NEMAHA VALLEY COMMUNITY HOSPITAL: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- NEMAHA VALLEY COMMUNITY HOSPITAL (EIN 48-0764456)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2013-11-12
- IRS object ID
- 201323169349302437
- Schema version
- 2012v2.1
- 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 | 2013-11-12T08:08:53-06:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 481026809 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Wendling Noe Nelson & Johnson LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 534 S Kansas Ave Suite 1500 | AddressLine1 |
| City | Topeka | City |
| State | KS | State |
| ZIP Code | 666033491 | 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 | 480764456 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Nemaha Valley Community Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NEMA | NameControl |
| Phone | 7853366181 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 Community Drive | AddressLine1 |
| City | Seneca | City |
| State | KS | State |
| ZIP Code | 66538 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Stan Regehr | Name |
| Title | CEO | Title |
| Phone | 7853366181 | Phone |
| Date Signed | 2013-11-08 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Eric L Otting | Name |
| PTIN | P00298454 | PTIN |
| Phone | 7852334226 | Phone |
| Date Prepared | 2013-11-08 | 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) |
|---|---|---|
| Name Of Principal Officer Person | Stan Regehr | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 Community Drive | AddressLine1 |
| City | Seneca | City |
| State | KS | State |
| ZIP Code | 66538 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 11489739 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | nemvch.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1969 | YearFormation |
| State Legal Domicile | KS | StateLegalDomicile |
| Activity Or Mission Description | The Nemaha Valley Community Hospital provides an acute care hospital to the surrounding area. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 159 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 73961 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 94729 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 10350361 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 11322949 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 21660 | InvestmentIncomePriorYear |
| Investment Income Current Year | 18587 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 59775 | OtherRevenuePriorYear |
| Other Revenue Current Year | 53474 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 10505757 | TotalRevenuePriorYear |
| Total Revenue Current Year | 11489739 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 6108815 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 6400507 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 671 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4514689 | OtherExpensePriorYear |
| Other Expenses Current Year | 4448672 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 10623504 | TotalExpensesPriorYear |
| Total Expenses Current Year | 10849179 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -117747 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 640560 | RevenuesLessExpensesCY |
| Total Assets BOY | 13852059 | TotalAssetsBOY |
| Total Assets EOY | 14713342 | TotalAssetsEOY |
| Total Liabilities BOY | 9122539 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 9288874 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 4729520 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 5424468 | NetAssetsOrFundBalancesEOY |
| Mission Description | The Nemaha Valley Community Hospital is dedicated to providing quality health care and other related services in a compassionate manner sufficient to meet the primary health care needs of its patrons within the scope of its resources and staff. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 9626496 | Expense |
| Revenue | 11351338 | Revenue |
| Description | Nemaha Valley Community Hospital provides inpatient and outpatient hospital services and clinic services to patients in its service area. | Description |
| Total Program Service Expense | 9626496 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 23 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 159 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Connie Ingwerson | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7853366181 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 Community Drive | AddressLine1 |
| City | Seneca | City |
| State | KS | State |
| ZIP Code | 66538 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (16 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Kathy O'Brien | |||||||
| Chairwoman | 1.00 | X | X | 0 | 0 | 0 | |
| Joyce Schmitz | |||||||
| Secretary | 1.00 | X | X | 0 | 0 | 0 | |
| Judy Deters | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Dr William Bartkoski | |||||||
| Physician/Trustee | 40.00 | X | 219283 | 0 | 15048 | ||
| Jim Runnebaum | |||||||
| Vice Chairman | 1.00 | X | X | 0 | 0 | 0 | |
| Steve Haverkamp | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Dennis Henry | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Ed Mohney | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Leroy Strathman | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Steve Kramer | |||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | ||
| Stan Regehr | |||||||
| CEO | 40.00 | X | 151857 | 0 | 6060 | ||
| Connie Ingwerson | |||||||
| CFO | 40.00 | X | 78530 | 0 | 4521 | ||
| Dr Jody Bieker | |||||||
| Physician | 40.00 | 204263 | 0 | 27864 | X | ||
| Dr James Lueger | |||||||
| Physician | 40.00 | 214283 | 0 | 14250 | X | ||
| Karen Hynek | |||||||
| ARNP | 40.00 | 105575 | 0 | 9335 | X | ||
| Dr Angela Stueve | |||||||
| Physician | 40.00 | 220303 | 0 | 28476 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1194094 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 105554 | TotalOtherCompensation |
| Number Individuals GT100 K | 6 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Harry Stewart | |||||
| PO Box 147 | Seneca | KS | 66538 | Anesthesia Services | 318216 |
| Healthcare Management Services | |||||
| 2739 Momemtum Place | Chicago | IL | 60689 | IT Maintenance | 245917 |
| Stormont Vail Healthcare | |||||
| 1500 SW 10th Avenue | Topeka | KS | 66604 | Lab Services | 136955 |
| Shared Medical Services | |||||
| PO Box 330 | Cottage Grove | WI | 53527 | MRI Scans | 115345 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Government Grants | 35865 | GovernmentGrants |
| All Other Contributions | 58864 | AllOtherContributions |
| Total Contributions | 94729 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Patient service revenue | 621990 | 10546822 | 10546822 |
| Electronic Health Record Incentiv | 621990 | 776127 | 776127 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 11322949 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 18587 | TotalRevenueColumn |
| Exclusion | $18,587 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| Miscellaneous | 621990 | 28389 | 28389 | |
| Dietary Income | 621990 | 25085 | $25,085 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 53474 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 11489739 | TotalRevenueColumn |
| Related Or Exempt Function Income | 11351338 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $43,672 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 242878 | Total |
| Management And General | 242878 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5088851 | Total |
| Program Services | 4613598 | ProgramServices |
| Management And General | 475253 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 130143 | Total |
| Program Services | 118131 | ProgramServices |
| Management And General | 12012 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 622381 | Total |
| Program Services | 545529 | ProgramServices |
| Management And General | 76852 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 316254 | Total |
| Program Services | 274307 | ProgramServices |
| Management And General | 41947 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9518 | Total |
| Management And General | 9518 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16432 | Total |
| Program Services | 8676 | ProgramServices |
| Management And General | 7756 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40060 | Total |
| Program Services | 39731 | ProgramServices |
| Management And General | 329 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 193006 | Total |
| Program Services | 193006 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 59657 | Total |
| Program Services | 43446 | ProgramServices |
| Management And General | 16211 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 577553 | Total |
| Program Services | 577553 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 836186 | Total |
| Program Services | 778535 | ProgramServices |
| Management And General | 57651 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 105167 | Total |
| Program Services | 105167 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Supplies | 1054074 | 1025045 | 29029 | |
| Professional fees | 891639 | 782952 | 108016 | 671 |
| Equipment rental and ma | 484791 | 382242 | 102549 | |
| Miscellaneous | 85017 | 83484 | 1533 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 95572 | Total |
| Program Services | 55094 | ProgramServices |
| Management And General | 40478 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10849179 | Total |
| Program Services | 9626496 | ProgramServices |
| Management And General | 1222012 | ManagementAndGeneral |
| Fundraising | 671 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 278632 | BOY |
| EOY | 121204 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3489148 | BOY |
| EOY | 4139439 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4980 | BOY |
| EOY | 200 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1266160 | BOY |
| EOY | 1161014 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 241504 | BOY |
| EOY | 221319 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 221276 | BOY |
| EOY | 236546 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 16860945 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 8743248 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8287076 | BOY |
| EOY | 8117697 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 63283 | BOY |
| EOY | 715923 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13852059 | BOY |
| EOY | 14713342 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 712539 | BOY |
| EOY | 1013874 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8410000 | BOY |
| EOY | 8275000 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9122539 | BOY |
| EOY | 9288874 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4729520 | BOY |
| EOY | 5370080 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 54388 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4729520 | BOY |
| EOY | 5424468 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13852059 | BOY |
| EOY | 14713342 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 640560 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 54388 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | 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
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 54681 | OtherCostOrOtherBasis |
| Book Value | 54681 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 11442718 | OtherCostOrOtherBasis |
| Depreciation | 5222584 | Depreciation |
| Book Value | 6220134 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5363546 | OtherCostOrOtherBasis |
| Depreciation | 3520664 | Depreciation |
| Book Value | 1842882 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 8117697 | TotalOfBookValueLandBuildings |
| Tot Revenue Etc Audited Fincl Stmt | 11489739 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 11489739 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 11489739 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 10849179 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 10849179 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 10849179 | TotalExpensesPerForm990 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 72649 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 72649 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00670 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 364636 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 132022 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 232614 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02140 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 437285 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 132022 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 305263 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02810 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 63397 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14270 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 49127 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00450 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4851 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 4851 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 68248 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14270 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 53978 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00490 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 505533 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 146292 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 359241 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03300 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense | $194,412 | BadDebtExpenseAmount |
| Amount Attributable To | 77765 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 5370298 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 5587964 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -217666 | 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 | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | 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 | Nemaha Valley Community Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 Community Drive | AddressLine1 |
| City | Seneca | City |
| State | KS | State |
| ZIP Code | 66538 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Nemaha Valley Community Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | 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 |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 1 | OtherFacilities |
| CHNA Widely Available | 1 | 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 |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 0 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 0 | UsesFPGFree |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 200.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Permit Lien On Residence | X | PermitLienOnResidence |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Medicare Rate | X | MedicareRate |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| Part II: N/A | |
| Part III, Line 4: Nemaha Valley Community Hospital provides for accounts receivable that could become uncollectible in the future by establishing an allowance to reduce the carrying value of such receivables to their estimated net realizable value. This estimate is based on the aging of its accounts receivable by payor and historical collection experience. | |
| Part III, Line 8: The Hospital provides service to all patients in their service area, regardless of the patient's ability to pay, and any shortfall absorbed by the Hospital is a benefit to the community. | |
| Part III, Line 9b: Nemaha Valley Community Hospital makes every effort to get correct financial and billing information and to educate patients on the eligibility requirements of charity care programs and payment options. | |
| Part V, Section B, Line 3: Community members were invited to attend three meetings in which their input was requested to determine the health needs of the community. The community members decided what the health care needs are and prioritized these needs. | Nemaha Valley Community Hospital |
| Part V, Section B, Line 4: Sabetha Community Hospital, Inc. | Nemaha Valley Community Hospital |
| Part V, Section B, Line 7: The scope of one specific need identified was too large and the sponsors of the health needs assessment are unable to address it at this time due to financial constraints. | Nemaha Valley Community Hospital |
| Part V, Section B, Line 10: The hospital's Financial Assistance policy makes financial assistance available to all patients who qualify under Federal Poverty Guidelines (FPG). Discounts begin for patients whose income is up to 200 percent of FPG. The hospital's assistance begins at a 20 percent discount of amounts generally billed and increases to a 90 percent discount for patients at or below 100 percent of the FPG. | Nemaha Valley Community Hospital |
| Part VI, Line 2: A Community Health Needs Assessment was conducted in October 2012. The health care needs of the commmunity were identified during this assessment through input of the community members who participated in multiple meetings held to gather this information. | |
| Part VI, Line 3: Notification associated with patient encounter. | |
| Part VI, Line 4: The community served is primarily residents who reside in Nemaha County Kansas and consists of approximately 2,000 residents. The median family income is $42,617. 15.5% of the community residents live below federal poverty level, and 1.9% of the community residents live below 50% of the federal poverty level. Neighboring hospitals are located in Sabetha, Pawnee County, NE, and Hiawatha. They are approximately 15, 20, and 28 miles away respectively. | |
| Part VI, Line 5: The Hospital notifies the public in quarterly newsletters about services available at the hospital. The Hospital offers periodic diabetic educational programs and education programs for expectant mothers. The Hospital uses all excess funds to maintain and improve Hospital facilities and equipment and to insure the delivery of high quality patient care services. | |
| Part VI, Line 6: N/A |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Dr William Bartkoski | ||||||||||||||
| Physician/Trustee | 219283 | 0 | 0 | 0 | 0 | 0 | 10527 | 0 | 4521 | 0 | 234331 | 0 | 0 | 0 |
| Stan Regehr | ||||||||||||||
| CEO | 136857 | 0 | 15000 | 0 | 0 | 0 | 6060 | 0 | 0 | 0 | 157917 | 0 | 0 | 0 |
| Dr Jody Bieker | ||||||||||||||
| Physician | 204263 | 0 | 0 | 0 | 0 | 0 | 9293 | 0 | 18571 | 0 | 232127 | 0 | 0 | 0 |
| Dr James Lueger | ||||||||||||||
| Physician | 214283 | 0 | 0 | 0 | 0 | 0 | 9729 | 0 | 4521 | 0 | 228533 | 0 | 0 | 0 |
| Dr Angela Stueve | ||||||||||||||
| Physician | 220303 | 0 | 0 | 0 | 0 | 0 | 9905 | 0 | 18571 | 0 | 248779 | 0 | 0 | 0 |
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 | City of Seneca Kansas | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 486026237 | IssuerEIN |
| CUSIP Number | 81712RAP4 | CUSIPNumber |
| Date Issued | 2008-12-01 | DateIssued |
| Issue Price | 8835000 | IssuePrice |
| Description Of Purpose | To refund notes payable and construction costs for an addition to Hospital | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Amount Retired | 560000 | AmountRetired |
| Total Proceeds | 8852850 | TotalProceeds |
| Capitalized Interest | 498789 | CapitalizedInterest |
| Issuance Costs From Proceeds | 161472 | IssuanceCostsFromProceeds |
| Capital Expenditures | 6834436 | CapitalExpenditures |
| Other Spent Proceeds | 1358153 | OtherSpentProceeds |
| Year Of Subst Completion | 2011 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 1 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Bond Iss Meet Prvt Security Pay Test | 0 | BondIssMeetPrvtSecurityPayTest |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedProp |
| Non Qualified Bond Remed Procdrs | 0 | NonQualifiedBondRemedProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiled |
| Rebate Not Due Yet | 0 | RebateNotDueYet |
| Exception To Rebate | 0 | ExceptionToRebate |
| No Rebate Due | 0 | NoRebateDue |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqs |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Sara Kramer | |||
| Daughter of Board Member/Daughter-in-law of Board Member | 39662 | Employed by Nemaha Valley Community Hospital as the Director of the dietary department. | 0 |
| Tina Palic | |||
| Daughter of Board Member | 73502 | Employed by Nemaha Valley Community Hospital as the Director of the occupational/physical therapy department. | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 6 | The hospital is a not-for-profit corporation with 10 members at December 31, 2012. | |
| Form 990, Part VI, Section A, line 7a | The Medical Center's corporate members elect the governing body. | |
| Form 990, Part VI, Section B, line 11 | The 990 is not formally presented to the board prior to filing. The document is made available upon request. | |
| Form 990, Part VI, Section B, line 12c | The board in required to annually sign conflict of interest statements. | |
| Form 990, Part VI, Section B, line 15a | The CEO salary and compensation is approved by the hospital's board. | |
| Form 990, Part VI, Section C, line 19 | Documents are available upon request. | |
| Form 990, Part XI, line 9: | Temporarily restricted net assets, contributions and grants 54,388. | Changes in Net Assets or Fund Balances: |
| FORM 990 PART XI, Line 2C | The board is responsible for the oversight of the financial statement audit and selection of the independent accountant. The independent accountant presents the financial statements and related communications to the Board for their approval. | Financial Statement Reporting |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Nemaha Valley Health Care Foundation | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 Community Drive | AddressLine1 |
| City | Seneca | City |
| State | KS | State |
| ZIP Code | 66538 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 481097250 | EIN |
| Primary Activities | Fundraising for the benefit of Nemaha Valley Community Hospital | PrimaryActivities |
| Legal Domicile State | KS | LegalDomicileState |
| Exempt Code Section | 501(c)(3) | ExemptCodeSection |
| Public Charity Status | 509(a) | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Nemaha Valley Community Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | 1 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Nemaha Valley Community Hospital Foundation | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionType |
| Amount Involved | 50000 | AmountInvolved |
| Method Of Amt Determination | Actual amount | MethodOfAmtDetermination |