2022-10-31T15:56:57-05:00 2021-12-31 450250958 EIDE BAILLY LLP 18081 BURT STREET SUITE 200 OMAHA NE 680224722 990 2021-01-01 470378779 THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION MARY 4024634521 715 NORTH ST JOSEPH AVE HASTINGS NE 68901 ERIC BARBER PRESIDENT/CEO 4024634521 2022-10-17 1 ERIC BARBER 999009999 MEGAN L KOZIOL P01544037 4023302660 2022-10-17 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z MARY LANNING HEALTHCARE ERIC BARBER 715 NORTH ST JOSEPH AVE HASTINGS NE 68901 223552175 0 X WWW.MARYLANNING.ORG X 1915 NE ADVANCING OUR TRADITION OF SERVICE, EDUCATION AND COMMUNITY INVOLVEMENT, MARY LANNING HEALTHCARE IS DEDICATED TO EXCELLENCE, OFFERING HOPE, HEALTH AND HEALING. 7 6 1395 70 419985 0 16157633 5478038 195788600 203486899 1816218 3336723 953045 917693 214715496 213219353 1264418 358656 0 0 107733183 113299695 0 0 0 89892404 95484798 198890005 209143149 15825491 4076204 238418227 234718484 70691265 52425776 167726962 182292708 X ADVANCING OUR TRADITION OF SERVICE, EDUCATION AND COMMUNITY INVOLVEMENT, MARY LANNING HEALTHCARE IS DEDICATED TO EXCELLENCE, OFFERING HOPE, HEALTH AND HEALING. 0 0 194679144 358656 203486899 MARY LANNING HEALTHCARE (MLH) PROVIDES HEALTHCARE SERVICES TO THE GENERAL PUBLIC AND OPERATES ROUTINE SERVICE BEDS, ICU BEDS TOTALING 26,847 PATIENT DAYS. MLH HAD 173,179 OUTPATIENT VISITS AND EMERGENCY ROOM VISITS OF 14,760 IN 2021. MLH ALSO OPERATES A HOME HEALTH PROGRAM AND A SCHOOL OF NURSING. IN ADDITION, MLH OPERATES FOURTEEN PHYSICIAN CLINICS IN CENTRAL NEBRASKA, ALONG WITH AN OUTREACH PROGRAM TO SMALLER HOSPITALS IN WHICH TOGETHER MLH SEES APPROXIMATELY 40,000 PATIENTS PER YEAR. MLH OFFERS BEHAVIORAL HEALTH SERVICES ON AN INPATIENT AND OUTPATIENT BASIS, ACCOUNTING FOR 5,222 INPATIENT DAYS AND APPROXIMATELY 30,000 OUTPATIENT VISITS.MLH PROVIDES SEVERAL COMMUNITY PROGRAMS AS WELL. WE LIST ONLY THREE OF THEM. MLH PROVIDES COMMUNITY OUTREACH AND MATERNAL CHILD HEALTH ASSESSMENTS AND EDUCATION AT A COST OF OVER $280,000. MLH PROVIDES A PLACE FOR FAMILY MEMBERS TO STAY AT A MINIMAL COST DURING TREATMENT, AT A COST OF $247,242 IN 2021. MLH ALSO HAS A PHARMACEUTICAL PATIENT ASSISTANCE PROGRAM THAT ASSISTS THOSE UNABLE TO PAY FOR PRESCRIPTION MEDICATIONS TO FIND ALTERNATIVE FUNDING THROUGH PHARMACEUTICAL COMPANIES AT A COST OF $196,514. TO PROVIDE THESE SERVICES, MLH ABSORBED OVER $34 MILLION IN COSTS DURING 2021. OVER $26 MILLION OF THAT RELATES TO CARE PROVIDED TO MEDICARE AND MEDICAID PATIENTS WITH AN ADDITIONAL $2.1 MILLION IN CARE TO THE UNINSURED IN THE FORM OF CHARITY CARE. 194679144 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 149 0 1 1395 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 7 6 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X SHAWN NORDBY 4024615344 715 N ST JOSEPH AVE HASTINGS NE 68901 X BRENT HOOD PHYSICIAN 40.00 0.00 X 1651815 0 50545 MEHMET COPUR PHYSICIAN 40.00 0.00 X 861207 0 26356 KALPESH GANATRA PHYSICIAN 40.00 0.00 X 827996 0 48405 BARRY BOHLEN PHYSICIAN THRU 02/21 40.00 0.00 X 839657 0 18082 ERIC BARBER PRESIDENT/CEO 40.00 0.10 X 581401 0 48875 ZACH FREY PHYSICIAN 40.00 0.00 X 573715 0 49861 SHAWN NORDBY CHIEF FINANCIAL OFFICER 40.00 0.10 X 248108 0 34408 MICHAEL ALLEN TREASURER 1.00 40.00 X X 0 154758 33769 JEFF S ANDERSON CHAIR 1.00 0.00 X X 0 0 0 MICHELE BEVER VICE-CHAIR 1.00 0.00 X X 0 0 0 CLARENCE GARY ANDERSON SECRETARY 1.00 0.00 X X 0 0 0 JANIS JOHNSON TRUSTEE 1.00 0.00 X 0 0 0 ANNA STEHLIK TRUSTEE 1.00 0.00 X 0 0 0 DANIEL HEROLD TRUSTEE 1.00 0.00 X 0 0 0 5583899 154758 310301 166 0 1 0 MEDEFIS CONSOLIDATED BOX 5068 NEW YORK NY 100875068 CONTRACTED STAFFING 2833411 CHIEF INDUSTRIES INC 3942 W OLD HWY 30 GRAND ISLAND NE 68803 CONSTRUCTION SERVICES 2694225 THE NEBRASKA MEDICAL CENTER 4350 DEWEY AVE OMAHA NE 68105 SOFTWARE SUPPORT 1980721 SS PSYCHIATRY GROUP 4110 HARGORD STREET GRAND ISLAND NE 68803 PSYCHIATRIC PHYSICIAN COVERAGE 1182079 SCOTT BELL MD PC 715 N KANSAS AVE SUITE 207 HASTINGS NE 68901 NEUROSURGEON 902000 38 971197 4216198 290643 5478038 ALL OTHER PATIENT REVE 621300 125302557 125302557 NET MEDICARE REVENUE 621300 59814297 59814297 NET MEDICAID REVENUE 621300 15326269 15326269 RADIOLOGY SCHOOL 621300 137433 137433 2906343 2906343 203486899 1360724 1360724 271675 0 271675 271675 271675 7932913 4189579 7834411 2312082 98502 1877497 1975999 1975999 202971 186329 16642 16642 CAFETERIA 722210 649034 649034 CATERING 722320 138080 138080 EXCEL 722320 14253 14253 -171991 267652 -439643 629376 213219353 203486899 419985 3834431 X 358656 358656 912792 912792 100209 100209 82655246 77221942 5433304 4027246 3753335 273911 20310988 18866454 1444534 5293214 4892091 401123 305937 305937 77082 77082 163104 163104 24573005 21673728 2899277 4623286 4403633 219653 3947575 3774163 173412 243685 230016 13669 1585 1585 1289132 1185634 103498 8241579 7282448 959131 1661369 1493787 167582 MEDICAL SUPPLIES 38636634 38625658 10976 BAD DEBT EXPENSE 7965861 7965861 FOOD EXPENSE 996645 822059 174586 REPAIRS 957184 887651 69533 1801135 1141819 659316 209143149 194679144 14464005 0 6750 3251534 8702849 22878277 23899742 215937 220137 2124162 2423297 5440424 5616250 2064251 2391406 197754231 134990733 61922666 62763498 74974936 55688666 60423414 67722612 1825440 5122626 3457837 238418227 234718484 20209882 23141777 211127 47535 16589156 14103145 2032813 1400426 10244976 8579589 21403311 5153304 70691265 52425776 X 118872979 129265278 48853983 53027430 167726962 182292708 238418227 234718484 X 4076204 6200098 47 4289397 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 0 0 1 14930 14930 0 PART II-B, LINE 1: A PORTION OF DUES PAID TO AHA, NHA AND NABHO ARE FOR LOBBYING PURPOSES. 43653512 4050230 47703742 44556774 -619651 283611 43653512 43777313 779461 44556774 45647223 -1869910 43777313 46342323 -695100 45647223 0.00000 1.00000 0.00000 0 1 1 4997408 4997408 106425048 70370798 36054250 77085594 63259767 13825827 9246181 1360168 7886013 62763498 JOINT VENTURES 8527849 F BENEFICIAL INTEREST IN FOUNDATION 12972373 F BENEFICIAL INTEREST IN TRUST 46222390 F 67722612 THIRD PARTY REIMBURSEMENT CONTRACTS 1225467 MALPRACTICE RESERVE 470000 DEFERRED COMPENSATION 3457837 5153304 X PART V, LINE 4: TEMPORARILY RESTRICTED FUNDS ARE HELD FOR CAPITAL ACQUISITION, SCHOLARSHIPS, EDUCATION AND COMMUNITY HEALTH CARE. PERMANENTLY RESTRICTED FUND ASSETS ARE HELD IN PERPETUITY WITH THE INCOME USED FOR HOSPITAL OPERATIONS, SCHOLARSHIPS AND RESEARCH. PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPITAL HAS RECEIVED A DETERMINATION LETTER THAT IT IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN TAX-EXEMPT STATUS. HMI IS A LIMITED LIABILITY COMPANY OF WHICH THE HOSPITAL OWNS AN 88.8% INTEREST. HMI IS TAXED UNDER THE PARTNERSHIP PROVISIONS OF THE INTERNAL REVENUE CODE. INCOME OF HMI IS REPORTED AND RESPECTIVE INCOME TAXES ARE PAID DIRECTLY BY THE MEMBERS. THE HOSPITAL ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES. THE HOSPITAL RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT DECEMBER 31, 2021 AND 2020, THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS ACCRUED. PART V, LINE 3A(II): MARY LANNING HEALTHCARE FOUNDATION AND MARY LANNING HOSPITAL TRUST HOLD ENDOWMENT FUNDS RESTRICTED TO DISTRIBUTION TO MARY LANNING HEALTHCARE. THESE FUNDS ARE REFLECTED ON MARY LANNING HEALTHCARE'S BALANCE SHEET IN "INVESTMENTS - OTHER SECURITIES AND ARE SHOWN ON SCHEDULE D, PART VII. THESE FUNDS ARE NOT UNDER THE CONTROL OF MARY LANNING HEALTHCARE. 1 1 X 1 X 125.000000000000 1 X 1 1 1 0 1 1 2129106 2129106 0.01060 25118327 14307799 10810528 0.05370 27247433 14307799 12939634 0.06430 30922 885371 35322 850049 0.00420 315 1210497 119380 1091117 0.00540 582 14193 14193 0.00010 2330 263188 0 263188 0.00130 34149 2373249 154702 2218547 0.01100 34149 29620682 14462501 15158181 0.07530 6787 0 6787 0.00000 75 36811 0 36811 0.00020 75 43598 43598 0.00020 1 7965861 2200000 41623973 57752409 -16128436 X 1 1 1 HASTINGS SURGICAL CENTER LLC SURGICAL CENTER 0.20830 0.00000 0.16330 2 HASTINGS MEDICAL IMAGING LLC MEDICAL IMAGING 0.88800 0.00000 0.11200 1 1 MARY LANNING HEALTHCARE 715 NORTH ST JOSEPH AVENUE HASTINGS NE 68901 WWW.MARYLANNING.ORG 010002 X X X X MARY LANNING HEALTHCARE 1 0 0 1 X X X X X X X X X 21 1 1 1 1 X HTTPS://WWW.MARYLANNING.ORG/ABOUT-US/COMMUNITY-NEEDS-ASSESSMENTS X 1 21 1 HTTPS://WWW.MARYLANNING.ORG/ABOUT-US/COMMUNITY-NEEDS-ASSESSMENTS 0 1 X 125.000000000000 200.000000000000 X X X X 1 1 X X X 1 X HTTPS://WWW.MARYLANNING.ORG/PATIENT-VISITOR-INFO/FINANCIAL-ASSISTANCE X HTTPS://WWW.MARYLANNING.ORG/PATIENT-VISITOR-INFO/FINANCIAL-ASSISTANCE X HTTPS://WWW.MARYLANNING.ORG/PATIENT-VISITOR-INFO/FINANCIAL-ASSISTANCE X X X X X X X 1 X 0 X X X X 1 X 0 0 MARY LANNING HEALTHCARE PART V, SECTION B, LINE 5: MARY LANNING HEALTHCARE (MLH) CONDUCTED ITS COMMUNITY HEALTH NEEDS ASSESSMENT IN 2021 USING THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) PROCESS. THIS WAS CONDUCTED IN PARTNERSHIP WITH THE SOUTH HEARTLAND DISTRICT HEALTH DEPARTMENT (SHDHD). THE COMMUNITY HEALTH NEEDS ASSESSMENT ENABLED MARY LANNING'S ADMINISTRATIVE TEAM AND BOARD OF TRUSTEES TO INCLUDE THE FINDINGS IN THE OVERALL STRATEGIC PLAN AND TO CREATE AN IMPLEMENTATION STRATEGY THAT IS IN ALIGNMENT WITH THE SHDHD'S CHIP (COMMUNITY HEALTH IMPROVEMENT PLAN) AS BOTH PLANS WORK TOGETHER TO ADDRESS THE NEEDS IN THE IDENTIFIED COMMUNITY. MARY LANNING HEALTHCARE PART V, SECTION B, LINE 6A: MEMBERS OF THE CORE TEAM FOR THE 2021 CHNA INCLUDED REPRESENTATIVES FROM BRODSTONE MEMORIAL HOSPITAL. MARY LANNING HEALTHCARE PART V, SECTION B, LINE 6B: OTHER NON-HOSPITAL ORGANIZATIONS INCLUDED: -SOUTH HEARTLAND DISTRICT HEALTH DEPARTMENT -THE NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES -UNITED WAY OF SOUTH CENTRAL NEBRASKA MARY LANNING HEALTHCARE PART V, SECTION B, LINE 11: THE HOSPITAL IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED THROUGH THE INITIAL MAPP ASSESSMENT IN 2018. THE 2021 MINI-MAPP PROCESS HELPED IDENTIFY AND VALIDATE THE PREVIOUSLY DETEMINED COMMUNITY NEEDS. THE PROCESS OF THE MINI MAPP IN 2021 AGAIN IDENTITIFED THE SAME FIVE AREAS OF NEED AND THESE AREAS WILL CONTINUE TO BE A PRIORITY FOR MARY LANNING HEALTHCARE.MARY LANNING PARTNERED WITH THE SOUTH HEARTLAND DISTRICT HEALTH DEPARTMENT TO COORDINATE OUR IMPLEMENTATION PLAN WITH THEIR COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). A STEERING COMMITTEE FOR EACH OF THE FIVE GOAL AREAS MEETS BI-ANNUALLY. FROM THAT COMMITTEE, A SUBCOMMITTEE OF EMPLOYEES FROM BOTH ORGANIZATIONS AND MEMBERS OF THE COMMUNITY IS FORMED. THE SUBCOMMITTEE MEETS REGULARLY TO ACCOMPLISH THESE GOALS. THE MARY LANNING TEAM ALSO CONTINUED TO UPDATE AND PROVIDE SERVICES IN THE FIVE AREAS OF NEED. HIGHLIGHTS FROM EACH AREA OF NEED INCLUDE THE FOLLOWING: OBESITY AND RELATED HEALTH CONDITIONS: MLH IS COMMITTED TO PROVIDING ACTIVITIES, EDUCATION AND ASSESSMENT TO ASSIST COMMUNITY MEMBERS WITH THE TOOLS AND RESOURCES FOR BETTER DISEASE PREVENTION AND SELF MANAGEMENT THROUGH THE FOLLOWING ACTIONS: CREATING A CHRONIC CARE MANAGEMENT POSITION, ESTABLISHING A DIABETES REGISTRY, OFFERING AT LEAST ONE DIABETES PREVENTION CLASS PER YEAR AND ENSURING THE CARDIAC AND PULMONARY REHAB PATIENTS COMPLETE EDUCATION FOCUSED ON THEIR DIAGNOSED DISEASE STATE AMONG OTHER ACTIVITIES. CANCER: MLH IS COMMITTED TO DECREASING THE INCIDENCE OF CANCER BY PROVIDING LIMITED SKIN SCREENINGS AT HEALTH FAIRS AND FOR EMPLOYEES, COORDINATING AN EVENT TO ADDRESS OVERALL WOMEN'S HEALTH, SEEKING FUNDS TO SUPPLY ORAL CHEMOTHERAPY FOR PATIENTS WHOSE COVERAGE DOES NOT PAY, ESTABLISHING A MAMMOGRAM REGISTRY AND ESTABLISHING A SYSTEM TO NOTIFY PATIENTS OF UPCOMING PREVENTATIVE SCREENINGS AT THE FIRST YEAR OF ELIGIBILITY. MENTAL HEALTH: MLH IS COMMITTED TO PROVIDE EDUCATION AND SCREENINGS IN CLINIC AND COACHING SETTINGS FOR BETTER MENTAL HEALTH ASSESSMENT AND SELF-CARE BY THE FOLLOWING ACTIONS: ESTABLISHING TRACKING MECHANISMS TO DEMONSTRATE THE USAGE OF MENTAL HEALTH RESOURCES, ESTABLISHING INSOMNIA PATHWAY AT HASTINGS FAMILY CARE, DEVELOPING A STRESS QUESTIONNAIRE TO PUT IN INITIAL EVALUATION PACKETS AND OTHER ACTIONS. SUBSTANCE MISUSE: MLH IS COMMITTED TO PROVIDING EDUCATION AND RESOURCES TO 100% OF HEALTHY BEGINNINGS CLIENTS WHO HAVE BEEN IDENTIFIED AS POTENTIAL OR CONFIRMED AT RISK FOR SUBSTANCE MISUSE, DEVELOPING A PRESENTATION ON SUBSTANCE MISUSE/MENTAL HEALTH TARGETED AT 8TH GRADERS AND INCORPORATING A HUMAN TRAFFICKING ASSESSMENT IN THE EMERGENCY ROOM. ACCESS TO CARE: MLH IS COMMITTED TO DEVELOPING A STRATEGY TO ENCOURAGE ACCESS TO SPECIALTY SERVICES BY EXPLORING TELEMEDICINE OUTREACH AND PROVIDING EDUCATION ABOUT HOME CARE SERVICES TO AT LEAST TWO COMMUNITY GROUPS EVERY QUARTER. MLH IS ALSO SEEKING TO INCREASE THE AVAILABILITY OF URGENT CARE IN THE CLINIC, AS WELL AS INCREASING THE PATIENTS ABILITY TO MANAGE THEIR OWN CARE. PRIORITIZED NEEDS STAKEHOLDERS IN THE 2018 MAPP PROCESS WERE ASKED TO RANK ALL NEEDS ON A SCALE TO DETERMINE PRIORITY AREAS. THE TOP FIVE RANKED AREAS THROUGH THIS PROCESS WERE: ACCESS TO CARE, MENTAL HEALTH, SUBSTANCE MISUSE, OBESITY AND RELATED HEALTH CONDITIONS AND CANCER. DURING THE 2021 MINI-MAPP PROCESS THESE AREAS OF NEED WERE VALIDATED THROUGH THE DATA COLLECTION AND REVIEW PROCESS. MARY LANNING HEALTHCARE PART V, SECTION B, LINE 16J: THE FULL POLICY IS AVAILABLE UPON REQUEST, FREE OF CHARGE, AS WELL AS ON THE HOSPITAL'S WEBSITE. A SUMMARY OF THE POLICY AND CONTACT INFORMATION IS POSTED ON MARY LANNING HEALTHCARE'S WEBSITE, PRINTED ON BILLING STATEMENTS, POSTED IN ALL ADMISSION AREAS AND PROVIDED IN WRITING TO ALL PATIENTS UPON CHECK IN. 14 1 - HASTINGS ORTHOPEDICS 2207 OSBORNE DR WEST STE 100 HASTINGS NE 68901 OUTPATIENT CLINIC 2 - HASTINGS FAMILY CARE 223 E 14TH STREET STE 100 HASTINGS NE 68901 OUTPATIENT CLINIC 3 - CENTRAL NE UROLOGY 2115 N KANSAS AVENUE STE 108 HASTINGS NE 68901 OUTPATIENT CLINIC 4 - CENTRAL NE UROLOGY 620 N ALPHA ST GRAND ISLAND NE 68803 OUTPATIENT CLINIC 5 - LANNING CENTER 815 S BURLINGTON AVENUE HASTINGS NE 68901 OUTPATIENT CLINIC 6 - CENTRAL NE GENERAL SURGERY 715 N KANSAS AVENUE STE 205 HASTINGS NE 68901 OUTPATIENT CLINIC 7 - HASTINGS PULMONARY & SLEEP 715 N KANSAS AVENUE STE 101 HASTINGS NE 68901 OUTPATIENT CLINIC 8 - CENTRAL NE FAMILY CARE 3016 W FAIDLEY AVE GRAND ISLAND NE 68803 OUTPATIENT CLINIC 9 - COMMUNITY HEALTH CENTER 606 N MINNESOTA AVENUE STE 1 HASTINGS NE 68901 OUTPATIENT CLINIC 10 - CENTRAL NE PAIN CENTER 715 N KANSAS AVENUE STE 202 HASTINGS NE 68901 OUTPATIENT CLINIC 11 - INSPIRED BRAIN & SPINE SURGERY 715 N KANSAS AVE STE 207 HASTINGS NE 68901 OUTPATIENT CLINIC 12 - WOUND CENTER 715 N KANSAS AVE STE 302 HASTINGS NE 68901 OUTPATIENT CLINIC 13 - BLUE HILL CLINIC 102 N PINE STREET BLUE HILL NE 68930 OUTPATIENT CLINIC 14 - MIDWEST COSMETIC & WOUND SURGERY 715 N KANSAS AVE STE 206 HASTINGS NE 68901 OUTPATIENT CLINIC PART I, LINE 3C: THE ORGANIZATION ONLY USED FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR FREE AND DISCOUNTED CARE. PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT IS NOT PREPARED BY A RELATED ORGANIZATION. PART I, LINE 7: THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE WAS A COST-TO-CHARGE RATIO. THE RATIO WAS DERIVED FROM WORKSHEET 2. PART I, LINE 7G: THE HOSPITAL DOES NOT REPORT ANY SUBSIDIZED HEALTH SERVICES ON LINE 7(G). PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $7,965,861. PART II, COMMUNITY BUILDING ACTIVITIES: HASTINGS FAMILY CARE, A CLINIC OF MLH, HOSTED PROJECT SEARCH STUDENTS FOR AN EIGHT WEEK ROTATION SO THAT THEY MAY GAIN JOB SKILLS TO PREPARE THEM FOR FUTURE JOB OPPORTUNITIES. PART III, LINE 2: GENERALLY, PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR RELATED DEDUCTIBLES AND COINSURANCE, WHICH VARY IN AMOUNT. THE HOSPITAL PROVIDES SERVICES TO UNINSURED PATIENTS, AND OFFERS THOSE UNINSURED PATIENTS A DISCOUNT, EITHER BY POLICY OR LAW, FROM STANDARD CHARGES. THE HOSPITAL ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS AND IMPLICIT PRICE CONCESSIONS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF CHANGE.FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020, NO SIGNIFICANT ADJUSTMENTS TO REVENUE WERE RECOGNIZED DUE TO CHANGES IN ESTIMATES OF IMPLICIT PRICE CONCESSIONS FOR PERFORMANCE OBLIGATIONS SATISFIED IN PRIOR YEARS. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE. PART III, LINE 3: IN ACCORDANCE WITH ITS MISSION OBJECTIVES, THE HOSPITAL PROVIDES FREE CARE TO PATIENTS WHO LACK FINANCIAL RESOURCES TO PAY FOR THE SERVICES THEY RECEIVE. IT IS THE POLICY OF THE HOSPITAL NOT TO PURSUE COLLECTION OF AMOUNTS DETERMINED TO BE PATIENT FINANCIAL ASSISTANCE. ACCORDINGLY, THE HOSPITAL DOES NOT REPORT THESE AMOUNTS IN PATIENT SERVICE REVENUE. THE ESTIMATED COST INCURRED BY THE HOSPITAL TO PROVIDE THESE SERVICES TO PATIENTS WHO ARE UNABLE TO PAY WAS APPROXIMATELY $2,200,000 AND $3,500,000 FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020, RESPECTIVELY. THE ESTIMATED COST OF THESE SERVICES WAS DETERMINED USING A RATIO OF COSTS TO STANDARD CHARGES AND APPLYING THAT RATIO TO THE STANDARD CHARGES ASSOCIATED WITH PROVIDING CHARITY CARE FOR THE PERIOD. STANDARD CHARGES ASSOCIATED WITH PROVIDING CARE TO CHARITY PATIENTS INCLUDES ONLY THE RELATED CHARGES FOR THOSE PATIENTS WHO ARE FINANCIALLY UNABLE TO PAY AND AND QUALIFY UNDER THE HOSPITAL'S PATIENT FINANCIAL ASSISTANCE/CHARITY CARE POLICY AND THAT DO NOT OTHERWISE QUALIFY FOR REIMBURSEMENT FROM A GOVERNMENTAL PROGRAM. PART III, LINE 4: THE COSTING METHODOLOGY USED IN DETERMINING THE BAD DEBT EXPENSES INCLUDES CALCULATING ON A MONTHLY BASIS THE TOTAL ESTIMATED AMOUNTS BASED ON HISTORICAL WRITE OFFS.THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT CONTAIN A SPECIFIC FOOTNOTE DESCRIBING BAD DEBT. FOOTNOTES TITLED "PATIENT RECEIVABLES," "PATIENT SERVICE REVENUE, AND "FINANCIAL ASSISTANCE/CHARITY CARE" CAN BE FOUND ON PAGES 8, 10 AND 11 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: FOR-PROFIT SPECIALITY HOSPITALS HAVE BEEN CARVING OUT CERTAIN HIGH-MARGIN SERVICES, LEAVING GENERAL ACUTE CARE HOSPITALS WITH LOWER-MARGIN MEDICARE SERVICES. THIS INDICATES THAT MEDICARE LOSSES CAN BE A RESULT OF RENDERING THESE LOWER-MARGIN SERVICES RATHER THAN INEFFICIENT OPERATIONS. ALL OF THE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT. PART III, LINE 9B: ACCOUNTS WILL BE SCREENED FOR APPROPRIATE REFERRAL TO FINANCIAL ASSISTANCE VS. BAD DEBT WRITE OFF DURING THE COLLECTION PROCESS. THE FINANCIAL ASSISTANCE POLICY DOES INCLUDE PROVISION FOR IMPLIED CHARITY CARE IF THERE IS SUFFICIENT KNOWLEDGE TO DETERMINE THAT THE PATIENT MEETS THE QUALIFYING FACTORS OF THE PROGRAM. PART VI, LINE 2: IN ADDITION TO THE STANDARD CHNAS CONDUCTED USING THE MAPP (2012, 2018) OR MINI-MAPP (2015, 2021), MARY LANNING UTILIZES OTHER METHODS OF ASSESSING THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES. IN PARTNERSHIP WITH THE SOUTH HEARTLAND DISTRICT HEALTH DEPARTMENT (SHDHD), THE 2018 CHNA INCLUDED A NEW SPECIAL FOCUS ON ACCESS TO CARE, TO INCLUDE FOCUS GROUPS WITH HEALTH SYSTEM USERS (IN ENGLISH AND SPANISH) AND FOCUS GROUPS WITH HEALTH SYSTEM PROVIDERS AND COMMUNITY LEADERS. THE OVERALL GOAL OF THIS SPECIAL FOCUS WAS TO IDENTIFY GAPS IN HEALTH SERVICES AND BARRIERS TO ACCESSING HEALTH CARE. IN 2021, MARY LANNING HAD A SPECIAL FOCUS ON MINORITY HEALTH ASSESSMENTS AND THE IMPACT OF THE PANDEMIC ON ACCESS TO SERVICES AND HEALTH BEHAVIORS. MARY LANNING ALSO PARTNERS WITH THE SHDHD ON AN ONGOING BASIS TO ASSESS OR RECEIVE ASSESSMENT REPORTS ON SPECIFIC HEALTH NEEDS, SUCH AS SKIN CANCER, TO SUPPORT PLANNING AND IMPLEMENTATION OF COMMUNITY OUTREACH PROGRAMS, SUCH AS FOR SKIN CANCER PREVENTIVE SCREENING OPPORTUNITIES. CLINICS ARE ALSO UTILIZING CLIENT/PATIENT POPULATION DATA REPORTED FROM THE ELECTRONIC HEALTH RECORDS TO UNDERSTAND THE NEEDS OF PATIENTS (SUCH AS HYPERTENSION MANAGEMENT OR PRE-DIABETES) AND ADDRESSING THESE NEEDS IN PART THROUGH PARTNERSHIPS WITH, AND REFERRALS TO, EVIDENCE-BASED COMMUNITY PROGRAMS. PART VI, LINE 3: MLH INFORMS AND EDUCATES PATIENTS BY POSTING SIGNS IN ALL ADMISSION AREAS AND PATIENT ROOMS. BROCHURES ARE AVAILABLE IN ADMISSION AREAS. ALL NON-INSURED INPATIENTS ARE PERSONALLY VISITED AND PATIENTS MAY HAVE DISCUSSIONS WITH A FINANICAL COUNSELOR AT ANYTIME DURING THE BILLING/COLLECTION PROCESS. PART VI, LINE 4: MLH'S PRIMARY SERVICE AREA IS ADAMS COUNTY WITH A SECONDARY AREA INCLUDING MERRICK, HALL, HAMILTON, KEARNEY, CLAY, FRANKLIN, WEBSTER, AND NUCKOLLS COUNTIES. THE ESTIMATED POPULATION OF ADAMS COUNTY IS 35,000 AND THE SECONDARY SERVICE AREA IS 93,000. ADAMS COUNTY IS 563 SQ. MILES. FIFTEEN PERCENT OF THE POPULATION IN ADAMS COUNTY IS MEDICARE AGE OR OLDER. PART VI, LINE 5: MARY LANNING CURRENTLY PROMOTES HEALTH IN THE COMMUNITY THROUGH OUTREACH TO A WIDE VARIETY OF COMMUNITY ORGANIZATIONS. MUCH FOCUS IS ALREADY PLACED ON THE FIVE PRIORITY NEED AREAS IDENTIFIED IN THE CHNA. MANY DEPARTMENTS WITHIN MARY LANNING PARTICIPATE IN COMMUNITY COALITIONS, PROVIDE OUTREACH TO WORKSITES AND COMMUNITY MEMBERS INCLUDING MINORITIES AND LOW INCOME GROUPS, EDUCATE AND PROVIDE LOW COST OR NO COST SCREENINGS AND CARE. PART VI, LINE 6: MARY LANNING IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. 1 MARY LANNING HEALTHCARE FOUNDATION 741 N DENVER AVE HASTINGS NE 68901 470800042 501(C)(3) 358656 0 TO ASSIST WITH THE OPERATING COSTS OF FUNDRAISING. 1 0 PART I, LINE 2: MARY LANNING HEALTHCARE ONLY MAKES CONTRIBUTIONS AND GRANTS TO CHARITABLE OR GOVERNMENTAL TAX EXEMPT ENTITIES. THE HOSPITAL VERIFIES THE TAX EXEMPT STATUS OF THE GRANT RECIPIENTS PRIOR TO MAKING THE GRANT. TERMS OF THE GRANT STATE THAT THE FUNDS ARE ONLY TO BE USED FOR CHARITABLE PURPOSES. X X 0 0 X X X 1 1 0 0 0 0 0 1 0 BRENT HOOD PHYSICIAN 1118940 0 532245 0 630 0 11600 0 38945 0 1702360 0 0 0 MEHMET COPUR PHYSICIAN 858435 0 0 0 2772 0 11600 0 14756 0 887563 0 0 0 KALPESH GANATRA PHYSICIAN 597216 0 230150 0 630 0 9460 0 38945 0 876401 0 0 0 BARRY BOHLEN PHYSICIAN THRU 02/21 490192 0 349093 0 372 0 11600 0 6482 0 857739 0 0 0 ERIC BARBER PRESIDENT/CEO 488167 0 92604 0 630 0 11600 0 37275 0 630276 0 77112 0 ZACH FREY PHYSICIAN 404999 0 168465 0 251 0 11600 0 38261 0 623576 0 0 0 SHAWN NORDBY CHIEF FINANCIAL OFFICER 220454 0 27347 0 307 0 10264 0 24144 0 282516 0 0 0 MICHAEL ALLEN TREASURER 0 127288 0 27470 0 0 0 6412 0 27357 0 188527 0 0 PART I, LINE 1A HEALTH OR SOCIAL CLUB DUES: A COUNTRY CLUB MEMBERSHIP IS PROVIDED TO ERIC BARBER AND SHAWN NORDBY FOR PERSONAL USE. THE VALUE OF THE MEMBERSHIP WAS INCLUDED AS TAXABLE WAGES IN THEIR 2021 W-2'S. CHAUFFEUR: VEHICLES OWNED BY MARY LANNING HEALTHCARE AND DRIVERS EMPLOYED BY THE HOSPITAL ARE MADE AVAILABLE TO PHYSICIANS WHO CHOOSE TO USE THEM FOR TRAVEL TO CLINICS IN OTHER CITIES. SUCH TRAVEL IS STRICTLY FOR HOSPITAL BUSINESS PURPOSES, AND THE PROVISION OF CARS AND DRIVERS ENABLES THE PHYSICIANS TO PERFORM VARIOUS ADMINISTRATIVE TASKS DURING THE TRAVEL TIME. PHYSICIANS ARE NOT REQUIRED TO "ACCOUNT" TO THE HOSPITAL FOR THE NUMBER OF MILES DRIVEN, AS THE ENTIRE TRAVEL COST IS A HOSPITAL BUSINESS EXPENSE. PART I, LINES 4A-B THE HOSPITAL CONTRIBUTED $95,000 TO A 457(F) ACCOUNT FOR ERIC BARBER. HE ALSO RECEIVED A DISTRIBUTION FROM A 457(F) ACCOUNT OF $77,112. DR. BARRY BOHLEN RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $244,998. PART I, LINE 7 THE PRESIDENT/CEO OF THE ORGANIZATION'S EMPLOYMENT AGREEMENT PROVIDES FOR UP TO A 20% DISCRETIONARY BONUS. A HOSPITAL AUTHORITY NO 1 OF ADAMS COUNTY NE 470762824 2015-08-27 28335905 RENOVATIONS & REFUND ISSUE (7/1/08) 0 0 0 A 14126680 28812743 7500327 21312417 2017 0 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 1 1 0 0 0 0 A 0 SCHEDULE K, PART IV, LINE 2C: (A) ISSUER NAME: HOSP AUTHORITY NO. 1 OF ADAMS COUNTY NE DATE THE REBATE COMPUTATION WAS PERFORMED: 07/31/2018 NOTE REGARDING THE REBATE COMPUTATION ON 7/31/2018: SINCE THE BOND PROCEEDS HAVE BEEN SPENT AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CALCULATIONS ARE NECESSARY. PART II, LINE 3: THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS. ERIC BARBER PRESIDENT/CEO OF ORGANIZATION FORGIVABLE LOAN X 200000 220137 0 1 1 220137 MONICA NORDBY EMPLOYEE OF ORGANIZATION AND SPOUSE OF SHAWN NORDBY, CFO 89010 EMPLOYEES W-2 WAGES & BENEFITS 0 ALEXIS NORDBY EMPLOYEE OF ORGANIZATION AND DAUGHTER OF SHAWN NORDBY, CFO 11199 EMPLOYEE W-2 WAGES 0 FORM 990, PART IV, LINE 13: FORM 990, PART IV, LINE 13 IS ANSWERED "NO" BECAUSE MARY LANNING HEALTHCARE'S PRIMARY PROGRAM SERVICE IS THE PROVISION OF MEDICAL CARE THROUGH ITS HOSPITAL. HOWEVER, IT ALSO CONDUCTS A NURSING SCHOOL IN CONJUNCTION WITH BRYAN COLLEGE OF HEALTH SCIENCES AND A RADIOLOGY SCHOOL. SCHEDULE E HAS NOT BEEN PREPARED BECAUSE THE ORGANIZATION DOES NOT CHECK BOX 2, PART I OF SCHEDULE A TO INDICATE IT IS A "SCHOOL". BOTH THE NURSING SCHOOL AND THE RADIOLOGY SCHOOL ARE OPERATED ON A NONDISCRIMINATORY BASIS. FORM 990, PART VI, SECTION A, LINE 2 MICHELE BEVER, VICE-CHAIR, AND JANIS JOHNSON, TRUSTEE, SHARE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF FORM 990 WAS PROVIDED TO THE MEMBERS OF THE BOARD ELECTRONICALLY AND WAS REVIEWED BY THOSE MEMBERS PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, TRUSTEES, COMMITTEE MEMBERS AND KEY EMPLOYEES MUST ANNUALLY REVIEW AND COMPLETE A CONFLICT SURVEY AND SIGN A CONFLICT OF INTEREST STATEMENT. AS PER THE POLICY, ANY POTENTIAL CONFLICT OF INTEREST MUST BE DISCLOSED AND MADE A MATTER OF RECORD. ANY PERSON WITH A POSSIBLE CONFLICT OF INTEREST IN ANY MATTER SHOULD NOT VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE PRESIDENT/CEO'S COMPENSATION IS REVIEWED BY THE FULL BOARD OF TRUSTEES ANNUALLY. TARGETS ARE SET AND COMPENSATION IS APPROVED. ON FEBRUARY 25, 2020, THE BOARD PRESIDENT AND TREASURER CONSULTED WITH KATHY NOLAN REGARDING THE REASONABLENESS OF CEO COMPENSATION. MS. NOLAN OFFERED HER RECOMMENDATION ON MARCH 3, 2020. IT IS THE BOARD'S GOAL TO REVIEW CEO COMPENSATION IN DETAIL A MINIMUM OF EVERY THIRD YEAR. FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST THROUGH MARY LANNING HEALTHCARE'S ADMINISTRATIVE OFFICES. FORM 990, PART VII, SECTION A, COLUMN B: MICHAEL ALLEN IS EMPLOYED BY MARY LANNING TRUST, A RELATED ENTITY. FORM 990, PART IX, LINE 11G PROFESSIONAL MEDICAL FEES: PROGRAM SERVICE EXPENSES 4,301,295. MANAGEMENT AND GENERAL EXPENSES 52,216. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,353,511. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 17,372,433. MANAGEMENT AND GENERAL EXPENSES 2,847,061. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,219,494. FORM 990, PART XI, LINE 9: ELIMINATED EXPENSES -774,651. CHANGE IN BENEFICIAL INTEREST OF FOUNDATION 1,813,818. CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUSTS 3,250,230. FORM 990, PART XI, LINE 2C: THE BOARD OF TRUSTEES OF THE ORGANIZATION ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MARY LANNING HEALTHCARE FOUNDATION 741 N DENVER AVE HASTINGS NE 68901 470800042 FUNDRAISING ACTIVITIES NE 501(C)(3) LINE 12A, I THE MARY LANNING HOSPITAL ASSOCIATION 1 MARY LANNING HOSPITAL TRUST 122 N HASTINGS AVE HASTINGS NE 68901 476000224 INVESTMENT MANAGEMENT NE 501(C)(3) LINE 12B, II THE MARY LANNING HOSPITAL ASSOCIATION 1 HASTINGS MEDICAL IMAGING LLC 715 N ST JOSEPH AVE HASTINGS NE 68901 851318481 RADIOLOGY EXAMS NE THE MARY LANNING HOSPITAL ASSOCIATION RADIOLOGY -389466 0 1 0.88000 0 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 MARY LANNING HEALTHCARE FOUNDATION B 358656 CASH TRANSFER MARY LANNING HEALTHCARE FOUNDATION C 171197 CASH TRANSFER MARY LANNING HOSPITAL TRUST C 800000 CASH TRANSFER