PHELPS MEMORIAL HEALTH CENTER: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- PHELPS MEMORIAL HEALTH CENTER (EIN 47-0481628)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-13
- IRS object ID
- 202323179349302652
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-11-13T09:10:14-06:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18081 BURT ST STE 200 | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 680224722 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470481628 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHELPS MEMORIAL HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PHEL | BusinessNameControlTxt |
| Phone | 3089952211 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1215 TIBBALS STREET | AddressLine1Txt |
| City | HOLDREGE | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68949 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LOREN SCHRODER | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 3089952211 | PhoneNum |
| Signature | 2023-11-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | LOREN | PersonFirstNm |
| Person Last | SCHRODER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MEGAN L KOZIOL CPA | PreparerPersonNm |
| PTIN | P01544037 | PTIN |
| Phone | 4023302660 | PhoneNum |
| Preparation | 2023-11-09 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARK HARREL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1215 TIBBALS STREET | AddressLine1Txt |
| City | HOLDREGE | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68949 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $84,732,747 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PHELPSMEMORIAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1963 | FormationYr |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Activity Or Mission | PROGRESSIVE FAMILY-CENTERED HEALTH CARE PROVIDING EXCEPTIONAL QUALITY AND COMPASSIONATE CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 363 | TotalEmployeeCnt |
| Total Volunteers | 87 | TotalVolunteersCnt |
| Total Gross UBI | $459,443 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $34,729 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,689,063 | PYContributionsGrantsAmt |
| CY Contributions Grants | $929,167 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $61,622,345 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $71,294,259 | CYProgramServiceRevenueAmt |
| PY Investment Income | $7,112,007 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,511,698 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,298,988 | PYOtherRevenueAmt |
| CY Other Revenue | $1,146,342 | CYOtherRevenueAmt |
| PY Total Revenue | $73,722,403 | PYTotalRevenueAmt |
| CY Total Revenue | $74,881,466 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $10,350 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $30,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $21,917,564 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $25,434,106 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $36,382,162 | PYOtherExpensesAmt |
| CY Other Expenses | $42,461,513 | CYOtherExpensesAmt |
| PY Total Expenses | $58,310,076 | PYTotalExpensesAmt |
| CY Total Expenses | $67,925,619 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $15,412,327 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,955,847 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $173,907,477 | TotalAssetsBOYAmt |
| Total Assets EOY | $157,386,632 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $35,952,912 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $31,586,922 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $137,954,565 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $125,799,710 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO ALWAYS PROVIDE EXCEPTIONAL QUALITY AND COMPASSIONATE CARE FOR THE FAMILIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $37,073,127 | ExpenseAmt |
| Grant | $30,000 | GrantAmt |
| Revenue | $29,046,738 | RevenueAmt |
| Desc | PHELPS MEMORIAL HEALTH CENTER (HEALTH CENTER) IS A NOT-FOR-PROFIT NEBRASKA CORPORATION THAT OPERATES A 25-BED CRITICAL ACCESS HOSPITAL LOCATED IN HOLDREGE, NEBRASKA. THE HEALTH CENTER PROVIDES INPATIENT, OUTPATIENT, SWING BED, EMERGENCY, CLINIC AND AMBULANCE SERVICES IN THE LOCAL AREA. ADMITTING PHYSICIANS ARE PRIMARILY PRACTITIONERS IN THE LOCAL AREA.THE HEALTH CENTER PROVIDES PATIENT FINANCIAL ASSISTANCE TO PATIENTS WHO ARE FINANCIALLY UNABLE TO PAY FOR HEALTHCARE SERVICES THEY RECEIVE. IT IS THE POLICY OF THE HEALTH CENTER NOT TO PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS PATIENT FINANCIAL ASSISTANCE. ACCORDINGLY, THE HEALTH CENTER DOES NOT REPORT THESE AMOUNTS IN PATIENT SERVICE REVENUE. THE HEALTH CENTER DETERMINES THE COSTS ASSOCIATED WITH PROVIDING PATIENT FINANCIAL ASSISTANCE 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 OF CARING FOR THESE PATIENTS FOR THE YEAR ENDED DECEMBER 31, 2022 WAS APPROXIMATELY $550,000. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $9,636,934 | ExpenseAmt |
| Revenue | $19,313,978 | RevenueAmt |
| Desc | PHARMACY - THE PHARMACY DEPARTMENT OVERSEES MEDICATION PURCHASING, STORAGE, DISPENSING, AND THE UTILIZATION THROUGHOUT PHELPS MEMORIAL HEALTH CENTER. THE PHARMACY STAFF PLAYS AN IMPORTANT ROLE IN PROVIDING DRUG INFORMATION TO HEALTH CARE PROFESSIONALS AT PHELPS MEMORIAL HEALTH CENTER. WITH THE USE OF DISPENSING TECHNOLOGIES, INCLUDING SMART INFUSION PUMPS, AND BAR-CODING BEDSIDE, THE PHARMACY DEPARTMENT AT PHELPS MEMORIAL HEALTH CENTER GIVES PATIENT SAFETY A TOP PRIORITY. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $7,505,986 | ExpenseAmt |
| Revenue | $15,043,213 | RevenueAmt |
| Desc | PHYSICIAN CLINIC - PHELPS MEMORIAL HEALTH CENTER IS DEDICATED TO PROVIDING OUR PATIENTS WITH A HIGH LEVEL OF QUALITY CARE, RIGHT HERE IN HOLDREGE, NEBRASKA. PHMC CONTRACTS WITH MANY VISITING SPECIALISTS TO PROVIDE OUR PATIENTS WITH THE SPECIALTY CARE THEY NEED WITHOUT LEAVING TOWN. VISITING PHYSICIANS AND SURGEONS PROVIDE SPECIALTIES IN THE AREAS OF CARDIOLOGY, EAR, NOSE, THROAT, GENERAL SURGERY, PAIN MANAGEMENT, NEPHROLOGY, OBSTETRICS AND GYNECOLOGY, ONCOLOGY, OPTHALMOLOGY, ORTHOPAEDICS, SPINE, PODIATRY, PULMONARY, UROLOGY, AND WOUND TREATMENT. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,916,959 | ExpenseAmt |
| Revenue | $7,850,220 | RevenueAmt |
| Desc | PHYSICAL THERAPY - THE THERAPY CENTER INCLUDES A LARGE GYM FOR TRAINING AND REHABILITATION, A WHIRLPOOL ROOM FOR WOUND CARE AND A SPORTS FLOOR FOR ATHLETIC TRAINING. PHYSICAL THERAPY ALLOWS INDIVIDUALS TO DEVELOP, RESTORE AND MAINTAIN MAXIMUM MOVEMENT AND FUNCTIONAL ABILITY THROUGHOUT LIFE. THIS INCLUDES PROVIDING SERVICES IN CIRCUMSTANCES WHERE MOVEMENT AND FUNCTION ARE THREATENED BY AGING, INJURY, OR DISEASE. THE HYDROWORX THERAPY POOL HELPS PATIENTS RECOVER FROM SURGERY AND ARTHRITIC SYMPTOMS AS WELL AS ATHLETIC REHABILITATION.OCCUPATIONAL THERAPY INCORPORATES MEANINGFUL AND PURPOSEFUL OCCUPATION TO ENABLE PEOPLE WITH LIMITATIONS OR IMPAIRMENTS TO PARTICIPATE IN EVERYDAY LIFE. OCCUPATIONAL THERAPISTS WORK WITH INDIVIDUALS, FAMILIES, GROUPS, AND POPULATIONS TO FACILITATE HEALTH AND WELL-BEING THROUGH ENGAGEMENT OR RE-ENGAGEMENT IN OCCUPATIONS AND EVERYDAY ACTIVITIES. OCCUPATIONAL THERAPY MAY INCLUDE RESTORING FUNCTION, ADAPTING THE PATIENT'S ENVIRONMENT, OR EVEN HELPING PATIENTS FIND EQUIPMENT TO HELP THEM PARTICIPATE MORE INDEPENDENTLY IN THEIR EVERYDAY ACTIVITIES. OCCUPATIONAL THERAPY HAS MORE ROOM TO EXPAND THEIR SERVICES AND BETTER SERVE THEIR PATIENTS.SPEECH THERAPY ADDRESSES PEOPLE'S SPEECH PRODUCTION, VOCAL PRODUCTION, SWALLOWING DIFFICULTIES AND LANGUAGE NEEDS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $3,916,959 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $7,850,220 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $58,133,006 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | Yes (1) | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 75 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 363 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LOREN D SCHRODER CFO | PersonNm |
| Phone | 3089952211 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1215 TIBBALS STREET | AddressLine1Txt |
| City | HOLDREGE | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68949 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| MARK HARREL | |||||||
| CEO | 40.00 | Yes (X) | $540,009 | $0 | $67,684 | ||
| LOREN D SCHRODER | |||||||
| CFO | 40.00 | Yes (X) | $385,699 | $0 | $64,928 | ||
| RUBEN CHAVEZ | |||||||
| CRNA | 40.00 | $274,401 | $0 | $46,954 | Yes (X) | ||
| JAMIE ROOKS | |||||||
| CRNA | 40.00 | $257,028 | $0 | $62,765 | Yes (X) | ||
| MELISSA ALBERS | |||||||
| CRNA | 40.00 | $245,874 | $0 | $49,030 | Yes (X) | ||
| TYLER FRIES | |||||||
| DIRECTOR OF PHARMACY | 40.00 | $182,982 | $0 | $45,442 | Yes (X) | ||
| TESHA BROADFOOT | |||||||
| CHIEF NURSING OFFICER | 40.00 | $183,742 | $0 | $32,986 | Yes (X) | ||
| NATALIE NELSEN | |||||||
| PRESIDENT | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MIKE PELSTER | |||||||
| VICE PRESIDENT | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| STEVE KNESS | |||||||
| TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| BENJAMIN LANS | |||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| ZACH EGGER DO | |||||||
| CHIEF OF STAFF | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| KYLE ANDERSON | |||||||
| MEMBER | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| RYAN BAUER | |||||||
| MEMBER | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| JOEL BERGMAN | |||||||
| MEMBER | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| STEPHANIE DANNEHL | |||||||
| MEMBER | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| NANCY GARRELTS | |||||||
| MEMBER | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| LINDA HEIDEN | |||||||
| MEMBER | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| MARK KRAUS | |||||||
| MEMBER | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| WAYNE QUINCY | |||||||
| MEMBER | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| WILLIAM SANDY MD | |||||||
| MEMBER | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| JESSICA SUNDQUIST | |||||||
| MEMBER | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,069,735 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $369,789 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 32 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| RURAL PARTNERS IN MEDICINE LLC | |||||
| PO BOX 772519 | STEAMBOAT SPRINGS | CO | 80477 | SPECIALTY PHYSICIANS | $3,119,605 |
| INSPIRE HOLDREGE LLC | |||||
| 2810 W 35TH ST | KEARNEY | NE | 68845 | CONTRACTED LABOR | $2,069,314 |
| NEBRASKA PROVIDER ALLIANCE LLC | |||||
| PO BOX 470 | HOLDREGE | NE | 68949 | CONTRACTED SERVICES/CHRONIC CARE MANAGEM | $1,644,743 |
| HOLDREGE MEDICAL CLINIC | |||||
| 516 WEST 14TH AVE | HOLDREGE | NE | 68949 | EMERGENCY ROOM AND REHAB. COVERAGE | $1,578,414 |
| MEDEFIS CONSOLIDATED | |||||
| PO BOX 5068 | NEW YORK | NY | 100875068 | CONTRACTED LABOR | $1,279,350 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $162,836 | GovernmentGrantsAmt |
| All Other Contributions | $766,331 | AllOtherContributionsAmt |
| Total Contributions | $929,167 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 621110 | $68,970,990 | $68,970,990 |
| AIR TRANSPORTATION | 621990 | $1,327,814 | $1,327,814 |
| PHARMACY REVENUE | 621110 | $482,700 | $482,700 |
| CAFETERIA | 722514 | $194,066 | $194,066 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $318,689 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $278,579 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $40,110 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $71,294,259 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,591,895 | TotalRevenueColumnAmt |
| Exclusion | $2,591,895 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $727,009 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $727,009 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $727,009 | TotalRevenueColumnAmt |
| Exclusion | $727,009 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,000,000 | SecuritiesAmt |
| Other | $3,771,084 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $6,128,421 | SecuritiesAmt |
| Other | $3,722,860 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$1,128,421 | SecuritiesAmt |
| Other | $48,224 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,080,197 | TotalRevenueColumnAmt |
| Exclusion | -$1,080,197 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CUSTOM SOFTWARE LEASE | Desc |
| Business | 541519 | BusinessCd |
| Total Revenue Column | $419,333 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $419,333 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $419,333 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $74,881,466 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $71,254,149 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $459,443 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,238,707 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,000 | TotalAmt |
| Program Services | $30,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,058,320 | TotalAmt |
| Management And General | $1,058,320 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,544,870 | TotalAmt |
| Program Services | $15,767,252 | ProgramServicesAmt |
| Management And General | $2,777,618 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $392,986 | TotalAmt |
| Program Services | $364,191 | ProgramServicesAmt |
| Management And General | $28,795 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,143,333 | TotalAmt |
| Program Services | $3,199,513 | ProgramServicesAmt |
| Management And General | $943,820 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,294,597 | TotalAmt |
| Program Services | $1,047,440 | ProgramServicesAmt |
| Management And General | $247,157 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $338,000 | TotalAmt |
| Management And General | $338,000 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $178,763 | TotalAmt |
| Program Services | $18,505 | ProgramServicesAmt |
| Management And General | $160,258 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,574 | TotalAmt |
| Program Services | $25,574 | ProgramServicesAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,426 | TotalAmt |
| Management And General | $4,426 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $324,096 | TotalAmt |
| Program Services | $324,096 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,880,033 | TotalAmt |
| Program Services | $13,054,735 | ProgramServicesAmt |
| Management And General | $1,825,298 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $317,660 | TotalAmt |
| Program Services | $4,289 | ProgramServicesAmt |
| Management And General | $313,371 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,299,357 | TotalAmt |
| Program Services | $5,793,508 | ProgramServicesAmt |
| Management And General | $505,849 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,144,155 | TotalAmt |
| Program Services | $994,638 | ProgramServicesAmt |
| Management And General | $149,517 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,532,593 | TotalAmt |
| Program Services | $2,088,679 | ProgramServicesAmt |
| Management And General | $443,914 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $793,895 | TotalAmt |
| Program Services | $693,561 | ProgramServicesAmt |
| Management And General | $100,334 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,512,085 | TotalAmt |
| Program Services | $6,816,667 | ProgramServicesAmt |
| Management And General | $695,418 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $632,676 | TotalAmt |
| Program Services | $564,744 | ProgramServicesAmt |
| Management And General | $67,932 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $6,516,437 | $6,516,437 | |
| DUES AND SUBSCRIPTIONS | $784,537 | $671,892 | $112,645 |
| TAXES AND LICENSES | $31,654 | $31,654 | |
| UBI TAXES | $26,274 | $26,274 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,298 | TotalAmt |
| Program Services | $99,357 | ProgramServicesAmt |
| Management And General | $19,941 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,925,619 | TotalAmt |
| Program Services | $58,133,006 | ProgramServicesAmt |
| Management And General | $9,792,613 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,451 | BOYAmt |
| EOY | $5,300 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,594,256 | BOYAmt |
| EOY | $7,202,737 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,341,684 | BOYAmt |
| EOY | $7,776,935 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,062,772 | BOYAmt |
| EOY | $1,253,649 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,605,513 | BOYAmt |
| EOY | $1,334,205 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $124,028,010 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $64,759,471 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,294,236 | BOYAmt |
| EOY | $59,268,539 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $93,207,864 | BOYAmt |
| EOY | $76,491,809 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,527 | BOYAmt |
| EOY | $48,836 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,084 | BOYAmt |
| EOY | $298,850 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,704,090 | BOYAmt |
| EOY | $3,705,772 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $173,907,477 | BOYAmt |
| EOY | $157,386,632 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,411,073 | BOYAmt |
| EOY | $6,934,795 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,300,490 | BOYAmt |
| EOY | $14,781,956 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,978,295 | BOYAmt |
| EOY | $9,443,763 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,263,054 | BOYAmt |
| EOY | $426,408 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,952,912 | BOYAmt |
| EOY | $31,586,922 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $137,467,028 | BOYAmt |
| EOY | $125,350,682 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $487,537 | BOYAmt |
| EOY | $449,028 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $137,954,565 | BOYAmt |
| EOY | $125,799,710 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $173,907,477 | BOYAmt |
| EOY | $157,386,632 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $6,955,847 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$19,013,201 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$97,501 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $4,426 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $4,426 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | A PORTION OF THE DUES PAID TO NHA AND AHA ARE ATTRIBUTABLE TO LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $606,685 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $33,579 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $640,264 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $567,283 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $39,402 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $606,685 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $545,964 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $21,319 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $567,283 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $519,175 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $26,789 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $545,964 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $520,982 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $27,977 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $29,784 | OtherExpendituresAmt |
| End Year Balance | $519,175 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.66000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.34000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $695,258 | OtherCostOrOtherBasisAmt |
| Book Value | $695,258 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $79,550,231 | OtherCostOrOtherBasisAmt |
| Depreciation | $37,583,730 | DepreciationAmt |
| Book Value | $41,966,501 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $38,113,747 | OtherCostOrOtherBasisAmt |
| Depreciation | $25,781,437 | DepreciationAmt |
| Book Value | $12,332,310 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,668,774 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,394,304 | DepreciationAmt |
| Book Value | $4,274,470 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $59,268,539 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | 457B DEFERRED COMP PLAN PAYABLE | Desc |
| Amt | $426,408 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $426,408 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE INTENDED USES FOR THE ENDOWMENT FUNDS ARE CHILD HEALTHCARE AND UNUSUAL HARDSHIP COSTS. |
| PART X, LINE 2: | THE HEALTH CENTER ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ASC TOPIC 740, INCOME TAXES. THE HEALTH CENTER RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT DECEMBER 31, 2022 AND 2021, THE HEALTH CENTER HAD NO UNCERTAIN TAX POSITIONS ACCRUED. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $550,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $550,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00810 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,276,565 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,277,732 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $998,833 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01470 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,826,565 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,277,732 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,548,833 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02280 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $104,073 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $104,073 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $82,145 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $82,145 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $400,325 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $88,201 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $312,124 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00460 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $586,543 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $88,201 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $498,342 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00730 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,413,108 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,365,933 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,047,175 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03010 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,294 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,294 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $30,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $30,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $75,349 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $75,349 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,987 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $15,987 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,357 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $25,357 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,120 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $19,120 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,010 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,010 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $170,117 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $170,117 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $382,075 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $58,075 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $27,183,070 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $30,014,271 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,831,201 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHELPS MEMORIAL HEALTH CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1215 TIBBALS ST | AddressLine1Txt |
| City | HOLDREGE | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68949 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.PHELPSMEMORIAL.COM | WebsiteAddressTxt |
| State License | 610003 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHELPS MEMORIAL HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 22 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, PAGE 8 | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, PAGE 8 | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.PHELPSMEMORIAL.COM/HEALTH-CENTER/FINANCIAL-ASSISTANCE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.PHELPSMEMORIAL.COM/HEALTH-CENTER/FINANCIAL-ASSISTANCE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.PHELPSMEMORIAL.COM/HEALTH-CENTER/FINANCIAL-ASSISTANCE | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PHELPS MEMORIAL HEALTH CENTER | PART V, SECTION B, LINE 5: DATA WAS GATHERED THROUGH A SURVEY STARTING ON AUGUST 22, 2022 AND ENDED ON SEPTEMBER 9, 2022 FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY. A SURVEY OF A SELECT GROUP OF LOCAL EXPERT ADVISORS AS WELL AS THE BROAD COMMUNITY WAS PERFORMED TO REVIEW AND PROVIDE FEEDBACK ON THE PRIOR CHNA AND TO ASCERTAIN THE CONTINUED RELEVANCE OF PREVIOUSLY IDENTIFIED NEEDS. ADDITIONALLY, THE GROUP REVIEWED THE DATA GATHERED FROM SECONDARY SOURCES TO SUPPORT THE DETERMINATION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY. INPUT WAS OBTAINED FROM THE FOLLOWING CLASSIFICATIONS:1) PUBLIC HEALTH OFFICIAL2) GOVERNMENT EMPLOYEE OR REPRESENTATIVE3) MINORITY OR UNDERSERVED POPULATION4) CHRONIC DISEASE GROUPS5) COMMUNITY RESIDENT6) EDUCATOR7) HEALTHCARE PROFESSIONAL |
| PHELPS MEMORIAL HEALTH CENTER | PART V, SECTION B, LINE 6B: QUORUM HEALTH RESOURCES |
| PHELPS MEMORIAL HEALTH CENTER | PART V, SECTION B, LINE 11: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED IN 2022 AND IDENTIFIED THE FOLLOWING NEEDS:- MENTAL HEALTH- AFFORDABILITY- CHRONIC DISEASE MANAGEMENT: CANCER, OBESITY, HEART DISEASE, DIABETES- WOMEN'S HEALTHMENTAL HEALTH- TRANSPORTS PROVIDED FOR PATIENTS TO OTHER FACILITIES WITH HIGHER-LEVEL PSYCHIATRIC NEEDS- PRIMARY CARE PROVIDERS CONDUCT DEPRESSION/MENTAL HEALTH SCREENINGS DURING WELLNESS VISITS- PMHC HAS A GOOD STANDING RELATIONSHIP WITH LOCAL COUNSELORS IN THE COMMUNITY WHERE THEY CAN REFER PATIENTS- A SAFE ROOM IS AVAILABLE ONSITE TO PROVIDE PROTECTIVE SPACE FOR PATIENTS WITH IDENTIFIED BEHAVIORAL HEALTH ISSUES UNTIL THE PATIENT CAN BE TRANSFERRED- HEALTHCARE STAFF PROVIDE SERVICES TO INPATIENTS, OUTPATIENTS, AND EMPLOYEES, AND HELP PROVIDE ACCESS TO BEHAVIORAL HEALTH RESOURCES AND OTHER CONTACTS IN THE COMMUNITY- EMPLOYEE ASSISTANCE PROGRAM (EAP) IS AVAILABLE TO HOSPITAL EMPLOYEES AND FAMILIES THAT COVERS SESSIONS FOR COUNSELING AND PROVIDES EDUCATIONAL MATERIALS, RESOURCES, AND REFERRALS- ATTEND REGION 3 BEHAVIORAL HEALTH SERVICES MEETINGS TO HELP COORDINATE COMMUNITY EFFORTS TO ADDRESS MENTAL HEALTH NEEDS- HOST PRESENTATIONS TO AREA HIGH SCHOOL STUDENTS ON MENTAL HEALTH AND SUICIDE PREVENTION- TELE-PSYCHIATRY SERVICES ARE AVAILABLE FOR PATIENTS WHO NEED A HIGHER LEVEL OF CARETHE IMPACT OF ACTIONS TAKEN SINCE THE IMMEDIATELY PRECEDING CHNA:- SHARED EDUCATION ON MENTAL HEALTH AND HOW PATIENTS CAN GET CONNECTED WITH MENTAL HEALTH RESOURCES AT PMHC- CONTINUED TO WORK WITH REGION 3 BEHAVIORAL HEALTH SERVICES TO ADDRESS MENTAL HEALTH NEEDS IN THE COMMUNITYADDITIONALLY, PMHC PLANS TO TAKE THE FOLLOWING STEPS TO ADDRESS THIS NEED:- INCREASE EDUCATION AND AWARENESS OF MENTAL HEALTH SERVICES THAT ARE AVAILABLE IN THE COMMUNITY THROUGH MARKETING AND INVOLVEMENT IN COMMUNITY EVENTS- PROVIDE DE-ESCALATION TRAINING FOR EMERGENCY DEPARTMENT (ED) AND CLINIC STAFFAFFORDABILITY- FINANCIAL ASSISTANCE POLICY WITH A SLIDING FEE SCALE AND SELF-PAY DISCOUNTS- FINANCIAL COUNSELORS ON STAFF TO HELP PATIENTS UNDERSTAND AND PAY THEIR BILLS, AND ORGANIZE PAYMENT PLANS- STAFF AVAILABLE TO HELP PATIENTS SIGN UP FOR MEDICAID AND PROVIDE INFORMATION ON THE HEALTH INSURANCE EXCHANGE- PHELPS MEDICAL GROUP CLINIC INCREASES ACCESS TO AFFORDABLE WOMEN'S HEALTH AND PRIMARY CARE- PRICE TRANSPARENCY IS AVAILABLE ON THE HOSPITAL WEBSITE- HOSPITAL UNDERWRITES BANK LOANS FOR PATIENTS TO HELP COVER SERVICES- THE CARE MANAGEMENT TEAM SCREENS ADMITTED INPATIENTS FOR FINANCIAL ASSISTANCE- FREE BLOOD PRESSURE CHECKS AND CONTINUOUS GLUCOSE MONITORING ARE PROVIDED AT LOCAL NURSING HOMES- SIMPLE SOLUTIONS PROGRAM PROVIDES FREE DIABETIC EDUCATIONTHE IMPACT OF ACTIONS TAKEN SINCE THE IMMEDIATELY PRECEDING CHNA:- ADDED THE PATIENT NAVIGATOR SUCCESS PROGRAM TO HELP CONNECT PATIENTS WITH SERVICES, RECEIVE TIMELY CARE, AND SUPPORT CARE COORDINATION- NOW OFFERING FREE CPR CLASSES TO THE COMMUNITY- NOW PROVIDING FREE COLORECTAL SCREENING KITS TO ELIGIBLE PATIENTS TO INCREASE ACCESS TO PREVENTATIVE SCREENINGS- ADDED TELEHEALTH VIRTUAL VISIT SERVICES WHICH ALLOW PATIENTS TO RECEIVE CARE AT HOME WITHOUT NEEDING TO TRAVELADDITIONALLY, PMHC PLANS TO TAKE THE FOLLOWING STEPS TO ADDRESS THIS NEED:- EVALUATE OPPORTUNITIES TO PROVIDE TRANSPORTATION TO PATIENTS TO INCREASE ACCESS TO CARE FOR PRIORITY POPULATIONSCHRONIC DISEASE MANAGEMENT- CHRONIC CARE MANAGEMENT PROGRAM AT THE RURAL MEDICINE CLINIC- ONCOLOGY AND HEMATOLOGY OUTREACH CLINIC PROVIDES CHEMOTHERAPY, INFUSION THERAPY, AND FOLLOW-UP APPOINTMENTS- DIGITAL MAMMOGRAPHY, PET/CT (LUNG SCREENINGS) ARE AVAILABLE ON SITE- GENERAL SURGERY IS AVAILABLE FOR BIOPSIES WITH FULL LAB SERVICES- FREE ANNUAL COLON CANCER SCREENINGS- ENDOSCOPY AND COLONOSCOPY PROCEDURES AVAILABLE ON SITE- PROMOTION OF BREAST CANCER AWARENESS MONTH, AND EDUCATION ON TESTING AND PREVENTION FOR OTHER TYPES OF CANCERS- ANNUAL SPONSOR OF RELAY FOR LIFE WITH A PARTICIPATING HOSPITAL TEAM- CANCER SURVIVORS' DINNER AND EDUCATION EVENT- RAISE MONEY EACH YEAR FOR CANCER RESEARCH ORGANIZATIONS- CARDIAC REHABILITATION PROGRAM- CARDIOLOGY OUTREACH CLINICS ARE AVAILABLE ON-SITE, AND CARDIOLOGISTS PERFORM OUTREACH AND EDUCATION IN THE COMMUNITY- HOST TRAINING EVENT FOR LOCAL FIRST RESPONDERS/EMTS ON STEMI PROTOCOL- PROVIDE COMMUNITY EDUCATION, MARKETING, AND FUNDRAISING FOR GO RED FOR WOMEN IN FEBRUARY- REGISTERED DIETICIAN ON STAFF WHO WORKS WITH INPATIENTS AND OUTPATIENTS- SPONSOR OF THE ANNUAL SILVER RUN (LOCAL FUN RUN) TO HELP SUPPORT LOCAL YMCA; OVERALL CORPORATE SPONSOR OF YMCA- SPONSOR MULTIPLE LOCAL EVENTS PROMOTING PHYSICAL ACTIVITY AND HEALTH & WELLNESS- SHARES MATERIALS, COLLATERAL, AND PUBLIC SERVICE ANNOUNCEMENTS WITH EDUCATION ON HEALTH AND WELLNESS AND PREVENTIVE SCREENINGS- SIMPLE SOLUTIONAL PRE-DIABETES PROGRAM EDUCATES INDIVIDUALS TO TRY AND PREVENT OR DELAY THE ONSET OF TYPE 2 DIABETES- ON-SITE WOUND CARE CLINIC AVAILABLE- GRANTS FUNDS TO THE FOLLOWING NON-PROFIT ORGANIZATIONS: YMCA OF THE PRAIRIE; MS RUN THE US; CHEER AND DANCE CLINIC; SHAMROCK SHUFFLE; ALZHEIMER'S ASSOCIATION WALK; TEAMMATES WALK; HPS FOUNDATION GOLF; SILVER RUN; NEBRASKA KIDNEY ASSOCIATION WALK; RAY RUYBALID TENNIS TOURNEY; MOTIVATION FITNESS JOURNEY; HOLDREGE DUSTER BOOSTER CLUB; BETRAND VIKING BOOSTER CLUB; YMCA BIKE TO WORK; BERTRAND, HOLDREGE, AND LOOMIS SCHOOL BEEF PROGRAMS- CERTIFIED DIABETES EDUCATOR ON STAFF WHO WORKS WITH INPATIENTS AND OUTPATIENTS THROUGH ONE-ON-ONE CONSULTATIONS; SPEAKS ON LOCAL RADIO SEGMENT "HEALTH TALK; PRESENTS AT LOCAL SCHOOLS; PROVIDES FREE GLUCOMETERS TO SOME PATIENTS- PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH THERAPY ARE OFFERED TO STROKE PATIENTSTHE IMPACT OF ACTIONS TAKEN SINCE THE IMMEDIATELY PRECEDING CHNA:- OPENED A CARDIAC CATH PROGRAM WITH A CARDIAC-SPECIFIC PHYSICIANS ASSISTANT (PA) WHO PROVIDES EDUCATION- ADDED THE PATIENT NAVIGATOR SUCCESS PROGRAM TO HELP CONNECT PATIENTS WITH SERVICES, RECEIVE TIMELY CARE, AND SUPPORT CARE COORDINATION- ADDED AN IN-HOUSE PET SCANNER- THE CARDIAC REHABILITATION PROGRAM RECEIVED CERTIFICATION FROM THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION (AACVPR)ADDITIONALLY, PMHC PLANS TO TAKE THE FOLLOWING STEPS TO ADDRESS THIS NEED:- FORMED A PARTNERSHIP WITH ANOTHER LOCAL FACILITY TO OFFER RADIATION/ONCOLOGY SERVICES TO INCREASE THE AVAILABILITY OF ONCOLOGY SERVICES AND PROCEDURES- PROVIDE FREE COLORECTAL SCREENING KITS TO ELIGIBLE PATIENTS TO INCREASE ACCESS TO PREVENTATIVE SCREENINGS- PROVIDE CT CALCIUM SCORING AS A PREVENTATIVE SCREENING OPTION- CONTINUE TO PROVIDE EDUCATION AND PROGRAMMING AROUND HEALTH AND WELLNESS TO REDUCE THE BURDEN OF CHRONIC DISEASE IN THE COMMUNITYWOMEN'S HEALTH- PROMOTION OF BREAST CANCER AWARENESS MONTH, AND EDUCATION ON TESTING AND PREVENTION FOR OTHER TYPES OF CANCERS- HOST BREAST CANCER AWARENESS AND EDUCATION EVENTS- OBSTETRICS AND GYNECOLOGICAL SERVICES PROVIDED ONSITE- WOMEN'S HEALTH SERVICES PROVIDED AT PHELPS MEDICAL GROUP CLINIC: WELL-WOMAN VISITS, GYNECOLOGY, BREAST HEALTH, HEART HEALTH, LUNG HEALTH, REPRODUCTIVE AND SEXUAL HEALTH- LACTATION COUNSELING SERVICES- BIRTHING AND BEGINNING EDUCATION (BABE) CLASS- "WE'RE GONNA HAVE A BABY!" SIBLING CLASS- OCCUPATIONAL THERAPY WORKS WITH THE ONCOLOGY TEAM TO OFFER A LYMPHOMA PROGRAM- ED PATIENTS ARE SCREENED FOR SAFETY AND CONNECTED WITH THE S.A.F.E. CENTER IF NEEDED- PMHC PROVIDES SUPPORT AND DONATIONS TO THE S.A.F.E. CENTER- OFFER CPR AND FIRST AID CLASSES- PROVIDE COMMUNITY EDUCATION, MARKETING, AND FUNDRAISING FOR GO RED FOR WOMEN IN FEBRUARYTHE IMPACT OF ACTIONS TAKEN SINCE THE IMMEDIATELY PRECEDING CHNA:- HOSTED "POSITIVELY PINK," A CANCER AWARENESS AND EDUCATIONAL EVENT WHERE OVER 80 WOMEN WERE EDUCATED ABOUT AVAILABLE PREVENTION SCREENINGS- OCCUPATIONAL THERAPIST RECEIVED CERTIFICATION AS A PREGNANCY AND POSTPARTUM CORRECTIVE EXERCISE SPECIALIST TO BE ABLE TO ASSIST WOMEN HAVING PREGNANCY OR POSTPARTUM ISSUES- ADDED THE CENTRICITY PERINATAL MONITORING SYSTEMADDITIONALLY, PMHC PLANS TO TAKE THE FOLLOWING STEPS TO ADDRESS THIS NEED:- PROVIDE A SAFE AND CALM HOSPITAL ENVIRONMENT SO THAT MOTHERS CAN FEEL COMFORTABLE LEAVING THEIR BABIES TO RECEIVE CARE AT THE HOSPITAL- ADD WOMEN'S HEALTH SCREENING SERVICES LIKE STEREOTACTIC BREAST BIOPSY IN MAMMOGRAPHY, VACUUM ASSIST BREAST BIOPSY IN ULTRASOUND, AND BREAST MRITHERE ARE NO IDENTIFIED NEEDS THAT ARE NOT BEING ADDRESS UNDER THE CURRENT ASSESSMENT. |
| PHELPS MEMORIAL HEALTH CENTER | PART V, SECTION B, LINE 13H: TO RECEIVE FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY, YOU MUST BE FINANCIALLY INDIGENT OR MEDICALLY INDIGENT. TO QUALIFY AS FINANCIALLY INDIGENT YOU MUST BE UNINSURED OR UNDERINSURED AND HAVE A HOUSEHOLD INCOME EQUAL TO OR LESS THAN 200% OF FEDERAL POVERTY LEVEL. PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE AS FINANCIALLY INDIGENT ARE ELIGIBLE FOR 100% FINANCIAL ASSISTANCE ON THEIR BALANCE AS SET FORTH IN THE POLICY. TO QUALIFY FOR FINANCIAL ASSISTANCE AS MEDICALLY INDIGENT THE PATIENT MUST BE UNINSURED OR UNDERINSURED WITH MEDICAL BILLS THAT EXCEED 12% OF THEIR HOUSEHOLD INCOME. ANY REMAINING AMOUNT WILL BE CONSIDERED FINANCIAL ASSISTANCE UNDER THIS POLICY. |
| PART V, SECTION B, LINES 7A AND 10A: | COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGYWWW.PHELPSMEMORIAL.COM/HEALTH-CENTER/COMMUNITY-HEALTH-NEEDS-ASSESSMENT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - PHELPS MEDICAL GROUP | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1315 TIBBALS STREET | AddressLine1Txt |
| City | HOLDREGE | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68949 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | RURAL HEALTH CLINIC | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | TO RECEIVE FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY, YOU MUST BE FINANCIALLY INDIGENT OR MEDICALLY INDIGENT. TO QUALIFY AS FINANCIALLY INDIGENT YOU MUST BE UNINSURED OR UNDERINSURED AND HAVE A HOUSEHOLD INCOME EQUAL TO OR LESS THAN 200% OF FEDERAL POVERTY LEVEL. PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE AS FINANCIALLY INDIGENT ARE ELIGIBLE FOR 100% FINANCIAL ASSISTANCE ON THEIR BALANCE AS SET FORTH IN THE POLICY. TO QUALIFY FOR FINANCIAL ASSISTANCE AS MEDICALLY INDIGENT THE PATIENT MUST BE UNINSURED OR UNDERINSURED WITH MEDICAL BILLS THAT EXCEED 12% OF THEIR HOUSEHOLD INCOME. ANY REMAINING AMOUNT WILL BE CONSIDERED FINANCIAL ASSISTANCE UNDER THIS POLICY. |
| PART I, LINE 6A: | THE COMMUNITY BENEFIT REPORT IS PREPARED BY THE STAFF AT PMHC AND IS POSTED ON PMHC'S WEBSITE. |
| 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, AND HEALTH PROFESSIONS EDUCATION, LINE 7F, 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: | COALITION BUILDING:ONE OF THE MAJOR COMMUNITY BUILDING ACTIVITIES THAT PMHC HELPS LEAD IS THE SAFE COMMUNITIES COALITION. PMHC EMPLOYS ONE COALITION MEMBER, INCLUDING THE COALITION COORDINATOR WHO IS RESPONSIBLE FOR THE DAY-TO-DAY ORGANIZATIONAL RESPONSIBILITIES, MINUTES, AGENDAS, AND PROGRAM AND EVENT COORDINATION. SAFE COMMUNITIES COALITION IS A GROUP OF REPRESENTATIVES FROM SEVERAL COMMUNITY AGENCIES, INCLUDING PHELPS MEMORIAL HEALTH CENTER, HOLDREGE POLICE DEPARTMENT, PHELPS COUNTY SHERIFF'S DEPARTMENT, NEBRASKA STATE PATROL, YMCA OF THE PRAIRIE, SAFE CENTER, TWO RIVERS PUBLIC HEALTH DEPARTMENT, HOLDREGE, LOOMIS, AND BERTRAND SCHOOLS, AND OTHERS. PMHC ALSO WORKS WITH OTHER COMMUNITY EMS SQUADS, TO ARRANGE MUTUAL AID AMBULANCE HANDOFFS. PMHC STAFF LEAVE THE PMHC AMBULANCE AND TAKE IT THE REMAINDER OF THE WAY TO THE HOSPITAL, THUS BEING ABLE TO GIVE A HIGHER LEVEL OF CARE TO THE PATIENT. THIS SERVICE IS NOT BILLED TO ANYONE BY PMHC. ANOTHER ORGANIZATION THAT PMHC HAS BEEN SUPPORTING IS CASA (COURT APPOINTED SPECIAL ADVOCATES). THIS IS A NATIONAL ASSOCIATION THAT SUPPORTS AND PROMOTES COURT-APPOINTED ADVOCATES FOR ABUSED OR NEGLECTED CHILDREN. THIS YEAR PMHC HELPED COORDINATE AN EMS MASS CASUALTY DRILL FOR AREA FIRST RESPONDERS WITH 30 PMHC EMPLOYEES PARTICIPATING. DONATIONS WERE GIVEN TO AREA AGENCIES (FIRE & EMS) TO HELP WITH SAFETY WITHIN THESE ORGANIZATIONS.LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS:PMHC WORKED WITH VARIOUS LOCAL GROUPS INCLUDING TEAMMATES, 4-H PROGRAMS, AND AREA SCHOOLS TO PROVIDE THE OPPORTUNITY FOR COMMUNITY MEMBERS TO DEVELOP LEADERSHIP SKILLS IN VARIOUS AREAS SUCH AS MENTORING, FIRST AID & COMMUNITY RESOURCES.COMMUNITY SUPPORT:PMHC WORKED WITH LAW ENFORCEMENT, CRIME STOPPERS, AND LOCAL MEDIA TO HELP EDUCATE THE COMMUNITY ON SAFETY, CHILD DEVELOPMENT AND CRIME/ABUSE PREVENTION. PMHC ALLOWS MANY OF ITS EMPLOYEES TO BE INVOLVED IN COMMUNITY ORGANIZATIONS, MANY SITTING ON THE BOARD OF THESE. PMHC ALSO SUPPORTS AREA ACTIVITIES SUCH AS BACKPACK BLESSINGS, RED CROSS BELL RINGING AND TOYS FOR TOTS, AND FOOD PANTRY TO NAME A FEW BY ALLOWING EMPLOYEES TO PARTICIPATE. PMHC ALSO HOSTS BLOOD DRIVES SEVERAL TIMES THROUGHOUT THE YEAR AND ENCOURAGES EMPLOYEES TO GIVE. AREA CHILDREN BENEFITED BY PMHC SUPPORTING CHILDCARE PROVIDERS, SCHOOLS, AND SUMMER LUNCH PROGRAMS.ECONOMIC DEVELOPMENT:PMHC WORKED WITH PHELPS COUNTY DEVELOPMENT CORP (PCDC) BY DONATING TO THE PROSPERITY PROJECT. PCDC LEADS ECONOMIC EFFORTS IN PHELPS COUNTY. THEY ADVOCATE WITH LOCAL OFFICIALS AND COLLABORATE WITH REGIONAL PARTNERS TO PROVIDE BUSINESS SUPPORT. PMHC ALSO EMPLOYS A MEMBER ON THE LOAN COMMITTEE AND RETAIL COMMITTEE FORMED BY PCDC. PMHC ALSO SUPPORTS THE HOLDREGE AREA CHAMBER OF COMMERCE WHICH ADVOCATES FOR ECONOMIC DEVELOPMENT.COMMUNITY HEALTH IMPROVEMENT ADVOCACY:PMHC HELPED SUPPORT SCAR (SOUTH CENTRAL AREA RECOVERY), A GROUP THAT WOULD PROVIDE HEALING AND RECOVERY THROUGH 12-STEP ORGANIZATIONS, SUPPORT GROUPS AND GENERAL COUNSELING. PMHC EMPLOYES A MEMBER OF THE COMMUNITY REDEVELOPMENT AUTHORITY WITH THE CITY OF HOLDREGE. |
| PART III, LINE 2: | THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE ORGANIZATION DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSION BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THIS CLASS 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 15.2% 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 10 AND 11 OF THE ATTACHED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THE ENTIRE MEDICARE SHORTFALL IS CONSIDERED A COMMUNITY BENEFIT. SERVICES ARE PROVIDED TO PATIENTS UNDER THE MEDICARE PROGRAM EVEN THOUGH THE HOSPITAL KNOWS THEY WILL NOT RECOVER ALL OF THE COSTS FROM PROVIDING THE SERVICES. THIS PROGRAM IS CONSIDERED SUBSIDIZED BY THE HOSPITAL AND OTHER PAYORS. PATIENTS RELY ON THESE SERVICES FOR THEIR HEALTH AND WELL-BEING AND ARE ESSENTIAL FOR THEIR ACCESS TO HEALTHCARE. 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: | THE HOSPITAL WILL NOT TAKE ECAS 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 HOSPITAL DOES NOT TAKE ECAS AGAINST THE PATIENTS FOR AT LEAST 120 DAYS FROM THE DATE THE HOSPITAL PROVIDES THE PATIENT WITH THE FIRST POST-DISCHARGE BILL FOR CARE. A WRITTEN NOTICE IS SENT TO THE PATIENT AT LEAST 30 DAYS PRIOR TO ANY ECAS. THE NOTICE CONTAINS THE FOLLOWING INFORMATION:1. NOTIFIES THE PATIENT OF THE AVAILABILITY OF FINANCIAL ASSISTANCE,2. IDENTIFIES THE SPECIFIC ECA(S) THE HOSPITAL INTENDS TO INITIATE AGAINST THE PATIENT,3. STATES A DEADLINE AFTER WHICH ECAS MAY BE INITIATED THAT IS NO EARLIER THAN 30 DAYS AFTER THE DATE THE NOTICE IS PROVIDED TO THE PATIENT,4. PROVIDES A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY, AND5. MAKES A REASONABLE EFFORT TO ORALLY NOTIFY THE PATIENT ABOUT THE POTENTIAL AVAILABILITY OF FINANCIAL ASSISTANCE. |
| PART VI, LINE 2: | PHELPS MEMORIAL HEALTH CENTER MANAGEMENT, BOARD OF DIRECTORS AND MEDICAL STAFF MEET EVERY 3 TO 5 YEARS FOR A MAJOR STRATEGIC PLANNING AGENDA THAT INCLUDES ASSESSMENT OF THE HEALTH CARE NEEDS OF THE COMMUNITY. OUTSIDE RESOURCES ARE UTILIZED TO IDENTIFY THE CURRENT PATIENT DEMOGRAPHIC TRENDS, HEALTH CARE CONCERNS IN OUR COUNTY AND STATE, PHYSICIAN NEED, ETC. EVERY YEAR MANAGEMENT, BOARD OF DIRECTORS AND MEDICAL STAFF MEET TO DISCUSS AND ASSESS THE ONGOING HEALTH CARE NEEDS OF THE COMMUNITY AND DEVELOP AN ANNUAL BUSINESS PLAN TO ADDRESS THESE NEEDS IN THE UPCOMING YEAR. |
| PART VI, LINE 3: | PHELPS MEMORIAL HEALTH CENTER PATIENT CARE COORDINATORS AND PATIENT FINANCIAL LIASONS MONITOR PATIENTS WITHIN THE HOSPITAL AND IDENTIFY POSSIBLE PATIENTS THAT COULD QUALIFY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT. A REPRESENTATIVE THEN MEETS WITH THE PATIENT TO ASSIST IN REGISTERING FOR SUCH ASSISTANCE. EVERY PATIENT REGISTERING AT PHELPS MEMORIAL HEALTH CENTER IS GIVEN A BILLING PAMPHLET THAT EXPLAINS THE FINANCIAL ASSISTANCE PROGRAM. ATTACHED TO EVERY STATEMENT THERE IS A PAYMENT OPTIONS LETTER THAT ALLOWS PATIENTS TO INQUIRE ABOUT THE FINANCIAL ASSISTANCE PROGRAM. EVERY PATIENT WITH A SELF PAY BALANCE IS SENT A LETTER INFORMING THEM PHELPS MEMORIAL HEALTH CENTER HAS A FINANCIAL ASSISTANCE PROGRAM THAT THEY MAY APPLY FOR. |
| PART VI, LINE 4: | PHELPS MEMORIAL HEALTH CENTER (PMHC) IS A NOT-FOR-PROFIT NEBRASKA CORPORATION THAT OPERATES A 25-BED CRITICAL ACCESS HOSPITAL LOCATED IN HOLDREGE, NEBRASKA. PHELPS COUNTY NEBRASKA IS LOCATED ON THE HIGH PLAINS IN RURAL NEBRASKSA. THE PRIMARY INDUSTRY IS AGRICULTURE INCLUDING CROPS AND LIVESTOCK. ADDITIONAL INDUSTRY INCLUDES MANUFACTURING. PMHC'S PRIMARY SERVICE AREA IS THE COUNTY OF PHELPS AND PORTIONS OF SURROUNDING COUNTIES WITH A TOTAL SERVICE POPULATION OF APPROXIMATELY 20,000.THE MEDIAN HOUSEHOLD INCOME IN HOLDREGE, NE IS $53,241 AND 15.2% OF INDIVIDUALS ARE BELOW THE FEDERAL POVERTY LEVEL. |
| PART VI, LINE 5: | PHELPS MEMORIAL HEALTH CENTER IS THE LEADING ENTITY FOR HEALTH PROMOTION IN THE COMMUNITY IN PARTNERSHIP WITH LOCAL PHYSICIANS, OTHER HEALTH CARE PROFESSIONALS AND THE LOCAL PUBLIC HEALTH DEPARTMENT. THE HOSPITAL IS GOVERNED BY A VOLUNTEER GROUP OF LOCAL CITIZENS REPRESENTING ALL ASPECTS OF THE COMMUNITY. THE MEDICAL STAFF IS OPEN TO ALL PHYSICIANS AND MEDICAL STAFF PROFESSIONALS THAT MEET CREDENTIALING CRITERIA. PMHC PROVIDES EMERGENCY ROOM SERVICES REGARDLESS OF ABILITY TO PAY. EXCESS FUNDS ARE REINVESTED IN EQUIPMENT AND BUILDING UPGRADES.PHELPS MEMORIAL HEALTH CENTER MAINTAINS A PERMANENT SUB-COMMITTEE OF THE BOARD THAT SUPPORTS AND PROMOTES COMMUNITY HEALTH PROJECTS THROUGH GRANT FUNDING AND OTHER ASSISTANCE. IN ADDITION, THE HOSPITAL PROVIDES MULTIPLE HEALTH RELATED EVENTS TO THE PUBLIC AT NO CHARGE THAT ADDRESS HEALTH CARE NEEDS AND RISKS OF THE COMMUNITY. |
| PART VI, LINE 6: | PMCH IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| YOUNG MEN'S CHRISTIAN ASSOCIATION OF THE PRAIRIE | ||||||||
| 1415 BROADWAY PO BOX 618 | HOLDREGE | NE | 68949 | 470807617 | 501(C)(3) | $10,000 | $0 | DAYCARE USED BUS AND PAINT |
| VILLAGE OF BERTRAND | ||||||||
| 516 MINOR AVENUE | BERTRAND | NE | 68927 | 476006103 | GOVERNMENT ENTITY | $10,000 | $0 | BASEBALL FIELD RENOVATIONS |
| SOUTH CENTRAL AREA RECOVERY | ||||||||
| PO BOX 13 | HOLDREGE | NE | 68949 | 834379726 | 501(C)(3) | $10,000 | $0 | REMODEL OF EXISTING BATHROOMS |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 3 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ALL GRANTS ARE MADE TO LOCAL ORGANIZATIONS IN PHELPS COUNTY AND SURROUNDING COUNTIES. THERE IS CRITERIA IN PLACE TO ENSURE GRANTS ARE AWARDED TO ORGANIZATIONS MEETING FOUNDATION GUIDELINES. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | 0 | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARK HARREL | ||||||||||||||
| CEO | $423,900 | $0 | $115,833 | $0 | $276 | $0 | $29,647 | $0 | $38,037 | $0 | $607,693 | $0 | $0 | $0 |
| LOREN D SCHRODER | ||||||||||||||
| CFO | $302,678 | $0 | $82,745 | $0 | $276 | $0 | $27,494 | $0 | $37,434 | $0 | $450,627 | $0 | $0 | $0 |
| RUBEN CHAVEZ | ||||||||||||||
| CRNA | $261,460 | $0 | $12,833 | $0 | $108 | $0 | $12,268 | $0 | $34,686 | $0 | $321,355 | $0 | $0 | $0 |
| JAMIE ROOKS | ||||||||||||||
| CRNA | $244,087 | $0 | $12,833 | $0 | $108 | $0 | $19,062 | $0 | $43,703 | $0 | $319,793 | $0 | $0 | $0 |
| MELISSA ALBERS | ||||||||||||||
| CRNA | $237,431 | $0 | $8,333 | $0 | $110 | $0 | $12,849 | $0 | $36,181 | $0 | $294,904 | $0 | $0 | $0 |
| TYLER FRIES | ||||||||||||||
| DIRECTOR OF PHARMACY | $155,847 | $0 | $27,027 | $0 | $108 | $0 | $13,361 | $0 | $32,081 | $0 | $228,424 | $0 | $0 | $0 |
| TESHA BROADFOOT | ||||||||||||||
| CHIEF NURSING OFFICER | $140,044 | $0 | $43,578 | $0 | $120 | $0 | $0 | $0 | $32,986 | $0 | $216,728 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 1A | FormAndLineReferenceDesc |
| Explanation | PHELPS MEMORIAL HEALTH CENTER PROVIDES A MEMBERSHIP TO A COUNTRY CLUB FOR THE CEO OF THE ORGANIZATION. THE MEMBERSHIP ALLOWS THE CEO AND OTHER MEMBERS OF THE STAFF TO TAKE EMPLOYEES, CLIENTS, AND VENDORS OUT TO THE COUNTRY CLUB AND IS LIMITED TO BUSINESS USE. FURTHERMORE, THE ORGANIZATION UTILIZES THE COUNTRY CLUB'S FACILITY FOR MEETINGS AND OTHER EVENTS. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| THE COUNTY OF PHELPS IN THE STATE OF NEBRASKA | ||||||||
| A | 476006496 | 000000000 | 2021-03-16 | $9,585,509 | REFUND BOND ISSUED 12/20/2018 | 0 | 0 | 0 |
| THE COUNTY OF PHELPS IN THE STATE OF NEBRASKA | ||||||||
| B | 476006496 | 000000000 | 2021-04-29 | $8,267,757 | REFUND BONDS ISSUED 10/30/2012 AND 12/12/2012 | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Other Spent ProceedsOtherSpentProceedsAmt | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|
| A | $1,159,982 | $9,585,509 | $9,585,509 | Yes (1) | 0 | Yes (1) | Yes (1) |
| B | $1,159,874 | $8,267,757 | $8,267,757 | Yes (1) | 0 | Yes (1) | Yes (1) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | Yes (1) | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AIR 37 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | TODD GARRELTS, HUSBAND OF NANCY GARRELTS, BOARD MEMBER, OWNS 100% OF AIR 37 | RelationshipDescriptionTxt |
| Transaction | $909,395 | TransactionAmt |
| Transaction | ADJACENT AIR, LLC, A DISREGARDED ENTITY OF PHELPS MEMORIAL HEALTH CENTER, PAID AIR 37 FOR MANAGEMENT FEES, HANGER RENTAL AND REIMBURSEMENT OF OTHER EXPENSES. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE BOARD AND HAS AUTHORITY TO MAKE DECISIONS ON BEHALF OF THE BOARD IN INSTANCES DEEMED TO BE AN EMERGENCY SITUATION. |
| FORM 990, PART VI, SECTION A, LINE 6 | EVERY DONOR OF A GIFT OF $100 OR MORE TO PHELPS COUNTY MEMORIAL HOSPITAL ASSOCIATION SHALL BE A MEMBER OF PHELPS MEMORIAL HEALTH CENTER. |
| FORM 990, PART VI, SECTION A, LINE 7A | EACH MEMBER OF PHELPS MEMORIAL HEALTH CENTER HAS ONE VOTE IN THE ELECTION OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF THE FORM 990 WILL BE PROVIDED TO THE BOARD OF DIRECTORS BEFORE IT IS FILED. THE CEO AND CFO REVIEW THE FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | PMHC BOARD OF TRUSTEES DISCLOSE CONFLICTS OF INTEREST ON AN ANNUAL BASIS BY SIGNING A CONFLICT OF INTEREST STATEMENT. ALL MEMBERS OF THE BOARD OF DIRECTORS, THE TOP MANAGEMENT OFFICIAL (CEO) AND THE TOP FINANCIAL OFFICIAL (CFO) ARE REQUIRED TO DISCLOSE, ON AN ANNUAL BASIS, ALL INTERESTS THAT COULD GIVE RISE TO A CONFLICT. THESE DISCLOSURES ARE REVIEWED BY THE BOARD OF DIRECTORS, THE CEO AND THE ORGANIZATION'S COMPLIANCE OFFICER. ACTUAL CONFLICTS ARE ALSO REVIEWED BY THE ENTIRE BOARD OF DIRECTORS. UPON A DIRECTOR'S DISCLOSURE OF A CONFLICT OF INTEREST, THAT DIRECTOR WITHDRAWS FROM BOARD CONSIDERATION AND DISCUSSION, DOES NOT PARTICIPATE IN THE VOTING OR DECISION-MAKING AND, AT THE REQUEST OF THE PRESIDENT, IS EXCUSED FROM THE BOARD MEETING DURING DISCUSSION AND VOTING. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OF DIRECTORS CONDUCTS AN ANNUAL EVALUATION FOR THE CEO AND CFO. A NATIONAL COMPARATIVE BENCHMARK IS PRESENTED TO THE BOARD OF DIRECTORS. THIS COMPARATIVE DATA IS BASED ON SIMILAR HOSPITAL SIZE AND SIMILAR ANNUAL NET REVENUE. THIS DATA IS UTILIZED BY THE BOARD OF DIRECTORS IN ADDITION TO THE ANNUAL PERFORMANCE OF THE CEO AND CFO TO DETERMINE COMPENSATION. THE DELIBERATION AND DETERMINATION IS DOCUMENTED IN THE PERSONNEL FILES. |
| FORM 990, PART VI, SECTION C, LINE 19 | PHELPS MEMORIAL HEALTH CENTER DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | PHYSICIAN AND MEDICAL FEES: PROGRAM SERVICE EXPENSES 6,506,565. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,506,565. OUTSIDE PHYSICAL AND OCCUPATIONAL THERAPY FEES: PROGRAM SERVICE EXPENSES 1,458,844. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,458,844. X-RAY SERVICES: PROGRAM SERVICE EXPENSES 536,201. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 536,201. OTHER FEES FOR SERVICE: PROGRAM SERVICE EXPENSES 4,244,525. MANAGEMENT AND GENERAL EXPENSES 1,825,298. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,069,823. SURGICAL SERVICES: PROGRAM SERVICE EXPENSES 308,600. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 308,600. |
| FORM 990, PART XI, LINE 9: | CHANGE IN INTEREST IN NEBRASKA PROVIDER ALLIANCE, LLC 299,566. BOOK-TAX DIFFERENCE IN LICENSE REVENUE -245,755. LOSS ATTRIBUTABLE TO NON-CONTROLLING INTEREST -48,802. CONTRIBUTION TO AFFILIATE -102,510. |
| FORM 990, PART XII, LINE 2C: | THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS HAS RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| ADJACENT AIR LLC | |||||||||
| 1215 TIBBALS STREET | HOLDREGE | NE | 68949 | 843951918 | OPERATE AIR TRANSPORTATION | NE | $1,392,814 | $5,442,806 | PHELPS MEMORIAL HEALTH CENTER |
| ADJACENT PROPERTIES LLC | |||||||||
| 413 EAST AVENUE PO BOX 466 | HOLDREGE | NE | 68949 | 470481628 | MANAGE REAL ESTATE HOLDINGS | NE | $722,904 | $5,383,876 | PHELPS MEMORIAL HEALTH CENTER |
| ADJACENT ENTERTAINMENT LLC | |||||||||
| 1215 TIBBALS STREET | HOLDREGE | NE | 68949 | 853735617 | THEATER OPERATION | NE | $214,459 | $1,862,121 | PHELPS MEMORIAL HEALTH CENTER |
| PMHC PHARMACY GROUP | |||||||||
| 1215 TIBBALS STREET | HOLDREGE | NE | 68949 | 872087872 | RETAIL PHARMACY OPERATION | NE | $15,954 | $427,994 | PHELPS MEMORIAL HEALTH CENTER |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PAPJV LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1215 TIBBALS ST | AddressLine1Txt |
| City | HOLDREGE | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68949 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 920534929 | EIN |
| Primary Activities | CARDIAC CATHETERIZATION LAB | PrimaryActivitiesTxt |
| Legal Domicile State | NE | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHELPS MEMORIAL HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | -$80,266 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $491,894 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | Yes (1) | GeneralOrManagingPartnerInd |
| Ownership | 0.51000 | OwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| PAPJV LLC | ||
| B | $102,510 | CASH TRANSFERRED |
| PAPJV LLC | ||
| A | $4,200 | CASH TRANSFERRED |