2014-03-03T08:44:55-06:00 2013-06-30 BKD LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2012-07-01 440537826 Community Hospital Association Inc % SUZANNE SOUTHARD COMM 6606862211 PO Box 107 Suite Fairfax MO 644460107 SUZANNE SOUTHARD 8162216300 2014-05-15 true Michael J Engle 8162216300 2012 2015-11-30 17:44:51Z MYRA EVANS 26136 US HWY 59 FAIRFAX MO 64446 11828180 false X WWW.FAIRFAXMED.COM X 1976 MO TO PROVIDE QUALITY ACUTE CARE, EMERGENCY, AND OUTPATIENT HOSPITAL SERVICES. 15 13 132 90 0 0 607905 139766 11227439 11151530 5735 182845 295827 326575 12136906 11800716 52981 43860 0 0 5110727 5219557 0 0 107429 7559846 7322824 12723554 12586241 -586648 -785525 19529044 23503036 13037596 12627349 6491448 10875687 X TO BE THE HEALTHCARE PROVIDER OF CHOICE FOR THE COMMUNITIES WE SERVE. false false 9932242 43860 11151530 SEE SCHEDULE O 9932242 true true false true false false false false false false true false false false false true false true false false false false false false true false true true false true true false false false false false false false false false false false false false true true true false false true 6 0 true 132 true false false false false false true true false false false false X 15 13 false true false false false true true true true false false true true true true true true true true false MO X SUZANNE SOUTHARD 6606862211 26136 US HWY 59 FAIRFAX MO 64446 ROBERT JACKSON 1.0 1.0 X X 0 0 0 PAULA MILLER 1.0 X X 0 0 0 SANDRA FUHRMAN 1.0 1.0 X X 0 0 0 RICHARD OSWALD 1.0 1.0 X 0 0 0 SARAH WATKINS 1.0 X 0 0 0 JACQUE GEBHARDS 1.0 X 0 0 0 STEVE CUNNINGHAM 1.0 1.0 X 0 0 0 JASON GARST 1.0 X 0 0 0 CHAD DERR 1.0 X 0 0 0 BEVERLY JONES 1.0 X 0 0 0 MIKE FISHER 1.0 X 0 0 0 EDUARDO FERNANDEZ MD 1.0 1.0 X 0 0 0 DEBBIE GLEASON 1.0 X 0 131015 12437 KRISTI ATKINSON 1.0 X 0 103638 8484 VIRGINIA LOW 1.0 X 0 0 0 MYRA EVANS 40.0 1.0 X 0 201494 14483 SUZANNE SOUTHARD 40.0 1.0 X 54965 0 5595 GARY MCINTYRE 40.0 X 143296 0 2172 198261 436147 43171 1 false true false DOCS WHO CARE PHYSICIAN SERVICES 359706 CPSI COMPTR SUPPORT SVCS 136152 FOCUSONE SOLUTIONS LLC TEMPORARY STAFFING 175193 MORGAN ANESTHESIA SERVICES CRNA SERVICES 149988 DELTA HEALTHCARE PROVIDERS TEMPORARY STAFFING 143106 5 94463 6800 38503 139766 NET PATIENT SERVICE REVENUE 621990 11151530 11151530 11151530 180607 180607 0 0 0 0 0 2238 2238 2238 2238 52108 94463 27464 24644 24644 0 0 INCENTIVE REVENUE 900099 240597 240597 CAFETERIA 621990 51052 51052 All Other Misc Revenue 900099 10282 10282 10282 10282 301931 11800716 11151530 509420 X 0 43860 43860 0 0 290553 290553 0 4140831 3229848 869575 41408 83154 64860 17462 832 379976 298933 77359 3684 325043 253534 68259 3250 231804 180807 48679 2318 24328 18976 5109 243 68085 53106 14298 681 0 0 0 1696453 1323233 356255 16965 52244 40751 10971 522 388341 302906 81552 3883 0 0 219792 171438 46156 2198 34781 27129 7304 348 0 0 594234 463503 124789 5942 0 1689975 1318180 354895 16900 75054 58542 15761 751 REPAIRS & MAINT. 448147 349555 94111 4481 Medical Supplies 688571 688571 BAD DEBT 767398 767398 EMPLOYEE RECRUITMENT 112006 87365 23521 1120 231611 189747 39961 1903 12586241 9932242 2546570 107429 27870 116181 330049 633396 97335 31221 1344633 1321908 0 0 0 0 0 0 332474 308528 69003 82529 21390874 6120098 16926680 15270776 0 5647869 0 0 0 0 0 0 401000 90628 19529044 23503036 753133 717605 0 0 0 0 0 0 0 0 0 0 12284463 11909744 0 0 0 0 13037596 12627349 X 6491448 10875687 0 0 0 0 6491448 10875687 19529044 23503036 X -785525 189251 4980513 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 3915 false false 3915 false 309117 309117 5569332 1132246 4437086 13420262 4576961 8843301 2092163 410891 1681272 15270776 0 0 X 12220322 189251 230355 419606 11800716 11800716 12623304 37063 37063 12586241 12586241 UNCERTAIN TAX POSITIONS DISCLOSURE SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. RECONCILIATION OF REVENUE SCHEDULE D, PART XI, LINE 2D RELATED ORGANIZATION'S REVENUE 202,891 SPECIAL EVENT EXPENSES 27,464 ------- TOTAL $230,355 RECONCILIATION OF EXPENSES SCHEDULE D, PART XII, LINE 2D RELATED ORGANIZATION'S EXPENSES 9,599 SPECIAL EVENT EXPENSES 27,464 ------- TOTAL $37,063 GOLF TOURNAMENT 49257 20263 28994 1680 4519 3130 7219 ANNUAL APPEAL 67486 67486 368 1 29828 24200 5628 150 3268 7130 146571 44463 102108 1680 4519 150 6398 14717 27464 74644 true true true X true X true true false true true 244309 244309 0.01940 1567564 845266 722298 0.05740 1811873 845266 966607 0.07680 23572 1385 22187 0.00010 35350 600 34750 0.00280 237159 212452 24707 0.00200 1920 1920 0.00020 298001 214437 83564 0.00510 2109874 1059703 1050171 0.08190 141 141 0.00010 3891 3891 0.00030 7328 7328 0.00060 11360 11360 0.00100 false 767398 56558 5977171 5958515 18656 X true true 1 1 COMMUNITY HOSPITAL-FAIRFAX

26136 US HWY 59 FAIRFAX MO 64446

http://www.fairfaxmed.com/ X X X X COMMUNITY HOSPITAL-FAIRFAX 1 true X X X X X X X X X 12 true false true X X X X X X X true false true true 200. true 200. true X X X X X X true true X X X X X true false X X X X true X false false 1 PRIMARY CARE CLINIC

26136 US HWY 59 FAIRFAX MO 64446

PRIMARY CARE PHYSICIAN CLINIC SCHEDULE H, PART I, LINE 7 THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART I, LINE 7, OF SCHEDULE H, IS A COST TO CHARGE RATIO. SCHEDULE H, PART I, LINE 7, COLUMN F THE AMOUNT OF BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES FOR CALCULATING THE NET COMMUNITY BENEFIT EXPENSE PERCENTAGE WAS $767,398. SCHEDULE H, PART I, LINE 7G THE HOSPITAL INCLUDED $96,577 FROM A PHYSICIAN CLINIC. COMMUNITY BUILDING ACTIVITIES SCHEDULE H, PART II COMMUNITY HOSPITAL-FAIRFAX PARTICIPATES IN YEAR ROUND COMMUNITY BUILDING ACTIVITIES. IN FEBRUARY, COMMUNITY HOSPITAL-FAIRFAX SPONSORS A WEAR RED CHALLENGE. BUSINESSES, ORGANIZATIONS AND SCHOOLS ARE CHALLENGED TO WEAR RED FOR HEART HEALTH. IN RETURN, HEART HEALTHY INFORMATION IS MAILED TO EACH PARTICIPANT FOR THEIR EMPLOYEES. HUNDREDS PARTICIPATE EACH YEAR. IN ADDITION TO CELEBRATING HEART HEALTH AWARENESS MONTH, MONTHLY BLOOD PRESSURE CLINICS ARE OFFERED IN THREE LOCATIONS EVERY MONTH OF THE YEAR IN THE CH-F SERVICE AREA AS A SERVICE TO OUR COMMUNITY. PEDIATRIC ORIENTATION IS HELD IN THE SPRING OF EACH YEAR. 90 AREA FIRST GRADERS ARE INVITED INTO THE HOSPITAL TO ROLE PLAY WHAT IT MIGHT BE LIKE TO A PATIENT. FIRST GRADERS REALLY ENJOY RIDING IN THE WHEELCHAIR AND PUSHING BUTTONS ON THE HOSPITAL BED. ALSO, HELD EACH SPRING IS THE KID'S CAF. THIS IS AN EVENT WHERE CHILDREN GET TO "PLAY WITH THEIR FOOD" AND LEARN ABOUT HEALTHY EATING CHOICES. SEED SPITTING, CRACKER CRITTERS AND MAKING THEIR OWN SANDWICHES ARE JUST A FEW FUN ACTIVITIES. HOSPITAL EMPLOYEES ALSO SET UP A MOCK GROCERY STORY AND KIDS DO THEIR OWN SHOPPING. AFTER THEIR CARTS ARE FULL, VOLUNTEERS SHOW THEM WHAT ARE HEALTHY CHOICES AND WHERE THEY MIGHT MAKE OTHER CHOICES. AFTER THE KIDS CAF, THE HOSPITAL RENTS THE LOCAL SWIMMING POOL FOR KIDS TO ENJOY! IN THE LATE SUMMER, COMMUNITY HOSPITAL-FAIRFAX SPONSORS THE BACK TO SCHOOL FAIR. THIS IS A FAIR FOR LOW INCOME FAMILIES TO RECEIVE FREE SCHOOL SUPPLIES PRIOR TO THE SCHOOL YEAR STARTING. COMMUNITY HOSPITAL-FAIRFAX ORGANIZES THE COLLECTION OF FUNDS AND PURCHASES THE SUPPLIES. 150 CHILDREN WERE ABLE TO FILL BACKPACKS WITH NEEDED SUPPLIES LAST YEAR! IN THE FALL, COMMUNITY HOSPITAL-FAIRFAX INVITES MEN TO COME TO THE HOSPITAL FOR A FREE PROSTATE SCREENING CLINIC. THE PSA TEST IS OFFERED AT A REDUCED COST AND THE EXAM IS FREE. 60 TO 75 MEN PARTICIPATE IN THIS ACTIVITY ANNUALLY. DURING PHYSICAL THERAPY MONTH, THERAPISTS TRAVEL THE HOSPITAL SERVICE AREA AND OFFER FREE FALL RISK ASSESSMENTS AND ASSISTIVE DEVICE ASSESSMENTS AT AREA NUTRITION CENTERS. UP TO 50 RECEIVE THIS HELPFUL SCREENING EACH YEAR IN AN EFFORT TO REDUCE THEIR POTENTIAL FOR FALLS. OCTOBER BRINGS WITH IT BREAST CANCER MONTH. COMMUNITY HOSPITAL-FAIRFAX DELIVERS BAGS OF MINTS AND MAMMOGRAM REMINDERS TO AREA BUSINESSES IN AN EFFORT TO RAISE AWARENESS FOR WOMEN RECEIVING THIS IMPORTANT SCREENING. FOR THE FIRST TIME IN 2012/2013, CH-F OFFERED FREE SCREENINGS TO HIGH SCHOOL STUDENTS FOR HEART HEALTH. 88 STUDENTS PARTICIPATED IN THE SCREENINGS LAST YEAR. EACH STUDENT RECEIVED FREE GLUCOSE, BODY COMPOSITION, BLOOD PRESSURE AND BLOOD CHOLESTEROL CHECKS ALONG WITH ONE ON ONE NUTRITIONAL AND EXERCISE ASSESSMENT. THE FIRST WEEKEND OF NOVEMBER IS AN EXCITING TIME FOR THE COMMUNITY'S WOMEN AS THE ANNUAL ME MARKET KICKS OFF. A GYM FULL OF SHOPPING OPPORTUNITIES ATTRACTS ABOUT 250 WOMEN ANNUALLY. ALONG WITH SHOPPING, WOMEN CAN RECEIVE FREE SCREENINGS AND HEALTH INFORMATION. CHOLESTEROL, GLUCOSE, BODY COMPOSITION, HEART HEALTH AND A FREE FALL RISK ASSESSMENT ARE ALL OFFERED FREE OF CHARGE OR AT A VERY REDUCED COST. BAD DEBT EXPENSE SCHEDULE H, PART III, LINE 4 THE HOSPITAL USED THE ACTUAL ACCOUNT BALANCE AMOUNTS WRITTEN OFF AND SENT TO COLLECTION AGENCIES (NO HOME HEALTH OR PCC) FOR THE TOTAL ON LINE 2. LINE 3 IS THE AMOUNT OF ACCOUNT BALANCES WRITTEN OFF TO BAD DEBTS THAT POSSIBLY WOULD HAVE QUALIFIED FOR CHARITY HAD THEY BEEN WILLING TO PROVIDE THE NECESSARY INFORMATION, AND THE TOTAL OF BANKRUPTCIES THE HOSPITAL HAD TO WRITE OFF. THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HOSPITAL BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. COLLECTION PRACTICES SCHEDULE H, PART III, LINE 9B Collection policy states all uninsured and insured patients are informed on their first statement of services that Community Hospital has a grant program (for financial assistance) for those who qualify. This same type of 'assistance available' information is also in the Patient Information brochures in the patient rooms and waiting areas. Patients may qualify for a charity discount or a medically indigent discount, depending on their financial situation and using the Federal Poverty Guidelines. BILLING TO INDIVIDUALS WITHOUT INSURANCE COVERING EMERGENCY SCHEDULE H, PART V, SECTION B, LINE 19D The hospital charges all patients the same rate whether they have insurance coverage or not. A 30% discount off billed charges is offered to uninsured patients, and the balance of a 30% discount (after insurance pays) to apply to deductibles and co-insurance owed to those that have insurance coverage. NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2 A COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED BY COMMUNITY HOSPITAL-FAIRFAX. FOUR FOCUS GROUPS WITH 50 EXPERTS THAT REPRESENT CHILDREN, ELDERLY, LAW ENFORCEMENT AND THE UNDERPRIVELEDGED WERE HELD BETWEEN SEPT. AND OCT. AND THE FINDINGS WRITTEN INTO A REPORT THAT WAS USED IN CONJUNCTION WITH THE WHOLE COMMUNITY SURVEY THAT WAS CONDUCTED. THE SURVEY PROCESS KICKED OFF IN NOVEMBER OF 2012. THE SURVEY WAS EMAILED TO 4400 HOMES AND OFFERED ONLINE. NEWSPAPER AND SOCIAL MEDIA WERE ALSO USED. DROP BOXES WERE ALSO PLACED AT LOCAL SENIOR CENTERS AND NEWSPAPER OFFICES. COMMUNITY HOSPITAL-FAIRFAX ALSO PARTNERED WITH COMMUNITY SERVICES INC., THE AGENCY THAT SERVES THE UNDERPRIVELEDGED IN OUR AREA, TO DISTRIBUTE SURVEYS TO THEIR CLIENTS. NEARLY 60 SURVEYS WERE COLLECTED THROUGH THAT PARTNERSHIP. FOCUS GROUPS WERE RECONVENED IN 2013 TO DISCUSS THE RESULTS OF THE SURVEY. THEIR INPUT LEAD TO AN IMPLEMENTATION PLAN THAT WAS APPROVED BY THE BOARD OF DIRECTORS IN THE SPRING OF 2013. THE PLAN WAS THEN WIDELY DISTRIBUTED THROUGH NEWSPAPER AND THE CH-F WEBSITE IN MAY AND JUNE OF 2013. A TIMELINE WAS COMPLETED AND WORK COMMENCED ON THE PLAN IN THE SUMMER OF 2013. THE FULL REPORT AND IMPLEMENTATION PLAN CAN BE FOUND AT http://www.fairfaxmed.com/index.php/news/chna1/. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI, LINE 3 Community Hospital Business Office staff will discuss with inpatients and outpatients the options available to help the patients meet their financial obligations to Community Hospital. They discuss the federal/state government programs available and the hospital's financial assistance program. Then information is included in the statements sent to patients (explaining the amounts owed by the patient's insurance or the patient), much the same information as is discussed in person. COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4 COMMUNITY HOSPITAL-FAIRFAX SERVES THE ATCHISON, HOLT AND WESTERN NODAWAY COUNTIES, POPULATION APPROXIMATELY 10,700. THERE ARE FIVE MAIN TOWNS IN ATCHISON AND HOLT, ALL WITH POPULATIONS BELOW 2,000. THE POPULATION IS ALL RURAL AND THE ECONOMY IS LARGELY DRIVEN BY AGRICULTURE. THE POPULATION IS AGING WITH A MEDIAN HOUSEHOLD INCOME OF $40,261. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 5 TO EDUCATE AND PROVIDE SERVICES TO ITS COMMUNITY, COMMUNITY HOSPITAL RESPONDS BY PROVIDING THE FOLLOWING ACTIVITIES: MONTHLY FREE BLOOD PRESSURE SCREENING AT AREA NUTRITION CENTERS; IN FEBRUARY, COMMUNITY HOSPITAL-FAIRFAX SPONSORS A WEAR RED CHALLENGE. BUSINESSES, ORGANIZATIONS AND SCHOOLS ARE CHALLENGED TO WEAR RED FOR HEART HEALTH. IN RETURN, HEART HEALTHY INFORMATION IS MAILED TO EACH PARTICIPANT FOR THEIR EMPLOYEES. HUNDREDS PARTICIPATE EACH YEAR; DIABETES COUNSELING CLASSES WITH A REGISTERED DIETICIAN AND CERTIFIED DIABETES EDUCATOR; FREE GLUCOSE SCREENING, BMI CHECKS AND BLOOD PRESSURE CHECKS AT ANNUAL WOMEN'S EVENT; AN ANNUAL KID'S CAFE WHICH INVOLVES CHILDREN LEARNING HEALTHY EATING CHOICES, AND A POOL PARTY FOR THE PARTICIPANTS WHICH PROMOTES PHYSICAL ACTIVITY; AN ANNUAL BACK TO SCHOOL FAIR WHERE SCHOOL SUPPLIES ARE DISTRIBUTED TO NEEDY CHILDREN AND HEALTHY EATING CHOICES ARE DISCUSSED; AN ANNUAL PROSTATE SCREENING WHICH INCLUDES A FREE EXAM FOR LOCAL RESIDENTS. true TUITION AND BOOKS ASSISTANCE 5 43860 MONITORING THE USE OF GRANT FUNDS IN THE U.S. SCHEDULE I, PART I, LINE 2 STUDENTS COMPLETE AND SUBMIT APPLICATIONS FOR SCHOLARSHIPS TWICE A YEAR. A COMMITTEE MEETS AND DETERMINES WHO IS AWARDED A SCHOLARSHIP. THE AMOUNT OF THE SCHOLARSHIPS AWARDED IS DEPENDENT ON THE ANNUAL BUDGET. X X false false false false false false false false false MYRA EVANS 0 201494 0 0 0 0 0 7841 0 6642 0 215977 0 0 COMPENSATION FROM RELATED ORGANIZATION FORM 990, PART VII, SECTION A, LINE 1A AND SCHEDULE J, PART II THE CEO COMPENSATION IS PAID THROUGH A MANAGEMENT CONTRACT WITH THE NEBRASKA MEDICAL CENTER (NMC), A RELATED ORGANIZATION. THE RELATED COMPENSATION PAID TO DIRECTORS IS FOR THEIR EMPLOYMENT WITH NMC, NOT FOR THEIR ROLE AS A DIRECTOR WITH THE HOSPITAL. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A COMMUNITY HOSPITAL-FAIRFAX (CH-F) PRIDES ITSELF IN PROVIDING ACCESS TO HEALTHCARE TO A REGION WHERE HEALTH SERVICES ARE SPARSE, THE PHYSICIAN RATIO IS 2750:1 (NATIONAL BENCHMARK IS 631:1) AND EMERGENCY SERVICES WOULD OTHERWISE BE 30 MILES OR MORE FROM THE POPULATION CENTERS. COMMUNITY HOSPITAL-FAIRFAX PROVIDES THE NORTHWEST MISSOURI AREA POPULATION OF 11,000 IN HOLT, ATCHISON AND WESTERN NODAWAY COUNTY WITH A 24 HOUR EMERGENCY ROOM, ACUTE CARE (INCLUDING OBSTETRICS) AND POST-ACUTE CARE SERVICES, MANY OUTPATIENT SERVICES, SURGERY, ANCILLARY SERVICES, AND A FULL-SERVICE THERAPY DEPARTMENT. IN ADDITION TO SERVING THE HEALTH NEEDS OF A POPULATION THAT WOULD OTHERWISE NOT HAVE ACCESS TO CARE, COMMUNITY HOSPITAL-FAIRFAX CONTINUES TO INVEST IN A HEALTHY FUTURE FOR THE COMMUNITY. CH-F TRIES TO FOCUS ON THE GREATEST HEALTH NEEDS IN THE COMMUNITY WHICH TEND TO BE CHRONIC DISEASES SUCH AS HEART DISEASE, COPD AND ASTHMA, STROKE AND DIABETES. RISK FACTORS FOR THESE DISEASES ARE OBESITY, CIGARETTE SMOKING AND PHYSICAL INACTIVITY. NEARLY 30% OF THE CH-F SERVICE POPULATION IS OBESE, 69% REPORT PHYSICAL INACTIVITY AND 26% SMOKE. TO EDUCATE AND PROVIDE SERVICES TO A COMMUNITY WHERE THESE CHRONIC CONDITIONS PREVAIL, THE FOLLOWING ACTIVITIES ARE PART OF CH-F'S RESPONSE TO HEALTH NEEDS OF THE COMMUNITY: 1. MONTHLY FREE BLOOD PRESSURE CHECKS AT AREA NUTRITION CENTERS. 2. FEBRUARY HEART HEALTHY AWARENESS EVENT WITH 40 BUSINESSES AND 5 SCHOOLS PARTICIPATING. 3. DIABETES COUNSELING CLASSES WITH A REGISTERED DIETICIAN AND CERTIFIED DIABETES EDUCATOR. 4. FREE GLUCOSE SCREENINGS, BMI CHECKS AND BLOOD PRESSURE CHECKS BIANNUALLY AT A WOMEN'S EVENT (ATTENDED BY 275 WOMEN). 5. ATTENDANCE AT AREA HEALTH FAIRS OFFERING FREE SCREENINGS. 6. CH-F IS STROKE READY AND HAS PROTOCOL IN PLACE TO RESPOND TO A STROKE WITHIN 60 MINUTES. 7. CH-F SPONSORS HEALTHY EATING ACTIVITIES FOR KIDS. THE KID'S CAF TEACHES KIDS ABOUT THE FOOD PLATE AND ENCOURAGES CHILDREN TO TRY NEW HEALTHY FOODS. OVER 100 CHILDREN WERE REACHED THROUGH THIS ACTIVITY IN FY2013 WITH 150 CHILDREN AND FAMILIES ATTENDING A POOL PARTY AFTER THE EVENT SPONSORED BY THE HOSPITAL. 8. CH-F STAFF TEACHES HEALTHY EATING CHOICES AT THE AREA BACK TO SCHOOL FAIR WHERE SCHOOL SUPPLIES ARE DISTRIBUTED TO NEEDY CHILDREN. OVER 100 CHILDREN WERE REACHED THROUGH THIS ACTIVITY. 9. CH-F ALSO SPONSORS AN ANNUAL POOL PARTY TO CELEBRATE KIDS ATTENDANCE AT THE KID'S CAF AND PROMOTE PHYSICAL ACTIVITY. 10. AN ANNUAL PROSTATE SCREENING IS HELD BY CH-F. A FREE EXAM WAS PROVIDED TO NEARLY 60 MEN THIS YEAR. IN ADDITION TO RESPONDING TO AREA HEALTH CONCERNS, CH-F ALSO WANTS TO ENSURE THAT THERE ARE HEALTHCARE PROVIDERS FOR FUTURE GENERATIONS IN NORTHWEST MISSOURI. $3,000 IN SCHOLARSHIPS IS AWARDED EACH YEAR TO STUDENTS ENROLLED IN A HEALTHCARE PROGRAM. A CAREER DAY WAS ALSO HOSTED FOR AREA 8TH GRADERS. 52 STUDENTS ATTENDED TO LEARN ABOUT HEALTHCAREERS THROUGH HANDS ON ACTIVITIES WITH PHYSICIANS, LABORATORY, RADIOLOGY, NURSING AND PHYSICAL THERAPHY EMPLOYEES. AS THE SOLE HEALTHCARE FACILITY IN THE AREA, CH-F TAKES SERIOUS ITS OBLIGATION TO BE PREPARED IN AN EMERGENCY. OVER 55 HOURS WERE SPENT BY CH-F'S EMERGENCY PREPAREDNESS COORDINATOR LAST YEAR TRAINING TO BE READY IN CASE A DISASTER STRIKES. CH-F CONTINUES TO SERVE THE COMMUNITY BY PROVIDING HEALTHCARE TO A POPULATION THAT WOULD NOT OTHERWISE HAVE ACCESS. RECRUITING PHYSICIANS, NURSES, THERAPISTS AND OTHER HEALTHCARE PROVIDERS IS ONGOING, PURCHASING STATE OF THE ART EQUIPMENT WHEN POSSIBLE AND MAKING SURE THAT EACH MEMBER OF OUR COMMUNITY HAS THE CARE THEY DESERVE IS NOT AN EASY TASK, BUT ONE CH-F IS PROUD TO DO. DELEGATION OF CONTROL OVER MANAGEMENT DUTIES FORM 990, PART VI, SECTION A, LINE 3 COMMUNITY HOSPITAL ASSOCIATION, INC. HOLDS A MANAGEMENT CONTRACT WITH THE NEBRASKA MEDICAL CENTER (NMC). NMC APPOINTS A CHIEF EXECUTIVE OFFICER TO MANAGE DAY-TO-DAY OPERATIONS. FORM 990 REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11B AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE FORM 990. THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S ADMINISTRATION. ANY QUESTIONS OR CONCERNS THE ORGANIZATION'S ADMINISTRATION HAVE ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS ARE MADE. THE 990 WITH ALL COMPLETED SCHEDULES IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE 990. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION ANNUALLY OBTAINS WRITTEN AFFIRMATIONS FROM EACH OFFICER AND DIRECTOR AS TO THEIR COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. IF A DISCLOSURE OCCURS, THE MATTER IS VOTED ON BY THE BOARD OF DIRECTORS. IF A MAJORITY VOTE OCCURS THEN THE DISCLOSURE IS CONSIDERED A CONFLICT. THE CONFLICTED INDIVIDUAL MAY NOT VOTE OR PARTICIPATE IN THE MATTERS INVOLVING THE CONFLICT. IT IS NOTED IN THE BOARD MEETING MINUTES THAT THE INDIVIDUAL ABSTAINED FROM VOTING. COMPENSATION REVIEW FORM 990, PART VI, SECTION B, LINES 15A & 15B THE ORGANIZATION USES COMPARABILITY DATA TO DETERMINE THE COMPENSATION OF THE CEO AND OTHER OFFICERS. THE COMPENSATION OF THE CEO IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. THE COMPENSATION OF THE OTHER OFFICERS IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. AVAILABILITY OF DOCUMENTS FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. OTHER CHANGES IN NET ASSETS OR FUND BALANCES FORM 990, PART XI, LINE 9 RESTATEMENT OF HOSPITAL'S INVESTMENT ACCOUNTS PREVIOUSLY RECORDED ON FOUNDATION'S BALANCE SHEET $4,980,513 APPOINTMENT OF GOVERNING BODY FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S BY-LAWS STATE THAT THE BOARD OF DIRECTORS SHALL CONSIST OF FIFTEEN MEMBERS WITH EIGHT REPRESENTING THE NEBRASKA MEDICAL CENTER. THOSE EIGHT MEMBERS ARE NOMINATED BY THE MEDICAL CENTER AND THE CHA BOARD OF DIRECTORS CAN EITHER ELECT OR REJECT THE NOMINEES. IF REJECTED, THE MEDICAL CENTER WILL NOMINATE OTHER CANDIDATES UNTIL A NOMINEE IS ELECTED BY THE BOARD. GOVERNANCE DECISIONS BY PERSONS OTHER THAN THE GOVERNING BODY FORM 990, PART VI, SECTION A, LINE 7B NEBRASKA HEALTH SYSTEM HAS THE RIGHT TO APPROVE ANY CHANGE TO CHA'S ARTICLES OF INCORPORATION OR CORPORATE BYLAWS AMENDING, MODIFYING OR REPEALING THE RIGHTS OF NHS UNDER THE AFFILIATION AGREEMENT. NHS ALSO HAS THE RIGHT TO APPROVE ANY SALE OR LEASE OF MORE THAN ONE-HALF OF THE ASSETS COMPRISING CHA, OR ANY MERGER OR CONSOLIDATION OF CHA WITH ANOTHER ENTITY, OR THE DISSOLUTION OF CHA. OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:EMERGENCY ROOM PHYSICIAN FEES TOTAL FEES:510398 OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:PHARMACY FEES TOTAL FEES:148200 OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:ANESTHESIOLOGY FEES TOTAL FEES:149989 OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PROFESSIONAL FEES TOTAL FEES:887866 COMMUNITY HEALTCARE FOUNDATION 26136 US HWY 59 FAIRFAX MO 64446 431757553 SUPPORT ORG MO 501(C)(3) 11A CHA true THE NEBRASKA MEDICAL CENTER 4350 DEWEY AVENUE OMAHA NE 68198 911858433 HOSPITAL NE 501(C)(3) 3 NA false CLARKSON COLLEGE 101 SOUTH 42ND STREET OMAHA NE 68131 363649217 COLLEGE NE 501(C)(3) 2 NMC true BELLEVUE MED CTR 2500 BMC DRIVE BELLEVUE NE 68123 204305186 ACUTE CARE NE NMC RELATED 0 0 false 0 false NHS ORTHOPAEDIC SERVICES INC 988145 NEBRASKA MEDICAL CENTER OMAHA NE 68198 470845238 INVESTMENT SVCS NE NMC C CORP 0 0 true NEBRASKA HEALTH PARTNERS INC 987400 NEBRASKA MEDICAL CENTER OMAHA NE 68198 470816463 MANAGEMENT NE NMC C CORP 0 0 true false false true false true false false false false false false true false true true false true false false