FAITH REGIONAL HEALTH SERVICES: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- FAITH REGIONAL HEALTH SERVICES (EIN 47-0796875)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-10-26
- IRS object ID
- 202332999349300748
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-10-26T13:17:34-05:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18081 BURT ST STE 200 | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 680224722 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470796875 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAITH REGIONAL HEALTH SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FAIT | BusinessNameControlTxt |
| Phone | 4023714880 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1500 KOENIGSTEIN AVENUE PO BOX 869 | AddressLine1Txt |
| City | NORFOLK | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 687020869 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JANNA CLINE | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 4023714880 | PhoneNum |
| Signature | 2023-10-26 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JANNA | PersonFirstNm |
| Person Last | CLINE | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MEGAN L KOZIOL CPA | PreparerPersonNm |
| PTIN | P01544037 | PTIN |
| Phone | 4023302660 | PhoneNum |
| Preparation | 2023-10-24 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KELLY DRISCOLL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1500 KOENIGSTEIN AVENUE PO BOX 869 | AddressLine1Txt |
| City | NORFOLK | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 687020869 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $268,655,031 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.FRHS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1996 | FormationYr |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE ACUTE, SKILLED AND OUTPATIENT SERVICES TO INDIVIDUALS IN OUR SERVICE AREA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 1998 | TotalEmployeeCnt |
| Total Volunteers | 28 | TotalVolunteersCnt |
| Total Gross UBI | $273,423 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $243,043 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,365,427 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,186,882 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $292,707,231 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $261,280,318 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,263,698 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,361,455 | CYInvestmentIncomeAmt |
| PY Other Revenue | $887,256 | PYOtherRevenueAmt |
| CY Other Revenue | $627,270 | CYOtherRevenueAmt |
| PY Total Revenue | $300,223,612 | PYTotalRevenueAmt |
| CY Total Revenue | $266,455,925 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $324,099 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $225,961 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $144,821,895 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $147,813,490 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $273,925 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $146,770,510 | PYOtherExpensesAmt |
| CY Other Expenses | $118,034,554 | CYOtherExpensesAmt |
| PY Total Expenses | $291,916,504 | PYTotalExpensesAmt |
| CY Total Expenses | $266,074,005 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $8,307,108 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $381,920 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $286,490,479 | TotalAssetsBOYAmt |
| Total Assets EOY | $262,709,523 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $118,741,263 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $99,115,717 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $167,749,216 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $163,593,806 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO SERVE CHRIST BY PROVIDING ALL PEOPLE WITH EXEMPLARY MEDICAL SERVICES IN AN ENVIRONMENT OF LOVE AND CARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $224,774,327 | ExpenseAmt |
| Grant | $225,961 | GrantAmt |
| Revenue | $249,189,482 | RevenueAmt |
| Desc | FAITH REGIONAL PROVIDES HEALTHCARE TO ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY OR THEIR INSURANCE PROVIDER. DURING THE YEAR, FAITH REGIONAL PROVIDED SIGNIFICANT SERVICES FOR MEDICARE AND MEDICAID PATIENTS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $15,892,054 | ExpenseAmt |
| Revenue | $12,474,313 | RevenueAmt |
| Desc | MANY SERVICES PROVIDED BY FAITH REGIONAL ARE DONE TO MEET SPECIFIC NEEDS OF THE COMMUNITY BECAUSE NO OTHER SERVICES ARE AVAILABLE. AS A RESULT, THESE SERVICES ARE PROVIDED KNOWING THAT THEY WILL NOT BE FINANCIALLY VIABLE OR SELF-SUPPORTING. THESE SERVICES INCLUDE BEHAVIORAL HEALTH INPATIENT AND OUTPATIENT SERVICES, CHILD ADVOCACY, DIABETIC EDUCATION, DIALYSIS SERVICES, ACUTE REHABILITATIVE SERVICES, HOME HEALTH CARE AND TRANSITIONAL CARE (LONG-TERM REHABILITATION) SERVICES. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $679,266 | ExpenseAmt |
| Revenue | $0 | RevenueAmt |
| Desc | A SUBSTANTIAL PORTION OF COMMUNITY BENEFITS PROVIDED BY FAITH REGIONAL IS THE PROVISION OF PATIENT CARE SERVICES THAT ARE NOT PAID FOR EITHER BY THE PATIENT OR THIRD PARTY INSURANCE. DURING 2022, FAITH PROVIDED PATIENTS JUST UNDER SEVEN HUNDRED THOUSAND DOLLARS IN ASSISTANCE WITH PAYING THEIR HOSPITAL BILLS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $241,345,647 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 101 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1998 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JANNA CLINE | PersonNm |
| Phone | 4026447249 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1500 KOENIGSTEIN AVENUE PO BOX 869 | AddressLine1Txt |
| City | NORFOLK | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 687020869 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| FADI RZOUQ MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | Yes (X) | $4,373,512 | $0 | $48,874 | ||
| TRISTAN L HARTZELL MD | ||||||||
| PHYSICIAN | 40.00 | 1.00 | Yes (X) | $3,680,758 | $0 | $1,398 | ||
| JOHN LAMMLI MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | Yes (X) | $1,198,372 | $0 | $46,296 | ||
| NATHAN HERMAN MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | Yes (X) | $1,162,323 | $0 | $49,556 | ||
| BEETHOVEN BROWN MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | Yes (X) | $1,177,611 | $0 | $11,083 | ||
| KELLY DRISCOLL | ||||||||
| CEO | 39.00 | 2.00 | $758,697 | $0 | $48,857 | Yes (X) | ||
| ROBERT PRINCE MD | ||||||||
| MEMBER - MEDICAL DIRECTOR | 40.00 | 0.00 | $744,111 | $0 | $45,021 | Yes (X) | ||
| LANE HANDKE MD | ||||||||
| MEMBER - CHIEF OF STAFF | 40.00 | 0.00 | $549,044 | $0 | $42,370 | Yes (X) | ||
| JANNA CLINE | ||||||||
| VP FINANCE | 39.00 | 2.00 | $238,398 | $0 | $30,149 | Yes (X) | ||
| LINDA MILLER RN | ||||||||
| CHAIR | 1.50 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| BRETT JACKSON | ||||||||
| VICE CHAIR | 1.50 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| SUE FUCHTMAN | ||||||||
| SECRETARY | 1.50 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| JOHN ROBERTSON | ||||||||
| TREASURER | 1.00 | 2.50 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| STEF LACEY MD | ||||||||
| MEMBER | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| TRAVIS RUTJENS | ||||||||
| MEMBER | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| JACQUE COLLISON | ||||||||
| MEMBER | 1.00 | 3.50 | $0 | $0 | $0 | Yes (X) | ||
| JOSH GOSSMAN | ||||||||
| MEMBER | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| DIANE BECKER | ||||||||
| MEMBER | 1.00 | 2.50 | $0 | $0 | $0 | Yes (X) | ||
| BRAD DINKEL | ||||||||
| MEMBER | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| LEON ROSENTHAL | ||||||||
| MEMBER | 1.00 | 2.50 | $0 | $0 | $0 | Yes (X) | ||
| PRESTON SUNDERMAN | ||||||||
| MEMBER | 1.00 | 2.50 | $0 | $0 | $0 | Yes (X) | ||
| CORY SHAW | ||||||||
| MEMBER (THRU 10/2022) | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $13,882,826 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $323,604 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 117 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PATHOLOGY MEDICAL SERVICE | |||||
| PO BOX 82653 | LINCOLN | NE | 68501 | LAB SERVICES | $542,000 |
| SIOUX CITY NIGHT PATROL | |||||
| PO BOX 3276 | SIOUX CITY | IA | 51102 | SECURITY SERVICES | $352,630 |
| BROGAN & LAMMLI | |||||
| 3204 W BENJAMIN AVE | NORFOLK | NE | 68701 | LEGAL SERVICES | $179,676 |
| EIDE BAILLY LLP | |||||
| 18081 BURT STREET | OMAHA | NE | 68022 | ACCOUNTING SERVICES | $137,787 |
| VIRTUAL RADIOLOGIC CORPORATION | |||||
| 25983 NETWORK PLACE | CHICAGO | IL | 60673 | LAB SERVICES | $124,259 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 10 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $47,000 | FederatedCampaignsAmt |
| Related Organizations | $2,767,691 | RelatedOrganizationsAmt |
| All Other Contributions | $372,191 | AllOtherContributionsAmt |
| Total Contributions | $3,186,882 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $167,486,899 | $167,486,899 |
| PATIENT SVC M'CARE/MEDICAID | 621110 | $80,116,636 | $80,116,636 |
| LEASED MEDICAL EMPLOYEES | 621110 | $2,869,379 | $2,869,379 |
| PHYSICIAN CLINICS | 621110 | $1,149,995 | $1,149,995 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,657,409 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,657,409 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $261,280,318 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,277,080 | TotalRevenueColumnAmt |
| Exclusion | $1,277,080 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $661,971 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $819,427 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$157,456 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$157,456 | TotalRevenueColumnAmt |
| Exclusion | -$157,456 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,305,185 | SecuritiesAmt |
| Other | $151,419 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,286,633 | SecuritiesAmt |
| Other | $85,596 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $18,552 | SecuritiesAmt |
| Other | $65,823 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $84,375 | TotalRevenueColumnAmt |
| Exclusion | $84,375 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $9,312 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $7,450 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,862 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $1,862 | UnrelatedBusinessRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MHR HOME CARE, LLC | Desc |
| Business | 456199 | BusinessCd |
| Total Revenue Column | $271,561 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $271,561 | UnrelatedBusinessRevenueAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $511,303 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $383,477 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $127,826 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $782,864 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $266,455,925 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $261,663,795 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $273,423 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,331,825 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $225,961 | TotalAmt |
| Program Services | $225,961 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,456,647 | TotalAmt |
| Program Services | $1,380,546 | ProgramServicesAmt |
| Management And General | $1,076,101 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $524,109 | TotalAmt |
| Program Services | $524,109 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $120,602,670 | TotalAmt |
| Program Services | $111,559,381 | ProgramServicesAmt |
| Management And General | $8,838,556 | ManagementAndGeneralAmt |
| Fundraising | $204,733 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,514,981 | TotalAmt |
| Program Services | $3,256,829 | ProgramServicesAmt |
| Management And General | $252,679 | ManagementAndGeneralAmt |
| Fundraising | $5,473 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,369,820 | TotalAmt |
| Program Services | $11,863,944 | ProgramServicesAmt |
| Management And General | $1,501,547 | ManagementAndGeneralAmt |
| Fundraising | $4,329 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,345,263 | TotalAmt |
| Program Services | $6,780,882 | ProgramServicesAmt |
| Management And General | $548,316 | ManagementAndGeneralAmt |
| Fundraising | $16,065 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $431,554 | TotalAmt |
| Program Services | $8,403 | ProgramServicesAmt |
| Management And General | $423,151 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $212,013 | TotalAmt |
| Program Services | $4,128 | ProgramServicesAmt |
| Management And General | $207,885 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,009,760 | TotalAmt |
| Program Services | $25,008,861 | ProgramServicesAmt |
| Fundraising | $899 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $907,829 | TotalAmt |
| Program Services | $7,167 | ProgramServicesAmt |
| Management And General | $900,662 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,404,718 | TotalAmt |
| Program Services | $9,409,992 | ProgramServicesAmt |
| Management And General | $986,091 | ManagementAndGeneralAmt |
| Fundraising | $8,635 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,619,112 | TotalAmt |
| Program Services | $7,320,878 | ProgramServicesAmt |
| Management And General | $1,287,271 | ManagementAndGeneralAmt |
| Fundraising | $10,963 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,065,114 | TotalAmt |
| Program Services | $6,692,739 | ProgramServicesAmt |
| Management And General | $372,375 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $253,863 | TotalAmt |
| Program Services | $227,672 | ProgramServicesAmt |
| Management And General | $20,850 | ManagementAndGeneralAmt |
| Fundraising | $5,341 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $602,747 | TotalAmt |
| Program Services | $542,069 | ProgramServicesAmt |
| Management And General | $52,664 | ManagementAndGeneralAmt |
| Fundraising | $8,014 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,200,220 | TotalAmt |
| Program Services | $86,868 | ProgramServicesAmt |
| Management And General | $2,113,352 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,519,066 | TotalAmt |
| Program Services | $8,938,650 | ProgramServicesAmt |
| Management And General | $4,580,416 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,266,650 | TotalAmt |
| Program Services | $216,326 | ProgramServicesAmt |
| Management And General | $1,050,324 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| INCOME TAX | $34,531 | $34,531 | ||
| MEDICAL SUPPLIES | $42,899,781 | $42,899,781 | ||
| MISCELLANEOUS | $3,378,738 | $3,372,173 | $604 | $5,961 |
| FOOD | $865,910 | $865,327 | $583 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $362,948 | TotalAmt |
| Program Services | $118,430 | ProgramServicesAmt |
| Management And General | $241,006 | ManagementAndGeneralAmt |
| Fundraising | $3,512 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $266,074,005 | TotalAmt |
| Program Services | $241,345,647 | ProgramServicesAmt |
| Management And General | $24,454,433 | ManagementAndGeneralAmt |
| Fundraising | $273,925 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $190,982 | BOYAmt |
| EOY | $152,063 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $67,375,791 | BOYAmt |
| EOY | $56,344,001 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,084,865 | BOYAmt |
| EOY | $28,936,969 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,926,393 | BOYAmt |
| EOY | $2,172,183 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,776,453 | BOYAmt |
| EOY | $4,469,606 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,089,469 | BOYAmt |
| EOY | $4,900,162 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $305,935,597 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $188,601,808 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $122,461,782 | BOYAmt |
| EOY | $117,333,789 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,861,644 | BOYAmt |
| EOY | $35,945,553 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,338,141 | BOYAmt |
| EOY | $3,248,352 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,384,959 | BOYAmt |
| EOY | $9,206,845 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $286,490,479 | BOYAmt |
| EOY | $262,709,523 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,966,356 | BOYAmt |
| EOY | $31,612,672 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,787,203 | BOYAmt |
| EOY | $55,940,463 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,866,670 | BOYAmt |
| EOY | $8,118,756 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,121,034 | BOYAmt |
| EOY | $3,443,826 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $118,741,263 | BOYAmt |
| EOY | $99,115,717 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $167,749,216 | BOYAmt |
| EOY | $162,593,806 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,000,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $167,749,216 | BOYAmt |
| EOY | $163,593,806 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $286,490,479 | BOYAmt |
| EOY | $262,709,523 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $381,920 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$4,537,330 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $13,254 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $13,254 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | FAITH REGIONAL PAID DUES TO THE NEBRASKA HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THE DUES WERE USED FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,611,965 | BeginningYearBalanceAmt |
| Contributions | $76 | ContributionsAmt |
| Investment Earnings Or Losses | -$169,311 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $6,442,730 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,533,918 | BeginningYearBalanceAmt |
| Contributions | $50 | ContributionsAmt |
| Investment Earnings Or Losses | $1,077,997 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $6,611,965 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,523,918 | BeginningYearBalanceAmt |
| Contributions | $10,000 | ContributionsAmt |
| Investment Earnings Or Losses | $1,022,500 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,022,500 | OtherExpendituresAmt |
| End Year Balance | $5,533,918 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,052,916 | BeginningYearBalanceAmt |
| Contributions | $15,000 | ContributionsAmt |
| Investment Earnings Or Losses | $1,454,367 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $3,998,365 | OtherExpendituresAmt |
| End Year Balance | $5,523,918 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,361,450 | BeginningYearBalanceAmt |
| Contributions | $50 | ContributionsAmt |
| Investment Earnings Or Losses | -$308,584 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $8,052,916 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00800 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.99200 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,220,548 | OtherCostOrOtherBasisAmt |
| Book Value | $4,220,548 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $132,660,891 | OtherCostOrOtherBasisAmt |
| Depreciation | $71,510,896 | DepreciationAmt |
| Book Value | $61,149,995 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $154,590,228 | OtherCostOrOtherBasisAmt |
| Depreciation | $112,030,705 | DepreciationAmt |
| Book Value | $42,559,523 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,463,930 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,060,207 | DepreciationAmt |
| Book Value | $9,403,723 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $117,333,789 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED THIRD PARTY PAYOR SETTLEMENTS - MEDICARE & MEDICAID | $969,000 |
| LEASE LIABILITY | $2,474,826 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,443,826 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | CARSON CANCER CENTER ENDOWMENT FUNDS ARE PERMANENTLY SET ASIDE TO GENERATE INVESTMENT EARNINGS TO BE USED TO FUND CAPITAL EQUIPMENT PURCHASES AND/OR OPERATIONS OF THE CARSON REGIONAL CANCER CENTER. INVESTMENT EARNINGS ON THESE FUNDS ARE RESTRICTED AS TO USE. GENERAL ENDOWMENT FUNDS ARE PERMANENTLY SET ASIDE TO GENERATE INVESTMENT EARNINGS. INVESTMENT EARNINGS ON THESE FUNDS ARE NOT RESTRICTED AS TO USE. THE HOSPICE ENDOWMENT FUNDS ARE PERMANENTLY SET ASIDE TO GENERATE INVESTMENT EARNINGS TO BENEFIT THE HOSPICE PROGRAM AND ITS PATIENTS. INVESTMENT INCOME ON THESE FUNDS IS RESTRICTED AS TO USE. THE CARDIAC SERVICES ENDOWMENT FUNDS ARE PERMANENTLY SET ASIDE TO GENERATE INVESTMENT EARNINGS TO FUND FAITH REGIONAL HEALTH SERVICE'S CARDIAC PROGRAM CAPITAL AND/OR OPERATIONAL EXPENSES. THE EDUCATION ENDOWMENT FUNDS ARE PERMANENTLY SET ASIDE TO GENERATE INVESTMENT EARNINGS TO BENEFIT FAITH REGIONAL HEALTH SERVICE'S EDUCATION PROGRAMS AND ITS EFFORTS TO RECRUIT AND RETAIN EMPLOYEES. INVESTMENT INCOME ON THESE FUNDS IS RESTRICTED AS TO USE. ST. JOSEPH'S NURSING HOME/SKYVIEW VILLA ENDOWMENT FUNDS ARE PERMANENTLY SET ASIDE TO GENERATE INVESTMENT EARNINGS TO BE USED TO FUND CAPITAL EQUIPMENT PURCHASES AND/OR OPERATION OF ST. JOSEPH'S NURSING HOME AND SKYVIEW VILLA. INVESTMENT EARNINGS ON THESE FUNDS ARE RESTRICTED AS TO USE. THE PEDIATRIC ENDOWMENT FUNDS ARE PERMANENTLY SET ASIDE TO GENERATE INVESTMENT EARNINGS TO BENEFIT FAITH REGIONAL HEALTH SERVICE'S CHILDREN'S CARE FUND. DONORS MAY SPECIFY CONTRIBUTIONS TO ANY OF THE ENDOWMENT FUNDS. |
| PART X, LINE 2: | FAITH REGIONAL HEALTH SERVICES ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. FAITH RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT DECEMBER 31, 2022 AND 2021, FAITH HAD NO UNCERTAIN TAX POSITIONS ACCRUED. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 400.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | 0 | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 198 | PersonsServedCnt |
| Total Community Benefit Expns | $584,566 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $415,738 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $168,828 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 9208 | PersonsServedCnt |
| Total Community Benefit Expns | $16,204,239 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,730,665 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,473,574 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01680 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 9406 | PersonsServedCnt |
| Total Community Benefit Expns | $16,788,805 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,146,403 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,642,402 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01740 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,686,066 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,686,066 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01010 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,444,370 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,444,370 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00540 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,417,740 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,417,740 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01280 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $352,541 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $352,541 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,900,717 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,900,717 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02960 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 9406 | PersonsServedCnt |
| Total Community Benefit Expns | $24,689,522 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,146,403 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,543,119 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04700 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $11,613,088 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $46,746,527 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $61,921,882 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$15,175,355 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 NORTHEAST NE SURGICAL CENTER LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | SURGICAL SERVICES | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.60420 | OrgProfitOrOwnershipPct |
| Ofcr Etc Profit Or Ownership | 0.00000 | OfcrEtcProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.39580 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 2 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (2 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Website AddressWebsiteAddressTxt | State LicenseStateLicenseNum | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | Emergency Room24 HrsEmergencyRoom24HrsInd | Facility Reporting GroupFacilityReportingGroupCd |
|---|---|---|---|---|---|---|---|---|---|---|
| FAITH REGIONAL HEALTH SERVICES - WEST | ||||||||||
| 1 | 2700 WEST NORFOLK AVENUE | NORFOLK | NE | 68701 | WWW.FRHS.ORG | 520001 | Yes (X) | Yes (X) | Yes (X) | A |
| FAITH REGIONAL HEALTH SERVICES - EAST | ||||||||||
| 2 | 1500 KOENIGSTEIN AVENUE | NORFOLK | NE | 68701 | WWW.FRHS.ORG | 520002 | Yes (X) | Yes (X) | A | |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FACILITY REPORTING GROUP - A | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 22 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTPS://WWW.FRHS.ORG/ABOUT-US/REPORTS/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://WWW.FRHS.ORG/ABOUT-US/REPORTS/ | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 400.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | FRHS.ORG/PATIENTS-VISITORS/BILLING-INSURANCE-FINANCIAL-ASSISTANCE/FINANCIAL | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | FRHS.ORG/PATIENTS-VISITORS/BILLING-INSURANCE-FINANCIAL-ASSISTANCE/FINANCIAL | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | FRHS.ORG/PATIENTS-VISITORS/BILLING-INSURANCE-FINANCIAL-ASSISTANCE/FINANCIAL | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, SECTION B | FACILITY REPORTING GROUP A |
| FACILITY REPORTING GROUP A CONSISTS OF: | - FACILITY 1: FAITH REGIONAL HEALTH SERVICES - WEST, - FACILITY 2: FAITH REGIONAL HEALTH SERVICES - EAST |
| FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: | THE MULTI-STEP PROCESS BEGAN WITH THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP (MAPP) PROCESS. A NUMBER OF INDIVIDUALS AND ORGANIZATIONS WITH A COMMON INTEREST IN PUBLIC HEALTH CONTRIBUTED TO IDENTIFYING THE TRENDS, FACTORS, AND EVENTS THAT INFLUENCE THE HEALTH AND QUALITY OF LIFE IN OUR COMMUNITIES AND/OR THE WORK OF THE PUBLIC HEALTH SYSTEM. CONTRIBUTORS REPRESENTED A VARIETY OF ARENAS, SECTORS AND BACKGROUNDS, AND EVERY EFFORT WAS PLACED ON HAVING EQUAL AND FAIR REPRESENTATION ACROSS ALL COUNTIES AND SECTOR FOCUS AREAS. INPUT FROM DIVERSE SECTORS INVOLVED IN PUBLIC HEALTH WAS OBTAINED THROUGH KEY INFORMANT INTERVIEWS FROM THE FOLLOWING GROUPS:-ECONOMIC DEVELOPMENT-CHAMBER OF COMMERCE-FINANCIAL INSTITUTION-HOSPITAL/CLINIC WORKERS-ELVPHD BOARD OF HEALTH-TRAILS COMMITTEE MEMBERS-LONG-TERM CARE-MEDICAL RESPONSE SYSTEMS-NEBRASKA DHHS-VETERAN SERVICE OFFICER-UNL COUNTY EXTENSION-ELECTED OFFICIALS-JUVENILE DIVERSION-LEAGUE OF HUMAN DIGNITY-NORFOLK SAFE COMMUNITIES-BEHAVIORAL HEALTH-HOSPITAL BOARD MEMBERS-NEBRASKA SEE TO LEARN PROGRAM-PUBLIC HEALTH LIAISON/ADVOCATE-SCHOOL NURSES AND SCHOOL ADMINISTRATORS-CENTER FOR RURAL AFFAIRS-CUMING COUNTY PUBLIC POWER DISTRICT-LAW ENFORCEMENT-INSTITUTES OF HIGHER EDUCATION-COMMUNITY-BASED ORGANIZATIONS-CITY EMPLOYEES-NEBRASKA BICYCLING ALLIANCE-AREA AGENCY ON AGING-PONCA TRIBE OF NEBRASKA-FEDERALLY-QUALIFIED HEALTH CENTER-NORFOLK FAMILY COALITION-NEIGHBORING LOCAL PUBLIC HEALTH DEPARTMENTSCOMMUNITY ENGAGEMENT WAS AN OVERARCHING CONCEPT ENCOMPASSING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND FORMATION OF THE COMMUNITY HEALTH IMPROVEMENT PLAN. |
| FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A: | FAITH REGIONAL HEALTH SERVICES - WEST AND FAITH REGIONAL HEALTH SERVICES - EAST PARTNERED WITH THE ELKHORN LOGAN VALLEY PUBLIC HEALTH DEPARTMENT (ELVPHD) AND ITS RESPECTIVE DISTRICT HOSPITALS TO COMPLETE THE CHNA, THOSE HOSPITALS ARE AS FOLLOWS:-ST. FRANCIS MEMORIAL HOSPITAL, WEST POINT, NE (CUMING COUNTY) |
| FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6B: | FAITH REGIONAL HEALTH SERVICES PARTNERED WITH ITS LOCAL HEALTH DEPARTMENT, ELKHORN LOGAN VALLEY PUBLIC HEALTH DEPARTMENT TO COMPLETE THE CHNA. |
| FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11: | FAITH REGIONAL HEALTH SERVICES HAS IDENTIFIED TWO PRIORITY AREAS IN THE CHNA: CANCER PREVENTION AND SCREENING AND BEHAVIORAL/MENTAL HEALTH. FOR EACH OF THESE AREAS, GOALS AND IMPLEMENTATION STRATEGIES ARE IDENTIFIED IN THE HOSPITAL COMMUNITY HEALTH IMPLEMENTATION PLAN.THE GOALS FOCUSED ON CANCER PREVENTION AND SCREENING INCLUDE THE FOLLOWING: 1) INCREASE CANCER SCREENING AND PREVENTION IN OUR SERVICE AREA. 2) INCREASING PATIENT AND PROVIDER COMMUNICATION ABOUT SCREENINGS UTILIZING ELECTRONIC HEALTH RECORD (HER) EPIC. 3) DECREASED THE BURDEN OF OBESITY IN THE ELVPHD DISTRICT AS A SIGNIFICANT RISK FACTOR FOR CANCER.THE GOALS FOCUSED ON BEHAVIORAL/MENTAL HEALTH INCLUDE THE FOLLOWING: 1) INCREASE INTERNSHIP AND PRECEPTORSHIP OPPORTUNITIES IN THE INPATIENT OR OUTPATIENT SETTINGS FOR MENTAL HEALTH NURSING, MENTAL HEALTH THERAPISTS AND SOCIAL WORK DEGREES. 2) INCREASE TELEHEALTH ENCOUNTERS IN THE OUTPATIENT CLINIC IN BOTH MED MANAGEMENT AND THERAPY ENCOUNTERS. 3) DECREASE FINANCIAL BARRIERS TO INDIVIDUALS RECEIVING MENTAL HEALTH SERVICES, INPATIENT AND OUTPATIENT THROUGH USE OF REGION IV FUNDING.THERE WERE NOT ANY NEEDS IDENTIFIED IN THE CHNA THAT ARE NOT BEING ADDRESSED BY THE HOSPITAL. |
| FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 13B: | FOR MEDICARE PATIENTS, THE HOSPITAL MAY USE THE ORIGINAL DETERMINATION AMOUNT. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - NORTHEAST NE SURGERY CENTER LLC | ||||
| 301 NORTH 27TH ST STE 3 | NORFOLK | NE | 68701 | SURGERY CENTER |
| 3 - ST JOSEPH REHABILITATION & CARE CTR | ||||
| 401 N 18TH STREET | NORFOLK | NE | 68701 | SKILLED NURSING FACILITY |
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | FAITH REGIONAL USES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR DISCOUNTED CARE. FINANCIALLY RESPONSIBLE PARTIES WHO SUBMIT A COMPLETE, VERIFIABLE APPLICATION FOR FINANCIAL ASSISTANCE WILL BE CONSIDERED FOR FREE OR REDUCED "CHARITY CARE" FINANCIAL ASSISTANCE ON THE BASIS OF THE FEDERAL POVERTY GUIDELINES (400% FPG LIMIT).ELIGIBILITY FOR THIS PROGRAM WILL BE DETERMINED BY FAMILY SIZE, GROSS INCOME BASED ON THE FEDERAL POVERY GUIDELINES AND AN ASSET TEST. THE GROSS INCOME LEVELS ARE UPDATED EACH YEAR AS THE FEDERAL POVERTY GUIDELINES ARE UPDATED.CHARITY CARE MAY BE GRANTED WITH RESPECT TO ANY DOLLARS OWED BY A FINANCIALLY RESPONSIBLE PARTY, INCLUDING, BUT NOT LIMITED TO, DEDUCTIBLE, COINSURANCE AND COPAYMENT AMOUNTS; CHARGES FOR NON-COVERED SERVICES AND MEDICAID COST OF SHARE AMOUNTS.CHARITY CARE MAY BE AUTHORIZED FOR FINANCIALLY RESPONSIBLE PARTIES WITH INCOME LEVELS EXCEEDING 400% FPG IN THE CASE OF UNUSUAL, SPECIAL AND/OR EXTENUATING CIRCUMSTANCES. THESE INSTANCES ARE GENERALLY DUE TO MEDICAL CATASTROPHE SITUATIONS. |
| PART I, LINE 6A: | FAITH REGIONAL'S ANNUAL COMMUNITY BENEFIT REPORT IS NOT PREPARED BY A RELATED ORGANIZATION. |
| PART I, LINE 7: | FAITH REGIONAL USES A COST ACCOUNTING SYSTEM TO DETERMINE COSTS REPORTABLE ON PART I, LINE 7 (AND ELSEWHERE ON SCHEDULE H). THE FIRST STEP IN THE COST ACCOUNTING PROCESS IS TO ALLOCATE THE OVERHEAD EXPENSES (ADMINISTRATION AND GENERAL, PLANT, ETC) TO THE REVENUE PRODUCING DEPARTMENTS (OPERATING ROOM, IMAGING, ONCOLOGY, ETC). THIS IS DONE SIMILAR TO THE MEDICARE COST REPORT USING A SINGLE STEP DOWN METHOD TO ALLOCATE THE COSTS USING APPLICABLE STATISTICS. FOR EXAMPLE: PLANT EXPENSES ARE ALLOCATED DOWN TO THE OTHER DEPARTMENTS USING CURRENT SQUARE FOOTAGE SO DEPARTMENTS WITH MORE SQUARE FOOTAGE WILL BE ALLOCATED MORE PLANT EXPENSES; DIETARY EXPENSES ARE ALLOCATED BASED ON MEALS SERVED; EMPLOYEE BENEFITS ARE ALLOCATED BASED ON SALARIES; ADMINISTRATIVE AND GENERAL EXPENSES ARE ALLOCATED BASED ON ACCUMULATED COSTS; AND SO ON. ONCE ALL THE OVERHEAD EXPENSES ARE ALLOCATED TO THE REVENUE PRODUCING DEPARTMENTS THE COSTS ARE FURTHER ALLOCATED DOWN TO THE CHARGE CODE LEVEL. IN ORDER TO DO THIS, TWO DIFFERENT METHODS ARE USED DEPENDING ON THE DEPARTMENT. SPECIFIC DEPARTMENTS USE A RVU (RELATIVE VALUE UNIT) ALLOCATION WHERE EACH PROCEDURE IS WEIGHTED BY THE INTENSITY OF THE SERVICE AND IS THEN ALLOCATED COST BASED ON THAT LEVEL OF INTENSITY. FOR EXAMPLE AN XRAY WITH SEDATION IS MORE COMPLICATED AND TIME INTENSIVE THAN A SIMPLE CHEST XRAY SO IT WOULD HAVE A HIGHER RVU VALUE AND, IN TURN, A HIGHER COST ALLOCATED TO IT. THE DEPARTMENTS USING THIS ALLOCATION METHOD ARE IMAGING, CARDIAC CATH, CT, MRI, ULTRASOUND, NUCLEAR MEDICINE, RADIATION ONCOLOGY, AND REHAB (PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY).THE OTHER DEPARTMENTS USE A RATIO OF COST TO CHARGE METHOD TO ALLOCATE THE COSTS DOWN TO THE CHARGE CODE LEVEL.AFTER ALL THE COSTS HAVE BEEN ALLOCATED TO THE CHARGE CODES THE COSTING IS APPLIED TO ALL PATIENT ACCOUNTS BASED ON THEIR CHARGES TO DETERMINE THE COST OF THEIR ENCOUNTER AND THEN REPORTS CAN BE RUN TO DETERMINE THE PROFITABILITY OF CERTAIN PAYORS, SERVICE LINES OR DEPARTMENTS. |
| PART I, LINE 7G: | MANY SERVICES PROVIDED BY FAITH REGIONAL ARE DONE SO TO MEET SPECIFIC NEEDS OF THE COMMUNITY BECAUSE NO OTHER SERVICES ARE AVAILABLE. AS A RESULT, THESE SERVICES ARE PROVIDED KNOWING THAT THEY WILL NOT BE FINANCIALLY VIABLE OR SELF-SUPPORTING. FAITH REGIONAL DID NOT INCLUDE ANY PHYSICIAN CLINIC EXPENSES AS SUBSIDIZED HEALTH SERVICES. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THE ORGANIZATION DID NOT HAVE ANY COMMUNITY BUILDING ACTIVITIES DURING THE YEAR. |
| PART III, LINE 2: | CONSISTENT WITH FAITH'S MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THEREFORE, FAITH HAS DETERMINED IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTS WITH UNINSURED BALANCES (COPAYS AND DEDUCTIBLES). THE IMPLICIT PRICE CONCESSIONS INCLUDED IN ESTIMATING TRANSACTION PRICE REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THE AMOUNTS FAITH EXPECTS TO COLLECT BASED ON COLLECTION HISTORY WITH THOSE PATIENTS. |
| PART III, LINE 3: | FAITH PROVIDES PATIENT FINANCIAL ASSISTANCE TO PATIENTS WHO ARE FINANCIALLY UNABLE TO PAY FOR THE HEALTHCARE SERVICES THEY RECEIVE. IT IS THE POLICY OF FAITH NOT TO PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS PATIENT FINANCIAL ASSISTANCE. ACCORDINGLY, FAITH DOES NOT REPORT THESE AMOUNTS IN OPERATING REVENUE. |
| PART III, LINE 4: | THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT CONTAIN A SPECIFIC FOOTNOTE DESCRIBING BAD DEBT. BAD DEBT EXPENSE IS IDENTIFIED ON THE CONSOLIDATED STATEMENT OF OPERATIONS WHICH IS CONSISTENT WITH THE REPORTING PRACTICE OF OTHER HEALTH CARE ORGANIZATIONS. HOWEVER, THE FOOTNOTES TITLED "PATIENT RECEIVABLES" "PATIENT SERVICE REVENUE AND "PATIENT FINANCIAL ASSISTANCE" CAN BE FOUND ON PAGES 8, 10, 11, AND 12 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | "MEDICARE ALLOWABLE COSTS OF CARE" WAS CALCULATED FROM INFORMATION IN THE MEDICARE COST REPORT D, E & H WORKSHEETS. IT DOES NOT INCLUDE ALL OF THE MEDICARE REVENUES AND COSTS. IF ALL OF THE MEDICARE REVENUES AND COSTS WERE INCLUDED, THE SHORTFALL WOULD BE GREATER THAN THAT SHOWN ON LINE 7. THE SHORTFALL REPRESENTS ACTUAL UNREIMBURSED COSTS INCURRED BY FAITH REGIONAL HEALTH SERVICES IN PROVIDING SERVICES TO INDIVIDUALS ELIGIBLE FOR MEDICARE. THE COMMUNITY BENEFITS BECAUSE THE HOSPITAL APPLIES OTHER REVENUES TO COVER THE COSTS OF CARING FOR MEDICARE PATIENTS. |
| PART III, LINE 9B: | THROUGHOUT THE COLLECTION PROCESS EACH ACCOUNT IS ALSO CONSIDERED FOR FINANCIAL ASSISTANCE FOR THOSE GUARANTORS THAT ARE FINANCIALLY UNABLE TO PAY OR EXPRESS INABILITY TO PAY. ALL CORRESPONDENCE, INCLUDING STATEMENTS AND COLLECTION LETTERS INCLUDE A STATEMENT THAT "FINANCIAL ASSISTANCE MAY BE AVAILABLE." ACCOUNTS THAT ARE NOT SUCCESSFULLY RESOLVED ARE CONSIDERED FOR REFERRAL TO OUTSIDE COLLECTION AGENCIES. THE PATIENT ACCOUNTS' STAFF MEMBER WILL REVIEW THE ACCOUNT TO INSURE ALL PROCESSES ARE COMPLETE, AND THEN FLAG THE ACCOUNT TO BE SENT TO OUTSIDE COLLECTION AGENCIES. THE COLLECTION AGENCIES UTILIZED ALSO HAVE COPIES OF THE FINANCIAL ASSISTANCE POLICY AND APPLICATION IF THE NEED ARISES. |
| PART VI, LINE 2: | FAITH REGIONAL CHOSE TO PARTNER WITH THE ELKHORN LOGAN VALLEY PUBLIC HEALTH DEPARTMENT (ELVPHD) AND ITS RESPECTIVE DISTRICT HOSPITALS TO COMPLETE THE JOINT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2022. IN ADDITION TO THE PUBLIC HEALTH DEPARTMENT'S ASSESSMENT, FAITH REGIONAL IS INTIMATELY INVOLVED IN THE ELKHORN ECONOMIC DEVELOPMENT ASSOCIATION, BOTH ON THE BOARD AND THROUGH FINANCIAL SUPPORT. THAT INVOLVEMENT IS INTENDED TO FACILITATE COMMUNITY GROWTH, JOB DEVELOPMENT, INFRASTRUCTURE DEVELOPMENT AND BUSINESS EDUCATION/TRAINING. FAITH REGIONAL IS ALSO A MEMBER OF THE NORFOLK CHAMBER OF COMMERCE WHICH IS INVOLVED IN BUSINESS RETAIL DEVELOPMENT AND SUPPORT AS WELL AS THE COMMUNITY IMPROVEMENT PROJECTS. FAITH ALSO WORKS WITH ORGANIZATIONS LIKE THE ORPHAN GRAIN TRAIN IN PROVIDING MEDICINE AND MEDICAL EQUIPMENT/SUPPLIES TO OTHER NATIONS IN NEED. |
| PART VI, LINE 3: | PATIENTS RECEIVING CARE ARE GIVEN INFORMATION REGARDING FAITH REGIONAL'S FINANCIAL ASSISTANCE PROGRAM THROUGH THE USE OF BROCHURES HANDED OUT BY REGISTRATION, HOSPITAL SOCIAL SERVICES, M.A.S.H. (MEDICAL ADVOCACY SERVICES FOR HEALTHCARE) PERSONNEL AND BY PATIENT ACCOUNTS STAFF. ANY PATIENT OR FAMILY MEMBER THAT EXPRESSES CONCERN REGARDING ABILITY TO PAY FOR SERVICES WILL BE DIRECTED TO A SOCIAL WORKER, REGISTRATION CLERK, CASHIER OR FINANCIAL SERVICES REPRESENTATIVE WHO WILL THEN GIVE THEM AN APPLICATION FOR PATIENT FINANCIAL ASSISTANCE ALONG WITH A BROCHURE EXPLAINING HOW TO COMPLETE THE APPLICATION. THE APPLICATION WILL NEED TO BE SUBMITTED ALONG WITH PROOF OF THEIR GROSS INCOME FOR THE PRECEDING THREE MONTHS. THIS CAN BE ACCOMPLISHED BY PROVIDING CHECK STUBS FOR THE PRECEDING THREE MONTHS, PROVIDING THE MOST RECENTLY FILED STATE AND FEDERAL TAX RETURNS, PROVIDING A PROFIT AND LOSS STATEMENT IF SELF-EMPLOYED OR BY PRESENTING A STATEMENT FROM THEIR EMPLOYER (ON COMPANY LETTERHEAD) INDICATING GROSS INCOME FOR EACH OF THE PREVIOUS THREE MONTHS. MEDICARE PATIENTS MAY SHOW THEIR ORIGINAL DETERMINATION AMOUNT, A PHOTOCOPY OF A MONTHLY CHECK OR A COPY OF THEIR BANK STATEMENT.THE FINANCIAL SERVICES REPRESENTATIVE WILL THEN MULTIPLY THE GROSS INCOME FOR THE THREE MONTHS BY FOUR TO GET AN ANNUAL GROSS INCOME. THE FINANCIAL SERVICE REPRESENTATIVE WILL ALSO REVIEW THE PATIENT'S ASSETS TO SEE IF THERE IS SUFFICIENT EQUITY TO HELP PAY FOR HEALTH SERVICES. THE EQUITY OF ASSETS WILL BE DETERMINED AS FOLLOWS: REAL ESTATE - WE WILL EXCLUDE THE PRIMARY RESIDENCE ALONG WITH UP TO 1 ACRE OF LAND THAT THE RESIDENCE IS ON; WE WILL INCLUDE RENTAL PROPERTIES, ALL HOMES OR REAL PROPERTY ABOVE AND BEYOND THE PRIMARY RESIDENCE, CABINS, RECREATIONAL PROPERTY, ETC., AS WELL AS REAL ESTATE OWNED FOR BUSINESS PURPOSES.PERSONAL PROPERTY - WE WILL EXCLUDE ONE VEHICLE PER WAGE EARNER (OR SOCIAL SECURITY OR DISABILITY RECIPIENT); WE WILL CONSIDER THE EQUITY IN MOTOR VEHICLES (MOTORCYCLES, MOTOR HOMES, BOATS, BOAT TRAILERS AND ATVS).OTHER PERSONAL PROPERTY WILL INCLUDE STOCKS, BONDS, CDS, FUTURES, ANTIQUE COLLECTIBLES AND ANY OTHER COLLECTIONS OF VALUE.THE HOUSEHOLD SIZE WILL BE DETERMINED USING THE FEDERAL HOUSEHOLD DEFINITIONS.IF THERE IS AN OMISSION OF INFORMATION ON THE APPLICATIONS OR INFORMATION PROVIDED APPEARS TO BE INCORRECT, A LETTER WILL BE SENT TO THE PATIENT REQUESTING THE MISSING INFORMATION OR REQUESTING CLARIFICATION OF THE INFORMATION. THE DATE THAT THE LETTER IS SENT WILL BE DOCUMENTED ON A LOG OF PENDING APPLICATIONS. IF THE REQUESTED DOCUMENTATION IS NOT RETURNED IN NINE WORKING DAYS, THE APPLICATION WILL BE DENIED.FINANCIAL SERVICES WILL REVIEW THE APPLICATION AND ASSETS AND MAKE A DETERMINATION WITHIN 10 DAYS OF THE RECEIPT OF A COMPLETE APPLICATION. THE FINANCIAL COUNSELOR WILL THEN NOTIFY (BY LETTER) THE PATIENT INDICATING THAT THE APPLICATION HAS BEEN APPROVED OR DENIED. IF THE APPLICATION IS DENIED THE PATIENT MAY APPLY AGAIN IF THEIR FINANCIAL CIRCUMSTANCES CHANGE FOR SERVICES NOT PREVIOUSLY IN COLLECTIONS AND NO FURTHER BACK THAN SIX MONTHS FROM THE DATE OF APPLICATION FOR ACTIVE ACCOUNTS. |
| PART VI, LINE 4: | FAITH REGIONAL'S PRIMARY SERVICE AREA CONSISTS OF ANTELOPE, BOONE, HOLT, KNOX, MADISON, PIERCE, PLATTE, STANTON AND WAYNE COUNTIES IN NEBRASKA REPRESENTING A POPULATION OF APPROXIMATELY 90,000 PEOPLE. THE HOSPITAL'S SECONDARY SERVICE AREA CONSISTS OF CEDAR, COLFAX, CUMING AND DIXON COUNTIES IN NEBRASKA REPRESENTING APPROXIMATELY 35,000 PEOPLE. FAITH REGIONAL ALSO HAS A TERTIARY SERVICE AREA OF BOYD, BROWN, BURT, CHERRY, DAKOTA, GARFIELD, KAYA PAHA, NANCE, ROCK, THURSTON AND WHEELER COUNTIES IN NEBRASKA WITH APPROXIMATELY A POPULATION OF 57,400.BASED ON THE 2015 U.S. CENSUS INFORMATION, THE ABOVE COUNTIES IN THE FRHS PRIMARY AND SECONDARY SERVICE AREAS REPRESENT A TOTAL POPULATION OF 155,935. THE AVERAGE AGE IS 41.1 YEARS AND CONSISTS MOSTLY OF WHITE AT 92.7%, HISPANIC OR LATINO AT 8.2% AND BLACK OR AFRICAN AMERICAN AT .4%.THE MEDIAN HOUSEHOLD INCOME OF OUR SERVICE AREA IS $45,527 AND THE PER CAPITA INCOME IS $22,551, COMPARED TO THE MEDIAN HOUSEHOLD INCOME FOR NEBRASKA AT $50,695 AND THE PER CAPITA INCOME AT $26,113. |
| PART VI, LINE 5: | FAITH REGIONAL, A NOT-FOR-PROFIT HEALTH CARE FACILITY, LOCATED IN NORTHEAST NEBRASKA, OPERATES FOR THE BENEFIT OF THE INDIVIDUALS IN THE SERVICE AREA. FAITH REGIONAL SERVES ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND DOES NOT LIMIT ITS SERVICES OR DISCRIMINATE AGAINST ANYONE ON THE BASIS OF RACE, COLOR, SEX, NATIONAL ORIGIN, SEXUAL ORIENTATION, RELIGION, AGE, DISABILITY, DISEASE OR DIAGNOSIS. FAITH REGIONAL ALSO PROVIDES COMMUNICATIONS SERVICES (E.G. BILINGUAL STAFF AND INTERPRETERS, SIGN LANGUAGE INTERPRETERS, TDD SERVICES, ETC) FOR SENSORY IMPAIRED INDIVIDUALS. FAITH REGIONAL EVALUATES ITSELF ON ITS EFFECTIVENESS ANNUALLY BY EXAMINING ITS ABILITY TO FULFILL ITS MISSION, ACCOMPLISH ITS VISION, PROVIDE SERVICE AND MAINTAIN ITS VALUES. FAITH REGIONAL'S MISSION, VISION, SERVICE AND VALUES ARE: THE MISSION: THE MISSION IS TO SERVE CHRIST BY PROVIDING ALL PEOPLE WITH EXEMPLARY MEDICAL SERVICES IN AN ENVIRONMENT OF LOVE AND CARE.THE VISION: THE VISION OF FAITH REGIONAL HEALTH SERVICES IS TO BECOME A REGIONAL REFERRAL CENTER BY PROVIDING THE MOST COMPREHENSIVE, HIGH QUALITY HEALTH SERVICES TO THE RESIDENTS OF NORTHEAST NEBRASKA. THE VALUES:-SPIRITUALITY-EXCELLENCE-INTEGRITY-COMPASSION-RESPECT-STEWARDSHIPFAITH REGIONAL'S PROGRAM SERVICE ACCOMPLISHMENTS ARE BASED ON THE COMMUNITY ACCOUNTABILITY STANDARDS DEVELOPED BY THE VOLUNTARY HOSPITALS OF AMERICA (VHA). THESE FOUR STANDARDS ARE:1) DEMONSTRATE LEADERSHIP AS A CHARITABLE INSTITUTION.2) PROVIDING ESSENTIAL HEALTH CARE SERVICES.3) BEING ACCOUNTABLE TO THE COMMUNITY.4) MAINTAINING EVIDENCE OF COMMITMENT TO COMMUNITY BENEFIT.FAITH REGIONAL RECOGNIZES ITS OBLIGATION TO DEMONSTRATE LEADERSHIP AS A CHARITABLE ORGANIZATION BY PROVIDING A FULL RANGE OF HEALTH CARE, HEALTH EDUCATION AND WELLNESS RELATED SERVICES TO THE COMMUNITY, AND PARTICIPATING IN FEDERAL, STATE AND LOCAL PROGRAMS TO PROVIDE HEALTH BENEFITS TO THOSE IN NEED. FAITH REGIONAL FINANCIALLY SUPPORTS VARIOUS OUTREACH ACTIVITIES IN WHICH HOSPITAL PROVIDERS TRAVEL OUT TO SURROUNDING COMMUNITIES TO PROVIDE SERVICES WHICH MAY OTHERWISE NOT BE AVAILABLE. FAITH REGIONAL PROVIDES TRANSPORTATION SERVICES PRIMARILY TO RADIATION ONCOLOGY PATIENTS AT NO CHARGE.FAITH REGIONAL REMAINS ACCOUNTABLE TO THE COMMUNITY BY WORKING WITH A VOLUNTEER GOVERNING BOARD THAT IS REPRESENTATIVE OF THE COMMUNITY IT SERVES. COOPERATION WITH COMMUNITY BASED HEALTH ORGANIZATIONS IDENTIFY PERTINENT ISSUES RELATED TO ESSENTIAL SERVICES, CHARITY CARE, HEALTH CARE COST CONTAINMENT, COMMUNITY BENEFIT ACTIVITIES AND OTHERS AS APPROPRIATE. FAITH REGIONAL CONTINUES TO OPERATE UNDER A VOLUNTEER GOVERNING BOARD AND REMAINS ACTIVELY INVOLVED IN ADVOCATING PUBLIC AWARENESS OF HEALTH CARE AND HEALTH CARE POLICY ISSUES. DISCLOSURES OF COMMUNITY BENEFIT INFORMATION AND ADVOCACY ISSUES ARE PROVIDED THROUGH A VARIETY OF MEDIA INCLUDING MEDIA RELEASES AND ITS INTERNET WEBSITE: WWW.FRHS.ORG.FAITH REGIONAL'S CONTRIBUTION TO THE COMMUNITY NOT ONLY INCLUDES COMPENSATED AND DONATED TIME BUT ALSO EQUIPMENT, MATERIALS AND SPACE. MEETING ROOMS ARE PROVIDED AS NEEDED AND EQUIPMENT AND MATERIALS (E.G. COMPUTERS, COPIER, FAXES, TELEPHONES, CHILDBIRTH PROPS, PROJECTORS, MANNEQUINS, HEARING BOOTH, AUDIOMETERS, BEDS, MONITORS, WARMING UNITS, MINOR INSTRUMENTS, ETC.) ARE PROVIDED AT NO CHARGE. A MAJOR CONCERN IN HEALTH CARE THAT CAN SOMETIMES BE "HIDDEN" IS THAT OF SEXUAL ABUSE AND NEGLECT IN CHILDREN. THE NORTHEAST NEBRASKA CHILD ADVOCACY PROGRAM AT FAITH REGIONAL PROVIDES A SAFE, NON THREATENING ENVIRONMENT WHERE CHILDREN (AGES INFANT TO 18) WHO ARE VICTIMS OF ABUSE RECEIVE IMMEDIATE MEDICAL CARE AND FORENSIC INTERVIEWS FROM VARIOUS AGENCIES WORKING TOGETHER. ALL OF THESE SERVICES ARE AVAILABLE FREE TO FAMILIES WITHIN A 24-COUNTY AREA. |
| PART VI, LINE 6: | FAITH REGIONAL IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. |
| PART VI, LINE 7: | NOT APPLICABLE |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| NE NEBRASKA ALL STAR CLASSIC | ||||||||
| 309 N 5TH ST | NORFOLK | NE | 68701 | 461257935 | 501(C)(3) | $20,000 | $0 | SPONSORSHIPS |
| FOR THE GIRLS NORFOLK | ||||||||
| PO BOX 1124 | NORFOLK | NE | 68702 | 460972709 | 501(C)(3) | $7,500 | $0 | SPONSORSHIPS |
| NORFOLK AREA UNITED WAY | ||||||||
| PO BOX 1041 | NORFOLK | NE | 68702 | 470492054 | 501(C)(3) | $6,000 | $0 | ANNUAL GIVING/CAPITAL CAMPAIGN |
| NORFOLK FAMILY YMCA | ||||||||
| 301 W BENJAMIN AVE | NORFOLK | NE | 68701 | 465709553 | 501(C)(3) | $105,000 | $0 | FACILITY EXPANSION AND ROUNDTABLE EVENT |
| GREATER NORFOLK ECONOMIC DEVELOPMENT FOUNDATION | ||||||||
| 609 W NORFOLK AVE | NORFOLK | NE | 68701 | 363441719 | 501(C)(3) | $50,000 | $0 | TO PROVIDE TRANSPORTATION FOR EMPLOYEES TO AND FROM WORK. |
| KNIGHTS OF AKSARBEN FOUNDATION | ||||||||
| 2120 SOUTH 72ND ST STE 800 | OMAHA | NE | 68124 | 470447496 | 501(C)(3) | $10,000 | $0 | SPONSORSHIPS |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 6 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | CASH DONATIONS ARE MADE TO ORGANIZATIONS, MANY OF WHICH HAVE HEALTH CARE OR SOCIAL SERVICES MISSIONS. THESE DONATIONS ARE SOMETIMES RESTRICTED FOR A SPECIFIC USE OR ACTIVITY. 501(C)(3) ORGANIZATIONS ARE BOUND BY THEIR ARTICLES OF ORGANIZATION AND STATED MISSIONS TO CONDUCT ACTIVITIES STRICTLY FOR CHARITABLE PURPOSES. FAITH REGIONAL DOES NOT REQUEST GRANT REPORTS FROM DONEE CHARITABLE ORGANIZATIONS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FADI RZOUQ MD | ||||||||||||||
| PHYSICIAN | $963,601 | $0 | $3,409,371 | $0 | $540 | $0 | $12,200 | $0 | $36,674 | $0 | $4,422,386 | $0 | $0 | $0 |
| TRISTAN L HARTZELL MD | ||||||||||||||
| PHYSICIAN | $1,079,338 | $0 | $2,600,880 | $0 | $540 | $0 | $0 | $0 | $1,398 | $0 | $3,682,156 | $0 | $0 | $0 |
| JOHN LAMMLI MD | ||||||||||||||
| PHYSICIAN | $703,770 | $0 | $494,062 | $0 | $540 | $0 | $12,200 | $0 | $34,096 | $0 | $1,244,668 | $0 | $0 | $0 |
| NATHAN HERMAN MD | ||||||||||||||
| PHYSICIAN | $510,317 | $0 | $651,702 | $0 | $304 | $0 | $12,200 | $0 | $37,356 | $0 | $1,211,879 | $0 | $0 | $0 |
| BEETHOVEN BROWN MD | ||||||||||||||
| PHYSICIAN | $1,169,513 | $0 | $0 | $0 | $8,098 | $0 | $9,324 | $0 | $1,759 | $0 | $1,188,694 | $0 | $0 | $0 |
| KELLY DRISCOLL | ||||||||||||||
| CEO | $685,108 | $0 | $60,829 | $0 | $12,760 | $0 | $12,200 | $0 | $36,657 | $0 | $807,554 | $0 | $0 | $0 |
| ROBERT PRINCE MD | ||||||||||||||
| MEMBER - MEDICAL DIRECTOR | $676,614 | $0 | $63,933 | $0 | $3,564 | $0 | $9,150 | $0 | $35,871 | $0 | $789,132 | $0 | $0 | $0 |
| LANE HANDKE MD | ||||||||||||||
| MEMBER - CHIEF OF STAFF | $547,335 | $0 | $0 | $0 | $1,709 | $0 | $15,016 | $0 | $27,354 | $0 | $591,414 | $0 | $0 | $0 |
| JANNA CLINE | ||||||||||||||
| VP FINANCE | $237,122 | $0 | $500 | $0 | $776 | $0 | $7,277 | $0 | $22,872 | $0 | $268,547 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | PHYSICIANS HAVE AN OPPORTUNITY TO EARN PRODUCTION BONUSES IF THE PROVIDER REACHES ABOVE RELATIVE VALUE UNIT AMOUNTS. PAYOUTS ARE DEPENDENT ON THEIR BASE SALARY PERCENTILE. PHYSICIANS ALSO HAVE AN OPPORTUNITY TO EARN A QUALITY BONUS IF THEY MEET CERTAIN CRITERIA THROUGHOUT THE YEAR WHICH INCLUDES MIPS-QPP TARGETS, MEETING ATTENDANCE, COMMUNITY SERVICE, AND EVENT SPONSORSHIPS. PHYSICIANS RECEIVING THESE BONUSES DURING THE YEAR INCLUDE THE FOLLOWING: TRISTAN HARTZELL, M.D. FADI RZOUQ, M.D. NATHAN HERMAN, M.D. JOHN LAMMLI, M.D. ROBERT PRINCE, M.D. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| HOSPITAL AUTHORITY #1 OF MADISON COUNTY NEBRASKA | ||||||||
| A | 521357975 | 557352EX5 | 2017-08-17 | $44,772,246 | REFUND PRIOR ISSUES (07/10/08 & 11/20/08) | 0 | 0 | 0 |
| HOSPITAL AUTHORITY #1 OF MADISON COUNTY NEBRASKA | ||||||||
| B | 521357975 | 2018-01-01 | $12,075,000 | REFUND PRIOR ISSUES (8/17/17) | 0 | 0 | 0 | |
| HOSPITAL AUTHORITY #1 OF MADISON COUNTY NEBRASKA | ||||||||
| C | 521357975 | 557352FQ9 | 2018-05-10 | $32,483,481 | CONSTRUCT FACILITY | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Capitalized InterestCapitalizedInterestAmt | Capital ExpendituresCapitalExpendituresAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $19,545,000 | $45,107,444 | $712,032 | $44,395,412 | 2010 | Yes (1) | Yes (1) | Yes (1) | Yes (1) | ||
| B | $6,175,000 | $12,075,000 | $12,075,000 | 2010 | Yes (1) | 0 | Yes (1) | Yes (1) | |||
| C | $3,920,000 | $32,804,303 | $580,862 | 2019 | 0 | 0 | Yes (1) | Yes (1) | $22,597 | $32,200,844 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0.00540 | 0.00000 | 0.00540 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | 0.00540 | 0.00000 | 0.00540 | 0 | 0 | 0 |
| C | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | 0 |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) |
| C | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
| C | Yes (1) |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| DATE REBATE COMPUTATION PERFORMED | ISSUER NAME: HOSPITAL AUTHORITY #1 OF MADISON COUNTY NEBRASKA DATE THE REBATE COMPUTATION WAS PERFORMED: 07/01/2018 ISSUER NAME: HOSPITAL AUTHORITY #1 OF MADISON COUNTY NEBRASKA DATE THE REBATE COMPUTATION WAS PERFORMED: 07/01/2018 ISSUER NAME: HOSPITAL AUTHORITY #1 OF MADISON COUNTY NEBRASKA DATE THE REBATE COMPUTATION WAS PERFORMED: 12/31/2019 |
| SCHEDULE K SUPPLENTAL INFORMATION | SCHEDULE K, PART II, LINE 3: THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS. |
| SCHEDULE K, PART IV, ARBITRAGE, LINC 2C: | NOTE REGARDING THE FIRST REBATE COMPUTATION ON 7/1/18: AS NO REBATABLE ARBITRAGE WAS EARNED ON THE ADVANCE REFUNDING ESCROW AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA RIDE BASIS, NO FURTHER REBATE ANALYSIS IS NECESSARY. NOTE REGARDING THE SECOND REBATE COMPUTATION ON 7/1/18: 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. NOTE REGARDING THE COMPUTATION ON 12/31/19: SINCE THE BOND PROCEEDS HAVE BEEN SPENT AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CALCULATIONS ARE NECESSARY. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| TRACY COLLISON | |||
| DAUGHTER-IN-LAW OF JACQUE COLLISON, A BOARD MEMBER | $140,958 | TRACY IS AN EMPLOYEE OF FAITH REGIONAL HEALTH SERVICES. | 0 |
| CHRISTINE PRINCE | |||
| WIFE OF ROBERT PRINCE, A BOARD MEMBER | $129,904 | CHRISTINE IS AN EMPLOYEE OF FAITH REGIONAL HEALTH SERVICES. | 0 |
| SHARON GOSSMAN | |||
| MOTHER OF JOSH GOSSMAN, A BOARD MEMBER | $186,765 | SHARON IS AN EMPLOYEE OF FAITH REGIONAL HEALTH SERVICES. | 0 |
| KENDRA MITTEIS | |||
| SISTER OF BRAD DINKEL, A BOARD MEMBER | $66,482 | KENDRA IS AN EMPLOYEE OF FAITH REGIONAL HEALTH SERVICES. | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | THE EXECUTIVE COMMITTEE, CONSISTING OF THE IMMEDIATE PAST CHAIR, THE CHAIR, THE VICE CHAIR, THE SECRETARY, THE TREASURER, AND ONE PHYSICIAN BOARD MEMBER, HAS AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. IF THE IMMEDIATE PAST CHAIR IS NO LONGER A VOTING DIRECTOR, HE OR SHE SHALL NEVERTHELESS SERVE IN A VOTING CAPACITY ON THE EXECUTIVE COMMITTEE. |
| FORM 990, PART VI, SECTION A, LINE 6 | FAITH REGIONAL HAS ONE NONPROFIT 501(C)(3) CORPORATE MEMBER, LUTHERAN COMMUNITY HOSPITAL ASSOCIATION, A RELATED ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE CORPORATE MEMBER, LUTHERAN COMMUNITY HOSPITAL ASSOCIATION, APPOINTS 13 VOTING MEMBERS OF THE BOARD OF DIRECTORS OF FAITH REGIONAL HEALTH SERVICES. |
| FORM 990, PART VI, SECTION A, LINE 7B | CERTAIN POWERS ARE RESERVED TO ITS SOLE MEMBER, LUTHERAN COMMUNITY HOSPITAL ASSOCIATION. THERE ARE 13 RESERVED POWERS, INCLUDING APPOINTMENT AND REMOVAL OF DIRECTORS, OTHER THAN CHIEF OF STAFF AND THE PHYSICIAN SERVICES MEDICAL DIRECTOR, AMENDMENT OF THE ARTICLES OF INCORPORATION AND BYLAWS, AMENDMENT OF THE MISSION, VISION AND VALUE STATEMENTS, AMONG OTHERS. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 INFORMATION SCHEDULES ARE COMPLETED IN-HOUSE BY THE REIMBURSEMENT ACCOUNTANT AND REVIEWED BY THE CONTROLLER AND CFO. THE INFORMATION IS PROVIDED FOR RETURN PREPARATION AND SIGNATURE. FORM 990 IS REVIEWED AND DISCUSSED WITH THE CFO AND COPIES OF THE COMPLETED RETURN ARE DISTRIBUTED TO THE BOARD MEMBERS FOR REVIEW PRIOR TO SUBMISSION TO THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | FAITH REGIONAL'S BOARD MEMBERS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT AND DISCLOSURE ANNUALLY. ANY CONFLICTS ARE REVIEWED BY BOTH THE GOVERNANCE COMMITTEE AND INDEPENDENT LEGAL COUNSEL. THE GOVERNANCE COMMITTEE PRESENTS RECOMMENDATIONS TO THE FULL BOARD. A MEMBER WITH A CONFLICT IS EXCUSED FROM THE BOARD DELIBERATIONS AND ACTION. |
| FORM 990, PART VI, SECTION B, LINE 15 | DETERMINATION OF COMPENSATION FOR THE CEO AND OTHER OFFICERS IS MADE BY GATHERING DATA FROM EXTERNAL SURVEYS AND THE FORM 990 DATA PROVIDED BY COMPARABLE FACILITIES. FACILITIES USED ARE DETERMINED BY SIMILAR BED SIZE, NET REVENUES AND NUMBER OF FTES. WAGES ARE GATHERED AND COMPARED BY TITLE, RESPONSIBILITIES AND YEARS OF EXPERIENCE. THE SALARY RECOMMENDATIONS ARE MADE BY THE HUMAN RESOURCE DEPARTMENT. THE GOVERNING BOARD APPROVES THE SALARY RECOMMENDATIONS FOR THE CEO; THE CEO APPROVES THE RECOMMENDATIONS FOR THE OTHER OFFICERS AND VICE-PRESIDENTS; AND THE VICE-PRESIDENTS APPROVE THE RECOMMENDATIONS FOR THE DIRECTORS OF VARIOUS HOSPITAL DEPARTMENTS. |
| FORM 990, PART VI, SECTION C, LINE 19 | FAITH REGIONAL DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART XII, LINE 2C: | THE FINANCE/AUDIT COMMITTEE OF THE BOARD OF DIRECTORS ASSUMES RESPONSBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| FAITH REGIONAL PHYSICIAN SERVICES LLC | |||||||||
| 2700 WEST NORFOLK AVENUE | NORFOLK | NE | 68701 | 421629846 | PHYSICIAN SERVICES | NE | $46,612,728 | $25,277,471 | FAITH REGIONAL HEALTH SERVICES |
| FAITH REGIONAL HEALTH SERVICES PHO INC | |||||||||
| 2700 WEST NORFOLK AVENUE | NORFOLK | NE | 68701 | IMPROVE HEALTHCARE SERVICES | NE | $0 | $0 | FAITH REGIONAL HEALTH SERVICES | |
| ST JOSEPH'S REHABILITATION AND CARE CENTER | |||||||||
| 401 N 18TH ST | NORFOLK | NE | 68701 | 470796875 | NURSING HOME | NE | $5,970,364 | $6,138,626 | FAITH REGIONAL HEALTH SERVICES |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| LUTHERAN COMMUNITY HOSPITAL ASSOCIATION | |||||||||||
| 2700 W NORFOLK AVE | NORFOLK | NE | 68701 | 470396139 | SUPPORT FAITH REGIONAL HEALTH SERVICES | NE | 501(C)(3) | LINE 3 | N/A | 0 | |
| FAITH REGIONAL HEALTH SERVICES FOUNDATION | |||||||||||
| 2700 W NORFOLK AVE | NORFOLK | NE | 68701 | 911772474 | SUPPORT FAITH REGIONAL HEALTH SERVICES | NE | 501(C)(3) | LINE 12A, I | Yes (1) | FAITH REGIONAL HEALTH SERVICES | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHEAST NEBRASKA SURGERY CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 301 N 27TH STREET | AddressLine1Txt |
| City | NORFOLK | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470819088 | EIN |
| Primary Activities | OUTPATIENT SURGERY | PrimaryActivitiesTxt |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $1,123,094 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $3,045,291 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Ownership | 0.60420 | OwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| NORTHEAST NEBRASKA SURGERY CENTER | ||
| O | $2,649,838 | FAIR MARKET VALUE |
| NORTHEAST NEBRASKA SURGERY CENTER | ||
| J | $625,585 | FAIR MARKET VALUE |
| FAITH REGIONAL HEALTH SERVICES FOUNDATION | ||
| C | $2,767,691 | FAIR MARKET VALUE |
| NORTHEAST NEBRASKA SURGERY CENTER | ||
| D | $425,138 | FAIR MARKET VALUE |
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