2018-11-05T14:58:50-06:00 2017-12-31 476097913 SEIM JOHNSON LLP 18081 BURT STREET SUITE 200 OMAHA NE 680224722 990 2017-01-01 470662290 NORTH PLATTE NEBRASKA HOSPITAL CORP NORT 3085688000 601 WEST LEOTA STREET NORTH PLATTE NE 69103 THOMAS LEGEL CFO 3085688000 2018-11-05 1 WENDY R COOLEY P01523804 4023302660 209.34.201.180 2018-11-05 13:47:45 CS P B319C935D5CD5DD24452FA9CD51ABCBD1A9C8C2C B319C935D5CD5DD24452FA9CD51ABCBD1A9C8C2C 2017 2018-06-14 16:35:46Z GREAT PLAINS HEALTH THOMAS LEGEL 601 WEST LEOTA STREET NORTH PLATTE NE 69103 223305084 0 X WWW.GPHEALTH.ORG X 1971 NE PROVIDE ACUTE, PREVENTIVE AND OTHER HEALTHCARE SERVICES. 15 10 1322 205 141191 0 0 7500 199116347 212196049 5035332 4801635 473100 474182 204624779 217479366 133767 176312 0 0 94613278 96594312 0 0 0 102176828 108269639 196923873 205040263 7700906 12439103 337925088 363965086 124547339 125628763 213377749 238336323 TO INSPIRE HEALTH AND HEALING BY PUTTING PATIENTS FIRST -- ALWAYS. 0 0 180844926 176312 182422977 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 THAT ARE NEW AND HAVE GROWN IN THE PAST THREE YEARS ARE ONCOLOGY, CARDIOLOGY, ORTHOPEDICS, HYPERBARIC AND WOUND CARE, AND THE DIABETIC PROGRAM TO MEET THE HEALTH CHALLENGES OF OUR COMMUNITIES. 12919711 18851191 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. THE INPATIENT ADMISSIONS CONTINUE TO GROW AND THE MEDICARE CASE MIX ACUITY HAS INCREASED BY 12% OVER THE PAST TWO YEARS. 1794177 2589789 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. 909911 8033271 909911 8033271 196468725 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 1 0 0 1 204 0 1 1322 1 1 1 0 0 0 0 0 0 0 0 1 0 X 15 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X THOMAS LEGEL CFO 3086967193 601 WEST LEOTA NORTH PLATTE NE 69103 NEWTON MACK MD CHAIR 1.00 2.00 X X 0 0 0 DARREL SMITH VICE CHAIR 1.00 2.00 X X 0 0 0 JAY ENGEL SECRETARY/TREASURER 1.00 2.00 X X 0 0 0 BYRON BARKSDALE MD DIRECTOR 1.00 1.00 X 0 0 0 MARGE BEATTY DIRECTOR 1.00 1.00 X 0 0 0 CLARK DIFFENDAFFER MD CHIEF OF STAFF/DIRECTOR 1.00 2.00 X 53000 0 0 NARAYANA KODURI MD VICE CHIEF OF STAFF/DIRECT 38.00 2.00 X 536556 0 42247 DWIGHT LIVINGSTON DIRECTOR 1.00 1.00 X 0 0 0 MARK OETTINGER DIRECTOR 1.00 1.00 X 0 0 0 DAN O'NEILL DIRECTOR 1.00 1.00 X 0 0 0 JOHN PATTERSON DIRECTOR 1.00 2.00 X 0 0 0 LANCE POLK DIRECTOR 1.00 2.00 X 0 0 0 MISTY ROBERTSON DIRECTOR 1.00 2.00 X 0 0 0 JIM SMITH MD DIRECTOR 38.00 2.00 X 428162 0 46647 JODY TOMANEK DIRECTOR 1.00 2.00 X 0 0 0 MELVIN MCNEA CEO 38.00 2.00 X 358037 0 39870 KRYSTAL CLAYMORE SENIOR VP OF FIN & STRAT (THRU 11/6/17) 38.00 2.00 X 324845 0 43647 THOMAS LEGEL CFO 38.00 2.00 X 25100 0 2392 MICHAEL SIMONSON PHYSICIAN (GPH) 40.00 0.00 X 1155437 0 43647 BRENDON CURTIS PHYSICIAN (GPH) 40.00 0.00 X 980970 0 42147 HENRIK MIKE-MAYER PHYSICIAN (GPH) 40.00 0.00 X 889934 0 42661 JOHN HANNAH PHYSICIAN (GPH) 40.00 0.00 X 889369 0 43528 MARK MCKENZIE PHYSICIAN (GPH) 40.00 0.00 X 888808 0 43447 6530218 0 390233 110 0 1 0 AVANT HEALTHCARE PROFESSIONALS 1211 SEMORAN BLVD CASSELBERRY FL 32707 STAFFING SERVICES 1223127 WEATHERBY LOCUMS INC 6451 N FEDERAL HWY 800 FORT LAUDERDALE FL 33308 STAFFING SERVICES 660172 ALLIANCE RECRUITING RESOURCES 900 ROCKMEAD DR 274 KINGWOOD TX 77339 RECRUITING SERVICES 493059 HUDSON STAFFING 2340 BADGER DR HUDSON WI 54016 STAFFING SERVICES 385526 BAIRD HOLM MCEACHEN PEDERSEN 1700 FARNAM ST 1500 OMAHA NE 68102 LEGAL SERVICES 383483 44 7500 7500 7500 PATIENT SERVICE REVENUE 624100 135732924 135732924 MEDICARE/MEDICAID PAYMENTS 624100 71984755 71984755 PATHOLOGY REVENUE 624100 3293681 3293681 OTHER OPERATING REVENUE 624100 592805 592805 EHR INCENTIVE PAYMENTS 624100 535933 535933 55951 55951 212196049 2916398 2916398 27430 -27430 -27430 -27430 7669548 13977 5790328 7960 1879220 6017 1885237 1885237 NORTH PLATTE SURGICAL CENTER 621400 1279526 1279526 CAFETERIA REVENUE 722210 659242 659242 INVESTMENT IN FOUNDATION 900099 210203 210203 -1647359 -1788550 141191 501612 217479366 211897228 141191 5433447 X 176312 176312 1847503 1053612 793891 216909 216909 75199056 71983279 3215777 1996626 1913780 82846 12688066 12098839 589227 4646152 4412211 233941 255718 255718 454102 454102 86053 86053 387168 387168 25933517 24526932 1406585 458484 9979 448505 5027536 4809986 217550 5481453 5392628 88825 2769449 2753627 15822 275516 250559 24957 4059469 4059469 16822775 16769538 53237 627031 624032 2999 MEDICAL SUPPLIES 34747608 34747608 BAD DEBTS 9873073 9873073 EDUCATION & TRAINING 530172 428092 102080 DUES & SUBSCRIPTIONS 316503 207522 108981 164012 160738 3274 205040263 196468725 8571538 0 4526 4526 124691952 149999446 23878732 28069981 1184963 1007170 5326910 5709598 3978259 2842357 278749986 156192572 135921809 122557414 23203316 26935396 4205197 3047146 13954 0 15515470 23792052 337925088 363965086 16441934 19661206 102293627 99774040 5811778 6193517 124547339 125628763 X 209769527 228928442 3608222 9407881 213377749 238336323 337925088 363965086 X 12439103 6719812 5799659 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 10459 10459 0 PART II-B, LINE 1: THE $10,459 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. 769471 769471 138409600 48529897 89879703 2361021 1051494 1309527 130409016 103381014 27028002 6800878 3230167 3570711 122557414 MISCELLANEOUS RECEIVABLE 808256 DUE FROM AFFILIATES 5283493 DEFERRED COMPENSATION 4227696 RECEIVABLE ON INSURANCE CLAIM 830000 INTEREST IN GREAT PLAINS FOUNDATION 12642607 23792052 ESTIMATED THIRD PARTY SETTLEMENTS 1965821 DEFERRED COMPENSATION 4227696 6193517 X PART X, LINE 2: GP HEALTH AND REGENCY ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. GPMAI IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(2) OF THE INTERNAL REVENUE CODE. NPNPG IS A LIMITED LIABILITY COMPANY WHOLLY OWNED BY GP HEALTH. GP HEALTH, REGENCY AND GPMAI HAVE RECEIVED A DETERMINATION LETTER THAT IT IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN TAX-EXEMPT STATUS. GPHEI IS A FOR-PROFIT CORPORATION THAT RECOGNIZED NO FEDERAL AND STATE INCOME TAX EXPENSE IN 2017 AND 2016, RESPECTIVELY. GPHEI DID NOT RECOGNIZE ANY FEDERAL AND STATE INCOME TAX EXPENSE IN 2017 AND 2016 DUE TO OPERATING LOSSES INCURRED DURING THE YEAR. GPHIN IS A FOR-PROFIT CORPORATION SUBJECT TO FEDERAL AND STATE INCOME TAXES. GPHIN DID NOT RECOGNIZE ANY FEDERAL AND STATE INCOME TAX EXPENSE IN 2017 AND 2016 DUE TO OPERATING LOSSES INCURRED DURING THE YEAR. MNMV IS A LIMITED LIABILITY COMPANY OF WHICH GP HEALTH OWNS A 60% INTEREST. THE ORGANIZATION ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. THE ORGANIZATION RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT DECEMBER 31, 2017 AND 2016, THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS ACCRUED. 1 1 X 1 X 1 X 1 1 0 1 1 9343521 1328796 8014725 0.04110 12348184 8740328 3607856 0.01850 21691705 10069124 11622581 0.05960 20029 1526670 5150 1521520 0.00780 53 391316 0 391316 0.00200 204 1527417 298578 1228839 0.00630 263680 1875 261805 0.00130 20000 296760 0 296760 0.00150 40286 4005843 305603 3700240 0.01890 40286 25697548 10374727 15322821 0.07850 20000 32896 0 32896 0.00020 634 0 634 0.00000 20000 33530 33530 0.00020 0 9873073 0 52397946 69862342 -17464396 X 1 1 1 PHYSICIAN HOSPITAL CONTRACTING ORGANIZATION NEGOTIATES HEALTHCARE CONTRACTS FOR PHYSICIANS AND THE HOSPITAL 0.50000 0.00000 0.50000 2 NORTH PLATTE SURGERY CENTER LLC PROVIDES OUTPATIENT SURGERY SERVICES 0.50000 0.00000 0.50000 3 MID-NE MEDICAL VENTURES LEASES OF PHYSICIAN'S OFFICE BUILDING 0.60000 0.05000 0.35000 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 X 16 1 0 0 1 X WWW.GPHEALTH.ORG 1 16 1 WWW.GPHEALTH.ORG 0 1 X 150.000000000000 250.000000000000 X X X X 1 1 X X X 1 X WWW.GPHEALTH.ORG X WWW.GPHEALTH.ORG X WWW.GPHEALTH.ORG 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 3J: THE GREAT PLAINS HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED FROM JULY TO SEPTEMBER 2016. THE ANALYSIS INCLUDED CAREFUL REVIEW OF THE MOST CURRENT HEALTH DATA AVAILABLE, APPLICABLE DEMOGRAPHIC REVIEW AND INPUT FROM KEY COMMUNITY REPRESENTATIVES. ASSESSMENT RESULTS LED TO THE IDENTIFICATION OF SIX PRIORITY AREAS:1. INCREASED ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE AND EDUCATION2. PREVENTION EDUCATION TO ADDRESS CHRONIC DISEASES, PREVENTABLE CONDITIONS AND READMISSIONS, AND HIGH MORTALITY RATES3. INCREASED ACCESS TO SAFE AND AFFORDABLE HOUSING4. COLLABORATION WITH LOCAL ORGANIZATIONS TO IMPROVE COMMUNITY HEALTH5. IMPROVED ACCESS TO CARE6. CONTINUED PHYSICIAN RECRUITMENT AND RETENTION GREAT PLAINS HEALTH PART V, SECTION B, LINE 5: DURING THE RESEARCH AND COLLABORATION PHASE OF CHNA DEVELOPMENT, GREAT PLAINS HEALTH CONDUCTED PHONE INTERVIEWS WITH PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING STATE, LOCAL, TRIBAL OR REGIONAL GOVERNMENTAL PUBLIC HEALTH DEPARTMENT (OR EQUIVALENT DEPARTMENT OR AGENCY) WITH KNOWLEDGE, INFORMATION OR EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY; MEMBERS OF A MEDICALLY UNDERSERVED, LOW-INCOME OR MINORITY POPULATIONS IN THE COMMUNITY, OR INDIVIDUALS OR ORGANIZATIONS SERVING OR REPRESENTING THE INTERESTS OF SUCH POPULATIONS AND COMMUNITY LEADERS. 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' LEADERSHIP PRIORITIZED AND DECIDED TO ADDRESS ALL OF THE SIGNIFICANT NEEDS IDENTIFIED IN THE CHNA. THE FINAL LIST OF PRIORITIZED NEEDS, IN DESCENDING ORDER, IS LISTED BELOW:1. INCREASED ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE AND EDUCATION2. PREVENTION EDUCATION TO ADDRESS CHRONIC DISEASES, PREVENTABLE CONDITIONS AND READMISSIONS, AND HIGH MORTALITY RATES3. INCREASED ACCESS TO SAFE AND AFFORDABLE HOUSING4. COLLABORATION WITH LOCAL ORGANIZATIONS TO IMPROVE COMMUNITY HEALTH5. IMPROVED ACCESS TO CARE6. CONTINUED PHYSICIAN RECRUITMENT AND RETENTIONTHE GREAT PLAINS LEADERSHIP TEAM DEVELOPED THE FOLLOWING IMPLEMENTATION PLAN TO IDENTIFY SPECIFIC ACTIVITIES AND SERVICES WHICH DIRECTLY ADDRESS THESE PRIORITIES. THE OBJECTIVES WERE IDENTIFIED BY STUDYING THE PRIORITIZED HEALTH NEEDS, WITHIN THE CONTEXT OF THE HEALTH SYSTEM'S OVERALL STRATEGIC PLAN, AND THE AVAILABILITY OF FINITE RESOURCES. THE PLAN INCLUDES A RATIONALE FOR EACH PRIORITY, FOLLOWED BY OBJECTIVES, SPECIFIC IMPLEMENTATION ACTIVITIES, AND THE ANTICIPATED IMPACT AND EVALUATION.PRIORITY ONE: INCREASED ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE AND EDUCATION - IMPLEMENTATION ACTIVITIES INCLUDE EVALUATING THE IMPLEMENTATION OF A TELEMEDICINE PROGRAM FOR MENTAL AND BEHAVIORAL HEALTH EVALUATIONS AND ADOLESCENT PSYCHIATRY, EXPLORING THE RECRUITMENT OF ADDITIONAL ADULT PSYCHIATRISTS TO THE AREA AND PARTICIPATING IN COMMUNITY DISCUSSIONS ABOUT THE EXPANSION OF DETOX SERVICES IN THE LOCAL COMMUNITY.PRIORITY TWO: PREVENTION EDUCATION TO ADDRESS CHRONIC DISEASES, PREVENTABLE CONDITIONS AND READMISSIONS, AND HIGH MORTALITY RATES - IMPLEMENTATION ACTIVITIES INCLUDE OFFERING COMMUNITY SCREENINGS, PROVIDING COMMUNITY HEALTH EDUCATION AND INSPIRING HEALTH THROUGH HUMAN AND FINANCIAL CAPITAL.PRIORITY THREE: INCREASED ACCESS TO SAFE AND AFFORDABLE HOUSING - IMPLEMENTATION ACTIVITIES INCLUDE ASSISTING WITH HOUSING FOR FAMILIES AND FRIENDS OF PATIENTS WHO ARE SUBJECT TO HOSPITAL STAYS BECOMING ACTIVE PARTICIPANTS IN INNOVATIVE SOLUTIONS TO GROW SAFE HOUSING OPTIONS IN THE COMMUNITY.PRIORITY FOUR: COLLABORATION WITH LOCAL ORGANIZATIONS TO IMPROVE COMMUNITY HEALTH - IMPLEMENTATION ACTIVITIES INCLUDE HOSPITAL PERSONNEL SERVING IN LEADERSHIP ROLES AND AS VOLUNTEERS WITH MANY AGENCIES AND COMMITTEES IN THE COMMUNITY, OFFERING COMMUNITY SCREENINGS AND SPONSORING VARIOUS COMMUNITY ACTIVITIES.PRIORITY FIVE: IMPROVED ACCESS TO CARE - IMPLEMENTATION ACTIVITIES INCLUDE DEVELOPING AND IMPLEMENTING A STRATEGY TO BETTER SERVE CRITICAL CARE PATIENTS, EXPANDING CAPABILITIES OF VARIOUS DEPARTMENTS AND CONTINUING TO OFFER FINANCIAL ASSISTANCE PROGRAMS TO THOSE IN NEED.PRIORITY SIX: CONTINUED PHYSICIAN RECRUITMENT AND RETENTION - IMPLEMENTATION ACTIVITIES INCLUDE PROMOTING ITS AVAILABLE PRIMARY CARE AND SPECIALTY PHYSICIAN SERVICES THROUGH SOCIAL MEDIA OUTLETS, LOCAL NEWSPAPERS, RADIO ADS, DIRECT MAIL, AND BILLBOARDS AND PARTICIPATING IN PHYSICIAN RETENTION STRATEGIES SUCH AS SOCIAL GATHERINGS FOR PHYSICIANS AND ABIDING BY MGMA STANDARDS FOR PHYSICIAN SALARIES.THERE ARE NOT ANY SIGNIFICANT NEEDS IDENTIFIED IN THE MOST RECENT CHNA THAT ARE NOT BEING ADDRESSED. GREAT PLAINS HEALTH PART V, SECTION B, LINE 13B: IF A PATIENT'S COMBINED OUTSTANDING MEDICAL BILLS, AFTER INSURANCE PAYS, EXCEEDS 7.5% OF THEIR ANNUAL GROSS INCOME, THEY WILL RECEIVE AN ADDITIONAL 25% 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, AS WELL AS 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. 1 1 - NORTH PLATTE SURGERY CENTER LLC 621 WEST FRANCIS STREET NORTH PLATTE NE 69101 OUTPATIENT SURGERIES PART I, LINE 3C: GREAT PLAINS HEALTH (GPH) MAY MAKE A DETERMINATION OF ELIGIBILTY AT ANY STAGE OF THE PROCESS, INCLUDING PAST ASSIGNMENT TO AN OUTSIDE COLLECTION AGENCY. EACH PATIENT REQUESTING FINANCIAL ASSISTANCE WILL BE ASKED TO COMPLETE A FINANCIAL QUESTIONNAIRE AND TO PROVIDE COPIES OF DOCUMENTATION INCLUDING THEIR MOST RECENT FEDERAL INCOME TAX FORM, COPIES OF RECENT PAY STUBS, BANK STATEMENTS AND OTHER APPROPRIATE INDICATORS OF INCOME. A REFERRAL FOR FINANCIAL ASSITANCE MAY BE RECOMMENDED BY THE PATIENT, FAMILY MEMBER, PHYSICIAN OR HOSPITAL DEPARTMENTS AND PROVIDED BASED ON INFORMATION FROM OTHER SOURCES. FULL FINANCIAL ASSISTANCE WILL GENERALLY BE PROVIDED WHEN GROSS HOUSEHOLD INCOME IS EQUAL TO OR LESS THAN 150% OF THE FEDERAL POVERTY GUIDELINES. A SLIDING FEE SCALE DISCOUNT WILL BE APPLIED FOR HOUSEHOLD INCOME UP TO 250% OF THE FEDERAL POVERTY GUIDELINES. THE INCOME LEVELS WILL BE UPDATED ANNUALLY BASED UPON THE MOST CURRENT FEDERAL POVERTY GUIDELINES. PART I, LINE 6A: GPH'S COMMUNITY BENEFIT REPORT IS PREPARED BY THE STAFF OF GPH. PART I, LINE 7: GPH UTILIZED AN OVERALL COST TO CHARGE RATIO (TOTAL EXPENSES - BAD DEBT) / GROSS PATIENT SERVICE REVENUE = PERCENTAGE OF COST TO CHARGE. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES REPORTED ON LINE 7G INCLUDE TRAINING FOR EMS, OUTREACH, LIFE SUPPORT OUTSIDE, AND ER, TRAUMA, AND LIFE SUPPORT FOR HOSPITAL EDUCATION. 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 $ 9,873,073. 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: IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND ESTIMATES A PERCENTAGE OF THOSE ACCOUNTS THAT WILL TRANSITION TO SELF-PAY PATIENTS BASED ON HISTORICAL ANALYSIS. THE ESTIMATED PERCENTAGE OF THOSE TRANSITION ACCOUNTS ARE ADDED TO RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL). THE ORGANIZATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE ORGANIZATION HAS ADOPTED A POLICY RELATIVE TO SELF-PAY DISCOUNTS, WHEREBY CHARGES AND SUBSEQUENT BILLINGS WERE REDUCED TO APPROXIMATE REIMBURSEMENT LEVELS RECEIVED FROM GOVERNMENTAL THIRD-PARTY PAYORS.PAYMENT FOR SERVICES IS EXPECTED WITHIN THIRTY DAYS OF RECEIPT OF THE BILLING. ACCOUNTS CONSIDERED PAST DUE ARE SENT TO COLLECTION AGENCIES WHEN INTERNAL COLLECTION EFFORTS HAVE BEEN UNSUCCESSFUL. ANY AMOUNTS DEEMED UNCOLLECTIBLE ARE WRITTEN OFF ON A MONTHLY BASIS. THE ORGANIZATION DOES NOT CHARGE INTEREST ON OUTSTANDING BALANCES OWED. PART III, LINE 3: THE ORGANIZATION PROVIDES CHARITY CARE TO PATIENTS WHO ARE FINANCIALLY UNABLE TO PAY FOR THE HEALTHCARE SERVICES THEY RECEIVE. PATIENTS WHO QUALIFY FOR CHARITY CARE ARE GIVEN A PERCENTAGE DISCOUNT FROM ESTABLISHED CHARGES BASED ON A SLIDING SCALE USING POVERTY GUIDELINES. IT IS THE POLICY OF THE ORGANIZATION NOT TO PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. ACCORDINGLY, THE ORGANIZATION DOES NOT REPORT THESE AMOUNTS IN NET PATIENT SERVICE REVENUE OR IN THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE ORGANIZATION DETERMINES THE COSTS ASSOCIATED WITH PROVIDING CHARITY CARE BY AGGREGATING THE DIRECT AND INDIRECT COSTS, INCLUDING SALARIES, BENEFITS, SUPPLIES, AND OTHER OPERATING EXPENSES, BASED ON THE OVERALL COST TO CHARGE RATIO FOR GP HEALTH AND NPNPG. THE COSTS OF CARING FOR CHARITY CARE PATIENTS FOR THE YEARS ENDED DECEMBER 31, 2017 AND 2016 WERE APPROXIMATELY $3,800,000 AND $3,480,000, RESPECTIVELY. PART III, LINE 4: THE COSTING METHODOLOGY USED IN DETERMINING THE BAD DEBT EXPENSES INCLUDES CALCULATING ON A MONTHLY BASIS THE TOTAL ESTIMATED AMOUNTS BASED ON HISTORICAL WRITE OFFS.THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT CONTAIN A SPECIFIC FOOTNOTE DESCRIBING BAD DEBT. FOOTNOTES TITLED "PATIENT ACCOUNTS RECEIVABLE, NET," "NET PATIENT SERVICE REVENUE, AND "CHARITY CARE" CAN BE FOUND ON PAGES 9 AND 11 OF THE ATTACHED AUDITED 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. 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 (ADMINISTRATIVE POLICY 8210-0008). 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 123,026 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 86,000.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), TRI COUNTY HOSPITAL (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 74.1% GPH'S INPATIENT CASES- THE 2014 POPULATION WAS 35,815 SECONDARY SERVICE AREA- CONSISTS OF NINETEEN COUNTIES EXTENDING NORTH TO SOUTH DAKOTA, SOUTH TO KANSAS AND WEST TO COLORADO - ACCOUNTS FOR 25.9% OF GPH'S INPATIENT CASES - POPULATION 86,462 IN 2012 - LARGEST EMPLOYER IS UNION PACIFIC WITH 2,300 EMPLOYEES AT THE END OF 2013 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. PART VI, LINE 6: GREAT PLAINS HEALTH IS NOT PART OF AN AFFILIATED HEALTHCARE SYSTEM, BUT ASSISTS IN IDENTIFYING AND RECRUITING TOP PHYSICIANS IN NEEDED SPECIALTIES. 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, A HOME HEALTH AGENCY, 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, RENT INDEPENDENT LIVING APARTMENTS TO THE ELDERLY AND PROVIDE PHYSICIAN PROFESSIONAL MEDICAL SERVICES AND OTHER PROGRAMS TO PATIENTS. PART VI, LINE 7: GPH DOES NOT FILE A COMMUNITY BENEFIT REPORT WITH ANY STATE. 1 NEBRASKALAND DAYS INC PO BOX 706 NORTH PLATTE NE 69103 470521025 501(C)(4) 20000 SPONSOR OF 2017 EVENTS PLATTE RIVER FITNESS SERIES 1300 MCDONALD ROAD NORTH PLATTE NE 69101 476006297 GOVERNMENTAL 17500 SPONSOR OF 2017 EVENTS CREATIVITY UNLIMITED ARTS COUNCIL PO BOX 266 NORTH PLATTE NE 69103 202209105 501(C)(3) 10000 FOR RENOVATION TO THE PRAIRIE ARTS CENTER UNITED WAY OF NORTH PLATTE PO BOX 172 NORTH PLATTE NE 69103 470525576 501(C)(3) 5000 SUPPORT OF THE MID-PLAINS UNITED WAY CAMPAIGN TO SUPPORT LOCAL COMMUNITY SUPPORT ORGANIZATIONS NORTH PLATTE CHAMBER OF COMMERCE 502 S DEWEY ST NORTH PLATTE NE 69101 237355570 GOVERNMENTAL 85750 SHOT IN THE ARM HOUSING INCENTIVE PROGRAM AMERICAN HEART ASSOCIATION 5375 SOUTHWEST 7TH ST TOPEKA KS 66606 135613797 501(C)(3) 5000 PURCHASE OF CPR KITS FOR LINCOLN COUNTY SCHOOLS AS AN EDUCATIONAL TOOL. 308 BMX INC PO BOX 1152 NORTH PLATTE NE 69103 813779247 501(C)(3) 5000 SPONSOR AT USA BMX SANCTIONED TRACK 6 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 0 0 NARAYANA KODURI MD VICE CHIEF OF STAFF/DIRECT 385541 0 149040 0 1975 0 10800 0 31447 0 578803 0 0 0 JIM SMITH MD DIRECTOR 418055 0 9333 0 774 0 10800 0 35847 0 474809 0 0 0 MELVIN MCNEA CEO 343827 0 13022 0 1188 0 10600 0 29270 0 397907 0 0 0 KRYSTAL CLAYMORE SENIOR VP OF FIN & STRAT (THRU 11/6/ 318479 0 6100 0 266 0 10800 0 32847 0 368492 0 0 0 MICHAEL SIMONSON PHYSICIAN (GPH) 1085092 0 68983 0 1362 0 10800 0 32847 0 1199084 0 0 0 BRENDON CURTIS PHYSICIAN (GPH) 886876 0 93824 0 270 0 10800 0 31347 0 1023117 0 0 0 HENRIK MIKE-MAYER PHYSICIAN (GPH) 839475 0 1365 0 49094 0 10800 0 31861 0 932595 0 0 0 JOHN HANNAH PHYSICIAN (GPH) 763861 0 125100 0 408 0 10800 0 32728 0 932897 0 0 0 MARK MCKENZIE PHYSICIAN (GPH) 762934 0 125100 0 774 0 10800 0 32647 0 932255 0 0 0 A HOSPITAL AUTHORITY NO 1 OF LINCOLN COUNTY NEBRASKA 971837633 533282BQ1 2012-11-15 109560864 CONSTRUCT/UPDATE FACILITIES AND REFUND PRIOR REVENUE BONDS 0 0 0 A 6075000 109877098 1189899 98296247 9390952 2015 1 1 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 1 0 0 0 1 1 A 1 PART II, LINE 3: THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS. PART III, LINE 3(A): WHILE THE HOSPITAL HAS MANAGEMENT OR SERVICE CONTRACTS THAT MAY RESULT IN PRIVATE BUSINESS USE OF BOND-FINANCED PROPERTY, SUCH CONTRACTS DO NOT GIVE RISE TO PRIVATE USE UNDER THE PRINCIPLES OF REV. PROC. 97-13. PART IV; LINE 2C: DATE THE REBATE COMPUTATION WAS PERFORMED: 10/31/2017. NOTE REGARDING THE REBATE COMPUTATION: SINCE THE BOND PROCEEDS HAVE BEEN SPENT AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CALCULATIONS ARE NECESSARY. BYRON L BARKSDALE MR. BARKSDALE, A DIRECTOR, IS THE OWNER OF PATHOLOGY SERVICES, PC 361055 PATHOLOGY SERVICES 0 MICHELLE L MCNEA SPOUSE OF MELVIN MCNEA, OFFICER. 93150 EMPLOYMENT WITH THE HOSPITAL 0 MOLLY H WALKER DAUGHTER OF MELVIN MCNEA, OFFICER. 76756 EMPLOYMENT WITH THE HOSPITAL 0 TRISHA A JORGENSEN STEP-DAUGHTER OF DWIGHT LIVINGSTON, DIRECTOR. 47003 EMPLOYMENT WITH THE HOSPITAL 0 0 FORM 990, PART VI, SECTION B, LINE 11B COPIES OF THE FORM 990 ARE DISTRIBUTED TO THE AUDIT COMMITTEE OF THE BOARD FOR REVIEW. THIS IS DONE VIA THE BOARD PORTAL WHICH IS AVAILABLE TO ALL BOARD MEMBERS. FOLLOW UP IS DISCUSSED AT THE NEXT MEETING FOLLOWING THE FILING OF THE FORM 990. 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 AND KEY EMPLOYEES 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, OFFICERS, AND KEY EMPLOYEES. 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 AND KEY EMPLOYEES 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 AND KEY EMPLOYEES. 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 SENIOR VP OF FINANCE & STRATEGY, GOVERNING DOCUMENTS WILL BE MADE AVAILABLE TO THE PUBLIC FOR REVIEW AT THE HOSPITAL'S ADMINSTRATIVE OFFICE. FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 1,042,111. MANAGEMENT AND GENERAL EXPENSES 326,613. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,368,724. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 5,147,376. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,147,376. SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 9,206,189. MANAGEMENT AND GENERAL EXPENSES 583,467. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,789,656. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 6,582,193. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,582,193. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,549,063. MANAGEMENT AND GENERAL EXPENSES 496,505. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,045,568. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN GREAT PLAINS HEALTH CARE FOUNDATION 5,799,659. 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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