2026-06-04T13:28:07-07:00 2025-06-30 990 2024-07-01 470439599 MADONNA REHABILITATION HOSPITAL MADO 4024133000 5401 South St Lincoln NE 68506 KENNETH HOPKINS VICE PRESIDENT & CHIEF FINANCIAL OF 4024133000 2025-12-11 1 2024 2025-03-06 01:10:19Z KENNETH L HOPKINS 5401 SOUTH STREET 5401 SOUTH STREET LINCOLN NE 68506 216632556 0 X WWW.MADONNA.ORG X 1967 NE Madonna Rehabilitation Hospitals is a Catholic organization that exists to provide medical and physical rehabilitation services to children and adults throughout the nation. We rehabilitate those who have sustained injuries or disabling conditions so they can fully participate in life; lead research to improve outcomes; and prevent physical disabilities and promote wellness through community programs. 21 20 2338 123 0 0 3891669 7778124 181929837 191222124 3151831 17632308 0 0 188973337 216632556 0 0 0 0 131013664 143061565 0 0 0 57780842 63334374 188794506 206395939 178831 10236617 295138430 292782229 89153937 89017640 205984493 203764589 Madonna Rehabilitation Hospitals is a Catholic organization that exists to provide medical and physical rehabilitation services to children and adults throughout the nation. We rehabilitate those who have sustained injuries or disabling conditions so they can fully participate in life; lead research to improve outcomes; and prevent physical disabilities and promote wellness through community programs. 0 0 118046842 0 135833415 Madonna fulfills this mission by delivering expert and comprehensive rehabilitation, treating each person as a unique individual. Madonna's hospitals integrate the physical, psychological, social, spiritual and vocational aspects of each patient's life. The hospitals' programs support the unmet needs of our community and region and are devoted to returning people to their homes, communities and jobs or school. In FY 2025, Madonna admitted 2,603 hospital inpatients from 13states. The hospital received referrals from 703 physicians and 96 hospitals or health care facilities. In FY 2025, Madonna operated two inpatient rehabilitation facilities (IRFs): Madonna Rehabilitation Hospital Lincoln (MRH-L) and Acute Rehabilitation Omaha (AR-O) and two long-term care hospitals (LTCHs): Madonna Rehabilitation Specialty Hospital Lincoln (MRSH-L) and Madonna Rehabilitation Specialty Hospital Omaha (MRSH-O). MRH-L, AR-O, MRSH-L and MRSH-O offer comprehensive care to ensure continuity as patients' progress in their recovery or from one hospital to another. All hospitals employ an interdisciplinary team approach involving the patient and family, referring physician, rehabilitation physician, hospitalist, case manager, nutrition therapist, respiratory therapist, rehabilitation nurse, physical and occupational therapists, orthotic and prosthetic technician, psychologist, social workers, speech-language pathologists, therapeutic recreation specialists, vocational rehabilitation consultants and spiritual care counselors. Madonna's experienced staff treat thousands of individuals through inpatient and outpatient services every year, offering every patient the latest techniques and methods to produce the best results. As one of the largest, freestanding rehabilitation hospital systems in the United States, Madonna provides: * Intensive therapy programming * Programs with less intensive therapy, depending on the needs of the patient * 24-hour rehabilitation nursing and physician supervision * A continuum of services to ensure progress is maintained from inpatient to outpatient programs Our specialty rehabilitation programs focus on the needs of children and adults following traumatic injury and illness, including: brain injury, spinal cord injury, stroke, pulmonary conditions, neurological disorders and major multiple trauma. Madonna Rehabilitation Hospitals has 14 separate program accreditations from the Commission on the Accreditation of Rehabilitation Facilities (CARF) in the area of medical rehabilitation. This includes: * Inpatient Rehabilitation Programs for the IRFs and LTCHs * Brain Injury Program - Inpatient/Outpatient (adult and pediatric) * Spinal Cord Specialty Program - Inpatient/Outpatient (adult and pediatric), Lincoln Only * Stroke Specialty Program - Inpatient/Outpatient (adult) * Pediatric Specialty Program - Inpatient/Outpatient * Cancer Rehabilitation Specialty Program - Inpatient (adult), Omaha Only * Interdisciplinary Outpatient Medical Rehabilitation Programs - Multiple Service Madonna Rehabilitation Hospital Lincoln Patients at MRH-L rank in the top 11% nationally in terms of complexity, while discharging back to community settings at a higher rate according to industry benchmarks. Despite this complexity, 73% of patients discharged directly to a community setting. Additionally, the overall patient satisfaction rate for MRH-L was 88%. Acute Rehabilitation Omaha In October of 2025, Madonna will complete its ninth year of operating rehabilitation beds in Omaha. AR-O, overall, returned 79% of patients to a community destination rather than to an institution. Additionally, the overall patient satisfaction rate for AR-O was 91%. Madonna Rehabilitation Specialty Hospital Lincoln MRSH-L FY 2025 patient discharge to home or to an acute rehabilitation hospital to continue their recovery was 61% for the year. 86% of patients admitted on a mechanical ventilator weaned in an average of 14 days. Additionally, the overall patient satisfaction rate for MRSH-L was 89%. Madonna Rehabilitation Specialty Hospital Omaha MRSH-O FY 2025 patient discharge to home or to an acute rehabilitation hospital to continue their recovery was 50% for the year. 54% of patients admitted on a mechanical ventilator weaned in an average of 10 days. Additionally, the overall patient satisfaction rate for MRSH-O was 94%. 25499041 0 23140772 St. Jane de Chantal (St. Jane) is comprised of a 24-bed ventilator and special care unit (VAU/SN), a 30-bed Transitional Care Rehabilitation Unit (TCU) and a 49-bed nursing home. In addition to resident care, the organization completed phase one, and initiated phase two, of a multi-year construction and renovation project. This remodel provides each resident a private room; a significant enhancement to the facility's physical environment. By transitioning to private accommodations, the nursing home is addressing clinical complexities of residents while also improving physical comfort, mental health and psychosocial well-being. The project incorporates the latest innovations in design to provide a safer, more therapeutic and dignified living environment for residents. In FY 2025, St. Jane De Chantal maintained a 5-star overall rating from the Centers of Medicare & Medicaid Services (CMS). This rating indicates it is in the top 10% of all nursing facilities, nationwide, reviewed by CMS. In addition to the overall rating. The facility also received a 5-star rating for health survey, quality measures, and staffing. 14222729 0 13261209 Madonna Outpatient Therapy is committed to providing excellent care for patients who need outpatient rehabilitation. Outpatient Therapy offers a range of rehabilitation services for sports injuries, orthopedic sprains, strains and post-operative care to comprehensive rehabilitation for neurological conditions. Outpatient Therapy includes the Occupational Health & Wellness program, which combines occupational health, wellness, safety and coordination of care for workers' compensation injuries with the expert services conveniently available from Madonna Rehabilitation Hospitals, Madonna Outpatient Therapy clinics and Madonna Wellness Club. In FY 2025, Outpatient Therapy had a 2.6% increase in registrations and a 1.7% increase in visits compared to the prior year, resulting in more patients served across all locations. Outpatient Therapy experienced growth in all areas including post-operative care, preventative care, and post-injury care, as well as those programmatic patients who were treated throughout the Madonna continuum of care. 23628822 0 18986728 Madonna's Physicians Clinic is a specialty, referral-based clinic combining several areas of expertise under one roof. This clinic treats various musculoskeletal injuries and neurological conditions while helping to determine a patient's best path forward. In FY 2025, the Physicians Clinic served 6,299 patients in 79,633 visits; an increase of 12% patients served year over year and a 31% increase in visits. Madonna Wellness Club is a medically-based health, fitness and wellness facility and the first to be based on a rehabilitation model. Madonna Wellness Club provides medical, therapeutic and educational fitness and wellness expertise in addition to the latest technology. In FY 2025, Wellness Club increased memberships by .4% over the prior year, ending the year with 3,654 total members. The Wellness Club continues to expand essential medical and wellness programming in several key areas to further enhance the continuum of care that Madonna provides. 23628822 0 18986728 181397434 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 41 0 1 2338 1 0 0 0 0 0 0 0 0 0 0 0 0 X 21 20 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X KENNETH L HOPKINS 4024134224 5401 South St Lincoln NE 68506 ADAM T KAFKA PHYSICIAN MEDICAL DIRECTOR 40 0 X 715490 0 35954 PAUL A DONGILLI PRESIDENT AND CHIEF EXECUTIVE OFFICER 40 1 X X 693373 0 45022 JIAXIN J TRAN STAFF PHYSIATRIST 40 0 X 444909 0 29656 MORGAN T LAHOLT STAFF PHYSIATRIST 40 0 X 432330 0 33435 DONALD J SCHMIDT SENIOR MEDICAL DIRECTOR (OMAHA) 40 0 X 380946 0 53448 MATTHEW L DRIEWER STAFF HOSPITALIST 40 0 X 381998 0 34187 JULIE D LYON CHIEF MEDICAL OFFICER 40 0 X 406825 0 3910 KENNETH L HOPKINS VICE PRESIDENT & CHIEF FINANCIAL OFFICER 40 0 X 321884 0 44494 MICHAEL J HEDDERMAN VICE PRESIDENT & CHIEF FINANCIAL OFFICER 40 0 X 325859 0 26006 CHRISTOPHER A LEE VICE PRESIDENT AND CHIEF OPERATIONS OFFICER 40 0 X 298495 0 48056 JUDITH M BURNFIELD VICE PRESIDENT OF RESEARCH 40 0 X 233705 0 35261 RENAE M W FEILMEIER VICE PRESIDENT & CHIEF HUMAN RESOURCES OFFICER 40 0 X 230425 0 32281 LYNN R HALLOWELL-GOTTSLEBEN VICE PRESIDENT REHABILITATION 40 0 X 216152 0 16046 TERASA M FARLIN VICE PRESIDENT PATIENT CARE & CNO 40 0 X 199224 0 28004 LINDA S SUNDELL-SULLIVAN VICE PRESIDENT REFERRAL RELATIONS 40 0 X 197651 0 13925 DAVID J REESE VICE PRESIDENT & CHIEF ADMINISTRATIVE OFFICER 40 0 X 145443 0 9653 DANIEL W GRIESS VP FACILITIES MANAGEMENT SYSTEM & ANCILLARY SERVICES 40 0 X 127720 0 7789 JEFFREY GROMOWSKY VP & PHYSICIAN PRACTICE ADMINISTRATOR 40 0 X 99632 0 8389 LAUREN PUGLIESE CHAIRPERSON 1 1 X X 0 0 0 TERRY ZACH MD VICE CHAIRPERSON 1 0 X X 0 0 0 JOHN SULLIVAN FR VICE PRESIDENT 1 0 X X 0 0 0 DAN VOKOUN SECRETARY 1 0 X X 0 0 0 WILL DOUGLAS TREASURER 1 0 X X 0 0 0 SCOTT CASSELS MEMBER 1 0 X 0 0 0 JOHN COFFEY MEMBER 1 0 X 0 0 0 HEIDI DOANE MEMBER 1 0 X 0 0 0 PHIL ESSAY MD MEMBER 1 0 X 0 0 0 DAVID GANNON MD MEMBER 1 0 X 0 0 0 ADAM HAYES MEMBER 1 0 X 0 0 0 KACEY LEMPKA MEMBER 1 0 X 0 0 0 ALEX MCKIERNAN MEMBER 1 0 X 0 0 0 BRAD NIETFELDT MEMBER 1 0 X 0 0 0 GARY PERKINS MEMBER 1 0 X 0 0 0 PATRICK SPETHMAN MEMBER 1 0 X 0 0 0 GREG VASEK MEMBER 1 0 X 0 0 0 NICK WILWERDING MEMBER 1 0 X 0 0 0 SARAH WALKER PHD MEMBER 1 0 X 0 0 0 MARIA LIGHTHALL MEMBER 1 1 X 0 0 0 MIKE PALLESEN MEMBER 1 0 X 0 0 0 5852061 0 505516 164 0 1 0 TRIAGE LLC P O BOX 773328 CHICAGO IL 606773328 MEDICAL SERVICES 4981206 NEBRASKA MEDICINE 4350 DEWEY AVE OMAHA NE 68105 MEDICAL SERVICES 2191256 UNMC 985045 NEBRASKA MEDICAL CENTER OMAHA NE 68198 MEDICAL EDUCATION 1983993 FIVE NINES TECHNOLOGY GROUP P O BOX 744821 LOS ANGELES CA 900744821 ITS SERVICES 1627906 HEALTH CAROUSEL P O BOX 714216 CINCINNATI OH 452714216 MEDICAL SERVICES 864034 30 0 0 0 1128489 0 6649635 266663 7778124 Patient Service Revenue (net) 900099 135833415 135833415 0 0 Long-Term Care 900099 23140772 23140772 0 0 Outpatient 900099 13261209 13261209 0 0 Physician Services 900099 11323272 11323272 0 0 7663456 7663456 0 0 191222124 17632308 0 0 17632308 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216632556 191222124 0 17632308 X 0 0 0 0 0 0 0 0 3496388 0 3496388 0 0 0 0 0 111774792 100887170 10887622 0 3422815 3422815 0 0 16143938 14773883 1370055 0 8223632 7615851 607781 0 0 0 0 0 87838 0 87838 0 103232 0 103232 0 36109 0 36109 0 0 0 0 0 0 0 22068673 19943524 2125149 0 1105124 217102 888022 0 11138816 10678604 460212 0 2803805 1141432 1662373 0 0 0 0 0 3331998 2235999 1095999 0 591778 523129 68649 0 0 0 0 0 373086 367738 5348 0 2800081 2452900 347181 0 0 0 0 0 12223269 11077075 1146194 0 1416180 1416180 0 0 PROVIDER TAX 3789318 3789318 0 0 1465067 854714 610353 0 206395939 181397434 24998505 0 17661985 12407825 48325780 51888442 1643471 1818541 2252905 2407869 316035528 150160976 168823884 165874552 55899487 58142154 530918 242846 295138430 292782229 25638385 28034158 57882999 55905274 5632553 5078208 89153937 89017640 X 204959772 203363893 1024721 400696 205984493 203764589 295138430 292782229 X 10236617 -11832496 0 0 0 -624025 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 0 0 1 216109 216109 0 Schedule C, Part II-B, Line 1 Following is a description of the activities that resulted in the expenses totaled on line 1-j above: Madonna Rehabilitation Hospital ("Madonna") has retained the lobbying services of a local lobbying firm to monitor legislation at the state level in Nebraska impacting Nebraska hospitals and long term care facilities generally, and Madonna specifically. Madonna is a member of the Nebraska Hospital Association ("NHA"). As part of its activities, the NHA provides lobbying services and monitors state legislation of concern to its members. On the national level, Madonna is a member of the American Rehabilitation Providers Association ("AMRPA") and the National Association of Long Term Hospitals ("NALTH"). Among other services provided to its members, AMRPA and NALTH lobby and monitor federal legislation on behalf of their members. 0 8492376 8492376 0 202574719 78941299 123633420 0 0 0 0 0 93238293 66093355 27144938 0 11730140 5126322 6603818 165874552 0 457 PLANS 3931440 LEASE LIABILITY 676768 CURRENT PORTION OF WORK COMP 470000 5078208 X 205424085 -11832496 0 0 0 -11832496 217256581 0 -624025 -624025 216632556 206395939 0 0 0 0 0 206395939 0 0 0 206395939 Schedule D, Part X, Line 2 The Hospital is organized as a Nebraska nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Hospital is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the entity is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Schedule D, Part XI, Line 4b CHANGES IN TEMPORARILY RESTRICTED NET ASSETS. 1 1 X 1 X 3 0 1 1 0 1 1 1190765 1190765 0.0058 1853231 1853231 0.0091 0 0 3043996 0 3043996 0.0149 184814 184814 0.0009 1218936 1218936 0.006 826065 826065 0.0377 319549 319549 0.0016 192218 192218 0.0009 0 0 2741582 0 2741582 0.0471 0 0 5785578 0 5785578 0.0620 2 23187 484 22703 0.0001 2 0 23187 484 22703 0.0001 1 11219501 0 47751225 68828370 -21077145 X 1 1 3 1 MADONNA REHABILITAION HOSPITAL LINCOLN 5401 SOUTH ST LINCOLN NE 68506 WWW.MADONNA.ORG 500005 X ACUTE REHABILITATION HOSPITAL A 2 MADONNA REHABILITATION SPECIALTY HOSPITAL OMAHA 17500 BURKE STREET OMAHA NE 68118 WWW.MADONNA.ORG H000129 X LONG TERM CARE HOSPITAL A 3 MADONNA REHABILITATION SPECIALTY HOSPITAL LINCOLN 5401 SOUTH STREET LINCOLN NE 68506 WWW.MADONNA.ORG 507001 X LONG TERM CARE HOSPITAL A A 0 0 1 X X X X X X X X 24 1 0 0 1 X SEE PART V SECTION C NARRATIVE FOR FULL WEB ADDRESS X 1 24 0 1 0 1 X 300 0 X X X X X 1 1 X X X 1 X https://www.madonna.org/patient-resources/patient-financial-services X https://www.madonna.org/patient-resources/patient-financial-services X https://www.madonna.org/patient-resources/patient-financial-services X X X X X 1 X 0 X X X X X 0 X X 0 0 Schedule H, Part V, Section B, Line 5-Group A * Madonna uses multiple avenues to collect data regarding the needs of its community, including patient satisfaction surveys, meeting minutes from local, state, regional and national organizations, capital campaign requests and other data sources. This is an ongoing process that is integrated into strategic planning and annual goal setting. A needs assessment questionnaire was distributed to the community and the results were collected and analyzed in fiscal year 2025 (tax year 2024). The results were discussed at Strategic Planning Committee meetings during the planning phases for fiscal year 2025. Hospital leadership regularly reviews and discusses community needs during weekly administrative team meetings. Many of these needs are addressed through capital item requests and programming updates and/or additions. Additionally, community needs are brought forth and discussed in numerous organizational and individual meetings at all levels. Madonna Rehabilitation Hospital executives, managers and clinicians are encouraged to meet with their counterparts in peer institutions and to pursue leadership positions in their areas of expertise. Each year, Madonna staff members are elected and/or are appointed to boards, special task forces and other leadership positions. In these positions, Madonna staff gets direct input from colleagues in affiliated organizations and with patients in the community served. Schedule H, Part V, Section B, Line 11-Group A This implementation strategy (Strategy) addresses the prioritized Community Health Care Needs Identified in the Community Health Needs Assessment (CHNA) conducted for the fiscal 2025 year and approved by the hospital's Board of Directors. The plan also meets the requirements for community benefit planning as set forth in Section 501(r) of the Internal Revenue Code (the "Code") as part of the Affordable Care Act. The CHNA for Madonna Rehabilitation Hospital may be reviewed in its entirety at https://www.madonna.org/about-us under 'Community Health Needs Assessment'. Areas of Focus As a result of the analysis, three areas were identified as the priorities on which Madonna will focus for the next three years. These three needs are: Lincoln Campus physical plant alignment with clinical needs, Lincoln campus clinical and ancillary services expansion, and the Nebraska Physiatrist Residency Program. Priority #1: Align the Lincoln Campus physical plant with space required to meet the clinical needs of a high-acuity, specialized patient population (Madonna's "community"). Strategy: Expand and construct physical space to support the specialized equipment, cutting edge technology and family involvement required for Physical Medicine and Rehabilitation programs. Priority #2: Expand Lincoln Campus on-site clinical and ancillary services required to meet the clinical needs of a high-acuity, specialized patient population (Madonna's "community"). Strategy: Implement/expand appropriate on-site diagnostic imaging, laboratory, telemetry, specialized physician services and nursing skills to improve patient quality and outcomes. Priority #3: Complete the implementation of the newly established Physical Medicine and Rehabilitation Graduate Medical Education Residency Training Program. Strategy: In collaboration with the University of Nebraska Medical Center College of Medicine (UNMC-COM), gradually increase the number of residents to the four year program capacity of 16 residents in 2022. Additionally, in collaboration with UNMC-COM, recruit and fill all required faculty positions. Next Steps This implementation strategy will be executed over the next three years. Periodic evaluation of objectives for each identified priority will be conducted to assure that Madonna is on track to complete the plan as described. At the end of fiscal year 2022 Madonna Rehabilitation Hospital will review the Implementation Strategy and report on the success experienced through the collaborative efforts of improving the health needs of the community. Schedule H, Part V, Section B, Line 13-Group A FPG is used to determine eligibility for financial assistance. If financial assistance is granted, it is for free care only. Schedule H, Part V, Section B, Line 16a-Group A FAP: https://www.madonna.org/financial-services/ Schedule H, Part V, Section B, Line 16b-Group A FAP Application website: https://www.madonna.org/financial-services/ Schedule H, Part V, Section B, Line 16c-Group A FAP Plain Language Summary website: https://www.madonna.org/financial-services/ Schedule H, Part V, Section B, Line 20e-Group A * Madonna Rehabilitation Hospital offers the following: * Assistance with filling out applications for SSI, SSD, Medicaid and/or General Assistance * Advocate for the patient with third party payers, government payers, and other entities that may restrict or deny benefits inappropriately * Assist patient/families with billing/payment questions from prior stays to help escalate resolution and ensure that all appropriate documents have been returned to the payer for claims adjudication * Extended payment plans * Liability settlement pending without any other payer source * Courtesy calls at time of final notice and prior to listing for collections Schedule H, Part V, Section B, Line 22d-Group A * The amount of financial assistance is considered to be 100% of charges less the contractual adjustment for Amounts Generally Billed (AGB). AGB is the weighted average percentage as calculated by dividing the sum of commercial and Medicare contractual adjustments by the sum of commercial and Medicare gross charges. 4 ST JANE DE CHANTAL 2200 S 52ND STREET LINCOLN NE 68506 NURSING FACILITY (NF) MADONNA THERAPY PLUS 5401 SOUTH STREET LINCOLN NE 68506 OUTPATIENT CLINICS (4) MADONNA PROACTIVE HEALTH & FITNESS 7111 STEPHANIE LANE LINCOLN NE 68516 MEDICAL FITNESS CENTER REHABILITATION SPECIALISTS 5445 SOUTH STREET LINCOLN NE 68506 INPATIENT & OUTPATIENT PHYSICIAN CLINIC Schedule H, Part I, Line 3c If financial assistance is granted, it is for free care only. Schedule H, Part I, Line 6a The Community Benefit report is made available cost-free to the public at https://www.madonna.org/theindependent. Schedule H, Part I, Line 7 Medicare losses have increased significantly in recent years and no longer approximate the costs incurred to serve Medicare patients. This is due to reimbursement methodology changes that have resulted in decreasing payments despite inflationary growth in costs. Schedule H, Part II Madonna's medically based health and fitness center (Madonna ProActive) is focused on improving the overall wellness of the community by reducing chronic risk factors through various health programs. Madonna's Adaptive Sports program provides opportunities for children and adults with acquired physical disabilities to participate in recreational activities that are designed to promote physical health and wellness. The program is open to Madonna inpatients and outpatients as well as community members. Schedule H, Part III, Section A, Line 4 The Hospital reports patient accounts receivable for services rendered at net realizable amounts from third-party payers, patients and others. Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability 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 assesses those accounts that will transition to self-pay patients based on analysis of payment history. Those transition accounts are considered in conjunction with self-pay patients (which include 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 provision for bad debts in the period of service on the basis of its past experience, which indicates that certain 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. In many cases, the Hospital is able to negotiate payment subsequent to the initial determination of the collectability of the account. In these cases, the Hospital records additional contractual allowances and discounts. Upon consideration of the fact certain patient accounts that were previously allowed for are collected through negotiation and adjusted at the time of payment, the Hospital has determined the provision for bad debts is not significant to the financial statements and has combined with contractual allowances and discounts. Schedule H, Part III, Section B, Line 8 A cost accounting system is used by Madonna and it addresses all patient segments. None of the shortfall has been reported as community benefit Schedule H, Part III, Section C, Line 9b All charges for patients found eligible for financial assistance are waived. Once this eligibility is confirmed, all collection activities are discontinued. Schedule H, Part VI, Line 2 The entire process of assessment is included in the description in Part V, Section B. Schedule H, Part VI, Line 3 The insurance status of all patients is assessed at the time of admission. The admissions process includes regular communication with patients and their families, and insurance status is a significant part of this process. Patients without insurance are assisted in their applications for Medicaid if it appears they may qualify. Patients whose Medicaid applications are pending are regularly admitted. Financial Assistance is granted to patients who are denied for Medicaid but are unable to pay, in accordance with the Financial Assistance Policy. Schedule H, Part VI, Line 4 Madonna is one of the nation's largest specialized rehabilitation hospitals. Madonna treats children and adults with complex disabilities due to traumatic brain injury, spinal cord injury, stroke, neurological disorders, burns, pulmonary disease, cancer and other disabling conditions. This is Madonna's "community" - the people who require inpatient post-acute physical rehabilitation to reduce or eliminate impairments, activity limitations, and participation restrictions. Unlike acute care hospitals, Madonna does not define "community served" as a geographic area, but rather by the priority population that requires these highly specialized services. This population includes people of all ages, gender, income level, and race from throughout the country. Schedule H, Part VI, Line 5 In an effort to meet the growing needs of the pediatric population, Madonna has expanded its designated area and features a pediatric therapy gym, allowing the youngest patients to receive age-appropriate rehabilitation services. Madonna has also renovated the Kit Scott Therapeutic Learning Center. The goal of the Learning Center is to help students successfully transition back to their home and school settings. Madonna also provides services to the community which would otherwise be unavailable or underserved, such as community medical transportation. Madonna physicians and therapists also present at numerous conferences throughout the year, providing recognized expertise to the community on rehabilitation and other relevant topics. In addition to our medical facilities (which include Lincoln's first medical fitness facility), Madonna provides volunteer and financial support to the community. Madonna employees donate hundreds of units of blood onsite each year and serve more than 1,000 meals each year at Matt Talbot Kitchen. Financial support include individual employee and organizational donations of money and supplies to patients and their families, area food banks, churches, missionaries, social services organizations, and health associations. In some cases, Madonna organizes fundraisers designed to benefit these organizations. Outside organizations are also allowed to use Madonna's meeting rooms at no charge. Schedule H, Part VI, Line 7 Nebraska is the only state in which Madonna Rehabilitation Hospital files a community benefit report. X X X X X 0 0 0 1 0 0 0 0 0 ADAM T KAFKA PHYSICIAN MEDICAL DIRECTOR 715490 0 0 0 0 0 25700 0 10254 0 751444 0 0 0 PAUL A DONGILLI PRESIDENT AND CHIEF EXECUTIVE OFFICER 693373 0 0 0 0 0 43200 0 1822 0 738395 0 0 0 JIAXIN J TRAN STAFF PHYSIATRIST 444909 0 0 0 0 0 27918 0 1738 0 474565 0 0 0 MORGAN T LAHOLT STAFF PHYSIATRIST 432330 0 0 0 0 0 25700 0 7735 0 465765 0 0 0 JULIE D LYON CHIEF MEDICAL OFFICER 406825 0 0 0 0 0 0 0 3910 0 410735 0 0 0 MATTHEW L DRIEWER STAFF HOSPITALIST 381998 0 0 0 0 0 28651 0 5536 0 416185 0 0 0 DONALD J SCHMIDT SENIOR MEDICAL DIRECTOR (OMAHA) 380946 0 0 0 0 0 36193 0 17255 0 434394 0 0 0 MICHAEL J HEDDERMAN VICE PRESIDENT & CHIEF FINANCIAL OFFICER 325859 0 0 0 0 0 24318 0 1688 0 351865 0 0 0 KENNETH L HOPKINS VICE PRESIDENT & CHIEF FINANCIAL OFFICER 321884 0 0 0 0 0 35322 0 9172 0 366378 0 0 0 CHRISTOPHER A LEE VICE PRESIDENT AND CHIEF OPERATIONS OFFICER 298495 0 0 0 0 0 33588 0 14468 0 346551 0 0 0 JUDITH M BURNFIELD VICE PRESIDENT OF RESEARCH 233705 0 0 0 0 0 27881 0 7380 0 268966 0 0 0 RENAE M W FEILMEIER VICE PRESIDENT & CHIEF HUMAN RESOURCES OFFICER 230425 0 0 0 0 0 21643 0 10638 0 262706 0 0 0 LYNN R HALLOWELL-GOTTSLEBEN VICE PRESIDENT REHABILITATION 216152 0 0 0 0 0 12850 0 3196 0 232198 0 0 0 TERASA M FARLIN VICE PRESIDENT PATIENT CARE & CNO 199224 0 0 0 0 0 20611 0 7393 0 227228 0 0 0 LINDA S SUNDELL-SULLIVAN VICE PRESIDENT REFERRAL RELATIONS 197651 0 0 0 0 0 10279 0 3646 0 211576 0 0 0 DAVID J REESE VICE PRESIDENT & CHIEF ADMINISTRATIVE OFFICER 145443 0 0 0 0 0 7754 0 1899 0 155096 0 0 0 DANIEL W GRIESS VP FACILITIES MANAGEMENT SYSTEM & ANCILLARY SERVICES 127720 0 0 0 0 0 5923 0 1866 0 135509 0 0 0 JEFFREY GROMOWSKY VP & PHYSICIAN PRACTICE ADMINISTRATOR 99632 0 0 0 0 0 4155 0 4234 0 108021 0 0 0 Schedule J, Part I, Line 5 All hospital managers, approximately eighty, are eligible participants of the hospital's Management Incentive Compensation Plan. The Plan provides a structure for measuring the hospital's overall quality and financial performance. This plan allows for recognition and compensation when the hospital's performance exceeds baseline criteria. Upon achievement of an established quality benchmark, compensation is determined based upon a fixed formula encompassing revenues, earnings and participants' wages. The formula is applied equally to all participants. A Hospital Authority No 2 of Douglas County NE 521440796 2014-09-25 86048946 construct, equip and furnish new hospital facility in Omaha, NE 0 0 0 A 25255000 0 86048946 0 5911150 0 989867 0 0 79147929 0 0 2016 0 0 1 1 A 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 Schedule K, Part I, Column c-09/25/2014 86,048,946 Hospital Authority No 2 of Douglas County NE Bond CUSIP #'s associated with issue: 25923P AA3, 25923P AB1, 25923P AC9, 25923P AD7, 25923P AE5, 25923P AF2, 25923P AS4, 25923P AG0, 25923P AH8, 25923P AJ4, 25923P AV7, 25923P AK1, 25923P AL9, 25923P AM7, 25923P AN5, 25923P AP0, 25923P AR6, 25923P AT2, 25923P AU9, 25923P AQ8 Schedule K, Part IV, Line 2c-09/25/2014 86,048,946 Hospital Authority No 2 of Douglas County NE Rebate computation performed May 15, 2018. X VARIOUS 322 266663 COST 0 0 1 1 Schedule M, Part I, Line 32b USE OF VARIOUS FINANCIAL INSTITUTIONS TO SELL STOCK GIFTS RECEIVED. Schedule M, Part I, Line 33 USE OF VARIOUS FINANCIAL INSTITUTIONS TO SELL STOCK GIFTS RECEIVED. Form 990, Part VI, Section A, Line 3 Food service operations are contracted with Aramark; an outside management corporation. No current or former officers, directors, trustees, key employees, or highest compensated employees were compensated by Aramark during the tax year. Form 990, Part VI, Section A, Line 6 The Diocesan Health Ministries, a Nebraska Nonprofit Corporation, is the sole member of Madonna Rehabilitation Hospital. Form 990, Part VI, Section A, Line 7a The Diocesan Health Ministries may designate one member of the organization's Board of Directors, as provided in the organization's articles of incorporation. Form 990, Part VI, Section A, Line 7b The Member, Diocesan Health Ministries, has final approval of: (1) Changes in philosophy and mission; (2) Matters involving sale, lease, transfer, exchange, disposition, pledge or alienation of real property in excess of five hundred thousand dollars ($500,000.00); (3) Matters involving purchase and/or encumbrance with debt, in any way, of real property in excess of five hundred thousand dollars ($500,000.00); (4) Community members nominated to serve on the Board of Directors; (5) Amendments, alterations or changes in the Articles of Incorporation or Bylaws; (6) The annual capital budget; (7) CEO selection; (8) Merger, consolidation, dissolution. The Board of Directors approves and forwards to the Member, for its review the annual report and the operating budget. Form 990, Part VI, Section B, Line 11b Prior to filing the organization's Form 990, the Chief Financial Officer presents the completed Form 990 and an executive overview of the Form 990 to the Finance and Audit Committee of the Board of Directors at a regularly scheduled meeting. The Finance and Audit Committee approves a motion to accept and forward to the Board of Directors the Form 990. Subsequently, the Finance and Audit Committee Board Chairperson (the organization's Board Treasurer) presents the Form 990 to the Board of Directors. Upon Board resolution to accept the Form 990 the Form 990 is filed with the Internal Revenue Service. Form 990, Part VI, Section B, Line 12c The organization annually distributes its Conflict of Interest Policy and Disclosure Form to Directors, Officers and key employees. The responses are reviewed by the Board of Directors and its counsel, and any appropriate action is taken, based upon those responses and the subsequent review. Form 990, Part VI, Section B, Line 15 Madonna Executive Compensation Plan The Executive Compensation Committee will make recommendations for the annual compensation of the Chief Executive Officer (CEO), and Chief Financial Officer (CFO). The Madonna Executive Compensation plan requires national salary benchmarks be used for the CEO and CFO positions. -Base Salary: the executive compensation committee annually determines the CEO's base salary by reviewing 990 data from nonprofit rehabilitation hospitals at a national level as well as other relevant data. Ideally, the data from nonprofit rehabilitation hospitals should be for hospitals within approximately plus or minus 50% of Madonna's gross revenues recognizing a need for a minimum of at least eight comparable sized institutions. The analysis includes reporting the salaries for benchmark firms (from 990 data) reported by the Vice President human resources. Other sources of information and data may be used as needed from third party salary surveys in addition to or in lieu of 990 data as deemed necessary from year to year. The annual compensation adjustment for the CEO and CFO is to represent both the market changes and the merit performance. Form 990, Part VI, Section C, Line 19 Summarized financial information is made available to the public on an annual basis through the publication of the Hospital's public annual report. In addition, the public annual report is available on the Hospital's website. The Hospital's governing documents and conflict of interest policy are not available to the public. Form 990, Part IX, Line 11g CONTRACT LABOR: TOTAL 5,970,203 PROGRAM 5,968,433 MANAGEMENT 1,770 FUNDRAISING 0. MAINTENANCE CONTRACTS: TOTAL 57,526 PROGRAM 57,526 MANAGEMENT 0 FUNDRAISING 0. MEDICAL SERVICE FEES: TOTAL 5,286,499 PROGRAM 5,286,499 MANAGEMENT 0 FUNDRAISING 0. MISCELLANEOUS OTHER: TOTAL 10,754,444 PROGRAM 8,631,066 MANAGEMENT 2,123,379 FUNDRAISING 0. TOTAL 11g: TOTAL 22,068,673 PROGRAM 19,943,524 MANAGEMENT 2,125,149 FUNDRAISING 0. Form 990, Part XI, Line 9 Change in temporarily restricted net assets. MADONNA FOUNDATION 5401 SOUTH ST LINCOLN NE 68506 237159940 FUNDRAISING SUPPORT NE 501 (c)(3) 12b (Type II) MADONNA REHABILITATION HOSPITALS 1 MADONNA INC 5401 SOUTH ST LINCOLN NE 68506 363397284 HEALTHCARE MANAGEMENT NE 501 (c)(3) 12b (Type II) MADONNA REHABILITATION HOSPITALS 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 1 MADONNA FOUNDATION l 195000 FINANCIAL RECORD MADONNA FOUNDATION m 1471126 FINANCIAL RECORD MADONNA FOUNDATION p 144224 FINANCIAL RECORD MADONNA FOUNDATION s 1115721 FINANCIAL RECORD MADONNA INC s -100 FINANCIAL RECORD