2025-11-11T07:33:36-06:00 2024-12-31 450250958 EIDE BAILLY LLP 18081 BURT ST STE 200 OMAHA NE 680224722 990 2024-01-01 470662290 NORTH PLATTE NEBRASKA HOSPITAL CORP NORT 3085688000 601 W LEOTA S NORTH PLATTE NE 69103 SUMMER OWEN CFO 3085688000 2025-11-10 1 1 MEGAN L KOZIOL CPA P01544037 4023302660 2025-11-10 2024 2025-03-06 01:10:19Z GREAT PLAINS HEALTH IVAN MITCHELL 601 W LEOTA S NORTH PLATTE NE 69103 336619885 0 X WWW.GPHEALTH.ORG X 1971 NE PROVIDE ACUTE, PREVENTIVE AND OTHER HEALTHCARE SERVICES. 15 12 1631 110 116120 0 979339 712388 288738381 312651522 4137752 12377621 1835088 2081363 295690560 327822894 132415 1321874 0 0 143227892 155623705 0 0 376192 135562510 143196656 278922817 300142235 16767743 27680659 532753920 579535707 125925072 117380820 406828848 462154887 TO INSPIRE HEALTH AND HEALING BY PUTTING PATIENTS FIRST -- ALWAYS. 0 0 255699000 1321874 274094552 GREAT PLAINS HEALTH IS A NOT FOR PROFIT HEALTH SYSTEM COMMITTED TO MEETING THE HEALTHCARE NEEDS OF THE COMMUNITIES WE SERVE. OUR MEDICAL STAFF, BOARD AND LEADERSHIP BELIEVE WE OFFER SPECIALTIES THAT PROVIDE HIGH QUALITY AND LOW COST CARE TO OUR PATIENTS. SPECIALTIES, SUCH AS CARDIOLOGY, ONCOLOGY, ORTHOPEDICS AND NEUROSURGERY CONTINUE TO GROW AND MEET THE HEALTH CHALLENGES OF OUR COMMUNITIES. 21623342 33686824 GREAT PLAINS HEALTH OPERATES A 116-BED INPATIENT HOSPITAL. THE INPATIENT CARE PROVIDED IN THOSE UNITS ARE THE FOLLOWING: MEDICAL, SURGICAL, INTENSIVE CARE, CORONARY CARE, OBSTETRICS, LABOR & DELIVERY, NICU, AND BEHAVIOR HEALTH SERVICES. GREAT PLAINS HEALTH PATIENTS COME FROM PRIMARY AND SECONDARY MARKETS. ADDITIONALLY, GREAT PLAINS HEALTH OPERATES 30 SPECIALTY OUTPATIENT DEPARTMENTS TO FURTHER MEET THE MEDICAL NEEDS OF THE COMMUNITIES. 2366515 6835389 GREAT PLAINS HEALTH IS DEDICATED TO MEETING THE BEHAVIORAL HEALTH NEEDS OF THE COMMUNITIES WE SERVE. TO HELP MEET THOSE NEEDS, WE OPERATE A DEDICATED BEHAVIORAL HEALTH UNIT/FLOOR AT THE HOSPITAL. THE UNIT ACCEPTS A WIDE VARIETY OF BEHAVIORAL DIAGNOSIS AND ISSUES. GREAT PLAINS HEALTH ALSO OFFERS OUTPATIENT BEHAVIORAL HEALTH SERVICES TO PEDIATRICS, ADOLESCENTS AND ADULTS NEEDING OUTPATIENT SERVICES. 279688857 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 176 0 1 1631 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 X SUMMER OWEN CFO 3085687193 601 WEST LEOTA NORTH PLATTE NE 69103 JACOB WIESEN DIRECTOR/PHYSICIAN (GPH) 40.00 X 1162006 0 55438 JOVANKA VULSANOVIC MD DIRECTOR/PHYSICIAN (GPH) 40.00 X 359214 0 13800 LINDSAY PEDERSON CHAIR 1.00 X X 0 0 0 MATTHEW HAWKS VICE CHAIR 1.00 X X 0 0 0 DAN O'NEILL SECRETARY/TREASURER 1.00 X X 0 0 0 MIKE JACOBSON PLANNING AND STRATEGY COMMITTEE CHAIR 1.00 X 0 0 0 BENJAMIN KLUG MD CHIEF OF STAFF/DIRECTOR 1.00 X 0 0 0 MICHAEL CUNNING DIRECTOR 1.00 X 0 0 0 PETE VOLZ DIRECTOR 1.00 X 0 0 0 ML MARTIN DIRECTOR 1.00 X 0 0 0 JAYNA SCHAAF DIRECTOR 1.00 X 0 0 0 KAYE MONIE DIRECTOR 1.00 X 0 0 0 RYAN PURDY DIRECTOR 1.00 X 0 0 0 LELAND POPPE DIRECTOR 1.00 X 0 0 0 SHAWN MURDOCK DIRECTOR 1.00 X 0 0 0 IVAN MITCHELL CEO 40.00 X 601825 0 58487 SUMMER OWEN CFO 39.00 X 345671 0 43003 WAYNE L WARREN MD PHYSICIAN (GPH) 40.00 X 2021837 0 45711 PUSHKAR M KANADE MD PHYSICIAN (GPH) 40.00 X 1368770 0 56754 NARAYANA KODURI MD PHYSICIAN (GPH) 40.00 X 1309857 0 57104 MICHAEL SIMONSON MD PHYSICIAN (GPH) 40.00 X 1116044 0 55087 NATHAN JACOBSON MD PHYSICIAN (GPH) 40.00 X 1138352 0 22750 9423576 0 408134 271 0 1 0 SAMPSON CONSTRUCTION 5825 SOUTH 14TH STREET LINCOLN NE 68512 CONTRUCTION AND GENERAL CONTRACTING 11692353 MEDICAL SOLUTIONS LLC 1010 N 102ND STREET SUITE 300 OMAHA NE 68114 HEALTHCARE STAFFING 3925615 HEALTH CAROUSEL LLC 3805 EDWARDS RD 700 CINCINNATI OH 45209 STAFFING SERVICES 3858020 COLLABORATIVE SOLUTIONS LLC 300 FRANK W BURR BLVD TEANECK NJ 07666 SOFTWARE CONSULTANTS 1952315 GUARDIAN HEALTHCARE PROVIDERS 2208 N WEBB RD UNIT 3 GRAND ISLAND NE 68803 STAFFING SERVICES 1330528 49 712388 712388 PATIENT SERVICE REVENUE 624100 310099801 310099801 OTHER OPERATING REVENUE 624100 2349653 2349653 MANAGEMENT FEES 624100 202068 202068 312651522 10036891 10036891 168317 0 168317 168317 168317 11124985 12736 8748659 48332 2376326 -35596 2340730 2340730 CAFETERIA REVENUE 900099 935799 935799 MID-NEBRASKA MEDICAL VENTURES 621110 467982 467982 NORTH PLATTE SURGICAL CENTER 621400 217069 217069 292196 176076 116120 1913046 327822894 314616765 116120 12377621 X 1321874 1321874 2642204 1591837 1050367 792778 792778 121447710 114441334 6779109 227267 4956668 4798360 151116 7192 18734121 17651614 1041136 41371 7050224 6520390 514035 15799 220000 220000 403545 403545 176527 176527 473420 473420 36085775 30890898 5184272 10605 730832 226927 503066 839 3818151 2956099 830198 31854 11051290 10348152 686219 16919 5324844 5078162 244198 2484 107990 99772 8218 2487884 2261169 224793 1922 17368088 16127693 1226883 13512 1455462 1358126 96511 825 MEDICAL SUPPLIES 61553486 61532814 20672 TAXES 530074 530074 EDUCATION & TRAINING 521644 474383 42365 4896 DUES & SUBSCRIPTIONS 327227 142187 184441 599 560417 544214 16095 108 300142235 279688857 20077186 376192 126203 182885 46361836 34777178 36725408 35057645 1451999 1141142 9343029 10879765 4012083 5112878 339958683 195858547 141462220 144100136 271543271 312174888 8404766 14331331 1630213 8280851 11692892 13497008 532753920 579535707 27748280 24130858 81744965 77649679 16431827 15600283 125925072 117380820 X 404924979 460331542 1903869 1823345 406828848 462154887 532753920 579535707 X 27680659 27725904 -80524 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 17406 17406 0 PART II-B, LINE 1: THE $17,406 REPRESENTS THE PORTION OF THE DUES PAID TO THE NEBRASKA HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION THAT ARE USED FOR LOBBYING BY THOSE ORGANIZATIONS. 2335247 2335247 195582325 95953130 99629195 3244216 2839413 404803 120283084 92522097 27760987 18513811 4543907 13969904 144100136 DEFERRED COMPENSATION 11878137 OPERATING LEASES LIABILITY 3722146 15600283 X PART X, LINE 2: THE ORGANIZATION BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE ORGANIZATION WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. 1 1 X 1 X 1 X 1 1 0 1 1 1959 4242356 0 4242356 0.01410 5766 34976996 23188790 11788206 0.03930 7725 39219352 23188790 16030562 0.05340 19357 1737816 20309 1717507 0.00570 75 469921 0 469921 0.00160 2082 2975285 1144281 1831004 0.00610 657659 222762 434897 0.00140 1449036 0 1449036 0.00480 21514 7289717 1387352 5902365 0.01960 29239 46509069 24576142 21932927 0.07300 20000 2702 0 2702 0.00000 500 9245 0 9245 0.00000 2000 4295 0 4295 0.00000 22500 16242 16242 0.00000 0 388685 68409 98877556 149733217 -50855661 X 1 1 1 NORTH PLATTE SURGERY CENTER LLC PROVIDES OUTPATIENT SURGERY SERVICES 0.50000 0.00000 0.50000 2 MID-NE MEDICAL VENTURES LEASES OF PHYSICIAN'S OFFICE BUILDING 0.60000 0.00000 0.40000 1 1 GREAT PLAINS HEALTH 601 WEST LEOTA NORTH PLATTE NE 69101 WWW.GPHEALTH.ORG 510001 X X X GREAT PLAINS HEALTH 1 0 0 1 X X X X X X X X X 22 1 0 0 1 X WWW.GPHEALTH.ORG/ABOUT-US/COMMUNITY-IMPACT X 1 22 1 WWW.GPHEALTH.ORG/ABOUT-US/COMMUNITY-IMPACT 0 1 X 200.000000000000 350.000000000000 X X X X X 1 1 X X X 1 X GPHEALTH.ORG/PATIENTS-VISITORS/ESTIMATES-BILLING-FINANCIAL-ASSISTANCE-PRICE X GPHEALTH.ORG/PATIENTS-VISITORS/ESTIMATES-BILLING-FINANCIAL-ASSISTANCE-PRICE X GPHEALTH.ORG/PATIENTS-VISITORS/ESTIMATES-BILLING-FINANCIAL-ASSISTANCE-PRICE X X X X X X X 1 X 0 X X X X X 1 X 0 0 GREAT PLAINS HEALTH PART V, SECTION B, LINE 5: GPHEALTH PROVIDED CHC CONSULTING WITH A LIST OF PERSONS WITH SPECIAL KNOWLEDGE OF PUBLIC HEALTH IN LINCOLN COUNTY, INCLUDING PUBLIC HEALTH REPRESENTATIVES AND OTHER INDIVIDUALS WHO FOCUS SPECIFICALLY ON UNDERREPRESENTED GROUPS. FROM THAT LIST, 29 IN DEPTH PHONE INTERVIEWS WERE CONDUCTED. DURING THESE INTERVIEWS, THE HEALTH NEEDS OF THE COMMUNITY, ACCESS ISSUES, BARRIERS AND ISSUES RELATED TO SPECIFIC POPULATIONS WERE DISCUSSED. GREAT PLAINS HEALTH PART V, SECTION B, LINE 11: GREAT PLAINS HEALTH LEADERSHIP PRIORITIZED AND DECIDED TO ADDRESS ALL OF THE PRIORITIZED NEEDS IN VARIOUS CAPACITIES THROUGH A HOSPITAL SPECIFIC IMPLEMENTATION PLAN.THE FINAL LIST OF PRIORITIZED NEEDS IS LISTED BELOW IN DESCENDING ORDER:1. RECRUIT AND RETAIN QUALITY HEALTH PROFESSIONALS.2. INCREASE ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE.3. IMPROVE ACCESS TO MEDICAL AND DENTAL CARE.4. INCREASE PREVENTION, EDUCATION TO REDUCE THE PREVALENCE OF CHRONIC DISEASES, PREVENTABLE CONDITIONS, READMISSIONS, AND HIGH MORTALITY RATES.5. INCREASE ACCESS TO SAFE AND AFFORDABLE HOUSING.THERE ARE NO SIGNIFICANT IDENTIFIED NEEDS THAT ARE NOT BEING ADDRESSED.IN THE CURRENT TAX YEAR, GPH HAS ADDRESSED THE PRIORITIES AS FOLLOWS:1. RECRUIT AND RETAIN QUALITY HEALTHCARE PROFESSIONALS: WE HAVE FILLED THE PHYSICIAN NEEDS IDENTIFIED IN THE ANNUAL MEDICAL STAFF NEEDS ASSESSMENT. IN 2024, WE HIRED ONE ONCOLOGIST, ONE OBGYN, AND TWO GENERAL SURGEONS. ADDITIONALLY, WE HAVE MAINTAINED ABOVE THE INDUSTRY AVERAGE FOR RETENTION RATE OF PHYSICIANS AT 9%. WE PROVIDE MONTHLY CME EDUCATION TO PROVIDERS WHICH AIDS IN RETENTION. WE ROUND ON 100% OF PHYSICIANS ANNUALLY. OUR LEADERSHIP SERVES AS THE CHAMBER AND DEVELOPMENT BOARD CHAIR AS WELL AS LEADS THE NP RECREATION ALLIANCE TO CONTINUE IMPROVING QUALITY OF LIFE IN NORTH PLATTE FOR RETENTION. WE OFFER NURSE AND PRECEPTOR PROGRAMS. WE HAVE SEVERAL RESIDENCY PROGRAMS, INCLUDING A PA PROGRAM AND A PT PROGRAM. WE HELPED 4 STAFF MEMBERS GO FROM RN TO BSN, WE HAD TWO STUDENTS WE TRAINED IN SURGICAL TECH IN PARTNERSHIP WITH SECC AND MPCC. WE HOSTED A CAREER CAMP FOR MIDDLE SCHOOL KIDS, HOSTED THE PRE-MED CLUB AND ATTENDED AREA CAREER PROGRAMS AT SCHOOLS AND WITH THE ESU. WE HAD 4 STUDENTS COMPLETE THE ACCELERATED BSN PROGRAM, AND PROVIDED HOUSING TO 74 STUDENTS.2. INCREASE ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE: WE CONTINUE TO PROVIDE INPATIENT AND OUTPATIENT PSYCHIATRIC SERVICES. EXECUTIVE MEMBERS OF THE STAFF PARTICIPATE IN A COMMITTEE ON STARTING A DETOX IN OUR REGION. ASSISTED IN WRITING A GRANT WITH LOCAL PARTNERS. ORGANIZED A MOCK TRIAL FOR SANE AND SART TEAMS. WE MAINTAIN A FULL TIME RN CASE MANAGER FOR BEHAVIORAL HEALTH SERVICES PATIENTS. THREE STAFF MEMBERS CERTIFIED IN PLAY FOR EXPANDED AUTISM SERVICES. OUR PSYCHIATRIST MEETS WEEKLY WITH SCHOOL AND COUNSELORS TO ENSURE NEEDS ARE BEING MET. HOSTED A MENTAL HEALTH DAY IN 2024 TO 250 STUDENTS. WE CONTINUE TO SCREEN ALL PEDIATRIC AND FAMILY MEDICINE PATIENTS FOR DEPRESSION.3. IMPROVE ACCESS TO MEDICAL AND DENTAL CARE: DURING THE YEAR, GPH LAUNCHED SELF SCHEDULING IN PRIMARY CARE CLINICS. 58% OF OUR PATIENTS UTILIZE MYCHART PATIENT PORTAL. EXECUTIVE LEADERS PARTICIPATE IN A DENTAL COMMITTEE EXPLORING WAYS TO PROVIDE INDIGENT DENTAL SERVICES TO MEDICAID PATIENTS. PROVIDED $1,366,509 IN PATIENT MEDICATION ASSISTANCE. PROVIDED $25,218,586 IN FINANCIAL ASSISTANCE AND CHARITY CARE. WE LAUNCHED OUTREACH CLINICS IN ORTHOPAEDICS, ONCOLOGY AND CARDIOLOGY IN COZAD. WE HIRED A CERTIFIED DIABETIC EDUCATOR IN 2024.4. INCREASED PREVENTION EDUCATION TO REDUCE THE PREVALENCE OF CHRONIC CONDITIONS: WE EDUCATED 13 STUDENTS ON BREASTFEEDING 101. WE HELD ONE CLASS IN ENGLISH AND ONE IN SPANISH OF HANDS-ONLY CPR. WE HOSTED TWO BLOOD DRIVES WITH THE RED CROSS. LEADERSHIP SERVES AS LEADERS ON COMMUNITY TASK FORCES. $1.3 MILLION WAS PROVIDED TO LOCAL ORGANIZATIONS FOR VARIOUS INITIATIVES SUCH AS HOUSING PROJECTS, COMMUNITY EVENTS, LOCAL NON-PROFITS. PROVIDED $500 TO LOCAL SCHOOLS FOR SAFE, DRUG-FREE POST PROM EVENTS. AN EMPLOYEE CAMPAIGN NETTED $1,952 FOR THE UNITED WAY. GPGIVES GAVE A $5,000 MATCH. COMPLETED 429 LOW COST HEART SCREENINGS. OFFERED PICKLEBALL TRAINING FREE OF CHARGE TO OUR EMPLOYEES. SCREENED 43 AT OUR STROKE SCREENING. PROVIDED EMS RUN REVIEWS QUARTERLY AND ARE THE KEY SPONSOR TO THE EMS CONFERENCE ANNUALLY. PROVIDED FREE ATHLETIC TRAINING SERVICES TO 15 AREA HIGH SCHOOLS.5. INCREASE ACCESS TO SAFE AND AFFORDABLE HOUSING: PROVIDED DOWN PAYMENT ASSISTANCE TO 24 EMPLOYEES, TOTALING $357,480. PROVIDED $250,000 TO HABITAT FOR HUMANITY. GREAT PLAINS HEALTH PART V, SECTION B, LINE 13B: SYSTEM HOSPITAL WILL APPLY PRESUMPTIVE ELIGIBILITY CRITERIA TO FACILITATE PROMPT RECOGNITION OF ELIGIBILITY FOR FINANCIAL ASSISTANCE. CIRCUMSTANCES INCLUDE HOMELESSNESS, DEATH WITHOUT ESTATE, AND EMERGENCY SERVICES FOR OUT-OF-STATE MEDICAID PATIENTS. GREAT PLAINS HEALTH PART V, SECTION B, LINE 13H: IF A PATIENT'S COMBINED OUTSTANDING MEDICAL BILLS, AFTER INSURANCE PAYS, EXCEEDS 7.5% OF THEIR ANNUAL GROSS INCOME, THEY WILL RECEIVE AN ADDITIONAL 15% DISCOUNT ON TOP OF THE FINANCIAL ASSISTANCE DISCOUNT WITH THE COMBINED DISCOUNT NOT TO EXCEED 100% OF THE OUTSTANDING BALANCE. OUTSTANDING MEDICAL BILLS ARE NOT RESTRICTED TO JUST GREAT PLAINS HEALTH SERVICES BUT CAN BE ANY MEDICAL SERVICES. CURRENT STATEMENTS MUST BE PROVIDED SHOWING THE OUTSTANDING BALANCES CLAIMED. GREAT PLAINS HEALTH PART V, SECTION B, LINE 16J: THE WRITTEN FINANCIAL ASSISTANCE POLICY IS ON GPH'S WEBSITE, AND TELEPHONE NUMBERS TO PATIENT FINANCIAL SERVICES AND FINANCIAL COUNSELING ARE PRINTED ON THE BACK SIDE OF EACH PAGE OF THE PATIENT BILLING STATEMENT. POSTERS REGARDING AVAILABILITY OF FINANCIAL ASSISTANCE ARE POSTED AT PATIENT POINTS OF ENTRY THROUGHOUT THE HOSPITAL FACILITY. GREAT PLAINS HEALTH PART V, SECTION B, LINE 20E: GPH WORKS WITH PATIENTS THROUGH PHONE AND IN-PERSON INTERVIEWS TO DETERMINE THE PATIENT'S FINANCIAL SITUATION AND TO DETERMINE IF THE INDIVIDUAL QUALIFIES FOR ASSISTANCE, SUCH AS MEDICAID. PATIENTS CAN ALSO REQUEST FINANCIAL ASSISTANCE AND SUBMIT DOCUMENTS THROUGH THE PATIENT PORTAL. 1 1 - NORTH PLATTE SURGERY CENTER LLC 621 WEST FRANCIS STREET NORTH PLATTE NE 69101 OUTPATIENT SURGERIES PART I, LINE 3C: ASIDE FROM FEDERAL PROVERY GUIDELINES, GPH ALSO UTILIZES THE FOLLOWING FACTORS TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE: ASSET LEVEL, MEDICAL INDIGENCY, UNDERINSURANCE STATUS, PRESUMPTIVE ELIGIBILITY AND TOTAL OUTSTANDING MEDICAL BILLS. PART I, LINE 6A: GPH'S COMMUNITY BENEFIT REPORT IS PREPARED BY THE STAFF OF GPH. PART I, LINE 7: CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. UNREIMBURSED MEDICAID ON LINE 7B WAS CALCULATED USING THE COSTING METHODS TO PREPARE THE COST REPORTS. COMMUNITY HEALTH IMPROVEMENT SERVICES, LINE 7E, HEALTH PROFESSIONS EDUCATION, LINE 7F, RESEARCH, LINE 7H, AND CONTRIBUTIONS, LINE 7I, ARE REPORTED BASED ON ACTUAL EXPENSES REPORTED IN THE GENERAL LEDGER. THE COST FOR SUBSIDIZED HEALTH SERVICES REPORTED ON LINE 7G WAS CALCULATED USING THE RATIO OF PATIENT COST TO CHARGES ON WORKSHEET 2. PART II, COMMUNITY BUILDING ACTIVITIES: GPH HAS MANY ACTIVITES TO PROMOTE HEALTH IN THE COMMUNITIES IT SERVES. THESE ACTIVITIES INCLUDE: RECRUITMENT OF PHYSICIANS TO MEET NEED, SPONSORING HEALTH FAIR, SPORTS CLINICS AND SUPPORT GROUPS, PHYSICIANS SERVING ON COMMUNITY BOARDS, 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: THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE ORGANIZATION DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION EXPERIENCE WITH VARIOUS CLASSES OF PATIENTS. PART III, LINE 3: THE ESTIMATED AMOUNT OF THE ORGANIZATION'S IMPLICIT PRICE CONCESSIONS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS CALCULATED BASED ON AN APPROXIMATE 17.6% OF INDIVIDUALS LIVING BELOW THE POVERTY LEVEL IN THE SERVICE AREA. PART III, LINE 4: THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES IMPLICIT PRICE CONCESSIONS IS LOCATED IN FOOTNOTE 1 ON PAGES 16 AND 17 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: THE MEDICARE SHORTFALL IS BASED ON THE INFORMATION FROM THE COST REPORT. THESE COSTS ARE MEDICARE REIMBURSABLE COSTS, NOT ALL COSTS. THESE MEDICARE REIMBURSABLE COSTS SHOULD BE TREATED AS A COMMUNITY BENEFIT TO THE EXTENT THAT MEDICARE REVENUES DO NOT COVER THE COSTS, THEREFORE THE ENTIRE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT. WE DO NOT USE ANY NEGOTIATION TOOL WITH MEDICARE FOR OUR RATES; THE RATES THAT WE ARE PAID ARE MANDATED. HENCE, THIS DOES NOT GIVE US THE ABILITY AS A PROVIDER TO RECEIVE SUFFICIENT REVENUES TO COVER THE MEDICARE COSTS. AS A FACILITY WE ARE WORKING TOWARD COSTS SAVINGS. PART III, LINE 9B: IF THE COLLECTION AGENCY LEARNS INFORMATION THAT INDICATES THAT THE PATIENT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE GPH CHARITY CARE POLICY, THEN THE COLLECTION AGENCY SHALL PROMPTLY NOTIFY THE PATIENT FINANCIAL SERVICES DIRECTOR AND CEASE ANY FURTHER COLLECTION ACTIVITY UNTIL GPH DETERMINES THE PATIENT ELIGIBILITY. PART VI, LINE 2: GPH USES STRATEGIC PLANNING PROCESSES, MARKET STUDIES, OPEN FORUMS WITH PHYSICIANS, COMMUNITY FOCUS GROUPS, CUSTOMER SERVICE SURVEYS AND COMMUNITY SURVEYS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITIES GPH SERVES. PATIENT CARE AND SUPPORT SERVICES PROVIDED BY GPH ARE BASED ON GPH'S MISSION, VISION, VALUES AND STANDARDS OF BEHAVIOR. PATIENT CARE AND ANCILLARY SERVICES ARE ORGANIZED IN RESPONSE TO PATIENT NEEDS AS IDENTIFIED THROUGH THE STRATEGIC PLANNING PROCESS. THE GPH STRATEGIC PLAN FOCUSES ON ACHIEVING A CONTINUUM OF CARE TO MEET THE NEEDS OF THE COMMUNITY SERVED. THE STRATEGIC PLANNING PROCESS IS COMPLETED APPROXIMATELY EVERY THREE TO FIVE YEARS. PART VI, LINE 3: FOR PATIENTS THAT GPH DETERMINES ARE FINANCIALLY INDIGENT, THE PATIENT/GUARANTOR WILL BE NOTIFIED AND ASSISTED BY THE GPH PATIENT FINANCIAL SERVICES IN APPLYING FOR FINANCIAL ASSISTANCE. IF NO SOURCE OF FINANCIAL ASSISTANCE IS AVAILABLE, THE ACCOUNT WILL BE REVIEWED FOR A CHARITY ALLOWANCE ACCORDING TO THE HOSPITAL'S CHARITY POLICY. CASE MANAGERS ARE AVAILABLE AT GPH TO ASSIST PATIENTS AND THEIR FAMILIES WITH THE FINANCIAL AND SOCIAL STRESS THAT ACCOMPANY ILLNESS AND HOSPITALIZATION. CASE MANAGERS HAVE A WORKING KNOWLEDGE OF SOCIAL WORK THEORIES AND ARE ABLE TO ASSIST PATIENTS WITH CONTACTING COMMUNITY AGENCIES THAT CAN ASSIST THEM IN RECOVERY AND FINANCIAL NEEDS. AN OUTSIDE AGENCY IS USED TO PROVIDE ASSISTANCE TO PATIENTS IN DETERMINING THEIR ELIGIBILITY FOR MEDICAID. ONE-ON-ONE FINANCIAL COUNSELING IS AVAILABLE TO EVERY PATIENT, UPON REQUEST. PART VI, LINE 4: GREAT PLAINS HEALTH IS THE ONLY HOSPITAL IN LINCOLN COUNTY AND IS A REGIONAL REFERRAL HOSPITAL FOR NINETEEN OTHER COUNTIES IN NEBRASKA. GPH SERVES A MARKET OF OVER 134,000 RESIDENTS. OVER NINETY-THREE PERCENT OF GPH'S INPATIENT ADMISSIONS COME FROM WITHIN THIS MARKET. SEVENTY-TWO PERCENT OF THE PATIENTS COME FROM LINCOLN COUNTY. THE PRIMARY SERVICE AREA IS DEFINED AS LINCOLN COUNTY. THE SECONDARY SERVICE AREA INCLUDES THE FOLLOWING NINETEEN COUNTIES: ARTHUR, FRONTIER, HOOKER, PERKINS, CHASE, GRANT, GOSPER, KEITH, RED WILLOW, FURNAS, DUNDY, CHERRY, CUSTER, HAYES, LOGAN, THOMAS, DAWSON, HITCHCOCK, AND MCPHERSON. THE TOTAL POPULATION OF THE SECONDARY SERVICE AREA IS ABOUT 99,000.THE POPULATION IN THE SERVICE AREA IS EXPECTED TO CONTINUE THE SHIFT TOWARDS AN AGING POPULATION THAT WOULD INCREASE SERVICE UTILIZATION. HOSPITALS IN THE SECONDARY SERVICE AREA ARE: CHASE COUNTY COMMUNITY HOSPITAL (CHASE COUNTY), CHERRY COUNTY HOSPITAL (CHERRY COUNTY), CALLAWAY DISTRICT HOSPITAL (CUSTER COUNTY), JENNIE M. MELHAM MEMORIAL HOSPITAL (CUSTER COUNTY), COZAD COMMUNITY HOSPITAL (DAWSON COUNTY), GOTHENBURG MEMORIAL HOSPITAL (DAWSON COUNTY), LEXINGTON REGIONAL MEDICAL CENTER (DAWSON COUNTY), DUNDY COUNTY HOSPITAL (DUNDY COUNTY), TRI VALLEY HEALTH SYSTEM (FURNAS COUNTY), OGALLALA COMMUNITY HOSPITAL (KEITH COUNTY), PERKINS COUNTY HEALTH SERVICES (PERKINS COUNTY), AND COMMUNITY HOSPITAL (RED WILLOW COUNTY).MARKET OVERVIEWPRIMARY SERVICE AREA- CONSISTS OF LINCOLN COUNTY- ACCOUNTS FOR NEARLY 64% GPH'S INPATIENT CASES- THE 2024 POPULATION WAS 33,728SECONDARY SERVICE AREA- CONSISTS OF NINETEEN COUNTIES EXTENDING NORTH TO SOUTH DAKOTA, SOUTH TO KANSAS AND WEST TO COLORADO - ACCOUNTS FOR 28% OF GPH'S INPATIENT CASES - POPULATION 96,995 IN 2024 - LARGEST EMPLOYER IS UNION PACIFIC PART VI, LINE 5: GPH HAS MANY ACTIVITES TO PROMOTE HEALTH IN THE COMMUNITIES IT SERVES. THESE ACTIVITIES INCLUDE: RECRUITMENT OF PHYSICIANS TO MEET NEED, SPONSORING HEALTH FAIR, SPORTS CLINICS AND SUPPORT GROUPS, PHYSICIANS SERVING ON COMMUNITY BOARDS, 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.GPH PROVIDES EDUCATION TO THE COMMUNITY ON VARIOUS HEALTH PROGRAMS FOR EMPLOYEES, EMPLOYERS AND THE COMMUNITY GPH SERVES. MANY MEMBERS OF THE STAFF HOLD SPEAKING ENGAGEMENTS TO PROVIDE MEDICAL INFORMATION TO THE COMMUNITY. THE MEDICATION ASSISTANCE PROGRAM ASSISTS PATIENTS TO FIND OTHER MEANS TO AFFORD THEIR PRESCRIPTIONS.THE HEALTH CENTER OPERATES ACUTE AND PSYCHIATRIC CARE BEDS AND PROVIDES VARIOUS OUTPATIENT AND EMERGENCY MEDICAL TREATMENT SERVICES. THE AFFILIATES LEASE AND SELL HOME MEDICAL EQUIPMENT TO THE PUBLIC, RENT OFFICE SPACE TO PHYSICIAN PRACTICES AND PROVIDE PHYSICIAN PROFESSIONAL MEDICAL SERVICES AND OTHER PROGRAMS TO PATIENTS. PART VI, LINE 6: GREAT PLAINS HEALTH IS NOT PART OF AN AFFILIATED HEALTHCARE SYSTEM. 1 MID-NEBRASKA COMMUNITY COLLEGE 601 W STATE FARM ROAD NORTH PLATTE NE 69101 470519583 GOVERNMENTAL 26500 0 SCOREBOARD AND ELECTRICAL TECH BUILDING HABITAT FOR HUMANITY 420 N COTTONWOOD ST NORTH PLATTE NE 69101 911833181 501(C)(3) 250000 0 SUPPORT FOR ORGANIZATION'S EXEMPT PURPOSE HOPE-ESPERANZA 5258 E STATE FARM RD NORTH PLATTE NE 69101 873977032 501(C)(3) 6000 0 INTERNATIONAL BAZAARE MID-NEBRASKA COMMUNITY FOUNDATION INC 121 N DEWEY ST STE 112 PO BOX 1321 NORTH PLATTE NE 69101 470604965 501(C)(3) 1001000 0 RECREATION CENTER AND POKER CYCLE. 3 1 PART I, LINE 2: GREAT PLAINS HEALTH PROVIDES SPONSORSHIP DOLLARS TO CHARITABLE EVENTS IN THE LOCAL AREA. THE ORGANIZATION GIVES TO CHARITABLE ORGANIZATIONS IN THE AREA WHICH BENEFIT THE LOCAL COMMUNITY. X X X X 0 0 0 0 0 0 0 1 0 WAYNE L WARREN MD PHYSICIAN (GPH) 1997515 0 685 0 23637 0 13800 0 32601 0 2068238 0 0 0 PUSHKAR M KANADE MD PHYSICIAN (GPH) 1303612 0 61024 0 4134 0 13800 0 43644 0 1426214 0 0 0 NARAYANA KODURI MD PHYSICIAN (GPH) 1218646 0 86542 0 4669 0 13800 0 43994 0 1367651 0 0 0 JACOB WIESEN DIRECTOR/PHYSICIAN (GPH) 1088662 0 69066 0 4278 0 13800 0 42328 0 1218134 0 0 0 MICHAEL SIMONSON MD PHYSICIAN (GPH) 1045832 0 67486 0 2726 0 13800 0 41977 0 1171821 0 0 0 NATHAN JACOBSON MD PHYSICIAN (GPH) 957501 0 180551 0 300 0 13800 0 9640 0 1161792 0 0 0 IVAN MITCHELL CEO 549880 0 20200 0 31745 0 13800 0 45377 0 661002 0 0 0 SUMMER OWEN CFO 325171 0 20200 0 300 0 13800 0 29893 0 389364 0 0 0 JOVANKA VULSANOVIC MD DIRECTOR/PHYSICIAN (GPH) 358564 0 200 0 450 0 13800 0 690 0 373704 0 0 0 PART I, LINE 7 PHYSICIANS ARE ELIGIBLE FOR NON-FIXED QUALITY COMPENSATION BONUSES. QUALITY INDICATORS FOR QUALITY COMPENSATION SHALL BE OBJECTIVE, IDENTIFIABLE STANDARDS THAT ARE ESTABLISHED BY GPH, THE PHYSICIAN, AND EXECUTIVE IN WRITING ON AN ANNUAL BASIS PRIOR TO THE BEGINNING OF A NEW CONTRACT YEAR. SAID QUALITY METRICS SHALL NOT RELATE IN ANY MANNER TO THE VOLUME OR VALUE OF REFERRALS OR OTHER BUSINESS GENERATED BY PHYSICIAN FOR HOSPITAL OR AFFILIATES THEREOF OR BASED UPON REDUCING OR REFUSING CARE PROVIDED TO BENEFICIARIES OF THE FEDERAL PROGRAMS. THE FOLLOWING PHYSICIANS RECEIVED BONUSES DURING THE YEAR: KANADE, PUSHKAR M. KODURI, NARAYANA M. JACOBSON, NATHAN A. SIMONSON, MICHAEL L. WIESEN, JACOB JOSEPH RUYBAL SON-IN-LAW OF PETE VOLZ, DIRECTOR 31923 EMPLOYMENT WITH HOSPITAL 0 EDUARDO A F FREITAS SPOUSE OF JOVANKA VUKSANOVIC, DIRECTOR 746276 EMPLOYMENT WITH HOSPITAL 0 STEPHANIE WIESEN SPOUSE OF JACOB WIESEN, DIRECTOR 14580 EMPLOYMENT WITH HOSPITAL 0 FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE, CONSISTING OF THE OFFICERS OF THE BOARD OF DIRECTORS, HAS THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION HAS TWO CLASSES OF MEMBERS, CHARTER MEMBERS AND PATRON MEMBERS. CHARTER MEMBERS CONTRIBUTED TO THE ORIGINAL FUND DRIVE. THOSE INDIVIDUAL WHO CONTRIBUTE $500 TO EITHER GPH OR THE FOUNDATION AND DID NOT CONTRIBUTE DURING THE ORIGINAL FUND DRIVE SHALL BE DESIGNATED AS PATRON MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS ARE ENTITLED TO ONE VOTE IN ELECTIONS OF BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B MEMBERS HAVE THE POWER TO APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS, A MERGER, A CONSOLIDATION, DISSOLUTION, OR SALE OF ALL OR SUBSTANTIALLY ALL THE ASSETS. FORM 990, PART VI, SECTION B, LINE 11B COPIES OF THE FORM 990 ARE AVAILABLE TO THE BOARD ON A PORTAL. THE BOARD IS NOTIFIED WHEN IT IS AVAILABLE FOR VIEWING. FORM 990, PART VI, SECTION B, LINE 12C GPH PROVIDES A CONFLICT OF INTEREST QUESTIONNAIRE TO EACH OFFICER AND DIRECTOR. THE CONFLICT OF INTEREST QUESTIONNAIRE IS COMPLETED AND RETURNED ANNUALLY. ANY QUESTIONABLE SITUATION IS DISCLOSED ON THE QUESTIONNAIRE. FURTHERMORE, ANY POTENTIAL CONFLICTS ARISING DURING THE YEAR ARE TO BE REPORTED TO ADMINISTRATION. THE CONFLICTS REVIEW COMMITTEE REVIEWS ANY TRANSACTIONS THAT MAY BE CONSIDERED TO HAVE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE GREAT PLAINS HEALTH BOARD OF DIRECTORS STRIVES TO COMPENSATE OFFICERS AT LEVELS THAT ARE COMPETITIVE IN THE MARKETPLACE, COST EFFECTIVE AND, AS MUCH AS POSSIBLE, INTERNALLY EQUITABLE. THE EXECUTIVE COMMITTEE FOR THE BOARD OF DIRECTORS MEETS NO LESS THAN ANNUALLY TO REVIEW COMPENSATION PACKAGES FOR GPH'S PRESIDENT AND OFFICERS. COMPENSATION DATA IS GATHERED BY AN INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT BY SURVEYING COMPARABLE POSITIONS AT PEER INSTITUTIONS, ENSURING THAT COMPENSATION PACKAGES ARE MEETING FAIR MARKET VALUE. A COMPLETE ANALYSIS OF DATA IS REQUESTED FROM THE CONSULTANT AT LEAST EVERY FOUR YEARS. THE INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT IS ULTIMATELY ACCOUNTABLE TO THE EXECUTIVE COMMITTEE AND THE BOARD. THE EXECUTIVE COMMITTEE ANNUALLY RECOMMENDS TO THE BOARD THE SELECTION/RETENTION OF THE INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT; REVIEWS COMPENSATION RECOMMENDATIONS; AND DETERMINES THOSE OFFICERS FOR WHOM WRITTEN EMPLOYMENT CONTRACTS WILL BE REQUIRED. THE BOARD OF DIRECTORS HAS THE AUTHORITY TO ANNUALLY AUTHORIZE MANAGEMENT TO PROCEED WITH IMPLEMENTATION OF PROPOSED COMPENSATION OF OFFICERS. FORM 990, PART VI, SECTION C, LINE 19 GREAT PLAINS HEALTH DOES NOT MAKE ITS CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. UPON WRITTEN REQUEST TO THE CFO, GOVERNING DOCUMENTS WILL BE MADE AVAILABLE TO THE PUBLIC FOR REVIEW AT THE HOSPITAL'S ADMINSTRATIVE OFFICE. FORM 990, PART IX, LINE 11G PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 10,261,378. MANAGEMENT AND GENERAL EXPENSES 24,872. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,286,250. SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 14,827,909. MANAGEMENT AND GENERAL EXPENSES 444,775. FUNDRAISING EXPENSES 696. TOTAL EXPENSES 15,273,380. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,031. MANAGEMENT AND GENERAL EXPENSES 1,184,228. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,185,259. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 5,800,580. MANAGEMENT AND GENERAL EXPENSES 3,530,397. FUNDRAISING EXPENSES 9,909. TOTAL EXPENSES 9,340,886. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN GREAT PLAINS HEALTH CARE FOUNDATION -80,524. FORM 990, PART XII, LINE 2C: THE BOARD OF DIRECTORS OF GREAT PLAINS HEALTH ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEARS. 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