REGIONAL WEST GARDEN COUNTY: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- REGIONAL WEST GARDEN COUNTY (EIN 39-1904975)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-15
- IRS object ID
- 201813199349312336
- Schema version
- 2017v2.3
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-15T13:05:09-07:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 363314157 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REGIONAL WEST HEALTH SERVICES | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4021 AVENUE B | AddressLine1Txt |
| City | SCOTTSBLUFF | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 693614602 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391904975 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REGIONAL WEST GARDEN COUNTY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | REGI | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4021 AVENUE B | AddressLine1Txt |
| City | SCOTTSBLUFF | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 69361 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL ICKOWSKI | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3086301149 | PhoneNum |
| Signature | 2018-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMY HOLZWORTH CPA | PreparerPersonNm |
| PTIN | P00284207 | PTIN |
| Phone | 3086302823 | PhoneNum |
| Preparation | 2018-11-15 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 167.68.16.49 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-11-15 | IPDt |
| IP Tm | 14:05:09 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | BD55BCBAF3C68CDF1F389F5BA574DD8D29DEB7E8 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | BD55BCBAF3C68CDF1F389F5BA574DD8D29DEB7E8 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHAEL ICKOWSKI | PrincipalOfficerNm |
| Gross Receipts | $7,766,260 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GCHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1984 | FormationYr |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF REGIONAL WEST GARDEN COUNTY IS TO PROVIDE HIGH QUALITY HEALTH CARE BY COMBINING CLINICAL AND SERVICE EXCELLENCE TO ENHANCE THE QUALITY OF LIFE OF THE COMMUNITIES SERVED. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 120 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $88,574 | PYContributionsGrantsAmt |
| CY Contributions Grants | $468,431 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,593,812 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $7,283,820 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,359 | PYInvestmentIncomeAmt |
| CY Investment Income | $6,720 | CYInvestmentIncomeAmt |
| PY Other Revenue | $138,925 | PYOtherRevenueAmt |
| CY Other Revenue | $7,289 | CYOtherRevenueAmt |
| PY Total Revenue | $7,824,670 | PYTotalRevenueAmt |
| CY Total Revenue | $7,766,260 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $5,500,953 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,865,761 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,925,224 | PYOtherExpensesAmt |
| CY Other Expenses | $2,557,801 | CYOtherExpensesAmt |
| PY Total Expenses | $8,426,177 | PYTotalExpensesAmt |
| CY Total Expenses | $8,423,562 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$601,507 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$657,302 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,997,224 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,570,209 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,080,508 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,310,795 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$1,083,284 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$1,740,586 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF REGIONAL WEST GARDEN COUNTY IS TO PROVIDE HIGH QUALITY HEALTH CARE BY COMBINING CLINICAL AND SERVICE EXCELLENCE TO ENHANCE THE QUALITY OF LIFE OF THE COMMUNITIES SERVED. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $2,899,216 | ExpenseAmt |
| Revenue | $4,545,333 | RevenueAmt |
| Desc | REGIONAL WEST GARDEN COUNTY IS A NONPROFIT FACILITY CRITICAL ACCESS HOSPITAL THAT INCLUDES A 10 BE ACUTE CARE UNIT DESIGNED TO PROVIDE SPECIAL CARE FOR ACUTELY ILL PATIENTS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,478,318 | ExpenseAmt |
| Revenue | $1,872,574 | RevenueAmt |
| Desc | REGIONAL WEST GARDEN COUNTY INCLUDES A 40 BED NURSING HOME INTERMEDICATE LONG TERM CARE FACILITY. ITS PURPOSE IS TO PROVIDE 24 HOUR LICENSED NURSING CARE THAT ASSISTS RESIDENTS IN MEETING THEIR DAILY NEEDS AND HELPS THEM MAINTAIN THEIR OPTIMUM FUNCTIONAL LEVEL WITHIN AN ATMOSPHERE OF COMFORT AND DIGNITIY. REGIONAL WEST GARDEN COUNTY NURSING HOME ALSO OFFERS ADULT DAY CARE, RESPITE CARE, AND HOSPICE SERVICES. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,082,821 | ExpenseAmt |
| Revenue | $859,969 | RevenueAmt |
| Desc | REGIONAL WEST GARDEN COUNTY CLINIC IS A RURAL HEALTH CLINIC THAT PROVIDES PHYSICIAN APPOINTMENTS AND WALK IN CARE FOR RESIDENTS IN THE SOUTHEASTERN NEBRASKA PANHANDLE. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,963,207 | ExpenseAmt |
| Revenue | $18,233 | RevenueAmt |
| Desc | REGIONAL WEST GARDEN COUNTY ALSO PROVIDES ADMINISTRATIVE SUPPORT SERVICES NECESSARY TO ACCOMPLISH THE PRIMARY PROGRAM SERVICES OF THE HOSPITAL. THESE SERVICES ARE ADMINISTRATIVE, TECHNOLOGY, HUMAN RESOURCES, BILLING, HOUSEKEEPING, MEDICAL RECORDS AND OTHER SERVICES NECESSARY TO KEEP OPERATIONS RUNNING. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $2,963,207 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $18,233 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $8,423,562 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 19 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 120 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL ICKOWSKI | PersonNm |
| Phone | 3086301111 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4021 AVENUE B | AddressLine1Txt |
| City | SCOTTSBLUFF | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 69361 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| PAUL HOFMEISTER | |||||||||
| BOARD MEMBER | 1.00 | 40.00 | Yes (X) | $0 | $538,124 | $97,091 | |||
| HOD KOSMAN | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MARY MATHER | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| CASPER CORFIELD | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| BEV KRAJEWSKI | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JOHN MENTGEN | |||||||||
| CHAIRMAN | 1.00 | 40.00 | $0 | $513,036 | $249,768 | Yes (X) | |||
| MICHAEL ICKOWSKI | |||||||||
| CFO | 1.00 | 40.00 | $0 | $305,591 | $71,001 | Yes (X) | |||
| EVELYN YORK | |||||||||
| SECRETARY | 1.00 | 40.00 | $0 | $57,198 | $36,946 | Yes (X) | |||
| STEPHEN BOYER | |||||||||
| MEDICAL DIRE | 40.00 | $304,399 | $0 | $48,401 | Yes (X) | ||||
| WYATT KRAMER | |||||||||
| PA | 40.00 | $209,110 | $0 | $15,135 | Yes (X) | ||||
| LAURIE SOPER | |||||||||
| APRN | 40.00 | $206,625 | $0 | $19,721 | Yes (X) | ||||
| DAVID GRIFFITHS | |||||||||
| TREASURER | $0 | $382,483 | $0 | Yes (X) | |||||
| MATTHEW HASLAM | |||||||||
| DIRECTOR | 40.00 | $0 | $292,748 | $43,445 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $720,134 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,089,180 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $581,508 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line2ContractorAddress/USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|
| PRIME TIME HEALTHCARE LLC | ||||||
| PO BOX 3544 | OMAHA | NE | 68103 | AGENCY STAFF | $152,070 | |
| QUADRA MED | ||||||
| PO BOX 74008556 | CHICAGO | IL | 606748556 | MAINTENANCE CON | $147,286 | |
| MEDICAL SOLUTIONS | ||||||
| PO BOX 310737 | DES MOINES | IA | 503310737 | AGENCY STAFF | $135,770 | |
| STAT STAFFING LLC | ||||||
| PO BOX 45 | OSHKOSH | NE | 69154 | AGENCY STAFF | $109,340 | 101 E AVE F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,111 | GovernmentGrantsAmt |
| All Other Contributions | $466,320 | AllOtherContributionsAmt |
| Total Contributions | $468,431 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET HOSPITAL PATIENT REVENUE | 623000 | $4,454,317 | $4,454,317 |
| NURSING HOME PATIENT REVENUE | 623000 | $1,872,574 | $1,872,574 |
| HEALTH CLINIC PATIENT REVENUE | 621110 | $859,560 | $859,560 |
| OTHER OPERATING REVENUE | 623000 | $97,369 | $97,369 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $7,283,820 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,720 | TotalRevenueColumnAmt |
| Exclusion | $1,720 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $5,000 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $5,000 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,000 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,000 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| OTHER NON-OPERATING REVENUE | $7,089 | $7,089 |
| SALE OF MINOR EQUIPMENT | $200 | $200 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $7,289 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,766,260 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,296,109 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $1,720 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $152,244 | TotalAmt |
| Program Services | $152,244 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,014,289 | TotalAmt |
| Program Services | $4,014,289 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $136,938 | TotalAmt |
| Program Services | $136,938 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,291,140 | TotalAmt |
| Program Services | $1,291,140 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $271,150 | TotalAmt |
| Program Services | $271,150 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,695 | TotalAmt |
| Program Services | $28,695 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36 | TotalAmt |
| Program Services | $36 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,094 | TotalAmt |
| Program Services | $32,094 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $300,990 | TotalAmt |
| Program Services | $300,990 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,668 | TotalAmt |
| Program Services | $14,668 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,559 | TotalAmt |
| Program Services | $10,559 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $198,193 | TotalAmt |
| Program Services | $198,193 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,006 | TotalAmt |
| Program Services | $23,006 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,665 | TotalAmt |
| Program Services | $5,665 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,551 | TotalAmt |
| Program Services | $10,551 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $150,351 | TotalAmt |
| Program Services | $150,351 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,959 | TotalAmt |
| Program Services | $66,959 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| OTHER PURCHASED SVCS | $1,048,288 | $1,048,288 |
| PATIENT BILLABLE SUPPLIES | $210,606 | $210,606 |
| NONBILLABLE PATIENT SUPPL | $116,164 | $116,164 |
| SERVICE CONTRACT | $90,849 | $90,849 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $250,127 | TotalAmt |
| Program Services | $250,127 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,423,562 | TotalAmt |
| Program Services | $8,423,562 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,095,478 | BOYAmt |
| EOY | $753,858 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,291,872 | BOYAmt |
| EOY | $883,091 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $121,556 | BOYAmt |
| EOY | $126,382 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,581 | BOYAmt |
| EOY | $1,118 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,298,492 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $492,732 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $479,737 | BOYAmt |
| EOY | $805,760 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,997,224 | BOYAmt |
| EOY | $2,570,209 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $200,461 | BOYAmt |
| EOY | $135,415 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $156,501 | BOYAmt |
| EOY | $80,673 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,723,546 | BOYAmt |
| EOY | $4,094,707 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,080,508 | BOYAmt |
| EOY | $4,310,795 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$1,083,284 | BOYAmt |
| EOY | -$1,740,586 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$1,083,284 | BOYAmt |
| EOY | -$1,740,586 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,997,224 | BOYAmt |
| EOY | $2,570,209 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$657,302 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,298,492 | OtherCostOrOtherBasisAmt |
| Depreciation | $492,732 | DepreciationAmt |
| Book Value | $805,760 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $805,760 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATES | $2,965,452 |
| DUE TO THIRD PARTY PAYOR | $483,595 |
| SALARIES & BENEFITS PAYABLE | $367,975 |
| LEASEHOLD PAYABLE GCHS | $277,685 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,094,707 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | false | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $26,081 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $26,081 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00310 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $133,186 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $133,186 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01580 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $159,267 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $159,267 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01890 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $159,267 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $159,267 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01890 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $293,873 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $3,029,408 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $4,109,492 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,080,084 | 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 (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | 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 | REGIONAL WEST GARDEN COUNTY | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1100 WEST 2ND | AddressLine1Txt |
| City | OSHKOSH | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 69154 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REGIONAL WEST GARDEN COUNTY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 17 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.GCHEALTH.ORG | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | GCHEALTH.ORG | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | 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 | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | 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 (true) | IncludesPublicityMeasuresInd |
| 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 |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, REGIONAL WEST GARDEN COUNTY - PART V, LINE 5 | REGIONAL WEST GARDEN COUNTY PARTICIPATED WITH OTHER HOSPITALS IN THE RURAL NEBRASKA HEALTHCARE NETWORK (RNHN) IN A JOINT PLANNING PROCESS FACILITATED BY PANHANDLE PUBLIC HEALTH DISTRICT. MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) IS A PARTNERSHIP-BASED FRAMEWORK TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT AND DEVELOP A COMMUNITY HEALTH IMPROVEMENT PLAN. MAPP EMPHASIZES THE PARTNERSHIP WITH ALL SECTORS OF THE PUBLIC HEALTH SYSTEM TO EVALUATE THE HEALTH STATUS OF THE REGION IT SERVES, IDENTIFY PRIORITY AREAS, AND DEVELOP PLANS FOR IMPLEMENTATION. RWGC HOSTED FOCUS GROUPS FOR RESIDENTS OF THE SERVICE AREA IN MAY 2014 AS PART OF THE COMMUNITY THEMES AND STRENGTHS ASSESSMENT. PARTICIPANTS INCLUDED REPRESENTATIVES FROM THE HOSPITAL, PUBLIC SCHOOL SYSTEM, GARDEN COUNTY, AND LOCAL BUSINESSES. |
| FACILITY 1, REGIONAL WEST GARDEN COUNTY - PART V, LINE 6B | GARDEN COUNTY WORKED WITH THE REST OF THE MEMBERS OF THE RNHN NETWORK FOR IDEAS AND WITH THE PANHANDLE PUBLIC HEALTH DISTRICT (PPHD). |
| FACILITY 1, REGIONAL WEST GARDEN COUNTY - PART V, LINE 11 | NEEDS WERE ADDRESSED USING A PRIORITIZATION MATRIX TO HELP IDENTIFY THE AREAS OF NEED THAT MAY BE BETTER ADDRESSED BY OTHER ORGANIZATIONS OR AGENCIES IN THE REGION WITH A PRIMARY FUNCTION THAT DIRECTLY FOCUSED ON THOSE AREAS, AND ALSO TO IDENTIFY THE NEEDS THAT MOST CLOSELY ALIGNED WITH BOTH THE PURPOSE AND MISSION OF THE HOSPITAL AND COULD BE ADDRESSED EFFECTIVELY WITH THE RESOURCES THAT THE THE HOSPITAL HAS CURRENTLY. NEEDS THAT WERE NOT ADDRESSED IN THE IMPLEMENTATION STRATEGY EITHER WERE BETTER ADDRESSED BY OTHER AGENCIES OR ORGANIZATIONS IN THE REGION, OR WERE OUTSIDE OF THE SPECIFIC PURPOSE AND MISSION OF THE HOSPITAL AND COULD NOT BE ADDRESSED USING THE CURRENT RESOURCES. NEEDS IDENTIFIED FOR THE IMPLEMENTATION STRATEGY WERE THOSE THE BOARD BELIEVED THAT THE HOSPITAL COULD MOST EFFECTIVELY ADDRESS WITH THE RESOURCES AVAILABLE. |
| FACILITY 1, REGIONAL WEST GARDEN COUNTY - PART V, LINE 15E | RWGC FOLLOWS THE FINANCIAL ASSISTANCE POLICY OF REGIONAL WEST MEDICAL CENTER, A RELATED TAX-EXEMPT HOSPITAL UNDER THE CONTROL OF REGIONAL WEST HEALTH SERVICES. |
| FACILITY 1, REGIONAL WEST GARDEN COUNTY - PART V, LINE 16J | REGIONAL WEST GARDEN COUNTY DID NOT POST SPANISH-TRANSLATED VERSIONS OF ITS FINANCIAL ASSISTANCE POLICY AND PLAIN LANGUAGE SUMMARY OF ITS FINANCIAL ASSISTANCE POLICY ON ITS WEBSITE. THE FAILURE TO POST THESE TRANSLATED DOCUMENTS ON RWGC'S WEBSITE WAS INADVERTENT, BUT RWGC BELIEVES INDIVIDUAL PATIENTS WERE NOT HARMED. THE ISSUES WERE DISCOVERED DURING AN AUDIT OF RWMC'S 501(R) PRACTICES. ALTHOUGH DISCOVERED DURING THE AUDIT, THE ISSUES WERE CORRECTED WHEN RWGC POSTED TRANSLATED DOCUMENTS ON ITS WEBSITE IN 2017. |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | THE BAD DEBT EXPENSE ON THE AUDITED FINANCIAL STATEMENTS IS STATED IN TERMS OF UNREALIZABLE REVENUE, RATHER THAN AT THE ACTUAL COSTS ASSOCIATED WITH THE BAD DEBT. A COST TO CHARGE RATIO IS APPLIED TO THE BAD DEBT EXPENSE TO ESTIMATE THE COST OF THE BAD DEBT. A SIMILAR METHOD IS USED TO DETERMINE THE COSTS OF THE CHARITY CARE FOR THE ORGANIZATION. |
| PART III, LINE 8 - MEDICARE EXPLANATION | APPROXIMATELY 39% OF REVENUE IS FROM PATIENTS PARTICIPATING IN THE MEDICARE PROGRAM, THUS PROVIDING SERVICES TO MEDICARE PATIENTS IS A PROMOTION OF HEALTHCARE SERVICES TO A SIGNIFICANT PORTION OF THE POPULATION OF THE COMMUNITY AND REGION THAT RWGC SERVES. MEDICARE COST IS THE ALLOWABLE COSTS AS REPORTED ON THE RWGC COST REPORT FOR 2016. |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | THE COLLECTION POLICY AND THE RELATED CHARITY CARE POLICY, STATES THAT SINCE A PATIENT'S ABILITY TO PAY FOR HEALTHCARE CAN CHANGE, A CHARITY DETERMINATION CAN BE MADE PRIOR TO, DURING OR FOLOWWING TREATMENT AT RWGC. ONCE A PATIENT HAS DEMONSTRATED OR COMMUNICATED A NEED THROUGH NONPAYMENT, OR THROUGH A COMPLETED FINANCIAL ASSISTANCE APPLICATION, THE FINACIAL ASSITANCE TEAM OF RWGC WILL REVIEW THE ACCOUNT AND BASED ON FEDERAL POVERTY GUIDELINES WILL MAKE A DETERMINATION OF WHETHER THE ACCOUNT QUALIFIES FOR CHARITY CARE TREATMENT. SOME ITEMS CONSIDERED IN THE DETERMINATION, ACCORDING TO THE RWGC POLICY, ARE: ABILITY TO PAY, EXHAUSTION OF MEDICARE OR MEDICAID BENEFITS COMBINED WITH INABILITY TO PAY, DISCOUNTED CARE FOR THOSE UNABLE TO PAY; ALL OTHER POSSIBLE SOURCES OF COLLECTION USING SOUND BUSINESS PRACTICES HAVE BEEN MADE TO ENABLE THE PATIENT TO PAY; CARE PROVIDED TO A DECEASED PATIENT WITH NO ESTATE; OR CARE PROVIDED TO A PATIENT AFTER WHICH A NEGOTIATED SETTLEMENT WAS MADE FOR THE PATIENT'S ACCOUNT. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PAUL HOFMEISTER | ||||||||||||
| BOARD MEMBER | $295,889 | $242,235 | $71,273 | $25,818 | $635,215 | $231,046 | ||||||
| JOHN MENTGEN | ||||||||||||
| CHAIRMAN | $483,171 | $29,865 | $214,819 | $34,949 | $762,804 | |||||||
| MICHAEL ICKOWSKI | ||||||||||||
| CFO | $290,718 | $14,873 | $61,286 | $9,715 | $376,592 | |||||||
| STEPHEN BOYER | ||||||||||||
| MEDICAL DIRECTOR | $303,251 | $1,148 | $12,735 | $35,666 | $352,800 | |||||||
| WYATT KRAMER | ||||||||||||
| PA | $209,110 | $15,129 | $6 | $224,245 | ||||||||
| LAURIE SOPER | ||||||||||||
| APRN | $206,625 | $17,999 | $1,722 | $226,346 | ||||||||
| DAVID GRIFFITHS | ||||||||||||
| TREASURER | $382,483 | $382,483 | $382,483 | |||||||||
| MATTHEW HASLAM | ||||||||||||
| DIRECTOR | $275,509 | $1,624 | $10,685 | $32,760 | $336,193 | $15,615 | ||||||
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PAGE 1, PART I, LINE 4 | FormAndLineReferenceDesc |
| Explanation | PAUL HOFMEISTER 0 242,781 0 JOHN MENTGEN 0 111,027 0 MICHAEL ICKOWSKI 0 51,214 0 DAVID GRIFFITHS 0 382,483 0 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4D | REGIONAL WEST GARDEN COUNTY ALSO PROVIDES ADMINISTRATIVE SUPPORT SERVICES NECESSARY TO ACCOMPLISH THE PRIMARY PROGRAM SERVICES OF THE HOSPITAL. THESE SERVICES ARE ADMINISTRATIVE, TECHNOLOGY, HUMAN RESOURCES, BILLING, HOUSEKEEPING, MEDICAL RECORDS AND OTHER SERVICES NECESSARY TO KEEP OPERATIONS RUNNING. |
| FORM 990, PAGE 6, PART VI, LINE 11B | FORM WAS PRESENTED TO AND REVIEWED BY THE BOARD IN THE MONTH PRIOR TO THE FILING DEADLINE. |
| FORM 990, PAGE 6, PART VI, LINE 12C | ANNUAL DISCLOSURE BY BOARD MEMBERS OF ANY CONFLICT OF INTEREST, AS SET FORTH IN THE POLICIES, IS REQUIRED. FOR ANY POSSIBLE CONFLICT OF INTEREST IDENTIFIED, THE REMAINING BOARD DETERMINES IF IT ACTUALLY CONSTITUTES A CONFLICT OF INTEREST WITHOUT THE CONFLICTED BOARD MEMBER PRESENT. IF A CONFLICT OF INTEREST IS DETERMINED TO EXIST, THE BOARD, LESS THE CONFLICTED MEMBER, WILL THEN DECIDE THE LEVEL OF INVOLVEMENT OF THE MEMBER IN DECISION MAKING FOR THE ENTITY, IF THERE IS AN ALTERNATIVE ARRANGEMENT THAT WILL ELIMINATE THE CONFLICT OF INTEREST, AND THE APPROPRIATENESS OF THE CONFLICTED MEMBER CONTINUING AS A BOARD MEMBER. FAILURE TO DISCLOSE A CONFLICT OF INTEREST CAN RESULT IN DISCIPLINARY AND CORRECTIVE ACTION FOR THE CONFLICTED MEMBER. |
| FORM 990, PAGE 6, PART VI, LINE 15A | COMPENSATION FOR THE EXECUTIVE DIRECTOR IS DETERMINED BY AN INDEPENDENT COMPENSATION COMMITTEE MADE UP OF BOARD MEMBERS FROM THE PARENT COMPANY. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS AND POLICIES ARE MADE AVAILABLE TO THE PUBLIC THROUGH BEING POSTED ON THE ORGANIZATION'S WEBSITE. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 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 | Business Name Line2DirectControllingEntityName/BusinessNameLine2Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| REGIONAL WEST HEALTH SERVICES | |||||||||||
| 4021 AVENUE B | SCOTTSBLUFF | NE | 69361 | 363314157 | ADMIN SUPP | NE | 501C3 | 12A | NA | false | |
| REGIONAL WEST MEDICAL CENTER | |||||||||||
| 4021 AVENUE B | SCOTTSBLUFF | NE | 69361 | 470385129 | HOSPITAL | 501C3 | 3 | RWHS | false | REGIONAL WEST HEALTH SERVICES | |
| REGIONAL WEST FOUNDATION | |||||||||||
| 4021 AVENUE B | SCOTTSBLUFF | NE | 69361 | 237171022 | FDRAISING | 501C3 | 12A | RWHS | false | REGIONAL WEST HEALTH SERVICES | |
| REGIONAL WEST VILLAGE | |||||||||||
| 4021 AVENUE B | SCOTTSBLUFF | NE | 69361 | 363314162 | RETIREMENT | 501C3 | 10 | RWHS | false | REGIONAL WEST HEALTH SERVICES | |
| REGIONAL WEST PHYSICIANS CLINIC | |||||||||||
| 4021 AVENUE B | SCOTTSBLUFF | NE | 69361 | 363314159 | DR CLINICS | 501C3 | 3 | RWHS | false | REGIONAL WEST HEALTH SERVICES | |
| REGIONAL WEST HEALTH SERVICES & AFF | |||||||||||
| 4021 AVENUE B | SCOTTSBLUFF | NE | 69361 | 470658690 | HEALTH PLA | NE | 501C9 | 12C | RWHS | false | REGIONAL WEST HEALTH SERVICES |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REGIONAL CARE INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4021 AVE B | AddressLine1Txt |
| City | SCOTTSBLUFF | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 69361 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470760050 | EIN |
| Primary Activities | TPA | PrimaryActivitiesTxt |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C CORP | EntityTypeTxt |
| Share Of Total Income | $4,541,709 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $3,121,000 | ShareOfEOYAssetsAmt |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REGIONAL WEST MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | M | TransactionTypeTxt |
| Involved | $845,375 | InvolvedAmt |
| Method Of Amount Determination | CASH | MethodOfAmountDeterminationTxt |
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