2014-09-23T14:21:59-05:00 2014-04-30 476097913 SEIM JOHNSON LLP 18081 BURT STREET SUITE 200 OMAHA NE 680224722 990 2013-05-01 470388012 BRODSTONE MEMORIAL HOSPITAL BROD 4028793281 520 EAST 10TH STREET SUPERIOR NE 689781225 JOHN KEELAN CEO 4028793281 2014-09-16 1 BARBARA J FAJEN P00400874 4023302660 2013 2015-11-30 17:44:51Z JOHN KEELAN 520 EAST 10TH STREET SUPERIOR NE 689781225 22288046 0 X WWW.BRODSTONEHOSPITAL.ORG X 1927 NE BRODSTONE MEMORIAL HOSPITAL IS A NOT-FOR-PROFIT CRITICAL ACCESS HOSPITAL ESTABLISHED TO DELIVER QUALITY, AFFORDABLE HEALTH CARE IN A CARING, SAFE AND COMPASSIONATE ENVIRONMENT TO ALL PERSONS OF SUCH NEED IN A TOTALLY NON-DISCRIMINATORY MANNER. 6 6 196 100 0 0 917518 201904 21238748 21948019 77139 46466 38405 38933 22271810 22235322 0 0 0 0 11318806 11222155 0 0 0 9473148 9625461 20791954 20847616 1479856 1387706 26565636 25990591 11619240 9728230 14946396 16262361 X BRODSTONE MEMORIAL HOSPITAL IS A NOT-FOR-PROFIT COMMUNITY ACUTE CARE MEDICAL/SURGICAL CRITICAL ACCESS HOSPITAL ESTABLISHED TO DELIVER QUALITY, AFFORDABLE HEALTH CARE IN A CARING, SAFE AND COMPASSIONATE ENVIRONMENT TO ALL PERSONS OF SUCH NEED IN A TOTALLY NON-DISCRIMINATORY MANNER. 0 1 19163688 21948019 BRODSTONE MEMORIAL HOPSITAL PROVIDES SHORT TERM INPATIENT AND OUTPATIENT SERVICES SUCH AS ACUTE CARE, ICU, OB, AND NURSERY WITHIN THE SCOPE OF ITS HOSPITAL LICENSE TO ALL PATIENTS IN A NON-DISCRIMINATORY MANNER. THE HOSPITAL ALSO OPERATES TWO RURAL HEALTH CLINICS. 19163688 1 1 0 1 0 0 0 0 0 1 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 26 0 1 196 1 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X SANDRA J BORDEN CFO 4028793281 520 EAST 10TH STREET SUPERIOR NE 68978 PAT MCCORD PRESIDENT 2.00 X X 0 0 0 LYNN CULBERTSON VICE-PRESIDENT 2.00 X X 0 0 0 KATHY ESSINK SECRETARY 2.00 X X 0 0 0 JULIE SIMONSEN TREASURER 2.00 X X 0 0 0 JUDY GROVE MEMBER 2.00 X 0 0 0 MARLIN MEYER MEMBER 2.00 X 0 0 0 JOHN KEELAN CEO 40.00 X 198716 0 30926 SANDRA BORDEN CFO 40.00 X 134714 0 29917 TIMOTHY BLECHA MD MEDICAL STAFF DIRECTOR 40.00 X 260656 0 40335 JULIE THEIS MD PHYSICIAN 40.00 X 182554 0 38966 ROBERT LEIBEL MD PHYSICIAN 40.00 X 174463 0 37623 JASON HASS PA-C PHYSICIAN ASSISTANT 40.00 X 113849 0 36621 BRADLEY GARDNER PHYSICAL THERAPY DIRECTOR 40.00 X 104817 0 36283 1169769 0 250671 7 0 1 0 CARDINAL HEALTH-OWEN 21377 NETWORK PLACE CHICAGO IL 60673 PHARMACY SERVICES 1115941 HEALTHLAND INC PO BOX 856554 MINNEAPOLIS MN 55485 SOFTWARE MAINTENANCE 240765 GE HEALTHCARE PO BOX 96483 CHICAGO IL 60693 EQUIPMENT MAINTENANCE 194018 LORI HARRIS CRNA PA 3207 NORTHWOOD COURT NEWTON KS 67114 CRNA 190000 PRAIRIE WINDS ANESTH LLC 2551 Z ROAD WEBBER KS 66970 CRNA 190000 13 8000 7348 186556 201904 MEDICARE/MEDICAID 621110 12003810 12003810 NET PATIENT SERVICE REVENUE 621110 7066908 7066908 PHARMACY 446110 2759267 2759267 EHR INCENTIVE REVENUE 621110 69000 69000 MISCELLANEOUS INCOME 621990 40748 40748 8286 8286 21948019 64241 64241 32507 50282 -17775 -17775 -17775 1232 7348 2442 -1210 -1210 CAFETERIA REVENUE 900099 40143 40143 40143 22235322 21948019 0 85399 394273 394273 8435660 7671784 763876 1841589 1664374 177215 550633 481730 68903 22497 22497 61499 61499 270057 269585 472 70943 70943 930136 881725 48411 512376 512376 313490 313490 74804 55129 19675 252692 252692 1609668 1609668 206600 206600 MEDICAL SUPPLIES 4356680 4356680 BAD DEBT EXPENSE 676847 676847 MISCELLANEOUS EXPENSE 224833 129289 95544 DUES AND SUBSCRIPTIONS 42339 10776 31563 20847616 19163688 1683928 0 200 200 7798627 6122916 2748484 3365701 224567 246881 478272 432479 23099952 10822697 13059828 12277255 328242 1330229 13718 0 1913698 2214930 26565636 25990591 1573379 1819557 296284 297732 0 7610941 9749577 0 11619240 9728230 X 13216233 14402043 203314 218185 1526849 1642133 14946396 16262361 26565636 25990591 X 1387706 46110 -117851 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2064 2064 0 PART II-B, LINE 1: PORTION OF NEBRASKA HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION DUES ALLOCABLE TO LOBBYING ACTIVITIES. 1526849 0 156146 23337 0 17525 1642133 1395429 85539 104553 39140 19532 1526849 1403603 -8174 1395429 1294935 108665 1403603 1098170 196765 1294935 0.00000 1.00000 0.00000 1 0 117890 117890 13717967 5097779 8620188 8821665 5488874 3332791 442430 236044 206386 12277255 ESTIMATED THIRD-PARTY PAYOR SETTLEMENT 399000 DEFERRED FINANCING COSTS, NET 158193 BENEFICIAL INTEREST IN TRUSTS 1642133 INTEREST RECEIVABLE 15604 2214930 X 21489176 46110 -115409 -69299 21558475 676847 676847 22235322 20173211 2442 2442 20170769 676847 676847 20847616 PART V, LINE 4: INTEREST EARNINGS MAY BE USED FOR OPERATIONS, HOWEVER THE PRINCIPAL IS TO BE MAINTAINED AS A PERMANENT ENDOWMENT. PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN TAX EXEMPT STATUS. IN GENERAL, SUCH STANDARDS REQUIRE THE HOSPITAL TO MEET A COMMUNITY BENEFIT STANDARD AND COMPLY WITH VARIOUS LAWS AND REGULATIONS. THE HOSPITAL ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. THE HOSPITAL RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT APRIL 30, 2014 AND 2013, THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS ACCRUED. WITH FEW EXCEPTIONS, THE HOSPITAL IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL, STATE OR LOCAL TAX AUTHORITIES FOR YEARS ENDED PRIOR TO APRIL 30, 2011. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN BENEFICIAL INTEREST IN TRUSTS 139,377. FUNDRAISING EXPENSES 2,442. LOSS ON EARLY EXTINGUISHMENT OF DEBT -257,228. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 676,847. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 2,442. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 676,847. 1 1 X 1 X 1 X 1 1 1 0 1 1 183820 0 183820 0.00910 1443652 1400392 43260 0.00210 1627472 1400392 227080 0.01120 474071 59401 414670 0.02060 474071 59401 414670 0.02060 2101543 1459793 641750 0.03180 1 676847 0 9911021 10180213 -269192 X 1 1 1 1 BRODSTONE MEMORIAL HOSPITAL 520 E 10TH SUPERIOR NE 68978 X X X X BRODSTONE MEMORIAL HOSPITAL 1 1 X X X X X X X X X X 12 1 1 1 X WWW.BRODSTONEHOSPITAL.ORG X X X X X X X 0 0 1 1 100.000000000000 1 200.000000000000 1 X X X X X X 1 1 X X X X X X 1 0 X 1 X 0 0 BRODSTONE MEMORIAL HOSPITAL PART V, SECTION B, LINE 1J: COMMUNITY HEALTH NEEDS ASSESSMENT - SOUTH HEARTLAND'S PROCESSTHE SHDHD MAPP/CHIP PROCESS BEGAN WITH IDENTIFICATION OF CORE PLANNING TEAM MEMBERS WHOSE RESPONSIBILITIES WERE TO REVIEW THE MAPP PROCESS, COMPLETE A READINESS ASSESSMENT, DISCUSS AND DEFINE "COMMUNITY" FOR EACH HOSPITAL, REVIEW STAKEHOLDER CATEGORIES, IDENTIFY STAKEHOLDERS, DETERMINE TIMELINES AND DISCUSS RESOURCES TO IMPLEMENT THE PROCESS. ALL THREE HOSPITALS IN THE DISTRICT COMMITTED TO PARTICIPATE WITH SHDHD IN MAPP AND SIGNED MEMORANDA OF UNDERSTANDING OUTLINING THEIR CONTRIBUTIONS INCLUDING RESOURCES. HOSPITAL ADMINISTRATORS IDENTIFIED STAFF MEMBERS TO PARTICIPATE IN THE CORE TEAM. THIS TEAM WAS ALSO RESPONSIBLE FOR OVERSEEING THE IMPLEMENTATION AND MANAGEMENT OF THE PROCESS. THE CORE TEAM INCLUDED EIGHT MEMBERS: HOSPITAL ADMINISTRATORS AND/OR APPOINTED STAFF FROM BRODSTONE MEMORIAL HOSPITAL, MARY LANNING HEALTHCARE, WEBSTER COUNTY COMMUNITY HOSPITAL, CLAY COUNTY HEALTH DEPARTMENT DIRECTOR, SHDHD BOARD OF HEALTH PRESIDENT, AND SHDHD DIRECTOR. THE FIRST PLANNING MEETING WAS HELD SEPTEMBER 2, 2011. THE ASSESSMENT PHASE CONSISTED OF IMPLEMENTING ALL FOUR OF THE MAPP ASSESSMENTS AND WAS CARRIED OUT, WITH ASSISTANCE FROM A CONTRACTED FACILITATOR, DURING THE PERIOD OF OCTOBER 1, 2011 - AUGUST 30, 2012. FOLLOWING THE ASSESSMENT PHASE, THE COMMUNITY (VIA STAKEHOLDER WORK GROUPS) IDENTIFIED STRATEGIC ISSUES AND FORMULATED GOALS AND STRATEGIES FOR ADDRESSING EACH ISSUE. COMMUNITY STAKEHOLDERS COLLABORATED IN A FACILITATED DEVELOPMENT OF A COMMUNITY (DISTRICT-WIDE) HEALTH IMPROVEMENT PLAN (CHIP). IN 2013 AND BEYOND, WORK GROUPS FOR EACH PRIORITY WILL MOVE THE PLAN COMPONENTS INTO THE ACTION PHASE (CHIP IMPLEMENTATION), WITH OVERSIGHT AND EVALUATION PLANNING FROM THE MAPP/CHIP CORE TEAM, WHICH WILL CONTINUE TO MEET 1-2 TIMES A YEAR FOR THE DURATION OF THE CHIP. BRODSTONE SELECTED A CORE TEAM TO BE INVOLVED WITH THE PROCESS. KAREN TINKHAM, ADMINISTRATIVE ASSISTANT, KORI FIELD, DIRECTOR OF NURSING AND MICHELL HARRIS, REGISTERED NURSE, WERE SELECTED AS BRODSTONE'S REPRESENTATIVES. THESE REPRESENTATIVES REPORTED DIRECTLY TO BRODSTONE'S ADMINISTRATIVE TEAM, THE TEAM RESPONSIBLE FOR THE NEEDS ASSESSMENT AND THE IMPLEMENTATION STRATEGY.THE CHNA ALSO INCLUDED BRODSTONE MEMORIAL HOSPITAL'S ACTION PLAN ALONG WITH THE IMPLEMENTATION STRATEGY, TIME FRAME AND RESPONSIBLE PARTY. BRODSTONE MEMORIAL HOSPITAL PART V, SECTION B, LINE 3: MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) IS A STRATEGIC APPROACH TO COMMUNITY HEALTH IMPROVEMENT. SOUTH HEARTLAND DISTRICT HEALTH DEPARTMENT (SHDHD) USED THIS TOOL TO FACILITATE THE 4-COUNTY HEALTH DISTRICT IN EFFORTS TO IMPROVE HEALTH AND QUALITY OF LIFE THROUGH COMMUNITY-WIDE AND COMMUNITY-DRIVEN STRATEGIC PLANNING. THIS PROCESS HELPED THE DISTRICT IDENTIFY AND PLAN THE USE OF RESOURCES TAKING INTO ACCOUNT THE UNIQUE CIRCUMSTANCES AND NEEDS OF THE DISTRICT AND THE INDIVIDUAL COMPONENT COUNTIES. IT ALSO PROMOTED NEW AND SOLIDIFIED EXISTING PARTNERSHIPS IN OUR COMMUNITIES AND ACROSS THE DISTRICT. THE MAPP ASSESSMENT PROCESS LEADS TO THE DEVELOPMENT OF A COMMUNITY-WIDE HEALTH IMPROVEMENT PLAN (CHIP), WHICH CAN ONLY BE ADOPTED AND REALISTICALLY IMPLEMENTED IF THE COMMUNITY HAS CONTRIBUTED TO THE PLAN DEVELOPMENT. SHDHD WORKED TO ENSURE PARTICIPATION BY A BROAD CROSS SECTION OF THE DISTRICT INVITING REPRESENTATIVES FROM MANY SECTORS OF OUR COMMUNITIES. IN ADDITION, MAPP ALSO SUPPORTS ORGANIZATIONAL ACTION PLAN DEVELOPMENT BY EACH OF THE PARTICIPATING ENTITIES INCLUDING THE KEY HOSPITAL PARTNERS FOR THEIR SERVICE AREAS.THROUGH THE MAPP PROCESS, THE SOUTH HEARTLAND DISTRICT CONTINUED TO STRENGTHEN THE LOCAL PUBLIC HEALTH SYSTEM. WE DEFINED THE LOCAL PUBLIC HEALTH SYSTEM AS ALL OF THE ENTITIES THAT CONTRIBUTE TO THE DELIVERY OF PUBLIC HEALTH SERVICES WITHIN OUR COMMUNITIES. THIS INCLUDED PUBLIC AND PRIVATE ENTITIES, CIVIC AND FAITH-BASED ORGANIZATIONS, INDIVIDUALS, INFORMAL ASSOCIATIONS, FRONT-LINE AND GRASSROOTS WORKERS AND POLICY MAKERS. USING MAPP AS THE FRAMEWORK FOR THE COMMUNITY NEEDS ASSESSMENT ALLOWED SHDHD TO FOCUS ON THE 10 ESSENTIAL SERVICES OF PUBLIC HEALTH TO DEFINE WHO IS RESPONSIBLE FOR THE COMMUNITY'S HEALTH AND WELL-BEING.THE 10 ESSENTIAL PUBLIC HEALTH SERVICES ARE:1. MONITOR HEALTH STATUS TO IDENTIFY COMMUNITY HEALTH PROBLEMS. 2. DIAGNOSE AND INVESTIGATE HEALTH PROBLEMS AND HEALTH HAZARDS IN THE COMMUNITY.3. INFORM, EDUCATE, AND EMPOWER PEOPLE ABOUT HEALTH ISSUES.4. MOBILIZE COMMUNITY PARTNERSHIPS TO IDENTIFY AND SOLVE HEALTH PROBLEMS.5. DEVELOP POLICIES AND PLANS THAT SUPPORT INDIVIDUAL AND COMMUNITY HEALTH EFFORTS.6. ENFORCE LAWS AND REGULATIONS THAT PROTECT HEALTH AND ENSURE SAFETY.7. LINK PEOPLE TO NEEDED PERSONAL HEALTH SERVICES AND ASSURE THE PROVISION OF HEALTH CARE WHEN OTHERWISE UNAVAILABLE.8. ASSURE A COMPETENT PUBLIC HEALTH AND PERSONAL HEALTH CARE WORKFORCE.9. EVALUATE EFFECTIVENESS, ACCESSIBILITY AND QUALITY OF PERSONAL AND POPULATION-BASED HEALTH SERVICES.10. RESEARCH FOR NEW INSIGHTS AND INNOVATIVE SOLUTIONS TO HEALTH PROBLEMS.THE PHASES OF THE MAPP PROCESS ARE: ORGANIZING/PARTNERSHIP DEVELOPMENT, VISIONING, ASSESSMENT, IDENTIFYING STRATEGIC ISSUES, FORMULATING GOALS AND STRATEGIES, AND THE ACTION CYCLE FOR THE RESULTING COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). BRODSTONE MEMORIAL HOSPITAL PART V, SECTION B, LINE 4: BRODSTONE'S CHNA WAS CONDUCTED WITH WEBSTER COUNTY COMMUNITY HOSPITAL AND MARY LANNING MEMORIAL HEALTHCARE. BRODSTONE MEMORIAL HOSPITAL PART V, SECTION B, LINE 5D: COPIES OF THE CHNA REPORT ARE AVAILABLE AT ADMISSIONS. BRODSTONE MEMORIAL HOSPITAL PART V, SECTION B, LINE 6I: BRODSTONE MEMORIAL HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT PRIOR TO MAY 1, 2013. FROM THAT ASSESSMENT A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) WAS DEVELOPED. FIVE PRIORITY COMMUNITY HEALTH NEEDS WERE IDENTIFIED AS FOLLOWS: ACCESS TO CARE, CANCER, MENTAL HEALTH, OBESITY AND SUBSTANCE ABUSE. FOLLOWING IS A SUMMARY OF ACCOMPLISHMENTS IN THE LAST FISCAL YEAR.ACCESS TO CARE: MEANINGFUL USE IS PROCEEDING AND PLANS FOR A PATIENT PORTAL, ELECTRONICALLY PRESCRIBED CONTROLLED SUBSTANCES AND REPORTING TO CENTERS FOR MEDICAID/MEDICARE SERVICES ELECTRONICALLY WILL BE ACCOMPLISHED IN 2014. FUTURE PLANS INCLUDE ONLINE BILL PAYING, APPOINTMENT SCHEDULING AND MEANINGFUL USE STAGE 3. WE HAVE ALSO BEEN OFFERING ASSISTANCE IN DRAFTING ADVANCE DIRECTIVES.CANCER/IMPROVE MORBIDITY: WE HAVE BEEN COLLABORATING WITH THE LOCAL HEALTH DEPARTMENT BY BEING A MEMBER OF THE CANCER COALITION. THE GROUP MEETS MONTHLY WITH THE ORGANIZATIONAL MEETING BEING HELD IN THE FIRST QUARTER 2014. A WOMEN'S HEALTH EVENT WAS HELD IN OCTOBER 2013 TO PROMOTE BREAST HEALTH, AS WELL AS EDUCATIONAL SESSIONS CONCERNING DIABETES AND URINARY INCONTINENCE. THE ANNUAL NUCKOLLS COUNTY HEALTH FAIR WAS HELD IN APRIL 2014 WITH SPECIAL EMPHASIS ON COLON CANCER AWARENESS.MENTAL HEALTH: THERE ARE NOT MANY WAYS WE CAN SUPPORT THE NEEDS OF PATIENTS WITH MENTAL HEALTH ISSUES, HOWEVER WE HAVE BEEN PROVIDING SPACE AT OUR FACILITY, AT NO CHARGE TO THE PATIENT, FOR MENTAL HEALTH PROVIDERS TO DELIVER SERVICES TO PATIENTS VIA TELEHEALTH. THIS INCLUDES TECHNICAL SUPPORT.OBESITY: AT BRODSTONE, WE ARE WORKING ON DEVELOPING AN EMPLOYEE WELLNESS PROGRAM. AS THE LARGEST EMPLOYER IN OUR COUNTY, ENCOURAGING WELLNESS TO OUR EMPLOYEES IMPACTS A LARGE PERCENTAGE OF OUR COMMUNITY. WE HAVE PARTNERED WITH THE LOCAL GROCERY STORE TO PROMOTE THEIR NEW PROGRAM TO MAKE HEALTHY CHOICES WHEN GROCERY SHOPPING. WE HAVE HELD FUNDRAISING EVENTS AT THE HOSPITAL TO SUPPORT THE SIMIC RECREATION CENTER, A NOT-FOR-PROFIT FACILITY THAT PROVIDES A PLACE FOR PEOPLE TO WALK DURING INCLEMENT WEATHER. BRODSTONE'S GOOD BEGINNINGS PROGRAM, WHICH IS OFFERED AT NO CHARGE TO PARENTS OF YOUNG CHILDREN, HELPS CLIENTS DEVELOP GOOD NUTRITION HABITS, ENCOURAGES AND SUPPORTS BREAST FEEDING AND EXERCISE WITH INCENTIVES FOR MEETING THEIR GOALS. BRODSTONE IS PLANNING A FAMILY FUN RUN TO BE HELD IN MAY 2014 TO PROMOTE EXERCISE. BRODSTONE PROVIDES CONFERENCE SPACE AND ADVERTISING FOR OVEREATERS ANONYMOUS WEEKLY MEETINGS WHICH ARE OPEN TO THE PUBLIC. BRODSTONE ALSO SUPPORTS THE LOCAL FOOD PANTRY WHICH PROVIDES HEALTHY MEALS TO THOSE WHO QUALIFY.SUBSTANCE ABUSE: THIS ALSO IS AN AREA WHERE BRODSTONE DOESN'T HAVE A LOT OF RESOURCES TO OFFER THEIR PATIENTS. BRODSTONE DOES SUPPORT HORIZON RECOVERY IN THEIR EFFORTS TO EXPAND THEIR COVERAGE TO NUCKOLLS COUNTY. AT THE ANNUAL HEALTH FAIR, BRODSTONE PROVIDED PHARMACEUTICAL PERSONNEL TO PROVIDE AN OPPORTUNITY FOR PRESCRIPTION AND OUTDATED MEDICATIONS TO BE DISPOSED. BRODSTONE MEMORIAL HOSPITAL PART V, SECTION B, LINE 7: THE MAJORITY OF THE ACTION NEEDING TO BE ADDRESSED IN THE CATEGORIES OF CANCER, MENTAL HEALTH AND SUBSTANCE ABUSE FALL OUT OF THE SCOPE OF EXPERTISE AND RESOURCES OF THE HOSPITAL. BRODSTONE MEMORIAL HOSPITAL PART V, SECTION B, LINE 12I: BRODSTONE MEMORIAL HOSPITAL USES THE COST OF SUPPLIES, SALARIES AND OTHER EXPENSES TO DETERMINE BRODSTONE'S CHARGES TO PATIENTS. BRODSTONE PERIODICALLY USES CHARGEMASTER REVIEWS FOR REVIEW OF CHARGES. BRODSTONE MEMORIAL HOSPITAL PART V, SECTION B, LINE 14G: BRODSTONE MEMORIAL HOSPITAL POSTS THE WRITTEN FINANCIAL ASSISTANCE POLICY ON ITS WEBSITE, HAS BROCHURES AVAILABLE WHERE PATIENTS ARE ADMITTED, INCLUDES THE POLICY IN PATIENT HANDBOOKS AND SENDS THE POLICY TO PATIENTS UPON REQUEST. BRODSTONE MEMORIAL HOSPITAL PART V, SECTION B, LINE 18E: OTHER EFFORTS INCLUDE HELPING INDIVIDUALS APPLY FOR FINANCIAL ASSISTANCE, MEDICAID, DISABILITY BENEFITS, INSURANCE FROM THE MARKETPLACE AND OTHER AVAILABLE BENEFITS. 2 SUPERIOR FAMILY MEDICAL CENTER 525 E 11TH ST SUPERIOR NE 68978 RURAL HEALTH CLINIC NELSON FAMILY MEDICAL CENTER 76 W 8TH ST NELSON NE 68961 RURAL HEALTH CLINIC PART I, LINE 3C: NOT APPLICABLE: FEDERAL POVERTY GUIDELINES ARE USED TO DETERMINE ELIGIBILITY FOR PROVIDING FREE CARE AND DISCOUNTED CARE TO LOW INCOME INDIVIDUALS. PART I, LINE 6A: BRODSTONE'S COMMUNITY BENEFIT REPORT IS NOT PREPARED BY A RELATED ORGANIZATION. PART I, LINE 7: THE COST TO CHARGE RATIO AS FOLLOWS WAS USED TO DETERMINE CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS AT COST: (TOTAL EXPENSES - BAD DEBT) / GROSS PATIENT SERVICE REVENUE = PERCENTAGE OF COST TO CHARGE. OTHER COMMUNITY BENEFIT EXPENSES ARE STATED AT COST BASED ON BRODSTONE'S INTERNAL ACCOUNTING RECORDS. PART I, LINE 7G: THERE ARE NO COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC INCLUDED ON LINE 7G. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 676,847. PART II, COMMUNITY BUILDING ACTIVITIES: THERE ARE NO ACTIVITIES REPORTED IN PART II, HOWEVER, BRODSTONE HAS MANY ACTIVITIES TO PROMOTE HEALTH IN THE COMMUNITIES SERVED. THESE ACTIVITIES INCLUDE: SPONSOR OF HEALTH FAIR, SUPPORT GROUPS, EDUCATION PROGRAMS AND MEDICATION ASSISTANCE. THE DONATED SERVICES AND FUNDS HELP FURTHER THE MISSION AND GOALS OF COMMUNITY ORGANIZATIONS WHICH, IN TURN, HELP IMPROVE OVERALL HEALTH STATUS AND QUALITY OF LIFE OF THE COMMUNITIES SERVED. PART III, LINE 2: IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR THOSE ACCOUNTS OVER A CERTAIN AGE BASED ON DISCHARGE THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL 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. 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. PART III, LINE 3: NO PART OF THE ORGANIZATION'S BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PART III, LINE 4: BRODSTONE'S FINANCIAL STATMENTS DO NOT CONTAIN A SPECIFIC FOOTNOTE DESCRIBING BAD DEBT. HOWEVER, THE FOLLOWING IS THE TEXT OF THE FOOTNOTES TITLED "PATIENT RECEIVABLES, NET," "NET PATIENT SERVICE REVENUE," AND "CHARITY CARE":PATIENT RECEIVABLES, NET:THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYORS, PATIENTS AND OTHERS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR THOSE ACCOUNTS OVER A CERTAIN AGE BASED ON DISCHARGE THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL 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. 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.NET PATIENT SERVICE REVENUE:THE HOSPITAL HAS AGREEMENTS WITH THIRD-PARTY PAYORS THAT PROVIDE FOR PAYMENTS TO THE HOSPITAL AT AMOUNTS DIFFERENT FROM ITS ESTABLISHED RATES. PAYMENT ARRANGEMENTS INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES, AND PER DIEM PAYMENTS. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE DETERMINED.CHARIY CARE: THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE IN THE STATEMENTS OF OPERATIONS.THE HOSPITAL IS DEDICATED TO PROVIDING COMPREHENSIVE HEALTHCARE SERVICES TO ALL SEGMENTS OF SOCIETY, INCLUDING THE AGED AND OTHERWISE ECONOMICALLY DISADVANTAGED. IN ADDITION, THE HOSPITAL PROVIDES A VARIETY OF COMMUNITY HEALTH SERVICES AT OR BELOW COST.IN ACCORDANCE WITH ITS MISSION OBJECTIVES, THE HOSPITAL PROVIDES FREE CARE TO PATIENTS WHO LACK FINANCIAL RESOURCES TO PAY FOR THE SERVICES THEY RECEIVE. INCLUDED IN THE PROVISION FOR CONTRACTUAL ALLOWANCES IS THE VALUE (AT STANDARD CHARGES) OF THESE SERVICES TO PATIENTS WHO ARE UNABLE TO PAY, THAT IS ELIMINATED FROM NET PATIENT SERVICE REVENUES WHEN IT IS DETERMINED THEY QUALIFY UNDER THE HOSPITAL'S CHARITY CARE POLICY. THE ESTIMATED COST INCURRED BY THE HOSPITAL TO PROVIDE THESE SERVICES TO PATIENTS WHO ARE UNABLE TO PAY WAS APPROXIMATELY $165,000 AND $449,000 FOR THE YEARS ENDED APRIL 30, 2014 AND 2013, RESPECTIVELY. THE ESTIMATED COST OF THESE CHARITY CARE SERVICES WAS DETERMINED USING A RATIO OF COSTS TO GROSS CHARGES AND APPLYING THAT RATIO TO THE GROSS CHARGES ASSOCIATED WITH PROVIDING CARE TO CHARITY PATIENTS FOR THE PERIOD. GROSS CHARGES ASSOCIATED WITH PROVIDING CARE TO CHARITY PATIENTS INCLUDES ONLY THE RELATED CHARGES FOR THOSE PATIENTS WHO ARE FINANCIALLY UNABLE TO PAY AND QUALIFY UNDER THE HOSPITAL'S CHARITY CARE POLICY AND THAT DO NOT OTHERWISE QUALIFY FOR REIMBURSEMENT FROM A GOVERNMENTAL PROGRAM. DURING THE YEARS ENDED APRIL 30, 2014 AND 2013, THE HOSPITAL RECEIVED NO FUNDS TO HELP DEFRAY THE COSTS OF INDIGENT CARE. PART III, LINE 8: "MEDICARE ALLOWABLE COSTS OF CARE" WAS CALCULATED FROM INFORMATION IN THE MEDICARE COST REPORT D, E, H & M WORKSHEETS, OR PS&R. THESE COSTS ARE MEDICARE REIMBURSABLE COSTS, NOT ALL COSTS. NO MEDICARE SHORTFALL IS TREATED AS COMMUNITY BENEFIT. PART III, LINE 9B: PATIENTS WHO QUALIFY FOR MEDICAID WILL AUTOMATICALLY QUALIFY FOR FINANCIAL ASSISTANCE AND MAY QUALIFY FOR MORE IF THEY COMPLETE THE FINANCIAL ASSISTANCE APPLICATION. THESE PATIENTS WILL NOT BE SENT TO COLLECTIONS IF THEY PAY THE AMOUNT FOR WHICH THEY QUALIFY.BRODSTONE'S POLICIES AND PROCEDURES FOR INTERNAL AND EXTERNAL COLLECTION PRACTICES TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR CHARITY, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR CHARITY FROM THE HOSPITAL AND A PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS OR HER PAYMENT AGREEMENTS WITH THE HOSPITAL. FOR PATIENTS WHO QUALIFY FOR CHARITY AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR BILLS, BRODSTONE MAY OFFER EXTENDED PAYMENT PLANS TO ELIGIBLE PATIENTS, WILL NOT IMPOSE WAGE GARNISHMENTS OR LIENS, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES AND WILL CEASE ALL COLLECTION EFFORTS. PART VI, LINE 2: BRODSTONE ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES THROUGH A SURVEY. THE BUDGETING PROCESS PUBLISHES SUGGESTIONS AND STRATEGIC PLANNING. HOSPITAL STAFF ALSO NETWORKS WITH OTHER HEALTH CARE ORGANIZATIONS TO DEVELOP IDEAS OF WHAT CAN BE DONE TO IMPROVE THE AVAILABILITY OF SERVICES IN THE COMMUNITY. PART VI, LINE 3: BRODSTONE HAS A BROCHURE CALLED CHARITY POLICY THAT ADDRESSESS THE FINANCIAL ASSISTANCE AVAILABILITY. IT IS POSTED AT THE ADMISSIONS AREAS AND EMERGENCY ROOM. THE CHARITY POLICY IS DISCUSSED WHEN MAKING PAYMENT ARRANGEMENTS. PART VI, LINE 4: SUPERIOR HAS A POPULATION OF 1,933 AND IS LOCATED ON THE NEBRASKA-KANSAS BORDER. BRODSTONE'S SERVICE AREA COVERS ALL OF NUCKOLLS COUNTY AND PARTS OF 2 OTHER COUNTIES IN NEBRASKA AND 3 COUNTIES IN KANSAS. THE MEDIAN HOUSEHOLD INCOME FOR NUCKOLLS COUNTY IS $33,875 COMPARED TO THE U.S. AVERAGE AT $51,324 AND THE NEBRASKA AVERAGE OF $51,381. THE AREA POPULATION IS PREDOMINATELY WHITE ELDERLY AND LOW INCOME. 74% OF THE HOSPITAL'S PATIENTS ARE MEDICARE PATIENTS. PART VI, LINE 5: BRODSTONE'S GOVERNING BODY CONSISTS OF 1 MAN AND 5 WOMEN WITH NO IMMEDIATE FAMILY TIES TO ANY EMPLOYEE NOR ARE THEY CONTRACTORS OF THE ORGANIZATION. ALL BOARD MEMBERS ARE RESIDENTS OF NUCKOLLS COUNTY, NE. ALL FAMILY PRACTICE PHYSIANS AND MIDLEVELS IN THE AREA WHO HAVE REQUESTED MEDICAL STAFF PRIVILEGES AND MEET THE REQUIREMENTS HAVE PRIVILIGES AT THE HOSPITAL. TWO DENTISTS HAVE COURTESY PRIVELEGES. ALL SURPLUS FUNDS OF THE ORGANIZATION ARE USED TO FUND THE BUDGET FOR THE COMING YEARS OR SET ASIDE FOR FUTURE PROJECTS. PART VI, LINE 6: BRODSTONE MEMORIAL HOSPITAL IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. PART VI, LINE 7: BRODSTONE DOES NOT FILE A COMMUNITY BENEFIT REPORT WITH ANY STATE. X 1 1 X X X X 0 0 0 1 0 0 0 0 0 JOHN KEELAN CEO 198716 0 0 0 0 0 6110 0 24816 0 229642 0 0 0 SANDRA BORDEN CFO 134714 0 0 0 0 0 4168 0 25749 0 164631 0 0 0 TIMOTHY BLECHA MD MEDICAL STAFF DIRECTOR 211688 0 48968 0 0 0 7103 0 33232 0 300991 0 0 0 JULIE THEIS MD PHYSICIAN 182554 0 0 0 0 0 5768 0 33198 0 221520 0 0 0 ROBERT LEIBEL MD PHYSICIAN 174463 0 0 0 0 0 5444 0 32179 0 212086 0 0 0 JASON HASS PA-C PHYSICIAN ASSISTANT 113849 0 0 0 0 0 3671 0 32950 0 150470 0 0 0 PART I, LINE 1A JOHN KEELAN, CEO, IS PROVIDED THE LOCAL COUNTRY CLUB MEMBERSHIP. PART I, LINE 5 IN ACCORDANCE WITH RELATED EMPLOYMENT CONTRACTS, ADDITIONAL COMPENSATION IS PAID BASED ON REVENUES GENERATED BY EACH MEDICAL PROVIDER, AS DEFINED. THESE ADDITIONAL AMOUNTS HAVE BEEN LISTED AS INCENTIVE COMPENSATION IN PART II OF THIS SCHEDULE. A THE CITY OF SUPERIOR NEBRASKA 476006376 2013-05-22 4000000 REFUND ISSUES (9/9/03, 9/10/09, 9/10/09) 0 0 0 B THE COUNTY OF NUCKOLLS NEBRASKA 476006492 2013-05-22 4000000 REFUND ISSUES (9/9/03, 9/10/09, 9/10/09) 0 0 0 A 194530 4000000 4000000 2010 1 0 1 1 B 194530 4000000 4000000 2010 1 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 0 1 1 0 0 0 0 1 B 0 0 1 1 0 0 0 0 1 A 1 B 1 SCHEDULE K, PART IV, LINE 2C: (A) ISSUER NAME: CITY OF SUPERIOR, NEBRASKA DATE THE REBATE COMPUTATION WAS PERFORMED: 05/22/2013 (B) ISSUER NAME: THE COUNTY OF NUCKOLLS, NEBRASKA DATE THE REBATE COMPUTATION WAS PERFORMED: 05/22/2013 NOTE REGARDING THE REBATE COMPUTATIONS: SINCE THE BOND PROCEEDS WERE SPENT ON THE ISSUE DATE, A SPENDING EXCEPTION WAS MET, AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CALCULATIONS ARE NECESSARY. FORM 990, PART III, LINE 3 BRODSTONE MEMORIAL HOSPITAL CEASED OPERATIONS OF THE HOME HEALTH AGENCY AS OF JULY 1, 2013. THE HOME HEALTH AGENCY ACCOUNTED FOR $72,593 OR .31% OF GROSS PATIENT SERVICE REVENUE AND $170,307 OR .85% OF EXPENSES IN TAX YEAR 2012. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM. BEFORE IT IS FILED, IT IS GIVEN A DETAILED REVIEW BY MANAGEMENT AND THEN A GENERAL REVIEW BY THE BOARD OF DIRECTORS AT A REGULARLY SCHEDULED BOARD MEETING. A FINAL COPY OF THE FORM 990 WILL BE ELECTRONICALLY FILED AFTER APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS WHO HAVE A CONFLICT OF INTEREST WOULD REFRAIN FROM DISCUSSION AND VOTING ON THOSE MATTERS. THERE IS AN ANNUAL BOARD MEMBER TRAINING THAT COVERS THIS POLICY. ADDITIONALLY, ALL BOARD MEMBERS ARE WELL ACQUAINTED WITH EACH OTHER SO IF THERE WAS A CONFLICT OF INTEREST AND THE BOARD MEMBER DID NOT DISCLOSE, THE OTHER BOARD MEMBERS WOULD BRING IT TO THE BOARD'S ATTENTION. FORM 990, PART VI, SECTION B, LINE 15 THE HUMAN RESOURCE DIRECTOR PREPARES A SALARY SURVEY ANNUALLY FOR ALL JOBS DESCRIPTIONS WITH HOSPITALS OF SIMILAR SIZE AND REVENUES. THE BOARD OF DIRECTORS REVIEWS THE SURVEY AND PRIOR SALARY INCREASES FOR THE CEO BEFORE GRANTING PAY INCREASES. THE HUMAN RESOURCE DIRECTOR AND CFO MAKE RECOMMENDATIONS TO THE CEO FOR OTHER EMPLOYEES. THE CEO REVIEWS THE SURVEY, PRIOR SALARY INCREASES, AND RECOMMENDATIONS BEFORE APPROVING PAY INCREASES FOR EMPLOYEES. THE PAY INCREASES ARE APPROVED BY THE BOARD OF DIRECTORS DURING THE BUDGET PROCESS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC, BUT FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST IN TRUSTS 139,377. LOSS ON EARLY EXTINGUISHMENT OF DEBT -257,228. FORM 990, PART XII, LINE 2C: THE BOARD OF DIRECTORS ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.