FAITH REGIONAL HEALTH SERVICES: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: FAITH REGIONAL HEALTH SERVICES (EIN 47-0796875)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-11-14
IRS object ID: 201333189349301918
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 C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-11-14T09:27:28-06:00	Timestamp
Tax Period End Date	2012-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	476097913	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SEIM JOHNSON LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	18081 BURT STREET SUITE 200	AddressLine1
City	OMAHA	City
State	NE	State
ZIP Code	680224722	ZIPCode

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

Filer Filer

Field	Value	IRS element (for citing)
EIN	470796875	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	FAITH REGIONAL HEALTH SERVICES	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	FAIT	NameControl
Phone	4023714880	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1500 KOENIGSTEIN AVENUE PO BOX 869	AddressLine1
City	NORFOLK	City
State	NE	State
ZIP Code	687020869	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	JOHN WILKER	Name
Title	CFO	Title
Phone	4023713402	Phone
Date Signed	2013-11-11	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	BARBARA J FAJEN	Name
PTIN	P00400874	PTIN
Phone	4023302660	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	TIMOTHY AUWARTER	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	1500 KOENIGSTEIN AVENUE PO BOX 869	AddressLine1
City	NORFOLK	City
State	NE	State
ZIP Code	687020869	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	162295197	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.FRHS.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1996	YearFormation
State Legal Domicile	NE	StateLegalDomicile
Activity Or Mission Description	FAITH REGIONAL HEALTH SERVICES IS A HEALTHCARE ORGANIZATION PROVIDING ACUTE, SKILLED AND OUTPATIENT SERVICES TO INDIVIDUALS IN OUR SERVICE AREA.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	15	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	10	NbrIndependentVotingMembers
Total Nbr Employees	1600	TotalNbrEmployees
Total Nbr Volunteers	155	TotalNbrVolunteers
Total Gross UBI	214083	TotalGrossUBI
Net Unrelated Business Txbl Income	141283	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	1241736	ContributionsGrantsPriorYear
Contributions Grants Current Year	1105992	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	148226036	ProgramServiceRevenuePriorYear
Program Service Revenue CY	159645558	ProgramServiceRevenueCY
Investment Income Prior Year	2002325	InvestmentIncomePriorYear
Investment Income Current Year	-940321	InvestmentIncomeCurrentYear
Other Revenue Prior Year	175877	OtherRevenuePriorYear
Other Revenue Current Year	117811	OtherRevenueCurrentYear
Total Revenue Prior Year	151645974	TotalRevenuePriorYear
Total Revenue Current Year	159929040	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	449695	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	476246	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	71891251	SalariesEtcPriorYear
Salaries Etc Current Year	77098650	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	324112	TotalFundrsngExpCurrentYear
Other Expense Prior Year	74189647	OtherExpensePriorYear
Other Expenses Current Year	79954879	OtherExpensesCurrentYear
Total Expenses Prior Year	146530593	TotalExpensesPriorYear
Total Expenses Current Year	157529775	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	5115381	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	2399265	RevenuesLessExpensesCY
Total Assets BOY	188031415	TotalAssetsBOY
Total Assets EOY	188970154	TotalAssetsEOY
Total Liabilities BOY	102340882	TotalLiabilitiesBOY
Total Liabilities EOY	100689378	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	85690533	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	88280776	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	FAITH REGIONAL HEALTH SERVICES (FAITH REGIONAL), A NOT-FOR-PROFIT HEALTH CARE FACILITY LOCATED IN NORTHEAST NEBRASKA OPERATES FOR THE BENEFIT OF THE INDIVIDUALS IN ITS SERVICE AREA. FAITH SERVES ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND DOES NOT LIMIT ITS SERVICES OR DISCRIMINATE AGAINST ANYONE ON THE BASIS OF RACE, COLOR, SEX, NATIONAL ORIGIN, SEXUAL ORIENTATION, RELIGION, AGE, DISABILITY, DISEASE, OR DIAGNOSIS.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	66647994	Expense
Revenue	48710496	Revenue
Description	FAITH REGIONAL PROVIDES HEALTHCARE TO ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY OR THEIR INSURANCE PROVIDER. DURING 2012, FAITH PROVIDED 11,624 PATIENT DAYS TO MEDICARE PATIENTS AND 1,871 PATIENT DAYS TO MEDICAID PATIENTS.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	12554427	Expense
Revenue	10230706	Revenue
Description	MANY SERVICES PROVIDED BY FAITH REGIONAL ARE DONE TO MEET SPECIFIC NEEDS OF THE COMMUNITY BECAUSE NO OTHER SERVICES ARE AVAILABLE. AS A RESULT, THESE SERVICES ARE PROVIDED KNOWING THAT THEY WILL NOT BE FINANCIALLY VIABLE OR SELF-SUPPORTING. THESE SERVICES INCLUDE BEHAVIORAL HEALTH INPATIENT AND OUTPATIENT SERVICES, DIALYSIS SERVICES, CARDIOPULMONARY REHABILTIATION SERVICES, HOME HEALTH CARE AND TRANSITIONAL CARE (LONG-TERM REHABILITIATION) SERVICES.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	3055767	Expense
Description	A SUBSTANTIAL PORTION OF COMMUNITY BENEFITS PROVIDED BY FAITH REGIONAL IS THE PROVISION OF PATIENT CARE SERVICES THAT ARE NOT PAID FOR EITHER BY THE PATIENT OR A THIRD PARTY INSURANCE. DURING 2012, FAITH PROVIDED PATIENTS OVER $3 MILLION IN ASSISTANCE WITH PAYING THEIR HOSPITAL BILLS.	Description

Activity Other ActivityOther

Field	Value	IRS element (for citing)
Expense	57094835	Expense
Grants	476246	Grants
Revenue	100130379	Revenue
Description	FAITH REGIONAL IS COMMITTED TO MAINTAINING AND ENHANCING THE QUALITY OF CARE THROUGH THE PROVISION OF EDUCATION TO EMPLOYEES AND MEDICAL STAFF AND THROUGH THE OFFERING OF BENEFITS THAT SUPPORT THIS.BENEFITS TO OUR EMPLOYEES INCLUDE EDUCATIONAL LOANS, TUITION REIMBURSEMENT AND WORKSHOP EXPENSE REIMBURSEMENT. IN 2012, A TOTAL OF 48,760 HOURS OF EDUCATION HOURS WERE PROVIDED TO OUR 1,300 EMPLOYEES AND MEDICAL STAFF MEMBERS. OF THIS TOTAL, 26,000 HOURS WERE COMPLETED ONLINE.FAITH REGIONAL ALSO PROMOTES HEALTHCARE CAREERS BY PARTICIPATING AT HIGH SCHOOL CAREER FAIRS AND OFFERING STUDENT SHADOWING.	Description

Field	Value	IRS element (for citing)
Total Of Other Program Service Exp	57094835	TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt	476246	TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev	100130379	TotalOfOtherProgramServiceRev
Total Program Service Expense	139353023	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	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	1	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	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	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	1	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	1	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	1	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	88	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	1600	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
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	15	NbrVotingGoverningBodyMembers
Number Independent Voting Members	10	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	1	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	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	1	InvestmentInJointVenture
Written Policy Or Procedure	1	WrittenPolicyOrProcedure
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	JOHN WILKER	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	4026447249	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1500 KOENIGSTEIN AVENUE PO BOX 869	AddressLine1
City	NORFOLK	City
State	NE	State
ZIP Code	687020869	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (29 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Highest Compensated EmployeeHighestCompensatedEmployee
WALTER LAMMLI
CHAIR	1.00	0.00	X	X	0	0	0
JEFFREY EISENMENGER
VICE CHAIR	1.00	0.00	X	X	0	0	0
JEFFREY PAPE OD
TREASURER	1.00	1.00	X	X	0	0	0
BERNARD AUTEN
SECRETARY	1.00	0.00	X	X	0	0	0
JAMES ALBIN MD
MEMBER	1.00	0.00	X		0	0	0
CRAIG BOCHE
MEMBER	1.00	1.00	X		0	0	0
ANITA BRENNEMAN
MEMBER	1.00	1.00	X		0	0	0
JOHN DINKEL
MEMBER	1.00	1.00	X		0	0	0
JOHN HUSCHER MD
MEMBER	1.00	0.00	X		142905	0	18261
DANIEL KARMAZIN DDS
MEMBER	1.00	1.00	X		0	0	0
RICHARD MEYER OD
MEMBER	1.00	1.00	X		0	0	0
LINDA MILLER
MEMBER	1.00	1.00	X		0	0	0
SCOTT MILLER
MEMBER	1.00	1.00	X		0	0	0
JAMES SCHEER
MEMBER	1.00	1.00	X		0	0	0
TOD VOSS MD
MEMBER	1.00	0.00	X		0	0	0
JAMES J SINEK
CEO	38.00	2.00		X	481208	0	32257
DOUGLAS WISMER
CFO (THRU 2/10/12)	38.00	2.00		X	50821	0	2229
BILL LUKE
INTERIM CFO (2/10/12-7/16/12)	38.00	2.00		X	151913	0	0
JOHNATHAN WILKER
CFO (FROM 7/16/12)	38.00	2.00		X	68385	0	4517
TIMOTHY AUWARTER
VP SUPPORT/ANCILLARY	40.00	0.00		X	112912	0	13103
TIMOTHY DAVY MD
VP MEDICAL AFFAIRS	40.00	0.00		X	104030	0	5201
KELLY DRISCOLL
VP/CHIEF NURSING OFFICER	40.00	0.00		X	159966	0	21412
JANET PINKELMAN
VP HUMAN RESOURCES	40.00	0.00		X	156679	0	8066
PATRICK ROCHE
COO - FRPS	40.00	0.00		X	153825	0	21456
MOHAMMAD IMRAN MD
CARDIOLOGIST	40.00	0.00			654082	0	18255	X
RAVISHANKAR KALAGA MD
CARDIOLOGIST	40.00	0.00			649788	0	18256	X
DOUGLAS WELSH MD
CARDIOLOGIST	40.00	0.00			674514	0	28256	X
GEORGE YARED MD
GASTROENTEROLOGIST	40.00	0.00			655370	0	25756	X
JEFFREY YOSTEN MD
EMERGENCY ROOM PHYSICIAN	40.00	0.00			543441	0	23415	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	4759839	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	240440	TotalOtherCompensation
Number Individuals GT100 K	73	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
QUAMMEN HEALTH CARE CONSULTANT
552 BRANDIES CIRCLE B4	MURFREESBORO	TN	37128	IT CONSULTING	1733487
NEBRASKA LAB INC
PO BOX 82643	LINCOLN	NE	68501	LAB SERVICES	691977
SIOUX CITY NIGHT PATROL
PO BOX 3276	SIOUX CITY	IA	51102	SECURITY SERVICES	345155
PATHOLOGY MEDICAL SERVICES
PO BOX 82653	LINCOLN	NE	68501	PATHOLOGY SERVICES	190965
BROGAN & GRAY PC LLO
110 NORTH 16TH STREET SUITE 19	NORFOLK	NE	68701	LEGAL SERVICES	150295

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	10	NumberOfContractorsGT100K
Federated Campaigns	33732	FederatedCampaigns
Related Organizations	1001338	RelatedOrganizations
All Other Contributions	70922	AllOtherContributions
Total Contributions	1105992	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue	ExclusionExclusionAmount
NET PATIENT SVC REVENUE	623000	108512102	108512102
MEDICARE/MEDICAID	623000	42865817	42865817
OTHER OPERATING REVENUE	900099	5851563	5277586	61693	$512,284
PHYSICIAN CLINICS	621110	1302468	1302468
LEASED MEDICAL EMPLOYEES	900099	1113608	1113608

Field	Value	IRS element (for citing)
Total Program Service Revenue	159645558	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	440714	TotalRevenueColumn
Exclusion	$440,714	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	931564	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	966143	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	-34579	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	-34579	TotalRevenueColumn
Exclusion	-$34,579	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Other	18979	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Other	1400014	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Other	-1381035	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	-1381035	TotalRevenueColumn
Exclusion	-$1,381,035	ExclusionAmount

Other Revenue Misc OtherRevenueMisc

Field	Value	IRS element (for citing)
Description	MHR HOME CARE LLC	Description
Business Code	446199	BusinessCode
Total Revenue Column	152390	TotalRevenueColumn
Unrelated Business Revenue	152390	UnrelatedBusinessRevenue

Field	Value	IRS element (for citing)
Total Other Revenue	152390	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	159929040	TotalRevenueColumn
Related Or Exempt Function Income	159071581	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	214083	UnrelatedBusinessRevenue
Exclusion	-$462,616	ExclusionAmount

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	X	InfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	476246	Total
Program Services	476246	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	1709146	Total
Program Services	917816	ProgramServices
Management And General	791330	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	218806	Total
Program Services	218806	ProgramServices

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	59502634	Total
Program Services	53652772	ProgramServices
Management And General	5635977	ManagementAndGeneral
Fundraising	213885	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	2674683	Total
Program Services	2674683	ProgramServices

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	8734068	Total
Program Services	8672304	ProgramServices
Management And General	59556	ManagementAndGeneral
Fundraising	2208	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	4259313	Total
Program Services	4259313	ProgramServices

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	234330	Total
Management And General	234330	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	83766	Total
Management And General	83766	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	61729	Total
Management And General	61729	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	51007	Total
Management And General	51007	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	15840717	Total
Program Services	9772659	ProgramServices
Management And General	6016704	ManagementAndGeneral
Fundraising	51354	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	185465	Total
Program Services	177098	ProgramServices
Management And General	8367	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	5512618	Total
Program Services	3502492	ProgramServices
Management And General	1961183	ManagementAndGeneral
Fundraising	48943	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	3069112	Total
Program Services	587813	ProgramServices
Management And General	2476518	ManagementAndGeneral
Fundraising	4781	Fundraising

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	3239622	Total
Program Services	2965654	ProgramServices
Management And General	273968	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	72948	Total
Program Services	50290	ProgramServices
Management And General	22118	ManagementAndGeneral
Fundraising	540	Fundraising

Interest Interest

Field	Value	IRS element (for citing)
Total	4109985	Total
Program Services	4109985	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	11541908	Total
Program Services	11505353	ProgramServices
Management And General	36555	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	791189	Total
Program Services	783778	ProgramServices
Management And General	7411	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral	FundraisingFundraising
MEDICAL SUPPLIES	24422538	24422538
BAD DEBT	10439539	10439539
DUES & SUBSCRIPTIONS	273979	139457	132121	2401
LICENSES	24427	24427

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	157529775	Total
Program Services	139353023	ProgramServices
Management And General	17852640	ManagementAndGeneral
Fundraising	324112	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	213	BOY
EOY	155	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	34071093	BOY
EOY	38528178	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	17107418	BOY
EOY	20640775	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	1647453	BOY
EOY	3807853	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	3841458	BOY
EOY	4181427	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	1178593	BOY
EOY	720866	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	194336860	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	88458176	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	115164159	BOY
EOY	105878684	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	9004798	BOY
EOY	10771375	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	15302	BOY
EOY	15215	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	1902408	BOY
EOY	1781791	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	4098520	BOY
EOY	2643835	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	188031415	BOY
EOY	188970154	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	14251628	BOY
EOY	16504751	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	72855943	BOY
EOY	70087888	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	12769181	BOY
EOY	10173078	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	2464130	BOY
EOY	3923661	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	102340882	BOY
EOY	100689378	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	85662070	BOY
EOY	88244041	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	28463	BOY
EOY	36735	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	85690533	BOY
EOY	88280776	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	188031415	BOY
EOY	188970154	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	2399265	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	190978	ReconciliationUnrealizedInvest
Reconcilation Other Changes	0	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 C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	0	DirectContactLegislators
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$8,297	OtherActivitiesAmount
Total Lobbying Expenditures IIB	8297	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1:	ReturnReference
Explanation	FAITH REGIONAL PAID DUES TO THE NEBRASKA ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS, AMERICAN HOSPITAL ASSOCIATION AND NEBRASKA ASSOCIATION OF HOME AND COMMUNITY HEALTH AGENCIES. A PORTION OF THE DUES WERE USED FOR LOBBYING ACTIVITIES. DUES PAID WHICH ARE ALLOCABLE TO LOBBYING EXPENSES WERE $3,910, $4,250 AND $137, RESPECTIVELY.	Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	5578113	BeginningOfYearBalance
Contributions	12162	Contributions
Investment Earnings Or Losses	444388	InvestmentEarningsOrLosses
Grants Or Scholarships	10092	GrantsOrScholarships
End Of Year Balance	6024571	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	5670101	BeginningOfYearBalance
Contributions	13321	Contributions
Investment Earnings Or Losses	-38571	InvestmentEarningsOrLosses
Grants Or Scholarships	66738	GrantsOrScholarships
End Of Year Balance	5578113	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	5188508	BeginningOfYearBalance
Contributions	2727	Contributions
Investment Earnings Or Losses	517780	InvestmentEarningsOrLosses
Grants Or Scholarships	38914	GrantsOrScholarships
End Of Year Balance	5670101	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	4493972	BeginningOfYearBalance
Contributions	6814	Contributions
Investment Earnings Or Losses	721427	InvestmentEarningsOrLosses
Grants Or Scholarships	33705	GrantsOrScholarships
End Of Year Balance	5188508	EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	5706317	BeginningOfYearBalance
Contributions	4188	Contributions
Investment Earnings Or Losses	-1146496	InvestmentEarningsOrLosses
Grants Or Scholarships	71037	GrantsOrScholarships
End Of Year Balance	4492972	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.00000	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	1.00000	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	0.00000	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	1	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	1	AreRelatedOrgsListedScheduleR

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1006212	OtherCostOrOtherBasis
Book Value	1006212	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	7149316	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	86216377	OtherCostOrOtherBasis
Depreciation	39187113	Depreciation
Book Value	54178580	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	176685	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	95592135	OtherCostOrOtherBasis
Depreciation	47294205	Depreciation
Book Value	48474615	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	4196135	OtherCostOrOtherBasis
Depreciation	1976858	Depreciation
Book Value	2219277	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	105878684	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescription	AmountAmount
ESTIMATED THIRD PARTY PAYOR SETTLEMENTS - MEDICARE & MEDICAID	$1,549,027
DEFERRED COMPENSATION	$2,374,634

Field	Value	IRS element (for citing)
Total Of Amounts	3923661	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:	PART V, LINE 4:	CARSON CANCER CENTER ENDOWMENT FUNDS ARE PERMANENTLY SET ASIDE TO GENERATE INVESTMENT EARNINGS TO BE USED TO FUND CAPITAL EQUIPMENT PURCHASES AND/OR OPERATIONS OF THE CARSON REGIONAL CANCER CENTER. INVESTMENT EARNINGS ON THESE FUNDS ARE TEMPORARILY RESTRICTED AS TO USE. GENERAL ENDOWMENT FUNDS ARE PERMANENTLY SET ASIDE TO GENERATE INVESTMENT EARNINGS. INVESTMENT EARNINGS ON THESE FUNDS ARE NOT RESTRICTED AS TO USE. THE HOSPICE ENDOWMENT FUNDS ARE PERMANENTLY SET ASIDE TO GENERATE INVESTMENT EARNINGS TO BENEFIT THE HOSPICE PROGRAM AND ITS PATIENTS. INVESTMENT INCOME ON THESE FUNDS ARE TEMPORARILY RESTRICTED AS TO USE. THE CARDIAC SERVICES ENDOWMENT FUNDS ARE PERMANENTLY SET ASIDE TO GENERATE INVESTMENT EARNINGS TO FUND FAITH REGIONAL HEALTH SERVICE'S CARDIAC PROGRAM CAPITAL AND/OR OPERATIONAL EXPENSES. THE EDUCATION ENDOWMENT FUNDS ARE PERMANENTLY SET ASIDE TO GENERATE INVESTMENT EARNINGS TO BENEFIT FAITH REGIONAL HEALTH SERVICE'S EDUCATION PROGRAMS AND ITS EFFORTS TO RECRUIT AND RETAIN EMPLOYEES. INVESTMENT INCOME ON THESE FUNDS ARE TEMPORARILY RESTRICTED AS TO USE. ST. JOSEPH'S NURSING HOME/SKYVIEW VILLA ENDOWMENT FUNDS ARE PERMANENTLY SET ASIDE TO GENERATE INVESTMENT EARNINGS TO BE USED TO FUND CAPITAL EQUIPMENT PURCHASES AND/OR OPERATION OF ST. JOSEPH'S NURSING HOME AND SKYVIEW VILLA. INVESTMENT EARNINGS ON THESE FUNDS ARE TEMPORARILY RESTRICTED AS TO USE. THE PEDIATRIC ENDOWMENT FUNDS ARE PERMANENTLY SET ASIDE TO GENERATE INVESTMENT EARNINGS TO BENEFIT FAITH REGIONAL HEALTH SERVICE'S CHILDREN'S CARE FUND. DONORS CAN SPECIFY CONTRIBUTIONS TO ANY OF THE ENDOWMENT FUNDS.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	PART X, LINE 2:	FRHS AND THE FOUNDATION ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C) (3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL AND NEBRASKA STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. FRPS IS A LIMITED LIABILITY COMPANY WHOLLY OWNED BY FAITH. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN TAX-EXEMPT STATUS. IN GENERAL, SUCH STANDARDS REQUIRE FRHS AND THE FOUNDATION TO MEET A COMMUNITY BENEFIT STANDARD AND COMPLY WITH VARIOUS LAWS AND REGULATIONS. FRHS ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. FAITH RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT DECEMBER 31, 2012 AND 2011, FAITH HAD NO UNCERTAIN TAX POSITIONS ACCRUED. WITH FEW EXCEPTIONS, FAITH IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS ENDED PRIOR TO DECEMBER 31, 2009.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	1	FPGReferenceFreeCare

Other Percentage OtherPercentage

Field	Value	IRS element (for citing)
Other	X	Other
Free Other Percentage	400.000000000000	FreeOtherPercentage

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent400	X	Pcent400
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	0	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1356761	TotalCommunityBenefitExpense
Net Community Benefit Expense	1356761	NetCommunityBenefitExpense
Percent Of Total Expense	0.00920	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	9214287	TotalCommunityBenefitExpense
Direct Offsetting Revenue	5410790	DirectOffsettingRevenue
Net Community Benefit Expense	3803497	NetCommunityBenefitExpense
Percent Of Total Expense	0.02590	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	10571048	TotalCommunityBenefitExpense
Direct Offsetting Revenue	5410790	DirectOffsettingRevenue
Net Community Benefit Expense	5160258	NetCommunityBenefitExpense
Percent Of Total Expense	0.03510	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	827225	TotalCommunityBenefitExpense
Direct Offsetting Revenue	67340	DirectOffsettingRevenue
Net Community Benefit Expense	759885	NetCommunityBenefitExpense
Percent Of Total Expense	0.00520	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	12554427	TotalCommunityBenefitExpense
Direct Offsetting Revenue	10230706	DirectOffsettingRevenue
Net Community Benefit Expense	2323721	NetCommunityBenefitExpense
Percent Of Total Expense	0.01580	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	425881	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	425881	NetCommunityBenefitExpense
Percent Of Total Expense	0.00290	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	13807533	TotalCommunityBenefitExpense
Direct Offsetting Revenue	10298046	DirectOffsettingRevenue
Net Community Benefit Expense	3509487	NetCommunityBenefitExpense
Percent Of Total Expense	0.02390	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	24378581	TotalCommunityBenefitExpense
Direct Offsetting Revenue	15708836	DirectOffsettingRevenue
Net Community Benefit Expense	8669745	NetCommunityBenefitExpense
Percent Of Total Expense	0.05900	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$10,439,539	BadDebtExpenseAmount
Amount Attributable To	0	AmountAttributableTo
Amount Reimbursed By Medicare	35433181	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	44711651	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-9278470	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Other	X	Other

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

Field	Value	IRS element (for citing)
Business Name Line1	1 NORTHEAST NE IMAGING CENTER LLC	BusinessNameLine1

Field	Value	IRS element (for citing)
Description Ent Primary Activity	IMAGING SERVICES	DescriptionEntPrimaryActivity
Organization Profit Or Ownership	0.25000	OrganizationProfitOrOwnership
Officers Etc Profit Or Ownership	0.00000	OfficersEtcProfitOrOwnership
Physicans Profit Or Ownership	0.75000	PhysicansProfitOrOwnership

Field	Value	IRS element (for citing)
Number Of Hospital Facilities	2	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumber	Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Licensed HospitalLicensedHospital	General Medical And SurgicalGeneralMedicalAndSurgical	Er24 HoursEr24Hours	Facility Reporting GroupFacilityReportingGroup
FAITH REGIONAL HEALTH SERVICES - WEST
1	2700 NORFOLK AVENUE	NORFOLK	NE	68701	X	X	X	A
FAITH REGIONAL HEALTH SERVICES - EAST
2	1500 KOENIGSTEIN AVE	NORFOLK	NE	68701	X	X		A

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	FACILITY REPORTING GROUP - A	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	0	CHNAConducted
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	400.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	400.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Uninsured Discount	X	UninsuredDiscount
Medicaid Medicare	X	MedicaidMedicare
State Regulation	X	StateRegulation
Other Factors	X	OtherFactors
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Available On Request	X	AvailableOnRequest
Actions On Nonpayment	0	ActionsOnNonpayment
Collection Activities	0	CollectionActivities
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	3	NumberOfOtherFacilities

Other Facilities OtherFacilities (3 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
NORTHEAST NE SURGERY CENTER LLC
301 NORTH 27TH ST STE 3	NORFOLK	NE	68701	SURGERY CENTER
NORTHEAST NE IMAGING CENTER LLC
301 NORTH 27TH ST STE 15	NORFOLK	NE	68701	IMAGING CENTER
ST JOSEPH REHABILITIATION & CARE CTR
401 N 18TH STREET	NORFOLK	NE	68701	SKILLED NURSING FACILITY

Form990 Schedule H Part VI Form990ScheduleHPartVI (20 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
PART I, LINE 3C: FAITH REGIONAL USES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR DISCOUNTED CARE. FINANCIALLY RESPONSIBLE PARTIES WHO SUBMIT A COMPLETE, VERIFIABLE APPLICATION FOR FINANCIAL ASSISTANCE WILL BE CONSIDERED FOR FREE OR REDUCED "CHARITY CARE" FINANCIAL ASSISTANCE ON THE BASIS OF THE FEDERAL POVERTY GUIDELINES (400% FPG LIMIT).ELIGIBILITY FOR THIS PROGRAM WILL BE DETERMINED BY FAMILY SIZE, GROSS INCOME BASED ON THE FEDERAL POVERY GUIDELINES AND AN ASSET TEST. THE GROSS INCOME LEVELS ARE UPDATED EACH YEAR AS THE FEDERAL POVERTY GUIDELINES ARE UPDATED.CHARITY CARE MAY BE GRANTED WITH RESPECT TO ANY DOLLARS OWED BY A FINANCIALLY RESPONSIBLE PARTY, INCLUDING, BUT NOT LIMITED TO, DEDUCTIBLE, COINSURANCE AND COPAYMENT AMOUNTS; CHARGES FOR NON-COVERED SERVICES AND MEDICAID COST OF SHARE AMOUNTS.CHARITY CARE MAY BE AUTHORIZED FOR FINANCIALLY RESPONSIBLE PARTIES WITH INCOME LEVELS EXCEEDING 400% FPG IN THE CASE OF UNUSUAL, SPECIAL AND/OR EXTENUATING CIRCUMSTANCES. THESE INSTANCES ARE GENERALLY DUE TO MEDICAL CATASTROPHE SITUATIONS.
PART I, LINE 6A: FAITH REGIONAL'S ANNUAL COMMUNITY BENEFIT REPORT IS NOT PREPARED BY A RELATED ORGANIZATION.
PART I, LINE 7: FAITH REGIONAL USES A COST ACCOUNTING SYSTEM TO DETERMINE COSTS REPORTABLE ON PART I, LINE 7 (AND ELSEWHERE ON SCHEDULE H). THE FIRST STEP IN THE COST ACCOUNTING PROCESS IS TO ALLOCATE THE OVERHEAD EXPENSES (ADMINISTRATION AND GENERAL, PLANT, ETC) TO THE REVENUE PRODUCING DEPARTMENTS (OPERATING ROOM, IMAGING, ONCOLOGY, ETC). THIS IS DONE SIMILAR TO THE MEDICARE COST REPORT USING A SINGLE STEP DOWN METHOD TO ALLOCATE THE COSTS USING APPLICABLE STATISTICS. FOR EXAMPLE: PLANT EXPENSES ARE ALLOCATED DOWN TO THE OTHER DEPARTMENTS USING CURRENT SQUARE FOOTAGE SO DEPARTMENTS WITH MORE SQUARE FOOTAGE WILL BE ALLOCATED MORE PLANT EXPENSES; DIETARY EXPENSES ARE ALLOCATED BASED ON MEALS SERVED; EMPLOYEE BENEFITS ARE ALLOCATED BASED ON SALARIES; ADMINISTRATIVE AND GENERAL EXPENSES ARE ALLOCATED BASED ON ACCUMULATED COSTS; AND SO ON. ONCE ALL THE OVERHEAD EXPENSES ARE ALLOCATED TO THE REVENUE PRODUCING DEPARTMENTS THE COSTS ARE FURTHER ALLOCATED DOWN TO THE CHARGE CODE LEVEL. IN ORDER TO DO THIS WE USE TWO DIFFERENT METHODS DEPENDING ON THE DEPARTMENT. FOR SPECIFIC DEPARTMENTS WE USE A RVU (RELATIVE VALUE UNIT) ALLOCATION WHERE EACH PROCEDURE IS WEIGHTED BY THE INTENSITY OF THE SERVICE AND IS THEN ALLOCATED COST BASED ON THAT LEVEL OF INTENSITY. FOR EXAMPLE AN XRAY WITH SEDATION IS MORE COMPLICATED AND TIME INTENSIVE THAN A SIMPLE CHEST XRAY SO IT WOULD HAVE A HIGHER RVU VALUE AND, IN TURN, A HIGHER COST ALLOCATED TO IT. THE DEPARTMENTS USING THIS ALLOCATION METHOD ARE IMAGING, CARDIAC CATH, CT, MRI, ULTRASOUND, NUCLEAR MEDICINE, RADIATION ONCOLOGY, AND REHAB (PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY).FOR THE OTHER DEPARTMENTS WE USE A RATIO OF COST TO CHARGE METHOD TO ALLOCATE THE COSTS DOWN TO THE CHARGE CODE LEVEL.AFTER ALL THE COSTS HAVE BEEN ALLOCATED TO THE CHARGE CODES THE COSTING IS APPLIED TO ALL PATIENT ACCOUNTS BASED ON THEIR CHARGES TO DETERMINE THE COST OF THEIR ENCOUNTER AND THEN REPORTS CAN BE RUN TO DETERMINE THE PROFITABILITY OF CERTAIN PAYORS, SERVICE LINES OR DEPARTMENTS.
PART I, LINE 7G: MANY SERVICES PROVIDED BY FAITH REGIONAL ARE DONE SO TO MEET SPECIFIC NEEDS OF THE COMMUNITY BECAUSE NO OTHER SERVICES ARE AVAILABLE. AS A RESULT, THESE SERVICES ARE PROVIDED KNOWING THAT THEY WILL NOT BE FINANCIALLY VIABLE OR SELF-SUPPORTING. FAITH REGIONAL DID NOT INCLUDE COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS AS SUBSIDIZED SERVICES.A SUBSIDIZED HEALTH SERVICE BENEFIT WAS CALCULATED FOR THE ACUTE REHABILITIATION, BEHAVIORAL HEALTH INPATIENT SERVICES, CARDIOPULMONARY REHABILITATION, DIALYSIS, HOME HEALTH CARE, TRANSITIONAL CARE (LONG-TERM REHABILITATION) AND SKILLED NURSING CARE DEPARTMENTS TO RECOGNIZE THAT THESE AREAS OPERATE AT A NEGATIVE MARGIN WHEN THE INDIRECT COSTS ARE CONSIDERED.THE REPORTED SUBSIDIZED LOSS REPRESENTS THE DIFFERENCE IN NET REVENUE RECEIVED FROM ALL PAYORS IN ADDITION TO ANY MISCELLANEOUS OPERATING REVENUE REPORTED BY THE DEPARTMENT LESS TOTAL OPERATING EXPENSES (DIRECT + INDIRECT COSTS INCLUDED) APPLICABLE TO EACH DEPARTMENT.
PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 10439539.
PART II: NONE
PART III, LINE 4: THE AUDITED FINANCIAL STATEMENT FOOTNOTES FOR FAITH REGIONAL DO NOT CONTAIN A FOOTNOTE RELATED TO BAD DEBT EXPENSE. BAD DEBT EXPENSE IS IDENTIFIED ON THE CONSOLIDATED STATEMENT OF OPERATIONS WHICH IS CONSISTENT WITH THE REPORTING PRACTICE OF OTHER HEALTH CARE ORGANIZATIONS. HOWEVER, THE FOLLOWING IS THE TEXT OF THE FOOTNOTE TITLED "PATIENT RECEIVABLES, NET":PATIENT RECEIVABLES, NET:FAITH REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, FAITH ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FAITH RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.PAYMENT FOR SERVICES IS EXPECTED WITHIN THIRTY DAYS OF RECEIPT OF THE BILLING. ACCOUNTS CONSIDERED PAST DUE ARE SENT TO COLLECTION AGENCIES WHEN INTERNAL COLLECTION EFFORTS HAVE BEEN UNSUCCESSFUL. ANY AMOUNTS DEEMED UNCOLLECTIBLE ARE WRITTEN OFF ON A MONTHLY BASIS. FAITH DOES NOT CHARGE INTEREST ON OUTSTANDING BALANCES OWED.THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS ACCOUNTED FOR SEPARATELY IN CHARITY CARE, THEREFORE THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE THAT IS ATTRIBUTABLE TO ELIGIBLE PATIENTS IS ZERO.FAITH REGIONAL ACCOUNTS FOR DISCOUNTS OR PAYMENTS ON PATIENT ACCOUNTS PREVIOUSLY DETERMINED AS BAD DEBT BY CREDITING THE BAD DEBT EXPENSE ACCOUNT.
PART III, LINE 8: "MEDICARE ALLOWABLE COSTS OF CARE" WAS CALCULATED FROM INFORMATION IN THE MEDICARE COST REPORT D, E, H & M WORKSHEETS, OR PS&R. IT DOES NOT INCLUDE ALL OF THE MEDICARE REVENUES AND COSTS. IF ALL OF THE MEDICARE REVENUES AND COSTS WERE INCLUDED, THE SHORTFALL WOULD BE GREATER THAN THAT SHOWN ON LINE 7. THE SHORTFALL REPRESENTS ACTUAL UNREIMBURSED COSTS INCURRED BY FAITH REGIONAL HEALTH SERVICES IN PROVIDING SERVICES TO INDIVIDUALS ELIGIBLE FOR MEDICARE. THE COMMUNITY BENEFITS BECAUSE THE HOSPITAL APPLIES OTHER REVENUES TO COVER THE COSTS OF CARING FOR MEDICARE PATIENTS.
PART III, LINE 9B: THROUGHOUT THE COLLECTION PROCESS EACH ACCOUNT IS ALSO CONSIDERED FOR FINANCIAL ASSISTANCE FOR THOSE GUARANTORS THAT ARE FINANCIALLY UNABLE TO PAY OR EXPRESS INABILITY TO PAY. ALL CORRESPONDENCE, INCLUDING STATEMENTS AND COLLECTION LETTERS INCLUDE A STATEMENT THAT "FINANCIAL ASSISTANCE MAY BE AVAILABLE." ACCOUNTS THAT ARE NOT SUCCESSFULLY RESOLVED ARE CONSIDERED FOR REFERRAL TO OUTSIDE COLLECTION AGENCIES. THE PATIENT ACCOUNTS' STAFF MEMBER WILL REVIEW THE ACCOUNT TO INSURE ALL PROCESSES ARE COMPLETE, AND THEN FLAG THE ACCOUNT TO BE SENT TO OUTSIDE COLLECTION AGENCIES. THE COLLECTION AGENCIES WE UTILIZE ALSO HAVE COPIES OF OUR FINANCIAL ASSISTANCE POLICY AND APPLICATION IF THE NEED ARISES.
PART VI, LINE 2: FAITH REGIONAL DOES NOT COMPLETE A FORMAL NEEDS ASSESSMENT AT THIS TIME AS THE PUBLIC HEALTH DEPARTMENT HAS DONE SEVERAL IN THE PAST COUPLE OF YEARS AND FAITH HAS CHOSEN NOT TO DUPLICATE THE WORK AS THE HEALTH DEPARTMENT DOES A COMPLETE REPORT. IN ADDITION TO THE PUBLIC HEALTH DEPARTMENT'S ASSESSMENT, FAITH REGIONAL IS INTIMATELY INVOLVED IN THE ELKHORN ECONOMIC DEVELOPMENT ASSOCIATION, BOTH ON THE BOARD AND THROUGH FINANCIAL SUPPORT. THAT INVOLVMENT IS INTENDED TO FACILITATE COMMUNITY GROWTH, JOB DEVELOPMENT, INFRASTRUCTURE DEVELOPMENT AND BUSINESS EDUCATION/TRAINING. FAITH REGIONAL IS ALSO A MEMBER OF THE NORFOLK CHAMBER OF COMMERCE WHICH IS INVOLVED IN BUSINESS RETAIL DEVELOPMENT AND SUPPORT AS WELL AS THE COMMUNITY IMPROVEMENT PROJECTS. FAITH ALSO WORKS WITH ORGANIZATIONS LIKE THE ORPHAN GRAIN TRAIN IN PROVIDING MEDICINE AND MEDICAL EQUIPMENT/SUPPLIES TO OTHER NATIONS IN NEED.
PART VI, LINE 3: PATIENTS RECEIVING CARE ARE GIVEN INFORMATION REGARDING FAITH REGIONAL'S FINANCIAL ASSISTANCE PROGRAM THROUGH THE USE OF BROCHURES HANDED OUT BY REGISTRATION, HOSPITAL SOCIAL SERVICES, M.A.S.H. (MEDICAL ADVOCACY SERVICES FOR HEALTHCARE) PERSONNEL, AND BY PATIENT ACCOUNTS STAFF. ANY PATIENT OR FAMILY MEMBER THAT EXPRESSES CONCERN REGARDING ABILITY TO PAY FOR SERVICES WILL BE DIRECTED TO A SOCIAL WORKER, REGISTRATION CLERK, CASHIER, OR FINANCIAL SERVICES REPRESENTATIVE WHO WILL THEN GIVE THEM AN APPLICATION FOR PATIENT FINANCIAL ASSISTANCE ALONG WITH A BROCHURE EXPLAINING HOW TO COMPLETE THE APPLICATION. THE APPLICATION WILL NEED TO BE SUBMITTED ALONG WITH PROOF OF THEIR GROSS INCOME FOR THE PRECEDING THREE MONTHS. THIS CAN BE ACCOMPLISHED BY PROVIDING CHECK STUBS FOR THE PRECEDING THREE MONTHS, PROVIDING THE MOST RECENTLY FILED TAX RETURN, PROVIDING A PROFIT AND LOSS STATEMENT IF SELF-EMPLOYED, OR BY PRESENTING A STATEMENT FROM THEIR EMPLOYER (ON COMPANY LETTERHEAD) INDICATING GROSS INCOME FOR EACH OF THE PREVIOUS THREE MONTHS. MEDICARE PATIENTS MAY SHOW THEIR ORIGINAL DETERMINATION AMOUNT, A PHOTOCOPY OF A MONTHLY CHECK, OR A COPY OF THEIR BANK STATEMENT.THE FINANCIAL SERVICES REPRESENTATIVE WILL THEN MULTIPLY THE GROSS INCOME FOR THE THREE MONTHS BY FOUR TO GET AN ANNUAL GROSS INCOME. THE FINANCIAL SERVICE REPRESENTATIVE WILL ALSO REVIEW THE PATIENT'S ASSETS TO SEE IF THERE IS SUFFICIENT EQUITY TO HELP PAY FOR HEALTH SERVICES. THE EQUITY OF ASSETS WILL BE DETERMINED AS FOLLOWS: REAL ESTATE - WE WILL EXCLUDE THE PRIMARY RESIDENCE ALONG WITH UP TO 1 ACRE OF LAND THAT THE RESIDENCE IS ON; WE WILL INCLUDE RENTAL PROPERTIES, ALL HOMES OR REAL PROPERTY ABOVE AND BEYOND THE PRIMARY RESIDENCE, CABINS, RECREATIONAL PROPERTY, ETC., AS WELL AS REAL ESTATE OWNED FOR BUSINESS PURPOSES.PERSONAL PROPERTY - WE WILL EXCLUDE ONE VEHICLE PER WAGE EARNER (OR SOCIAL SECURITY OR DISABILITY RECIPIENT); WE WILL CONSIDER THE EQUITY IN MOTOR VEHICLES (MOTORCYCLES, MOTOR HOMES, BOATS, BOAT TRAILERS, AND ATVS).OTHER PERSONAL PROPERTY WILL INCLUDE STOCKS, BONDS, CDS, FUTURES, ANTIQUE COLLECTIBLES, AND ANY OTHER COLLECTIONS OF VALUE.THE HOUSEHOLD SIZE WILL BE DETERMINED USING THE FEDERAL HOUSEHOLD DEFINITIONS.IF THERE IS AN OMISSION OF INFORMATION ON THE APPLICATIONS OR INFORMATION PROVIDED APPEARS TO BE INCORRECT, A LETTER WILL BE SENT TO THE PATIENT REQUESTING THE MISSING INFORMATION OR REQUESTING CLARIFICATION OF THE INFORMATION. THE DATE THAT THE LETTER IS SENT WILL BE DOCUMENTED ON A LOG OF PENDING APPLICATIONS. IF THE REQUESTED DOCUMENTATION IS NOT RETURNED IN NINE WORKING DAYS, THE APPLICATION WILL BE DENIED.FINANCIAL SERVICES WILL REVIEW THE APPLICATION AND ASSETS AND MAKE A DETERMINIATION WITHIN 10 DAYS OF THE RECEIPT OF A COMPLETE APPLICATION. THE FINANCIAL COUNSELOR WILL THEN NOTIFY (BY LETTER) THE PATIENT INDICATING THAT THE APPLCIATION HAS BEEN APPROVED OR DENIED. IF THE APPLICATION IS DENIED THE PATIENT MAY APPLY AGAIN IF THEIR FINANCIAL CIRCUMSTANCES CHANGE FOR SERVICES NOT PREVIOUSLY IN COLLECTIONS AND NO FURTHER BACK THAN SIX MONTHS FROM THE DATE OF APPLICATION FOR ACTIVE ACCOUNTS.
PART VI, LINE 4: FAITH REGIONAL'S PRIMARY SERVICE AREA CONSISTS OF ANTELOPE, HOLT, KNOX, MADISON, PIERCE, PLATTE, STANTON AND WAYNE COUNTIES IN NEBRASKA REPRESENTING A POPULATION OF APPROXIMATELY 116,000 PEOPLE. THE HOSPITAL'S SECONDARY SERVICE AREA CONSISTS OF BOONE, CEDAR, COLFAX, CUMING AND DIXON COUNTIES IN NEBRASKA REPRESENTING APPROXIMATELY 40,000 PEOPLE. FAITH REGIONAL ALSO HAS A TERTIARY SERVICE AREA OF CHERRY, BROWN, KEYA PAHA, ROCK, BOYD, GARFIELD, WHEELER, GREELEY, NANCE, DAKOTA, THURSTON AND BURT COUNTIES IN NEBRASKA WITH APPROXIMATELY A POPULATION OF 57,400.FOR THE YEAR ENDED DECEMBER 31, 2012, 88% OF FAITH REGIONAL'S DISCHARGES WERE FROM PATIENTS RESIDING IN THE PRIMARY SERVICE AREA; 7% FROM THE SECONDARY; AND 3% FROM THE TERTIARY SERVICE AREAS. THE REMAINING 2% OF DISCHARGES WERE FROM PATIENTS RESIDING OUTSIDE OF THE DEFINED SERVICE AREA.DEMOGRAPHIC SURVEY (SOURCE: US CENSUS BUREAU 2010 CENSUS)MADISON COUNTY:TOTAL POPULATION: 34,876AVERAGE INCOME: $42,911"PERCENT OF INDIVIDUALS BELOW POVERTY LEVEL": 12%BREAKOUT OF POPULATION BY AGE:AGE POPULATION % OF TOTALLESS THAN 19 9,911 28.4%20 - 24 2,458 7.1%25 - 44 8,037 23.0%45 - 64 9,346 26.8%65+ 5,124 14.7%TOTAL 34,876 100.0%BREAKOUT OF POPULATION BY RACE:RACE POPULATION % OF TOTALWHITE 30,752 88.2%BLACK/AFRICAN AMERICAN 444 1.3%AMERICAN INDIAN 401 1.1%ASIAN/PACIFIC ISLANDER 183 0.5%OTHER 3,096 8.9%TOTAL 34,876 100.0%
PART VI, LINE 5: FAITH REGIONAL, A NOT-FOR-PROFIT HEALTH CARE FACILITY, LOCATED IN NORTHEAST NEBRASKA, OPERATES FOR THE BENEFIT OF THE INDIVIDUALS IN THE SERVICE AREA. FAITH REGIONAL SERVES ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND DOES NOT LIMIT ITS SERVICES OR DISCRIMINATE AGAINST ANYONE ON THE BASIS OF RACE, COLOR, SEX, NATIONAL ORIGIN, SEXUAL ORIENTATION, RELIGION, AGE, DISABILITY, DISEASE, OR DIAGNOSIS. FAITH REGIONAL ALSO PROVIDES COMMUNICATIONS SERVICES (E.G. BILINGUAL STAFF AND INTERPRETERS, SIGN LANGUAGE INTERPRETERS, TDD SERVICES, ETC) FOR SENSORY IMPAIRED INDIVIDUALS. FAITH REGIONAL EVALUATES ITSELF ON ITS EFFECTIVENESS ANNUALLY BY EXAMINING ITS ABILITY TO FULFILL ITS MISSION, ACCOMPLISH ITS VISION, PROVIDE SERVICE, AND MAINTAIN ITS VALUES. FAITH REGIONAL'S MISSION, VISION, SERVICE, AND VALUES ARE: THE MISSION: THE MISSION IS TO SERVE CHRIST BY PROVIDING ALL PEOPLE WITH EXEMPLARY MEDICAL SERVICES IN AN ENVIRONMENT OF LOVE AND CARE.THE VISION: THE VISION OF FAITH REGIONAL HEALTH SERVICES IS TO BECOME A REGIONAL REFERRAL CENTER BY PROVIDING THE MOST COMPREHENSIVE, HIGH QUALITY HEALTH SERVICES TO THE RESIDENTS OF NORTHEAST NEBRASKA. THE VALUES:SPIRITUALITYEXCELLENCEINTEGRITYCOMPASSIONRESPECTSTEWARDSHIPFAITH REGIONAL'S PROGRAM SERVICE ACCOMPLISHMENTS ARE BASED ON THE COMMUNITY ACCOUNTABILITY STANDARDS DEVELOPED BY THE VOLUNTARY HOSPITALS OF AMERICA (VHA). THESE FOUR STANDARDS ARE:1) DEMONSTRATE LEADERSHIP AS A CHARITABLE INSTITUTION.2) PROVIDING ESSENTIAL HEALTH CARE SERVICES.3) BEING ACCOUNTABLE TO THE COMMUNITY.4) MAINTAING EVIDENCE OF COMMITMENT TO COMMUNITY BENEFIT.FAITH REGIONAL RECOGNIZES ITS OBLIGATION TO DEMONSTRATE LEADERSHIP AS A CHARITABLE ORGANIZATION BY PROVIDING A FULL RANGE OF HEALTH CARE, HEALTH EDUCATION AND WELLNESS RELATED SERVICES TO THE COMMUNITY, AND PARTICIPATING IN FEDERAL, STATE AND LOCAL PROGRAMS TO PROVIDE HEALTH BENEFITS TO THOSE IN NEED.DURING 2012, FAITH REGIONAL PARTICIPATED IN A VARIETY OF PROGRAMS INTENDED TO BENEFIT THE ELDERLY AND NEEDY POPULATIONS WITHIN, AND THOSE INDIVIDUALS ENTERING, ITS SERVICE AREA. THESE INCLUDE MEDICARE, MEDICAID, CHAMPUS, WORKERS COMPENSATION, AND OTHER DISCOUNTED HEALTH INSURANCE PROGRAMS. FAITH IS ALSO A PARTICIPATING PROVIDER WITH SEVERAL COMMERCIAL INSURANCE COMPANIES PROVIDING MANAGED CARE TO EMPLOYERS IN OUR COMMUNITIES. THIS PARTICIPATION PROVIDES INDIVIDUALS WITH ACCESS TO A LOCAL HEALTH CARE PROVIDER. IN ADDITION, FAITH PROVIDES CHARITY CARE FOR THOSE INDIVIDUALS, WHEN IDENTIFIED, WHO ARE FOUND TO BE UNABLE TO PAY FOR SERVICES RENDERED. BECAUSE OF ITS PARTICIPATATION IN VARIOUS HEALTH INSURANCE AND CHARITY PROGRAMS, FAITH REGIONAL ACCEPTS CONTRACTUALLY DISCOUNTED PAYMENTS AS PAYMENT IN FULL. THIS DISCOUNTED PAYMENT VARIES WITH THE TYPE OF THIRD PARTY PAYOR. THESE AMOUNTS, CONTRACTUAL ADJUSTMENTS, ARE DISCOUNTED FROM NORMAL CHARGES. IN ADDITION TO PROVIDING UNCOMPENSATED MEDICAL CARE, DURING 2012, FAITH REGIONAL ALSO PROVIDED CASH AND IN-KIND CONTRIBUTIONS TO VARIOUS COMMUNITY ORGANIZATIONS TO FURTHER THE MISSION OF THOSE ORGANIZATIONS AND IMPROVE OVERALL AWARENESS OF HEALTHCARE RELATED ISSUES IN OUR COMMUNITIES. ORGANIZATIONS RECEIVING CASH OR IN-KIND CONTRIBUTIONS FROM FAITH INCLUDE:THE AMERICAN RED CROSS, AMERICAN HEART ASSOCIATION, CITY OF NORFOLK, BIRTHRITE OF NORFOLK, PLANNED APPROACH TO COMMUNITY HEALTH (PATCH), AND NORFOLK AREA CHAMBER OF COMMERCE. ALSO DURING 2012, FAITH CONTRIBUTED FINANCIAL SUPPORT FOR A NEW 4-YEAR NURSING SCHOOL IN NORFOLK, NE THROUGH COLLABORATION BETWEEN NORTHEAST COMMUNITY COLLEGE AND THE UNIVERSITY OF NEBRASKA.FAITH REGIONAL ALSO FINANCIALLY SUPPORTS THE NORFOLK COMMUNITY "FREE CLINIC" THROUGH PHYSICIAN RECRUITMENT AND CLINIC SPACE DONATION. FAITH REGIONAL PROVIDES TRANSPORTATION SERVICES PRIMARILY TO RADIATION ONCOLOGY PATIENTS AT NO CHARGE.FAITH REGIONAL REMAINS ACCOUNTABLE TO THE COMMUNITY BY WORKING WITH A VOLUNTEER GOVERNING BOARD THAT IS REPRESENTATIVE OF THE COMMUNITY IT SERVES. COOPERATION WITH COMMUNITY BASED HEALTH ORGANIZATIONS IDENTIFY PERTINENT ISSUES RELATED TO ESSENTIAL SERVICES, CHARITY CARE, HEALTH CARE COST CONTAINMENT, COMMUNITY BENEFIT ACTIVITIES AND OTHERS AS APPROPRIATE. FAITH REGIONAL CONTINUES TO OPERATE UNDER A VOLUNTEER GOVERNING BOARD AND REMAINS ACTIVELY INVOLVED IN ADVOCATING PUBLIC AWARENESS OF HEALTH CARE AND HEALTH CARE POLICY ISSUES. DISCLOSURES OF COMMUNITY BENEFIT INFORMATION AND ADVOCACY ISSUES ARE PROVIDED THROUGH A VARIETY OF MEDIA INCLUDING MEDIA RELEASES AND ITS INTERNET WEBSITE: WWW.FRHS.ORGFAITH REGIONAL'S CONTRIBUTION TO THE COMMUNITY NOT ONLY INCLUDES COMPENSATED AND DONATED TIME BUT ALSO EQUIPMENT, MATERIALS AND SPACE. MEETING ROOMS ARE PROVIDED AS NEEDED AND EQUIPMENT AND MATERIALS (E.G. COMPUTERS, COPIER,FAXES, TELEPHONES, CHILDBIRTH PROPS, PROJECTORS, MANNEQUINS, HEARING BOOTH, AUDIOMETERS, BEDS, MONITORS, WARMING UNITS, MINOR INSTRUMENTS, ETC) ARE PROVIDED AT NO CHARGE. A MAJOR CONCERN IN HEALTH CARE THAT CAN SOMETIMES BE "HIDDEN" IS THAT OF SEXUAL ABUSE AND NEGLECT IN CHILDREN. THE NORTHEAST NEBRASKA CHILD ADVOCACY PROGRAM AT FAITH REGIONAL PROVIDES A SAFE, NON THREATENING ENVIRONMENT WHERE CHILDREN (AGES INFANT TO 18) WHO ARE VICTIMS OF ABUSE RECEIVE IMMEDIATE MEDICAL CARE AND FORENSIC INTERVIEWS FROM VARIOUS AGENCIES WORKING TOGETHER. ALL OF THESE SERVICES ARE AVAILABLE FREE TO FAMILIES WITHIN A 24-COUNTY AREA.
PART VI, LINE 6: N/A
PART VI, LINE 7: N/A
SEE BELOW	PART V, LINE 8 FACILITY REPORTING GROUP A
OTHER BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE FEDERAL POVERTY GUIDELINES SCALE AND APPLICATION.	FACILITY 1 -- FAITH REGIONAL HEALTH SERVICES - WEST	PART V, SECTION B, LINE 12H:
USES FEDERAL POVERTY GUIDELINES TO DETERMINE MAXIMUM AMOUNTS.	FACILITY 1 -- FAITH REGIONAL HEALTH SERVICES - WEST	PART V, SECTION B, LINE 20D:
OTHER BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE FEDERAL POVERTY GUIDELINES SCALE AND APPLICATION.	FACILITY 2 -- FAITH REGIONAL HEALTH SERVICES - EAST	PART V, SECTION B, LINE 12H:
USES FEDERAL POVERTY GUIDELINES TO DETERMINE MAXIMUM AMOUNTS.	FACILITY 2 -- FAITH REGIONAL HEALTH SERVICES - EAST	PART V, SECTION B, LINE 20D:

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Recipient Table RecipientTable (8 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Non Cash AssistanceAmountOfNonCashAssistance	Method Of ValuationMethodOfValuation	Description Of Non Cash AssistanceDescriptionOfNonCashAssistance	Purpose Of GrantPurposeOfGrant	Amount Of Cash GrantAmountOfCashGrant
THE AMERICAN RED CROSS
3838 DEWEY AVENUE	OMAHA	NE	68105	530196605	501(C)(3)	5744	FMV	IN-KIND RENT	DEFRAY OPERATING COSTS
NORTHEAST NEBRASKA AREA HEALTH EDUCATION CENTER (AHEC)
110 NORTH 16TH STREET SUITE 2	NORFOLK	NE	68701	223867376	501(C)(3)	26436	FMV	IN-KIND RENT	DEFRAY OPERATING COSTS
NORFOLK COMMUNITY HEALTHCARE CLINIC INC
110 NORTH 16TH STREET SUITE 16	NORFOLK	NE	68701	470833378	501(C)(3)	43686	FMV	IN-KIND RENT	DEFRAY OPERATING COSTS
UNIVERSITY OF NE - UNMC COLLEGE OF NURSING
3838 HOLDREGE STREET	LINCOLN	NE	68503	470049123	501(C)(3)				HELP FUND NEW NURSING COLLEGE LOCATION IN NORFOLK, NE	250000
AMERICAN HEART ASSOCIATION
460 N LINDBERGH BLVD	ST LOUIS	MO	63141	135613797	501(C)(3)				GO RED FOR WOMEN EVENT	10000
NORFOLK AREA UNITED WAY
333 WEST NORFOLK AVENUE	NORFOLK	NE	68701	470492054	501(C)(3)				TO BUILD A STRONGER, HEALTHIER AND COMPASSIONATE COMMUNITY BY UNITING PEOPLE AND RESOURCES TO DEVELOP OR EXPAND HUMAN SERVICE PROGRAMS.	7500
SUSAN G KOMEN BREAST CANCER FOUNDATION
12103 PACIFIC STREET	OMAHA	NE	68154	260056671	501(C)(3)				TO SAVE LIVES BY EMPOWERING PEOPLE, ENSURING QUALITY CARE FOR ALL, AND ENERGIZING SCIENCE TO DISCOVER AND DELIVER CURES FOR BREAST CANCER.	5000
NORTHEAST NEBRASKA ALL STAR FOOTBALL CLASSIC
609 WEST NORFOLK AVENUE	NORFOLK	NE	68701	461257935	PENDING 501(C)(3)				TO FUND THE NORTHEAST NEBRASKA ALL STAR FOOTBALL CLASSIC.	20000

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	8	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	0	TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	PROCEDURE FOR MONITORING GRANTS IN THE U.S.:	Identifier
Return Reference	PART I, LINE 2:	ReturnReference
Explanation	SCHEDULE I, PART I, LINE 2: IN-KIND DONATIONS OF RENT ARE MADE TO 501(C)(3) ORGANIZATIONS. THESE DONATIONS HELP THE DONEE ORGANIZATIONS MINIMIZE CASH NEEDED FOR OPERATING COSTS AND ALLOW THE ORGANIZATIONS TO USE THEIR AVAILABLE FUNDS IN FURTHERANCE OF THEIR MISSIONS. CASH DONATIONS ARE ALSO MADE TO 501(C)(3) ORGANIZATIONS, MANY OF WHICH HAVE HEALTH CARE OR SOCIAL SERVICES MISSIONS. THESE DONATIONS ARE SOMETIMES RESTRICTED FOR A SPECIFIC USE OR ACTIVITY. 501(C)(3) ORGANIZATIONS ARE BOUND BY THEIR ARTICLES OF ORGANIZATION AND STATED MISSIONS TO CONDUCTING ACTIVITIES STRICTLY FOR CHARITABLE PURPOSES. FAITH REGIONAL DOES NOT REQUEST GRANT REPORTS FROM DONEE CHARITABLE ORGANIZATIONS.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Payments	X	IdemnificationGrossUpPayments
Housing Allowance Or Residence	X	HousingAllowanceOrResidence
Club Dues Or Fees	X	ClubDuesOrFees
Written Policy Re T And E Expenses	1	WrittenPolicyReTAndEExpenses
Substantiation Required	1	SubstantiationRequired
Independent Consultant	X	IndependentConsultant
Form990 Of Other Organizations	X	Form990OfOtherOrganizations
Written Employment Contract	X	WrittenEmploymentContract
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 (11 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
JOHN HUSCHER MD
MEMBER	142905	0	0	0	0	0	7510	0	10751	0	161166	0	0	0
JAMES J SINEK
CEO	481208	0	0	0	0	0	7500	0	24757	0	513465	0	0	0
BILL LUKE
INTERIM CFO (2/10/12-7/16/12)	151913	0	0	0	0	0	0	0	0	0	151913	0	0	0
KELLY DRISCOLL
VP/CHIEF NURSING OFFICER	159966	0	0	0	0	0	4746	0	16666	0	181378	0	0	0
JANET PINKELMAN
VP HUMAN RESOURCES	156679	0	0	0	0	0	7893	0	173	0	164745	0	0	0
PATRICK ROCHE
COO - FRPS	153825	0	0	0	0	0	8273	0	13183	0	175281	0	0	0
MOHAMMAD IMRAN MD
CARDIOLOGIST	605043	0	49039	0	0	0	0	0	18255	0	672337	0	0	0
RAVISHANKAR KALAGA MD
CARDIOLOGIST	625653	0	24135	0	0	0	0	0	18256	0	668044	0	0	0
DOUGLAS WELSH MD
CARDIOLOGIST	617048	0	57466	0	0	0	10000	0	18256	0	702770	0	0	0
GEORGE YARED MD
GASTROENTEROLOGIST	609611	0	45759	0	0	0	7500	0	18256	0	681126	0	0	0
JEFFREY YOSTEN MD
EMERGENCY ROOM PHYSICIAN	515485	0	27956	0	0	0	7500	0	15915	0	566856	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
PART I, LINE 1A	JAMES J. SINEK'S YMCA MEMBERSHIP AND COUNTRY CLUB DUES ARE PAID BY FAITH REGIONAL. THE AMOUNTS PAID FOR THESE ITEMS ARE ADDED TO MR. SINEK'S W-2 AS WAGES. TIMOTHY AUWARTER'S HOUSING ALLOWANCE IS PAID BY FAITH REGIONAL HEALTH SERVICES. THE AMOUNT PAID FOR THIS ITEM IS ADDED TO MR. AUWARTER'S W-2 AS WAGES.
PART III	PART II: COMPENSATION REPORTED FOR BILL LUKE IS COMPENSATION RECEIVED SOLELY FROM FRHS, A RELATED ORGANIZATION. BILL LUKE ALSO RECEIVED COMPENSATION FROM LUKE AND ASSOCIATES, INC., AN UNRELATED BUSINESS. MR. LUKE'S SERVICES FOR LUKE AND ASSOCAITES, INC. ARE NOT RELATED TO FRHS, AND ARE IS NOT REPORTED IN THIS FORM 990.	SUPPLEMENTAL INFORMATION

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Bond ReferenceBondReferenceCd	Issuer EINIssuerEIN	CUSIP NumberCUSIPNumber	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer	Pool FinancingPoolFinancing
HOSPITAL AUTHORITY #1 OF MADISON COUNTY NEBRASKA
A	521357975	557463DR9	2008-07-10	65501382	FUND NEW BED TOWER AND REIMBURSE PRIOR CAPITAL, REFUND PRIOR ISSUES	0	0	0
HOSPITAL AUTHORITY #1 OF MADISON COUNTY NEBRASKA
B	521357975	557352EF4	2008-11-20	15000000	CONSTRUCTION OF TOWER	0	0	0

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Bond ReferenceBondReferenceCd	Amount RetiredAmountRetired	Total ProceedsTotalProceeds	Amount In Reserve FundAmountInReserveFund	Capitalized InterestCapitalizedInterest	Capital ExpendituresCapitalExpenditures	Other Spent ProceedsOtherSpentProceeds	Year Of Subst CompletionYearOfSubstCompletion	Current RefundingCurrentRefunding	Advance RefundingAdvanceRefunding	Final Allocation MadeFinalAllocationMade	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind	Credit EnhancementCreditEnhancement
A	10665000	67161489	5748281	113793	38580806	22718609	2010	1	1	1	1
B		15039468			15016635		2010	0	0	1	1	22833

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedProperty	Any Lease ArrangementsAnyLeaseArrangements	Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Engage Bond Counsel ContractsEngageBondCounselContracts	Any Research AgreementsAnyResearchAgreements	Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers	Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI	Total Private Business UseTotalPrivateBusinessUse	Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest	Change In Use Bond Financed PropChangeInUseBondFinancedProp	Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A	0	0	1	1	0	0.00540	0.00000	0.00540	0	0	0
B	0	0	1	1	0	0.00000	0.00000	0.00000	0	0	0

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 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	0	1	1	0	0	0	0	0	0
B	0	1	1	0	1	0	0	0	0

Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)

Bond ReferenceBondReferenceCd	Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A	0
B	0

Form990 Schedule K Part VI Form990ScheduleKPartVI (2 entries)

IdentifierIdentifier

ExplanationExplanation

SCHEDULE K SUPPLENTAL INFORMATION

SCHEDULE K, PART II, LINE 3: THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS.

PART III, LINE 7: DURING THE APPLICABLE TAX YEAR, THE ORGANIZATION CONSIDERED ITS TAX-EXEMPT BOND TRANSCRIPTS AND RELATED DOCUMENTATION AS ITS PRACTICES AND PROCEDURES FOR POST-ISSUANCE COMPLIANCE. AS OF THE DATE OF FILING, THE ORGANIZATION CONTINUES TO PROCEED TOWARD THE ADOPTION OF A FORMAL POLICY AND PROCEDURES TO ADDRESS POST-ISSUANCE COMPLIANCE OF ITS TAX-EXEMPT BOND LIABILITIES. SUCH POLICY IS EXPECTED TO BE ADOPTED DURING THE FOURTH QUARTER OF 2013. PART V: DURING THE APPLICABLE TAX YEAR, THE ORGANIZATION CONSIDERED ITS TAX-EXEMPT BOND TRANSCRIPTS AND RELATED DOCUMENTATION AS ITS PRACTICES AND PROCEDURES FOR POST-ISSUANCE COMPLIANCE, INCLUDING IDENTIFICATION AND CORRECTION OF OF VIOLATIONS. AS OF THE DATE OF FILING, THE ORGANIZATION CONTINUES TO PROCEED TOWARD THE ADOPTION OF A FORMAL POLICY AND PROCEDURES TO ADDRESS POST-ISSUANCE COMPLIANCE OF ITS TAX-EXEMPT BOND LIABILITIES AND THE TIMELY IDENTIFICATION AND CORRECTION OF VIOLATIONS. SUCH POLICY IS EXPECTED TO BE ADOPTED DURING THE FOURTH QUARTER OF 2013.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (6 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
PAMELA PILE
PAMELA'S BROTHER IS JOHN DINKEL, A BOARD MEMBER.	43507	PAMELA IS AN EMPLOYEE OF FAITH REGIONAL HEALTH SERVICES.	0
LORI KNAPP
LORI'S BROTHER-IN-LAW IS SCOTT MILLER, A BOARD MEMBER.	43454	LORI IS AN EMPLOYEE OF FAITH REGIONAL HEALTH SERVICES.	0
DANIELLE FREUDENBURG
DANIELLE'S BROTHER-IN-LAW IS SCOTT MILLER, A BOARD MEMBER.	41472	DANIELLE IS AN EMPLOYEE OF FAITH REGIONAL HEALTH SERVICES.	0
GERTRUDE BOESHART
GERTRUDE'S SON-IN-LAW IS CRAIG BOCHE, A BOARD MEMBER.	30699	GERTRUDE IS AN EMPLOYEE OF FAITH REGIONAL HEALTH SERVICES.	0
MARY KAY UHING
MARY KAY'S BROTHER-IN-LAW IS JOHN DINKEL, A BOARD MEMBER.	50072	MARY KAY IS AN EMPLOYEE OF FAITH REGIONAL HEALTH SERVICES.	0
AMY KARMAZIN
AMY'S FATHER-IN-LAW IS DANIEL KARMAZIN, A BOARD MEMBER.	9602	AMY IS AN EMPLOYEE OF FAITH REGIONAL HEALTH SERVICES.	0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6	FAITH REGIONAL HAS ONE NONPROFIT 501(C)(3) CORPORATE MEMBER, LUTHERAN COMMUNITY HOSPITAL ASSOCIATION.
FORM 990, PART VI, SECTION A, LINE 7A	PURSUANT TO FAITH REGIONAL'S 2008 RESTATED BYLAWS, THE SOLE CORPORATE MEMBER, LUTHERAN COMMUNITY HOSPITAL ASSOCIATION, APPOINTS 14 OF THE 15 VOTING MEMBERS OF THE BOARD OF DIRECTORS OF FAITH REGIONAL HEALTH SERVICES.
FORM 990, PART VI, SECTION A, LINE 7B	FAITH REGIONAL'S RESTATED BYLAWS RESERVE CERTAIN POWERS TO ITS SOLE MEMBER, LUTHERAN COMMUNITY HOSPITAL ASSOCIATION. THERE ARE 13 RESERVED POWERS, INCLUDING APPOINTMENT AND REMOVAL OF DIRECTORS, OTHER THAN CHIEF OF STAFF, AMENDMENT OF THE ARTICLES OF INCORPORATION AND BYLAWS, AMENDMENT OF THE MISSION, VISION AND VALUE STATEMENTS, AMONG OTHERS.
FORM 990, PART VI, SECTION B, LINE 11	FORM 990 INFORMATION SCHEDULES ARE COMPLETED IN-HOUSE BY THE REIMBURSEMENT ACCOUNTANT AND REVIEWED BY THE CFO. THE INFORMATION IS PROVIDED TO SEIM JOHNSON, LLP IN OMAHA, NE FOR RETURN PREPARATION AND SIGNATURE. POST-AUDIT REVIEW, FORM 990 AND SCHEDULES ARE MAILED TO EACH BOARD MEMBER. FORM 990 IS REVIEWED AND DISCUSSED AT THE SCHEDULED BOARD MEETING PRIOR TO SUBMISSION TO IRS.
FORM 990, PART VI, SECTION B, LINE 12C	FAITH REGIONAL'S BOARD MEMBERS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT AND DISCLOSURE ANNUALLY. ANY CONFLICTS ARE REVIEWED BY THE BOARD. A MEMBER WITH A CONFLICT IS EXCUSED FROM THE BOARD DELIBERATIONS AND ACTION.
FORM 990, PART VI, SECTION B, LINE 15	DETERMINATION OF COMPENSATION FOR THE CEO AND OTHER OFFICERS AND KEY EMPLOYEES IS MADE BY GATHERING DATA FROM EXTERNAL SURVEYS AND THE FORM 990 DATA PROVIDED BY COMPARABLE FACILITIES. FACILITIES USED ARE DETERMINED BY SIMILAR BED SIZE, NET REVENUES AND NUMBER OF FTES. WAGES ARE GATHERED AND COMPARED BY TITLE, RESPONSIBILITIES, AND YEARS OF EXPERIENCE. THE SALARY RECOMMENDATIONS ARE MADE BY THE HUMAN RESOURCE DEPARTMENT. THE GOVERNING BOARD APPROVES THE SALARY RECOMMENDATIONS FOR THE CEO; THE CEO APPROVES THE RECOMMENDATIONS FOR THE OTHER OFFICERS AND VICE-PRESIDENTS; AND THE VICE-PRESIDENTS APPROVE THE RECOMMENDATIONS FOR THE "DIRECTORS" OF VARIOUS HOSPITAL DEPARTMENTS.
FORM 990, PART VI, SECTION C, LINE 19	FAITH REGIONAL DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
FORM 990, PART VII, SECTION A, LINE 1A:	COMPENSATION REPORTED FOR BILL LUKE IS COMPENSATION RECEIVED SOLELY FROM FRHS, A RELATED ORGANIZATION. BILL LUKE ALSO RECEIVED COMPENSATION FROM LUKE AND ASSOCIATES, INC., AN UNRELATED BUSINESS. MR. LUKE'S SERVICES FOR LUKE AND ASSOCAITES, INC. ARE NOT RELATED TO FRHS, AND ARE IS NOT REPORTED IN THIS FORM 990.
FORM 990, PART IX, LINE 11G	LEASED MEDICAL EMPLOYEE SALARIES: PROGRAM SERVICE EXPENSES 105,037. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 105,037. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 3,465,987. MANAGEMENT AND GENERAL EXPENSES 1,732,715. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,198,702. MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 546,004. MANAGEMENT AND GENERAL EXPENSES 2,746,950. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,292,954. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,368,510. MANAGEMENT AND GENERAL EXPENSES 1,352,714. FUNDRAISING EXPENSES 50,759. TOTAL EXPENSES 4,771,983. COLLECTION FEES: PROGRAM SERVICE EXPENSES 50,101. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 50,101. SPEAKER FEES: PROGRAM SERVICE EXPENSES 655. MANAGEMENT AND GENERAL EXPENSES 27,994. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 28,649. BILLING SERVICE FEE: PROGRAM SERVICE EXPENSES 602,473. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 602,473. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 1,633,892. MANAGEMENT AND GENERAL EXPENSES 155,570. FUNDRAISING EXPENSES 595. TOTAL EXPENSES 1,790,057. OTHER FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 761. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 761.	OTHER FEES
FORM 990, PART XII, LINE 2C:	THE FINANCE/AUDIT COMMITTEE MEETS MONTHLY TO REVIEW OUR UNAUDITED FINANCIAL STATEMENTS. IN NOVEMBER OF EACH YEAR THEY MEET TO APPROVE OUR ANNUAL BUDGET AND FIVE-YEAR STRATEGIC FINANCIAL PLAN. IN DECEMBER THEY WILL REVIEW AND APPROVE THE ENGAGEMENT LETTER PREPARED BY OUR EXTERNAL AUDITORS, SEIM JOHNSON, LLP, WHICH OUTLINES THE SCOPE OF THEIR AUDIT AND THEIR FEES AND EXPENSES. AT THE CLOSE OF THE AUDIT THEY MEET WITH THE FAITH REGIONAL EXECUTIVE TEAM AND SEIM JOHNSON, LLP REPRESENTATIVES TO DISCUSS ANY AUDIT ISSUES. IN MID TO LATE MARCH THEY THEN MEET AGAIN WITH SEIM JOHNSON, LLP REPRESENTATIVES TO DISCUSS THE DRAFT AND FINAL AUDITED FINANCIAL STATEMENTS INCLUDING THEIR OPINION. REGARDING THE SELECTION OF AN EXTERNAL AUDITOR, THE COMMITTEE HAS IN THE PAST SELECTED UP TO THREE REGIONAL CPA FIRMS SPECIALIZING IN HEALTHCARE AUDITS TO SEND RFPS TO AND THEN REVIEW THE RFPS AT A LATER DATE. THE LAST TIME THIS WAS DONE THEY REAFFIRMED THE RETENTION OF SEIM JOHNSON, LLP AS THE EXTERNAL AUDITOR. EACH FIVE YEARS, ALTHOUGH NOT REQUIRED BY THE SARBANES-OXLEY LEGISLATION, SEIM JOHNSON, LLP ROTATES ONE OF THEIR PARTNERS TO THE FAITH REGIONAL ENGAGEMENT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	FAITH REGIONAL PHYSICIAN SERVICES LLC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	2700 WEST NORFOLK AVENUE	AddressLine1
City	NORFOLK	City
State	NE	State
ZIP Code	68701	ZIPCode

Field	Value	IRS element (for citing)
EIN	421629846	EIN
Primary Activities	PHYSICIAN SERVICES	PrimaryActivities
Legal Domicile State	NE	LegalDomicileState
Total Income	13848882	TotalIncome
EOY Assets	5723290	EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	FAITH REGIONAL HEALTH SERVICES	BusinessNameLine1

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	Public Charity StatusPublicCharityStatus	Direct Controlling Entity NADirectControllingEntityNA	Controlled OrgControlledOrg	Business Name Line1DirectControllingEntityName/BusinessNameLine1
LUTHERAN COMMUNITY HOSPITAL ASSOCIATION
2700 W NORFOLK AVE	NORFOLK	NE	68701	470396139	SUPPORT FAITH REGIONAL HEALTH SERVICES	NE	501(C)(3)	3	N/A	0
FAITH REGIONAL HEALTH SERVICES FOUNDATION
1500 KOENIGSTEIN AVE	NORFOLK	NE	68701	911772474	SUPPORT FAITH REGIONAL HEALTH SERVICES	NE	501(C)(3)	11A		1	FAITH REGIONAL HEALTH SERVICES

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	NORTHEAST NEBRASKA SURGERY CENTER	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	301 N 27TH STREET	AddressLine1
City	NORFOLK	City
State	NE	State
ZIP Code	68701	ZIPCode

Field	Value	IRS element (for citing)
EIN	470819088	EIN
Primary Activity	OUTPATIENT SURGERY	PrimaryActivity
Legal Domicile State	NE	LegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	FAITH REGIONAL HEALTH SERVICES	BusinessNameLine1

Field	Value	IRS element (for citing)
Predominant Income Type	RELATED	PredominantIncomeType
Share Of Total Income	442633	ShareOfTotalIncome
Share Of EOY Assets	1901211	ShareOfEOYAssets
Disproportionate Allocations	0	DisproportionateAllocations
General Or Managing Partner	0	GeneralOrManagingPartner
Percentage Ownership	0.94800	PercentageOwnership

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	1	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	1	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	1	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	1	SharingOfFacilities
Sharing Of Paid Employees	1	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	1	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
FAITH REGIONAL HEALTH SERVICES FOUNDATION
C	1001338	FAIR MARKET VALUE
NORTHEAST NEBRASKA SURGERY CENTER
O	1109133	FAIR MARKET VALUE
NORTHEAST NEBRASKA SURGERY CENTER
A	270390	FAIR MARKET VALUE
NORTHEAST NEBRASKA SURGERY CENTER
S	441758	FAIR MARKET VALUE