BRODSTONE MEMORIAL HOSPITAL: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- BRODSTONE MEMORIAL HOSPITAL (EIN 47-0388012)
- Tax period
- 2024-05-01 to 2025-04-30
- Filed
- 2026-02-02
- IRS object ID
- 202630339349300608
- Schema version
- 2024v5.5
- 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 O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2026-02-02T06:51:03-06:00 | ReturnTs |
| Tax Period End | 2025-04-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18081 BURT ST STE 200 | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 680224722 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-05-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470388012 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRODSTONE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BROD | BusinessNameControlTxt |
| Phone | 4028793281 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 520 E 10TH ST PO BOX 187 | AddressLine1Txt |
| City | SUPERIOR | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 689781225 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TREG VYZOUREK | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 4028793281 | PhoneNum |
| Signature | 2026-01-30 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MEGAN L KOZIOL CPA | PreparerPersonNm |
| PTIN | P01544037 | PTIN |
| Phone | 4023302660 | PhoneNum |
| Preparation | 2026-01-30 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRODSTONE HEALTHCARE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TREG VYZOUREK | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 520 E 10TH ST PO BOX 187 | AddressLine1Txt |
| City | SUPERIOR | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 689781225 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $44,948,902 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BRODSTONEHEALTHCARE.ORG/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1927 | FormationYr |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Activity Or Mission | TO DELIVER INPATIENT, OUTPATIENT AND AMBULATORY CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 275 | TotalEmployeeCnt |
| Total Volunteers | 40 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,287,066 | PYContributionsGrantsAmt |
| CY Contributions Grants | $342,961 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $38,761,209 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $43,214,161 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,040,031 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,153,254 | CYInvestmentIncomeAmt |
| PY Other Revenue | $82,110 | PYOtherRevenueAmt |
| CY Other Revenue | $68,768 | CYOtherRevenueAmt |
| PY Total Revenue | $42,170,416 | PYTotalRevenueAmt |
| CY Total Revenue | $44,779,144 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $130,178 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $68,848 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $21,226,626 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $21,644,444 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $49,784 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $16,956,996 | PYOtherExpensesAmt |
| CY Other Expenses | $18,399,421 | CYOtherExpensesAmt |
| PY Total Expenses | $38,313,800 | PYTotalExpensesAmt |
| CY Total Expenses | $40,112,713 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,856,616 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,666,431 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $70,431,891 | TotalAssetsBOYAmt |
| Total Assets EOY | $77,672,236 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $16,650,012 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $18,985,420 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $53,781,879 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $58,686,816 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | OUR MISSION IS TO PROVIDE EXCEPTIONAL AND PROGRESSIVE HEALTHCARE TO THE COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $25,251,149 | ExpenseAmt |
| Grant | $68,848 | GrantAmt |
| Revenue | $24,337,542 | RevenueAmt |
| Desc | ANCILLARY SERVICES - BRODSTONE MEMORIAL HOSPITAL IS A 25 BED CRITICAL ACCESS HOSPITAL. SERVICES PROVIDED BY BRODSTONE INCLUDE ANESTHESIOLOGY, RADIOLOGY, CT SCANS, LABORATORY, BLOOD ADMINISTRATION, INHALATION THERAPY, SLEEP STUDIES, PHYSICAL AND OCCUPATIONAL THERAPY, SPEECH THERAPY, ELECTROCARDIOLOGY AND ECHOCARDIOLOGY, BEHAVIORAL HEALTH, CHEMOTHERAPY, NUCLEAR MEDICINE AND EMERGENCY SERVICES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $4,802,166 | ExpenseAmt |
| Revenue | $5,026,626 | RevenueAmt |
| Desc | PHYSICIAN' CLINICS - BRODSTONE MEMORIAL HOSPITAL OWNS 3 RURAL HEALTH CLINICS IN SUPERIOR, NELSON, AND EDGAR, NE. THREE BOARD CERTIFIED FAMILY PRACTICE PHYSICIANS, FOUR PA-C, AND TWO APRNS SERVE ALL AGES FROM CHILDREN TO SENIOR CITIZENS. ONE APRN IS PSYCHIATRIC-MENTAL HEALTH NP CERTIFIED TO PROVIDE BEHAVIORAL HEALTH SERVICES. IN ADDITION TO DIAGNOSING AND TREATING ILLNESS, THEY ALSO PROVIDE PREVENTIVE CARE, ROUTINE CHECKUPS, IMMUNIZATION AND SCREENING TESTS, AND HOSPITALIZATION AND NURSING HOME CARE, AND OBSTETRICS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $4,073,373 | ExpenseAmt |
| Revenue | $5,015,392 | RevenueAmt |
| Desc | NURSING SERVICES - BRODSTONE MEMORIAL HOSPITAL IS A 25 BED CRITICAL ACCESS HOSPITAL, WITH A RECENT 41,900 SQUARE FOOT ADDITION OF AN ER, PATIENT WING, INFUSION SUITES AND HEALING GARDEN. THE NEW SPACE HAS ENHANCED PATIENT SAFETY, SECURITY AND PRIVACY AND FEATURES 17 NEW PATIENT ROOMS INCLUDING AN OB/NURSERY AREA. NURSING SERVICES WORK WITH THE MEDICAL STAFF TO DELIVER QUALITY, AFFORDABLE HEALTH CARE IN A CARING, SAFE AND COMPASSIONATE ENVIRONMENT TO ALL PATIENTS. BRODSTONE PROVIDED 1,351 PATIENT DAYS OF INPATIENT CARE AND 724 PATIENT DAYS OF SWING BED CARE. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,333,897 | ExpenseAmt |
| Revenue | $8,834,601 | RevenueAmt |
| Desc | BRODSTONE'S PHARMACY DEPARTMENT PREPARES AND DISPENSES MEDICATION BY REVIEWING AND INTERPRETING PHYSICIAN ORDERS. THE PHARMACISTS DETECT THERAPEUTIC INCOMPATIBILITIES, ADVISE INTERVENTIONS, ANSWER QUESTIONS FROM HEALTH PROFESSIONALS, AND COUNSEL PATIENTS ON DRUG THERAPIES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $2,333,897 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $8,834,601 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $36,460,585 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 69 | IRPDocumentCnt |
| IRP Document W2 G | 32 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 275 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CRYSTAL WYATT | PersonNm |
| Phone | 4028793281 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 520 EAST 10TH STREET | AddressLine1Txt |
| City | SUPERIOR | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68978 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| ROYCE SCHOTT | ||||||||
| PRESIDENT | 2.00 | 0.20 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JANET EGGERS | ||||||||
| VICE-PRESIDENT | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| PIPER HODGE | ||||||||
| SECRETARY | 2.00 | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BETH SIEBECKER | ||||||||
| TREASURER | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JACKI PORTER | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| SANDY BORDEN | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| TREG VYZOUREK | ||||||||
| CEO | 39.80 | 0.20 | Yes (X) | $399,916 | $0 | $50,593 | ||
| CRYSTAL WYATT | ||||||||
| CFO | 39.80 | 0.20 | Yes (X) | $128,180 | $0 | $43,958 | ||
| TIMOTHY BLECHA MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $401,631 | $0 | $62,288 | Yes (X) | ||
| JULIE THEIS MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $376,105 | $0 | $24,298 | Yes (X) | ||
| RAYMOND HELLER MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $321,000 | $0 | $37,252 | Yes (X) | ||
| CHRISTOPHER SOUCHEK | ||||||||
| CRNA | 40.00 | 0.00 | $262,222 | $0 | $50,667 | Yes (X) | ||
| MATTHEW GATLIN PA-C | ||||||||
| PHYSICIAN ASSISTANT | 40.00 | 0.00 | $265,162 | $0 | $40,204 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,154,216 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $309,260 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 24 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CARDINAL HEALTH-OWEN PHARMACY SERVICE | |||||
| 21377 NETWORK PLACE | CHICAGO | IL | 60673 | MEDICAL SERVICES | $2,812,996 |
| RURAL PARTNERS IN MEDICINE LLC | |||||
| 8181 ARISTA PLACE SUITE 100 | BROOMFIELD | CO | 80021 | MEDICAL SERVICES | $665,457 |
| LYTLE CONSTRUCTION | |||||
| 18505 E 163 ST | LAKE WINNEBAGO | MO | 64034 | CONSTRUCTION SERVICES | $492,519 |
| BD CONSTRUCTION | |||||
| 209 E 6TH STREET | KEARNEY | NE | 68848 | CONSTRUCTION SERVICES | $368,243 |
| LORI G HARRIS CRNA LLC | |||||
| 3207 NORTHWOOD COURT | NEWTON | KS | 67114 | MEDICAL SERVICES | $266,928 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 12 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $317,785 | RelatedOrganizationsAmt |
| All Other Contributions | $25,176 | AllOtherContributionsAmt |
| Total Contributions | $342,961 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $39,039,896 | $39,039,896 |
| 340B PHARMACY REVENUE | 456110 | $3,658,564 | $3,658,564 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $515,701 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $515,701 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $43,214,161 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,201,552 | TotalRevenueColumnAmt |
| Exclusion | $1,201,552 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $121,460 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $169,758 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$48,298 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$48,298 | TotalRevenueColumnAmt |
| Exclusion | -$48,298 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CAFETERIA REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $68,768 | TotalRevenueColumnAmt |
| Exclusion | $68,768 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $68,768 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $44,779,144 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $43,214,161 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,222,022 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,848 | TotalAmt |
| Program Services | $65,848 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,000 | TotalAmt |
| Program Services | $3,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $623,251 | TotalAmt |
| Management And General | $623,251 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,601,052 | TotalAmt |
| Program Services | $14,735,364 | ProgramServicesAmt |
| Management And General | $865,688 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $552,608 | TotalAmt |
| Program Services | $521,138 | ProgramServicesAmt |
| Management And General | $31,470 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,797,438 | TotalAmt |
| Program Services | $3,526,468 | ProgramServicesAmt |
| Management And General | $270,970 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,070,095 | TotalAmt |
| Program Services | $976,670 | ProgramServicesAmt |
| Management And General | $93,425 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,163 | TotalAmt |
| Management And General | $73,163 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,455,999 | TotalAmt |
| Program Services | $3,195,136 | ProgramServicesAmt |
| Management And General | $257,839 | ManagementAndGeneralAmt |
| Fundraising | $3,024 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,075 | TotalAmt |
| Program Services | $608 | ProgramServicesAmt |
| Management And General | $99,467 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,576,321 | TotalAmt |
| Program Services | $2,871,987 | ProgramServicesAmt |
| Management And General | $657,574 | ManagementAndGeneralAmt |
| Fundraising | $46,760 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $379,395 | TotalAmt |
| Program Services | $346,215 | ProgramServicesAmt |
| Management And General | $33,180 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $299,752 | TotalAmt |
| Program Services | $272,318 | ProgramServicesAmt |
| Management And General | $27,434 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $463,477 | TotalAmt |
| Program Services | $417,326 | ProgramServicesAmt |
| Management And General | $46,151 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,151,051 | TotalAmt |
| Program Services | $2,837,286 | ProgramServicesAmt |
| Management And General | $313,765 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $430,153 | TotalAmt |
| Program Services | $387,321 | ProgramServicesAmt |
| Management And General | $42,832 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PHARMACY EXPENSES | $3,393,435 | $3,393,435 | |
| MEDICAL SUPPLIES | $2,651,567 | $2,634,678 | $16,889 |
| DIETARY FOOD & SUPPLIES | $275,787 | $275,787 | |
| COLLECTIONS EXPENSE | $148,128 | $148,128 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,118 | TotalAmt |
| Management And General | $1,118 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,112,713 | TotalAmt |
| Program Services | $36,460,585 | ProgramServicesAmt |
| Management And General | $3,602,344 | ManagementAndGeneralAmt |
| Fundraising | $49,784 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,693,878 | BOYAmt |
| EOY | $5,414,464 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,700,378 | BOYAmt |
| EOY | $24,759,794 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,766,495 | BOYAmt |
| EOY | $8,092,138 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $71,980 | BOYAmt |
| EOY | $62,361 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $394,203 | BOYAmt |
| EOY | $360,715 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $570,559 | BOYAmt |
| EOY | $584,796 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $56,818,430 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $26,990,597 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,729,544 | BOYAmt |
| EOY | $29,827,833 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,187,193 | BOYAmt |
| EOY | $4,410,848 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,317,661 | BOYAmt |
| EOY | $4,159,287 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,431,891 | BOYAmt |
| EOY | $77,672,236 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,263,223 | BOYAmt |
| EOY | $3,210,355 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,874,912 | BOYAmt |
| EOY | $10,725,554 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $511,877 | BOYAmt |
| EOY | $5,049,511 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,650,012 | BOYAmt |
| EOY | $18,985,420 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,127,491 | BOYAmt |
| EOY | $56,985,313 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,654,388 | BOYAmt |
| EOY | $1,701,503 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,781,879 | BOYAmt |
| EOY | $58,686,816 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,431,891 | BOYAmt |
| EOY | $77,672,236 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $4,666,431 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $191,391 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $47,115 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $3,807 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $3,807 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | BRODSTONE MEMORIAL HOSPITAL PAID DUES TO THE AMERICAN HOSPITAL ASSOCIATION AND THE NEBRASKA HOSPITAL ASSOCIATION, A PORTION OF THE DUES WERE USED FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,524,476 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $200,295 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $101,109 | GrantsOrScholarshipsAmt |
| Other Expenditures | $13,350 | OtherExpendituresAmt |
| Administrative Expenses | $38,721 | AdministrativeExpensesAmt |
| End Year Balance | $1,571,591 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,452,743 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $227,635 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $100,989 | GrantsOrScholarshipsAmt |
| Other Expenditures | $26,333 | OtherExpendituresAmt |
| Administrative Expenses | $28,580 | AdministrativeExpensesAmt |
| End Year Balance | $1,524,476 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,545,374 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $30,725 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $93,698 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $29,658 | AdministrativeExpensesAmt |
| End Year Balance | $1,452,743 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,733,236 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$95,776 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $56,892 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $35,193 | AdministrativeExpensesAmt |
| End Year Balance | $1,545,374 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,443,862 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $364,430 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $55,867 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $19,189 | AdministrativeExpensesAmt |
| End Year Balance | $1,733,236 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $117,890 | OtherCostOrOtherBasisAmt |
| Book Value | $117,890 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $40,879,042 | OtherCostOrOtherBasisAmt |
| Depreciation | $14,981,796 | DepreciationAmt |
| Book Value | $25,897,246 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,403,235 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,758,484 | DepreciationAmt |
| Book Value | $3,644,751 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $418,263 | OtherCostOrOtherBasisAmt |
| Depreciation | $250,317 | DepreciationAmt |
| Book Value | $167,946 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $29,827,833 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| BENEFICIAL INTEREST IN TRUSTS | $1,571,590 |
| DEFERRED COMPENSATION | $441,416 |
| INTEREST RECEIVABLE | $92 |
| RIGHT OF USE ASSETS | $2,103,816 |
| INVESTMENT IN JOINT VENTURES | $42,373 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $4,159,287 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED COMPENSATION | $368,977 |
| RIGHT OF USE LIABILITIES | $2,120,796 |
| ESTIMATED THIRD-PARTY PAYOR SETTLEM | $2,559,738 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,049,511 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | INTEREST EARNINGS MAY BE USED FOR OPERATIONS, HOWEVER THE PRINCIPLE IS TO BE MAINTAINED AS A PERMANENT ENDOWMENT. |
| PART X, LINE 2: | THE HOSPITAL ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ASC 740, INCOME TAXES. THE HOSPITAL RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT APRIL 30, 2025 AND 2024, THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS ACCRUED. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 87 | PersonsServedCnt |
| Total Community Benefit Expns | $145,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $145,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00360 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,767,237 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,459,335 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $307,902 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00770 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 87 | PersonsServedCnt |
| Total Community Benefit Expns | $3,912,237 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,459,335 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $452,902 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01130 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 54 | PersonsServedCnt |
| Total Community Benefit Expns | $100,750 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $100,750 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00250 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 16690 | PersonsServedCnt |
| Total Community Benefit Expns | $9,417,322 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,290,580 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,126,742 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10290 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1525 | PersonsServedCnt |
| Total Community Benefit Expns | $33,706 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $33,706 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 18269 | PersonsServedCnt |
| Total Community Benefit Expns | $9,551,778 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,290,580 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,261,198 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10620 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 18356 | PersonsServedCnt |
| Total Community Benefit Expns | $13,464,015 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,749,915 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,714,100 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11750 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 1525 | PersonsServedCnt |
| Total Community Benefit Expns | $49,759 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $49,759 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 32 | ActivitiesOrProgramsCnt |
| Persons Served | 6400 | PersonsServedCnt |
| Total Community Benefit Expns | $6,900 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,900 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 15 | ActivitiesOrProgramsCnt |
| Persons Served | 758 | PersonsServedCnt |
| Total Community Benefit Expns | $28,359 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,541 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $24,818 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 49 | ActivitiesOrProgramsCnt |
| Persons Served | 8683 | PersonsServedCnt |
| Total Community Benefit Expns | $85,018 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,541 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $81,477 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00200 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $586,744 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $70,409 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $11,248,609 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $11,284,339 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$35,730 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRODSTONE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 520 E 10TH | AddressLine1Txt |
| City | SUPERIOR | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68978 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTPS://WWW.BRODSTONEHEALTHCARE.ORG/ | WebsiteAddressTxt |
| State License | 570001 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRODSTONE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 24 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTPS://WWW.BRODSTONEHEALTHCARE.ORG/PATIENTS/COMMUNITY-HEALTH-NEEDS-ASSESSM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 24 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://WWW.BRODSTONEHEALTHCARE.ORG/PATIENTS/COMMUNITY-HEALTH-NEEDS-ASSESSM | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.BRODSTONEHEALTHCARE.ORG/PATIENTS/FINANCE-SERVICES | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.BRODSTONEHEALTHCARE.ORG/PATIENTS/FINANCE-SERVICES | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.BRODSTONEHEALTHCARE.ORG/PATIENTS/FINANCE-SERVICES | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| BRODSTONE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 3J: THE REPORT INCLUDES A LIST OF MEASURES IN THE FIVE YEAR PLAN (2025 THROUGH 2030) AND THE COMMUNITY HEALTH IMPROVEMENT PLAN (2025 THROUGH 2030) FIRST YEAR ENDED 4/30/2025. THE PLAN INCLUDES PERFORMANCE MEASURES ALONG WITH STRATEGIES AND ACTIVITIES FOR THE PRIORITY AREAS OF ACCESS TO CARE, MENTAL WELLBEING, CHRONIC DISEASE, AND SENIOR HEALTH. |
| BRODSTONE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 5: INCLUDED IN THE REPORT ARE RESULTS FROM A PUBLIC HEALTH SURVEY THAT WAS MADE AVAILABLE OVER A 4 COUNTY AREA (WEBSTER, ADAMS, CLAY AND NUCKOLLS). PUBLICLY AVAILABLE SECONDARY DATA WAS SUPPLEMENTED WITH AN ONLINE COMMUNITY SURVEY AND FIVE FOCUS GROUPS, INCLUDING ONE FOR SPANISH-SPEAKING RESIDENTS. ADDITIONAL, THE ASSESSMENT FOR ADVANCING COMMUNITY TRANSFORMATION (AACT) GATHERED INPUT FROM COMMUNITY ORGANIZATIONS AND STAKEHOLDERS TO IDENTIFY OPPORTUNITIES FOR ADVANCING HEALTH EQUITY. |
| BRODSTONE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 6A: BRODSTONE'S CHNA WAS CONDUCTED WITH MARY LANNING HEALTHCARE AND WEBSTER COUNTY COMMUNITY HOSPITAL. |
| BRODSTONE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 6B: BRODSTONE'S CHNA WAS CONDUCTED WITH SOUTH HEARTLAND DISTRICT HEALTH DEPARTMENT, CLAY COUNTY HEALTH DEPARTMENT, AND UNITED WAY OF SOUTH-CENTRAL NEBRASKA. |
| BRODSTONE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 11: IN THE MOST RECENT CHNA CONDUCTED THE FOLLOWING NEEDS WERE IDENTIFIED: MENTAL HEALTH & WELLBEING, CHRONIC ILLNESS, AND ELDER/SENIOR CARE.MENTAL HEALTH & WELLBEING: -EXPAND ACCESS TO MENTAL HEALTH IN ADOLESCENTS. -RAISE AWARENESS TO REDUCE STIGMA. -CREATE FURTHER ACCESS TO MENTAL HEALTH SUPPORT.CHRONIC ILLNESS: -EXPAND CHRONIC CARE. -CREATE AWARENESS OF HEART DISEASE. -IMPLEMENTATION OF A 3-4-50 PROGRAM. A PUBLIC HEALTH STRATEGY DESIGNED TO HIGHLIGHT THE CONNECTION BETWEEN CERTAIN BEHAVIORS, CHRONIC DISEASES, AND PREMATURE DEATHS (3 BEHAVIORS CONTRIBUTE TO THESE 4 CHRONIC DISEASES, WHICH TOGETHER ACCOUNT FOR MORE THAN 50% OF ALL PREMATURE DEATHS).ELDER/SENIOR CARE: -INCREASE ACCESS BY SUPPORTING TRANSPORTATION OPTIONS.-DEVELOP AN AGE-FRIENDLY COMMUNITY (NEBRASKA HOSPITAL ASSOCIATION/AMERICAN HOSPITAL ASSOCIATION PROGRAM)-PROVIDE EDUCATION AND TRAININGS FOR THE COMMUNITY ON CYBERSECURITY AND SCAM PREVENTION.THE FACILITY CONDUCTED A NEW CHNA IN THE CURRENT TAX YEAR AND HASN'T HAD THE OPPORTUNITY TO ADDRESS ALL AREAS YET. HOWEVER, WE HAVE BEEN ABLE TO ADDRESS A FEW AREAS. BRODSTONE IS CONTINUOUSLY WORKING ON ACCESS TO CARE. BRODSTONE IS NOW ABOUT TO SEND OUT AUTOMATED TEXT MESSAGE APPOINTMENT REMINDERS. BRODSTONE HAS PARTNERED WITH A COMPANY TO PROVIDE TELE-STROKE PROVIDERS FOR ER COVERAGE FOR SIGNIFICANT NEUROLOGICAL SITUATIONS. IN ADDITION, WE WERE ABLE TO ADD UROLOGY TO THE MONTHLY SPECIALISTS THAT COME TO BRODSTONE. WE ADDED AN ADDITIONAL DAY EACH MONTH FOR PODIATRY SERVICES. BRODSTONE CONTINUES TO PROVIDE BASELINE CONCUSSION TESTING FOR AREA SCHOOLS INCLUDING: SUPERIOR, LAWRENCE/NELSON, AND SANDY CREEK. HOSTED A HEALTH & WELLNESS EXPO OFFERING SKIN CHECKS, FLU SHOTS, WATER TESTING KITS, CPR DEMONSTRATIONS, INSURANCE EDUCATION, AND CYBER-SECURITY AWARENESS. CONTINUE TO PROVIDE A WALKING CLUB 3 DAYS A WEEK FOR INDOOR ACTIVITY YEAR ROUND ENGAGING THE COMMUNITY OF SUPERIOR. IN ADDITION, FITNESS CLASSES ARE OFFERED 3 DAYS A WEEK EARLIER IN THE DAY FOR THOSE WORKING DURING WALKING CLUB HOURS. TAI CHI CLASSES WERE OFFERED TO HELP WITH MOBILITY ISSUES. MENTAL HEALTH WAS A HEALTH PRIORITY GOAL LAST YEAR AND THIS YEAR. IN THE CURRENT YEAR, THE FACILITY HAD AN EMPLOYEE WHO COMPLETED EDUCATION FOR CERTIFIED PLAY THERAPY AND LMHP (LICENSED MENTAL HEALTH PRACTITIONER) TO BE ABLE TO PROVIDE IN-PERSON SERVICES FOR ADOLESCENT POPULATIONS. IN ADDITION, THE EMPLOYEE WILL BE WORKING MORE HOURS TO PROVIDE MORE OPENINGS FOR THE ADOLESCENT POPULATION. TO ADDRESS THE CHRONIC ILLNESS NEED, BRODSTONE HAS PARTNERED WITH CHARTSPAN TO ENHANCE THE CARE PROVIDED TO MEDICARE PATIENTS THROUGH A COMPREHENSIVE CARE MANAGEMENT PROGRAM TO HELP REDUCE CHRONIC ILLNESS. THIS INITIATIVE WILL SIGNIFICANTLY IMPROVE PATIENT SUPPORT AND ACCESS TO HEALTHCARE RESOURCES. ELIGIBLE PATIENTS WILL RECEIVE CORRESPONDENCE, INCLUDING PHONE CALLS, LETTERS, OR EMAILS REGARDING ENROLLMENT IN THE PROGRAM.BRODSTONE WILL CONTINUE TO PROVIDE WELLNESS ACTIVITIES FOR THE COMMUNITY TO GET PEOPLE ACTIVE. WE HOSTED THE ANNUAL FIREKRACKER RUN OFFERING A 1 MILE PREDICT, 2 MILE WALK/RUN, AND A 5K WALK/RUN FOR PARTICIPANTS. SEATED YOGA WAS OFFERED FOR 4 MONTHS ALONG WITH TAI CHI FOR 7 MONTHS WITH 2 SEPARATE SESSIONS. A GROCERY STORE TOUR WAS OFFERED WITH HOW TO EAT HEALTHY ON A BUDGET. 19 INDIVIDUALS PARTICIPATED IN THE FACILITY'S HEALTHY LIVING PROGRAM. PRESENTATIONS WERE PRESENTED ON THE TOPICS OF HIDDEN SUGARS, MENTAL HEALTH, AND VAPING IN A LOCAL SCHOOL TO STUDENTS IN A HEALTH CLASS. WE ARE EVALUATING HOW TO INCREASE ACCESS FOR ELDER/SENIOR CARE BY SUPPORTING TRANSPORTATION OPTIONS. THERE WERE NO SIGNIFICANT NEEDS IDENTIFIED THAT ARE NOT BEING ADDRESSED. |
| BRODSTONE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 13H: IN INSTANCES WHEN A PATIENT MAY APPEAR ELIGIBLE FOR FINANCIAL ASSISTANCE, BUT THERE IS NO FINANCIAL APPLICATION FORM ON FILE DUE TO A LACK OF SUPPORTING DOCUMENTATION, FINANCIAL ASSISTANCE MAY STILL BE GRANTED IN CERTAIN SITUATIONS BASED ON PRESUMPTIVE CIRCUMSTANCES. OFTEN THERE IS ADEQUATE INFORMATION PROVIDED BY THE PATIENT OR THROUGH OTHER SOURCES, WHICH COULD PROVIDE SUFFICIENT EVIDENCE TO PROVIDE THE PATIENT WITH FINANCIAL ASSISTANCE. IN THE EVENT THERE IS NO EVIDENCE TO SUPPORT A PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE, BRODSTONE COULD USE OUTSIDE AGENCIES IN DETERMINING ESTIMATED INCOME AMOUNTS FOR THE BASIS OF DETERMINING FINANCIAL ASSISTANCE ELIGIBILITY AND POTENTIAL DISCOUNT AMOUNTS. PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED IN CERTAIN SITUATIONS, AND BASED ON THE APPROVAL OF BRODSTONE'S MANAGEMENT, ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE:A) STATE-FUNDED PRESCRIPTION PROGRAMS;B) TRANSIENT, HOMELESS OR RECEIVED CARE FROM A HOMELESS CLINIC, OR UNIDENTIFIED PERSONS;C) PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC);D) FOOD STAMP ELIGIBILITY;E) ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED (E.G., MEDICAID SPEND-DOWN);F) CRIME VICTIMS BILLED CHARGES AFTER STATE OR FEDERAL FUNDS HAVE PAID OR ARE EXHAUSTED;G) LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS;H) PATIENT IS DECEASED WITH NO KNOWN ESTATE OR RESPONSIBLE PARTY; ANDI) PERSONS WHO INCOME IS AT OR BELOW 100% OF THE CURRENT POVERTY LEVEL. |
| BRODSTONE MEMORIAL HOSPITAL | PART V, SECTION B, LINE 15E: PATIENTS MAY APPLY FOR ASSISTANCE BY CALLING BRODSTONE MEMORIAL HOSPITAL AT 402-207-1539 AND REQUESTING A FINANCIAL ASSISTANCE APPLICATION; OR BY REQUESTING AN APPLICATION IN PERSON FROM REGISTRATION OR THE BUSINESS OFFICE. AN APPLICATION MAY BE DOWNLOADED FROM THE HOSPITAL'S WEBSITE. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - SUPERIOR FAMILY MEDICAL CENTER | ||||
| 525 E 11TH ST | SUPERIOR | NE | 68978 | RURAL HEALTH CLINIC |
| 2 - NELSON FAMILY MEDICAL CENTER | ||||
| 76 W 8TH ST | NELSON | NE | 68961 | RURAL HEALTH CLINIC |
| 3 - EDGAR MEDICAL CLINIC | ||||
| 315 N C ST | EDGAR | NE | 68935 | RURAL HEALTH CLINIC |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | IN ADDITION TO FEDERAL POVERTY GUIDELINES, THE HOSPITAL ALSO USES MEDICAL INDIGENCY TO DETERMINE ELIGIBILITY OF FREE OR DISCOUNTED CARE. IN INSTANCES WHEN A PATIENT MAY APPEAR ELIGIBLE FOR FINANCIAL ASSISTANCE, BUT THERE IS NO FINANCIAL APPLICATION FORM ON FILE DUE TO A LACK OF SUPPORTING DOCUMENTATION, FINANCIAL ASSISTANCE MAY STILL BE GRANTED IN CERTAIN SITUATIONS BASED ON PRESUMPTIVE CIRCUMSTANCES. OFTEN THERE IS ADEQUATE INFORMATION PROVIDED BY THE PATIENT OR THROUGH OTHER SOURCES, WHICH COULD PROVIDE SUFFICIENT EVIDENCE TO PROVIDE THE PATIENT WITH FINANCIAL ASSISTANCE. IN THE EVENT THERE IS NO EVIDENCE TO SUPPORT A PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE, BRODSTONE COULD USE OUTSIDE AGENCIES IN DETERMINING ESTIMATED INCOME AMOUNTS FOR THE BASIS OF DETERMINING FINANCIAL ASSISTANCE ELIGIBILITY AND POTENTIAL DISCOUNT AMOUNTS. PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED IN CERTAIN SITUATIONS, AND BASED ON THE APPROVAL OF BRODSTONE'S MANAGEMENT, ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE:A) STATE-FUNDED PRESCRIPTION PROGRAMS;B) TRANSIENT, HOMELESS OR RECEIVED CARE FROM A HOMELESS CLINIC, OR UNIDENTIFIED PERSONS;C) PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC);D) FOOD STAMP ELIGIBILITY;E) ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED (E.G., MEDICAID SPEND-DOWN);F) CRIME VICTIMS BILLED CHARGES AFTER STATE OR FEDERAL FUNDS HAVE PAID OR ARE EXHAUSTED;G) LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS;H) PATIENT IS DECEASED WITH NO KNOWN ESTATE OR RESPONSIBLE PARTY; ANDI) PERSONS WHO INCOME IS AT OR BELOW 100% OF THE CURRENT POVERTY LEVEL. |
| PART I, LINE 7: | CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. UNREIMBURSED MEDICAID ON LINE 7B, AND SUBSIDIZED HEALTH SERVICES, LINE 7G, WERE CALCULATED USING THE COSTING METHODS TO PREPARE THE COST REPORTS. HEALTH PROFESSIONS EDUCATION, LINE 7F, AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT, LINE 7I, ARE REPORTED BASED ON ACTUAL EXPENSES REPORTED IN THE GENERAL LEDGER. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THE COMMUNITY BUILDING ACTIVITIES PROMOTED THE HEALTH OF THE COMMUNITIES ITS SERVES THROUGH SEVERAL DIFFERENT AREAS. SEVERAL MEMBERS OF THE SR. LEADERSHIP MEETING SAT IN ON THE DEVELOPMENT OF THE CITY'S COMPREHENSIVE 10 YEAR PLAN. THIS INCLUDED ECONOMIC DEVELOPMENT IDEAS AND WAYS TO IMPROVE SUPERIOR. THE HOSPITAL HAS PARTNERED WITH THE NC3 DAYCARE TO PROVIDE ADDITIONAL OPPORTUNITIES FOR CHILD CARE IN THE AREA. THERE HAS BEEN A SHORTAGE AND HAS CREATED STAFFING ISSUES DUE TO NO DAYCARE. BRODSTONE CONTINUES TO PROVIDE HAMBURGERS AND HOTDOGS FOR NON-PROFIT COMMUNITY ORGANIZATIONS TO HELP RAISE FUNDS FOR THEIR SPECIFIC AREAS; SEVERAL HAVE BEEN SUPPORTING LOCAL SCHOOLS. BRODSTONE'S COMMUNITY WELLNESS HAS PROVIDED WALKING SCHOOL BUS FOR SCHOOL AGE KIDS, MORNING FITNESS CLASSES AND WALKING CLUBS INSIDE SO INDIVIDUALS HAVE A SAFE PLACE TO WALK YEAR AROUND. BIKE RODEO WAS CONDUCTED TO PROVIDE EDUCATION AROUND BIKE SAFETY, HELMET FITTINGS, AND SAFETY CHECKS. THE FIREKRACKER RUN IS AN ANNUAL EVENT CONDUCTED TO PROMOTE WELLNESS WITHIN INDIVIDUALS. TAI CHI IS DONE TO HELP PROMOTE BALANCE IN THE ELDERLY POPULATION ALONG WITH SEATED YOGA. A GROCERY STORE TOUR WAS CONDUCTED TO HELP EDUCATE THE PUBLIC ON HOW TO EAT HEALTHY ON A BUDGET WITH DIFFERENT IDEAS. |
| PART III, LINE 2: | THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE ORGANIZATION DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSION BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THIS CLASS OF PATIENTS. |
| PART III, LINE 3: | THE ESTIMATED AMOUNT OF THE ORGANIZATION'S IMPLICIT PRICE CONCESSIONS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS CALCULATED BASED ON AN APPROXIMATE 12.0% OF INDIVIDUALS LIVING BELOW THE POVERTY LEVEL IN THE SERVICE AREA. |
| PART III, LINE 4: | THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES IMPLICIT PRICE CONCESSIONS IS LOCATED IN FOOTNOTE 1 ON PAGES 13 THROUGH 14 OF THE ATTACHED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THE ENTIRE MEDICARE SHORTFALL IS CONSIDERED A COMMUNITY BENEFIT. SERVICES ARE PROVIDED TO PATIENTS UNDER THE MEDICARE PROGRAM EVEN THOUGH THE HOSPITAL KNOWS THEY WILL NOT RECOVER ALL OF THE COSTS FROM PROVIDING THE SERVICES. THIS PROGRAM IS CONSIDERED SUBSIDIZED BY THE HOSPITAL AND OTHER PAYORS. PATIENTS RELY ON THESE SERVICES FOR THEIR HEALTH AND WELL-BEING AND ARE ESSENTIAL FOR THEIR ACCESS TO HEALTHCARE. TOTAL REVENUE RECEIVED FROM MEDICARE IS THE GROSS REIMBURSEMENT PLUS SETTLEMENT. BOTH TOTAL REVENUE RECEIVED FROM MEDICARE AND THE MEDICARE ALLOWABLE COSTS ARE REPORTED FROM THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CENTERS FOR MEDICARE AND MEDICAID SERVICES.HOSPITAL SERVICES RENDERED ON A FEE SCHEDULE ARE NOT INCLUDED IN THE MEDICARE CALCULATIONS PER THE 990 INSTRUCTIONS. HAD THIS BEEN REPORTED THE HOSPITAL WOULD HAVE HAD A GREATER LOSS FROM MEDICARE SERVICES OF $162,312.MEDICARE FEE SCHEDULE REVENUE $288,251MEDICARE ESTIMATED COSTS OF CARE RELATING TO PAYMENTS $450,563NET (SHORTAGE) $(162,312) |
| PART III, LINE 9B: | PATIENTS WHO QUALIFY FOR MEDICAID WILL AUTOMATICALLY QUALIFY FOR FINANCIAL ASSISTANCE AND MAY QUALIFY FOR MORE IF THEY COMPLETE THE FINANCIAL ASSISTANCE APPLICATION. THESE PATIENTS WILL NOT BE SENT TO COLLECTIONS IF THEY PAY THE AMOUNT FOR WHICH THEY QUALIFY.BRODSTONE'S POLICIES AND PROCEDURES FOR INTERNAL AND EXTERNAL COLLECTION PRACTICES TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR CHARITY, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR CHARITY FROM THE HOSPITAL AND A PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS OR HER PAYMENT AGREEMENTS WITH THE HOSPITAL. FOR PATIENTS WHO QUALIFY FOR CHARITY AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR BILLS, BRODSTONE MAY OFFER EXTENDED PAYMENT PLANS TO ELIGIBLE PATIENTS, WILL NOT IMPOSE WAGE GARNISHMENTS OR LIENS, WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES AND WILL CEASE ALL COLLECTION EFFORTS. |
| PART VI, LINE 2: | BRODSTONE ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES THROUGH A SURVEY, AND PUBLISHES SUGGESTIONS AND STRATEGIC PLANNING RESULTS. HOSPITAL STAFF ALSO NETWORK WITH OTHER HEALTH CARE ORGANIZATIONS TO DEVELOP IDEAS OF WHAT CAN BE DONE TO IMPROVE THE AVAILABILITY OF SERVICES IN THE COMMUNITY. |
| PART VI, LINE 3: | BRODSTONE HAS A BROCHURE CALLED CHARITY POLICY THAT ADDRESSESS THE FINANCIAL ASSISTANCE AVAILABILITY. IT IS POSTED AT THE ADMISSIONS AREAS AND EMERGENCY ROOM. THE CHARITY POLICY IS DISCUSSED WHEN MAKING PAYMENT ARRANGEMENTS. THIS POLICY IS ALSO AVAILABLE ON THE HOSPITAL'S WEBSITE. |
| PART VI, LINE 4: | SUPERIOR HAS A POPULATION OF 1,826 AND IS LOCATED ON THE NEBRASKA-KANSAS BORDER. BRODSTONE'S SERVICE AREA COVERS ALL OF NUCKOLLS COUNTY AND PARTS OF 2 OTHER COUNTIES IN NEBRASKA AND 3 COUNTIES IN KANSAS. THE MEDIAN HOUSEHOLD INCOME FOR NUCKOLLS COUNTY IS $69,323 COMPARED TO THE U.S. AVERAGE AT $77,719 AND THE NEBRASKA AVERAGE OF $82,485. THE AREA POPULATION IS PREDOMINATELY WHITE ELDERLY AND LOW INCOME. 49.6% OF THE HOSPITAL'S PATIENTS ARE MEDICARE PATIENTS. |
| PART VI, LINE 5: | BRODSTONE'S GOVERNING BODY CONSISTS OF INDIVIDUALS WITH NO IMMEDIATE FAMILY TIES TO ANY EMPLOYEE NOR ARE THEY CONTRACTORS OF THE ORGANIZATION. ALL BOARD MEMBERS HAVE SUPERIOR NEBRASKA ADDRESSES BUT 2 MEMBERS LIVE IN JEWELL COUNTY, KANSAS. ALL FAMILY PRACTICE PHYSICIANS AND MIDLEVELS IN THE AREA WHO HAVE REQUESTED MEDICAL STAFF PRIVILEGES AND MEET THE REQUIREMENTS HAVE PRIVILEGES AT THE HOSPITAL. ONE DENTIST HAS COURTESY PRIVELEGES. ALL SURPLUS FUNDS OF THE ORGANIZATION ARE USED TO FUND THE BUDGET FOR THE COMING YEARS OR SET ASIDE FOR FUTURE PROJECTS. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRODSTONE MEMORIAL HOSPITAL FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 520 EAST 10TH STREET | AddressLine1Txt |
| City | SUPERIOR | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68978 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 851276014 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $65,848 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Purpose Of Grant | REIMBURSE FOUNDATION FOR FUNDRAISING EXPENSES AND CONTRIBUTE FUNDS FOR PROGRAM SUPPORT. | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL ONLY GRANTS FUNDS TO ITS RELATED FOUNDATION. THEREFORE, IT IS ABLE TO MONITOR THE USE OF THE GRANT FUNDS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (1) | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TIMOTHY BLECHA MD | ||||||||||||||
| PHYSICIAN | $275,065 | $0 | $126,566 | $0 | $0 | $0 | $35,422 | $0 | $26,866 | $0 | $463,919 | $0 | $0 | $0 |
| TREG VYZOUREK | ||||||||||||||
| CEO | $399,916 | $0 | $0 | $0 | $0 | $0 | $13,800 | $0 | $36,793 | $0 | $450,509 | $0 | $0 | $0 |
| JULIE THEIS MD | ||||||||||||||
| PHYSICIAN | $294,845 | $0 | $81,260 | $0 | $0 | $0 | $12,993 | $0 | $11,305 | $0 | $400,403 | $0 | $0 | $0 |
| RAYMOND HELLER MD | ||||||||||||||
| PHYSICIAN | $280,255 | $0 | $40,745 | $0 | $0 | $0 | $9,602 | $0 | $27,650 | $0 | $358,252 | $0 | $0 | $0 |
| CHRISTOPHER SOUCHEK | ||||||||||||||
| CRNA | $262,222 | $0 | $0 | $0 | $0 | $0 | $10,420 | $0 | $40,247 | $0 | $312,889 | $0 | $0 | $0 |
| MATTHEW GATLIN PA-C | ||||||||||||||
| PHYSICIAN ASSISTANT | $213,100 | $0 | $52,062 | $0 | $0 | $0 | $10,844 | $0 | $29,360 | $0 | $305,366 | $0 | $0 | $0 |
| CRYSTAL WYATT | ||||||||||||||
| CFO | $125,103 | $0 | $3,077 | $0 | $0 | $0 | $5,442 | $0 | $38,516 | $0 | $172,138 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 5 | FormAndLineReferenceDesc |
| Explanation | IN ACCORDANCE WITH RELATED EMPLOYMENT CONTRACTS, ADDITIONAL COMPENSATION IS PAID BASED ON REVENUES GENERATED BY EACH MEDICAL PROVIDER, AS DEFINED. THESE ADDITIONAL AMOUNTS HAVE BEEN LISTED AS INCENTIVE COMPENSATION IN PART II OF THIS SCHEDULE. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|
| THE CITY OF SUPERIOR NEBRASKA | |||||||
| A | 476006376 | 2013-05-22 | $4,000,000 | REFUND ISSUES (9/9/03, 9/10/09, 9/10/09) | 0 | 0 | 0 |
| THE COUNTY OF NUCKOLLS NEBRASKA | |||||||
| B | 476006492 | 2013-05-22 | $4,000,000 | REFUND ISSUES (9/9/03, 9/10/09, 9/10/09) | 0 | 0 | 0 |
| CITY OF SUPERIOR NEBRASKA | |||||||
| C | 476006376 | 2019-12-12 | $10,000,000 | CONSTRUCT AND EQUIP FACILITY | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Capital ExpendituresCapitalExpendituresAmt |
|---|---|---|---|---|---|---|---|---|---|
| A | $2,999,993 | $4,000,000 | $4,000,000 | 2010 | Yes (1) | 0 | Yes (1) | Yes (1) | |
| B | $2,999,993 | $4,000,000 | $4,000,000 | 2010 | Yes (1) | 0 | Yes (1) | Yes (1) | |
| C | $1,076,330 | $10,000,000 | 2024 | 0 | 0 | Yes (1) | Yes (1) | $10,000,000 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
| C | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) |
| C | 0 | 0 | 0 | Yes (1) | Yes (1) | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
| C | Yes (1) |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K, PART IV, LINE 2C: | FormAndLineReferenceDesc |
| Explanation | (A) ISSUER NAME: CITY OF SUPERIOR, NEBRASKA DATE THE REBATE COMPUTATION WAS PERFORMED: 08/07/2020 (B) ISSUER NAME: THE COUNTY OF NUCKOLLS, NEBRASKA DATE THE REBATE COMPUTATION WAS PERFORMED: 08/07/2020 (C) ISSUER NAME: CITY OF SUPERIOR, NEBRASKA DATE THE REBATE COMPUTATION WAS PERFORMED: 03/31/2024 NOTE REGARDING THE 8/7/2020 REBATE COMPUTATIONS: SINCE THE BOND PROCEEDS WERE SPENT ON THE ISSUE DATE, A SPENDING EXCEPTION WAS MET, AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CALCULATIONS ARE NECESSARY. NOTE REGARDING THE 3/31/2024 REBATE COMPUTATION: SINCE THE BOND PROCEEDS ARE SPENT AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CALCULATIONS ARE NECESSARY. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 8B | THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM. BEFORE IT IS FILED, IT IS GIVEN A DETAILED REVIEW BY MANAGEMENT AND THEN A GENERAL REVIEW BY THE BOARD OF DIRECTORS AT A REGULARLY SCHEDULED BOARD MEETING. A FINAL COPY OF THE FORM 990 WILL BE ELECTRONICALLY FILED AFTER APPROVAL. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS WHO HAVE A CONFLICT OF INTEREST WOULD REFRAIN FROM DISCUSSION AND VOTING ON THOSE MATTERS. THERE IS AN ANNUAL BOARD MEMBER TRAINING THAT COVERS THIS POLICY. ADDITIONALLY, ALL BOARD MEMBERS ARE WELL ACQUAINTED WITH EACH OTHER SO IF THERE WAS A CONFLICT OF INTEREST AND THE BOARD MEMBER DID NOT DISCLOSE, THE OTHER BOARD MEMBERS WOULD BRING IT TO THE BOARD'S ATTENTION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE HUMAN RESOURCE DIRECTOR PREPARES A SALARY SURVEY ANNUALLY FOR ALL JOBS DESCRIPTIONS WITH HOSPITALS OF SIMILAR SIZE AND REVENUES. THE BOARD OF DIRECTORS REVIEWS THE SURVEY AND PRIOR SALARY INCREASES FOR THE CEO BEFORE GRANTING PAY INCREASES. THE HUMAN RESOURCE DIRECTOR AND CFO MAKE RECOMMENDATIONS TO THE CEO FOR OTHER EMPLOYEES. THE CEO REVIEWS THE SURVEY, PRIOR SALARY INCREASES, AND RECOMMENDATIONS BEFORE APPROVING PAY INCREASES FOR EMPLOYEES. THE PAY INCREASES ARE APPROVED BY THE BOARD OF DIRECTORS DURING THE BUDGET PROCESS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC, BUT FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | CHANGE IN BENEFICIAL INTEREST IN TRUSTS 47,115. |
| FORM 990, PART XII, LINE 2C: | THE BOARD OF DIRECTORS ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| PNC VESTEY TRUST UA UNB & NORTHERN CO SUCC BENEFIT BRODSTONE MEM HOSP | ||||||||||
| 116 ALLEGHENY CENTER MALL | PITTSBURGH | PA | 15212 | 226023351 | ASSISTING IN THE OPERATIONS OF BRODSTONE MEMORIAL HOSPITAL | PA | 4947(A)(1) | PF | BRODSTONE MEMORIAL HOSPITAL | Yes (1) |
| BRODSTONE MEMORIAL HOSPITAL FOUNDATION | ||||||||||
| 520 EAST 10TH STREET | SUPERIOR | NE | 68978 | 851276014 | TO SUPPORT BRODSTONE MEMORIAL HOSPITAL | NE | 501(C)(3) | LINE 12A, I | BRODSTONE MEMORIAL HOSPITAL | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| PNC VESTEY TRUST | ||
| C | $57,109 | FMV |
| BRODSTONE MEMORIAL HOSPITAL FOUNDATION | ||
| B | $65,848 | FMV |
| BRODSTONE MEMORIAL HOSPITAL FOUNDATION | ||
| C | $260,676 | FMV |