COLUMBUS COMMUNITY HOSPITAL INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: COLUMBUS COMMUNITY HOSPITAL INC (EIN 47-0542043)
Tax period: 2015-05-01 to 2016-04-30
Filed: 2017-02-07
IRS object ID: 201730389349301663
Schema version: 2015v3.0
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	2017-02-07T16:07:51-06:00	ReturnTs
Tax Period End	2016-04-30	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	2015-05-01	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	% SHAUNA CZARNICK	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	MICHAEL T HANSEN	PersonNm
Person Title	CEO	PersonTitleTxt
Signature	2017-02-03	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

Field	Value	IRS element (for citing)
Tax	2015	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	$89,993,256	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	710	TotalEmployeeCnt
Total Volunteers	246	TotalVolunteersCnt
Total Gross UBI	$20,886	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$43,973	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$209,336	PYContributionsGrantsAmt
CY Contributions Grants	$562,546	CYContributionsGrantsAmt
PY Program Service Revenue	$85,845,372	PYProgramServiceRevenueAmt
CY Program Service Revenue	$88,053,768	CYProgramServiceRevenueAmt
PY Investment Income	$278,753	PYInvestmentIncomeAmt
CY Investment Income	$349,992	CYInvestmentIncomeAmt
PY Other Revenue	$865,945	PYOtherRevenueAmt
CY Other Revenue	$1,026,950	CYOtherRevenueAmt
PY Total Revenue	$87,199,406	PYTotalRevenueAmt
CY Total Revenue	$89,993,256	CYTotalRevenueAmt
PY Grants And Similar Paid	$1,527,434	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$1,135,910	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$38,405,724	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$40,237,051	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$32,675,999	PYOtherExpensesAmt
CY Other Expenses	$35,305,130	CYOtherExpensesAmt
PY Total Expenses	$72,609,157	PYTotalExpensesAmt
CY Total Expenses	$76,678,091	CYTotalExpensesAmt
PY Revenues Less Expenses	$14,590,249	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$13,315,165	CYRevenuesLessExpensesAmt
Total Assets BOY	$100,393,386	TotalAssetsBOYAmt
Total Assets EOY	$114,831,604	TotalAssetsEOYAmt
Total Liabilities BOY	$6,203,038	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$7,057,792	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$94,190,348	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$107,773,812	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	$73,095,628	ExpenseAmt
Grant	$300	GrantAmt
Revenue	$88,763,274	RevenueAmt
Desc	Columbus Community Hospital (CCH) is a 47 bed acute care hospital which currently employs over 650 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 a driver's rehabilitation program. The Hospital's Wiggles and Giggles Therapy for Kids offers pediatric physical, occupational and speech for children ranging in age from babies to adolescents. In November 2012, the Hospital began offering the STAR cancer rehabilitation program, which includes physical, occupational and speech therapies. The STAR acronym stands for Survivorship, Training and Rehabilitation and CCH is one of only three hospitals in Nebraska to have achieved STAR program certification. The Hospital's program therapists are all certified through the STAR program. Over 74 STAR program referrals have been received through local providers, resulting in consultation for potential rehabilitation needs. In addition to physical, occupational and speech therapy, some of the participants have benefitted from nutritional consultations as well as psychosocial referrals. In addition, some of these patients have needed care for pulmonary issues and cardiovascular concerns. Several STAR participants have graduated from the program and transitioned into the Hospital's medical wellness program. - 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 90 to 100 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 over 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 clinic 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 clinic sees about 100 patients 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.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$1,135,610	ExpenseAmt
Grant	$1,135,610	GrantAmt
Revenue	$0	RevenueAmt
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, 100% 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	$74,231,238	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	50	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	710	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
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	SHAUNA CZARNICK	PersonNm
Phone	4025623362	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 (22 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)	$191,220	$0	$37,752
Chad Van Cleave
VP Finance	40.0	0.0		Yes (X)	$119,261	$0	$36,900
J Joseph Barbaglia
VP Finance - Retired	40.0	0.0		Yes (X)	$170,375	$0	$19,488
Scott Messersmith
VP Operations	40.0	0.0		Yes (X)	$109,343	$0	$26,336
James Goulet
VP Operations - Retired	40.0	0.0		Yes (X)	$213,515	$0	$32,333
Linda Walline
VP Nursing	40.0	0.0		Yes (X)	$196,070	$0	$29,592
Michael Hansen
President/CEO/Secretary	39.0	1.0		Yes (X)	$405,910	$0	$70,122
Dustin Volkmer MD
Physician	40.0	0.0			$463,906	$0	$32,622	Yes (X)
Edward Fehringer MD
Physician	40.0	0.0			$659,858	$0	$32,622	Yes (X)
Mark Howerter MD
Physician	40.0	0.0			$484,087	$0	$32,622	Yes (X)
Michael McGuire MD
Physician	40.0	0.0			$524,033	$0	$32,622	Yes (X)
Richard Cimpl
Physician	40.0	0.0			$619,548	$0	$32,622	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$4,157,126	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$415,633	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	44	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
TSP Construction Services Inc
1112 N West Ave	Sioux Falls	SD	571041333	Construction	$4,833,755
McKesson Technologies Inc
PO Box 98347	Chicago	IL	60693	IT Consulting	$924,697
Inpatient Physician Associates
3200 Pine Lake Rd Suite A	Lincoln	NE	68516	Hospitalist Svcs	$694,106
Renovo Solutions LLC
1801 E Park Court Plaza Suite 206	Santa Ana	CA	92701	Equipment Maint	$167,281
The Roberts Group Inc
730 N Grand Ave	Waukesha	WI	53186	Marketing Company	$101,852

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	5	CntrctRcvdGreaterThan100KCnt
Related Organizations	$539,702	RelatedOrganizationsAmt
All Other Contributions	$22,844	AllOtherContributionsAmt
Total Contributions	$562,546	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Service Revenue	621110	$87,475,747	$87,475,747
Meaningful Use Payment	900099	$578,021	$578,021

Field	Value	IRS element (for citing)
Total Program Service Revenue	$88,053,768	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$266,172	TotalRevenueColumnAmt
Exclusion	$266,172	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

Rental Income Or Loss RentalIncomeOrLossGrp

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

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

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

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$83,820	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	$83,820	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$83,820	TotalRevenueColumnAmt
Exclusion	$83,820	ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

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

Net Income From Gaming NetIncomeFromGamingGrp

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

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	$58,359	$58,359
Cafeteria	722514	$296,558		$296,558
Health Watch	900099	$59,077	$59,077

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$612,956	TotalRevenueColumnAmt
Related Or Exempt Func Income	$592,070	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$20,886	UnrelatedBusinessRevenueAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,026,950	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$89,993,256	TotalRevenueColumnAmt
Related Or Exempt Func Income	$88,763,274	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$20,886	UnrelatedBusinessRevenueAmt
Exclusion	$646,550	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

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

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$1,135,610	TotalAmt
Program Services	$1,135,610	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	$1,405,694	TotalAmt
Management And General	$1,405,694	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	$30,719,704	TotalAmt
Program Services	$30,719,704	ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,128,234	TotalAmt
Program Services	$1,128,234	ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$4,765,516	TotalAmt
Program Services	$4,765,516	ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$2,217,903	TotalAmt
Program Services	$2,217,903	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	$67,519	TotalAmt
Management And General	$67,519	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$151,017	TotalAmt
Management And General	$151,017	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$6,547	TotalAmt
Management And General	$6,547	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	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$3,249,349	TotalAmt
Program Services	$3,249,349	ProgramServicesAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$213,745	TotalAmt
Management And General	$213,745	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$10,254,390	TotalAmt
Program Services	$9,956,282	ProgramServicesAmt
Management And General	$298,108	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$1,756,092	TotalAmt
Program Services	$1,756,092	ProgramServicesAmt

Royalties RoyaltiesGrp

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

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,675,681	TotalAmt
Program Services	$1,675,681	ProgramServicesAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$195,511	TotalAmt
Management And General	$195,511	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	$108,712	TotalAmt
Management And General	$108,712	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	$5,750,635	TotalAmt
Program Services	$5,750,635	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$288,911	TotalAmt
Program Services	$288,911	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt
Provision for Bad Debts	$5,429,402	$5,429,402
Minor Equip & Financing AGR	$2,223,518	$2,223,518
Purchased Services	$2,038,720	$2,038,720
Recruiting	$375,552	$375,552

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,519,829	TotalAmt
Program Services	$1,519,829	ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$76,678,091	TotalAmt
Program Services	$74,231,238	ProgramServicesAmt
Management And General	$2,446,853	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$3,994,478	BOYAmt
EOY	$8,653,858	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	$10,097,589	BOYAmt
EOY	$8,358,859	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	$0	BOYAmt
EOY	$594,349	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,399,607	BOYAmt
EOY	$1,569,487	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$1,918,503	BOYAmt
EOY	$1,853,872	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$115,891,454	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$63,668,176	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$48,961,389	BOYAmt
EOY	$52,223,278	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$33,844,577	BOYAmt
EOY	$41,380,166	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	$177,243	BOYAmt
EOY	$197,735	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$100,393,386	BOYAmt
EOY	$114,831,604	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$6,203,038	BOYAmt
EOY	$7,057,792	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	$6,203,038	BOYAmt
EOY	$7,057,792	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$94,190,348	BOYAmt
EOY	$107,773,812	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	$94,190,348	BOYAmt
EOY	$107,773,812	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$100,393,386	BOYAmt
EOY	$114,831,604	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$13,315,165	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$268,299	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	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$6,547	OtherActivitiesAmt
Total Lobbying Expenditures	$6,547	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 1i	FormAndLineReferenceDesc
Explanation	Dues paid to American Hospital Association allocated to lobbying $3,052 and dues paid to Nebraska Hospital Association allocated to lobbying $3,495.	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	$1,806,283	BeginningYearBalanceAmt
Contributions	$25,774	ContributionsAmt
End Year Balance	$1,832,057	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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 Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

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

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,573,063	BeginningYearBalanceAmt
Contributions	$94,673	ContributionsAmt
End Year Balance	$1,667,736	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	$63,099,138	OtherCostOrOtherBasisAmt
Depreciation	$24,253,050	DepreciationAmt
Book Value	$38,846,088	BookValueAmt

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovementsGrp

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$44,522,290	OtherCostOrOtherBasisAmt
Depreciation	$36,977,299	DepreciationAmt
Book Value	$7,544,991	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$7,117,751	OtherCostOrOtherBasisAmt
Depreciation	$2,437,827	DepreciationAmt
Book Value	$4,679,924	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$52,223,278	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 2016 and 2015, 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
Percent100	Yes (X)	Percent100Ind
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	$511,365	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$511,365	NetCommunityBenefitExpnsAmt
Total Expense	0.00720	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,144,286	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$958,970	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,185,316	NetCommunityBenefitExpnsAmt
Total Expense	0.04470	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,655,651	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$958,970	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,696,681	NetCommunityBenefitExpnsAmt
Total Expense	0.05190	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Persons Served	64175	PersonsServedCnt
Total Community Benefit Expns	$266,012	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,872	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$261,140	NetCommunityBenefitExpnsAmt
Total Expense	0.00370	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$779,233	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,992	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$771,241	NetCommunityBenefitExpnsAmt
Total Expense	0.01080	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$36,437	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$36,437	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Persons Served	64175	PersonsServedCnt
Total Community Benefit Expns	$1,081,682	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$12,864	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,068,818	NetCommunityBenefitExpnsAmt
Total Expense	0.01500	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Persons Served	64175	PersonsServedCnt
Total Community Benefit Expns	$5,737,333	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$971,834	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,765,499	NetCommunityBenefitExpnsAmt
Total Expense	0.06690	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$415,654	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$44,422	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$371,232	NetCommunityBenefitExpnsAmt
Total Expense	0.00520	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Persons Served	690	PersonsServedCnt
Total Community Benefit Expns	$5,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$5,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Persons Served	347	PersonsServedCnt
Total Community Benefit Expns	$14,759	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$24,502	DirectOffsettingRevenueAmt

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Persons Served	205	PersonsServedCnt
Total Community Benefit Expns	$426	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$426	NetCommunityBenefitExpnsAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Persons Served	1242	PersonsServedCnt
Total Community Benefit Expns	$435,839	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$68,924	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$376,658	NetCommunityBenefitExpnsAmt
Total Expense	0.00530	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$5,429,402	BadDebtExpenseAmt
Reimbursed By Medicare	$21,337,861	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$25,697,467	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$4,359,606	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	0.4445	0.5555

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
Information Gaps	Yes (X)	InformationGapsInd
CHNA Conducted	14	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	14	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	100	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 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
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Average Negotiated Rates	Yes (X)	AverageNegotiatedRatesInd
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	- Alegent Health Memorial Hospital, Schuyler - Genoa Community Hospital - Boone County Health Center
Schedule H, Part V, Line 6b	- Columbus Area United Way - East Central District Health Department
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.ASPX
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: Improve access to comprehensive, quality health care services. CCH will take the lead exploring and/or implementing the following: - Objective: Reduce the death rate from cancer of the uterus/cervix. - Action Step: Explore ways to provide a free PAP screening event at CCH. Collaborate with the University of Nebraska Medical Center on cancer management. - Objective: Reduce the female breast cancer death rate. - Action Step: Research funding options to increase the number of uninsured/underinsured women's access to mammography. An application was submitted on December 13, 2012 to the Susan G. Komen Foundation for a grant in the amount of $9,000. - Objective: Reduce one of the barriers to care. Look at the feasibility of creating a volunteer transportation program for patients. - Action Step: Explore programs operated by volunteers. - Objective: Explore other disease health screening opportunities to increase access to health care and develop a plan to address early screening. - Action Step: CCH will take the lead for the Tune Up For Life Health Fair and explore options for more screenings. - Objective: To increase access to care, facilitate communication opportunities between providers and patients. - Action Step: Provide and support nurse triage line to area local providers for a small fee. - Objective: Implement a home monitoring program for patients receiving home health services. - Action Step: Ensure home health tele-monitoring systems are being utilized by patients. - Objective: Provide community screenings and an information day regarding diabetes. - Action Step: CCH will be the lead for Diabetes Awareness Day, scheduled year in October. - Objective: Explore forming a geriatric assessment team to complete patient testing and evaluation of best setting for patients. - Action Step: Collaboration with Pender Hospital and Columbus Family Practice. Family Support: To improve the stability, health and well-being of women, infants, children and families through the effective use of community resources. The child well-being work group will take the lead in exploring and/or implementing the objectives and action steps. Obesity: Promote healthy weight and reduce chronic disease risk. Columbus Community Hospital's dedication to helping create a healthier community is seen in the Hospital's commitment to building the Columbus Wellness Center. The Center not only provides increased access to exercise and fitness, but to registered dietitians as well. Through classes and individual consultation, the dietitians can help address lifestyle changes that decrease health issues associated with obesity and chronic disease. CCH is also taking the lead in exploring and/or implementing the following: - Objective: Reduce the number of adults who are considered obese. - Action Step: Include the Chamber of Commerce and meet with local HR representatives monthly to develop a worksite wellness plan that is user-friendly and can be packaged and ready for business use. - Objective: Grow the Platte County CHIP Obesity Prevention Coalition and gather resources for public distribution. - Action Step: Have coalition members invite other community agencies and individuals to join. Gather list of resources available for physical activity and nutrition and distribute to area businesses. Regularly publish articles in newspaper and on the website. Substance Abuse: Reduce substance abuse to protect the health, safety and quality of life for all, especially children in grades 6-12. The East Central District Health Department, Columbus Police Department and Platte County Sheriff's Department will take the lead in exploring and/or implementing the objectives and actions steps. CCH will provide advice and support as requested. Mental Health: Improve mental health through prevention and by ensuring access to appropriate, quality mental health services. The Platte County Mental Health CHIP group will take the lead in exploring and/or implementing the objectives and action steps. CCH will provide advice and support as requested.
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 16i	Information brochures on Financial/Charity Assistance (F/C) are available in key areas of the Hospital. The CCH website has information regarding F/C assistance as well as applications in both Spanish and English and the patient statements also contain information regarding F/C assistance. The F/C applications are available to all staff on the Hospital's internal "h" drive under the "forms" category. The Hospital's Emergency Department registration desk, main registration area, patient accounts desk and Social Services Department all have F/C applications readily available in both English and Spanish.

Field	Value	IRS element (for citing)
Facility	10	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (10 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
Premier Physical Therapy of CCH
US 30 Center Bldg 3100-23rd St St	Columbus	NE	686013161	Outpatient Physical Therapy SPORTS TRAINING SERVICES
Wiggles & Giggles Therapy for Kids
3912 38th Street Suite B	Columbus	NE	686015100	Pediatric Therapy Services
Occupational Health Services of CCH
3005-19th St Suite 300	Columbus	NE	686014252	Emp Health Care Svcs to Prevent & Treat Work Injuries
Wound Healing Center
4600-38th St Suite 165	Columbus	NE	68601	Wound Treatment Center
Humphrey Clinic of CCH
3003 Main Street	Humphrey	NE	686423155	Clinic in small town to offer medical services to residents
Hospice of Columbus Community Hospital
3005-19th St Suite 600	Columbus	NE	686014248	Hospice Services
Columbus Community Hospital Sleep Lab
3020-19th St Suite 100	Columbus	NE	686014252	Polysomnographic Sleep Testing
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
Rehabilitative Services
3912 38th Street Suite B	Columbus	NE	686015100	Outpatient Physical Therapy, Occupational Therapy and Speech Therapy

Supplemental Information Detail SupplementalInformationDetail (15 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 REPRESENT THE MAJORITY OF THESE DONATIONS, THE LARGEST AMOUNT, $25,000, GOING TO THE EAST CENTRAL DISTRICT HEALTH DEPARTMENT TO SUPPORT COMMUNITY HEALTH PROGRAMS. OTHER CASH DONATIONS WERE MADE TO SMALLER ORGANIZATIONS FOR PROGRAMS OR EVENTS RELATING TO HEALTH. THE IN-KIND DONATIONS, $101, WERE MEALS ON WHEELS CARDS FOR THOSE WHO COULD NOT AFFORD THE MEALS. Schedule H, PART I, LINE 7, COLUMN (F) THE AMOUNT OF 71,248,689 USED AS THE DENOMINATOR TO COMPUTE COLUMN (F) IS CALCULATED BY TAKING TOTAL FUNCTIONAL EXPENSES OF 76,678,091 MINUS BAD DEBT EXPENSE OF 5,429,402.
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.
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. Charity care is kept separate from bad debt.
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 centers 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 service 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 IRC 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. 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; The basis for calculating amounts charged to eligible patients; The method for applying for assistance; 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 organizations external environment in terms of opportunities and threats, as well as an assessment of the organizations 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, Student 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 and 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 continue growth in the CCH Foundation.
Patient Education of Eligibility for Assistance	Financial assistance information is available on the Hospitals website, including links to additional, in-depth information. 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. The State has Medicaid applications available online. Our Patient Accounts 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 patients 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.
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 44,613 visits for the fiscal year ending April, 2014. In 2005, our outpatient visits over a twelve month period totaled 38,129. This 17% increase in our outpatient visits over the past nine years is a reflection of the significant impact the Demonstration Project has had on our Hospital. Service Capacity The W.O.C. Clinic opened in August of 2008. It has grown to 1,107 patients/visits as of April 30, 2014. The identified service area includes a 45-mile radius around Columbus. The W.O.C. Clinic is located in the visiting physician office suite in the attached Medical Office Building. The Clinic has scheduled visits two days per week with additional nurse staff time spent each week assisting outpatient clients with wound applications, as well as assisting in the application of wound vacs in surgery or on our medical floor. W.O.C. staff also schedules appointments and other responsibilities for the Clinic such as ordering supplies and maintaining compliance with national standards. Prior to the opening of the W.O.C. Clinic, patients seeking this specialized treatment were required to travel an average of 75 miles to see a wound center specialist. The volume we are seeing at this Clinic reinforces the amount of community need that existed for this service and has greatly increased local access for so many high acuity patients and their families. Our nurses are WCOM certified, so in addition to wound care, patients who have challenges with ostomy appliances and continence problems can be addressed through our Clinic. To replace older, existing systems, CCH recently installed a new CT scanner, new radiologic/fluoroscopy system and nuclear medicine camera. The Hospital recently opened a womens imaging area within the Hospital, which is separate from the rest of the Radiology Department. The registration area was recently renovated which provides additional privacy for patients. On February 8, 2012, we reduced our mammography procedure pricing by 21% as well as sought and received a Susan G. Komen grant. The grant provided uninsured and underinsured women in our community access to lifesaving mammograms. The Hospitals Foundation also provided matching funding for the grant. Because of the Hospitals participation in the Demonstration Project, CCH was able to purchase bone density equipment, support equipment and train staff in the use of this procedure. In the past, CCH had contracted for mobile density services, but the purchase of this equipment has increased access to care for our community and eliminated the need to wait for diagnosis from a mobile units intermittent service or travel out of town for the procedure. Columbus Community Hospital is a 47 bed, acute care hospital offering a variety of surgical procedures and short term hospitalizations. All 47 beds are licensed for either acute care or swing bed patients. In addition, CCH provides comprehensive outpatient laboratory, radiology, respiratory and rehabilitative services. We also provide free 24/7 interpreter services. Our facility offers comprehensive care, including intensive care, medical-surgical care, inpatient and outpatient general, ENT, urology, podiatry, orthopedic surgical procedures. Other ancillary services offered include: respiratory, wound care, diabetes education, endoscopy and cardiopulmonary rehabilitation. In 2006, the Hospitals Emergency Department was designated as a Level III Trauma Center, with nurses certified in TNCC, ACLS and PALS. Eight of the Emergency Department nurses are also certified in ENPC. A 30,000 square foot addition to the ED was completed in 2012. The expanded area allowed the ED to add two trauma bays, a two-bay ambulance garage, a dedicated decontamination area, a dedicated family grief and counseling room, covered drive-up access and a negative air-pressure room, which allows patients with communicable disease to be treated while protecting other patients and staff. CCH has an open emergency room available to all in need regardless of race, creed, age or ability to pay. The Hospital also has an open medical staff. The Hospitals Home Health/Hospice interdisciplinary services are available to patients within a 30 mile radius of Columbus, offering in-home telehealth monitoring. The CCH Sleep Lab provides polysomnographic sleep testing, available for both daytime and home sleep tests. In January 2010, the Hospital hired a fulltime RN as the Orthopedic Service Line Coordinator. In November of that same year, a multi-disciplinary team was organized to review, standardize and improve the patients total joint process from diagnosis to post-surgical recovery. In March 2012, the acquired Columbus Orthopedic and Sports Medicine Clinic, enabling the Hospital to expand the service line and ensure the communitys aging population orthopedic services close to home. In May, 2013, the Hospital expanded the RN Coordinators responsibility into case management in the Transitional Care Department. This expansion of duties enabled the Hospital to plan for continuity of care post-hospitalization. Three cardiologists have relocated to Columbus, providing full time cardiology services to the area. Since 2010, 63 physicians have been recruited to serve the needs of our primary and secondary service areas, including 55 MDs, 1 DPM and 7 mid-level providers. Thirty-four of these providers are full time, while the other 29 are serving in a visiting capacity. To increase access to CCH, the Hospital has completed construction on three road projects on and around the campus. Two clinic buildings, one for a family practice group and one for a pharmacy, have been completed as well.
Promotion of Community Health	In addition to construction of the Columbus Wellness Center, the Hospital reinvests capital to improve patient care, attract the best qualified staff, and provide medical education and prevention activities in our community. The Hospital is living its mission and vision within the community. Our Mission: To improve the health of the communities we serve. Our Vision: To compassionately deliver the States highest quality of patient care. Columbus Community Hospitals care values are: - Integrity - Compassion - Accountability - Respect - Excellence The Hospital has prioritized our capital reinvestment by aligning it to the strategic plan. Our plan consists of six organizational pillars with goals and strategies associated to each. The six Pillars of Excellence are: - Quality - Culture - People - Services - Facilities - Finance Measurement of ongoing operational performance is organized around these pillars. The pillars were strategically identified as common measures around which operational performance is organized in many health care institutions and adapted for CCH.
Affiliated Health Care System	N/A
State Filing of Community Benefit Report	None

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	838	RecipientCnt
Non Cash Assistance	$1,135,610	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 (11 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	$129,347	$0	$11,800	$0	$50,073	$0	$15,730	$0	$23,844	$0	$230,794	$0	$0	$0
Chad Van Cleave
VP Finance	$119,261	$0	$0	$0	$0	$0	$14,878	$0	$23,519	$0	$157,658	$0	$0	$0
J Joseph Barbaglia
VP Finance - Retired	$75,068	$0	$32,816	$0	$62,491	$0	$8,477	$0	$12,299	$0	$191,151	$0	$0	$0
James Goulet
VP Operations - Retired	$165,362	$0	$30,153	$0	$18,000	$0	$10,311	$0	$24,418	$0	$248,244	$0	$0	$0
Linda Walline
VP Nursing	$150,409	$0	$27,661	$0	$18,000	$0	$7,570	$0	$24,221	$0	$227,861	$0	$0	$0
Michael Hansen
President/CEO/Secretary	$347,285	$0	$40,625	$0	$18,000	$0	$48,100	$0	$26,405	$0	$480,415	$0	$0	$0
Dustin Volkmer MD
Physician	$463,906	$0	$0	$0	$0	$0	$10,600	$0	$26,348	$0	$500,854	$0	$0	$0
Edward Fehringer MD
Physician	$531,182	$0	$110,676	$0	$18,000	$0	$10,600	$0	$26,402	$0	$696,860	$0	$0	$0
Mark Howerter MD
Physician	$484,087	$0	$0	$0	$0	$0	$10,600	$0	$26,215	$0	$520,902	$0	$0	$0
Michael McGuire MD
Physician	$494,476	$0	$29,557	$0	$0	$0	$10,600	$0	$26,179	$0	$560,812	$0	$0	$0
Richard Cimpl
Physician	$490,012	$0	$111,536	$0	$18,000	$0	$10,600	$0	$26,348	$0	$656,496	$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 2015 calendar year. Amounts deferred from the plan were included in Column C of the Schedule J: Michael Hansen - $37,500 Amy Blaser - $10,080 Chad Van Cleave - $10,033
Schedule J, Part I, Line 3	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, from salary surveys, and then 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: - James Goulet - 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 5.0%, regardless of the outcomes of the other measures. Bonuses paid to physicians are based on productivity. The incentives were paid in this fiscal year for work done in the previous fiscal year. The bonuses paid were: - Michael Hansen - $40,625 - Richard Cimpl, MD - $111,536 - Edward Fehringer, MD - $110,676 - Michael McGuire, MD - $29,557 - Joe Barbaglia - $32,816 - Amy Blaser - $11,800 - James Goulet - $30,153 - Linda Walline - $27,661

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 Change in interest in Healthpark LLC & ZARZ LLC 268,299

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 11, 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)	0.44450
HealthPark LLC
PO Box 1800	Columbus	NE	68602	470836733	Property Mgmt	NE	Hlthpk Title Co	Related	$0	$0	false	$0	Yes (true)	0.27210

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (true)	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	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	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Columbus Community Hospital Foundation
c	$539,702	Cash
Healthpark Title Company
k	$77,547	Book
Healthpark Title Company
s	$482,300	Cash