REGIONAL WEST PHYSICIANS CLINIC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- REGIONAL WEST PHYSICIANS CLINIC (EIN 36-3314159)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-15
- IRS object ID
- 201833199349312333
- Schema version
- 2017v2.3
- 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 | 2018-11-15T13:05:09-07:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 363314157 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REGIONAL WEST HEALTH SERVICES | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4021 AVENUE B | AddressLine1Txt |
| City | SCOTTSBLUFF | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 693614602 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363314159 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REGIONAL WEST PHYSICIANS CLINIC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | REGI | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4021 AVENUE B | AddressLine1Txt |
| City | SCOTTSBLUFF | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 69361 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL ICKOWSKI | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3086301111 | PhoneNum |
| Signature | 2018-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMY HOLZWORTH CPA | PreparerPersonNm |
| PTIN | P00284207 | PTIN |
| Phone | 3086302823 | PhoneNum |
| Preparation | 2018-11-15 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 167.68.16.49 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-11-15 | IPDt |
| IP Tm | 14:05:09 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | BD55BCBAF3C68CDF1F389F5BA574DD8D29DEB7E8 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | BD55BCBAF3C68CDF1F389F5BA574DD8D29DEB7E8 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $67,634,538 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.RWHS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1984 | FormationYr |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE HEALTH CARE TO THE REGION INCLUDING THE UNDERSERVED. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 412 | TotalEmployeeCnt |
| Total Gross UBI | $38,114 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$11,818 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $22,959,200 | PYContributionsGrantsAmt |
| CY Contributions Grants | $23,359,200 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $52,147,499 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $44,101,030 | CYProgramServiceRevenueAmt |
| PY Investment Income | $566 | PYInvestmentIncomeAmt |
| CY Investment Income | $966 | CYInvestmentIncomeAmt |
| PY Other Revenue | $382,136 | PYOtherRevenueAmt |
| CY Other Revenue | $115,734 | CYOtherRevenueAmt |
| PY Total Revenue | $75,489,401 | PYTotalRevenueAmt |
| CY Total Revenue | $67,576,930 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $78,671 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $28,392 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $46,896,480 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $44,014,606 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $28,263,385 | PYOtherExpensesAmt |
| CY Other Expenses | $24,140,161 | CYOtherExpensesAmt |
| PY Total Expenses | $75,238,536 | PYTotalExpensesAmt |
| CY Total Expenses | $68,183,159 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $250,865 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$606,229 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,961,423 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,615,240 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,917,083 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,177,129 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $44,340 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$561,889 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDE HEALTH CARE TO THE REGION INCLUDING THE UNDERSERVED. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $68,096,579 | ExpenseAmt |
| Grant | $28,392 | GrantAmt |
| Desc | REGIONAL WEST PHYSICIANS CLINIC IS A MULTI-SPECIALTY MEDICAL GROUP OF MORE THAN 70 PHYSICIANS AND ASSOCIATED HEALTH CARE PROVIDERS. THE CLINIC IS A PHYSICIAN-LED, PHYSICIAN-GOVERNED SUBIDIARY OF REGIONAL WEST HEALTH SERVICES. IN THE TRADITION OF THE MAYO CLINIC AND OTHER SUCCESSFUL EXAMPLES OF PHYSICIAN HOSPITAL INTEGRATION, REGIONAL WEST PHYSICIANS CLINIC IS COMMITTED TO PROVIDING THE HIGHEST QUALITY PATIENT CARE AND SERVICE, PATIENT-DRIVEN HEALTH CARE GOVERNANCE AND LEADERSHIP, AND COMMUNITY OUTREACH TO THE REGION. | Desc |
| Total Program Service Expenses | $68,096,579 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 47 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 412 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL ICKOWSKI | PersonNm |
| Phone | 3086301111 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4021 AVENUE B | AddressLine1Txt |
| City | SCOTTSBLUFF | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 69361 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (50 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ARMANDO MAGANA | ||||||||||
| PHYSICIAN | 40.00 | Yes (X) | $780,818 | $0 | $46,664 | |||||
| MARK HARTMAN | ||||||||||
| PHYSICIAN | 40.00 | Yes (X) | $643,023 | $10,657 | $41,544 | |||||
| JASON WALSH | ||||||||||
| PHYSICIAN | 40.00 | Yes (X) | $544,212 | $0 | $44,760 | |||||
| JEFFREY HOLLOWAY | ||||||||||
| PHYSICIAN | 40.00 | Yes (X) | $508,222 | $0 | $45,564 | |||||
| BRENT ELLISON | ||||||||||
| PHYSICIAN | 40.00 | Yes (X) | $480,291 | $15,498 | $39,370 | |||||
| JAMES MASSEY | ||||||||||
| VP OF SURGER | 40.00 | Yes (X) | $493,275 | $0 | $28,721 | |||||
| JOSEPH MARGHEIM | ||||||||||
| PHYSICIAN | 40.00 | Yes (X) | $452,918 | $16,826 | $53,988 | |||||
| DAVID HOLDT | ||||||||||
| PRESIDENT | 40.00 | Yes (X) | $449,223 | $0 | $80,925 | Yes (X) | ||||
| DORISA POLK | ||||||||||
| PHYSICIAN | 40.00 | Yes (X) | $442,000 | $0 | $44,306 | |||||
| SHEILA WEBB-BOWLES | ||||||||||
| PHYSICIAN | 40.00 | Yes (X) | $433,251 | $0 | $90,204 | |||||
| LISA SCHEPPERS | ||||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $394,866 | $130,603 | 40.00 | ||||
| VINCENT BJORLING | ||||||||||
| CHAIRPERSON | 40.00 | Yes (X) | $364,939 | $0 | $43,576 | Yes (X) | ||||
| KENT LACEY | ||||||||||
| PHYSICIAN | 40.00 | Yes (X) | $311,854 | $0 | $44,809 | |||||
| TADD GREENFIELD | ||||||||||
| COO | 1.00 | Yes (X) | $0 | $116,169 | $29,273 | 40.00 | ||||
| LISA SCHEPPERS | ||||||||||
| CMO | Yes (X) | $0 | $0 | $0 | ||||||
| JOHN MENTGEN | ||||||||||
| CEO | 1.00 | $0 | $513,036 | $249,768 | Yes (X) | 40.00 | ||||
| MICHAEL ICKOWSKI | ||||||||||
| CFO | 1.00 | $0 | $305,591 | $71,001 | Yes (X) | 40.00 | ||||
| SHIRLEY GOMPERT | ||||||||||
| SECRETARY | 40.00 | $36,115 | $0 | $28,167 | Yes (X) | |||||
| TIMOTHY FRIEDLEIN | ||||||||||
| PHYSICIAN | 40.00 | $791,404 | $0 | $39,260 | Yes (X) | |||||
| ROMMIE HUGHES | ||||||||||
| PHYSICIAN | 40.00 | $724,227 | $0 | $44,914 | Yes (X) | |||||
| JASON LATOWSKY | ||||||||||
| PHYSICIAN | 40.00 | $504,325 | $55,858 | $44,761 | Yes (X) | |||||
| MATTHEW BRUNER | ||||||||||
| PHYSICIAN | 40.00 | $517,803 | $0 | $45,126 | 2.00 | Yes (X) | ||||
| DANIEL ROWLAND | ||||||||||
| PHYSICIAN | 40.00 | $325,129 | $61,943 | $29,591 | Yes (X) | |||||
| MICHELLE CHELOHA | ||||||||||
| PHYSICIAN | 40.00 | $386,010 | $0 | $43,518 | Yes (X) | |||||
| KATE PAINTER | ||||||||||
| PHYSICIAN | 40.00 | $359,360 | $0 | $39,580 | Yes (X) | |||||
| WENDY REEVES | ||||||||||
| PHYSICIAN | 40.00 | $284,762 | $51,788 | $34,127 | Yes (X) | |||||
| LODEWYK PAPENFUS | ||||||||||
| PHYSICIAN | 40.00 | $315,468 | $0 | $44,545 | Yes (X) | |||||
| AARON CISAR | ||||||||||
| PHYSICIAN | 40.00 | $222,471 | $81,587 | $38,802 | Yes (X) | |||||
| LINDSEY MOSEL | ||||||||||
| PHYSICIAN | 40.00 | $237,834 | $51,755 | $38,248 | Yes (X) | |||||
| TARA LONGORIA | ||||||||||
| PHYSICIAN | 40.00 | $267,040 | $0 | $44,883 | Yes (X) | |||||
| PATRICK BROWN | ||||||||||
| PHYSICIAN | 40.00 | $194,399 | $0 | $36,907 | Yes (X) | |||||
| SONDRA HOLLOWAY | ||||||||||
| PHYSICIAN | 40.00 | $191,572 | $0 | $44,358 | Yes (X) | |||||
| MONICA SARAWAGI | ||||||||||
| PHYSICIAN | 40.00 | $174,638 | $0 | $14,052 | Yes (X) | |||||
| RAQEEB HAQUE | ||||||||||
| PHYSICIAN | 40.00 | $846,087 | $36,661 | $92,173 | Yes (X) | |||||
| OMAR JIMENEZ | ||||||||||
| PHYSICIAN | 40.00 | $649,823 | $0 | $34,664 | Yes (X) | |||||
| TROY DEAN | ||||||||||
| PHYSICIAN | 40.00 | $478,014 | $0 | $92,350 | Yes (X) | |||||
| PETER MEYER | ||||||||||
| ER PHYSICIAN | 40.00 | $454,240 | $0 | $81,454 | Yes (X) | |||||
| THOMAS TOLOMEO | ||||||||||
| ANESTHESIOLO | $446,478 | $0 | $37,592 | Yes (X) | ||||||
| JON MORGAN | ||||||||||
| PHYSICIAN | 40.00 | $242,697 | $0 | $37,102 | Yes (X) | |||||
| AMANULLAH BILAL | ||||||||||
| PHYSICIAN | 40.00 | $328,564 | $67,660 | $37,681 | Yes (X) | |||||
| JONATHAN MCNEELY | ||||||||||
| PHYSICIAN | 40.00 | $323,075 | $67,660 | $38,975 | Yes (X) | |||||
| REGINA LECONTE | ||||||||||
| PHYSICIAN | 40.00 | $345,870 | $0 | $25,864 | Yes (X) | |||||
| ERIC WIEBE | ||||||||||
| PHYSICIAN | 40.00 | $280,529 | $0 | $45,510 | Yes (X) | |||||
| JOE JETER | ||||||||||
| PHYSICIAN AS | 40.00 | $199,438 | $0 | $30,139 | Yes (X) | |||||
| MARY TOMPKINS | ||||||||||
| APRN | 40.00 | $118,486 | $0 | $55,469 | Yes (X) | |||||
| REBECCA BOWMAN | ||||||||||
| APRN | 40.00 | $109,566 | $0 | $44,594 | Yes (X) | |||||
| SUE SCHOENEMAN | ||||||||||
| APRN | $0 | $103,814 | $12,154 | 40.00 | Yes (X) | |||||
| JOHN BLOMSTEDT | ||||||||||
| PHYSICIAN | 40.00 | $389,035 | $0 | $44,263 | Yes (X) | |||||
| ANDREW JAHODA | ||||||||||
| PHYSICIAN | 40.00 | $280,842 | $104,883 | $24,709 | Yes (X) | |||||
| JONATHAN GOCHNOUR | ||||||||||
| PHYSICIAN | 40.00 | $333,026 | $51,683 | $16,838 | Yes (X) | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $17,262,353 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,107,935 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,447,446 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 43 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| COMPHEALTH ASSOCIATES INC | |||||
| PO BOX 972670 | DALLAS | TX | 753972670 | PROFESSIONAL | $3,447,363 |
| RURAL PARTNERS IN MEDICINE | |||||
| PO BOX 772519 | STEAMBOAT SPRINGS | CO | 80477 | PROFESSIONAL | $1,109,355 |
| HEALTH MOUNT LLC | |||||
| 1326 MONTGOMERY LN | SOUTHLAKE | TX | 76092 | PROFESSIONAL | $1,089,678 |
| GLOBAL HOSPITALIST SOLUTIONS LLC | |||||
| 5865 RIDGEWAY CENTER PARKWAY | MEMPHIS | TN | 38120 | MEDICAL SVCS | $835,667 |
| WEATHERBY LOCUMS INC | |||||
| PO BOX 972633 | DALLAS | TX | 753972633 | PROFESSIONAL | $659,743 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 14 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $23,359,200 | RelatedOrganizationsAmt |
| Total Contributions | $23,359,200 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| NET PATIENT REVENUES | $38,343,769 | $38,343,769 |
| CONSULTING REVENUE | $5,757,261 | $5,757,261 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $44,101,030 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $966 | TotalRevenueColumnAmt |
| Exclusion | $966 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $95,722 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $57,608 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $38,114 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $38,114 | UnrelatedBusinessRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS OTHER REVENUE | Desc |
| Total Revenue Column | $77,620 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $77,620 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $77,620 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $67,576,930 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $44,178,650 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $38,114 | UnrelatedBusinessRevenueAmt |
| Exclusion | $966 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,392 | TotalAmt |
| Program Services | $28,392 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,108,972 | TotalAmt |
| Program Services | $10,108,972 | ProgramServicesAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,811,289 | TotalAmt |
| Program Services | $2,811,289 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,809,993 | TotalAmt |
| Program Services | $22,809,993 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $957,111 | TotalAmt |
| Program Services | $957,111 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,614,192 | TotalAmt |
| Program Services | $5,614,192 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,713,049 | TotalAmt |
| Program Services | $1,713,049 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,057 | TotalAmt |
| Program Services | $6,057 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,580 | TotalAmt |
| Management And General | $86,580 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,611,150 | TotalAmt |
| Program Services | $12,611,150 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,251 | TotalAmt |
| Program Services | $55,251 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,566 | TotalAmt |
| Program Services | $172,566 | ProgramServicesAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,133 | TotalAmt |
| Program Services | $2,133 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,091,342 | TotalAmt |
| Program Services | $2,091,342 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $189,860 | TotalAmt |
| Program Services | $189,860 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,065 | TotalAmt |
| Program Services | $105,065 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $354 | TotalAmt |
| Program Services | $354 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $227,938 | TotalAmt |
| Program Services | $227,938 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $711,302 | TotalAmt |
| Program Services | $711,302 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| PHARMACY | $2,813,261 | $2,813,261 |
| OTHER PURCHASED SERVICES | $2,078,195 | $2,078,195 |
| BAD DEBT | $1,567,753 | $1,567,753 |
| MEDICAL SUPPLIES | $783,828 | $783,828 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $637,526 | TotalAmt |
| Program Services | $637,526 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,183,159 | TotalAmt |
| Program Services | $68,096,579 | ProgramServicesAmt |
| Management And General | $86,580 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,822 | BOYAmt |
| EOY | $140,203 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,705,294 | BOYAmt |
| EOY | $3,352,874 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $85,831 | BOYAmt |
| EOY | $319,976 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $232,224 | BOYAmt |
| EOY | $102,523 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,983,211 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,361,178 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $806,973 | BOYAmt |
| EOY | $622,033 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,057,279 | BOYAmt |
| EOY | $77,631 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,961,423 | BOYAmt |
| EOY | $4,615,240 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,901,201 | BOYAmt |
| EOY | $5,177,129 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,882 | BOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,917,083 | BOYAmt |
| EOY | $5,177,129 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,340 | BOYAmt |
| EOY | -$561,889 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,340 | BOYAmt |
| EOY | -$561,889 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,961,423 | BOYAmt |
| EOY | $4,615,240 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$606,229 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | false | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $206,302 | OtherCostOrOtherBasisAmt |
| Depreciation | $121,578 | DepreciationAmt |
| Book Value | $84,724 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,776,909 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,239,600 | DepreciationAmt |
| Book Value | $537,309 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $622,033 | TotalBookValueLandBuildingsAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SCOTTS BLUFF COUNTY FAIR | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10625 CO RD E | AddressLine1Txt |
| City | MITCHELL | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 69357 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRC Section | GOV | IRCSectionDesc |
| Cash Grant | $5,368 | CashGrantAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (47 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ARMANDO MAGANA | |||||||||||
| PHYSICIAN | $646,218 | $131,036 | $3,564 | $10,800 | $35,864 | $827,482 | |||||
| MARK HARTMAN | |||||||||||
| PHYSICIAN | $641,781 | $1,242 | $10,800 | $30,744 | $684,567 | $10,657 | $10,657 | ||||
| JASON WALSH | |||||||||||
| PHYSICIAN | $505,320 | $38,082 | $810 | $10,800 | $33,960 | $588,972 | |||||
| JEFFREY HOLLOWAY | |||||||||||
| PHYSICIAN | $506,980 | $1,242 | $10,800 | $34,764 | $553,786 | ||||||
| BRENT ELLISON | |||||||||||
| PHYSICIAN | $479,855 | $436 | $5,565 | $33,805 | $519,661 | $15,498 | $15,498 | ||||
| JAMES MASSEY | |||||||||||
| VP OF SURGER | $452,061 | $41,214 | $10,800 | $17,921 | $521,996 | ||||||
| JOSEPH MARGHEIM | |||||||||||
| PHYSICIAN | $452,482 | $436 | $17,395 | $36,593 | $506,906 | $16,826 | $16,826 | ||||
| DAVID HOLDT | |||||||||||
| PRESIDENT | $398,343 | $50,880 | $48,077 | $32,848 | $530,148 | ||||||
| DORISA POLK | |||||||||||
| PHYSICIAN | $356,857 | $84,599 | $544 | $10,800 | $33,506 | $486,306 | |||||
| SHEILA WEBB-BOWLES | |||||||||||
| PHYSICIAN | $432,815 | $436 | $55,142 | $35,062 | $523,455 | ||||||
| LISA SCHEPPERS | |||||||||||
| BOARD MEMBER | $8,508 | $525,469 | $386,358 | $97,325 | $33,278 | ||||||
| VINCENT BJORLING | |||||||||||
| CHAIRPERSON | $354,696 | $7,864 | $2,379 | $10,800 | $32,776 | $408,515 | |||||
| KENT LACEY | |||||||||||
| PHYSICIAN | $309,988 | $1,866 | $8,905 | $35,904 | $356,663 | ||||||
| JOHN MENTGEN | |||||||||||
| CEO | $29,865 | $762,804 | $483,171 | $214,819 | $34,949 | ||||||
| MICHAEL ICKOWSKI | |||||||||||
| CFO | $14,873 | $376,592 | $290,718 | $61,286 | $9,715 | ||||||
| TIMOTHY FRIEDLEIN | |||||||||||
| PHYSICIAN | $448,651 | $340,668 | $2,085 | $10,800 | $28,460 | $830,664 | |||||
| ROMMIE HUGHES | |||||||||||
| PHYSICIAN | $585,690 | $137,295 | $1,242 | $10,800 | $34,114 | $769,141 | |||||
| JASON LATOWSKY | |||||||||||
| PHYSICIAN | $408,968 | $94,967 | $390 | $10,800 | $33,961 | $549,086 | $55,858 | $55,858 | |||
| MATTHEW BRUNER | |||||||||||
| PHYSICIAN | $428,481 | $88,865 | $457 | $10,800 | $34,326 | $562,929 | |||||
| DANIEL ROWLAND | |||||||||||
| PHYSICIAN | $324,269 | $860 | $29,591 | $354,720 | $61,943 | $61,943 | |||||
| MICHELLE CHELOHA | |||||||||||
| PHYSICIAN | $363,623 | $21,811 | $576 | $10,800 | $32,718 | $429,528 | |||||
| KATE PAINTER | |||||||||||
| PHYSICIAN | $255,953 | $103,155 | $252 | $10,800 | $28,780 | $398,940 | |||||
| WENDY REEVES | |||||||||||
| PHYSICIAN | $224,123 | $60,425 | $214 | $10,800 | $23,327 | $318,889 | $51,788 | $51,788 | |||
| LODEWYK PAPENFUS | |||||||||||
| PHYSICIAN | $294,841 | $19,316 | $1,311 | $10,800 | $33,745 | $360,013 | |||||
| AARON CISAR | |||||||||||
| PHYSICIAN | $222,471 | $8,201 | $30,601 | $261,273 | $81,587 | $81,587 | |||||
| LINDSEY MOSEL | |||||||||||
| PHYSICIAN | $226,931 | $10,748 | $155 | $9,662 | $28,586 | $276,082 | $51,755 | $51,755 | |||
| TARA LONGORIA | |||||||||||
| PHYSICIAN | $222,876 | $43,944 | $220 | $10,800 | $34,083 | $311,923 | |||||
| PATRICK BROWN | |||||||||||
| PHYSICIAN | $193,998 | $401 | $7,932 | $28,975 | $231,306 | ||||||
| SONDRA HOLLOWAY | |||||||||||
| PHYSICIAN | $191,572 | $4,200 | $40,158 | $235,930 | |||||||
| MONICA SARAWAGI | |||||||||||
| PHYSICIAN | $143,014 | $31,522 | $102 | $6,149 | $7,903 | $188,690 | |||||
| RAQEEB HAQUE | |||||||||||
| PHYSICIAN | $845,601 | $486 | $76,132 | $16,041 | $938,260 | $36,661 | $36,661 | ||||
| OMAR JIMENEZ | |||||||||||
| PHYSICIAN | $648,581 | $1,242 | $34,664 | $684,487 | |||||||
| TROY DEAN | |||||||||||
| PHYSICIAN | $477,579 | $435 | $58,569 | $33,781 | $570,364 | ||||||
| PETER MEYER | |||||||||||
| ER PHYSICIAN | $452,365 | $1,875 | $47,702 | $33,752 | $535,694 | ||||||
| THOMAS TOLOMEO | |||||||||||
| ANESTHESIOLOGIST | $444,396 | $2,082 | $4,188 | $33,404 | $484,070 | ||||||
| JON MORGAN | |||||||||||
| PHYSICIAN | $242,697 | $4,137 | $32,965 | $279,799 | |||||||
| AMANULLAH BILAL | |||||||||||
| PHYSICIAN | $328,286 | $278 | $10,800 | $26,881 | $366,245 | $67,660 | $67,660 | ||||
| JONATHAN MCNEELY | |||||||||||
| PHYSICIAN | $322,580 | $495 | $23,156 | $15,819 | $362,050 | $67,660 | $67,660 | ||||
| REGINA LECONTE | |||||||||||
| PHYSICIAN | $345,332 | $538 | $10,800 | $15,064 | $371,734 | ||||||
| ERIC WIEBE | |||||||||||
| PHYSICIAN | $280,062 | $467 | $10,800 | $34,710 | $326,039 | ||||||
| JOE JETER | |||||||||||
| PHYSICIAN ASSISTANT | $65,267 | $134,147 | $24 | $16,549 | $13,590 | $229,577 | |||||
| MARY TOMPKINS | |||||||||||
| APRN | $117,436 | $658 | $392 | $24,059 | $31,410 | $173,955 | |||||
| REBECCA BOWMAN | |||||||||||
| APRN | $109,500 | $66 | $9,771 | $34,823 | $154,160 | ||||||
| SUE SCHOENEMAN | |||||||||||
| APRN | $115,968 | $103,814 | $9,279 | $2,875 | |||||||
| JOHN BLOMSTEDT | |||||||||||
| PHYSICIAN | $291,292 | $97,443 | $300 | $10,800 | $33,463 | $433,298 | |||||
| ANDREW JAHODA | |||||||||||
| PHYSICIAN | $280,437 | $405 | $10,600 | $14,109 | $305,551 | $104,883 | $104,883 | ||||
| JONATHAN GOCHNOUR | |||||||||||
| PHYSICIAN | $332,807 | $219 | $16,838 | $349,864 | $51,683 | $51,683 | |||||
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PAGE 1, PART I, LINE 4 | FormAndLineReferenceDesc |
| Explanation | DAVID HOLDT 0 800 0 LISA SCHEPPERS 0 39,800 0 TADD GREENFIELD 0 13,009 0 JOHN MENTGEN 0 111,027 0 MICHAEL ICKOWSKI 0 51,214 0 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | FORM IS PRESENTED TO AND REVIEWED BY THE BOARD IN THE MONTH PRIOR TO THE FILING DEADLINE. |
| FORM 990, PAGE 6, PART VI, LINE 12C | ANNUAL DISCLOSURE BY BOARD MEMBERS OF ANY CONFLICT OF INTEREST, AS SET FORTH IN THE POLICIES, IS REQUIRED. FOR ANY POSSIBLE CONFLICT OF INTEREST IDENTIFIED, THE REMAINING BOARD DETERMINES IF IT ACTUALLY CONSTITUTES A CONFLICT OF INTEREST WITHOUT THE CONFLICTED BOARD MEMBER PRESENT. IF A CONFLICT OF INTEREST IS DETERMINED TO EXIST, THE BOARD, LESS THE CONFLICTED MEMBER, WILL THEN DECIDE THE LEVEL OF INVOLVEMENT OF THE MEMBER IN DECISION MAKING FOR THE ENTITY, IF THERE IS AN ALTERNATIVE ARRANGEMENT THAT WILL ELIMINATE THE CONFLICT OF INTEREST, AND THE APPROPRIATENESS OF THE CONFLICTED MEMBER CONTINUING AS A BOARD MEMBER. FAILURE TO DISCLOSE A CONFLICT OF INTEREST CAN RESULT IN DISCIPLINARY AND CORRECTIVE ACTION FOR THE CONFLICTED MEMBER. |
| FORM 990, PAGE 6, PART VI, LINE 15A | COMPENSATION FOR THE COO IS DETERMINED BY THE COMPENSATION COMMITTEE OF THE RWHS BOARD. THE DETERMINATION IS BASED ON MARKET DATA AND RECOMMENDATIONS FROM AN INDEPENDENT CONSULTING FIRM WHO COLLECTS THAT INFORMATION FOR COMPARISON PURPOSES. MINUTES ARE KEPT OF THESE MEETINGS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | COMPENSATION FOR THE CEO AND KEY EMPLOYEES IS REVIEWED BY AN INDEPENDENT CONSULTANT ON AN ANNUAL BASIS TO ENSURE THE COMPENSATION PLAN MEETS REASONABLENESS TESTING COMPARED TO MGMA COMPENSATION SURVEY. THE COMPENSATION MODEL IS ALSO REVIEWED BY LEGAL COUNSEL FOR REASONABLENESS AND COMPLIANCE WITH IRS REQUIREMENTS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS AND POLICIES ARE MADE AVAILABLE TO THE PUBLIC THROUGH BEING POSTED ON THE ORGANIZATION'S WEBSITE. |
| FORM 990, PART IX, LINE 11G | MEDICAL TRANSCRIPTION & BILLI 336,629 0 0 LOCUM MEDICAL COVERAGE FEES 12,274,521 0 0 TOTAL 12,611,150 0 0 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Business Name Line2DirectControllingEntityName/BusinessNameLine2Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| REGIONAL WEST HEALTH SERVICES | ||||||||||||
| 4021 AVENUE B | SCOTTSBLUFF | NE | 69361 | 363314157 | SUPPORT | NE | 501C3 | 12A | N/A | false | ||
| REGIONAL WEST MEDICAL CENTER | ||||||||||||
| 4021 AVENUE B | SCOTTSBLUF | NE | 69361 | 470385129 | HOSPITAL | 501C3 | 3 | N/A | false | |||
| REGIONAL WEST GARDEN COUNTY | ||||||||||||
| 4021 AVENUE B | SCOTTSBLUF | NE | 69361 | 391904975 | CAH | 501C3 | 3 | false | RWHS | REGIONAL WEST HEALTH SERVICES | ||
| REGIONAL WEST FOUNDATION | ||||||||||||
| 4021 AVENUE B | SCOTTSBLUF | NE | 69361 | 237171022 | FDRAISING | 501C3 | 12B | N/A | false | |||
| REGIONAL WEST VILLAGE | ||||||||||||
| 4021 AVENUE B | SCOTTSBLUF | NE | 69361 | 363314162 | RETIREMENT | 501C3 | 10 | N/A | false | |||
| REGIONAL WEST HEALTH SERVICES & AFF | ||||||||||||
| 4021 AVENUE B | SCOTTSBLUF | NE | 69361 | 470658690 | HEALTH PLA | 501C9 | N/A | false | ||||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REGIONAL CARE INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4021 AVENUE B | AddressLine1Txt |
| City | SCOTTSBLUF | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 69361 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470760050 | EIN |
| Primary Activities | TPA | PrimaryActivitiesTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| REGIONAL WEST MEDICAL CENTER | ||
| K | $1,374,296 | CASH |
| REGIONAL WEST FOUNDATION | ||
| B | $4,880 | CASH |
| REGIONAL WEST MEDICAL CENTER | ||
| C | $23,359,200 | CASH |
| REGIONAL WEST MEDICAL CENTER | ||
| M | $338,364 | CASH |