﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" returnVersion="2013v4.0">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2015-01-20T16:24:48-06:00</ReturnTs>
    <TaxPeriodEndDt>2014-07-31</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>470585450</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1>DOHMAN AKERLUND &amp; EDDY LLC</BusinessNameLine1>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1>PO BOX 470</AddressLine1>
        <City>AURORA</City>
        <State>NE</State>
        <ZIPCode>688180470</ZIPCode>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2013-08-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>470421272</EIN>
      <BusinessName>
        <BusinessNameLine1>COMMUNITY MEDICAL CENTER INC</BusinessNameLine1>
      </BusinessName>
      <BusinessNameControlTxt>COMM</BusinessNameControlTxt>
      <PhoneNum>4022456500</PhoneNum>
      <USAddress>
        <AddressLine1>3307 BARADA STREET</AddressLine1>
        <City>FALLS CITY</City>
        <State>NE</State>
        <ZIPCode>68355</ZIPCode>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>SCOTT L SAWYER</PersonNm>
      <PersonTitleTxt>CHIEF FINANCIAL OFFICER</PersonTitleTxt>
      <PhoneNum>4022456500</PhoneNum>
      <SignatureDt>2015-01-20</SignatureDt>
      <DiscussWithPaidPreparerInd>true</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>TIMOTHY J COUFAL</PreparerPersonNm>
      <PTIN>P00964304</PTIN>
      <PhoneNum>4026946404</PhoneNum>
      <PreparationDt>2015-01-20</PreparationDt>
    </PreparerPersonGrp>
    <TaxYr>2013</TaxYr>
    <BuildTS>2016-02-25 16:41:14Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCount="8">
    <IRS990 documentId="RetDoc3" referenceDocumentId="RetDoc8">
      <PrincipalOfficerNm>RYAN LARSEN</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1>SAME AS ABOVE</AddressLine1>
        <City>FALLS CITY</City>
        <State>NE</State>
        <ZIPCode>68355</ZIPCode>
      </USAddress>
      <GrossReceiptsAmt>23947398</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>false</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>HTTP://CMCFC.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1995</FormationYr>
      <LegalDomicileStateCd>NE</LegalDomicileStateCd>
      <ActivityOrMissionDesc>TO 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>
      <VotingMembersGoverningBodyCnt>8</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>8</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>209</TotalEmployeeCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <PYContributionsGrantsAmt>322375</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>369340</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>21918647</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>23561032</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>-164667</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>17026</CYInvestmentIncomeAmt>
      <CYOtherRevenueAmt>0</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>22076355</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>23947398</CYTotalRevenueAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>9299760</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>9531424</CYSalariesCompEmpBnftPaidAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>11340134</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>12357518</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>20639894</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>21888942</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>1436461</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>2058456</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>36545625</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>39380003</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>20620643</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>21397759</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>15924982</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>17982244</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>TO 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>
      <SignificantNewProgramSrvcInd>false</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>false</SignificantChangeInd>
      <ExpenseAmt>18648413</ExpenseAmt>
      <Desc>COMMUNITY MEDICAL CENTER PROVIDES MEDICAL SERVICES TO MEET THE NEEDS OF THE PEOPLE OF RICHARDSON COUNTY AND THE SURROUNDING COMMUNITIES. COMMUNITY MEDICAL CENTER PROVIDED 1,963 INPATIENT DAYS, 1,336 SWING-BED DAYS, 125 NURSERY DAYS, 11,555 CLINIC VISITS AND NUMEREOUS OUTPATIENT SERVICES DURING THE YEAR. COMMUNITY BENEFITS INCLUDE 456,813 OF SUBSIDIZED HEALTH SERVICES, 394,342 OF TRADITIONAL CHARITY CARE,321,465 OF BAD DEBT, 19,875 OF COMMUNITY ACTIVITIES, 9,945 OF COMMUNITY SERVICES, AND 12,000 OF HEALTH EDUCATION.</Desc>
      <TotalProgramServiceExpensesAmt>18648413</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc4">true</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1">true</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>false</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>false</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>false</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc5">false</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc5">false</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc5">false</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc5">false</CreditCounselingInd>
      <TempOrPermanentEndowmentsInd referenceDocumentId="RetDoc5">true</TempOrPermanentEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc5">true</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc5">false</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc5">false</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc5">false</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc5">true</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc5">true</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc5">true</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc5">false</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>false</SchoolOperatingInd>
      <ForeignOfficeInd>false</ForeignOfficeInd>
      <ForeignActivitiesInd>false</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>false</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>false</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>false</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>false</FundraisingActivitiesInd>
      <GamingActivitiesInd>false</GamingActivitiesInd>
      <OperateHospitalInd referenceDocumentId="RetDoc6">true</OperateHospitalInd>
      <AuditedFinancialStmtAttInd referenceDocumentId="RetDoc2">true</AuditedFinancialStmtAttInd>
      <GrantsToOrganizationsInd>false</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>false</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc7">true</ScheduleJRequiredInd>
      <TaxExemptBondsInd>false</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>false</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>false</PYExcessBenefitTransInd>
      <LoanOutstandingInd>false</LoanOutstandingInd>
      <GrantToRelatedPersonInd>false</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>false</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>false</BusinessRlnWithFamMemInd>
      <BusinessRlnWithOfficerEntInd>false</BusinessRlnWithOfficerEntInd>
      <DeductibleNonCashContriInd>false</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>false</DeductibleArtContributionInd>
      <TerminateOperationsInd>false</TerminateOperationsInd>
      <PartialLiquidationInd>false</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc9">false</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc9">true</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>false</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc9">false</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc9">false</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>true</ScheduleORequiredInd>
      <IRPDocumentCnt>45</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>true</BackupWthldComplianceInd>
      <EmployeeCnt>209</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>true</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>false</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>false</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>false</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>false</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>false</NondeductibleContributionsInd>
      <IndoorTanningServicesInd>false</IndoorTanningServicesInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>8</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>8</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>false</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>false</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>false</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>false</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>false</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>false</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>false</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>true</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>true</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>false</OfficerMailingAddressInd>
      <LocalChaptersInd>false</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>false</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>true</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>true</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>true</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>false</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>true</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>true</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>false</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>false</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>SCOTT L SAWYER</PersonNm>
        <PhoneNum>4022456501</PhoneNum>
        <USAddress>
          <AddressLine1>3307 BARADA STREET</AddressLine1>
          <City>FALLS CITY</City>
          <State>NE</State>
          <ZIPCode>68355</ZIPCode>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>KENT BIEKER</PersonNm>
        <TitleTxt>CHAIRPERSON</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NICK HARLING</PersonNm>
        <TitleTxt>VICE-CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TONY BRUNETTE</PersonNm>
        <TitleTxt>TREASURER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARGARET MCINTEER</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN C HUNZEKER</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LAURIE KIMBROUGH</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CR JAMES DDS</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN WILSON</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>STEVE SEVERIN</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RENIE GERWECK</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RYAN LARSEN</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>161256</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>38285</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SCOTT SAWYER</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>142653</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>24040</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BARBARA HOWARD</PersonNm>
        <TitleTxt>CHIEF CLINIC</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>101958</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>15927</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID BORG</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>360295</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>52606</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SANDRA CATLIN</PersonNm>
        <TitleTxt>APRN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>185562</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>24680</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GAYLE KELLER</PersonNm>
        <TitleTxt>APRN</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>116460</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>26290</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1068184</TotalReportableCompFromOrgAmt>
      <TotalOtherCompensationAmt>181828</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>6</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>false</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1>PRTS-NACHTIGAL LLC</BusinessNameLine1>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1>700 OREGON STREET</AddressLine1>
            <City>HIAWATHA</City>
            <State>KS</State>
            <ZIPCode>66434</ZIPCode>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PT/OT SERVICES</ServicesDesc>
        <CompensationAmt>659122</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1>SHADOW ANESTHESIA SERVICES</BusinessNameLine1>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1>65675 711 ROAD</AddressLine1>
            <City>FALLS CITY</City>
            <State>NE</State>
            <ZIPCode>68355</ZIPCode>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>ANESTHESIA SVCS</ServicesDesc>
        <CompensationAmt>370025</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1>CARDINAL HEALTH</BusinessNameLine1>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1>21337 NETWORK PLACE</AddressLine1>
            <City>CHICAGO</City>
            <State>IL</State>
            <ZIPCode>60673</ZIPCode>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PHARMACY SVCS</ServicesDesc>
        <CompensationAmt>351873</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1>NHI OUTREACH CLINICAL SERVICES</BusinessNameLine1>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1>7440 S 91ST STREET</AddressLine1>
            <City>LINCOLN</City>
            <State>NE</State>
            <ZIPCode>68501</ZIPCode>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>NM &amp; ECHO SERV</ServicesDesc>
        <CompensationAmt>179272</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1>NAVIN HAFFTY &amp; ASSOCIATES LLC</BusinessNameLine1>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1>1900 WEST PARK DRIVE</AddressLine1>
            <City>WESTBOROUGH</City>
            <State>MA</State>
            <ZIPCode>01581</ZIPCode>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>CONSULTING SERV</ServicesDesc>
        <CompensationAmt>153428</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>6</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>290043</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>79297</AllOtherContributionsAmt>
      <TotalContributionsAmt>369340</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>NET PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>622110</BusinessCd>
        <TotalRevenueColumnAmt>23331279</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>23331279</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MISCELLANEOUS HOPSITAL REV</Desc>
        <BusinessCd>622110</BusinessCd>
        <TotalRevenueColumnAmt>124513</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>124513</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>CAFETERIA</Desc>
        <BusinessCd>722310</BusinessCd>
        <TotalRevenueColumnAmt>74752</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>74752</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>LIFELINE</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>30488</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>30488</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>23561032</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>14986</TotalRevenueColumnAmt>
        <ExclusionAmt>14986</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <OtherAmt>2040</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <GainOrLossGrp>
        <OtherAmt>2040</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>2040</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>2040</RelatedOrExemptFuncIncomeAmt>
      </NetGainOrLossInvestmentsGrp>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>23947398</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>23563072</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>14986</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>405867</TotalAmt>
        <ProgramServicesAmt>101958</ProgramServicesAmt>
        <ManagementAndGeneralAmt>303909</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>6978340</TotalAmt>
        <ProgramServicesAmt>5912676</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1065664</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>292738</TotalAmt>
        <ProgramServicesAmt>226100</ProgramServicesAmt>
        <ManagementAndGeneralAmt>66638</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1353907</TotalAmt>
        <ProgramServicesAmt>1117142</ProgramServicesAmt>
        <ManagementAndGeneralAmt>236765</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>500572</TotalAmt>
        <ProgramServicesAmt>406646</ProgramServicesAmt>
        <ManagementAndGeneralAmt>93926</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>9714</TotalAmt>
        <ManagementAndGeneralAmt>9714</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>26810</TotalAmt>
        <ManagementAndGeneralAmt>26810</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>3249233</TotalAmt>
        <ProgramServicesAmt>2980964</ProgramServicesAmt>
        <ManagementAndGeneralAmt>268269</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>36939</TotalAmt>
        <ProgramServicesAmt>7407</ProgramServicesAmt>
        <ManagementAndGeneralAmt>29532</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>139669</TotalAmt>
        <ProgramServicesAmt>56672</ProgramServicesAmt>
        <ManagementAndGeneralAmt>82997</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <OccupancyGrp>
        <TotalAmt>304299</TotalAmt>
        <ProgramServicesAmt>302991</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1308</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>36896</TotalAmt>
        <ProgramServicesAmt>20269</ProgramServicesAmt>
        <ManagementAndGeneralAmt>16627</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>40893</TotalAmt>
        <ProgramServicesAmt>24572</ProgramServicesAmt>
        <ManagementAndGeneralAmt>16321</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>901213</TotalAmt>
        <ProgramServicesAmt>767794</ProgramServicesAmt>
        <ManagementAndGeneralAmt>133419</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>2008020</TotalAmt>
        <ProgramServicesAmt>1710744</ProgramServicesAmt>
        <ManagementAndGeneralAmt>297276</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>67707</TotalAmt>
        <ProgramServicesAmt>2609</ProgramServicesAmt>
        <ManagementAndGeneralAmt>65098</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>CENTRAL SUPPLY</Desc>
        <TotalAmt>2049739</TotalAmt>
        <ProgramServicesAmt>2049739</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PHARMACY</Desc>
        <TotalAmt>1424363</TotalAmt>
        <ProgramServicesAmt>1424363</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>REPAIR AND MAINTENANCE</Desc>
        <TotalAmt>530709</TotalAmt>
        <ProgramServicesAmt>310524</ProgramServicesAmt>
        <ManagementAndGeneralAmt>220185</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>ADMIN OFFICE</Desc>
        <TotalAmt>290473</TotalAmt>
        <ProgramServicesAmt>4778</ProgramServicesAmt>
        <ManagementAndGeneralAmt>285695</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>1240841</TotalAmt>
        <ProgramServicesAmt>1220465</ProgramServicesAmt>
        <ManagementAndGeneralAmt>20376</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>21888942</TotalAmt>
        <ProgramServicesAmt>18648413</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3240529</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>6381512</BOYAmt>
        <EOYAmt>12416827</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>3601651</BOYAmt>
        <EOYAmt>4185858</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>12809</BOYAmt>
        <EOYAmt>500</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>4623371</BOYAmt>
        <EOYAmt>3234046</EOYAmt>
      </AccountsReceivableGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>4688</BOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>57816</BOYAmt>
        <EOYAmt>107721</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>242702</BOYAmt>
        <EOYAmt>275454</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>27816426</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>9685594</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>19845235</BOYAmt>
        <EOYAmt>18130832</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>5983</BOYAmt>
        <EOYAmt>135799</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>408063</BOYAmt>
        <EOYAmt>382966</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>1361795</BOYAmt>
        <EOYAmt>510000</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>36545625</BOYAmt>
        <EOYAmt>39380003</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>1394348</BOYAmt>
        <EOYAmt>1658932</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <EOYAmt>369445</EOYAmt>
      </DeferredRevenueGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>17083068</BOYAmt>
        <EOYAmt>16765855</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>2143227</BOYAmt>
        <EOYAmt>2603527</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>20620643</BOYAmt>
        <EOYAmt>21397759</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
      <UnrestrictedNetAssetsGrp>
        <BOYAmt>15924982</BOYAmt>
        <EOYAmt>17982244</EOYAmt>
      </UnrestrictedNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>15924982</BOYAmt>
        <EOYAmt>17982244</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>36545625</BOYAmt>
        <EOYAmt>39380003</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>2058456</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-1194</NetUnrlzdGainsLossesInvstAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>false</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc4">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="RetDoc5">
      <CYEndwmtFundGrp>
        <BeginningYearBalanceAmt>2528700</BeginningYearBalanceAmt>
        <ContributionsAmt>579415</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>4686</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>3112800</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>1755831</BeginningYearBalanceAmt>
        <ContributionsAmt>768898</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>3982</InvestmentEarningsOrLossesAmt>
        <AdministrativeExpensesAmt>11</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>2528700</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>993457</BeginningYearBalanceAmt>
        <ContributionsAmt>837845</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>3438</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>78887</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>22</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>1755831</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>979328</BeginningYearBalanceAmt>
        <ContributionsAmt>791569</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>1275</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>778715</OtherExpendituresAmt>
        <EndYearBalanceAmt>993457</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>561962</BeginningYearBalanceAmt>
        <ContributionsAmt>11553894</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>3723</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>11140251</OtherExpendituresAmt>
        <EndYearBalanceAmt>979328</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <BoardDesignatedBalanceEOYPct>1.00000</BoardDesignatedBalanceEOYPct>
      <EndowmentsHeldUnrelatedOrgInd>false</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>false</EndowmentsHeldRelatedOrgInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>1184880</OtherCostOrOtherBasisAmt>
        <BookValueAmt>1184880</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>17345085</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>4522342</DepreciationAmt>
        <BookValueAmt>12822743</BookValueAmt>
      </BuildingsGrp>
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>1637624</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>473011</DepreciationAmt>
        <BookValueAmt>1164613</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>7437013</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>4690241</DepreciationAmt>
        <BookValueAmt>2746772</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>211824</OtherCostOrOtherBasisAmt>
        <BookValueAmt>211824</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>18130832</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>CONDITIONAL CONTRIBUTION</Desc>
        <Amt>1950000</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>EST THIRD-PARTY PAYOR SETTLEMENTS</Desc>
        <Amt>530000</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>DEFERRED COMPENSATION</Desc>
        <Amt>123527</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>2603527</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <TotalRevEtcAuditedFinclStmtAmt>23946204</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>-1194</NetUnrealizedGainsInvstAmt>
      <RevenueNotReportedAmt>-1194</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>23947398</RevenueSubtotalAmt>
      <TotalRevenuePerForm990Amt>23947398</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>21888942</TotExpnsEtcAuditedFinclStmtAmt>
      <ExpensesSubtotalAmt>21888942</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>21888942</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 2, PART V, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FUNDS INCLUDE 6,235 DESIGNATED BY THE BOARD FOR CAPITAL IMPROVEMENTS, 211,244 DESIGNATED BY THE BOARD FOR DEFERRED COMPENSATION, 333,720 DESIGNATED BY A LONG-TERM DEBT COVENANT ON THE USDA LOAN, 599,713 DESIGNATED BY BANK SNB TO BE USED FOR EQUIPMENT AND 1,961,888 DESIGNATED AS A DEBT SINKING FUND.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 3, PART X</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MEDICAL CENTER IS EXEMPT FROM PAYMENT OF FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, BUT IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE MEDICAL CENTER FOLLOWS FINANCIAL ACCOUNTING STANDARDS BOARD APPLICABLE ACCOUNTING STANDARDS FOR UNCERTAINTIES IN INCOME TAXES AND REQUIRED DISCLOSURES THEREON. AS OF JULY 31, 2014 AND 2013, THERE IS NO RESERVE FOR UNCERTAIN TAX POSITIONS. THE MEDICAL CENTER HAS NOT RECOGNIZED ANY INTEREST OR PENALTIES IN RELATION TO INCOME TAX FILINGS AS OF OR FOR THE YEARS ENDED JULY 31, 2014 OR 2013. ADDITIONALLY, TAX YEARS ENDED JULY 31, 2012, 2013 AND 2014 ALL REMAIN OPEN AND ARE SUBJECT TO POTENTIAL EXAMINATION BY TAXING JURISDICTIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="RetDoc6">
      <FinancialAssistancePolicyInd>true</FinancialAssistancePolicyInd>
      <WrittenPolicyInd>true</WrittenPolicyInd>
      <AllHospitalsPolicyInd>X</AllHospitalsPolicyInd>
      <FPGReferenceFreeCareInd>true</FPGReferenceFreeCareInd>
      <Percent200Ind>X</Percent200Ind>
      <FPGReferenceDiscountedCareInd>true</FPGReferenceDiscountedCareInd>
      <Percent300Ind>X</Percent300Ind>
      <FreeCareMedicallyIndigentInd>true</FreeCareMedicallyIndigentInd>
      <FinancialAssistanceBudgetInd>true</FinancialAssistanceBudgetInd>
      <ExpensesExceedBudgetInd>true</ExpensesExceedBudgetInd>
      <UnableToProvideCareInd>false</UnableToProvideCareInd>
      <AnnualCommunityBnftReportInd>true</AnnualCommunityBnftReportInd>
      <ReportPublicallyAvailableInd>true</ReportPublicallyAvailableInd>
      <FinancialAssistanceAtCostTyp>
        <TotalCommunityBenefitExpnsAmt>394342</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>394342</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.01800</TotalExpensePct>
      </FinancialAssistanceAtCostTyp>
      <TotalFinancialAssistanceTyp>
        <TotalCommunityBenefitExpnsAmt>394342</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>394342</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.01800</TotalExpensePct>
      </TotalFinancialAssistanceTyp>
      <CommunityHealthServicesGrp>
        <TotalCommunityBenefitExpnsAmt>9945</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>9945</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00050</TotalExpensePct>
      </CommunityHealthServicesGrp>
      <HealthProfessionsEducationGrp>
        <TotalCommunityBenefitExpnsAmt>12000</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>12000</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00050</TotalExpensePct>
      </HealthProfessionsEducationGrp>
      <SubsidizedHealthServicesGrp>
        <TotalCommunityBenefitExpnsAmt>456813</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>456813</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.02090</TotalExpensePct>
      </SubsidizedHealthServicesGrp>
      <TotalOtherBenefitsGrp>
        <TotalCommunityBenefitExpnsAmt>478758</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>478758</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.02190</TotalExpensePct>
      </TotalOtherBenefitsGrp>
      <TotalCommunityBenefitsGrp>
        <TotalCommunityBenefitExpnsAmt>873100</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>873100</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.03990</TotalExpensePct>
      </TotalCommunityBenefitsGrp>
      <PhysicalImprvAndHousingGrp>
        <TotalCommunityBenefitExpnsAmt>12500</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>12500</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00060</TotalExpensePct>
      </PhysicalImprvAndHousingGrp>
      <EconomicDevelopmentGrp>
        <TotalCommunityBenefitExpnsAmt>5000</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>5000</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00020</TotalExpensePct>
      </EconomicDevelopmentGrp>
      <CommunitySupportGrp>
        <TotalCommunityBenefitExpnsAmt>2375</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>2375</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00010</TotalExpensePct>
      </CommunitySupportGrp>
      <TotalCommuntityBuildingActyGrp>
        <TotalCommunityBenefitExpnsAmt>19875</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>19875</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00090</TotalExpensePct>
      </TotalCommuntityBuildingActyGrp>
      <BadDebtExpenseReportedInd>true</BadDebtExpenseReportedInd>
      <BadDebtExpenseAmt>321465</BadDebtExpenseAmt>
      <BadDebtExpenseAttributableAmt>32147</BadDebtExpenseAttributableAmt>
      <ReimbursedByMedicareAmt>11932367</ReimbursedByMedicareAmt>
      <CostOfCareReimbursedByMedcrAmt>11623238</CostOfCareReimbursedByMedcrAmt>
      <MedicareSurplusOrShortfallAmt>309129</MedicareSurplusOrShortfallAmt>
      <CostingMethodologyUsedGrp>
        <OtherInd>X</OtherInd>
      </CostingMethodologyUsedGrp>
      <WrittenDebtCollectionPolicyInd>true</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>false</FinancialAssistancePrvsnInd>
      <HospitalFacilitiesCnt>1</HospitalFacilitiesCnt>
      <HospitalFacilitiesGrp>
        <FacilityNum>1</FacilityNum>
        <BusinessName>
          <BusinessNameLine1>COMMUNITY MEDICAL CENTER</BusinessNameLine1>
        </BusinessName>
        <USAddress>
          <AddressLine1>3307 BARADA STREET</AddressLine1>
          <City>FALLS CITY</City>
          <State>NE</State>
          <ZIPCode>68355</ZIPCode>
        </USAddress>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <CriticalAccessHospitalInd>X</CriticalAccessHospitalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
      </HospitalFacilitiesGrp>
      <HospitalFcltyPoliciesPrctcGrp>
        <HospitalFacilityName>
          <BusinessNameLine1>COMMUNITY MEDICAL CENTER</BusinessNameLine1>
        </HospitalFacilityName>
        <FacilityNum>1</FacilityNum>
        <CHNAConductedInd>true</CHNAConductedInd>
        <CommunityDefinitionInd>X</CommunityDefinitionInd>
        <CommunityDemographicsInd>X</CommunityDemographicsInd>
        <ExistingResourcesInd>X</ExistingResourcesInd>
        <HowDataObtainedInd>X</HowDataObtainedInd>
        <CommunityHealthNeedsInd>X</CommunityHealthNeedsInd>
        <OtherHealthIssuesInd>X</OtherHealthIssuesInd>
        <CommunityHlthNeedsIdProcessInd>X</CommunityHlthNeedsIdProcessInd>
        <ConsultingProcessInd>X</ConsultingProcessInd>
        <InformationGapsInd>X</InformationGapsInd>
        <OtherInd>X</OtherInd>
        <CHNAConductedYr>13</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>true</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>false</CHNAConductedWithOtherFcltsInd>
        <CHNAReportWidelyAvailableInd>true</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>HTTP://CMCFC.ORG</OwnWebsiteURLTxt>
        <RptAvailableUponRequestInd>X</RptAvailableUponRequestInd>
        <AdoptImplementationStrategyInd>X</AdoptImplementationStrategyInd>
        <ExecImplementationStrategyInd>X</ExecImplementationStrategyInd>
        <DevelopCommunityWidePlanInd>X</DevelopCommunityWidePlanInd>
        <ExecCommunityWidePlanInd>X</ExecCommunityWidePlanInd>
        <PrioritizeHealthNeedsInd>X</PrioritizeHealthNeedsInd>
        <AllNeedsAddressedInd>true</AllNeedsAddressedInd>
        <OrganizationIncurExciseTaxInd>false</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>true</EligCriteriaExplainedInd>
        <FPGUsedDeterEligFreeCareInd>true</FPGUsedDeterEligFreeCareInd>
        <FPGFamilyIncmLmtFreeCarePct>200.000000000000</FPGFamilyIncmLmtFreeCarePct>
        <FPGUsedDetermEligDscntCareInd>true</FPGUsedDetermEligDscntCareInd>
        <FPGFamilyIncmLmtDscntCarePct>300.000000000000</FPGFamilyIncmLmtDscntCarePct>
        <ExplainedBasisInd>true</ExplainedBasisInd>
        <IncomeLevelInd>X</IncomeLevelInd>
        <AppFinancialAsstExplnInd>true</AppFinancialAsstExplnInd>
        <IncludesPublicityMeasuresInd>true</IncludesPublicityMeasuresInd>
        <PostedOnWebsiteInd>X</PostedOnWebsiteInd>
        <AvailableOnRequestInd>X</AvailableOnRequestInd>
        <OtherPublicityInd>X</OtherPublicityInd>
        <FAPActionsOnNonpaymentInd>true</FAPActionsOnNonpaymentInd>
        <CollectionActivitiesInd>false</CollectionActivitiesInd>
        <FAPNotifiedUponAdmissionInd>X</FAPNotifiedUponAdmissionInd>
        <FAPNotifiedBeforeDischargeInd>X</FAPNotifiedBeforeDischargeInd>
        <FAPNotifiedAllPatientsInd>X</FAPNotifiedAllPatientsInd>
        <DocumentedEligDeterminationInd>X</DocumentedEligDeterminationInd>
        <NondisEmergencyCarePolicyInd>true</NondisEmergencyCarePolicyInd>
        <OtherMethodUsedInd>X</OtherMethodUsedInd>
        <AmountsGenerallyBilledInd>false</AmountsGenerallyBilledInd>
        <GrossChargesInd>false</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>FACILITY 1, COMMUNITY MEDICAL CENTER - PART V, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>FOCUS GROUP MEETINGS WERE HELD AS PART OF THE MAPP (MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS) STRATGIC PLANNING PROCESS. REPRESENTATIVES FROM BOTH FALLS CITY AND HUMBOLDT INCLUDED THE THREE SCHOOL DISTRICTS, MINISTERIAL ASSOCIATION, HOME HEALTH CARE, LONG TERM CARE, LAW ENFORCEMENT, AMBULANCE SERVICES (FOR PROFIT AND VOLUNTEER), MEDICAL COMMUNITY, COUNTY GOVERNMENT, EMERGENCY MANAGEMENT, SCHOOL NURSING, THE HOSPITAL, AND THE HEALTH DEPARTMENT.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>FACILITY 1, COMMUNITY MEDICAL CENTER - PART V, LINE 14G</FormAndLineReferenceDesc>
        <ExplanationTxt>AT ADMISSION OR AT LEAST PRIOR TO DISCHARGE REGISTRATION PERSONNEL REFER UNINSURED AND/OR LOW INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE POLICY.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>FACILITY 1, COMMUNITY MEDICAL CENTER - PART V, LINE 20D</FormAndLineReferenceDesc>
        <ExplanationTxt>THE 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.</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>2</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>FAMILY MEDICINE</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>3307 BARADA STREET</AddressLine1>
            <City>FALLS CITY</City>
            <State>NE</State>
            <ZIPCode>68355</ZIPCode>
          </USAddress>
          <FacilityTxt>RURAL HEALTH CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1>HUMBOLDT FAMILY MEDICINE</BusinessNameLine1>
          </BusinessName>
          <USAddress>
            <AddressLine1>1120 GRAND AVENUE</AddressLine1>
            <City>HUMBOLDT</City>
            <State>NE</State>
            <ZIPCode>68376</ZIPCode>
          </USAddress>
          <FacilityTxt>RURAL HEALTH CLINIC</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7, COLUMN (F) - EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE</FormAndLineReferenceDesc>
        <ExplanationTxt>NO BAD DEBT EXPENSE IS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) AS BAD DEBT EXPENSE OF 492,327 IS REPORTED WITH NET PATIENT SERVICE REVENUE ON FORM 990, PART VIII, LINE 2.A., CONSISTENT WITH FINANCIAL STATEMENTS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE WAS A COST TO CHARGE RATIO.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II - COMMUNITY BUILDING ACTIVITIES</FormAndLineReferenceDesc>
        <ExplanationTxt>COMMUNITY-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 5,000 TO SACRED HEART - PROJECT RENEW 125. THE ORGANIZATION ALSO CONTRIBUTED 2,375 TO VARIOUS HEALTH-ORIENTED ACTIVITIES AND SCHOOL PROJECTS DURING THE YEAR.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY</FormAndLineReferenceDesc>
        <ExplanationTxt>OVERALL 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 492,327.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE</FormAndLineReferenceDesc>
        <ExplanationTxt>AFTER 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS</FormAndLineReferenceDesc>
        <ExplanationTxt>ACCOUNTS 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 INCREASED FROM 556,000 AT JULY 31, 2013 TO 750,000 AT JULY 31, 2014 AS UNINSURED/SELF-PAY ACCOUNTS OVER 181 DAYS OUTSTANDING INCREASED OVER 56%.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 8 - MEDICARE EXPLANATION</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MEDICARE COST REPORT WAS USED TO DETERMINE THE AMOUNTS REPORTED ON LINE 6.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 2 - NEEDS ASSESSMENT</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION USES ITS CHNA TO ASSESS THE NEEDS OF THE COMMUNITY IT SERVICES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE</FormAndLineReferenceDesc>
        <ExplanationTxt>THE 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 4 - COMMUNITY INFORMATION</FormAndLineReferenceDesc>
        <ExplanationTxt>RICHARDSON 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH</FormAndLineReferenceDesc>
        <ExplanationTxt>THE 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.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleH>
    <IRS990ScheduleJ documentId="RetDoc7">
      <ClubDuesOrFeesInd>X</ClubDuesOrFeesInd>
      <WrittenPolicyRefTAndEExpnssInd>true</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>true</SubstantiationRequiredInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>false</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>true</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>false</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>RYAN LARSEN</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>154256</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>7000</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>18167</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>20118</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>199541</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SCOTT SAWYER</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>102153</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>40500</BonusFilingOrganizationAmount>
        <DeferredCompensationFlngOrgAmt>14141</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>9899</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>166693</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DAVID BORG</PersonNm>
        <TitleTxt>PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>139327</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>189048</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>31920</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>32452</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>20154</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>412901</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SANDRA CATLIN</PersonNm>
        <TitleTxt>APRN</TitleTxt>
        <BaseCompensationFilingOrgAmt>58035</BaseCompensationFilingOrgAmt>
        <BonusFilingOrganizationAmount>124509</BonusFilingOrganizationAmount>
        <OtherCompensationFilingOrgAmt>3018</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>9327</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>15353</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>210242</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PAGE 1, PART I, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>RYAN LARSEN, CEO - ACHE DUES 325</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PAGE 1, PART I, LINE 5A</FormAndLineReferenceDesc>
        <ExplanationTxt>PROVIDER PRODUCTIVITY BONUSES ARE CALCULATED BASED ON RURAL HEALTH CLINIC REVENUES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART III</FormAndLineReferenceDesc>
        <ExplanationTxt>PRODUCTIVITY BONUSES BASED ON REVENUES: DAVID BORG 189,048 SANDRA CATLIN 124,409</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc8">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>MANAGEMENT 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>COMPENSATION FOR THE CEO IS DETERMINED BY THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS UTILIZE INDEPENDENT PARTIES OR STUDIES OCCASIONALLY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNING DOCUMENTS, CONFLICTS OF INTEREST STATEMENTS, AND FINANCIAL STATEMETNS ARE NOT MADE AVAILABLE TO THE PUBLIC WITHOUT APPROVAL BY THE BOARD OF DIRECTORS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>PHYSICAL THERAPY CONTRACT SVC 475,380 0 0 CRNA CONTRACT SVC 399,817 0 0 PHARMACY PURCHASED SVC 306,756 0 0 INFORMATION SYSTEMS PURCHASED 0 49,453 0 ER DOCTORS CONTRACT SVC 61,295 0 0 INFORMATION SYSTEMS CONSULTIN 0 5,900 0 BLOOD PROC/STRNG/ADM PURCHASE 57,993 0 0 MRI PURCHASED SVC 118,000 0 0 OCCUPATIONAL THERAPY CONTRACT 171,033 0 0 ER CONTRACT LABOR 67,635 0 0 LABORATORY CONTRACT SERVICE 89,096 0 0 ECHOCARDIOGRAPHY PURCHASED SV 86,636 0 0 NUCLEAR MED PURCHASED SVC 66,494 0 0 VASCULAR STUDIES PURCHASED SV 70,581 0 0 PHARMACY RX CONTRACT SVC 70,499 0 0 QUALITY ASSURANCE PURCHASED S 33,657 0 0 LAUNDRY PURCHASED SVC 29,333 0 0 ADMINISTRATION PURCHASED SVC 0 42,631 0 SPEECH THERAPY PURCHASED SVC 36,457 0 0 SLEEP STUDY PURCHASED SVC 50,250 0 0 HUMBOLDT CLINIC PHYSICIAN CON 31,438 0 0 HLTH INFO MGMT PURCHASED SVC 0 25,349 0 HUMAN RESOURCES PURCHASED SVC 0 20,287 0 ALL OTHER 155,848 0 0 OPERATING ROOM PURCHASED SERV 25,218 0 0 PHYSICIAN CONTRACT SERVICES 535,548 37,838 0 PT ACCTG BILLING FEES 0 27,581 0 PT ACCTG PURCHASED SERV 0 32,842 0 MIS COMPUTER MAINTENANCE 0 26,388 0 NURSING ADMIN CONTRACT LABOR 42,000 0 0</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc9">
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1>FALLS CITY HOMEFRONT DEVELOPMENT</BusinessNameLine1>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1>111 E 17TH STREET</AddressLine1>
          <City>FALLS CITY</City>
          <State>NE</State>
          <ZIPCode>68355</ZIPCode>
        </USAddress>
        <EIN>463845964</EIN>
        <PrimaryActivitiesTxt>DEVELOPER</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <PredominantIncomeTypeTxt>UNRELATED</PredominantIncomeTypeTxt>
        <ShareOfTotalIncomeAmt>-1194</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>196306</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
        <OwnershipPct>0.50000</OwnershipPct>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1>COMMUNITY MEDICAL CENTER FOUNDATION</BusinessNameLine1>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1>3307 BARADA STREET</AddressLine1>
          <City>FALLS CITY</City>
          <State>NE</State>
          <ZIPCode>68355</ZIPCode>
        </USAddress>
        <EIN>463491851</EIN>
        <PrimaryActivitiesTxt>SUPPORT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NE</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1>CMC</BusinessNameLine1>
          <BusinessNameLine2>COMMUNITY MEDICAL CENTER FOUNDATION</BusinessNameLine2>
        </DirectControllingEntityName>
        <EntityTypeTxt>C CORP</EntityTypeTxt>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>false</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE R</FormAndLineReferenceDesc>
        <ExplanationTxt>PART VI, RELATED ORGANIZATION (1) - COMMUNITY MEDICAL CENTER IS THE SOLE MEMBER OF COMMUNITY MEDICAL CENTER FOUNDATION, A NONPROFIT CORPORATION, THAT IS AWAITING APPROVAL OF TAX-EXEMPT STATUS FROM THE IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleR>
  </ReturnData>
</Return>