2018-08-10T15:10:19-05:00 2017-09-30 470585450 DOHMAN AKERLUND & EDDY LLC PO BOX 470 AURORA NE 688180470 990 2016-10-01 470379039 YORK GENERAL HEALTH CARE SERVICES YORK 4023626671 2222 LINCOLN AVENUE YORK NE 68467 ROBERT MCQUISTAN VP OF FINANCE 4023626671 2018-07-02 true TIMOTHY J COUFAL P00964304 4026946404 2018-07-02 2016 2022-09-23 18:48:47Z ROBERT MCQUISTAN SAME AS C ABOVE YORK NE 68467 45349527 false X WWW.YORKGENERAL.ORG X 1946 NE TO BE A REGIONAL HEALTHCARE PROVIDER FOR THE CITIZENS OF YORK COUNTY AND ITS CONTIGUOUS COUNTIES WITH READILY ACCESSIBLE HIGH QUALITY PRIMARY, OBSTETRICAL, MENTAL HEALTH, MEDICAL, SURGICAL, PEDIATRIC, AND LONG TERM HEALTH CARE PROGRAMS AND SERVICES. TO PROVIDE HIGH QUALITY PHYSICAL AND MANPOWER RESOURCES. TO OPERATE WITHIN RESPONSIBLE FISCAL GUIDELINES WITHOUT COMPROMISING PATIENT AND RESIDENT CARE IN PROVIDING PHYSICAL RESOURCES, MANPOWER AND SERVICES. TO BE A LEADER IN ADVOCATING HIGH QUALITY HEALH CARE PROGRAMS, DEVELOPING RESOURCES, AND PROVIDING SERVICES AND PROGRAMS THAT MEET BOTH PREVENTATIVE AND PRIMARY HEALTH CARE NEEDS TO THE CITIZENS OF THE SERVICE AREA. TO ESTABLISH AN ON-GOING PROCESS THAT INSURES THAT THE ORGANIZATION IS MEASURABLY MEETING ITS MISSION COMMITMENTS TO ITS PATIENTS, RESIDENTS, PHYSICAINS, EMPLOYEES, AND COMMUNITIES. 12 7 601 0 41241 58080 41604760 44646797 218987 232797 93017 93550 41958005 45031224 0 0 22943261 24420151 0 0 17991220 18451512 40934481 42871663 1023524 2159561 75425266 76753396 22704996 21873565 52720270 54879831 X TO BE A REGIONAL HEALTHCARE PROVIDER FOR THE CITIZENS OF YORK COUNTY AND ITS CONTIGUOUS COUNTIES WITH READILY ACCESSIBLE HIGH QUALITY PRIMARY, OBSTETRICAL, MENTAL HEALTH, MEDICAL, SURGICAL, PEDIATRIC, AND LONG TERM HEALTH CARE PROGRAMS AND SERVICES. TO PROVIDE HIGH QUALITY PHYSICAL AND MANPOWER RESOURCES. TO OPERATE WITHIN RESPONSIBLE FISCAL GUIDELINES WITHOUT COMPROMISING PATIENT AND RESIDENT CARE IN PROVIDING PHYSICAL RESOURCES, MANPOWER AND SERVICES. TO BE A LEADER IN ADVOCATING HIGH QUALITY HEALH CARE PROGRAMS, DEVELOPING RESOURCES, AND PROVIDING SERVICES AND PROGRAMS THAT MEET BOTH PREVENTATIVE AND PRIMARY HEALTH CARE NEEDS TO THE CITIZENS OF THE SERVICE AREA. TO ESTABLISH AN ON-GOING PROCESS THAT INSURES THAT THE ORGANIZATION IS MEASURABLY MEETING ITS MISSION COMMITMENTS TO ITS PATIENTS, RESIDENTS, PHYSICAINS, EMPLOYEES, AND COMMUNITIES. false false 30993065 44646798 PROVIDED 2,858 PATIENT DAYS OF MEDICAL SERVICES AND 40,041 LONG-TERM CARE RESIDENT DAYS TO A VARIETY OF PATIENTS REGARDLESS OF ABILITY TO PAY FOR THOSE SERVICES. PROVIDE ADDITIONAL SERVICES TO ADDRESS INDIVIDUAL HEALTH INCLUDING ASSISTED LIVING, FITNESS CENTER, HOME HEALTH AND CHILD CARE. 30993065 true true false false false false false false false true true false false false true true true false false false false false false false false false true true false false true true false false false false false false false true true true false false false false false true false false false true 44 0 true 601 true false false false false false true true X 12 7 true false false false false false false true true false false true true true true true true true true false X ROBERT MCQUISTAN 4023626671 2222 LINCOLN AVENUE YORK NE 68467 CHARLES HARRIS CHAIRMAN 0.25 X 0 0 0 DON WITTE VICE CHAIR 0.25 X 0 0 0 ANN KIRKPATRICK SECRETARY 0.25 X 0 0 0 CG KELLY HOLTHUS TREASURER 0.25 X 0 0 0 PATRICK HOTOVY MD CHIEF OF STA 0.25 X 0 0 0 KRIS HOLOCH MEMBER 0.25 X 0 0 0 DARROLL J LOSCHEN MEMBER 0.25 X 0 0 0 CY NORTH MEMBER 0.25 X 0 0 0 CANDACE OTTE MEMBER 0.25 X 0 0 0 SALLY RUBEN MEMBER 0.25 X 0 0 0 JERRY STAHR MEMBER 0.25 X 0 0 0 KELLY THOMAS MEMBER 0.25 X 0 0 0 CHARLES SCHULZ CEO (RETIRED 40.00 X 234683 0 26079 JENNIFER OBERMIER VP OF NURSIN 40.00 X 173295 0 26443 ROBERT MCQUISTAN VP OF FINANC 40.00 X 169440 0 23370 JAY COLBURN VP OF LTC 40.00 X 131924 0 0 JAMES ULRICH CEO 40.00 X 36910 0 2979 THOMAS C MCKENNY CRNA 40.00 X 247158 0 19496 MATTHEW MONTGOMERY CRNA 40.00 X 210537 0 21293 MICHAEL D MONFORE CRNA 40.00 X 209629 0 13694 CORNELL H BONDE PHARMACIST 40.00 X 155261 0 20364 ERIK PETERSON PHARMACIST 40.00 X 132493 0 0 JOHN KOWALSKI PHYSICAL THE 40.00 X 117812 0 0 JAMIE H JOHNSON PHARMACIST 35.00 X 109662 0 0 BRENT ENNINGA OCCUPATIONAL 40.00 X 109032 0 0 2037836 153718 14 false true false YORK MEDICAL CLINIC 2114 N LINCOLN AVE YORK NE 68467 ER PHYSICIAN 1027728 SAMPSON CONSTRUCTION 3730 S 14TH ST LINCOLN NE 68502 CONST MGR 659305 MIDLANDS MECHANICAL INC 8425 WIRT ST OMAHA NE 68134 CONTRACTOR 508521 MCCORMICKS HEATINGAC 302 GRANT AVE YORK NE 68467 CONTRACTOR 496807 JLC INC PO BOX 147 YORK NE 68467 CONTRACTOR 412165 13 58080 58080 NET PATIENT SERVICE REVENUE 622110 32877620 32877620 NET RESIDENT SERVICE REVENUE 623110 8583555 8583555 HEARTHSTONE HOUSING 623990 1972143 1972143 HC+ MANAGEMENT AND STAFFING 900099 302341 302341 DAYCARE 624410 302298 302298 608840 608840 44646797 226119 226119 342645 249095 93550 93550 93550 75886 69208 6678 6678 6678 45031224 44653475 319669 1413576 840619 572957 18258889 13493578 4765311 560373 404367 156006 2809299 2148661 660638 1378014 995447 382567 35567 35567 238287 238287 1160818 834337 326481 139560 70710 68850 567054 394934 172120 4441651 3093460 1348191 PRO CARE OF PATIENTS-HOSP 7261014 7261014 ADMINISTRATIVE&GENERAL-HO 1756217 1756217 RENTAL/LEASE 465867 420904 44963 DIETARY-LTC 410541 22917 387624 1974936 1012117 962819 42871663 30993065 11878598 0 7877830 8786160 10122349 10317800 5222267 5669978 62152 62152 861460 882242 474070 544524 99801303 50599645 49819063 49201658 986075 1288882 75425266 76753396 4476002 5139049 180449 28904 17980000 16635000 68545 70612 22704996 21873565 X 52092101 54243378 628169 636453 52720270 54879831 75425266 76753396 2159561 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5935928 2107300 704574 -2626104 -4770 6116928 6887341 2148025 667786 -3761597 -5627 5935928 8743132 4541776 706516 -7097088 -6989 6887341 5386637 6445694 726323 -3808797 -6725 8743132 7221798 2545451 925319 -5302529 -3402 5386637 0.89600 0.10400 false false 456000 1305027 1761027 73863095 30662189 43200906 1744511 1178103 566408 21310572 18759353 2551219 1122098 1122098 49201658 DEPOSITS 60612 EST. THIRD-PARTY PAYOR SETTLEMENTS 10000 70612 X 44976076 44976076 55148 55148 45031224 42824799 42824799 46864 46864 42871663 SCHEDULE D, PAGE 2, PART V, LINE 4 ASSETS WHOSE USE IS LIMITED OR RESTRICTED: FUNDS ON DEPOSIT WITH TRUSTEE - 2,684,438 BOND FUNDS AND DEBT SERVICE FUNDS ARE AVAILABLE TO MEET PRINCIPAL AND INTEREST PAYMENTS ON BONDS OUTSTANDING. CONSTRUCTION FUNDS ARE USED TO PAY COSTS OF THE HOSPITAL PROJECT. BY BOARD FOR ENDOWMENT FUND - 2,686,049 ASSETS SET ASIDE FOR FUTURE CAPITAL IMPROVEMENTS. BY BOARD FOR SCHOLARSHIP FUND - 99,805 INTENDED FOR SCHOLARSHIPS IN THE HEALTHCARE FIELD. BY DONORS OR GRANTORS - 636,453 INTENDED FOR VARIOUS HOSPITAL EQUIPMENT AND OPERATIONS. ESCROW DEPOSITS - 10,183 RETURNED TO DUPLEX OWNERS OR LESSEES AND APARTMENT RESIDENTS. SCHEDULE D, PAGE 3, PART X THE MEDICAL FACILITY HAS NO RESERVE FOR UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2017 AND 2016. SCHEDULE D, PAGE 4, PART XI, LINE 4B TEMPORARILY RESTRICTED CONTRIBUTIONS 55,148 SCHEDULE D, PAGE 4, PART XII, LINE 4B NET ASSETS RELEASED FROM RESTRICTION FOR OPERATING PURPOSE 46,864 true true X true X true X true true true false true true 662178 662178 0.01540 2134831 1795251 339580 0.00790 2797009 1795251 1001758 0.02340 68253 68253 0.00160 75258 75258 0.00180 3895011 3264999 630012 0.01470 2250 2250 0.00010 4040772 3264999 775773 0.01810 6837781 5060250 1777531 0.04150 48187 48187 0.00110 94800 94800 0.00220 65049 65049 0.00150 144453 144453 0.00340 352489 352489 0.00820 true 481486 24074 13249562 13096983 152579 X true true 1 1 YORK GENERAL HEALTH CARE SERVICES 2222 LINCOLN AVE YORK NE 68467 X X X SKILLED NURSING, ASST. LIVING YORK GENERAL HEALTH CARE SERVICES 1 false false true X X X X X X X X X 15 true false true true X WWW.YORKGENERAL.ORG X true 15 true WWW.YORKGENERAL.ORG false false true X 100.000000000000 200.000000000000 X X X true true X X X X true X WWW.YORKGENERAL.ORG X WWW.YORKGENERAL.ORG X WWW.YORKGENERAL.ORG X X X X X X X true X false X X X X true X false false FACILITY 1, YORK GENERAL HEALTH CARE SERVICES - PART V, LINE 5 IN APRIL OF 2015, FOUR CORNERS HEALTH DEPARTMENT LAUNCHED A COMMUNITY ASSESSMENT PROJECT THAT WILL HAVE LASTING EFFECTS FOR THE ENTIRE PUBLIC HEALTH SYSTEM IN THE DISTRICT. MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) IS A DYNAMIC PROCESS DEVELOPED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AND THE NATIONAL ASSOCIATION OF CITY AND COUNTY HEALTH OFFICIALS (NACCHO) THAT HELPS COMMUNITIES PRIORITIZE PUBLIC HEALTH ISSUES AND IDENTIFY RESOURCES FOR ADDRESSING THEM. COMMUNITY OWNERSHIP IS THE FUNDAMENTAL COMPONENT OF MAPP. THE MAPP PROJECT INCLUDES FOUR COMMUNITY ASSESSMENTS. IN THIS REPORT, WE HAVE FOCUSED ON THE RESULTS OF THE COMMUNITY THEMES AND STRENGTHS ASSESSMENT. THE COMMUNITY THEMES AND STRENGTHS ASSESSMENT FOCUSES ON COLLECTING THE COMMUNITYS PERSPECTIVE ON ISSUES SUCH AS HEALTH CARE, EDUCATION, CARE FOR OLDER ADULTS, JOBS, SUPPORT NETWORKS, HEALTH PROBLEMS, AND RISKY BEHAVIORS. A SURVEY WAS DESIGNED BY UTILIZING A SAMPLE SURVEY PROVIDED BY NACCHO. MAPP ADVISORY COMMITTEE MEMBERS WORKED TOGETHER TO DISTRIBUTE PAPER COPIES OF THE SURVEYS AT COMMUNITY MEETINGS SUCH AS ROTARY, KIWANIS, OR SERTOMA CLUBS. THEY WERE TAKEN TO CHURCHES, SCHOOL EVENTS, COUNTY FAIRS, ETC. THE SURVEY WAS DISTRIBUTED THROUGHOUT THE DISTRICT FROM MAY TO OCTOBER 2015. RESPONSES WERE RECEIVED FROM 817 INDIVIDUALS. IN YORK COUNTY, 350 RESPONSES WERE RECEIVED. COLLABORATORS INCLUDE INDIVIDUALS FROM POLK COUNTY EXTENSION SERVICES, YORK MEDICAL CLINIC, HENDERSON HEALTH CARE, MIDWEST COVENANT HOME, POLK COUNTY HEALTH DEPARTMENT, PARISH NURSING, TABITHA, BUTLER COUNTY, YORK PUBLIC SCHOOL NURSE, YORK COLLEGE, EPWORTH VILLAGE, SEWARD COUNTY EXTENSION, BLUE VALLEY COMMUNITY ACTION, ANNIE JEFFREY, MEMORIAL HEALTH CARE SYSTEMS (SEWARD), BUTLER COUNTY EXTENSION, DAVID CITY SENIOR CENTER, ST. JOSEPH'S VILLA, YORK GENERAL HEALTH CARE SERVICES AND DAVID PLACE. FACILITY 1, YORK GENERAL HEALTH CARE SERVICES - PART V, LINE 6B CONDUCTED CHNA IN CONJUCTION WITH FOUR CORNERS PUBLIC HEALTH. FACILITY 1, YORK GENERAL HEALTH CARE SERVICES - PART V, LINE 11 YORK GENERAL IS ADDRESSING THE FIVE HEALTH NEEDS IDENTIFIED IN THE COMMUNITY BY: 1. OBESITY: YORK GENERAL WELLNESS CENTER PROVIDES AN AFFORDABLE OPTION FOR COMMUNITY MEMBERS SEEKING TO INCREASE THEIR PHYSICAL ACTIVITY AND WELL BEING. WELLNESS STAFF CAN PROVIDE CONSULTATION TO INDIVIDUAL COMMUNITY MEMBER'S THAT FOCUSES ON HEALTHLY LIFESTYLE MAINTENANCE. YORK GENERAL HOSPITAL CAN PROVIDE NUTRITIONAL COUNSELING WITH ONE OF OUR REGISTERED DIETICIANS. 2. CANCER: YORK GENERAL HOSPITAL PROVIDES COMPREHENSIVE CANCER SERVICES TO AREA PATIENTS. YORK GENERAL'S ONCOLOGY DEPARTMENT AND EXPERIENCED STAFF ARE EQUIPPED TO PROVIDE CARE TO PATIENTS RECEIVING CHEMOTHERAPY AND RELATED CANCER TREATMENTS. YORK GENERAL HOSPITAL SPECIALTY CLINIC PROVIDES A VISITING ONCOLOGY PHYSICIAN TWICE A MONTH IN SPECIALTY CLINIC, ALLOWING PATIENTS TO RECEIVE TREATMENT CLOSE TO HOME. 3. SUICIDE: YORK GENERAL EMERGENCY DEPARTMENT TREATS VARIOUS PATIENTS WHO ARE DEALING WITH SUICIDE OR SEEKING TREATMENT DUE TO SUICIDAL TENDENCIES. YORK GENERAL ABILITY TO IMPACT PATIENTS AND THE COMMUNITY WILL INCLUDE THOSE THAT SEEK TREATMENT DUE TO SUICIDAL TENDENCIES, AND EDUCATION OF THE COMMUNITY. 4. MENTAL HEALTH PROBLEMS: YORK GENERAL CURRENTLY PROVIDES FOUR DAYS OF SPECIALTY CLINIC COVERAGE WITH A MENTAL HEALTH PROFESSIONAL. YORK GENERAL DOES NOT HAVE INPATIENT MENTAL HEALTH TREATMENT AVAILABLE, BUT CAN ADDRESS THAT COMMUNITY NEED OF OUTPATIENT SERVICES THROUGH OUR SPECIALTY CLINIC. 5. ALCOHOL ABUSE: BASIC REFERRAL SERVICES FOR SUBSTANCE ABUSE TREATMENT ARE AVAILABLE. YORK GENERAL HOSPITAL IS NOT ABLE TO PROVIDE LONG TERM INPATIENT SUBSTANCE ABUSE TREATMENT. IT IS IN THE BEST INTEREST OF THE PATIENT TO ACCEPT REFERRAL AS WE DO NOT HAVE THE STAFF WITH THE EXPERTISE AVAILABLE IN SUBSTANCE ABUSE TREATMENT. YORK GENERAL HOSPITAL IS ABLE TO REFER PATIENT WITH SUBSTANCE ABUSE NEEDS TO VARIETY OF SERVICES THROUGHOUT THE STATE OF NEBRASKA. WE ARE ABLE TO ADDRESS ALCOHOL ABUSE IN THE COMMUNITY THROUGH PROMOTING AWARENESS AND PROVIDING EDUCATION. FACILITY 1, YORK GENERAL HEALTH CARE SERVICES - PART V, LINE 16J THE POLICY IS MENTIONED ON ALL FOLLOW UP ACCOUNT COLLECTION PHONE CALLS. 5 YORK GENERAL HEARTHSTONE 2222 LINCOLN AVE YORK NE 68467 SKILLED NURSING FACILITY YORK GENERAL DIALYSIS 2319 LINCOLN AVE YORK NE 68467 DIALYSIS YORK GENERAL HOME HEALTH 2319 LINCOLN AVE YORK NE 68467 HOME HEALTH AGENCY YORK GENERAL WILLOW BROOK ASST LIVG 2714 N LINCOLN AVE YORK NE 68467 ASSISTED LIVING YORK GEN MEADOWLARK INDEP LIVING 406 MEADOWVIEW DR YORK NE 68467 INDEPENDENT LIVING PART I, LINE 6A - RELATED ORGANIZATION INFORMATION COMMUNITY BENEFIT REPORT WAS PREPARED IN CONJUNCTION WITH THE NEBRASKA HOSPITAL ASSOCIATION. PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION COSTING METHODOLOGY FOR TABLE IN PART I - OVERALL COST TO CHARGE RATIO EXCEPT FOR SUBSIDISED HEALTH SERVICES WHERE COSTS WERE TAKEN FROM THE MEDICARE COST REPORT. PART II - COMMUNITY BUILDING ACTIVITIES THE HOSPITAL HAS MANY ACTIVITIES TO PROMOTE HEALTH IN THE COMMUNITIES SERVED. THESE ACTIVITIES INCLUDE SPONSOR OF HEALTH FAIR, SUPPORT GROUPS, EDUCATION PROGRAMS, AND MEDICATION ASSISTANCE. THE DONATED SERVICES AND FUNDS HELP FURTHER THE MISSION AND GOALS OF COMMUNITY ORGANIZATIONS WHICH, IN TURN, HELP IMPROVE OVERALL HEALTH STATUS AND QUALITY OF LIFE OF THE COMMUNITIES SERVED. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY THE ORGANIZATION'S FINANCIAL STATEMENT FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE IS FOOTNOTE (2), STARTING ON PAGE 13 OF THE FINANCIAL STATEMENTS. PART III, LINE 2 - COSTING METHODOLOGY FOR LINE 2 - OVERALL COST TO CHARGE RATIO WAS USED TO DETERMINE AMOUNTS REPORTED ON SCHEDULE H, PART III, LINE 2. BAD DEBT EXPENSE REPORTED WAS 1,003,686. PART III, LINE 3 - COSTING METHODOLOGY FOR LINE 3 - AFTER REVIEW OF BAD DEBTS WRITTEN OFF IT WAS DETERMINED APPROXIMATELY 5% OF BAD DEBT ACCOUNTS WRITTEN OFF WOULD HAVE QUALIFIED FOR CHARITY CARE IF THE INDIVIDUALS WOULD HAVE COMPLETED THE APPLICATION PROCESS. PART III, LINE 8 - RATIONALE FOR INCLUDING BAD DEBT AMOUNTS AS COMMUITY BENEFIT - WE DO NOT CONSIDER BAD DEBT AS COMMUNITY BENEFIT. PART III, LINE 8 - MEDICARE EXPLANATION THE MEDICARE COST REPORT WHICH USES COST TO CHARGE RATIOS BY DEPARTMENT WAS USED TO DETERMINE THE AMOUNTS REPORTED ON LINE 8. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION COLLECTION ACTIONS. FAILURE TO MAKE AND HONOR SATISFACTORY ARRANGEMENTS FOR PAYMENT TO THE HOSPITAL MAY RESULT IN REFERRAL TO A COLLECTION AGENCY, REPORTING TO THE CREDIT AGENCIES, AND LEGAL ACTION. THE HOSPITAL WILL NOT TAKE AN EXTRAORDINARY COLLECTION ACTION (LEGAL ACTION, REPORTING TO CREDIT AGENCY) UNTIL REASONABLE EFFORTS HAVE BEEN TAKEN TO DETERMINE IF A PERSON IS ELIGIBLE FOR FINANCIAL ASSISTANCE. IF A PERSON APPLIES FOR FINANCIAL ASSISTANCE UNDER THIS POLICY, ALL COLLECTION EFFORTS WILL STOP UNTIL THE DETERMINATION OF ELIGIBILITY FOR FINANCIAL ASSISTANCE IS MADE. IN THE EVENT A PATIENT APPLIES FOR FINANCIAL ASSISTANCE IN A TIMELY MANNER RELATED TO THE DATE WHEN CARE WAS PROVIDED AND IS DEEMED TO QUALIFY FOR FINANCIAL ASSISTANCE, THE HOSPITAL WILL TAKE STEPS TO REVERSE COLLECTION ACTIONS, REPORTS, AND OTHER ACTIONS THAT HAVE BEEN TAKEN TO OBTAIN PAYMENT. UPON RECEIPT OF A COMPLETED FINANCIAL ASSISTANCE APPLICATION, NO FURTHER COLLECTION ACTION SHALL BE TAKEN AGAINST A PATIENT UNTIL THE FINANCE COMMITTEE HAS REVIEWED AND MADE A DETERMINATION ON THE APPLICATION ACCORDING TO THE PROCESS SET FORTH HEREIN. PART VI, LINE 2 - NEEDS ASSESSMENT THE BOARD MEMBERS ARE ACTIVE IN THE COMMUNITY AND IN TOUCH WITH THE RESIDENTS OF YORK COUNTY AND ARE AWARE OF THE NEEDS OF THE COMMUNITY, ON AN ONGOING BASIS. THE ADDITION OF OUR DIALYSIS PROGRAM WAS A RESULT OF BOARD INTERACTION WITH THE COMMUNITY. IN ADDITION, THE ORGANIZATION CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT IN DECEMBER 2015. EFFORTS WERE COORDINATED WITH THE LOCAL PUBLIC HEALTH OFFICE. THE HOSPITAL HAS DEVELOPED ONGOING RELATIONSHIPS WITH THE PUBLIC SCHOOL SYSTEM AND LOCAL COLLEGE AND ARE MADE AWARE OF ANY HEALTHCARE NEEDS FROM THESE INSTITUTIONS. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE THE CHARITY CARE NOTICE IS POSTED IN THE ADMITTING BOOTHS AT THE MAIN ENTRANCE, IN ER, AND IN THE SPECIALTY CLINIC. A WRITTEN NOTICE IS PROVIDED TO EACH PERSON SEEKING SERVICES. THE CHARITY CARE POLICY IS ALSO DISCUSSED WITH PATIENTS WHEN MAKING COLLECTION CALLS. PART VI, LINE 4 - COMMUNITY INFORMATION YORK, NE IS LOCATED AT THE INTERSECTION OF U.S. HIGHWAY 81 AND INTERSTATE 80. THE POPULATION OF YORK COUNTY AS OF 2010 WAS 13,665. THE AVERAGE HOUSEHOLD INCOME IS ALMOST 54,000. THE UNEMPLOYMENT RATE IN THE YORK COUNTY AREA WAS 4.3% IN 2009. AS OF 2008, APPROXIMATELY 9% OF PEOPLE OF ALL AGES WERE IN POVERTY. YORK COUNTY IS CURRENTLY NOT DESIGNATED AS A MEDICALLY UNDERSERVED AREA. APPROXIMATELY 6% OF HOSPITAL REVENUES ARE FROM MEDICAID ELIGIBLE PATIENTS. APPROXIMATELY 3% OF HOSPITAL GROSS REVENUES ARE FROM PATIENTS WITH NO INSURANCE COVERAGE. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE PRIMARY SERVICE AREA OF YORK GENERAL HEALTH CARE SERVICES. THE OCCUPATIONS OF THE BOARD MEMBERS INCLUDE BUSINESS PROFESSIONALS, RETIRED MEDICAL PROFESSIONALS, FARMER, AND LAWYER. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY. SURPLUS FUNDS ARE USED TO UPDATE AND ADD NEW TECHNOLOGY AND EQUIPMENT, ADD NEW SERVICES, AND UPDATE THE PHYSICAL FACILITIES. OVER THE PAST YEARS, PROJECTS THAT HAVE BEEN EITHER PARTIALLY FUNDED OR TOTALLY FUNDED WITH SURPLUS REVENUES INCLUDE THE FOLLOWING: A NEW 129 BED NURSING HOME TO REPLACE AN OUTDATED AND UNSAFE FACILITY, NEW ASSISTED LIVING FACILITY, ADDITION OF DIALYSIS SERVICES FOR THE COMMUNITY, NEW MEDICAL OFFICE BUILDING AND WELLNESS CENTER, HOSPITAL REMODEL AND EXPANSION, DIGITAL MAMMOGRAPHY, AND CT AND MRI UPDATES. THESE ARE SOME OF THE MORE RECENT MAJOR PROJECTS. WE HAVE BEEN ABLE TO MAKE AVAILABLE TO THE RESIDENTS OF YORK THESE NEW SERVICES. THE ORGANIZATION IS ALSO ACTIVE IN ONGOING HEALTH AND WELLNESS ACTIVITIES IN THE COMMUNITY AND SCHOOLS. X false true X X false true false false false false false false false CHARLES SCHULZ CEO (RETIRED) 218343 16340 9747 16332 260762 JENNIFER OBERMIER VP OF NURSING 165795 7500 6810 19633 199738 ROBERT MCQUISTAN VP OF FINANCE 163440 6000 7043 16327 192810 THOMAS C MCKENNY CRNA 247158 10260 9236 266654 MATTHEW MONTGOMERY CRNA 210537 9018 12275 231830 MICHAEL D MONFORE CRNA 209629 4458 9236 223323 CORNELL H BONDE PHARMACIST 155261 6889 13475 175625 SCHEDULE J, PAGE 1, PART I, LINE 1A A NEW CEO WAS HIRED IN OCTOBER 2016. HE WAS GIVEN A TEMPORARY HOUSING ALLOWANCE UNTIL HIS EXISTING RESIDENCE SOLD AND WAS ABLE TO MOVE TO THE COMMUNITY. TOTAL ALLOWANCE FOR 2016 WAS 4,080. SCHEDULE J, PAGE 1, PART I, LINE 1B THE HOUSING ALLOWANCE WAS NEGOTIATED IN THE CEO EMPLOYMENT CONTRACT. THE EMPLOYMENT CONTRACT WAS AUTHORIZED BY THE BOARD OF DIRECTORS EXECUTIVE COMMITTEE. SCHEDULE J, PAGE 1, PART I, LINE 4 CHARLES SCHULZ 0 9,747 0 JENNIFER OBERMIER 0 6,810 0 ROBERT MCQUISTAN 0 7,043 0 THOMAS C. MCKENNY 0 10,260 0 MATTHEW MONTGOMERY 0 9,018 0 MICHAEL D. MONFORE 0 4,458 0 A HOSPITAL AUTH NO 1 OF YORK COUNTY NE 470769138 986356HC0 2013-07-09 3380000 REFUND PRIOR ISSUES (04/15/03) false false false B HOSPITAL AUTH NO 1 2014 LTCHOSP 470769138 986356HD8 2014-04-30 8780000 REFUNDS PRIOR ISSUES (09/23/09) AND HOSPITAL PROJECT false false false C HOSPITAL AUTH NO 1 2015 HOSPITAL 470769138 986356HR7 2015-07-02 8250000 REFUNDS PRIOR ISSUE (09/30/10) AND HOSPITAL PROJECT false false false A 1320000 3380000 344896 3380000 2005 true false true true B 1565000 8797790 883764 2316 3152722 5468886 false true true true C 890000 8260333 681536 1691950 6568383 true false true true A false false false false false false true B false false false false false false true C false false false false false false true A false true true false false false false false true B false true false false false false false false true C false true true false false false false false true A true B true C true SCHEDULE K - ADDITIONAL INFORMATION HOSPITAL AUTH NO. 1 2014 LTC/HOSP. THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS. HOSPITAL AUTH NO. 1 2015 HOSPITAL THE TOTAL PROCEEDS DO NOT EQUAL THE SUMMATION OF LINES 4-12 DUE TO TRANSFERRED OR REPLACEMENT PROCEEDS IN LINE 4. CORNERSTONE BANK SEE PART V SEE PART V false SCHEDULE L, PART V SCHEDULE L, PART IV: (A) NAME OF INTERESTED PERSON: CORNERSTONE BANK (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION: C.G. KELLY HOLTUS IS PRESIDENT OF CORNERSTONE BANK, HIS DAUGHTER KRIS HOLOCH IS ALSO EMPLOYED AS AN OFFICER AT CORNERSTONE BANK AND TOGETHER THEY OWN GREATER THAN 35% INTEREST IN CORNERSTONE BANK. CHARLES HARRIS, KELLY THOMAS, AND CANDACE OTTE ARE ALL ON CORNERSTONE BANK'S BOARD OF DIRECTORS. (C) & (D) AMOUNT AND DESCRIPTION OF TRANSACTION: VARIOUS TRANSACTIONS IN CAPICITY AS YORK GENERAL HEALTH CARE SERVICES' FINANICAL INSTITUTION. ADDIONTALLY, CORNERSTONE BANK IS TRUSTEE TO BOND FUNDS IN WHICH 1,864,152 WAS DEPOSITED THIS YEAR. FORM 990 - ORGANIZATION'S MISSION TO BE A REGIONAL HEALTHCARE PROVIDER FOR THE CITIZENS OF YORK COUNTY AND ITS CONTIGUOUS COUNTIES WITH READILY ACCESSIBLE HIGH QUALITY PRIMARY, OBSTETRICAL, MENTAL HEALTH, MEDICAL, SURGICAL, PEDIATRIC, AND LONG TERM HEALTH CARE PROGRAMS AND SERVICES. TO PROVIDE HIGH QUALITY PHYSICAL AND MANPOWER RESOURCES. TO OPERATE WITHIN RESPONSIBLE FISCAL GUIDELINES WITHOUT COMPROMISING PATIENT AND RESIDENT CARE IN PROVIDING PHYSICAL RESOURCES, MANPOWER AND SERVICES. TO BE A LEADER IN ADVOCATING HIGH QUALITY HEALH CARE PROGRAMS, DEVELOPING RESOURCES, AND PROVIDING SERVICES AND PROGRAMS THAT MEET BOTH PREVENTATIVE AND PRIMARY HEALTH CARE NEEDS TO THE CITIZENS OF THE SERVICE AREA. TO ESTABLISH AN ON-GOING PROCESS THAT INSURES THAT THE ORGANIZATION IS MEASURABLY MEETING ITS MISSION COMMITMENTS TO ITS PATIENTS, RESIDENTS, PHYSICAINS, EMPLOYEES, AND COMMUNITIES. FORM 990, PAGE 6, PART VI, LINE 2 C.G. KELLY HOLTHUS KRIS HOLOCH TREASURER BOARD MEMBER FAMILY C.G. KELLY HOLTHUS CORNERSTONE BANK TREASURER PRESIDENT GREATER THAN 35% OWNER KRIS HOLOCH CORNERSTONE BANK BOARD MEMBER OFFICER OFFICER CHARLES HARRIS CORNERSTONE BANK CHAIRMAN DIRECTOR DIRECTOR KELLY THOMAS CORNERSTONE BANK BOARD MEMBER DIRECTOR DIRECTOR CANDACE OTTE CORNERSTONE BANK BOARD MEMBER DIRECTOR DIRECTOR FORM 990, PAGE 6, PART VI, LINE 11B THE 990 IS REVIEWED BY THE VP OF FINANCE AND IS SENT TO EACH DIRECTOR FOR THEIR REVIEW. FORM 990, PAGE 6, PART VI, LINE 12C ANY MEMBERS WITH A CONFLICT OF INTEREST ABSTAIN FROM VOTING. THE ABSTENTION IS DOCUMENTED IN THE MEETING MINUTES. FORM 990, PAGE 6, PART VI, LINE 15A THE BOARD OF DIRECTORS REVIEWS THE COMPENSATION FOR THE CEO. A COMPARISON OF AREA CEOS IS INCLUDED. FORM 990, PAGE 6, PART VI, LINE 15B A SALARY SURVEY FOR KEY EMPLOYEES IS COMPLETED BY HUMAN RESOURCES. THE H.R. DIRECTOR REVIEWS THE INFORMATION WITH THE CEO AND A RECOMMENDATION IS MADE. FORM 990, PAGE 6, PART VI, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST STATEMENTS, AND FINANCIAL STATEMENTS ARE ALL AVAILABLE UPON REQUEST FOR REVIEW ON THE PREMISES. MEADOW VIEW RETIREMENT HOMES 2319 N LINCOLN AVE YORK NE 68467 900149281 SR. LIVING NE 501C3 YGHCS false HOME CARE PLUS 2319 N LINCOLN AVE YORK NE 68467 470807087 HOME HLTH NE 501C3 YGHCS false false false false false false false false false false true false true false false false false false false false HOME CARE PLUS J 600 HOME CARE PLUS L 302341