BRODSTONE MEMORIAL HOSPITAL: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- BRODSTONE MEMORIAL HOSPITAL (EIN 47-0388012)
- Tax period
- 2020-05-01 to 2021-04-30
- Filed
- 2022-02-01
- IRS object ID
- 202210329349300411
- Schema version
- 2020v4.2
- 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 M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-02-01T08:23:13-06:00 | ReturnTs |
| Tax Period End | 2021-04-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 476097913 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SEIM JOHNSON LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18081 BURT STREET SUITE 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 | 2020-05-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470388012 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRODSTONE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BROD | BusinessNameControlTxt |
| Phone | 4028793281 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 520 EAST 10TH STREET | AddressLine1Txt |
| City | SUPERIOR | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 689781225 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TREG VYZOUREK | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 4028793281 | PhoneNum |
| Signature | 2022-01-31 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | TREG | PersonFirstNm |
| Person Last | VYZOUREK | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MEGAN L KOZIOL | PreparerPersonNm |
| PTIN | P01544037 | PTIN |
| Phone | 4023302660 | PhoneNum |
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 | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TREG VYZOUREK | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 520 EAST 10TH STREET | AddressLine1Txt |
| City | SUPERIOR | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 689781225 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $37,258,240 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BRODSTONEHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1927 | FormationYr |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Activity Or Mission | BRODSTONE MEMORIAL HOSPITAL IS A NOT-FOR-PROFIT CRITICAL ACCESS HOSPITAL DELIVERING INPATIENT, OUTPATIENT AND AMBULATORY CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 237 | TotalEmployeeCnt |
| Total Volunteers | 220 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,050,094 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,496,334 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $30,074,690 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $33,286,875 | CYProgramServiceRevenueAmt |
| PY Investment Income | $405,693 | PYInvestmentIncomeAmt |
| CY Investment Income | $215,059 | CYInvestmentIncomeAmt |
| PY Other Revenue | $90,651 | PYOtherRevenueAmt |
| CY Other Revenue | $54,979 | CYOtherRevenueAmt |
| PY Total Revenue | $31,621,128 | PYTotalRevenueAmt |
| CY Total Revenue | $37,053,247 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $14,181 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $15,549,730 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $16,791,009 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $42,429 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $12,637,904 | PYOtherExpensesAmt |
| CY Other Expenses | $13,828,981 | CYOtherExpensesAmt |
| PY Total Expenses | $28,187,634 | PYTotalExpensesAmt |
| CY Total Expenses | $30,634,171 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,433,494 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,419,076 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $49,966,697 | TotalAssetsBOYAmt |
| Total Assets EOY | $49,224,428 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $18,964,744 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,181,163 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $31,001,953 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $38,043,265 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | COMPASSIONATE. DEDICATED. UNIFIED. WE CARE FOR YOU. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $18,853,211 | ExpenseAmt |
| Grant | $14,181 | GrantAmt |
| Revenue | $18,191,850 | RevenueAmt |
| Desc | ANCILLARY SERVICES - BRODSTONE MEMORIAL HOSPITAL IS A 25 BED CRITICAL ACCESS HOSPITAL. SERVICES PROVIDED BY BRODSTONE INCLUDE ANESTHESIOLOGY, RADIOLOGY, CT SCANS, LABORATORY, BLOOD ADMINISTRATION, INHALATION THERAPY, SLEEP STUDIES, PHYSICAL AND OCCUPATIONAL THERAPY, SPEECH THERAPY, ELECTROCARDIOLOGY AND ECHOCARDIOLOGY, BEHAVIORAL HEALTH, NUCLEAR MEDICINE AND EMERGENCY SERVICES.DURING 2021, BRODSTONE HAD 1,496 EMERGENCY ROOM VISITS AND PERFORMED 539 SURGERIES. THE LABORATORY PERFORMED 52,594 TESTS AND PHYSICAL THERAPY SERVICES PROVIDED 10,086 TREATMENTS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,478,691 | ExpenseAmt |
| Revenue | $2,992,443 | RevenueAmt |
| Desc | PHYSICIAN' CLINICS - BRODSTONE MEMORIAL HOSPITAL OWNS 3 RURAL HEALTH CLINICS IN SUPERIOR, NELSON, AND EDGAR, NE. THREE BOARD CERTIFIED FAMILY PRACTICE PHYSICIANS, TWO PA-C, AND TWO APRNS SERVE ALL AGES FROM CHILDREN TO SENIOR CITIZENS. IN ADDITION TO DIAGNOSING AND TREATING ILLNESS, THEY ALSO PROVIDE PREVENTIVE CARE, ROUTINE CHECKUPS, IMMUNIZATION AND SCREENING TESTS, AND HOSPITALIZATION AND NURSING HOME CARE, AND OBSTETRICS. THE CLINICS HAD 13,373 VISITS IN 2021. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,395,701 | ExpenseAmt |
| Revenue | $3,189,383 | RevenueAmt |
| Desc | NURSING SERVICES - BRODSTONE MEMORIAL HOSPITAL IS A 25 BED CRITICAL ACCESS HOSPITAL. NURSING SERVICES WORK WITH THE MEDICAL STAFF TO DELIVER QUALITY, AFFORDABLE HEALTH CARE IN A CARING, SAFE AND COMPASSIONATE ENVIRONMENT TO ALL PATIENTS. BRODSTONE PROVIDED 1,307 PATIENT DAYS OF INPATIENT CARE AND 686 PATIENT DAYS OF SWING BED CARE IN 2021. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,959,174 | ExpenseAmt |
| Revenue | $8,913,199 | RevenueAmt |
| Desc | PHARMACY AND INTRAVENOUS THERAPY - BRODSTONE'S PHARMACY DEPARTMENT PREPARES AND DISPENSES MEDICATION BY REVIEWING AND INTERPRETING PHYSICIAN ORDERS. THE PHARMACISTS DETECT THERAPEUTIC INCOMPATIBILITIES, ADVISE INTERVENTIONS, ANSWER QUESTIONS FROM HEALTH PROFESSIONALS, AND COUNSEL PATIENTS ON DRUG THERAPIES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $1,959,174 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $8,913,199 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $27,686,777 | 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 | Yes (1) | 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 | Yes (1) | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | 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 | 42 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 237 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| 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 | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | 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 | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CRYSTAL WYATT | PersonNm |
| Phone | 4028793281 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 520 EAST 10TH STREET | AddressLine1Txt |
| City | SUPERIOR | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68978 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| PAT MCCORD | ||||||||
| PRESIDENT | 2.00 | 0.20 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JANET EGGERS | ||||||||
| VICE-PRESIDENT | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JUDY GROVE | ||||||||
| SECRETARY | 2.00 | 0.20 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JODENE CLABAUGH | ||||||||
| TREASURER | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JACKI PORTER | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| BETH SIEBECKER | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| TREG VYZOUREK | ||||||||
| CEO | 39.80 | 0.20 | Yes (X) | $260,500 | $0 | $45,555 | ||
| SANDRA BORDEN | ||||||||
| CFO | 40.00 | 0.00 | Yes (X) | $169,119 | $0 | $33,937 | ||
| TIMOTHY BLECHA MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $320,522 | $0 | $38,218 | Yes (X) | ||
| JULIE THEIS MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $286,270 | $0 | $46,178 | Yes (X) | ||
| MATTHEW GATLIN PA-C | ||||||||
| PHYSICIAN ASSISTANT | 40.00 | 0.00 | $226,915 | $0 | $34,368 | Yes (X) | ||
| ROBERT LEIBEL MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $202,057 | $0 | $44,345 | Yes (X) | ||
| JASON HASS PA-C | ||||||||
| PHYSICIAN ASSISTANT | 40.00 | 0.00 | $183,666 | $0 | $44,543 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,649,049 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $287,144 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 17 | 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 |
|---|---|---|---|---|---|
| BD CONSTRUCTION | |||||
| 209 E 6TH STREET PO BOX 726 | KEARNEY | NE | 68848 | CONSTRUCTION SERVICES | $2,219,973 |
| CARDINAL HEALTH PHARMACY SERVICES LLC | |||||
| 21377 NETWORK PLACE | CHICAGO | IL | 60673 | PHARMACY SERVICES | $622,467 |
| CG-ID LLC | |||||
| 319 E FRANCIS SUITE 101 | NORTH PLATTE | NE | 69101 | ARCHITECTURE SERVICES | $452,588 |
| UNMC PHYSICIANS | |||||
| 983135 NEBRASKA MEDICAL CENTER | OMAHA | NE | 68198 | LAB SERVICES | $268,103 |
| IP PATHWAYS LLC | |||||
| 5940 S 118TH CIR | OMAHA | NE | 68137 | SOFTWARE MAINTENANCE SERVICES | $264,526 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 14 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $121,510 | RelatedOrganizationsAmt |
| Government Grants | $3,293,046 | GovernmentGrantsAmt |
| All Other Contributions | $81,778 | AllOtherContributionsAmt |
| Noncash Contributions | $78,227 | NoncashContributionsAmt |
| Total Contributions | $3,496,334 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| ANCILLARY SERVICES | 621110 | $17,982,441 | $17,982,441 |
| PHARMACY & INTRAVENOUS THERAPY | 621110 | $5,620,449 | $5,620,449 |
| 340B PHARMACY REVENUE | 446110 | $3,292,750 | $3,292,750 |
| NURSING SERVICES | 621110 | $3,189,383 | $3,189,383 |
| PHYSICIAN CLINICS | 621110 | $2,992,443 | $2,992,443 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $209,409 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $209,409 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $33,286,875 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $212,775 | TotalRevenueColumnAmt |
| Exclusion | $212,775 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $207,277 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $195,948 | SecuritiesAmt |
| Other | $9,045 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $11,329 | SecuritiesAmt |
| Other | -$9,045 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,284 | TotalRevenueColumnAmt |
| Exclusion | $2,284 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CAFETERIA REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $54,979 | TotalRevenueColumnAmt |
| Exclusion | $54,979 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $54,979 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,053,247 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $33,286,875 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $270,038 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,181 | TotalAmt |
| Program Services | $14,181 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $509,111 | TotalAmt |
| Management And General | $509,111 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,056,781 | TotalAmt |
| Program Services | $11,161,672 | ProgramServicesAmt |
| Management And General | $864,415 | ManagementAndGeneralAmt |
| Fundraising | $30,694 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,386,398 | TotalAmt |
| Program Services | $3,105,816 | ProgramServicesAmt |
| Management And General | $280,582 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $838,719 | TotalAmt |
| Program Services | $751,963 | ProgramServicesAmt |
| Management And General | $86,756 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,645 | TotalAmt |
| Management And General | $80,645 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,404 | TotalAmt |
| Management And General | $68,404 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,594 | TotalAmt |
| Management And General | $39,594 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,506,538 | TotalAmt |
| Program Services | $3,353,707 | ProgramServicesAmt |
| Management And General | $152,831 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,298 | TotalAmt |
| Program Services | $3,298 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,691,579 | TotalAmt |
| Program Services | $1,485,893 | ProgramServicesAmt |
| Management And General | $193,951 | ManagementAndGeneralAmt |
| Fundraising | $11,735 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $626,861 | TotalAmt |
| Program Services | $561,736 | ProgramServicesAmt |
| Management And General | $65,125 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $312,177 | TotalAmt |
| Program Services | $280,103 | ProgramServicesAmt |
| Management And General | $32,074 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $165,081 | TotalAmt |
| Program Services | $161,441 | ProgramServicesAmt |
| Management And General | $3,640 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $165,124 | TotalAmt |
| Program Services | $141,417 | ProgramServicesAmt |
| Management And General | $23,707 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,723,293 | TotalAmt |
| Program Services | $1,475,874 | ProgramServicesAmt |
| Management And General | $247,419 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $181,158 | TotalAmt |
| Program Services | $155,149 | ProgramServicesAmt |
| Management And General | $26,009 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $4,261,800 | $4,261,800 | |
| BAD DEBT EXPENSE | $571,616 | $571,616 | |
| DIETARY FOOD & SUPPLIES | $152,942 | $152,942 | |
| MISCELLANEOUS EXPENSES | $150,901 | $150,901 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,970 | TotalAmt |
| Program Services | $48,169 | ProgramServicesAmt |
| Management And General | $79,801 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,634,171 | TotalAmt |
| Program Services | $27,686,777 | ProgramServicesAmt |
| Management And General | $2,904,965 | ManagementAndGeneralAmt |
| Fundraising | $42,429 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,478,275 | BOYAmt |
| EOY | $1,450,347 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,779,958 | BOYAmt |
| EOY | $17,807,851 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,698,402 | BOYAmt |
| EOY | $3,026,702 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,316 | BOYAmt |
| EOY | $27,126 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $260,999 | BOYAmt |
| EOY | $320,015 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $375,011 | BOYAmt |
| EOY | $498,707 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $38,651,820 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $19,431,719 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,254,832 | BOYAmt |
| EOY | $19,220,101 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,270,278 | BOYAmt |
| EOY | $4,079,521 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,824,626 | BOYAmt |
| EOY | $2,794,058 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,966,697 | BOYAmt |
| EOY | $49,224,428 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,626,241 | BOYAmt |
| EOY | $3,501,757 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,498,843 | BOYAmt |
| EOY | $3,996,290 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,655,400 | BOYAmt |
| EOY | $2,655,400 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $660,516 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,184,260 | BOYAmt |
| EOY | $367,200 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,964,744 | BOYAmt |
| EOY | $11,181,163 | 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 | $29,382,756 | BOYAmt |
| EOY | $36,136,859 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,619,197 | BOYAmt |
| EOY | $1,906,406 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,001,953 | BOYAmt |
| EOY | $38,043,265 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,966,697 | BOYAmt |
| EOY | $49,224,428 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $6,419,076 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $332,862 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $289,374 | 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 | 0 | FederalGrantAuditRequiredInd |
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 | $2,605 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,605 | 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 | BRODSTONE MEMORIAL HOSPITAL PAID DUES TO THE AMERICAN HOSPITAL ASSOCIATION AND THE NEBRASKA 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 | $1,443,862 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $364,430 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $55,867 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $19,189 | AdministrativeExpensesAmt |
| End Year Balance | $1,733,236 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,535,156 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$16,648 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $44,846 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $29,800 | AdministrativeExpensesAmt |
| End Year Balance | $1,443,862 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,718,248 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $68,028 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $221,036 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $30,084 | AdministrativeExpensesAmt |
| End Year Balance | $1,535,156 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,745,868 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $96,344 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $93,784 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $30,180 | AdministrativeExpensesAmt |
| End Year Balance | $1,718,248 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,675,710 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $150,828 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $51,354 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $29,316 | AdministrativeExpensesAmt |
| End Year Balance | $1,745,868 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $117,890 | OtherCostOrOtherBasisAmt |
| Book Value | $117,890 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,832,401 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,537,099 | DepreciationAmt |
| Book Value | $13,295,302 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,423,101 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,708,230 | DepreciationAmt |
| Book Value | $2,714,871 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,278,428 | OtherCostOrOtherBasisAmt |
| Depreciation | $186,390 | DepreciationAmt |
| Book Value | $3,092,038 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $19,220,101 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| BENEFICIAL INTEREST IN TRUSTS | $1,733,236 |
| INTEREST RECEIVABLE | $6,205 |
| DEFERRED COMPENSATION | $367,200 |
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENT | $237,400 |
| PATIENT CUSTOMER CONTRACTS | $450,017 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,794,058 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DEFERRED COMPENSATION LIABILITIES | Desc |
| Amt | $367,200 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $367,200 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | INTEREST EARNINGS MAY BE USED FOR OPERATIONS, HOWEVER THE PRINCIPAL IS TO BE MAINTAINED AS A PERMANENT ENDOWMENT. |
| PART X, LINE 2: | THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN TAX EXEMPT STATUS. IN GENERAL, SUCH STANDARDS REQUIRE THE HOSPITAL TO MEET A COMMUNITY BENEFIT STANDARD AND COMPLY WITH VARIOUS LAWS AND REGULATIONS. THE HOSPITAL ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) 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 APRIL 30, 2021 AND 2020, THE HOSPITAL 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 |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| 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 | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 52 | PersonsServedCnt |
| Total Community Benefit Expns | $198,818 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $198,818 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00660 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,670,898 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,185,883 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $485,015 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01610 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 52 | PersonsServedCnt |
| Total Community Benefit Expns | $1,869,716 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,185,883 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $683,833 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02270 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 22 | ActivitiesOrProgramsCnt |
| Persons Served | 1509 | PersonsServedCnt |
| Total Community Benefit Expns | $180,203 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,679 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $170,524 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00570 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 56 | PersonsServedCnt |
| Total Community Benefit Expns | $346,129 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,500 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $338,629 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01130 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 22 | ActivitiesOrProgramsCnt |
| Persons Served | 1565 | PersonsServedCnt |
| Total Community Benefit Expns | $526,332 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,179 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $509,153 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01700 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 22 | ActivitiesOrProgramsCnt |
| Persons Served | 1617 | PersonsServedCnt |
| Total Community Benefit Expns | $2,396,048 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,203,062 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,192,986 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03970 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 2000 | PersonsServedCnt |
| Total Community Benefit Expns | $8,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 2000 | PersonsServedCnt |
| Total Community Benefit Expns | $8,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $571,616 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $15,884,864 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $14,748,688 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $1,136,176 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRODSTONE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 520 E 10TH | AddressLine1Txt |
| City | SUPERIOR | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68978 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTPS://WWW.BRODSTONEHOSPITAL.ORG | WebsiteAddressTxt |
| State License | 570001 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRODSTONE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| 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 |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 18 | 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.BRODSTONEHOSPITAL.ORG/PATIENTS-AND-VISITORS/COMMUNITY-HEALTH-NE | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://WWW.BRODSTONEHOSPITAL.ORG/PATIENTS-AND-VISITORS/COMMUNITY-HEALTH-NE | 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 | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| 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 |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.BRODSTONEHOSPITAL.ORG/PATIENTS-AND-VISITORS/FINANCE-SERVICES/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.BRODSTONEHOSPITAL.ORG/PATIENTS-AND-VISITORS/FINANCE-SERVICES/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.BRODSTONEHOSPITAL.ORG/PATIENTS-AND-VISITORS/FINANCE-SERVICES/ | 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 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 Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| BRODSTONE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 3J: THE REPORT INCLUDES A LIST OF MEASURES IN THE THREE YEAR PLAN (2018 THROUGH 2021) AND THE COMMUNITY HEALTH IMPROVEMENT PLAN (2018 THROUGH 2021) FIRST YEAR ENDED 4/30/2020. THE PLAN INCLUDES PERFORMANCE MEASURES ALONG WITH STRATEGIES AND ACTIVITIES FOR THE PRIORITY AREAS OF ACCESS TO CARE, MENTAL HEALTH, SUBSTANCE MISUSE, OBESITY & RELATED HEALTH CONDITIONS, AND CANCER. |
| BRODSTONE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 5: INCLUDED IN THE REPORT ARE RESULTS FROM A PUBLIC HEALTH SURVEY THAT WAS MADE AVAILABLE OVER A 4 COUNTY AREA (WEBSTER, ADAMS, CLAY AND NUCKOLLS), FOLLOWED BY A BROAD SPECTRUM OF STAKEHOLDERS THAT PARTICIPATED IN FOCUS GROUPS AND CONTRIBUTED TO EACH ASSESSMENT, DATA REVIEW, PRIORITY SETTING, AND STRATEGY MEETINGS. ITEMS FOR DISCUSSION WERE GAPS IN SERVICES, WHERE COMMUNITY MEMBERS GO FOR HEALTHCARE, WHERE DO THEY GET THEIR HEALTH INFORMATION, THEIR BIGGEST HEATHCARE CONCERNS, AND WHAT HEALTHCARE SERVICES ARE USED (OR NOT USED) BY THE PEOPLE THEY KNOW. ALSO DISCUSSED WERE THE STRENGTHS OF LOCAL HEALTHCARE AND FUTURE DEMANDS.THIS WAS A COLLABORATION BETWEEN SOUTH HEARTLAND DISTRICT HEALTH DEPARTMENT, MARY LANNING HEALTHCARE IN HASTINGS, WEBSTER COUNTY HOSPITAL IN RED CLOUD, CLAY COUNTY HEALTH DEPARTMENT IN CLAY COUNTY AND BRODSTONE MEMORIAL HOSPITAL IN SUPERIOR. A REPORT FOR THE FIRST YEAR OF THE PLAN MAY BE FOUND ON THE WEBSITE BRODSTONEHOSPITAL.ORG. |
| BRODSTONE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 6A: BRODSTONE'S CHNA WAS CONDUCTED WITH WEBSTER COUNTY COMMUNITY HOSPITAL AND MARY LANNING HEALTHCARE. |
| BRODSTONE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 6B: BRODSTONE'S CHNA WAS CONDUCTED WITH SOUTH HEARTLAND DISTRICT HEALTH DEPARTMENT AND THE CLAY COUNTY HEALTH DEPARTMENT AS THAT COUNTY DOES NOT HAVE A HOSPITAL. |
| BRODSTONE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 11: THE STRATEGIES THAT WERE SCHEDULED FOR THIS YEAR ON OUR COMMUNITY HEALTH IMPROVEMENT PLAN THAT WERE ACCOMPLISHED ARE AS FOLLOWS:HEALTH PRIORITY GOAL #1: ACCESS TO CAREWE CONTINUE TO ENHANCE THE PATIENT PORTAL SERVICE AND INCREASE NEW SUBSCRIBERS. WE INTEND TO USE THE PORTAL FOR TEXT APPOINTMENT REMINDERS, BUT WE ARE NOT ABLE TO AUTOMATE THE TEXTS AT THIS POINT.CENTRALIZED SCHEDULING IS ALSO IN OUR FUTURE PLANS FOR BRODSTONE.ENT PROVIDER DAYS WERE ADDED THIS FY. THE ADDITION OF ENDOCRINOLOGY IS ALSO IN PROCESS. WE CONTINUE TO WORK TO ADD OTHER SPECIALTIES AND ADDITIONAL DAYS FOR EXISTING SERVICES. WE CONTINUE TO WORK ON RECRUITING AN ADDITIONAL PROVIDER FOR OUR RURAL HEALTH CLINIC. THIS IS AN ONGOING PROCESS. PURCHASED VAN TO PROVIDE TRANSPORTATION TO SENIORS IN NEED OF OUTPATIENT BEHAVIORAL HEALTH SERVICES WHO OTHERWISE WERE NOT ABLE TO ACCESS SERVICES. WE DO PROVIDE TRANSPORTATION FOR THRIVE CENTER (MENTAL HEALTH) PATIENTS THAT HAVE NO OTHER MODE OF TRANSPORTATION FOR THEIR APPOINTMENTS. CURRENTLY EVALUATING EXPANSION OF TRANSPORTATION FOR OTHER AREAS OF NEED.BRODSTONE HAS A DESIGNATED FINANCIAL COUNSELOR THAT WORKS WITH PATIENTS THROUGH OUR FINANCIAL ASSISTANCE PROGRAM FOR CHARITY CARE, BANK LOANS AND SELF-PAYMENT PLANS. WE HAVE HELPED 115 PATIENTS WITH FINANCING THROUGH OUR MEDICAL LOAN PROGRAM.WE HAVE ADDED CHARGE PROFILES TO OUR PATIENT LIABILITY ESTIMATOR (PLE) TOOL. AS OF JANUARY 1, 2021, PATIENTS ARE NOW ABLE TO RUN ESTIMATES ONLINE FROM OUR WEBSITE.WE DO STILL PLAN TO DEVELOP A PATIENT ADVISORY TEAM; HOWEVER, WE DO NOT HAVE ONE AT THIS TIME.BECAUSE OF COVID-19, OUR HEALTH FAIR FORMAT CHANGED THIS FY. THE HEALTH FAIR WAS HELD WITHIN THE HOSPITAL AND CLINICS AND INCLUDED THE FOLLOWING SERVICES: BLOOD PROFILE, VITAMIN D, PSA, CAROTID ARTERY DOPPLER SCREENING, ABDOMINAL AORTIC ANEURYSM SCREENING, AND FOREARM BONE DENSITY SCREENING. HEALTH FAIRS WERE HELD AT THREE SCHOOLS, SUPERIOR PUBLIC SCHOOLS, SOUTH CENTRAL USD #5 LAWRENCE/NELSON AND SOUTH CENTRAL USD #5 SANDY CREEK FOR STAFF AND AT ONE EMPLOYER, SOUTH CENTRAL PUBLIC POWER DISTRICT IN NELSON.A SPORTS MEDICINE PROGRAM IS ESTABLISHED WITH THREE SCHOOLS, SUPERIOR PUBLIC SCHOOLS, SOUTH CENTRAL USD #5 LAWRENCE/NELSON AND SOUTH CENTRAL USD #5 SANDY CREEK.A SPORTS METRICS PROGRAM HAS BEEN DEPLOYED IN ONE SCHOOL WITH PLANS OF EXPANDING TO OTHERS.THE EXPANSION OF THE BUSINESS WELLNESS PROGRAM IS ADDRESSED IN PRIORITY #4.HEALTH PRIORITY GOAL #2: MENTAL HEALTHBRODSTONE MEMORIAL HOSPITAL CONTINUES TO CONTRACT WITH BOYS TOWN PSYCHIATRY TO BE A HUB FOR THEIR SERVICES. BECAUSE OF THIS AGREEMENT, SERVICES ARE AVAILABLE TO AREA YOUTH, AGES 5 TO 18 YEARS, BOTH AT BRODSTONE SPECIALTY CLINIC AND SUPERIOR PUBLIC SCHOOLS. WHILE BRODSTONE HAS HAD MENTAL HEALTH SERVICES AVAILABLE VIA TELEHEALTH THROUGH THE UNIVERSITY OF NEBRASKA AT LINCOLN, IT IS ALSO AVAILABLE AT SUPERIOR SCHOOLS.BRODSTONE BEHAVIORAL HEALTH VISITS HAVE INCREASED NEARLY 75% WITH 1,926 VISITS TO THE THRIVE CENTER THIS FY.ERICA FERRELL, PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER, INCREASED HER OFFICE DAYS AT BRODSTONE SPECIALTY CLINIC FROM TWICE A MONTH TO FIVE TIMES A MONTH, THUS INCREASING THE NUMBER OF APPOINTMENTS AVAILABLE TO PATIENTS.HEALTH PRIORITY GOAL #3: SUBSTANCE MISUSEWE CONTINUE TO DEVELOP BEST PRACTICE PROTOCOLS FOR LOW BACK PAIN, SEPSIS, OPIOID AND DIABETES. OUR GOAL IS TO REDUCE THE NUMBER OF OPIOID PRESCRIPTIONS BY 50 OVER THE THREE-YEAR PERIOD. WE DID NOT BEGIN TRACKING THE NUMBER OF PRESCRIPTIONS AT THE BEGINNING OF FY 19, WE DO NOT HAVE A BASELINE. WE ARE WORKING TO REPORT THESE NUMBERS. WE PLAN TO PARTNER WITH THE SCHOOL TO DEVELOP A DRUG EDUCATION PROGRAM, HOWEVER WE HAVE NOT DONE SO YET.HEALTH PRIORITY GOAL #4: OBESITY & RELATED HEALTH CONDITIONSBRODSTONE CONTINUES TO WORK ON CHRONIC CARE MANAGEMENT. OUR GOAL WAS TO HAVE A 5% INCREASE IN THE NUMBER OF PATIENTS SERVED. WE HAD A 14% DECREASE ON PATIENTS IN THE LAST FY.WE HAVE NOT FORMALIZED OUR TRANSITIONAL CARE PROGRAM. THIS IS STILL A WORK IN PROGRESS.WE HAVE WORKED ON TARGETED TRANSITIONAL CARE FOR COPD & HEART FAILURE.OUR GOAL WAS TO INSTITUTE A TEAM BASED CARE PROGRAM WITH 80% ATTENDANCE OF ALL DEPARTMENTS INVOLVED. TOTAL STAFF ATTENDANCE WAS AT 97%.WE HAVE NOT ACTIVELY EXPANDED OUR BUSINESS HEALTH PROGRAM THIS FY DUE TO COVID. AT THIS TIME OUR LAB IS PERFORMING THE DRUG SCREENINGS AND THERAPY FUNCTIONAL SCREENINGS FOR ONE BUSINESS. WELLNESS ACTIVITIES FOR THE COMMUNITY IN THE LAST FISCAL YEAR INCLUDED YOGA IN THE PARK, TWO WALK/RUN EVENTS, WALKING SCHOOL BUS AND GOLF COURSES WERE SUPPLIED WITH SUN SAFETY INFORMATION, SUN SCREEN AND BUG SPRAY. WE IMPLEMENTED A COMMUNITY FITNESS CHALLENGE 100 & 20 FOR 30 THIS FY. WE ALSO IMPLEMENTED A NEW PLATFORM FOR WELLNESS/FITNESS FOR OUR EMPLOYEES CALLED BURN ALONG. THIS ONLINE PLATFORM ALLOWS EMPLOYEES TO SHARE WELLNESS/FITNESS PROGRAMS WITH THEIR FAMILY AND FRIENDS.WE HAD A DECREASE IN USE OF THE AQUA THERAPY POOL. WE WENT FROM 312 VISITS IN FY20 TO 155 VISITS IN FY21. THIS DECREASE WAS DUE TO COVID.HEALTH PRIORITY GOAL #5: CANCEROUR OBJECTIVE WAS TO ACHIEVE ACO GOALS BY BEING MORE PROACTIVE WITH PATIENT WELLNESS VISITS AND SCREENINGS. A FAVORABLE OUTCOME WOULD BE A 10% INCREASE. IN FY 20 WE HAD A 32% INCREASE IN WELLNESS VISITS. WE WILL CONTINUE TO WORK ON INCREASING THE INDIVIDUAL SCREENINGS OF COLON, BREAST AND BMI.WE HAVE EDUCATED OUR STAFF FOR THE TOBACCO CESSATION PROGRAM AND WILL PROMOTE THE PROGRAM IN THE NEXT FISCAL YEAR. WE HAVE HAD A SETBACK DUE TO COVID-19. |
| BRODSTONE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 13H: IN INSTANCES WHEN A PATIENT MAY APPEAR ELIGIBLE FOR FINANCIAL ASSISTANCE, BUT THERE IS NO FINANCIAL APPLICATION FORM ON FILE DUE TO A LACK OF SUPPORTING DOCUMENTATION, FINANCIAL ASSISTANCE MAY STILL BE GRANTED IN CERTAIN SITUATIONS BASED ON PRESUMPTIVE CIRCUMSTANCES. OFTEN THERE IS ADEQUATE INFORMATION PROVIDED BY THE PATIENT OR THROUGH OTHER SOURCES, WHICH COULD PROVIDE SUFFICIENT EVIDENCE TO PROVIDE THE PATIENT WITH FINANCIAL ASSISTANCE. IN THE EVENT THERE IS NO EVIDENCE TO SUPPORT A PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE, BRODSTONE COULD USE OUTSIDE AGENCIES IN DETERMINING ESTIMATED INCOME AMOUNTS FOR THE BASIS OF DETERMINING FINANCIAL ASSISTANCE ELIGIBILITY AND POTENTIAL DISCOUNT AMOUNTS. PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED IN CERTAIN SITUATIONS, AND BASED ON THE APPROVAL OF BRODSTONE'S MANAGEMENT, ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE:A) STATE-FUNDED PRESCRIPTION PROGRAMS;B) TRANSIENT, HOMELESS OR RECEIVED CARE FROM A HOMELESS CLINIC, OR UNIDENTIFIED PERSONS;C) PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC);D) FOOD STAMP ELIGIBILITY;E) ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED (E.G., MEDICAID SPEND-DOWN);F) CRIME VICTIMS BILLED CHARGES AFTER STATE OR FEDERAL FUNDS HAVE PAID OR ARE EXHAUSTED;G) LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS;H) PATIENT IS DECEASED WITH NO KNOWN ESTATE OR RESPONSIBLE PARTY; ANDI) PERSONS WHO INCOME IS AT OR BELOW 100% OF THE CURRENT POVERTY LEVEL. |
| BRODSTONE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 15E: PATIENTS MAY APPLY FOR ASSISTANCE BY CALLING BRODSTONE MEMORIAL HOSPITAL AT 402-207-1539 AND REQUESTING A FINANCIAL ASSISTANCE APPLICATION; OR BY REQUESTING AN APPLICATION IN PERSON FROM REGISTRATION OR THE BUSINESS OFFICE. AN APPLICATION MAY BE DOWNLOADED FROM THE HOSPITAL'S WEBSITE. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - SUPERIOR FAMILY MEDICAL CENTER | ||||
| 525 E 11TH ST | SUPERIOR | NE | 68978 | RURAL HEALTH CLINIC |
| 2 - NELSON FAMILY MEDICAL CENTER | ||||
| 76 W 8TH ST | NELSON | NE | 68961 | RURAL HEALTH CLINIC |
| 3 - EDGAR MEDICAL CLINIC | ||||
| 315 N C ST | EDGAR | NE | 68935 | RURAL HEALTH CLINIC |
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | NOT APPLICABLE: FEDERAL POVERTY GUIDELINES ARE USED TO DETERMINE ELIGIBILITY FOR PROVIDING FREE CARE AND DISCOUNTED CARE TO LOW INCOME INDIVIDUALS. |
| PART I, LINE 6A: | BRODSTONE'S COMMUNITY BENEFIT REPORT IS NOT PREPARED BY A RELATED ORGANIZATION. |
| PART I, LINE 7: | THE COST TO CHARGE RATIO AS FOLLOWS WAS USED TO DETERMINE CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS AT COST: (TOTAL EXPENSES - BAD DEBT) / GROSS PATIENT SERVICE REVENUE = PERCENTAGE OF COST TO CHARGE. OTHER COMMUNITY BENEFIT EXPENSES ARE STATED AT COST BASED ON BRODSTONE'S INTERNAL ACCOUNTING RECORDS. |
| PART I, LINE 7G: | THERE ARE NO COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC INCLUDED ON LINE 7G. |
| PART I, LINE 7, COLUMN (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 $ 571,616. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | BRODSTONE HAS MANY ACTIVITIES TO PROMOTE HEALTH IN THE COMMUNITIES SERVED. THESE ACTIVITIES INCLUDE: SPONSOR OF HEALTH FAIR, SUPPORT GROUPS, EDUCATION PROGRAMS AND MEDICATION ASSISTANCE. THE DONATED SERVICES AND FUNDS HELP FURTHER THE MISSION AND GOALS OF COMMUNITY ORGANIZATIONS WHICH, IN TURN, HELP IMPROVE OVERALL HEALTH STATUS AND QUALITY OF LIFE OF THE COMMUNITIES SERVED. |
| PART III, LINE 2: | GENERALLY, PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR RELATED DEDUCTIBLES AND COINSURANCE, WHICH VARY IN AMOUNT. THE HOSPITAL PROVIDES SERVICES TO UNINSURED PATIENTS, AND OFFERS THOSE UNINSURED PATIENTS A DISCOUNT, EITHER BY POLICY OR LAW, FROM STANDARD CHARGES. THE HOSPITAL ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS AND IMPLICIT PRICE CONCESSIONS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF CHANGE. FOR THE YEARS ENDED APRIL 30, 2021 AND 2020, NO SIGNIFICANT ADJUSTMENTS TO REVENUE WERE RECOGNIZED DUE TO CHANGES IN ESTIMATES OF IMPLICIT PRICE CONCESSIONS FOR PERFORMANCE OBLIGATIONS SATISFIED IN PRIOR YEARS. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE. |
| PART III, LINE 3: | THE HOSPITAL PROVIDES PATIENT FINANCIAL ASSISTANCE TO PATIENTS WHO ARE FINANCIALLY UNABLE TO PAY FOR THE HEALTHCARE SERVICES THEY RECEIVE. IT IS THE POLICY OF THE HOSPITAL NOT TO PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS PATIENT FINANCIAL ASSISTANCE. ACCORDINGLY, THE HOSPITAL DOES NOT REPORT THESE AMOUNTS IN PATIENT SERVICE REVENUE. THE HOSPITAL DETERMINES THE COSTS ASSOCIATED WITH PROVIDING PATIENT FINANCIAL ASSISTANCE BY AGGREGATING THE DIRECT AND INDIRECT COSTS, INCLUDING SALARIES, BENEFITS, SUPPLIES, ANDOTHER OPERATING EXPENSES, BASED ON AN OVERALL COST TO CHARGE RATIO. THE COSTS OF CARING FOR THESE PATIENTS FOR THE YEARS ENDED APRIL 30, 2021 AND 2020 WAS APPROXIMATELY $147,000 AND $251,000, RESPECTIVELY. THE ESTIMATED COST OF THESE CHARITY CARE SERVICES WAS DETERMINED USING A RATIO OF COSTS TO GROSS CHARGES AND APPLYING THAT RATIO TO THE GROSS CHARGES ASSOCIATED WITH PROVIDING CARE TO CHARITY PATIENTS FOR THE PERIOD. GROSS CHARGES ASSOCIATED WITH PROVIDING CARE TO CHARITY PATIENTS INCLUDES ONLY THE RELATED CHARGES FOR THOSE PATIENTS WHO ARE FINANCIALLY UNABLE TO PAY AND QUALIFY UNDER THE HOSPITAL'S CHARITY CARE POLICY AND THAT DO NOT OTHERWISE QUALIFY FOR REIMBURSEMENT FROM A GOVERNMENTAL PROGRAM. DURING THE YEARS ENDED APRIL 30, 2021 AND 2020, THE HOSPITAL RECEIVED $3,079,683 AND $0 FROM THE HEALTH RESOURCES AND SERVICES ADMINISTRATION, RESPECTIVELY TO HELP DEFRAY THE COSTS OF INDIGENT CARE. |
| PART III, LINE 4: | THE HOSPITAL'S FINANCIAL STATMENTS DO NOT CONTAIN A SPECIFIC FOOTNOTE DESCRIBING BAD DEBT. HOWEVER, PAGES 8, 11 AND 12 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS INCLUDE FOOTNOTES TITLED "PATIENT RECEIVABLES", "PATIENT SERVICE REVENUE AND "PATIENT FINANCIAL ASSISTANCE". |
| PART III, LINE 8: | "MEDICARE ALLOWABLE COSTS OF CARE" WAS CALCULATED FROM INFORMATION IN THE MEDICARE COST REPORT D, E, H & M WORKSHEETS, OR PS&R. THESE COSTS ARE MEDICARE REIMBURSABLE COSTS, NOT ALL COSTS. NO MEDICARE SHORTFALL IS TREATED AS COMMUNITY BENEFIT. |
| PART III, LINE 9B: | PATIENTS WHO QUALIFY FOR MEDICAID WILL AUTOMATICALLY QUALIFY FOR FINANCIAL ASSISTANCE AND MAY QUALIFY FOR MORE IF THEY COMPLETE THE FINANCIAL ASSISTANCE APPLICATION. THESE PATIENTS WILL NOT BE SENT TO COLLECTIONS IF THEY PAY THE AMOUNT FOR WHICH THEY QUALIFY.BRODSTONE'S POLICIES AND PROCEDURES FOR INTERNAL AND EXTERNAL COLLECTION PRACTICES TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR CHARITY, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR CHARITY FROM THE HOSPITAL AND A PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS OR HER PAYMENT AGREEMENTS WITH THE HOSPITAL. FOR PATIENTS WHO QUALIFY FOR CHARITY AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR BILLS, BRODSTONE MAY OFFER EXTENDED PAYMENT PLANS TO ELIGIBLE PATIENTS, WILL NOT IMPOSE WAGE GARNISHMENTS OR LIENS, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES AND WILL CEASE ALL COLLECTION EFFORTS. |
| PART VI, LINE 2: | BRODSTONE ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES THROUGH A SURVEY. THE BUDGETING PROCESS PUBLISHES SUGGESTIONS AND STRATEGIC PLANNING. HOSPITAL STAFF ALSO NETWORKS WITH OTHER HEALTH CARE ORGANIZATIONS TO DEVELOP IDEAS OF WHAT CAN BE DONE TO IMPROVE THE AVAILABILITY OF SERVICES IN THE COMMUNITY. |
| PART VI, LINE 3: | BRODSTONE HAS A BROCHURE CALLED CHARITY POLICY THAT ADDRESSESS THE FINANCIAL ASSISTANCE AVAILABILITY. IT IS POSTED AT THE ADMISSIONS AREAS AND EMERGENCY ROOM. THE CHARITY POLICY IS DISCUSSED WHEN MAKING PAYMENT ARRANGEMENTS. THIS POLICY IS ALSO AVAILABLE ON THE HOSPITAL'S WEBSITE. |
| PART VI, LINE 4: | SUPERIOR HAS A POPULATION OF 1,755 AND IS LOCATED ON THE NEBRASKA-KANSAS BORDER. BRODSTONE'S SERVICE AREA COVERS ALL OF NUCKOLLS COUNTY AND PARTS OF 2 OTHER COUNTIES IN NEBRASKA AND 3 COUNTIES IN KANSAS. THE MEDIAN HOUSEHOLD INCOME FOR NUCKOLLS COUNTY IS $43,388 COMPARED TO THE U.S. AVERAGE AT $62,843 AND THE NEBRASKA AVERAGE OF $61,439. THE AREA POPULATION IS PREDOMINATELY WHITE ELDERLY AND LOW INCOME. 49.6% OF THE HOSPITAL'S PATIENTS ARE MEDICARE PATIENTS. |
| PART VI, LINE 5: | BRODSTONE'S GOVERNING BODY CONSISTS OF FEMALES WITH NO IMMEDIATE FAMILY TIES TO ANY EMPLOYEE NOR ARE THEY CONTRACTORS OF THE ORGANIZATION. ALL BOARD MEMBERS HAVE SUPERIOR NEBRASKA ADDRESSES BUT 2 MEMBERS LIVE IN JEWELL COUNTY, KANSAS. ALL FAMILY PRACTICE PHYSIANS AND MIDLEVELS IN THE AREA WHO HAVE REQUESTED MEDICAL STAFF PRIVILEGES AND MEET THE REQUIREMENTS HAVE PRIVILEGES AT THE HOSPITAL. ONE DENTIST HAS COURTESY PRIVELEGES. ALL SURPLUS FUNDS OF THE ORGANIZATION ARE USED TO FUND THE BUDGET FOR THE COMING YEARS OR SET ASIDE FOR FUTURE PROJECTS. |
| PART VI, LINE 6: | BRODSTONE MEMORIAL HOSPITAL IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. |
| PART VI, LINE 7: | BRODSTONE DOES NOT FILE A COMMUNITY BENEFIT REPORT WITH ANY STATE. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRODSTONE MEMORIAL HOSPITAL FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 520 EAST 10TH STREET | AddressLine1Txt |
| City | SUPERIOR | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68978 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 851276014 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $14,181 | CashGrantAmt |
| Purpose Of Grant | REIMBURSE FOUNDATION FOR FUNDRAISING EXPENSES. | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | 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 | THE HOSPITAL ONLY GRANTS FUNDS TO ITS RELATED FOUNDATION. THEREFORE, IT IS ABLE TO MONITOR THE USE OF THE GRANT FUNDS. | 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 | Yes (1) | 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 | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TIMOTHY BLECHA MD | ||||||||||||||
| PHYSICIAN | $231,896 | $0 | $87,285 | $0 | $1,341 | $0 | $8,550 | $0 | $29,668 | $0 | $358,740 | $0 | $0 | $0 |
| JULIE THEIS MD | ||||||||||||||
| PHYSICIAN | $269,928 | $0 | $16,088 | $0 | $254 | $0 | $7,584 | $0 | $38,594 | $0 | $332,448 | $0 | $0 | $0 |
| TREG VYZOUREK | ||||||||||||||
| CEO | $260,181 | $0 | $0 | $0 | $319 | $0 | $8,007 | $0 | $37,548 | $0 | $306,055 | $0 | $0 | $0 |
| MATTHEW GATLIN PA-C | ||||||||||||||
| PHYSICIAN ASSISTANT | $203,099 | $0 | $23,708 | $0 | $108 | $0 | $6,953 | $0 | $27,415 | $0 | $261,283 | $0 | $0 | $0 |
| ROBERT LEIBEL MD | ||||||||||||||
| PHYSICIAN | $199,317 | $0 | $1,750 | $0 | $990 | $0 | $6,282 | $0 | $38,063 | $0 | $246,402 | $0 | $0 | $0 |
| JASON HASS PA-C | ||||||||||||||
| PHYSICIAN ASSISTANT | $177,681 | $0 | $5,750 | $0 | $235 | $0 | $5,776 | $0 | $38,767 | $0 | $228,209 | $0 | $0 | $0 |
| SANDRA BORDEN | ||||||||||||||
| CFO | $168,174 | $0 | $0 | $0 | $945 | $0 | $5,194 | $0 | $28,743 | $0 | $203,056 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 5 | FormAndLineReferenceDesc |
| Explanation | IN ACCORDANCE WITH RELATED EMPLOYMENT CONTRACTS, ADDITIONAL COMPENSATION IS PAID BASED ON REVENUES GENERATED BY EACH MEDICAL PROVIDER, AS DEFINED. THESE ADDITIONAL AMOUNTS HAVE BEEN LISTED AS INCENTIVE COMPENSATION IN PART II OF THIS SCHEDULE. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|
| THE CITY OF SUPERIOR NEBRASKA | |||||||
| A | 476006376 | 2013-05-22 | $4,000,000 | REFUND ISSUES (9/9/03, 9/10/09, 9/10/09) | 0 | 0 | 0 |
| THE COUNTY OF NUCKOLLS NEBRASKA | |||||||
| B | 476006492 | 2013-05-22 | $4,000,000 | REFUND ISSUES (9/9/03, 9/10/09, 9/10/09) | 0 | 0 | 0 |
| CITY OF SUPERIOR NEBRASKA | |||||||
| C | 476006376 | 2019-12-12 | $10,000,000 | CONSTRUCT AND EQUIP FACILITY | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | UnspentUnspentAmt |
|---|---|---|---|---|---|---|---|---|---|
| A | $1,878,489 | $4,000,000 | $4,000,000 | 2010 | Yes (1) | 0 | Yes (1) | Yes (1) | |
| B | $1,878,489 | $4,000,000 | $4,000,000 | 2010 | Yes (1) | 0 | Yes (1) | Yes (1) | |
| C | $50,001 | 0 | 0 | 0 | Yes (1) | $50,001 |
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 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
| C | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
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 | Yes (1) | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | Yes (1) | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) |
| C | 0 | Yes (1) | 0 | 0 | Yes (1) | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K, PART IV, LINE 2C: | FormAndLineReferenceDesc |
| Explanation | (A) ISSUER NAME: CITY OF SUPERIOR, NEBRASKA DATE THE REBATE COMPUTATION WAS PERFORMED: 08/07/2020 (B) ISSUER NAME: THE COUNTY OF NUCKOLLS, NEBRASKA DATE THE REBATE COMPUTATION WAS PERFORMED: 08/07/2020 NOTE REGARDING THE 8/7/2020 REBATE COMPUTATIONS: SINCE THE BOND PROCEEDS WERE SPENT ON THE ISSUE DATE, A SPENDING EXCEPTION WAS MET, AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CALCULATIONS ARE NECESSARY. PART II, LINE 3, COLUMN C - THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) AS THIS DEBT WAS ISSUED ON A DRAW-DOWN BASIS AND THE TOTAL PRINCIPAL AVAILABLE HAS NOT YET BEEN DRAWN. | ExplanationTxt |
Schedule L IRS990ScheduleL
Grnt Asst Bnft Interested Prsn GrntAsstBnftInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BEN VYZOUREK | PersonNm |
| Relationship With Org | BEN IS THE SON OF THE CEO, TREG VYZOUREK. | RelationshipWithOrgTxt |
| Cash Grant | $1,000 | CashGrantAmt |
| Type Of Assistance | CASH GRANT | TypeOfAssistanceTxt |
| Assistance Purpose | HEALTH CAREER EDUCATION | AssistancePurposeTxt |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | OTHER SUPPLIES | Desc |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $78,227 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | DIRECTORS JUDY GROVE AND JACKI PORTER HAVE A FAMILY RELATIONSHIP. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM. BEFORE IT IS FILED, IT IS GIVEN A DETAILED REVIEW BY MANAGEMENT AND THEN A GENERAL REVIEW BY THE BOARD OF DIRECTORS AT A REGULARLY SCHEDULED BOARD MEETING. A FINAL COPY OF THE FORM 990 WILL BE ELECTRONICALLY FILED AFTER APPROVAL. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS WHO HAVE A CONFLICT OF INTEREST WOULD REFRAIN FROM DISCUSSION AND VOTING ON THOSE MATTERS. THERE IS AN ANNUAL BOARD MEMBER TRAINING THAT COVERS THIS POLICY. ADDITIONALLY, ALL BOARD MEMBERS ARE WELL ACQUAINTED WITH EACH OTHER SO IF THERE WAS A CONFLICT OF INTEREST AND THE BOARD MEMBER DID NOT DISCLOSE, THE OTHER BOARD MEMBERS WOULD BRING IT TO THE BOARD'S ATTENTION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE HUMAN RESOURCE DIRECTOR PREPARES A SALARY SURVEY ANNUALLY FOR ALL JOBS DESCRIPTIONS WITH HOSPITALS OF SIMILAR SIZE AND REVENUES. THE BOARD OF DIRECTORS REVIEWS THE SURVEY AND PRIOR SALARY INCREASES FOR THE CEO BEFORE GRANTING PAY INCREASES. THE HUMAN RESOURCE DIRECTOR AND CFO MAKE RECOMMENDATIONS TO THE CEO FOR OTHER EMPLOYEES. THE CEO REVIEWS THE SURVEY, PRIOR SALARY INCREASES, AND RECOMMENDATIONS BEFORE APPROVING PAY INCREASES FOR EMPLOYEES. THE PAY INCREASES ARE APPROVED BY THE BOARD OF DIRECTORS DURING THE BUDGET PROCESS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC, BUT FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PHARMACY: PROGRAM SERVICE EXPENSES 1,829,035. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,829,035. ANESTHESIA: PROGRAM SERVICE EXPENSES 427,990. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 427,990. LABORATORY: PROGRAM SERVICE EXPENSES 174,708. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 174,708. NUCLEAR MEDICINE: PROGRAM SERVICE EXPENSES 89,412. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 89,412. OTHER FEES FOR SERVICE: PROGRAM SERVICE EXPENSES 832,562. MANAGEMENT AND GENERAL EXPENSES 152,831. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 985,393. |
| FORM 990, PART XI, LINE 9: | CHANGE IN BENEFICIAL INTEREST IN TRUSTS 289,374. |
| FORM 990, PART XII, LINE 2C: | THE BOARD OF DIRECTORS ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
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 | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| PNC VESTEY TRUST UA UNB & NORTHERN CO SUCC BENEFIT BRODSTONE MEM HOSP | ||||||||||
| 116 ALLEGHENY CENTER MALL | PITTSBURGH | PA | 15212 | 226023351 | ASSISTING IN THE OPERATIONS OF BRODSTONE MEMORIAL HOSPITAL | PA | 4947(A)(1) | PF | BRODSTONE MEMORIAL HOSPITAL | Yes (1) |
| BRODSTONE MEMORIAL HOSPITAL FOUNDATION | ||||||||||
| 520 EAST 10TH STREET | SUPERIOR | NE | 68978 | 851276014 | TO SUPPORT BRODSTONE MEMORIAL HOSPITAL | NE | 501(C)(3) | LINE 12A, I | BRODSTONE MEMORIAL HOSPITAL | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | 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 | 0 | 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 | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| PNC VESTEY TRUST | ||
| C | $66,510 | FMV |
| BRODSTONE MEMORIAL HOSPITAL FOUNDATION | ||
| C | $55,000 | CASH |