2017-12-18T14:46:10-06:00 2017-06-30 481026809 Wendling Noe Nelson & Johnson LLC 534 S Kansas Ave Suite 1500 Topeka KS 666033491 990 2016-07-01 480764456 Nemaha Valley Community Hospital NEMA 7853366181 1600 Community Drive Seneca KS 66538 KILEY FLOYD CEO 7853366181 2017-12-11 1 Eric L Otting P00298454 7852334226 2017-12-11 98.172.114.81 2017-12-11 16:21:59 CS P 3A39E9190EA99C2EBB271F449F6F0388DDE8489C F008BB08EB70EDC311476F7A876346CF87ED8437 2016 2018-03-14 21:41:22Z Kiley Floyd 1600 Community Drive Seneca KS 66538 15573401 0 X nemvch.com X 1969 KS Nemaha Valley Community Hospital provides acute care services to the surrounding area. 12 11 166 10 0 0 582758 596755 13231906 14849564 74771 84085 39342 42997 13928777 15573401 0 0 0 0 8704325 9333637 0 0 27538 4896872 5653130 13601197 14986767 327580 586634 19013291 22058771 13456065 15914911 5557226 6143860 Nemaha Valley Community Hospital is dedicated to providing quality health care and other related services in a compassionate manner sufficient to meet the primary health care needs of its patrons within the scope of its resources and staff. 0 0 13055122 14866357 Nemaha Valley Community Hospital provides inpatient and outpatient hospital services and clinic services to patients in its service area. 13055122 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 23 0 1 166 1 0 0 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 1 1 0 0 X Connie Ingwerson 7853366181 1600 Community Drive Seneca KS 66538 Leroy Strathman Chairman 1.00 X X 0 0 0 Ed Mohney Vice Chairman 1.00 X X 0 0 0 Fred Henry Secretary 1.00 X X 0 0 0 Bill Love Trustee 1.00 X 0 0 0 Jim Runnebaum Trustee 1.00 X 0 0 0 Judy Deters Trustee 1.00 X 0 0 0 Steve Haverkamp Trustee 1.00 X 0 0 0 Dennis Henry Trustee 1.00 X 0 0 0 Leah Hermesch Trustee 1.00 X 0 0 0 Kris Enneking Trustee 1.00 X 0 0 0 Glen Meyer Trustee through August 2016 1.00 X 0 0 0 Dr Angela Stueve Physician/Trustee 40.00 X 352714 0 26089 Kathy O'Brien Director 1.00 X 0 0 0 Kiley Floyd Chief Executive Officer 40.00 X 64045 0 6462 Connie Ingwerson Chief Financial Officer 40.00 X 100297 0 6242 William Bartkoski DO Physician 40.00 X 336399 0 28156 Harry Stewart CRNA 40.00 X 320690 0 21619 Dr Jarod Snyder Physician 40.00 X 268327 0 30163 Dr Heather Cooper Physician 40.00 X 265776 0 14716 Lori Lueger APRN 40.00 X 120272 0 7593 1828520 0 141040 6 0 1 0 Medhost of Tennessee Inc 2739 Momemtum Place Chicago IL 60689 IT Maintenance 270060 Stormont Vail Healthcare 1500 SW 10th Avenue Topeka KS 66604 Lab Services 167744 2 202 434918 161635 596755 Patient service revenue 621990 14525401 14525401 340B retail drug program 446110 324163 324163 14849564 82935 82935 1150 0 1150 1150 1150 Dietary Income 722210 27354 27354 Miscellaneous 621990 15643 15643 42997 15573401 14866357 0 110289 248364 248364 7196208 6460104 713997 22107 167217 145352 21865 1302356 1143108 155336 3912 419492 364641 53603 1248 6698 6698 925177 662376 262530 271 31723 11338 20385 122386 39388 82998 172145 172145 172604 172604 72165 40357 31808 685891 685891 880594 876133 4461 94625 77845 16780 Medical Supplies/Drugs 1659909 1659909 Equipment rental and ma 564105 500832 63273 Miscellaneous 147836 145005 2831 Education 61763 48739 13024 55509 21500 34009 14986767 13055122 1904107 27538 121351 121354 9368732 12159291 1666942 2206456 233036 235770 317348 272358 18598578 11789621 6956939 6808957 65996 65996 282947 188589 19013291 22058771 1166065 2325766 1464145 12290000 12125000 13456065 15914911 X 5549828 6133797 7398 10063 5557226 6143860 19013291 22058771 586634 0 X 0 1 X 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 4607 0 0 0 4607 0 Part II-B, Line 1: Nemaha Valley Community Hospital is a member of the Kansas Hospital Association and the American Hospital Association. Both of these organizations engage in lobbying activities as part of the services provided to members. The above amount was estimated based on a percentage of membership dues. 54681 54681 11425743 6635831 4789912 6383621 5153790 1229831 734533 734533 6808957 X Part X, Line 2: The Hospital is a not-for-profit corporation as described in Section 501(c)(3) of the Internal Revenue Code and is exempt from federal taxes on related income pursuant to Sction 501(a) of the Code. 1 1 0 1 X 1 1 0 1 1 59534 59534 0.00400 390437 212112 178325 0.01190 449971 212112 237859 0.01590 3808411 2972891 835520 0.05580 493 493 0.00000 3808904 2972891 836013 0.05580 4258875 3185003 1073872 0.07170 1 143860 57544 6150376 6221014 -70638 X 1 1 1 1 Nemaha Valley Community Hospital 1600 Community Drive Seneca KS 66538 X X X X Rural health clinic Nemaha Valley Community Hospital 1 0 0 1 X X X X X X X X X 15 1 1 0 1 X http://www.nemvch.com/resources X 1 15 1 http://www.nemvch.com/resources 0 1 X 200.000000000000 X X X X 1 1 X X X 1 X http://www.nemvch.com/resources/ X http://www.nemvch.com/resources/ X http://www.nemvch.com/resources/ X X X X X X 1 X 0 X X X X 1 X 0 0 Nemaha Valley Community Hospital Part V, Section B, Line 5: Community members were invited to attend a meeting in which their input was requested to determine the health needs of the community. The community members decided what the health care needs are and prioritized these needs. These members included medical professionals, government employees, leaders of non-profit organizations, and hospital employees. Nemaha Valley Community Hospital Part V, Section B, Line 6a: Sabetha Community Hospital, Inc Nemaha Valley Community Hospital Part V, Section B, Line 11: To promote health, wellness, and chronic disease prevention, the Hospital regularly provided health and wellness education to the public through in-person talks and through social media posts to educate on health and mental health issues. Also, the Hospital played a slide show in multiple waiting rooms and on local television which highlighted the Hospital's services and informed viewers about health related issues. The Hospital regularly conducted newspaper articles, radio ads, and a newsletter to highlight health related topics. Finally, the hospital provided education to the public through their annual Health Fair.To improve access to mental health assistance, the Hospital continued to provide an online screening tool for mental health diseases. The Hospital has continued two tele-health mental health clinics that provide psychiatry & therapy for the young and old. The Hospital continued to educate the public about mental health issues through social media and its newsletter. Part I, Line 7: This amount was determined by multiplying a cost-to-charge ratio derived from Worksheet 2 by the Medical Center's bad debt expense for the tax year. Part I, Line 7g: The costs of subsidized health services include costs attributable to a rural health clinic in the amount of $632,369. Part II, Community Building Activities: N/A Part III, Line 4: Nemaha Valley Community Hospital provides for accounts receivable that could become uncollectible in the future by establishing an allowance to reduce the carrying value of such receivables to their estimated net realizable value. This estimate is based on the aging of its accounts receivable by payor and historical collection experience. See note A5 (page 7) of the audited financial statements regarding the allowance for uncollectible accounts.Part III Line 2:This amount was determined by multiplying a cost-to-charge ratio derived from Worksheet 2 by the Medical Center's bad debt expense for the tax year.Part III, Line 3:This amount was determined based on the overall income level of patients that submit all required documentation under the Hospital's financial assistance policy. As a tax-exempt hospital, we must provide necessary services regardless of the patient's ability to pay for that care. Making quality patient care available to all in our community, regardless of their economic means, qualifies bad debts as a community benefit. Part III, Line 8: Medicare costs were obtained from the Medical Center's as-filed Medicare cost report for the tax year. The shortfall is a benefit to the Medical Center's community since it represents health care provided at less than cost to elderly and needy residents of the Medical Center's service area. Part III, Line 9b: Nemaha Valley Community Hospital makes every effort to get correct financial and billing information and to educate patients on the eligibility requirements of charity care programs and payment options. Part VI, Line 2: N/A Part VI, Line 3: Notification associated with patient encounter. Part VI, Line 4: The community served is primarily residents who reside in Nemaha County Kansas and consists of approximately 2,000 residents. The median family income is $38,611. 11.8% of the community residents live below federal poverty level, and 4.1% of the community residents live below 50% of the federal poverty level. Neighboring hospitals are located in Sabetha, Pawnee County, NE, and Hiawatha. They are approximately 21, 20, and 28 miles away respectively. Part VI, Line 5: The Hospital maintains a Facebook page which posts general health information topics and announces dates of general health-related group activities. The Hospital offers periodic diabetic educational programs and education programs for expectant mothers. The Hospital uses all excess funds to maintain and improve Hospital facilities and equipment and to insure the delivery of high quality patient care services. Part VI, Line 6: N/A X X 0 0 0 0 0 0 0 0 0 Dr Angela Stueve Physician/Trustee 255592 0 97122 0 0 0 11373 0 14716 0 378803 0 0 0 William Bartkoski DO Physician 293328 0 43071 0 0 0 13350 0 14806 0 364555 0 0 0 Harry Stewart CRNA 320690 0 0 0 0 0 13957 0 7662 0 342309 0 0 0 Dr Jarod Snyder Physician 233979 0 34348 0 0 0 15447 0 14716 0 298490 0 0 0 Dr Heather Cooper Physician 229781 0 35995 0 0 0 0 0 14716 0 280492 0 0 0 A City of Seneca Kansas 486026237 81712RAP4 2008-12-01 8835000 To refund notes payable and construction costs for an addition to Hospital 0 0 0 B City of Seneca Kansas 486026237 81712RBB4 2015-02-19 4455000 To refund a portion of 2008 series bond 0 0 0 A 1165000 8835000 498789 161535 6834436 1358153 2011 0 1 1 1 B 4455000 4108369 88270 363920 0 1 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 0 0 1 1 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 Date Rebate Computation Performed Issuer Name: City of Seneca, Kansas Date the Rebate Computation was Performed: 06/01/2013 Form 990, Part VI, Section B, line 11b The 990 is presented to the finance committee of the board prior to filing. The document is made available to all other board members upon request. Form 990, Part VI, Section B, line 12c The board is required to annually sign conflict of interest statements. Form 990, Part VI, Section B, line 15a The CEO salary and compensation is approved by the Hospital's board. Form 990, Part VI, Section C, line 19 Documents are available upon request. Nemaha Valley Health Care Foundation 1600 Community Drive Seneca KS 66538 481097250 Fundraising for the benefit of community healthcare KS 501(c)(3) Line 7 Nemaha Valley Community Hospital 1 0 0 1 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0