MADONNA REHABILITATION SYSTEMS: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- MADONNA REHABILITATION SYSTEMS (EIN 46-4473701)
- Tax period
- 2014-03-01 to 2015-02-28
- Filed
- 2015-07-09
- IRS object ID
- 201521909349300717
- Schema version
- 2014v5.0
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-07-09T10:31:27-05:00 | ReturnTs |
| Tax Period End | 2015-02-28 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-03-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 464473701 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADONNA REHABILITATION SYSTEMS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MADO | BusinessNameControlTxt |
| Phone | 4024133000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5401 SOUTH STREET | AddressLine1Txt |
| City | LINCOLN | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 685062134 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | VICTOR WITKOWICZ | PersonNm |
| Person Title | SENIOR VP AND CFO | PersonTitleTxt |
| Phone | 4024133000 | PhoneNum |
| Signature | 2015-07-09 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Initial Return | Yes (X) | InitialReturnInd |
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADONNA REHABILITATION SPECIALTY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | VICTOR WITKOWICZ | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5401 SOUTH STREET | AddressLine1Txt |
| City | LINCOLN | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 685062134 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,552,648 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MADONNA.ORG/BELLEVUE/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2014 | FormationYr |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Activity Or Mission | MADONNA REHABILITATION SYSTEMS WAS FORMED BY MADONNA REHABILITATION HOSPITAL "MRH" TO SERVE AS MRH'S NEW LONG-TERM CARE HOSPITAL "LTCH" COMPONENT OF ITS MADONNA OMAHA PROJECT IN OMAHA, NEBRASKA. IT IS A CATHOLIC HOSPITAL THAT PROVIDES PHYSICAL MEDICINE AND REHABILITATION SERVICES TO ADULTS THROUGHOUT THE NATION. WE REHABILITATE THOSE WHO HAVE SUSTAINED INJURIES OR DISABLING CONDITIONS SO THEY CAN FULLY PARTICIPATE IN LIFE; LEAD RESEARCH TO IMPROVE OUTCOMES; AND PREVENT PHYSICAL DISABILITIES AND PROMOTE WELLNESS THROUGH COMMUNITY PROGRAMS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 81 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $1,552,648 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| CY Total Revenue | $1,552,648 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $2,963,253 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| CY Other Expenses | $4,072,187 | CYOtherExpensesAmt |
| CY Total Expenses | $7,035,440 | CYTotalExpensesAmt |
| CY Revenues Less Expenses | -$5,482,792 | CYRevenuesLessExpensesAmt |
| Total Assets EOY | $2,612,509 | TotalAssetsEOYAmt |
| Total Liabilities EOY | $2,095,301 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances EOY | $517,208 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | MADONNA REHABILITATION SYSTEMS WAS FORMED BY MADONNA REHABILITATION HOSPITAL "MRH" TO SERVE AS MRH'S NEW LONG-TERM CARE HOSPITAL "LTCH" COMPONENT OF ITS MADONNA OMAHA PROJECT IN OMAHA, NEBRASKA. IT IS A CATHOLIC HOSPITAL THAT PROVIDES PHYSICAL MEDICINE AND REHABILITATION SERVICES TO ADULTS THROUGHOUT THE NATION. WE REHABILITATE THOSE WHO HAVE SUSTAINED INJURIES OR DISABLING CONDITIONS SO THEY CAN FULLY PARTICIPATE IN LIFE; LEAD RESEARCH TO IMPROVE OUTCOMES; AND PREVENT PHYSICAL DISABILITIES AND PROMOTE WELLNESS THROUGH COMMUNITY PROGRAMS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,695,586 | ExpenseAmt |
| Revenue | $1,552,648 | RevenueAmt |
| Desc | MADONNA REHABILITATION SYSTEMS FULFILLS THIS MISSION BY DELIVERING EXPERT AND COMPREHENSIVE REHABILITATION, TREATING EACH PERSON AS A UNIQUE INDIVIDUAL. MADONNA'S REHABILITATION PROGRAMS INTEGRATE THE PHYSICAL, PSYCHOLOGICAL, SOCIAL, SPIRITUAL AND VOCATIONAL ASPECTS OF EACH PATIENT'S LIFE. THE HOSPITAL'S PROGRAMS SUPPORT THE UNMET NEEDS OF OUR COMMUNITY AND REGION AND ARE DEVOTED TO RETURNING PEOPLE TO THEIR HOMES, COMMUNITIES AND JOBS OR SCHOOL.MADONNA REHABILITATION SPECIALTY HOSPITAL LEASED SPACE IN THE NEBRASKA MEDICINE -BELLEVUE LOCATION FOR A 32-BED HOSPITAL WITHIN ITS FACILITY. THE MADONNA REHABILITATION SPECIALTY HOSPITAL, LOCATED ON THE FOURTH FLOOR, OPENED IN APRIL 2014 SERVING 16 PATIENTS THE FIRST MONTH.ACCORDING TO PAUL DONGILLI, JR., PHD, FACHE, EXECUTIVE VICE PRESIDENT AND CHIEF OPERATIONS OFFICER OF MADONNA REHABILITATION HOSPITAL, MADONNA IS ADDRESSING THE URGENT NEED TO PROVIDE INPATIENT REHABILITATION SERVICES FOR INDIVIDUALS WITH COMPLEX MEDICAL CONDITIONS, INCLUDING PULMONARY CONDITIONS, IN THE OMAHA AREA WHILE MADONNA'S OMAHA CAMPUS IS UNDER CONSTRUCTION. WITH A POPULATION OF MORE THAN 800,000, OMAHA IS CURRENTLY UNDERSERVED IN POST-ACUTE HEALTH CARE SERVICES. ACCORDING TO AN HDR INDEPENDENT STUDY, 1,300 INDIVIDUALS EACH YEAR WOULD QUALIFY FOR REHABILITATION IN THE METRO AREA BUT ARE REFERRED TO NURSING HOMES BECAUSE THERE ARE NOT ENOUGH POST ACUTE HOSPITAL BEDS IN OMAHA.THE PLAN IS TO RELOCATE THE 32-BEDS TO MADONNA'S OMAHA CAMPUS WHEN IT OPENS IN FALL OF 2016.THE CURRENT HOSPITAL PROVIDES INPATIENT SERVICES FOR REHABILITATIVE CARE FOR:VENTILATOR MANAGEMENTCOMPLEX WOUND MANAGEMENT MEDICALLY COMPLEX PATIENTSMADONNA IS ACCREDITED BY JOINT COMMISSION ON ACCREDITATION OF HOSPITALS.FROM APRIL 1, 2014 TO APRIL 30, 2015, MADONNA REHABILITATION SPECIALTY HOSPITAL SERVED 144 TOTAL PATIENTS FROM PRIMARILY THE OMAHA AREA. IT RECEIVED REFERRALS FROM 16 HOSPITALS AND 111 PHYSICIANS. | Desc |
| Total Program Service Expenses | $5,695,586 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 3 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 81 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | 0 | Form8899Filedind |
| Form1098 C Filed | 0 | Form1098CFiledInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VICTOR WITKOWICZ | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4024133000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5401 SOUTH STREET | AddressLine1Txt |
| City | LINCOLN | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 685062134 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| LYNN ROPER | ||||||||
| CHAIRPERSON | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| TOM SMITH | ||||||||
| VICE CHAIRPERSON | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MARSHA LOMMEL | ||||||||
| PRESIDENT AND CHIEF EXECUTIVE OFFICER | 1.00 | Yes (X) | Yes (X) | $0 | $732,434 | $44,905 | 40.00 | |
| FR JOHN SULLIVAN | ||||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DAN TOMES MD | ||||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| RICH HERINK | ||||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| PAUL A DONGILLI | ||||||||
| EXECUTIVE VICE PRESIDENT AND COO | 1.00 | $0 | $410,872 | $34,986 | 40.00 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,143,306 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $79,891 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| BELLEVUE MEDICAL CENTER LLC | |||||
| 988145 NEBRASKA MEDICAL CNTR | OMAHA | NE | 681988145 | VARIOUS SERVICES | $1,587,217 |
| KIEWIT BUILDING GROUP INC | |||||
| 302 S 36TH ST STE 500 | OMAHA | NE | 68131 | CONSTRUCTION BUILDOUT | $152,264 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENU | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $1,552,648 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,552,648 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,552,648 | TotalProgramServiceRevenueAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,552,648 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,552,648 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,384,311 | TotalAmt |
| Program Services | $2,287,045 | ProgramServicesAmt |
| Management And General | $97,266 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,706 | TotalAmt |
| Program Services | $16,706 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $384,523 | TotalAmt |
| Program Services | $352,946 | ProgramServicesAmt |
| Management And General | $31,577 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $177,713 | TotalAmt |
| Program Services | $170,778 | ProgramServicesAmt |
| Management And General | $6,935 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $917,535 | TotalAmt |
| Program Services | $58,640 | ProgramServicesAmt |
| Management And General | $858,895 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $250 | TotalAmt |
| Management And General | $250 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,350 | TotalAmt |
| Management And General | $44,350 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $953,490 | TotalAmt |
| Program Services | $953,490 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,238 | TotalAmt |
| Management And General | $1,238 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $563,566 | TotalAmt |
| Program Services | $509,132 | ProgramServicesAmt |
| Management And General | $54,434 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $124,787 | TotalAmt |
| Program Services | $28,609 | ProgramServicesAmt |
| Management And General | $96,178 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,123,015 | TotalAmt |
| Program Services | $1,121,308 | ProgramServicesAmt |
| Management And General | $1,707 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,118 | TotalAmt |
| Program Services | $42,658 | ProgramServicesAmt |
| Management And General | $24,460 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,428 | TotalAmt |
| Program Services | $1,448 | ProgramServicesAmt |
| Management And General | $1,980 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $263,925 | TotalAmt |
| Program Services | $148,894 | ProgramServicesAmt |
| Management And General | $115,031 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Total | $9,485 | TotalAmt |
| Program Services | $3,932 | ProgramServicesAmt |
| Management And General | $5,553 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,035,440 | TotalAmt |
| Program Services | $5,695,586 | ProgramServicesAmt |
| Management And General | $1,339,854 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $382,507 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $465,270 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $169,611 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $175,054 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,683,992 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $263,925 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,420,067 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,612,509 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,095,301 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,095,301 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $517,208 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $517,208 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,612,509 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$5,482,792 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $6,000,000 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,683,992 | OtherCostOrOtherBasisAmt |
| Depreciation | $263,925 | DepreciationAmt |
| Book Value | $1,420,067 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,420,067 | TotalBookValueLandBuildingsAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $69,826 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $69,826 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $69,826 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $69,826 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01000 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 8 | PersonsServedCnt |
| Total Community Benefit Expns | $474,891 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $474,891 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06840 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 8 | PersonsServedCnt |
| Total Community Benefit Expns | $474,891 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $474,891 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06840 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 8 | PersonsServedCnt |
| Total Community Benefit Expns | $544,717 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $544,717 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07840 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $69,826 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $744,362 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $5,357,996 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$4,613,634 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | 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 | MADONNA REHABILITATION SYSTEMS | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2500 BELLEVUE MEDICAL CNTR DR 4TH | AddressLine1Txt |
| Address Line2 | FLOOR | AddressLine2Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 681231591 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.MADONNA.ORG | WebsiteAddressTxt |
| State License | H000125 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADONNA REHABILITATION SYSTEMS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | Yes (1) | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | Yes (1) | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | 0 | CHNAConductedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| 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 |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | 0 | NondisEmergencyCarePolicyInd |
| No Emergency Care | Yes (X) | NoEmergencyCareInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MADONNA REHABILITATION SYSTEMS | PART V, SECTION B, LINE 2: THE HOSPITAL WAS A FIRST-YEAR ENTITY THAT ADMITTED ITS FIRST PATIENTS ON APRIL 1, 2014.MADONNA REHABILITATION SYSTEMS:PART V, SECTION B, LINE 3: IN ACCORDANCE WITH THE INTERNAL REVENUE SERVICE FINAL RULE PUBLISHED IN THE FEDERAL REGISTER ON DECEMBER 31, 2014, NEW HOSPITAL FACILITIES ARE NOT REQUIRED TO MEET CHNA REQUIREMENTS BEFORE THE LAST DAY OF THE SECOND TAXABLE YEAR THAT BEGINS AFTER THE HOSPITAL FACILITY WAS PLACED INTO SERVICE. THEREFORE, MADONNA REHABILITATION SYSTEMS IS NOT REQUIRED TO COMPLETE THE CHNA BEFORE FEBRUARY 28, 2017. |
| MADONNA REHABILITATION SYSTEMS | PART V, SECTION B, LINE 13H: FPG IS USED TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. IF FINANCIAL ASSISTANCE IS GRANTED, IT IS FOR FREE CARE ONLY. |
| MADONNA REHABILITATION SYSTEMS | PART V, SECTION B, LINE 22D: THE AMOUNT OF FINANCIAL ASSISTANCE IS CONSIDERED TO BE 100% OF CHARGES. |
| MADONNA REHABILITATION SYSTEMS | PART V, SECTION B, LINE 24: ALL PATIENTS ARE CHARGED THE SAME AMOUNT REGARDLESS OF PAYER SOURCE OR ABILITY TO PAY. MADONNA FINANCIAL ASSISTANCE AND THE OPPORTUNITY TO SATISFY THE ACCOUNT FOR A REDUCED AMOUNT ARE AVAILABLE TO ALL PATIENTS. |
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | THE COMMUNITY BENEFIT INFORMATION FOR THIS HOSPITAL WAS INCLUDED IN THE COMMUNITY BENEFIT REPORT FOR THE RELATED ORGANIZATION MADONNA REHABILITATION HOSPITAL. |
| PART I, LINE 7E: | AS A START-UP HOSPITAL, MADONNA REHABILITATION SYSTEMS IS REQUIRED TO PROVIDE FREE CARE FOR A MINIMUM OF 20 PATIENTS TO MEET HOSPITAL CERTIFICATION AND STATE LICENSING REQUIREMENTS. THERE WERE EIGHT PATIENTS SERVED DURING THIS TIME THAT HAD PRIVATE INSURANCE. MADONNA REHABILITATION SYSTEMS RECEIVED NO PAYMENT ON $474,891 IN CHARGES RELATED TO THESE PATIENTS. THE REMAINING PATIENTS WERE MEDICARE PATIENTS AND ARE INCLUDED IN PART III, SECTION B, LINES FIVE THROUGH SEVEN. |
| PART II, LINE 2: | ACCORDING TO AN ASSOCIATE PROFESSOR OF ECONOMICS AND DIRECTOR OF THE BUREAU OF BUSINESS RESEARCH AT THE UNIVERSITY OF NEBRASKA-LINCOLN, THE $93.6 MILLION OMAHA CAMPUS PROJECT WILL CREATE AN ECONOMIC IMPACT OF:$122 MILLION DURING THE TWO-YEAR CONSTRUCTION PHASE.450 INITIAL JOBS - 250 OF WHICH ARE IN CONSTRUCTION.$66 MILLION OF ANNUAL REVENUE, CREATING AN ECONOMIC IMPACT OF $126 MILLION.1,170 JOBS (OMAHA CAMPUS POSITIONS AND AFFILIATED PRODUCT/SERVICES JOBS) WILL BE CREATED ONCE THE FACILITY IS OPERATIONAL.THE EXPENSES ASSOCIATED WITH THE IMPACT ARE INCLUDED IN THE OPERATING LOSSES IN PARTS I AND III. |
| PART III, LINE 4: | THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL EVALUATES INDIVIDUAL ACCOUNTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND ASSESSES THOSE ACCOUNTS THAT WILL TRANSITION TO SELF-PAY PATIENTS. THOSE TRANSITION ACCOUNTS ARE CONSIDERED IN CONJUNCTION WITH SELF-PAY PATIENTS (WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL). THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE WHICH INDICATES THAT CERTAIN PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN MANY CASES, THE HOSPITAL IS ABLE TO NEGOTIATE PAYMENT SUBSEQUENT TO THE INITIAL DETERMINATION OF THE COLLECTABILITY OF THE ACCOUNT. IN THESE CASES, THE HOSPITAL RECORDS ADDITIONAL CONTRACTUAL ALLOWANCES AND DISCOUNTS. UPON CONSIDERATION OF THE FACT CERTAIN PATIENT ACCOUNTS THAT WERE PREVIOUSLY ALLOWED FOR ARE COLLECTED THROUGH NEGOTIATION AND ADJUSTED AT THE TIME OF PAYMENT, THE HOSPITAL HAS DETERMINED THE PROVISION FOR BAD DEBTS IS NOT SIGNIFICANT TO THE FINANCIAL STATEMENTS AND HAS COMBINED WITH CONTRACTUAL ALLOWANCES AND DISCOUNTS. |
| PART III, LINE 8: | THE AMOUNT WAS DETERMINED USING INTERNAL PROGRAM FINANCIAL STATEMENTS WHICH USE DEPARTMENTALIZED COST TO CHARGE RATIOS AND OTHER ALLOCATION METHODS TO DETERMINE THE COST BASIS. |
| PART III, LINE 9B: | THE PATIENT MUST PROVIDE DOCUMENTATION (OUTLINED IN THE APPLICATION) WHICH WILL DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE (FA). IF IT IS DETERMINED THAT THE PATIENT QUALIFIES FOR 100% FA, NO FURTHER COLLECTION EFFORTS ARE MADE. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | NE |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARSHA LOMMEL | ||||||||||||||
| PRESIDENT AND CHIEF EXECUTIVE OFFICE | $0 | $595,315 | $0 | $137,119 | $0 | $0 | $0 | $41,401 | $0 | $3,504 | $0 | $777,339 | $0 | $0 |
| PAUL A DONGILLI | ||||||||||||||
| EXECUTIVE VICE PRESIDENT AND COO | $0 | $327,340 | $0 | $83,532 | $0 | $0 | $0 | $28,963 | $0 | $6,023 | $0 | $445,858 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | THE PRESIDENT & CEO, MARSHA LOMMEL, IS PAID BY MADONNA REHABILITATION HOSPITAL, A RELATED ENTITY. THE HOSPITAL'S PROCESS FOR DETERMINING HER COMPENSATION CONSISTS OF THE FOLLOWING: THE EXECUTIVE COMPENSATION COMMITTEE ANNUALLY DETERMINES THE CEO'S BASE SALARY BY REVIEWING 990 DATA FROM NONPROFIT REHABILITATION HOSPITALS AT A NATIONAL LEVEL. THE DATA FROM NONPROFIT REHABILITATION HOSPITALS SHOULD BE FOR HOSPITALS WITHIN APPROXIMATELY PLUS OR MINUS 50% OF MADONNA'S GROSS REVENUES RECOGNIZING A NEED FOR A MINIMUM OF AT LEAST EIGHT COMPARABLE SIZED INSTITUTIONS. THE ANALYSIS INCLUDES CALCULATING THE SALARIES FOR BENCHMARK FIRMS PROVIDED BY THE DIRECTOR OF HUMAN RESOURCES. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART IV, LINE 20B: | MADONNA REHABILITATION SYSTEMS IS PART OF A CONSOLIDATED GROUP OF RELATED ORGANIZATIONS AND WAS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS AT JUNE 30, 2014. NO INDEPENDENT AUDIT WAS PERFORMED FOR MADONNA REHABILITATION SYSTEMS INDIVIDUALLY FOR ITS INITIAL YEAR. |
| FORM 990, PART VI, SECTION A, LINE 3 | VARIOUS SERVICES SUCH AS PHARMACY, ENVIRONMENTAL SERVICES, FOOD SERVICES AND OTHER SERVICES ARE CONTRACTED THROUGH THE BELLEVUE MEDICAL CENTER; AN OUTSIDE MEDICAL CORPORATION. NO CURRENT OR FORMER OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, OR HIGHEST COMPENSATED EMPLOYEES WERE COMPENSATED BY BELLEVUE MEDICAL CENTER DURING THE TAX YEAR. |
| FORM 990, PART VI, SECTION A, LINE 6 | MADONNA REHABILITATION HOSPITAL, A NEBRASKA NONPROFIT CORPORATION, IS THE SOLE MEMBER OF MADONNA REHABILITATION SYSTEMS. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE DIOCESAN HEALTH MINISTRIES MAY DESIGNATE ONE MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS, AS PROVIDED IN THE ORGANIZATION'S ARTICLES OF INCORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING RESERVE POWERS ARE VESTED IN THE SOLE MEMBER, MADONNA REHABILITATION HOSPITAL: THE BOARD OF DIRECTORS SHALL APPROVE AND FORWARD TO THE MEMBER, FOR FINAL APPROVAL: (I) CHANGES IN PHILOSOPHY AND MISSION; (II) MATTERS INVOLVING SALE, LEASE, TRANSFER, EXCHANGE, DISPOSITION, PLEDGE OR ALIENATION OF REAL PROPERTY IN EXCESS OF FIVE HUNDRED THOUSAND DOLLARS ($500,000.00); (III) MATTERS INVOLVING PURCHASE AND/OR ENCUMBRANCE WITH DEBT, IN ANY WAY, OF REAL PROPERTY IN EXCESS OF FIVE HUNDRED THOUSAND DOLLARS ($500,000.00); (IV) LAY MEMBERS NOMINATED TO SERVE ON THE BOARD OF DIRECTORS; (V) AMENDMENTS, ALTERATIONS OR CHANGES IN THE ARTICLES OF INCORPORATION OR BYLAWS; (VI) THE ANNUAL CAPITAL BUDGET; (I) PRESIDENT AND CEO SELECTION; AND (II) MERGER, CONSOLIDATION, DISSOLUTION. THE BOARD OF DIRECTORS APPROVES AND FORWARDS TO THE MEMBER, FOR ITS REVIEW: THE ANNUAL REPORT; AND THE OPERATING BUDGET. |
| FORM 990, PART VI, SECTION B, LINE 11 | PRIOR TO FILING THE ORGANIZATION'S FORM 990, THE CHIEF FINANCIAL OFFICER PRESENTS THE COMPLETED FORM 990 AND AN EXECUTIVE OVERVIEW OF THE FORM 990 TO THE BOARD OF DIRECTORS AT A REGULARLY SCHEDULED MEETING. UPON BOARD RESOLUTION TO ACCEPT THE FORM 990 THE FORM 990 IS FILED WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION ANNUALLY DISTRIBUTES ITS CONFLICT OF INTEREST POLICY AND DISCLOSURE FORM TO DIRECTORS, OFFICERS AND KEY EMPLOYEES. THE RESPONSES ARE REVIEWED BY THE BOARD OF DIRECTORS AND ITS COUNSEL, AND ANY APPROPRIATE ACTION IS TAKEN, BASED UPON THOSE RESPONSES AND THE SUBSEQUENT REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO IS COMPENSATED BY THE RELATED ENTITY, MADONNA REHABILITATION HOSPITAL. THE FOLLOWING IS THE EXECUTIVE COMPENSATION PLAN FOR MADONNA REHABILITATION HOSPITAL. THE EXECUTIVE COMPENSATION COMMITTEE WILL MAKE RECOMMENDATIONS FOR THE ANNUAL COMPENSATION OF THE CHIEF EXECUTIVE OFFICER (CEO), CHIEF OPERATIONS OFFICER (COO), AND CHIEF FINANCIAL OFFICER (CFO). THE MADONNA EXECUTIVE COMPENSATION PLAN REQUIRES NATIONAL SALARY BENCHMARKS BE USED FOR THE CEO, COO AND CFO POSITIONS. -BASE SALARY: THE EXECUTIVE COMPENSATION COMMITTEE ANNUALLY DETERMINES THE CEO'S BASE SALARY BY REVIEWING 990 DATA FROM NONPROFIT REHABILITATION HOSPITALS AT A NATIONAL LEVEL. THE DATA FROM NONPROFIT REHABILITATION HOSPITALS SHOULD BE FOR HOSPITALS WITHIN APPROXIMATELY PLUS OR MINUS 50% OF MADONNA'S GROSS REVENUES RECOGNIZING A NEED FOR A MINIMUM OF AT LEAST EIGHT COMPARABLE SIZED INSTITUTIONS. THE ANALYSIS INCLUDES CALCULATING THE SALARIES FOR BENCHMARK FIRMS PROVIDED BY THE DIRECTOR HUMAN RESOURCES. COMPARATIVE SALARIES FOR THE COO AND CFO WILL BE PROVIDED TO THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD. THE PHILOSOPHY IS TO MATCH THE COMPENSATION OF OTHER NON-PROFIT REHABILITATION HOSPITALS, USING THE SAME GUIDELINES AS OUTLINED IN PARAGRAPH 1. ABOVE. |
| FORM 990, PART VI, SECTION C, LINE 19 | SUMMARIZED FINANCIAL INFORMATION IS MADE AVAILABLE TO THE PUBLIC ON AN ANNUAL BASIS THROUGH THE PUBLICATION OF THE HOSPITAL'S PUBLIC ANNUAL REPORT. IN ADDITION, THE PUBLIC ANNUAL REPORT IS AVAILABLE ON THE HOSPITAL'S WEBSITE. THE HOSPITAL'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | MEDICAL SERVICES & PHARMACY: PROGRAM SERVICE EXPENSES 369,479. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 369,479. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 584,011. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 584,011. |
| FORM 990, PART XI, LINE 9: | CAPITAL INFUSION 6,000,000. |
| FORM 990, PART XII, LINE 2B: | MADONNA REHABILITATION SYSTEMS IS PART OF A CONSOLIDATED GROUP OF RELATED ORGANIZATIONS AND WAS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS AT JUNE 30, 2014. NO INDEPENDENT AUDIT WAS PERFORMED FOR MADONNA REHABILITATION SYSTEMS INDIVIDUALLY FOR ITS INITIAL YEAR. |
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 | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MADONNA REHABILITATION HOSPITAL | |||||||||||
| 5401 SOUTH STREET | LINCOLN | NE | 68506 | 470439599 | HEALTHCARE | NE | 501(C)(3) | HOSPITAL | N/A | 0 | |
| MADONNA FOUNDATION | |||||||||||
| 5401 SOUTH STREET | LINCOLN | NE | 68506 | 237159940 | FUNDRAISING SUPPORT | NE | 501(C)(3) | 11B (TYPE II) | 0 | MADONNA REHABILITATION HOSPITAL | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| MADONNA REHABILITATION HOSPITAL | ||
| C | $6,000,000 | FINANCIAL RECORD |
| MADONNA REHABILITATION HOSPITAL | ||
| J | $29,458 | FINANCIAL RECORD |
| MADONNA REHABILITATION HOSPITAL | ||
| K | $71,387 | FINANCIAL RECORD |
| MADONNA REHABILITATION HOSPITAL | ||
| L | $85,578 | FINANCIAL RECORD |
| MADONNA REHABILITATION HOSPITAL | ||
| M | $1,058,430 | FINANCIAL RECORD |
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