COLUMBUS COMMUNITY HOSPITAL INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: COLUMBUS COMMUNITY HOSPITAL INC (EIN 47-0542043)
Tax period: 2016-05-01 to 2017-04-30
Filed: 2018-03-06
IRS object ID: 201820659349300017
Schema version: 2016v3.1
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-03-06T11:10:08-06:00	ReturnTs
Tax Period End	2017-04-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	KPMG LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	1212 North 96th Street Suite 300	AddressLine1Txt
City	Omaha	CityNm
State Abbreviation	NE	StateAbbreviationCd
ZIP	68114	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-05-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	470542043	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Columbus Community Hospital Inc	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% JENNIFER WEICK	InCareOfNm
Business Name Control	COLU	BusinessNameControlTxt
Phone	4025623357	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO Box 1800	AddressLine1Txt
City	Columbus	CityNm
State Abbreviation	NE	StateAbbreviationCd
ZIP	68602	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	CHAD VAN CLEAVE	PersonNm
Person Title	CFO	PersonTitleTxt
Signature	2018-03-05	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Donald Neal JR	PreparerPersonNm
PTIN	P00798244	PTIN
Phone	4023481450	PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	167.68.102.5	IPv4AddressTxt

Field	Value	IRS element (for citing)
Federal Original Submission Id	47006120180655000000	FederalOriginalSubmissionId
Federal Original Submission Id	2018-03-06	FederalOriginalSubmissionIdDt
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	DB8C3D1FB4BDA2FF595D15457AF05C6EFA64716E	AtSubmissionCreationDeviceId
At Submission Filing Device Id	55718AD0153E791F3315D72D27656E543FED7AC8	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	Chad Van Cleave	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4600 38th Street	AddressLine1Txt
City	Columbus	CityNm
State Abbreviation	NE	StateAbbreviationCd
ZIP	68601	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$94,990,468	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.columbushosp.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1972	FormationYr
Legal Domicile State	NE	LegalDomicileStateCd
Activity Or Mission	Our mission is to improve the health of the communities we serve.	ActivityOrMissionDesc
Voting Members Governing Body	10	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	754	TotalEmployeeCnt
Total Volunteers	245	TotalVolunteersCnt
Total Gross UBI	$13,524	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$228	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$562,546	PYContributionsGrantsAmt
CY Contributions Grants	$166,412	CYContributionsGrantsAmt
PY Program Service Revenue	$88,053,768	PYProgramServiceRevenueAmt
CY Program Service Revenue	$92,297,270	CYProgramServiceRevenueAmt
PY Investment Income	$349,992	PYInvestmentIncomeAmt
CY Investment Income	$476,260	CYInvestmentIncomeAmt
PY Other Revenue	$1,026,950	PYOtherRevenueAmt
CY Other Revenue	$1,793,461	CYOtherRevenueAmt
PY Total Revenue	$89,993,256	PYTotalRevenueAmt
CY Total Revenue	$94,733,403	CYTotalRevenueAmt
PY Grants And Similar Paid	$1,135,910	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$1,127,833	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$40,237,051	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$44,490,247	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$35,305,130	PYOtherExpensesAmt
CY Other Expenses	$37,097,142	CYOtherExpensesAmt
PY Total Expenses	$76,678,091	PYTotalExpensesAmt
CY Total Expenses	$82,715,222	CYTotalExpensesAmt
PY Revenues Less Expenses	$13,315,165	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$12,018,181	CYRevenuesLessExpensesAmt
Total Assets BOY	$114,831,604	TotalAssetsBOYAmt
Total Assets EOY	$127,571,692	TotalAssetsEOYAmt
Total Liabilities BOY	$7,057,792	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$7,824,117	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$107,773,812	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$119,747,575	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	Our mission is to improve the health of the communities we serve.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$79,142,051	ExpenseAmt
Grant	$5,300	GrantAmt
Revenue	$92,786,527	RevenueAmt
Desc	Columbus Community Hospital (CCH) is a 47 bed acute care hospital which currently employs over 750 people. It is a significant, positive economic force for the Columbus area, returning dollars into the economy through local purchases by the organization and salaries that return to the community. It is an asset for the local communities where patients can obtain quality health care without the need to drive over 50 miles for care. CCH offers a variety of services that provide necessary care for area residents. Below is a brief summary of services offered by Columbus Community Hospital: - All 47 beds of the Hospital's acute care services are also certified as swing beds. - CCH provides certified, dedicated medical interpreters to assist non-English speaking patients. The interpreters are available in-house or on-call 24/7 and serve as a liaison between the care providers and the patient. - The Hospital provides ICU, medical surgical, OB and orthopedic services, along with a variety of complimentary ancillary services. These ancillary services include wound care, diabetic education and cardiac rehab and also include clinical pharmacy services. To enhance patient safety, CCH uses bar-coded medication administration, smart pumps and computerized physician order entry. - So that area residents can receive care close to home, CCH offers rehabilitative services that include physical therapy, speech therapy, occupational therapy as well as specialized multidisciplinary therapy programs such as thrive cancer rehabilitation care, parkinson wellness program, consussion management team, complete decongestive lymphedema therapy clinic, a driver's rehabilitation program, visual and vestibular rehab, aquatic therapy program, and pelvic floor dysfunction (male/female urinary incontinence and pelvic pain) program. The Hospital's Wiggles and Giggles Therapy for Kids offers pediatric physical, occupational and speech for children ranging in age from infants to adolescents. In November 2015, outpatient therapy services moved into first floor space with greater access for patients at the new columbus wellness center and now patients are integrated and transitioned into medical wellness programs after discharge such as the parkinson's exercise group, THE LOUD CROWD voice exercise group, tbi & stroke support group, spinefit exercise classes, aquatic exercise classes, and tai chi for better balance classes. - Nurses in the Hospital's Same Day Services (SDS) Department prepare patients for surgery and care for patients in both the inpatient and outpatient setting. The Department oversees several outpatient procedures, including an average of 80 endoscopy procedures each month. SDS nurses also administer blood transfusions and chemotherapy infusions. - CCH offers some of the most advanced imaging services including MRI, CT, Digital Mammography and ultrasound. Radiologists are on campus and/or available 24/7. All images are digital, and the dictation used by radiologists is voice recognized and becomes part of the digital image. - The Hospital's laboratory performs an average of 13,000 tests per month for both inpatients and outpatients. - The CCH Emergency Department (ED) employs highly trained emergency physicians and nurses, offering 24/7 care. Other Hospital departments providing support in the ED include Respiratory Care, Social Work, Laboratory, Medical Interpreters and Diagnostic Imaging. In May, 2006, the CCH Emergency Department was designated as a Level III Trauma Center. The Medical Staff and personnel in the Trauma Center have received specialized training to resuscitate and stabilize trauma patients. The Trauma Program provides systematic review of trauma care and participates in injury prevention activities throughout the community. - CCH opened wound care services in August, 2008, offering office hours one day per week. The identified service area includes a 45-mile radius around Columbus. By January 2009, a second day was added to support the demand. The program has exceeded the anticipated demand and provides a much needed service close to home. The center averages more than 100 patient visits per month for wound care. - For services located in facilities off-site, the larger services are Home Health and Hospice. Home Health provides skilled health services for patients at their place of residence. The program is medically directed and must be ordered by the attending physician. Home Health is Medicare and Medicaid Certified and meets the requirements of the Joint Commission. Services provided within the program are: - Supervision and administration of medications - Intravenous therapy - Instructing patients in diabetic management - Nutritional assessments - Home Health aides - Personal care services - Occupational, speech and physical therapies - Hospice services are provided to persons who are no longer receiving curative treatment and whose life expectancy is six months or less. Care is provided by an interdisciplinary team which consists of the physician, nurse, social worker, therapist, Home Health aide, spiritual advisor, volunteer and other health professionals. - Our local Healthy Family Nebraska Program (HFN) targets young, primarily single, pregnant mothers and their families. Our voluntary HFN home visitation program targets the most vulnerable young women and their families by offering them intense, in-home education, support and resources. This home visiting program covers families in a four county area. The HFN requires each mother/family to actively participate in building an individualized family plan. This strength-based approach promotes self-improvement and enhances self-esteem and independence for our young parents that will help them make better decisions and break out of destructive cycles. - The CCH Sleep Lab offers complete polysomnographic sleep testing by trained and licensed sleep technicians for the purpose of diagnosing obstructive/central sleep apnea. Both daytime and night sleep studies are performed. - Occupational Health Services (OHS) offers a menu of health care services designed to prevent and treat injuries in the workplace. Partnering with employers in more than 800 companies and with other health care professions, OHS provides the Columbus and regional area businesses and industry with a comprehensive range of services designed to support and maintain a healthy, safe workforce while assisting them in meeting OSHA and DOT compliance regulations. Their full range of services include: - A comprehensive testing procedure called Physical Capacity Profile (PCP) that matches employees to the job and is designed to accommodate individuals with handicaps. The PCP system was developed by an orthopedic physician. Through use of this testing, musculoskeletal imbalances are detected which helps employers place employees in the appropriate job to minimize the potential of injury. - 24/7 drug and alcohol testing services - Pre-employment/post job offer physical assessments - On-site nursing services - Hearing/vision testing - Hearing conservation program management - Respiratory fit testing - Respiratory evaluation services - Flu shots and immunization programs - Wellness programs - Lifeline, an in-home emergency response program, provides the vital safety net that many people need to continue living at home in familiar and comforting surroundings. The program is completely focused on ensuring the patient's independence, safety and well-being in their home. It operates with a bracelet worn by the patient with a button that can be pressed if help is needed. Pre-determined responders are summoned to their home or emergency transfer can be call if needed. - Meals on Wheels are prepared by the Nutrition Services Department and are delivered by community volunteers. Seniors and physically handicapped adults qualify for the program. Special diets can also be accommodated. Financial assistance is available through the Nebraska Department of Social Services. - The Hospital also participates in and has hosted county-wide natural disaster and pandemic drills. As a member of a larger preparedness team, RROMRS, CCH can assist or receive assistance from this region's Medicare providers. Through these drills and exercises, the Hospital is well-prepared to handle a natural disaster or pandemic should one arise. - To better service our community, Columbus Community Hospital has partnered with Columbus Children's Healthcare to create the Columbus Community Hospital Pediatric Hospitalist Program in May of 2017. This service is applicable to inpatient and observation care only to patients ages newborn to age 18. Pediatric Hospitalists routinely complete rounds in morning and evenings, and as census and acuity demands. Physicians from other communities who are not currently credentialed at Columbus Community Hospital may refer to the Pediatric Hospitalist group for admission.Community Hospital may refer to the Pediatric Hospitalist gro	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$1,122,533	ExpenseAmt
Grant	$1,122,533	GrantAmt
Desc	PROVIDE UNCOMPENSATED SERVICES TO PEOPLE WHO ARE UNABLE TO PAY. CCH CHARITY/FINANCIAL AID POLICY REFLECTS THE MISSION, VISION AND VALUES OF CCH. IT IS INTENDED TO ASSIST LOW-INCOME, UNDERINSURED, AND UNINSURED INDIVIDUALS WHOSE FINANCIAL STATUS, UNDER THE HOSPITAL'S QUALIFICATION CRITERIA, MAKES IT IMPRACTICAL OR IMPOSSIBLE TO PAY FOR NECESSARY MEDICAL SERVICES. CCH HAS A FIDUCIARY RESPONSIBILITY TO SEEK PAYMENT FOR SERVICES FROM THOSE WHO CAN PAY, AND EVERY EFFORT WILL BE MADE TO APPLY CONSISTENT, FAIR AND EQUITABLE FINANCIAL AID PRACTICES IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. CCH FOLLOWS THE FEDERAL POVERTY GUIDELINES (FPG) TO DETERMINE BOTH ELIGIBILITY FOR FREE CARE, 130% OF FPG, AND DISCOUNTED CARE, 200% FPG. CCH ALSO OFFERS CATASTROPHIC CHARITY ASSISTANCE. IF THE APPLICANT QUALIFIES FOR PARTIAL CHARITY/FINANCIAL ASSISTANCE AND THE TOTAL BALANCE AFTER ALL WRITE-OFF'S IS GREATER THAN $1,200, AN ADDITIONAL WRITE-OFF WILL BE DONE AS OUTLINED BELOW: - REDUCE TO $1,200 - ADJUSTMENTS WILL BE DONE FROM OLDEST TO NEWEST	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$80,264,584	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	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	Yes (true)	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	Yes (true)	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	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	Yes (true)	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	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	Yes (true)	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	55	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	754	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
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	10	GoverningBodyVotingMembersCnt
Independent Voting Member	10	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
States Where Copy Of Return Is Fld	NE	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	JENNIFER WEICK	PersonNm
Phone	4025624646	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4600 38th Street	AddressLine1Txt
City	Columbus	CityNm
State Abbreviation	NE	StateAbbreviationCd
ZIP	68601	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd
Brian Schmidt
Chairman	1.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
Clark Lehr
Vice Chairman	1.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
Brett Bonwell
Treasurer	1.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
Beth Przymus
Director	1.0	0.0	Yes (X)		$0	$0	$0
Bonnie McPhillips
Director	1.0	0.0	Yes (X)		$0	$0	$0
Christian VanKirk MD
Director	1.0	0.0	Yes (X)		$0	$0	$0
Jeffrey Gotschall MD
Director	1.0	0.0	Yes (X)		$0	$0	$0
Ronald Ernst MD
Director	1.0	0.0	Yes (X)		$0	$0	$0
Stan Emerson
Director	1.0	0.0	Yes (X)		$0	$0	$0
Tim Tooley
Director	1.0	0.0	Yes (X)		$0	$0	$0
Amy Blaser
VP Business Development	40.0	0.0		Yes (X)	$147,980	$0	$40,397
Chad Van Cleave
VP Finance	40.0	0.0		Yes (X)	$145,427	$0	$39,757
Scott Messersmith
VP Operations	40.0	0.0		Yes (X)	$127,239	$0	$38,896
Linda Walline
VP Nursing	40.0	0.0		Yes (X)	$202,212	$0	$43,502
Michael Hansen
President/CEO/Secretary	39.0	1.0		Yes (X)	$441,708	$0	$73,656
Dustin Volkmer MD
Physician	40.0	0.0			$536,748	$0	$34,156	Yes (X)
Edward Fehringer MD
Physician	40.0	0.0			$651,704	$0	$34,156	Yes (X)
Mark Howerter MD
Physician	40.0	0.0			$473,619	$0	$34,156	Yes (X)
Michael McGuire MD
Physician	40.0	0.0			$498,138	$0	$34,156	Yes (X)
Richard Cimpl MD
Physician	40.0	0.0			$581,573	$0	$34,166	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$3,806,348	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$406,998	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	52	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	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
B-D Construction Inc
2154 East 32nd Ave	Columbus	NE	68601	Construction	$1,940,294
McKesson Technologies Inc
PO Box 98347	Chicago	IL	60693	IT Consulting	$1,506,686
Inpatient Physician Associates
3200 Pine Lake Rd Suite A	Lincoln	NE	68516	Hospitalist Svcs	$996,935
JOURNEY GROUP COMPANIES
4500 W 58TH STREET	SIOUX FALLS	SD	57108	CONSTRUCTION	$417,016
ECG MANAGMENT CONSULTANTS
PO BOX 74008176	CHICAGO	IL	60674	MGMT CONSULTING	$191,679

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	10	CntrctRcvdGreaterThan100KCnt
Related Organizations	$147,588	RelatedOrganizationsAmt
All Other Contributions	$18,824	AllOtherContributionsAmt
Total Contributions	$166,412	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	Net Patient Service Revenue	Desc
Business	621110	BusinessCd
Total Revenue Column	$92,297,270	TotalRevenueColumnAmt
Related Or Exempt Func Income	$92,297,270	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$92,297,270	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$476,190	TotalRevenueColumnAmt
Exclusion	$476,190	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$375,740	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$257,065	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$118,675	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$118,675	TotalRevenueColumnAmt
Exclusion	$118,675	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$70	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	$70	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$70	TotalRevenueColumnAmt
Exclusion	$70	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
Meals on Wheels	900099	$70,099	$70,099
Cafeteria	900099	$297,334		$297,334
Health Watch	900099	$56,991	$56,991

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,250,362	TotalRevenueColumnAmt
Related Or Exempt Func Income	$362,167	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$13,524	UnrelatedBusinessRevenueAmt
Exclusion	$874,671	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,674,786	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$94,733,403	TotalRevenueColumnAmt
Related Or Exempt Func Income	$92,786,527	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$13,524	UnrelatedBusinessRevenueAmt
Exclusion	$1,766,940	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$5,300	TotalAmt
Program Services	$5,300	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$1,122,533	TotalAmt
Program Services	$1,122,533	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,300,774	TotalAmt
Management And General	$1,300,774	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$33,695,151	TotalAmt
Program Services	$33,695,151	ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,191,314	TotalAmt
Program Services	$1,191,314	ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$5,968,944	TotalAmt
Program Services	$5,968,944	ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$2,334,064	TotalAmt
Program Services	$2,334,064	ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$160,253	TotalAmt
Management And General	$160,253	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$221,127	TotalAmt
Management And General	$221,127	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$7,191	TotalAmt
Management And General	$7,191	ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$5,704	TotalAmt
Program Services	$5,704	ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$3,593,681	TotalAmt
Program Services	$3,593,681	ProgramServicesAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$290,352	TotalAmt
Management And General	$290,352	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$11,293,855	TotalAmt
Program Services	$11,170,258	ProgramServicesAmt
Management And General	$123,597	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$1,843,025	TotalAmt
Program Services	$1,843,025	ProgramServicesAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,472,528	TotalAmt
Program Services	$1,472,528	ProgramServicesAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$212,892	TotalAmt
Management And General	$212,892	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$134,452	TotalAmt
Management And General	$134,452	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$7,161,889	TotalAmt
Program Services	$7,161,889	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$273,501	TotalAmt
Program Services	$273,501	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
Provision for Bad Debts	$4,450,101	$4,450,101	$0	$0
Minor Equip & Financing AGR	$2,424,469	$2,424,469
Purchased Services	$2,362,890	$2,362,890
Recruiting	$511,594	$511,594

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$677,638	TotalAmt
Program Services	$677,638	ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$82,715,222	TotalAmt
Program Services	$80,264,584	ProgramServicesAmt
Management And General	$2,450,638	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$8,653,858	BOYAmt
EOY	$11,776,546	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$8,358,859	BOYAmt
EOY	$10,954,395	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$594,349	BOYAmt
EOY	$644,121	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,569,487	BOYAmt
EOY	$1,826,002	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$1,853,872	BOYAmt
EOY	$2,130,291	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$117,516,929	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$63,938,290	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$52,223,278	BOYAmt
EOY	$53,578,639	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$41,380,166	BOYAmt
EOY	$46,390,805	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$197,735	BOYAmt
EOY	$270,893	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$114,831,604	BOYAmt
EOY	$127,571,692	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$7,057,792	BOYAmt
EOY	$7,824,117	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$7,057,792	BOYAmt
EOY	$7,824,117	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$107,773,812	BOYAmt
EOY	$119,747,575	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$107,773,812	BOYAmt
EOY	$119,747,575	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$114,831,604	BOYAmt
EOY	$127,571,692	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$12,018,181	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$141,991	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$186,409	OtherChangesInNetAssetsAmt
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	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	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 C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	Yes (true)	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$7,191	OtherActivitiesAmt
Total Lobbying Expenditures	$7,191	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule C, Part II-B, Line 1g	FormAndLineReferenceDesc
Explanation	Direct contact with state and federal legislators, their staff and other government officials. We have advocated for rural healthcare legislation (e.g. Rural Hospital Demonstration Program). Schedule C, Part II-B, Line 1I Dues paid to American Hospital Association allocated to lobbying $3,020 and dues paid to Nebraska Hospital Association allocated to lobbying $4,171.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,832,057	BeginningYearBalanceAmt
Contributions	$14,348	ContributionsAmt
End Year Balance	$1,846,405	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,806,283	BeginningYearBalanceAmt
Contributions	$25,774	ContributionsAmt
End Year Balance	$1,832,057	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,798,246	BeginningYearBalanceAmt
Contributions	$8,037	ContributionsAmt
End Year Balance	$1,806,283	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,742,125	BeginningYearBalanceAmt
Contributions	$56,121	ContributionsAmt
End Year Balance	$1,798,246	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,667,736	BeginningYearBalanceAmt
Contributions	$74,389	ContributionsAmt
End Year Balance	$1,742,125	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	1.00000	PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (true)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (true)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,152,275	OtherCostOrOtherBasisAmt
Book Value	$1,152,275	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$64,346,398	OtherCostOrOtherBasisAmt
Depreciation	$27,295,400	DepreciationAmt
Book Value	$37,050,998	BookValueAmt

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovementsGrp

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$42,052,125	OtherCostOrOtherBasisAmt
Depreciation	$33,787,565	DepreciationAmt
Book Value	$8,264,560	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$9,966,131	OtherCostOrOtherBasisAmt
Depreciation	$2,855,325	DepreciationAmt
Book Value	$7,110,806	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$53,578,639	TotalBookValueLandBuildingsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt
Total Liability	$0	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule D, Part V, Line 4

Endowment funds are held and maintained by Columbus Community Hospital Foundation. The endowment funds exist in support of improved health services by Columbus Community Hospital.

Schedule D, Part X, Line 2

The Hospital adopted Financial Accounting Standards Baord (FASB) Interpretation No. 48, Accounting for Uncertainty in Income Taxes - an Interpretation of FASB Statement No, 109. FIN 48 provides specific guidance on how to address uncertainty in accounting for income tax assets and liabilities, prescribing recognition thresholds and measurement attributes. The adoption of FIN 48 by Columbus Community Hospital did not have a material impact on the Hospital's financial position, results of operations, or cash flows. In fiscal years ending 2017 and 2016, management determined that there are no income tax positions requiring recognition in the financial statements.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	130.	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent200 D	Yes (X)	Percent200DInd
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$558,909	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$558,909	NetCommunityBenefitExpnsAmt
Total Expense	0.00710	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,714,940	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,308,945	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,405,995	NetCommunityBenefitExpnsAmt
Total Expense	0.03070	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,273,849	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,308,945	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,964,904	NetCommunityBenefitExpnsAmt
Total Expense	0.03780	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Persons Served	161186	PersonsServedCnt
Total Community Benefit Expns	$218,718	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,000	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$216,718	NetCommunityBenefitExpnsAmt
Total Expense	0.00280	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$599,586	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$599,586	NetCommunityBenefitExpnsAmt
Total Expense	0.00770	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$26,354	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$26,354	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Persons Served	161186	PersonsServedCnt
Total Community Benefit Expns	$844,658	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,000	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$842,658	NetCommunityBenefitExpnsAmt
Total Expense	0.01080	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Persons Served	161186	PersonsServedCnt
Total Community Benefit Expns	$6,118,507	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,310,945	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,807,562	NetCommunityBenefitExpnsAmt
Total Expense	0.04860	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Persons Served	7960	PersonsServedCnt
Total Community Benefit Expns	$866,826	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$83,933	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$782,893	NetCommunityBenefitExpnsAmt
Total Expense	0.01000	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Persons Served	320	PersonsServedCnt
Total Community Benefit Expns	$23,800	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$9,985	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$13,815	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Persons Served	2165	PersonsServedCnt
Total Community Benefit Expns	$2,831	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,831	NetCommunityBenefitExpnsAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Persons Served	10445	PersonsServedCnt
Total Community Benefit Expns	$893,457	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$93,918	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$799,539	NetCommunityBenefitExpnsAmt
Total Expense	0.01020	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$4,450,101	BadDebtExpenseAmt
Reimbursed By Medicare	$20,100,992	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$24,616,919	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$4,515,927	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)

Primary ActivitiesPrimaryActivitiesTxt	Org Profit Or OwnershipOrgProfitOrOwnershipPct	Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
HealthPark LLC
Property management	0.2721	0.7279
ZARZ LLC
Property management	0.1	0.9

Field	Value	IRS element (for citing)
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	Columbus Community Hospital Inc	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4600 38th Street	AddressLine1Txt
City	Columbus	CityNm
State Abbreviation	NE	StateAbbreviationCd
ZIP	686011800	ZIPCd

Field	Value	IRS element (for citing)
Website Address	www.colubushosp.org	WebsiteAddressTxt
State License	License #630001	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd
Other	47 Bed Acute Care Hospital w/ 24 hr ER Services	OtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Columbus Community Hospital Inc	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	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	15	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	See Section C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	15	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	See Section C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	130.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	200.	FPGFamilyIncmLmtDscntCarePct
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	See Section C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	See Section C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	See Section C	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 Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Line 5	MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP (MAPP) PROCESS WAS DEVELOPED BY AND IS RECOMMENDED FOR COMMUNITY ASSESSMENT BY THE NATIONAL ASSOCIATION OF CITY AND COUNTY HEALTH OFFICIALS (NACCHO) AND CENTER FOR DISEASE CONTROL (CDC). MAPP WAS ALSO A RECOMMENDED COMMUNITY ASSESSMENT BY THE NEBRASKA RURAL HEALTH ASSOCIATION IN ITS COMMUNITY HEALTH ASSESSMENT COLLABORATIVE PRELIMINARY RECOMMENDATIONS FOR NEBRASKA'S COMMUNITY, NONPROFIT HOSPITALS TO COMPLY WITH NEW REQUIREMENTS FOR TAX EXEMPT STATUS ENACTED BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (SEPTEMBER OF 2011). MAPP ALLOWS FOR INPUT FROM PARTIES WHO REPRESENT BROAD INTERESTS IN THE COMMUNITIES. INPUT FROM DIVERSE SECTORS INCLUDING MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY POPULATIONS AND INDIVIDUALS FROM DIVERSE AGE GROUPS WAS OBTAINED THROUGH SURVEYS, TARGETED FOCUS GROUPS, OPEN PUBLIC MEETINGS AND TARGET INVITATIONS TO COMMUNITY LEADERS AND AGENCIES. THE HOSPITAL'S PARTICIPATION IN THE CURRENT MAPP ASSESSMENT IS THE MOST THOROUGH TO DATE WITH OVER 100 INDIVIDUALS IN THE DISTRICT PARTICIPATING IN THE PROCESS. THIS DOES NOT COUNT THE 1,000 INDIVIDUAL SURVEYS OR FOCUS GROUP PARTICIPANTS.
Schedule H, Part V, Line 6a	- CHI Health, Schuyler - Genoa Community Hospital - Boone County Health Center
Schedule H, Part V, Line 6b	- East Central District Health Department - Good Neighbor Community Health Center
Schedule H, Part V, Line 7a	The detailed assessment and related components are available via link on https://www.columbushosp.org/news_events/community_health_needs_assessment _chna.aspx or available on request and available for review at Columbus Community Hospital.
Schedule H, Part V, Line 10a	THE IMPLEMENTATION STRATEGY IS AVAILABLE VIA LINK ON HTTPS://WWW.COLUMBUSHOSP.ORG/NEWS_EVENTS/CHIP_IMPLEMENTATION_PLAN_2015.ASP X
Schedule H, Part V, Line 11	CHNA Identified Health Care Needs The following "health priorities" were identified as recommended areas of intervention under the CHNA conducted in collaboration with the East Central District Health Department (contracting with Schmeekle Research, Inc.), covering the counties of Platte (where CCH is located), Boone, Colfax and Nance: - Access to health care - Obesity - Family support - Substance abuse - Mental health CCH will work hand-in-hand with the East Central District Health Department and other health and business-related agencies to address these needs. Specifically, CCH will take the lead in addressing the identified needs of access to health care and obesity by conducting the activities described below. It will support the identified needs of family support, substance abuse and mental health as requested by other participants of the CHNA that have agreed to take the lead in these areas. These participants already have programs in place and expertise in these areas. The allocation of duties in addressing these identified health care needs promotes program effectiveness and supports the efficient allocation of limited health care dollars. Implementation Strategy Access to Health Care: Objective: Currently working with UNMC to explore tele-endocrinology service. Action Step: Expanded telehealth services to include: access to psychiatry, geriatric psychiatry, endocrinology and pulmonary services. Began Telestroke Services and telehealth behavioral health assessment out of Emergency Department. Our community accesses these services through our Visiting Physicians Clinic and/or our Emergency Department. Objective: Make eHealth Library on CCH Website good resource for public Action Step: eHealth library/CCH website continues to be updated with the newest information on service lines and resources. eHealth Library has been accessed more each year. It continues to be a reputable resource for all. The eHealth Library has been promoted through tactics such as: social media posts, newspaper promotion, access to the library through a link on our homepage and a link on our Health Education Departments webpage, and through postcard handouts that were developed and are distributed by our Pre-admissions Department. These tactics aim to continually engage the public in the latest health news and drive them to our eHealth Library for additional health information. Approximately 529 more visitors accessed the eHealth Library in FY 2017 (2,429 visitors) compared to FY 2016 (1,900 visitors). Objective: Expanding Visiting Physicians Clinic (VPC) to increase office hours. Physician recruitment for multiple specialties and local family practice clinics. Action Step: Continued physician recruitment and increased access to Visiting Physicians Clinic. -2017 acquisition of ENT clinic to allow for expansion of providers and services -Physician recruitment includes the addition of multiple subspecialties to include: otolaryngologist, radiologist, pediatricians, cardiologist, hospitalist, ophthalmologist, orthopedics, psychiatrist, urologist, neurologist, interventional pain, pediatric urologist and family practice and cancer geneticist. -Welcomed six new physicians to area specialty clinics and family practice clinics -Began CCH Pediatric Hospitalist Program, contracted service agreement with CCH and Columbus Childrens Healthcare. Available for patients 18 years and younger for inpatient and observation care at CCH. A combination of regular and NICU inpatients along with newborn and observation admissions are served by this program, averaging in total 15 patients per month. Objective: Community Wellness and lifestyle change Action Step: Great success in promoting healthy lifestyles in a variety of methods. -Healthy cooking demonstration classes offered monthly. For FYE 2017, 134 people participated in the Healthy Cooking classes. -Therapy Wellness Gardens. The multi-level planters house herbs that patients with limited mobility can tend to expand their skills while landscaping and gardening. For FYE 2017, 12 patients participated in the Therapy Wellness Gardens. -Healthy Mobile Bus (Hy-Vee) at Columbus Wellness Center offers free screenings and diagnostic services including bone mineral density screen, multiple wellness screenings and a wellness profile complete with blood analysis offered for a reduced price. From May 1, 2016 April 30, 2017, two Hy-Vee Healthy You Mobile events were held at the Columbus Wellness Center. Please see the number of community members served at each event below for your reference: August 16, 2016 21 community members March 22, 2017 15 community members -Continuing the CHIP program to promote evidence-based medical guidelines to live a healthy lifestyle. CHIP Program continues to grow and expand. CHIP classes being offered through July 7th. The program is offered to physician-referred clients and has been expanded to the general public. To date, there have been 124 graduates of the CHIP program. Total weight lost: 999 lbs. Objective: Establish Child Care Services for employees and the community Action Step: CCH Child Care Facility opens with capacity for 105 infants and children from six weeks to 13 years of age. Approximately 149 children were served in FYE 2017 at the CCH Child Care facility. Objective: Expanded patient transportation for CCH clients in order to service our clients safely, efficiently and ensure they have a safe ride home. Action Step: Contracted with Checker Cab company to provide 24/7 access cab service available for patients up to a 150-mile disposition radius. Objective: CCH exploring behavioral health service line enhancement within the community. Action Step: Establish telehealth behavioral health line to Bryan from the Emergency Department. Exploring ways to bring needed crisis stabilization services and respite beds to the area. Access to Health Care objectives has remained a priority area through the last three cycles. Each key objective has seen improvements when measured in comparison to data on these SMART indicators from one survey to the next. Overall, the goal is to incrementally increase the number of people who visit an MD in a year. Our current SMART indicator is: 'Increase the percent of people who visited an MD in the past twelve months'. It is currently up to 65 percent, from 62.1 percent in the previous survey and considerably up from 52 percent in the 2009 survey. These objectives related to the success of these action plans, can be measured and quantified. With the increase in availability of these health resources, MD offices and specialist clinics, as well as the increase in available screenings, people are, in fact, getting in front of a medical provider more frequently than in the past. It is expected that a strong emphasis in these and additional heath care needs will continue as a primary focus in the future cycles. Family Health and Wellness (Obesity): Objective: Grow the Platte County CHIP Obesity Coalition and gather resources for public distribution. Action Step: Through a grant funded opportunity through the Rural Futures Institute, the Platte County Lifestyle Coalition has been participating in quarterly workshops beginning in October 2017. These workshops are led by faculty from University of Kansas, University of Nebraska Kearney and UNMC. The goal of these workshops is to align various wellness activities as offered through Columbus Community Hospital and area business and industry to continue to change the culture of health and wellness, making our community and surrounding area a healthier place in which to live. Membership of the coalition has also grown through various direct email and calling efforts to include local representatives of secondary education, business, industry and county employees. Objective: Reduce the number of community members who are considered obese. Action Step: Since June 2016, the Columbus Community Hospital has implemented the Complete Health Improvement Program (CHIP). The program is a twelve week, eighteen session program designed for intensive therapeutic lifestyle change. Participants also are required to participate in baseline, midpoint and endpoint biometrics and fasting lab work. Upon successful completion of the program, participants are invited to participate in Club CHIP, a post CHIP support program designed to encourage CHIP graduates to maintain their health improvements long term. In FY 2017, 90 people participated in CHIP with 81 of them successfully completing the program. Family Support: To improve the stability, health and well-being of women, infants, children and families through effective use of community resources. The Child Well-Being Group (CWB) through their Zero2Eight initiatives and activities lead the way in identifying and addressing family needs. The Platte Colfax Zero2Eight Child Well-Being (CWB) coalitions leadership team is managing the Community Based Child Abuse Prevention (CBCAP), Promoting Safe an
Schedule H, Part V, Line 16A	https://www.columbushosp.org/for_patients_visitors/patients_financial_info rmation/discount_charity_care_programs.aspx
Schedule H, Part V, Line 16B	https://www.columbushosp.org/sites/www/Uploads/Charity-Financial%20Assista nce%20Application%20-%20English.pdf https://www.columbushosp.org/sites/www/Uploads/Charity-Financial%20Assista nce%20Applicaiton%20-%20Spanish.pdf
SCHEDULE H, PART V, LINE 16C	https://www.columbushosp.org/sites/www/Uploads/files/CCHFinancialAssistanc ePolicySummary.pdf

Field	Value	IRS element (for citing)
Facility	4	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
Humphrey Clinic of CCH
3003 Main Street	Humphrey	NE	686423155	Rural Health Clinic to offer medical services to residents
Hospice of Columbus Community Hospital
3005-19th St Suite 600	Columbus	NE	686014248	Hospice Services
Home Health of Columbus Community Hosp
3005-16th St Suite 600	Columbus	NE	686014248	Home Health Services
Columbus Orthopedic & Sports Med Clinic
4508 38th St Suite 133	Columbus	NE	686011668	Free Standing Clinic

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 3c	N/A
Schedule H, Part I, Line 6a	A COMMUNITY BENEFIT REPORT IS INCLUDED EACH YEAR IN THE HOSPITAL'S QUARTERLY NEWSLETTER HOUSECALL WITH AN ELECTRONIC VERSION OF THE NEWSLETTER HOUSED ON THE HOSPITAL'S WEBSITE. A SEPARATE LANDING PAGE ON THE WEBSITE WAS ALSO CREATED FOR THE REPORT TO PROVIDE EASY ACCESS TO THE REPORT.
Schedule H, Part I, Line 7B	THE REVENUE GENERATED BY MEDICAID PATIENTS IS MULTIPLIED BY THE COST TO CHARGE RATIO DEVELOPED IN WORKSHEET 2. THE REMAINING PRODUCT IS THE CALCULATED COST ASSOCIATED WITH THE CHARGES FROM MEDICAID PATIENTS. THESE COSTS ARE REDUCED BY THE REIMBURSEMENTS COLLECTED FOR THE MEDICAID CHARGES. THE REMAINING NUMBER IS THE NET COMMUNITY BENEFIT EXPENSE. SCHEDULE H, PART I, LINE 7E EXPENSES REPRESENT WAGES ALONG WITH SERVICES AND SUPPLIES PURCHASED BY THE HOSPITAL. DIRECT OFFSETTING REVENUES REPRESENT CASH COLLECTED FOR THESE SERVICES. SCHEDULE H, PART I, LINE 7I CASH DONATIONS MADE TO EAST CENTRAL HEALTH DEPARTMENT (ECHD) AND THE GOOD NEIGHBOR COMMUNITY HEALTH CENTER REPRESENT THE MAJORITY OF THESE DONATIONS. DONATIONS INCLUDE $8,000 FOR CERVICAL CANCER SCREENINGS FOR LOW-INCOME PATIENTS. PART I, LINE 7, COLUMN (F) THE AMOUNT OF 78,265,121 USED AS THE DENOMINATOR TO COMPUTE COLUMN (F) IS CALCULATED BY TAKING TOTAL FUNCTIONAL EXPENSES OF 82,715,222 MINUS BAD DEBT EXPENSE OF $4,450,101.
Schedule H, Part II	Community Building Activities Columbus Community Hospital (CCH) continues to collaborate with the local Chamber of Commerce to recruit skilled professionals to fill job openings in the community. The Hospital also provides support and staff time to assist in highlighting the health care community, offering specific department or Hospital tours in order to recruit skilled professionals to live and work in Columbus. On Hospital-donated land, the City of Columbus created a twelve acre urban lake and, on the same property, an additional 20 acres designated as the future site of a fire station. A handicap/stroller-accessible dock on the urban lake allows access for fishing or to watch water fowl rest in the area as they migrate through Columbus. The urban lake provides a community space within the city limits for people of all ages. The Hospital continues to partner with our local public health department and community health center (CHC) on several projects and community disease prevention initiatives, providing financial support and professional staff time as liaisons to these community partnerships throughout the year. Working together with these agencies, some of the chronic disease and accident prevention strategies addressed include: Type II Diabetes, hypertension and heart disease, pre and postnatal newborn care, physical activity and exercise, colon cancer prevention and early detection, and community preparedness for natural and man-made disasters. These programs reach countless members of the community each year, making a difference in the lives of people living with chronic health issues. Other hospital-driven community health initiatives include: free flu shots for residents at the shelter for the homeless and participation in numerous community health fairs/events each year providing medical screenings and free health information/education.To encourage entry into the medical profession, Columbus Community Hospital partners with local day care facilities, area schools and colleges, offering its medical professionals as guest speakers or instructors at hands-on learning events. To help in recruitment of health care professionals and also to relieve the daycare shortage in Columbus, the Hospital Board has also approved the construction of an on-site daycare and pre-school for Hospital employees. Columbus Community Hospital has an independent Board of Directors, consisting of community leaders with diverse backgrounds. The CCH Board approved the construction of a $21 million, 85,723 square foot community wellness facility that opened on October 27, 2015. The Columbus Family YMCA leased, below fair market value, 62,397 square feet of the facility that is available for use by the entire community and includes: 2 gyms, 3 pools, and weight and exercise equipment. Classes for wellness and fitness are provided by health care professionals from the Hospital and YMCA staff. In separate areas, the facility also houses the Hospital's adult and pediatric therapies. As a way to celebrate the two-year anniversary of Columbus Community Hospital Rehabilitative Services relocating to the Columbus Wellness Center, Columbus Community Hospital hosted an open house for all patients both past and present. Held at the Columbus Wellness Center, coffee, apple cider, hors d'oeuvres, door prizes were all welcomed features of the event. Musicians including cello, piano and flute brought a relaxing and beautiful atmosphere as physical, occupational and speech therapists shared memories with their patients. The event also acknowledged the exponential growth the Hospital's Rehabilitative Services department and the Columbus Wellness Center have seen since it was completed in 2015.
Schedule H, Part III, Line 2	The methodology used to estimate bad debt expense is to take the private pay write-offs for the year and divide them by the total revenue generated from self-pay patients and multiply the product by the self-pay accounts receivable. This gives the amount of reserve necessary to cover the potential bad debt in current self-pay accounts receivable. Bad debt expense for the fiscal year is the amount of additional expense necessary to bring that reserve account to the calculated (estimated) balance.
Schedule H, Part III, Line 3	N/A
Schedule H, Part III, Line 4	Financial statements do not include any text for bad debt. The amount in Line 2 is the book bad debt amount.
Schedule H, Part III, Line 8	In accordance with 42 CFR 413.24, Columbus Community Hospital uses the step-down method as its costing methodology. Departments within a provider are usually divided into two types: 1) Those that produce patient care revenue (e.g., routing services, radiology), and 2) Those that do not directly generate patient care revenue, but are utilized as a service by other departments (e.g., laundry and linen, dietary). The two types of departments are commonly referred to as revenue-producing cost centers and nonrevenue-producing cost centers. Although nonrevenue-producing cost center do not directly produce patient care revenue, they contribute indirectly to patient care revenue generated by serving as a service to the revenue-producing centers and also to other nonrevenue-producing centers. Therefore, for the purpose of proper matching of revenue and expenses, the cost of the revenue-producing centers should include both its direct expenses and its proportionate share of the costs of each nonrevenue-producing center (indirect costs) based on the amount of services received. The process of allocating the cost of a particular nonrevenue-producing center to other nonrevenue-producing centers and revenue-producing centers is performed by utilizing a set of statistics (e.g. pounds of laundry for allocating laundry and linen costs, square feet for allocating depreciation building costs). Every nonrevenue-producing cost center has the potential of being allocated to every other nonrevenue-producing cost center in addition to the revenue-producing cost centers. This precludes a simple allocation of the direct expense of the nonrevenue-producing cost center because the indirect costs derived from allocation of other nonrevenue-producing cost centers must be computed in determining the full cost (direct and indirect costs) of the nonrevenue-producing cost center being allocated. The step-down method recognizes that services furnished by certain nonrevenue-producing departments are utilized by certain other nonrevenue-producing centers as well as by the revenue-producing centers. All costs of nonrevenue-producing centers are allocated to all centers that they serve, regardless of whether or not these centers produce revenue. The cost of the nonrevenue-producing center servicing the greatest number of other centers, while receiving benefits from the least number of centers, is apportioned first. Following the apportionment of the cost of the non-revenue-producing center, that center will be considered closed and no further costs are apportioned to that center. This applies even though it may have received some service from a center whose cost is apportioned later. Generally, if two centers furnish services to an equal number of centers while receiving benefits from an equal number, that center which has the greatest amount of expense should be allocated first.
Schedule H, Part III, Line 9b	The purpose of our Financial Assistance/Charity Program is to further the charitable mission of CCH by providing financially disadvantaged and other qualified patients with an avenue to apply for and receive free or discounted care consistent with the requirements of the Internal Revenue Code and implementing regulations under Section 501(r). CCH's Financial Assistance Policy reflects the mission, vision and values of CCH. It is intended to assist low income, uninsured and underinsured individuals whose financial status, under the hospital's qualification criteria, makes it impractical or impossible to pay for medically necessary and emergency care. Our Financial Assistance Program has an implied and presumptive avenue, as well as medical indigence. This Program provides a fair and comprehensive system of distributing free or discounted medical care to poor and financially disadvantaged patients within the available resources of CCH. This Policy addresses: Eligibility criteria for financial assistance, The extent to which financial assistance includes free and discounted care, and medically indigent care, The basis for calculating amounts charged to eligible patients (the calculations of amounts generally billed), The method for applying for assistance and application period, Actions that may be taken by CCH in the event of nonpayment, and Measures to widely publicize the Policy. CCH recognizes the individual's right to obtain quality health care regardless of age, sex, race, disability, national origin, marital status, sexual orientation, personal beliefs or their ability to pay. CCH has a fiduciary responsibility to seek payment for services from those who can pay. Needs Assessment In 2010, Columbus Community Hospital began implementing a five year strategic plan. The plan includes a thorough assessment of the organization's external environment in terms of opportunities and threats, as well as an assessment of the organization's internal strengths and weaknesses. The plan also includes strategic issues, goals and related strategies for future organizational effectiveness. Six organizational pillars were identified: Quality, Culture, People, Service, Facilities and Finance. 1) Quality: Quality efforts have been focused on Evidence-Based Processes (EBP) and educating staff on the importance of using and integrating these processes in daily operations. CCH has implemented an electronic medical record to afford ease of information access and communication across the continuum of care. The clinical leadership groups for nursing and respiratory therapy have initiated a review of how to integrate EBP into the clinical areas and will be starting classes to educate staff within and outside nursing. 2) Culture: In an effort to achieve a high performance organization, CCH is in the process of implementing a 4-part culture improvement initiative that includes: TeamSTEPPS, Just Culture, patient focused excellence and Lean/Six Sigma Process Improvement. The Hospital continues to work with the Studer Group to hardwire appropriate tools, focusing on improving patient outcomes and create a culture/environment, making CCH an employer of choice, and where physicians want to bring their patients for care. 3) People: CCH has continued to be aggressive in its recruitment efforts to attract and retain the workforce needed to support strategic growth initiatives across all service lines. CCH is initiating a new on-boarding process for new employees. In addition, nursing has updated their orientation program and has trained preceptors and nurse mentors/coaches. 4) Services: CCH performs an annual comprehensive program review of existing and new services and has ranked priority service line development in the areas of hospital medicine, orthopedics, cardiology, cancer and rehab services. 5) Facilities: CCH has developed a comprehensive master facilities plan that can adapt to current and future patient care needs. An Emergency Department expansion was completed in 2012 with a new Medical Office Building recently completed to house visiting physicians and the Wound, Ostomy, and Continence Care (W.O.C.) Clinic. 6) Finance: CCH is working diligently to maintain financial stability. Our approach includes: work to extend the Demonstration Project with an alternate plan in place if the program is discontinued. The Hospital maintains a conservative successful investment strategy and continued growth in the CCH Foundation. Patient Education of Eligibility for Assistance Financial assistance information is available on the Hospital's website, including links to additional, in-depth information. CCH has taken measures to widely publicize the Financial Assistance Policy. Patient Charity/Financial Assistance Program: 1) If patients feel their income is not sufficient to pay for services at Columbus Community Hospital, they are encouraged to contact the Patient Accounts Department and/or Social Workers for information regarding charity/financial assistance. 2) Further information about Medicare/Medicaid/Charity Care is provided in both English and Spanish on our website and at each registration and patient accounts area. The State has Medicaid applications available online. Our Patient Accounts, registration and Social Services staff can provide patients with financial/charity applications in either English or Spanish. 3) Additionally, signage is posted directing patients to call as needed for financial help. Referrals are built into to the medical admission software. If patients share concerns about the cost or their lack of coverage, a referral is generated to Social Services staff who will see patients, individually, and counsel on specific circumstances. 4) Monthly statements include the following information: a. Payment plans b. Charity/Financial Assistance Program c. 24/7 online Business Office access, which includes information on payment plans, charity/financial assistance and applications for financial/charity assistant available in both English and Spanish that can be downloaded from our website. A hard copy with information is also available in the Guide to Patient Services located in each patient's room, as well as informative brochures located in outpatient areas. A step-by-step tutorial is also available, to help educate patients regarding what they need to bring when registering. 5) Also posted in English and Spanish are one page Policy Summary of Financial Assistance, listing of CCH and CCH - employed physicians, practioners and clinics, and a listing of independent physicians and other independents. Community Information The Local Economy Columbus Community Hospital is located in Columbus, Nebraska, which is the largest city in Platte County. With a growing population of 33,066, Platte County is the largest county of the seven counties in the CCH service area. From July 31, 2013 to July 31, 2014, unemployment in the City of Columbus decreased slightly from 3.9% or 756 jobless to 3.3% or 610 jobless. During this same period of time, the Nebraska jobless rate was 3.6% and the National average was reported at 6.2%. As reported in Money Magazine, Columbus is listed as the third best place in the U.S. to find employment and in the top 100 best small towns to live. Three counties in Nebraska were listed in the Top Ten Counties in the U.S. to live and work, including Platte, Madison (which is contiguous to Platte County) and Sarpy County near Lincoln, Nebraska. Our local economy is based on agriculture and manufacturing, with many industrial companies attracted by plentiful, low-priced hydroelectric power. A hard-working, well-educated workforce, low energy costs and a local environment friendly to business provide encouragement for strong economic and industrial development within our area. Among the major employers are Archer Daniels Midland (ADM), an ethanol manufacturing company; FLEXCON; Central Confinement Services; Pillen Family Farms; Vishay; two BD Medical Plants, medical equipment companies; Behlen Manufacturing, which manufactures steel buildings; and Nebraska Public Power, with headquarters located in Columbus. According to the Nebraska Department of labor, Columbus is considered a major hub for the manufacturing industry and has a greater share of manufacturing employment than other Nebraska metropolitan areas. We continue to see an influx of single and young families moving into our area seeking employment. Our community growth correlates to our continuing increase in hospital outpatient visits. Outpatient visits reached 52,976 visits for the fiscal year ending April, 2017. In 2005, our outpatient visits over a twelve month period totaled 38,129. This 38.9% increase in our outpatient visits over the past TWELVE years is a reflection of the significant impact the Demonstration Project has had on our Hospital. Service Capacity The WOUND, OSTOMY & CONTINENCE (WOC) HEALTH CENTER opened in August of 2008. It has grown to 1,416 patients/visits as

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

Field	Value	IRS element (for citing)
Grant Type	CHARITY CARE TO PATIENTS	GrantTypeTxt
Recipient	627	RecipientCnt
Non Cash Assistance	$1,122,533	NonCashAssistanceAmt
Valuation Method Used	BOOK	ValuationMethodUsedDesc
Non Cash Assistance	WRITE-OFF OF MED EXP	NonCashAssistanceDesc

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule I, Part I, Line 2	FormAndLineReferenceDesc
Explanation	Columbus Community Hospital does not typically give out donations, but occasionally a request is brought forward and the Board determines that it is in the best interest of the community to provide a particular grant. Prior to providing the grant, the Hospital determines that the organization it gives to is a 501(C)(3) organization or a government agency. The Hospital will also make grants to these related organizations as necessary to support their exempt purpose.	ExplanationTxt

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
Form990 Of Other Organizations	Yes (X)	Form990OfOtherOrganizationsInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
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	Yes (true)	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 (10 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Amy Blaser
VP Business Development	$135,379	$0	$12,601	$0	$0	$0	$16,841	$0	$25,334	$0	$190,155	$0	$0	$0
Chad Van Cleave
VP Finance	$132,885	$0	$12,542	$0	$0	$0	$16,201	$0	$25,325	$0	$186,953	$0	$0	$0
Scott Messersmith
VP Operations	$123,534	$0	$0	$0	$3,705	$0	$15,340	$0	$25,109	$0	$167,688	$0	$0	$0
Linda Walline
VP Nursing	$157,507	$0	$16,904	$0	$27,801	$0	$19,946	$0	$25,743	$0	$247,901	$0	$0	$0
Michael Hansen
President/CEO/Secretary	$376,833	$0	$46,875	$0	$18,000	$0	$51,100	$0	$26,517	$0	$519,325	$0	$0	$0
Dustin Volkmer MD
Physician	$448,374	$0	$88,374	$0	$0	$0	$10,600	$0	$27,459	$0	$574,807	$0	$0	$0
Edward Fehringer MD
Physician	$484,483	$0	$149,221	$0	$18,000	$0	$10,600	$0	$27,460	$0	$689,764	$0	$0	$0
Mark Howerter MD
Physician	$473,619	$0	$0	$0	$0	$0	$10,600	$0	$27,411	$0	$511,630	$0	$0	$0
Michael McGuire MD
Physician	$464,991	$0	$33,147	$0	$0	$0	$10,600	$0	$27,291	$0	$536,029	$0	$0	$0
Richard Cimpl MD
Physician	$462,731	$0	$100,842	$0	$18,000	$0	$10,600	$0	$27,470	$0	$619,643	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, Part I, Line 1a	The Organization paid for social and health club dues as part of the CEO's employment agreement. These amounts were reflected on the CEO's W-2.
Schedule J, Part I, Line 4b	The following reportable individuals participated in a supplemental nonqualified retirement plan during the 2016 calendar year. Amounts deferred from the plan were included in Column C of the Schedule J: Amy Blaser - $10,988 Chad Van Cleave - $11,238 Scott Messersmith - $10,431 Linda Walline - $13,929 Michael Hansen - $40,500
Schedule J, Part I, Line 4c	The Hospital's Executive Compensation Committee, made up of independent Hospital Board members, reviews the CEO's compensation annually. The wage range is compared to information provided by third party consultants. Decisions are documented.
Schedule J, Part I, Line 6a	With the assistance of Towers-Watson, executive compensation consultants, the Board authorized paying an incentive to the executives for meeting specific Board-Established Directives. The Board authorized paying up to 25% of base compensation for Michael Hansen and up to 20% for the following VPs: - Linda Walline - Amy Blaser - Chad Van Cleave The incentive is based on goals established by the Board which are now reviewed annually. One of the goals is the Hospital's operating margin. The Board determines the associated metrics for each individual goal. Each of the goals is then assigned a weight based on the level of importance, as determined by the Board. The results are entered and the metric is tabulated. That number is multiplied by the corresponding weight. Once weighted, the figures are added in total to establish a score between 1 and 5. No incentive is paid if the Hospital's operating margin falls below 7.0%, regardless of the outcomes of the other measures. Any physician bonuses are based on productivity. The incentives were paid in this fiscal year for work done in the previous fiscal year. The bonuses paid were: - AMY BLASER - $12,601 - CHAD VAN CLEAVE - $12,542 - LINDA WALLINE - $16,904 - MICHAEL HANSEN - $46,875 - DUSTIN VOLKMER, M.D. - $88,374 - EDWARD FEHRINGER, M.D. - $149,221 - MICHAEL MCGUIRE, M.D. - $33,147 - RICHARD CIMPL, M.D. - $100,842

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI, Line 11b	The Form 990 will be available for all the Members of the Finance Committee to review. Upon Committee review, the 990 will then be submitted to the full Board for review and the Board will make any corrections if applicable.
Form 990, Part VI, Line 12c	Columbus Community Hospital monitors any conflict of interest based on their Conflict of Interest Policy. Employees and Volunteers are required to fully disclose any conflict of interest that may exist or appears to exist. Hospital reviews any of these conflicts and works with the Vice President or CEO to determine if a conflict exists. If one does exist, the Hospital initiates actions to manage, reduce, or eliminate the conflict.
Form 990, Part VI, Line 15a	The Hospital's Executive Compensation Committee, made up of independent Hospital Board Members, reviews the CEO's compensation annually. The wage range is compared to information provided by third party consultants. Decisions are documented.
Form 990, Part VI, Line 15b	The Hospital's CEO and Director of Human Resources, review the VP's and other highly compensated employee's compensation annually. The wage range is compared to information provided by third party consultants. Decisions are documented.
Form 990, Part VI, Line 19	At Columbus Community Hospital, a 3-ring binder exists in the Executive Assistant's office labeled for public disclosure which includes the most current of the following: A) Governing Documents which are the Hospital's Bylaws B) Conflict of Interest Policy C) Audited Financial Statements D) Forms 990 and 990-T
Form 990, Part XI, Line 9	Other changes: A) HealthPark, LLC separate 990 income - $186,409

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
Columbus Community Hospital Foundation
4600 38th Street	Columbus	NE	68601	470836747	Fundraising	NE	501(C)(3)	Line 12, I	CCH	Yes (true)
Healthpark Title Company
4600 38th Street	Columbus	NE	68601	470830945	Holding Co	NE	501(C)(2)	N/A	CCH	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	UBI Code VUBICodeVAmt	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct
ZARZ LLC
PO Box 1800	Columbus	NE	68602	273676428	Property Mgmt	NE	Hlthpk Title Co	RELATED	$0	$0	false	$0	Yes (true)	0.10000
HealthPark LLC
PO Box 1800	Columbus	NE	68602	470836733	Property Mgmt	NE	Hlthpk Title Co	RELATED	$0	$0	false	$0	Yes (true)	0.27210

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	platte valley physician hospital org	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO Box 1800	AddressLine1Txt
City	Columbus	CityNm
State Abbreviation	NE	StateAbbreviationCd
ZIP	68602	ZIPCd

Field	Value	IRS element (for citing)
EIN	470790385	EIN
Primary Activities	HEALTH ADMIN	PrimaryActivitiesTxt
Legal Domicile State	NE	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	CCH	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Entity Type	EXEMPT ORG	EntityTypeTxt
Share Of Total Income	$300	ShareOfTotalIncomeAmt
Share Of EOY Assets	$7,728	ShareOfEOYAssetsAmt
Ownership	1.00000	OwnershipPct
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	false	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	Yes (true)	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	Yes (true)	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	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (true)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Columbus Community Hospital Foundation
c	$147,588	Cash
Healthpark Title Company
k	$64,672	Book