2024-11-01T14:52:00-05:00 2023-12-31 450250958 EIDE BAILLY LLP 18081 BURT ST STE 200 OMAHA NE 680224722 990 2023-01-01 470378779 THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION MARY 4024634521 715 NORTH ST JOSEPH AVE HASTINGS NE 68901 ERIC BARBER PRESIDENT/CEO 4024634521 2024-11-01 1 1 MEGAN L KOZIOL CPA P01544037 4023302660 2024-11-01 2023 2024-10-15 13:58:12Z MARY LANNING HEALTHCARE ERIC BARBER 715 NORTH ST JOSEPH AVE HASTINGS NE 68901 374335391 0 X WWW.MARYLANNING.ORG X 1915 NE PROVIDES INPATIENT, OUTPATIENT, EMERGENCY, ACUTE REHABILITATION, PSYCHIATRIC, AND CLINIC SERVICES. 7 6 1386 95 526738 51329 2572870 13066647 210371984 213814369 649276 14441494 1357860 1865805 214951990 243188315 383424 321442 0 0 114612364 118050662 0 0 0 109904784 108839362 224900572 227211466 -9948582 15976849 234669490 249638390 74471601 86480649 160197889 163157741 X ADVANCING OUR TRADITION OF SERVICE, EDUCATION AND COMMUNITY INVOLVEMENT, MARY LANNING HEALTHCARE IS DEDICATED TO EXCELLENCE, OFFERING HOPE, HEALTH AND HEALING. 0 0 210959070 321442 213814369 THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION D/B/A MARY LANNING HEALTHCARE (MLH), LOCATED IN HASTINGS, NEBRASKA, IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL WHICH PROVIDES INPATIENT, OUTPATIENT, EMERGENCY CARE, ACUTE REHABILITATION, PSYCHIATRIC SERVICES AND PHYSICIAN CLINIC SERVICES. MARY LANNING HEALTHCARE PROVIDES HEALTHCARE SERVICES TO THE GENERAL PUBLIC AND OPERATES ROUTINE SERVICE BEDS, ICU BEDS TOTALING 24,836 PATIENT DAYS. MLH HAD 203,631 OUTPATIENT VISITS AND EMERGENCY ROOM VISITS OF 14,873 IN 2023. MLH ALSO OPERATES A HOME HEALTH PROGRAM AND A SCHOOL OF NURSING. IN ADDITION, MLH OPERATES FOURTEEN PHYSICIAN CLINICS IN CENTRAL NEBRASKA, ALONG WITH AN OUTREACH PROGRAM TO SMALLER HOSPITALS IN WHICH TOGETHER MLH SEES APPROXIMATELY 30,000 PATIENTS PER YEAR. MLH OFFERS BEHAVIORAL HEALTH SERVICES ON AN INPATIENT AND OUTPATIENT BASIS, ACCOUNTING FOR 5,263 INPATIENT DAYS AND APPROXIMATELY 10,000 OUTPATIENT VISITS.MLH PROVIDES SEVERAL COMMUNITY PROGRAMS AS WELL. WE LIST ONLY THREE OF THEM. MLH PROVIDES A PLACE FOR FAMILY MEMBERS TO STAY AT A MINIMAL COST DURING TREATMENT, AT A COST OF $171,983 IN 2023. MLH ALSO HAS A PHARMACEUTICAL PATIENT ASSISTANCE PROGRAM THAT ASSISTS THOSE UNABLE TO PAY FOR PRESCRIPTION MEDICATIONS TO FIND ALTERNATIVE FUNDING THROUGH PHARMACEUTICAL COMPANIES AT A COST OF $143,865. TO PROVIDE THESE SERVICES, MLH ABSORBED OVER $37 MILLION IN COSTS DURING 2023. OVER $32 MILLION OF THAT RELATES TO CARE PROVIDED TO MEDICARE AND MEDICAID PATIENTS WITH AN ADDITIONAL $1.3M IN CARE TO THE UNINSURED IN THE FORM OF CHARITY CARE. 210959070 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 170 0 1 1386 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 7 6 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X SHAWN NORDBY 4024615344 715 N ST JOSEPH AVE HASTINGS NE 68901 X MICHAEL ALLEN TREASURER 1.00 40.00 X X 0 152800 22263 JEFF S ANDERSON CHAIR 1.00 0.00 X X 0 0 0 MICHELE BEVER VICE CHAIR 1.00 0.00 X X 0 0 0 ANNA STEHLIK SECRETARY 1.00 0.00 X X 0 0 0 CLARENCE GARY ANDERSON TRUSTEE 1.00 0.00 X 0 0 0 JANIS JOHNSON TRUSTEE 1.00 0.00 X 0 0 0 DANIEL HEROLD TRUSTEE 1.00 0.00 X 0 0 0 ERIC BARBER PRESIDENT/CEO 40.00 0.10 X 529682 0 68513 SHAWN NORDBY CHIEF FINANCIAL OFFICER 40.00 0.10 X 241457 0 67909 BRENT HOOD PHYSICIAN 40.00 0.00 X 1690147 0 71263 KALPESH GANATRA PHYSICIAN 40.00 0.00 X 800424 0 70235 MEHMET COPUR PHYSICIAN 40.00 0.00 X 782349 0 35199 SOE MIN TUN PHYSICIAN 40.00 0.00 X 666068 0 76563 SHAWN ACINO PHYSICIAN 40.00 0.00 X 563941 0 52978 5274068 152800 464923 190 0 1 0 CHIEF INDUSTRIES INC 3942 W OLD HWY 30 GRAND ISLAND NE 68803 CONSTRUCTION CONTRACTOR 12433604 MEDEFIS CONSOLIDATED BOX 5068 NEW YORK NY 100875068 CONTRACTED STAFFING 5606307 THE NEBRASKA MEDICAL CENTER 4350 DEWEY AVE OMAHA NE 68105 SOFTWARE SUPPORT 3569300 UNITI MED RECRUITING RESOURCES LLC 1000 N 90TH ST SUITE 400 OMAHA NE 68114 CONTRACTED STAFFING 1406575 SS PSYCHIATRY GROUP 4110 HARGORD STREET GRAND ISLAND NE 68803 PSYCHIATRIC PHYSICIAN COVERAGE 1312631 40 12076222 990425 13066647 ALL OTHER PATIENT REVENUE 621110 128175649 128175649 NET MEDICARE REVENUE 621110 64518647 64518647 NET MEDICAID REVENUE 621110 17478009 17478009 RADIOLOGY SCHOOL 621500 154860 154860 3487204 3487204 213814369 619591 619591 645963 0 645963 645963 645963 144743678 130921775 13821903 13821903 13821903 252090 225301 26789 26789 CAFETERIA 722514 696676 696676 PARTNERSHIP INCOME 621610 312044 342405 -30361 CATERING 722320 173979 173979 10354 10354 1193053 243188315 213814369 526738 15780561 X 321442 321442 907561 907561 123666 123666 84822172 79087778 5734394 2858169 2630304 227865 23832236 21740890 2091346 5506858 5086328 420530 153848 153848 81447 81447 130307 130307 35150857 31852540 3298317 1135415 910102 225313 5179450 4717561 461889 157385 144155 13230 687000 608898 78102 10070768 8984129 1086639 1853474 1669036 184438 MEDICAL SUPPLIES 49505070 49488534 16536 FOOD 1146238 1025038 121200 REPAIRS AND MAINTENANCE 512355 498803 13552 DUES & SUBSCRIPTIONS 346331 182405 163926 2729417 1887461 841956 227211466 210959070 16252396 0 5750 4950 1333675 38473346 21891899 25415915 1481288 0 6383502 6572918 1866383 2799994 245374327 152862119 90412241 92512208 43318327 8872454 7802811 7282756 1447260 3295258 58726354 64408591 234669490 249638390 24606605 27827785 40963 2885865 11854932 10478213 14990219 14990685 18841491 17923162 4137391 12374939 74471601 86480649 X 109604176 110780555 50593713 52377186 160197889 163157741 234669490 249638390 X 15976849 -10199044 -2817953 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 0 0 1 17426 17426 0 PART II-B, LINE 1: A PORTION OF DUES PAID TO AHA, NHA AND NABHO ARE FOR LOBBYING PURPOSES. 45165996 993606 46159602 47703742 -2537746 45165996 43653512 4050230 47703742 44556774 -619651 283611 43653512 43777313 779461 44556774 0.00000 1.00000 0.00000 0 1 1 5226920 5226920 139047349 78823167 60224182 91149286 72373556 18775730 9950772 1665396 8285376 92512208 DEFERRED COMPENSATION ASSETS 3337847 BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATION 7704252 BENEFICIAL INTEREST IN PERPETUAL TRUSTS 45490382 RIGHT OF USE ASSETS 7876110 64408591 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 922049 MALPRACTICE RESERVE 470000 DEFERRED COMPENSATION LIABILITIES 3337847 RIGHT OF USE LIABILITIES 7645043 12374939 X PART V, LINE 4: MARY LANNING HEALTHCARE FOUNDATION AND MARY LANNING HOSPITAL TRUST, BOTH RELATED ORGANIZATIONS, HOLD ENDOWMENT FUNDS RESTRICTED TO DISTRIBUTION TO MARY LANNING HEALTHCARE. THESE FUNDS ARE SHOWN AS BENEFICIAL INTERESTS IN OTHER ASSETS ON THE BALANCE SHEET. THE FUNDS ARE NOT UNDER THE CONTROL OF MARY LANNING HEALTHCARE. THE ENDOWMENT FUNDS ARE HELD FOR CAPITAL ACQUISITION, HOSPITAL OPERATIONS, SCHOLARSHIPS, EDUCATION, RESEARCH, AND COMMUNITY HEALTH CARE. PART X, LINE 2: THE HOSPITAL ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES. THE HOSPITAL RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT DECEMBER 31, 2023 AND 2022, THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS ACCRUED. 1 1 X 1 X 125.000000000000 1 X 1 1 1 0 1 1 1268618 1268618 0.00560 29584656 17423469 12161187 0.05350 30853274 17423469 13429805 0.05910 32 41084 429628 1412 428216 0.00190 12 180 749291 114380 634911 0.00280 3 170 12316 0 12316 0.00010 6 3847 191178 0 191178 0.00080 53 45281 1382413 115792 1266621 0.00560 53 45281 32235687 17539261 14696426 0.06470 1 5281 0 5281 0.00000 1 5281 5281 0.00000 1 6337841 792230 37198357 57697831 -20499474 X 1 1 1 HASTINGS SURGICAL CENTER LLC SURGICAL CENTER 0.18870 0.00000 0.16330 2 HASTINGS MEDICAL IMAGING LLC MEDICAL IMAGING 0.60600 0.00000 0.15400 1 1 THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION 715 NORTH ST JOSEPH AVENUE HASTINGS NE 68901 WWW.MARYLANNING.ORG 010002 X X X X THE MARY LANNING MEMORIAL HOSPITAL ASSOC 1 0 0 1 X X X X X X X X X 21 1 1 1 1 X HTTPS://WWW.MARYLANNING.ORG/ABOUT-US/COMMUNITY-NEEDS-ASSESSMENTS X 1 21 1 HTTPS://WWW.MARYLANNING.ORG/ABOUT-US/COMMUNITY-NEEDS-ASSESSMENTS 0 1 X 125.000000000000 200.000000000000 X X X X 1 1 X X X 1 X HTTPS://WWW.MARYLANNING.ORG/PATIENT-VISITOR-INFO/FINANCIAL-ASSISTANCE X HTTPS://WWW.MARYLANNING.ORG/PATIENT-VISITOR-INFO/FINANCIAL-ASSISTANCE X HTTPS://WWW.MARYLANNING.ORG/PATIENT-VISITOR-INFO/FINANCIAL-ASSISTANCE X X X X X X X 1 X 0 X X X X 1 X 0 0 THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 5: MARY LANNING HEALTHCARE (MLH) CONDUCTED ITS COMMUNITY HEALTH NEEDS ASSESSMENT IN 2021 USING THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) PROCESS. THIS WAS CONDUCTED IN PARTNERSHIP WITH THE SOUTH HEARTLAND DISTRICT HEALTH DEPARTMENT (SHDHD). THE COMMUNITY HEALTH NEEDS ASSESSMENT ENABLED MARY LANNING'S ADMINISTRATIVE TEAM AND BOARD OF TRUSTEES TO INCLUDE THE FINDINGS IN THE OVERALL STRATEGIC PLAN AND TO CREATE AN IMPLEMENTATION STRATEGY THAT IS IN ALIGNMENT WITH THE SHDHD'S CHIP (COMMUNITY HEALTH IMPROVEMENT PLAN) AS BOTH PLANS WORK TOGETHER TO ADDRESS THE NEEDS IN THE IDENTIFIED COMMUNITY. THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 6A: MEMBERS OF THE CORE TEAM FOR THE 2021 CHNA INCLUDED REPRESENTATIVES FROM BRODSTONE MEMORIAL HOSPITAL. THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 6B: OTHER NON-HOSPITAL ORGANIZATIONS INCLUDED: -SOUTH HEARTLAND DISTRICT HEALTH DEPARTMENT -THE NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES -UNITED WAY OF SOUTH CENTRAL NEBRASKA THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 11: MARY LANNING PARTNERED WITH THE SOUTH HEARTLAND DISTRICT HEALTH DEPARTMENT TO COORDINATE OUR IMPLEMENTATION PLAN WITH THEIR COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). A STEERING COMMITTEE FOR EACH OF THE FIVE GOAL AREAS MEETS BI-ANNUALLY. FROM THAT COMMITTEE, A SUBCOMMITTEE OF EMPLOYEES FROM BOTH ORGANIZATIONS AND MEMBERS OF THE COMMUNITY IS FORMED. THE SUBCOMMITTEE MEETS REGULARLY TO ACCOMPLISH THESE GOALS. THE MARY LANNING TEAM ALSO CONTINUED TO UPDATE AND PROVIDE SERVICES IN THE FIVE AREAS OF NEED. HIGHLIGHTS FROM EACH AREA OF NEED INCLUDE THE FOLLOWING: OBESITY AND RELATED HEALTH CONDITIONS: MLH IS COMMITTED TO PROVIDING ACTIVITIES, EDUCATION AND ASSESSMENT TO ASSIST COMMUNITY MEMBERS WITH THE TOOLS AND RESOURCES FOR BETTER DISEASE PREVENTION AND SELF MANAGEMENT THROUGH THE FOLLOWING ACTIONS: CREATING A CHRONIC CARE MANAGEMENT POSITION, ESTABLISHING A DIABETES REGISTRY, OFFERING AT LEAST ONE DIABETES PREVENTION CLASS PER YEAR AND ENSURING THE CARDIAC AND PULMONARY REHAB PATIENTS COMPLETE EDUCATION FOCUSED ON THEIR DIAGNOSED DISEASE STATE AMONG OTHER ACTIVITIES. CANCER: MLH IS COMMITTED TO DECREASING THE INCIDENCE OF CANCER BY PROVIDING LIMITED SKIN SCREENINGS AT HEALTH FAIRS AND FOR EMPLOYEES, COORDINATING AN EVENT TO ADDRESS OVERALL WOMEN'S HEALTH, SEEKING FUNDS TO SUPPLY ORAL CHEMOTHERAPY FOR PATIENTS WHOSE COVERAGE DOES NOT PAY, ESTABLISHING A MAMMOGRAM REGISTRY AND ESTABLISHING A SYSTEM TO NOTIFY PATIENTS OF UPCOMING PREVENTATIVE SCREENINGS AT THE FIRST YEAR OF ELIGIBILITY. MENTAL HEALTH: MLH IS COMMITTED TO PROVIDE EDUCATION AND SCREENINGS IN CLINIC AND COACHING SETTINGS FOR BETTER MENTAL HEALTH ASSESSMENT AND SELF-CARE BY THE FOLLOWING ACTIONS: ESTABLISHING TRACKING MECHANISMS TO DEMONSTRATE THE USAGE OF MENTAL HEALTH RESOURCES, ESTABLISHING INSOMNIA PATHWAY AT HASTINGS FAMILY CARE, DEVELOPING A STRESS QUESTIONNAIRE TO PUT IN INITIAL EVALUATION PACKETS AND OTHER ACTIONS. SUBSTANCE MISUSE: MLH IS COMMITTED TO PROVIDING EDUCATION AND RESOURCES TO 100% OF HEALTHY BEGINNINGS CLIENTS WHO HAVE BEEN IDENTIFIED AS POTENTIAL OR CONFIRMED AT RISK FOR SUBSTANCE MISUSE, DEVELOPING A PRESENTATION ON SUBSTANCE MISUSE/MENTAL HEALTH TARGETED AT 8TH GRADERS AND INCORPORATING A HUMAN TRAFFICKING ASSESSMENT IN THE EMERGENCY ROOM. ACCESS TO CARE: MLH IS COMMITTED TO DEVELOPING A STRATEGY TO ENCOURAGE ACCESS TO SPECIALTY SERVICES BY EXPLORING TELEMEDICINE OUTREACH AND PROVIDING EDUCATION ABOUT HOME CARE SERVICES TO AT LEAST TWO COMMUNITY GROUPS EVERY QUARTER. MLH IS ALSO SEEKING TO INCREASE THE AVAILABILITY OF URGENT CARE IN THE CLINIC, AS WELL AS INCREASING THE PATIENTS ABILITY TO MANAGE THEIR OWN CARE. NEEDS IDENTIFIED BUT NOT ADDRESSED INCLUDE AGING PROBLEMS, ENVIRONMENTAL ISSUES, AND CHILD ABUSE AND NEGLECT/DOMESTIC VIOLENCE. THESE NEEDS, WHILE SIGNIFICANT, ARE BETTER SERVED BY LEVERAGING THE EXPERTISE OF OTHER ORGANIZATIONS. THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 16J: THE FULL POLICY IS AVAILABLE UPON REQUEST, FREE OF CHARGE, AS WELL AS ON THE HOSPITAL'S WEBSITE. A SUMMARY OF THE POLICY AND CONTACT INFORMATION IS POSTED ON MARY LANNING HEALTHCARE'S WEBSITE, PRINTED ON BILLING STATEMENTS, POSTED IN ALL ADMISSION AREAS AND PROVIDED IN WRITING TO ALL PATIENTS UPON CHECK IN. 13 1 - HASTINGS ORTHOPEDICS 2207 OSBORNE DR WEST STE 100 HASTINGS NE 68901 OUTPATIENT CLINIC 2 - HASTINGS FAMILY CARE 715 N KANSAS AVE STE 208 HASTINGS NE 68901 OUTPATIENT CLINIC 3 - CENTRAL NE UROLOGY 2115 N KANSAS AVENUE STE 108 HASTINGS NE 68901 OUTPATIENT CLINIC 4 - CENTRAL NE UROLOGY 620 N ALPHA ST GRAND ISLAND NE 68803 OUTPATIENT CLINIC 5 - LANNING CENTER 815 S BURLINGTON AVENUE HASTINGS NE 68901 OUTPATIENT CLINIC 6 - CENTRAL NE GENERAL SURGERY 715 N KANSAS AVENUE STE 205 HASTINGS NE 68901 OUTPATIENT CLINIC 7 - HASTINGS PULMONARY & SLEEP 715 N KANSAS AVENUE STE 101 HASTINGS NE 68901 OUTPATIENT CLINIC 8 - CENTRAL NE FAMILY CARE 3016 W FAIDLEY AVE GRAND ISLAND NE 68803 OUTPATIENT CLINIC 9 - CENTRAL NE KIDNEY CARE 715 N KANSAS AVENUE STE 202 HASTINGS NE 68901 OUTPATIENT CLINIC 10 - INSPIRED BRAIN & SPINE SURGERY 715 N KANSAS AVE STE 207 HASTINGS NE 68901 OUTPATIENT CLINIC 11 - WOUND CENTER 715 N KANSAS AVE STE 302 HASTINGS NE 68901 OUTPATIENT CLINIC 12 - BLUE HILL CLINIC 102 N PINE STREET BLUE HILL NE 68930 OUTPATIENT CLINIC 13 - MIDWEST COSMETIC & WOUND SURGERY 715 N KANSAS AVE STE 206 HASTINGS NE 68901 OUTPATIENT CLINIC PART I, LINE 3C: THE ORGANIZATION ONLY USED FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR FREE AND DISCOUNTED CARE. PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT IS NOT PREPARED BY A RELATED ORGANIZATION. PART I, LINE 7: CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. UNREIMBURSED MEDICAID ON LINE 7B WAS CALCULATED USING THE COSTING METHODS TO PREPARE THE COST REPORTS. COMMUNITY HEALTH IMPROVEMENT SERVICES, LINE 7E, HEALTH PROFESSIONS EDUCATION, LINE 7F, AND CONTRIBUTIONS FOR COMMUNITY BENEFIT, LINE 7I, ARE REPORTED BASED ON ACTUAL EXPENSES REPORTED IN THE GENERAL LEDGER. THE COST FOR SUBSIDIZED HEALTH SERVICES REPORTED ON LINE 7G WAS CALCULATED USING THE RATIO OF PATIENT COST TO CHARGES ON WORKSHEET 2. PART I, LINE 7G: NO COSTS ASSOCIATED WITH PHYSICIAN CLINICS WERE INCLUDED AS SUBSIDIZED HEALTH SERVICES. PART II, COMMUNITY BUILDING ACTIVITIES: HASTINGS FAMILY CARE, A CLINIC OF MLH, HOSTED PROJECT SEARCH STUDENTS FOR AN EIGHT WEEK ROTATION SO THAT THEY MAY GAIN JOB SKILLS TO PREPARE THEM FOR FUTURE JOB OPPORTUNITIES. PART III, LINE 2: THE HOSPITAL DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION EXPERIENCE WITH VARIOUS CLASSES OF PATIENTS. PART III, LINE 3: THE ESTIMATED AMOUNT OF THE ORGANIZATION'S IMPLICIT PRICE CONCESSIONS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS CALCULATED BASED ON AN APPROXIMATE 12.5% OF INDIVIDUALS LIVING BELOW THE POVERTY LEVEL IN THE SERVICE AREA. PART III, LINE 4: THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES IMPLICIT PRICE CONCESSIONS IS LOCATED IN FOOTNOTE 1 ON PAGES 14 AND 15 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: THE HOSPITAL PROVIDES SERVICES TO MEDICARE PATIENTS REGARDLESS OF A SURPLUS OR SHORTFALL BECAUSE ACCESS TO HEALTHCARE AND INDIVIDUAL'S HEALTH IS IMPORTANT TO THE HOSPITAL. THEREFORE, ANY SHORTFALL IS CONSIDERED A COMMUNITY BENEFIT.TOTAL REVENUE RECEIVED FROM MEDICARE IS THE GROSS REIMBURSEMENT PLUS SETTLEMENT. BOTH TOTAL REVENUE RECEIVED FROM MEDICARE AND THE MEDICARE ALLOWABLE COSTS ARE REPORTED FROM THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CENTERS FOR MEDICARE AND MEDICAID SERVICES. PART III, LINE 9B: ACCOUNTS WILL BE SCREENED FOR APPROPRIATE REFERRAL TO FINANCIAL ASSISTANCE VS. BAD DEBT WRITE OFF DURING THE COLLECTION PROCESS. THE FINANCIAL ASSISTANCE POLICY DOES INCLUDE PROVISION FOR IMPLIED CHARITY CARE IF THERE IS SUFFICIENT KNOWLEDGE TO DETERMINE THAT THE PATIENT MEETS THE QUALIFYING FACTORS OF THE PROGRAM. PART VI, LINE 2: IN ADDITION TO THE STANDARD CHNAS CONDUCTED USING THE MAPP (2012, 2018) OR MINI-MAPP (2015, 2021), MARY LANNING UTILIZES OTHER METHODS OF ASSESSING THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES. IN PARTNERSHIP WITH THE SOUTH HEARTLAND DISTRICT HEALTH DEPARTMENT (SHDHD), THE 2018 CHNA INCLUDED A NEW SPECIAL FOCUS ON ACCESS TO CARE, TO INCLUDE FOCUS GROUPS WITH HEALTH SYSTEM USERS (IN ENGLISH AND SPANISH) AND FOCUS GROUPS WITH HEALTH SYSTEM PROVIDERS AND COMMUNITY LEADERS. THE OVERALL GOAL OF THIS SPECIAL FOCUS WAS TO IDENTIFY GAPS IN HEALTH SERVICES AND BARRIERS TO ACCESSING HEALTH CARE. IN 2022, MARY LANNING HAD A SPECIAL FOCUS ON MINORITY HEALTH ASSESSMENTS AND THE IMPACT OF THE PANDEMIC ON ACCESS TO SERVICES AND HEALTH BEHAVIORS. MARY LANNING ALSO PARTNERS WITH THE SHDHD ON AN ONGOING BASIS TO ASSESS OR RECEIVE ASSESSMENT REPORTS ON SPECIFIC HEALTH NEEDS TO SUPPORT PLANNING AND IMPLEMENTATION OF COMMUNITY OUTREACH PROGRAMS. CLINICS ARE ALSO UTILIZING CLIENT/PATIENT POPULATION DATA REPORTED FROM THE ELECTRONIC HEALTH RECORDS TO UNDERSTAND THE NEEDS OF PATIENTS (SUCH AS HYPERTENSION MANAGEMENT OR PRE-DIABETES) AND ADDRESSING THESE NEEDS IN PART THROUGH PARTNERSHIPS WITH, AND REFERRALS TO, EVIDENCE-BASED COMMUNITY PROGRAMS. PART VI, LINE 3: MLH INFORMS AND EDUCATES PATIENTS BY POSTING SIGNS IN ALL ADMISSION AREAS AND PATIENT ROOMS. BROCHURES ARE AVAILABLE IN ADMISSION AREAS. ALL NON-INSURED INPATIENTS ARE PERSONALLY VISITED AND PATIENTS MAY HAVE DISCUSSIONS WITH A FINANICAL COUNSELOR AT ANYTIME DURING THE BILLING/COLLECTION PROCESS. PART VI, LINE 4: MLH'S PRIMARY SERVICE AREA IS ADAMS COUNTY WITH A SECONDARY AREA INCLUDING MERRICK, HALL, HAMILTON, KEARNEY, CLAY, FRANKLIN, WEBSTER, AND NUCKOLLS COUNTIES. THE ESTIMATED POPULATION OF ADAMS COUNTY IS 35,000 AND THE SECONDARY SERVICE AREA IS 93,000. ADAMS COUNTY IS 563 SQ. MILES. FIFTEEN PERCENT OF THE POPULATION IN ADAMS COUNTY IS MEDICARE AGE OR OLDER. PART VI, LINE 5: MARY LANNING CURRENTLY PROMOTES HEALTH IN THE COMMUNITY THROUGH OUTREACH TO A WIDE VARIETY OF COMMUNITY ORGANIZATIONS. MUCH FOCUS IS ALREADY PLACED ON THE FIVE PRIORITY NEED AREAS IDENTIFIED IN THE CHNA. MANY DEPARTMENTS WITHIN MARY LANNING PARTICIPATE IN COMMUNITY COALITIONS, PROVIDE OUTREACH TO WORKSITES AND COMMUNITY MEMBERS INCLUDING MINORITIES AND LOW INCOME GROUPS, EDUCATE AND PROVIDE LOW COST OR NO COST SCREENINGS AND CARE. PART VI, LINE 6: MARY LANNING IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. 1 MARY LANNING HEALTHCARE FOUNDATION 741 N DENVER AVE HASTINGS NE 68901 470800042 501(C)(3) 321442 0 ASSIST WITH FUNDRAISING OPERATING COSTS 1 0 PART I, LINE 2: MARY LANNING HEALTHCARE ONLY MAKES CONTRIBUTIONS AND GRANTS TO CHARITABLE OR GOVERNMENTAL TAX EXEMPT ENTITIES. THE HOSPITAL VERIFIES THE TAX EXEMPT STATUS OF THE GRANT RECIPIENTS PRIOR TO MAKING THE GRANT. TERMS OF THE GRANT STATE THAT THE FUNDS ARE ONLY TO BE USED FOR CHARITABLE PURPOSES. X 0 0 X X X X 0 1 0 0 0 0 0 1 0 BRENT HOOD PHYSICIAN 961461 0 728056 0 630 0 13200 0 58063 0 1761410 0 0 0 KALPESH GANATRA PHYSICIAN 591796 0 207998 0 630 0 11872 0 58363 0 870659 0 0 0 MEHMET COPUR PHYSICIAN 778246 0 0 0 4103 0 13200 0 21999 0 817548 0 0 0 SOE MIN TUN PHYSICIAN 577401 0 88289 0 378 0 13200 0 63363 0 742631 0 0 0 SHAWN ACINO PHYSICIAN 560741 0 0 0 3200 0 13200 0 39778 0 616919 0 0 0 ERIC BARBER PRESIDENT/CEO 517127 0 11589 0 966 0 13200 0 55313 0 598195 0 76103 0 SHAWN NORDBY CHIEF FINANCIAL OFFICER 229943 0 10986 0 528 0 10063 0 57846 0 309366 0 0 0 MICHAEL ALLEN TREASURER 0 152800 0 0 0 0 0 6396 0 15867 0 175063 0 0 PART I, LINE 1A HEALTH OR SOCIAL CLUB DUES: A COUNTRY CLUB MEMBERSHIP IS PROVIDED TO ERIC BARBER AND SHAWN NORDBY FOR PERSONAL USE. THE VALUE OF THE MEMBERSHIP WAS INCLUDED AS TAXABLE WAGES IN THEIR 2023 W-2'S. PART I, LINE 4B THE HOSPITAL CONTRIBUTED $90,000 TO A 457(F) ACCOUNT FOR ERIC BARBER, PRESIDENT/CEO. ERIC ALSO RECEIVED A TAXABLE DISTRIBUTION FROM A 457(F) ACCOUNT OF $76,103. PART I, LINE 7 ERIC BARBER, PRESIDENT/CEO, EMPLOYMENT AGREEMENT PROVIDES FOR UP TO A 20% DISCRETIONARY BONUS. A HOSPITAL AUTHORITY NO 1 OF ADAMS COUNTY NE 470762824 000000000 2015-08-27 28335905 RENOVATIONS AND REFUND ISSUE (7/1/08) 0 0 0 A 17776091 28812743 7500327 21312417 2017 0 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 1 1 0 0 0 0 A 0 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: HOSPITAL AUTHORITY NO 1 OF ADAMS COUNTY, NE DATE THE REBATE COMPUTATION WAS PERFORMED: 07/31/2018 SCHEDULE K, PART IV, LINE 2C: NOTE REGARDING THE REBATE COMPUTATION ON 7/31/2018: SINCE THE BOND PROCEEDS HAVE BEEN SPENT AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CALCULATIONS ARE NECESSARY. PART II, LINE 3: THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS. MONICA NORDBY SPOUSE OF SHAWN NORDBY, CFO 83578 COMPENSATION AND BENEFITS AS EMPLOYEE 0 ALEXIS NORDBY DAUGHTER OF SHAWN NORDBY, CFO 40088 COMPENSATION AND BENEFITS AS EMPLOYEE 0 FORM 990, PART IV, LINE 13: FORM 990, PART IV, LINE 13 IS ANSWERED "NO" BECAUSE MARY LANNING HEALTHCARE'S PRIMARY PROGRAM SERVICE IS THE PROVISION OF MEDICAL CARE THROUGH ITS HOSPITAL. HOWEVER, IT ALSO CONDUCTS A NURSING SCHOOL IN CONJUNCTION WITH BRYAN COLLEGE OF HEALTH SCIENCES AND A RADIOLOGY SCHOOL. SCHEDULE E HAS NOT BEEN PREPARED BECAUSE THE ORGANIZATION DOES NOT CHECK BOX 2, PART I OF SCHEDULE A TO INDICATE IT IS A "SCHOOL". BOTH THE NURSING SCHOOL AND THE RADIOLOGY SCHOOL ARE OPERATED ON A NONDISCRIMINATORY BASIS. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE, CONSISTING OF THE CHAIR, VICE CHAIR, SECRETARY AND TREASURER, HAS THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 2 MICHELE BEVER, VICE CHAIR, AND JANIS JOHNSON, TRUSTEE, HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF FORM 990 WAS PROVIDED TO THE MEMBERS OF THE BOARD ELECTRONICALLY AND WAS REVIEWED BY THOSE MEMBERS PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, TRUSTEES, COMMITTEE MEMBERS AND KEY EMPLOYEES MUST ANNUALLY REVIEW AND COMPLETE A CONFLICT SURVEY AND SIGN A CONFLICT OF INTEREST STATEMENT. AS PER THE POLICY, ANY POTENTIAL CONFLICT OF INTEREST MUST BE DISCLOSED AND MADE A MATTER OF RECORD. ANY PERSON WITH A POSSIBLE CONFLICT OF INTEREST IN ANY MATTER SHOULD NOT VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE PRESIDENT/CEO'S COMPENSATION IS REVIEWED BY THE BOARD OF TRUSTEES ON AN ANNUAL BASIS. TARGETS ARE SET AND COMPENSATION IS APPROVED. IN 2022, THE VICE PRESIDENT OF HUMAN RESOURCES PROVIDED RESULTS OF A SURVEY COMPARING CEO COMPENSATION TO NEBRASKA AND REGIONAL AREA FACILITIES. THE BOARD REVIEWED THAT INFORMATION PRIOR TO SETTING CEO COMPENSATION. IT IS THE BOARD'S GOAL TO REVIEW CEO COMPENSATION IN DETAIL A MINIMUM OF EVERY THIRD YEAR. FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST THROUGH MARY LANNING HEALTHCARE'S ADMINISTRATIVE OFFICES. FORM 990, PART VII, SECTION A, COLUMN B: MICHAEL ALLEN IS EMPLOYED BY MARY LANNING TRUST, A RELATED ENTITY. FORM 990, PART IX, LINE 11G PROFESSIONAL MEDICAL FEES: PROGRAM SERVICE EXPENSES 9,687,130. MANAGEMENT AND GENERAL EXPENSES 248,218. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,935,348. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 22,165,410. MANAGEMENT AND GENERAL EXPENSES 3,050,099. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 25,215,509. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUSTS 993,606. CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATION -3,811,559. FORM 990, PART XI, LINE 2C: THE BOARD OF TRUSTEES OF THE ORGANIZATION ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MARY LANNING HEALTHCARE FOUNDATION 741 N DENVER AVE HASTINGS NE 68901 470800042 FUNDRAISING AND SUPPORT NE 501(C)(3) LINE 12A, I THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION 1 MARY LANNING HOSPITAL TRUST 122 N HASTINGS AVE HASTINGS NE 68901 476000224 INVESTMENT MANAGEMENT NE 501(C)(3) LINE 12A, I THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION 1 HASTINGS MEDICAL IMAGING LLC 715 N ST JOSEPH AVE HASTINGS NE 68901 851318481 RADIOLOGY SERVICES NE THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION RELATED -160843 0 1 0.61400 0 1 1 0 1 0 0 0 0 0 0 0 1 1 1 0 0 0 1 MARY LANNING HEALTHCARE FOUNDATION B 321442 CASH TRANSFER MARY LANNING HEALTHCARE FOUNDATION C 5132790 CASH TRANSFER MARY LANNING HOSPITAL TRUST C 6943432 CASH TRANSFER MARY LANNING HOSPITAL TRUST E 1500000 FAIR MARKET VALUE