2024-11-14T11:03:19-06:00 2023-12-31 470617373 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2023-01-01 470426285 MEMORIAL COMMUNITY HOSPITAL MEMO 4024262182 810 NORTH 22ND STREET BLAIR NE 68008 TIM SCHNACK VP OPERATIONAL FINANCE & CFO 4024261295 2024-11-14 1 0 MARK STOCKI P00642127 3032989100 2023 2024-10-15 13:58:12Z JENNIFER NEWBY 810 NORTH 22ND STREET BLAIR NE 68008 54142596 0 X WWW.MCHHS.ORG X 1956 NE AS AN ENGAGED TEAM OF PHYSICIANS, MEDICAL PROFESSIONALS, AND SUPPORT STAFF WE ARE COMMITTED TO DELIVERING STATE-OF-THE-ART HEALTH CARE TAILORED TO OUR UNIQUE COMMUNITY AND SECOND TO NONE IN THE AREA. 8 7 341 8 0 0 1205943 365246 45922708 50570975 130336 401719 1187314 2785495 48446301 54123435 0 0 0 0 26138601 27425875 0 0 0 18166396 19603487 44304997 47029362 4141304 7094073 56664523 63204493 12573653 11549306 44090870 51655187 X AS A COMMUNITY HOSPITAL, MEMORIAL COMMUNITY HOSPITAL AND HEALTH SYSTEM OF BLAIR HAS STAYED COMMITTED TO KEEPING RESIDENTS OF WASHINGTON AND BURT COUNTY IN GOOD HEALTH. MEMORIAL COMMUNITY HOSPITAL HAS STRIVEN TO IMPROVE THE HEALTH STATUS OF RURAL NEBRASKA RESIDENTS THROUGH THE FOLLOWING SERVICES: 24-HOUR EMERGENCY CARE WITH HELIPORT ACCOMMODATIONS, LABOR AND DELIVERY AND CARDIOVASCULAR. CARDIOVASCULAR SERVICES INCLUDE THE FOLLOWING NON-INVASIVE DIAGNOSTICS STUDIES SUCH AS EKG, TELEMETRY MONITORING, TREADMILL STRESS TESTING, ECHO CARDIOGRAM, AND STRESS ECHO CARDIOGRAM. MEMORIAL COMMUNITY HOSPITAL AND HEALTH SYSTEM PROVIDES A VARIETY OF SPECIALTY CLINICS LOCATED IN BLAIR. ALLERGY/ASTHMA/IMMUNOLOGY, PAIN MANAGEMENT/ANESTHESIA, CARDIOLOGY, ENDOCRINOLOGY, ENT, GENERAL SURGERY, OB/GYN, NEPHROLOGY, NEUROLOGY, NEUROSURGERY, ONCOLOGY, ORTHOPEDICS, ORTHOTICS/PROSTHETICS, PLASTIC SURGERY, DERMATOLOGY, AND PODIATRY. 0 0 5971164 8736167 MEMORIAL COMMUNITY HOSPITAL OF BLAIR PROVIDES HEALTH CLINICS FOR THE RESIDENTS OF BLAIR AND SURROUNDING COMMUNITIES WITH HEALTH CARE PROVIDERS IN A VARIETY OF MEDICAL SPECIALTIES. THE HEALTH CLINICS REVENUE OF $8,736,167 IS THE GROSS REVENUE AFTER CONTRACTUAL ADJUSTMENTS. 1799383 4114911 MEMORIAL COMMUNITY HOSPITAL OF BLAIR PROVIDES THE RESIDENTS OF BLAIR AND SURROUNDING COMMUNITIES 24 HOUR EMERGENCY ROOM SERVICES. THE EMERGENCY SERVICES REVENUE OF $4,114,911 IS THE GROSS REVENUE AFTER CONTRACTUAL ADJUSTMENTS. 2273364 5177402 MEMORIAL COMMUNITY HOSPITAL OF BLAIR PROVIDES THE RESIDENTS OF BLAIR AND SURROUNDING COMMUNITIES WITH A VARIETY OF THERAPY SERVICES, INCLUDING PHYSICAL AND OCCUPATIONAL THERAPY, SPEECH THERAPY, SLEEP STUDIES, AND RESPIRATORY THERAPY. THE THERAPY SERVICES REVENUE OF $5,177,402 IS THE GROSS REVENUE AFTER CONTRACTUAL ADJUSTMENTS. 23748361 32542495 23748361 32542495 33792272 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 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 0 0 0 0 0 1 1 1 0 0 1 12 0 1 341 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 7 0 1 0 0 1 1 0 1 1 0 0 0 1 1 1 0 1 0 1 1 0 X JENNIFER NEWBY 4024262182 810 NORTH 22ND STREET BLAIR NE 68008 X JOHN SIMONSON MD BOARD MEMBER/PHYSICIAN 40.00 0.00 X 312627 0 8465 SARAH CHATT TREASURER 1.00 0.00 X X 0 0 0 NEIL SMITH SECRETARY 1.00 0.00 X X 0 0 0 KYLE ACRE CHAIR 1.00 1.00 X X 0 0 0 SANDRA BAUMBERGER MD BOARD MEMBER/PHYSICIAN 40.00 0.00 X 277694 0 13073 ROBIN CONYERS BOARD MEMBER 1.00 0.00 X 0 0 0 GREGG DRABEK MD VICE CHAIR 25.00 0.00 X X 0 0 0 LORI NAHNSEN BOARD MEMBER 1.00 0.00 X 0 0 0 MANUELA WOLF PRESIDENT & CEO 40.00 1.00 X 0 0 0 TIM SCHNACK FORMER CFO (TERMED 09/23) 40.00 1.00 X 0 0 0 JENNIFER NEWBY CFO 40.00 1.00 X 0 0 0 KEVIN SISK MD PHYSICIAN 40.00 0.00 X 539665 0 11423 TONY TRAN CRNA 40.00 0.00 X 360131 0 13073 JEREMY LEE MD PHYSICIAN 40.00 0.00 X 372311 0 4469 SANTOSH KUMAR MD PHYSICIAN 40.00 0.00 X 357826 0 14216 AMANDA DUXBURY MD PHYSICIAN 40.00 0.00 X 308553 0 11503 2528807 0 76222 53 0 1 1 CHI HEALTH 198 INVERNESS DR WEST ENGLEWOOD CO 80112 MGMT FEES/HEALTH SVCS 1631005 RURAL PARTNERS IN MEDICINE 11880 AIRPORT WAY BROOMFIELD CO 80021 MEDICAL SERVICES 1063319 SIGNATURE PERFORMANCE 10330 REGENCY PARKWAY DR 335 OMAHA NE 68114 BUSINESS OFFICE SERVICES 942146 PSYCHIATRIC MEDICAL CARE LLC 111 N 181ST ST 203 ELKHORN NE 68022 MEDICAL SERVICES 504928 ALEGENT CREIGHTON HEALTH 12809 WEST DODGE RD OMAHA NE 68154 MEDICAL SERVICES 409652 24 102160 263011 75 365246 NET PATIENT REVENUE 621110 50570975 50570975 50570975 419650 419650 117193 1230 115963 115963 115963 17931 -17931 -17931 -17931 PHARMACY 456110 2532626 2532626 DIETARY 621110 72512 72512 OTHER MISC REVENUES 900099 64394 64394 2669532 54123435 50570975 0 3187214 23024309 16402457 6621852 518360 369278 149082 2489727 1773675 716052 1393479 992711 400768 500000 500000 15542 15542 42300 42300 7246 7246 1785045 1332828 452217 121369 86463 34906 59167 48800 10367 534849 534849 15563 4497 11066 147977 136479 11498 291610 291610 2541991 2526543 15448 288465 288465 SUPPLIES 8291808 6817854 1473954 PURCHASED SERVICES 3728336 1726559 2001777 EQUIPMENT RENTAL AND MA 843770 593076 250694 DUES & SUBSCRIPTIONS 177584 111996 65588 210865 35351 175514 47029362 33792272 13237090 0 20764874 26134868 9634550 11335576 667753 792139 185365 232194 66174627 48170785 18758451 18003842 6280959 6344081 372571 361793 56664523 63204493 4577504 5431440 6576742 5372919 1419407 744947 12573653 11549306 X 44090870 51655187 44090870 51655187 56664523 63204493 7094073 470244 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 7246 7246 0 PART II-B, LINE 1: THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN HOSPITAL ASSOCIATION - $4,797 CATHOLIC HEALTH ASSOCIATION - $2,449 886525 886525 23179800 13454909 9724891 37669013 32042150 5626863 4439289 2673726 1765563 18003842 ESTIMATED THIRD-PARTY SETTLEMENTS 631900 INTEREST RATE SWAP LIABILITY 113047 744947 X PART X, LINE 2: IN ACCORDANCE WITH FASB INTERPRETATION NO 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, INCLUDED IN FASB ASC SUBTOPIC 740-10 - INCOME TAXES - THE HOSPITAL RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THIS IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGEMENT OCCURS. IN 2023 AND 2022, MANAGEMENT DETERMINED THAT THERE ARE NO INCOME TAX POSITIONS REQUIRING RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS. 1 1 X 0 0 1 1 0 1 1 307 315989 315989 0.00670 3793664 3110709 682955 0.01450 307 4109653 3110709 998944 0.02120 20 864 81417 81417 0.00170 63 38096 38096 0.00080 15 51890 51890 0.00110 98 864 171403 171403 0.00360 98 1171 4281056 3110709 1170347 0.02480 2 13409 13409 0.00030 23 730 7980 7980 0.00020 10 1 515 515 0.00000 4 65 1694 1694 0.00000 39 796 23598 23598 0.00050 1 2086630 0 14911863 14932107 -20244 X 1 1 1 1 MEMORIAL COMMUNITY HOSPITAL 810 NORTH 22ND STREET BLAIR NE 68008 WWW.MCHHS.ORG 790001 X X X X MEMORIAL COMMUNITY HOSPITAL 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X HTTPS://MCHHS.ORG/CHIP-CHNA/ X SEE PART V, PAGE 8 X 1 22 1 HTTPS://MCHHS.ORG/CHIP-CHNA/ 0 1 X X X 1 1 X X X 1 X HTTPS://MCHHS.ORG/PATIENT-BILLING-FINANCIAL-ASSISTANCE/ X HTTPS://MCHHS.ORG/PATIENT-BILLING-FINANCIAL-ASSISTANCE/ X HTTPS://MCHHS.ORG/PATIENT-BILLING-FINANCIAL-ASSISTANCE/ X X X X 1 X 0 X X X X 1 X 0 0 MEMORIAL COMMUNITY HOSPITAL PART V, SECTION B, LINE 5: IN 2022, LEADERSHIP FROM MEMORIAL COMMUNITY HOSPITAL COLLABORATED WITH THE THREE RIVERS PUBLIC HEALTH DEPARTMENT (TRPHD) AND SCHMEECKLE RESEARCH GROUP TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR THE THREE RURAL COUNTIES SERVED BY THE TRPHD, WHICH INCLUDES WASHINGTON COUNTY, THE COUNTY IN WHICH MEMORIAL COMMUNITY HOSPITAL & HEALTH SYSTEM IS LOCATED. THE CHNA IS A FOLLOW-UP TO AND EXPANSION OF SIMILAR REPORTS CONDUCTED IN 2003, 2007, 2012, 2016 AND 2019. THE TRPHD HAS COMPLETED A CHNA AND DEVELOPED A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) USING THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP (MAPP) PROCESS. MEMORIAL COMMUNITY HOSPITAL & HEALTH SYSTEM'S LEADERSHIP AND STAFF HAVE BEEN INVOLVED IN THE CHNA PLANNING PROCESS THROUGH SERVICE ON THE CHNA STEERING COMMITTEE AND PARTICIPATION IN THE MAPP PROCESS. A LARGE FOCUS GROUP COMPOSED OF DIVERSE MEMBERS OF THE COMMUNITY WAS AN IMPORTANT COMPONENT OF THE CHNA AND CHIP PLANNING PROCESS. MCH&HS LEADERS PARTICIPATED IN THE FORUM AND COMMUNITY DIALOGUE TO REVIEW THE CHNA AND IDENTIFY COMMUNITY HEALTH PRIORITIES, ASSETS AND GAPS IN WASHINGTON COUNTY. THE CHNA HAS ALSO BEEN SHARED WITH THE MEMORIAL COMMUNITY HOSPITAL & HEALTH SYSTEM BOARD OF DIRECTORS. THE MCH&HS CHNA IS LOCATED ON MCH&HS WEBSITE WWW.MCHHS.ORG AND THE FULL REPORT IS LOCATED AT WWW.THREERIVERSPUBLICHEALTH.ORG. MEMORIAL COMMUNITY HOSPITAL & HEALTH SYSTEM LEADERSHIP USED THIS CHNA DURING ITS ANNUAL STRATEGIC AND BUDGETING AND PROVIDED A MEMORIAL COMMUNITY HOSPITAL & HEALTH SYSTEM IMPLEMENTATION PLAN TO ADDRESS THE PRIORITIZED HEALTH NEEDS. MEMORIAL COMMUNITY HOSPITAL PART V, SECTION B, LINE 6A: FREMONT AREA MEDICAL CENTER & SAUNDERS COUNTY COMMUNITY HOSPITAL MEMORIAL COMMUNITY HOSPITAL PART V, SECTION B, LINE 6B: THREE RIVERS HEALTH DEPARTMENT MEMORIAL COMMUNITY HOSPITAL PART V, SECTION B, LINE 11: THIS REPORT PROVIDES A COMPREHENSIVE OVERVIEW OF THE 2023 BEHAVIORAL HEALTH AND HEALTHY LIFESTYLES/OBESITY COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) EFFORTS ACROSS DODGE, SAUNDERS, AND WASHINGTON COUNTIES, HIGHLIGHTING COLLABORATIONS, PROGRAM REACH, AND KEY OUTCOMES.COUNTY REPRESENTATION AND PARTNERSHIPS: THROUGHOUT THE YEAR, OUR ORGANIZATION FOSTERED NEW AND STRENGTHENED EXISTING PARTNERSHIPS TO PROMOTE BEHAVIORAL HEALTH AND HEALTHY LIFESTYLES. NOTABLY, WE COLLABORATED WITH VOLUNTEERS ASSISTING SENIORS (VAS) TO OFFER HEALTHCARE COVERAGE AND MEDICARE COUNSELING DURING OPEN ENROLLMENT, AND PARTNERED WITH THE CHATT CENTER IN TEKAMAH TO SUPPORT LOCAL "CHATT TALKS." ADDITIONALLY, SCHOOLS AND THE YMCA JOINED US TO PROMOTE HEALTHY LIFESTYLES AMONG CHILDREN. PARTNERSHIPS WERE FURTHER STRENGTHENED WITH SCHOOL MEDICAL CAREER CLUBS AND CNA PROGRAMS, PROVIDING EDUCATIONAL AND CAREER-SHADOWING OPPORTUNITIES TO EXPAND AWARENESS OF OUR SERVICES.BEHAVIORAL HEALTH PROGRAMS AND REACH: IN BEHAVIORAL HEALTH, SEVERAL PROGRAMS WERE IMPLEMENTED, REACHING A BROAD AUDIENCE. THE VILLAGE CONNECT SUPPORT GROUP LAUNCHED SUCCESSFULLY AND MEETS TWICE MONTHLY. OUR MENTAL HEALTH AWARENESS WALK AND SUICIDE AWARENESS WALK ENGAGED 50 AND 40 PARTICIPANTS, RESPECTIVELY, RAISING COMMUNITY AWARENESS. EDUCATIONAL MATERIALS TO INCREASE AWARENESS OF AND ACCESS TO BEHAVIORAL HEALTH SERVICES AS WELL AS TO REDUCE THE STIGMA OF SEEKING HELP FOR BEHAVIORAL HEALTH ISSUES WERE DISTRIBUTED AT LOCAL CLINICS, LIBRARIES, AND YMCA LOCATIONS, COMPLEMENTED BY WEBSITE IMPROVEMENTS AND NEW BROCHURES TO INCREASE ACCESS TO MENTAL HEALTH RESOURCES.HEALTHY LIFESTYLES PROGRAMS AND REACH: OUR HEALTHY LIFESTYLES INITIATIVES INCLUDED MONTHLY BLOGS ON NUTRITION AND HEALTHY EATING AND A MONTHLY LUNCH & LEARN SERIES ATTENDED BY 20-25 GUESTS PER SESSION. ADDITIONAL FITNESS AND WELLNESS PROGRAMS INTRODUCED INCLUDED THE PWR MOVES CLASS FOR PARKINSON'S PATIENTS, A SENIOR EXERCISE CLASS, A TAI CHI CLASS FOR BETTER BALANCE, AN ADVANCED TAI CHI CLASS, AND A PELVIC FLOOR THERAPY CLASS. A NEW MOM AND BREASTFEEDING SUPPORT GROUP PROVIDED BOTH EDUCATION AND COMMUNITY SUPPORT. WE SAW A TOTAL OF 33 PATIENTS FOR OUTPATIENT DIETITIAN SERVICES FOR WEIGHT MANAGEMENT IN 2023. ADDITIONALLY, WE EMBARKED ON AN INITIATIVE TO ENSURE TO TRACK THE PERCENTAGE OF DIABETIC PATIENTS WHOSE MOST RECENT HEMOGLOBIN A1C WAS GREATER THAN 9% OR HAS NOT BEEN COMPLETED IN THE LAST 12 MONTHS.KEY SUCCESSES: NOTABLE ACHIEVEMENTS THIS YEAR INCLUDE AN INCREASE IN MEDICARE WELLNESS VISITS FROM 492 TO 624, REFLECTING A STRONG RESPONSE TO EDUCATIONAL OUTREACH. THE PARTNERSHIP WITH A DIETITIAN RESULTED IN WELL-RECEIVED HEALTHY EATING BLOGS, AND OUR PROGRAMS YIELDED POSITIVE PATIENT SUCCESS STORIES. ADDITIONALLY, THE MEDICARE COUNSELING PROGRAM PROVIDED A VALUABLE RESOURCE FOR PATIENTS NAVIGATING THEIR OPTIONS.DIABETES CARE: WE EXCEEDED OUR GOAL OF 80% PATIENTS WHO HAD A HEMOGLOBIN A1C ABOVE 9% OR HAD NOT HAD IT CHECKED IN THE LAST 12 MONTHS, WITH A RATE OF COMPLIANCE OF 89.4%.CHALLENGES: DESPITE OUR PROGRESS, RECRUITMENT FOR THE LIVING WELL CLASS REMAINS A CHALLENGE, WITH PARTICIPATION RATES BELOW EXPECTATIONS. CONTINUED EFFORTS WILL FOCUS ON ENHANCING OUTREACH FOR THIS PROGRAM.ADDITIONAL COMMENTS: THE ONGOING COMMITMENT OF OUR ORGANIZATION AND PARTNERS IS ESSENTIAL AS WE WORK TO FURTHER ENHANCE THESE INITIATIVES. WE LOOK FORWARD TO BUILDING ON THIS YEAR'S SUCCESS TO PROMOTE BEHAVIORAL HEALTH AND HEALTHY LIFESTYLES IN THE COMING YEAR. MEMORIAL COMMUNITY HOSPITAL PART V, SECTION B, LINE 13B: THE AMOUNT OF FINANCIAL ASSISTANCE WRITE-OFF FOR MEMORIAL COMMUNITY HOSPITAL AND HEALTH SYSTEM IS BASED ON A FINANCIAL ASSISTANCE SLIDING FEE SCHEDULE UTILIZING A DERIVATIVE OF THE CURRENT US DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (HUD) VERY LOW INCOME GUIDELINES, WHICH ARE UPDATED ANNUALLY. FINANCIAL ASSISTANCE MAY ALSO BE GRANTED IN CERTAIN CIRCUMSTANCES INVOLVING A CATASTROPHIC OCCURRENCE RESULTING IN MEDICAL BILLS GROSSLY EXCEEDING THE PATIENT'S ABILITY TO PAY AND IN THESE SITUATIONS, THE PATIENT'S RESPONSIBILITY WILL BE LIMITED TO 30% OF THE FAMILY'S GROSS ANNUAL INCOME. SCHEDULE H, PART V, SECTION B, LINE 7B HTTPS://WWW.THREERIVERSPUBLICHEALTH.ORG/RESOURCES/DATA/COMMUNITY-HEALTH-IMPROVEMENT-PLAN-CHIP 3 1 - BLAIR CLINIC 812 NORTH 22ND STREET BLAIR NE 68008 PRIMARY CARE CLINIC 2 - FORT CALHOUN CLINIC 4929 COUNTY ROAD P-43 FORT CALHOUN NE 68023 PRIMARY CARE CLINIC 3 - COTTONWOOD CLINIC 3519 HIGHWAY 32 TEKAMAH NE 68061 PRIMARY CARE CLINIC PART I, LINE 3C: THE AMOUNT OF FINANCIAL ASSISTANCE WRITE-OFF FOR MEMORIAL COMMUNITY HOSPITAL AND HEALTH SYSTEM IS BASED ON A FINANCIAL ASSISTANCE SLIDING FEE SCHEDULE UTILIZING A DERIVATIVE OF THE CURRENT US DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (HUD) VERY LOW INCOME GUIDELINES, WHICH ARE UPDATED ANNUALLY. DESIGNEES OF MCH HELP PATIENTS SEEK REIMBURSEMENT FROM LOCAL, STATE, AND FEDERAL PROGRAMS AT NO CHARGE TO THE PATIENT WHEN THERE IS NO OTHER SOURCE OF PAYMENT. AFTER THESE EFFORTS/RESOURCES HAVE BEEN EXHAUSTED, PATIENTS ARE ASSISTED IN THE APPLICATION PROCESS FOR FINANCIAL ASSISTANCE. THE APPLICATION PROCESS INCLUDES COMPLETING A PERSONAL FINANCIAL APPLICATION AND PROVIDING VERIFICATION DOCUMENTS. THESE VERIFICATION DOCUMENTS MAY INCLUDE, BUT ARE NOT LIMITED TO, RECEIVING A COPY OF THE APPLICANT'S FEDERAL TAX RETURN, PAY STUB, BANK STATEMENTS, A CALL TO EMPLOYERS, OR A CREDIT REPORT, THE APPLICANT'S NET WORTH AND/OR LIQUID ASSETS, AND REASONABLE HOUSEHOLD OR BUSINESS EXPENSES. FINANCIAL ASSISTANCE MAY ALSO BE GRANTED IN CERTAIN CIRCUMSTANCES INVOLVING A CATASTROPHIC OCCURRENCE RESULTING IN MEDICAL BILLS GROSSLY EXCEEDING THE PATIENT'S ABILITY TO PAY AND IN THESE SITUATIONS, THE PATIENT'S RESPONSIBILITY WILL BE LIMITED TO 30% OF THE FAMILY'S GROSS ANNUAL INCOME. PART I, LINE 7: THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE WERE WORKSHEETS WITHIN THE SCHEDULE H INSTRUCTIONS. THE COST TO CHARGE RATIO USED IN THE CALCULATION WAS DERIVED FROM THE FILED 2023 COST REPORT. PART I, LINE 7G: MEMORIAL COMMUNITY HOSPITAL DOES NOT PROVIDE SUBSIDIZED HEALTH SERVICES. SCHEDULE H, PART I, LINE 6A MEMORIAL COMMUNITY HOSPITAL PRODUCES A COMMUNITY BENEFIT REPORT THAT IS SENT TO THE NEBRASKA HOSPITAL ASSOCIATION FOR DATA COLLECTION PURPOSES. PART II, COMMUNITY BUILDING ACTIVITIES: MEMORIAL COMMUNITY HOSPITAL AND HEALTH SYSTEM'S (MCH) MISSION IS TO HEAL, NURTURE AND PROMOTE WELLNESS IN THE COMMUNITIES WE SERVE. 2023 PRESENTED ANOTHER YEAR OF OPPORTUNITIES FOR MCH POST PANDEMIC. IN 2023, MCH DEMONSTRATED GREAT RESILIENCE FOLLOWING A PERIOD OF TIME WHERE THE HEALTHCARE ENVIRONMENT WAS SIGNIFICANTLY IMPACTED. MCH RETURNED TO MORE REGULAR ACTIVITY IN TERMS OF SUPPORTING COMMUNITY ORGANIZATION AND ALSO EVENTS THAT WERE HELD INTERNALLY. MCH BEGAN TO SEE MORE SHADOWING OPPORTUNITIES AND WELCOMED STUDENTS, BOTH HIGH SCHOOL AND COLLEGE, INTO OUR FACILITY TO PRESENT THEM WITH OPPORTUNITIES TO LEARN ABOUT MCH AND VARIOUS CAREER OPPORTUNITIES THAT WE OFFER. OUR PFAC GROUP RE-ENGAGED AND COMMUNITY EDUCATION THROUGH LUNCH AND LEARNS CONTINUED TO WELCOME MANY GUESTS ON A MONTHLY BASIS WHO LEARNED ABOUT VARIOUS HEALTH-RELATED TOPICS. MCH WAS ABLE TO SUPPORT PROGRAMS AND EVENTS SUCH AS THE BIKE RODEO, PARADES, CHAMBER AFTER HOURS AND COFFEES, STOP THE BLEED COURSES, CPR CLASSES, AND DIFFERENT CLASSES FOR SENIORS SUCH AS THE SENIOR EXERCISE CLASSES. WE ALSO HOSTED TWO BABY EXPOS IN SUPPORT OF THE MCH LABOR & DELIVERY DEPARTMENT AND HELD A CHRISTMAS CELEBRATION FOR THE COMMUNITY. BLOOD DRIVES WERE ALSO HELD IN PARTNERSHIP WITH THE AMERICAN RED CROSS. MCH LEADERSHIP SERVED ON THE WASHINGTON COUNTY CHAMBER BOARD, THE GATEWAY DEVELOPMENT BOARD AND THE UNITED WAY BOARD IN SUPPORT OF ECONOMIC DEVELOPMENT AND COMMUNITY BUILDING EFFORTS. MCH WAS PLEASED TO ENGAGE IN VARIOUS ACTIVITIES AS WE ARE DEDICATED TO THE COMMUNITY AS PART OF OUR MISSION. MCH LEADERSHIP ALSO PARTICIPATED IN SEVERAL ADVOCACY OPPORTUNITIES TO EXPRESS SUPPORT FOR INITIATIVES TO KEEP OUR COMMUNITIES SAFE AND ECONOMICALLY SOUND. PART III, LINE 2: COSTING METHODOLOGY FOR AMOUNTS REPORTED ON LINE 2 IS DETERMINED USING THE ORGANIZATION'S COST/CHARGE RATIO OF 59.50%. WHEN DISCOUNTS ARE EXTENDED TO SELF-PAY PATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE. PART III, LINE 3: COMMUNITY MEMORIAL HOSPITAL DOES NOT BELIEVE THAT ANY PORTION OF BAD DEBT EXPENSE COULD REASONABLY BE ATTRIBUTED TO PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE SINCE AMOUNTS DUE FROM THOSE INDIVIDUALS' ACCOUNTS WILL BE RECLASSIFIED FROM BAD DEBT EXPENSE TO CHARITY CARE WITHIN 30 DAYS FOLLOWING THE DATE THAT THE PATIENT IS DETERMINED TO QUALIFY FOR CHARITY CARE. PART III, LINE 4: THE AUDITED FOOTNOTES FOR MEMORIAL COMMUNITY HOSPITAL AND MEDICAL CENTER DO NOT CONTAIN FOOTNOTES RELATED TO BAD DEBT EXPENSE. BAD DEBT EXPENSE IS IDENTIFIED ON THE CONSOLIDATED STATEMENT OF OPERATION WHICH IS CONSISTENT WITH THE REPORTING PRACTICE OF OTHER HEALTH CARE ORGANIZATIONS. BAD DEBT EXPENSE AT 100% CHARGE VALUE WAS MULTIPLIED BY THE RATIO DERIVED FROM THE SCHEDULE H WORKSHEETS IN THE SCHEDULE H INSTRUCTIONS TO ARRIVE AT AN APPROXIMATE COST VALUE. PART III, LINE 8: MEMORIAL COMMUNITY HOSPITAL EXCLUDED MEDICARE SHORTFALLS FROM THE OVERALL COMMUNITY BENEFIT REPORT.THE MEDICARE CHARGES REPORTED ON LINE 5 AND LINE 6 ARE FROM THE 2023 FILED COST REPORT WHICH USED A COST TO CHARGE RATIO. PART III, LINE 9B: ALL ACCOUNTS MUST HAVE GONE THROUGH A MINIMUM OF THREE STATEMENT CYCLES ENSURING THE GUARANTOR HAS HAD TIME TO REVIEW AND PAY ON THE ACCOUNTS OWED ON. NO ACCOUNT WILL BE PREPARED FOR COLLECTIONS BEFORE IT HAS REACHED 121 DAYS FROM THE DATE OF POST DISCHARGE BILLING. ALL ACCOUNTS MUST HAVE ONE DOCUMENTED, ATTEMPTED PHONE CALL TO THE GUARANTOR. PATIENTS WILL BE GIVEN THE OPPORTUNITY TO APPLY FOR MCHHS' FINANCIAL ASSISTANCE PROGRAM IN THE EVENT THAT THEY ARE UNABLE TO MEET THEIR FINANCIAL OBLIGATIONS. THE FINANCIAL CLASS ON THE EFFECTED EPISODES WILL BE CHANGED TO "FA AND A FINAL ATTEMPT LETTER WHICH INCLUDES INFORMATION REGARDING THE MCH FINANCIAL ASSISTANCE PROGRAM AND IT'S AVAILABILITY TO QUALIFIED APPLICANTS WILL BE SENT INDICATING THAT A PAYMENT OR RESPONSE IS NECESSARY OR ELSE THE ACCOUNT WOULD BE SENT TO AN OUTSIDE AGENCY FOR COLLECTION ATTEMPTS. IF A PATIENT CONTACTS MCHHS TO INQUIRE ABOUT FINANCIAL ASSISTANCE AND THE ACCOUNT IS LESS THAN 240 DAYS, THEN ALL COLLECTION EFFORTS WILL BE CEASED AND THE PATIENT WILL BE GIVEN 2 WEEKS TO COMPLETE AND RETURN THE REQUIRED APPLICATION AND DOCUMENTS. SHOULD THE PATIENT NOT QUALIFY AND/OR NOT RETURN THE REQUIRED APPLICATION, THEN COLLECTION EFFORTS SHALL RESUME. SHOULD PATIENTS COMPLETE AND RETURN THE REQUIRED APPLICATION AND DOCUMENTS AT ANY TIME PRIOR TO 241 DAYS, THEN COLLECTION EFFORTS WILL CEASE UNTIL THE APPLICATION IS REVIEWED.MEMORIAL COMMUNITY HOSPITAL'S COLLECTION POLICY DOES CONTAIN PROVISIONS OF THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. PART VI, LINE 2: MEMORIAL COMMUNITY HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES THROUGH MULTIPLE CHANNELS INCLUDING COMMUNITY HEALTH FAIRS, WELLNESS PROGRAMS, PROVIDING OCCUPATIONAL HEALTH SERVICES, LISTENING TO PATIENT AND COMMUNITY VOICES AS WELL AS WATCHING NATIONAL TRENDS. PART VI, LINE 3: THERE ARE SEVERAL FINANCIAL ASSISTANCE ACCESS POINTS THROUGHOUT A PATIENT'S CARE CYCLE. BILLS CONTAIN FINANCIAL ASSISTANCE VERBIAGE, BROCHURES ARE AVAILABLE IN CLINICS AND THE HOSPITAL, AND THERE IS INFORMATION ON FINANCIAL ASSISTANCE POSTED AT REGISTRATION POINTS THROUGHOUT CLINICS AND THE HOSPITAL. INFORMATION ON THE MCH FINANCIAL ASSISTANCE POLICIES IS LOCATED AT WWW.MCHHS.ORG. DESIGNEES SUCH AS FINANCIAL COUNSELORS OF MCH HELP PATIENTS SEEK REIMBURSEMENT FROM LOCAL, STATE AND FEDERAL PROGRAMS AT NO CHARGE TO THE PATIENT, WHEN THERE IS NO OTHER SOURCE OF PAYMENT. AFTER THESE EFFORTS/RESOURCES HAVE BEEN EXHAUSTED, PATIENTS ARE ASSISTED IN THE APPLICATION PROCESS FOR FINANCIAL ASSISTANCE. PART VI, LINE 4: MEMORIAL COMMUNITY HOSPITAL AND HEALTH SYSTEM OF BLAIR, NEBRASKA SERVES BOTH WASHINGTON AND BURT COUNTIES IN NEBRASKA. WASHINGTON COUNTY NEBRASKA HAS AN ESTIMATED POPULATION OF 21,167 AND APPROXIMATELY 61% OF THE POPULATION IN WASHINGTON COUNTY IS CONSIDERED RURAL. CENSUS ESTIMATES SHOW THAT WASHINGTON COUNTY'S RACIAL AND ETHNIC MAKEUP IS 4.4% OF THE POPULATION AND ITS MEDIAN AGE IS 41.5 AS COMPARED TO THE STATE AT 36.6. THE MEDIAN HOUSEHOLD INCOME IS $83,491 COMPARED TO $73,360 FOR THE STATE OF NEBRASKA. IN WASHINGTON COUNTY, 25.6% OF SCHOOL AGE CHILDREN IN BLAIR, 14.1% IN FORT CALHOUN, AND 21.9 % IN ARLINGTON WERE ELIGIBLE FOR FREE OR REDUCED LUNCH BASED ON DATA FROM JUNE 2023, COMPARED TO 45.2% IN THE STATE. BURT COUNTY HAS A POPULATION OF 6,727 AND IT'S ETHNIC AND RACIAL MAKEUP IS 7% OF THE POPULATION. THE MEDIAN HOUSEHOLD INCOME IS $55,769. IN BURT COUNTY, 33.6% OF TEKAMAH SCHOOL AGE CHILDREN, 9.6 % IN OAKLAND/CRAIG AND 51.5% IN LYONS/DECATUR RECEIVED FREE OR REDUCED LUNCH AT SCHOOL. PART VI, LINE 5: MCH&HS PROMOTES THE HEALTH OF ITS COMMUNITY THROUGH FINANCIAL AND IN-KIND DONATIONS. BOARD OF DIRECTORS - THE BOARD OF DIRECTORS MANAGE THE AFFAIRS OF MEMORIAL COMMUNITY HOSPITAL IN BLAIR, NEBRASKA. THERE ARE SEVEN DIRECTORS WHO SERVE ON THE BOARD: THREE MEMBERS FROM THE COMMUNITY, THREE MEMBERS FROM CHI HEALTH AND ONE MEMBER FROM THE MCH&HS MEDICAL STAFF. THE BOARD OF DIRECTORS IS COMPROMISED OF INDIVIDUALS WHO ARE LEADERS IN THE FIELDS OF BUSINESS, HEALTHCARE, ACCOUNTING AND MEDICINE AND WHO UNDERSTAND THEIR ROLE IN PROVIDING STRONG CORPORATE GOVERNANCE. EMERGENCY DEPARTMENT - MEMORIAL COMMUNITY HEALTH HAS A FULL-TIME EMERGENCY DEPARTMENT THAT IS OPEN TO THE PUBLIC AND PROVIDES MEDICAL SCREENING, EXAMINATION, AND STABILIZING TREATMENT WITHIN THE CAPABILITIES AND CAPACITIES OF THE HOSPITAL REGARDLESS OF BUT NOT LIMITED TO THE PATIENT'S RACE, COLOR, SEX, AGE AND/OR ABILITY TO PAY. MCH&HS IS IN COMPLIANCE WITH THE FEDERAL EMTALA GUIDELINES. MEDICAL STAFF - MCH&HS MAINTAIN AN OPEN MEDICAL STAFF. ALL QUALIFIED MDS, DSO, OTHER HEALTHCARE PRACTITIONERS, AND MID-LEVEL PRACTITIONERS ARE ELIGIBLE TO APPLY FOR PRIVILEGES AT THE HOSPITAL. MCH&HS POLICY ON PHYSICIAN CREDENTIALING IS THAT NO INDIVIDUAL IS TO BE DENIED MEDICAL STAFF APPOINTMENT BASED ON SEX, RACE, CREED, COLOR OR NATIONAL ORIGIN. THE STANDARDS A PHYSICIAN MUST MEET FOR APPOINTMENT RELATE TO (1) EDUCATIONAL QUALIFICATION AND LICENSING, (2) PROFESSIONAL COMPETENCE, (3) CHARACTER, (4) ETHICAL STANDING, AND (5) ABILITY TO RELATE TO AND WORK WITH OTHERS. APPLICATIONS ARE REVIEWED AT SEVERAL LEVELS WITHIN THE ORGANIZATION. PHYSICIANS WHO HAVE BEEN GRANTED STAFF PRIVILEGES AUTOMATICALLY BECOME A MEMBER OF THE MEDICAL STAFF AT THE HOSPITAL FOR WHICH PRIVILEGES HAVE BEEN GRANTED. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: NE 0 0 0 1 1 0 0 0 0 KEVIN SISK MD PHYSICIAN 269546 0 270119 0 0 0 0 0 11423 0 551088 0 0 0 JEREMY LEE MD PHYSICIAN 361978 0 10333 0 0 0 0 0 4469 0 376780 0 0 0 TONY TRAN CRNA 351798 0 8333 0 0 0 0 0 13073 0 373204 0 0 0 SANTOSH KUMAR MD PHYSICIAN 346326 0 11500 0 0 0 0 0 14216 0 372042 0 0 0 JOHN SIMONSON MD BOARD MEMBER/PHYSICIAN 223693 0 88934 0 0 0 0 0 8465 0 321092 0 0 0 AMANDA DUXBURY MD PHYSICIAN 250635 0 57918 0 0 0 0 0 11503 0 320056 0 0 0 SANDRA BAUMBERGER MD BOARD MEMBER/PHYSICIAN 214231 0 63463 0 0 0 0 0 13073 0 290767 0 0 0 PART I, LINE 3 DURING THE CALENDAR YEAR 2023, COMPENSATION FOR THE CEO WAS ESTABLISHED AND PAID BY CHI HEALTH, AN UNRELATED ORGANIZATION. CHI HEALTH USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION: (1) COMPENSATION SURVEYS OR STUDIES (2) INDEPENDENT COMPENSATION CONSULTANT AND (3) APPROVAL BY THE BOARD COMPENSATION COMMITTEE. PART I, LINE 5 ON A QUARTERLY BASIS, PHYSICIANS ARE ELIGIBLE FOR A BONUS IF THEIR OWN PERSONAL GROSS REVENUE PRODUCTION (WITH CERTAIN LIMITS ON WHAT IS INCLUDED) EXCEED A THRESHOLD. THEY THEN GET X% OF THE AMOUNT OVER THAT GROSS REVENUE THRESHOLD. THEY ARE ALSO ELIGIBLE FOR A KEY PERFORMANCE INDICATOR (KPI) ANNUAL BONUS ONLY IF THE COMBINED EBIDA (MCH AND ITS RELATED ORGANIZATION) TARGET IS ACHIEVED. THE KPI ANNUAL BONUSES ARE NOT BASED ON THE PHYSICIANS' SALARIES BUT BASED ON HOW THEY PERFORM ON THE 5 METRICS OF THE KPI PLAN. MCH PHYSICIANS ARE ELIGIBLE FOR A KEY PERFORMANCE INDICATOR (KPI) ANNUAL BONUS ONLY IF THE COMBINED EBIDA (MCH AND ITS RELATED ORGANIZATION) TARGET IS ACHIEVED. THE KPI ANNUAL BONUSES ARE NOT BASED ON THE PHYSICIANS' SALARIES BUT BASED ON HOW THEY PERFORM ON THE 5 METRICS OF THE KPI PLAN. A HOSPITAL AUTH #1 OF WASHINGTON CNTY NE 521441599 2007-06-19 9250000 CONSTRUCTION OF FACILITY 0 0 0 B HOSPITAL AUTH #1 OF WASHINGTON CNTY NE 521441599 2008-05-22 8000000 CONSTRUCTION OF FACILITY 0 0 0 A 6749964 9493722 173747 9319975 0 0 1 1 B 5127117 8059333 65000 7994333 0 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 0 1 1 0 0 0 0 0 B 0 0 1 1 1 1 FNB OF OMAHA 201.000000000000 1 0 0 0 0 A 0 B 0 SCHEDULE K, PART I NOTE REGARDING THE REBATE COMPUTATION SINCE THE BOND PROCEEDS HAVE BEEN SPENT, A SPENDING EXCEPTION WAS MET, AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CALCULATIONS ARE NECESSARY. SCHEDULE K, PART I, COLUMN (A) BOND RENEWAL IN 2017, MEMORIAL COMMUNITY HOSPITAL AMENDED ITS 2007 BOND SERIES WITH A NEW INTEREST RATE OF 3.01%. FORM 990, PART VI, SECTION A, LINE 3 THE CEO AND CFO OF MEMORIAL COMMUNITY HOSPITAL CORPORATION (HOSPITAL) ARE PROVIDED BY CHI HEALTH. THE CEO & CFO ARE EMPLOYEES OF CHI HEALTH, AND THE HOSPITAL REIMBURSES CHI HEALTH FOR THEIR COMPENSATION AND BENEFITS. THE HOSPITAL PAYS CHI HEALTH A MANAGEMENT FEE EQUAL TO THE DIRECT COST OF THEIR COMPENSATION AND BENEFITS PLUS 10% OF EARNINGS BEFORE INTEREST, DEPRECIATION, AND AMORTIZATION. FORM 990, PART VI, SECTION A, LINE 6 CORPORATE MEMBERS MEMORIAL COMMUNITY HOSPITAL CORPORATION (HOSPITAL) HAS TWO MEMBERS - MEMORIAL COMMUNITY HEALTH SYSTEM, INC (MCHS) AND ALEGENT HEALTH - IMMANUEL MEDICAL CENTER (IMMANUEL). FORM 990, PART VI, SECTION A, LINE 7A BOARD MEMBERS THE HOSPITAL HAS A SEVEN MEMBER BOARD OF DIRECTORS. MCHS APPOINTS THREE OF THESE BOARD MEMBERS, IMMANUEL APPOINTS THREE, AND THE MEDICAL STAFF APPOINTS ONE MEMBER, WHO IS ALWAYS THE MEDICAL STAFF PRESIDENT. ALL OFFICIAL ACTIONS OF THE BOARD REQUIRE AN AFFIRMATIVE VOTE OF TWO-THIRDS OF THE ENTIRE BOARD OF DIRECTORS. A SIMPLE MAJORITY OF THE BOARD OF DIRECTORS CONSTITUTES A QUORUM FROM THE TRANSACTION OF BUSINESS. FORM 990, PART VI, SECTION B, LINE 11B NO REVIEW WAS OR WILL BE CONDUCTED. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, EACH BOARD MEMBER SIGNS A CONFLICT OF INTEREST STATEMENT AND IS GIVEN A COPY OF THE CONFLICT OF INTEREST POLICY. THE CHAIRMAN OF THE BOARD REVIEWS THESE STATEMENTS AND ENSURES THAT BOARD MEMBERS EXCUSE THEMSELVES FROM DISCUSSIONS AT BOARD MEETINGS ON TOPICS WHERE THEY HAVE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15B EXECUTIVE COMPENSATION THE OFFICERS OF THE BOARD ARE NOT COMPENSATED FOR THEIR DUTIES, THEY ARE VOLUNTEERS. THE OFFICERS OF THE CORPORATION (THE EXECUTIVES) ARE COMPENSATED BASED ON RECOMMENDATION OF THE COMPENSATION COMMITTEE OF THE BOARD. THE COMPENSATION COMMITTEE LOOKS AT COMPARATIVE HOSPITAL AND INDUSTRY SALARY INFORMATION IN SETTING BASE SALARIES AND REVIEWS AND APPROVES THE INDIVIDUAL GOALS PROPOSED BY THE EXECUTIVE TEAM FOR INCENTIVE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 MEMORIAL COMMUNITY HOSPITAL'S AUDIT REPORT IS MADE AVAILABLE TO THE PUBLIC. THE CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART VI, SECTION B, LINE 16B JOINT VENTURE POLICY MEMORIAL COMMUNITY HOSPITAL HAS NOT FORMALLY ADOPTED A WRITTEN POLICY OR WRITTEN PROCEDURE REGARDING JOINT VENTURES. HOWEVER, MCH EVALUATES THE JOINT VENTURE BEFORE ENTERING INTO AN AGREEMENT, TO ENSURE THEY DO NOT ENTER INTO ANY JOINT VENTURE THAT WOULD JEOPARDIZE THE HOSPITALS' EXEMPT PURPOSE. FORM 990, PART VII, SECTION A, LINE 1A JENNIFER NEWBY & MANUELA WOLF'S COMPENSATION JENNIFER NEWBY & MANUELA WOLF ARE THE CFO AND CEO OF MEMORIAL COMMUNITY HOSPITAL, RESPECTFULLY, AND ARE PAID BY CHI HEALTH. MEMORIAL COMMUNITY HOSPITAL PAID CHI HEALTH FOR THEIR SERVICES PROVIDED. THEREFORE, JENNIFER NWEBY & MANUELA WOLF SHOW $0 REPORTABLE COMPENSATION FROM THE FILING ORGANIZATION AND FROM ANY RELATED ORGANIZATION AS THEY WERE DIRECTLY PAID BY CHI HEALTH. FORM 990, PART VII, SECTION A, LINE 5 DR. DRABEK PROVIDES MEDICAL DIRECTOR AND SURGICAL SERVICES TO MEMORIAL COMMUNITY HOSPITAL (MCH). DR. DRABEK IS AN EMPLOYEE OF ALEGENT CREIGHTON CLINIC WHO LEASES DR. DRABEK TO MCH ON A PART TIME BASIS. MCH PAYS ALEGENT CREIGHTON CLINIC FOR DR. DRABEK'S SERVICES. MEMORIAL COMMUNITY HOSPITAL FOUNDATION 810 N 22ND STREET BLAIR NE 68008 113660156 SUPPORT NE 501(C)(3) LINE 7 N/A 0 MEMORIAL COMMUNITY HEALTH SYSTEM 810 N 22ND STREET BLAIR NE 68008 470718840 HEALTH SYSTEM NE 501(C)(3) LINE 7 N/A 0 MCH AUXILIARY THRIFT SHOP 810 N 22ND STREET BLAIR NE 68008 470748162 AUXILIARY NE 501(C)(3) LINE 7 N/A 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 MEMORIAL COMMUNITY HOSPITAL FOUNDATION CORPORATION C 72235 COST