2013-03-28T14:21:53-05:00 2012-06-30 BKD LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2011-07-01 440537826 Community Hospital Association Inc % SUZANNE SOUTHARD COMM 6606862211 PO Box 107 Fairfax MO 644460107 MYRA EVANS 2013-05-15 true Michael J Engle 8162216300 2011 2016-02-25 16:41:14Z MYRA EVANS 26136 US HWY 59 FAIRFAX MO 64446 12165256 false X WWW.FAIRFAXMED.COM X 1976 MO TO PROVIDE QUALITY ACUTE CARE, EMERGENCY, AND OUTPATIENT HOSPITAL SERVICES. 15 13 104 90 0 0 1081477 607905 10395665 11227439 23547 5735 96916 295827 11597605 12136906 819009 52981 0 0 4615909 5110727 0 0 109177 6645621 7559846 12080539 12723554 -482934 -586648 20517337 19529044 13439241 13037596 7078096 6491448 X TO BE THE HEALTHCARE PROVIDER OF CHOICE FOR THE COMMUNITIES WE SERVE. false false 10022668 5775 11227439 SEE SCHEDULE O 10022668 true true false true false false false false false false true false false false false true false true false false false false false false true false true true false true true false false false false false false false false false false false false false true true true false false true 8 0 true 104 true false false false false false true true false false false false X 15 13 false true false false false false false true true false false true true true true true true true true false MO X SUZANNE SOUTHARD 6606862211 26136 US HWY 59 FAIRFAX MO 64446 X ROBERT JACKSON 1.0 X X 0 0 0 NANCY HURST 1.0 X X 0 0 0 SANDRA FUHRMAN 1.0 X X 0 0 0 RICHARD OSWALD 1.0 X 0 0 0 BILL SMITH 1.0 X 0 0 0 JACQUE GEBHARDS 1.0 X 0 0 0 STEVE CUNNINGHAM 1.0 X 0 0 0 JASON GARST 1.0 X 0 0 0 CHAD DERR 1.0 X 0 0 0 BEVERLY WHITE 1.0 X 0 0 0 PATRICIA FISHER 1.0 X 0 0 0 EDUARDO FERNANDEZ MD 1.0 X 0 0 0 DEBBIE GLEASON 1.0 X 0 105947 17669 KRISTI ATKINSON 1.0 X 0 86434 13343 PAULA MILLER 1.0 X 0 0 0 WC BUD TICE 1.0 X 0 143172 10396 STEPHANIE DAUBERT 1.0 X 0 179536 17143 MYRA EVANS 40.0 X 174244 0 23145 SUZANNE SOUTHARD 40.0 X 54131 0 11961 GARY MCINTYRE 40.0 X 138704 0 2081 367079 515089 95738 2 false true false DOCS WHO CARE PHYSICIAN SERVICES 303137 CPSI COMPTR SUPPORT SVCS 288860 FOCUSONE SOLUTIONS LLC TEMPORARY STAFFING 282033 MORGAN ANESTHESIA SERVICES CRNA SERVICES 149989 SODEXHO INC AFFILIATES ENVIRONMENT SERVICES 126037 7 162860 381784 63261 607905 NET PATIENT SERVICE REVENUE 621990 11227439 11227439 11227439 4735 4735 0 0 1000 1000 1000 1000 57718 162860 28350 29368 29368 0 0 EHR INCENTIVE REVENUE 900099 201250 201250 CAFETERIA 621990 54380 54380 All Other Misc Revenue 900099 10829 10829 10829 10829 266459 12136906 11227439 0 301562 0 52981 52981 0 0 259773 259773 0 3904574 3005620 858749 40205 99937 76928 21980 1029 533501 412385 115699 5417 312942 240893 68827 3222 225698 173735 49639 2324 13262 10208 2917 137 65943 50761 14503 679 0 0 0 1706867 1313894 375398 17575 41035 31587 9025 423 388959 299409 85545 4005 0 0 230301 177279 50651 2371 49061 37766 10790 505 0 0 620204 477414 136404 6386 0 1669891 1285430 367266 17195 93559 72019 20577 963 REPAIRS & MAINT. 383920 295529 84437 3954 Medical Supplies 728967 728967 BAD DEBT 945706 945706 MEDICAID 173013 173013 223460 161144 59529 2787 12723554 10022668 2591709 109177 0 27870 333260 330049 168070 97335 1412026 1344633 0 0 0 0 0 0 276067 332474 92834 69003 21356804 4430124 17816084 16926680 0 0 0 0 0 0 0 0 418996 401000 20517337 19529044 575912 753133 0 0 0 0 0 0 0 0 0 0 12863329 12284463 0 0 0 0 13439241 13037596 X 7078096 6491448 0 0 0 0 7078096 6491448 20517337 19529044 -586648 0 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 2062 false false 2062 false 309117 309117 5569332 733571 4835761 13373477 3434089 9939388 2104878 262464 1842414 16926680 0 0 12136906 12723554 -586648 -586648 11835325 50418 50418 11784907 351999 351999 12136906 12764101 40547 40547 12723554 12723554 UNCERTAIN TAX POSITIONS DISCLOSURE SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. RECONCILIATION OF REVENUE SCHEDULE D, PART XII, LINE 2D RELATED ORGANIZATION'S REVENUE 22,068 SPECIAL EVENT EXPENSES 28,350 ------- TOTAL $50,418 RECONCILIATION OF REVENUE SCHEDULE D, PART XII, LINE 4B CONTRIBUTION FROM RELATED ENTITY $351,999 RECONCILIATION OF EXPENSES SCHEDULE D, PART XIII, LINE 2D RELATED ORGANIZATION'S EXPENSES 12,197 SPECIAL EVENT EXPENSES 28,350 ------- TOTAL $40,547 GOLF TOURNAMENT 66550 40885 25665 1680 6526 40 3412 6428 ANNUAL APPEAL 123431 100000 23431 817 1 30597 21975 8622 180 3735 5532 220578 162860 57718 1680 6526 220 7147 12777 28350 29368 true true true X true X true true false false 153281 153281 0.01200 1674985 919216 755769 0.05940 1828266 919216 909050 0.07140 12011 1305 10706 13775 13775 0.00110 304958 234437 70522 0.00440 765 765 0.00010 331509 235742 95768 0.00560 2159775 1154958 1004818 0.07700 465 465 9383 9383 0.00070 31086 31086 0.00240 40934 40934 0.00310 false 945706 149872 6117965 6096363 21602 X true true 1 1 COMMUNITY HOSPITAL-FAIRFAX

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X X X X COMMUNITY HOSPITAL-FAIRFAX 1 true true 200. true 200. true X X X X X X true true X X X X X true false true X false false 1 PRIMARY CARE CLINIC

26136 US HWY 59 FAIRFAX MO 64446

PRIMARY CARE PHYSICIAN CLINIC SCHEDULE H, PART I, LINE 7 THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART I, LINE 7, OF SCHEDULE H, IS A COST TO CHARGE RATIO. SCHEDULE H, PART I, LINE 7, COLUMN F THE AMOUNT OF BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES FOR CALCULATING THE NET COMMUNITY BENEFIT EXPENSE PERCENTAGE WAS $945,706. SCHEDULE H, PART I, LINE 7G THE HOSPITAL INCLUDED $60,415 FROM A PHYSICIAN CLINIC. COMMUNITY BUILDING ACTIVITIES SCHEDULE H, PART II Community Hospital-Fairfax participates in year round community building activities. In February, Community Hospital-Fairfax sponsors a Wear Red Challenge. Businesses, organizations and schools are challenged to wear red for heart health. In return, heart healthy information is mailed to each participant for their employees. Hundreds participate each year. In addition to celebrating heart health awareness month, monthly blood pressure clinics are offered in three locations every month of the year in the CH-F service area as a service to our community. Pediatric Orientation is held in the spring of each year. 90 area first graders are invited into the hospital to role play what it might be like to a patient. First graders really enjoy riding in the wheelchair and pushing buttons on the hospital bed. Also, held each spring is the Kid's Caf. This is an event where children get to "play with their food" and learn about healthy eating choices. Seed spitting, cracker critters and making their own sandwiches are just a few fun activities. Hospital employees also set up a mock grocery story and kids do their own shopping. After their carts are full, volunteers show them what are healthy choices and where they might make other choices. After the Kids Caf, the hospital rents the local swimming pool for kids to enjoy! In the late summer, Community Hospital-Fairfax sponsors the Back to School Fair. This is a fair for low income families to receive free school supplies prior to the school year starting. Community Hospital-Fairfax organizes the collection of funds and purchases the supplies. 150 children were able to fill backpacks with needed supplies last year! In the fall, Community Hospital-Fairfax invites men to come to the hospital for a free prostate screening clinic. The PSA test is offered at a reduced cost and the exam is free. 60 to 75 men participate in this activity annually. During Physical Therapy month, therapists travel the hospital service area and offer free fall risk assessments and assistive device assessments at area nutrition centers. Up to 50 receive this helpful screening each year in an effort to reduce their potential for falls. October brings with it Breast Cancer Month. Community Hospital-Fairfax delivers bags of mints and mammogram reminders to area businesses in an effort to raise awareness for women receiving this important screening. The first weekend of November is an exciting time for the community's women as the annual Me Market kicks off. A gym full of shopping opportunities attracts about 250 women annually. Along with shopping, women can receive free screenings and health information. Cholesterol, glucose, body composition, heart health and a free fall risk assessment are all offered free of charge or at a very reduced cost. BAD DEBT EXPENSE SCHEDULE H, PART III, LINE 4 THE HOSPITAL USED THE ACTUAL ACCOUNT BALANCE AMOUNTS WRITTEN OFF AND SENT TO COLLECTION AGENCIES (NO HOME HEALTH OR PCC) FOR THE TOTAL ON LINE 2. LINE 3 IS THE AMOUNT OF ACCOUNT BALANCES WRITTEN OFF TO BAD DEBTS THAT POSSIBLY WOULD HAVE QUALIFIED FOR CHARITY HAD THEY BEEN WILLING TO PROVIDE THE NECESSARY INFORMATION, AND THE TOTAL OF BANKRUPTCIES THE HOSPITAL HAD TO WRITE OFF. THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HOSPITAL BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. MEDICARE SHORTFALL SCHEDULE H, PART III, LINE 8 THE HOSPITAL'S SERVICE AREA IS APPROXIMATELY 23% MEDICARE BENEFICIARIES WHO PREFER TO GET THEIR MEDICAL CARE LOCALLY. 56% OF THE HOSPITAL'S REVENUE IS GENERATED BY THESE MEDICARE BENEFICIARIES. OUR CUSTOMER SERVICE SURVEYS RATE COMMUNITY HOSPITAL CONSISTENTLY OVER 90%, SHOWING THESE MEDICARE BENEFICIARIES APPRECIATE THE SERVICES COMMUNITY HOSPITAL PROVIDES AND HOW THE SERVICES ARE PROVIDED. THE COSTING SOURCE WAS THE FY12 MEDICARE COST REPORT. COLLECTION PRACTICES SCHEDULE H, PART III, LINE 9B Collection policy states all uninsured and insured patients are informed on their first statement of services that Community Hospital has a grant program (for financial assistance) for those who qualify. This same type of 'assistance available' information is also in the Patient Information brochures in the patient rooms and waiting areas. Patients may qualify for a charity discount or a medically indigent discount, depending on their financial situation and using the Federal Poverty Guidelines. BILLING TO INDIVIDUALS WITHOUT INSURANCE COVERING EMERGENCY SCHEDULE H, PART V, SECTION B, LINE 19D The hospital charges all patients the same rate whether they have insurance coverage or not. A 30% discount off billed charges is offered to uninsured patients, and the balance of a 30% discount (after insurance pays) to apply to deductibles and co-insurance owed to those that have insurance coverage. NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2 The Community Health Needs Assessment is underway at Community Hospital-Fairfax. The secondary research was completed in June-July of 2012. Four focus groups with 50 experts that represent children, elderly, law enforcement and the underpriveledged were held between Sept. and Oct. and the findings written into a report that will be used in conjunction with the whole community survey that is currently being conducted. The survey process kicked off in November of 2012. The survey was emailed to 4400 homes and offered online. Newspaper and social media were also used. Drop boxes were also placed at local senior centers and newspaper offices. Community Hospital-Fairfax also partnered with Community Services Inc., the agency that serves the underpriveledged in our area, to distribute surveys to their clients. Nearly 60 surveys were collected through that partnership. To date, the return rate has been about 15% with more surveys still coming in. This data will be analyzed and a team put together to determine a solution in the FQ2013 with the full report available for wide distribution by May of 2013. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI, LINE 3 Community Hospital Business Office staff will discuss with inpatients and outpatients the options available to help the patients meet their financial obligations to Community Hospital. They discuss the federal/state government programs available and the hospital's financial assistance program. Then information is included in the statements sent to patients (explaining the amounts owed by the patient's insurance or the patient), much the same information as is discussed in person. COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4 Community Hospital-Fairfax serves the Atchison, Holt and western Nodaway Counties, population approximately 10,700. There are five main towns in Atchison and Holt, all with populations below 2,000. The population is all rural and the economy is largely driven by agriculture. The population is aging with a median household income of $40,261. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 5 TO EDUCATE AND PROVIDE SERVICES TO ITS COMMUNITY, COMMUNITY HOSPITAL RESPONDS BY PROVIDING THE FOLLOWING ACTIVITIES: MONTHLY FREE BLOOD PRESSURE SCREENING AT AREA NUTRITION CENTERS; AN ANNUAL 'HEART HEALTHY' EVENT WITH A Q&A SESSION WITH AN ONSITE CARDIOLOGIST, AND FREE BLOOD PRESSURE CHECKS; DIABETES COUNSELING CLASSES WITH A REGISTERED DIETICIAN AND CERTIFIED DIABETES EDUCATOR; FREE GLUCOSE SCREENING, BMI CHECKS AND BLOOD PRESSURE CHECKS AT ANNUAL WOMEN'S EVENT; AN ANNUAL KID'S CAFE WHICH INVOLVES CHILDREN LEARNING HEALTHY EATING CHOICES, AND A POOL PARTY FOR THE PARTICIPANTS WHICH PROMOTES PHYSICAL ACTIVITY; AN ANNUAL BACK TO SCHOOL FAIR WHERE SCHOOL SUPPLIES ARE DISTRIBUTED TO NEEDY CHILDREN AND HEALTHY EATING CHOICES ARE DISCUSSED; AN ANNUAL PROSTATE SCREENING WHICH INCLUDES A FREE EXAM FOR LOCAL RESIDENTS. true TUITION AND BOOKS ASSISTANCE 9 52981 MONITORING THE USE OF GRANT FUNDS IN THE U.S. SCHEDULE I, PART I, LINE 2 STUDENTS COMPLETE AND SUBMIT APPLICATIONS FOR SCHOLARSHIPS TWICE A YEAR. A COMMITTEE MEETS AND DETERMINES WHO IS AWARDED A SCHOLARSHIP. THE AMOUNT OF THE SCHOLARSHIPS AWARDED IS DEPENDENT ON THE ANNUAL BUDGET. X X false false false false false false false false false MYRA EVANS 174244 0 0 0 0 0 18396 0 4749 0 197389 0 0 0 WC BUD TICE 0 143172 0 0 0 0 0 6946 0 3450 0 153568 0 0 STEPHANIE DAUBERT 0 179536 0 0 0 0 0 13436 0 3707 0 196679 0 0 COMPENSATION FROM RELATED ORGANIZATION FORM 990, PART VII, SECTION A, LINE 1A AND SCHEDULE J, PART II THE CEO COMPENSATION IS PAID THROUGH A MANAGEMENT CONTRACT WITH THE NEBRASKA MEDICAL CENTER (NMC), A RELATED ORGANIZATION. THE RELATED COMPENSATION PAID TO DIRECTORS IS FOR THEIR EMPLOYMENT WITH NMC, NOT FOR THEIR ROLE AS A DIRECTOR WITH THE HOSPITAL. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A COMMUNITY HOSPITAL-FAIRFAX (CH-F) PRIDES ITSELF IN PROVIDING ACCESS TO HEALTHCARE TO A REGION WHERE HEALTH SERVICES ARE SPARSE, THE PHYSICIAN RATIO IS 2750:1 (NATIONAL BENCHMARK IS 631:1) AND EMERGENCY SERVICES WOULD OTHERWISE BE 30 MILES OR MORE FROM THE POPULATION CENTERS. COMMUNITY HOSPITAL-FAIRFAX PROVIDES THE NORTHWEST MISSOURI AREA POPULATION OF 11,000 IN HOLT, ATCHISON AND WESTERN NODAWAY COUNTY WITH A 24 HOUR EMERGENCY ROOM, ACUTE CARE (INCLUDING OBSTETRICS) AND POST-ACUTE CARE SERVICES, MANY OUTPATIENT SERVICES, SURGERY, ANCILLARY SERVICES, AND A FULL-SERVICE THERAPY DEPARTMENT. IN ADDITION TO SERVING THE HEALTH NEEDS OF A POPULATION THAT WOULD OTHERWISE NOT HAVE ACCESS TO CARE, COMMUNITY HOSPITAL-FAIRFAX CONTINUES TO INVEST IN A HEALTHY FUTURE FOR THE COMMUNITY. CH-F TRIES TO FOCUS ON THE GREATEST HEALTH NEEDS IN THE COMMUNITY WHICH TEND TO BE CHRONIC DISEASES SUCH AS HEART DISEASE, COPD AND ASTHMA, STROKE AND DIABETES. RISK FACTORS FOR THESE DISEASES ARE OBESITY, CIGARETTE SMOKING AND PHYSICAL INACTIVITY. NEARLY 30% OF THE CH-F SERVICE POPULATION IS OBESE, 69% REPORT PHYSICAL INACTIVITY AND 26% SMOKE. TO EDUCATE AND PROVIDE SERVICES TO A COMMUNITY WHERE THESE CHRONIC CONDITIONS PREVAIL, THE FOLLOWING ACTIVITIES ARE PART OF CH-F'S RESPONSE TO HEALTH NEEDS OF THE COMMUNITY: 1. MONTHLY FREE BLOOD PRESSURE CHECKS AT AREA NUTRITION CENTERS. 2. FEBRUARY HEART HEALTHY AWARENESS EVENT WITH 40 BUSINESSES AND 5 SCHOOLS PARTICIPATING. 3. DIABETES COUNSELING CLASSES WITH A REGISTERED DIETICIAN AND CERTIFIED DIABETES EDUCATOR. 4. FREE GLUCOSE SCREENINGS, BMI CHECKS AND BLOOD PRESSURE CHECKS BIANNUALLY AT A WOMEN'S EVENT (ATTENDED BY 275 WOMEN). 5. ATTENDANCE AT AREA HEALTH FAIRS OFFERING FREE SCREENINGS. 6. CH-F IS STROKE READY AND HAS PROTOCOL IN PLACE TO RESPOND TO A STROKE WITHIN 60 MINUTES. 7. CH-F SPONSORS HEALTHY EATING ACTIVITIES FOR KIDS. THE KID'S CAF TEACHES KIDS ABOUT THE FOOD PLATE AND ENCOURAGES CHILDREN TO TRY NEW HEALTHY FOODS. OVER 100 CHILDREN WERE REACHED THROUGH THIS ACTIVITY IN FY2012 WITH 150 CHILDREN AND FAMILIES ATTENDING A POOL PARTY AFTER THE EVENT SPONSORED BY THE HOSPITAL. 8. CH-F STAFF TEACHES HEALTHY EATING CHOICES AT THE AREA BACK TO SCHOOL FAIR WHERE SCHOOL SUPPLIES ARE DISTRIBUTED TO NEEDY CHILDREN. OVER 100 CHILDREN WERE REACHED THROUGH THIS ACTIVITY. 9. CH-F ALSO SPONSORS AN ANNUAL POOL PARTY TO CELEBRATE KIDS ATTENDANCE AT THE KID'S CAF AND PROMOTE PHYSICAL ACTIVITY. 10. AN ANNUAL PROSTATE SCREENING IS HELD BY CH-F. A FREE EXAM WAS PROVIDED TO NEARLY 60 MEN THIS YEAR. IN ADDITION TO RESPONDING TO AREA HEALTH CONCERNS, CH-F ALSO WANTS TO ENSURE THAT THERE ARE HEALTHCARE PROVIDERS FOR FUTURE GENERATIONS IN GENERATIONS IN NORTHWEST MISSOURI. $6,000 IN SCHOLARSHIPS IS AWARDED EACH YEAR TO STUDENTS ENROLLED IN A HEALTHCARE PROGRAM. ADDITIONALLY, CH-F STAFF LOGGED OVER 375 HOURS IN FY2012 WITH AREA HIGH SCHOOL STUDENTS AS THEY JOB SHADOWED. A CAREER DAY WAS ALSO HOSTED FOR AREA 8TH GRADERS. 52 STUDENTS ATTENDED TO LEARN ABOUT HEALTHCAREERS THROUGH HANDS ON ACTIVITIES WITH PHYSICIANS, LABORATORY, RADIOLOGY, NURSING AND PHYSICAL THERAPHY EMPLOYEES. AS THE SOLE HEALTHCARE FACILITY IN THE AREA, CH-F TAKES SERIOUS ITS OBLIGATION TO BE PREPARED IN AN EMERGENCY. OVER 55 HOURS WERE SPENT BY CH-F'S EMERGENCY PREPAREDNESS COORDINATOR LAST YEAR TRAINING TO BE READY IN CASE A DISASTER STRIKES. CH-F CONTINUES TO SERVE THE COMMUNITY BY PROVIDING HEALTHCARE TO A POPULATION THAT WOULD NOT OTHERWISE HAVE ACCESS. RECRUITING PHYSICIANS, NURSES, THERAPISTS AND OTHER HEALTHCARE PROVIDERS IS ONGOING, PURCHASING STATE OF THE ART EQUIPMENT WHEN POSSIBLE AND MAKING SURE THAT EACH MEMBER OF OUR COMMUNITY HAS THE CARE THEY DESERVE IS NOT AN EASY TASK, BUT ONE CH-F IS PROUD TO DO. DELEGATION OF CONTROL OVER MANAGEMENT DUTIES FORM 990, PART VI, SECTION A, LINE 3 COMMUNITY HOSPITAL ASSOCIATION, INC. HOLDS A MANAGEMENT CONTRACT WITH THE NEBRASKA MEDICAL CENTER (NMC). NMC APPOINTS A CHIEF EXECUTIVE OFFICER TO MANAGE DAY-TO-DAY OPERATIONS. FORM 990 REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11B AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE FORM 990. THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S ADMINISTRATION. ANY QUESTIONS OR CONCERNS THE ORGANIZATION'S ADMINISTRATION HAVE ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS ARE MADE. THE 990 WITH ALL COMPLETED SCHEDULES IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE 990. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION ANNUALLY OBTAINS WRITTEN AFFIRMATIONS FROM EACH OFFICER AND DIRECTOR AS TO THEIR COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. IF A DISCLOSURE OCCURS, THE MATTER IS VOTED ON BY THE BOARD OF DIRECTORS. IF A MAJORITY VOTE OCCURS THEN THE DISCLOSURE IS CONSIDERED A CONFLICT. THE CONFLICTED INDIVIDUAL MAY NOT VOTE OR PARTICIPATE IN THE MATTERS INVOLVING THE CONFLICT. IT IS NOTED IN THE BOARD MEETING MINUTES THAT THE INDIVIDUAL ABSTAINED FROM VOTING. COMPENSATION REVIEW FORM 990, PART VI, SECTION B, LINES 15A & 15B THE ORGANIZATION USES COMPARABILITY DATA TO DETERMINE THE COMPENSATION OF THE CEO AND OTHER OFFICERS. THE COMPENSATION OF THE CEO IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. THE COMPENSATION OF THE OTHER OFFICERS IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. AVAILABILITY OF DOCUMENTS FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ROBERT JACKSON TITLE:DIRECTOR/VICE PRESIDENT HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SANDRA FUHRMAN TITLE:DIRECTOR/SECRETARY/TREASURER HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:BILL SMITH TITLE:DIRECTOR HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:STEVE CUNNINGHAM TITLE:DIRECTOR HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:BEVERLY WHITE TITLE:DIRECTOR HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:EDUARDO FERNANDEZ, M.D. TITLE:DIRECTOR HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MYRA EVANS TITLE:CEO HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SUZANNE SOUTHARD TITLE:CFO HOURS:1 COMMUNITY HEALTCARE FOUNDATION 26136 US HWY 59 FAIRFAX MO 64446 431757553 SUPPORT ORG MO 501(C)(3) 11A CHA true THE NEBRASKA MEDICAL CENTER 4350 DEWEY AVENUE OMAHA NE 68198 911858433 HOSPITAL NE 501(C)(3) 3 NA false CLARKSON COLLEGE 101 SOUTH 42ND STREET OMAHA NE 68131 363649217 COLLEGE NE 501(C)(3) 2 NMC false BELLEVUE MED CTR 2500 BMC DRIVE BELLEVUE NE 68123 204305186 ACUTE CARE NE NMC RELATED 0 0 false 0 false 0.00000 NHS ORTHOPAEDIC SERVICES INC 988145 NEBRASKA MEDICAL CENTER OMAHA NE 68198 470845238 INVESTMTN SVCS NE NMC C CORP 0 0 0.00000 NEBRASKA HEALTH PARTNERS INC 987400 NEBRASKA MEDICAL CENTER OMAHA NE 68198 470816463 MANAGEMENT NE NMC C CORP 0 0 0.00000 false false true false true false false false false false true false true true false true false false COMMUNITY HEALTHCARE FOUNDATION C 381784 FMV