STRATEGY STUDIO / PUBLIC DATA EXPLORER

PAWNEE COUNTY MEDICAL FOUNDATION: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
PAWNEE COUNTY MEDICAL FOUNDATION (EIN 47-0673168)
Tax period
2010-07-01 to 2011-06-30
Filed
2011-12-01
IRS object ID
201123359349300617
Schema version
2010v3.4
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

FieldValueIRS element (for citing)
Timestamp2011-12-01T15:24:35-06:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DOHMAN AKERLUND & EDDY LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 470AddressLine1
CityAURORACity
StateNEState
ZIP Code688180470ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN470673168EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1PAWNEE COUNTY MEDICAL FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlPAWNNameControl
Phone4028692276Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 I STREETAddressLine1
CityPAWNEE CITYCity
StateNEState
ZIP Code68420ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameROBERT GYHRAName
TitleTREASURERTitle
Phone4028692276Phone
Date Signed2011-11-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTIMOTHY J COUFALName
Phone4026946404Phone
Date Prepared2011-12-01DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDR GEORGE VOIGTLANDERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1SAME AS C ABOVEAddressLine1
CityPAWNEE CITYCity
StateNEState
ZIP Code68420ZIPCode
FieldValueIRS element (for citing)
Gross Receipts285556GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1982YearFormation
State Legal DomicileNEStateLegalDomicile
Activity Or Mission DescriptionADVANCE 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 Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members4NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year698116ContributionsGrantsPriorYear
Contributions Grants Current Year262411ContributionsGrantsCurrentYear
Program Service Revenue Prior Year14000ProgramServiceRevenuePriorYear
Program Service Revenue CY11000ProgramServiceRevenueCY
Investment Income Prior Year17585InvestmentIncomePriorYear
Investment Income Current Year12145InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year729701TotalRevenuePriorYear
Total Revenue Current Year285556TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year500000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY122250GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year33554OtherExpensePriorYear
Other Expenses Current Year43065OtherExpensesCurrentYear
Total Expenses Prior Year533554TotalExpensesPriorYear
Total Expenses Current Year165315TotalExpensesCurrentYear
Revenues Less Expenses Prior Year196147RevenuesLessExpensesPriorYear
Revenues Less Expenses CY120241RevenuesLessExpensesCY
Total Assets BOY1603821TotalAssetsBOY
Total Assets EOY1739165TotalAssetsEOY
Total Liabilities BOY5036TotalLiabilitiesBOY
Total Liabilities EOY12732TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1598785NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1726433NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionADVANCE 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 ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense162884Expense
Grants122250Grants
DescriptionTO ADVANCE THE OBJECTIVES AND PURPOSES OF PAWNEE COUNTY MEMORIAL HOSPITAL, A 501 (C)3 ORGANIZATION.Description
Total Program Service Expense162884TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingfalseComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members4NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicyfalseConflictOfInterestPolicy
Whistleblower PolicyfalseWhistleblowerPolicy
Document Retention PolicyfalseDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonROBERT GYHRANamePerson
Telephone Number4028692276TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 85AddressLine1
CitySTEINAUERCity
StateNEState
ZIP Code68441ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (5 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
DR GEORGE VOIGTLANDER
PRESIDENT0.25X01833676418
BYFORD METZGER
MEMBER0.25X000
ROBERT GYHRA
MEMBER1.00X000
WILLARD BINDER
MEMBER0.25X000
GARY FARWELL
MEMBER0.25X000
FieldValueIRS element (for citing)
Total Reportable Comp Frm Rltd Orgs183367TotalReportableCompFrmRltdOrgs
Total Other Compensation6418TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
All Other Contributions262411AllOtherContributions
Total Contributions262411TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionAMBULANCE LEASE INCOMEDescription
Business Code532000BusinessCode
Total Revenue Column11000TotalRevenueColumn
Related Or Exempt Function Income11000RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue11000TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column12145TotalRevenueColumn
Exclusion$12,145ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column285556TotalRevenueColumn
Related Or Exempt Function Income11000RelatedOrExemptFunctionIncome
Exclusion$12,145ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total122250Total
Program Services122250ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total975Total
Management And General975ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total24634Total
Program Services24634ProgramServices

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
EDUCATION1600016000
INVESTEMENT FEES11411141
OFFICE SUPPLIES315315

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total165315Total
Program Services162884ProgramServices
Management And General2431ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY621878BOY
EOY710097EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY809201BOY
EOY816268EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY27256BOY
EOY18825EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis285869LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec225767LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY33400BOY
EOY60102EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY104571BOY
EOY126350EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY7515BOY
EOY7523EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1603821BOY
EOY1739165EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY5036BOY
EOY12732EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY5036BOY
EOY12732EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1591270BOY
EOY1718910EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY7515BOY
EOY7523EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1598785BOY
EOY1726433EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1603821BOY
EOY1739165EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses120241ReconcilationRevenueExpenses
Reconcilation Other Changes7407ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type2XSupportingOrg509a3Type2
Certification CheckboxXCertificationCheckbox
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1PAWNEE COUNTY MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
EIN363169688EIN
Type Of Organization3TypeOfOrganization
Listed In Governing DoctrueListedInGoverningDoc
Supported Organization NotifiedtrueSupportedOrganizationNotified
Organized In UStrueOrganizedInUS
Amount$122,250Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts122250SumOfAmounts

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance7515BeginningOfYearBalance
Investment Earnings Or Losses8InvestmentEarningsOrLosses
End Of Year Balance7522EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance8013BeginningOfYearBalance
Administrative Expenses498AdministrativeExpenses
End Of Year Balance7515EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance48509BeginningOfYearBalance
Grants Or Scholarships40259GrantsOrScholarships
Administrative Expenses237AdministrativeExpenses
End Of Year Balance8013EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance1.00000BoardDesignatedEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis285869OtherCostOrOtherBasis
Depreciation225767Depreciation
Book Value60102BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings60102TotalOfBookValueLandBuildings

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierINTENDED USES FOR ENDOWMENT FUNDSIdentifier
Return ReferenceSCHEDULE D, PAGE 2, PART V, LINE 4ReturnReference
ExplanationFUNDS ARE HELD IN TRUST AND DISTRIBUTED TO FOUNDATION WHEN REQUESTED BY BOARD OF DIRECTORS.Explanation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1PAWNEE COUNTY MEMORIAL HOSPITALBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1600 I STREETAddressLine1
CityPAWNEE CITYCity
StateNEState
ZIP Code68420ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient363169688EINOfRecipient
IRC SectionGOVIRCSection
Amount Of Cash Grant122250AmountOfCashGrant
Purpose Of GrantCAPITAL PROJECTPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of Other Organizations1TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATESIdentifier
Return ReferenceSCHEDULE I, PAGE 1, PART I, LINE 2ReturnReference
ExplanationTHE 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

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonDR GEORGE VOIGTLANDERNamePerson
Comp Based On Related Orgs183367CompBasedOnRelatedOrgs
Deferred Comp Related Orgs6418DeferredCompRelatedOrgs
Total Compensation Related Orgs189785TotalCompensationRelatedOrgs

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990 - ORGANIZATION'S MISSIONADVANCE 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 990FORM 990, PAGE 6, PART VI, LINE 11BTHE RETURN IS REVIEWED BY ONE MEMBER OF MANAGEMENT PRIOR TO FILING.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST.
RELATED ORGANIZATIONSFORM 990, PAGE 7, PART VIIDR. GEORGE VOIGTLANDER'S AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATION ARE 48.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1PAWNEE COUNTY MEMORIAL HOSPITALBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1600 I STREETAddressLine1
CityPAWNEE CITYCity
StateNEState
ZIP Code68420ZIPCode
FieldValueIRS element (for citing)
EIN363169688EIN
Primary ActivitiesHOSPITALPrimaryActivities
Legal Domicile StateNELegalDomicileState
Exempt Code Section501C3ExemptCodeSection
Public Charity Status3PublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled OrgfalseControlledOrg

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1PAWNEE COUNTY AMBULANCEBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1600 I STREETAddressLine1
CityPAWNEE CITYCity
StateNEState
ZIP Code68420ZIPCode
FieldValueIRS element (for citing)
EIN470647810EIN
Primary ActivityAMBULANCEPrimaryActivity
Legal Domicile StateNELegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
PAWNEE COUNTY MEMORIAL HOSPITAL
B122250COST OF MEDICAL EQUIPMENT
PAWNEE COUNTY AMBULANCE
I11000FMV OF USE OF PROPERTY