2024-07-02T09:29:17-05:00 2023-09-30 450250958 EIDE BAILLY LLP 18081 BURT ST STE 200 OMAHA NE 680224722 990 2022-10-01 470375220 MEMORIAL HEALTH CARE SYSTEMS MEMO 4026432971 300 N COLUMBIA AVE SEWARD NE 68434 GREG JERGER CHIEF FINANCIAL OFFICER 4026432971 2024-07-01 1 GREG JERGER 999009999 1 MEGAN L KOZIOL CPA P01544037 4023302660 2024-07-01 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z GREG JERGER 300 N COLUMBIA AVE SEWARD NE 68434 48224441 0 X WWW.MHCS.US X 1947 NE WE PROVIDE HOSPITAL ACUTE INPATIENT, SKILLED NURSING, AND OUTPATIENT SERVICES FOR THE RESIDENTS OF OUR COMMUNITY. WE PROVIDE FAMILY PRACTICE PHYSICIAN CLINIC SERVICES TO THE COMMUNITIES IN OUR SERVICE AREA. 7 7 313 23 0 0 2161507 1098519 42708073 44336837 1702220 1853419 250134 469203 46821934 47757978 0 0 0 0 23853708 24836170 0 0 58995 17020135 16653090 40873843 41489260 5948091 6268718 88992285 96622421 5353996 5146749 83638289 91475672 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 20382597 25581401 HOSPITAL OUTPATIENT SERVICES - THE HOSPITAL PROVIDES OUTPATIENT DIAGNOSTIC, THERAPEUTIC, SURGICAL AND EMERGENCY SERVICES TO THE COMMUNITY. THERE WERE APPROXIMATELY 39,592 OUTPATIENT VISITS THIS YEAR. 7646632 8269834 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 30,857 OFFICE VISITS THIS YEAR. 5166691 6484512 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 4,523 PATIENT DAYS THIS YEAR. 1770054 4025155 FAMILY PHARMACY AND OTHER SERVICES. 1770054 4025155 34965974 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 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 49 0 1 313 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 0 X GREG JERGER 4026432971 300 NORTH COLUMBIA AVE SEWARD NE 68434 MIKE HECKER CHAIRPERSON 6.00 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 JOHN HUGHES DIRECTOR THRU 12/22 4.00 X 0 0 0 LANA DAWS DIRECTOR 4.00 X 0 0 0 JILL EBERSPACHER 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 GREG JERGER CHIEF FINANCIAL OFFICER 55.00 X 367166 0 52449 ROGER REAMER CHIEF EXECUTIVE OFFICER 55.00 X 387283 0 51349 JAMES PLASEK MEDICAL DOCTOR 55.00 X 434760 0 66137 JOEL GABRIEL MEDICAL DOCTOR 55.00 X 320201 0 66348 JARED KETNER MEDICAL DOCTOR 55.00 X 344067 0 66139 TRISHA SAMS MEDICAL DOCTOR 55.00 X 307039 0 65990 CONNIE NOVAK MEDICAL DOCTOR 55.00 X 306014 0 65944 2466530 0 434356 37 0 1 0 ACUTE CARE INC 1609 N ANKENY BLVD SUITE 200 ANKENY IA 50023 PHYSICIAN ER SERVICES 904406 MAXIM HEALTHCARE SERVICES 7227 LEE DEFOREST DRIVE COLUMBIA MD 21046 CONTRACT NURSING SERVICES 481070 SAMPSON CONSTRUCTION COMPANY INC 5825 S 14TH STREET LINCOLN NE 68512 CONSTRUCTION SERVICES 449407 ENGINEERED CONTROLS 10703 J STREET OMAHA NE 68127 HVAC MAINTENANCE & REPAIRS 437638 MEDICAL INFORMATION TECHNOLOGY INC MEDITECH CIRCLE WESTWOOD MA 02090 SOFTWARE MAINTENANCE SERVICES 376505 15 746341 272198 79980 15321 1098519 MEDICARE 621400 21376785 21376785 COMMERICAL PAYORS & SELF PAY 621400 21298316 21298316 MEDICAID 621400 1661736 1661736 44336837 1034028 1034028 996265 289589 424668 41795 571597 247794 819391 819391 JOINT VENTURE INCOME 624100 279190 279190 DAY CARE REVENUE 624100 141772 141772 DIETARY REVENUE 623990 24176 24176 24065 24065 469203 47757978 44360902 0 2298557 X 858247 858247 18790684 15768728 2993160 28796 671732 571389 99178 1165 3260265 2691275 562885 6105 1255242 1036357 217030 1855 22643 22643 37751 37751 29821 29821 4935370 4373262 560368 1740 135390 1840 132527 1023 1796983 1415807 364968 16208 6167 6167 536573 479954 56619 3067573 2729453 338120 308550 274540 34010 MEDICAL SUPPLIES 5296260 5296260 FOOD 189100 189100 DUES & SUBSCRIPTIONS 168531 42315 124392 1824 TRAINING & EDUCATION 93684 67000 26405 279 28694 28694 41489260 34965974 6464291 58995 2131 2133 36624574 35225670 5300529 6174146 56250 49375 729225 660452 401050 601905 53307558 32718076 20963746 20589482 14503391 24205076 10411389 9114182 88992285 96622421 2961965 3313664 2392031 1833085 5353996 5146749 X 76183566 83125863 7454723 8349809 83638289 91475672 88992285 96622421 X 6268718 888662 680003 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 6558 6558 0 PART II-B, LINE 1: A PORTION OF DUES PAID TO NHA, AHA, NALA/NCAL AND THE CHAMBER OF COMMERCE IS DEDICATED TO LOBBYING ACTIVITIES. 1572334 16841 198242 1787417 2441843 1660 -370536 500633 1572334 2090776 3445 347622 2441843 1937298 1288 152190 2090776 1898604 626 38068 1937298 0.00000 0.85985 0.14015 0 0 380521 380521 19932178 11384199 8547979 30732353 20123130 10609223 2262506 1210747 1051759 20589482 702357 F BENEFICIAL INT - PERPETUAL TRUST 6562392 F LONG TERM CERTIFICATES OF DEPOSIT 1849433 C 9114182 ESTIMATED THIRD-PARTY SETTLEMENTS 520039 DEFERRED COMPENSATION LIABILITY 1313046 1833085 X 49296822 888662 680003 1568665 47728157 29821 29821 47757978 41459439 0 41459439 29821 29821 41489260 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 ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN TOPIC 740 OF THE ACCOUNTING STANDARDS CODIFICATION, INCOME TAXES. THE SYSTEM RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT SEPTEMBER 30, 2023 AND 2022, THE SYSTEM HAD NO UNCERTAIN TAX POSITIONS ACCRUED. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN INTEREST IN BENEFICIAL TRUST 680,003. 1 1 X 1 X 175.000000000000 1 X 1 1 0 0 126421 126421 0.00300 2619577 2096728 522849 0.01260 2745998 2096728 649270 0.01560 2745998 2096728 649270 0.01560 0 599174 0 15932606 16410925 -478319 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 21 1 0 1 1 X WWW.MHCS.US/PATIENTS-VISITORS X 1 21 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 A TOTAL OF 19 INDIVIDUALS THAT COLLABORATED ON OUR CHNA. THESE INDIVIDUALS REPRESENTED A WIDE VARIETY OF COMMUNITY INTERESTS, INCLUDING HEALTH DEPARTMENTS, PUBLIC SCHOOLS, PHYSICIANS PRACTICES, MENTAL HEALTH, NURSING HOMES, AND VARIOUS COMMUNITY REPRESENTATIVES. THIS COMMUNITY TEAM USED A PROCESS DEVELOPED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AND THE NATIONAL ASSOCIATION OF CITY AND COUNTY HEALTH OFFICIALS (NACCHO). THIS PROCESS IS CALLED MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) AND IT WAS 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 - MHCS ARRANGES FOR A BEHAVIORAL HEALTH PRACTITIONER TO REGULARLY HOLD CLINICS AT THE MEMORIAL HOSPITAL SPECIALTY CLINIC. THIS PROVIDES VITAL ACCESS TO MENTAL HEALTH CARE CLOSE TO HOME. OUR FAMILY PRACTICE PHYSICIANS CAN ALSO RECOGNIZE MENTAL HEALTH COMPLICATIONS DURING VISITS AND REFER TO APPROPRIATE SOURCES FOR ADDITIONAL TREATMENT. 2. CANCER - MHCS STAFF IS TRAINED TO ADMINISTER INFUSION THERAPY AND PROVIDE CARE TO PATIENTS RECEIVING CHEMOTHERAPY AND RELATED CANCER TREATMENTS. MHCS ALSO PROVIDES CANCER SCREENING SERVICES TO THE COMMUNITY. 3. AGING ISSUES - MHCS PROVIDES PRIMARY CARE HOSPITAL INPATIENT, HOSPITAL OUTPATIENT, EMERGENCY DEPARTMENT, AND PHYSICIAN SERVICES TO THE AGING POPULATION IN ITS COMMUNITY. MHCS ARRANGES FOR VARIOUS SPECIALISTS TO PROVIDE ON-SITE VISITS TO THIS POPULATION FOR SPECIALTY CARE. MHCS PROVIDES TRAINED SOCIAL SERVICE WORKERS THAT ACT AS A VITAL RESOURCE TO THIS POPULATION. 4. HEART DISEASE & STROKE - MHCS PROVIDES REGULAR EDUCATION ON HEART DISEASE & STROKE. MHCS PROVIDES A SPECIALTY PHYSICIAN CLINIC WITH PHYSICIAN SPECIALISTS IN THESE AREAS. MHCS'S EMERGENCY DEPARTMENT IS WELL EQUIPPED & TRAINED, AND PREPARED TO PROVIDE EMERGENCY TREATMENT. 5. HIGH BLOOD PRESSURE - MHCS PROVIDES FAMILY PRACTICE PHYSICIANS TRAINED TO IDENTIFY AND TREAT HIGH BLOOD PRESSURE. MHCS PROVIDES A SPECIALTY PHYSICIAN CLINIC WITH PHYSICIAN SPECIALISTS IN THIS AREA. MHCS PROVIDES AN ANNUAL HEALTH FAIR WITH SCREENING, AND PROVIDES REGULAR PATIENT EDUCATION. 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. PART I, LINE 6A: THE ORGANIZATION DID NOT PREPARE A COMMUNITY BENEFIT REPORT DURING THE YEAR. PART I, LINE 7: THE ORGANIZATION USED THE COST-TO-CHARGE RATIO FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, PROVIDED BY THE IRS IN THE INSTRUCTIONS OF FORM 990, SCHEDULE H. PART I, LINE 7G: THERE ARE NO COSTS REPORTED ON LINE 7G. THEREFORE, THERE WOULD BE NO COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC INCLUDED ON LINE 7G. PART II, COMMUNITY BUILDING ACTIVITIES: THERE ARE NO COMMUNITY BUILDING ACTIVITIES TO REPORT. PART III, LINE 2: THE SYSTEM DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION EXPERIENCE WITH VARIOUS CLASSES OF PATIENTS. PART III, LINE 3: NONE OF THE ORGANIZATION'S IMPLICIT PRICE CONCESSIONS ARE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THEREFORE, THERE WOULD BE NO COSTS INCLUDED AS A COMMUNITY BENEFIT. PART III, LINE 4: THE HOSPITAL'S FINANCIAL STATEMENTS CONTAIN A FOOTNOTE, "NET PATIENT SERVICE REVENUE," DESCRIBING IMPLICIT PRICE CONCESSIONS ON PAGES 10 AND 11 OF THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE ORGANIZATION USED VARIOUS WORKSHEETS FROM THE MEDICARE COST REPORT FOR THE YEAR ENDED SEPTEMBER 30, 2023 TO CALCULATE PART III, LINES 5 AND 6. MEDICARE CURRENTLY PAYS CRITICAL ACCESS HOSPITALS (CAH) 101% OF ALLOWABLE COSTS. MEDICARE PAYS THE ORGANIZATION'S RURAL HEALTH CLINICS (RHC) AT COST SUBJECT TO CERTAIN LIMITS. THERE IS GENERALLY NO MEDICARE SHORTFALL ON CAH SERVICES EXCEPT FOR SEQUESTRATION. THE SHORTFALL IS MAINLY GENERATED BY NON-RHC PHYSICIAN SERVICES THAT ARE PAID UNDER THE MEDICARE FEE SCHEDULE. MEDICARE SHORTFALLS IN PAYMENT SHOULD BE CONSIDERED A COMMUNITY BENEFIT AS IT IS PART OF THE ORGANIZATION'S MISSION TO PROVIDE THESE SERVICES EVEN IF MEDICARE REIMBURSEMENT IS BELOW COST. 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 COSTS FOR THESE SERVICES ARE NOT SEPARATELY IDENTIFIED AS "COMMUNITY BENEFIT" EXPENSES ELSEWHERE IN THIS RETURN. IT IS LIKELY THESE COSTS EXCEED $100,000 PER YEAR, AND THERE IS NO OFFSETTING REVENUE. 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. PART VI, LINE 6: THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. X 1 1 X X X 0 0 0 1 0 0 0 0 0 JAMES PLASEK MEDICAL DOCTOR 226159 0 208511 0 90 0 12200 0 53937 0 500897 0 0 0 ROGER REAMER CHIEF EXECUTIVE OFFICER 338516 0 48767 0 0 0 12200 0 39149 0 438632 0 0 0 GREG JERGER CHIEF FINANCIAL OFFICER 321152 0 46014 0 0 0 12200 0 40249 0 419615 0 0 0 JARED KETNER MEDICAL DOCTOR 226159 0 117650 0 258 0 12200 0 53939 0 410206 0 0 0 JOEL GABRIEL MEDICAL DOCTOR 226159 0 93982 0 60 0 12200 0 54148 0 386549 0 0 0 TRISHA SAMS MEDICAL DOCTOR 226159 0 80790 0 90 0 12200 0 53790 0 373029 0 0 0 CONNIE NOVAK MEDICAL DOCTOR 226159 0 79717 0 138 0 12200 0 53744 0 371958 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 676 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 AUGUST 2018 AND ANNUAL COMPENSATION WAS SET UNDER THE CEO CONTRACT FOR A 5 YEAR PERIOD OF 2019 THROUGH 2023. 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 676 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 3,545,245. MANAGEMENT AND GENERAL EXPENSES 560,368. FUNDRAISING EXPENSES 1,740. TOTAL EXPENSES 4,107,353. EMERGENCY ROOM PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 828,017. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 828,017. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN BENEFICIAL TRUST 680,003. 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. CHARITABLE TRUST TRUST NE MEMORIAL HEALTH CARE SYSTEMS 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 CHARITABLE TRUST C 746341 CASH TRANSFERRED EQUALS FMV