COMMUNITY MEDICAL CENTER INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY MEDICAL CENTER INC (EIN 47-0421272)
- Tax period
- 2012-08-01 to 2013-07-31
- Filed
- 2014-03-17
- IRS object ID
- 201410769349300041
- Schema version
- 2012v2.3
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-03-17T17:01:46-05:00 | Timestamp |
| Tax Period End Date | 2013-07-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOHMAN AKERLUND & EDDY LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 470 | AddressLine1 |
| City | AURORA | City |
| State | NE | State |
| ZIP Code | 688180470 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-08-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470421272 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY MEDICAL CENTER INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COMM | NameControl |
| Phone | 4022456500 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3307 BARADA STREET | AddressLine1 |
| City | FALLS CITY | City |
| State | NE | State |
| ZIP Code | 68355 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SCOTT L SAWYER | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Phone | 4022456500 | Phone |
| Date Signed | 2014-03-17 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TIMOTHY J COUFAL | Name |
| Phone | 4026946404 | Phone |
| Date Prepared | 2014-03-17 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | RYAN LARSEN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | SAME AS ABOVE | AddressLine1 |
| City | FALLS CITY | City |
| State | NE | State |
| ZIP Code | 68355 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 22494738 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | HTTP://CMCFC.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1995 | YearFormation |
| State Legal Domicile | NE | StateLegalDomicile |
| Activity Or Mission Description | 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. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 194 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 29209 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 322375 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 20483880 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 21918647 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 93895 | InvestmentIncomePriorYear |
| Investment Income Current Year | -164667 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 20606984 | TotalRevenuePriorYear |
| Total Revenue Current Year | 22076355 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 8798302 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 9299760 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 10228672 | OtherExpensePriorYear |
| Other Expenses Current Year | 11340134 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 19026974 | TotalExpensesPriorYear |
| Total Expenses Current Year | 20639894 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1580010 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1436461 | RevenuesLessExpensesCY |
| Total Assets BOY | 35434322 | TotalAssetsBOY |
| Total Assets EOY | 36545625 | TotalAssetsEOY |
| Total Liabilities BOY | 20945801 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 20620643 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 14488521 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 15924982 | NetAssetsOrFundBalancesEOY |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 17091377 | Expense |
| Description | COMMUNITY MEDICAL CENTER PROVIDES MEDICAL SERVICES TO MEET THE NEEDS OF THE PEOPLE OF RICHARDSON COUNTY AND THE SURROUNDING COMMUNITIES. COMMUNITY MEDICAL CENTER PROVIDED 2,050 INPATIENT DAYS, 1,350 SWING-BED DAYS, 125 NURSERY DAYS, 11,742 CLINIC VISITS AND NUMEREOUS OUTPATIENT SERVICES DURING THE YEAR. COMMUNITY BENEFITS INCLUDE 511,152 OF SUBSIDIZED HEALTH SERVICES, 345,544 OF TRADITIONAL CHARITY CARE, 228,847 OF BAD DEBT, 16,980 OF COMMUNITY ACTIVITIES, 14,999 OF COMMUNITY SERVICES, AND 9,000 OF HEALTH EDUCATION. | Description |
| Total Program Service Expense | 17091377 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 49 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 194 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | false | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | SCOTT L SAWYER | NamePerson |
| Telephone Number | 4022456501 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3307 BARADA STREET | AddressLine1 |
| City | FALLS CITY | City |
| State | NE | State |
| ZIP Code | 68355 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (15 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| STEVE SEVERIN | |||||||
| CHAIRPERSON | 1.00 | X | 0 | 0 | 0 | ||
| KENT BIEKER | |||||||
| VICE-CHAIR | 1.00 | X | 0 | 0 | 0 | ||
| RENIE GERWECK | |||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | ||
| CHUCK HUNZEKER | |||||||
| TREASURER | 1.00 | X | 0 | 0 | 0 | ||
| LAURIE KIMBROUGH | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| DANA RATHJE | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| RODGER MERZ | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| JOHN WILSON | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| CR JAMES | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| TONY BRUNETTE | |||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||
| RYAN LARSEN | |||||||
| CEO | 40.00 | 156426 | 0 | 38181 | X | ||
| SCOTT SAWYER | |||||||
| CFO | 40.00 | 110017 | 0 | 25727 | X | ||
| BARBARA HOWARD | |||||||
| CHIEF CLINIC | 40.00 | 101354 | 0 | 16033 | X | ||
| DAVID BORG | |||||||
| PHYSICIAN | 40.00 | 374314 | 0 | 58505 | X | ||
| SANDRA CATLIN | |||||||
| APRN | 40.00 | 196492 | 0 | 30184 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 938603 | TotalReportableCompFromOrg |
| Total Other Compensation | 168630 | TotalOtherCompensation |
| Number Individuals GT100 K | 5 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| PRTS-NACHTIGAL LLC | |||||
| 700 OREGON STREET | HIAWATHA | KS | 66434 | PT/OT SERVICES | 615825 |
| SHADOW ANESTHESIA SERVICES | |||||
| 65675 711 ROAD | FALLS CITY | NE | 68355 | ANESTHESIA SVCS | 342983 |
| CARDINAL HEALTH | |||||
| 21337 NETWORK PLACE | CHICAGO | IL | 60673 | PHARMACY SVCS | 293305 |
| NHI OUTREACH CLINICAL SERVICES | |||||
| 7440 S 91ST STREET | LINCOLN | NE | 68501 | NM & ECHO SERV | 172862 |
| SHARED MEDICAL SERVICES | |||||
| PO BOX 330 | COTTAGE GROVE | WI | 53527 | MRI SERVICES | 129295 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Government Grants | 310470 | GovernmentGrants |
| All Other Contributions | 11905 | AllOtherContributions |
| Total Contributions | 322375 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 622110 | 21774282 | 21774282 |
| CAFETERIA | 722310 | 69729 | 69729 |
| MISCELLANEOUS HOPSITAL REV | 622110 | 45611 | 45611 |
| LIFELINE | 900099 | 29025 | 29025 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 21918647 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 14753 | TotalRevenueColumn |
| Exclusion | $14,753 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 238963 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 418383 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -179420 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -179420 | TotalRevenueColumn |
| Related Or Exempt Function Income | -179420 | RelatedOrExemptFunctionIncome |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 22076355 | TotalRevenueColumn |
| Related Or Exempt Function Income | 21739227 | RelatedOrExemptFunctionIncome |
| Exclusion | $14,753 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 367796 | Total |
| Program Services | 101354 | ProgramServices |
| Management And General | 266442 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6855073 | Total |
| Program Services | 5796397 | ProgramServices |
| Management And General | 1058676 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 290331 | Total |
| Program Services | 229189 | ProgramServices |
| Management And General | 61142 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1299083 | Total |
| Program Services | 1072225 | ProgramServices |
| Management And General | 226858 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 487477 | Total |
| Program Services | 397318 | ProgramServices |
| Management And General | 90159 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14852 | Total |
| Management And General | 14852 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26875 | Total |
| Management And General | 26875 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3130533 | Total |
| Program Services | 2456086 | ProgramServices |
| Management And General | 674447 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26315 | Total |
| Program Services | 6346 | ProgramServices |
| Management And General | 19969 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 126625 | Total |
| Program Services | 61649 | ProgramServices |
| Management And General | 64976 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 298291 | Total |
| Program Services | 293546 | ProgramServices |
| Management And General | 4745 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 78856 | Total |
| Program Services | 45566 | ProgramServices |
| Management And General | 33290 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32202 | Total |
| Program Services | 26050 | ProgramServices |
| Management And General | 6152 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 917181 | Total |
| Program Services | 759494 | ProgramServices |
| Management And General | 157687 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1672519 | Total |
| Program Services | 1384971 | ProgramServices |
| Management And General | 287548 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 64591 | Total |
| Program Services | 2663 | ProgramServices |
| Management And General | 61928 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| CENTRAL SUPPLY | 1658230 | 1658230 | |
| PHARMACY | 1317232 | 1317232 | |
| REPAIR AND MAINTENANCE | 551248 | 373886 | 177362 |
| ADMIN OFFICE | 280725 | 4677 | 276048 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1143859 | Total |
| Program Services | 1104498 | ProgramServices |
| Management And General | 39361 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20639894 | Total |
| Program Services | 17091377 | ProgramServices |
| Management And General | 3548517 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7360252 | BOY |
| EOY | 6381512 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2828675 | BOY |
| EOY | 3601651 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 89404 | BOY |
| EOY | 12809 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3070292 | BOY |
| EOY | 4623371 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38312 | BOY |
| EOY | 4688 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 45119 | BOY |
| EOY | 57816 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 210919 | BOY |
| EOY | 242702 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 27576532 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 7731297 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20244216 | BOY |
| EOY | 19845235 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3531 | BOY |
| EOY | 5983 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 433602 | BOY |
| EOY | 408063 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1110000 | BOY |
| EOY | 1361795 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35434322 | BOY |
| EOY | 36545625 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1363086 | BOY |
| EOY | 1394348 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17413402 | BOY |
| EOY | 17083068 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2169313 | BOY |
| EOY | 2143227 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20945801 | BOY |
| EOY | 20620643 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14488521 | BOY |
| EOY | 15924982 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14488521 | BOY |
| EOY | 15924982 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35434322 | BOY |
| EOY | 36545625 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 1436461 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1755831 | BeginningOfYearBalance |
| Contributions | 768898 | Contributions |
| Investment Earnings Or Losses | 3982 | InvestmentEarningsOrLosses |
| Administrative Expenses | 11 | AdministrativeExpenses |
| End Of Year Balance | 2528700 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 993457 | BeginningOfYearBalance |
| Contributions | 837845 | Contributions |
| Investment Earnings Or Losses | 3438 | InvestmentEarningsOrLosses |
| Other Expenditures | 78887 | OtherExpenditures |
| Administrative Expenses | 22 | AdministrativeExpenses |
| End Of Year Balance | 1755831 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 979328 | BeginningOfYearBalance |
| Contributions | 791569 | Contributions |
| Investment Earnings Or Losses | 1275 | InvestmentEarningsOrLosses |
| Other Expenditures | 778715 | OtherExpenditures |
| End Of Year Balance | 993457 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 561962 | BeginningOfYearBalance |
| Contributions | 11553894 | Contributions |
| Investment Earnings Or Losses | 3723 | InvestmentEarningsOrLosses |
| Other Expenditures | 11140251 | OtherExpenditures |
| End Of Year Balance | 979328 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 1.00000 | BoardDesignatedEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1184880 | OtherCostOrOtherBasis |
| Book Value | 1184880 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 17345085 | OtherCostOrOtherBasis |
| Depreciation | 3551647 | Depreciation |
| Book Value | 13793438 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1637624 | OtherCostOrOtherBasis |
| Depreciation | 371217 | Depreciation |
| Book Value | 1266407 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 7294523 | OtherCostOrOtherBasis |
| Depreciation | 3808433 | Depreciation |
| Book Value | 3486090 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 114420 | OtherCostOrOtherBasis |
| Book Value | 114420 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 19845235 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| CONDITIONAL CONTRIBUTION | $2,000,000 |
| DEFERRED COMPENSATION | $119,926 |
| EST THIRD-PARTY PAYOR SETTLEMENTS | $23,301 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2143227 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 22076355 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 22076355 | RevenueSubtotal |
| Total Revenue Per Form990 | 22076355 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 20639894 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 20639894 | ExpensesSubtotal |
| Total Expenses Per Form990 | 20639894 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| INTENDED USES FOR ENDOWMENT FUNDS | SCHEDULE D, PAGE 2, PART V, LINE 4 | THE FUNDS INCLUDE 6,076 DESIGNATED BY THE BOARD FOR CAPITAL IMPROVEMENTS, 177,222 DESIGNATED BY THE BOARD FOR DEFERRED COMPENSATION, 278,100 DESIGNATED BY A LONG-TERM DEBT COVENANT ON THE USDA LOAN, 599,713 DESIGNATED LOAN PROCEEDS TO BE USED FOR EQUIPMENT AND 1,467,589 DESIGNATED AS A DEBT SINKING FUND. |
| LIABILITY UNDER FIN 48 FOOTNOTE | SCHEDULE D, PAGE 3, PART X | 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 (FASB) APPLICABLE ACCOUNTING STANDARDS FOR UNCERTAINTIES IN INCOME TAXES AND REQUIRED DISCLOSURES THEREON. AS OF JULY 31, 2013 AND 2012, 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, 2013 OR 2012. ADDITIONALLY, TAX YEARS ENDED JULY 31, 2011, 2012 AND 2013 ALL REMAIN OPEN AND ARE SUBJECT TO POTENTIAL EXAMINATION BY TAXING JURISDICTIONS. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 345544 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 345544 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01670 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 345544 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 345544 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01670 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 16499 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 16499 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9000 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 9000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 557823 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 46670 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 511153 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02480 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 583322 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 46670 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 536652 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02600 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 928866 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 46670 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 882196 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04270 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 7500 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 7500 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 5000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 5000 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 2980 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2980 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 15480 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 15480 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $228,847 | BadDebtExpenseAmount |
| Amount Attributable To | 22885 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 11617172 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 11436100 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 181072 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | false | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3307 BARADA STREET | AddressLine1 |
| City | FALLS CITY | City |
| State | NE | State |
| ZIP Code | 68355 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Other | X | Other |
| Needs Assessment Conducted | 13 | NeedsAssessmentConducted |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | false | OtherFacilities |
| CHNA Widely Available | true | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| All Needs Addressed | true | AllNeedsAddressed |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 200.0 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 300.0 | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 2 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| FAMILY MEDICINE | ||||
| 3307 BARADA STREET | FALLS CITY | NE | 68355 | RURAL HEALTH CLINIC |
| HUMBOLDT FAMILY MEDICINE | ||||
| 1120 GRAND AVENUE | HUMBOLDT | NE | 68376 | RURAL HEALTH CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE | PART I LINE 7 COLUMN F | NO BAD DEBT EXPENSE IS INCLUDED ON FORM 990 PART IX LINE 25 COLUMN A AS BAD DEBT EXPENSE OF 323650 IS REPORTED WITH NET PATIENT SERVICE REVENUE ON FORM 990 PART VIII LINE 2A CONSISTENT WITH FINANCIAL STATEMENTS |
| COSTING METHODOLOGY EXPLANATION | PART I LINE 7 | THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE WAS A COST TO CHARGE RATIO |
| COMMUNITY BUILDING ACTIVITIES | PART II | COMMUNITYBUILDING ACTIVITIES INCLUDE PROGRAMS THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS SUCH AS POVERTY HOMELESSNESS AND ENVIRONMENTAL PROBLEMS THE ORGANIZATION PROVIDED 5000 TO FALLS CITY ECONMIC DEVELOPMENT AND GROWTH ENTERPRISE EDGE TO SUPPORT ECONOMIC DEVELOPMENT IN FALLS CITY AND RICHARDSON COUNTY THE ORGANIZATION FUNDED 5000 TO THE BALL FIELD PROJECT AND 2500 TO THE MAIN STREET PROJECT IN SUPPORT OF TWO COMMUNITY IMPROVEMENT AND REVITALIZATION PROJECTS THE ORGANIZATION ALSO CONTRIBUTED 2980 TO VARIOUS HEALTHORIENTED ACTIVITIES AND SCHOOL PROJECTS DURING THE YEAR |
| BAD DEBT EXPENSE EXPLANATION | PART III LINE 4 | FINANCIAL STATEMENT FOOTNOTE 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 THIRDPARTY 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 UNINSUREDSELFPAY PATIENTS WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRDPARTY 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 UNINSUREDSELFPAY PATIENTS INCREASED FROM 470000 AT JULY 31 2012 TO 556000 AT JULY 31 2013 AS INSURED AND UNINSUREDSELFPAY ACCOUNTS RECEIVABLE BALANCES INCREASED BY APPROXIMATELY 700000 COSTING METHODOLOGY FOR LINE 2 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 323650 COSTING METHODOLOGY FOR LINE 3 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 |
| MEDICARE EXPLANATION | PART III LINE 8 | THE MEDICARE COST REPORT WAS USED TO DETERMINE THE AMOUNTS REPORTED ON LINE 6 |
| NEEDS ASSESSMENT | PART VI | THE ORGANIZATION USES ITS CHNA TO ASSESS THE NEEDS OF THE COMMUNITY IT SERVICES |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PART VI | THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER THE ORGANIZATIONS 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 ANDOR TO HAVE LOW INCOME TO FINANCIAL COUNSELORS WHO WILL DISCUSS THE POLICY |
| COMMUNITY INFORMATION | PART VI | 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 8363 DECLINING 123 FROM 2000 PERSONS 65 YEARS AND OLDER IS 232 WHILE PERSONS 18 AND YOUNGER IS 210 ETHNIC BACKGROUDS BY PERCENT INCLUDE WHITE 942 AMERICAN INDIAN AND ALASKA NATIVE PERSONS 33 WITH ALL OTHERS REPORTING LESS THAN 2 THERE ARE 3782 HOUSEHOLDS WITH AN AVERAGE OF 215 PERSONS PER HOUSEHOLD MEDIAN HOUSEHOLD INCOME IS 38977 WITH 159 OF PERSONS BELOW THE POVERTY LEVEL THERE ARE 55184 TOTAL SQUARE MILES AND 152 PERSON PER SQUARE MILE |
| HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE | PART VI | THE ORGANIZATIONS BOARD OF DIRECTORS IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATIONS 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 NEWUPDATED MEDICAL EQUIPMENT |
| ADDITIONAL INFORMATION | PART VI | PART I LINE 7G THERE ARE 177237 IN COSTS ATTRIBUTABLE TO A RURAL HEALTH CLINIC INCLUDED ON LINE 7G COMMUNITY MEDICAL CENTER LINE NUMBER 1 PART V LINE 5A CHNA CAN BE ACCESSED AT WWWCMCFCORG |
| COMMUNITY MEDICAL CENTER LINE NUMBER 1 PART V LINE 3 | PART V LINE 3 | 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 |
| COMMUNITY MEDICAL CENTER LINE NUMBER 1 PART V LINE 14G | PART V LINE 14G | AT ADMISSION OR AT LEAST PRIOR TO DISCHARGE REGISTRATION PERSONNEL REFER UNINSURED ANDOR LOW INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE POLICY |
| COMMUNITY MEDICAL CENTER LINE NUMBER 1 PART V LINE 20D | PART V LINE 20D | 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 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | true | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg |
|---|---|---|---|---|---|---|
| RYAN LARSEN | ||||||
| CEO | 145426 | 11000 | 17935 | 20246 | 194607 | |
| DAVID BORG | ||||||
| PHYSICIAN | 143182 | 193719 | 38212 | 20293 | 432819 | 37413 |
| SANDRA CATLIN | ||||||
| APRN | 57675 | 126592 | 9891 | 20293 | 226676 | 12225 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| FRINGE OR EXPENSE EXPLANATION | SCHEDULE J, PAGE 1, PART I, LINE 1A | RYAN LARSEN, CEO - ACHE DUES 325.00, LIONS CLUB DUES 140.00, FALLS CITY ROTARY CLUB 74.00 |
| COMPENSATION CONTINGENT UPON REVENUES OF ORGANIZATION | SCHEDULE J, PAGE 1, PART I, LINE 5A | PROVIDER PRODUCTIVITY BONUSES ARE CALCULATED BASED ON RURAL HEALTH CLINIC REVENUES. |
| OTHER ADDITIONAL INFORMATION | SCHEDULE J, PART III | PRODUCTIVITY BONUSES BASED ON REVENUES: DAVID BORG 165,119 SANDRA CATLIN 124,792 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | 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. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | 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. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | COMPENSATION FOR THE CEO IS DETERMINED BY THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS UTILIZE INDEPENDENT PARTIES OR STUDIES OCCASIONALLY. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS, CONFLICTS OF INTEREST STATEMENTS, AND FINANCIAL STATEMETNS ARE NOT MADE AVAILABLE TO THE PUBLIC WITHOUT APPROVAL BY THE BOARD OF DIRECTORS. |
| OTHER FEES FOR SERVICES | FORM 990, PART IX, LINE 11G | PHYSICAL THERAPY CONTRACT SVC 446,904 0 0 CRNA CONTRACT SVC 363,775 0 0 PHARMACY PURCHASED SVC 293,583 0 0 INFORMATION SYSTEMS PURCHASED 0 287,519 0 ER DOCTORS CONTRACT SVC 225,720 0 0 INFORMATION SYSTEMS CONSULTIN 0 219,754 0 BLOOD PROC/STRNG/ADM PURCHASE 92,042 0 0 MRI PURCHASED SVC 108,575 0 0 OCCUPATIONAL THERAPY CONTRACT 190,906 0 0 ER CONTRACT LABOR 85,186 0 0 LABORATORY CONTRACT SERVICE 85,037 0 0 ECHOCARDIOGRAPHY PURCHASED SV 80,403 0 0 NUCLEAR MED PURCHASED SVC 70,264 0 0 VASCULAR STUDIES PURCHASED SV 56,783 0 0 PHARMACY RX CONTRACT SVC 42,432 0 0 QUALITY ASSURANCE PURCHASED S 50,658 0 0 LAUNDRY PURCHASED SVC 39,250 0 0 ADMINISTRATION PURCHASED SVC 0 30,821 0 SPEECH THERAPY PURCHASED SVC 28,753 0 0 SLEEP STUDY PURCHASED SVC 26,100 0 0 HUMBOLDT CLINIC PHYSICIAN CON 23,975 0 0 HLTH INFO MGMT PURCHASED SVC 0 21,014 0 HUMAN RESOURCES PURCHASED SVC 0 22,980 0 ALL OTHER 145,740 92,359 0 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY MEDICAL CENTER FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3307 BARADA STREET | AddressLine1 |
| City | FALLS CITY | City |
| State | NE | State |
| ZIP Code | 68355 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 463491851 | EIN |
| Primary Activity | SUPPORT | PrimaryActivity |
| Legal Domicile State | NE | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CMC | BusinessNameLine1 |
| Business Name Line2 | COMMUNITY MEDICAL CENTER FOUNDATION | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C CORP | TypeOfEntity |
| Controlled Org | false | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ADDITIONAL INFORMATION | Identifier |
| Return Reference | SCHEDULE R | ReturnReference |
| Explanation | 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 TAXEXEMPT STATUS FROM THE IRS | Explanation |