CHRISTIAN HOMES INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: CHRISTIAN HOMES INC (EIN 47-0378776)
Tax period: 2012-07-01 to 2013-06-30
Filed: 2013-11-11
IRS object ID: 201313169349300411
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 K
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-11-11T14:15:47-06:00	Timestamp
Tax Period End Date	2013-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	KOSKI PROFESSIONAL GROUP PC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	10516 BURT CIR	AddressLine1
City	OMAHA	City
State	NE	State
ZIP Code	681142062	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	470378776	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	CHRISTIAN HOMES INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	CHRI	NameControl
Phone	3089954493	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1923 WEST 4TH AVENUE	AddressLine1
City	HOLDREGE	City
State	NE	State
ZIP Code	68949	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	STEVE BERGSTROM	Name
Title	CHAIRMAN	Title
Phone	3089954493	Phone
Date Signed	2013-11-06	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	ROBERT J DICK JR	Name
Phone	4024454040	Phone
Date Prepared	2013-11-11	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Gross Receipts	7662372	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.CHRISOMA.COM	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1889	YearFormation
State Legal Domicile	NE	StateLegalDomicile
Activity Or Mission Description	PROVIDE HOUSING AND SERVICES TO THE ELDERLY AND INFIRMED IN A MANNER THAT PROVIDES FOR THE PHYSICAL, MENTAL, SOCIAL, AND SPIRITUAL WELFARE OF THE RESIDENTS.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	15	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	0	NbrIndependentVotingMembers
Total Nbr Employees	205	TotalNbrEmployees
Total Nbr Volunteers	50	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	56755	ContributionsGrantsPriorYear
Contributions Grants Current Year	243620	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	6014811	ProgramServiceRevenuePriorYear
Program Service Revenue CY	6694088	ProgramServiceRevenueCY
Investment Income Prior Year	23084	InvestmentIncomePriorYear
Investment Income Current Year	56673	InvestmentIncomeCurrentYear
Other Revenue Prior Year	258880	OtherRevenuePriorYear
Other Revenue Current Year	484372	OtherRevenueCurrentYear
Total Revenue Prior Year	6353530	TotalRevenuePriorYear
Total Revenue Current Year	7478753	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	4415126	SalariesEtcPriorYear
Salaries Etc Current Year	4705398	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	2382893	OtherExpensePriorYear
Other Expenses Current Year	2723913	OtherExpensesCurrentYear
Total Expenses Prior Year	6798019	TotalExpensesPriorYear
Total Expenses Current Year	7429311	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-444489	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	49442	RevenuesLessExpensesCY
Total Assets BOY	14324568	TotalAssetsBOY
Total Assets EOY	14295082	TotalAssetsEOY
Total Liabilities BOY	10701594	TotalLiabilitiesBOY
Total Liabilities EOY	10564571	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	3622974	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	3730511	NetAssetsOrFundBalancesEOY
Mission Description	PROVIDE HOUSING AND SERVICES TO THE ELDERLY AND INFIRMED IN A MANNER THAT PROVIDES FOR THE PHYSICAL, MENTAL, SOCIAL, AND SPIRITUAL WELFARE OF THE RESIDENTS.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	6918397	Expense
Revenue	6711826	Revenue
Description	NURSING HOME CARE AND ASSISTED LIVING FOR THE ELDERLY	Description
Total Program Service Expense	6918397	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	false	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	false	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	false	Hospital
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	false	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	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	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	1	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	205	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
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	15	NbrVotingGoverningBodyMembers
Number Independent Voting Members	0	NumberIndependentVotingMembers
Family Or Business Relationship	false	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	true	ElectionOfBoardMembers
Decisions Subject To Approval	true	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	true	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	false	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	false	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	DONALD BAKKE	NamePerson
Telephone Number	3089954493	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1923 WEST 4TH AVENUE	AddressLine1
City	HOLDREGE	City
State	NE	State
ZIP Code	68949	ZIPCode

Field	Value	IRS element (for citing)
No Listed Persons Compensated	X	NoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (15 entries)

TitleTitle	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Average Hours Per WeekAverageHoursPerWeek
CHARLIE REESER
VICE CHAIRMA	X	X	0	0	0
DON HOLEN
BOARD MEMBER	X		0	0	0
DONALD BAKKE
EXEC. DIRECT	X	X	0	0	0	40.00
DOUG GUSTAFSON
BOARD MEMBER	X		0	0	0
JIM SWANSON
BOARD MEMBER	X		0	0	0
REV TOM THOMPSON
BOARD MEMBER	X		0	0	0
MARLYS ANDERSON
SECRETARY	X	X	0	0	0
MIKE THORELL
BOARD MEMBER	X		0	0	0
REVEREND WES HOLEN
BOARD MEMBER	X		0	0	0
REVEREND NOAH PALMER
EX-OFFICIO	X	X	0	0	0
STEVE BERGSTROM
CHAIRMAN	X	X	0	0	0
STEVE STROUP
BOARD MEMBER	X		0	0	0
DR KEVIN CARNES
EX-OFFICIO	X	X	0	0	0
WAYNE COWAN
BOARD MEMBER	X		0	0	0
TERRY WOOLLEN
BOARD MEMBER	X		0	0	0

Field	Value	IRS element (for citing)
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	NEW WEST ORTHOPAEDIC & SPORTS REHAB	BusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	2810 WEST 35TH STREET SUITE 2	AddressLine1
City	KEARNEY	City
State	NE	State
ZIP Code	68845	ZIPCode

Field	Value	IRS element (for citing)
Description Of Services	THERAPY SERVICE	DescriptionOfServices
Compensation	247172	Compensation

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	1	NumberOfContractorsGT100K
Government Grants	48007	GovernmentGrants
All Other Contributions	195613	AllOtherContributions
Total Contributions	243620	TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PRIVATE REVENUE	3514720	3514720
MEDICARE & MEDICAID REVENUE	3179368	3179368

Field	Value	IRS element (for citing)
Total Program Service Revenue	6694088	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	38935	TotalRevenueColumn
Exclusion	$38,935	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	618861	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	183619	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	435242	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	435242	TotalRevenueColumn
Exclusion	$435,242	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Other	17738	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Other	17738	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	17738	TotalRevenueColumn
Related Or Exempt Function Income	17738	RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescription	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount
MEALS	38061	$38,061
MISCELLANEOUS	11069	$11,069

Field	Value	IRS element (for citing)
Total Other Revenue	49130	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	7478753	TotalRevenueColumn
Related Or Exempt Function Income	6711826	RelatedOrExemptFunctionIncome
Exclusion	$523,307	ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	119675	Total
Management And General	119675	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	3392788	Total
Program Services	3225604	ProgramServices
Management And General	167184	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	932890	Total
Program Services	857013	ProgramServices
Management And General	75877	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	260045	Total
Program Services	238816	ProgramServices
Management And General	21229	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	53337	Total
Management And General	53337	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	14918	Total
Program Services	5541	ProgramServices
Management And General	9377	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	22220	Total
Program Services	7916	ProgramServices
Management And General	14304	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	317572	Total
Program Services	317572	ProgramServices

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	39938	Total
Program Services	35110	ProgramServices
Management And General	4828	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	383238	Total
Program Services	383238	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	701742	Total
Program Services	701742	ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
SUPPLIES	627988	627988
CONTRACT LABOR	269260	269260
EQUIP. RENTAL & MAINT.	90078	90078
MEDICAL ASSESSMENT FEE	84438	84438

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	119184	Total
Program Services	74081	ProgramServices
Management And General	45103	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	7429311	Total
Program Services	6918397	ProgramServices
Management And General	510914	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	591693	BOY
EOY	446690	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	161721	BOY
EOY	112066	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	622594	BOY
EOY	801224	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	19553	BOY
EOY	19553	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	1006	BOY
EOY	22587	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	18764539	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	7328531	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	11031951	BOY
EOY	11436008	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	864282	BOY
EOY	968481	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	1031768	BOY
EOY	488473	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	14324568	BOY
EOY	14295082	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	508971	BOY
EOY	593870	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	19746	BOY
EOY	41455	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	10133356	BOY
EOY	9876756	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	39521	BOY
EOY	52490	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	10701594	BOY
EOY	10564571	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	3622974	BOY
EOY	3730511	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	3622974	BOY
EOY	3730511	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	14324568	BOY
EOY	14295082	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	49442	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	58095	ReconciliationUnrealizedInvest
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)
Publicly Supported Org509a2	X	PubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	412757	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	46922	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	234845	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	56755	CurrentTaxYearMinus1Year
Current Tax Year	243620	CurrentTaxYear
Total	994899	Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	6182062	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	6215481	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	6277716	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	5917449	CurrentTaxYearMinus1Year
Current Tax Year	6515458	CurrentTaxYear
Total	31108166	Total

Total509 Total509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	6594819	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	6262403	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	6512561	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	5974204	CurrentTaxYearMinus1Year
Current Tax Year	6759078	CurrentTaxYear
Total	32103065	Total

Field	Value	IRS element (for citing)
Public Support Total509	32103065	PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	51525	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	35514	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	35188	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	23084	CurrentTaxYearMinus1Year
Current Tax Year	38935	CurrentTaxYear
Total	184246	Total

Investment Income And UBTI InvestmentIncomeAndUBTI

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	51525	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	35514	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	35188	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	23084	CurrentTaxYearMinus1Year
Current Tax Year	38935	CurrentTaxYear
Total	184246	Total

Other Income509 OtherIncome509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	60788	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	29745	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	25022	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	52330	CurrentTaxYearMinus1Year
Current Tax Year	49129	CurrentTaxYear
Total	217014	Total

Total Support Total TotalSupportTotal

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	6707132	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	6327662	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	6572771	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	6049618	CurrentTaxYearMinus1Year
Current Tax Year	6847142	CurrentTaxYear
Total	32504325	Total

Field	Value	IRS element (for citing)
Public Support Percentage509	0.98770	PublicSupportPercentage509
Prior Year Support Percentage	0.98500	PriorYearSupportPercentage
Investment Income Percentage	0.01000	InvestmentIncomePercentage
Prior Yr Invest Income Percentage	0.01000	PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509	X	ThirtyThreePercntTestsCY509

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

Land Land

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	250354	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	61952	OtherCostOrOtherBasis
Book Value	312306	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	33071	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	15354073	OtherCostOrOtherBasis
Depreciation	5445475	Depreciation
Book Value	9941669	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	585293	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	2479796	OtherCostOrOtherBasis
Depreciation	1883056	Depreciation
Book Value	1182033	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	11436008	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescription	AmountAmount
SECURITY DEPOSITS	$50,120
MISCELLANEOUS ADJUSTMENT	$2,370

Field	Value	IRS element (for citing)
Total Of Amounts	52490	TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt	7536848	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	58095	NetUnrealizedGainsInvestments
Revenue Not Rptd F990	58095	RevenueNotRptdF990
Revenue Subtotal	7478753	RevenueSubtotal
Total Revenue Per Form990	7478753	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	7429311	TotExpensesEtcAuditedFinclStmt
Expenses Subtotal	7429311	ExpensesSubtotal
Total Expenses Per Form990	7429311	TotalExpensesPerForm990

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	HOSP AUTH NO 1 OF PHELPS COUNTY	BusinessNameLine1

Field	Value	IRS element (for citing)
Issuer EIN	410777710	IssuerEIN
Date Issued	2010-10-27	DateIssued
Issue Price	10360000	IssuePrice
Description Of Purpose	REFUND PRIOR ISSUE (10/1/98) CONSTRUCT/RENOVATE EXISTING FACILITIES.	DescriptionOfPurpose
Defeased	false	Defeased
On Behalf Of Issuer	false	OnBehalfOfIssuer
Pool Financing	false	PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Amount Retired	483244	AmountRetired
Total Proceeds	10363140	TotalProceeds
Amount In Reserve Fund	250246	AmountInReserveFund
Capitalized Interest	586687	CapitalizedInterest
Issuance Costs From Proceeds	207200	IssuanceCostsFromProceeds
Capital Expenditures	5773731	CapitalExpenditures
Other Spent Proceeds	3545273	OtherSpentProceeds
Amount Unspent	3	AmountUnspent
Current Refunding	true	CurrentRefunding
Advance Refunding	false	AdvanceRefunding
Final Allocation Made	false	FinalAllocationMade
Adequate Books And Recds Maintaind	true	AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	false	OwningBondFinancedProperty
Any Lease Arrangements	false	AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty	false	MngmentCntrctBondFinancdPrprty
Any Research Agreements	false	AnyResearchAgreements
Bond Iss Meet Prvt Security Pay Test	false	BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop	false	ChangeInUseBondFinancedProp
Remedial Action Taken	false	RemedialActionTaken
Non Qualified Bond Remed Procdrs	false	NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	false	Form8038TFiled
Rebate Not Due Yet	true	RebateNotDueYet
Exception To Rebate	false	ExceptionToRebate
No Rebate Due	false	NoRebateDue
Variable Rate Issue	true	VariableRateIssue
Hedge Identified In Books And Recds	false	HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC	false	GrossProceedsInvestedInGIC
Gross Proceeds Invested	false	GrossProceedsInvested
Written Proc To Monitor Reqs	false	WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Proc To Undertk Corrective Action	false	ProcToUndertkCorrectiveAction

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ELECTION OF MEMBERS AND THEIR RIGHTS	FORM 990, PAGE 6, PART VI, LINE 7A	BOARD MEMBERS ARE FIRST NOMINATED BY A NOMINATING COMMITTEE COMPRISED OF CURRENT BOARD MEMBERS. THEY ARE THEN ELECTED DURING THE YEARLY MIDWEST EVANGELICAL FREE CHURCH CONFERENCE.
DECISIONS SUBJECT TO APPROVAL OF MEMBERS	FORM 990, PAGE 6, PART VI, LINE 7B	IF A LOAN REQUIRES THE PLEDGING OF ASSETS, PERMISSION IS REQUIRED OF THE BOARD OF THE MIDWEST DISTRICT OF THE EVANGELICAL FREE CHURCH OF AMERICA.
OFFICERS WHO CANNOT BE REACHED	FORM 990, PAGE 6, PART VI, LINE 9	CHARLIE REESER 717 HANCOCK HOLDREGE, NE 68949 DON HOLEN 302 STABLE DRIVE BERTRAND, NE 68927 DOUG GUSTAFSON 1123 GARFIELD ST HOLDREGE, NE 68949 JIM SWANSON 3210 11TH AVE KEARNEY, NE 68845 REV TOM THOMPSON PO BOX 160 LOOMIS, NE 68958 MARLYS ANDERSON 73984 I RD LOOMIS, NE 68958 MIKE THORELL PO BOX 244 LOOMIS, NE 68958 REVEREND WES HOLEN PO BOX 291 OXFORD, NE 68967 REVEREND NOAH PALMER 218 WEST 18TH ST KEARNEY, NE 68847 STEVE BERGSTROM 73171 RD 20 AXTELL, NE 68924 STEVE STROUP 1319 VALERIE AVENUE HOLDREGE, NE 68949 DR. KEVIN CARNES 1404 DEEP CREEK LANE MANHATTAN, KS 66502 WAYNE COWAN 43395 RD 725 OXFORD, NE 68967 TERRY WOOLLEN 71361 US HWY 183 ALMA, NE 68920
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990	FORM 990, PAGE 6, PART VI, LINE 11B	THE EXECUTIVE DIRECTOR REVIEWS THE FORM 990 AND NOTIFIES THE PREPARER OF ANY CHANGES. THE FORM 990 IS AVAILABLE FOR REVIEW BY BOARD MEMBERS AT THEIR REQUEST.
ENFORCEMENT OF CONFLICTS POLICY	FORM 990, PAGE 6, PART VI, LINE 12C	THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY.
COMPENSATION PROCESS FOR TOP OFFICIAL	FORM 990, PAGE 6, PART VI, LINE 15A	COMPARABILITY OF COMPENSATION FOR TOP MANAGEMENT OFFICIALS IS REVIEWED THROUGH AN INDEPENDENT CONSULTANT SPECIALIZING IN LONG-TERM CARE AS WELL AS BY AN INDUSTRY SURVEY CONDUCTED ON A STATE WIDE BASIS.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION	FORM 990, PAGE 6, PART VI, LINE 19	GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	MIDWEST DISTRICT OF THE EVANGELICAL	BusinessNameLine1
Business Name Line2	FREE CHURCH OF AMERICA	BusinessNameLine2

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	218 W 18TH ST	AddressLine1
City	KEARNEY	City
State	NE	State
ZIP Code	68845	ZIPCode

Field	Value	IRS element (for citing)
EIN	410721672	EIN
Primary Activities	CHURCH	PrimaryActivities
Legal Domicile State	NE	LegalDomicileState
Exempt Code Section	501C	ExemptCodeSection
Public Charity Status	1	PublicCharityStatus
Direct Controlling Entity NA	N/A	DirectControllingEntityNA
Controlled Org	false	ControlledOrg

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