2017-09-25T13:50:39-05:00 2016-12-31 476097913 SEIM JOHNSON LLP 18081 BURT STREET SUITE 200 OMAHA NE 680224722 990 2016-01-01 470690286 VISITING NURSE HEALTH SERVICES VISI 4023425566 12565 WEST CENTER ROAD NO 100 OMAHA NE 68144 DAVID VANLANDINGHAM VP & CFO 4029304064 2017-09-21 1 WENDY R COOLEY P01523804 4023302660 209.34.201.180 2017-09-21 09:44:42 CD P 283418A69B405FF99BFD473E52D2AE202F92D27A FCEDDD786A52D146CD6D5AF04BB3D8B974087028 2016 2021-01-29 14:40:06Z DAVID E VANLANDINGHAM 12565 WEST CENTER ROAD NO 100 OMAHA NE 68144 5163400 0 X WWW.THEVNACARES.ORG X 1986 NE THE MISSION OF THE VISITING NURSE HEALTH SERVICES IS TO FOSTER THE DIGNITY AND WELL-BEING OF THE RESIDENTS OF OUR COMMUNITIES BY DELIVERING THE HIGHEST QUALITY HOME AND COMMUNITY-BASED HEALTH CARE SERVICES THAT PROVIDE PEACE OF MIND, QUALITY OF LIFE, AND INDEPENDENCE. 26 25 158 45 0 0 2745339 2420351 2749345 2743049 0 0 0 0 5494684 5163400 173095 156436 0 0 3637893 3680847 0 0 0 1541338 1442616 5352326 5279899 142358 -116499 1806187 1700655 285618 296585 1520569 1404070 DELIVERING COMMUNITY-BASED CARE THAT PROVIDES PEACE OF MIND, QUALITY OF LIFE AND INDEPENDENCE. 0 0 2625816 156436 1206450 FAMILY SUPPORT WHICH INCLUDES MULTIDISCIPLINARY (PUBLIC HEALTH NURSING, SOCIAL WORK, FAMILY SUPPORT) HOME VISITATION SERVICES TO VULNERABLE AND AT-RISK FAMILIES (FOCUSED ON PREGNANT TEENS, WOMEN WITH INFANTS AND YOUNG CHILDREN). CARE MAY BE PROVIDED IN HOMES, HOMELESS SHELTERS, OR WHEREVER THE FAMILY RESIDES. 1701910 1084899 CONTRACT/PRIVATE PAY WHICH INCLUDES COMMUNITY-BASED SERVICES THAT SERVE A SPECIFIC POPULATION WITH A FOCUS ON PREVENTIVE HEALTH ACTIVITIES. INCLUDES SCHOOL HEALTH, ANNUAL COMMUNITY FLU CAMPAIGN, AND PRIVATE DUTY COMPANION SERVICES TO SENIORS. 818506 451700 HOME CARE WHICH INCLUDES BOTH SKILLED (NURSING, THERAPIES, SOCIAL WORK) AND NON-SKILLED SERVICES (HOME HEALTH AIDE AND HOMEMAKER) PROVIDED TO THE POOR, FRAIL, ELDERLY AND DISABLED WHO ARE NOT ELIGIBLE FOR COVERED SERVICES (MEDICARE, ETC) BUT NEED ASSISTANCE WITH DAILY ACTIVITIES IN ORDER TO REGAIN HEALTH AND/OR STAY SAFE AND WELL IN THEIR HOMES. 5146232 1 1 0 0 0 0 0 0 0 1 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 14 0 1 158 1 0 0 0 0 0 0 0 0 0 0 X 26 25 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X X DAVID E VANLANDINGHAM VP & CFO 4023425566 12565 WEST CENTER ROAD SUITE 100 OMAHA NE 68144 X NEIL FORTKAMP CHAIR 1.00 4.00 X X 0 0 0 JASON TONJES VICE CHAIR 1.00 4.00 X X 0 0 0 PAM STENE HAGGE SECRETARY 1.00 4.00 X X 0 0 0 MIKALA HOLTZ TREASURER 1.00 4.00 X X 0 0 0 JOSIE ABBOUD DIRECTOR 1.00 0.00 X 0 0 0 DEANNA BOESE DIRECTOR 1.00 0.00 X 0 0 0 AMY CRAWFORD DIRECTOR 1.00 0.00 X 0 0 0 DR HARRIS FRANKEL DIRECTOR 1.00 0.00 X 0 0 0 BETH FURLONG DIRECTOR 1.00 0.00 X 0 0 0 DEBORAH ISTAS DIRECTOR 1.00 0.00 X 0 0 0 RUSS IWAN DIRECTOR 1.00 0.00 X 0 0 0 PEG KENNEDY DIRECTOR 1.00 0.00 X 0 0 0 ADAM KUENNING DIRECTOR 1.00 0.00 X 0 0 0 RANDY LENHOFF DIRECTOR 1.00 0.00 X 0 0 0 JOHN MARSHALL DIRECTOR 1.00 0.00 X 0 0 0 ROSENDA OVALLE DIRECTOR 1.00 0.00 X 0 0 0 SCOTT PETERS DIRECTOR 1.00 0.00 X 0 0 0 TERRY PETERSON DIRECTOR 1.00 0.00 X 0 0 0 LORI REID DIRECTOR 1.00 0.00 X 0 0 0 KEVIN ROCHFORD DIRECTOR 1.00 0.00 X 0 0 0 MIKE ROMANO DIRECTOR 1.00 0.00 X 0 0 0 RAY STOUPA DIRECTOR 1.00 0.00 X 0 0 0 TERI TIPTON DIRECTOR 1.00 0.00 X 0 0 0 BRENDA WATKE DIRECTOR 1.00 0.00 X 0 0 0 KATHLEEN ZAJIC DIRECTOR 1.00 0.00 X 0 0 0 JAMES SUMMERFELT PRESIDENT & CEO 5.00 55.00 X X 0 317617 28362 DAVID VANLANDINGHAM CFO 5.00 55.00 X 0 140669 9891 0 458286 38253 0 0 1 0 0 574804 58314 390410 1396823 2420351 HOME HEALTH CARE SVCS 621610 2090070 2090070 MANAGEMENT SERVICES 561000 652979 652979 2743049 5163400 2743049 0 0 156436 156436 3124218 3038082 86136 64770 62984 1786 261347 243874 17473 230512 224157 6355 865298 865298 99884 87393 12491 763 763 118464 114376 4088 108552 108193 359 17180 16795 385 MEDICAL SUPPLIES 200648 196054 4594 BAD DEBTS 23927 23927 DUES AND SUBSCRIPTIONS 4215 4215 3685 3685 5279899 5146232 133667 0 1800 100 444039 519200 436195 429559 237243 278781 41354 58637 12820 12820 0 0 645556 414378 1806187 1700655 285618 296585 285618 296585 X 448469 445413 1072100 958657 1520569 1404070 1806187 1700655 -116499 0 X X 0 1 X 1 1 1 X 2716709 2648898 2709117 2745339 2420351 13240414 2716709 2648898 2709117 2745339 2420351 13240414 1029405 12211009 13240414 13332594 0.92230 0.91010 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 578904 13373 12794 579 578904 578904 13083 9320 3763 578904 578908 13662 9961 3705 578904 578908 18641 14994 3647 578908 578908 20300 16453 3847 578908 0.00000 1.00000 0.00000 0 1 1 12820 12820 0 0 INTERCOMPANY RECEIVABLE 414378 414378 X PART V, LINE 4: THE ENDOWMENT IS HELD BY VISITING NURSE FOUNDATION, AN AFFILIATE THAT WAS FORMED TO FURTHER THE MISSION OF VISITING NURSE HEALTH SERVICES AND VISITING NURSE ASSOCIATION OF THE MIDLANDS. THE ENDOWMENT IS MAINTAINED IN PERPETUITY TO GENERATE INCOME TO SUPPORT THE OPERATIONS OF VISITING NURSE HEALTH SERVICES AND VISITING NURSE ASSOCIATION OF THE MIDLANDS. PART X, LINE 2: THE ENTITIES OF THE ASSOCIATION ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN TAX-EXEMPT STATUS. IN GENERAL, SUCH STANDARDS REQUIRE ALL OF THE AFFILIATED ENTITIES TO MEET A COMMUNITY BENEFIT STANDARD AND COMPLY WITH VARIOUS LAWS AND REGULATIONS. THE ASSOCIATION ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. THE ASSOCIATION RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT DECEMBER 31, 2016 AND 2015, THE ASSOCIATION HAD NO UNCERTAIN TAX POSITIONS ACCRUED. 1 VISITING NURSE ASSOCIATION OF THE MIDLANDS 12565 WEST CENTER ROAD SUITE 100 OMAHA NE 68144 470690207 501(C)(3) 156308 TO AID IN THE PROGRAMS AND SERVICES INCLUDING HOME HEALTH CARE AND HOSPICE. 1 0 PART I, LINE 2: AS THE VISITING NURSE HEALTH SERVICES GAVE FUNDING TO A RELATED ORGANIZATION, VNHS IS ABLE TO MONITOR THE USE AND MAINTAIN RECORDS THAT SUBSTANTIATE THE ASSISTANCE. 0 1 0 0 0 0 0 0 0 JAMES SUMMERFELT PRESIDENT & CEO 0 272679 0 43750 0 1188 0 7950 0 20412 0 345979 0 0 DAVID VANLANDINGHAM CFO 0 137215 0 3000 0 454 0 4238 0 5653 0 150560 0 0 PART I, LINE 3 VISITING NURSE HEALTH SERVICES (VNHS) DOES NOT PAY COMPENSATION TO A CEO OR EXECUTIVE DIRECTOR. VISITING NURSE ASSOCIATION OF THE MIDLANDS (VNAM) PAYS THE COMPENSATION OF JAMES SUMMERFELT WHO SERVES AS THE TOP MANAGEMENT OFFICIAL OF VISITING NURSE HEALTH SERVICES. VNAM UTILIZED THE FOLLOWING FOR DETERMINING HIS COMPENSATION: FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY AND APPROVAL BY THE BOARD. PART I, LINE 4B VISITING NURSE ASSOCIATION OF THE MIDLANDS (VNAM), A RELATED ENTITY, SPONSORED A 457(F) PLAN FOR CERTAIN EXECUTIVES OF THE ORGANIZATION. JAMES SUMMERFELT PARTICIPATED IN THE PLAN. VNAM DID NOT MAKE ANY CONTRIBUTIONS TO THE PLAN DURING 2016. THE PLAN WAS ELIMINATED IN 2016 AND THE BALANCES WERE PAID OUT. JAMES SUMMERFELT RECEIVED A PAYOUT OF $21,961. FORM 990, PART VI, SECTION B, LINE 11B VNHS WILL SHARE THE FORM 990 WITH THE GOVERNING BODY PRIOR TO SUBMISSION. IF A REGULARLY SCHEDULED MEETING DOES NOT OCCUR BEFORE THE FORM 990 DEADLINE FOR SUBMISSION, THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS WILL MEET, REVIEW THE FORM 990, AND RELAY INFORMATION TO THE GOVERNING BODY AT THE NEXT REGULARLY SCHEDULED BOARD MEETING. THE CFO COORDINATES THE PREPARATION OF FORM 990 WITH AN OUTSIDE ACCOUNTING FIRM, AND REVIEWS A DRAFT COPY. THE PRESIDENT / CEO AND THE VICE PRESIDENT FINANCE / CFO WILL PROVIDE FORM 990 TO THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS, OFFICERS AND KEY EMPLOYEES COMPLETE AND SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY. ELECTRONIC COPIES ARE KEPT IN THE ADMINISTRATIVE OFFICE. MEMBERS OF THE BOARD OF DIRECTORS ARE AWARE OF THE POLICY AND EXCUSE THEMSELVES FROM THE VOTE WHEN APPROPRIATE. THE CONFLICT OF INTEREST POLICY STATEMENTS ARE REVIEWED BY THE PRESIDENT AND CEO, WHO MAKES HIMSELF AWARE OF ANY POTENTIAL CONFLICTS THAT MAY ARISE. ALL MEMBERS OF THE BOARD OF DIRECTORS AND LEADERSHIP TEAM COMPLETE AND SIGN CONFLICT OF INTEREST STATEMENTS. BOARD MEMBERS ARE REQUIRED BY THE ORGANIZATION'S BYLAWS TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST OR CONFLICT OF INTEREST TRANSACTIONS TO BE APPROVED BY BOARD VOTE. FORM 990, PART VI, SECTION B, LINE 15A THE CEO IS COMPENSATED THROUGH VISITING NURSE ASSOCIATION OF THE MIDLANDS (VNAM), AN AFFILIATE OF VISITING NURSE HEALTH SERVICES. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS APPROVES THE COMPENSATION FOR THE CEO. SALARY COMPARISONS ARE CONDUCTED WHEN DETERMINED NECESSARY BY THE COMMITTEE; REVIEWS OF A PAID COMPARABILITY STUDY AND COMPARABLE COMPANY FORMS 990 HAVE BEEN COMPLETED IN THE PAST, THE MOST RECENT IN 2016. A PERFORMANCE EVALUATION PROCESS IS COMPLETED ANNUALLY BY THE BOARD OF DIRECTORS AND THE EXECUTIVE COMMITTEE MAKES THE FINAL DETERMINATION ON THE CEO'S SALARY BASED ON THE EVALUATION PROCESS. ALL DISCUSSIONS ARE RECORDED IN COMMITTEE MINUTES. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION B; FORM 990 PART VIII; AND FORM 990 PART IX: VISITING NURSE HEALTH SERVICES (VNHS) SHARES ITS FACILITY, ITS EMPLOYEES AND OTHER EXPENSES WITH FOUR RELATED ORGANIZATIONS: VISITING NURSE ASSOCIATION OF THE MIDLANDS, VISITING NURSE FOUNDATION, VISITING NURSE ASSOCIATION OF POTTAWATTAMIE COUNTY AND EASTER SEAL SOCIETY OF NEBRASKA, INC. VNHS RECEIVES MANAGEMENT FEES AND EXPENSE SHARING FEES FROM THOSE ORGANIZATIONS AND ALSO PAYS MANAGEMENT FEES TO THOSE ORGANIZATIONS. FEES RECEIVED ARE REPORTED ON PART VIII, LINE 2 AND FEES PAID ARE REPORTED ON PART IX, LINE 11A. AS THE FEES ARE PAID TO A RELATED OPERATING CHARITABLE ENTITY, THE MANAGEMENT FEES PAID ARE NOT REPORTED AS AN INDEPENDENT CONTRACTOR PAYMENT ON PART VII, SECTION B. FORM 990, PART XI, LINE 2C: THE FINANCE AND AUDIT COMMITTEE IS RESPONSIBLE FOR EVALUATION AND OVERSIGHT OF THE FINANCIAL NEEDS AND STATUS OF THE VNA AND FOR THE ESTABLISHMENT AND REVIEW OF POLICIES DESIGNED TO MEET SUCH NEEDS. THE COMMITTEE REVIEWS AND RECOMMENDS APPROVAL OF THE ANNUAL OPERATING AND CAPITAL BUDGETS, REVIEWS AND RECOMMENDS APPROVAL TO THE VNA BOARD MONTHLY FINANCIAL PROGRESS AS REPORTED BY STAFF TOWARDS ANNUAL BUDGET PLANS, ENSURES ACCURACY OF FINANCIAL REPORTING INCLUDING MONITORING OF INTERNAL CONTROLS, OVERSEES THE ACCOUNTING AND FINANCIAL REPORTING PROCESS AND THE INDEPENDENT AUDIT OF THE FINANCIAL STATEMENTS AND SELECTS, OVERSEES AND COMPENSATES THE EXTERNAL AUDITORS. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. VISITING NURSE ASSOCIATION OF THE MIDLANDS 12565 WEST CENTER ROAD STE 100 OMAHA NE 68144 470690207 HOME CARE, HOSPICE, PHARMACY NE 501(C)(3) LINE 7 VISITING NURSE HEALTH SERVICES 1 VISITING NURSE FOUNDATION 12565 WEST CENTER ROAD STE 100 OMAHA NE 68144 470690846 FUNDRAISING, INVESTMENTS NE 501(C)(3) LINE 12A, I VISITING NURSE HEALTH SERVICES 1 VISITING NURSE ASSOCIATION OF POTTAWATTAMIE COUNTY 822 S MAIN STE 102 COUNCIL BLUFFS IA 51503 420681048 HOME CARE, PUBLIC HEALTH IA 501(C)(3) LINE 7 VISITING NURSE HEALTH SERVICES 1 EASTER SEAL SOCIETY OF NEBRASKA INC 12565 WEST CENTER ROAD STE 100 OMAHA NE 68144 470457872 DISABILITY ASSISTANCE NE 501(C)(3) LINE 7 VISITING NURSE HEALTH SERVICES 1 0 1 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 VISITING NURSE ASSOCIATION OF THE MIDLANDS Q 619525 FAIR MARKET VALUE VISITING NURSE ASSOCIATION OF THE MIDLANDS P 851023 FAIR MARKET VALUE VISITING NURSE ASSOCIATION OF THE MIDLANDS B 156308 FAIR MARKET VALUE VISITING NURSE FOUNDATION C 58314 FAIR MARKET VALUE SCHEDULE R, PAGE 3, PART V, LINE 2 VISITING NURSE HEALTH SERVICES SHARES ITS FACILITY WITH FOUR AFFILIATES, VISITING NURSE ASSOCIATION OF THE MIDLANDS, VISITING NURSE FOUNDATION, VISITING NURSE ASSOCIATION OF POTTAWATTAMIE COUNTY AND EASTER SEAL SOCIETY OF NEBRASKA, INC. USE OF THE FACILITY BY THE FOUR ORGANIZATIONS OVERLAPS. THEREFORE, IT IS DIFFICULT TO QUANTIFY THE COST OF THE PORTION USED BY EACH ORGANIZATION.