2021-03-29T09:45:39-05:00 2020-06-30 481026809 Wendling Noe Nelson & Johnson LLC 623 SW 10th Ave Suite 300 Topeka KS 66612 990 2019-07-01 480764456 Nemaha Valley Community Hospital NEMA 7853366181 1600 Community Drive Seneca KS 66538 KILEY FLOYD CEO 7853366181 2021-03-18 1 Eric L Otting P00298454 7852334226 2021-03-18 2019 2022-09-23 18:48:47Z Kiley Floyd 1600 Community Drive Seneca KS 66538 17202744 0 X nemvch.com X 1969 KS Nemaha Valley Community Hospital's mission statement is to provide personalized, compassionate healthcare while promoting wellness in the communities we serve. 13 11 164 34 0 0 669920 831688 16601554 16217138 83961 94016 169274 59902 17524709 17202744 0 0 0 0 10744987 10990068 0 0 12830 6604787 6175515 17349774 17165583 174935 37161 17278050 21840206 9627054 14152049 7650996 7688157 Nemaha Valley Community Hospital's mission statement is to provide personalized, compassionate healthcare while promoting wellness in the communities we serve. 0 0 14715135 16253774 Nemaha Valley Community Hospital provides inpatient and outpatient hospital services and clinic services to patients in its service area. 14715135 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 1 22 0 1 164 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 11 1 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 1 1 0 0 X Abbie Thomas 7853366181 1600 Community Drive Seneca KS 66538 Leroy Strathman Trustee 1.00 X 0 0 0 Ed Mohney Chairman 1.00 X X 0 0 0 Fred Henry Vice-Chairman 1.00 X X 0 0 0 Bill Love Trustee 1.00 X 0 0 0 Katie Nordhus Trustee 1.00 X 0 0 0 Dennis Henry Trustee 1.00 X 0 0 0 Leah Hermesch Trustee 1.00 X 0 0 0 Mike Steinlage Trustee 1.00 X 0 0 0 Kris Enneking Secretary/Treasurer 1.00 X X 0 0 0 Mary Haverkamp Trustee 1.00 X 0 0 0 Dr William Bartkoski Physician/Trustee 40.00 X 354315 0 28280 Dr James Lueger Physician/Trustee 1.00 X 14650 0 0 TJ Haverkamp Trustee 1.00 X 0 0 0 Kiley Floyd CEO 40.00 X 138439 0 15911 Connie Ingwerson CFO through Aug. 2019 40.00 X 106720 0 6699 Abbie Thomas Contract CFO beginning Sept. 2019 20.00 X 18654 0 0 Harry Stewart CRNA 40.00 X 319400 0 38611 Dr Heather Myers Physician 40.00 X 411296 0 17702 Dr Angela Stueve Physician 40.00 X 336553 0 24623 Lori Lueger APRN 40.00 X 161426 0 17689 Dr Jarod Snyder Physician 40.00 X 321077 0 25615 2182530 0 175130 10 0 1 0 Cerner Corporation PO Box 959156 St Louis MO 63195 Patient Accounting System 392414 Stormont Vail Healthcare 1500 SW 10th Avenue Topeka KS 66604 Lab Services - Outreach 202550 Medhost of Tennessee Inc 6550 Carothers Parkay Suite 160 Franklin TN 37067 IT Maintenance 126393 Shared Medical Services Inc PO Box 330 Cottage Grove WI 53527 MRI Scans 123165 4 2095 504408 325185 831688 Patient service revenue 621110 15489178 15489178 340B retail drug program 446110 727960 727960 16217138 93616 93616 400 0 400 400 400 Dietary Income 722210 23266 23266 Miscellaneous 621110 22242 22242 Outside services 900099 14394 14394 59902 17202744 16253774 0 117282 627488 400769 226719 8106866 7188942 908310 9614 325016 288089 36549 378 1378471 1212037 164887 1547 552227 483254 68366 607 14205 14205 994588 722522 272065 1 30232 10510 19722 83226 65497 17718 11 11645 8734 2911 146125 128938 17100 87 34546 21297 13248 1 335288 296663 38424 201 1189126 1025931 162926 269 140579 123599 16961 19 Supplies 2145583 2071644 73880 59 Equipment rental and ma 754222 560663 193536 23 Collection fees 116121 8950 107171 Education 67944 62786 5158 112085 34310 77762 13 17165583 14715135 2437618 12830 198795 1504 7445890 12820377 1777767 1371972 272677 253466 303418 323339 21118130 14971256 7035564 6146874 243939 922674 17278050 21840206 1987054 2846087 3985962 7640000 7320000 9627054 14152049 X 7641798 7579330 9198 108827 7650996 7688157 17278050 21840206 37161 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 4233 0 0 0 4233 0 Part II-B, Line 1: Nemaha Valley Community Hospital is a member of the Kansas Hospital Association and the American Hospital Association. Both of these organizations engage in lobbying activities as part of the services provided to members. The above amount was estimated based on a percentage of membership dues. 54681 54681 11761048 7969812 3791236 9224525 7001444 2223081 77876 77876 6146874 X 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 taxes on related income pursuant to Sction 501(a) of the Code. 1 1 0 1 X 1 1 0 1 1 187060 24236 162824 0.00950 848102 468837 379265 0.02210 1035162 493073 542089 0.03160 4006475 2876759 1129716 0.06580 775 775 0.00000 4007250 2876759 1130491 0.06580 5042412 3369832 1672580 0.09740 1 206562 82625 6343667 6372817 -29150 X 1 1 1 1 Nemaha Valley Community Hospital 1600 Community Drive Seneca KS 66538 X X X X Rural health clinic Nemaha Valley Community Hospital 1 0 0 1 X X X X X X X X X 18 1 1 0 1 X http://www.nemvch.com/resources X 1 18 1 http://www.nemvch.com/resources 0 1 X 200.000000000000 X X X X 1 1 X X X 1 X http://www.nemvch.com/resources/ X http://www.nemvch.com/resources/ X http://www.nemvch.com/resources/ X X X X X X 1 X 0 X X X X 1 X 0 0 Nemaha Valley Community Hospital Part V, Section B, Line 5: Community members were invited to attend a meeting in which their input was requested to determine the health needs of the community. The community members identified the health care needs that should be prioritized. These members included medical professionals, government employees, leaders of non-profit organizations, and hospital employees. Nemaha Valley Community Hospital Part V, Section B, Line 6a: Sabetha Community Hospital Nemaha Valley Community Hospital Part V, Section B, Line 11: To promote health education, the Hospital emphasized educational programs with a focus on hypertension, diabetes, smoking cessation, increased seat belt usage, and car seat safety. To improve access to mental health assistance, the Hospital provided support and education to ER staff regarding mental health issues and available resources. The Hospital has continued two tele-health mental health clinics that provide psychiatry & therapy for the young and old. The Hospital continued to educate the public about mental health issues through social and local media and promoted existing mental health services, facilities and providers. To prevent alcohol abuse, the Hospital provided financial support for specific efforts related to activities in local schools. The hospital also participated in an underage drinking educational video for Nemaha County. Furthermore, the Hospital partnered with Mirrors, Inc. for counseling services and promoted the counseling services of NVCH staff. Finally, the Hopsital provided a board member for the United 4 Youth organization.To promote cancer care, the Hospital collaborated with local chapters of the American Cancer Society to provide cancer screenings and awareness activities. The Hospital provided education to the community on ways to protect themselves from different forms of cancer such as proper sun screen usage to prevent skin cancer and smoking cessation to prevent lung cancer. The Hospital also educated on the importance of preventive health care visits in early cancer detection and successful treatments. The Hospital collaborated with women's health providers to ensure that the female population is receiving yearly mammograms. Additionally, the Hopsital explored the opportunity for local chemotherapy treatments and sought to strengthen the relationship with oncology providers to expand outpatient clinics. Furthermore, the Hopsital initiated diagnosis counseling to refer patients to resources, provide education, and serve as a resource for patients. The Hospital also participated in the KU Survive Cancer Survivorship Project. Finally, the Hospital wrote a request to the State of Kansas Health Department asking them to validate cancer incidence rates. To prevent obesity, the Hospital sponsored community activities that promote nutrition, physical fitness, and outdoor activities and exercise for the entire family. The Hospital supported the community farmers market in order to encourage local produce and healthy food choices. The Hospital continued to educate business and industry on the benefits of offering wellness programs for their employees and also suggested primary care and other providers to refer patients to nutritionists and diabetic educators. Finally, the Hospital provided educational programs titled "Prevent T2 Prediabetes and "Living Healthy with Diabetes." To prevent substance abuse, the Hospital continued to monitor prescription drug abuse by creating an alert system between physicians and pharmacies for drug abuse. The Hospital continued to participate in Ktracks to identify abuse and participated in regional efforts for opioid management. In addition, the Hospital promoted the counseling services of local providers and promoted the disposal of old prescriptions, especially opioids, at the local police department.To improve child care, the Hospital conducted child care support education such as teen babysitting classes. The Hospital continued to provide support for licensure such as CPR Classes and education on infection prevention and child immunizations. Part I, Line 7: This amount was determined by multiplying a cost-to-charge ratio derived from Worksheet 2 for the tax year. Part I, Line 7g: The net community benefit expense of subsidized health services include costs attributable to a rural health clinic in the amount of $882,813. Part II, Community Building Activities: N/A Part III, Line 4: Nemaha Valley Community Hospital provides for accounts receivable that could become uncollectible in the future by establishing an allowance to reduce the carrying value of such receivables to their estimated net realizable value. This estimate is based on the aging of its accounts receivable by payor and historical collection experience. See note A4 (page 7) of the audited financial statements regarding the allowance for uncollectible accounts.Part III Line 2:This amount was determined by multiplying a cost-to-charge ratio derived from Worksheet 2 for the tax year.Part III, Line 3:This amount was determined based on the overall income level of patients that submit all required documentation under the Hospital's financial assistance policy. As a tax-exempt hospital, we must provide necessary services regardless of the patient's ability to pay for that care. Making quality patient care available to all in our community, regardless of their economic means, qualifies this amount as a community benefit. Part III, Line 8: Medicare costs were obtained from the Medical Center's as-filed Medicare cost report for the tax year. The shortfall is a benefit to the Medical Center's community since it represents health care provided at less than cost to elderly and needy residents of the Medical Center's service area. Part III, Line 9b: Nemaha Valley Community Hospital makes every effort to get correct financial and billing information and to educate patients on the eligibility requirements of charity care programs and payment options. Part VI, Line 2: N/A Part VI, Line 3: Notification associated with patient encounter. Part VI, Line 4: The community served is primarily residents who reside in Nemaha County Kansas and consists of approximately 2,084 residents. The median family income is $53,478. 7.20% of the community residents live below federal poverty level. Neighboring hospitals are located in Sabetha, Pawnee County, NE, and Hiawatha. They are approximately 21, 20, and 28 miles away respectively. Part VI, Line 5: The Hospital maintains a Facebook page which posts general health information topics and announces dates of general health-related group activities. The Hospital offers periodic diabetic educational programs and education programs for expectant mothers. The Hospital uses all excess funds to maintain and improve Hospital facilities and equipment and to insure the delivery of high quality patient care services. Part VI, Line 6: N/A X X 0 0 0 0 0 0 0 0 0 Dr William Bartkoski Physician/Trustee 323421 0 30894 0 0 0 12385 0 15895 0 382595 0 0 0 Kiley Floyd CEO 133439 0 5000 0 0 0 6117 0 9794 0 154350 0 0 0 Harry Stewart CRNA 319400 0 0 0 0 0 11049 0 27562 0 358011 0 0 0 Dr Heather Myers Physician 342348 0 68948 0 0 0 9185 0 8517 0 428998 0 0 0 Dr Angela Stueve Physician 285133 0 51420 0 0 0 12127 0 12496 0 361176 0 0 0 Lori Lueger APRN 128007 0 33419 0 0 0 6382 0 11307 0 179115 0 0 0 Dr Jarod Snyder Physician 275808 0 45269 0 0 0 12711 0 12904 0 346692 0 0 0 A City of Seneca Kansas 486026237 81712RAP4 2008-12-01 8835000 To refund notes payable and construction costs for an addition to Hospital 0 0 0 B City of Seneca Kansas 486026237 81712RBB4 2015-02-19 4455000 To refund a portion of 2008 series bond 0 0 0 A 5335000 8835000 498789 161535 6834436 1358153 2011 0 0 1 1 B 635000 4455000 88270 4517530 2018 1 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 0 0 1 1 0 0 0 1 B 1 0 0 0 0 1 A 1 B 1 Date Rebate Computation Performed Issuer Name: City of Seneca, Kansas Date the Rebate Computation was Performed: 06/01/2018 Margie Heinen Family member of Dennis Henry, Board Member 68769 Employment 0 Mary Strathman Family member of Dennis Henry, Board Member 29575 Employment 0 Lynda Cross Family member of Mary Haverkamp and Mike Steinlage, Board Members 124795 Employment 0 Form 990, Part VI, Section A, line 2 Mary Haverkamp, Board Member, is a family relation to Mike Steinlage, Board Member. Form 990, Part VI, Section B, line 11b The 990 is presented to the finance committee of the board prior to filing. The document is made available to all other board members upon request. Form 990, Part VI, Section B, line 12c The board is required to annually sign conflict of interest statements. Form 990, Part VI, Section B, line 15a The CEO salary and compensation is approved by the Hospital's board. Form 990, Part VI, Section C, line 19 Documents are available upon request. 990 Part XII Line 2c The 990 is presented to the finance committee of the board prior to filing. The document is made available to all board members upon request. Nemaha Valley Health Care Foundation 1600 Community Drive Seneca KS 66538 481097250 Fundraising for the benefit of community healthcare KS 501(c)(3) Line 7 Nemaha Valley Community Hospital 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0