2017-11-15T13:37:32-07:00 2016-12-31 363314157 REGIONAL WEST HEALTH SERVICES 4021 AVENUE B SCOTTSBLUFF NE 693614602 990 2016-01-01 363314159 REGIONAL WEST PHYSICIANS CLINIC REGI 4021 AVENUE B SCOTTSBLUFF NE 69361 MICHAEL ICKOWSKI CFO 3086353711 2017-11-15 true AMY HOLZWORTH CPA P00284207 3086302823 2017-11-15 6942DBE293EE23EAAFB65441E4C497608E5EF7E2 CCD344DB358877955BD6CDA542A4954E7FA27565 2016 2017-02-10 21:41:12Z MICHAEL ICKOWSKI 75590815 false X WWW.RWHS.ORG X 1984 NE PROVIDE HEALTH CARE TO THE REGION INCLUDING THE UNDERSERVED. 14 0 390 77890 4126 22959200 53716029 52147499 -1970 566 462098 382136 54176157 75489401 38221 78671 0 46323475 46896480 0 0 26217435 28263385 72579131 75238536 -18402974 250865 5666509 5961423 5873034 5917083 -206525 44340 PROVIDE HEALTH CARE TO THE REGION INCLUDING THE UNDERSERVED. false false 75151956 78671 52147499 REGIONAL WEST PHYSICIANS CLINIC IS A MULTI-SPECIALTY MEDICAL GROUP OF MORE THAN 70 PHYSICIANS AND ASSOCIATED HEALTH CARE PROVIDERS. THE CLINIC IS A PHYSICIAN-LED, PHYSICIAN-GOVERNED SUBIDIARY OF REGIONAL WEST HEALTH SERVICES. IN THE TRADITION OF THE MAYO CLINIC AND OTHER SUCCESSFUL EXAMPLES OF PHYSICIAN HOSPITAL INTEGRATION, REGIONAL WEST PHYSICIANS CLINIC IS COMMITTED TO PROVIDING THE HIGHEST QUALITY PATIENT CARE AND SERVICE, PATIENT-DRIVEN HEALTH CARE GOVERNANCE AND LEADERSHIP, AND COMMUNITY OUTREACH TO THE REGION. 75151956 true false false false false false false false false false true false false true true false false true false false false false false false false false false true false true false false false false false false false false false false false false false true false false false true 38 0 390 true true true false false false false false false false false false false false X 14 0 false false false false false false false true true false false true true true true true true true true false X MICHAEL ICKOWSKI 3086301111 4021 AVENUE B SCOTTSBLUFF NE 69361 JEFFREY HOLLOWAY PHYSICIAN 40.00 X 707634 0 43968 ARMANDO MAGANA PHYSICIAN 40.00 X 699725 0 45118 JASON WALSH PHYSICIAN 40.00 X 698688 0 43513 MARK HARTMAN PHYSICIAN 40.00 X 659145 0 37050 VINCENT BJORLING CHAIRPERSON 40.00 X X 585268 0 40417 JAMES MASSEY VP OF SURGER 40.00 X 518541 0 27405 BRENT ELLISON PHYSICIAN 40.00 X 482165 0 41657 DORISA POLK PHYSICIAN 40.00 X 478790 0 42784 LISA SCHEPPERS CMO 5.00 40.00 X 17796 403457 108164 DAVID HOLDT PRESIDENT 40.00 X X 408840 0 113508 SHEILA WEBB-BOWLES PHYSICIAN 40.00 X 397880 0 79020 JOSEPH MARGHEIM PHYSICIAN 40.00 X 363957 0 56762 KENT LACEY PHYSICIAN 40.00 X 321566 0 45284 TADD GREENFIELD COO 0.00 40.00 X 0 246040 50771 JOHN MENTGEN CEO 2.00 40.00 X 0 520293 289783 MICHAEL ICKOWSKI CFO 2.00 40.00 X 0 52526 10679 SHIRLEY GOMPERT SECRETARY 40.00 X 34828 0 25109 ROMMIE HUGHES PHYSICIAN 40.00 X 792419 0 43758 MATTHEW BRUNER PHYSICIAN 40.00 X 554691 0 43619 JASON LATOWSKY PHYSICIAN 40.00 X 424147 0 43782 WENDY REEVES PHYSICIAN 40.00 X 421506 0 42878 KATE PAINTER PHYSICIAN 40.00 X 377414 0 38849 REGINA LECONTE PHYSICIAN 40.00 X 346920 0 23188 AMANULLAH BILAL PHYSICIAN 40.00 X 334173 0 49183 MOHAMMED SIDDIQUI PHYSICIAN 40.00 X 325595 0 11167 JONATHAN MCNEELY PHYSICIAN 40.00 X 319696 0 36634 ERIC WIEBE PHYSICIAN 40.00 X 235325 0 42638 USMAN AKHTAR PHYSICIAN 40.00 X 189970 0 16284 JOE JETER PHYSICIAN AS 40.00 X 179665 0 29498 RAQEEB HAQUE PHYSICIAN 40.00 X 846637 0 41275 TIMOTHY FRIEDLEIN PHYSICIAN 40.00 X 817045 0 36064 OMAR JIMENEZ PHYSICIAN 40.00 X 741505 0 33318 JONATHAN GOCHNOUR PHYSICIAN 40.00 X 554581 0 38297 ANDREW JAHODA PHYSICIAN 40.00 X 523763 0 57594 JON MORGAN PHYSICIAN 35.00 5.00 X 248025 11067 42361 TODD SORENSEN FORMER CEO X 1200 103013 4162 JOHN BLOMSTEDT PHYSICIAN 40.00 X 501851 0 43054 15110951 1336396 1818595 35 true true false COMPHEALTH ASSOCIATES INC PO BOX 972670 DALLAS TX 753972670 PROFESSIONAL 3402459 RURAL PARTNERS IN MEDICINE PO BOX 772519 STEAMBOAT SPRINGS CO 80477 PROFESSIONAL 1117883 HEALTH MOUNT LLC 1326 MONTGOMERY LN SOUTHLAKE TX 76092 PROFESSIONAL 954002 QUALITY SYSTEMS INC 795 HORSHAM ROAD HORSHAM PA 19044 PROFESSIONAL 721567 WEATHERBYY LOCUMS INC PO BOX 972633 DALLAS TX 753972633 PROFESSIONAL 672220 12 22959200 22959200 NET PATIENT REVENUES 46512350 46512350 CONSULTING REVENUE 5635149 5635149 52147499 566 566 179304 101414 77890 77890 MISCELLANEOUS OTHER REVENUE 304246 304246 304246 75489401 52451745 77890 566 X 78671 78671 11348673 11348673 910404 910404 26382306 26382306 979719 979719 5525745 5525745 1749633 1749633 97193 97193 86580 86580 10041543 10041543 52814 52814 156960 156960 1781 1781 2075725 2075725 192182 192182 152832 152832 1247 1247 256781 256781 727074 727074 PHARMACY 9093214 9093214 OTHER PURCHASED SERVICES 2222793 2222793 BAD DEBT 1701749 1701749 MEDICAL SUPPLIES 745910 745910 657007 657007 75238536 75151956 86580 0 487460 73822 3980460 3705294 338193 85831 69544 232224 3962553 3155580 691632 806973 99220 1057279 5666509 5961423 5838916 5901201 34118 15882 5873034 5917083 X -206525 44340 -206525 44340 5666509 5961423 250865 X false true X true false X 206302 103841 102461 3756251 3051739 704512 806973 OTHER RECEIVABLES 1057279 1057279 CAPITAL LEASE PAYABLE 15882 15882 true SCOTTS BLUFF COUNTY FAIR 10625 CO RD E MITCHELL NE 69357 GOV 5522 REGIONAL WEST FOUNDATION 4021 AVENUE B SCOTTSBLUF NE 69361 237171022 GOV 54800 X true true X X X X false true false false false false false false false JEFFREY HOLLOWAY PHYSICIAN 494405 211987 1242 10600 33368 751602 ARMANDO MAGANA PHYSICIAN 640468 56935 2322 10600 34518 744843 JASON WALSH PHYSICIAN 497453 200425 810 10600 32913 742201 MARK HARTMAN PHYSICIAN 657903 1242 10712 26338 696195 VINCENT BJORLING CHAIRPERSON 354446 229202 1620 10652 29765 625685 JAMES MASSEY VP OF SURGER 459231 59310 10710 16695 545946 BRENT ELLISON PHYSICIAN 479763 2402 8916 32741 523822 DORISA POLK PHYSICIAN 352707 125539 544 10600 32184 521574 LISA SCHEPPERS CMO 17796 395641 7816 77275 30889 17796 511621 DAVID HOLDT PRESIDENT 390651 18189 83953 29555 522348 SHEILA WEBB-BOWLES PHYSICIAN 397509 371 46163 32857 476900 JOSEPH MARGHEIM PHYSICIAN 362117 1840 22450 34312 420719 KENT LACEY PHYSICIAN 299020 21556 990 10600 34684 366850 TADD GREENFIELD COO 213570 15000 17470 33646 17125 296811 JOHN MENTGEN CEO 465002 55291 256234 33549 810076 ROMMIE HUGHES PHYSICIAN 579624 211553 1242 10600 33158 836177 MATTHEW BRUNER PHYSICIAN 427897 126377 417 10600 33019 598310 JASON LATOWSKY PHYSICIAN 424147 10883 32899 467929 WENDY REEVES PHYSICIAN 291281 129955 270 10734 32144 464384 KATE PAINTER PHYSICIAN 255703 121459 252 11156 27693 416263 REGINA LECONTE PHYSICIAN 346382 538 10600 12588 370108 AMANULLAH BILAL PHYSICIAN 333876 297 25658 23525 383356 MOHAMMED SIDDIQUI PHYSICIAN 312854 12741 10700 467 336762 JONATHAN MCNEELY PHYSICIAN 319201 495 20222 16412 356330 ERIC WIEBE PHYSICIAN 234806 519 9772 32866 277963 USMAN AKHTAR PHYSICIAN 189850 120 10779 5505 206254 JOE JETER PHYSICIAN ASSISTANT 53683 125949 33 17400 12098 209163 RAQEEB HAQUE PHYSICIAN 846151 486 27185 14090 887912 TIMOTHY FRIEDLEIN PHYSICIAN 448401 366559 2085 10600 25464 853109 OMAR JIMENEZ PHYSICIAN 740263 1242 33318 774823 JONATHAN GOCHNOUR PHYSICIAN 554220 361 10888 27409 592878 ANDREW JAHODA PHYSICIAN 523763 30227 27367 581357 JON MORGAN PHYSICIAN 246061 11067 1890 74 8874 458 31643 1386 288542 12911 TODD SORENSEN FORMER CEO 1200 103013 4162 1200 107175 JOHN BLOMSTEDT PHYSICIAN 291042 210509 300 10671 32383 544905 SCHEDULE J, PAGE 1, PART I, LINE 4 LISA SCHEPPERS 0 29,250 0 DAVID HOLDT 0 40,260 0 TADD GREENFIELD 0 40,845 0 JOHN MENTGEN 0 164,651 0 MICHAEL ICKOWSKI 0 5,467 0 JON MORGAN 0 260 0 FORM 990, PAGE 6, PART VI, LINE 11B FORM IS 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 COO IS DETERMINED BY THE COMPENSATION COMMITTEE OF THE RWHS BOARD. THE DETERMINATION IS BASED ON MARKET DATA AND RECOMMENDATIONS FROM AN INDEPENDENT CONSULTING FIRM WHO COLLECTS THAT INFORMATION FOR COMPARISON PURPOSES. MINUTES ARE KEPT OF THESE MEETINGS. FORM 990, PAGE 6, PART VI, LINE 15B COMPENSATION FOR THE CEO AND KEY EMPLOYEES IS REVIEWED BY AN INDEPENDENT CONSULTANT ON AN ANNUAL BASIS TO ENSURE THE COMPENSATION PLAN MEETS REASONABLENESS TESTING COMPARED TO MGMA COMPENSATION SURVEY. THE COMPENSATION MODEL IS ALSO REVIEWED BY LEGAL COUNSEL FOR REASONABLENESS AND COMPLIANCE WITH IRS REQUIREMENTS. 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. FORM 990, PART IX, LINE 11G MEDICAL TRANSCRIPTION & BILLI 327,427 0 0 LOCUM MEDICAL COVERAGE FEES 9,714,116 0 0 TOTAL 10,041,543 0 0 REGIONAL WEST HEALTH SERVICES 4021 AVENUE B SCOTTSBLUFF NE 69361 363314157 SUPPORT NE 501C3 12A N/A false REGIONAL WEST MEDICAL CENTER 4021 AVENUE B SCOTTSBLUF NE 69361 470385129 HOSPITAL 501C3 3 N/A false REGIONAL WEST GARDEN COUNTY 4021 AVENUE B SCOTTSBLUF NE 69361 391904975 CAH 501C3 3 RWHS REGIONAL WEST HEALTH SERVICES false REGIONAL WEST FOUNDATION 4021 AVENUE B SCOTTSBLUF NE 69361 237171022 FDRAISING 501C3 12B N/A false REGIONAL WEST VILLAGE 4021 AVENUE B SCOTTSBLUF NE 69361 363314162 RETIREMENT 501C3 10 N/A false REGIONAL WEST HEALTH SERVICES & AFF 4021 AVENUE B SCOTTSBLUF NE 69361 470658690 HEALTH PLA 501C9 N/A false REGIONAL CARE INC 4021 AVENUE B SCOTTSBLUF NE 69361 470760050 TPA N/A false false true true false false false false false false false false false false false false true false false false REGIONAL WEST MEDICAL CENTER P 836027 CASH REGIONAL WEST FOUNDATION B 58000 CASH REGIONAL WEST MEDICAL CENTER C 22959200 CASH