STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

COMMUNITY MEDICAL CENTER INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY MEDICAL CENTER INC (EIN 47-0421272)
Tax period
2014-08-01 to 2015-07-31
Filed
2016-03-15
IRS object ID
201630759349301068
Schema version
2014v6.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2016-03-15T17:06:28-05:00ReturnTs
Tax Period End2015-07-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN470585450PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DOHMAN AKERLUND & EDDY LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 470AddressLine1Txt
CityAURORACityNm
State AbbreviationNEStateAbbreviationCd
ZIP688180470ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-08-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN470421272EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY MEDICAL CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOMMBusinessNameControlTxt
Phone4022456500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13307 BARADA STREETAddressLine1Txt
CityFALLS CITYCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68355ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSCOTT L SAWYERPersonNm
Person TitleCHIEF FINANCIAL OFFICERPersonTitleTxt
Phone4022456500PhoneNum
Signature2016-03-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTIMOTHY J COUFALPreparerPersonNm
PTINP00964304PTIN
Phone4026946404PhoneNum
Preparation2016-03-15PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-08-17 19:52:53ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerRYAN LARSENPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1SAME AS ABOVEAddressLine1Txt
CityFALLS CITYCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68355ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$25,074,281GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressHTTP://CMCFC.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1995FormationYr
Legal Domicile StateNELegalDomicileStateCd
Activity Or MissionTO OFFER GENERAL HEALTHCARE SERVICES WITHIN THE SCOPE OF ITS LICENSE AND CAPABILITIES; TO RENDER HEALTHCARE TO ALL PERSONS WITHOUT RESPECT TO RACE, REGLIGIOUS BELIEFS OR FINANCIAL STANDING.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee211TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$369,340PYContributionsGrantsAmt
CY Contributions Grants$332,484CYContributionsGrantsAmt
PY Program Service Revenue$23,561,032PYProgramServiceRevenueAmt
CY Program Service Revenue$24,714,740CYProgramServiceRevenueAmt
PY Investment Income$17,026PYInvestmentIncomeAmt
CY Investment Income$22,307CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$23,947,398PYTotalRevenueAmt
CY Total Revenue$25,069,531CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$9,531,424PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$9,875,924CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$25,678CYTotalFundraisingExpenseAmt
PY Other Expenses$12,357,518PYOtherExpensesAmt
CY Other Expenses$12,999,279CYOtherExpensesAmt
PY Total Expenses$21,888,942PYTotalExpensesAmt
CY Total Expenses$22,875,203CYTotalExpensesAmt
PY Revenues Less Expenses$2,058,456PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,194,328CYRevenuesLessExpensesAmt
Total Assets BOY$39,380,003TotalAssetsBOYAmt
Total Assets EOY$40,354,108TotalAssetsEOYAmt
Total Liabilities BOY$21,397,759TotalLiabilitiesBOYAmt
Total Liabilities EOY$20,170,439TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$17,982,244NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$20,183,669NetAssetsOrFundBalancesEOYAmt
MissionTO OFFER GENERAL HEALTHCARE SERVICES WITHIN THE SCOPE OF ITS LICENSE AND CAPABILITIES; TO RENDER HEALTHCARE TO ALL PERSONS WITHOUT RESPECT TO RACE, REGLIGIOUS BELIEFS OR FINANCIAL STANDING.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$19,049,816ExpenseAmt
DescCOMMUNITY MEDICAL CENTER PROVIDES MEDICAL SERVICES TO MEET THE NEEDS OF THE PEOPLE OF RICHARDSON COUNTY AND THE SURROUNDING COMMUNITIES. COMMUNITY MEDICAL CENTER PROVIDED 1,973 INPATIENT DAYS, 1,277 SWING-BED DAYS, 78 NURSERY DAYS, 12,227 CLINIC VISITS AND NUMEREOUS OUTPATIENT SERVICES DURING THE YEAR. COMMUNITY BENEFITS INCLUDE 354,597 OF SUBSIDIZED HEALTH SERVICES, 510,526 OF TRADITIONAL CHARITY CARE,49,517 OF BAD DEBT, 18,524 OF COMMUNITY ACTIVITIES, 9,615 OF COMMUNITY SERVICES, AND 20,250 OF HEALTH EDUCATION.Desc
Total Program Service Expenses$19,049,816TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document60IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee211EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonSCOTT L SAWYERPersonNm
Phone4022456501PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13307 BARADA STREETAddressLine1Txt
CityFALLS CITYCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68355ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
KENT BIEKER
CHAIRPERSON1.00Yes (X)$0$0$0
NICK HARLING
VICE-CHAIR1.00Yes (X)$0$0$0
TONY BRUNETTE
TREASURER1.00Yes (X)$0$0$0
MARGARET MCINTEER
SECRETARY1.00Yes (X)$0$0$0
LAURIE KIMBROUGH
DIRECTOR1.00Yes (X)$0$0$0
CR JAMES
DIRECTOR1.00Yes (X)$0$0$0
BONNIE KANEL
DIRECTOR1.00Yes (X)$0$0$0
JOHN WILSON
DIRECTOR1.00Yes (X)$0$0$0
JOHN HUNZEKER
DIRECTOR1.00Yes (X)$0$0$0
RYAN LARSEN
CEO40.00$175,405$0$41,088Yes (X)
SCOTT SAWYER
CFO40.00$117,859$0$27,436Yes (X)
BARBARA HOWARD
CHIEF CLINIC40.00$112,028$0$17,580Yes (X)
DAVID BORG
PHYSICIAN40.00$359,071$0$55,797Yes (X)
SANDRA CATLIN
APRN40.00$172,990$0$24,722Yes (X)
GAYLE KELLER
APRN40.00$135,131$0$29,373Yes (X)
NIKI DEEDS
PA-C40.00$115,158$0$10,750Yes (X)
JAYNE GUNN
APRN40.00$112,129$0$19,489Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,299,771TotalReportableCompFromOrgAmt
Total Other Compensation$226,235TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K9IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
DANIEL SAMANI MD
12215 W 164TH TERRACEOLATHEKS66062PHYSICIAN SERV$805,675
PRTS-NACHTIGAL LLC
700 OREGON STREETHIAWATHAKS66434PT/OT SERVICES$667,807
SHADOW ANESTHESIA SERVICES
65675 711 ROADFALLS CITYNE68355ANESTHESIA SVCS$440,307
CARDINAL HEALTH
21337 NETWORK PLACECHICAGOIL60673PHARMACY SVCS$389,741
NHI OUTREACH CLINICAL SERVICES
7440 S 91ST STREETLINCOLNNE68501NM & ECHO SERV$187,946
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt
Government Grants$199,504GovernmentGrantsAmt
All Other Contributions$132,980AllOtherContributionsAmt
Total Contributions$332,484TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE622110$24,324,135$24,324,135
PHARMACY446110$220,423$220,423
CAFETERIA722310$77,077$77,077
MISCELLANEOUS HOPSITAL REV622110$66,625$66,625
LIFELINE900099$26,480$26,480
FieldValueIRS element (for citing)
Total Program Service Revenue$24,714,740TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$22,324TotalRevenueColumnAmt
Exclusion$22,324ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$4,733OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$4,750OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$17OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$17TotalRevenueColumnAmt
Related Or Exempt Func Income-$17RelatedOrExemptFuncIncomeAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$25,069,531TotalRevenueColumnAmt
Related Or Exempt Func Income$24,714,723RelatedOrExemptFuncIncomeAmt
Exclusion$22,324ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$405,292TotalAmt
Program Services$112,028ProgramServicesAmt
Management And General$293,264ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,217,601TotalAmt
Program Services$5,902,923ProgramServicesAmt
Management And General$1,314,678ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$314,236TotalAmt
Program Services$242,775ProgramServicesAmt
Management And General$71,461ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,423,627TotalAmt
Program Services$922,772ProgramServicesAmt
Management And General$500,855ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$515,168TotalAmt
Program Services$409,251ProgramServicesAmt
Management And General$105,917ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$21,976TotalAmt
Management And General$21,976ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$27,200TotalAmt
Management And General$27,200ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,614,932TotalAmt
Program Services$3,358,919ProgramServicesAmt
Management And General$256,013ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$36,443TotalAmt
Program Services$7,266ProgramServicesAmt
Management And General$29,177ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$120,570TotalAmt
Program Services$50,924ProgramServicesAmt
Management And General$69,646ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$320,338TotalAmt
Program Services$319,122ProgramServicesAmt
Management And General$1,216ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$46,819TotalAmt
Program Services$29,555ProgramServicesAmt
Management And General$17,264ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$27,949TotalAmt
Program Services$21,930ProgramServicesAmt
Management And General$6,019ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$884,716TotalAmt
Program Services$737,853ProgramServicesAmt
Management And General$146,863ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,005,955TotalAmt
Program Services$1,672,967ProgramServicesAmt
Management And General$332,988ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$73,969TotalAmt
Program Services$3,528ProgramServicesAmt
Management And General$70,441ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
CENTRAL SUPPLY$2,098,528$2,098,528
PHARMACY$1,442,933$1,442,933
REPAIR AND MAINTENANCE$580,497$402,041$178,456
ADMIN OFFICE$277,878$4,752$247,648$25,478

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,418,576TotalAmt
Program Services$1,309,749ProgramServicesAmt
Management And General$108,627ManagementAndGeneralAmt
Fundraising$200FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$22,875,203TotalAmt
Program Services$19,049,816ProgramServicesAmt
Management And General$3,799,709ManagementAndGeneralAmt
Fundraising$25,678FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$12,416,827BOYAmt
EOY$15,145,258EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$4,185,858BOYAmt
EOY$4,382,144EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$500BOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,234,046BOYAmt
EOY$2,586,305EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$107,721BOYAmt
EOY$158,487EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$275,454BOYAmt
EOY$308,512EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$28,425,307LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$11,498,162LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$18,130,832BOYAmt
EOY$16,927,145EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$135,799BOYAmt
EOY$63,565EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$382,966BOYAmt
EOY$358,334EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$510,000BOYAmt
EOY$424,358EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$39,380,003BOYAmt
EOY$40,354,108EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,658,932BOYAmt
EOY$1,459,852EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$369,445BOYAmt
EOY$185,779EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$16,765,855BOYAmt
EOY$16,436,652EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,603,527BOYAmt
EOY$2,088,156EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$21,397,759BOYAmt
EOY$20,170,439EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$17,982,244BOYAmt
EOY$20,183,669EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$17,982,244BOYAmt
EOY$20,183,669EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$39,380,003BOYAmt
EOY$40,354,108EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$2,194,328ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$7,097NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,112,800BeginningYearBalanceAmt
Contributions$513,796ContributionsAmt
Investment Earnings Or Losses$6,078InvestmentEarningsOrLossesAmt
Other Expenditures$324,450OtherExpendituresAmt
End Year Balance$3,308,224EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,528,700BeginningYearBalanceAmt
Contributions$579,415ContributionsAmt
Investment Earnings Or Losses$4,686InvestmentEarningsOrLossesAmt
End Year Balance$3,112,800EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,755,831BeginningYearBalanceAmt
Contributions$768,898ContributionsAmt
Investment Earnings Or Losses$3,982InvestmentEarningsOrLossesAmt
Administrative Expenses$11AdministrativeExpensesAmt
End Year Balance$2,528,700EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$993,457BeginningYearBalanceAmt
Contributions$837,845ContributionsAmt
Investment Earnings Or Losses$3,438InvestmentEarningsOrLossesAmt
Other Expenditures$78,887OtherExpendituresAmt
Administrative Expenses$22AdministrativeExpensesAmt
End Year Balance$1,755,831EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$979,328BeginningYearBalanceAmt
Contributions$791,569ContributionsAmt
Investment Earnings Or Losses$1,275InvestmentEarningsOrLossesAmt
Other Expenditures$778,715OtherExpendituresAmt
End Year Balance$993,457EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY1.00000BoardDesignatedBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,184,880OtherCostOrOtherBasisAmt
Book Value$1,184,880BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$17,349,803OtherCostOrOtherBasisAmt
Depreciation$5,451,779DepreciationAmt
Book Value$11,898,024BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,637,624OtherCostOrOtherBasisAmt
Depreciation$574,806DepreciationAmt
Book Value$1,062,818BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,158,560OtherCostOrOtherBasisAmt
Depreciation$5,471,577DepreciationAmt
Book Value$2,686,983BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$94,440OtherCostOrOtherBasisAmt
Book Value$94,440BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$16,927,145TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
CONDITIONAL CONTRIBUTION$1,900,000
DEFERRED COMPENSATION$157,698
EST THIRD-PARTY PAYOR SETTLEMENTS$30,458
FieldValueIRS element (for citing)
Total Liability$2,088,156TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$25,076,628TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$7,097NetUnrealizedGainsInvstAmt
Revenue Not Reported$7,097RevenueNotReportedAmt
Revenue Subtotal$25,069,531RevenueSubtotalAmt
Total Revenue Per Form990$25,069,531TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$22,875,203TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$22,875,203ExpensesSubtotalAmt
Total Expenses Per Form990$22,875,203TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PAGE 2, PART V, LINE 4THE FUNDS INCLUDE 6,436 DESIGNATED BY THE BOARD FOR CAPITAL IMPROVEMENTS, 245,414 DESIGNATED BY THE BOARD FOR DEFERRED COMPENSATION, 333,720 DESIGNATED BY A LONG-TERM DEBT COVENANT ON THE USDA LOAN, 275,263 DESIGNATED LOAN PROCEEDS TO BE USED FOR EQUIPMENT AND 2,447,391 DESIGNATED AS A DEBT SINKING FUND.
SCHEDULE D, PAGE 3, PART XAS OF JULY 31, 2015 AND 2014, THERE IS NO RESERVE FOR UNCERTAIN TAX POSITIONS.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$510,526TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$510,526NetCommunityBenefitExpnsAmt
Total Expense0.02230TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$510,526TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$510,526NetCommunityBenefitExpnsAmt
Total Expense0.02230TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,615TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$9,615NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$20,250TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$20,250NetCommunityBenefitExpnsAmt
Total Expense0.00090TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$354,597TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$354,597NetCommunityBenefitExpnsAmt
Total Expense0.01550TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$384,462TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$384,462NetCommunityBenefitExpnsAmt
Total Expense0.01680TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$894,988TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$894,988NetCommunityBenefitExpnsAmt
Total Expense0.03910TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,500TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$7,500NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$5,000NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,024TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$6,024NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$18,524TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$18,524NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$49,517BadDebtExpenseAmt
Bad Debt Expense Attributable$4,952BadDebtExpenseAttributableAmt
Reimbursed By Medicare$12,045,312ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$12,133,259CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$87,947MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnfalseFinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY MEDICAL CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line13307 BARADA STREETAddressLine1Txt
CityFALLS CITYCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68355ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.CMCFC.ORGWebsiteAddressTxt
State LicenseH000112StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.CMCFC.ORGOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLWWW.CMCFC.ORGStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWWCMCFCORGFAPAvailableOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesYes (true)CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FACILITY 1, COMMUNITY MEDICAL CENTER - PART V, LINE 5A SURVEY WAS CONDUCTED BY THE SOUTHEAST (NEBRASKA) DISTRICT HEALTH DEPARTMENT AND COMMUNITY MEDICAL CENTER. THE HOSPITAL CONSULTED WITH LOCAL GOVERNMENT, SCHOOLS, CHURCHES, MEDICAL PRACTITIONERS, SENCA AND HEALTH SERVICE ORGANIZATIONS.
FACILITY 1, COMMUNITY MEDICAL CENTER - PART V, LINE 7DCOPIES PROVIDED TO GOVERNMENT ENTITIES AND OTHER HEALTHCARE PARTNERS IN THE HEALTH DISTRICT.
FACILITY 1, COMMUNITY MEDICAL CENTER - PART V, LINE 11INCREASE BEHAVIORAL HEALTH RESOURCES IN THE COMMUNITY, SUPPORT EFFORTS AND ACTIVITIES TO DEVELOP FITNESS ACTIVITIES IN CONJUCTION WITH EDUCATION AND PROGRAMS TO SUPPORT HEALTHY EATING. LAUNCH CAMPAIGN TO INCREASE AWARENESS OF CANCER RISK FACTORS AND MAKE SCREENINGS AVAILABLE. PROMOTE SMOKING AND TOBACCO CESSATION EFFORTS.
FACILITY 1, COMMUNITY MEDICAL CENTER - PART V, LINE 16IAT ADMISSION OR AT LEAST PRIOR TO DISCHARGE REGISTRATION PERSONNEL REFER UNINSURED AND/OR LOW INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE POLICY.
FACILITY 1, COMMUNITY MEDICAL CENTER - PART V, LINE 22DTHE HOSPITAL FACILITY CHARGES PATIENTS WITHOUT INSURANCE THE SAME RATES AS PATIENTS WHO HAVE INSURANCE FOR THOSE SERVICES AT THE HOSPITAL FACILITY. PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE ARE GIVEN A MINIMUM OF 25% DISCOUNT ON SERVICES. THE 25% REDUCTION IS BETTER THAN THE AVERAGE OF ITS THREE LOWEST NEGOTIATED COMMERICAL INSURANCE RATES.
FieldValueIRS element (for citing)
Facility2FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
FAMILY MEDICINE
3307 BARADA STREETFALLS CITYNE68355RURAL HEALTH CLINIC
HUMBOLDT FAMILY MEDICINE
1120 GRAND AVENUEHUMBOLDTNE68376RURAL HEALTH CLINIC

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSENO BAD DEBT EXPENSE IS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) AS BAD DEBT EXPENSE OF 71,956 IS REPORTED WITH NET PATIENT SERVICE REVENUE ON FORM 990, PART VIII, LINE 2.A., CONSISTENT WITH FINANCIAL STATEMENTS.
PART I, LINE 7 - COSTING METHODOLOGY EXPLANATIONTHE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE WAS A COST TO CHARGE RATIO.
PART II - COMMUNITY BUILDING ACTIVITIESCOMMUNITY-BUILDING ACTIVITIES INCLUDE PROGRAMS THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS, AND ENVIRONMENTAL PROBLEMS. THE ORGANIZATION PROVIDED 5,000 TO FALLS CITY ECONMIC DEVELOPMENT AND GROWTH ENTERPRISE (EDGE) TO SUPPORT ECONOMIC DEVELOPMENT IN FALLS CITY AND RICHARDSON COUNTY. THE ORGANIZATION FUNDED 5,000 TO THE BALL FIELD PROJECT AND 2,500 TO THE MAIN STREET PROJECT IN SUPPORT OF TWO COMMUNITY IMPROVEMENT AND REVITALIZATION PROJECTS. THE ORGANIZATION ALSO CONTRIBUTED 6,024 TO VARIOUS HEALTH-ORIENTED COMMUNITY ACTIVITIES AND SCHOOL PROJECTS DURING THE YEAR.
PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGYOVERALL COST TO CHARGE RATIO WAS USED TO DETERMINE AMOUNTS REPORTED ON SCHEDULE H, PART III, LINE 2. BAD DEBT EXPENSE REPORTED ON FORM 990, PART VIII, LINE 2A WAS 71,956.
PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCEAFTER REVIEW OF BAD DEBTS WRITTEN OFF IT WAS DETERMINED APPROXIMATELY 10% OF BAD DEBT ACCOUNTS WRITTEN OFF WOULD HAVE QUALIFIED FOR CHARITY CARE IF THE INDIVIDUALS WOULD HAVE COMPLETED THE APPLICATION PROCESS. RATIONALE FOR INCLUDED BAD DEBT AS A COMMUNITY BENEFIT - BY LAW, THE ORGANIZATION CANNOT REFUSE CERTAIN SERVICES TO PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY, THUS BAD DEBT SHOULD BE INCLUDED AS A COMMUNITY BENEFIT.
BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTSACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE MEDICAL CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE MEDICAL CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH UNINSURED/SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE MEDICAL CENTER RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. AS A RESULT, THERE IS AT LEAST A REASONABLE POSSIBILITY THAT RECORDED ESTIMATES WILL CHANGE BY A MATERIAL AMOUNT IN THE NEAR TERM. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR UNINSURED/SELF-PAY PATIENTS DECREASED FROM 750,000 AT JULY 31, 2014 TO 530,000 AT JULY 31, 2015 AS ALL NON-MEDICARE AND NON-MEDICAID ACCOUNTS DECREASED OVER 25%.
PART III, LINE 8 - MEDICARE EXPLANATIONTHE MEDICARE COST REPORT WAS USED TO DETERMINE THE AMOUNTS REPORTED ON LINE 6.
PART VI, LINE 2 - NEEDS ASSESSMENTTHE ORGANIZATION USES ITS CHNA TO ASSESS THE NEEDS OF THE COMMUNITY IT SERVICES.
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCETHE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER THE ORGANIZATION'S HELPFUL OPTIONS FOR PATIENT EXPENSES (HOPE) PROGRAM OR FINANCIAL ASSISTANCE POLICY BY HAVING THE INFORMATION AVAILABLE ON THEIR WEBSITE, PROVIDING THE INFORMATION TO ALL WHO INQUIRE ABOUT OBTAINING FINANCIAL ASSISTANCE, AND BY REFERRING THOSE KNOWN TO BE UNINSURED AND/OR TO HAVE LOW INCOME TO FINANCIAL COUNSELORS WHO WILL DISCUSS THE POLICY.
PART VI, LINE 4 - COMMUNITY INFORMATIONRICHARDSON COUNTY, NEBRASKA IS PRIMARILY RURAL AND INCLUDES THE CITIES OF BARADA, DAWSON, FALLS CITY, HUMBOLDT, PRESTON, RULO, SALEM SHUBERT, STELLA, AND VERDON. IT IS LOCATED IN THE SOUTHEAST CORNER OF NEBRASKA. POPULATION ACCORDING TO THE 2010 CENSUS IS 8,363, DECLINING 12.3% FROM 2000. PERSONS 65 YEARS AND OLDER IS 23.2% WHILE PERSONS 18 AND YOUNGER IS 21.0%. ETHNIC BACKGROUDS BY PERCENT INCLUDE WHITE - 94.2%, AMERICAN INDIAN AND ALASKA NATIVE PERSONS - 3.3%, WITH ALL OTHERS REPORTING LESS THAN 2%. THERE ARE 3,782 HOUSEHOLDS WITH AN AVERAGE OF 2.15 PERSONS PER HOUSEHOLD. MEDIAN HOUSEHOLD INCOME IS 38,977 WITH 15.9% OF PERSONS BELOW THE POVERTY LEVEL. THERE ARE 551.84 TOTAL SQUARE MILES AND 15.2 PERSON PER SQUARE MILE.
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTHTHE ORGANIZATION'S BOARD OF DIRECTORS IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVALEDGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY. IN ADDITION, THE ORGANIZATION CONTINUALLY APPLIES SURPLUS FUNDS TOWARD THE IMPROVEMENT OF PATIENT CARE, SUCH AS NEW FACILITIES AND THE PURCHASE OF NEW/UPDATED MEDICAL EQUIPMENT.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgYes (true)CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmountDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmt
RYAN LARSEN
CEO$160,405$15,000$18,884$22,204$216,493
DAVID BORG
PHYSICIAN$138,982$180,724$33,563$22,234$414,868$39,365
SANDRA CATLIN
APRN$58,161$114,735$8,692$16,030$197,712$94
GAYLE KELLER
APRN$55,677$79,335$7,139$22,234$164,504$119

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PAGE 1, PART I, LINE 1ARYAN LARSEN, CEO - LIONS DUES 327.50 / ROTARY DUES 70.00
SCHEDULE J, PAGE 1, PART I, LINE 5APROVIDER PRODUCTIVITY BONUSES ARE CALCULATED BASED ON RURAL HEALTH CLINIC REVENUES.
SCHEDULE J, PART IIIPRODUCTIVITY BONUSES BASED ON REVENUES: DAVID BORG 180,724 SANDRA CATLIN 114,735 GAYLE KELLER 79,335

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BTHE FORM 990 IS REVIEWED BY THE CFO AND IS PRESENTED TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS FOR APPROVAL PRIOR TO FILING THE RETURN.
FORM 990, PAGE 6, PART VI, LINE 12CMANAGEMENT CONTINUALLY REVIEWS OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ANNUAL DISCLOSURES AND RELATIONSHIPS WITH COMMUNITY MEDICAL CENTER TO IDENTIFY POSSIBLE CONFLICTS OF INTEREST. ONCE A CONFLICT OF INTEREST IS IDENTIFIED, THE CONFLICT WOULD BE DOCUMENTED AND MONITORED TO ENSURE APPROPRIATE ACTION IS TAKEN BASED ON THE SITUATION.
FORM 990, PAGE 6, PART VI, LINE 15ACOMPENSATION FOR THE CEO IS DETERMINED BY THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS UTILIZE INDEPENDENT PARTIES OR STUDIES OCCASIONALLY.
FORM 990, PAGE 6, PART VI, LINE 19GOVERNING DOCUMENTS, CONFLICTS OF INTEREST STATEMENTS, AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC WITHOUT APPROVAL BY THE BOARD OF DIRECTORS.
FORM 990, PART IX, LINE 11GCONSULTING FEES 36,000 13,142 0 COLLECTION FEES 0 9,644 0 BILLING FEES 762 39,242 0 COMPUTER MAINTENANCE 0 25,575 0 SERVICE AND LICENSE FEES 15,379 5,923 0 BANK/CREDIT CARD FEES 0 20,240 0 STORAGE FEES 1,385 0 0 CONTRACT LABOR 11,820 0 0 PURCHASED SERVICE 931,006 142,247 0 CONTRACT SERVICE 2,353,418 0 0 DIETARY CONTRACT SERVICE 9,149 0 0

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY MEDICAL CENTER FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line13307 BARADA STREETAddressLine1Txt
CityFALLS CITYCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68355ZIPCd
FieldValueIRS element (for citing)
EIN463491851EIN
Primary ActivitiesSUPPORTPrimaryActivitiesTxt
Legal Domicile StateNELegalDomicileStateCd
Exempt Code Section501C3ExemptCodeSectionTxt
Public Charity Status11APublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1CMCBusinessNameLine1Txt
Business Name Line2COMMUNITY MEDICAL CENTER INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Controlled OrganizationfalseControlledOrganizationInd

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1FALLS CITY HOMEFRONT DEVELOPMENTBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1111 E 17TH STREETAddressLine1Txt
CityFALLS CITYCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68355ZIPCd
FieldValueIRS element (for citing)
EIN463845964EIN
Primary ActivitiesDEVELOPERPrimaryActivitiesTxt
Legal Domicile StateNELegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Predominant Income TypeUNRELATEDPredominantIncomeTypeTxt
Share Of Total Income$8,000ShareOfTotalIncomeAmt
Share Of EOY Assets$112,306ShareOfEOYAssetsAmt
Disproportionate AllocationsfalseDisproportionateAllocationsInd
General Or Managing PartnerfalseGeneralOrManagingPartnerInd
Ownership0.50000OwnershipPct
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd