2017-05-15T13:52:23-05:00 2016-09-30 476097913 SEIM JOHNSON LLP 18081 BURT STREET SUITE 200 OMAHA NE 680224722 990 2015-10-01 470379834 BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER INC BEAT 4022283344 4800 HOSPITAL PARKWAY PO BOX 278 BEATRICE NE 68310 ALAN STREETER CFO 4022283344 2017-05-11 1 MARC D BEHRENS P01543366 4023302660 2015 2021-01-29 14:40:06Z ALAN STREETER 4800 HOSPITAL PARKWAY PO BOX 278 BEATRICE NE 68310 72729613 0 X WWW.BEATRICECOMMUNITYHOSPITAL.COM X 1968 NE BEATRICE COMMUNITY HOSPITAL AND HEALTH CENTER, INC. IS DEDICATED TO BEING THE HEALTHCARE RESOURCE FOR THE COMMUNITIES WE SERVE BY PROVIDING QUALITY SERVICES AND COMPASSIONATE CARE. OUR VISION STATEMENT IS: TO BE THE TRUSTED CHOICE FOR EXEMPLARY, COMPASSIONATE, PATIENT-AND-FAMILY-CENTERED HEALTHCARE FOR BEATRICE AND THE COMMUNITIES WE SERVE. 15 12 594 60 156294 146351 195590 188592 70184298 71743563 86617 78922 605740 718536 71072245 72729613 251106 169489 0 0 38826040 39090956 0 0 0 29358142 31924970 68435288 71185415 2636957 1544198 94042491 93610376 50294602 48354689 43747889 45255687 X BEATRICE COMMUNITY HOSPITAL AND HEALTH CENTER IS DEDICATED TO BEING THE HEALTHCARE RESOURCE FOR THE COMMUNITIES WE SERVE BY PROVIDING QUALITY SERVICES AND COMPASSIONATE CARE. 0 0 45563886 56458707 HOSPITAL INPATIENT AND OUTPATIENT CARE: SERVICES INCLUDE ANCILLARY AND ACUTE CARE ALONG WITH SERVING AS A CLINICAL EDUCATION SITE FOR STUDENTS FOR AREAS INVOLVING THE PHYSICAL THERAPY DEPARTMENT, THE EMERGENCY DEPARTMENT, THE SPEECH PATHOLOGY DEPARTMENT, THE OCCUPATIONAL THERAPY DEPARTMENT AND THE NURSING DEPARTMENT. 11149857 9478248 PHYSICIAN CLINICS: SERVICES INCLUDE ACUTE CARE SERVICES AS WELL AS PROVIDING SPORTS PHYSICALS FOR LOCAL HIGH SCHOOL ATHLETES AND FOR PARTICIPANTS IN THE SPECIAL OLYMPICS. 2352252 2484254 HOSPICE/LONG-TERM CARE: SERVICES INCLUDE CARE-TAKING FOR THE ELDERLY ALONG WITH PROVIDING A GRIEF RECOVERY PROGRAM FOR THOSE PEOPLE WHO HAVE LOST A LOVED ONE TO DEATH.HOME HEALTH IS AVAILABLE FOR PEOPLE OF ALL AGES, ASSISTING THEM IN THE RECOVERY AND REHABILITATION FROM ALL TYPES OF ILLNESS, INJURIES AND OTHER HEALTH PROBLEMS. SKILLED INTERMITTENT HOME CARE THAT IS PHYSICIAN ORDERED IS PROVIDED BY REGISTERED NURSES, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPISTS AND NURSE AIDES. AREAS SERVED INCLUDE: GAGE, JEFFERSON, PAWNEE AND SALINE COUNTIES. 413973 169489 3468320 OTHER PROGRAM 413973 169489 3468320 59479968 1 1 0 1 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 21 0 1 594 1 1 1 0 0 0 0 0 0 0 0 0 X 15 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X ALAN STREETER CFO 4022283344 4800 HOSPITAL PARKWAY PO BOX 278 BEATRICE NE 68310 MITCHELL DEINES CHAIRMAN 5.00 2.00 X X 0 0 0 LARRY THIMM VICE CHAIRMAN 4.00 2.00 X X 0 0 0 LEROY JANZEN SECRETARY 4.00 1.00 X X 0 0 0 JAMES ENSZ TREASURER 4.00 2.00 X X 0 0 0 CHRISTINE BECKMAN LMT MEMBER 2.00 0.00 X 0 0 0 BLAKE BUTLER MD MEMBER 40.00 0.00 X 492761 0 40407 BARBARA JOHNSEN CPA MEMBER 2.00 0.00 X 0 0 0 STEPHANIE PERKINS MEMBER 2.00 0.00 X 0 0 0 BOB REED MEMBER 2.00 0.00 X 0 0 0 ERIC THOMSEN MD MEMBER 40.00 0.00 X 250834 0 39089 VERDELLA VETROVSKY MEMBER 2.00 0.00 X 0 0 0 DR BRENDA MCNIFF MEMBER 2.00 0.00 X 0 0 0 DR STEVE SANDMAN MEMBER 2.00 1.00 X 0 0 0 BRUCE VITOSH MEMBER 2.00 0.00 X 0 0 0 JIM BAUER MEMBER 2.00 1.00 X 0 0 0 THOMAS SOMMERS CEO 36.00 4.00 X 387198 0 39941 ALAN STREETER CFO 36.00 4.00 X 167503 0 39587 DR JOHN FINDLEY CMO 40.00 0.00 X 289547 0 29569 DEREK WEICHEL MD PHYSICIAN 40.00 0.00 X 626614 0 47677 RONALD BEAR MD PHYSICIAN 40.00 0.00 X 430530 0 27775 PAUL ZUERCHER PHYSICIAN 40.00 0.00 X 399233 0 45216 BRETT STUDLEY MD PHYSICIAN 40.00 0.00 X 369466 0 47766 AMANDA LOEFFLER PHYSICIAN 40.00 0.00 X 350212 0 23195 3763898 0 380222 56 0 1 0 CASPERS CONSTRUCTION 800 S 10TH ST BEATRICE NE 68310 CONSTRUCTION 4010356 AOSNC LLC 9140 W DODGE RD OMAHA NE 68114 CONSTRUCTION 302970 GE HEALTHCARE CAMDEN GROUP 29 NORTH WACKER DRIVE SUITE 1010 CHICAGO IL 60606 HEALTHCARE CONSULTING 293748 GREENWAY MEDICAL TECHNOLOGIES INC 4301 W BOY SCOUT BLVD SUITE 800 TAMPA FL 33607 HEALTHCARE CONSULTING 285110 MEDICAL SOLUTIONS 1010 N 102ND ST 300 OMAHA NE 68114 MEDICAL STAFFING 239286 18 153492 35100 188592 PATIENT SERVICE - PRIVATE PAY 621110 36671886 36671886 PATIENT SERVICE - MEDICARE & MEDI 621110 31749323 31749323 340B PROGRAM REVENUE 621300 2548260 2548260 PHARMACY REVENUE 621300 312093 312093 MANAGEMENT FEES 561000 177392 177392 284609 284609 71743563 72156 72156 62328 0 62328 62328 62328 6766 0 6766 6766 6766 CAFETERIA REVENUE 722210 304979 304979 MHR HOME CARE LLC 446199 156294 156294 PURCHASE DISCOUNTS 900099 145966 145966 48969 48969 656208 72729613 71889529 156294 495198 169489 169489 1776436 857700 918736 46177 46177 29837804 26318244 3519560 1497975 1307999 189976 3970569 3349334 621235 1961995 1689750 272245 78565 78565 18429 18429 5056051 2873558 2182493 305109 126794 178315 3323624 2639418 684206 1521897 57405 1464492 1170216 1145509 24707 149626 146231 3395 379693 268360 111333 2224885 1933318 291567 5859797 5091881 767916 244759 233016 11743 INCOME TAXES 70476 70476 MEDICAL SUPPLIES 8236858 8236858 BAD DEBTS 2791686 2791686 LICENSES & DUES 279536 123965 155571 213763 73276 140487 71185415 59479968 11705447 0 1065 1218 25563375 26318753 10355379 9576399 34583 144416 2336506 2418357 947988 1024484 92635893 46518107 46693956 46117786 5003575 4663074 486895 452418 2619169 2893471 94042491 93610376 9219631 8735632 41074971 39619057 50294602 48354689 X 43477070 45029768 270819 225919 43747889 45255687 94042491 93610376 X 1544198 8500 -44900 X X 1 X 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 6116 6116 0 PART II-B, LINE 1: BCH IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION(AHA) AND THE NEBRASKA HOSPITAL ASSOCIATION(NHA). FOR 2016, THE AHA AND NHA HAVE ESTIMATED THAT 22.80% AND 11.36%, RESPECTIVELY, OF MEMBERSHIP DUES WILL BE USED FOR LOBBYING ACTIVITIES. 1450952 30600 132222 39164 1574610 1334989 186851 -27545 43343 1450952 1288188 46801 1334989 1184704 103484 1288188 1017976 5955 160773 1184704 0.80170 0.17250 0.02580 0 1 1 901362 901362 29425438 10464234 18961204 56679301 34402231 22277070 270389 5359403 1651642 3978150 46117786 X 69901527 8500 -44900 -36400 69937927 2791686 2791686 72729613 68393729 0 68393729 2791686 2791686 71185415 PART V, LINE 4: THE ENDOWMENT FUNDS ARE HELD BY BEATRICE COMMUNITY HOSPITAL FOUNDATION, INC., A SUPPORTING ORGANIZATION OF BEATRICE COMMUNITY HOSPITAL AND HEALTH CENTER. THESE FUNDS ARE BEING HELD TO PROVIDE HEALTH PROFESSIONAL SCHOLARSHIPS AND SUPPORT THE BEATRICE COMMUNITY HOSPITAL HOSPICE PROGRAM, CAPITAL IMPROVEMENTS AND SPIRITUAL LIFE. PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPITAL HAS 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. IN GENERAL, SUCH STANDARDS REQUIRE THE HOSPITAL TO MEET A COMMUNITY BENEFIT STANDARD AND COMPLY WITH VARIOUS LAWS AND REGULATIONS. THE HOSPITAL ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDENCE INCLUDED IN TOPIC 740 OF THE ACCOUNTING STANDARDS CODIFICATION, INCOME TAXES. THE HOSPITAL RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT SEPTEMBER 30, 2016 AND 2015, THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS ACCRUED. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN INTEREST IN BEATRICE COMMUNITY HOSPITAL FOUNDATION -44,900. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 2,791,686. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS 2,791,686. 1 1 1 X 1 X 1 1 1 0 1 1 930699 0 930699 0.01360 6565742 5671507 894235 0.01310 7496441 5671507 1824934 0.02670 3443001 0 3443001 0.05030 486998 0 486998 0.00710 3929999 3929999 0.05740 11426440 5671507 5754933 0.08410 1 2791686 0 21917521 21731229 186292 X 1 1 1 1 BEATRICE COMMUNITY HOSPITAL AND HEALTH C 4800 HOSPITAL PARKWAY BEATRICE NE 683106906 WWW.BEATRICECOMMUNITYHOSPITAL.COM H000119 X X X X BEATRICE COMM HOSP & HEALTH CENTER INC 1 0 0 0 1 1 50000 1 X 200.000000000000 200.000000000000 X X X X X 1 1 X X X 1 X HTTP://WWW.BEATRICECOMMUNITYHOSPITAL.COM X HTTP://WWW.BEATRICECOMMUNITYHOSPITAL.COM X HTTP://WWW.BEATRICECOMMUNITYHOSPITAL.COM X X X X X 1 X 0 X X X X X 1 X 0 0 BEATRICE COMM HOSP & HEALTH CENTER, INC. PART V, SECTION B, LINE 13H: OTHER PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE INCLUDE: - MEDICAID PATIENTS ARE CONSIDERED PRE-ENROLLED FOR FINANCIAL ASSISTANCE. HOWEVER, A COMPLETED APPLICATION IS REQUIRED FOR DETERMINATION OF POSSIBLE COPAYMENTS; - PATIENTS INELIGIBLE FOR ANY GOVERNMENT HEALTH CARE PROGRAM ETC.TO QUALIFY FOR ASSISTANCE, ELIGIBLE PATIENTS MUST COMPLETE AN APPLICATION BY THE LATER OF THE 240TH DAY AFTER THE FIRST POST DISCHARGE BILLING STATEMENT IS PROVIDED TO THE PATIENT OR NOT LESS THAN 30 DAYS AFTER THE DATE THE HOSPITAL PROVIDES THE PATIENT THE REQUIRED FINAL NOTICE TO COMMENCE EXTRAORDINARY COLLECTION ACTIONS. BEATRICE COMM HOSP & HEALTH CENTER, INC. PART V, SECTION B, LINE 16I: OTHER MEASURES TO PUBLICIZE THE FINANCIAL ASSISTANCE POLICY INCLUDE:- THE POLICY WILL BE INCLUDED WITH INFORMATION IN OR ON THE BILLING STATEMENTS;- THE POLICY INFORMATION WILL BE DISTRIBUTED AT THE PATIENT ACCESS POINTS;- THE POLICY WILL BE PRESENTED TO THE PATIENT AS THEY PRESENT FOR MEDICAL SERVICES, INCLUDING ADMISSION;- THE POLICY WILL BE DISTRIBUTED IN INFORMATION WITH DISCHARGE MATERIALS;- THE POLICY WILL BE MENTIONED WHEN DISCUSSING AN INDIVIDUAL'S BILL OVER THE TELEPHONE. BEATRICE COMM HOSP & HEALTH CENTER, INC. PART V, SECTION B, LINE 20E: ONCE A DETERMINATION OF FINANCIAL ASSISTANCE HAS BEEN AUTHORIZED, PATIENT FINANCIAL SERVICES WILL MAIL A LETTER TO THE INDIVIDUAL INDICATING THE FINANCIAL ASSISTANCE AMOUNT WITH ANY REMAINING BALANCE DUE OR REFUND FOR ANY EXCESS PAYMENTS. THE FINANCIAL ASSISTANCE DETERMINATION MAY TAKE UP TO 180 DAYS OVER THE COURSE OF TREATMENT FOR WHICH FINANCIAL ASSISTANCE WAS ORIGINALLY SOUGHT, UNLESS THERE IS A CHANGE IN THE FINANCIAL OR MARITAL STATUS OF THE INDIVIDUAL. BEATRICE COMM HOSP & HEALTH CENTER, INC. PART V, SECTION B, LINE 22D: THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FAP ELIGIBLE INDIVIDUALS WILL NOT BE MORE THAN THE AMOUNT GENERALLY BILLED (AGB) TO THOSE WHO HAVE INSURANCE COVERAGE. THE HOSPITAL DETERMINES AGB BY MULTIPLYING THE GROSS CHARGES FOR CARE PROVIDED TO PATIENTS BY THE AGB PERCENTAGE. THE HOSPITAL HAS ELECTED TO USE THE LOOK-BACK METHOD IN WHICH THE AGB PERCENTAGE IS BASED ON MEDICARE FEE FOR SERVICE AND ALL PRIVATE INSURANCE AS PRIMARY PAYER. THE AGB IS UPDATED ANNUALLY. PART V, SECTION B, LINE 3 AND 12A: DISCLOSURE AND CORRECTION OF FAILURE TO MEET IRC SECTION 501(R)(3) REQUIREMENTS, PURSUANT TO REV. PROC. 2015-21: THE BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC. (THE HOSPITAL) FAILED TO COMPLETE A CHNA REPORT AND APPROVE AN IMPLEMENTATION PLAN AS REQUIRED UNDER IRC SEC. 501(R)(3) FOR ITS HOSPITAL FACILITY LOCATED AT 4800 HOSPITAL PARKWAY, BEATRICE, NE 68310-6906. THE HOSPITAL LAST COMPLETED A CHNA REPORT AND APPROVED AN IMPLEMENTATION PLAN DURING ITS 2012 TAX YEAR, FISCAL YEAR ENDING SEPTEMBER 30, 2013. THEREFORE, UNDER IRC SEC. 501(R)(3) THE HOSPITAL WAS REQUIRED TO COMPLETE A NEW CHNA REPORT AND APPROVE AN IMPLEMENTATION PLAN DURING THE 2015 TAX YEAR; FISCAL YEAR ENDING SEPTEMBER 30, 2016. THE CHNA REPORT WAS REQUIRED TO BE COMPLETED BY SEPTEMBER 30, 2016 AND THE IMPLEMENTATION PLAN WAS REQUIRED TO BE APPROVED BY AN AUTHORIZED GOVERNING BODY BY FEBRUARY 15, 2017, HOWEVER DUE TO SEVERAL UNFORESEEN CIRCUMSTANCES NEITHER THE CHNA REPORT NOR THE IMPLEMENTATION PLAN WAS COMPLETE BY THEIR APPLICABLE DUE DATES.THE FAILURE TO MEET THE REQUIREMENTS OF IRC SEC. 501(R)(3) WAS DUE TO UNFORESEEN CIRCUMSTANCES OUTSIDE THE CONTROL OF THE HOSPITAL MANAGEMENT. THE HOSPITAL INTENDED TO COMPLETE THE CHNA AND IMPLEMENTATION PLAN DURING THE 2015 TAX YEAR. THE HOSPITAL BEGAN WORKING ON A NEW STRATEGIC PLAN, WHICH WOULD BE FOLLOWED BY A NEW CHNA, IN EARLY 2015. THIS PROJECT WAS HALTED IN MARCH OF 2015 WHEN THE HOSPITAL'S CEO, THOMAS SOMMERS, TOOK A MEDICAL LEAVE OF ABSENCE. MR. SOMMERS RETURNED FOR A BRIEF PERIOD IN JUNE OF 2015, BUT THEN TOOK MEDICAL LEAVE AGAIN UNTIL JANUARY 2016. DURING MR. SOMMERS'S ABSENCE, SENIOR LEADERSHIP TRIED TO CONTINUE THE STRATEGIC PLANNING PROCESS, BUT DUE TO THE UNCERTAINTY OF THE LEADERSHIP AND STRATEGIC DIRECTION OF THE HOSPITAL IT WAS DETERMINED THAT CONTINUING WOULD NOT BE PRACTICAL UNTIL MR. SOMMERS RETURNED OR THE LEADERSHIP WAS DEFINED.MR. SOMMERS RESUMED HIS POSITION AS HOSPITAL CEO IN JANUARY 2016. ON JANUARY 26, 2016, THE BOARD APPROVED A CONTRACT WITH AN OUTSIDE SERVICE PROVIDER, GE HEALTHCARE/CAMDEN GROUP, FOR STRATEGIC PLANNING SERVICES. THE CONTRACT WITH THE SERVICE PROVIDER CALLED FOR A TIMELINE OF 18-20 WEEKS TO COMPLETE THE STRATEGIC PLANNING ONCE THE ENGAGEMENT WAS STARTED. AT THAT POINT, THE TIMING OF COMPLETING THE CHNA WAS PENDING, AS THE CHNA COULD NOT BEGIN UNTIL THE BOARD HAD APPROVED THE NEW STRATEGIC PLAN. A FEW MONTHS PASSED BEFORE THE SERVICE PROVIDER BEGAN THE STRATEGIC PLANNING ENGAGEMENT.THE STRATEGIC PLANNING RESUMED IN JUNE OF 2016, BUT WAS NOT FINALIZED AND APPROVED BY THE HOSPITAL BOARD UNTIL JANUARY 2017. THE GE HEALTHCARE/CAMDEN GROUP WAS ENGAGED AND BEGAN WORK ON THE CHNA IMMEDIATELY AFTER THE STRATEGIC PLAN'S BOARD APPROVAL. THE TIMELINE WAS TO HAVE THE CHNA COMPLETED BY MAY 15, 2017; THE DATE MANAGEMENT BELIEVED THE CHNA WAS REQUIRED TO BE COMPLETED IN ORDER TO BE IN COMPLIANCE WITH IRC SEC. 501(R)(3). MANAGEMENT WAS NOTIFIED IN APRIL 2017 BY THE HOSPITAL'S ACCOUNTING FIRM DURING PREPARATION OF THE 2015 FORM 990 OF THE CORRECT DEADLINES FOR COMPLETION OF THE CHNA AND IMPLEMENTATION PLAN, AND THAT THE HOSPITAL WAS NOT IN COMPLIANCE.AFTER BEING NOTIFIED OF THIS FAILURE BY THE ACCOUNTING FIRM, MANAGEMENT IMMEDIATELY BEGAN WORKING TO FINALIZE THE CHNA AS SOON AS POSSIBLE. THE CHNA AND APPROVED IMPLEMENTATION PLAN WERE COMPLETED ON MAY 4, 2017, THE DATE THE FINAL REPORTS WERE MADE WIDELY AVAILABLE TO THE PUBLIC ELECTRONICALLY ON THE HOSPITAL'S WEBSITE AND IN PAPER FORM AT THE HOSPITAL FACILITY. MANAGEMENT IS NOW AWARE OF THE NECESSARY TIMING FOR FUTURE CHNA REPORTS AND APPROVED IMPLEMENTATION PLANS TO BE CONSIDERED COMPLETE WITH REGARD TO A CERTAIN TAX YEAR. THE HOSPITAL WILL ADD WRITTEN IRC SEC. 501(R) COMPLIANCE PROCEDURES THAT WILL INSURE PROPER TIMING OF THE CHNA AND IMPLEMENTATION PLAN IN FUTURE TAX YEARS. THE HOSPITAL IS AWARE THAT A CHNA MUST BE CONDUCTED ONCE EVERY THREE TAX YEARS AND HAS ADJUSTED ITS SCHEDULES TO ENSURE THE HOSPITAL IS IN COMPLIANCE GOING FORWARD. THE HOSPITAL IS DISCLOSING THIS IRC SEC. 501(R)(3) COMPLIANCE FAILURE IN ACCORDANCE WITH REV. PROC. 2015-21. IT HAS CORRECTED THIS FAILURE AS PROVIDED IN REV. PROC. 2015-21 AND IT WILL BE IN COMPLIANCE FOR THE 2016, 2017 AND 2018 TAX YEARS. THE NEXT YEAR A CHNA AND IMPLEMENTATION PLAN ARE REQUIRED TO BE COMPLETED IS THE 2019 TAX YEAR; THREE YEARS AFTER THE CHNA AND IMPLEMENTATION PLAN COMPLETION IN THE 2016 TAX YEAR. THE CHNA REPORT MUST BE COMPLETED BY SEPTEMBER 30, 2020 AND THE IMPLEMENTATION PLAN MUST BE APPROVED AND WIDELY AVAILABLE BY FEBRUARY 15, 2021. 5 1 - THE BEATRICE WOMEN'S & CHILDREN'S CLINIC 4800 HOSPITAL PARKWAY PO BOX 278 BEATRICE NE 68310 OUTPATIENT OB/GYN CLINIC 2 - WYMORE MEDICAL CLINIC 116 EAST H STREET WYMORE NE 68318 OUTPATIENT PHYSICIAN CLINIC 3 - GAGE COUNTY MEDICAL CLINIC 1101 N 10TH STREET BEATRICE NE 68310 OUTPATIENT PHYSICIAN CLINIC 4 - BEATRICE MEDICAL CENTER 805 W COURT STREET BEATRICE NE 68310 OUTPATIENT PHYSICIAN CLINIC 5 - BEATRICE INTERNAL MEDICINE 4800 HOSPITAL PARKWAY PO BOX 278 BEATRICE NE 68310 OUTPATIENT PHYSICIAN CLINIC PART I, LINE 3C: FEDERAL POVERTY GUIDELINES ARE USED TO DETERMINE ELIGIBILITY FOR PROVIDING FREE AND DISCOUNTED CARE TO LOW INCOME INDIVIDUALS. PART I, LINE 6A: BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER INC.'S COMMUNITY BENEFIT REPORT IS NOT PREPARED BY A RELATED ORGANIZATION. PART I, LINE 7: THE COST TO CHARGE RATIO WAS USED TO DETERMINE CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS AT COST. OTHER COMMUNITY BENEFIT EXPENSES ARE STATED AT COST AS DERIVED FROM BEATRICE COMMUNITY HOSPITAL AND HEALTH CENTER'S INTERNAL ACCOUNTING RECORDS. PART I, LINE 7G: AS THERE ARE NO SUBSIDIZED HEALTH SERVICES REPORTED ON LINE 7G, THERE ARE NO COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC ON LINE 7G. PART I, LN 7 COL(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 $2,791,686. PART II, COMMUNITY BUILDING ACTIVITIES: NOT APPLICABLEOUR MOST SIGNIFICANT "COMMUNITY BENEFIT" ACTIVITIES WOULD INCLUDE:1. READY, SET, GO! BACK-TO-SCHOOL PROGRAM. BCHHC PARTNERS WITH THE BEATRICE SALVATION ARMY TO PROVIDE A VARIETY OF FREE SERVICES AND ITEMS TO MEET THE BACK-TO-SCHOOL NEEDS OF LOW-INCOME GAGE COUNTY RESIDENTS. DURING THIS EVENT, FAMILIES CAN RECEIVE FREE SCHOOL PHYSICALS, A PACKAGE OF PERSONAL CARE ITEMS LIKE A TOOTHBRUSH AND TOOTHPASTE, AND A BACKPACK WITH SCHOOL SUPPLIES. IN ADDITION, THERE ARE EDUCATIONAL BOOTHS ON NUTRITION AND DIABETES AS WELL AS INFORMATIONAL BOOTHS BY ORGANIZATIONS SUCH AS BOY SCOUTS AND GIRL SCOUTS.2. JOB SHADOWING. BCHHC OFFERS AN EXTENSIVE JOB SHADOWING PROGRAM THAT ALLOWS UPPER HIGH SCHOOL AND COLLEGE-AGED STUDENTS TO SHADOW PHYSICIANS AND CLINICAL STAFF IN ANY DEPARTMENT FOR A FIRST-HAND LOOK AT HEALTH-RELATED CAREERS. 3. PEOPLE CARING FOR PEOPLE. PEOPLE CARING FOR PEOPLE IS A FREE HOSPITAL SERVICE THAT SENDS A REGISTERED NURSE TO THE HOMES OF ALL NEWBORNS IN THE COUNTY TO ENSURE THAT NEWBORNS ARE THRIVING IN THE HOME AND PARENTS CAN ASK QUESTIONS AND LEARN ABOUT RESOURCES IN THE COMMUNITY. PART III, LINE 4: THE HOSPITAL'S FINANCIAL STATMENTS DO NOT CONTAIN A SPECIFIC FOOTNOTE DESCRIBING BAD DEBT. HOWEVER, PAGES 8 AND 10 OF THE ATTACHED FINANCIAL STATEMENTS INCLUDE FOOTNOTES TITLED "PATIENT RECEIVABLES, NET," "NET PATIENT SERVICE REVENUE AND "CHARITY CARE". PART III, LINE 8: "MEDICARE ALLOWABLE COSTS OF CARE" WAS CALCULATED FROM INFORMATION IN THE MEDICARE COST REPORT, D, E, H AND M WORKSHEETS, OR PS&R. PART III, LINE 9B: CHARITY CARE DOCUMENTS AND EDUCATION ARE PROVIDED AT THE POINTS OF REGISTRATION (I.E., ED AND OUTPATIENT). INFORMATION RELATED TO AVAILABILITY IS IDENTIFIED ON THE MONTHLY STATEMENTS. THE PATIENT ACCOUNT REPRESENTATIVES FOR "SELF PAY" PATIENTS NOTIFY THE PATIENT/GUARANTOR DURING COLLECTION CALLS OF THE AVAILIBILITY OF FINANCIAL ASSISTANCE. THE FINANCIAL ASSISTANCE POLICY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE AVAILABLE ON THE WEBSITE.THE COLLECTIONS - CHARITY WRITE-OFF POLICY PROVIDES THAT ONCE THE RESPONSIBLE PARTY HAS BEEN DETERMINED TO BE ELIGIBLE FOR PATIENT FINANCIAL ASSISTANCE, A LETTER TO THE RESPONSIBLE PARTY WILL BE SENT INDICATING THE FREE CARE AMOUNT AND THE REMAINING BALANCE DUE. THE BALANCE DUE MAY BE PAID BY INSTALLMENT PAYMENTS USING THE GUIDELINES OF THE HOSPITAL POLICY ON COLLECTIONS OF PRIVATE PAY ACCOUNTS. PART VI, LINE 2: THE DEMAND ANALYSIS PERFORMED BEGINS WITH THE ASSUMPTION THE HISTORICAL TRENDS WILL BE CONTINUED BUT AUGMENTED BY INCREASED GROWTH IN INPATIENT AND OUTPATIENT SERVICES. THE FOLLOWING ARE ELEMENTS OF PLANNING USED BY MANAGEMENT IN FORMULATING THE DEMAND FOR HOSPITAL SERVICES:- MARKET ASSESSMENT OF OTHER HEALTHCARE PROVIDERS WITHIN THE SERVICE AREA- HISTORIC AND FORECASTED INPATIENT AND OUTPATIENT UTILIZATION WITH THE SERVICE AREA- MARKET SHARE BY SERVICE AND HOSPITAL USE RATES- SERVICE AREA USE RATES- HOSPITAL'S MEDICAL STAFF PART VI, LINE 3: CHARITY CARE DOCUMENTS AND EDUCATION ARE PROVIDED AT THE POINTS OF REGISTRATION (I.E., ED AND OUTPATIENT). INFORMATION RELATED TO AVAILABILITY IS IDENTIFIED ON THE MONTHLY STATEMENTS. THE PATIENT ACCOUNT REPRESENTATIVES FOR "SELF-PAY" PATIENTS NOTIFY THE PATIENT/GUARANTOR DURING COLLECTION CALLS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. THE FINANCIAL ASSISTANCE POLICY AND APPLICATION FOR FINANCIAL ASSISTANCE ARE AVAILABLE ON THE WEBSITE. PART VI, LINE 4: BEATRICE, NE IS LOCATED IN GAGE COUNTY IN THE SOUTHEASTERN PART OF NEBRASKA. BEATRICE IS LOCATED 40 MILES SOUTH OF LINCOLN, NE. THE CLOSEST HOSPITAL FACILITY IS 32 MILES WEST. THE MAIN COMPETITION IS FROM TWO LINCOLN, NE HOSPITALS. THE PRIMARY SERVICE AREA (PSA) HAS BEEN DEFINED AS BEATRICE/ZIP CODE 68310 COUNTY AND HAS AN AGING POPULATION THAT UTILIZES HOSPITAL HEALTH SERVICES. THE AGE GROUP OF 65 AND OVER COMPRISES 20% OF THE TOTAL POPULATION OF THE PSA FOR THE HOSPITAL IN 2008 AND THAT AGE DEMOGRAPHIC IS PROJECTED TO INCREASE TO 21% IN THE NEXT TEN YEARS. PART VI, LINE 5: BEATRICE COMMUNITY HOSPITAL BUDGETS ANNUALLY SALARY EXPENSES OF APPROXIMATELY $45,000 FOR WELLNESS PROGRAMS TO BENEFIT THE HEALTH-RELATED PROGRAMS SPONSORED BY THE HOSPITAL AND OTHER ORGANIZATIONS IN THE COMMUNITY. THE HOSPITAL SPONSORS AN ANNUAL HEALTH FAIR EVERY SPRING WITH FREE OR REDUCED COST SCREENINGS AND A VARIETY OF EDUCATIONAL BOOTHS BY HOSPITAL DEPARTMENTS AND COMMUNITY PARTNERS.A FREE DIABETES HEALTH FAIR FOR THE COMMUNITY IS HELD IN THE FALL. DIABETES EDUCATORS PROVIDE EDUCATIONAL PROGRAMS, ALONG WITH FREE SCREENINGS.FREE ONGOING EDUCATIONAL PROGRAMS ON HEALTH TOPICS, KNOWN AS HEALTHY CONNECTIONS, ARE HELD THROUGHOUT THE YEAR FEATURING TOPICS SUCH AS DIABETES, NUTRITION, HEART DISEASE AND MEDICARE.EVENING IN PINK IS AN ANNUAL EDUCATIONAL AND FELLOWSHIP PROGRAM HELD IN OCTOBER TO RAISE AWARENESS ABOUT BREAST CANCER. IN ADDITION, THE HOSPITAL PARTICIPATES IN THE ANNUAL AMERICAN CANCER SOCIETY RELAY FOR LIFE EVENT BY SERVING A FREE MEAL TO ALL PARTICIPATING CANCER SURVIVORS TO KICK OFF THE RELAY EVENT.PEOPLE CARING FOR PEOPLE PROVIDES IN-HOME ASSESSMENTS AND EDUCATIONAL RESOURCES TO EACH FAMILY WITH A NEWBORN THAT RESIDES IN GAGE COUNTY. THE HOME VISITATION PROGRAM PROMOTES POSITIVE PARENTING SKILLS.A PARTNERSHIP OF BEATRICE COMMUNITY HOSPITAL, THE SALVATION ARMY AND THE BEATRICE COMMUNITY HOSPITAL FOUNDATION, ALONG WITH SERVICE ORGANIZATION DONATIONS, SPONSOR READY, SET, GO!, AN ANNUAL BACK-TO-SCHOOL PROGRAM. SOME OF THE ITEMS GIVEN AWAY INCLUDE: A BOOK BAG, SCHOOL SUPPLIES, SHAMPOO, SOAP, SCHOOL PHYSICALS, HAIRCUT VOUCHERS, CLOTHING VOUCHERS, SHOE DISCOUNT COUPONS, HEALTH INFORMATION AND MORE.FLU AND PNEUMONIA SHOT CLINICS ARE PROVIDED TO RESIDENTS OF GAGE COUNTY.THE HOSPITAL GIVES AWAY BOTTLES OF WATER AT THE GAGE COUNTY FAIR AND DURING HOMESTEAD DAYS CELEBRATION ACTIVITIES DURING THE SUMMER AS A WAY TO REDUCE DEHYDRATION AND HEALTH-RELATED ISSUES EXPERIENCED BY COMMUNITY MEMBERS DURING THESE HOT SUMMER OUTDOOR ACTIVITIES.CHILD CAR SEAT SAFETY INITIATIVES INCLUDE HAVING LABOR AND DELIVERY AND NURSERY NURSES CERTIFIED IN CHILD CAR SEAT SAFETY. A FREE ANNUAL CHILD CAR SEAT SAFETY EVENT IS HELD FOR COMMUNITY RESIDENTS.HOSPICE CONDUCTS A GRIEF EDUCATION AND SUPPORT PROGRAM FOR THOSE PEOPLE IN THE COMMUNITY WHO HAVE LOST A LOVED ONE TO DEATH. THIS PROGRAM IS HELD ON A QUARTERLY BASIS.AN EDUCATIONAL PROGRAM FOR FIRST-GRADERS IS OFFERED EVERY SPRING. AREA SCHOOLS ARE INVITED TO BRING THEIR FIRST-GRADERS TO THE HOSPITAL TO BECOME FAMILIAR WITH THE HOSPITAL, LEARN ABOUT COMMON CHILDHOOD HEALTH CONCERNS SUCH AS A BROKEN ARM, AND MEET DOCTORS AND NURSES.IN-KIND AND EMPLOYEE SUPPORT WAS GIVEN TO A VARIETY OF LOCAL HEALTHCARE-RELATED ORGANIZATIONS AND ACTIVITIES, SUCH AS UNITED WAY, BEATRICE PUBLIC SCHOOLS BACKPACK PROGRAM, ALZHEIMER'S MEMORY WALK, MOTHER TO MOTHER MINISTRY, PUBLIC HEALTH SOLUTIONS PUBLIC HEALTH DEPARTMENT, GREAT STRIDES FOR CYSTIC FIBROSIS, MOSAIC, BLUE VALLEY BEHAVIORAL HEALTH, WALK TO PREVENT SUICIDE, ETC.THE GAGE COUNTY AMBULANCE SERVICES UTILIZES HOSPITAL STAFF TO TRAIN AND PROVIDE CLINICAL PRACTICUM FOR THE EMT-I AND PARAMEDIC PROGRAM.EMPLOYEES SERVED CANCER SURVIVOR SUPPER AT THE ANNUAL RELAY FOR LIFE EVENT. OTHER EMPLOYEES WORKED WITH THESE ORGANIZATIONS ON BEHALF OF BEATRICE COMMUNITY HOSPITAL: AMERICAN CANCER SOCIETY, UNITED WAY, AMERICAN HEART ASSOCIATION, BEATRICE MARY YMCA, ALZHEIMER'S ASSOCIATION, AMERICAN DIABETES ASSOCIATION, MOTHER TO MOTHER MINISTRY AND OTHER PROFESSIONAL ORGANIZATIONS.THE HOSPITAL SPONSORS AN INFORMATIONAL RADIO PROGRAM THAT COVERS GENERAL HEALTHCARE TOPICS OF INTEREST TO THE COMMUNITY, SUCH AS ORGAN DONATION, STRESS DURING THE HOLIDAYS, DIABETES, NUTRITION, ETC.THE HOSPITAL WORKS WITH COLLEGES AND UNIVERSITIES TO SERVE AS A TRAINING SITE FOR NURSING AND OTHER HEALTH-CARE RELATED JOBS. THE HOSPITAL HAS AN EXTENSIVE JOB SHADOWING PROGRAM FOR HIGH SCHOOL AND COLLEGE STUDENTS INTERESTED IN HEALTHCARE. THE HOSPITAL IS A CERTIFIED AMERICAN HEART ASSOCIATION TRAINING SITE, AND PROVIDES CPR AND OTHER TRAINING TO LOCAL BUSINESSES AND EMERGENCY SERVICES. STAFF ALSO PARTICIPATE IN TEACHING HANDS ONLY CPR TO FIFTH-GRADERS AT THE ANNUAL PROGRESSIVE AGRICULTURE SAFETY DAY.THE CHIEF COMPLIANCE OFFICER SERVES ON THE BOARD OF DIRECTORS FOR THE 5-COUNTY DISTRICT PUBLIC HEALTH DEPARTMENT NAMED SOLUTIONS PUBLIC HEALTH.THE HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT AND ACTION PLAN. ONE OF THE OUTCOMES IS TO WORK WITH PUBLIC HEALTH SOLUTIONS PUBLIC HEALTH DEPARTMENT ON A GAGE COUNTY PLANNING COMMITTEE TO ADDRESS OBESITY ISSUES IN THE COMMUNITY.THE HOSPITAL INVITES THE RED CROSS BLOODMOBILE BUS TO VISIT THE HOSPITAL CAMPUS SEVERAL TIMES A YEAR AND ENCOURAGES EMPLOYEES TO DONATE BLOOD DURING WORK HOURS TO SUPPORT THE HEALTHCARE INDUSTRY'S ONGOING NEED FOR BLOOD SUPPLIES AROUND THE COUNTRY. PART VI, LINE 6: NOT APPLICABLE 0 BEATRICE RETIREMENT INC 4800 HOSPITAL PARKWAY BEATRICE NE 68310 470649975 501(C)(3) 162000 OPERATION EXPENSES HEALTH SYSTEMS OF BEATRICE INC 4800 HOSPITAL PARKWAY BEATRICE NE 68310 470691891 501(C)(3) 7489 OPERATION EXPENSES 2 0 PART I, LINE 2: BECAUSE THE RECIPIENTS OF THE GRANT MONEY WERE BEATRICE RETIREMENT, INC. AND HEALTH SYSTEMS OF BEATRICE, INC., BOTH RELATED ORGANIZATIONS, BEATRICE COMMUNITY HOSPITAL AND HEALTH CENTER, INC. IS ABLE TO MONITOR THE USE OF THE GRANT FUNDS. X X X X 0 0 0 0 0 0 0 0 0 BLAKE BUTLER MD MEMBER 378784 0 113977 0 0 0 15600 0 24807 0 533168 0 0 0 ERIC THOMSEN MD MEMBER 250834 0 0 0 0 0 15473 0 23616 0 289923 0 0 0 THOMAS SOMMERS CEO 386766 0 0 0 432 0 15600 0 24341 0 427139 0 0 0 ALAN STREETER CFO 167071 0 0 0 432 0 10465 0 29122 0 207090 0 0 0 DR JOHN FINDLEY CMO 289547 0 0 0 0 0 0 0 29569 0 319116 0 0 0 DEREK WEICHEL MD PHYSICIAN 626614 0 0 0 0 0 15600 0 32077 0 674291 0 0 0 RONALD BEAR MD PHYSICIAN 369909 0 60621 0 0 0 15600 0 12175 0 458305 0 0 0 PAUL ZUERCHER PHYSICIAN 386498 0 12735 0 0 0 15600 0 29616 0 444449 0 0 0 BRETT STUDLEY MD PHYSICIAN 354665 0 14801 0 0 0 15600 0 32166 0 417232 0 0 0 AMANDA LOEFFLER PHYSICIAN 341995 0 8217 0 0 0 0 0 23195 0 373407 0 0 0 A HOSPITAL AUTHORITY NO 1 OF GAGE COUNTY NEBRASKA 470785499 NONEAVAIL 2015-03-20 9934971 PARTIAL REFUND PRIOR BONDS (06/08/10) 0 0 0 B HOSPITAL AUTHORITY NO 1 OF GAGE COUNTY NEBRASKA 470785499 362615AL0 2010-06-24 30000000 CONSTRUCTION OF FACILITY 0 0 0 A 315914 9934971 951023 175362 9759609 2012 1 0 1 1 B 30150084 2871743 2181107 27968976 2012 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 1 1 0 0 0 0 0 1 B 0 0 1 1 0 0 0 0 1 A 1 B 1 PART IV, LINE 2C: ISSUER NAME: HOSPITAL AUTHORITY NO. 1 OF GAGE COUNTY, NE. DATE THE REBATE COMPUTATION WAS PERFORMED: 05/31/2015 PART II, LINE 3: THE TOTAL PROCEEDS DO NOT EQUAL THE SUMMATION OF LINES 4 - 12 DUE TO TRANSFERRED OR REPLACEMENT PROCEEDS IN LINE 4. PART II, LINE 3: THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS. RONALD BEAR MD HIGHEST COMPENSATED EMPLOYEE COMPENSATION AGREEMENT X 40000 20000 0 1 1 DR JOHN FINDLEY KEY EMPLOYEE COMPENSATION AGREEMENT X 25000 14583 0 1 1 PAUL ZUERCHER HIGHEST COMPENSATED EMPLOYEE COMPENSATION AGREEMENT X 80000 24000 0 1 1 AMANDA LOEFFLER HIGHEST COMPENSATED EMPLOYEE COMPENSATION AGREEMENT X 130000 85833 0 1 1 144416 COLLEEN DEINES COLLEEN IS THE WIFE OF MITCHELL DEINES, BOARD MEMBER 46177 COLLEEN DEINES IS EMPLOYED BY BEATRICE COMMUNITY HOSPITAL AND HEALTH CENTER, INC. 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WAS MADE AVAILABLE TO ALL BOARD MEMBERS VIA THE BOARD PORTAL. THE FINANCE COMMITTEE WAS INSTRUCTED TO REVIEW THE FORM 990. ONCE THEY REVIEWED THE FORM 990, THEY RECOMMENDED SUBMISSION OF THE FORM 990 TO THE IRS. PRIOR TO FILING, EACH BOARD MEMBER WILL HAVE ACCESS TO THE FORM 990 VIA THE BOARD PORTAL. FORM 990, PART VI, SECTION B, LINE 12C EVERY BOARD MEMBER, ADMINISTRATIVE EMPLOYEE AND DEPARTMENT MANAGER IS REQUIRED TO FILL OUT A NEW CONFLICT OF INTEREST FORM DURING THE FIRST QUARTER OF THE YEAR. THESE ARE KEPT ON FILE WITH THE CHIEF COMPLIANCE OFFICER. FORM 990, PART VI, SECTION B, LINE 15 LISTED BELOW IS INFORMATION FROM OUR POLICY ON WAGE AND SALARY ADMINISTRATION. THIS POLICY APPLIES TO ALL EMPLOYEES EXCEPT EXECUTIVE LEVEL STAFF AND THOSE WITH WRITTEN CONTRACTS (PHYSICIANS, ALLIED HEALTH STAFF, ETC.). AN OUTSIDE CONSULTING FIRM MAKES COMPENSATION RECOMMENDATIONS TO THE BOARD OF DIRECTORS BASED UPON MARKET DATA FOR THE POSITION. A. STRUCTURE OF THE WAGE AND SALARY PLAN 1. PAY GRADES AND WAGE SCALES/RANGES ARE ESTABLISHED TO REWARD EMPLOYEES FOR DIFFERENT LEVELS OF SKILLS, RESPONSIBILITY AND KNOWLEDGE. JOB POSITIONS ARE ASSIGNED A PAY GRADE BASED UPON MARKET CONDITIONS, SKILLS, RESPONSIBILITY, EDUCATION EXPERIENCE, PHYSICAL DEMANDS AND WORKING CONDITIONS REQUIRED OF THE POSITION. EACH PAY GRADE HAS A RANGE OF PAY FROM MINIMUM TO MAXIMUM, ESTABLISHED TO REWARD EMPLOYEES FOR EXPERIENCE AND PERFORMANCE. B. ADJUSTMENTS TO THE WAGE AND SALARY PLAN: 1. THE WAGE PLAN IS REVIEWED AT LEAST ANNUALLY TO ENSURE COMPETITIVE SALARIES FOR ALL POSITIONS. LABOR MARKET SURVEYS ARE COMPLETED AND UTILIZED ON A REGULAR BASIS. BASED UPON MARKET INFORMATION AND/OR A REVIEW OF JOB DESCRIPTIONS, ADJUSTMENTS MAY BE MADE TO THE WAGE AND SALARY PLAN THAT INCLUDE ADJUSTMENTS TO THE OVERALL WAGE AND SALARY STRUCTURE OR REPOSITIONING OF A SPECIFIC JOB POSITION(S) TO A DIFFERENT PAY GRADE. FOR THE CEO POSITION THAT IS HELD BY THOMAS SOMMERS, THE BOARD CHAIR WORKS WITH A CONSULTING COMPANY, IH STRATEGIES, TO DETERMINE THE APPROPRIATE COMPENSATION. THIS INFORMATION IS APPROVED BY THE EXECUTIVE COMMITTEE OF THE HOSPITAL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN BEATRICE COMMUNITY HOSPITAL FOUNDATION -44,900. FORM 990, PART XI, LINE 2C: THERE HAVE BEEN NO CHANGES FROM THE PRIOR YEAR. THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS SELECTS THE INDEPENDENT ACCOUNTANT AND HAS THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT. UPON COMPLETION OF THE AUDIT, THE AUDITING FIRM PRESENTS THE RESULTS AND FINDINGS TO THE FINANCE COMMITTEE. HEALTH SYSTEM OF BEATRICE INC 4800 HOSPITAL PARKWAY PO BOX 278 BEATRICE NE 683106906 470691891 MANAGEMENT COMPANY NE 501(C)(3) LINE 11C, III-FI N/A 0 HOMESTEAD VILLAGE INC 1119 MONROE BEATRICE NE 68310 470591716 APARTMENTS FOR LOW INCOME ELDERLY INDIVIDUALS NE 501(C)(3) LINE 9 HEALTH SYSTEM OF BEATRICE INC 0 PARKVIEW VILLAGE INC 1200 SOUTH 8TH STREET BEATRICE NE 68310 363381263 APARTMENTS FOR LOW INCOME ELDERLY INDIVIDUALS NE 501(C)(3) LINE 9 HEALTH SYSTEM OF BEATRICE INC 0 BEATRICE COMMUNITY HOSP FOUNDATION INC 4800 HOSPITAL PARKWAY PO BOX 641 BEATRICE NE 68310 473024984 FINANCIAL SUPPORT FOR BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC. NE 501(C)(3) LINE 11C, III-FI HEALTH SYSTEM OF BEATRICE INC 0 BEATRICE RETIREMENT INC 4800 HOSPITAL PARKWAY PO BOX 278 BEATRICE NE 683106906 470649975 RETIREMENT FACILITY NE 501(C)(3) LINE 9 HEALTH SYSTEM OF BEATRICE INC 0 PHYSICIAN'S BUILDING INC 4800 HOSPITAL PARKWAY BEATRICE NE 68310 470697398 OFFICE RENTAL NE N/A C 0 0 1 1 1 0 0 0 0 0 0 1 1 0 1 1 0 1 0 0