PAWNEE COUNTY MEDICAL FOUNDATION: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- PAWNEE COUNTY MEDICAL FOUNDATION (EIN 47-0673168)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2013-11-04
- IRS object ID
- 201313089349300911
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-04T10:59:49-06:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | 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 | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470673168 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PAWNEE COUNTY MEDICAL FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PAWN | NameControl |
| Phone | 4028692276 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 I STREET | AddressLine1 |
| City | PAWNEE CITY | City |
| State | NE | State |
| ZIP Code | 68420 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ROBERT GYHRA | Name |
| Title | TREASURER | Title |
| Phone | 4028692276 | Phone |
| Date Signed | 2013-10-29 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TIMOTHY J COUFAL | Name |
| Phone | 4026946404 | Phone |
| Date Prepared | 2013-10-29 | 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 | DR GEORGE VOIGTLANDER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | SAME AS C ABOVE | AddressLine1 |
| City | PAWNEE CITY | City |
| State | NE | State |
| ZIP Code | 68420 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 448819 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1982 | YearFormation |
| State Legal Domicile | NE | StateLegalDomicile |
| Activity Or Mission Description | ADVANCE THE OBJECTIVES AND PURPOSES OF PAWNEE COUNTY MEMORIAL HOSPITAL, PAWNEE CITY, NEBRASKA, BY PROVIDING HEALTH CARE SERVICES, FACILITIES AND PROGRAMS IN SUPPORT OF PAWNEE COUNTY MEMORIAL HOSPITAL'S EFFORTS TO ASSIST THOSE SUFFERING FROM ANY DISEASE, INFIRMITY OR HEALTH NECESSITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 5 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 4 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 314710 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 417100 | ContributionsGrantsCurrentYear |
| Program Service Revenue CY | 63 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 9738 | InvestmentIncomePriorYear |
| Investment Income Current Year | 24040 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 7616 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 324448 | TotalRevenuePriorYear |
| Total Revenue Current Year | 448819 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 77632 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 18100 | OtherExpensePriorYear |
| Other Expenses Current Year | 29927 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 18100 | TotalExpensesPriorYear |
| Total Expenses Current Year | 107559 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 306348 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 341260 | RevenuesLessExpensesCY |
| Total Assets BOY | 2070654 | TotalAssetsBOY |
| Total Assets EOY | 2446129 | TotalAssetsEOY |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2070654 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2446129 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | ADVANCE THE OBJECTIVES AND PURPOSES OF PAWNEE COUNTY MEMORIAL HOSPITAL, PAWNEE CITY, NEBRASKA, BY PROVIDING HEALTH CARE SERVICES, FACILITIES AND PROGRAMS IN SUPPORT OF PAWNEE COUNTY MEMORIAL HOSPITAL'S EFFORTS TO ASSIST THOSE SUFFERING FROM ANY DISEASE, INFIRMITY OR HEALTH NECESSITY. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 90334 | Expense |
| Grants | 77632 | Grants |
| Description | TO ADVANCE THE OBJECTIVES AND PURPOSES OF PAWNEE COUNTY MEMORIAL HOSPITAL, A 501 (C)3 ORGANIZATION. | Description |
| Total Program Service Expense | 90334 | 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 | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | 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 | false | Hospital |
| Grants To Organizations | true | 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 | true | 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 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | false | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| 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 |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 5 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 4 | 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 | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | false | ConflictOfInterestPolicy |
| Whistleblower Policy | false | WhistleblowerPolicy |
| Document Retention Policy | false | DocumentRetentionPolicy |
| Compensation Process CEO | false | 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 | ROBERT GYHRA | NamePerson |
| Telephone Number | 4028692276 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 85 | AddressLine1 |
| City | STEINAUER | City |
| State | NE | State |
| ZIP Code | 68441 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (5 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| DR GEORGE VOIGTLANDER | ||||||
| PRESIDENT | 0.25 | 40.00 | X | 0 | 161897 | 5666 |
| BYFORD METZGER | ||||||
| MEMBER | 0.25 | X | 0 | 0 | 0 | |
| ROBERT GYHRA | ||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | |
| WILLARD BINDER | ||||||
| MEMBER | 0.25 | X | 0 | 0 | 0 | |
| GARY FARWELL | ||||||
| MEMBER | 0.25 | X | 0 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp Frm Rltd Orgs | 161897 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 5666 | TotalOtherCompensation |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| All Other Contributions | 417100 | AllOtherContributions |
| Noncash Contributions | 313595 | NoncashContributions |
| Total Contributions | 417100 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS REVENUE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 63 | TotalRevenueColumn |
| Related Or Exempt Function Income | 63 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 63 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 24040 | TotalRevenueColumn |
| Exclusion | $24,040 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 7616 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 7616 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7616 | TotalRevenueColumn |
| Exclusion | $7,616 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 448819 | TotalRevenueColumn |
| Related Or Exempt Function Income | 63 | RelatedOrExemptFunctionIncome |
| Exclusion | $31,656 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 77632 | Total |
| Program Services | 77632 | ProgramServices |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 975 | Total |
| Program Services | 975 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1852 | Total |
| Program Services | 1852 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1875 | Total |
| Program Services | 1875 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral | Program ServicesProgramServices |
|---|---|---|---|
| INVESTEMENT FEES | 15172 | 15172 | |
| EDUCATION | 8000 | 8000 | |
| BAD DEBT EXPENSE | 1650 | 1650 | |
| OFFICE SUPPLIES | 403 | 403 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 107559 | Total |
| Program Services | 90334 | ProgramServices |
| Management And General | 17225 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 338266 | BOY |
| EOY | 266142 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 821108 | BOY |
| EOY | 824552 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14436 | BOY |
| EOY | 2503 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 313595 | LandBuildingsEquipmentBasis |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42247 | BOY |
| EOY | 313595 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 847568 | BOY |
| EOY | 1032304 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7029 | BOY |
| EOY | 7033 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2070654 | BOY |
| EOY | 2446129 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2063625 | BOY |
| EOY | 2439096 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7029 | BOY |
| EOY | 7033 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2070654 | BOY |
| EOY | 2446129 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2070654 | BOY |
| EOY | 2446129 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 341260 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 34215 | ReconcilationOtherChanges |
| 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 Consolidated | X | FinancialStatementConsolidated |
| 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) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type2 | X | SupportingOrg509a3Type2 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | false | ContribByControllingIndividual |
| Contribution By Related Party | false | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | false | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PAWNEE COUNTY MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363169688 | EIN |
| Type Of Organization | 3 | TypeOfOrganization |
| Listed In Governing Doc | true | ListedInGoverningDoc |
| Supported Organization Notified | true | SupportedOrganizationNotified |
| Organized In US | true | OrganizedInUS |
| Amount | $77,632 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 77632 | SumOfAmounts |
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 | 7029 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 4 | InvestmentEarningsOrLosses |
| End Of Year Balance | 7033 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 7522 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -493 | InvestmentEarningsOrLosses |
| End Of Year Balance | 7029 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 7515 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 7 | InvestmentEarningsOrLosses |
| End Of Year Balance | 7522 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 8013 | BeginningOfYearBalance |
| Administrative Expenses | 498 | AdministrativeExpenses |
| End Of Year Balance | 7515 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 48509 | BeginningOfYearBalance |
| Grants Or Scholarships | 40259 | GrantsOrScholarships |
| Administrative Expenses | 237 | AdministrativeExpenses |
| End Of Year Balance | 8013 | 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 | 313595 | OtherCostOrOtherBasis |
| Book Value | 313595 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 313595 | TotalOfBookValueLandBuildings |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | INTENDED USES FOR ENDOWMENT FUNDS | Identifier |
| Return Reference | SCHEDULE D, PAGE 2, PART V, LINE 4 | ReturnReference |
| Explanation | FUNDS ARE HELD IN TRUST AND DISTRIBUTED TO FOUNDATION WHEN REQUESTED BY BOARD OF DIRECTORS. | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PAWNEE COUNTY MEMORIAL HOSPITAL | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 I STREET | AddressLine1 |
| City | PAWNEE CITY | City |
| State | NE | State |
| ZIP Code | 68420 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 363169688 | EINOfRecipient |
| Amount Of Cash Grant | 77632 | AmountOfCashGrant |
| Purpose Of Grant | CAPITAL PROJECT | PurposeOfGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES | Identifier |
| Return Reference | SCHEDULE I, PAGE 1, PART I, LINE 2 | ReturnReference |
| Explanation | THE PURPOSE OF THE FOUNDATION IS TO SUPPORT PAWNEE COUNTY MEMORIAL HOSPITAL, A 501 (C)3 ORGANIZATION. AS SUCH, THE ONLY GRANTS THAT ARE ISSUED ARE FOR THE BENEFIT OF THE HOSPITAL. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DR GEORGE VOIGTLANDER | NamePerson |
| Title | PRESIDENT | Title |
| Comp Based On Related Orgs | 161897 | CompBasedOnRelatedOrgs |
| Deferred Comp Related Orgs | 5666 | DeferredCompRelatedOrgs |
| Total Compensation Related Orgs | 167563 | TotalCompensationRelatedOrgs |
Schedule M IRS990ScheduleM
Real Estate Other RealEstateOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 313595 | NoncashContribsRptdF990 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGifts |
| Third Parties Used | false | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990 - ORGANIZATION'S MISSION | ADVANCE THE OBJECTIVES AND PURPOSES OF PAWNEE COUNTY MEMORIAL HOSPITAL, PAWNEE CITY, NEBRASKA, BY PROVIDING HEALTH CARE SERVICES, FACILITIES AND PROGRAMS IN SUPPORT OF PAWNEE COUNTY MEMORIAL HOSPITAL'S EFFORTS TO ASSIST THOSE SUFFERING FROM ANY DISEASE, INFIRMITY OR HEALTH NECESSITY. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE RETURN IS REVIEWED BY ONE MEMBER OF MANAGEMENT PRIOR TO FILING. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. |
| RECONCILIATION OF CHANGES - OTHER | FORM 990, PART XI, LINE 9 | CHANGE IN INTEREST IN NET ASSETS OF TRUST 0 |
| OTHER CHANGES IN NET ASSETS EXPLANATION | FORM 990, PART XI, LINE 9 | NET UNREALIZED GAIN ON INVESTMENTS 84,954 CHANGE IN INTEREST IN NET ASSETS OF TRUST 4 CHANGE IN EQUITY INTEREST OF AMBULANCE CO. 50,743 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PAWNEE COUNTY MEMORIAL HOSPITAL | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 I STREET | AddressLine1 |
| City | PAWNEE CITY | City |
| State | NE | State |
| ZIP Code | 68420 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363169688 | EIN |
| Primary Activities | HOSPITAL | PrimaryActivities |
| Legal Domicile State | NE | LegalDomicileState |
| Exempt Code Section | 501C3 | ExemptCodeSection |
| Public Charity Status | 3 | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | false | ControlledOrg |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PAWNEE COUNTY AMBULANCE | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 I STREET | AddressLine1 |
| City | PAWNEE CITY | City |
| State | NE | State |
| ZIP Code | 68420 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470647810 | EIN |
| Primary Activity | AMBULANCE | PrimaryActivity |
| Legal Domicile State | NE | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| 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 | true | 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 | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| PAWNEE COUNTY MEMORIAL HOSPITAL | ||
| B | 54840 | CASH FOR CAPITAL PROJECT |
| PAWNEE COUNTY MEMORIAL HOSPITAL | ||
| R | 22792 | ASSETS TRANSFERRED |