2020-02-06T10:23:09-06:00 2019-06-30 476097913 SEIM JOHNSON LLP 18081 BURT STREET SUITE 200 OMAHA NE 680224722 990 2018-07-01 237161473 OSMOND GENERAL HOSPITAL INC OSMO 4027483393 402 NORTH MAPLE OSMOND NE 68765 LON M KNIEVEL CHIEF EXECUTIVE OFFICER 4027483393 2020-02-06 1 MEGAN L KOZIOL P01544037 4023302660 209.34.201.180 2020-02-06 07:35:41 CS P 4492BEC4F3BAD6652306010BEE5B0619D04D8C2F B319C935D5CD5DD24452FA9CD51ABCBD1A9C8C2C 2018 2020-09-22 18:59:49Z LON M KNIEVEL 402 NORTH MAPLE OSMOND NE 68765 8589451 0 X WWW.OSMONDHOSPITAL.ORG X 1966 NE PROVIDE HEALTHCARE SERVICES TO ALL INDIVIDUALS IN THE COMMUNITY REGARDLESS OF THEIR ABILITY TO PAY. 9 8 91 8 0 0 13465 336085 7823646 8038996 50677 176377 36522 37993 7924310 8589451 0 0 0 0 4007339 3862496 0 0 0 3796861 4096240 7804200 7958736 120110 630715 6376252 7243677 1926619 2135499 4449633 5108178 OSMOND GENERAL HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH OF OSMOND AND THE SURROUNDING COMMUNITIES BY PROVIDING HIGH QUALITY, PERSONALIZED, AND TECHNOLOGICALLY CURRENT HEALTH CARE WITH COMPASSION, DIGNITY, AND RESPECT IN A COST EFFECTIVE AND SAFE MANNER. 0 0 6792039 8038996 OSMOND GENERAL HOSPITAL, INC SERVES ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND DOES NOT LIMIT ITS SERVICES OR DISCRIMINATE BASED ON RACE, SEX, NATIONAL ORGIN, OR RELIGION. DURING 2018-2019, OSMOND PROVIDED 1,872 INPATIENT DAYS, 356 RELATED TO MEDICAL/SURGICAL AND 1,516 RELATED TO SWING-BED. THERE WERE A TOTAL OF 117 OPERATIONS PERFORMED AND THE EMERGENCY ROOM TREATED 551 PATIENTS. IN ADDITION TO PROVIDING DIRECT INPATIENT AND OUTPATIENT SERVICES, OSMOND GENERAL HOSPITAL, INC. PROVIDED THE FOLLOWING SPECIALTY CLINICS: PODIATRY, UROLOGY, MOBILE MRI, BONE DENSITY, OB/GYN, MAMMOGRAPHY, EAR, NOSE, AND THROAT, SURGERY, ECHOCARDIOGRAPHY, CARDIOLOGY, ORTHOPEDIC CLINC, AND ULTRASOUND. 6792039 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 30 0 1 91 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 1 0 X JODI ASCHOFF CFO 4027483393 OSMOND GEN HOSPITAL 402 NORTH MAPLE OSMOND NE 68765 TIM KINT PRESIDENT 4.00 X X 0 0 0 DOUG KETELSEN VICE PRESIDENT 4.00 X X 0 0 0 THERESA STAPELMAN SECRETARY/TREASURER 2.00 X X 0 0 0 WALTER ASCHOFF MEMBER 2.00 X 0 0 0 ALTON FUELBERTH MEMBER 2.00 X 0 0 0 KEVIN LAUCK PA MEMBER 2.00 X 0 0 0 LORI MUNTER MEMBER 2.00 X 0 0 0 LARRY PAULSEN MEMBER 2.00 X 0 0 0 LON M KNIEVEL MEMBER/CEO 40.00 X X 143651 0 27932 JODI ASCHOFF CFO 40.00 X 64493 0 31 DAVID MWEBE MD PHYSICIAN 40.00 X 132082 0 10729 GILBERTO COLLAZO MD PHYSICIAN 40.00 X 127115 0 20354 ALICIA MAVIS NURSE PRACTITIONER 40.00 X 112372 0 15238 THERESA NEWCOMB NURSE PRACTITIONER 40.00 X 104607 0 13421 684320 0 87705 5 0 1 0 MHS DATA CENTER 625 3RD STREET PO BOX 366 PHILLIPSBURG KS 67661 SOFTWARE SUPPORT 474795 PSYCHIATRIC MEDICAL PO BOX 734606 DALLAS TX 75373 ADMINISTRATOR FOR ELDERLY POPULATION 339004 VITAL CARE PHARMACY 120 N 27TH STREET 200 NORFOLK NE 68701 PHARMACY 232039 ONE STAFF MEDICAL PO BOX 3544 OMAHA NE 68103 TRAVELING NURSES 227852 AMERISOURCE BERGEN 27550 NETWORK PLACE CHICAGO IL 60673 PHARMACY 167631 7 336085 336085 MEDICARE/MEDICAID 621110 4933542 4933542 PATIENT SERVICE REVENU 621110 3057399 3057399 LIFELINE 621910 2620 2620 45435 45435 8038996 176377 176377 21216 0 21216 21216 21216 CAFETERIA 624200 16075 16075 PHARMACY 624100 702 702 16777 8589451 8038996 0 214370 X 236107 236107 2833561 2436058 397503 584521 424456 160065 208307 169671 38636 32095 32095 67066 67066 2070972 1966634 104338 240118 210968 29150 134092 131870 2222 13157 10476 2681 5687 2213 3474 45529 44558 971 394744 386322 8422 70060 68565 1495 MEDICAL SUPPLIES 619651 609969 9682 BAD DEBT 217809 217809 MISCELLANEOUS 107724 52525 55199 FOOD 57683 57683 19853 2262 17591 7958736 6792039 1166697 0 525 525 1148564 2192285 1055478 1377673 80351 70593 28540 26899 8365061 5528859 2890242 2836202 650246 739500 522306 0 6376252 7243677 567536 630597 1359083 1209500 0 295402 1926619 2135499 X 4449633 4948580 159598 4449633 5108178 6376252 7243677 630715 27830 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 0 0 0 0 0 0 0 0 1 1082 1082 0 PART II-B, LINE 1: OSMOND GENERAL HOSPITAL PAYS DUES TO THE NEBRASKA HOSPITAL ASSOCIATION (NHA) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA) OF WHICH A PORTION IS USED FOR LOBBYING ACTIVITIES. FOR FISCAL YEAR 2019, 10.52% OF THE DUES PAID TO NHA AND 22.98% OF THE DUES PAID TO AHA WERE USED FOR LOBBYING. 47806 15461 63267 5758099 3871500 1886599 2444865 1570514 874351 98830 86845 11985 2836202 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 295402 295402 X 8399472 27830 27830 8371642 217809 217809 8589451 7740927 0 7740927 217809 217809 7958736 PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND 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 THE HOSPITAL'S TAX EXEMPT STATUS. THE HOSPITAL ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING THE GUIDANCE INCLUDED IN FASB ASC TOPIC 740, INCOME TAXES. THE HOSPITAL RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT JUNE 30, 2019 AND 2018, THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS ACCRUED. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 217,809. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 217,809. 1 1 X 1 X 1 X 150.000000000000 1 0 0 39332 0 39332 0.00510 197063 125762 71301 0.00920 236395 125762 110633 0.01430 9 1000 150833 0 150833 0.01950 1 10 2350 0 2350 0.00030 10 1010 153183 153183 0.01980 10 1010 389578 125762 263816 0.03410 1 180 7782 0 7782 0.00100 3 225 820 0 820 0.00010 4 405 8602 8602 0.00110 1 217809 0 4625448 4662164 -36716 X 1 1 1 1 OSMOND GENERAL HOSPITAL 402 NORTH MAPLE OSMOND NE 68765 OSMONDHOSPITAL.COM 620001 X X X X OSMOND GENERAL HOSPITAL 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X WWW.OSMONDHOSPITAL.ORG/COMMUNITY-EDUCATION/ X 1 18 1 WWW.OSMONDHOSPITAL.ORG/COMMUNITY-EDUCATION/ 0 1 X 100.000000000000 150.000000000000 X X X 1 1 X X X 1 X WWW.OSMONDHOSPITAL.ORG/PATIENT-VISITOR/FINANCIAL-ASSISTANCE/ X WWW.OSMONDHOSPITAL.ORG/PATIENT-VISITOR/FINANCIAL-ASSISTANCE/ X WWW.OSMONDHOSPITAL.ORG/PATIENT-VISITOR/FINANCIAL-ASSISTANCE/ X X X X X 1 X 0 X X X X 1 X 0 0 OSMOND GENERAL HOSPITAL PART V, SECTION B, LINE 5: OSMOND GENERAL HOSPITAL WORKED WITH THE NORTH CENTRAL DISTRICT HEALTH DEPARTMENT TO COMPLETE THE COMMUNITY HEALTH NEEDS ASSESSMENT PLAN. OSMOND GENERAL HOSPITAL PART V, SECTION B, LINE 6A: - ANTELOPE MEMORIAL IN NELIGH, NE- PLAINVIEW COMMUNITY HOSPITAL IN PLAINVIEW, NE- AVERA CREIGHTON HOSPITAL IN KNOX COUNTY, NE- AVERA ST. ANTHONY'S IN O'NEILL, NE- BROWN COUNTY HOSPITAL IN AINSWORTH, NE- CHERRY COUNTY HOSPITAL IN VALENTINE, NE- ROCK COUNTY HOSPITAL IN BASSETT, NE- WEST HOLT MEMORIAL HOSPITAL IN ATKINSON, NE- NIOBRARA VALLEY HOSPITAL IN LYNCH, NE OSMOND GENERAL HOSPITAL PART V, SECTION B, LINE 6B: NORTH CENTRAL DISTRICT HEALTH DEPARTMENT OSMOND GENERAL HOSPITAL PART V, SECTION B, LINE 11: THROUGH THE PROCESS OF COMPLETING THE COMMUNITY HEALTH NEEDS ASSESSMENT, AS WELL AS ASSESSING THE RESOURCES AVAILABLE TO THIS ORGANIZATION AND SURROUNDING COMMUNITIES, IT WAS DETERMINED THAT THE MOST SIGNIFICANT NEED TO BE ADDRESSED BY OSMOND GENERAL HOSPITAL IS THE DETECTION AND MANAGEMENT OF CHRONIC DISEASE, WITH A FOCUS PRIMARILY ON HEART DISEASE. BY TACKLING THIS SPECIFIC HEALTH ISSUE, OSMOND HOSPITAL HAS THE OPPORTUNITY TO VASTLY DECREASE THE OCCURRENCES AND SEVERITY OF LIFE THREATING DISEASES SUCH AS CARDIOVASCULAR DISEASE, DIABETES AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE.OSMOND GENERAL HOSPITAL WILL CONTINUE TO UTILIZE PROVEN COMMUNITY WEIGHT LOSS ACTIVITIES AS WELL AS INTRODUCE NEW STRATEGIES TO WORK WITH OTHER COMMUNITY PARTNERS TO INCREASE AWARENESS OF AND PROMOTE BETTER NUTRITIONAL ALTERNATIVES AND OPPORTUNITIES FOR PHYSICAL ACTIVITY. THIS GOAL WILL BE ACCOMPLISHED THROUGH THE DEVELOPMENT AND STRENGTHENING OF COMMUNITY PARTNERSHIPS, WORKPLACE WELLNESS PROGRAMS, NUTRITION AND PHYSICAL ACTIVITY EDUCATIONAL SESSIONS AS WELL AS PROGRAMS TO INVOLVE COMMUNITY MEMBERS IN WEIGHT LOSS AND PHYSICAL ACTIVITY CHALLENGES.AS A SECONDARY PRIORITY, OSMOND GENERAL HOSPITAL WILL ALSO EXPAND IT'S EFFORTS INTO ADDRESSING THE MENTAL HEALTH NEEDS OF THE COMMUNITIES IT SERVES WITH THE GOAL OF REDUCING THE SUICIDE RATE AMONG IT CITIZENS. OSMOND GENERAL HOSPITAL WILL UTILIZE TWO NEW SERVICES OFFERED ON AN OUTPATIENT BASIS; SENIOR LIFE SOLUTIONS, WHICH IS A GROUP MENTAL HEALTH THERAPY PROGRAM DIRECTED TOWARDS SENIORS; TELE-PSYCH IS OFFERED THROUGH A PARTNERSHIP WITH BRYAN TELE-MEDICINE AND GENESIS PSYCHIATRIC GROUP IN LINCOLN, NEBRASKA. OGH WILL ALSO PROMOTE MENTAL HEALTH AND SUICIDE PREVENTION THROUGH PUBLICATIONS AND ADVERTISEMENT.THERE WERE NO HEALTH NEEDS IDENTIFIED IN THE LATEST CHNA THAT ARE NOT BEING ADDRESSED. 3 1 - RANDOLPH CLINIC 106 EAST WAYNE RANDOLPH NE 68771 MEDICAL CLINIC 2 - WAUSA CLINIC 100 N LINCOLN WAUSA NE 68786 MEDICAL CLINIC 3 - OSMOND FAMILY PRACTICE PO BOX 370 OSMOND NE 68765 MEDICAL CLINIC PART I, LINE 3C: NO OTHER CRITERIA WAS USED TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. PART I, LINE 6A: A COMMUNITY BENEFIT REPORT WAS NOT PREPARED IN THE CURRENT YEAR. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24, COLUMN (A) BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $217,809. PART II, COMMUNITY BUILDING ACTIVITIES: OSMOND GENERAL HOSPITAL HELD A COMMUNITY HEALTH FAIR DURING THE YEAR. ALSO, THE STAFF PARTICIPATED IN THREE SCHOOL CAREER FAIRS. PART III, LINE 2: IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR THOSE ACCOUNTS OVER A CERTAIN AGE BASED ON DISCHARGE THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PART III, LINE 3: THE HOSPITAL PROVIDES CHARITY CARE TO PATIENTS WHO ARE FINANCIALLY UNABLE TO PAY FOR THE HEALTHCARE SERVICES THEY RECEIVE. IT IS THE POLICY OF THE HOSPITAL NOT TO PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. ACCORDINGLY, THE HOSPITAL DOES NOT REPORT THESE AMOUNTS IN NET PATIENT SERVICE REVENUE OR IN THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PART III, LINE 4: THE HOSPITAL'S FINANCIAL STATMENTS DO NOT CONTAIN A SPECIFIC FOOTNOTE DESCRIBING BAD DEBT. HOWEVER, PAGES 8, 9 AND 10 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS INCLUDE FOOTNOTES TITLED "PATIENT ACCOUNTS RECEIVABLES, NET", "NET PATIENT SERVICE REVENUE AND "CHARITY CARE". PART III, LINE 8: THE ORGANIZATION USED WORKSHEETS D-1, D-3, E, E-2 AND E-3 OF THE JUNE 30, 2019 COST REPORT. IT DOES NOT INCLUDE ALL OF THE MEDICARE REVENUES AND COSTS. IF ALL OF THE MEDICARE REVENUES AND COSTS WERE INCLUDED, THE SHORTFALL WOULD BE GREATER THAN THAT SHOWN ON LINE 7. THE SHORTFALL REPRESENTS ACTUAL UNREIMBURSED COSTS INCURRED BY OSMOND GENERAL HOSPITAL IN PROVIDING SERVICES TO INDIVIDUALS ELIGIBLE FOR MEDICARE. THE COMMUNITY BENEFITS BECAUSE THE HOSPITAL APPLIES OTHER REVENUES TO COVER THE COSTS OF CARING FOR MEDICARE PATIENTS. PART III, LINE 9B: THE HOSPITAL WILL NOT TAKE EXTRAORDINARY COLLECTION ACTIONS AGAINST A PATIENT OR ANY OTHER INDIVIDUAL WHO HAS ACCEPTED OR IS REQUIRED TO ACCEPT FINANCIAL RESPONSIBILITY FOR A PATIENT UNLESS AND UNTIL THE HOSPITAL HAS MADE "REASONABLE EFFORTS" TO DETERMINE WHETHER THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY. THE CEO IS RESPONSIBLE TO DETERMINE WHETHER THE HOSPITAL HAS ENGAGED IN REASONABLE EFFORTS TO DETERMINE WHETHER A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE. PART VI, LINE 2: THE ORGANIZATION USES DATA PROVIDED BY THE HEALTH DEPARTMENT TO DETERMINE THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. WITH THIS DATA, THE ORGANIZATION IS ABLE TO PINPOINT NEEDS OF THE COMMUNITY AND MOLD PROGRAMS AND INITIATIVES TO TARGET THOSE NEEDS. PART VI, LINE 3: IN THE HOSPITAL AND CLINICS, THE BILLING AND CHARITY CARE POLICIES ARE POSTED IN MULTIPLE LOCATIONS. PART VI, LINE 4: THE ORGANIZATION SERVES THE COMMUNITIES OF OSMOND, RANDOLPH AND WAUSA IN NORTHEASTERN NEBRASKA. THE ORGANIZATION ALSO SERVES THE COMMUNITIES OF PIERCE, COLERIDGE AND PLAINVIEW WITH ITS OUTREACH CLINICS AND OTHER SERVICES. OSMOND GENERAL HOSPITAL'S SERVICE AREA INCLUDES A POPULATION OF APPROXIMATELY 16,000. THE MEDIAN HOUSEHOLD INCOME FOR THE COMMUNITY IS $37,938 COMPARED TO THE U.S. AVERAGE OF $51,324 AND THE NEBRASKA AVERAGE OF $51,381. THE AREA POPULATION IS PREDOMINATELY WHITE ELDERLY AND LOW INCOME. PART VI, LINE 5: THE ORGANIZATION HAS MANY WAYS THAT IT FURTHERS ITS EXEMPT PURPOSE. THE ORGANIZATION PUBLISHES HEALTH RELATED ARTICLES IN AREA NEWSPAPERS, HOLDS THE CARDIAC REHAB CLINIC, AND MULTIPLE WELLNESS ACTIVITIES INCLUDING THE MAYO CLINIC DIET. THESE ACTIVITIES INCLUDE THE FUNWALK, SCHOOL HEALTH FAIRS, AND COMMUNITY HEALTH FAIRS. PART VI, LINE 6: THE ORGANIZATION HAS WORKED WITH HEARTLAND HEALTH AND THE NORTH CENTRAL HEALTH DEPARTMENT BUT DOES NOT HAVE ANY ACTIVITIES TO REPORT. THE ORGANIZATION IS OPEN TO WORKING WITH THESE AFFILIATES IN THE FUTURE TO PROMOTE THE HEALTH OF THE COMMUNITIES SERVED. X X X X 0 0 0 0 0 0 0 0 0 LON M KNIEVEL MEMBER/CEO 143651 0 0 0 0 0 6840 0 21092 0 171583 0 0 0 A HOSPITAL AUTHORITY NO 1 OF PIERCE COUNTY NEBRASKA 900198234 2017-02-28 1688000 REFUNDING HOSPITAL REVENUE BONDS DATED 01/05/11 AND 10/11/11 0 0 0 A 478500 1688000 25148 1688000 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 1 0 0 0 0 0 1 A 1 FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S 990 IS REVIEWED BY THE CEO AND CFO. IT IS PRESENTED TO THE BOARD AS SOON AS THE REVIEWS ARE COMPLETE, AND PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS REVIEWS OF THE CONFLICT OF INTEREST POLICY ANNUALLY. THE CONFLICT OF INTEREST FORMS ARE SIGNED BY THE BOARD AT THIS TIME. WHEN A CONFLICT IS PRESENT, THE BOARD MEMBER WITH THE CONFLICT ABSTAINS FROM DISCUSSION AND VOTE. THIS IS DOCUMENTED IN BOARD MINUTES WHEN THE OCCASION ARISES. FORM 990, PART VI, SECTION B, LINE 15 THE CEO COMPARES EMPLOYEES' SALARIES AND WAGES WITH OTHER NEBRASKA HOSPITALS USING A SURVEY FROM THE NEBRASKA HOSPITAL ASSOCIATION. FOLLOWING COMPARISON STUDIES, HE RECOMMENDS A PERCENTAGE INCREASE TO THE BOARD. THE FINAL WAGE ADJUSTMENT IS DETERMINED BY THE BOARD OF DIRECTORS. THE CEO AND CFO WAGE SCALES ARE COMPARED TO AREA HOSPITALS AND THE NHA SURVEY RESULTS. THE BOARD DISCUSSES AND DETERMINES THE LEVEL OF COMPENSATION. THE PHYSICIAN PAY SCALES ARE COMPARED TO PUBLISHED NATIONAL STANDARDS. FORM 990, PART VI, SECTION C, LINE 19 OSMOND GENERAL HOSPITAL DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PHYSICAL THERAPY FEES: PROGRAM SERVICE EXPENSES 86,916. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 86,916. OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 1,311,939. MANAGEMENT AND GENERAL EXPENSES 104,338. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,416,277. ANESTHESIA: PROGRAM SERVICE EXPENSES 91,812. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 91,812. PHARMACY SERVICES: PROGRAM SERVICE EXPENSES 58,637. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 58,637. LAB FEES: PROGRAM SERVICE EXPENSES 30,620. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 30,620. EMERGENCY ROOM PHYSICIANS FEES: PROGRAM SERVICE EXPENSES 386,710. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 386,710. FORM 990, PART XII, LINE 2C: THE FINANCE COMMITTEE IS COMPRISED OF THE TREASURER OF THE BOARD OF DIRECTORS AND AT LEAST THREE OTHER DIRECTORS. THE JOB OF THE FINANCE COMMITTEE IS TO SUPERVISE ALL CURRENT AND FUTURE FINANCES OF THE CORPORATION, INCLUDING THE REVIEW OF THE AUDITED FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.