CHADRON COMMUNITY HOSPITAL CORP: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- CHADRON COMMUNITY HOSPITAL CORP (EIN 47-0482234)
- Tax period
- 2019-10-01 to 2020-09-30
- Filed
- 2021-08-16
- IRS object ID
- 202142289349300839
- Schema version
- 2019v5.2
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-08-16T14:52:03-05:00 | ReturnTs |
| Tax Period End | 2020-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 460403496 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CASEY PETERSON LTD | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 909 ST JOSEPH ST STE 101 | AddressLine1Txt |
| City | RAPID CITY | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470482234 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHADRON COMMUNITY HOSPITAL CORPORATION | BusinessNameLine1Txt |
| Business Name Line2 | SERVICES | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHAD | BusinessNameControlTxt |
| Phone | 3084320286 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 825 CENTENNIAL DRIVE | AddressLine1Txt |
| City | CHADRON | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 69337 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NATHAN HOUGH | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 3084320286 | PhoneNum |
| Signature | 2021-08-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KAYLA GIESEY CPA | PreparerPersonNm |
| PTIN | P01874520 | PTIN |
| Phone | 6053481930 | PhoneNum |
| Preparation | 2021-08-16 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHADRON COMMUNITY HOSPITAL AND HEALTH SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | NATHAN HOUGH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 825 CENTENNIAL DRIVE | AddressLine1Txt |
| City | CHADRON | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 69337 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $27,495,571 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTPS://WWW.CHADRONHOSPITAL.COM/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1957 | FormationYr |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE AND SUPPORT HEALTH CARE AND COMMUNITY SERVICE PROGRAMS OF EXCELLENCE IN THE COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 258 | TotalEmployeeCnt |
| Total Volunteers | 34 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,048,155 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,214,482 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $24,529,830 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $26,037,907 | CYProgramServiceRevenueAmt |
| PY Investment Income | $14,063 | PYInvestmentIncomeAmt |
| CY Investment Income | $20,490 | CYInvestmentIncomeAmt |
| PY Other Revenue | $234,338 | PYOtherRevenueAmt |
| CY Other Revenue | $215,434 | CYOtherRevenueAmt |
| PY Total Revenue | $26,826,386 | PYTotalRevenueAmt |
| CY Total Revenue | $27,488,313 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $82,662 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $49,278 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $11,810,975 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,275,150 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $15,946 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $14,557,187 | PYOtherExpensesAmt |
| CY Other Expenses | $14,629,926 | CYOtherExpensesAmt |
| PY Total Expenses | $26,450,824 | PYTotalExpensesAmt |
| CY Total Expenses | $26,954,354 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $375,562 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $533,959 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $25,168,478 | TotalAssetsBOYAmt |
| Total Assets EOY | $35,177,876 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $16,826,159 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $26,301,598 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $8,342,319 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,876,278 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE AND SUPPORT HEALTH CARE AND COMMUNITY SERVICE PROGRAMS OF EXCELLENCE IN THE COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $24,950,928 | ExpenseAmt |
| Grant | $49,278 | GrantAmt |
| Revenue | $26,257,309 | RevenueAmt |
| Desc | CHADRON COMMUNITY HOSPITAL CORPORATION OFFERS ACCESS TO CARE. INDIVIDUALS SHALL BE ACCORDED IMPARTIAL ACCESS TO TREATMENT OR ACCOMMODATIONS THAT ARE AVAILABLE, AND MEDICALLY INDICATED, REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, RELIGION, ABILITY TO PAY, OR SOURCES OF PAYMENT FOR CARE. DURING THE FISCAL YEAR CHADRON COMMUNITY HOSPITAL CORPORATION PROVIDED INPATIENT SERVICES AS FOLLOWS: PATIENT DAYS ADULT AND PEDIATRICS 1204 SWING BED - SKILLED 358 NURSERY 156 TOTAL 1718 CHADRON COMMUNITY HOSPITAL CORPORATION EMERGENCY ROOM TREATED 2175 PATIENTS AND 424 SURGICAL PROCEDURES WERE PERFORMED IN THE SURGERY AREA. IN ADDITION TO PROVIDING DIRECT INPATIENT AND OUTPATIENT SERVICES, CHADRON COMMUNITY HOSPITAL PROVIDED OUR COMMUNITY/COUNTY RESIDENTS ACCESS TO A VARIETY OF SPECIALISTS. THE FOLLOWING TYPES OF SPECIALTY CLINICS AND SERVICES WERE PROVIDED: CARDIOLOGY, ORTHOPEDICS, EAR, NOSE AND THROAT, UROLOGY, INTERNAL MEDICINE, DERMATOLOGY, VASCULAR, OPHTHALMOLOGY, AND PODIATRY. THE FOLLOWING COMMUNITY SERVICES WERE PROVIDED AT A MINIMAL OR NO COST BASIS: 1. REGISTERED NURSE SUPPORT WAS PROVIDED TO OUR AREA FIRE AND RESCUE VOLUNTEERS AND LOCAL LAW ENFORCEMENT OFFICERS AND TEACHERS TO ADMINISTER VACCINATIONS.2. OUR HOME HEALTH PROFESSIONALS PROVIDE PRO TIME TESTING TO VETERANS, FREE OF CHARGE.3. HOME HEALTH PROFESSIONALS PROVIDE PRENATAL HOME VISITS TO NEWBORNS WITHIN DAWES/SIOUX AND SHERIDAN COUNTIES.4. WE PROVIDED FREE DIETARY COUNSELING SERVICES AND EDUCATION FOR DIABETIC AND LOW INCOME FAMILIES.5. MAMMOGRAPHY SERVICES ARE OFFERED TO WOMEN AT A GREATLY REDUCED PRICE, THROUGH THE EVERY WOMAN MATTERS PROGRAM.6. MEETING ROOMS ARE PROVIDED FREE OF CHARGE TO ALL OUTSIDE SERVICE ORGANIZATIONS WHO ARE PROMOTING GOOD HEALTH.7. WE PROVIDE HEALTH CARE PROFESSIONALS TO SPEAK AT VARIOUS ORGANIZATIONS/MEETING TO HELP EDUCATE AND PROMOTE HEALTH CARE CONCERNS AND ISSUES, FREE OF CHARGE. 8. COMMUNITY PRENATAL/MATERNITY CLASSES ARE PROVIDED AT NO COST TO ENSURE AVAILABILITY TO THESE SERVICES FOR THOSE WHO CANNOT AFFORD THE CLASS. PROFESSIONAL STAFF ARE PAID THEIR REGULAR SALARY FOR THESE SERVICES.9. CHADRON COMMUNITY HOSPITAL PROVIDES RECRUITMENT ASSISTANCE TO THE LOCAL COMMUNITY IN EFFORTS TO ATTRACT AND RETAIN NEEDED PRIMARY/FAMILY PRACTICE PHYSICIANS.10. STAFF HAS CONDUCTED NUMEROUS EDUCATIONAL PROGRAMS FOR THE SENIOR CITIZEN CENTER AND VARIOUS SERVICE ORGANIZATIONS INFORMING THEM OF THE ADVANCED DIRECTIVE PROGRAM AND THE VARIOUS PROPOSED HEALTH CARE BILLS.11. ADMINISTRATION HAS PROVIDED THE LOCAL/COUNTY RESIDENTS WITH NUMEROUS PUBLICATIONS PRINTED IN THE LOCAL NEWSPAPERS DEALING WITH ALL ASPECTS OF HEALTH CARE, TO INCLUDE THE RIGHTS AFFORDED TO ALL MEDICARE RECIPIENTS.12. A FOOD PANTRY IS OFFERED TO AREA RESIDENTS THAT HAVE UNIQUE CIRCUMSTANCES AND ARE NOT ELIGIBLE FOR OTHER FOOD ASSISTANCE.13. HOSPITAL STAFF VOLUNTEERS AT THE LOCAL SOUP KITCHEN "CLOSER TO HOME" ON A MONTHLY BASIS.14. OCCUPATIONAL THERAPY STAFF HAS ORGANIZED A BRAIN INJURY SUPPORT GROUP.15. THE HOSPITAL PURCHASED AN AED DEVICE AND PROVIDED TRAINING FOR THE COMMUNITY WELLNESS CENTER.16. THE HOSPITAL CONTRIBUTED TO THE FUNDING FOR THE COMMUNITY WELLNESS CENTER PROJECT.17. THE HOSPICE PROGRAM OFFERS REMEMBRANCE CEREMONIES TO ASSIST COMMUNITY MEMBERS IN DEALING WITH GRIEF.18. THE HOSPITAL PROVIDES ASSISTANCE TO AREA CANCER PATIENTS FOR MEDICAL EXPENSES THROUGH A PROGRAM CALLED "CIRCLE OF LIGHT".19. THE HOSPITAL DISTRIBUTES SAFETY INFORMATION TO AREA RESIDENTS VIA THE SCHOOLS AND LOCAL BUSINESSES.20. THE HOSPITAL PROVIDED COMMUNITY ACCESS TO FREE COVID TESTING, BEGINNING IN THE SUMMER OF 2020. | Desc |
| Total Program Service Expenses | $24,950,928 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| 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 | 0 | 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 | 70 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 258 | 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 | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | 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 | 0 | 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 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3084320286 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 825 CENTENNIAL DRIVE | AddressLine1Txt |
| City | CHADRON | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 69337 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| KERRY BAILEY | |||||||
| PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DAVID KAY | |||||||
| 1ST VICE PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| CURT PLOOSTER | |||||||
| 2ND VICE PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LARRY JOHNSON | |||||||
| SECRETARY/TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LEEANN FERLEY | |||||||
| PAST PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ROB BILA | |||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| RUTH HAMAKER | |||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MARY HANSEN | |||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JERRY MCCANCE | |||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JAMES NERUD | |||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MIKE PROVANCE | |||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| SHARON RICKENBACH | |||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| SHELLEY GRAVES | |||||||
| PHARMACY DIRECTOR | 40.00 | $153,633 | $0 | $16,011 | Yes (X) | ||
| LISA MILBURN | |||||||
| PHARMACIST | 40.00 | $117,442 | $0 | $15,078 | Yes (X) | ||
| KEITH BLAYLOCK | |||||||
| REHAB DIRECTOR | 40.00 | $120,396 | $0 | $13,470 | Yes (X) | ||
| JENNIFER FIELD | |||||||
| PHARMACIST | 40.00 | $121,244 | $0 | $4,667 | Yes (X) | ||
| BRENDA JOHNSON | |||||||
| NURSE PRACTITIONER | 40.00 | $117,083 | $0 | $5,233 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $629,798 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $54,459 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | 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 |
|---|---|---|---|---|---|
| REGIONAL WEST | |||||
| 4021 AVE B | SCOTTSBLUFF | NE | 69361 | HEALTHCARE AND MANAGEMENT SERVICES | $678,783 |
| CHADRON MEDICAL CLINIC | |||||
| PO BOX 431 | CHADRON | NE | 69337 | PROVIDER SERVICES | $640,491 |
| RURAL PARTNERS IN MEDICINE LLC | |||||
| 11880 AIRPORT WAY | BROOMFIELD | CO | 80021 | PROVIDER SERVICES | $465,360 |
| FOCUSONE SOLUTIONS LLC | |||||
| 13609 CALIFORNIA ST | OMAHA | NE | 68154 | LOCUM TENENS | $445,909 |
| SCHMITZ ANESTHESIA | |||||
| 180 BROWN RD | WHITNEY | NE | 69367 | CRNA SERVICES | $406,791 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $4,545 | FundraisingAmt |
| Government Grants | $700,313 | GovernmentGrantsAmt |
| All Other Contributions | $509,624 | AllOtherContributionsAmt |
| Total Contributions | $1,214,482 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | $23,643,213 | $23,643,213 |
| INDEPENDENT/ASSISTED LIVING APART | 623990 | $1,348,674 | $1,348,674 |
| WCHR PATIENT REVENUES | 621400 | $847,596 | $847,596 |
| OTHER OPERATING REVENUES | 900099 | $124,783 | $124,783 |
| CAFETERIA SALES | 722514 | $73,641 | $73,641 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $26,037,907 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,490 | TotalRevenueColumnAmt |
| Exclusion | $20,490 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $160,778 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $160,778 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $160,778 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $160,778 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $3,290 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $4,545 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $7,258 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$3,968 | TotalRevenueColumnAmt |
| Exclusion | -$3,968 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $58,624 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $58,624 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $58,624 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27,488,313 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $26,257,309 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $16,522 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,278 | TotalAmt |
| Program Services | $49,278 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,044,463 | TotalAmt |
| Program Services | $9,570,888 | ProgramServicesAmt |
| Management And General | $463,149 | ManagementAndGeneralAmt |
| Fundraising | $10,426 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $195,359 | TotalAmt |
| Program Services | $186,148 | ProgramServicesAmt |
| Management And General | $9,211 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,405,669 | TotalAmt |
| Program Services | $1,083,817 | ProgramServicesAmt |
| Management And General | $321,852 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $629,659 | TotalAmt |
| Program Services | $603,875 | ProgramServicesAmt |
| Management And General | $25,784 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $350,907 | TotalAmt |
| Management And General | $350,907 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,921 | TotalAmt |
| Management And General | $29,921 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,224 | TotalAmt |
| Program Services | $910 | ProgramServicesAmt |
| Management And General | $32,304 | ManagementAndGeneralAmt |
| Fundraising | $10 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,781,136 | TotalAmt |
| Program Services | $3,582,343 | ProgramServicesAmt |
| Management And General | $198,621 | ManagementAndGeneralAmt |
| Fundraising | $172 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,635 | TotalAmt |
| Program Services | $47,624 | ProgramServicesAmt |
| Management And General | $27,774 | ManagementAndGeneralAmt |
| Fundraising | $237 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $225,440 | TotalAmt |
| Program Services | $54,910 | ProgramServicesAmt |
| Management And General | $170,239 | ManagementAndGeneralAmt |
| Fundraising | $291 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $244,300 | TotalAmt |
| Program Services | $204,848 | ProgramServicesAmt |
| Management And General | $39,452 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $467,389 | TotalAmt |
| Program Services | $403,879 | ProgramServicesAmt |
| Management And General | $63,326 | ManagementAndGeneralAmt |
| Fundraising | $184 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,594 | TotalAmt |
| Program Services | $74,570 | ProgramServicesAmt |
| Management And General | $11,789 | ManagementAndGeneralAmt |
| Fundraising | $235 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,784 | TotalAmt |
| Program Services | $56,505 | ProgramServicesAmt |
| Management And General | $2,091 | ManagementAndGeneralAmt |
| Fundraising | $188 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $630,247 | TotalAmt |
| Program Services | $603,967 | ProgramServicesAmt |
| Management And General | $26,280 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,031,776 | TotalAmt |
| Program Services | $1,940,897 | ProgramServicesAmt |
| Management And General | $90,597 | ManagementAndGeneralAmt |
| Fundraising | $282 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $256,153 | TotalAmt |
| Program Services | $246,084 | ProgramServicesAmt |
| Management And General | $10,069 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $3,734,591 | $3,696,668 | $34,057 | $3,866 |
| BAD DEBT EXPENSE | $1,019,520 | $1,019,520 | ||
| REPAIRS AND MAINTENANCE | $625,268 | $607,942 | $17,277 | $49 |
| EQUIPMENT RENTAL | $450,991 | $430,530 | $20,461 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $528,050 | TotalAmt |
| Program Services | $485,725 | ProgramServicesAmt |
| Management And General | $42,319 | ManagementAndGeneralAmt |
| Fundraising | $6 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,954,354 | TotalAmt |
| Program Services | $24,950,928 | ProgramServicesAmt |
| Management And General | $1,987,480 | ManagementAndGeneralAmt |
| Fundraising | $15,946 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,877,422 | BOYAmt |
| EOY | $13,909,792 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,178,029 | BOYAmt |
| EOY | $1,230,865 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,556,947 | BOYAmt |
| EOY | $4,953,574 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,993 | BOYAmt |
| EOY | $25,684 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $426,204 | BOYAmt |
| EOY | $477,498 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $202,631 | BOYAmt |
| EOY | $251,305 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $41,224,212 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $26,895,054 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,860,247 | BOYAmt |
| EOY | $14,329,158 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,168,478 | BOYAmt |
| EOY | $35,177,876 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,430,084 | BOYAmt |
| EOY | $2,335,571 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,843 | BOYAmt |
| EOY | $4,235,178 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,339,232 | BOYAmt |
| EOY | $13,639,306 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,738,435 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $4,353,108 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,826,159 | BOYAmt |
| EOY | $26,301,598 | 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 | $8,077,208 | BOYAmt |
| EOY | $8,605,173 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $265,111 | BOYAmt |
| EOY | $271,105 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,342,319 | BOYAmt |
| EOY | $8,876,278 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,168,478 | BOYAmt |
| EOY | $35,177,876 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $533,959 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 0 | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $202,752 | OtherCostOrOtherBasisAmt |
| Book Value | $202,752 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $31,768,723 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,685,280 | DepreciationAmt |
| Book Value | $11,083,443 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $495,023 | OtherCostOrOtherBasisAmt |
| Depreciation | $191,803 | DepreciationAmt |
| Book Value | $303,220 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,276,938 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,017,971 | DepreciationAmt |
| Book Value | $2,258,967 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $480,776 | OtherCostOrOtherBasisAmt |
| Book Value | $480,776 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $14,329,158 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MEDICARE ADVANCED AND ACCELERATED PAYMENTS LIABILITY | Desc |
| Amt | $4,353,108 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,353,108 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $26,543,830 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $67,779 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | -$1,019,520 | OtherRevenueAmt |
| Revenue Not Reported | -$951,741 | RevenueNotReportedAmt |
| Revenue Subtotal | $27,495,571 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$7,258 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$7,258 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $27,488,313 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $26,009,871 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $67,779 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $7,258 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $75,037 | ExpensesNotReportedAmt |
| Expenses Subtotal | $25,934,834 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $1,019,520 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,019,520 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $26,954,354 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS NOT A PRIVATE FOUNDATION. THE HOSPITAL IS NOT LIABLE FOR INCOME TAXES IF IT OPERATES WITHIN THE CONFINES OF ITS EXEMPT STATUS, THOUGH THE HOSPITAL MAY BE RESPONSIBLE FOR TAXES ON UNRELATED BUSINESS ACTIVITIES. IN THE EVENT OF AN EXAMINATION OF THE INCOME TAX RETURNS, THE TAX LIABILITY OF THE HOSPITAL COULD BE CHANGED IF TAXING AUTHORITIES MAKE ADJUSTMENTS TO THE TAX-EXEMPT PURPOSE OF THE HOSPITAL OR IF TAXING AUTHORITIES DETERMINE ACTIVITIES ARE SUBJECT TO UNRELATED BUSINESS INCOME. AS OF SEPTEMBER 30, 2020, THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS THAT QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE HOSPITAL'S INCOME TAX FILLINGS ARE SUBJECT TO AUDIT BY VARIOUS TAXING AUTHORITIES. THE HOSPITAL IS NO LONGER SUBJECT TO FEDERAL AND STATE INCOME TAX EXAMINATIONS BY TAXING AUTHORITIES FOR YEARS BEFORE 2016. MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATION, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW, AND NEW AUTHORITATIVE RULINGS. THE HOSPITAL BELIEVES THEIR ESTIMATES ARE APPROPRIATE BASED ON CURRENT FACTS AND CIRCUMSTANCES. INTEREST AND PENALTIES ASSESSED BY INCOME TAXING AUTHORITIES, IF ANY, ARE INCLUDED IN INTEREST EXPENSE. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE -1,019,520. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES NETTED AGAINST REVENUES -7,258. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES NETTED AGAINST REVENUES 7,258. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 1,019,520. |
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 |
| Percent250 | Yes (X) | Percent250Ind |
| 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) |
|---|---|---|
| Total Community Benefit Expns | $244,295 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $244,295 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00940 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,635,476 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,208,119 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $427,357 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01650 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,879,771 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,208,119 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $671,652 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02590 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,879,771 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,208,119 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $671,652 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02590 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $112,511 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $133,178 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 7 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $1,492,616 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,859,983 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $22,411 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $22,411 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $31,846 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $40,448 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 11 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $1,659,384 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,033,609 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $22,411 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,019,520 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $178,416 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $10,049,886 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $10,541,385 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$491,499 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| 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 | CHADRON COMMUNITY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 825 CENTENNIAL DRIVE | AddressLine1Txt |
| City | CHADRON | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 69337 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTPS://WWW.CHADRONHOSPITAL.COM/ | WebsiteAddressTxt |
| 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 | CHADRON COMMUNITY 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://WWW.CHADRONHOSPITAL.COM | 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 | HTTP://WWW.PPHD.ORG/PAGES/CHIP.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 | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| 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://WWW.CHADRONHOSPITAL.COM/PATIENT-INFORMATION/FINANCIAL-SERVICES.HTML | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.CHADRONHOSPITAL.COM/PATIENT-INFORMATION/FINANCIAL-SERVICES.HTML | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.CHADRONHOSPITAL.COM/PATIENT-INFORMATION/FINANCIAL-SERVICES.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 Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| None Made | Yes (X) | NoneMadeInd |
| 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 (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| CHADRON COMMUNITY HOSPITAL | PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH SURVEY WAS DISTRIBUTED TO PANHANDLE RESIDENTS IN OCTOBER AND NOVEMBER OF 2019 VIA PAPER AND ELECTRONIC SURVEY. PAPER COPIES OF THE SURVEY WERE DISTRIBUTED BY HOSPITALS AND COMMUNITY-BASED ORGANIZATIONS. THE ELECTRONIC COPY WAS ADMINISTERED USING QUALTRICS, AND SHARED ONLINE BY WEBSITE, SOCIAL MEDIA, AND EMAIL BY PANHANDLE PUBLIC HEALTH DISTRICT (PPHD), LOCAL HOSPITALS, AND OTHER COMMUNITY ORGANIZATIONS. COUNTS AND PERCENTAGES FROM THE SURVEY RESPONSES WERE CALCULATED USING MICROSOFT EXCEL. RESPONSES WERE RECEIVED FROM 139 PEOPLE WHO LIVE IN CHADRON OR SIOUX COUNTIES, OR RESIDE ELSEWHERE BUT INDICATE THEY RECEIVE THEIR HEALTHCARE FROM CHADRON COMMUNITY HOSPITAL.PPHD COLLABORATED WITH BOX BUTTE GENERAL HOSPITAL, CHADRON COMMUNITY HOSPITAL, GORDON MEMORIAL HOSPITAL, KIMBALL HEALTH SERVICES, MORRILL COUNTY COMMUNITY HOSPITAL, REGIONAL WEST GARDEN COUNTY, REGIONAL WEST MEDICAL CENTER, AND SIDNEY REGIONAL MEDICAL CENTER TO HOLD A SERIES OF FOCUS GROUPS ACROSS THE PANHANDLE REGION. THE PURPOSE OF THE FOCUS GROUP WAS TO GATHER INPUT FROM COMMUNITY MEMBERS IN ORDER TO DEVELOP A BETTER UNDERSTANDING OF THE ISSUES THEY FEEL ARE IMPORTANT, THEIR CONCERNS, AND THEIR OVERALL PERCEPTION OF THEIR COMMUNITY. FOCUS GROUPS WERE LARGELY CONDUCTED IN SPRING OF THE YEAR 2020. BECAUSE OF THE COVID-19 PANDEMIC, A HANDFUL OF FOCUS GROUPS WERE COMPLETED VIA OPEN-ENDED SURVEY RATHER THAN IN PERSON.IN ADDITION, COMMUNITY MEMBERS SERVE ON THE HOSPITAL BOARD OF DIRECTORS. |
| CHADRON COMMUNITY HOSPITAL | PART V, SECTION B, LINE 6A: BOX BUTTE GENERAL HOSPITALGORDON MEMORIAL HOSPITALMORRILL COUNTY COMMUNITY HOSPITALPERKINS COUNTY HEALTH SERVICESREGIONAL WEST GARDEN COUNTYREGIONAL WEST MEDICAL CENTERSIDNEY REGIONAL MEDICAL CENTER |
| CHADRON COMMUNITY HOSPITAL | PART V, SECTION B, LINE 6B: RURAL NEBRASKA HEALTHCARE NETWORKSCOTTS BLUFF COUNTY HEALTH DEPARTMENTKIMBALL HEALTH SERVICESPANHANDLE PARTNERSHIPPANHANDLE AREA DEVELOPMENT DISTRICTNEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES |
| CHADRON COMMUNITY HOSPITAL | PART V, SECTION B, LINE 11: THE SIGNIFICANT NEEDS IDENTIFIED WERE REDUCING THE RATE OF EMERGENCY DEPARTMENT VISITS DUE TO FALLS AMONG OLDER ADULTS, INCREASING THE PROPORTION OF PEOPLE WHO DISCUSS INTERVENTIONS TO PREVENT CANCER WITH THEIR PROVIDERS, REDUCING THE PERCENT OF PEOPLE WHO HAVE EVER BEEN TOLD THEY HAVE HIGH BLOOD PRESSURE, INCREASING THE PROPORTION OF PERSONS WITH CO-OCCURRING SUBSTANCE USE DISORDERS AND MENTAL HEALTH DISORDERS WHO RECEIVE TREATMENT FOR BOTH DISORDERS, REDUCING FATAL AND NON-FATAL CHILD ABUSE AND NEGLECT, AND REDUCING THE ANNUAL NUMBER OF NEW CASES OF DIAGNOSED DIABETES IN THE POPULATION. THE HOSPITAL PLANS TO ADDRESS THESE NEEDS BY PROVIDING CHRONIC CARE MANAGEMENT WITH PATIENTS IN NEED, INCREASING REFERRALS TO FREE FECAL OCCULT BLOOD TESTS, PROMOTING PRESCRIPTION ASSISTANCE PROGRAMS TO PATIENTS WITH HYPERTENSION, DEVELOPING A NEW PHARMACOGENOMICS (PGX) MENTAL HEALTH SERVICE OPTION TO PATIENTS, MAINTAINING CIRCLE OF SECURITY CLASSES, MAINTAINING THE FAST PROGRAM IN THE COMMUNITY AND SCHOOLS, AND PROVIDING THE OPPORTUNITY FOR ALL CHADRON COMMUNITY HOSPITAL EMPLOYEES AND TO COMPLETE A HEALTH EVALUATION AND BIOMETRIC SCREENING. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - PRAIRIE PINES LODGE | ||||
| 900 W 7TH ST | CHADRON | NE | 69337 | ASSISTED LIVING |
| 2 - LEGEND BUTTES HEALTH SERVICES | ||||
| 11 PADDOCK ST | CRAWFORD | NE | 69339 | CLINIC SERVICES |
| 3 - WESTERN COMMUNITY HEALTH SERVICES | ||||
| 300 SHELTON ST | CHADRON | NE | 69337 | COMMUNITY HEALTH SERVICES |
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LN 7 COL(F): | THE HOSPITAL PROVIDES FOR AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON A REVIEW OF EXISTING RECEIVABLES, HISTORICAL COLLECTION INFORMATION, AND EXISTING ECONOMIC CONDITIONS. DELINQUENT RECEIVABLES ARE WRITTEN OFF BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE PATIENT AND OTHER THIRD-PARTY PAYORS. BAD DEBT RECOVERIES ARE CHARGED AGAINST THE ALLOWANCE AS REALIZED. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THE HOSPITAL PARTICIPATES IN SEVERAL COMMUNITY BUILDING ACTIVITES, INCLUDING PARTICIPATING IN AND PROMOTING EMPLOYEE WELLNESS INITIATIVES, ADVANCED DIRECTIVE EDUCATION FOR THE COMMUNITY, PROVIDING INFLUENZA VACCINATIONS TO FIRST RESPONDERS AND EDUCATORS, FREE IN-HOME WELL BABY CHECKS TO LOW INCOME PATIENTS, FREE DIETARY COUNSELING AND DIABETIC EDUCATION, LOW-COST MAMMOGRAPHY TO QUALIFYING PATIENTS, FREE COMMUNITY PRENATAL CLASSES, SUPPORT GROUPS RUN BY HOSPITAL PROFESSIONALS, AND FINANCIAL ASSISTANCE TO AREA CANCER PATIENTS. |
| PART III, LINE 2: | THE HOSPITAL PROVIDES FOR AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON A REVIEW OF EXISTING RECEIVABLES, HISTORICAL COLLECTION INFORMATION, AND EXISTING ECONOMIC CONDITIONS. DELINQUENT RECEIVABLES ARE WRITTEN OFF BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE PATIENT AND OTHER THIRD-PARTY PAYORS. BAD DEBT RECOVERIES ARE CHARGED AGAINST THE ALLOWANCE AS REALIZED. |
| PART III, LINE 9B: | THE HOSPITAL PROVIDES CARE TO PATIENTS WHO LACK FINANCIAL RESOURCES AND ARE DEEMED TO BE MEDICALLY INDIGENT BASED ON CRITERIA ESTABLISHED UNDER THE HOSPITAL'S CHARITY CARE POLICY. THIS CARE IS PROVIDED WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, SUCH AMOUNTS ARE NOT REPORTED AS REVENUE. THE HOSPITAL MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE PROVIDED. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY. THE CHARGES RELATED TO THIS CARE TOTALED $268,854 AND $455,208 IN FISCAL YEARS 2020 AND 2019, RESPECTIVELY. IN ADDITION, THE HOSPITAL PROVIDES SERVICES TO OTHER MEDICALLY INDIGENT PATIENTS UNDER VARIOUS STATE MEDICAID PROGRAMS. SUCH PROGRAMS PAY AMOUNTS THAT ARE LESS THAN THE COST OF THE SERVICES PROVIDED TO THE RECIPIENTS. |
| PART VI, LINE 2: | OUR ORGANIZATION MONITORS PATIENT TRENDS IN ORDER TO ADDRESS ADDITIONAL NEEDS NOT IDENTIFIED IN THE CHNA. FOR EXAMPLE, DURING THE PANDEMIC THE NEED FOR ACCESS TO FREE TESTING WAS IDENTIFIED AND WE WERE ONE OF THE FIRST HOSPITALS IN THE PANHANDLE TO PARTNER WITH TESTNEBRASKA TO PROVIDE FREE COVID TESTING OPPORTUNITIES IN OUR COMMUNITY. IN ADDITION, OUR ADMINISTRATIVE TEAM COMMUNICATES DIRECTLY WITH THE SCHOOL SYSTEMS, CHADRON STATE COLLEGE, AND THE CITY OF CHADRON IN EFFORT TO IDENTIFY HEALTHCARE NEEDS OUTSIDE OF THE CHNA. ANOTHER EXAMPLE OF OUR RESPONSE TO THIS IS PROVIDING FREE FLU SHOTS TO TEACHERS AND FIRST RESPONDERS. FOR THE LAST SEVERAL YEARS, OUR EMPLOYEES HAVE WENT ONSITE TO THESE ORGANIZATIONS TO PROVIDE FLU SHOTS. WE BELIEVE THAT BY BRINGING THE IMMUNIZATION TO THE SCHOOL AND TO THE FIRE STATIONS FOR EXAMPLE, GREATER PARTICIPATION IS ACHIEVED. |
| PART VI, LINE 3: | THE HOSPITAL NOTIFIES PATIENTS OF THE FINANCIAL ASSISTANCE POLICY (FAP) IN MULTIPLE WAYS: SIGNS POSTED THROUGHOUT THE HOSPITAL, DISTRIBUTING A PLAIN LANGUAGE SUMMARY BEFORE DISCHARGE, INCLUDING A PLAIN LANGUAGE SUMMARY OF THE POLICY WITH EACH BILL, POSTING THE POLICY ON THE HOSPITAL WEBSITE, AND COMMUNICATING THE FAP VERBALLY TO PATIENTS. |
| PART VI, LINE 4: | CHADRON COMMUNITY HOSPITAL SERVES THE NORTHWEST CORNER OF NEBRASKA, INCLUDING THE COUNTIES OF DAWES, SIOUX, AND SHERIDAN, AND THE COMMUNITIES OF HARRISON, CRAWFORD, CHADRON, HAY SPRINGS, AND RUSHVILLE. IN ADDITION, DUE TO THE FARMING AND RANCHING ECONOMY, THE HOSPITAL SERVES A GREAT DEAL OF RURAL RESIDENTS. |
| PART VI, LINE 5: | THE COMMUNITY IS DESIGNATED AS A SHORTAGE AREA FOR FAMILY PRACTICE PROVIDERS, SO THE HOSPITAL OFFERS RECRUITMENT ASSISTANCE IN EFFORT TO ATTRACT AND RETAIN NEEDED FAMILY PRACTICE PHYSICIANS. THE HOSPITAL HAS ALSO MADE SIGNIFICANT CONTRIBUTIONS TO COMMUNITY PROJECTS SUCH AS A COMMUNITY WELLNESS CENTER. IN ADDITION TO CONTRIBUTING FUNDS FOR THE CONSTRUCTION, THE HOSPITAL PURCHASED AN AED FOR THE FACILITY AND PROVIDED THE APPROPRIATE TRAINING TO THE COMMUNITY WELLNESS CENTER STAFF. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | CASH GRANTS TO CANCER PATIENTS | GrantTypeTxt |
| Recipient | 26 | RecipientCnt |
| Cash Grant | $49,278 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL MAINTAINS DETAILED RECORDS TO SUBSTANTIATE THE AMOUNT OF AWARDS TO GRANTEES. A FORMAL APPLICATION IS COMPLETED BY POTENTIAL GRANTEES AND SUBMITTED TO THE HOSPITAL. APPLICATIONS ARE REVIEWED AND GRANTS ARE AWARDED BASED ON ELIGIBILITY AND FINANCIAL NEED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHELLEY GRAVES | PersonNm |
| Title | PHARMACY DIRECTOR | TitleTxt |
| Base Compensation Filing Org | $153,633 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $4,941 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $11,070 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $169,644 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE HOSPITAL CEO AND CFO ARE EMPLOYED BY REGIONAL WEST MEDICAL CENTER, A HEALTHCARE ORGANIZATION PAID BY CHADRON COMMUNITY HOSPITAL CORPORATION FOR THEIR MANAGEMENT SERVICES. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS REVIEWED AND APPROVED BY THE CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS COMPLETE CONFLICT OF INTEREST DISCLOSURES ANNUALLY. BOARD MEMBERS DECLARE ANY CONFLICTS OF INTEREST AT THE BEGINNING OF EACH BOARD MEETING. |
| FORM 990, PART VI, SECTION C, LINE 18 | THE ORGANIZATION MAKES THE FORM 1023 AND FORM 990 AVAILABLE UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,413,687. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,413,687. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,168,656. MANAGEMENT AND GENERAL EXPENSES 198,621. FUNDRAISING EXPENSES 172. TOTAL EXPENSES 1,367,449. |