2026-07-08T07:47:50-05:00 2025-09-30 450250958 EIDE BAILLY LLP 18081 BURT ST STE 200 OMAHA NE 680224722 990 2024-10-01 470375220 MEMORIAL HEALTH CARE SYSTEMS MEMO 4026432971 300 N COLUMBIA AVE SEWARD NE 68434 GREG JERGER CHIEF FINANCIAL OFFICER 4026432971 2026-07-07 1 1 MEGAN L KOZIOL CPA P01544037 4023302660 2026-06-25 2024 2025-03-06 01:10:19Z GREG JERGER 300 N COLUMBIA AVE SEWARD NE 68434 69429595 0 X WWW.MHCS.US X 1947 NE PROVIDING EXCELLENCE IN HEALTH CARE SERVICES IN THE MOST APPROPRIATE SETTINGS. 7 7 323 14 0 0 369906 581296 43865604 47871295 2892877 3480283 -61159 157308 47067228 52090182 750000 250000 0 0 25571479 28159581 0 0 51791 17596846 18458508 43918325 46868089 3148903 5222093 102764564 109997556 5226499 6417842 97538065 103579714 X WE ENHANCE THE QUALITY OF LIFE FOR INDIVIDUALS IN OUR COMMUNITIES BY PROVIDING EXCELLENCE IN HEALTH CARE SERVICES IN THE MOST APPROPRIATE SETTINGS. 0 0 22836226 27924277 HOSPITAL OUTPATIENT SERVICES - THE HOSPITAL PROVIDES OUTPATIENT DIAGNOSTIC, THERAPEUTIC, SURGICAL AND EMERGENCY SERVICES TO THE COMMUNITY. THERE WERE APPROXIMATELY 41,490 OUTPATIENT VISITS THIS YEAR. 8316401 8528966 FAMILY PRACTICE PHYSICIAN CLINIC SERVICES - THE ORGANIZATION PROVIDES 9 BOARD CERTIFIED FAMILY PRACTICE PHYSICIANS AND 5 PHYSICIAN ASSISTANTS THAT STAFF THE CLINICS IN SEWARD, MILFORD AND UTICA. THESE CLINICS OFFER THE MAIN SOURCE OF PRIMARY CARE FOR THE COMMUNITY. THERE WERE APPROXIMATELY 28,180 OFFICE VISITS THIS YEAR. 5021725 6140596 HOSPITAL ACUTE INPATIENT, SKILLED NURSING AND ASSISTED LIVING SERVICES - THE HOSPITAL PROVIDES THREE DIFFERENT LEVELS OF INPATIENT SERVICES TO THE COMMUNITY TO MEET THE LEVEL OF CARE NEEDS FOR EACH PATIENT, INCLUDING DELIVERY AND NURSERY SERVICES. THERE WERE APPROXIMATELY 4,392 PATIENT DAYS THIS YEAR. 2566830 250000 5287476 FAMILY PHARMACY AND OTHER SERVICES. 2566830 250000 5287476 38741182 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 57 0 1 323 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 1 X GREG JERGER 4026432971 300 NORTH COLUMBIA AVE SEWARD NE 68434 MIKE HECKER CHAIRPERSON 8.00 X X 0 0 0 DONNA HAVENER VICE CHAIR 5.00 X X 0 0 0 MIKE TOMES SECRETARY/TREASURER 5.00 X X 0 0 0 LANA DAWS DIRECTOR 4.00 X 0 0 0 KEVIN WINGARD DIRECTOR 4.00 X 0 0 0 BRAD PERDUE DIRECTOR 4.00 X 0 0 0 MIKE FLYR DIRECTOR (BEG DEC 2025) 4.00 X 0 0 0 GREG JERGER CHIEF FINANCIAL OFFICER 55.00 X 392584 0 50088 ROGER REAMER CHIEF EXECUTIVE OFFICER 55.00 X 429992 0 48448 JAMES PLASEK PHYSICIAN 55.00 X 433091 0 60978 JOEL GABRIEL PHYSICIAN 55.00 X 345803 0 61332 JARED KETNER PHYSICIAN 55.00 X 378507 0 49841 CONNIE NOVAK PHYSICIAN 55.00 X 323344 0 60705 BRANDON HENLEY PHYSICIAN 55.00 X 373032 0 61332 2676353 0 392724 39 0 1 0 ACUTE CARE INC 1609 N ANKENY BLVD SUITE 200 ANKENY IA 50023 PHYSICIAN ER SERVICES 1047773 SAMPSON CONSTRUCTION COMPANY INC 5825 S 14TH STREET LINCOLN NE 68512 CONSTRUCTION SERVICES 494644 ONESTAFF MEDICAL LLC 10802 FARNAM DRIVE OMAHA NE 68154 CONTRACT NURSING SERVICES 426533 BRYAN MEDICAL CENTER 1600 S 48TH STREET LINCOLN NE 68506 MOBILE DIAGNOSTIC IMAGING 248361 TONNIGES ANESTHESIA 1301 OAK PRAIRIE CIRCLE LINCOLN NE 68528 CONTRACT ANESTHESIA SERVICES 221290 17 458115 85299 37882 581296 PATIENT SERVICE REVENUE 621400 42833974 42833974 PHARMACY REVENUE 456110 5037321 5037321 47871295 1943290 1943290 18876313 93 17325352 14061 1550961 -13968 1536993 1536993 DAY CARE REVENUE 624100 182235 182235 DIETARY REVENUE 623990 37592 37592 MISCELLANEOUS 624100 10020 10020 -72539 -72539 157308 52090182 47881315 0 3627571 X 250000 250000 963684 963684 20644756 17636344 2980322 28090 707465 598839 107474 1152 4424588 3648819 768492 7277 1419088 1171451 245766 1871 27086 27086 42208 42208 7879 7879 58732 58732 6041009 4315840 1723429 1740 75660 3169 71483 1008 2004367 1529742 466305 8320 11675 11675 535187 480579 54608 2860447 2545157 315290 376909 335365 41544 MEDICAL SUPPLIES 5855598 5855598 FOOD 219657 219657 DUES & SUBSCRIPTIONS 216541 45709 168833 1999 TRAINING & EDUCATION 103492 74973 28185 334 22061 22061 46868089 38741182 8075116 51791 2134 2760 33906744 30751325 5693061 5634743 36875 150208 711674 541692 527496 495918 54949434 37204811 19409598 17744623 33051096 43336784 9379981 10696993 45905 642510 102764564 109997556 3656531 3648032 1569968 2769810 5226499 6417842 X 88394868 94826119 9143197 8753595 97538065 103579714 102764564 109997556 X 5222093 1314040 -494484 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 7879 7879 0 PART II-B, LINE 1: A PORTION OF DUES PAID TO NHA, AHA, NRHA, NALA/NCAL AND THE CHAMBER OF COMMERCE IS DEDICATED TO LOBBYING ACTIVITIES. 2096374 1990 202892 100000 2201256 1787417 1350 392683 85076 2096374 1572334 16841 198242 1787417 2441843 1660 -370536 500633 1572334 2090776 3445 347622 2441843 0.00000 0.69970 0.30030 0 0 380521 380521 20864002 12955098 7908904 31800503 22858604 8941899 1904408 1391109 513299 17744623 590654 F BENEFICIAL INT - PERPETUAL TRUST 6552339 F LONG TERM CERTIFICATES OF DEPOSIT 3554000 C 10696993 ESTIMATED THIRD-PARTY SETTLEMENTS 798933 DEFERRED COMPENSATION LIABILITY 1808011 LEASE LIABILITY 162866 2769810 X 52601006 1314040 -744484 569556 52031450 58732 58732 52090182 46559357 0 46559357 58732 250000 308732 46868089 PART V, LINE 4: INCOME FROM THE HOSPITAL ENDOWMENT FUND WILL BE USED FOR MEMORIAL HOSPITAL TO ENHANCE AND IMPROVE THE QUALITY OF HOSPITAL SERVICES PROVIDED TO THE COMMUNITY. THIS COULD TAKE THE FORM OF KEEPING UP WITH CHANGING TECHNOLOGY, ACQUIRING THE BEST EQUIPMENT, OR IMPROVING OUR BUILDING FACILITIES. PART X, LINE 2: THE SYSTEM 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 SYSTEM 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. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN INTEREST IN BENEFICIAL TRUST -494,484. COMMUNITY DONATION -250,000. PART XII, LINE 4B - OTHER ADJUSTMENTS: COMMUNITY DONATION 250,000. 1 1 X 1 X 175.000000000000 1 X 1 1 0 0 154260 154260 0.00330 3595104 3553065 42039 0.00090 3749364 3553065 196299 0.00420 346729 346729 0.00740 346729 346729 0.00740 4096093 3553065 543028 0.01160 0 696017 48025 15821242 16539377 -718135 X 1 1 1 1 MEMORIAL HOSPITAL 300 N COLUMBIA AVE SEWARD NE 68434 WWW.MHCS.US 720001 X X X X MEMORIAL HEALTH CARE SYSTEMS 1 0 0 1 X X X X X X X X X 24 1 0 1 1 X WWW.MHCS.US/PATIENTS-VISITORS X 1 24 1 WWW.MHCS.US/PATIENTS-VISITORS 0 1 X 175.000000000000 300.000000000000 X X X 1 1 X X X 1 X WWW.MHCS.US/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE X WWW.MHCS.US/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE X WWW.MHCS.US/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 MEMORIAL HEALTH CARE SYSTEMS PART V, SECTION B, LINE 5: THERE WERE 15 INDIVIDUALS REPRESENTING VARIOUS AREA ORGANIZATIONS THAT COLLABORATED ON OUR CHNA. THE ORGANIZATIONS REPRESENTED A WIDE VARIETY OF COMMUNITY INTERESTS, INCLUDING HEALTH DEPARTMENTS, AGING SERVICES, HEALTH CARE SERVICES, CITY GOVERNMENT, COUNTY GOVERNMENT, SCHOOLS, AND OTHER COMMUNITY INTERESTS. THIS COMMUNITY TEAM USED A PROCESS DEVELOPED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AND THE NATIONAL ASSOCIATION FOR CITY AND COUNTY HEALTH OFFICIALS (NACCHO). THIS PROCESS IS CALLED MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP). A SURVEY WAS CONDUCTED AND DISTRIBUTED TO INDIVIDUALS THROUGHOUT THE COMMUNITY TO OBTAIN COMMUNITY WIDE INPUT. THE MAPP PROCESS AND THE SURVEY RESULTS WERE USED TO PRIORITIZE PUBLIC HEALTH ISSUES AND IDENTIFY RESOURCES FOR ADDRESSING THEM. MEMORIAL HEALTH CARE SYSTEMS PART V, SECTION B, LINE 6B: FOUR CORNERS HEALTH DEPARTMENT MEMORIAL HEALTH CARE SYSTEMS PART V, SECTION B, LINE 11: THERE WERE 5 HEALTH NEEDS IDENTIFIED IN THE NEEDS ASSESSMENT. MEMORIAL HEALTH CARE SYSTEMS (MHCS) DIRECTLY ADDRESSES ALL OF THESE 5 NEEDS AS FOLLOWS. 1. MENTAL HEALTH MEMORIAL HOSPITAL PROVIDES MENTAL HEALTH COUNSELING VIA TELEHEALTH AT THE MEMORIAL HOSPITAL SPECIALTY CLINIC GIVING PATIENTS READY ACCESS TO MENTAL HEALTH CARE CLOSE TO HOME. MEMORIAL HEALTH CARE SYSTEMS' (MHCS) FAMILY PRACTICE PROVIDERS LOCATED IN SEWARD, MILFORD AND UTICA, MANAGE PATIENTS' MENTAL HEALTH CARE NEEDS THROUGH DIAGNOSING AND TREATING MANY MENTAL HEALTH CONDITIONS. THEY CAN MAKE RECOMMENDATIONS FOR FURTHER TREATMENT FROM SPECIALISTS IF NEEDED. MHCS PROVIDES DEPRESSION SCREENING IN BOTH ITS HOSPITAL AND CLINICS TO IDENTIFY MENTAL HEALTH CONDITIONS AND DIRECT THE PATIENT TOWARDS APPROPRIATE CARE. MHCS HAS PARTNERED WITH SEWARD PUBLIC SCHOOLS, MILFORD PUBLIC SCHOOLS, CENTENNIAL PUBLIC SCHOOLS AND ESU5 TO OFFER A FULL-TIME LICENSED MENTAL HEALTH PRACTITIONER (LMHP) WITHIN THE SCHOOLS. THE LMHP IS VISIBLE AND PROACTIVE AT SCHOOLS TO HELP DESTIGMATIZE MENTAL HEALTH AND REDUCE ACCESS BARRIERS FOR STUDENTS AND THEIR FAMILIES. MHCS ALSO PARTNERS WITH BRYAN HEALTH TO USE A TELEHEALTH ASSESSMENT FOR ALL ER PATIENTS WHO MAY BE EVALUATED FOR MENTAL HEALTH ADMITTANCE AT A BRYAN FACILITY.2. CANCER - THE MEMORIAL HOSPITAL SPECIALTY CLINIC EMPLOYS THREE NURSES WITH CHEMOTHERAPY ADMINISTRATION CERTIFICATION. THIS GIVES PATIENTS CHEMOTHERAPY ADMINISTRATION ACCESS CLOSE TO HOME. MEMORIAL HOSPITAL PROVIDES CANCER SERVICES TO AREA PATIENTS APPROPRIATE FOR A CRITICAL ACCESS HOSPITAL. MEMORIAL HOSPITAL STAFF ARE TRAINED TO ADMINISTER INFUSION THERAPY ONSITE AND THE FACILITY IS EQUIPPED TO PROVIDE CARE TO PATIENTS RECEIVING CERTAIN CHEMOTHERAPY AND RELATED CANCER TREATMENTS. MEMORIAL HOSPITAL PROVIDES NUMEROUS SCREENING SERVICES TO DETECT CANCER AS EARLY AS POSSIBLE AND ASSIST IN PROVIDING INFORMATION REGARDING TREATMENT OPTIONS.3. POVERTY - MEMORIAL HOSPITAL IS COMMITTED TO CARING FOR OUR PATIENTS, INCLUDING PATIENTS WHO FINANCIALLY ARE UNABLE TO PAY FOR HOSPITAL SERVICES. PATIENTS ARE NOTIFIED OF OUR FINANCIAL ASSISTANCE POLICY THROUGH MULTIPLE RESOURCES. A SOCIAL DETERMINANTS OF HEALTH (SDOH) SCREENING IS ADMINISTERED TO EACH ER PATIENT. IF NEEDS ARE IDENTIFIED, RESOURCES ARE IDENTIFIED AND INFORMATION IS PROVIDED BASED ON SPECIFIC NEEDS WITH FOLLOW UP, IF REQUIRED. MHCS PARTICIPATES IN THE LOW-COST CHILDHOOD VACCINATION (VFC) PROGRAM. THE VFC OFFERS RECOMMENDED VACCINES TO ELIGIBLE CHILDREN FOR FREE OR REDUCED COST.4. AGING PROBLEMS - MHCS PROVIDES HIGHLY QUALIFIED PHYSICIANS SERVING THE ENTIRE COUNTY WHO SPECIALIZE IN FAMILY PRACTICE AND IN THE HEALTH ISSUE OF AGING PATIENTS. THE COMMUNITY'S AGING POPULATION ALSO HAS ACCESS TO SPECIALTY CARE WITHIN 13 SPECIALTIES LOCATED IN THE MEMORIAL HOSPITAL SPECIALTY CLINIC, WHICH ELIMINATES THE NEED TO TRAVEL FOR THESE SPECIALTY SERVICES. MEMORIAL HOSPITAL IS COMPRISED OF 24 BEDS PROVIDING INPATIENT ACUTE CARE/SWING BED REHABILITATION SERVICES TO PATIENTS OF ALL AGES WITH ACCESSIBILITY TO CARDIOPULMONARY, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY. MHCS THERAPY SERVICES PROVIDES FULL OUTPATIENT THERAPY SERVICES AS WELL. THE MHCS SOCIAL SERVICES DEPARTMENT GUIDES AGING PATIENTS TO OBTAIN APPROPRIATE RESOURCES, SERVICES AND LIVING ARRANGEMENTS FOLLOWING HOSPITALIZATION AND/OR REHABILITATION. MHCS CONTINUES TO SERVE AGING PATIENTS AND PROVIDE THE SERVICES THAT HAVE EARNED OUR RECOGNITION AS AN AGE-FRIENDLY HEALTH SYSTEM, AS AWARDED BY THE JOHN A. HARDFORD FOUNDATION, THE INSTITUTE FOR HEALTHCARE IMPROVEMENT, THE AMERICAN HOSPITAL ASSOCIATION AND THE CATHOLIC HEALTH ASSOCIATION.5. HEART DISEASE AND STROKE - THE MEMORIAL HOSPITAL PROVIDES AN EMERGENCY SERVICES DEPARTMENT WHICH IS ADEPT AT DIAGNOSING, TREATING, STABILIZING AND TRANSPORTING HEART AND STROKE PATIENTS WHEN NECESSARY. THE MEMORIAL HOSPITAL CARDIAC REHABILITATION DEPARTMENT OFFERS SERVICES TO PATIENTS AFFECTED BY HEART DISEASE. FOLLOWING THE AMERICAN HEART ASSOCIATION'S GUIDELINES, MEMORIAL HOSPITAL'S COMPREHENSIVE REHAB PROGRAM HELPS PATIENTS RECOVER AND REHABILITATE FROM HEART EVENTS IN A CONTROLLED, COMFORTABLE ENVIRONMENT. MHCS PROVIDES REGULAR EDUCATION ON HEART DISEASE AND STROKE THROUGH BLOG POSTS, PRESENTATIONS, ADVERTISING AND COMMUNITY EDUCATION EVENTS. MEMORIAL HOSPITAL'S SPECIALTY CLINIC PROVIDES THE COMMUNITY WITH THE EXPERTISE OF PHYSICIANS WHO SPECIALIZE IN CARDIOLOGY AND CARDIOVASCULAR SERVICES WITHOUT HAVING TO TRAVEL FOR THESE SERVICES. 4 1 - SEWARD FAMILY MEDICAL CENTER 250 N COLUMBIA AVE SEWARD NE 68434 RURAL HEALTH CLINIC 2 - SEWARD FAMILY PHARMACY 250 N COLUMBIA AVE SEWARD NE 68434 PHARMACY - CONVENIENCE OF PATIENT/EMPLOYEE 3 - MILFORD FAMILY MEDICAL CENTER 119 S C ST MILFORD NE 68405 RURAL HEALTH CLINIC 4 - UTICA FAMILY MEDICAL CENTER 100 4TH ST UTICA NE 68456 RURAL HEALTH CLINIC PART I, LINE 3C: THE HOSPITAL DOES NOT USE AN ASSET TEST OR OTHER THRESHOLD AS A FACTOR IN DETERMINING ELIGIBILITY FOR FREE FOR DISCOUNTED CARE. IN ADDITION TO FPG, THE ORGANIZATION ALSO USED MEDICAL INDIGENCY, INSURANCE STATUS AND UNDERINSURANCE STATUS. TO QUALIFY AS MEDICALLY INDIGENT, THE PATIENT MUST HAVE CURRENT UNPAID MEDICAL BILLS FOR SERVICES RENDERED WITHIN THE PAST SIX (6) MONTHS FROM THE DATE OF THE APPLICATION FROM ANY SOURCE IN EXCESS OF 30 PERCENT OF THE PATIENT'S HOUSEHOLD INCOME. PART I, LINE 7: CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. UNREIMBURSED MEDICAID ON LINE 7B WAS CALCULATED USING THE COSTING METHODS TO PREPARE THE COST REPORTS. COMMUNITY HEALTH IMPROVEMENT SERVICES, LINE 7E, ARE REPORTED BASED ON ACTUAL EXPENSES REPORTED IN THE GENERAL LEDGER. PART III, LINE 2: THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE ORGANIZATION DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSION BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THIS CLASS OF PATIENTS. PART III, LINE 3: THE ESTIMATED AMOUNT OF THE ORGANIZATION'S IMPLICIT PRICE CONCESSIONS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS CALCULATED BASED ON AN APPROXIMATE 6.9% OF INDIVIDUALS LIVING BELOW THE POVERTY LEVEL IN THE SERVICE AREA. PART III, LINE 4: THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES IMPLICIT PRICE CONCESSIONS IS LOCATED IN FOOTNOTE 1 ON PAGES 12 AND 13 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: THE ENTIRE MEDICARE SHORTFALL IS CONSIDERED A COMMUNITY BENEFIT. SERVICES ARE PROVIDED TO PATIENTS UNDER THE MEDICARE PROGRAM EVEN THOUGH THE HOSPITAL KNOWS THEY WILL NOT RECOVER ALL OF THE COSTS FROM PROVIDING THE SERVICES. THIS PROGRAM IS CONSIDERED SUBSIDIZED BY THE HOSPITAL AND OTHER PAYORS. PATIENTS RELY ON THESE SERVICES FOR THEIR HEALTH AND WELL-BEING AND ARE ESSENTIAL FOR THEIR ACCESS TO HEALTHCARE. TOTAL REVENUE RECEIVED FROM MEDICARE IS THE GROSS REIMBURSEMENT PLUS SETTLEMENT. BOTH TOTAL REVENUE RECEIVED FROM MEDICARE AND THE MEDICARE ALLOWABLE COSTS ARE REPORTED FROM THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CENTERS FOR MEDICARE AND MEDICAID SERVICES. PART III, LINE 9B: PATIENTS THAT ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE EITHER RECEIVE FREE EMERGENCY AND URGENT CARE IN THE HOSPITAL IF THEY ARE AT OR BELOW 175% OF POVERTY, OR A SLIDING DISCOUNT IF THEY ARE AT OR BELOW 300% OF POVERTY. SHOULD THESE PATIENTS OWE A PORTION OF THEIR BILL, THE ORGANIZATION FOLLOWS THE SAME COLLECTION POLICY AS IT DOES FOR PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE. THE PROCESS IS: 1) STATEMENTS ARE SENT MONTHLY; 2) PHONE CONTACT IS MADE AFTER 30-35 DAYS IF NO PAYMENT FROM FIRST STATEMENT; 3) IF THE PATIENT CANNOT PAY FULL BALANCE, MONTHLY PAYMENT ARRANGEMENTS ARE OFFERED; 4) AFTER 120 DAYS FROM FIRST STATEMENT THE ACCOUNT MAY BE SENT TO A COLLECTION AGENCY. PART VI, LINE 2: THE ORGANIZATION IS GOVERNED BY A VOLUNTEER BOARD OF DIRECTORS WHICH HAS 7 MEMBERS FROM THE COMMUNITY. THE BOARD OF DIRECTORS ASSISTS HOSPITAL ADMINISTRATION IN IDENTIFYING SERVICES NEEDED BY THE COMMUNITIES SERVED. PART VI, LINE 3: THE BUSINESS OFFICE IS EDUCATED ON HOW TO INFORM PATIENTS ABOUT THE PROCESS OF APPLYING FOR MEDICAID COVERAGE. OUR FINANCIAL ASSISTANCE POLICY, FAP SUMMARY AND FINANCIAL ASSISTANCE APPLICATION ARE ALL LISTED ON THE ORGANIZATION'S WEB-SITE. A COPY OF THE FAP SUMMARY IS INCLUDED WITH THE FINANCIAL AGREEMENT EACH PATIENT SIGNS UPON ADMISSION TO THE HOSPITAL. A NOTICE OF THE AVAILABILITY OF FINANCIAL ASSISTANCE IS ALSO INCLUDED ON ALL BILLING STATEMENTS SENT TO PATIENTS. PART VI, LINE 4: THE ORGANIZATION'S PRIMARY SERVICE AREA IS SEWARD COUNTY, NEBRASKA, WHICH HAS A POPULATION OF AROUND 17,000. IT MAINLY PROVIDES PRIMARY CARE SERVICES WITH SOME SPECIALTY CARE OFFERED BY VISITING SPECIALISTS THAT PRACTICE HERE MAINLY OUT OF LINCOLN, NEBRASKA. PART VI, LINE 5: THE ORGANIZATION OFFERS EXTENSIVE HEALTHCARE AND WELLNESS EDUCATION TO THE COMMUNITY ON AN ON-GOING BASIS. THE HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF AND HAS A GOVERNING BOARD OF DIRECTORS WHO ARE ALL MEMBERS OF THE COMMUNITY SERVED. ALL SURPLUS FUNDS ARE USED TO FURTHER THE MISSION OF PROVIDING EXCELLENT HEALTHCARE SERVICES TO THE MEMBERS OF THE COMMUNITIES SERVED. 1 SEWARD CHANGING THE GAME INC 612 SEWARD ST SEWARD NE 68434 831355502 501(C)(3) 250000 0 CONSTRUCTION OF A WELLNESS CENTER 1 0 PART I, LINE 2: THE ORGANIZATION PROVIDES GRANT FUNDS TO CLOSE COMMUNITY PARTNERS AND MONITORS THEIR USE THROUGHOUT THE CONSTRUCTION PHASES OF THE WELLNESS CENTER. X 1 1 X X 0 0 0 1 0 0 0 0 0 JAMES PLASEK PHYSICIAN 242745 0 190208 0 138 0 13800 0 49853 0 496744 0 0 0 ROGER REAMER CHIEF EXECUTIVE OFFICER 374069 0 55923 0 0 0 13800 0 36105 0 479897 0 0 0 GREG JERGER CHIEF FINANCIAL OFFICER 339876 0 52708 0 0 0 13800 0 37725 0 444109 0 0 0 BRANDON HENLEY PHYSICIAN 242745 0 130219 0 68 0 13800 0 50607 0 437439 0 0 0 JARED KETNER PHYSICIAN 242745 0 135504 0 258 0 13800 0 38718 0 431025 0 0 0 JOEL GABRIEL PHYSICIAN 242745 0 102998 0 60 0 13800 0 50160 0 409763 0 0 0 CONNIE NOVAK PHYSICIAN 242745 0 80461 0 138 0 13173 0 50245 0 386762 0 0 0 PART I, LINE 1A THE ORGANIZATION PROVIDES A SECTION 162 BONUS PLAN IN WHICH THE CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER RECEIVE TAXABLE COMPENSATION ON AN ANNUAL BASIS TO PURCHASE LIFE INSURANCE, DISABILITY INSURANCE, AND/OR OTHER INSURANCE BENEFITS. THE BONUS PLAN AND AMOUNT WERE ESTABLISHED BY THE BOARD OF DIRECTORS AND ARE GROSSED-UP PER THE PLAN DESIGN IN ORDER TO PROVIDE A FIXED AMOUNT AFTER TAXES THAT IS AVAILABLE FOR INSURANCE PREMIUMS. THE FULL TAXABLE AMOUNT IS INCLUDED IN BOX 5 OF THE W-2 AND HAS BEEN INCLUDED IN PART II OF THIS SCHEDULE J UNDER COLUMN B(II). PART I, LINE 5 PHYSICIANS RECEIVE BONUSES BASED ON THEIR INDIVIDUAL PROFESSIONAL CHARGES. FORM 990, PART VI, SECTION A, LINE 6 MEMORIAL HEALTH CARE SYSTEMS IS A CORPORATION THAT HAS MEMBERS. ANYONE DONATING $100 TO MEMORIAL HEALTH CARE SYSTEMS CAN FILL OUT AN APPLICATION AND BECOME A MEMBER. MEMORIAL HEALTH CARE SYSTEMS CURRENTLY HAS 651 CORPORATE MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF MEMORIAL HEALTH CARE SYSTEMS (AS DESCRIBED ON FORM 990, PART VI, SECTION A, LINE 6) ELECT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS OF MEMORIAL HEALTH CARE SYSTEMS (AS DESCRIBED ON FORM 990, PART VI, SECTION A, LINE 6) APPROVE ANY CHANGES IN THE ARTICLES OF INCORPORATION AND ANY CHANGES TO THE BYLAWS THAT EFFECT THE ELECTION OF THE BOARD OF DIRECTORS (VOTING RIGHTS). THE MEMBERS WOULD ALSO APPROVE ANY SIGNIFICANT DECISIONS, SUCH AS THE SALE OR MERGER OF THE CORPORATION OR A SALE OF ALL OF THE ASSETS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 8B THERE ARE NO COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE BOARD. ANY COMMITTEE WHICH REPORTS TO THE BOARD HAS ITS REPORT DOCUMENTED IN THE MINUTES OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE CHIEF FINANCIAL OFFICER IS RESPONSIBLE FOR THE TIMELY FILING OF THE FORM 990. THE ACTUAL FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. ALL INFORMATION IS PROVIDED BY THE ORGANIZATION TO THE ACCOUNTING FIRM WHO THEN PREPARES THE FORM 990 FOR SUBMITTAL TO THE IRS. PRIOR TO SUBMISSION TO THE IRS, A FULL COPY OF THE FORM 990 IS MADE AVAILABLE TO ALL BOARD MEMBERS. THE FORM 990 IS REVIEWED BY THE FINANCE COMMITTEE AT A REGULAR FINANCE COMMITTEE MEETING. THIS REVIEW MAY TAKE PLACE AFTER THE FORM 990 HAS BEEN FILED WITH THE IRS IN ORDER TO MEET THE FILING DEADLINE. THE FINANCE COMMITTEE REVIEW IS DOCUMENTED IN THE FINANCE COMMITTEE MINUTES WHICH ARE THEN APPROVED BY THE FULL BOARD AT THE NEXT REGULAR BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C EACH MEMBER OF THE BOARD OF DIRECTORS AND ALL SENIOR MANAGEMENT OFFICIALS OF THE ORGANIZATION FILE AN ANNUAL CONFLICT OF INTEREST FORM IN WHICH THEY ARE REQUIRED TO LIST ALL CONFLICTS OF INTEREST. ADMINISTRATION REVIEWS THE ANNUAL CONFLICT OF INTEREST STATEMENTS AND ALL CONFLICTS ARE REPORTED TO THE BOARD CHAIRPERSON. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS PERFORMS AN ANALYSIS OF THE FAIR MARKET VALUE OF COMPENSATION FOR BOTH THE CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER. LONGEVITY, QUALITY OF THE HEALTHCARE SERVICES PROVIDED, COMMUNITY PERCEPTION, AND FINANCIAL PERFORMANCE ARE ALL FACTORED INTO THE ANALYSIS. THE BOARD OF DIRECTORS THEN APPROVES THE COMPENSATION PACKAGES. THE LAST FULL REVIEW AND ANALYSIS WAS DONE IN OCTOBER 2023 AND ANNUAL COMPENSATION WAS SET UNDER THE CEO CONTRACT FOR A 3 YEAR PERIOD OF 2024 THROUGH 2026. THE CFO COMPENSATION WAS REVIEWED BY THE BOARD OF DIRECTORS AT THE SAME TIME AND THE CEO WAS DELEGATED THE AUTHORITY TO ADJUST AND MONITOR CFO COMPENSATION WITHIN THE PARAMETERS SET BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR ITS FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC. HOWEVER, THE CORPORATE MEMBERSHIP OF THE ORGANIZATION CONSISTS OF 651 MEMBERS OF THE COMMUNITY SERVED. THE CORPORATE MEMBERSHIP APPROVES THE ARTICLES OF INCORPORATION. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 3,465,681. MANAGEMENT AND GENERAL EXPENSES 1,723,429. FUNDRAISING EXPENSES 1,740. TOTAL EXPENSES 5,190,850. EMERGENCY ROOM PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 850,159. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 850,159. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN BENEFICIAL TRUST -494,484. FORM 990, PART XI, LINE 2C: THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. SEWARD URGENT CARE PARTNERSHIP LLC 2222 S 16TH STREET LINCOLN NE 68502 923319265 URGENT CARE NE MEMORIAL HEALTH CARE SYSTEMS RELATED -209899 414943 0 1 0.50000 CHARITABLE TRUST TRUST NE MEMORIAL HEALTH CARE SYSTEMS 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 CHARITABLE TRUST C 458115 CASH TRANSFERRED EQUALS FMV SEWARD URGENT CARE PARTNERSHIP LLC B 280000 CASH TRANSFERRED EQUALS FMV