	Temporarily restricted net assets ...........			3,487,136	28	3,596,681
29	Permanently restricted net assets ...........			6,949,755	29	7,441,833
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances ...........			330,743,847	33	363,255,914
34	Total liabilities and net assets/fund balances ........			408,504,999	34	443,880,353