FRANCISCAN CARE SERVICES INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- FRANCISCAN CARE SERVICES INC (EIN 47-0486026)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-10-31
- IRS object ID
- 202203049349300345
- Schema version
- 2021v4.2
- 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 O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-10-31T10:55:05-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | 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 STREET SUITE 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 | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470486026 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FRANCISCAN CARE SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FRAN | BusinessNameControlTxt |
| Phone | 4023722404 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 430 NORTH MONITOR STREET | AddressLine1Txt |
| City | WEST POINT | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 687881555 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TYLER TOLINE | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 4023722404 | PhoneNum |
| Signature | 2022-10-27 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | TYLER | PersonFirstNm |
| Person Last | TOLINE | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | WENDY R COOLEY | PreparerPersonNm |
| PTIN | P01523804 | PTIN |
| Phone | 4023302660 | PhoneNum |
| Preparation | 2022-10-27 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TYLER TOLINE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 430 NORTH MONITOR STREET | AddressLine1Txt |
| City | WEST POINT | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 687881555 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $47,642,222 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.FRANHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1964 | FormationYr |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF FRANCISCAN CARE SERVICES, INC. IS TO LIVE AND TO PROMOTE THE HEALING MISSION OF JESUS CHRIST. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 329 | TotalEmployeeCnt |
| Total Volunteers | 165 | TotalVolunteersCnt |
| Total Gross UBI | -$3,734 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,960,572 | PYContributionsGrantsAmt |
| CY Contributions Grants | $755,465 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $38,019,654 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $43,944,199 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,805,908 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,919,417 | CYInvestmentIncomeAmt |
| PY Other Revenue | $5,115 | PYOtherRevenueAmt |
| CY Other Revenue | $3,654 | CYOtherRevenueAmt |
| PY Total Revenue | $45,791,249 | PYTotalRevenueAmt |
| CY Total Revenue | $47,622,735 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $10,924 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $98,137 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $21,562,070 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $23,609,997 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $3,301 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $14,482,641 | PYOtherExpensesAmt |
| CY Other Expenses | $16,332,055 | CYOtherExpensesAmt |
| PY Total Expenses | $36,055,635 | PYTotalExpensesAmt |
| CY Total Expenses | $40,040,189 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $9,735,614 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $7,582,546 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $90,915,746 | TotalAssetsBOYAmt |
| Total Assets EOY | $100,320,154 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $19,615,554 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $20,267,560 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $71,300,192 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $80,052,594 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF FRANCISCAN CARE SERVICES, INC. IS TO LIVE AND TO PROMOTE THE HEALING MISSION OF JESUS CHRIST BY PROVIDING QUALITY HEALTH CARE AND HEALTH RELATED INPATIENT, OUTPATIENT, HOME HEALTH AND PHYSICIAN SERVICES TO ANYONE IN NORTHEAST NEBRASKA, REGARDLESS OF THEIR ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $35,062,526 | ExpenseAmt |
| Grant | $98,137 | GrantAmt |
| Revenue | $43,912,969 | RevenueAmt |
| Desc | FRANCISCAN CARE SERVICES MISSION IS TO PROVIDE QUALITY HEALTH CARE AND HEALTH RELATED INPATIENT, OUTPATIENT, HOME HEALTH AND PHYSICIAN SERVICES TO THE PEOPLE OF NORTHEASTERN NEBRASKA. THE CRITICAL ACCESS HOSPITAL PROVIDES A 24-HOUR EMERGENCY ROOM AND DOES NOT DISCRIMINATE AGAINST ANY PATIENT REGARDLESS OF THEIR ABILITY TO PAY. OUR CHARITY CARE POLICY FOLLOWS RECOMMENDED STANDARDS WHICH ARE BASED UPON THE FEDERAL POVERTY GUIDELINES. THIS POLICY IS COMMUNICATED TO OUR PATIENTS ON OUR WEBSITE AND AT OUR REGISTRATION DESKS.FRANCISCAN CARE SERVICES, INC. STATS: PATIENTS SERVED DURING THE YEAR: TOTAL IN-PATIENTS DISCHARGED 330 PATIENT DAYS - ACUTE 1,121 - SWING BED 732 - NURSERY 76 OUT-PATIENT & REGISTRATIONS 46,550 HOME HEALTH & HOSPICE 5,313PHYSICIAN CLINIC VISITS 24,378 THE HOSPITAL RECEIVES GENEROUS SUPPORT FROM THE COMMUNITY NOT ONLY FINANCIALLY BUT ALSO FROM APPROXIMATELY 165 VOLUNTEERS WHO DONATED 1,418 HOURS OF THEIR VALUABLE TIME. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $148,449 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $34,884 | RevenueAmt |
| Desc | ST. FRANCIS SERVICES MISSION IS TO PROVIDE EFFICIENT AND PERSONALIZED PHARMACEUTICAL SERVICES TO THE SURROUNDING AREA.ST. FRANCIS SERVICES, LLC STATS: PRESCRIPTIONS COUNT: NEW 620 REFILL 248 TOTAL 868 BRAND 93 GENERIC 775 TOTAL 868 | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $35,210,975 | 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 | 0 | 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 | 0 | 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 | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 77 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 329 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | 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 | Yes (1) | 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 | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALISA BRUNSING | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4023726717 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 430 NORTH MONITOR STREET | AddressLine1Txt |
| City | WEST POINT | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 687881555 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| TYLER TOLINE | |||||||||
| CEO & PRESIDENT | 45.00 | 0.40 | Yes (X) | Yes (X) | $365,515 | $0 | $32,280 | ||
| DAVID STEFFENSMEIER | |||||||||
| CHAIRMAN | 1.50 | 0.20 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| GARY KAUP | |||||||||
| VICE CHAIRMAN | 1.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| CHET MCWHORTER | |||||||||
| SECRETARY | 1.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| STEVE SWANSON | |||||||||
| TREASURER | 1.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| REGINA UHING | |||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| SR PATRICIA LINSSEN | |||||||||
| TRUSTEE | 2.40 | 7.40 | Yes (X) | $0 | $0 | $0 | |||
| JASON SMITH | |||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| BRIAN REIMERS | |||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| ALISA BRUNSING | |||||||||
| CFO | 50.00 | 0.00 | Yes (X) | $190,922 | $0 | $20,364 | |||
| TERRY NELSON | |||||||||
| ANCILLARY DIRECTOR | 55.00 | 0.00 | $215,808 | $0 | $60,573 | Yes (X) | |||
| SCOTT GREEN MD | |||||||||
| PHYSICIAN | 45.00 | 0.00 | $622,581 | $0 | $49,344 | Yes (X) | |||
| THOMAS COHEE MD | |||||||||
| PHYSICIAN | 44.00 | 0.00 | $604,046 | $0 | $44,484 | Yes (X) | |||
| RHETT ECKMANN MD | |||||||||
| PHYSICIAN | 44.00 | 0.00 | $570,210 | $0 | $47,241 | Yes (X) | |||
| BRIAN HASS MD | |||||||||
| PHYSICIAN | 45.00 | 0.00 | $597,005 | $0 | $47,241 | Yes (X) | |||
| RENAE MEYER MD | |||||||||
| PHYSICIAN | 43.00 | 0.00 | $389,557 | $0 | $43,448 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,555,644 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $344,975 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 23 | 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 |
|---|---|---|---|---|---|
| BECKENHAUER CONSTRUCTION | |||||
| 1901 RIVERSIDE BLVD | NORFOLK | NE | 68701 | CONSTRUCTION | $1,939,361 |
| CERNER CORPORATION | |||||
| 2800 ROCKCREEK PARKWAY | KANSAS CITY | MO | 64117 | IT SOFTWARE SUPPORT | $787,540 |
| KAT ANESTHESIA LLC | |||||
| 1125 E WASHINGTON ST | WEST POINT | NE | 68788 | ANESTHESIA SERVICES | $672,504 |
| LUCENT HEALTH SOLUTIONS INC | |||||
| PO BOX 306411 | NASHVILLE | TN | 372306411 | HEALTH PLAN ADMIN | $513,369 |
| MEYER BUILDING CO INC | |||||
| 650 E DEERE STREET | WEST POINT | NE | 68788 | CONSTRUCTION | $498,291 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 15 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $344,432 | RelatedOrganizationsAmt |
| Government Grants | $254,485 | GovernmentGrantsAmt |
| All Other Contributions | $156,548 | AllOtherContributionsAmt |
| Total Contributions | $755,465 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| HOSPITAL/CLINIC HEALTHCARE SERVIC | 621110 | $43,832,830 | $43,832,830 |
| DIETARY/CAFETERIA | 721000 | $76,485 | $76,485 |
| RETAIL PHARAMACY | 446110 | $34,884 | $34,884 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $43,944,199 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,918,617 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | -$3,734 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,922,351 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $800 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $800 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $800 | TotalRevenueColumnAmt |
| Exclusion | $800 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $23,141 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $19,487 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,654 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,654 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $47,622,735 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $43,947,853 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | -$3,734 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,923,151 | 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 | $98,137 | TotalAmt |
| Program Services | $98,137 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $885,462 | TotalAmt |
| Program Services | $767,013 | ProgramServicesAmt |
| Management And General | $118,449 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,710,606 | TotalAmt |
| Program Services | $15,900,008 | ProgramServicesAmt |
| Management And General | $1,810,598 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $443,315 | TotalAmt |
| Program Services | $351,648 | ProgramServicesAmt |
| Management And General | $91,667 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,462,112 | TotalAmt |
| Program Services | $2,811,694 | ProgramServicesAmt |
| Management And General | $650,418 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,108,502 | TotalAmt |
| Program Services | $987,129 | ProgramServicesAmt |
| Management And General | $121,373 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $112,328 | TotalAmt |
| Management And General | $112,328 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,030 | TotalAmt |
| Management And General | $83,030 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,051 | TotalAmt |
| Management And General | $4,051 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,365,923 | TotalAmt |
| Program Services | $3,847,968 | ProgramServicesAmt |
| Management And General | $517,955 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $235,836 | TotalAmt |
| Program Services | $234,315 | ProgramServicesAmt |
| Management And General | $1,521 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,950,184 | TotalAmt |
| Program Services | $1,793,783 | ProgramServicesAmt |
| Management And General | $156,401 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,231,448 | TotalAmt |
| Program Services | $991,966 | ProgramServicesAmt |
| Management And General | $239,482 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $689,874 | TotalAmt |
| Program Services | $587,022 | ProgramServicesAmt |
| Management And General | $102,852 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,385 | TotalAmt |
| Program Services | $91,042 | ProgramServicesAmt |
| Management And General | $12,343 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $122,039 | TotalAmt |
| Program Services | $117,335 | ProgramServicesAmt |
| Management And General | $4,704 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,366 | TotalAmt |
| Program Services | $136,428 | ProgramServicesAmt |
| Management And General | $32,938 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,177,601 | TotalAmt |
| Program Services | $2,561,440 | ProgramServicesAmt |
| Management And General | $616,161 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,619 | TotalAmt |
| Management And General | $134,619 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $3,685,686 | $3,685,686 | ||
| DUES & SUBSCRIPTIONS | $263,384 | $248,361 | $15,023 | |
| HOSPITAL AUXILIARY SUPP | $3,301 | $3,301 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,040,189 | TotalAmt |
| Program Services | $35,210,975 | ProgramServicesAmt |
| Management And General | $4,825,913 | ManagementAndGeneralAmt |
| Fundraising | $3,301 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,341,813 | BOYAmt |
| EOY | $1,170,074 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,854,508 | BOYAmt |
| EOY | $10,882,426 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,492,129 | BOYAmt |
| EOY | $6,239,833 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $920,977 | BOYAmt |
| EOY | $1,053,454 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $652,783 | BOYAmt |
| EOY | $642,674 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $68,416,369 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $45,722,300 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,197,689 | BOYAmt |
| EOY | $22,694,069 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,372,891 | BOYAmt |
| EOY | $55,738,036 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $342,734 | BOYAmt |
| EOY | $290,731 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,740,222 | BOYAmt |
| EOY | $1,608,857 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,915,746 | BOYAmt |
| EOY | $100,320,154 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,020,955 | BOYAmt |
| EOY | $7,981,182 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,009,147 | BOYAmt |
| EOY | $6,279,401 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,585,452 | BOYAmt |
| EOY | $6,006,977 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,615,554 | BOYAmt |
| EOY | $20,267,560 | 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 | $70,919,744 | BOYAmt |
| EOY | $79,842,514 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $380,448 | BOYAmt |
| EOY | $210,080 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $71,300,192 | BOYAmt |
| EOY | $80,052,594 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,915,746 | BOYAmt |
| EOY | $100,320,154 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $7,582,546 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,429,856 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$260,000 | OtherChangesInNetAssetsAmt |
| 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 | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
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 | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $4,051 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $4,051 | 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 | MEMBERSHIP DUES PAID TO HEALTH CARE ASSOCIATIONS OF WHICH A PERCENTAGE OF THE DUES ARE ALLOCATED TO LOBBYING ACTIVITIES. OCCASIONAL PHONE CALL OR EMAIL TO AND FROM OUR REPRESENTATIVES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $350,006 | OtherCostOrOtherBasisAmt |
| Book Value | $350,006 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $23,334,432 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,536,429 | DepreciationAmt |
| Book Value | $9,798,003 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $41,838,897 | OtherCostOrOtherBasisAmt |
| Depreciation | $32,185,871 | DepreciationAmt |
| Book Value | $9,653,026 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,893,034 | OtherCostOrOtherBasisAmt |
| Book Value | $2,893,034 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $22,694,069 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| MEDICARE ACCELERATED PAYMENTS PAYABLE | $4,794,490 |
| HHS STIMULUS FUNDS PAYABLE | $1,212,487 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $6,006,977 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $48,920,837 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $1,429,856 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $1,429,856 | RevenueNotReportedAmt |
| Revenue Subtotal | $47,490,981 | RevenueSubtotalAmt |
| Other Revenues Not Included | $131,754 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $131,754 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $47,622,735 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $39,914,388 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $39,914,388 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $125,801 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $125,801 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $40,040,189 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | AUXILIARY INCOME 9,254. GRANT REFUND AND CREDIT 122,500. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | AUXILIARY OPERATING EXPENSES 3,301. GRANT REFUND AND CREDIT 122,500. |
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 |
| Percent100 | Yes (X) | Percent100Ind |
| 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 | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| 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) |
|---|---|---|
| Persons Served | 104 | PersonsServedCnt |
| Total Community Benefit Expns | $182,178 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $182,178 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00450 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1550 | PersonsServedCnt |
| Total Community Benefit Expns | $2,395,700 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,603,530 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $792,170 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01980 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1654 | PersonsServedCnt |
| Total Community Benefit Expns | $2,577,878 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,603,530 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $974,348 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02430 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 3021 | PersonsServedCnt |
| Total Community Benefit Expns | $258,269 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $44,722 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $213,547 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00530 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 50 | PersonsServedCnt |
| Total Community Benefit Expns | $196,437 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $196,437 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00490 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 8189 | PersonsServedCnt |
| Total Community Benefit Expns | $8,165,842 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,275,464 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $890,378 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02220 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 11260 | PersonsServedCnt |
| Total Community Benefit Expns | $8,620,548 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,320,186 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,300,362 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03240 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 12914 | PersonsServedCnt |
| Total Community Benefit Expns | $11,198,426 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,923,716 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,274,710 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05670 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,610 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,610 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 871 | PersonsServedCnt |
| Total Community Benefit Expns | $84,117 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,221 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $81,896 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00200 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 64 | PersonsServedCnt |
| Total Community Benefit Expns | $24,950 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $24,950 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 935 | PersonsServedCnt |
| Total Community Benefit Expns | $114,677 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,221 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $112,456 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $612,600 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $122,520 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $14,422,909 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $14,574,986 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$152,077 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| 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 | ST FRANCIS MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 430 NORTH MONITOR STREET | AddressLine1Txt |
| City | WEST POINT | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68788 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.FRANHEALTH.ORG | WebsiteAddressTxt |
| State License | 180001 | 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 | ST FRANCIS MEMORIAL HOSPITAL | 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 | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | 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 | HTTPS://FRANHEALTH.ORG/ABOUT/NEEDS-ASSESSMENT.HTML | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://FRANHEALTH.ORG/ABOUT/NEEDS-ASSESSMENT.HTML | 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 | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| 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 |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://FRANHEALTH.ORG/PATIENTS-VISITORS/PATIENT-FINANCIAL-INFORMATION.HTML | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://FRANHEALTH.ORG/PATIENTS-VISITORS/PATIENT-FINANCIAL-INFORMATION.HTML | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://FRANHEALTH.ORG/PATIENTS-VISITORS/PATIENT-FINANCIAL-INFORMATION.HTML | 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 |
|---|---|
| ST. FRANCIS MEMORIAL HOSPITAL | PART V, SECTION B, LINE 5: ST. FRANCIS MEMORIAL HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED VIA SURVEYS AND A TOWN HALL MEETING WITH COMMUNITY STAKEHOLDERS.DATA WAS COLLECTED THROUGH COMMUNITY-LEVEL HEALTH SURVEYS ADMINISTERED ON-LINE AND THROUGH REGULAR MAIL AVAILABLE IN BOTH ENGLISH AND SPANISH. PATRONS WERE INVITED TO TAKE THE SURVEY BY MEANS OF SEVERAL ROUTES - INCLUDING PUBLIC PRESS RELEASES, RADIO PUBLIC SERVICE ANNOUNCEMENTS; CHAMBER OF COMMERCE NEWSLETTERS; THROUGH EMPLOYERS AND AREA BUSINESSES, SENIOR CITIZEN CENTERS; SOCIAL MEDIA POSTS; AND DISTRIBUTION OF PAPER FLYERS. THOSE INTERESTED IN TAKING THE SURVEY WERE ENCOURAGED TO DO SO ONLINE, OR WERE INVITED TO REQUEST A HARD-COPY SURVEY. THE NUMBER OF SURVEYS COMLETED WAS 1,422.ON APRIL 30, 2019, A COMMUNITY HEALTH IMPROVEMENT PLAN STAKEHOLDER TOWN HALL MEETING WAS HELD IN NORFOLK, NEBRASKA. ON MAY 1, 2019, AN IDENTICAL MEETING WAS HELD IN WEST POINT, NEBRASKA. APPROXIMATELY 260 INVITATIONS WERE SENT OUT TO KEY STAKEHOLDERS IN THE PUBLIC HEALTH SYSTEM. THE PUBLIC WAS INVITED TO ATTEND THE TOWN HALL MEETINGS AS WELL. THERE WERE 50 INDIVIDUALS THAT ATTENDED THE TOWN HALL MEETING IN WEST POINT, AND 34 INDIVIDUALS ATTENDED THE TOWN HALL MEETING IN NORFOLK. MEETING PARTICIPANTS INCLUDED INDIVIDUALS FROM THE FOLLOWING SECTORS: ELECTED OFFICIALS, HOSPITALS AND CLINICS, LONG-TERM CARE, BEHAVIORAL HEALTH, COMMUNITY-BASED ORGANIZATIONS, TRAILS COMMITTEE MEMBERS, CENTER FOR RURAL AFFAIRS, INSTITUTES OF HIGHER EDUCATION, HOSPITAL BOARD MEMBERS, PONCA TRIBE OF NEBRASKA, FEDERALLY-QUALIFIED HEALTH CENTER, CHAMBER OF COMMERCE, ECONOMIC DEVELOPMENT, UNL COUNTY EXTENSION, JUVENILE DIVERSION, PUBLIC HEALTH LIAISON/ADVOCATE, CUMING COUNTY PUBLIC POWER DISTRICT, LAW ENFORCEMENT, CITY EMPLOYEES, MEDICAL RESPONSE SYSTEMS, VETERAN SERVICE OFFICERS, AND SCHOOLS. |
| ST. FRANCIS MEMORIAL HOSPITAL | PART V, SECTION B, LINE 6A: ST. FRANCIS MEMORIAL HOSPITAL CONDUCTED ITS CHNA IN CONJUNCTION WITH MERCYONE OAKLAND MEDICAL CENTER IN OAKLAND, NEBRASKA AND FAITH REGIONAL HEALTH SERVICES IN NORFOLK, NEBRASKA. |
| ST. FRANCIS MEMORIAL HOSPITAL | PART V, SECTION B, LINE 6B: ST. FRANCIS MEMORIAL HOSPITAL CONDUCTED ITS CHNA IN CONJUNCTION WITH ELKHORN LOGAN VALLEY PUBLIC HEALTH DEPARTMENT. |
| ST. FRANCIS MEMORIAL HOSPITAL | PART V, SECTION B, LINE 11: THE 2019 CHNA REVEALED TWO MAIN HEALTH PRIORITIES IN OUR AREA: 1) CHRONIC DISEASE CONTROL AND SEPSIS AND 2) BEHAVIORAL/MENTAL HEALTH. THE CHNA IMPLEMENTATION PLAN HAS THE FOLLOWING GOALS TO IMPROVE THE HEALTH PRIORITIES IDENTIFIED.FOR THE HEALTH PRIORITY OF CHRONIC DISEASE CONTROL AND SEPSIS WE WILL:1. INCREASE PRIMARY CARE VISITS2. INCREASE SCREENING VISITS SUCH A MAMMOGRAMS, PROSTATE, COLONOSCOPY, AND VACCINATIONS.3. INCREASE PARTICIPATION IN THE CLINIC CHRONIC CARE MANAGEMENT PROGRAM.4. INCREASE PARTICIPATION IN THE CLINIC TRANSITIONAL CARE MANAGEMENT PROGRAM.5. IDENTIFY TOBACCO USERS AND PROVIDE CESSATION PROGRAM INFORMATION.6. SPONSOR INCREASED EAT WELL AND BE ACTIVE CLASSES.FOR THE HEALTH PRIORITY OF BEHAVIOR/MENTAL HEALTH WE WILL:1. RECRUIT BEHAVIORAL/MENTAL HEALTH PROVIDERS.2. DEVELOPMENT OF RECRUITMENT INCENTIVES.3. IDENTIFY TELEMEDICINE ALTERNATIVES.4. SUICIDE PREVENTION PROGRAM DEVELOPMENT.DURING THE DEVLOPMENT OF THE CHNA IT WAS DETERMINED THAT THE HEALTH PRIORITIES WERE REDUCED TO JUST TWO TO ACHIEVE A MORE-MEANINGFUL IMPACT ON THE SELECTED PRIORITIES. HOWEVER, IT SHOULD BE NOTED THAT SOME OF THE OTHER OPPORTUNITIES FOR PRIORITIZATION THAT WERE IDENTIFIED SUCH AS VAPING-RELATED LUNG DISEASE, OPIOID OVERDOSE/MISUSE, THE DISPROPORTIONATE RETIREMENT RATES OF HEALTHCARE PROFESSIONALS, POST-FLOOD WATER QUALITY ISSUES, NATURAL DISASTER PREPAREDNESS, ETC. ARE STILL ISSUES THAT WE FACE AND WORK THROUGH OFTEN. JUST BECAUSE THEY ARE NOT PART OF THE CHNA, DOES NOT MEAN THAT WE ARE NOT FOCUSING ON THEM AND WORKING TO IMPROVE THE OUTCOMES. |
| ST. FRANCIS MEMORIAL HOSPITAL | PART V, SECTION B, LINE 13H: OTHER FACTORS USED IN DETERMING ELIGIBILITY FOR FINACIAL ASSISTANCE INCLUDE ELIGIBILITY FOR MEDICAID, SOCIAL SECURITY OR A BANK LOAN. |
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | THE COMMUNITY BENEFIT REPORT IS NOT PREPARED BY A RELATED ORGANIZATION. |
| PART I, LINE 7: | A COST-TO-CHARGE RATIO WAS USED TO CALCULATE THE COST OF COMMUNITY BENEFIT EXPENSES DETAILED IN THE TABLE FOR PART I, LINE 7(A) - 7(K). THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. |
| PART I, LINE 7G: | SUBSIDIZED HEALTH SERVICES OF $890,378 ARE REPORTED ON LINE 7G. THIS AMOUNT REPRESENTS THE COMMUNITY BENEFIT ATTRIBUTABLE TO PHYSICIAN SERVICES. |
| PART I, LN 7 COL(F): | THE AMOUNT USED TO COMPUTE COLUMN (F) IS FROM THE AMOUNT REPORTED ON FORM 990, PART IX, LINE 25, COLUMN (A). |
| PART II, COMMUNITY BUILDING ACTIVITIES: | FRANCISCAN CARE SERVICES, INC. CURRENTLY HAS INVOLVEMENT IN THE ELKHORN LOGAN VALLEY PUBLIC HEALTH DEPARTMENT BOARD WHICH LOOKS AT HOW THE COMMUNITY ADDRESSES HEALTH AND SAFETY ISSUES, THE ACCESS INDIVIDUALS HAVE TO HEALTH CARE SERVICES, AND THE STAFF NECESSARY TO PROVIDE HEALTHCARE SERVICES. WE SPEND A CONSIDERABLE AMOUNT OF TIME AND EFFORT IN EDUCATING HEALTHCARE PROFESSIONALS. WE HAVE MANY RESIDENTS AND CLINICAL COLLEGE STUDENTS ON-SITE THROUGHOUT THE YEAR. WE ALSO HAVE A JOB SHADOWING PROGRAM FOR HIGH SCHOOL STUDENTS IN THE AREA. WE HELP EDUCATE THESE INDIVIDUALS IN THE HOPE THAT THEY WILL COME BACK TO THE COMMUNITY TO PROVIDE HEALTHCARE SERVICES. WE PROVIDE FUNDS FOR ACTIVITIES AT AREA SCHOOLS THAT PROVIDE A SAFE ENVIRONMENT AND EDUCATION FOR OUR YOUTH. WE HAVE MULTIPLE STAFF MEMBERS THAT ARE PART OF THE WEST POINT TRAILS PROJECT. THIS WAS A PROJECT TO HELP IMPROVE THE HEALTH AND WELLNESS OF THE PERSONS IN THE COMMUNITY AND SURROUNDING AREA. WE DONATE FUNDS TO DIFFERENT ORGANIZATIONS TO IMPROVE THE COMMUNITY'S HEALTH AND SAFETY. |
| PART III, LINE 2: | THE AMOUNT REPORTED ON LINE TWO IS TAKEN DIRECTLY FROM THE GENERAL LEDGER. THE AMOUNT THAT IS WRITTEN OFF TO BAD DEBT IS THE PATIENT'S ACCOUNT BALANCE WHEN IT IS DETERMINED THAT THE PATIENT WILL NOT PAY. THEREFORE, IF THE PATIENT IS SELF PAY AND HAS NOT PAID ANY OF THE BALANCE, THEN 100% OF CHARGES ARE WRITTEN OFF. IF THE PATIENT HAS COMMERCIAL INSURANCE AND CANNOT PAY THE 20% COINSURANCE THAT IS DUE AFTER INSURANCE HAS PAID AND THE CONTRACTUAL DISCOUNTS HAVE BEEN APPLIED, THEN ONLY THE 20% COINSURANCE THAT IS OWED BY THE PATIENT IS WRITTEN OFF TO BAD DEBT. |
| PART III, LINE 3: | THE AMOUNT REPORTED ON LINE THREE IS ESTIMATED BASED ON PAST FINANCIAL ANALYSIS PERFORMED BY THE PATIENT ACCOUNTING MANAGER AND THE PATIENT FINANCIAL COUNSELOR. HISTORICALLY, A REVIEW OF THE ACCOUNTS WRITTEN OFF TO BAD DEBT WAS DONE, TAKING INTO CONSIDERATION THE INDIVIDUAL'S FINANCIAL SITUATION. DURING THE REVIEW, ACCOUNTS THAT COULD HAVE BEEN WRITTEN OFF AS CHARITY CARE IF SUFFICIENT INFORMATION WAS RECEIVED WERE IDENTIFIED. AS A RESULT OF THE ANALYSIS, IT WAS DETERMINED THAT $122,520 WOULD POSSIBLY HAVE QUALIFIED AS CHARITY CARE.THERE IS A FINE LINE BETWEEN BAD DEBT AND CHARITY CARE. THERE ARE THOSE INDIVIDUALS WHO JUST WILL NOT PAY, BUT THERE ARE A LARGER NUMBER OF INDIVIDUALS WHO CANNOT PAY, BUT DO NOT WANT TO FILL OUT THE PAPERWORK FOR CHARITY CARE OR DO NOT WANT TO EVEN ASK FOR CHARITY CARE. WE HAVE ESTIMATED THAT $122,520 OF OUR BAD DEBT EXPENSE SHOULD HAVE BEEN CLASSIFIED AS CHARITY CARE IF THE APPROPRIATE PAPERWORK WAS RECEIVED. THESE ARE THE DOLLARS THAT SHOULD BE CLASSIFIED AS COMMUNITY BENEFIT. |
| PART III, LINE 4: | THE HOSPITAL'S FINANCIAL STATEMENTS DO NOT CONTAIN A SPECIFIC FOOTNOTE DESCRIBING BAD DEBT EXPENSE AND ALLOWANCE FOR DOUBTFUL ACCOUNTS. HOWEVER, PAGES 8, 9, 10 AND 11 OF THE ATTACHED FINANCIAL STATEMENTS INCLUDE FOOTNOTES TITLED "ACCOUNTS RECEIVABLE", "REVENUE RECOGNITION - PATIENT SERVICE REVENUE AND "FEDERAL FINANCIAL ASSISTANCE PROGRAMS" THAT DISCUSS BAD DEBT EXPENSE. |
| PART III, LINE 8: | TOTAL REVENUE RECEIVED FROM MEDICARE AND THE MEDICARE ALLOWABLE COSTS REPORTED ON PART III, LINES 5 & 6 WAS TAKEN DIRECTLY FROM THE 2021 MEDICARE COST REPORT. IN ADDITION TO THE REVENUE RECEIVED FROM MEDICARE AND THE MEDICARE ALLOWABLE COSTS REPORTED ON THE MEDICARE COST REPORT, WE ALSO RECEIVE MEDICARE PART B PAYMENTS (FEE SCHEDULE) FOR CERTAIN LAB, RADIOLOGY, AND PHYSICIAN SERVICES. THESE AMOUNTS ARE NOT INCLUDED ON THE MEDICARE COST REPORT. THE REVENUE RECEIVED FOR MEDICARE PART B SERVICES WAS $393,917 WHILE THE ASSOCIATED COSTS WERE $1,087,597 FOR A SHORTFALL OF ($693,680). THE COSTS FOR THE SERVICES REIMBURSED ON A FEE SCHEDULE METHODOLOGY WERE CALCULATED USING THE COST TO CHARGE RATIO FROM THE MEDICARE COST REPORT FOR THAT DEPARTMENT.THE SHORTFALL REPORTED ON PART III, LINE 7 OF ($152,077) AND THE MEDICARE PART B SHORTFALL OF ($693,680) FOR A TOTAL SHORTFALL OF ($845,757) SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE THESE ARE COSTS OVER AND ABOVE THE AMOUNT THAT MEDICARE PAYS US. THESE SERVICES ARE INTEGRAL TO THE COMMUNITY AND WOULD NOT BE AVAILABLE TO THE COMMUNITY IF THEY WERE NOT PROVIDED BY OUR FACILITY. |
| PART III, LINE 9B: | IN OUR BILLING AND COLLECTION POLICY THERE IS A SECTION ON FINANCIAL ASSISTANCE. IT STATES: "FRANCISCAN CARE SERVICES HAS A FINANCIAL ASSISTANCE PROGRAM TO ASSIST PATIENTS THAT ARE FINANCIALLY BURDENED AND UNABLE TO PAY FOR THEIR MEDICAL EXPENSES. A FINANCIAL ASSISTANCE APPLICATION MUST BE COMPLETED AND TURNED INTO THE PATIENT FINANCIAL COUNSELOR. A COPY OF THE MOST CURRENT TAX RETURN (IRS FORM 1040 OR 1040A) MUST ACCOMPANY THE FINANCIAL ASSISTANCE APPLICATION. A DETERMINATION OF APPROVAL OR DENIAL IS MADE FROM THIS APPLICATION AND IS BASED UPON ESTABLISHED GUIDELINES." |
| PART VI, LINE 2: | THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE ARE ASSESSED IN MANY DIFFERENT WAYS. WE WORK CLOSELY WITH THE ELKHORN LOGAN VALLEY PUBLIC HEALTH DEPARTMENT WHO SURVEYS THE AREA POPULATION TO ASCERTAIN HEALTH DISPARITIES, COLLABORATE ON HEALTH SCREENINGS, AND DETERMINE AREAS OF NEED. AS OUR PHYSICIANS AND OTHER HEALTH CARE WORKERS SEE PATIENTS THEY DISCUSS THEIR CURRENT STATUS AND WHAT ELSE WE CAN DO FOR THEM. ALSO, OUR BOARD MEMBERS AND EMPLOYEES WHO ARE IN THE PUBLIC ADVISE US AS TO WHAT HEALTH CARE NEEDS ARE IN THE COMMUNITY THAT WE DO NOT CURRENTLY ADDRESS. MANY OF OUR EMPLOYEES ARE INVOLVED IN STATE AND NATIONAL ORGANIZATIONS THAT KEEP US UP-TO-DATE ON THE CURRENT TRENDS IN HEALTH CARE THAT ARE BROUGHT BACK TO OUR COMMUNITY. THROUGH STRATEGIC PLANNING WITH THE PHYSICIANS, THE BOARD OF DIRECTORS, AND HOSPITAL LEADERS, WE LOOK AT WHAT THE NEEDS OF THE COMMUNITY ARE AND HOW WE CAN ADDRESS THEM. ALL OF THESE GROUPS WORK TOGETHER WITH ADMINISTRATION TO CONTINUE TO ADDRESS THE HEALTH CARE NEEDS OF THE COMMUNITY. |
| PART VI, LINE 3: | ON THE CONDITIONS OF ADMISSION AND CONSENT FOR TREATMENT FORM THAT IS SIGNED BY EACH PATIENT OF THE HOSPITAL, THERE IS A FINANCIAL AGREEMENT SECTION THAT STATES "IF YOU HAVE LIMITED INSURANCE OR DO NOT HAVE INSURANCE, YOU MAY REQUEST TO MEET WITH OUR PATIENT FINANCIAL COUNSELOR TO SET UP A PAYMENT PLAN OR TO DETERMINE IF YOU ARE ELIGIBLE FOR FINANCIAL ASSISTANCE." THE FINANCIAL ASSISTANCE POLICY (FAP), THE PLAIN LANGUAGE SUMMARY OF THE FAP, THE APPLICATION FOR FINANCIAL ASSISTANCE, AND FINANCIAL ASSISTANCE CONTACT INFORMATION IS POSTED AT THE MAIN ENTRANCE TO THE HOSPITAL AND CLINIC AND ALSO AT THE EMERGENCY ROOM ENTRANCE AND IS ALSO POSTED ON OUR WEBSITE AT HTTP://FRANHEALTH.ORG/PATIENTS-VISITORS/PATIENT-FINANCIAL-INFORMATION.HTML. A PLAIN LANGUAGE SUMMARY OF THE FAP IS OFFERED TO PATIENTS UPON REGISTRATION. ON OUR PATIENT BILLS THERE IS A SECTION THAT STATES "WE ALSO OFFER FINANCIAL ASSISTANCE TO PATIENTS WHO QUALIFY. PLEASE CONTACT THE PATIENT FINANCIAL COUNSELOR AT 402-372-4029 FOR MORE INFORMATION OR VISIT OUR WEBSITE AT HTTP://FRANHEALTH.ORG/PATIENTS-VISITORS/PATIENT-FINANCIAL-INFORMATION.HTML."ALSO, IF THE PATIENT FINANCIAL COUNSELOR CONTACTS A PATIENT REGARDING PAYMENT OF A BILL, A LETTER AND A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS SENT TO THEM WHICH STATES THAT IF THEY ARE UNABLE TO PAY THEIR BILL THEY MAY BE ELIGIBLE FOR OUR FINANCIAL ASSISTANCE PROGRAM. |
| PART VI, LINE 4: | FRANCISCAN CARE SERVICES, INC. IS LOCATED IN A RURAL AREA, PREDOMINANTLY AGRICULTURALLY BASED. THE POPULATION OF THE FIVE-COUNTY SERVICE AREA IS APPROXIMATELY 18,000 PEOPLE. THE MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $59,000. THE POPULATION IS PREDOMINANTLY CAUCASIAN, HIGH-SCHOOL EDUCATED, AND GERIATRIC IN NATURE. THERE IS A GROWING POPULATION OF HISPANIC DESCENT. |
| PART VI, LINE 5: | THE BOARD OF DIRECTORS IS COMPRISED OF INDIVIDUALS FROM THE SURROUNDING COMMUNITIES. THE BOARD MEMBERS ARE DIVERSE IN BACKGROUND RANGING FROM SISTERS FROM OUR SPONSOR, PUBLIC HEALTH DIRECTORS, BANKERS, AND BUSINESS OWNERS WHO ARE NEITHER EMPLOYEES (EXCEPT CEO), CONTRACTORS, OR FAMILY MEMBERS. WE HOPE THE DIVERSE BACKGROUNDS OF OUR BOARD MEMBERS GIVE US THE INSIGHT WE NEED TO FULFILL THE NEEDS OF THE COMMUNITY. FRANCISCAN CARE SERVICES, INC. HAS AN OPEN MEDICAL STAFF THAT INCLUDES SIX FAMILY PRACTICE PHYSICIANS, FIVE PHYSICIAN ASSISTANTS, AND THREE NURSE PRACTITIONERS. THERE ARE ALSO A NUMBER OF SPECIALISTS THAT COME IN FROM THE NEARBY COMMUNITIES OF NORFOLK, FREMONT, AND OMAHA TO MEET THE HEALTH NEEDS OF THE COMMUNITY. SPECIALISTS THAT SEE PATIENTS IN OUR OUTPATIENT CLINIC INCLUDE AUDIOLOGY, CARDIOLOGY, DERMATOLOGY, ENT, GENERAL SURGERY, NEPHROLOGY, NEUROLOGY, OBSTETRICS/GYNECOLOGY, ONCOLOGY, OPHTHALMOLOGY, ORTHOPEDICS, PAIN, PODIATRY, PULMONOLOGY, RHEUMATOLOGY, UROLOGY, AND VASCULAR. THERE ARE MANY DIFFERENT PROGRAMS THAT WE ARE ABLE TO OFFER DUE TO SURPLUS FUNDS FROM OPERATIONS. OUR CLINICS PROVIDE DISEASE MANAGEMENT THROUGH THE USE OF HEALTH COACHES TO HELP PATIENTS MANAGE CHRONIC HEALTH CONDITIONS SUCH AS DIABETES, HYPERTENSION, COPD, CLOTTING, AND OSTEOPOROSIS. THIS IS A PROGRAM THAT IS GOOD FOR OUR PATIENTS EVEN THOUGH WE RECEIVE LITTLE TO NO REIMBURSEMENT FOR PROVIDING THIS SERVICE. WE PROVIDE FREE SPORT SCREENS TO AREA ATHLETES WHO HAVE BEEN INJURED AT A PRACTICE OR GAME. WE OFFER REDUCED-COST SCREENS AND HEALTH EDUCATION TO BUSINESSES IN OUR SERVICE AREA TO REACH OUT TO THOSE INDIVIDUALS WHO DO NOT TAKE THE TIME TO COME TO OUR FACILITY TO SEE US. WE PROVIDE A NUMBER OF EXERCISE PROGRAMS FOR THE ELDERLY IN THE COMMUNITY. WE OFFER DISCOUNTED LABS TO THE COMMUNITY. WE ARE ALSO ABLE TO CONTINUALLY INVEST BACK INTO THE ORGANIZATION WITH NEW EQUIPMENT AND IMPROVEMENTS TO FACILITIES. IN 2021, SOME OF THE EQUIPMENT THAT WAS PURCHASED INCLUDES AN MRI, MICRODRILLS AND SAWS FOR ORTHOPEDIC CASES, DECONTAMINATION 3-BAY ADJUSTABLE SINK, ARTERIAL DOPPLER MACHINE, PHARMACY REFRIGERATOR, AND A SECURITY CAMERA UPGRADE. |
| PART VI, LINE 6: | FRANCISCAN CARE SERVICES, INC. IS A PART OF THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, A NOT-FOR-PROFIT SYSTEM OF ACUTE AND LONG-TERM HEALTH CARE FACILITIES LOCATED IN WISCONSIN, NEBRASKA AND OHIO. EACH ORGANIZATION WITHIN THE MINISTRY IS RESPONSIBLE FOR CARRYING OUT THE HEALING MISSION OF THE CATHOLIC CHURCH ACCORDING TO THE NEEDS OF THEIR COMMUNITY. |
| PART VI, LINE 7: | THE COMMUNITY BENEFIT REPORT IS FILED WITH THE NEBRASKA HOSPITAL ASSOCIATION. THE REPORT IS ALSO SENT TO OUR LOCAL MAYOR AND OUR STATE AND CONGRESSIONAL REPRESENTATIVES. |
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 | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|---|---|
| ORPHAN GRAIN TRAIN | ||||||||||
| 601 W PHILLIP AVE | NORFOLK | NE | 68701 | 311614650 | 501(C)(3) | $0 | $8,637 | FMV | MEDICAL SUPPLIES | PROGRAM SUPPORT |
| WEST POINT COMMUNITY FOUNDATION | ||||||||||
| PO BOX 65 | WEST POINT | NE | 68788 | 363819725 | 501(C)(3) | $50,000 | $0 | PROGRAM SUPPORT | ||
| ST JOSEPH'S ELDER SERVICES INC | ||||||||||
| 540 E WASHINGTON ST | WEST POINT | NE | 68788 | 814879204 | 501(C)(3) | $34,500 | $0 | PROGRAM SUPPORT | ||
| 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 | DURING 2021, FRANCISCAN CARE SERVICES TRANSFERRED CASH OF $50,000 TO WEST POINT COMMUNITY FOUNDATION FOR PROGRAM SUPPORT FOR THE NELIGH PARK INCLUSIVE PLAYGROUND, CASH OF $34,500 TO ST. JOSEPH'S ELDER SERVICES INC., A RELATED ENTITY UNDER FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MISTRIES, INC, AND MEDICAL SUPPLIES VALUED AT $8,637 TO ORPHAN GRAIN TRAIN FOR PROGRAM SUPPORT | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (1) | 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 (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SCOTT GREEN MD | ||||||||||||||
| PHYSICIAN | $436,361 | $0 | $172,032 | $0 | $14,188 | $0 | $14,500 | $0 | $34,844 | $0 | $671,925 | $0 | $0 | $0 |
| THOMAS COHEE MD | ||||||||||||||
| PHYSICIAN | $403,424 | $0 | $178,892 | $0 | $21,730 | $0 | $12,500 | $0 | $31,984 | $0 | $648,530 | $0 | $0 | $0 |
| BRIAN HASS MD | ||||||||||||||
| PHYSICIAN | $367,628 | $0 | $205,509 | $0 | $23,868 | $0 | $12,211 | $0 | $35,030 | $0 | $644,246 | $0 | $0 | $0 |
| RHETT ECKMANN MD | ||||||||||||||
| PHYSICIAN | $354,982 | $0 | $201,454 | $0 | $13,774 | $0 | $12,211 | $0 | $35,030 | $0 | $617,451 | $0 | $0 | $0 |
| RENAE MEYER MD | ||||||||||||||
| PHYSICIAN | $286,245 | $0 | $87,738 | $0 | $15,574 | $0 | $12,500 | $0 | $30,948 | $0 | $433,005 | $0 | $0 | $0 |
| TYLER TOLINE | ||||||||||||||
| CEO & PRESIDENT | $250,700 | $0 | $60,500 | $0 | $54,315 | $0 | $0 | $0 | $32,280 | $0 | $397,795 | $0 | $0 | $0 |
| TERRY NELSON | ||||||||||||||
| ANCILLARY DIRECTOR | $188,409 | $0 | $10,500 | $0 | $16,899 | $0 | $28,051 | $0 | $32,522 | $0 | $276,381 | $0 | $0 | $0 |
| ALISA BRUNSING | ||||||||||||||
| CFO | $157,601 | $0 | $28,889 | $0 | $4,432 | $0 | $8,966 | $0 | $11,398 | $0 | $211,286 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4B | DURING 2021, FRANCISCAN CARE SERVICES, INC. CONTRIBUTED FUNDS TO AN IRC SECTION 457(F) PLAN FOR THE FOLLOWING INDIVIDUALS: DR. COHEE $12,500 DR. GREEN $4,000 DR. ECKMANN $4,321 DR. HASS $4,321 DR. MEYER $12,500 MR. NELSON $16,500 |
| PART I, LINE 5 | IN EACH OF THE FAMILY PRACTICE PHYSICIAN'S CONTRACTS, THERE IS A SECTION THAT ESTABLISHES THE POTENTIAL AMOUNT OF SUPPLEMENTAL INCOME THAT THE PHYSICIANS MAY RECEIVE DURING THE YEAR BASED ON THEIR INDIVIDUAL PRODUCTIVITY. EACH OF THESE PHYSICIANS IS PAID A BASE SALARY AS AN EMPLOYED PHYSICIAN OF THE ORGANIZATION. IN ADDITION, THE PHYSICIAN MAY EARN ADDITIONAL COMPENSATION BASED ON A PRE-DETERMINED CALCULATED FORMULA AS STIPULATED IN THE CONTRACT. THE FORMULA IS CALCULATED BY TAKING THE INDIVIDUAL'S PRODUCTIVITY REVENUE FOR THE CALENDAR YEAR LESS ANY CONTRACTUAL ADJUSTMENTS OR WRITE-OFFS AND THEN MULTIPLYING THAT NET AMOUNT BY A PRE-DETERMINED PERCENTAGE. IF THIS CALCULATED AMOUNT EXCEEDS THEIR BASE SALARY, THE PHYSICIAN IS PAID THE VARIANCE. DURING THE YEAR, DR. GREEN, DR. ECKMANN, DR. COHEE, DR. HASS, AND DR. MEYER RECEIVED A PAYMENT. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPITAL AUTHORITY NO 1 OF CUMING COUNTY NE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 470762878 | BondIssuerEIN |
| Bond Issued | 2016-10-01 | BondIssuedDt |
| Issue Price | $10,000,000 | IssuePriceAmt |
| Purpose | FOR AN ADDITION TO AND IMPROVEMENTS FOR EXISTING HOSPITAL FACILITIES. | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $3,676,036 | RetiredAmt |
| Total Proceeds | $10,000,000 | TotalProceedsAmt |
| Other Spent Proceeds | $10,000,000 | OtherSpentProceedsAmt |
| Substantial Completion | 2012 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | Yes (1) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | Yes (1) | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K, PART I, LINE A, COLUMN F: | FormAndLineReferenceDesc |
| Explanation | THE BOND IS BEING REISSUED FOR FEDERAL TAX PURPOSES AS OF OCTOBER 1, 2016 DUE TO CHANGES TO THE TERMS OF THE OBLIGATION. THE NOTES WERE ORIGINALLY ISSUED FOR THE PURPOSE OF PROVIDING A LOAN TO FRANCISCAN CARE SERVICES, INC. (THE "HOSPITAL") FOR AN ADDITION TO AND IMPROVEMENTS FOR EXISTING HOSPITAL FACILITIES LOCATED IN THE CITY OF WEST POINT, NEBRASKA, OWNED BY THE HOSPITAL. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART IV, LINE 12A: | CHECKLIST OF REQUIRED SCHEDULES THE ORGANIZATIONS'S FINANCIAL STATEMENTS WERE AUDITED ON A CONSOLIDATED BASIS AT THE ORGANIZATION'S PARENT LEVEL. THE ORGANIZATION USES SCHEDULES FROM THE CONSOLIDATED AUDITED FINACIALS STATEMENTS FOR TAX RETURN PURPOSES. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION WHOSE SOLE CORPORATE MEMBER IS FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC., A WISCONSIN NON-STOCK, NOT FOR PROFIT CORPORATION IS THE SOLE CORPORATE MEMBER OF FRANCISCAN CARE SERVICES, INC. AND HAS THE AUTHORITY TO APPOINT AND REMOVE MEMBERS OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC., A WISCONSIN NON-STOCK, NOT FOR PROFIT CORPORATION HAS THE FOLLOWING RESERVED POWERS OVER FRANCISCAN CARE SERVICES, INC.: A) APPROVAL OF THE PHILOSOPHY, MISSION AND VALUES STATEMENTS OF THE CORPORATION. B) AMENDMENT OF ARTICLES OF INCORPORATION AND BY-LAWS OF THE CORPORATION. C) APPOINTMENT AND REMOVAL OF MEMBERS OF THE BOARD OF DIRECTORS. D) APPROVAL OF THE CREATION AND DISSOLUTION OF THIS CORPORATION OR ANY SUBSIDIARY CORPORATIONS, AS WELL AS APPROVAL OF ANY MERGER, CONSOLIDATION, AFFILIATION, JOINT VENTURE OR OTHER FORM OF CORPORATE REORGANIZATION OF THIS CORPORATION OR ANY SUBSIDIARY OF WHICH THIS CORPORATION IS THE MEMBER OR CONTROLLING SHAREHOLDER. E) APPOINTMENT, EVALUATION AND DISCHARGE OF THE PRESIDENT OF THE CORPORATION. F) APPROVAL OF BORROWING IN EXCESS OF THE LIMIT ESTABLISHED BY THE MEMBER. G) APPROVAL OF PURCHASE, MORTGAGE OR SALE OF REAL ESTATE, OR LEASE OF REAL ESTATE, BY OR TO THE CORPORATION FOR LONGER THAN ONE YEAR. H) IMPLEMENTATION OF SPONSOR APPOINTMENT, SALARY NEGOTIATION, AND REASSIGNMENT PROCESSES FOR FRANCISCAN SISTER PERSONNEL WITHIN THIS CORPORATION. I) APPROVAL OF CAPITAL AND OPERATING BUDGETS. J) REQUIREMENT OF A CERTIFIED AUDIT OF CORPORATE FUNDS AT ANY TIME AND APPROVAL OF THE FISCAL AUDITOR OF THE CORPORATION ANNUALLY. K) APPROVAL OF ALL INSURANCE CARRIERS AND INSURANCE COVERAGE FOR THE CORPORATION. L) APPROVAL OF LONG-RANGE OR STRATEGIC PLANS OF THE CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 IS REVIEWED PRIOR TO SUBMISSION TO THE IRS BY THE MEMBER (FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC.) AND THE FINANCE COMMITTEE OF THE FRANCISCAN CARE SERVICES, INC. BOARD OF DIRECTORS. A COPY OF THE FORM 990 WILL BE AVAILABLE FOR ALL BOARD MEMBERS TO REVIEW AT THEIR MONTHLY BOARD MEETING BEFORE THE FORM 990 IS FILED. FORM 990 IS MADE AVAILABLE IN THE ADMINSTRATIVE OFFICE FOR ANY INDIVIDUAL REQUESTING TO INSPECT IT AS REQUIRED BY INTERNAL REVENUE CODE 6104. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CORPORATE COMPLIANCE OFFICER (CCO) AND SEVERAL MEMBERS OF THE CORPORATE COMPLIANCE COMMITTEE ATTEND BOARD, ADMINSTRATIVE, AND DEPARTMENT MANAGER MEETINGS. THE CCO ENSURES THAT ALL BOARD, MEDICAL STAFF, ADMINISTRATION STAFF, DEPARTMENT MANAGERS, AND INDIVIDUALS WHO HAVE PURCHASING AUTHORITY REVIEW THE CONFLICT OF INTEREST POLICY ANNUALLY AND DISCLOSE ANY CONFLICTS THAT MIGHT EXIST. EACH INDIVIDUAL IS ALSO ASKED TO IDENTIFY ANY FAMILY MEMBERS THAT ARE AN EMPLOYEE OF FRANCISCAN CARE SERVICES, INC. (FCS) OR EMPLOYED BY A BUSINESS WITH WHICH FCS CONDUCTS BUSINESS. ANY NEW CONFLICTS THAT ARISE DURING THE YEAR NEED TO BE REPORTED TO THE CORPORATE COMPLIANCE OFFICER IMMEDIATELY. IF A CONFLICT EXISTS AT THE BOARD LEVEL, THE PERSON OR THE CCO OR COMMITTEE MEMBER IDENTIFIES THAT THE CONFLICT EXISTS AND THEN THE BOARD DETERMINES IF THE PERSON CAN TAKE PART IN THE DELIBERATIONS OR NEEDS TO LEAVE THE ROOM. THE PERSON WOULD NOT BE ABLE TO VOTE AND IT IS IDENTIFIED IN THE MINUTES OF THE MEETING. AT THE ADMINSTRATIVE LEVEL, THE STAFF MEMBER IDENTIFIES THE CONFLICT AND THE ADMINSTRATIVE TEAM DETERMINES IF THE PERSON CAN TAKE PART IN THE DISCUSSION OR NEEDS TO LEAVE THE ROOM. THIS IS ALSO THE POLICY AT THE MEDICAL STAFF AND MANAGER MEETINGS. |
| FORM 990, PART VI, SECTION B, LINE 15A | FRANCISCAN CARE SERVICES, INC. STRIVES TO PROVIDE A FAIR AND COMPETITIVE COMPENSATION PACKAGE FOR ITS EXECUTIVES. THIS PACKAGE SHALL INCLUDE, BUT IS NOT LIMITED TO SALARY, INCENTIVE BONUS, LIFE INSURANCE, HEALTH BENEFITS, AND A MATCHING DEFINED CONTRIBUTION TO A 403(B) RETIREMENT PLAN. THE SALARY RANGE AND TOTAL COMPENSATION SHALL BE BASED UPON SURVEYS OF THE GEOGRAPHIC WEST NORTH CENTRAL STATES AVERAGE FOR THE POSITION AS REPORTED BY AN INDEPENDENT EXECUTIVE COMPENSATION MARKET ANALYSIS FOR LIKE-SIZED ORGANIZATIONS AND THE EXECUTIVE COMPENSATION SURVEY FOR NEBRASKA HOSPITALS PROVIDED BY THE NEBRASKA HOSPITAL ASSOCIATION. BONUSES ARE GIVEN BASED UPON ACHIEVEMENT OF STRATEGIC GOALS AGREED UPON BY THE FRANCISCAN CARE SERVICES BOARD OF DIRECTORS AND THE PRESIDENT OF THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC. THESE BONUSES ARE BASED UPON A PERCENTAGE OF SALARY AND ARE NOT TO EXCEED 25%. THE PRESIDENT/CEO'S COMPENSATION IS SET BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS AND THE SPONSORED MINISTRIES PRESIDENT AFTER A PERFORMANCE APPRAISAL CONDUCTED BY THE EXECUTIVE COMMITTEE OF THE FCS BOARD (SERVING AS THE COMPENSATION COMMITTEE) AND THE PRESIDENT OF THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC. ALL MEMBERS OF THE BOARD PROVIDE THEIR INPUT THROUGH A WRITTEN APPRAISAL PRESENTED TO THE COMPENSATION COMMITTEE. MINUTES OF THE MEETING ARE KEPT BY THE SPONSORED MINISTRIES PRESIDENT. ALL OTHER EXECUTIVES ARE REVIEWED BY THE FRANCISCAN CARE SERVICES, INC. PRESIDENT/CEO, WHO SETS THEIR COMPENSATION BASED UPON THE ABOVE SURVEYS AND PRINCIPLES. |
| FORM 990, PART VI, SECTION C, LINE 19 | NO DOCUMENTS ARE AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | OTHER CONTRACTORS: PROGRAM SERVICE EXPENSES 3,847,968. MANAGEMENT AND GENERAL EXPENSES 517,955. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,365,923. |
| FORM 990, PART XI, LINE 9: | CHANGE IN BENEFICIAL INTEREST OF A CHARITABLE FOUNDATION -260,000. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST FRANCIS SERVICES LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 430 N MONITOR ST | AddressLine1Txt |
| City | WEST POINT | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68788 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 852622665 | EIN |
| Primary Activities | PHARMACY | PrimaryActivitiesTxt |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Total Income | $34,884 | TotalIncomeAmt |
| End Of Year Assets | $201,782 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FRANCISCAN CARE SERVICES INC | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| HOLY FAMILY CONVENT FRANCISCAN SISTERS | |||||||||||
| 2409 SOUTH ALVERNO ROAD | MANITOWOC | WI | 54220 | 390808523 | RELIGION | WI | 501(C)(3) | LINE 1 | N/A | 0 | |
| FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES INC | |||||||||||
| 1415 SOUTH RAPIDS ROAD | MANITOWOC | WI | 54220 | 391530622 | HEALTHCARE | WI | 501(C)(3) | LINE 1 | 0 | SEE LINE 1 | |
| ST FRANCIS MEMORIAL HOSPITAL FOUNDATION | |||||||||||
| 430 N MONITOR ST | WEST POINT | NE | 68788 | 470629079 | FUNDRAISING | NE | 501(C)(3) | LINE 12A, I | N/A | 0 | |
| ST JOSEPHS RETIRMENT COMMUNITY FOUNDATION | |||||||||||
| PO BOX 65 | WEST POINT | NE | 68788 | 470790644 | FUNDRAISING | NE | 501(C)(3) | LINE 12A, I | N/A | 0 | |
| ST PAUL ELDER SERVICES INC | |||||||||||
| 316 EAST 14TH STREET | KAUKAUNA | WI | 54130 | 391029149 | ELDER CARE | WI | 501(C)(3) | LINE 10 | 0 | SEE LINE 2 | |
| GOOD SAMARITAN MEDICAL CENTER | |||||||||||
| 800 FOREST AVENUE | ZANESVILLE | OH | 43701 | 314379479 | HOLDING COMPANY | OH | 501(C)(3) | LINE 12A, I | 0 | SEE LINE 2 | |
| ST JOSEPH'S ELDER SERVICES INC | |||||||||||
| 540 EAST WASHINGTON STREET | WEST POINT | NE | 68788 | 814879204 | ELDER CARE | NE | 501(C)(3) | LINE 10 | 0 | SEE LINE 2 | |
| HOLY FAMILY MEMORIAL INC | |||||||||||
| 2300 WESTERN AVE | MANITOWOC | WI | 54220 | 390806395 | HEALTHCARE | WI | 501(C)(3) | LINE 3 | 0 | SEE LINE 2 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLY FAMILY HEALTH SERVICES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3310 CALUMET AVENUE | AddressLine1Txt |
| City | MANITOWOC | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54220 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391572253 | EIN |
| Primary Activities | PHARMACY | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLY FAMILY MEMORIAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | 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 | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |