YORK GENERAL HOSPITAL: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- YORK GENERAL HOSPITAL (EIN 47-0379039)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-05-15
- IRS object ID
- 201411359349302416
- Schema version
- 2012v2.3
- 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) |
|---|---|---|
| Timestamp | 2014-05-15T10:38:22-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOHMAN AKERLUND & EDDY LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 470 | AddressLine1 |
| City | AURORA | City |
| State | NE | State |
| ZIP Code | 688180470 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470379039 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | YORK GENERAL HEALTH CARE SERVICES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | YORK | NameControl |
| Phone | 4023626671 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2222 LINCOLN AVENUE | AddressLine1 |
| City | YORK | City |
| State | NE | State |
| ZIP Code | 68467 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ROBERT MCQUISTAN | Name |
| Title | VP OF FINANCE | Title |
| Phone | 4023626671 | Phone |
| Date Signed | 2014-05-14 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TIMOTHY J COUFAL | Name |
| Phone | 4026946404 | Phone |
| Date Prepared | 2014-05-14 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | ROBERT MCQUISTAN VP OF FINANCE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | SAME AS C ABOVE | AddressLine1 |
| City | YORK | City |
| State | NE | State |
| ZIP Code | 68467 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 41115404 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.YORKGENERAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1946 | YearFormation |
| State Legal Domicile | NE | StateLegalDomicile |
| Activity Or Mission Description | 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. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 600 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 281012 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 386606 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 38107660 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 39899177 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 411780 | InvestmentIncomePriorYear |
| Investment Income Current Year | 431277 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 38830 | OtherRevenuePriorYear |
| Other Revenue Current Year | 68511 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 38839282 | TotalRevenuePriorYear |
| Total Revenue Current Year | 40785571 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 20892563 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 21271548 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 16014279 | OtherExpensePriorYear |
| Other Expenses Current Year | 17070203 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 36906842 | TotalExpensesPriorYear |
| Total Expenses Current Year | 38341751 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1932440 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2443820 | RevenuesLessExpensesCY |
| Total Assets BOY | 66745216 | TotalAssetsBOY |
| Total Assets EOY | 69140106 | TotalAssetsEOY |
| Total Liabilities BOY | 23373765 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 23324835 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 43371451 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 45815271 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 27885089 | Expense |
| Description | PROVIDED 3,845 PATIENT DAYS OF MEDICAL SERVICES AND 42,362 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. | Description |
| Total Program Service Expense | 27885089 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | true | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | true | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 46 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 600 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Indoor Tanning Services | true | IndoorTanningServices |
| Form720 Filed | true | Form720Filed |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | ROBERT MCQUISTAN | NamePerson |
| Telephone Number | 4023626671 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2222 LINCOLN AVENUE | AddressLine1 |
| City | YORK | City |
| State | NE | State |
| ZIP Code | 68467 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (24 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| CHARLES HARRIS | ||||||||
| CHAIRMAN | 0.25 | X | 0 | 0 | 0 | |||
| DON WITTE | ||||||||
| VICE CHAIR | 0.25 | X | 0 | 0 | 0 | |||
| ANN KIRKPATRICK | ||||||||
| SECRETARY | 0.25 | X | 0 | 0 | 0 | |||
| CG KELLY HOLTHUS | ||||||||
| TREASURER | 0.25 | X | 0 | 0 | 0 | |||
| DR TODD FAGO | ||||||||
| CHIEF OF STA | 0.25 | X | 0 | 0 | 0 | |||
| KRIS HOLOCH | ||||||||
| MEMBER | 0.25 | X | 0 | 0 | 0 | |||
| DARROLL J LOSCHEN | ||||||||
| MEMBER | 0.25 | X | 0 | 0 | 0 | |||
| CY NORTH | ||||||||
| MEMBER | 0.25 | X | 0 | 0 | 0 | |||
| CANDACE OTTE | ||||||||
| MEMBER | 0.25 | X | 0 | 0 | 0 | |||
| SALLY RUBEN | ||||||||
| MEMBER | 0.25 | X | 0 | 0 | 0 | |||
| JERRY STAHR | ||||||||
| MEMBER | 0.25 | X | 0 | 0 | 0 | |||
| KELLY THOMAS | ||||||||
| MEMBER | 0.25 | X | 0 | 0 | 0 | |||
| CHARLES SCHULZ | ||||||||
| CEO | 40.00 | 183707 | 0 | 25088 | X | |||
| JANE THOMPSON | ||||||||
| VP OF OPERAT | 40.00 | 145575 | 0 | 14834 | X | |||
| ROBERT MCQUISTAN | ||||||||
| VP OF FINANC | 40.00 | 126143 | 0 | 26336 | X | |||
| JENNIFER OBERMIER | ||||||||
| VP OF NURSIN | 40.00 | 120743 | 0 | 24198 | X | |||
| JAY COLBURN | ||||||||
| VP OF LTC | 40.00 | 112657 | 0 | 25492 | X | |||
| THOMAS C MCKENNY | ||||||||
| CRNA | 40.00 | 209796 | 0 | 17722 | X | |||
| MATTHEW MONTGOMERY | ||||||||
| CRNA | 40.00 | 186606 | 0 | 19936 | X | |||
| MICHAEL D MONFORE | ||||||||
| CRNA | 40.00 | 183067 | 0 | 16021 | X | |||
| CORNELL H BONDE | ||||||||
| PHARMACIST | 40.00 | 138975 | 0 | 0 | X | |||
| ERIK PETERSON | ||||||||
| PHARMACIST | 40.00 | 123975 | 0 | 0 | X | |||
| JAMIE JOHNSON | ||||||||
| PHARMACIST | 40.00 | 116796 | 0 | 0 | X | |||
| JOHN KOWALSKI | ||||||||
| PHYSICAL THE | 40.00 | 110304 | 0 | 0 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1758344 | TotalReportableCompFromOrg |
| Total Other Compensation | 169627 | TotalOtherCompensation |
| Number Individuals GT100 K | 12 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| YORK MEDICAL CLINIC | |||||
| 2114 N LINCOLN AVE | YORK | NE | 68467 | ER PHYSICIAN | 882895 |
| JERRY'S SHEETMETAL HEATING COOLING | |||||
| 907 W OKLAHOMA | GRAND ISLAND | NE | 68802 | CONSTRUCTION | 653592 |
| SAMPSON CONSTRUCTION | |||||
| 3730 S 14TH STREET | LINCOLN | NE | 68502 | CONSTRUCTION | 550308 |
| CONNER ROOFING CO | |||||
| 3702 DIVISION AVENUE | YORK | NE | 68467 | ROOFING | 412982 |
| WILLMAR ELECTRIC SERVICE | |||||
| PO BOX 394 | WILLMAR | MN | 56201 | ELECTRICIAN | 287011 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 14 | NumberOfContractorsGT100K |
| Government Grants | 235500 | GovernmentGrants |
| All Other Contributions | 151106 | AllOtherContributions |
| Total Contributions | 386606 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 622110 | 28893044 | 28893044 |
| NET RESIDENT SERVICE REVENUE | 623110 | 8695710 | 8695710 |
| HEARTHSTONE HOUSING | 623990 | 1263666 | 1263666 |
| DAYCARE | 624410 | 281911 | 281911 |
| HC+ MANAGEMENT AND STAFFING | 900099 | 219731 | 219731 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 545115 | TotalRevenueColumn |
| Related Or Exempt Function Income | 545115 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 39899177 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 419577 | TotalRevenueColumn |
| Exclusion | $419,577 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 311878 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 243367 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 68511 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 68511 | TotalRevenueColumn |
| Exclusion | $68,511 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 98166 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 86466 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 11700 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 11700 | TotalRevenueColumn |
| Related Or Exempt Function Income | 11700 | RelatedOrExemptFunctionIncome |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 40785571 | TotalRevenueColumn |
| Related Or Exempt Function Income | 39910877 | RelatedOrExemptFunctionIncome |
| Exclusion | $488,088 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1268294 | Total |
| Program Services | 700212 | ProgramServices |
| Management And General | 568082 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16260559 | Total |
| Program Services | 12076418 | ProgramServices |
| Management And General | 4184141 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 517972 | Total |
| Program Services | 379505 | ProgramServices |
| Management And General | 138467 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2005428 | Total |
| Program Services | 1446908 | ProgramServices |
| Management And General | 558520 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1219295 | Total |
| Program Services | 889432 | ProgramServices |
| Management And General | 329863 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20808 | Total |
| Management And General | 20808 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 115717 | Total |
| Management And General | 115717 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1001407 | Total |
| Program Services | 742348 | ProgramServices |
| Management And General | 259059 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 116033 | Total |
| Program Services | 96904 | ProgramServices |
| Management And General | 19129 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 630902 | Total |
| Program Services | 469420 | ProgramServices |
| Management And General | 161482 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3305269 | Total |
| Program Services | 2459274 | ProgramServices |
| Management And General | 845995 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PRO CARE OF PATIENTS-HOSP | 6692691 | 6692691 | |
| ADMINISTRATIVE&GENERAL-HO | 1706506 | 32573 | 1673933 |
| BAD DEBTS | 699707 | 699707 | |
| RENTAL/LEASE | 472748 | 421146 | 51602 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2308415 | Total |
| Program Services | 778551 | ProgramServices |
| Management And General | 1529864 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38341751 | Total |
| Program Services | 27885089 | ProgramServices |
| Management And General | 10456662 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8015932 | BOY |
| EOY | 11920434 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11380311 | BOY |
| EOY | 9582921 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4221798 | BOY |
| EOY | 4572601 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 62151 | BOY |
| EOY | 62151 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 877655 | BOY |
| EOY | 759977 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 269286 | BOY |
| EOY | 310030 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 74514309 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 33453112 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40780475 | BOY |
| EOY | 41061197 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1137608 | BOY |
| EOY | 870795 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66745216 | BOY |
| EOY | 69140106 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5089887 | BOY |
| EOY | 5601928 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 69182 | BOY |
| EOY | 46172 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18145000 | BOY |
| EOY | 16390000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 69696 | BOY |
| EOY | 1286735 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23373765 | BOY |
| EOY | 23324835 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42785558 | BOY |
| EOY | 45248551 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 585893 | BOY |
| EOY | 566720 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 43371451 | BOY |
| EOY | 45815271 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66745216 | BOY |
| EOY | 69140106 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 2443820 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 7221798 | BeginningOfYearBalance |
| Contributions | 2545451 | Contributions |
| Investment Earnings Or Losses | 925319 | InvestmentEarningsOrLosses |
| Other Expenditures | -5302529 | OtherExpenditures |
| Administrative Expenses | -3402 | AdministrativeExpenses |
| End Of Year Balance | 5386637 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 10783860 | BeginningOfYearBalance |
| Contributions | 2741265 | Contributions |
| Investment Earnings Or Losses | 815893 | InvestmentEarningsOrLosses |
| Other Expenditures | -7115444 | OtherExpenditures |
| Administrative Expenses | -3776 | AdministrativeExpenses |
| End Of Year Balance | 7221798 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 14114629 | BeginningOfYearBalance |
| Contributions | 2607394 | Contributions |
| Investment Earnings Or Losses | 703479 | InvestmentEarningsOrLosses |
| Other Expenditures | -6638482 | OtherExpenditures |
| Administrative Expenses | -3160 | AdministrativeExpenses |
| End Of Year Balance | 10783860 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 7640257 | BeginningOfYearBalance |
| Contributions | 9440267 | Contributions |
| Investment Earnings Or Losses | 564122 | InvestmentEarningsOrLosses |
| Other Expenditures | -3529727 | OtherExpenditures |
| Administrative Expenses | -290 | AdministrativeExpenses |
| End Of Year Balance | 14114629 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 8673112 | BeginningOfYearBalance |
| Contributions | 5972338 | Contributions |
| Investment Earnings Or Losses | 747559 | InvestmentEarningsOrLosses |
| Other Expenditures | -7752502 | OtherExpenditures |
| Administrative Expenses | -250 | AdministrativeExpenses |
| End Of Year Balance | 7640257 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.89480 | BoardDesignatedEOYBalance |
| Term Endowment EOY Balance | 0.10520 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 456000 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 1163192 | OtherCostOrOtherBasis |
| Book Value | 1619192 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 56265743 | OtherCostOrOtherBasis |
| Depreciation | 21580805 | Depreciation |
| Book Value | 34684938 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1479360 | OtherCostOrOtherBasis |
| Depreciation | 879219 | Depreciation |
| Book Value | 600141 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 13956311 | OtherCostOrOtherBasis |
| Depreciation | 10993088 | Depreciation |
| Book Value | 2963223 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1193703 | OtherCostOrOtherBasis |
| Book Value | 1193703 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 41061197 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| EST. THIRD-PARTY PAYOR SETTLEMENTS | $1,230,000 |
| DEPOSITS | $56,735 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1286735 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 40637445 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 40637445 | RevenueSubtotal |
| Other Revenues Not Included | 148126 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 148126 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 40785571 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 38174452 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 38174452 | ExpensesSubtotal |
| Other Expenses Not Included | 167299 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 167299 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 38341751 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| INTENDED USES FOR ENDOWMENT FUNDS | SCHEDULE D, PAGE 2, PART V, LINE 4 | ASSETS WHOSE USE IS LIMITED OR RESTRICTED: FUNDS ON DEPOSIT WITH TRUSTEE - 2,148,895 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 - 2,561,132 ASSETS SET ASIDE FOR FUTURE CAPITAL IMPROVEMENTS. BY BOARD FOR SCHOLARSHIP FUND - 99,707 INTENDED FOR SCHOLARSHIPS IN THE HEALTHCARE FIELD. BY DONORS OR GRANTORS - 566,720 INTENDED FOR VARIOUS HOSPITAL EQUIPMENT AND OPERATIONS. ESCROW DEPOSITS - 10,183 RETURNED TO DUPLEX OWNERS OR LESSEES AND APARTMENT RESIDENTS. |
| LIABILITY UNDER FIN 48 FOOTNOTE | SCHEDULE D, PAGE 3, PART X | THE MEDICAL FACILITY HAS NO RESERVE FOR UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2013 AND 2012. ADDITIONALLY, THE MEDICAL FACILITY HAS NOT RECOGNIZED ANY INTEREST OR PENALTIES IN RELATION TO INCOME TAX FILINGS AS OF OR FOR THE YEARS ENDED SEPTEMBER 30, 2013 OR 2012. FINALLY, TAX YEARS ENDED SEPTEMBER 30, 2010 THROUGH 2013 ALL REMAIN OPEN AND ARE SUBJECT TO POTENTIAL EXAMINATION BY TAXING JURISDICTIONS. |
| REVENUE AMOUNTS INCLUDED ON RETURN - OTHER | SCHEDULE D, PAGE 4, PART XI, LINE 4B | TEMPORARILY RESTRICTED CONTRIBUTIONS 148,126 |
| EXPENSE AMOUNTS INCLUDED ON RETURN - OTHER | SCHEDULE D, PAGE 4, PART XII, LINE 4B | NET ASSETS RELEASED FROM RESTRICTION FOR OPERATING PURPOSE 167,299 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | false | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 387581 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 387581 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01030 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1803326 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1569762 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 233564 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00620 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2190907 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1569762 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 621145 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01650 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 43343 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 43343 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 71786 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 71786 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00190 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3579137 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2657133 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 922004 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02450 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 212491 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 212491 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00560 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3906757 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2657133 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1249624 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03320 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6097664 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4226895 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1870769 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04970 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 28077 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 28077 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 72967 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 72967 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00190 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 154502 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 154502 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00410 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 255546 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 255546 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00670 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $420,590 | BadDebtExpenseAmount |
| Amount Attributable To | 21030 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 11072057 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 11047082 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 24975 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | YORK GENERAL HEALTH CARE SERVICES | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2222 LINCOLN AVE | AddressLine1 |
| City | YORK | City |
| State | NE | State |
| ZIP Code | 68467 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
| Other | SKILLED NURSING, ASST. LIVING | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | YORK GENERAL HEALTH CARE SERVICES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Other | X | Other |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | false | OtherFacilities |
| CHNA Widely Available | true | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | false | AllNeedsAddressed |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 100.0 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 200.0 | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Uninsured Discount | X | UninsuredDiscount |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Average Negotiated Rates | X | AverageNegotiatedRates |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 4 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (4 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| 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 MEADOWLARK ASST LIVING | ||||
| 406 MEADOWVIEW DR | YORK | NE | 68467 | ASSISTED LIVING |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| RELATED ORGANIZATION INFORMATION | PART I LINE 6A | REPORT IS NOT PREPARED BY A RELATED ORGANIZATION |
| EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE | PART I LINE 7 COLUMN F | INCLUDED ON FORM 990 PART IX LINE 25 COLUMN A BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS 699708 |
| COSTING METHODOLOGY EXPLANATION | PART I LINE 7 | 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 |
| COMMUNITY BUILDING ACTIVITIES | PART II | 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 |
| BAD DEBT EXPENSE EXPLANATION | PART III LINE 4 | THE ORGANIZATIONS FINANCIAL STATEMENT FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE IS FOOT 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 INCLUDED ON FORM 990 PART IX LINE 25 WAS 699708 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 |
| MEDICARE EXPLANATION | PART III LINE 8 | THE MEDICARE COST REPORT WHICH USES COST TO CHARGE RATIOS BY DEPARTMENT WAS USED TO DETERMINE THE AMOUNTS REPORTED ON LINE 8 |
| COLLECTION PRACTICES EXPLANATION | PART III LINE 9B | 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 |
| NEEDS ASSESSMENT | PART VI | 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 WILL BE CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT IN THE COMING YEAR WE WILL BE COORDINATING THESE EFFORTS WITH THE LOCAL PUBLIC HEALTH OFFICE |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PART VI | 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 |
| COMMUNITY INFORMATION | PART VI | YORK NE IS LOCATED AT THE INTERSECTION OF US HIGHWAY 81 AND INTERSTATE 80 THE POPULATION OF YORK COUNTY AS OF 2010 WAS 13665 THE AVERAGE HOUSEHOLD INCOME IS ALMOST 54000 THE UNEMPLOYMENT RATE IN THE YORK COUNTY AREA WAS 43 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 |
| HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE | PART VI | THE ORGANIZATIONS 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 |
| YORK GENERAL HEALTH CARE SERVICES LINE NUMBER 1 PART V LINE 3 | PART V LINE 3 | IN OCTOBER OF 2010 FOUR CORNERS HEALTH DEPARTMENT LAUNCHED A COMMUNITY HEALTH ASSESSMENT PROJECT THAT WILL HAVE LASTING EFFECTS FOR THE ENTIRE PUBLIC HEALTH SYSTEM IN THE DISTRICT A COMMUNITYDRIVEN PROCESS CALLED MAAP WAS CHOSEN TO COMPLETE THE ASSESSMENT MOBELIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP 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 THAT HELPS COMMUNITIES PRIORIZE PUBLIC HEALTH ISSUES AND IDENTIFY RESOURCES FOR ADDRESSING THEM COMMUNITY OWNERSHIP IS THE FUNDAMENTAL COMPONENT OF MAPP 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 UTILIZING A SAMPLE SURVEY TEMPLATE PROVIDED BY THE NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES DIVISION OF PUBLIC HEALTH COMMUNITY HEALTH AND PERFORMANCE MANAGEMENT MAPP PLANNING TEAM MEMBERS WORKED TOGETHER TO DISTRIBUTE PAPER COPIES OF THE SURVEYS AT COMMUNITY MEETINGS SUCH AS CHAMBER ROTARY KIWANIS AND LIONS CLUB THEY WERE TAKEN TO COMMUNITY BREAKFASTS CHURCHES SCHOOL EVENTS ETC THE GOAL WAS TO COLLECT RESPONSES FROM 500 INDIVIDUALS IN THE COMMUNITY 673 RESPONSES WERE RECEIVED BY THE END OF THE PROCESS THE MAPP PLANNING TEAM DECIDED TO COMPLETE THE ASSESSMENT AS A DAYLONG WORKSHOP FOR LOCAL PUBLIC HEALTH SYSTEM PARTICIPANTS OVER 300 INVITATIONS WERE DISTRIBUED THE WORKSHOP WAS ORGANIZED BY BREAKING DOWN THE TEN ESSENTIAL SERVICES INTO FULL GROUP AND SMALL GROUP SESSIONS FACILITATORS FOR THE DAY WERE VICKI DUEY EXECUTIVE DIRECTOR OF FCHD AND COLLEEN SVOBODA NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES FORTYNINE ATTENDEES WERE PRESENT REPRESENTING THIRTY AGENCIES AMOUNG THE FCHD DISTRICT FOR EACH ASSESSMENT QUESTION DISCUSSION FOLLOWED AS TO THE SERVICES AND PRACTICES AMOUNG SYSTEM PARTNERS THIS DISCUSSION HELPED TO BUILD THE KNOWLEDGE OF THE LOCAL PUBLIC HEALTH SYSTEM PARTNERS AS WELL AS RELATIONSHIPS AMOUNG THOSE PRESENT RESPONDENTS WERE THEN ASKED TO INDICATE THE LEVEL OF PROGRESS THEY FELT THE SYSTEM HAD MADE TOWARD THAT SERVICE THEY DID SO BY CHOOSING FROM THE FOLLOWING FIVE LEVELS OF PROGRESS NO MINIMAL MODERATE SIGNIFICANT AND OPTIMAL COLLABORATORS INCLUDE INDIVIDUALS FROM FOUR CORNERS HEALTH DEPARTMENT MIDWEST COVENANT HOME POLK COUNTY EXTENSION SERVICES AGING PARTERS YORK GENERAL HOSPITAL YORK MEDICAL CLINIC ANNIE JEFFREY HEALTH CARE SERVICES PARISH HEALTH NURSING HENDERSON HEALTH CARE SERVICES NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES POLK COUNTY HEALTH DEPARTMENT BUTLER COUNTY HEALTH CARE CENTER YORK COUNTY EXTENSION SERVICES EMERGENCY MANAGEMENT RIDGEWOOD CARE CENTER A RETIRED PHYSICIAN BLUE VALLEY COMMUNITY ACTION YORK AREA SENIOR CENTER CONCORDIA UNIVERSITY MOSAIC A COMMUNITY VOLUNTEER LEMKE MICHELS PSYCHOTHERAPY MEMORIAL HEALTH CARE SYSTEMS MAHONEY HOUSE BLUE VALLEY BEHAVIORAL HEALTH DAVID CITY SENIOR CENTER SEWARD PUBLIC SCHOOLS OSCEOLA GOOD SAMARITAN CENTER DAVID PLACE NURSING HOME TABITHA HOME CARE PLUS AND SUNRISE COUNTY MANOR |
| YORK GENERAL HEALTH CARE SERVICES LINE NUMBER 1 PART V LINE 7 | PART V LINE 7 | THE HOSPITAL WAS NOT ABLE TO ADDRESS THE NEEDS OF SUBSTANCE ABUSE DOMESTIC VIOLENCE BEHAVIORAL HEALTH AND MOTOR VEHICLE DEATHS DUE TO LACK OF FINANCIAL RESOURCES AND APPROPRIATE STAFF TRAINED TO DEAL WITH THESE ISSUES |
| YORK GENERAL HEALTH CARE SERVICES LINE NUMBER 1 PART V LINE 14G | PART V LINE 14G | THE POLICY IS MENTIONED ON ALL FOLLOW UP ACCOUNT COLLECTION PHONE CALLS |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|---|---|---|---|
| CHARLES SCHULZ | |||||
| CEO | 178707 | 5000 | 7512 | 17576 | 208795 |
| JANE THOMPSON | |||||
| VP OF OPERATIONS | 140575 | 5000 | 5723 | 9111 | 160409 |
| ROBERT MCQUISTAN | |||||
| VP OF FINANCE | 122143 | 4000 | 4947 | 21389 | 152479 |
| THOMAS C MCKENNY | |||||
| CRNA | 209796 | 8569 | 9153 | 227518 | |
| MATTHEW MONTGOMERY | |||||
| CRNA | 186606 | 7729 | 12207 | 206542 | |
| MICHAEL D MONFORE | |||||
| CRNA | 183067 | 3814 | 12207 | 199088 | |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS | Identifier |
| Return Reference | SCHEDULE J, PAGE 1, PART I, LINE 4 | ReturnReference |
| Explanation | CHARLES SCHULZ 0 7,512 0 JANE THOMPSON 0 5,723 0 ROBERT MCQUISTAN 0 4,947 0 JENNIFER OBERMIER 0 4,791 0 JAY COLBURN 0 4,525 0 THOMAS C. MCKENNY 0 8,569 0 MATTHEW MONTGOMERY 0 7,729 0 MICHAEL D. MONFORE 0 3,814 0 | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)
| Bond ReferenceBondReferenceCd | Business Name Line2IssuerName/BusinessNameLine2 | Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|---|---|
| HOSPITAL AUTHORITY NO 1 OF YORK | |||||||||
| A | COUNTY NEBRASKA | 470769138 | 986356FQ1 | 2009-09-23 | 5225000 | REFUND PRIOR ISSUE (12/20/01) | false | false | false |
| HOSPITAL AUTH NO 1 2009 HOSPITAL | |||||||||
| B | 470379039 | 986356GE7 | 2009-09-23 | 2190000 | HOSPITAL PROJECT | false | false | false | |
| HOSPITAL AUTH NO1 2010 HOSPITAL | |||||||||
| C | 470379039 | 986356GT4 | 2010-09-15 | 7195000 | HOSPITAL PROJECT | false | false | false | |
| HOSPITAL AUTH NO 1 OF YORK COUNTY | |||||||||
| D | NE | 470769138 | 986356HC0 | 2013-07-09 | 3380000 | REFUND PRIOR ISSUES (04/15/03) | false | false | false |
Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)
| Bond ReferenceBondReferenceCd | Amount RetiredAmountRetired | Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Other Spent ProceedsOtherSpentProceeds | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Capitalized InterestCapitalizedInterest | Capital ExpendituresCapitalExpenditures |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | 1425000 | 5225000 | 525444 | 5225000 | 2003 | true | false | true | true | ||
| B | 175000 | 2217391 | 186836 | 2011 | false | false | true | true | 2972 | 2027583 | |
| C | 7326952 | 592179 | 2012 | false | false | true | true | 9812 | 7317140 | ||
| D | 3380000 | 338266 | 3380000 | 2005 | true | false | true | true |
Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest | Change In Use Bond Financed PropChangeInUseBondFinancedProp | Remedial Action TakenRemedialActionTaken | Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs |
|---|---|---|---|---|---|---|---|---|
| A | false | false | false | false | false | false | false | true |
| B | false | false | false | false | false | false | false | true |
| C | false | false | false | false | false | false | false | true |
| D | false | false | false | false | false | false | false | true |
Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiled | Rebate Not Due YetRebateNotDueYet | Exception To RebateExceptionToRebate | No Rebate DueNoRebateDue | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Written Proc To Monitor ReqsWrittenProcToMonitorReqs |
|---|---|---|---|---|---|---|---|---|---|
| A | false | true | true | false | false | false | false | false | true |
| B | false | true | true | false | false | false | false | false | true |
| C | false | true | false | false | false | false | false | false | true |
| D | false | true | true | false | false | false | false | false | true |
Form990 Schedule K Part V Form990ScheduleKPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Proc To Undertk Corrective Action | true | ProcToUndertkCorrectiveAction |
Form990 Schedule K Part VI Form990ScheduleKPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DIFFERENCES IN ISSUE PRICE EXPLANATION | Identifier |
| Return Reference | SCHEDULE K | ReturnReference |
| Explanation | HOSPITAL AUTH NO 1 2009 HOSPITAL PART II LINE 3 TOTAL TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I COLUMN E DUE TO INVESTMENT EARNINGS HOSPITAL AUTH NO1 2010 HOSPITAL PART II LINE 3 THE TOTAL PROCEEDS DO NOT EQUAL THE SUMMATION OF LINES 4 12 DUE TO TRANSFERRED OR REPLACEMENT PROCEEDS IN LINE 4 | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CORNERSTONE BANK | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | SEE PART V | Relationship |
| Description Of Transaction | SEE PART V | DescriptionOfTransaction |
| Sharing Of Revenues | false | SharingOfRevenues |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ADDITIONAL INFORMATION | Identifier |
| Return Reference | SCHEDULE L PART V | ReturnReference |
| Explanation | SCHEDULE L PART IV A NAME OF INTERESTED PERSON CORNERSTONE BANK B RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION CG 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 DON WITTE DARROLL LOSCHEN AND KELLY THOMAS ARE ALL ON CORNERSTONE BANKS 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 1721125 WAS DEPOSITED THIS YEAR | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | 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. |
| RELATED PARTY INFORMATION AMONG OFFICERS | 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 DON WITTE CORNERSTONE BANK VICE CHAIR DIRECTOR DIRECTOR DARROLL J. LOSCHEN CORNERSTONE BANK BOARD MEMBER DIRECTOR DIRECTOR KELLY THOMAS CORNERSTONE BANK BOARD MEMBER DIRECTOR DIRECTOR |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | 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. |
| ENFORCEMENT OF CONFLICTS POLICY | 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. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | 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. |
| COMPENSATION PROCESS FOR OFFICERS | 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. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | 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
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|
| HEARTHSTONE 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 Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Comments