2024-11-06T11:13:32-06:00 2023-12-31 450250958 EIDE BAILLY LLP 18081 BURT ST STE 200 OMAHA NE 680224722 990 2023-01-01 470662290 NORTH PLATTE NEBRASKA HOSPITAL CORP NORT 3085688000 601 W LEOTA S NORTH PLATTE NE 69103 SUMMER OWEN CFO 3085688000 2024-11-06 1 1 MEGAN L KOZIOL CPA P01544037 4023302660 2024-11-06 2023 2024-10-15 13:58:12Z GREAT PLAINS HEALTH IVAN MITCHELL 601 W LEOTA S NORTH PLATTE NE 69103 365657711 0 X WWW.GPHEALTH.ORG X 1971 NE PROVIDE ACUTE, PREVENTIVE AND OTHER HEALTHCARE SERVICES. 15 11 1568 110 101750 0 913043 979339 270057515 288738381 1169578 4137752 2693993 1835088 274834129 295690560 357301 132415 0 0 131917600 143227892 0 0 340556 126087773 135562510 258362674 278922817 16471455 16767743 483495629 532753920 127322757 125925072 356172872 406828848 TO INSPIRE HEALTH AND HEALING BY PUTTING PATIENTS FIRST -- ALWAYS. 0 0 237735159 132415 254567977 GREAT PLAINS HEALTH IS A NOT FOR PROFIT HEALTH SYSTEM COMMITTED TO MEETING THE HEALTHCARE NEEDS OF THE COMMUNITIES WE SERVE. OUR MEDICAL STAFF, BOARD AND LEADERSHIP BELIEVE WE OFFER SPECIALTIES THAT PROVIDE HIGH QUALITY AND LOW COST CARE TO OUR PATIENTS. SPECIALTIES, SUCH AS CARDIOLOGY, ONCOLOGY, ORTHOPEDICS AND NEUROSURGERY CONTINUE TO GROW AND MEET THE HEALTH CHALLENGES OF OUR COMMUNITIES. 19765926 31118839 GREAT PLAINS HEALTH OPERATES A 116-BED INPATIENT HOSPITAL. THE INPATIENT CARE PROVIDED IN THOSE UNITS ARE THE FOLLOWING: MEDICAL, SURGICAL, INTENSIVE CARE, CORONARY CARE, OBSTETRICS, LABOR & DELIVERY, NICU, AND BEHAVIOR HEALTH SERVICES. GREAT PLAINS HEALTH PATIENTS COME FROM PRIMARY AND SECONDARY MARKETS. ADDITIONALLY, GREAT PLAINS HEALTH OPERATES 30 SPECIALTY OUTPATIENT DEPARTMENTS TO FURTHER MEET THE MEDICAL NEEDS OF THE COMMUNITIES. 2132166 3948942 GREAT PLAINS HEALTH IS DEDICATED TO MEETING THE BEHAVIORAL HEALTH NEEDS OF THE COMMUNITIES WE SERVE. TO HELP MEET THOSE NEEDS, WE OPERATE A DEDICATED BEHAVIORAL HEALTH UNIT/FLOOR AT THE HOSPITAL. THE UNIT ACCEPTS A WIDE VARIETY OF BEHAVIORAL DIAGNOSIS AND ISSUES. GREAT PLAINS HEALTH ALSO OFFERS OUTPATIENT BEHAVIORAL HEALTH SERVICES TO PEDIATRICS, ADOLESCENTS AND ADULTS NEEDING OUTPATIENT SERVICES. 259633251 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 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 145 0 1 1568 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 X SUMMER OWEN CFO 3085687193 601 WEST LEOTA NORTH PLATTE NE 69103 KRISTEN BURWICK DIRECTOR 40.00 X 828639 0 57091 JOVANKA VULSANOVIC MD DIRECTOR/PHYSICIAN (GPH) 40.00 X 354089 0 13681 JODY TOMANEK CHAIR 1.00 X X 0 0 0 LINDSAY PEDERSON VICE CHAIR 1.00 X X 0 0 0 DAN O'NEILL SECRETARY/TREASURER 1.00 X X 0 0 0 LADD LAKE MD CHIEF OF STAFF/DIRECTOR 1.00 X 0 0 0 MICHAEL CUNNING DIRECTOR 1.00 X 0 0 0 MATTHEW HAWKS DIRECTOR 1.00 X 0 0 0 MIKE JACOBSON DIRECTOR 1.00 X 0 0 0 PETE VOLZ DIRECTOR 1.00 X 0 0 0 ML MARTIN DIRECTOR 1.00 X 0 0 0 BENJAMIN KLUG MD VICE CHIEF OF STAFF/DIRECT 1.00 X 0 0 0 JAYNA SCHAAF DIRECTOR 1.00 X 0 0 0 KAYE MONIE DIRECTOR 1.00 X 0 0 0 RYAN PURDY DIRECTOR 1.00 X 0 0 0 JOE BOB ATKINS DIRECTOR (THRU 09/23) 1.00 X 0 0 0 IVAN MITCHELL CEO 40.00 X 544351 0 54941 SUMMER OWEN CFO 39.00 X 308070 0 41110 WAYNE L WARREN MD PHYSICIAN (GPH) 40.00 X 2071848 0 44772 PUSHKAR M KANADE MD PHYSICIAN (GPH) 40.00 X 1376671 0 56672 MICHAEL SIMONSON MD PHYSICIAN (GPH) 40.00 X 1261541 0 52091 NARAYANA KODURI MD PHYSICIAN (GPH) 40.00 X 1234087 0 55891 ANIL KUMAR MD PHYSICIAN (GPH) 40.00 X 1159106 0 50891 9138402 0 427140 242 0 1 0 SAMPSON CONSTRUCTION 440 REGENCY PKWY DR 131 OMAHA NE 68114 GENERAL CONTRACTOR 13363296 MEDEFIS CONSOLIDATED PO BOX 5068 NEW YORK NY 100575068 CONTRACTED NURSES 6398431 HEALTH CAROUSEL LLC 3805 EDWARDS RD 700 CINCINNATI OH 45209 STAFFING SERVICES 3286227 CARDIOSOLUTION LLC SPACER 4675 CORNELL ROAD SUITE 100 CINCINNATI OH 45241 CARDIOLOGY SERVICES 1598901 BRYAN TELEMEDICINE 1600 S 48TH ST LINCOLN NE 68506 TELEMEDICINE SERVICES 1434850 53 979339 979339 NET PATIENT SERVICE REVENUE 624100 287745272 287745272 OTHER OPERATING REVENUE 624100 847613 847613 MANAGEMENT FEES 624100 139060 139060 PATHOLOGY REVENUE 624100 6436 6436 288738381 1431093 1431093 105185 0 105185 105185 105185 72479398 194412 68734604 1232547 3744794 -1038135 2706659 2706659 NORTH PLATTE SURGICAL CENTER 621400 1113004 1113004 CAFETERIA REVENUE 900099 730776 730776 INVESTMENT IN GPHIN 900099 279954 279954 -393831 -495581 101750 1729903 295690560 289635758 101750 4973713 X 132415 132415 2201974 1253501 948473 1000903 1000903 110677188 103885167 6595443 196578 3293008 3122387 164485 6136 19417681 18358334 1021313 38034 6637138 6131359 493519 12260 220000 220000 316214 316214 127486 127486 476484 476484 35932721 31121040 4793998 17683 981838 567520 412663 1655 5828773 5093671 701528 33574 10266922 9608705 643212 15005 6002525 5742933 257038 2554 151211 130372 20839 2574419 2340807 231621 1991 16693986 15513531 1167643 12812 1398563 1308328 89466 769 MEDICAL SUPPLIES 52783919 52768341 15578 MISCELLANEOUS EXPENSES 525863 521766 3576 521 EDUCATION & TRAINING 521833 479131 42088 614 DUES & SUBSCRIPTIONS 461818 268765 192683 370 297935 284275 13660 278922817 259633251 18949010 340556 335910 126203 275775150 46361836 33215113 36725408 895643 1451999 8342995 9343029 4300305 4012083 322480668 181018448 132600672 141462220 271543271 6476929 8404766 1847575 1630213 19705337 11692892 483495629 532753920 25255590 27748280 85753347 81744965 16313820 16431827 127322757 125925072 X 354438360 404924979 1734512 1903869 356172872 406828848 483495629 532753920 X 16767743 37144460 -2509023 -747204 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 16052 16052 0 PART II-B, LINE 1: THE $16,052 REPRESENTS THE PORTION OF THE DUES PAID TO THE NEBRASKA HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION THAT ARE USED FOR LOBBYING BY THOSE ORGANIZATIONS. 2335247 2335247 187507481 87094008 100413473 3244216 2614967 629249 116815665 87089105 29726560 12578059 4220368 8357691 141462220 ESTIMATED THIRD PARTY SETTLEMENTS 813656 DEFERRED COMPENSATION 9712567 OPERATING LEASES LIABILITY 5905604 16431827 X PART X, LINE 2: THE ORGANIZATION ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. THE ORGANIZATION RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT DECEMBER 31, 2023 AND 2022, THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS ACCRUED. 1 1 X 1 X 1 X 1 1 0 1 1 2014 2296657 0 2296657 0.00820 5700 34732180 21258123 13474057 0.04830 7714 37028837 21258123 15770714 0.05650 21157 2036906 20669 2016237 0.00720 76 483235 0 483235 0.00170 2061 434629 434629 588484 257039 331445 0.00120 259529 0 259529 0.00090 23294 3802783 712337 3090446 0.01100 31008 40831620 21970460 18861160 0.06750 20000 2536 2536 0.00000 10900 10984 10984 0.00000 2000 7756 7756 0.00000 32900 21276 21276 0.00000 0 598754 105381 87972449 141722409 -53749960 X 1 1 1 NORTH PLATTE SURGERY CENTER LLC PROVIDES OUTPATIENT SURGERY SERVICES 0.50000 0.00000 0.50000 2 MID-NE MEDICAL VENTURES LEASES OF PHYSICIAN'S OFFICE BUILDING 0.60000 0.00000 0.40000 1 1 GREAT PLAINS HEALTH 601 WEST LEOTA NORTH PLATTE NE 69101 WWW.GPHEALTH.ORG 510001 X X X GREAT PLAINS HEALTH 1 0 0 1 X X X X X X X X X 22 1 0 0 1 X WWW.GPHEALTH.ORG/ABOUT-US/COMMUNITY-IMPACT X 1 22 1 WWW.GPHEALTH.ORG/ABOUT-US/COMMUNITY-IMPACT 0 1 X 200.000000000000 350.000000000000 X X X X X 1 1 X X X 1 X GPHEALTH.ORG/PATIENTS-VISITORS/ESTIMATES-BILLING-FINANCIAL-ASSISTANCE-PRICE X GPHEALTH.ORG/PATIENTS-VISITORS/ESTIMATES-BILLING-FINANCIAL-ASSISTANCE-PRICE X GPHEALTH.ORG/PATIENTS-VISITORS/ESTIMATES-BILLING-FINANCIAL-ASSISTANCE-PRICE X X X X X X X 1 X 0 X X X X X 1 X 0 0 GREAT PLAINS HEALTH PART V, SECTION B, LINE 5: GPHEALTH PROVIDED CHC CONSULTING WITH A LIST OF PERSONS WITH SPECIAL KNOWLEDGE OF PUBLIC HEALTH IN LINCOLN COUNTY, INCLUDING PUBLIC HEALTH REPRESENTATIVES AND OTHER INDIVIDUALS WHO FOCUS SPECIFICALLY ON UNDERREPRESENTED GROUPS. FROM THAT LIST, 29 IN DEPTH PHONE INTERVIEWS WERE CONDUCTED. DURING THESE INTERVIEWS, THE HEALTH NEEDS OF THE COMMUNITY, ACCESS ISSUES, BARRIERS AND ISSUES RELATED TO SPECIFIC POPULATIONS WERE DISCUSSED. GREAT PLAINS HEALTH PART V, SECTION B, LINE 11: GREAT PLAINS HEALTH LEADERSHIP PRIORITIZED AND DECIDED TO ADDRESS ALL OF THE PRIORITIZED NEEDS IN VARIOUS CAPACITIES THROUGH A HOSPITAL SPECIFIC IMPLEMENTATION PLAN.THE FINAL LIST OF PRIORITIZED NEEDS IS LISTED BELOW IN DESCENDING ORDER:1. RECRUIT AND RETAIN QUALITY HEALTH PROFESSIONALS.2. INCREASE ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE.3. IMPROVE ACCESS TO MEDICAL AND DENTAL CARE.4. INCREASE PREVENTION, EDUCATION TO REDUCE THE PREVALENCE OF CHRON'S DISEASES, PREVENTABLE CONDITIONS, READMISSIONS, AND HIGH MORTALITY RATES.5. INCREASE ACCESS TO SAFE AND AFFORDABLE HOUSING.GREAT PLAINS HEALTH LEADERSHIP HAS DEVELOPED AN IMPLEMENTATION PLAN TO IDENTIFY SPECIFIC ACTIVITIES AND SERVICES WHICH DIRECTLY ADDRESS THE IDENTIFIED PRIORITIES. THE OBJECTIVES WERE IDENTIFIED BY STUDYING THE PRIORITIZED HEALTH NEEDS, WITHIN THE CONTEXT OF THE HOSPITAL'S OVERALL STRATEGIC PLAN AND THE AVAILABILITY OF FINITE RESOURCES. THE PLAN INCLUDES A RATIONALE FOR EACH PRIORITY, FOLLOWED BY STRATEGIC OBJECTIVE ALIGNMENTS, SPECIFIC IMPLEMENTATION GOALS AND INITIATIVES, MEASUREMENT, RESPONSIBLE LEADERS AND ANNUAL PROGRESS/KEY RESULTS (AS APPROPRIATE). PRIORITY ONE: RECRUIT AND RETAIN QUALITY HEALTHCARE PROFESSIONALS. IMPLEMENTATION ACTIVITIES INCLUDE ACTIVELY RECRUITING HEALTHCARE PROFESSIONALS TO THE COMMUNITY, DEPLOYING RENTENTION STRATEGIES TO RETAIN PROVIDERS, ENGAGING IN COMMUNITY DEVELOPMENT, AND SEEKING TO GROW AND DEVELOP PROFESSIONALS WITH THE COMMUNITY.PRIORITY TWO: INCREASE ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE. IMPLEMENTATION ACTIVITIES INCLUDE PROVIDING POINTS OF ACCESS FOR MENTAL AND BEHAVIORAL HEALTH SERVICES IN THE COMMUNITY, UTILIZING TECHNOLOGY TO IMPROVE ACCESS TO MENTAL AND BEHAVIORAL HEALTH PARTNERSHIPS, GENERATING COMMUNITY AWARENESS AND EDUCATION ABOUT SUICIDE AND OTHER MENTAL HEALTH CONDITIONS, CREATING PARTNERSHIPS WITH LOCAL SCHOOLS AND AGENCIES TO REACH THE ADOLESCENT POPULATION, DEVELOPING MENTAL HEALTH SUPPORT SYSTEMS FOR EMPLOYEES OF GREAT PLAINS HEALTH, AND OFFERING SUPPORT SERVICES AND CLINICAL GUIDELINES DESIGNED TO ASSIST AREA PROVIDERS AND LINCOLN COUNTY RESIDENTS WITH THE DIAGNOSIS OF MENTAL OR BEHAVIORAL HEALTH. PRIORITY THREE: IMPROVE ACCESS TO MEDICAL AND DENTAL CARE. IMPLEMENTATION ACTIVITIES INCLUDE UTILIZING TECHNOLOGY TO IMPROVE ACCESS TO MEDICAL CARE, INCITING PRODUCTIVE DIALOGUE AROUND ACCESS TO LOW-INCOME DENTAL CARE IN LINCOLN COUNTY, ENGAGING IN PROGRAMS THAT SERVE THOSE UNABLE TO PAY FOR HEALTHCARE SERVICES, ENHANCING PHYSICAL STRUCTURE OF TREATMENT AREAS TO CREATE GREATER ACCESS TO CARE, AND EXPANDING LOCAL HEALTHCARE SERVICES SO THAT PATIENTS CAN STAY AS CLOSE TO HOME AS POSSIBLE FOR MEDICAL CARE.PRIORITY FOUR: INCREASE PREVENTION EDUCATION TO REDUCE THE PREVALENCE OF CHRONIC DISEASES, PREVENTABLE CONDITIONS, READMISSIONS AND HIGH MORTALITY RATES. IMPLEMENTATION ACTIVITIES INCLUDE OFFERING COMMUNITY EVENTS DESIGNED TO IMPROVE HEALTH AND WELLNESS, PARTNERING WITH LOCAL ORGANIZATIONS WHO WORK TO IMPROVE WELLNESS IN THE COMMUNITY, ENHANCING THE GPFIT! INITIATIVE TO IMPROVE COMMUNITY WELLNESS, PROVIDING COMMUNITY EDUCATION DESIGNED TO IMPROVE THE HEALTH OF THE COMMUNITY, PROVIDING COMMUNITY RESOURCES TO IMPROVE HEALTH AND WELLNESS, PROMOTING PREVENTION EDUCATION AND MESSAGING THROUGHOUT THE COMMUNITY, AND CREATING WRAP-AROUND SERVICES DESIGNED TO ENHANCE THE SUCCESS OF PATIENTS WITH CHRONIC DISEASE.PRIORITY FIVE: INCREASE ACCESS TO SAFE AND AFFORDABLE HOUSING. IMPLEMENTATION ACTIVITIES INCLUDE INCREASING ACCESS TO SAFE AND AFFORDABLE HOUSING OPTIONS IN THE COMMUNITY BY PARTICIPATING IN THE HOUSING TASK FORCE, ASSISTING WITH HOUSING DOWN PAYMENTS FOR HEALTHCARE WORKERS EMPLOYED AT GPH, WORKING WITH LOCAL HOTELS TO OFFER PATIENTS RECEIVING CARE AND THEIR FAMILIES DISCOUNTED RATES AND CONTINUING TO BE ACTIVELY ENGAGED IN INITIATIVES TO GROW HOUSING.THERE ARE NOT ANY SIGNIFICANT NEEDS IDENTIFIED IN THE MOST RECENT CHNA THAT ARE NOT BEING ADDRESSED. GREAT PLAINS HEALTH PART V, SECTION B, LINE 13B: SYSTEM HOSPITAL WILL APPLY PRESUMPTIVE ELIGIBILITY CRITERIA TO FACILITATE PROMPT RECOGNITION OF ELIGIBILITY FOR FINANCIAL ASSISTANCE. CIRCUMSTANCES INCLUDE HOMELESSNESS, DEATH WITHOUT ESTATE, AND EMERGENCY SERVICES FOR OUT-OF-STATE MEDICAID PATIENTS. GREAT PLAINS HEALTH PART V, SECTION B, LINE 13H: IF A PATIENT'S COMBINED OUTSTANDING MEDICAL BILLS, AFTER INSURANCE PAYS, EXCEEDS 7.5% OF THEIR ANNUAL GROSS INCOME, THEY WILL RECEIVE AN ADDITIONAL 15% DISCOUNT ON TOP OF THE FINANCIAL ASSISTANCE DISCOUNT WITH THE COMBINED DISCOUNT NOT TO EXCEED 100% OF THE OUTSTANDING BALANCE. OUTSTANDING MEDICAL BILLS ARE NOT RESTRICTED TO JUST GREAT PLAINS HEALTH SERVICES BUT CAN BE ANY MEDICAL SERVICES. CURRENT STATEMENTS MUST BE PROVIDED SHOWING THE OUTSTANDING BALANCES CLAIMED. GREAT PLAINS HEALTH PART V, SECTION B, LINE 16J: THE WRITTEN FINANCIAL ASSISTANCE POLICY IS ON GPH'S WEBSITE, AND TELEPHONE NUMBERS TO PATIENT FINANCIAL SERVICES AND FINANCIAL COUNSELING ARE PRINTED ON THE BACK SIDE OF EACH PAGE OF THE PATIENT BILLING STATEMENT. POSTERS REGARDING AVAILABILITY OF FINANCIAL ASSISTANCE ARE POSTED AT PATIENT POINTS OF ENTRY THROUGHOUT THE HOSPITAL FACILITY. GREAT PLAINS HEALTH PART V, SECTION B, LINE 20E: GPH WORKS WITH PATIENTS THROUGH PHONE AND IN-PERSON INTERVIEWS TO DETERMINE THE PATIENT'S FINANCIAL SITUATION AND TO DETERMINE IF THE INDIVIDUAL QUALIFIES FOR ASSISTANCE, SUCH AS MEDICAID. PATIENTS CAN ALSO REQUEST FINANCIAL ASSISTANCE AND SUBMIT DOCUMENTS THROUGH THE PATIENT PORTAL. 1 1 - NORTH PLATTE SURGERY CENTER LLC 621 WEST FRANCIS STREET NORTH PLATTE NE 69101 OUTPATIENT SURGERIES PART I, LINE 3C: ASIDE FROM FEDERAL PROVERY GUIDELINES, GPH ALSO UTILIZES THE FOLLOWING FACTORS TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE: ASSET LEVEL, MEDICAL INDIGENCY, UNDERINSURANCE STATUS, PRESUMPTIVE ELIGIBILITY AND TOTAL OUTSTANDING MEDICAL BILLS. PART I, LINE 6A: GPH'S COMMUNITY BENEFIT REPORT IS PREPARED BY THE STAFF OF GPH. 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, HEALTH PROFESSIONS EDUCATION, LINE 7F, RESEARCH, LINE 7H, AND CONTRIBUTIONS, LINE 7I, ARE REPORTED BASED ON ACTUAL EXPENSES REPORTED IN THE GENERAL LEDGER. THE COST FOR SUBSIDIZED HEALTH SERVICES REPORTED ON LINE 7G WAS CALCULATED USING THE RATIO OF PATIENT COST TO CHARGES ON WORKSHEET 2. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES REPORTED ON LINE 7G INCLUDE TRAINING FOR EMS, OUTREACH, LIFE SUPPORT OUTSIDE, AND ER, TRAUMA, AND LIFE SUPPORT FOR HOSPITAL EDUCATION. PART II, COMMUNITY BUILDING ACTIVITIES: GPH HAS MANY ACTIVITES TO PROMOTE HEALTH IN THE COMMUNITIES IT SERVES. THESE ACTIVITIES INCLUDE: RECRUITMENT OF PHYSICIANS TO MEET NEED, SPONSORING HEALTH FAIR, SPORTS CLINICS AND SUPPORT GROUPS, PHYSICIANS SERVING ON COMMUNITY BOARDS, EDUCATION PROGRAMS AND MEDICATION ASSISTANCE. THE DONATED SERVICES AND FUNDS HELP FURTHER THE MISSION AND GOALS OF COMMUNITY ORGANIZATIONS WHICH, IN TURN, HELP IMPROVE OVERALL HEALTH STATUS AND QUALITY OF LIFE OF THE COMMUNITIES SERVED. PART III, LINE 2: THE ORGANIZATION DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION EXPERIENCE WITH VARIOUS CLASSES 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 17.6% 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 15 AND 16 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: THE MEDICARE SHORTFALL IS BASED ON THE INFORMATION FROM THE COST REPORT. THESE COSTS ARE MEDICARE REIMBURSABLE COSTS, NOT ALL COSTS. THESE MEDICARE REIMBURSABLE COSTS SHOULD BE TREATED AS A COMMUNITY BENEFIT TO THE EXTENT THAT MEDICARE REVENUES DO NOT COVER THE COSTS, THEREFORE THE ENTIRE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT. WE DO NOT USE ANY NEGOTIATION TOOL WITH MEDICARE FOR OUR RATES; THE RATES THAT WE ARE PAID ARE MANDATED. HENCE, THIS DOES NOT GIVE US THE ABILITY AS A PROVIDER TO RECEIVE SUFFICIENT REVENUES TO COVER THE MEDICARE COSTS. AS A FACILITY WE ARE WORKING TOWARD COSTS SAVINGS. PART III, LINE 9B: IF THE COLLECTION AGENCY LEARNS INFORMATION THAT INDICATES THAT THE PATIENT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE GPH CHARITY CARE POLICY, THEN THE COLLECTION AGENCY SHALL PROMPTLY NOTIFY THE PATIENT FINANCIAL SERVICES DIRECTOR AND CEASE ANY FURTHER COLLECTION ACTIVITY UNTIL GPH DETERMINES THE PATIENT ELIGIBILITY. PART VI, LINE 2: GPH USES STRATEGIC PLANNING PROCESSES, MARKET STUDIES, OPEN FORUMS WITH PHYSICIANS, COMMUNITY FOCUS GROUPS, CUSTOMER SERVICE SURVEYS AND COMMUNITY SURVEYS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITIES GPH SERVES. PATIENT CARE AND SUPPORT SERVICES PROVIDED BY GPH ARE BASED ON GPH'S MISSION, VISION, VALUES AND STANDARDS OF BEHAVIOR. PATIENT CARE AND ANCILLARY SERVICES ARE ORGANIZED IN RESPONSE TO PATIENT NEEDS AS IDENTIFIED THROUGH THE STRATEGIC PLANNING PROCESS. THE GPH STRATEGIC PLAN FOCUSES ON ACHIEVING A CONTINUUM OF CARE TO MEET THE NEEDS OF THE COMMUNITY SERVED. THE STRATEGIC PLANNING PROCESS IS COMPLETED APPROXIMATELY EVERY THREE TO FIVE YEARS. PART VI, LINE 3: FOR PATIENTS THAT GPH DETERMINES ARE FINANCIALLY INDIGENT, THE PATIENT/GUARANTOR WILL BE NOTIFIED AND ASSISTED BY THE GPH PATIENT FINANCIAL SERVICES IN APPLYING FOR FINANCIAL ASSISTANCE. IF NO SOURCE OF FINANCIAL ASSISTANCE IS AVAILABLE, THE ACCOUNT WILL BE REVIEWED FOR A CHARITY ALLOWANCE ACCORDING TO THE HOSPITAL'S CHARITY POLICY (ADMINISTRATIVE POLICY 8210-0008). CASE MANAGERS ARE AVAILABLE AT GPH TO ASSIST PATIENTS AND THEIR FAMILIES WITH THE FINANCIAL AND SOCIAL STRESS THAT ACCOMPANY ILLNESS AND HOSPITALIZATION. CASE MANAGERS HAVE A WORKING KNOWLEDGE OF SOCIAL WORK THEORIES AND ARE ABLE TO ASSIST PATIENTS WITH CONTACTING COMMUNITY AGENCIES THAT CAN ASSIST THEM IN RECOVERY AND FINANCIAL NEEDS. AN OUTSIDE AGENCY IS USED TO PROVIDE ASSISTANCE TO PATIENTS IN DETERMINING THEIR ELIGIBILITY FOR MEDICAID. ONE-ON-ONE FINANCIAL COUNSELING IS AVAILABLE TO EVERY PATIENT, UPON REQUEST. PART VI, LINE 4: GREAT PLAINS HEALTH IS THE ONLY HOSPITAL IN LINCOLN COUNTY AND IS A REGIONAL REFERRAL HOSPITAL FOR NINETEEN OTHER COUNTIES IN NEBRASKA. GPH SERVES A MARKET OF OVER 134,000 RESIDENTS. OVER NINETY-THREE PERCENT OF GPH'S INPATIENT ADMISSIONS COME FROM WITHIN THIS MARKET. SEVENTY-TWO PERCENT OF THE PATIENTS COME FROM LINCOLN COUNTY. THE PRIMARY SERVICE AREA IS DEFINED AS LINCOLN COUNTY. THE SECONDARY SERVICE AREA INCLUDES THE FOLLOWING NINETEEN COUNTIES: ARTHUR, FRONTIER, HOOKER, PERKINS, CHASE, GRANT, GOSPER, KEITH, RED WILLOW, FURNAS, DUNDY, CHERRY, CUSTER, HAYES, LOGAN, THOMAS, DAWSON, HITCHCOCK, AND MCPHERSON. THE TOTAL POPULATION OF THE SECONDARY SERVICE AREA IS ABOUT 99,000.THE POPULATION IN THE SERVICE AREA IS EXPECTED TO CONTINUE THE SHIFT TOWARDS AN AGING POPULATION THAT WOULD INCREASE SERVICE UTILIZATION. HOSPITALS IN THE SECONDARY SERVICE AREA ARE: CHASE COUNTY COMMUNITY HOSPITAL (CHASE COUNTY), CHERRY COUNTY HOSPITAL (CHERRY COUNTY), CALLAWAY DISTRICT HOSPITAL (CUSTER COUNTY), JENNIE M. MELHAM MEMORIAL HOSPITAL (CUSTER COUNTY), COZAD COMMUNITY HOSPITAL (DAWSON COUNTY), GOTHENBURG MEMORIAL HOSPITAL (DAWSON COUNTY), LEXINGTON REGIONAL MEDICAL CENTER (DAWSON COUNTY), DUNDY COUNTY HOSPITAL (DUNDY COUNTY), TRI VALLEY HEALTH SYSTEM (FURNAS COUNTY), OGALLALA COMMUNITY HOSPITAL (KEITH COUNTY), PERKINS COUNTY HEALTH SERVICES (PERKINS COUNTY), AND COMMUNITY HOSPITAL (RED WILLOW COUNTY).MARKET OVERVIEWPRIMARY SERVICE AREA- CONSISTS OF LINCOLN COUNTY- ACCOUNTS FOR NEARLY 78% GPH'S INPATIENT CASES- THE 2020 POPULATION WAS 34,676SECONDARY SERVICE AREA- CONSISTS OF NINETEEN COUNTIES EXTENDING NORTH TO SOUTH DAKOTA, SOUTH TO KANSAS AND WEST TO COLORADO - ACCOUNTS FOR 17% OF GPH'S INPATIENT CASES - POPULATION 101,938 IN 2019 - LARGEST EMPLOYER IS UNION PACIFIC PART VI, LINE 5: GPH HAS MANY ACTIVITES TO PROMOTE HEALTH IN THE COMMUNITIES IT SERVES. THESE ACTIVITIES INCLUDE: RECRUITMENT OF PHYSICIANS TO MEET NEED, SPONSORING HEALTH FAIR, SPORTS CLINICS AND SUPPORT GROUPS, PHYSICIANS SERVING ON COMMUNITY BOARDS, EDUCATION PROGRAMS AND MEDICATION ASSISTANCE. THE DONATED SERVICES AND FUNDS HELP FURTHER THE MISSION AND GOALS OF COMMUNITY ORGANIZATIONS WHICH, IN TURN, HELP IMPROVE OVERALL HEALTH STATUS AND QUALITY OF LIFE OF THE COMMUNITIES SERVED. PART VI, LINE 6: GREAT PLAINS HEALTH IS NOT PART OF AN AFFILIATED HEALTHCARE SYSTEM, BUT ASSISTS IN IDENTIFYING AND RECRUITING TOP PHYSICIANS IN NEEDED SPECIALTIES. GPH PROVIDES EDUCATION TO THE COMMUNITY ON VARIOUS HEALTH PROGRAMS FOR EMPLOYEES, EMPLOYERS AND THE COMMUNITY GPH SERVES. MANY MEMBERS OF THE STAFF HOLD SPEAKING ENGAGEMENTS TO PROVIDE MEDICAL INFORMATION TO THE COMMUNITY. THE MEDICATION ASSISTANCE PROGRAM ASSISTS PATIENTS TO FIND OTHER MEANS TO AFFORD THEIR PRESCRIPTIONS.THE HEALTH CENTER OPERATES ACUTE AND PSYCHIATRIC CARE BEDS AND PROVIDES VARIOUS OUTPATIENT AND EMERGENCY MEDICAL TREATMENT SERVICES. THE AFFILIATES LEASE AND SELL HOME MEDICAL EQUIPMENT TO THE PUBLIC, RENT OFFICE SPACE TO PHYSICIAN PRACTICES AND PROVIDE PHYSICIAN PROFESSIONAL MEDICAL SERVICES AND OTHER PROGRAMS TO PATIENTS. PART VI, LINE 7: GPH DOES NOT FILE A COMMUNITY BENEFIT REPORT WITH ANY STATE. 1 NEBRASKALAND DAYS INC PO BOX 706 NORTH PLATTE NE 69103 470521025 501(C)(4) 43000 0 SPONSOR OF 2023 EVENTS PLATTE RIVER FITNESS SERIES 1300 MCDONALD NORTH PLATTE NE 69101 476006297 GOVERNMENTAL 17500 0 SPONSOR OF EVENTS CREATIVITY UNLIMITED ARTS COUNCIL PO BOX 266 NORTH PLATTE NE 69103 202209105 501(C)(3) 10000 0 RENOVATION TO THE PRAIRIE ARTS CENTER MID-NEBRASKA COMMUNITY FOUNDATION INC 121 N DEWEY ST STE 112 PO BOX 1321 NORTH PLATTE NE 69101 470604965 501(C)(3) 21000 0 COURT SPONSORSHIP TO SUPPORT NEW CODY PARK TENNIS AND PICKLEBALL COURTS. 3 1 PART I, LINE 2: GREAT PLAINS HEALTH PROVIDES SPONSORSHIP DOLLARS TO CHARITABLE EVENTS IN THE LOCAL AREA. THE ORGANIZATION GIVES TO CHARITABLE ORGANIZATIONS IN THE AREA WHICH BENEFIT THE LOCAL COMMUNITY. X X X X 0 0 0 0 0 0 0 1 0 WAYNE L WARREN MD PHYSICIAN (GPH) 2047583 0 859 0 23406 0 13200 0 31572 0 2116620 0 0 0 PUSHKAR M KANADE MD PHYSICIAN (GPH) 1315775 0 58095 0 2801 0 13200 0 43472 0 1433343 0 0 0 MICHAEL SIMONSON MD PHYSICIAN (GPH) 1203893 0 57348 0 300 0 13200 0 38891 0 1313632 0 0 0 NARAYANA KODURI MD PHYSICIAN (GPH) 1142832 0 90955 0 300 0 13200 0 42691 0 1289978 0 0 0 ANIL KUMAR MD PHYSICIAN (GPH) 1157271 0 1385 0 450 0 13200 0 37691 0 1209997 0 0 0 KRISTEN BURWICK DIRECTOR 819935 0 100 0 8604 0 13200 0 43891 0 885730 0 0 0 IVAN MITCHELL CEO 480337 0 42315 0 21699 0 13200 0 41741 0 599292 0 0 0 JOVANKA VULSANOVIC MD DIRECTOR/PHYSICIAN (GPH) 301733 0 51923 0 433 0 13200 0 481 0 367770 0 0 0 SUMMER OWEN CFO 279670 0 28100 0 300 0 12780 0 28330 0 349180 0 0 0 PART I, LINE 7 PHYSICIANS ARE ELIGIBLE FOR NON-FIXED QUALITY COMPENSATION BONUSES. QUALITY INDICATORS FOR QUALITY COMPENSATION SHALL BE OBJECTIVE, IDENTIFIABLE STANDARDS THAT ARE ESTABLISHED BY GPH, THE PHYSICIAN AND EXECUTIVE DIRECTOR IN WRITING ON AN ANNUAL BASIS PRIOR TO THE BEGINNING OF A NEW CONTRACT YEAR. SAID QUALITY METRICS SHALL NOT RELATE IN ANY MANNER TO THE VOLUME OR VALUE OF REFERRALS OR OTHER BUSINESS GENERATED BY PHYSICIAN FOR HOSPITAL OR AFFILIATES THEREOF OR BASED UPON REDUCING OR REFUSING CARE PROVIDED TO BENEFICIARIES OF FEDERAL PROGRAMS. THE FOLLOWING PHYSICIANS RECEIVED BONUSES DURING THE YEAR: MICHAEL SIMONSON, MD WAYNE WARREN, MD PUSHKAR KANADE, MD ANIL KUMAR, MD NARAYANA KODURI, MD JOVANKA VULSANOVIC, MD KRISTIN LAKE SPOUSE OF DR. LADD LAKE, DIRECTOR 144277 EMPLOYMENT WITH HOSPITAL 0 JOSEPH RUYBAL SON-IN-LAW OF PETE VOLZ, DIRECTOR 143523 EMPLOYMENT WITH HOSPITAL 0 EDUARDO A F FREITAS SPOUSE OF JOVANKA VUKSANOVIC, DIRECTOR 713103 EMPLOYMENT WITH HOSPITAL 0 FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE, CONSISTING OF THE OFFICERS OF THE BOARD OF DIRECTORS, HAS THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION HAS TWO CLASSES OF MEMBERS, CHARTER MEMBERS AND PATRON MEMBERS. CHARTER MEMBERS CONTRIBUTED TO THE ORIGINAL FUND DRIVE. THOSE INDIVIDUAL WHO CONTRIBUTE $500 TO EITHER GPH OR THE FOUNDATION AND DID NOT CONTRIBUTE DURING THE ORIGINAL FUND DRIVE SHALL BE DESIGNATED AS PATRON MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS ARE ENTITLED TO ONE VOTE IN ELECTIONS OF BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B MEMBERS HAVE THE POWER TO APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS, A MERGER, A CONSOLIDATION, DISSOLUTION, OR SALE OF ALL OR SUBSTANTIALLY ALL THE ASSETS. FORM 990, PART VI, SECTION B, LINE 11B COPIES OF THE FORM 990 ARE AVAILABLE TO THE BOARD ON A PORTAL. THE BOARD IS NOTIFIED WHEN IT IS AVAILABLE FOR VIEWING. FORM 990, PART VI, SECTION B, LINE 12C GPH PROVIDES A CONFLICT OF INTEREST QUESTIONNAIRE TO EACH OFFICER AND DIRECTOR. THE CONFLICT OF INTEREST QUESTIONNAIRE IS COMPLETED AND RETURNED ANNUALLY. ANY QUESTIONABLE SITUATION IS DISCLOSED ON THE QUESTIONNAIRE. FURTHERMORE, ANY POTENTIAL CONFLICTS ARISING DURING THE YEAR ARE TO BE REPORTED TO ADMINISTRATION. THE CONFLICTS REVIEW COMMITTEE REVIEWS ANY TRANSACTIONS THAT MAY BE CONSIDERED TO HAVE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE GREAT PLAINS HEALTH BOARD OF DIRECTORS STRIVES TO COMPENSATE OFFICERS AT LEVELS THAT ARE COMPETITIVE IN THE MARKETPLACE, COST EFFECTIVE AND, AS MUCH AS POSSIBLE, INTERNALLY EQUITABLE. THE EXECUTIVE COMMITTEE FOR THE BOARD OF DIRECTORS MEETS NO LESS THAN ANNUALLY TO REVIEW COMPENSATION PACKAGES FOR GPH'S PRESIDENT AND OFFICERS. COMPENSATION DATA IS GATHERED BY AN INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT BY SURVEYING COMPARABLE POSITIONS AT PEER INSTITUTIONS, ENSURING THAT COMPENSATION PACKAGES ARE MEETING FAIR MARKET VALUE. A COMPLETE ANALYSIS OF DATA IS REQUESTED FROM THE CONSULTANT AT LEAST EVERY FOUR YEARS. THE INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT IS ULTIMATELY ACCOUNTABLE TO THE EXECUTIVE COMMITTEE AND THE BOARD. THE EXECUTIVE COMMITTEE ANNUALLY RECOMMENDS TO THE BOARD THE SELECTION/RETENTION OF THE INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT; REVIEWS COMPENSATION RECOMMENDATIONS; AND DETERMINES THOSE OFFICERS FOR WHOM WRITTEN EMPLOYMENT CONTRACTS WILL BE REQUIRED. THE BOARD OF DIRECTORS HAS THE AUTHORITY TO ANNUALLY AUTHORIZE MANAGEMENT TO PROCEED WITH IMPLEMENTATION OF PROPOSED COMPENSATION OF OFFICERS. FORM 990, PART VI, SECTION C, LINE 19 GREAT PLAINS HEALTH DOES NOT MAKE ITS CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. UPON WRITTEN REQUEST TO THE CFO, GOVERNING DOCUMENTS WILL BE MADE AVAILABLE TO THE PUBLIC FOR REVIEW AT THE HOSPITAL'S ADMINSTRATIVE OFFICE. FORM 990, PART IX, LINE 11G PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 9,801,498. MANAGEMENT AND GENERAL EXPENSES 11,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,812,498. SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 4,609,611. MANAGEMENT AND GENERAL EXPENSES 2,461,425. FUNDRAISING EXPENSES 14,907. TOTAL EXPENSES 7,085,943. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 16,338,051. MANAGEMENT AND GENERAL EXPENSES 542,267. FUNDRAISING EXPENSES 466. TOTAL EXPENSES 16,880,784. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 371,880. MANAGEMENT AND GENERAL EXPENSES 1,779,306. FUNDRAISING EXPENSES 2,310. TOTAL EXPENSES 2,153,496. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN GREAT PLAINS HEALTH CARE FOUNDATION 169,357. EQUITY TRANSFER TO NPNHA, LLC -916,561. FORM 990, PART XII, LINE 2C: THE BOARD OF DIRECTORS OF GREAT PLAINS HEALTH ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEARS. 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