YORK GENERAL HOSPITAL: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- YORK GENERAL HOSPITAL (EIN 47-0379039)
- Tax period
- 2015-10-01 to 2016-09-30
- Filed
- 2017-02-15
- IRS object ID
- 201740469349302454
- Schema version
- 2015v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-02-15T12:49:50-06:00 | ReturnTs |
| Tax Period End | 2016-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 470585450 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOHMAN AKERLUND & EDDY LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 470 | AddressLine1Txt |
| City | AURORA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 688180470 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470379039 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | YORK GENERAL HEALTH CARE SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | YORK | BusinessNameControlTxt |
| Phone | 4023626671 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2222 LINCOLN AVENUE | AddressLine1Txt |
| City | YORK | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68467 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBERT MCQUISTAN | PersonNm |
| Person Title | VP OF FINANCE | PersonTitleTxt |
| Phone | 4023626671 | PhoneNum |
| Signature | 2016-02-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TIMOTHY J COUFAL | PreparerPersonNm |
| PTIN | P00964304 | PTIN |
| Phone | 4026946404 | PhoneNum |
| Preparation | 2017-02-14 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROBERT MCQUISTAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | SAME AS C ABOVE | AddressLine1Txt |
| City | YORK | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68467 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $42,203,859 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.YORKGENERAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1946 | FormationYr |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Activity Or Mission | TO BE A REGIONAL HEALTHCARE PROVIDER FOR THE CITIZENS OF YORK COUNTY AND ITS CONTIGUOUS COUNTIES WITH READILY ACCESSIBLE HIGH QUALITY PRIMARY, OBSTETRICAL, MENTAL HEALTH, MEDICAL, SURGICAL, PEDIATRIC, AND LONG TERM HEALTH CARE PROGRAMS AND SERVICES. TO PROVIDE HIGH QUALITY PHYSICAL AND MANPOWER RESOURCES. TO OPERATE WITHIN RESPONSIBLE FISCAL GUIDELINES WITHOUT COMPROMISING PATIENT AND RESIDENT CARE IN PROVIDING PHYSICAL RESOURCES, MANPOWER AND SERVICES. TO BE A LEADER IN ADVOCATING HIGH QUALITY HEALH CARE PROGRAMS, DEVELOPING RESOURCES, AND PROVIDING SERVICES AND PROGRAMS THAT MEET BOTH PREVENTATIVE AND PRIMARY HEALTH CARE NEEDS TO THE CITIZENS OF THE SERVICE AREA. TO ESTABLISH AN ON-GOING PROCESS THAT INSURES THAT THE ORGANIZATION IS MEASURABLY MEETING ITS MISSION COMMITMENTS TO ITS PATIENTS, RESIDENTS, PHYSICAINS, EMPLOYEES, AND COMMUNITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 605 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $126,581 | PYContributionsGrantsAmt |
| CY Contributions Grants | $41,241 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $40,023,239 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $41,604,760 | CYProgramServiceRevenueAmt |
| PY Investment Income | $521,766 | PYInvestmentIncomeAmt |
| CY Investment Income | $218,987 | CYInvestmentIncomeAmt |
| PY Other Revenue | $61,713 | PYOtherRevenueAmt |
| CY Other Revenue | $93,017 | CYOtherRevenueAmt |
| PY Total Revenue | $40,733,299 | PYTotalRevenueAmt |
| CY Total Revenue | $41,958,005 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $21,927,047 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $22,943,261 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $17,209,230 | PYOtherExpensesAmt |
| CY Other Expenses | $17,991,220 | CYOtherExpensesAmt |
| PY Total Expenses | $39,136,277 | PYTotalExpensesAmt |
| CY Total Expenses | $40,934,481 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,597,022 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,023,524 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $77,125,943 | TotalAssetsBOYAmt |
| Total Assets EOY | $75,425,266 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $25,429,197 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $22,704,996 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $51,696,746 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $52,720,270 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO BE A REGIONAL HEALTHCARE PROVIDER FOR THE CITIZENS OF YORK COUNTY AND ITS CONTIGUOUS COUNTIES WITH READILY ACCESSIBLE HIGH QUALITY PRIMARY, OBSTETRICAL, MENTAL HEALTH, MEDICAL, SURGICAL, PEDIATRIC, AND LONG TERM HEALTH CARE PROGRAMS AND SERVICES. TO PROVIDE HIGH QUALITY PHYSICAL AND MANPOWER RESOURCES. TO OPERATE WITHIN RESPONSIBLE FISCAL GUIDELINES WITHOUT COMPROMISING PATIENT AND RESIDENT CARE IN PROVIDING PHYSICAL RESOURCES, MANPOWER AND SERVICES. TO BE A LEADER IN ADVOCATING HIGH QUALITY HEALH CARE PROGRAMS, DEVELOPING RESOURCES, AND PROVIDING SERVICES AND PROGRAMS THAT MEET BOTH PREVENTATIVE AND PRIMARY HEALTH CARE NEEDS TO THE CITIZENS OF THE SERVICE AREA. TO ESTABLISH AN ON-GOING PROCESS THAT INSURES THAT THE ORGANIZATION IS MEASURABLY MEETING ITS MISSION COMMITMENTS TO ITS PATIENTS, RESIDENTS, PHYSICAINS, EMPLOYEES, AND COMMUNITIES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $30,098,819 | ExpenseAmt |
| Revenue | $41,604,760 | RevenueAmt |
| Desc | PROVIDED 3,072 PATIENT DAYS OF MEDICAL SERVICES AND 40,344 LONG-TERM CARE RESIDENT DAYS TO A VARIETY OF PATIENTS REGARDLESS OF ABILITY TO PAY FOR THOSE SERVICES. PROVIDE ADDITIONAL SERVICES TO ADDRESS INDIVIDUAL HEALTH INCLUDING ASSISTED LIVING, FITNESS CENTER, HOME HEALTH AND CHILD CARE. | Desc |
| Total Program Service Expenses | $30,098,819 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (true) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (true) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 38 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 605 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | Yes (true) | IndoorTanningServicesInd |
| Form720 Filed | Yes (true) | Form720FiledInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBERT MCQUISTAN | PersonNm |
| Phone | 4023626671 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2222 LINCOLN AVENUE | AddressLine1Txt |
| City | YORK | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68467 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| CHARLES HARRIS | ||||||||
| CHAIRMAN | 0.25 | Yes (X) | $0 | $0 | $0 | |||
| DON WITTE | ||||||||
| VICE CHAIR | 0.25 | Yes (X) | $0 | $0 | $0 | |||
| ANN KIRKPATRICK | ||||||||
| SECRETARY | 0.25 | Yes (X) | $0 | $0 | $0 | |||
| CG KELLY HOLTHUS | ||||||||
| TREASURER | 0.25 | Yes (X) | $0 | $0 | $0 | |||
| DR YE YE | ||||||||
| CHIEF OF STA | 0.25 | Yes (X) | $0 | $0 | $0 | |||
| KRIS HOLOCH | ||||||||
| MEMBER | 0.25 | Yes (X) | $0 | $0 | $0 | |||
| DARROLL J LOSCHEN | ||||||||
| MEMBER | 0.25 | Yes (X) | $0 | $0 | $0 | |||
| CY NORTH | ||||||||
| MEMBER | 0.25 | Yes (X) | $0 | $0 | $0 | |||
| CANDACE OTTE | ||||||||
| MEMBER | 0.25 | Yes (X) | $0 | $0 | $0 | |||
| SALLY RUBEN | ||||||||
| MEMBER | 0.25 | Yes (X) | $0 | $0 | $0 | |||
| JERRY STAHR | ||||||||
| MEMBER | 0.25 | Yes (X) | $0 | $0 | $0 | |||
| KELLY THOMAS | ||||||||
| MEMBER | 0.25 | Yes (X) | $0 | $0 | $0 | |||
| CHARLES SCHULZ | ||||||||
| CEO | 40.00 | $203,982 | $0 | $27,044 | Yes (X) | |||
| JENNIFER OBERMIER | ||||||||
| VP OF NURSIN | 40.00 | $149,330 | $0 | $26,473 | Yes (X) | |||
| ROBERT MCQUISTAN | ||||||||
| VP OF FINANC | 40.00 | $131,267 | $0 | $27,842 | Yes (X) | |||
| JAY COLBURN | ||||||||
| VP OF LTC | 40.00 | $123,717 | $0 | $25,934 | Yes (X) | |||
| MICHAEL D MONFORE | ||||||||
| CRNA | 40.00 | $202,888 | $0 | $12,988 | Yes (X) | |||
| THOMAS C MCKENNY | ||||||||
| CRNA | 40.00 | $195,617 | $0 | $18,476 | Yes (X) | |||
| MATTHEW MONTGOMERY | ||||||||
| CRNA | 40.00 | $186,430 | $0 | $20,645 | Yes (X) | |||
| CORNELL H BONDE | ||||||||
| PHARMACIST | 40.00 | $139,407 | $0 | $0 | Yes (X) | |||
| ERIK PETERSON | ||||||||
| PHARMACIST | 40.00 | $128,290 | $0 | $0 | Yes (X) | |||
| BRENT ENNINGA | ||||||||
| OCCUPATIONAL | 40.00 | $107,523 | $0 | $0 | Yes (X) | |||
| JOHN KOWALSKI | ||||||||
| PHYSICAL THE | 40.00 | $101,331 | $0 | $0 | Yes (X) | |||
| WILLIAM C KRAFT | ||||||||
| I.T. DIRECTO | 40.00 | $100,633 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,770,415 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $159,402 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 12 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| YORK MEDICAL CLINIC | |||||
| 2114 N LINCOLN AVE | YORK | NE | 68467 | ER PHYSICIAN | $1,025,860 |
| MIDLANDS MECHANICAL INC | |||||
| 8425 WIRT ST | OMAHA | NE | 68134 | CONTRACTOR | $1,015,071 |
| MCCORMICKS HEATINGAC | |||||
| 302 GRANT AVE | YORK | NE | 68467 | CONTRACTOR | $816,687 |
| SAMPSON CONSTRUCTION | |||||
| 3730 S 14TH ST | LINCOLN | NE | 68502 | CONST MGR | $608,713 |
| MIDWEST PARTITIONS | |||||
| PO BOX 327 | THEDFORD | NE | 69166 | CONTRACTOR | $586,209 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 14 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $41,241 | AllOtherContributionsAmt |
| Total Contributions | $41,241 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 622110 | $29,801,759 | $29,801,759 |
| NET RESIDENT SERVICE REVENUE | 623110 | $8,762,602 | $8,762,602 |
| HEARTHSTONE HOUSING | 623990 | $1,906,922 | $1,906,922 |
| DAYCARE | 624410 | $292,128 | $292,128 |
| HC+ MANAGEMENT AND STAFFING | 900099 | $240,542 | $240,542 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $600,807 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $600,807 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $41,604,760 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $216,822 | TotalRevenueColumnAmt |
| Exclusion | $216,822 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $338,871 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $245,854 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $93,017 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $93,017 | TotalRevenueColumnAmt |
| Exclusion | $93,017 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,165 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,165 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,165 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,165 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $41,958,005 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $41,606,925 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $309,839 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,193,231 | TotalAmt |
| Program Services | $734,265 | ProgramServicesAmt |
| Management And General | $458,966 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,529,206 | TotalAmt |
| Program Services | $12,935,157 | ProgramServicesAmt |
| Management And General | $4,594,049 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $558,133 | TotalAmt |
| Program Services | $397,991 | ProgramServicesAmt |
| Management And General | $160,142 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,308,257 | TotalAmt |
| Program Services | $1,702,817 | ProgramServicesAmt |
| Management And General | $605,440 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,354,434 | TotalAmt |
| Program Services | $986,686 | ProgramServicesAmt |
| Management And General | $367,748 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,144 | TotalAmt |
| Management And General | $18,144 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,936 | TotalAmt |
| Management And General | $134,936 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,063,836 | TotalAmt |
| Program Services | $770,844 | ProgramServicesAmt |
| Management And General | $292,992 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,164 | TotalAmt |
| Program Services | $82,610 | ProgramServicesAmt |
| Management And General | $25,554 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $531,768 | TotalAmt |
| Program Services | $395,954 | ProgramServicesAmt |
| Management And General | $135,814 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,508,154 | TotalAmt |
| Program Services | $3,356,769 | ProgramServicesAmt |
| Management And General | $1,151,385 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PRO CARE OF PATIENTS-HOSP | $7,164,879 | $7,164,879 | |
| ADMINISTRATIVE&GENERAL-HO | $1,472,165 | $1,472,165 | |
| PRO CARE OF PATIENTS-LTC | $499,341 | $499,341 | |
| RENTAL/LEASE | $487,451 | $430,596 | $56,855 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,002,382 | TotalAmt |
| Program Services | $640,910 | ProgramServicesAmt |
| Management And General | $1,361,472 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,934,481 | TotalAmt |
| Program Services | $30,098,819 | ProgramServicesAmt |
| Management And General | $10,835,662 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,339,917 | BOYAmt |
| EOY | $7,877,830 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,068,990 | BOYAmt |
| EOY | $10,122,349 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,076,471 | BOYAmt |
| EOY | $5,222,267 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,152 | BOYAmt |
| EOY | $62,152 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $840,788 | BOYAmt |
| EOY | $861,460 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $385,932 | BOYAmt |
| EOY | $474,070 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $95,867,497 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $46,048,434 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,788,304 | BOYAmt |
| EOY | $49,819,063 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,563,389 | BOYAmt |
| EOY | $986,075 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $77,125,943 | BOYAmt |
| EOY | $75,425,266 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,535,989 | BOYAmt |
| EOY | $4,476,002 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $474,879 | BOYAmt |
| EOY | $180,449 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,325,000 | BOYAmt |
| EOY | $17,980,000 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $93,329 | BOYAmt |
| EOY | $68,545 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,429,197 | BOYAmt |
| EOY | $22,704,996 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,081,945 | BOYAmt |
| EOY | $52,092,101 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $614,801 | BOYAmt |
| EOY | $628,169 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,696,746 | BOYAmt |
| EOY | $52,720,270 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $77,125,943 | BOYAmt |
| EOY | $75,425,266 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,023,524 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,887,341 | BeginningYearBalanceAmt |
| Contributions | $2,148,025 | ContributionsAmt |
| Investment Earnings Or Losses | $667,786 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | -$3,761,597 | OtherExpendituresAmt |
| Administrative Expenses | -$5,627 | AdministrativeExpensesAmt |
| End Year Balance | $5,935,928 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,743,132 | BeginningYearBalanceAmt |
| Contributions | $4,541,776 | ContributionsAmt |
| Investment Earnings Or Losses | $706,516 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | -$7,097,088 | OtherExpendituresAmt |
| Administrative Expenses | -$6,989 | AdministrativeExpensesAmt |
| End Year Balance | $6,887,341 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,386,637 | BeginningYearBalanceAmt |
| Contributions | $6,445,694 | ContributionsAmt |
| Investment Earnings Or Losses | $726,323 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | -$3,808,797 | OtherExpendituresAmt |
| Administrative Expenses | -$6,725 | AdministrativeExpensesAmt |
| End Year Balance | $8,743,132 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,221,798 | BeginningYearBalanceAmt |
| Contributions | $2,545,451 | ContributionsAmt |
| Investment Earnings Or Losses | $925,319 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | -$5,302,529 | OtherExpendituresAmt |
| Administrative Expenses | -$3,402 | AdministrativeExpensesAmt |
| End Year Balance | $5,386,637 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $10,783,860 | BeginningYearBalanceAmt |
| Contributions | $2,741,265 | ContributionsAmt |
| Investment Earnings Or Losses | $815,893 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | -$7,115,444 | OtherExpendituresAmt |
| Administrative Expenses | -$3,776 | AdministrativeExpensesAmt |
| End Year Balance | $7,221,798 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.89420 | BoardDesignatedBalanceEOYPct |
| Term Endowment Balance EOY | 0.10580 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $456,000 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $1,229,775 | OtherCostOrOtherBasisAmt |
| Book Value | $1,685,775 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $70,492,787 | OtherCostOrOtherBasisAmt |
| Depreciation | $28,005,806 | DepreciationAmt |
| Book Value | $42,486,981 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,730,759 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,101,645 | DepreciationAmt |
| Book Value | $629,114 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $19,920,840 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,940,983 | DepreciationAmt |
| Book Value | $2,979,857 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,037,336 | OtherCostOrOtherBasisAmt |
| Book Value | $2,037,336 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $49,819,063 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DEPOSITS | $58,545 |
| EST. THIRD-PARTY PAYOR SETTLEMENTS | $10,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $68,545 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $41,920,135 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $41,920,135 | RevenueSubtotalAmt |
| Other Revenues Not Included | $37,870 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $37,870 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $41,958,005 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $40,909,978 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $40,909,978 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $24,503 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $24,503 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $40,934,481 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PAGE 2, PART V, LINE 4 | ASSETS WHOSE USE IS LIMITED OR RESTRICTED: FUNDS ON DEPOSIT WITH TRUSTEE - 2,659,470 BOND FUNDS AND DEBT SERVICE FUNDS ARE AVAILABLE TO MEET PRINCIPAL AND INTEREST PAYMENTS ON BONDS OUTSTANDING. CONSTRUCTION FUNDS ARE USED TO PAY COSTS OF THE HOSPITAL PROJECT. BY BOARD FOR ENDOWMENT FUND - 2,538,321 ASSETS SET ASIDE FOR FUTURE CAPITAL IMPROVEMENTS. BY BOARD FOR SCHOLARSHIP FUND - 99,785 INTENDED FOR SCHOLARSHIPS IN THE HEALTHCARE FIELD. BY DONORS OR GRANTORS - 628,169 INTENDED FOR VARIOUS HOSPITAL EQUIPMENT AND OPERATIONS. ESCROW DEPOSITS - 10,183 RETURNED TO DUPLEX OWNERS OR LESSEES AND APARTMENT RESIDENTS. |
| SCHEDULE D, PAGE 3, PART X | THE MEDICAL FACILITY HAS NO RESERVE FOR UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2016 AND 2015. |
| SCHEDULE D, PAGE 4, PART XI, LINE 4B | TEMPORARILY RESTRICTED CONTRIBUTIONS 37,870 |
| SCHEDULE D, PAGE 4, PART XII, LINE 4B | NET ASSETS RELEASED FROM RESTRICTION FOR OPERATING PURPOSE 24,503 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $518,725 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $518,725 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01270 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,865,119 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,549,865 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $315,254 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00770 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,383,844 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,549,865 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $833,979 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02040 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $63,803 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $63,803 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $75,439 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $75,439 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,628,611 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,864,251 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $764,360 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01870 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $77,250 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $77,250 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,845,103 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,864,251 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $980,852 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02400 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,228,947 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,414,116 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,814,831 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04430 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $33,479 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $33,479 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $85,276 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $85,276 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00210 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $65,049 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $65,049 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $148,785 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $148,785 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00360 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $332,589 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $332,589 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00810 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $685,310 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $34,265 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $12,100,037 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $11,957,501 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $142,536 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | YORK GENERAL HEALTH CARE SERVICES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2222 LINCOLN AVE | AddressLine1Txt |
| City | YORK | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68467 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | SKILLED NURSING, ASST. LIVING | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | YORK GENERAL HEALTH CARE SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.YORKGENERAL.ORG | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.YORKGENERAL.ORG | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWWYORKGENERALORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWWYORKGENERALORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | Yes (true) | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Average Negotiated Rates | Yes (X) | AverageNegotiatedRatesInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, YORK GENERAL HEALTH CARE SERVICES - PART V, LINE 5 | IN APRIL OF 2015, FOUR CORNERS HEALTH DEPARTMENT LAUNCHED A COMMUNITY ASSESSMENT PROJECT THAT WILL HAVE LASTING EFFECTS FOR THE ENTIRE PUBLIC HEALTH SYSTEM IN THE DISTRICT. MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) IS A DYNAMIC PROCESS DEVELOPED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AND THE NATIONAL ASSOCIATION OF CITY AND COUNTY HEALTH OFFICIALS (NACCHO) THAT HELPS COMMUNITIES PRIORITIZE PUBLIC HEALTH ISSUES AND IDENTIFY RESOURCES FOR ADDRESSING THEM. COMMUNITY OWNERSHIP IS THE FUNDAMENTAL COMPONENT OF MAPP. THE MAPP PROJECT INCLUDES FOUR COMMUNITY ASSESSMENTS. IN THIS REPORT, WE HAVE FOCUSED ON THE RESULTS OF THE COMMUNITY THEMES AND STRENGTHS ASSESSMENT. THE COMMUNITY THEMES AND STRENGTHS ASSESSMENT FOCUSES ON COLLECTING THE COMMUNITYS PERSPECTIVE ON ISSUES SUCH AS HEALTH CARE, EDUCATION, CARE FOR OLDER ADULTS, JOBS, SUPPORT NETWORKS, HEALTH PROBLEMS, AND RISKY BEHAVIORS. A SURVEY WAS DESIGNED BY UTILIZING A SAMPLE SURVEY PROVIDED BY NACCHO. MAPP ADVISORY COMMITTEE MEMBERS WORKED TOGETHER TO DISTRIBUTE PAPER COPIES OF THE SURVEYS AT COMMUNITY MEETINGS SUCH AS ROTARY, KIWANIS, OR SERTOMA CLUBS. THEY WERE TAKEN TO CHURCHES, SCHOOL EVENTS, COUNTY FAIRS, ETC. THE SURVEY WAS DISTRIBUTED THROUGHOUT THE DISTRICT FROM MAY TO OCTOBER 2015. RESPONSES WERE RECEIVED FROM 817 INDIVIDUALS. IN YORK COUNTY, 350 RESPONSES WERE RECEIVED. COLLABORATORS INCLUDE INDIVIDUALS FROM POLK COUNTY EXTENSION SERVICES, YORK MEDICAL CLINIC, HENDERSON HEALTH CARE, MIDWEST COVENANT HOME, POLK COUNTY HEALTH DEPARTMENT, PARISH NURSING, TABITHA, BUTLER COUNTY, YORK PUBLIC SCHOOL NURSE, YORK COLLEGE, EPWORTH VILLAGE, SEWARD COUNTY EXTENSION, BLUE VALLEY COMMUNITY ACTION, ANNIE JEFFREY, MEMORIAL HEALTH CARE SYSTEMS (SEWARD), BUTLER COUNTY EXTENSION, DAVID CITY SENIOR CENTER, ST. JOSEPH'S VILLA, YORK GENERAL HEALTH CARE SERVICES AND DAVID PLACE. |
| FACILITY 1, YORK GENERAL HEALTH CARE SERVICES - PART V, LINE 6B | CONDUCTED CHNA IN CONJUCTION WITH FOUR CORNERS PUBLIC HEALTH. |
| FACILITY 1, YORK GENERAL HEALTH CARE SERVICES - PART V, LINE 11 | YORK GENERAL IS ADDRESSING THE FIVE HEALTH NEEDS IDENTIFIED IN THE COMMUNITY BY: 1. OBESITY: YORK GENERAL WELLNESS CENTER PROVIDES AN AFFORDABLE OPTION FOR COMMUNITY MEMBERS SEEKING TO INCREASE THEIR PHYSICAL ACTIVITY AND WELL BEING. WELLNESS STAFF CAN PROVIDE CONSULTATION TO INDIVIDUAL COMMUNITY MEMBER'S THAT FOCUSES ON HEALTHLY LIFESTYLE MAINTENANCE. YORK GENERAL HOSPITAL CAN PROVIDE NUTRITIONAL COUNSELING WITH ONE OF OUR REGISTERED DIETICIANS. 2. CANCER: YORK GENERAL HOSPITAL PROVIDES COMPREHENSIVE CANCER SERVICES TO AREA PATIENTS. YORK GENERAL'S ONCOLOGY DEPARTMENT AND EXPERIENCED STAFF ARE EQUIPPED TO PROVIDE CARE TO PATIENTS RECEIVING CHEMOTHERAPY AND RELATED CANCER TREATMENTS. YORK GENERAL HOSPITAL SPECIALTY CLINIC PROVIDES A VISITING ONCOLOGY PHYSICIAN TWICE A MONTH IN SPECIALTY CLINIC, ALLOWING PATIENTS TO RECEIVE TREATMENT CLOSE TO HOME. 3. SUICIDE: YORK GENERAL EMERGENCY DEPARTMENT TREATS VARIOUS PATIENTS WHO ARE DEALING WITH SUICIDE OR SEEKING TREATMENT DUE TO SUICIDAL TENDENCIES. YORK GENERAL ABILITY TO IMPACT PATIENTS AND THE COMMUNITY WILL INCLUDE THOSE THAT SEEK TREATMENT DUE TO SUICIDAL TENDENCIES, AND EDUCATION OF THE COMMUNITY. 4. MENTAL HEALTH PROBLEMS: YORK GENERAL CURRENTLY PROVIDES FOUR DAYS OF SPECIALTY CLINIC COVERAGE WITH A MENTAL HEALTH PROFESSIONAL. YORK GENERAL DOES NOT HAVE INPATIENT MENTAL HEALTH TREATMENT AVAILABLE, BUT CAN ADDRESS THAT COMMUNITY NEED OF OUTPATIENT SERVICES THROUGH OUR SPECIALTY CLINIC. 5. ALCOHOL ABUSE: BASIC REFERRAL SERVICES FOR SUBSTANCE ABUSE TREATMENT ARE AVAILABLE. YORK GENERAL HOSPITAL IS NOT ABLE TO PROVIDE LONG TERM INPATIENT SUBSTANCE ABUSE TREATMENT. IT IS IN THE BEST INTEREST OF THE PATIENT TO ACCEPT REFERRAL AS WE DO NOT HAVE THE STAFF WITH THE EXPERTISE AVAILABLE IN SUBSTANCE ABUSE TREATMENT. YORK GENERAL HOSPITAL IS ABLE TO REFER PATIENT WITH SUBSTANCE ABUSE NEEDS TO VARIETY OF SERVICES THROUGHOUT THE STATE OF NEBRASKA. WE ARE ABLE TO ADDRESS ALCOHOL ABUSE IN THE COMMUNITY THROUGH PROMOTING AWARENESS AND PROVIDING EDUCATION. |
| FACILITY 1, YORK GENERAL HEALTH CARE SERVICES - PART V, LINE 16I | THE POLICY IS MENTIONED ON ALL FOLLOW UP ACCOUNT COLLECTION PHONE CALLS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 4 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| YORK GENERAL HEARTHSTONE | ||||
| 2222 LINCOLN AVE | YORK | NE | 68467 | SKILLED NURSING FACILITY |
| YORK GENERAL DIALYSIS | ||||
| 2600 LINCOLN AVE | YORK | NE | 68467 | DIALYSIS |
| YORK GENERAL HOME HEALTH | ||||
| 2319 LINCOLN AVE | YORK | NE | 68467 | HOME HEALTH AGENCY |
| YORK GENERAL WILLOW BROOK ASST LIVG | ||||
| 2714 N LINCOLN AVE | YORK | NE | 68467 | ASSISTED LIVING |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A - RELATED ORGANIZATION INFORMATION | REPORT IS NOT PREPARED BY A RELATED ORGANIZATION. |
| PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION | COSTING METHODOLOGY FOR TABLE IN PART I - OVERALL COST TO CHARGE RATIO EXCEPT FOR SUBSIDISED HEALTH SERVICES WHERE COSTS WERE TAKEN FROM THE MEDICARE COST REPORT. |
| PART II - COMMUNITY BUILDING ACTIVITIES | THE HOSPITAL HAS MANY ACTIVITIES TO PROMOTE HEALTH IN THE COMMUNITIES SERVED. THESE ACTIVITIES INCLUDE SPONSOR OF HEALTH FAIR, SUPPORT GROUPS, 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 - BAD DEBT EXPENSE METHODOLOGY | THE ORGANIZATION'S FINANCIAL STATEMENT FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE IS FOOTNOTE (2), STARTING ON PAGE 13 OF THE FINANCIAL STATEMENTS. PART III, LINE 2 - COSTING METHODOLOGY FOR LINE 2 - OVERALL COST TO CHARGE RATIO WAS USED TO DETERMINE AMOUNTS REPORTED ON SCHEDULE H, PART III, LINE 2. BAD DEBT EXPENSE REPORTED WAS 986,897. PART III, LINE 3 - COSTING METHODOLOGY FOR LINE 3 - AFTER REVIEW OF BAD DEBTS WRITTEN OFF IT WAS DETERMINED APPROXIMATELY 5% OF BAD DEBT ACCOUNTS WRITTEN OFF WOULD HAVE QUALIFIED FOR CHARITY CARE IF THE INDIVIDUALS WOULD HAVE COMPLETED THE APPLICATION PROCESS. PART III, LINE 8 - RATIONALE FOR INCLUDING BAD DEBT AMOUNTS AS COMMUITY BENEFIT - WE DO NOT CONSIDER BAD DEBT AS COMMUNITY BENEFIT. |
| PART III, LINE 8 - MEDICARE EXPLANATION | THE MEDICARE COST REPORT WHICH USES COST TO CHARGE RATIOS BY DEPARTMENT WAS USED TO DETERMINE THE AMOUNTS REPORTED ON LINE 8. |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | COLLECTION ACTIONS. FAILURE TO MAKE AND HONOR SATISFACTORY ARRANGEMENTS FOR PAYMENT TO THE HOSPITAL MAY RESULT IN REFERRAL TO A COLLECTION AGENCY, REPORTING TO THE CREDIT AGENCIES, AND LEGAL ACTION. THE HOSPITAL WILL NOT TAKE AN EXTRAORDINARY COLLECTION ACTION (LEGAL ACTION, REPORTING TO CREDIT AGENCY) UNTIL REASONABLE EFFORTS HAVE BEEN TAKEN TO DETERMINE IF A PERSON IS ELIGIBLE FOR FINANCIAL ASSISTANCE. IF A PERSON APPLIES FOR FINANCIAL ASSISTANCE UNDER THIS POLICY, ALL COLLECTION EFFORTS WILL STOP UNTIL THE DETERMINATION OF ELIGIBILITY FOR FINANCIAL ASSISTANCE IS MADE. IN THE EVENT A PATIENT APPLIES FOR FINANCIAL ASSISTANCE IN A TIMELY MANNER RELATED TO THE DATE WHEN CARE WAS PROVIDED AND IS DEEMED TO QUALIFY FOR FINANCIAL ASSISTANCE, THE HOSPITAL WILL TAKE STEPS TO REVERSE COLLECTION ACTIONS, REPORTS, AND OTHER ACTIONS THAT HAVE BEEN TAKEN TO OBTAIN PAYMENT. UPON RECEIPT OF A COMPLETED FINANCIAL ASSISTANCE APPLICATION, NO FURTHER COLLECTION ACTION SHALL BE TAKEN AGAINST A PATIENT UNTIL THE FINANCE COMMITTEE HAS REVIEWED AND MADE A DETERMINATION ON THE APPLICATION ACCORDING TO THE PROCESS SET FORTH HEREIN. |
| PART VI, LINE 2 - NEEDS ASSESSMENT | THE BOARD MEMBERS ARE ACTIVE IN THE COMMUNITY AND IN TOUCH WITH THE RESIDENTS OF YORK COUNTY AND ARE AWARE OF THE NEEDS OF THE COMMUNITY, ON AN ONGOING BASIS. THE ADDITION OF OUR DIALYSIS PROGRAM WAS A RESULT OF BOARD INTERACTION WITH THE COMMUNITY. IN ADDITION, THE ORGANIZATION CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT IN DECEMBER 2015. EFFORTS WERE COORDINATED WITH THE LOCAL PUBLIC HEALTH OFFICE. |
| PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | THE CHARITY CARE NOTICE IS POSTED IN THE ADMITTING BOOTHS AT THE MAIN ENTRANCE, IN ER, AND IN THE SPECIALTY CLINIC. A WRITTEN NOTICE IS PROVIDED TO EACH PERSON SEEKING SERVICES. THE CHARITY CARE POLICY IS ALSO DISCUSSED WITH PATIENTS WHEN MAKING COLLECTION CALLS. |
| PART VI, LINE 4 - COMMUNITY INFORMATION | YORK, NE IS LOCATED AT THE INTERSECTION OF U.S. HIGHWAY 81 AND INTERSTATE 80. THE POPULATION OF YORK COUNTY AS OF 2010 WAS 13,665. THE AVERAGE HOUSEHOLD INCOME IS ALMOST 54,000. THE UNEMPLOYMENT RATE IN THE YORK COUNTY AREA WAS 4.3% IN 2009. AS OF 2008, APPROXIMATELY 9% OF PEOPLE OF ALL AGES WERE IN POVERTY. YORK COUNTY IS CURRENTLY NOT DESIGNATED AS A MEDICALLY UNDERSERVED AREA. APPROXIMATELY 6% OF HOSPITAL REVENUES ARE FROM MEDICAID ELIGIBLE PATIENTS. APPROXIMATELY 3% OF HOSPITAL GROSS REVENUES ARE FROM PATIENTS WITH NO INSURANCE COVERAGE. |
| PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH | THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE PRIMARY SERVICE AREA OF YORK GENERAL HEALTH CARE SERVICES. THE OCCUPATIONS OF THE BOARD MEMBERS INCLUDE BUSINESS PROFESSIONALS, RETIRED MEDICAL PROFESSIONALS, FARMER, AND LAWYER. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY. SURPLUS FUNDS ARE USED TO UPDATE AND ADD NEW TECHNOLOGY AND EQUIPMENT, ADD NEW SERVICES, AND UPDATE THE PHYSICAL FACILITIES. OVER THE PAST YEARS, PROJECTS THAT HAVE BEEN EITHER PARTIALLY FUNDED OR TOTALLY FUNDED WITH SURPLUS REVENUES INCLUDE THE FOLLOWING: A NEW 129 BED NURSING HOME TO REPLACE AN OUTDATED AND UNSAFE FACILITY, NEW ASSISTED LIVING FACILITY, ADDITION OF DIALYSIS SERVICES FOR THE COMMUNITY, NEW MEDICAL OFFICE BUILDING AND WELLNESS CENTER, HOSPITAL REMODEL AND EXPANSION, DIGITAL MAMMOGRAPHY, AND CT AND MRI UPDATES. THESE ARE SOME OF THE MORE RECENT MAJOR PROJECTS. WE HAVE BEEN ABLE TO MAKE AVAILABLE TO THE RESIDENTS OF YORK THESE NEW SERVICES. THE ORGANIZATION IS ALSO ACTIVE IN ONGOING HEALTH AND WELLNESS ACTIVITIES IN THE COMMUNITY AND SCHOOLS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|
| CHARLES SCHULZ | |||||
| CEO | $188,982 | $15,000 | $8,745 | $18,299 | $231,026 |
| JENNIFER OBERMIER | |||||
| VP OF NURSING | $141,830 | $7,500 | $5,967 | $20,506 | $175,803 |
| ROBERT MCQUISTAN | |||||
| VP OF FINANCE | $125,267 | $6,000 | $6,234 | $21,608 | $159,109 |
| MICHAEL D MONFORE | |||||
| CRNA | $202,888 | $4,166 | $8,822 | $215,876 | |
| THOMAS C MCKENNY | |||||
| CRNA | $195,617 | $9,654 | $8,822 | $214,093 | |
| MATTHEW MONTGOMERY | |||||
| CRNA | $186,430 | $8,446 | $12,199 | $207,075 | |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PAGE 1, PART I, LINE 4 | FormAndLineReferenceDesc |
| Explanation | CHARLES SCHULZ 0 8,745 0 JENNIFER OBERMIER 0 5,967 0 ROBERT MCQUISTAN 0 6,234 0 JAY COLBURN 0 5,428 0 MICHAEL D. MONFORE 0 4,166 0 THOMAS C. MCKENNY 0 9,654 0 MATTHEW MONTGOMERY 0 8,446 0 | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)
| Bond ReferenceBondReferenceCd | Business Name Line2IssuerName/BusinessNameLine2Txt | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|---|
| HOSPITAL AUTH NO 1 OF YORK COUNTY | |||||||||
| A | NE | 470769138 | 986356HC0 | 2013-07-09 | $3,380,000 | REFUND PRIOR ISSUES (04/15/03) | false | false | false |
| HOSPITAL AUTH NO 1 2014 LTCHOSP | |||||||||
| B | 470769138 | 986356HD8 | 2014-04-30 | $8,780,000 | REFUNDS PRIOR ISSUES (09/23/09) AND HOSPITAL PROJECT | false | false | false | |
| HOSPITAL AUTH NO 1 2015 HOSPITAL | |||||||||
| C | 470769138 | 986356HR7 | 2015-07-02 | $8,250,000 | REFUNDS PRIOR ISSUE (09/30/10) AND HOSPITAL PROJECT | false | false | false | |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Capitalized InterestCapitalizedInterestAmt | Capital ExpendituresCapitalExpendituresAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $930,000 | $3,380,000 | $341,336 | $3,380,000 | 2005 | Yes (true) | false | Yes (true) | Yes (true) | ||
| B | $1,050,000 | $8,797,638 | $883,612 | $5,468,866 | false | Yes (true) | Yes (true) | Yes (true) | $2,316 | $3,152,722 | |
| C | $450,000 | $8,260,333 | $675,954 | $6,568,383 | Yes (true) | false | Yes (true) | Yes (true) | $1,691,950 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | false | false | false | false | false | false | Yes (true) |
| B | false | false | false | false | false | false | Yes (true) |
| C | false | false | false | false | false | false | Yes (true) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | false | Yes (true) | Yes (true) | false | false | false | false | false | Yes (true) |
| B | false | Yes (true) | false | false | false | false | false | false | Yes (true) |
| C | false | Yes (true) | Yes (true) | false | false | false | false | false | Yes (true) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (true) |
| B | Yes (true) |
| C | Yes (true) |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K - ADDITIONAL INFORMATION | FormAndLineReferenceDesc |
| Explanation | HOSPITAL AUTH NO. 1 2014 LTC/HOSP. PART II, LINE 3 - THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS. HOSPITAL AUTH NO. 1 2015 HOSPITAL PART II, LINE 3 - THE TOTAL PROCEEDS DO NOT EQUAL THE SUMATION OF LINES 4- 12 DUE TO TRANSFERRED OR REPLACEMENT PROCEEDS IN LINE 4. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CORNERSTONE BANK | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | SEE PART V | RelationshipDescriptionTxt |
| Transaction | SEE PART V | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART V | FormAndLineReferenceDesc |
| Explanation | SCHEDULE L, PART IV: (A) NAME OF INTERESTED PERSON: CORNERSTONE BANK (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION: C.G. KELLY HOLTUS IS PRESIDENT OF CORNERSTONE BANK, HIS DAUGHTER KRIS HOLOCH IS ALSO EMPLOYED AS AN OFFICER AT CORNERSTONE BANK AND TOGETHER THEY OWN GREATER THAN 35% INTEREST IN CORNERSTONE BANK. CHARLES HARRIS, KELLY THOMAS, AND CANDACE OTTE ARE ALL ON CORNERSTONE BANK'S BOARD OF DIRECTORS. (C) & (D) AMOUNT AND DESCRIPTION OF TRANSACTION: VARIOUS TRANSACTIONS IN CAPICITY AS YORK GENERAL HEALTH CARE SERVICES' FINANICAL INSTITUTION. ADDIONTALLY, CORNERSTONE BANK IS TRUSTEE TO BOND FUNDS IN WHICH 1,838,861 WAS DEPOSITED THIS YEAR. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | TO BE A REGIONAL HEALTHCARE PROVIDER FOR THE CITIZENS OF YORK COUNTY AND ITS CONTIGUOUS COUNTIES WITH READILY ACCESSIBLE HIGH QUALITY PRIMARY, OBSTETRICAL, MENTAL HEALTH, MEDICAL, SURGICAL, PEDIATRIC, AND LONG TERM HEALTH CARE PROGRAMS AND SERVICES. TO PROVIDE HIGH QUALITY PHYSICAL AND MANPOWER RESOURCES. TO OPERATE WITHIN RESPONSIBLE FISCAL GUIDELINES WITHOUT COMPROMISING PATIENT AND RESIDENT CARE IN PROVIDING PHYSICAL RESOURCES, MANPOWER AND SERVICES. TO BE A LEADER IN ADVOCATING HIGH QUALITY HEALH CARE PROGRAMS, DEVELOPING RESOURCES, AND PROVIDING SERVICES AND PROGRAMS THAT MEET BOTH PREVENTATIVE AND PRIMARY HEALTH CARE NEEDS TO THE CITIZENS OF THE SERVICE AREA. TO ESTABLISH AN ON-GOING PROCESS THAT INSURES THAT THE ORGANIZATION IS MEASURABLY MEETING ITS MISSION COMMITMENTS TO ITS PATIENTS, RESIDENTS, PHYSICAINS, EMPLOYEES, AND COMMUNITIES. |
| FORM 990, PAGE 6, PART VI, LINE 2 | C.G. KELLY HOLTHUS KRIS HOLOCH TREASURER BOARD MEMBER FAMILY C.G. KELLY HOLTHUS CORNERSTONE BANK TREASURER PRESIDENT GREATER THAN 35% OWNER KRIS HOLOCH CORNERSTONE BANK BOARD MEMBER OFFICER OFFICER CHARLES HARRIS CORNERSTONE BANK CHAIRMAN DIRECTOR DIRECTOR KELLY THOMAS CORNERSTONE BANK BOARD MEMBER DIRECTOR DIRECTOR CANDACE OTTE CORNERSTONE BANK BOARD MEMBER DIRECTOR DIRECTOR |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE 990 IS REVIEWED BY THE VP OF FINANCE AND IS SENT TO EACH DIRECTOR FOR THEIR REVIEW. |
| FORM 990, PAGE 6, PART VI, LINE 12C | ANY MEMBERS WITH A CONFLICT OF INTEREST ABSTAIN FROM VOTING. THE ABSTENTION IS DOCUMENTED IN THE MEETING MINUTES. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE BOARD OF DIRECTORS REVIEWS THE COMPENSATION FOR THE CEO. A COMPARISON OF AREA CEOS IS INCLUDED. |
| FORM 990, PAGE 6, PART VI, LINE 15B | A SALARY SURVEY FOR KEY EMPLOYEES IS COMPLETED BY HUMAN RESOURCES. THE H.R. DIRECTOR REVIEWS THE INFORMATION WITH THE CEO AND A RECOMMENDATION IS MADE. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST STATEMENTS, AND FINANCIAL STATEMENTS ARE ALL AVAILABLE UPON REQUEST FOR REVIEW ON THE PREMISES. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| MEADOW VIEW RETIREMENT HOMES | |||||||||
| 2319 N LINCOLN AVE | YORK | NE | 68467 | 900149281 | SR. LIVING | NE | 501C3 | YGHCS | false |
| HOME CARE PLUS | |||||||||
| 2319 N LINCOLN AVE | YORK | NE | 68467 | 470807087 | HOME HLTH | NE | 501C3 | YGHCS | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt |
|---|---|
| HOME CARE PLUS | |
| J | $600 |
| HOME CARE PLUS | |
| L | $240,542 |
Comments