2023-05-11T15:56:40-05:00 2022-06-30 450250958 EIDE BAILLY LLP 18081 BURT ST STE 200 OMAHA NE 680224722 990 2021-07-01 237161473 OSMOND GENERAL HOSPITAL OSMO 4027483393 402 N MAPLE OSMOND NE 68765 LON M KNIEVEL CHIEF EXECUTIVE OFFICER 4027483393 2023-05-11 1 LON KNIEVEL 999009999 MEGAN L KOZIOL CPA P01544037 4023302660 2023-05-11 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z LON M KNIEVEL 402 N MAPLE OSMOND NE 68765 8743254 0 X WWW.OSMONDHOSPITAL.ORG X 1966 NE PROVIDE HEALTHCARE SERVICES TO ALL INDIVIDUALS IN THE COMMUNITY REGARDLESS OF THEIR ABILITY TO PAY. 9 7 75 10 0 0 3180894 184135 8216423 8033792 62882 91501 570422 377046 12030621 8686474 0 2000 0 0 4754425 4597776 0 0 0 3832324 3748850 8586749 8348626 3443872 337848 12251639 11468281 2847453 2079562 9404186 9388719 OSMOND GENERAL HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH OF OSMOND AND THE SURROUNDING COMMUNITIES BY PROVIDING HIGH QUALITY, PERSONALIZED, AND TECHNOLOGICALLY CURRENT HEALTH CARE WITH COMPASSION, DIGNITY, AND RESPECT IN A COST EFFECTIVE AND SAFE MANNER. 0 0 6931937 2000 8372883 OSMOND GENERAL HOSPITAL, INC SERVES ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND DOES NOT LIMIT ITS SERVICES OR DISCRIMINATE BASED ON RACE, SEX, NATIONAL ORGIN, OR RELIGION. DURING 2021-2022, OSMOND PROVIDED 2,147 INPATIENT DAYS, 327 RELATED TO MEDICAL/SURGICAL AND 1,820 RELATED TO SWING-BED. THERE WERE A TOTAL OF 126 OPERATIONS PERFORMED AND THE EMERGENCY ROOM TREATED 551 PATIENTS. IN ADDITION TO PROVIDING DIRECT INPATIENT AND OUTPATIENT SERVICES, OSMOND GENERAL HOSPITAL, INC. PROVIDED THE FOLLOWING SPECIALTY CLINICS: UROLOGY, MAMMOGRAPHY, SURGERY, CARDIOLOGY, PULMONOLOGY, PAIN, AND TELEHEALTH. 6931937 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 32 0 1 75 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 1 0 X JODI ASCHOFF CFO 4027483393 OSMOND GEN HOSPITAL 402 NORTH MAPLE OSMOND NE 68765 LON M KNIEVEL MEMBER/CEO 40.00 X X 186147 0 40669 TIM KINT PRESIDENT 4.00 X X 0 0 0 DOUG KETELSEN VICE PRESIDENT 4.00 X X 0 0 0 THERESA STAPELMAN SECRETARY/TREASURER 2.00 X X 0 0 0 DOUG KOEHLER MEMBER 2.00 X 0 0 0 STEPHANIE ANDERSON MEMBER 2.00 X 0 0 0 KEVIN LAUCK PA MEMBER 2.00 X 0 0 0 WILLIAM HEFNER MEMBER 2.00 X 0 0 0 WALTER ASCHOFF MEMBER 2.00 X 0 0 0 LARRY PAULSEN MEMBER THRU 04/22 2.00 X 0 0 0 LORI MUNTER MEMBER THRU 06/22 2.00 X 0 0 0 JODI ASCHOFF CFO 40.00 X 86531 0 11755 DR KELLY ELLIS DOCTOR 40.00 X 170528 0 21467 ALICIA MAVIS NURSE PRACTITIONER 40.00 X 161333 0 22971 BOBBIE JO MILLER NURSE PRACTITIONER 40.00 X 156582 0 8325 SAMANTHA KIZZIRE CLINIC/HOSPITAL APRN 40.00 X 112368 0 29492 873489 0 134679 5 0 1 0 MHS DATA CENTER 250 NO ROCK ROAD STE 160 WICHITA KS 67206 SOFTWARE SUPPORT 463513 PSYCHIATRIC MEDICAL PO BOX 734606 DALLAS TX 75373 ADMINISTRATOR FOR ELDERLY POPULATION 398567 AMERISOURCE BERGEN 27550 NETWORK PLACE CHICAGO IL 60673 PHARMACY 259321 BLOOMFIELD MEDICAL PARTNERS 105 SOUTH BROADWAY BLOOMFIELD NE 68718 ER COVERAGE 246918 WPS GOVERNMENT HEALTH ADMINISTRATORS PO BOX 8788 MADISON WI 537088788 MEDICARE SERVICES 239910 8 178310 5825 184135 MEDICARE/MEDICAID 621110 5856287 5856287 PATIENT SERVICE REVENU 621110 2177505 2177505 8033792 145331 145331 22016 0 22016 22016 22016 2950 56780 -53830 -53830 -53830 BAD DEBT RECOVERIES 624100 339091 339091 CAFETERIA 624200 14652 14652 PHARMACY 624100 1287 1287 355030 8686474 8372883 0 129456 X 2000 2000 325102 325102 3162501 2754070 408431 76720 63521 13199 801205 576594 224611 232248 190233 42015 9247 9247 88516 88516 1839667 1672077 167590 235098 187208 47890 152470 151261 1209 8894 7448 1446 7679 4356 3323 29994 29314 680 435371 425495 9876 65010 63535 1475 MEDICAL SUPPLIES 742168 722975 19193 MISCELLANEOUS 109901 76339 33562 LICENSES & FEES 22253 2929 19324 DUES AND SUBSCRIPTIONS 2582 2582 0 8348626 6931937 1416689 0 525 525 7654523 6972367 801988 896322 82690 90042 19693 22717 8315560 5845260 2443955 2470300 1248265 1016008 12251639 11468281 530600 645759 895333 730750 1421520 703053 2847453 2079562 X 9404186 9388719 9404186 9388719 12251639 11468281 337848 -353315 0 X X 0 1 X 1 0 X X 0 0 0 0 0 0 0 0 1 1247 1247 0 PART II-B, LINE 1: OSMOND GENERAL HOSPITAL PAYS DUES TO THE NEBRASKA HOSPITAL ASSOCIATION (NHA) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA) OF WHICH A PORTION IS USED FOR LOBBYING ACTIVITIES. FOR FISCAL YEAR 2022, 10.79% OF THE DUES PAID TO NHA AND 25.56% OF THE DUES PAID TO AHA WERE USED FOR LOBBYING. 15461 15461 6016825 4626334 1390491 1946923 1125343 821580 336351 93583 242768 2470300 REFUNDABLE ADVANCES 477340 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 225713 703053 X 8333159 -353315 -353315 8686474 0 8686474 8348626 0 8348626 0 8348626 PART X, LINE 2: THE HOSPITAL ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING THE GUIDANCE INCLUDED IN FASB ASC TOPIC 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 JUNE 30, 2022 AND 2021, THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS ACCRUED. 1 1 X 1 X 1 X 150.000000000000 1 0 0 83814 83814 0.01000 336357 225283 111074 0.01330 420171 225283 194888 0.02330 1 8 103899 103899 0.01240 2000 2000 0.00020 1 8 105899 105899 0.01260 1 8 526070 225283 300787 0.03590 4888 4888 0.00060 4888 4888 0.00060 1 0 0 4894819 4890329 4490 X 1 1 1 1 OSMOND GENERAL HOSPITAL 402 NORTH MAPLE OSMOND NE 68765 OSMONDHOSPITAL.ORG 620001 X X X X OSMOND GENERAL HOSPITAL 1 0 0 1 X X X X X X X X X 21 1 1 1 1 X WWW.OSMONDHOSPITAL.ORG/PATIENT-VISITOR-INFORMATION/NEW-PATIENT-FORMS/ X 1 21 1 WWW.OSMONDHOSPITAL.ORG/PATIENT-VISITOR-INFORMATION/NEW-PATIENT-FORMS/ 0 1 X 100.000000000000 150.000000000000 X X X 1 1 X X X 1 X HTTPS://WWW.OSMONDHOSPITAL.ORG/PATIENT-VISITOR/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.OSMONDHOSPITAL.ORG/PATIENT-VISITOR/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.OSMONDHOSPITAL.ORG/PATIENT-VISITOR/FINANCIAL-ASSISTANCE/ X X X X X 1 X 0 X X X X 1 X 0 0 OSMOND GENERAL HOSPITAL PART V, SECTION B, LINE 5: OSMOND GENERAL HOSPITAL WORKED WITH THE NORTH CENTRAL DISTRICT HEALTH DEPARTMENT TO COMPLETE THE COMMUNITY HEALTH NEEDS ASSESSMENT PLAN. OSMOND GENERAL HOSPITAL PART V, SECTION B, LINE 6A: - ANTELOPE MEMORIAL IN NELIGH, NE- PLAINVIEW COMMUNITY HOSPITAL IN PLAINVIEW, NE- AVERA CREIGHTON HOSPITAL IN KNOX COUNTY, NE- AVERA ST. ANTHONY'S IN O'NEILL, NE- BROWN COUNTY HOSPITAL IN AINSWORTH, NE- CHERRY COUNTY HOSPITAL IN VALENTINE, NE- ROCK COUNTY HOSPITAL IN BASSETT, NE- WEST HOLT MEMORIAL HOSPITAL IN ATKINSON, NE- NIOBRARA VALLEY HOSPITAL IN LYNCH, NE OSMOND GENERAL HOSPITAL PART V, SECTION B, LINE 6B: NORTH CENTRAL DISTRICT HEALTH DEPARTMENT OSMOND GENERAL HOSPITAL PART V, SECTION B, LINE 11: THROUGH THE PROCESS OF COMPLETING THE COMMUNITY HEALTH NEEDS ASSESSMENT, AS WELL AS ASSESSING THE RESOURCES AVAILABLE TO THIS ORGANIZATION AND SURROUNDING COMMUNITIES, IT WAS DETERMINED THAT THE MOST SIGNIFICANT NEED TO BE ADDRESSED BY OSMOND GENERAL HOSPITAL IS THE CARDIOVASCULAR HEALTH OF THE COMMUNITY. BY TACKLING THIS SPECIFIC HEALTH ISSUE, OSMOND HOSPITAL HAS THEOPPORTUNITY TO VASTLY DECREASE THE OCCURRENCES AND SEVERITY OF HEART DISEASE RESULTING IN HEART ATTACK AND DEATH.OSMOND GENERAL HOSPITAL WILL CONTINUE TO UTILIZE PROVEN COMMUNITY WEIGHT LOSS ACTIVITIES AS WELL AS INTRODUCE NEW STRATEGIES TO WORK WITH OTHER COMMUNITY PARTNERS TO INCREASE AWARENESS OF AND PROMOTE BETTER NUTRITIONAL ALTERNATIVES AND OPPORTUNITIES FOR PHYSICAL ACTIVITY. THIS GOAL WILL BE ACCOMPLISHED THROUGH THE DEVELOPMENT AND STRENGTHENING OF COMMUNITY PARTNERSHIPS, WORKPLACE WELLNESS PROGRAMS, BLOOD PRESSURE SCREENINGS, NUTRITION AND PHYSICAL ACTIVITY.AS A SECONDARY PRIORITY, OSMOND GENERAL HOSPITAL WILL ALSO EXPAND ITS EFFORTS INTO ADDRESSING THE MENTAL HEALTH NEEDS OF THE COMMUNITIES IT SERVES WITH THE GOAL OF REDUCING THE SUICIDE RATE AMONG IT CITIZENS. OSMOND GENERAL HOSPITAL WILL UTILIZE TWO SERVICES OFFERED ON ANOUTPATIENT BASIS: SENIOR LIFE SOLUTIONS, WHICH IS A GROUP MENTAL HEALTH THERAPY PROGRAM DIRECTED TOWARDS SENIORS; AS WELL AS A LICENSED INDEPENDENT MENTAL HEALTH PRACTITIONER WORKING IN OURRURAL HEALTH CLINIC. OGH WILL ALSO PROMOTE MENTAL HEALTH AND SUICIDE PREVENTION THROUGH PUBLICATIONS AND ADVERTISEMENT.THERE WERE NO HEALTH NEEDS IDENTIFIED IN THE LATEST CHNA THAT ARE NOT BEING ADDRESSED. 2 1 - RANDOLPH CLINIC 106 EAST WAYNE RANDOLPH NE 68771 MEDICAL CLINIC 2 - WAUSA CLINIC 100 N LINCOLN WAUSA NE 68786 MEDICAL CLINIC PART I, LINE 3C: NO OTHER CRITERIA WAS USED TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. PART I, LINE 6A: A COMMUNITY BENEFIT REPORT WAS NOT PREPARED IN THE CURRENT YEAR. PART I, LN 7 COL(F): DURING THE YEAR ENDED JUNE 30, 2022, THE BAD DEBT RECOVERIES EXCEEDED THE BAD DEBT EXPENSE. THERE IS NO BAD DEBT EXPENSE INCLUDED ON FORM 990, PART XI, LINE 25. PART II, COMMUNITY BUILDING ACTIVITIES: OSMOND GENERAL HOSPITAL HELD SEVERAL VACCINATION CLINICS AND BLOOD DRIVES, PROVIDED SPACE FOR WEEKLY AA MEETINGS, AS WELL AS PROVIDED CANCER KITS TO FAMILIES IN THE COMMUNITY. PART III, LINE 2: THE HOSPITAL DETERMINES THE TRANSACTION PRICE BASED ON STANDARD CHARGES FOR GOODS AND SERVICES PROVIDED, REDUCED BY CONTRACTUAL ADJUSTMENTS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO UNINSURED PATIENTS IN ACCORDANCE WITH THE HOSPITAL'S POLICY, AND OR IMPLICIT PRICE CONCESSIONS PROVIDED TO UNINSURED PATIENTS. THE HOSPITAL DETERMINES ITS ESTIMATES OF CONTRACTUAL ADJUSTMENTS AND DISCOUNTS BASED ON CONTRACTUAL AGREEMENTS, ITS DISCOUNT POLICIES AND HISTORICAL EXPERIENCE. THE HOSPITAL DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION EXPERIENCE WITH VARIOUS CLASSES OF PATIENTS. PART III, LINE 3: THE HOSPITAL PROVIDES PATIENT FINANCIAL ASSISTANCE TO PATIENTS WHO ARE FINANCIALLY UNABLE TO PAY FOR THE HEALTHCARE SERVICES THEY RECEIVE. IT IS THE POLICY OF THE HOSPITAL NOT TO PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS PATIENT FINANCIAL ASSISTANCE. ACCORDINGLY, THE HOSPITAL DOES NOT REPORT THESE AMOUNTS IN PATIENT SERVICE REVENUE. THE HOSPITAL DETERMINES THE COSTS ASSOCIATED WITH PROVIDING CHARITY CARE BY AGGREGATING THE DIRECT AND INDIRECT COSTS, INCLUDING SALARIES, BENEFITS, SUPPLIES, AND OTHER OPERATING EXPENSES, BASED ON AN OVERALL COST TO CHARGE RATIO. THE COSTS FOR CARING FOR THESE PATIENTS FOR THE YEAR ENDED JUNE 30, 2022 WAS APPROXIMATELY $298,000. PART III, LINE 4: THE HOSPITAL'S FINANCIAL STATMENTS DO NOT CONTAIN A SPECIFIC FOOTNOTE DESCRIBING BAD DEBT. HOWEVER, PAGES 7, 9 AND 10 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS INCLUDE FOOTNOTES TITLED "PATIENT ACCOUNTS RECEIVABLE", "PATIENT SERVICE REVENUE AND "PATIENT FINANCIAL ASSISTANCE". PART III, LINE 8: THE ORGANIZATION USED WORKSHEETS D-1, D-3, E, E-2 AND E-3 OF THE JUNE 30, 2022 COST REPORT. IT DOES NOT INCLUDE ALL OF THE MEDICARE REVENUES AND COSTS. IF ALL OF THE MEDICARE REVENUES AND COSTS WERE INCLUDED, THERE WOULD BE A LARGE SHORTFALL SHOWN ON LINE 7. THE SHORTFALL REPRESENTS ACTUAL UNREIMBURSED COSTS INCURRED BY OSMOND GENERAL HOSPITAL IN PROVIDING SERVICES TO INDIVIDUALS ELIGIBLE FOR MEDICARE. THE COMMUNITY BENEFITS BECAUSE THE HOSPITAL APPLIES OTHER REVENUES TO COVER THE COSTS OF CARING FOR MEDICARE PATIENTS. PART III, LINE 9B: THE HOSPITAL WILL NOT TAKE EXTRAORDINARY COLLECTION ACTIONS AGAINST A PATIENT OR ANY OTHER INDIVIDUAL WHO HAS ACCEPTED OR IS REQUIRED TO ACCEPT FINANCIAL RESPONSIBILITY FOR A PATIENT UNLESS AND UNTIL THE HOSPITAL HAS MADE "REASONABLE EFFORTS" TO DETERMINE WHETHER THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY. THE CEO IS RESPONSIBLE TO DETERMINE WHETHER THE HOSPITAL HAS ENGAGED IN REASONABLE EFFORTS TO DETERMINE WHETHER A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE. PART VI, LINE 2: THE ORGANIZATION USES DATA PROVIDED BY THE HEALTH DEPARTMENT TO DETERMINE THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. WITH THIS DATA, THE ORGANIZATION IS ABLE TO PINPOINT NEEDS OF THE COMMUNITY AND MOLD PROGRAMS AND INITIATIVES TO TARGET THOSE NEEDS. PART VI, LINE 3: IN THE HOSPITAL AND CLINICS, THE BILLING AND CHARITY CARE POLICIES ARE POSTED IN MULTIPLE LOCATIONS. PART VI, LINE 4: THE ORGANIZATION SERVES THE COMMUNITIES OF OSMOND, RANDOLPH AND WAUSA IN NORTHEASTERN NEBRASKA. THE ORGANIZATION ALSO SERVES THE COMMUNITIES OF PIERCE, COLERIDGE AND PLAINVIEW WITH ITS OUTREACH CLINICS AND OTHER SERVICES. OSMOND GENERAL HOSPITAL'S SERVICE AREA INCLUDES A POPULATION OF APPROXIMATELY 16,000. THE MEDIAN HOUSEHOLD INCOME FOR THE COMMUNITY IS $37,938 COMPARED TO THE U.S. AVERAGE OF $51,324 AND THE NEBRASKA AVERAGE OF $51,381. THE AREA POPULATION IS PREDOMINATELY WHITE ELDERLY AND LOW INCOME. PART VI, LINE 5: THE ORGANIZATION HAS MANY WAYS THAT IT FURTHERS ITS EXEMPT PURPOSE. THE ORGANIZATION PUBLISHES HEALTH RELATED ARTICLES IN AREA NEWSPAPERS, HOLDS THE CARDIAC REHAB CLINIC, AND MULTIPLE WELLNESS ACTIVITIES INCLUDING THE MAYO CLINIC DIET. THESE ACTIVITIES INCLUDE THE FUNWALK, SCHOOL HEALTH FAIRS, AND COMMUNITY HEALTH FAIRS. PART VI, LINE 6: THE ORGANIZATION HAS WORKED WITH HEARTLAND HEALTH AND THE NORTH CENTRAL HEALTH DEPARTMENT BUT DOES NOT HAVE ANY ACTIVITIES TO REPORT. THE ORGANIZATION IS OPEN TO WORKING WITH THESE AFFILIATES IN THE FUTURE TO PROMOTE THE HEALTH OF THE COMMUNITIES SERVED. X X X X 0 0 0 0 0 0 0 0 0 LON M KNIEVEL MEMBER/CEO 186112 0 0 0 35 0 6822 0 33847 0 226816 0 0 0 DR KELLY ELLIS DOCTOR 170493 0 0 0 35 0 0 0 21467 0 191995 0 0 0 ALICIA MAVIS NURSE PRACTITIONER 161298 0 0 0 35 0 0 0 22971 0 184304 0 0 0 BOBBIE JO MILLER NURSE PRACTITIONER 156547 0 0 0 35 0 0 0 8325 0 164907 0 0 0 A HOSPITAL AUTHORITY NO 1 OF PIERCE COUNTY NEBRASKA 900198234 2017-02-28 1688000 REFUNDING HOSPITAL REVENUE BONDS DATED 01/05/11 AND 10/11/11 0 0 0 A 957250 1688000 25148 1688000 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 1 0 0 0 0 0 1 A 1 WALTER ASCHOFF WALTER IS A BOARD MEMBER OF OSMOND GENERAL HOSPITAL 145532 WALTER IS THE 100% OWNER OF ASCHOFF CONSTRUCTION INC. WHICH PROVIDED CONSTRUCTION SERVICES TO OSMOND GENERAL HOSPITAL 0 FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE HAS THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S 990 IS REVIEWED BY THE CEO AND CFO. IT IS PRESENTED TO THE BOARD AS SOON AS THE REVIEWS ARE COMPLETE, AND PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS REVIEWS OF THE CONFLICT OF INTEREST POLICY ANNUALLY. THE CONFLICT OF INTEREST FORMS ARE SIGNED BY THE BOARD AT THIS TIME. WHEN A CONFLICT IS PRESENT, THE BOARD MEMBER WITH THE CONFLICT ABSTAINS FROM DISCUSSION AND VOTE. THIS IS DOCUMENTED IN BOARD MINUTES WHEN THE OCCASION ARISES. FORM 990, PART VI, SECTION B, LINE 15 THE CEO COMPARES EMPLOYEES' SALARIES AND WAGES WITH OTHER NEBRASKA HOSPITALS USING A SURVEY FROM THE NEBRASKA HOSPITAL ASSOCIATION. FOLLOWING COMPARISON STUDIES, HE RECOMMENDS A PERCENTAGE INCREASE TO THE BOARD. THE FINAL WAGE ADJUSTMENT IS DETERMINED BY THE BOARD OF DIRECTORS. THE CEO AND CFO WAGE SCALES ARE COMPARED TO AREA HOSPITALS AND THE NHA SURVEY RESULTS. THE BOARD DISCUSSES AND DETERMINES THE LEVEL OF COMPENSATION. THE PHYSICIAN PAY SCALES ARE COMPARED TO PUBLISHED NATIONAL STANDARDS. FORM 990, PART VI, SECTION C, LINE 19 OSMOND GENERAL HOSPITAL DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PHYSICAL THERAPY FEES: PROGRAM SERVICE EXPENSES 99,901. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 99,901. OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 1,159,650. MANAGEMENT AND GENERAL EXPENSES 167,590. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,327,240. ANESTHESIA: PROGRAM SERVICE EXPENSES 63,240. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 63,240. PHARMACY SERVICES: PROGRAM SERVICE EXPENSES 58,901. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 58,901. LAB FEES: PROGRAM SERVICE EXPENSES 16,347. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,347. EMERGENCY ROOM PHYSICIANS FEES: PROGRAM SERVICE EXPENSES 274,038. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 274,038. FORM 990, PART XII, LINE 2C: THE FINANCE COMMITTEE IS COMPRISED OF THE TREASURER OF THE BOARD OF DIRECTORS AND AT LEAST THREE OTHER DIRECTORS. THE JOB OF THE FINANCE COMMITTEE IS TO SUPERVISE ALL CURRENT AND FUTURE FINANCES OF THE CORPORATION, INCLUDING THE REVIEW OF THE AUDITED FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.