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PAWNEE COUNTY MEDICAL FOUNDATION: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
PAWNEE COUNTY MEDICAL FOUNDATION (EIN 47-0673168)
Tax period
2014-07-01 to 2015-06-30
Filed
2015-11-12
IRS object ID
201523169349302052
Schema version
2014v5.0
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)
Return2015-11-12T10:07:03-06:00ReturnTs
Tax Period End2015-06-30TaxPeriodEndDt

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 Begin2014-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN470673168EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PAWNEE COUNTY MEDICAL FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPAWNBusinessNameControlTxt
Phone4028692276PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 I STREETAddressLine1Txt
CityPAWNEE CITYCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68420ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonROBERT GYHRAPersonNm
Person TitleTREASURERPersonTitleTxt
Phone4028692276PhoneNum
Signature2015-09-24SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTIMOTHY J COUFALPreparerPersonNm
PTINP00964304PTIN
Phone4026946404PhoneNum
Preparation2015-09-25PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDR GEORGE VOIGTLANDERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1SAME AS C ABOVEAddressLine1Txt
CityPAWNEE CITYCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68420ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$189,452GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1982FormationYr
Legal Domicile StateNELegalDomicileStateCd
Activity Or MissionADVANCE THE OBJECTIVES AND PURPOSES OF PAWNEE COUNTY MEMORIAL HOSPITAL, PAWNEE CITY, NEBRASKA, BY PROVIDING HEALTH CARE SERVICES, FACILITIES AND PROGRAMS IN SUPPORT OF PAWNEE COUNTY MEMORIAL HOSPITAL'S EFFORTS TO ASSIST THOSE SUFFERING FROM ANY DISEASE, INFIRMITY OR HEALTH NECESSITY.ActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$36,487PYContributionsGrantsAmt
CY Contributions Grants$139,813CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$31,312PYInvestmentIncomeAmt
CY Investment Income$34,407CYInvestmentIncomeAmt
PY Other Revenue$11,041PYOtherRevenueAmt
CY Other Revenue$10,595CYOtherRevenueAmt
PY Total Revenue$78,840PYTotalRevenueAmt
CY Total Revenue$184,815CYTotalRevenueAmt
PY Grants And Similar Paid$20,750PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$65,507CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$254CYTotalFundraisingExpenseAmt
PY Other Expenses$62,740PYOtherExpensesAmt
CY Other Expenses$62,980CYOtherExpensesAmt
PY Total Expenses$83,490PYTotalExpensesAmt
CY Total Expenses$128,487CYTotalExpensesAmt
PY Revenues Less Expenses-$4,650PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$56,328CYRevenuesLessExpensesAmt
Total Assets BOY$2,581,412TotalAssetsBOYAmt
Total Assets EOY$2,623,208TotalAssetsEOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,581,412NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,623,208NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionADVANCE THE OBJECTIVES AND PURPOSES OF PAWNEE COUNTY MEMORIAL HOSPITAL, PAWNEE CITY, NEBRASKA, BY PROVIDING HEALTH CARE SERVICES, FACILITIES AND PROGRAMS IN SUPPORT OF PAWNEE COUNTY MEMORIAL HOSPITAL'S EFFORTS TO ASSIST THOSE SUFFERING FROM ANY DISEASE, INFIRMITY OR HEALTH NECESSITY.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$110,007ExpenseAmt
Grant$65,507GrantAmt
DescTO ADVANCE THE OBJECTIVES AND PURPOSES OF PAWNEE COUNTY MEMORIAL HOSPITAL, A 501 (C)3 ORGANIZATION.Desc
Total Program Service Expenses$110,007TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
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 LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
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 Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld CompliancefalseBackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
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 BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyfalseConflictOfInterestPolicyInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonROBERT GYHRAPersonNm
Phone4028692276PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 85AddressLine1Txt
CitySTEINAUERCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68441ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (5 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
DR GEORGE VOIGTLANDER
PRESIDENT0.2540.00Yes (X)$0$170,687$5,974
BYFORD METZGER
MEMBER0.25Yes (X)$0$0$0
ROBERT GYHRA
MEMBER1.00Yes (X)$0$0$0
WILLARD BINDER
MEMBER0.25Yes (X)$0$0$0
GARY FARWELL
MEMBER0.25Yes (X)$0$0$0
FieldValueIRS element (for citing)
Tot Reportable Comp Rltd Org$170,687TotReportableCompRltdOrgAmt
Total Other Compensation$5,974TotalOtherCompensationAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$139,813AllOtherContributionsAmt
Total Contributions$139,813TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$34,407TotalRevenueColumnAmt
Exclusion$34,407ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$15,232RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$4,637RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$10,595RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$10,595TotalRevenueColumnAmt
Exclusion$10,595ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$184,815TotalRevenueColumnAmt
Exclusion$45,002ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$65,507TotalAmt
Program Services$65,507ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$975TotalAmt
Management And General$975ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
EDUCATION$44,500$44,500
INVESTEMENT FEES$17,040$17,040
OFFICE SUPPLIES$254$254
MISCELLANEOUS$211$211

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$128,487TotalAmt
Program Services$110,007ProgramServicesAmt
Management And General$18,226ManagementAndGeneralAmt
Fundraising$254FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$243,303BOYAmt
EOY$740,309EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$827,249BOYAmt
EOY$380,388EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$313,595LandBldgEquipCostOrOtherBssAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$313,595BOYAmt
EOY$313,595EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,190,729BOYAmt
EOY$1,182,627EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$6,536BOYAmt
EOY$6,289EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,581,412BOYAmt
EOY$2,623,208EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,574,876BOYAmt
EOY$2,616,919EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$6,536BOYAmt
EOY$6,289EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,581,412BOYAmt
EOY$2,623,208EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,581,412BOYAmt
EOY$2,623,208EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$56,328ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$13,421NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$1,111OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type2Yes (X)SupportingOrgType2Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1PAWNEE COUNTY MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN363169688EIN
Organization Type3OrganizationTypeDesc
Governing Document ListedYes (true)GoverningDocumentListedInd
Support$65,507SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$65,507SupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (true)ListedByNameGoverningDocInd
Suprt Org No IRS DeterminationfalseSuprtOrgNoIRSDeterminationInd
Supported Org Section C456falseSupportedOrgSectionC456Ind
Supported Org Not Organized USfalseSupportedOrgNotOrganizedUSInd
Organization Change Suprt OrgfalseOrganizationChangeSuprtOrgInd
Support Non Supported OrgfalseSupportNonSupportedOrgInd
Payment Substantial ContribtrfalsePaymentSubstantialContribtrInd
Loan Disqualified PersonfalseLoanDisqualifiedPersonInd
Controlled Disqualified PrsnfalseControlledDisqualifiedPrsnInd
Disqualified Prsn Controll IntfalseDisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr IntfalseDisqualifiedPrsnOwnrIntInd
Excess Business Holdings RulesfalseExcessBusinessHoldingsRulesInd
Contribution ControllerfalseContributionControllerInd
Contribution FamilyfalseContributionFamilyInd
Contribution35 ControlledfalseContribution35ControlledInd
FieldValueIRS element (for citing)
Majority Dir Trst Supported OrgYes (true)MajorityDirTrstSupportedOrgInd

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$6,536BeginningYearBalanceAmt
Investment Earnings Or Losses-$247InvestmentEarningsOrLossesAmt
End Year Balance$6,289EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,033BeginningYearBalanceAmt
Investment Earnings Or Losses-$497InvestmentEarningsOrLossesAmt
End Year Balance$6,536EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,029BeginningYearBalanceAmt
Investment Earnings Or Losses$4InvestmentEarningsOrLossesAmt
End Year Balance$7,033EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,522BeginningYearBalanceAmt
Investment Earnings Or Losses-$493InvestmentEarningsOrLossesAmt
End Year Balance$7,029EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,515BeginningYearBalanceAmt
Investment Earnings Or Losses$7InvestmentEarningsOrLossesAmt
End Year Balance$7,522EndYearBalanceAmt
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$313,595OtherCostOrOtherBasisAmt
Book Value$313,595BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$313,595TotalBookValueLandBuildingsAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PAGE 2, PART V, LINE 4FormAndLineReferenceDesc
ExplanationFUNDS ARE HELD IN TRUST AND DISTRIBUTED TO FOUNDATION WHEN REQUESTED BY BOARD OF DIRECTORS.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedfalseGrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1PAWNEE COUNTY MEMORIAL HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 I STREETAddressLine1Txt
CityPAWNEE CITYCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68420ZIPCd
FieldValueIRS element (for citing)
Recipient EIN363169688RecipientEIN
Cash Grant$65,507CashGrantAmt
Purpose Of GrantCAPITAL PROJECTPurposeOfGrantTxt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PAGE 1, PART I, LINE 2FormAndLineReferenceDesc
ExplanationTHE PURPOSE OF THE FOUNDATION IS TO SUPPORT PAWNEE COUNTY MEMORIAL HOSPITAL, A 501 (C)3 ORGANIZATION. AS SUCH, THE ONLY GRANTS THAT ARE ISSUED ARE FOR THE BENEFIT OF THE HOSPITAL.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
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

FieldValueIRS element (for citing)
PersonDR GEORGE VOIGTLANDERPersonNm
TitlePRESIDENTTitleTxt
Compensation Based On Rltd Orgs$170,687CompensationBasedOnRltdOrgsAmt
Deferred Comp Rltd Orgs$5,974DeferredCompRltdOrgsAmt
Total Compensation Rltd Orgs$176,661TotalCompensationRltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990 - ORGANIZATION'S MISSIONADVANCE THE OBJECTIVES AND PURPOSES OF PAWNEE COUNTY MEMORIAL HOSPITAL, PAWNEE CITY, NEBRASKA, BY PROVIDING HEALTH CARE SERVICES, FACILITIES AND PROGRAMS IN SUPPORT OF PAWNEE COUNTY MEMORIAL HOSPITAL'S EFFORTS TO ASSIST THOSE SUFFERING FROM ANY DISEASE, INFIRMITY OR HEALTH NECESSITY.
FORM 990, PAGE 6, PART VI, LINE 11BTHE RETURN IS REVIEWED BY ONE MEMBER OF MANAGEMENT PRIOR TO FILING.
FORM 990, PAGE 6, PART VI, LINE 19GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9CHANGE IN INTEREST IN NET ASSETS OF TRUST 0
FORM 990, PART XI, LINE 9CHANGE IN EQUITY INTEREST OF AMBULANCE CO. 864 CHANGE IN INTEREST IN NET ASSETS OF TRUST 247

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1PAWNEE COUNTY MEMORIAL HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 I STREETAddressLine1Txt
CityPAWNEE CITYCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68420ZIPCd
FieldValueIRS element (for citing)
EIN363169688EIN
Primary ActivitiesHOSPITALPrimaryActivitiesTxt
Legal Domicile StateNELegalDomicileStateCd
Exempt Code Section501C3ExemptCodeSectionTxt
Public Charity Status3PublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled OrganizationfalseControlledOrganizationInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1PAWNEE COUNTY AMBULANCEBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 I STREETAddressLine1Txt
CityPAWNEE CITYCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68420ZIPCd
FieldValueIRS element (for citing)
EIN470647810EIN
Primary ActivitiesAMBULANCEPrimaryActivitiesTxt
Legal Domicile StateNELegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
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

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1PAWNEE COUNTY MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeBTransactionTypeTxt
Involved$65,507InvolvedAmt
Method Of Amount DeterminationCASH FOR CAPITAL PROJECTMethodOfAmountDeterminationTxt