TY 2023 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/1099-NEC)
(1) CURT COLSON PRESIDENT/CEO	0.2 ................. 41.2	X	X		0	217,359	54,774
(2) JOHN TERRILL CHAIRMAN/DIRECTOR	0.2 ................. 1.2	X	X		0	0	0
(3) ROGER JOHN SECRETARY/DIRECTOR	0.2 ................. 1.2	X	X		0	0	0
(4) STEVE CARLSON TREASURER/DIRECTOR	0.2 ................. 1.2	X	X		0	0	0
(5) ARTHUR HENDRICKSON DIRECTOR	0.2 ................. 1.2	X			0	0	0
(6) CHARLES WESTIN DIRECTOR (LEFT 5/23)	0.2 ................. 1.2	X			0	0	0
(7) DR BARBARA BROWN APPLEGATE DIRECTOR	0.2 ................. 1.2	X			0	0	0
(8) ALLEN VANDRIEL ADMINISTRATOR	40.0 ................. 0.0		X		195,657	0	42,486
(9) JASON BARB CFO	0.2 ................. 41.2		X		0	191,413	50,658
(10) SARAH RAGSDALE Administrator	40.0 ................. 0.0		X		124,848	0	26,280
(11) STEPHEN LEWIS CFO	40.0 ................. 0.0		X		140,349	0	36,941
(12) FERRILL CONANT PHYSICIAN	40.0 ................. 0.0			X	269,755	0	47,151
(13) HANNAH HAACK PHYSICIAN	40.0 ................. 0.0			X	343,732	0	64,944
(14) JUSTIN OVERMILLER PHYSICIAN	40.0 ................. 0.0			X	323,187	0	62,030
(15) LEAH WIEHL PHYSICIAN	40.0 ................. 0.0			X	171,370	0	40,570
(16) STEPHEN MOLL PHYSICIAN	40.0 ................. 0.0			X	264,027	0	59,463

(A) Name and business address	(B) Description of services	(C) Compensation
GPHA 250 N ROCK RD STE 160 WICHITA,KS67206	BILLING SERVICE/MGMT	1,401,295
HOLISTIC PAIN MANAGEMENT 3780 N GARFIELD LOVELAND,CO80538	PAIN MGMT SERVICE	767,290
MIDWEST ANESTHESIA ALLIANCE PO BOX 306 MEMPHIS,MO63555	CRNA SERVICES	448,942
AYA HEALTHCARE INC PO Box 123519 Dept 3519 Dallas,TX75312	Nurse Staffing	203,068
WOUND CARE SPECIALISTS PO BOX 71849 CHICAGO,IL606941849	WOUND CARE	193,900
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 11

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SCHEDULE A
(Form 990)

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.
right arrow

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

GREAT PLAINS OF SMITH CO INC

Employer identification number

48-1226830

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 12, 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 (Form 990).)

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 agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% 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 33 1/3% 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 on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

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

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

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

Cat. No. 11285F

Schedule A (Form 990) 2023

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 VI.)..
11	Total support. Add lines 7 through 10

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

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. 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—2022. 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—2023. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2022. 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 VI 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) 2023

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 on 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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. 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—2022. 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) 2023

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2023

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2023

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2023

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2023 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Name of the organization

GREAT PLAINS OF SMITH CO INC

Employer identification number

48-1226830

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, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) 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), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions 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 an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 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 an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled 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. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization GREAT PLAINS OF SMITH CO INC

Part I Contributors	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	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) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization GREAT PLAINS OF SMITH CO INC		Employer identification number 48-1226830

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) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization GREAT PLAINS OF SMITH CO INC			Employer identification number 48-1226830
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. 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.) $ 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) (2023)

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

SCHEDULE C
(Form 990)

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

right arrow

Complete if the organization is described below. right arrow

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public
Inspection

If the organization answered "Yes" on 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" on 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" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

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

Name of the organization

GREAT PLAINS OF SMITH CO INC

Employer identification number

48-1226830

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. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... right arrow

Volunteer hours for political campaign activities. See instructions ..................................................................

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 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

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 ..... right arrow

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

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

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-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990) 2022

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 right arrow

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 right arrow

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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2019	(b) 2020	(c) 2021	(d) 2022	(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) 2022

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 on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(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

4,120

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

4,120

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, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	A PORTION OF THE ANNUAL DUES PAID TO KHA AND AHA ARE USED FOR LOBBYING.

Schedule C (Form 990) 2022

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
right arrow

Attach to Form 990.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

GREAT PLAINS OF SMITH CO INC

Employer identification number

48-1226830

Part I

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

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of 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" on 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 July 25, 2006, 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 right arrow

Number of states where property subject to conservation easement is located right arrow

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, handling of violations, and enforcing conservation easements during the year
right arrow

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

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" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB 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 FASB 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)

Revenue included on Form 990, Part VIII, line 1 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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 FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

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

Cat. No. 52283D

Schedule D (Form 990) 2022

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" on 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


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
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, for escrow or custodial account liability? ...

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" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	956,098	985,545	972,031	877,459	936,018
b	Contributions ...	106,971	46,808	171,687	66,240	13,269
c	Net investment earnings, gains, and losses	178,743	-64,148	8,634	93,680	-38,761
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	104,092	12,107	166,807	65,348	33,067
f	Administrative expenses ....
g	End of year balance ......	1,137,720	956,098	985,545	972,031	877,459

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

Board designated or quasi-endowment right arrow

0 %

Permanent endowment right arrow

90.41 %

Term endowment right arrow

9.59 %

The percentages on 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)

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

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" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	395,701		395,701
b	Buildings ....	19,602,101	6,810,424	12,791,677
c	Leasehold improvements
d	Equipment ....	6,943,803	4,540,480	2,403,323
e	Other .....	4,351,407	1,720,306	2,631,101
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				18,221,802

Schedule D (Form 990) 2022

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on 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........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on 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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

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

(a) Description				(b) Book value
(1)FUNDS HELD BY ESCROW AGENT				1,677,731
(2)OTHER RECEIVABLES				189,637
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				1,867,368

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
DUE TO THIRD PARTY	723,681








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	723,681
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) 2022

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ...........	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
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
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
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
3	Subtract line 2e from line 1...................		3
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
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

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
Schedule D, Part X, Line 2 UNCERTAIN TAX POSITIONS	MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
Schedule D, Part V, Line 4 Intended uses of endowment funds	THE INTENDED USE OF THE ENDOWMENT FUNDS IS TO SUPPORT THE CONTINUING OPERATIONS OF THE REPORTING ORGANIZATION.

Schedule D (Form 990) 2022

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

GREAT PLAINS OF SMITH CO INC

Employer identification number

48-1226830

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: . . . . . . . .

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

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used 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) . . .			34,149		34,149	0.13 %
b	Medicaid (from Worksheet 3, column a) . . . . .			1,747,190	1,063,048	684,142	2.58 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .					0	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	0	1,781,339	1,063,048	718,291	2.71 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).			90,006		90,006	0.34 %
f	Health professions education (from Worksheet 5) . . .					0	0 %
g	Subsidized health services (from Worksheet 6) . . . .					0	0 %
h	Research (from Worksheet 7) .					0	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .					0	0 %
j	Total. Other Benefits . .	0	0	90,006	0	90,006	0.34 %
k	Total. Add lines 7d and 7j .	0	0	1,871,345	1,063,048	808,297	3.05 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

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)	(b) Persons served (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					0	0 %
2	Economic development					0	0 %
3	Community support					0	0 %
4	Environmental improvements					0	0 %
5	Leadership development and training for community members					0	0 %
6	Coalition building					0	0 %
7	Community health improvement advocacy					0	0 %
8	Workforce development					0	0 %
9	Other					0	0 %
10	Total	0	0	0	0	0	0 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

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

521,360

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. ......

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).....

1,063,048

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

1,747,190

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

-684,142

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) 2023

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?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)						Other (describe)
1	GREAT PLAINS OF SMITH CO INC 921 E HWY 36 SMITH CENTER,KS66967 WWW.SCMHKS.ORG H092001	X	X	X	X	RURAL HEALTH CLINIC

Schedule H (Form 990) 2023

Page 4

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)

	GREAT PLAINS OF SMITH CO INC
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

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 12......................

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 significant 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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

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

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

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): https://www.scmhks.org/about-us/community-health-needs-assessment/

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 21

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): https://www.scmhks.org/about-us/community-health-needs-assessment/

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

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)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, 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) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	GREAT PLAINS OF SMITH CO INC
Name of hospital facility or letter of facility reporting group

Yes

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 included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.0%
and FPG family income limit for eligibility for discounted care of %

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

HTTPS://WWW.SCMHKS.ORG/SERVICES/FINANCIAL-ASSISTANCE-RESOURCES/

The FAP application form was widely available on a website (list url):

HTTPS://WWW.SCMHKS.ORG/SERVICES/FINANCIAL-ASSISTANCE-RESOURCES/

A plain language summary of the FAP was widely available on a website (list url):
HTTPS://WWW.SCMHKS.ORG/SERVICES/FINANCIAL-ASSISTANCE-RESOURCES/

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	GREAT PLAINS OF SMITH CO INC
Name of hospital facility or letter of facility reporting group

Yes

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 all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized 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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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 Section C)

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

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

	GREAT PLAINS OF SMITH CO INC
Name of hospital facility or letter of facility reporting group

Yes

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 a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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 Section C.

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 Section C.

Schedule H (Form 990) 2023

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Schedule H, Part V, Section B, Line 3E	THE HOSPITAL FACILITY ANALYZED SEVERAL HEALTH NEEDS OF THE COMMUNITY AND HAS PRIORITIZED THOSE OF MOST CONCERN. THE PRIORITIZATION OF THE TOP SIGNIFICANT COMMUNITY HEALTH NEEDS IS DESCRIBED IN THE CHNA.
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - GREAT PLAINS OF SMITH CO, INC. THE OBJECTIVE OF THE SMITH COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS TO DETERMINE HEALTH NEEDS FROM THE PERSPECTIVE OF THE COMMUNITY IN COLLABORATION WITH THE HEALTH CARE PROVIDERS IN THE COMMUNITY. PARTICIPANTS IN A TOWN HALL MEETING HELD AS PART OF THE CHNA INCLUDED COMMUNITY RESIDENTS, GOVERNMENTAL, CIVIC, AND BUSINESS LEADERS IN THE COMMUNITY. THE ATTENDANCE ROSTER CAN BE FOUND IN SECTION V OF THE CHNA DOCUMENT.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - GREAT PLAINS OF SMITH CO, INC. THE CHNA CONDUCTED IN APRIL 2021 HIGHLIGHTED 10 ISSUES FOR SMITH COUNTY. THE ISSUES WERE: 1. DENTAL SERVICES 2. MENTAL HEALTH (DIAGNOSIS, PLACEMENT, AFTERCARE) 3. CHRONIC DISEASE MANAGEMENT 4. HOUSING 5. SPECIALITY SERVICES (OPTOMETRY AND PODIATRY) 6. AFFORDABLE INSURANCE/ACCESS TO MEDICAID 7. OBESITY (ACCESS TO EXERCISE) 8. DRUG & SUBSTANCE ABUSE 9. CHILD CARE 10. NURSING HOME/SENIOR CARE THE ISSUES IDENTIFIED WERE REVIEWED BY LEADERSHIP AND THE GOVERNING BOARD OF GREAT PLAINS OF SMITH COUNTY, INC. THEY WERE PRIORITIZED INTO AN IMPLEMENTATION PLAN, WHICH WAS PUBLISHED LATER IN 2021. THE CHNA REPORT, ALONG WITH THE IMPLEMENTATION PLAN ARE POSTED TO THE PUBLIC WEBSITE (WWW.SCMHKS.ORG). THE STRATEGY ADDRESSES EACH OF THE PRIORITIES IDENTIFIED, BUT ONLY TWO OF THE TEN ISSUES WERE RECOGNIZED AS BEING SOLELY WITHIN THE PURVIEW OF GREAT PLAINS OF SMITH COUNTY, INC. THOSE WERE ITEMS 3 AND 5. ITEMS 1, 2, 4, 6, 7, 8, 9, AND 10 WERE IDENTIFIED AS BEING ONLY ADDRESSABLE THROUGH A COLLABORATIVE APPROACH INVOLVING OTHER COMMUNITY PARTNERS. DURING THE INTERVAL BETWEEN COMPLETION OF THE CHNA AND THE END OF THE 2024 FISCAL YEAR, SIGNIFICANT PROGRESS WAS DEMONSTRATED IN ADDRESSING BOTH ITEM 3 AND 5. THE REMAINING 8 ISSUES ALSO HAD SIGNIFICANT PROGRESS DEMONSTRATED THROUGH COLLABORATION WITH OUTSIDE AGENCIES.

Schedule H (Form 990) 2023

Page 9

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?1
Name and address		Type of Facility (describe)
1	SMITH COUNTY FAMILY PRACTICE 921 E HWY 36 SMITH CENTER,KS66967	FAMILY PRACTICE
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2023

Page 10

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
Schedule H, Part I, Line 7 BAD DEBT EXCLUDED FOR PURPOSE OF CALCULATING COMMUNITY BENEFIT	THE BAD DEBT EXPENSE IS NOT CONSIDERED A COMMUNITY BENEFIT EXPENSE AND IS NOT INCLUDED IN SCHEDULE H, PART I, LINE 7. THE AMOUNT EXCLUDED IS $521,360.
Schedule H, Part VI ADDITIONAL DISCLOSURE REGARDING 501(R)	DURING PREPARATION OF THE 2023 FORM 990, THE ORGANIZATION WAS ALERTED TO MINOR AND INADVERTENT ERRORS RELATED TO 501(R) COMPLIANCE. PRIOR TO FILING THE 2023 FORM 990, THE ORGANIZATION HAS ADDRESSED THE FOLLOWING DEFICIENCIES: - PROVIDER LISTS POSTED ONLINE, INCLUDING THOSE COVERED AND NOT COVERED BY THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, DID NOT HAVE AN UPDATED TIME STAMP REFLECTING THAT THEY HAD BEEN REVIEWED IN THE LAST THREE MONTHS. THE LISTS HAVE BEEN UPDATED AND ARE AVAILABLE ON THEIR WEBSITE AT THE FOLLOWING LOCATION: https://www.scmhks.org/services/financial-assistance-resources/. PAPER COPIES OF THE LISTINGS ARE ALSO AVAILABLE AT THE HOSPITAL'S REGISTRATION DESK. - FEDERAL POVERTY GUIDELINES HAVE BEEN UPDATED TO INCLUDE THE CURRENT YEAR AND FUTURE YEARS. FPG GUIDELINES ARE AVAILABLE ON THE ORGANIZATION'S WEBSITE AT THE FOLLOWING LOCATION: https://www.scmhks.org/services/financial-assistance-resources/. - DURING QUARTERLY FINANCIAL CLOSE, STAFF WILL REVIEW THE WEBSITE AND MATERIALS AT THE REGISTRATION DESK TO ENSURE ALL REQUIRED DOCUMENTS, APPLICATIONS, AND POLICIES ARE AVAILABLE ELECTRONICALLY AND IN PAPER FORMAT. - DURING QUARTERLY FINANCIAL CLOSE, THE PROVIDER LISTINGS WILL BE REVIEWED AND UPDATED, INCLUDING AN UPDATED TIME AND DATE STAMP. - THE ORGANIZATION WILL CONTINUE TO IMPROVE LINES OF COMMUNICATIONS WITH THOSE RESPONSIBLE FOR WEBSITE MAINTENANCE AND PATIENT ACCOUNTS TO ENSURE THAT STAFF UNDERSTAND THE REQUIREMENTS OUTLINED IN THE 501(R) REGULATIONS.
Schedule H, Part I, Line 3c Eligibility criteria for free or discounted care	THE ORGANIZATION USED THE FOLLOWING CRITERIA TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE: ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, AND UNDER INSURANCE STATUS.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS IN THE TABLE OF PART I, LINE 7 OF SCHEDULE H, IS A COST TO CHARGE RATIO.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	HOSPITAL CHARGES THAT ARE NOT COLLECTED AND ARE NOT APPROVED FOR FINANCIAL ASSISTANCE ARE CLASSIFIED AS BAD DEBTS FROM PATIENTS WHO WILL NOT PAY.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	THE COSTING METHODOLOGY IS BASED ON THE ORGANIZATION'S MEDICARE COST-TO-CHARGE RATIO. WHILE WE RECOGNIZE THAT THERE WOULD BE SOME BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY, WE HAVE NO REASOBABLE BASIS FOR ESTIMATING THIS FIGURE. IF ELIGIBILITY IS KNOWN, THE AMOUNT WOULD FALL UNDER CHARITY CARE AND NOT BAD DEBT.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	THE APPLICABLE FOOTNOTE, NOTE 12, BEGINS ON PAGE 21 OF THE ATTACHED FINANCIAL STATEMENTS. Credit loss expense of $521,360 and $356,553 was recognized for the current fiscal year & prior year, respectively.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO. ANY SHORTFALL WOULD ARISE FROM PAYMENTS THAT ARE LESS THAN THE COSTS TO PROVIDE THE SERVICES. SHOULD A SHORTFALL OCCUR, IT SHOULD BE CONSIDERED COMMUNITY BENEFIT AS IT MUST BE ABSORBED IN ORDER TO CONTINUE PROVIDING CARE TO OUR COMMUNITY. IT IS ALSO IMPLIED IN INTERNAL REVENUE SERVICE RULING 69-545 WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR TAX-EXEMPT HOSPITALS AND INDICATES THAT PARTICIPATION IN PUBLICLY-FINANCED PROGRAMS, SUCH AS MEDICARE, IS EVIDENCE THAT A HOSPITAL MEETS THE COMMUNITY BENEFIT STANDARD.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	ALL CHARITY CARE AND CHARGES NOT TO BE COLLECTED DUE TO FINANCIAL ASSISTANCE COMPUTATIONS ARE EXEMPTED FROM COLLECTION POLICIES AND PRACTICES. THESE ACCOUNTS ARE REMOVED FROM THE COLLECTION CYCLE.
Schedule H, Part V, Section B, Line 16a FAP website	- GREAT PLAINS OF SMITH CO, INC: Line 16a URL: HTTPS://WWW.SCMHKS.ORG/SERVICES/FINANCIAL-ASSISTANCE-RESOURCES/;
Schedule H, Part V, Section B, Line 16b FAP Application website	- GREAT PLAINS OF SMITH CO, INC: Line 16b URL: HTTPS://WWW.SCMHKS.ORG/SERVICES/FINANCIAL-ASSISTANCE-RESOURCES/;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- GREAT PLAINS OF SMITH CO, INC: Line 16c URL: HTTPS://WWW.SCMHKS.ORG/SERVICES/FINANCIAL-ASSISTANCE-RESOURCES/;
Schedule H, Part VI, Line 2 Needs assessment	GREAT PLAINS OF SMITH COUNTY, INC. (GPSC) USES FORMAL AND INFORMAL METHODS TO DETERMINE THE NEEDS OF THE COMMUNITIES IT SERVES. OUTSIDE FACILITATORS HAVE BEEN USED TO ASSIST WITH FORMAL COMMUNITY HEALTH NEEDS ASSESSMENTS. THE FIRST OF THESE FORMAL ASSESSMENTS WAS COMPLETED IN 2012, FOLLOWED BY SUBSEQUENT ASSESSMENTS IN 2015, 2018 AND 2021. EACH OF THESE ASSESSMENTS INCLUDED SURVEYS MAILED TO MEMBERS OF THE COMMUNITY, FOLLOWED BY A PUBLIC FORUM DESIGNED TO GATHER INPUT IN AN INTERACTIVE FORMAT. FOLLOWING COMPLETION AND PUBLICATION OF EACH OF THE CHNAS, AN IMPLEMENTATION PLAN WAS DEVELOPED. IN 2021, THE SARS COV-2 PANDEMIC AND ITS IMPACT ON THE COMMUNITY AND ON PUBLIC GATHERINGS NECESSITATED A CHANGE IN TACTICS FOR THE FOURTH COMMUNITY HEALTH NEEDS ASSESSMENT. AFTER ANALYSIS OF THE SURVEYS AND THE PUBLIC INPUT, TEN AREAS OF COMMUNITY NEED WERE IDENTIFIED. THEY ARE OUTLINED IN THE CNHA DOCUMENT AND ARE ADDRESSED IN THE IMPLEMENTATION PLAN PUBLISHED IN 2022 AND UPDATED IN 2023. THE IMPLEMENTATION PLAN IS ATTACHED TO THIS SUMMARY. THE BOARD OF TRUSTEES OF SMITH COUNTY MEMORIAL HOSPITAL, WHICH CONSISTS OF FIVE MEMBERS APPOINTED BY THE SMITH COUNTY BOARD OF COMMISSIONERS, IS RESPONSIBLE FOR THE DELIVERY OF HEALTHCARE THROUGH SCMH. THE BOARD OF TRUSTEES HAS MAINTAINED A LEASE ARRANGEMENT WITH GREAT PLAINS HEALTH ALLIANCE (AND ITS PREDECESSOR, GREAT PLAINS LUTHERAN HOSPITALS) SINCE 1951. THIS LEASE ARRANGEMENT CREATES THE GREAT PLAINS OF SMITH COUNTY, INC. AS THE OPERATING ENTITY FOR THE DELIVERY OF SERVICES. THE BOARD OF TRUSTEES, ALTHOUGH NOT DIRECTLY INVOLVED IN THE GOVERNANCE OF THE DELIVERY SYSTEM, SERVE AS AN IMPORTANT CONDUIT FOR PUBLIC INPUT REGARDING THE NEEDS AND DELIVERY OF HEALTHCARE BY GREAT PLAINS OF SMITH COUNTY, INC.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	GREAT PLAINS OF SMITH COUNTY, INC. MAKES SIGNIFICANT EFFORTS TO PROVIDE INFORMATION TO THE PUBLIC REGARDING THE FUNCTION OF FEDERAL AND STATE PROGRAMS. WE USE FREQUENT SOCIAL MEDIA POSTS, NEWSPAPER ARTICLES, AND A BIANNUAL MAGAZINE TO PROVIDE INFORMATION ABOUT THE MEDICARE AND MEDICAID PROGRAMS, AND THE SERVICES THEY COVER. THE MAGAZINE-STYLE REPORT TO THE COMMUNITY HELPS TO EDUCATE THE COMMUNITY ABOUT PREVENTIVE HEALTH CARE, SERVICES AVAILABLE THROUGH GPSC, AND TOPICS RELATED TO INSURANCE PROGRAMS AVAILABLE IN THE COMMUNITY. DURING THE 2023 OPEN ENROLLMENT PERIOD FOR THE MEDICARE PROGRAM, GPSC UTILIZED THEIR OWN SHICK (SENIOR HEALTH INSURANCE FOR KANSAS) COUNSELOR WHO IS A LICENSED SOCIAL WORKER TO PROVIDE ONE ON ONE ASSISTANCE TO BENEFICIARIES. THESE MEETINGS ARE DESIGNED AS PURELY EDUCATIONAL TO ASSIST BENEFICIARIES IN SELECTING THE MOST BENEFICIAL MEDICARE RELATED PROGRAMS (ESPECIALLY SUPPLEMENTAL PLANS) DURING THE TIME WHEN THEY CAN MAKE THEIR ANNUAL SELECTION. OUR PATIENT CARE ADVOCATE, A LICENSED SOCIAL WORKER, PROVIDES INDIVIDUAL ASSISTANCE TO UNINSURED PATIENTS IN APPLICATION FOR COVERAGE UNDER THE KANCARE (KANSAS MEDICAID) PROGRAM. PATIENT ADVOCATE ALSO ASSISTS PATIENTS WITH THE INITIATION OF APPLICATIONS FOR FINANCIAL ASSISTANCE UNDER OUR CHARITY CARE PROGRAM. EVERY BILLING STATEMENT SENT TO PATIENTS CONTAINS INFORMATION ABOUT OUR FINANCIAL ASSISTANCE PROGRAM, INCLUDING INSTRUCTIONS ABOUT HOW TO INITIATE AN APPLICATION FOR ASSISTANCE. ADDITIONALLY, EVERY TELEPHONE CALL MADE TO PATIENTS REGARDING UNPAID BALANCES INCLUDES INFORMATION REGARDING THE OPTION TO APPLY FOR FINANCIAL ASSISTANCE. OUR FINANCIAL ASSISTANCE POLICY, ALONG WITH THE CONTACT IN FORMATION AND APPLICATION FORMS, IS ACCESSIBLE ON OUR PUBLIC WEBSITE.
Schedule H, Part VI, Line 4 Community information	THE 2020 UNITED STATES CENSUS REPORTED A TOTAL POPULATION IN SMITH COUNTY, KANSAS OF 3,570. THIS REPRESENTS A DECREASE OF 7.3% FROM THE 2010 CENSUS OF 3,853. THE POPULATION DENSITY IS APPROXIMATELY 4 PERSONS PER SQUARE MILE, CLASSIFYING THE COUNTY AS FRONTIER. APPROXIMATELY 96% OF THE POPULATION OF SMITH COUNTY IS REPORTED AS WHITE, WITH LESS THAN 1% EACH REPORTED AS BLACK, ASIAN, OR NATIVE AMERICAN. THE POPULATION IS NEARLY EVENLY DIVIDED BETWEEN MALE AND FEMALE. THE MEDIAN FAMILY INCOME IN SMITH COUNTY WAS REPORTED AS $43,429, COMPARED TO A NATIONAL MEDIAN OF $62,843. DESPITE THIS DISPARITY IN MEDIAN INCOME, THE CENSUS REPORTED 11.6% OF SMITH COUNTY RESIDENTS BEING BELOW THE POVERTY LEVEL, COMPARED TO 11.4% NATIONALLY. THIS INDICATES A HIGHER POPULATION IN THE LOW-MODERATE INCOME RANGE, BUT ABOVE THE POVERTY LEVEL. OF THE RESIDENTS LESS THAN 65 YEARS OF AGE IN SMITH COUNTY, 11.7% ARE REPORTED AS UNINSURED, COMPARED TO 10.2% NATIONALLY. THESE REPORTED NUMBERS ON UNINSURED LIKELY DO NOT REFLECT THE IMPACT OF THE COVID-19 PANDEMIC ON THE ECONOMY AND EMPLOYER-PROVIDED INSURANCE.
Schedule H, Part VI, Line 5 Promotion of community health	GREAT PLAINS OF SMITH COUNTY, INC. MAINTAINS AN OPEN MEDICAL STAFF, STRIVING FOR DIVERSITY TO REFLECT THE COMMUNITY AND SERVICE AREA. WE ADDED A TELEMEDICINE RHEUMATOLOGY AND ENDOCRINOLOGY CLINIC TO THE SPECIALTY CLINIC IN NOVEMBER 2023. THE ADDITION OF THESE CLINICS GAVE COMMUNITY MEMBERS ACCESS TO SPECIALISTS LOCALLY WITHOUT THE TRAVEL. THE UTILIZATION OF TELEHEALTH SERVICES TO EXPAND THE AVAILABILITY OF SERVICES, INCLUDING BEHAVIORAL HEALTH, HAVE SEEN SIGNIFICANT INCREASES IN USE DURING THE PAST YEAR. GREAT PLAINS OF SMITH COUNTY, INC. PARTNERED WITH HOLISTIC PAIN MANAGEMENT TO PROVIDE A PAIN MANAGEMENT CLINIC AND INCREASE AVAILABILITY OF PROCEDURES FOR PATIENTS WITH CHRONIC PAIN. THE SMITH COUNTY MEMORIAL HOSPITAL BOARD OF TRUSTEES, ALTHOUGH NOT DIRECTLY RESPONSIBLE FOR THE GOVERNANCE OF THE OPERATING ENTITY, NEVERTHELESS SERVES AS AN IMPORTANT LINK TO THE COMMUNITY. THE MEMBERSHIP OF THE BOARD OF TRUSTEES REPRESENTS THE GEOGRAPHIC DIVERSITY OF SMITH COUNTY, WITH MEMBERS APPOINTED TO REPRESENT VARIOUS REGIONS AND POPULATION CENTERS OF THE COUNTY. GREAT PLAINS OF SMITH COUNTY, INC. USES SIGNIFICANT EFFORTS TO PROMOTE THE HEALTH OF THE COMMUNITY. AMONG THESE EFFORTS ARE COMMUNICATION REGARDING HEALTHY LIFESTYLE, DISEASE PREVENTION AND DETECTION, AND COMMUNITY AWARENESS. WE USE SOCIAL MEDIA, OUR WEBSITE, RADIO AND TELEVISION ADVERTISING, AND NEWSPAPER ARTICLES AND ADVERTISING TO CONVEY IMPORTANT INFORMATION TO THE COMMUNITY. OTHER EFFORTS TO ENHANCE COMMUNITY EDUCATION INCLUDE STEPPING ON CLASSES OFFERED BY OUR EMERGENCY DEPARTMENT SUPERVISOR AND AN OCCUPATIONAL THERAPIST. THESE CLASSES, OFFERED TWICE PER YEAR IN VARIOUS LOCATIONS IN THE COUNTY, EMPHASIZE FALL PREVENTION THROUGH TECHNIQUES TO INCREASE BALANCE AND FLEXIBILITY TO OLDER RESIDENTS. THE TWO STAFF MEMBERS WHO TEACH THE CLASSES HAVE NOW BEEN ASKED TO SERVE AS STATEWIDE INSTRUCTOR TRAINERS IN AN EFFORT TO EXPAND THE AVAILABILITY OF THESE PROGRAMS IN OTHER COMMUNITIES. OTHER OFFERINGS INCLUDED ARE THE MEALS ON WHEELS PROGRAM, TELEHEALTH SERVICES, CARDIAC AND PULMONARY REHABILITATION PROGRAMS, AND EDUCATION PROGRAMS. THE MEALS ON WHEELS PROGRAM IS NOW COMPLETELY MANAGED BY GPSC, INCLUDING PREPARATION AND PACKAGING OF MEALS THAT ARE PROVIDED AT A DEEPLY DISCOUNTED COST TO HOMEBOUND MEMBERS OF THE COMMUNITY. GPSC HAS ALSO ASSUMED THE RESPONSIBILITY FOR SCHEDULING AND COORDINATING THE VOLUNTEER DELIVERY DRIVERS FOR THE MEALS, SUPPLEMENTED WHEN NECESSARY BY OUR PAID STAFF. ALTHOUGH ACCESS TO FACILITIES WAS LIMITED FOR A PERIOD OF TIME DUE TO THE PANDEMIC, THE CARDIAC REHABILITATION AND PULMONARY REHABILITATION PROGRAMS HAVE NOW RESUMED ACTIVITY, PROVIDING SERVICE TO GROWING NUMBERS OF BENEFICIARIES. EDUCATION PROGRAMS INCLUDE HEALTHY DIET PROGRAMS AND CHILDBIRTH EDUCATION PROGRAMS FOR EXPECTANT PARENTS. A COLLABORATIVE PROGRAM TO INCREASE SUPPORT SERVICES FOR BREASTFEEDING TO NEW MOTHERS WAS IMPLEMENTED IN 2022. THIS PROGRAM, A COLLABORATION BETWEEN GPSC HOSPITAL AND CLINIC STAFF, AS WELL AS STAFF FROM THE SMITH COUNTY HEALTH DEPARTMENT, SEEKS TO STANDARDIZE THE INFORMATION MADE AVAILABLE TO MOTHERS OF NEW BABIES. THE TRAINING FOR THE EMPOWER BEST PRACTICE BREASTFEEDING COLLABORATIVE WAS COMPLETED IN 2023. TRAINING AND CERTIFICATION PROGRAMS IN A VARIETY OF BASIC AND ADVANCED LIFESAVING TECHNIQUES. THESE INCLUDE BASIC LIFE SUPPORT (CPR), ADVANCED CARDIOVASCULAR LIFE SUPPORT, PEDIATRIC ADVANCED LIFE SUPPORT, NEONATAL RESUSCITATION, TRAUMA NURSE CORE CURRICULUM, AND BASIC AND ADVANCED FETAL MONITORING COURSES ARE OFFERED BY INSTRUCTOR STAFF FROM OUR FACILITY. THE TARGET AUDIENCE FOR THESE CLASSES IS OUR OWN STAFF, AS WELL AS STAFF FROM NEIGHBORING COMMUNITIES. IN GENERAL, WHEN WE BECOME AWARE OF A NEED FOR ADDITIONAL SERVICES TO THE COMMUNITY AND SERVICE AREA, WE TAKE STEPS TO ASSURE DEVELOPMENT AND DELIVERY OF PROGRAMS TO ADDRESS THE NEEDS OF THE COMMUNITY.
Schedule H, Part VI, Line 6 Affiliated health care system	SMITH COUNTY MEMORIAL HOSPITAL IS OPERATED BY GREAT PLAINS OF SMITH CO., INC., A SUBSIDIARY OF GREAT PLAINS HEALTH ALLIANCE. GPHA IS A 501(C)(3) NOT FOR PROFIT ORGANIZATION WHICH PROVIDES MANAGEMENT, FINANCE, BILLING, INFORMATION SYSTEMS, AND PHARMACY SUPPORT SERVICES TO ITS AFFILIATED ORGANIZATIONS. GPHA DOES NOT PROVIDE SERVICES DIRECTLY TO PATIENTS, BUT PROVIDES ACCESS TO PROFESSIONALS AND SYSTEMS WHICH MIGHT NOT OTHERWISE BE AVAILABLE OR AFFORDABLE TO SMALL RURAL HOSPITALS. GPHA PROVIDES EDUCATION AND ASSISTANCE IN AREAS SUCH AS HIPAA PRIVACY AND SECURITY, MEDICARE AND MEDICAID REIMBURSEMENT RULES AND REGULATIONS, MEANINGFUL USE REQUIREMENTS FOR ELECTRONIC HEALTH RECORDS, ETC. GREAT PLAINS HEALTH ALLIANCE BRINGS TOGETHER ITS NETWORKED CRITICAL ACCESS HOSPITALS IN KANSAS AND NEBRASKA TO LEARN FROM EACH OTHER AND DEVELOP BEST PRACTICES IN CARE PROVISION, MANAGEMENT, AND GOVERNANCE. AFFILIATED HOSPITALS RECEIVE POLICY GUIDANCE REGARDING FINANCIAL ASSISTANCE TO PATIENTS, CORPORATE COMPLIANCE, CONFLICTS OF INTEREST, AND MANY OTHER AREAS. GUIDANCE IS ALSO PROVIDED TO THE GOVERNING BOARDS OF AFFILIATED HOSPITALS TO ASSIST THEM IN FULFILLING THEIR FIDUCIARY RESPONSIBILITIES.

Schedule H (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- 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
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
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Attach to Form 990.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

GREAT PLAINS OF SMITH CO INC

Employer identification number

48-1226830

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 on 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 on 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 on 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 on 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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on 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," on line 5a or 5b, describe in Part III.

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

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

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

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

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

Were any amounts reported on 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" on 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) 2023

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 on 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, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on 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)
1CURT COLSON PRESIDENT/CEO	(i) (ii)	0 ------------- 213,766	0 ------------- 0	0 ------------- 3,593	0 ------------- 21,263	0 ------------- 33,511	0 ------------- 272,133	0 ------------- 0
2JASON BARB CFO	(i) (ii)	0 ------------- 190,136	0 ------------- 0	0 ------------- 1,277	0 ------------- 18,538	0 ------------- 32,120	0 ------------- 242,071	0 ------------- 0
3ALLEN VANDRIEL ADMINISTRATOR	(i) (ii)	189,192 ------------- 0	0 ------------- 0	6,465 ------------- 0	19,924 ------------- 0	22,562 ------------- 0	238,143 ------------- 0	0 ------------- 0
4STEPHEN LEWIS CFO	(i) (ii)	136,696 ------------- 0	0 ------------- 0	3,653 ------------- 0	14,426 ------------- 0	22,515 ------------- 0	177,290 ------------- 0	0 ------------- 0
5SARAH RAGSDALE Administrator	(i) (ii)	124,533 ------------- 0	0 ------------- 0	315 ------------- 0	12,103 ------------- 0	14,177 ------------- 0	151,128 ------------- 0	0 ------------- 0
6HANNAH HAACK PHYSICIAN	(i) (ii)	343,342 ------------- 0	0 ------------- 0	390 ------------- 0	32,200 ------------- 0	32,744 ------------- 0	408,676 ------------- 0	0 ------------- 0
7JUSTIN OVERMILLER PHYSICIAN	(i) (ii)	322,754 ------------- 0	0 ------------- 0	433 ------------- 0	32,200 ------------- 0	29,830 ------------- 0	385,217 ------------- 0	0 ------------- 0
8FERRILL CONANT PHYSICIAN	(i) (ii)	264,253 ------------- 0	0 ------------- 0	5,502 ------------- 0	27,072 ------------- 0	20,079 ------------- 0	316,906 ------------- 0	0 ------------- 0
9STEPHEN MOLL PHYSICIAN	(i) (ii)	263,744 ------------- 0	0 ------------- 0	283 ------------- 0	26,899 ------------- 0	32,564 ------------- 0	323,490 ------------- 0	0 ------------- 0
10LEAH WIEHL PHYSICIAN	(i) (ii)	171,046 ------------- 0	0 ------------- 0	324 ------------- 0	17,739 ------------- 0	22,831 ------------- 0	211,940 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2023

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

Schedule J, Part I, Line 3 FORM 990, PART VII

ANNUAL COMPENSATION REVIEWS ARE COMPLETED BY THE CEO AND CHIEF FINANCIAL OFFICER USING RECOMMENDATIONS PROVIDED BY DEPARTMENT MANAGERS AND CURRENT MARKET CONDITIONS. ALL EXECUTIVE EMPLOYEE SALARIES, INCLUDING THE PRESIDENT/CEO, ARE APPROVED BY THE GPHA BOARD OF DIRECTORS. THE AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES AND THE KANSAS HOSPITAL ASSOCIATION ALSO HAS COMPARABLE COMPENSATION DATA THAT CAN BE USED BY THE BOARD. THE CEO RETAINS DOCUMENTATION IN ADDITION TO THAT IN THE BOARD MINUTES.

Schedule J (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

SCHEDULE O
(Form 990)

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 990-EZ or to provide any additional information.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

GREAT PLAINS OF SMITH CO INC

Employer identification number

48-1226830

Return Reference	Explanation
Form 990, Part III, Line 4a PROGRAM SERVICE DESCRIPTION	THE LARGEST PROGRAM SERVICES MEASURED BY EXPENSES ARE: 1. SMITH COUNTY MEMORIAL HOSPITAL - THIS 16 BED CRITICAL ACCESS HOSPITAL PROVIDES A WIDE VARIETY OF INPATIENT AND OUTPATIENT MEDICAL SERVICES TO RESIDENTS OF THE SERVICE AREA. INCLUDED AMONG THESE SERVICES ARE THE FOLLOWING: A. INPATIENT CARE - I. ACUTE AND OBSERVATION (OUTPATIENT) CARE FOR PATIENTS WITH MEDICAL AND SURGICAL CONDITIONS. THIS INCLUDES NEONATAL, PEDIATRIC, ADULT, AND GERIATRIC PATIENTS. II. SKILLED SWING BED CARE FOR PATIENTS REQUIRING POST-ACUTE CARE, ESPECIALLY SKILLED NURSING AND REHABILITATION SERVICES. III. PRIVATE PAY CUSTODIAL CARE IS PROVIDED ON A LIMITED BASIS. MUCH OF THIS CARE IS PROVIDED TO PATIENTS WHO HAVE ELECTED HOSPICE BENEFITS BUT DO NOT HAVE FAMILY MEMBERS ABLE CARE FOR THEM IN THE HOME. B. OBSTETRICAL CARE INCLUDING PRENATAL EDUCATION, MONITORING AND DIAGNOSTIC SERVICES DURING THE PRENATAL PERIOD, AS WELL AS LABOR AND DELIVERY SERVICES DURING THE PERINATAL PERIOD. THIS INCLUDES SURGICAL CARE FOR SCHEDULED AND URGENT C SECTIONS NEEDED FOR DELIVERY. THIS AREA HAS SEEN INCREASED VOLUMES AS MANY SURROUNDING HOSPITALS HAVE DISCONTINUED OB PROGRAMS. C. EMERGENCY CARE AVAILABLE 24 HOURS PER DAY BY A STAFF OF SPECIALLY TRAINED REGISTERED NURSES, ADVANCED PRACTICE REGISTERED NURSES, PHYSICIAN ASSISTANTS, AND PHYSICIANS. ALL EMERGENCY DEPARTMENT STAFF ARE CERTIFIED IN VARIOUS TYPES OF ADVANCED LIFE SUPPORT PROGRAMS, INCLUDING ADVANCED CARDIOVASCULAR LIFE SUPPORT, PEDIATRIC ADVANCED LIFE SUPPORT, AND ADVANCED TRAUMA CARE COURSES. THIS FACILITY IS CERTIFIED AS A LEVEL IV TRAUMA CENTER AND IS CERTIFIED AS A STROKE CARE CENTER. TELEHEALTH SERVICES ARE AVAILABLE IN EACH OF THE TWO TRAUMA ROOMS, CONNECTING INSTANTLY TO REGISTERED NURSES AND BOARD CERTIFIED EMERGENCY PHYSICIANS AT A DEDICATED RESPONSE CENTER IN SOUTH DAKOTA. THIS TELEHEALTH SERVICE ALSO PROVIDES EVALUATION OF PATIENTS SUFFERING FROM CRISIS LEVEL BEHAVIORAL HEALTH EMERGENCY SERVICES. D. ANCILLARY DIAGNOSTIC AND THERAPEUTIC SERVICES. THESE INCLUDE: I. LABORATORY WITH STAFF AVAILABLE 24 HOURS PER DAY TO PERFORM A WIDE VARIETY OF CHEMISTRY, HEMATOLOGY, COAGULATION, URINALYSIS, BLOOD GAS, AS WELL AS BASIC MICROBIOLOGY TESTS. BLOOD BANKING IS ALSO AVAILABLE. A CONTRACTED REFERENCE LABORATORY PERFORMS MORE COMPLEX TESTING. PATHOLOGY SERVICES ARE ALSO PROVIDED THROUGH A CONTRACTED SERVICE. II. DIAGNOSTIC IMAGING SERVICES INCLUDE DIGITAL X-RAY, CT SCAN, DIAGNOSTIC ULTRASOUND, ECHOCARDIOGRAPHY, PORTABLE FLUOROSCOPY, MAMMOGRAPHY, AND BONE DENSITY. MOBILE SERVICES PROVIDED UNDER CONTRACT INCLUDE MRI AND NUCLEAR IMAGING. III. ANESTHESIA SERVICES ARE PROVIDED IN THE EMERGENCY, AMBULATORY SURGERY, AND INPATIENT SURGICAL SETTING BY A DEDICATED CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). A SEPARATE PAIN MANAGEMENT SERVICE UTILIZING A CONTRACTED SERVICE WAS IMPLEMENTED DURING THE YEAR AND HAS BEEN EXTREMELY SUCCESSFUL. THIS SERVICE INVOLVES EVALUATION OF PATIENT NEEDS BY A SPECIALLY TRAINED APRN, WITH INTERVENTIONAL PAIN MANAGEMENT SERVICES SUBSEQUENTLY PERFORMED BY A CRNA. IV. RESPIRATORY THERAPY AND PULMONARY FUNCTION ARE AVAILABLE, INCLUDING ACUTE INPATIENT AND EMERGENCY DEPARTMENT ASSISTANCE WITH AIRWAY MANAGEMENT, SUPPLEMENTAL OXYGEN, HELIOX, AND AEROSOL THERAPY, SHORT-TERM MECHANICAL VENTILATION, AND ASSISTANCE WITH NEONATAL RESUSCITATION. V. PHYSICAL AND OCCUPATIONAL THERAPY, AS WELL AS SPEECH LANGUAGE PATHOLOGY ARE AVAILABLE FOR INPATIENT AND OUTPATIENT CARE. VI. CARDIAC AND PULMONARY REHABILITATION SERVICES ARE PROVIDED TO PATIENTS ON A SCHEDULED BASIS. PATIENTS RECOVERING FROM CARDIAC EVENTS OR SURGERY, AND PATIENTS WITH CHRONIC PULMONARY DISEASE BENEFIT FROM THESE SERVICES. VII. WOUND CARE SERVICES ARE AVAILABLE THROUGH A CONTRACT SERVICE ON A WEEKLY BASIS. GPSC MEDICAL STAFF AND NURSING STAFF FROM THE RURAL HEALTH CLINIC HELP STAFF THIS CLINIC, WHICH PROVIDES DEBRIDEMENT AND CARE FOR SLOW-HEALING WOUNDS, AS WELL AS THE APPLICATION OF SKIN SUBSTITUTE PRODUCTS TO PROMOTE HEALING. VIII. DIAGNOSTIC SLEEP SERVICES INCLUDING BOTH ATTENDED AND HOME SLEEP STUDIES AND CPAP TITRATION ARE PROVIDED UNDER A CONTRACT ARRANGEMENT. IX.DIETARY SERVICES TO INPATIENTS AND OUTPATIENTS ARE PROVIDED BY A STAFF LED BY A REGISTERED CLINICAL DIETICIAN WHO IS ALSO OUR EXECUTIVE CHEF. TAILORING OF MEALS TO MEET THE THERAPEUTIC NEEDS AND DESIRES OF OUR INPATIENTS, COUPLED WITH EDUCATION REGARDING HEALTHIER FOOD CHOICES ARE PROVIDED TO EVERY INPATIENT. THE FOOD SERVICES STAFF ALSO PROVIDE AND PACKAGE THE MEALS FOR THE MEALS ON WHEELS PROGRAM. X. OUTPATIENT SPECIALTY CLINIC SERVICES ARE PROVIDED AT THE CAH BY A WIDE VARIETY OF PROVIDERS. THESE ARRANGEMENTS ALLOW US TO OFFER SPECIALTY SERVICES TO RESIDENTS OF THE AREA WITHOUT THE NEED FOR TRAVEL TO DISTANT LOCATIONS. SERVICES PROVIDED AT SCMH INCLUDE CARDIOLOGY (3 PROVIDERS), CARDIOVASCULAR SURGERY, PULMONOLOGY, NEPHROLOGY, GENERAL SURGERY (2 PROVIDERS), PODIATRY, ORTHOPEDIC SURGERY, UROLOGY, OB/GYN, DERMATOLOGY, RHEUMATOLOGY, ENDOCRINOLOGY, BEHAVIORAL HEALTH MEDICATION MANAGEMENT, AND COUNSELING SERVICES AND THE PREVIOUSLY MENTIONED PAIN MANAGEMENT SERVICE. 2. SMITH COUNTY FAMILY PRACTICE - THIS CERTIFIED RURAL HEALTH CLINIC PROVIDES PRIMARY CARE SERVICES TO PEDIATRIC, ADULT AND GERIATRIC PATIENTS FOR A FULL RANGE OF MEDICAL CONDITIONS. STAFFED BY FIVE BOARD CERTIFIED FAMILY MEDICINE PHYSICIANS AS WELL AS PHYSICIAN ASSISTANTS AND ADVANCED PRACTICE REGISTERED NURSES. IN ADDITION TO PRIMARY CARE SERVICES DELIVERED IN THE RHC, THESE PROVIDERS STAFF THE EMERGENCY DEPARTMENT AND INPATIENT AND OUTPATIENT AREAS OF THE CAH. THEY ALSO PROVIDE SERVICES TO PATIENTS (RESIDENTS) IN SKILLED NURSING AND ICF LONG TERM CARE FACILITIES IN SMITH, OSBORNE, AND PHILLIPS COUNTIES. PHYSICIANS ALSO SERVE AS MEDICAL DIRECTORS FOR TWO SKILLED NURSING FACILITIES, FOR SMITH COUNTY EMS, AND AS THE COUNTY HEALTH OFFICER. 3. 340B PHARMACY SERVICES - GREAT PLAINS OF SMITH COUNTY, INC. UTILIZES THE 340B PROGRAM OPERATED UNDER THE AUSPICES OF THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) TO OBTAIN DRUGS AND PHARMACEUTICALS FOR USE IN THE OUTPATIENT SETTING AT SMITH COUNTY MEMORIAL HOSPITAL (THE CAH) AS WELL AS THROUGH CONTRACTED ARRANGEMENTS WITH THREE AREA RETAIL PHARMACIES. THE DISCOUNTED PRICING AVAILABLE UNDER THIS PROGRAM (ALTHOUGH UNDER THREAT CURRENTLY BY UNILATERAL ACTION BY SOME DRUG MANUFACTURERS) ALLOWS US TO OFFSET THE COST OF DELIVERY OF SERVICES WITHIN OUR SERVICE AREA.
Form 990, Part VI, Line 2 BUSINESS RELATIONSHIPS	CURT COLSON AND JASON BARB HAVE A BUSINESS RELATIONSHIP. THEY ARE BOTH EMPLOYED BY, AND ALSO OFFICERS OF, A RELATED 501(C)(3) ORGANIZATION, GREAT PLAINS HEALTH ALLIANCE.
Form 990, Part VI, Line 15a 15B - PROCESS FOR DETERMINING OFFICER COMPENSATION	THE CEO AND CFO ARE COMPENSATED BY GREAT PLAINS HEALTH ALLIANCE, A RELATED ORGANIZATION. GPHA'S BOARD USES COMPARABILITY DATA IN SETTING THEIR SALARIES, AND DOCUMENTATION IS RETAINED OF THE BOARD'S DELIBERATIONS AND DECISIONS.
Form 990, Part VI, Line 6 Classes of members or stockholders	GREAT PLAINS HEALTH ALLIANCE, INC., A NOT-FOR-PROFIT 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF GREAT PLAINS OF SMITH CO., INC.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	GREAT PLAINS HEALTH ALLIANCE, INC., BEING THE SOLE MEMBER, HAS THE RIGHT TO ELECT AND APPROVE ALL THE BOARD MEMBERS.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	GREAT PLAINS HEALTH ALLIANCE, INC. (GPHA) IS THE SOLE MEMBER AND HAS THE AUTHORITY TO APPROVE THE ARTICLES OF INCORPORATION, BYLAWS, ELECTION TO OR REMOVAL FROM THE BOARD OF DIRECTORS, THE ANNUAL OPERATING AND CAPITAL BUDGETS, AND THE LONG RANGE OR STRATEGIC PLANS.
Form 990, Part VI, Line 11b Review of form 990 by governing body	THE 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE 990 IS THEN PROVIDED TO THE CHIEF EXECUTIVE OFFICER FOR REVIEW AND APPROVAL. AN ELECTRONIC DRAFT OF THE 990 WITH ALL REQUIRED SCHEDULES IS THEN PROVIDED TO THE FULL BOARD FOR REVIEW PRIOR TO FILING THE 990 WITH THE IRS.
Form 990, Part VI, Line 12c Conflict of interest policy	THE ORGANIZATION IS REQUIRED TO ADOPT GPHA'S CONFLICT OF INTEREST POLICY. ALL BOARD MEMBERS, OFFICERS, AND EMPLOYEES ARE SUBJECT TO THE CONFLICT OF INTEREST POLICY AND SIGN AN ANNUAL ACKNOWLEDGEMENT THAT THEY HAVE READ, UNDERSTAND AND COMPLIED WITH THE GPHA CONFLICT OF INTEREST POLICY. UNDER THE POLICY, ANY MEMBER WHO HAS A DIRECT OR INDIRECT (VIA FAMILY) FINANCIAL INTEREST IS CHARACTERIZED AS AN INTERESTED PERSON. INTERESTED PERSONS ARE REQUIRED TO DISCLOSE FINANCIAL INTERESTS WITH COMPANIES DOING BUSINESS WITH GPHA. THE INTERESTED PERSON MUST RECUSE THEMSELVES FROM FURTHER DISCUSSIONS OF THE TRANSACTION AND LEAVE THE ROOM. THE REMAINING NON-INTERESTED MEMBERS DECIDE IF A CONFLICT OF INTEREST EXISTS. THE BOARD CHAIR MAY APPOINT ANOTHER DISINTERESTED PARTY TO DISCUSS THE TRANSACTION OR THE REMAINING BOARD MEMBERS MAY VOTE TO ENTER INTO OR ABSTAIN FROM THE SUSPECT TRANSACTION. FAILURE TO DISCLOSE FINANCIAL INTERESTS BY INTERESTED BOARD MEMBERS WILL RESULT IN DISCIPLINARY ACTION, INCLUDING SANCTIONING BY BOARD. ALL CONFLICTS OF INTEREST AND THEIR ULTIMATE RESOLUTION ARE DOCUMENTED IN THE BOARD MINUTES. THE BOARD CONDUCTS PERIODIC REVIEWS TO DETERMINE THAT CONFLICTS ARE BEING IDENTIFIED AND RESOLVED ACCORDING TO POLICY DOCUMENTATION. REVIEWS BY OUTSIDE EXPERTS ARE PERMITTED, BUT NOT REQUIRED.
Form 990, Part VI, Line 19 Required documents available to the public	THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE COMPANY'S KANSAS ANNUAL REPORT IS ALSO AVAILABLE UPON REQUEST FROM THE KANSAS SECRETARY OF STATE.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	MISCELLANEOUS REVENUE - Total Revenue: 26587, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 26587;
Form 990, Part IX, Line 11g Other Fees	CONTRACTED MEDICAL STAFF - Total Expense: 3389100, Program Service Expense: 3389100, Management and General Expenses: , Fundraising Expenses: ; BILLING/COLLECTIONS - Total Expense: 627204, Program Service Expense: , Management and General Expenses: 627204, Fundraising Expenses: ; LAB SERVICES - Total Expense: 297175, Program Service Expense: 297175, Management and General Expenses: , Fundraising Expenses: ; PHARMACY SERVICES - Total Expense: 308059, Program Service Expense: 308059, Management and General Expenses: , Fundraising Expenses: ; ADMIN/HUMAN RESOURCES - Total Expense: 99992, Program Service Expense: , Management and General Expenses: 99992, Fundraising Expenses: ; MAINTENANCE/HOUSEKEEPING - Total Expense: 75857, Program Service Expense: 56865, Management and General Expenses: 18992, Fundraising Expenses: ; PLANT OPERATIONS - Total Expense: 41700, Program Service Expense: 31260, Management and General Expenses: 10440, Fundraising Expenses: ; DIETARY SERVICES - Total Expense: 575, Program Service Expense: 575, Management and General Expenses: , Fundraising Expenses: ;

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

Cat. No. 51056K

Schedule O (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- 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.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

GREAT PLAINS OF SMITH CO INC

Employer identification number

48-1226830

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)GREAT PLAINS HEALTH CARE FOUNDATION INC 250 N ROCK ROAD STE 160 WICHITA,KS67206 48-0955870	SUPPORT	KS	501(c)(3)	10	GPHA INC	Yes
(2)GREAT PLAINS HEALTH ALLIANCE INC 250 N ROCK ROAD STE 160 WICHITA,KS67206 48-0617739	MANAGEMENT	KS	501(c)(3)	3	NA		No
(3)GREAT PLAINS OF ELLINWOOD INC 250 N ROCK ROAD STE 160 WICHITA,KS67206 48-1226976	HOSPITAL	KS	501(c)(3)	3	GPHA INC	Yes
(4)GREAT PLAINS OF OTTAWA COUNTY INC 250 N ROCK ROAD STE 160 WICHITA,KS67206 48-1226856	HOSPITAL	KS	501(c)(3)	3	GPHA INC	Yes
(5)GREAT PLAINS OF SABETHA COUNTY INC 250 N ROCK ROAD STE 160 WICHITA,KS67206 48-1236156	HOSPITAL	KS	501(c)(3)	3	GPHA INC	Yes
(6)GREAT PLAINS OF CHEYENNE COUNTY INC 250 N ROCK ROAD STE 160 WICHITA,KS67206 48-1226831	HOSPITAL	KS	501(c)(3)	3	GPHA INC	Yes
(7)GREAT PLAINS OF REPUBLIC COUNTY INC 250 N ROCK ROAD STE 160 WICHITA,KS67206 48-1226977	HOSPITAL	KS	501(c)(3)	3	GPHA INC	Yes
(8)GPHA EMPLOYEE BENEFITS TRUST 250 N ROCK ROAD STE 160 WICHITA,KS67206 47-6918582	HEALTH PLAN	KS	501(c)(9)		GPHA INC	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2023

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	(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	(k) Percentage ownership

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	(h) Percentage ownership	Yes	No
(1) CHARITABLE REMAINDER TRUST (1)	CHARITABLE TR	KS	GP OF SMITH CTY					Yes
(2) CHARITABLE REMAINDER TRUST (1)	CHARITABLE TR	KS	GP OF SMITH CTY					Yes
(3) CHARITABLE REMAINDER TRUST (3)	CHARITABLE TR	KS	GP OF SMITH CTY					Yes

Schedule R (Form 990) 2023

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) ............................

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

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) ............................

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) .................

Yes

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 ............................

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

Yes

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) GPHA EMPLOYEE BENEFITS TRUST	R	1,112,911	FMV

Schedule R (Form 990) 2023

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?		(k) Percentage ownership
(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	(k) Percentage ownership

Schedule R (Form 990) 2023

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) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

1	Briefly describe the organization’s mission or most significant activities: THE OPERATION OF HOSPITAL FACILITIES FOR THE DELIVERY OF HEALTH CARE SERVICES, EDUCATION, AND WELLNESS WITHOUT REGARD TO RACE, CREED, COLOR, SEX OR FINANCIAL CIRCUMSTANCE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	6
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	5
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	183
6	Total number of volunteers (estimate if necessary) .............	6	7
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,012,270	240,325
9	Program service revenue (Part VIII, line 2g) .........	22,899,322	24,097,562
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	92,924	372,781
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	199,599	210,784
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	24,204,115	24,921,452
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
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)	11,188,679	12,312,200
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)....	14,262,704	14,160,142
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	25,451,383	26,472,342
19	Revenue less expenses. Subtract line 18 from line 12.......	-1,247,268	-1,550,890
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	33,511,448	32,530,756
21	Total liabilities (Part X, line 26).............	28,646,580	29,059,075
22	Net assets or fund balances. Subtract line 21 from line 20.....	4,864,868	3,471,681

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 22,496,366 including grants of $ 0 ) (Revenue $ 24,132,992 )
	GREAT PLAINS OF SMITH COUNTY, INC., DBA SMITH COUNTY MEMORIAL HOSPITAL, DELIVERS PRIMARY HEALTH CARE SERVICES TO RESIDENTS IN AN AREA THAT INCLUDES SMITH COUNTY, KANSAS. THE SERVICE AREA ALSO INCLUDES, TO A LESSER DEGREE, PHILLIPS, JEWELL, AND OSBORNE COUNTIES IN KANSAS, AS WELL AS FRANKLIN AND WEBSTER COUNTIES IN NEBRASKA. THE PRIMARY HEALTHCARE SERVICES ARE DELIVERED THROUGH A CRITICAL ACCESS HOSPITAL AND A PROVIDER-BASED RURAL HEALTH CLINIC. THE RURAL HEALTH CLINIC SERVED 15,307 PATIENTS FROM 41 ZIPCODES. SEE SCHEDULE O FOR CONTINUATION.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses22,496,366

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	1,832,925	408,772	485,297

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	11,664

f	All other contributions, gifts, grants, and similar amounts not included above		1f	228,661

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		240,325

		Business Code
2a	NET PATIENT SERVICE REVENUE	621300	20,939,663	20,939,663
b	340B PRESCRIPTION DRUG REVENUE	621300	3,157,899	3,157,899
c
d
e
f	All other program service revenue.		0	0	0	0
g	Total. Add lines 2a–2f .....		24,097,562

3 Investment income (including dividends, interest, and othersimilar amounts) ......			369,781			369,781
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a	6,005
b	Less: rental expenses	6b
c	Rental income or (loss)	6c	6,005	0
d	Net rental income or (loss).......			6,005			6,005
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a		3,000
b	Less: cost or other basis and sales expenses	7b		0
c	Gain or (loss)	7c	0	3,000
d	Net gain or (loss).........			3,000			3,000
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..

Business Code
11a	EMPLOYEE/GUEST MEALS		722513	115,475			115,475
b	MEALS ON WHEELS		722513	35,430	35,430
c	VENDOR REBATES		900099	27,287			27,287
d	All other revenue ....			26,587	0	0	26,587
e	Total. Add lines 11a–11d ......			204,779
12	Total revenue. See instructions.....			24,921,452	24,132,992	0	548,135

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	569,187		569,187
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........	9,060,091	8,235,145	824,946
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	721,984	644,704	77,280
9	Other employee benefits .......	1,305,252	1,083,178	222,074
10	Payroll taxes ...........	655,686	560,901	94,785
11	Fees for services (non-employees):
a	Management ......	139,688		139,688
b	Legal .........	3,045		3,045
c	Accounting ...........	200,847		200,847
d	Lobbying ...........	4,120		4,120
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)	4,839,662	4,083,034	756,628	0
12	Advertising and promotion ....	38,612		38,612
13	Office expenses .......	495,470	457,831	37,639
14	Information technology ......	36,040	17,624	18,416
15	Royalties ..
16	Occupancy ...........	474,626	355,796	118,830
17	Travel ............	9,676	6,422	3,254
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	105,760	65,791	39,969
20	Interest ...........	730,038	547,261	182,777
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	2,097,828	1,572,602	525,226
23	Insurance ...	235,314	176,399	58,915
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	4,457,399	4,457,399
b	EQUIPMENT RENTAL/MAINTENANCE	194,877	167,948	26,929
c	DUES & SUBSCRIPTIONS	64,100	31,291	32,809
d	ALL OTHER EXPENSES	33,040	33,040
e	All other expenses	0	0	0	0
25	Total functional expenses. Add lines 1 through 24e	26,472,342	22,496,366	3,975,976	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).

1	Cash–non-interest-bearing ........			3,816,889	1	164,148
2	Savings and temporary cash investments .........			4,421,743	2	8,819,386
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			2,567,448	4	2,970,841
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			329,031	8	259,103
9	Prepaid expenses and deferred charges ......			179,609	9	228,108
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	31,293,012
b	Less: accumulated depreciation	10b	13,071,210	20,090,704	10c	18,221,802
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			0	12
13	Investments—program-related. See Part IV, line 11 ..			0	13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			2,106,024	15	1,867,368
16	Total assets. Add lines 1 through 15 (must equal line 33)...			33,511,448	16	32,530,756

17	Accounts payable and accrued expenses .....	2,593,159	17	2,844,585
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	26,018,121	23	25,490,809
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	35,300	25	723,681
26	Total liabilities. Add lines 17 through 25..	28,646,580	26	29,059,075

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	3,908,767	27	2,333,958
28	Net assets with donor restrictions ...........	956,101	28	1,137,723
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	4,864,868	32	3,471,681
33	Total liabilities and net assets/fund balances ........	33,511,448	33	32,530,756