2023-11-09T11:14:37-06:00 2022-12-31 450250958 EIDE BAILLY LLP 18081 BURT ST STE 200 OMAHA NE 680224722 990 2022-01-01 470378779 THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION MARY 4024634521 715 NORTH ST JOSEPH AVE HASTINGS NE 68901 ERIC BARBER PRESIDENT/CEO 4024634521 2023-11-06 1 ERIC BARBER 999009999 1 MEGAN L KOZIOL CPA P01544037 4023302660 2023-11-06 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MARY LANNING HEALTHCARE ERIC BARBER 715 NORTH ST JOSEPH AVE HASTINGS NE 68901 243870983 0 X WWW.MARYLANNING.ORG X 1915 NE PROVIDES INPATIENT, OUTPATIENT, EMERGENCY, ACUTE REHABILITATION, PSYCHIATRIC, AND CLINIC SERVICES. 7 6 1369 85 491605 0 5478038 2572870 203486899 210371984 3336723 649276 917693 1357860 213219353 214951990 358656 383424 0 0 113299695 114612364 0 0 0 95484798 109904784 209143149 224900572 4076204 -9948582 234718484 234669490 52425776 74471601 182292708 160197889 X ADVANCING OUR TRADITION OF SERVICE, EDUCATION AND COMMUNITY INVOLVEMENT, MARY LANNING HEALTHCARE IS DEDICATED TO EXCELLENCE, OFFERING HOPE, HEALTH AND HEALING. 0 0 209788893 383424 210371984 THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION D/B/A MARY LANNING HEALTHCARE (MLH), LOCATED IN HASTINGS, NEBRASKA, IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL WHICH PROVIDES INPATIENT, OUTPATIENT, EMERGENCY CARE, ACUTE REHABILITATION, PSYCHIATRIC SERVICES AND PHYSICIAN CLINIC SERVICES. MARY LANNING HEALTHCARE PROVIDES HEALTHCARE SERVICES TO THE GENERAL PUBLIC AND OPERATES ROUTINE SERVICE BEDS, ICU BEDS TOTALING 26,847 PATIENT DAYS. MLH HAD 173,179 OUTPATIENT VISITS AND EMERGENCY ROOM VISITS OF 14,760 IN 2022. MLH ALSO OPERATES A HOME HEALTH PROGRAM AND A SCHOOL OF NURSING. IN ADDITION, MLH OPERATES SIXTEEN PHYSICIAN CLINICS IN CENTRAL NEBRASKA, ALONG WITH AN OUTREACH PROGRAM TO SMALLER HOSPITALS IN WHICH TOGETHER MLH SEES APPROXIMATELY 40,000 PATIENTS PER YEAR. MLH OFFERS BEHAVIORAL HEALTH SERVICES ON AN INPATIENT AND OUTPATIENT BASIS, ACCOUNTING FOR 5,222 INPATIENT DAYS AND APPROXIMATELY 30,000 OUTPATIENT VISITS.MLH PROVIDES SEVERAL COMMUNITY PROGRAMS AS WELL. WE LIST ONLY THREE OF THEM. MLH PROVIDES A PLACE FOR FAMILY MEMBERS TO STAY AT A MINIMAL COST DURING TREATMENT, AT A COST OF $183,350 IN 2022. MLH ALSO HAS A PHARMACEUTICAL PATIENT ASSISTANCE PROGRAM THAT ASSISTS THOSE UNABLE TO PAY FOR PRESCRIPTION MEDICATIONS TO FIND ALTERNATIVE FUNDING THROUGH PHARMACEUTICAL COMPANIES AT A COST OF $203,828. TO PROVIDE THESE SERVICES, MLH ABSORBED OVER $37 MILLION IN COSTS DURING 2022. OVER $32 MILLION OF THAT RELATES TO CARE PROVIDED TO MEDICARE AND MEDICAID PATIENTS WITH AN ADDITIONAL $936,000 IN CARE TO THE UNINSURED IN THE FORM OF CHARITY CARE. 209788893 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 186 0 1 1369 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 7 6 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X SHAWN NORDBY 4024615344 715 N ST JOSEPH AVE HASTINGS NE 68901 X BRENT HOOD PHYSICIAN 40.00 0.00 X 1843163 0 43157 ERIC BARBER PRESIDENT/CEO 40.00 0.10 X 835560 0 151353 KALPESH GANATRA PHYSICIAN 40.00 0.00 X 843836 0 40524 MEHMET COPUR PHYSICIAN 40.00 0.00 X 779281 0 22792 RANDALL DUCKERT PHYSICIAN 40.00 0.00 X 593115 0 40678 MATHEW STRITT PHYSICIAN 40.00 0.00 X 590931 0 40408 SHAWN NORDBY CHIEF FINANCIAL OFFICER 40.00 0.10 X 241979 0 28438 MICHAEL ALLEN TREASURER 1.00 40.00 X X 0 159310 26430 JEFF S ANDERSON CHAIR 1.00 0.00 X X 0 0 0 MICHELE BEVER VICE CHAIR 1.00 0.00 X X 0 0 0 ANNA STEHLIK SECRETARY 1.00 0.00 X X 0 0 0 CLARENCE GARY ANDERSON TRUSTEE 1.00 0.00 X 0 0 0 JANIS JOHNSON TRUSTEE 1.00 0.00 X 0 0 0 DANIEL HEROLD TRUSTEE 1.00 0.00 X 0 0 0 5727865 159310 393780 157 0 1 0 CHIEF INDUSTRIES INC 3942 W OLD HWY 30 GRAND ISLAND NE 68803 CONSTRUCTION CONTRACTOR 11880317 MEDEFIS CONSOLIDATED BOX 5068 NEW YORK NY 100875068 CONTRACTED STAFFING 9234300 THE NEBRASKA MEDICAL CENTER 4350 DEWEY AVE OMAHA NE 68105 SOFTWARE SUPPORT 2221960 CROSSCOUNTRY CONSULTING LLC 1 EAST ERIE STREET SUITE 525-4935 CHICAGO IL 60611 SOFTWARE BUILD VENDOR 1503112 SS PSYCHIATRY GROUP 4110 HARGORD STREET GRAND ISLAND NE 68803 PSYCHIATRIC PHYSICIAN COVERAGE 1336160 39 2361153 211717 2572870 ALL OTHER PATIENT REVENUE 621110 129450774 129450774 NET MEDICARE REVENUE 621110 60907719 60907719 NET MEDICAID REVENUE 621110 16253330 16253330 RADIOLOGY SCHOOL 621500 148347 148347 3611814 3611814 210371984 1146279 1146279 272011 0 272011 272011 272011 24562250 3676225 25041238 3694240 -478988 -18015 -497003 -497003 220252 183515 36737 36737 CAFETERIA 722210 636315 636315 PARTNERSHIP INCOME 621610 263141 341949 -78808 CATERING 722320 141338 141338 8318 8318 1049112 214951990 210371984 491605 1515531 X 383424 383424 1257330 1257330 92236 92236 83637238 78315178 5322060 2543005 2477188 65817 21787825 20220055 1567770 5294730 4892177 402553 364368 364368 86705 86705 156893 156893 32936609 30027282 2909327 5110123 4883213 226910 4570907 4376250 194657 243811 229882 13929 1332 1332 1182263 1090930 91333 8464406 7502128 962278 1811067 1631322 179745 MEDICAL SUPPLIES 43514868 43500443 14425 BAD DEBT 6568273 6568273 REPAIRS AND MAINTENANCE 1141992 1059173 82819 FOOD 1082529 945741 136788 2668638 1593998 1074640 224900572 209788893 15111679 0 6750 5750 8702849 1333675 23899742 21891899 220137 0 2423297 1481288 5616250 6383502 2391406 1866383 233716053 143303812 62763498 90412241 55688666 43318327 8527849 7802811 1825440 1447260 62652600 58726354 234718484 234669490 23141777 24606605 47535 40963 14103145 11854932 1400426 14990219 8579589 18841491 5153304 4137391 52425776 74471601 X 129265278 109604176 53027430 50593713 182292708 160197889 234718484 234669490 X -9948582 -8964061 -3182176 X X 0 1 X 1 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 0 0 1 17338 17338 0 PART II-B, LINE 1: A PORTION OF DUES PAID TO AHA, NHA AND NABHO ARE FOR LOBBYING PURPOSES. 47703742 -2537746 45165996 43653512 4050230 47703742 44556774 -619651 283611 43653512 43777313 779461 44556774 45647223 -1869910 43777313 0.00000 1.00000 0.00000 0 1 1 5131877 5131877 110202476 74260399 35942077 92784981 67558443 25226538 25596719 1484970 24111749 90412241 DEFERRED COMPENSATION ASSETS 2713767 BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATION 11515811 BENEFICIAL INTEREST IN PERPETUAL TRUSTS 44496776 58726354 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 953624 MALPRACTICE RESERVE 470000 DEFERRED COMPENSATION LIABILITIES 2713767 4137391 X PART V, LINE 4: MARY LANNING HEALTHCARE FOUNDATION AND MARY LANNING HOSPITAL TRUST, BOTH RELATED ORGANIZATIONS, HOLD ENDOWMENT FUNDS RESTRICTED TO DISTRIBUTION TO MARY LANNING HEALTHCARE. THESE FUNDS ARE SHOWN AS BENEFICIAL INTERESTS IN OTHER ASSETS ON THE BALANCE SHEET. THE FUNDS ARE NOT UNDER THE CONTROL OF MARY LANNING HEALTHCARE. THE ENDOWMENT FUNDS ARE HELD FOR CAPITAL ACQUISITION, HOSPITAL OPERATIONS, SCHOLARSHIPS, EDUCATION, RESEARCH, AND COMMUNITY HEALTH CARE. PART X, LINE 2: THE HOSPITAL ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES. THE HOSPITAL 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, THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS ACCRUED. 1 1 X 1 X 125.000000000000 1 X 1 1 1 0 1 1 936205 936205 0.00430 27324200 15089307 12234893 0.05600 28260405 15089307 13171098 0.06030 32 30540 549289 5322 543967 0.00250 11 273 1080315 119380 960935 0.00440 3 604 14948 0 14948 0.00010 5 2630 207598 0 207598 0.00100 51 34047 1852150 124702 1727448 0.00800 51 34047 30112555 15214009 14898546 0.06830 1 0 5461 0 5461 0.00000 2 135 225195 0 225195 0.00100 3 135 230656 230656 0.00100 1 6568273 1000000 39963704 59828238 -19864534 X 1 1 1 HASTINGS SURGICAL CENTER LLC SURGICAL CENTER 0.18870 0.00000 0.16330 2 HASTINGS MEDICAL IMAGING LLC MEDICAL IMAGING 0.60600 0.00000 0.15400 1 1 THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION 715 NORTH ST JOSEPH AVENUE HASTINGS NE 68901 WWW.MARYLANNING.ORG 010002 X X X X THE MARY LANNING MEMORIAL HOSPITAL ASSOC 1 0 0 1 X X X X X X X X X 21 1 1 1 1 X HTTPS://WWW.MARYLANNING.ORG/ABOUT-US/COMMUNITY-NEEDS-ASSESSMENTS X 1 21 1 HTTPS://WWW.MARYLANNING.ORG/ABOUT-US/COMMUNITY-NEEDS-ASSESSMENTS 0 1 X 125.000000000000 200.000000000000 X X X X 1 1 X X X 1 X HTTPS://WWW.MARYLANNING.ORG/PATIENT-VISITOR-INFO/FINANCIAL-ASSISTANCE X HTTPS://WWW.MARYLANNING.ORG/PATIENT-VISITOR-INFO/FINANCIAL-ASSISTANCE X HTTPS://WWW.MARYLANNING.ORG/PATIENT-VISITOR-INFO/FINANCIAL-ASSISTANCE X X X X X X X 1 X 0 X X X X 1 X 0 0 THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 5: MARY LANNING HEALTHCARE (MLH) CONDUCTED ITS COMMUNITY HEALTH NEEDS ASSESSMENT IN 2021 USING THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) PROCESS. THIS WAS CONDUCTED IN PARTNERSHIP WITH THE SOUTH HEARTLAND DISTRICT HEALTH DEPARTMENT (SHDHD). THE COMMUNITY HEALTH NEEDS ASSESSMENT ENABLED MARY LANNING'S ADMINISTRATIVE TEAM AND BOARD OF TRUSTEES TO INCLUDE THE FINDINGS IN THE OVERALL STRATEGIC PLAN AND TO CREATE AN IMPLEMENTATION STRATEGY THAT IS IN ALIGNMENT WITH THE SHDHD'S CHIP (COMMUNITY HEALTH IMPROVEMENT PLAN) AS BOTH PLANS WORK TOGETHER TO ADDRESS THE NEEDS IN THE IDENTIFIED COMMUNITY. THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 6A: MEMBERS OF THE CORE TEAM FOR THE 2021 CHNA INCLUDED REPRESENTATIVES FROM BRODSTONE MEMORIAL HOSPITAL. THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 6B: OTHER NON-HOSPITAL ORGANIZATIONS INCLUDED: -SOUTH HEARTLAND DISTRICT HEALTH DEPARTMENT -THE NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES -UNITED WAY OF SOUTH CENTRAL NEBRASKA THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 11: THE HOSPITAL IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED THROUGH THE INITIAL MAPP ASSESSMENT IN 2018. THE 2021 MINI-MAPP PROCESS HELPED IDENTIFY AND VALIDATE THE PREVIOUSLY DETEMINED COMMUNITY NEEDS. THE PROCESS OF THE MINI MAPP IN 2021 AGAIN IDENTITIFED THE SAME FIVE AREAS OF NEED AND THESE AREAS WILL CONTINUE TO BE A PRIORITY FOR MARY LANNING HEALTHCARE.MARY LANNING PARTNERED WITH THE SOUTH HEARTLAND DISTRICT HEALTH DEPARTMENT TO COORDINATE OUR IMPLEMENTATION PLAN WITH THEIR COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). A STEERING COMMITTEE FOR EACH OF THE FIVE GOAL AREAS MEETS BI-ANNUALLY. FROM THAT COMMITTEE, A SUBCOMMITTEE OF EMPLOYEES FROM BOTH ORGANIZATIONS AND MEMBERS OF THE COMMUNITY IS FORMED. THE SUBCOMMITTEE MEETS REGULARLY TO ACCOMPLISH THESE GOALS. THE MARY LANNING TEAM ALSO CONTINUED TO UPDATE AND PROVIDE SERVICES IN THE FIVE AREAS OF NEED. HIGHLIGHTS FROM EACH AREA OF NEED INCLUDE THE FOLLOWING: OBESITY AND RELATED HEALTH CONDITIONS: MLH IS COMMITTED TO PROVIDING ACTIVITIES, EDUCATION AND ASSESSMENT TO ASSIST COMMUNITY MEMBERS WITH THE TOOLS AND RESOURCES FOR BETTER DISEASE PREVENTION AND SELF MANAGEMENT THROUGH THE FOLLOWING ACTIONS: CREATING A CHRONIC CARE MANAGEMENT POSITION, ESTABLISHING A DIABETES REGISTRY, OFFERING AT LEAST ONE DIABETES PREVENTION CLASS PER YEAR AND ENSURING THE CARDIAC AND PULMONARY REHAB PATIENTS COMPLETE EDUCATION FOCUSED ON THEIR DIAGNOSED DISEASE STATE AMONG OTHER ACTIVITIES. CANCER: MLH IS COMMITTED TO DECREASING THE INCIDENCE OF CANCER BY PROVIDING LIMITED SKIN SCREENINGS AT HEALTH FAIRS AND FOR EMPLOYEES, COORDINATING AN EVENT TO ADDRESS OVERALL WOMEN'S HEALTH, SEEKING FUNDS TO SUPPLY ORAL CHEMOTHERAPY FOR PATIENTS WHOSE COVERAGE DOES NOT PAY, ESTABLISHING A MAMMOGRAM REGISTRY AND ESTABLISHING A SYSTEM TO NOTIFY PATIENTS OF UPCOMING PREVENTATIVE SCREENINGS AT THE FIRST YEAR OF ELIGIBILITY. MENTAL HEALTH: MLH IS COMMITTED TO PROVIDE EDUCATION AND SCREENINGS IN CLINIC AND COACHING SETTINGS FOR BETTER MENTAL HEALTH ASSESSMENT AND SELF-CARE BY THE FOLLOWING ACTIONS: ESTABLISHING TRACKING MECHANISMS TO DEMONSTRATE THE USAGE OF MENTAL HEALTH RESOURCES, ESTABLISHING INSOMNIA PATHWAY AT HASTINGS FAMILY CARE, DEVELOPING A STRESS QUESTIONNAIRE TO PUT IN INITIAL EVALUATION PACKETS AND OTHER ACTIONS. SUBSTANCE MISUSE: MLH IS COMMITTED TO PROVIDING EDUCATION AND RESOURCES TO 100% OF HEALTHY BEGINNINGS CLIENTS WHO HAVE BEEN IDENTIFIED AS POTENTIAL OR CONFIRMED AT RISK FOR SUBSTANCE MISUSE, DEVELOPING A PRESENTATION ON SUBSTANCE MISUSE/MENTAL HEALTH TARGETED AT 8TH GRADERS AND INCORPORATING A HUMAN TRAFFICKING ASSESSMENT IN THE EMERGENCY ROOM. ACCESS TO CARE: MLH IS COMMITTED TO DEVELOPING A STRATEGY TO ENCOURAGE ACCESS TO SPECIALTY SERVICES BY EXPLORING TELEMEDICINE OUTREACH AND PROVIDING EDUCATION ABOUT HOME CARE SERVICES TO AT LEAST TWO COMMUNITY GROUPS EVERY QUARTER. MLH IS ALSO SEEKING TO INCREASE THE AVAILABILITY OF URGENT CARE IN THE CLINIC, AS WELL AS INCREASING THE PATIENTS ABILITY TO MANAGE THEIR OWN CARE. PRIORITIZED NEEDS STAKEHOLDERS IN THE 2018 MAPP PROCESS WERE ASKED TO RANK ALL NEEDS ON A SCALE TO DETERMINE PRIORITY AREAS. THE TOP FIVE RANKED AREAS THROUGH THIS PROCESS WERE: ACCESS TO CARE, MENTAL HEALTH, SUBSTANCE MISUSE, OBESITY AND RELATED HEALTH CONDITIONS AND CANCER. DURING THE 2021 MINI-MAPP PROCESS THESE AREAS OF NEED WERE VALIDATED THROUGH THE DATA COLLECTION AND REVIEW PROCESS. THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION PART V, SECTION B, LINE 16J: THE FULL POLICY IS AVAILABLE UPON REQUEST, FREE OF CHARGE, AS WELL AS ON THE HOSPITAL'S WEBSITE. A SUMMARY OF THE POLICY AND CONTACT INFORMATION IS POSTED ON MARY LANNING HEALTHCARE'S WEBSITE, PRINTED ON BILLING STATEMENTS, POSTED IN ALL ADMISSION AREAS AND PROVIDED IN WRITING TO ALL PATIENTS UPON CHECK IN. 13 1 - HASTINGS ORTHOPEDICS 2207 OSBORNE DR WEST STE 100 HASTINGS NE 68901 OUTPATIENT CLINIC 2 - HASTINGS FAMILY CARE 715 N KANSAS AVE STE 208 HASTINGS NE 68901 OUTPATIENT CLINIC 3 - CENTRAL NE UROLOGY 2115 N KANSAS AVENUE STE 108 HASTINGS NE 68901 OUTPATIENT CLINIC 4 - CENTRAL NE UROLOGY 620 N ALPHA ST GRAND ISLAND NE 68803 OUTPATIENT CLINIC 5 - LANNING CENTER 815 S BURLINGTON AVENUE HASTINGS NE 68901 OUTPATIENT CLINIC 6 - CENTRAL NE GENERAL SURGERY 715 N KANSAS AVENUE STE 205 HASTINGS NE 68901 OUTPATIENT CLINIC 7 - HASTINGS PULMONARY & SLEEP 715 N KANSAS AVENUE STE 101 HASTINGS NE 68901 OUTPATIENT CLINIC 8 - CENTRAL NE FAMILY CARE 3016 W FAIDLEY AVE GRAND ISLAND NE 68803 OUTPATIENT CLINIC 9 - CENTRAL NE KIDNEY CARE 715 N KANSAS AVENUE STE 202 HASTINGS NE 68901 OUTPATIENT CLINIC 10 - INSPIRED BRAIN & SPINE SURGERY 715 N KANSAS AVE STE 207 HASTINGS NE 68901 OUTPATIENT CLINIC 11 - WOUND CENTER 715 N KANSAS AVE STE 302 HASTINGS NE 68901 OUTPATIENT CLINIC 12 - BLUE HILL CLINIC 102 N PINE STREET BLUE HILL NE 68930 OUTPATIENT CLINIC 13 - MIDWEST COSMETIC & WOUND SURGERY 715 N KANSAS AVE STE 206 HASTINGS NE 68901 OUTPATIENT CLINIC PART I, LINE 3C: THE ORGANIZATION ONLY USED FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR FREE AND DISCOUNTED CARE. PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT IS NOT PREPARED BY A RELATED ORGANIZATION. PART I, LINE 7: FINANCIAL ASSISTANCE AT COST WAS DETERMINED USING A RATIO OF COSTS TO STANDARD CHARGES AND APPLYING THAT RATIO TO THE STANDARD CHARGES ASSOCIATED WITH PROVIDING CHARITY CARE FOR THE PERIOD. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $6,568,273. PART II, COMMUNITY BUILDING ACTIVITIES: HASTINGS FAMILY CARE, A CLINIC OF MLH, HOSTED PROJECT SEARCH STUDENTS FOR AN EIGHT WEEK ROTATION SO THAT THEY MAY GAIN JOB SKILLS TO PREPARE THEM FOR FUTURE JOB OPPORTUNITIES. PART III, LINE 2: CONSISTENT WITH THE HOSPITAL'S MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THEREFORE, THE HOSPITAL 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 THE HOSPITAL EXPECTS TO COLLECT BASED ON COLLECTION HISTORY WITH THOSE PATIENTS. PART III, LINE 3: IN ACCORDANCE WITH ITS MISSION OBJECTIVES, THE HOSPITAL PROVIDES FREE CARE TO PATIENTS WHO LACK FINANCIAL RESOURCES TO PAY FOR THE SERVICES THEY RECEIVE. IT IS THE POLICY OF THE HOSPITAL NOT TO PURSUE COLLECTION OF AMOUNTS DETERMINED TO BE PATIENT FINANCIAL ASSISTANCE. ACCORDINGLY, THE HOSPITAL DOES NOT REPORT THESE AMOUNTS IN PATIENT SERVICE REVENUE. THE ESTIMATED COST INCURRED BY THE HOSPITAL TO PROVIDE THESE SERVICES TO PATIENTS WHO ARE UNABLE TO PAY WAS APPROXIMATELY $1,000,000 AND $2,200,000 FOR THE YEARS ENDED DECEMBER 31, 2022 AND 2021, RESPECTIVELY. THE ESTIMATED COST OF THESE SERVICES WAS DETERMINED USING A RATIO OF COSTS TO STANDARD CHARGES AND APPLYING THAT RATIO TO THE STANDARD CHARGES ASSOCIATED WITH PROVIDING CHARITY CARE FOR THE PERIOD. STANDARD CHARGES ASSOCIATED WITH PROVIDING CARE TO CHARITY PATIENTS INCLUDES ONLY THE RELATED CHARGES FOR THOSE PATIENTS WHO ARE FINANCIALLY UNABLE TO PAY AND AND QUALIFY UNDER THE HOSPITAL'S PATIENT FINANCIAL ASSISTANCE/CHARITY CARE POLICY AND THAT DO NOT OTHERWISE QUALIFY FOR REIMBURSEMENT FROM A GOVERNMENTAL PROGRAM. PART III, LINE 4: THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES IMPLICIT PRICE CONCESSIONS IS LOCATED IN FOOTNOTE 1 ON PAGES 11 AND 12 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: THE HOSPITAL PROVIDES SERVICES TO MEDICARE PATIENTS REGARDLESS OF A SURPLUS OR SHORTFALL BECAUSE ACCESS TO HEALTHCARE AND INDIVIDUAL'S HEALTH IS IMPORTANT TO THE HOSPITAL. THEREFORE, ANY SHORTFALL IS CONSIDERED A COMMUNITY BENEFIT.TOTAL REVENUE RECEIVED FROM MEDICARE IS THE GROSS REIMBURSEMENT PLUS SETTLEMENT. BOTH TOTAL REVENUE RECEIVED FROM MEDICARE AND THE MEDICARE ALLOWABLE COSTS ARE REPORTED FROM THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CENTERS FOR MEDICARE AND MEDICAID SERVICES. PART III, LINE 9B: ACCOUNTS WILL BE SCREENED FOR APPROPRIATE REFERRAL TO FINANCIAL ASSISTANCE VS. BAD DEBT WRITE OFF DURING THE COLLECTION PROCESS. THE FINANCIAL ASSISTANCE POLICY DOES INCLUDE PROVISION FOR IMPLIED CHARITY CARE IF THERE IS SUFFICIENT KNOWLEDGE TO DETERMINE THAT THE PATIENT MEETS THE QUALIFYING FACTORS OF THE PROGRAM. PART VI, LINE 2: IN ADDITION TO THE STANDARD CHNAS CONDUCTED USING THE MAPP (2012, 2018) OR MINI-MAPP (2015, 2021), MARY LANNING UTILIZES OTHER METHODS OF ASSESSING THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES. IN PARTNERSHIP WITH THE SOUTH HEARTLAND DISTRICT HEALTH DEPARTMENT (SHDHD), THE 2018 CHNA INCLUDED A NEW SPECIAL FOCUS ON ACCESS TO CARE, TO INCLUDE FOCUS GROUPS WITH HEALTH SYSTEM USERS (IN ENGLISH AND SPANISH) AND FOCUS GROUPS WITH HEALTH SYSTEM PROVIDERS AND COMMUNITY LEADERS. THE OVERALL GOAL OF THIS SPECIAL FOCUS WAS TO IDENTIFY GAPS IN HEALTH SERVICES AND BARRIERS TO ACCESSING HEALTH CARE. IN 2022, MARY LANNING HAD A SPECIAL FOCUS ON MINORITY HEALTH ASSESSMENTS AND THE IMPACT OF THE PANDEMIC ON ACCESS TO SERVICES AND HEALTH BEHAVIORS. MARY LANNING ALSO PARTNERS WITH THE SHDHD ON AN ONGOING BASIS TO ASSESS OR RECEIVE ASSESSMENT REPORTS ON SPECIFIC HEALTH NEEDS, SUCH AS SKIN CANCER, TO SUPPORT PLANNING AND IMPLEMENTATION OF COMMUNITY OUTREACH PROGRAMS, SUCH AS FOR SKIN CANCER PREVENTIVE SCREENING OPPORTUNITIES. CLINICS ARE ALSO UTILIZING CLIENT/PATIENT POPULATION DATA REPORTED FROM THE ELECTRONIC HEALTH RECORDS TO UNDERSTAND THE NEEDS OF PATIENTS (SUCH AS HYPERTENSION MANAGEMENT OR PRE-DIABETES) AND ADDRESSING THESE NEEDS IN PART THROUGH PARTNERSHIPS WITH, AND REFERRALS TO, EVIDENCE-BASED COMMUNITY PROGRAMS. PART VI, LINE 3: MLH INFORMS AND EDUCATES PATIENTS BY POSTING SIGNS IN ALL ADMISSION AREAS AND PATIENT ROOMS. BROCHURES ARE AVAILABLE IN ADMISSION AREAS. ALL NON-INSURED INPATIENTS ARE PERSONALLY VISITED AND PATIENTS MAY HAVE DISCUSSIONS WITH A FINANICAL COUNSELOR AT ANYTIME DURING THE BILLING/COLLECTION PROCESS. PART VI, LINE 4: MLH'S PRIMARY SERVICE AREA IS ADAMS COUNTY WITH A SECONDARY AREA INCLUDING MERRICK, HALL, HAMILTON, KEARNEY, CLAY, FRANKLIN, WEBSTER, AND NUCKOLLS COUNTIES. THE ESTIMATED POPULATION OF ADAMS COUNTY IS 35,000 AND THE SECONDARY SERVICE AREA IS 93,000. ADAMS COUNTY IS 563 SQ. MILES. FIFTEEN PERCENT OF THE POPULATION IN ADAMS COUNTY IS MEDICARE AGE OR OLDER. PART VI, LINE 5: MARY LANNING CURRENTLY PROMOTES HEALTH IN THE COMMUNITY THROUGH OUTREACH TO A WIDE VARIETY OF COMMUNITY ORGANIZATIONS. MUCH FOCUS IS ALREADY PLACED ON THE FIVE PRIORITY NEED AREAS IDENTIFIED IN THE CHNA. MANY DEPARTMENTS WITHIN MARY LANNING PARTICIPATE IN COMMUNITY COALITIONS, PROVIDE OUTREACH TO WORKSITES AND COMMUNITY MEMBERS INCLUDING MINORITIES AND LOW INCOME GROUPS, EDUCATE AND PROVIDE LOW COST OR NO COST SCREENINGS AND CARE. PART VI, LINE 6: MARY LANNING IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. 1 MARY LANNING HEALTHCARE FOUNDATION 741 N DENVER AVE HASTINGS NE 68901 470800042 501(C)(3) 383424 0 ASSIST WITH FUNDRAISING OPERATING COSTS 1 0 PART I, LINE 2: MARY LANNING HEALTHCARE ONLY MAKES CONTRIBUTIONS AND GRANTS TO CHARITABLE OR GOVERNMENTAL TAX EXEMPT ENTITIES. THE HOSPITAL VERIFIES THE TAX EXEMPT STATUS OF THE GRANT RECIPIENTS PRIOR TO MAKING THE GRANT. TERMS OF THE GRANT STATE THAT THE FUNDS ARE ONLY TO BE USED FOR CHARITABLE PURPOSES. X 0 0 X X X 0 1 0 0 0 0 0 1 0 BRENT HOOD PHYSICIAN 1091829 0 750704 0 630 0 12200 0 30957 0 1886320 0 0 0 ERIC BARBER PRESIDENT/CEO 794953 0 39977 0 630 0 122200 0 29153 0 986913 0 76043 0 KALPESH GANATRA PHYSICIAN 601662 0 241544 0 630 0 9466 0 31058 0 884360 0 0 0 MEHMET COPUR PHYSICIAN 776402 0 0 0 2879 0 12200 0 10592 0 802073 0 0 0 RANDALL DUCKERT PHYSICIAN 590343 0 0 0 2772 0 12200 0 28478 0 633793 0 0 0 MATHEW STRITT PHYSICIAN 546987 0 43290 0 654 0 12200 0 28208 0 631339 0 0 0 SHAWN NORDBY CHIEF FINANCIAL OFFICER 222451 0 19026 0 502 0 10021 0 18417 0 270417 0 0 0 MICHAEL ALLEN TREASURER 0 131568 0 27742 0 0 0 6372 0 20058 0 185740 0 0 PART I, LINE 1A HEALTH OR SOCIAL CLUB DUES: A COUNTRY CLUB MEMBERSHIP IS PROVIDED TO ERIC BARBER AND SHAWN NORDBY FOR PERSONAL USE. THE VALUE OF THE MEMBERSHIP WAS INCLUDED AS TAXABLE WAGES IN THEIR 2022 W-2'S. PART I, LINE 4B THE HOSPITAL CONTRIBUED $110,000 TO A 457(F) ACCOUNT FOR ERIC BARBER, PRESIDENT/CEO. ERIC ALSO RECEIVED A TAXABLE DISTRIBUTION FROM A 457(F) ACCOUNT OF $76,043. PART I, LINE 7 ERIC BARBER, PRESIDENT/CEO, EMPLOYMENT AGREEMENT PROVIDES FOR UP TO A 20% DISCRETIONARY BONUS. A HOSPITAL AUTHORITY NO 1 OF ADAMS COUNTY NE 470762824 000000000 2015-08-27 28335905 RENOVATIONS AND REFUND ISSUE (7/1/08) 0 0 0 A 16387597 28812743 7500327 21312417 2017 0 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 1 1 0 0 0 0 A 0 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: HOSPITAL AUTHORITY NO 1 OF ADAMS COUNTY, NE DATE THE REBATE COMPUTATION WAS PERFORMED: 07/31/2018 SCHEDULE K, PART IV, LINE 2C: NOTE REGARDING THE REBATE COMPUTATION ON 7/31/2018: 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. PART II, LINE 3: THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS. MONICA NORDBY SPOUSE OF SHAWN NORDBY, CFO 92236 COMPENSATION AND BENEFITS AS EMPLOYEE 0 FORM 990, PART IV, LINE 13: FORM 990, PART IV, LINE 13 IS ANSWERED "NO" BECAUSE MARY LANNING HEALTHCARE'S PRIMARY PROGRAM SERVICE IS THE PROVISION OF MEDICAL CARE THROUGH ITS HOSPITAL. HOWEVER, IT ALSO CONDUCTS A NURSING SCHOOL IN CONJUNCTION WITH BRYAN COLLEGE OF HEALTH SCIENCES AND A RADIOLOGY SCHOOL. SCHEDULE E HAS NOT BEEN PREPARED BECAUSE THE ORGANIZATION DOES NOT CHECK BOX 2, PART I OF SCHEDULE A TO INDICATE IT IS A "SCHOOL". BOTH THE NURSING SCHOOL AND THE RADIOLOGY SCHOOL ARE OPERATED ON A NONDISCRIMINATORY BASIS. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE, CONSISTING OF THE CHAIR, VICE CHAIR, SECRETARY AND TREASURER, HAS THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 2 MICHELE BEVER, VICE CHAIR, AND JANIS JOHNSON, TRUSTEE, HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF FORM 990 WAS PROVIDED TO THE MEMBERS OF THE BOARD ELECTRONICALLY AND WAS REVIEWED BY THOSE MEMBERS PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, TRUSTEES, COMMITTEE MEMBERS AND KEY EMPLOYEES MUST ANNUALLY REVIEW AND COMPLETE A CONFLICT SURVEY AND SIGN A CONFLICT OF INTEREST STATEMENT. AS PER THE POLICY, ANY POTENTIAL CONFLICT OF INTEREST MUST BE DISCLOSED AND MADE A MATTER OF RECORD. ANY PERSON WITH A POSSIBLE CONFLICT OF INTEREST IN ANY MATTER SHOULD NOT VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE PRESIDENT/CEO'S COMPENSATION IS REVIEWED BY THE BOARD OF TRUSTEES ON AN ANNUAL BASIS. TARGETS ARE SET AND COMPENSATION IS APPROVED. IN 2022, THE VICE PRESIDENT OF HUMAN RESOURCES PROVIDED RESULTS OF A SURVEY COMPARING CEO COMPENSATION TO NEBRASKA AND REGIONAL AREA FACILITIES. THE BOARD REVIEWED THAT INFORMATION PRIOR TO SETTING CEO COMPENSATION. IT IS THE BOARD'S GOAL TO REVIEW CEO COMPENSATION IN DETAIL A MINIMUM OF EVERY THIRD YEAR. FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST THROUGH MARY LANNING HEALTHCARE'S ADMINISTRATIVE OFFICES. FORM 990, PART VII, SECTION A, COLUMN B: MICHAEL ALLEN IS EMPLOYED BY MARY LANNING TRUST, A RELATED ENTITY. FORM 990, PART IX, LINE 11G PROFESSIONAL MEDICAL FEES: PROGRAM SERVICE EXPENSES 6,216,186. MANAGEMENT AND GENERAL EXPENSES 141,575. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,357,761. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 23,811,096. MANAGEMENT AND GENERAL EXPENSES 2,767,752. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 26,578,848. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUSTS -1,725,614. CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATION -1,456,562. FORM 990, PART XI, LINE 2C: THE BOARD OF TRUSTEES OF THE ORGANIZATION ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MARY LANNING HEALTHCARE FOUNDATION 741 N DENVER AVE HASTINGS NE 68901 470800042 FUNDRAISING AND SUPPORT NE 501(C)(3) LINE 12A, I THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION 1 MARY LANNING HOSPITAL TRUST 122 N HASTINGS AVE HASTINGS NE 68901 476000224 INVESTMENT MANAGEMENT NE 501(C)(3) LINE 12A, I THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION 1 HASTINGS MEDICAL IMAGING LLC 715 N ST JOSEPH AVE HASTINGS NE 68901 851318481 RADIOLOGY SERVICES NE THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION RELATED -146319 0 1 0.61400 0 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 MARY LANNING HEALTHCARE FOUNDATION B 383424 CASH TRANSFER MARY LANNING HEALTHCARE FOUNDATION C 111153 CASH TRANSFER MARY LANNING HOSPITAL TRUST C 2250000 CASH TRANSFER