REGIONAL WEST HEALTH SERVICES: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- REGIONAL WEST HEALTH SERVICES (EIN 36-3314157)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-14
- IRS object ID
- 201103189349305980
- Schema version
- 2010v3.4
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-14T15:14:52-06:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CONTRYMAN ASSOCIATES PC CPA'S | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 2246 | AddressLine1 |
| City | SCOTTSBLUFF | City |
| State | NE | State |
| ZIP Code | 69363 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363314157 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REGIONAL WEST HEALTH SERVICES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | REGI | NameControl |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4021 AVENUE B | AddressLine1 |
| City | SCOTTSBLUFF | City |
| State | NE | State |
| ZIP Code | 69361 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DAVID GRIFFITHS | Name |
| Title | TREASURER | Title |
| Date Signed | 2011-11-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DAN W CHARRON CPA CMA | Name |
| Phone | 3086357705 | Phone |
| Date Prepared | 2011-11-14 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DAVID GRIFFITHS TREASURER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4021 AVENUE B | AddressLine1 |
| City | SCOTTSBLUFF | City |
| State | NE | State |
| ZIP Code | 69361 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 9887221 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.RWHS.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Activity Or Mission Description | HEALTH CARE SERVICES FOR THE PEOPLE OF WESTERN NEBRASKA AND EASTERN WYOMING. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 85 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 31633 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 6073759 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 6476530 | InvestmentIncomePriorYear |
| Investment Income Current Year | 3617862 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 844 | OtherRevenuePriorYear |
| Other Revenue Current Year | 195600 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 6509007 | TotalRevenuePriorYear |
| Total Revenue Current Year | 9887221 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 225314 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Current Year | 6607623 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 3052227 | OtherExpensePriorYear |
| Other Expenses Current Year | 3239576 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 3277541 | TotalExpensesPriorYear |
| Total Expenses Current Year | 9847199 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 3231466 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 40022 | RevenuesLessExpensesCY |
| Total Assets BOY | 13851011 | TotalAssetsBOY |
| Total Assets EOY | 15094742 | TotalAssetsEOY |
| Total Liabilities BOY | 3916506 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2787686 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 9934505 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 12307056 | NetAssetsOrFundBalancesEOY |
| Mission Description | HEALTH CARE SERVICES FOR THE PEOPLE OF WESTERN NEBRASKA AND EASTERN WYOMING. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 9825713 | Expense |
| Revenue | 6269359 | Revenue |
| Description | REGIONAL WEST HEALTH SERVICES PROVIDES A CONTINUUM OF CARE THROUGH PROGRAMS DEVELOPED IN ACUTE, SKILLED, INTERMEDIATE, RESIDENTIAL, HOME AND AMBULATORY CARE FOR THE PEOPLE IN THE REGION OF WESTERN NEBRASKA AND EASTERN WYOMING. | Description |
| Total Program Service Expense | 9825713 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | false | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 29 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 85 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | true | InvestmentInJointVenture |
| Written Policy Or Procedure | true | WrittenPolicyOrProcedure |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DAVID GRIFFITHS | NamePerson |
| Telephone Number | 3086301111 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4021 AVENUE B | AddressLine1 |
| City | SCOTTSBLUFF | City |
| State | NE | State |
| ZIP Code | 69361 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Average Hours Per WeekAverageHoursPerWeek | TitleTitle | OfficerOfficer | Key EmployeeKeyEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| DAVID HOLDT MD | ||||||||
| X | 0 | 544756 | 28747 | |||||
| GLEN FORNEY MD | ||||||||
| X | 0 | 532695 | 27427 | 1.00 | ||||
| JEFFREY HOLLOWAY MD | ||||||||
| X | 0 | 528266 | 27927 | |||||
| TODD S SORENSEN MD | ||||||||
| X | 481872 | 0 | 74874 | 40.00 | PRESIDENT | X | ||
| DAVID GRIFFITHS | ||||||||
| X | 227106 | 0 | 33983 | 40.00 | TREASURER | X | ||
| TOM HOLYOKE | ||||||||
| X | 0 | 84021 | 0 | 1.00 | ||||
| HOD KOSMAN | ||||||||
| X | 0 | 0 | 0 | 1.00 | CHAIRMAN | X | ||
| DONALD M GENTRY MD | ||||||||
| X | 0 | 0 | 0 | 1.00 | ||||
| JANE HUNTER EDD | ||||||||
| X | 0 | 0 | 0 | 1.00 | ||||
| ROBERT L KELLEY JR | ||||||||
| X | 0 | 0 | 0 | 1.00 | ||||
| MARK GILLAM | ||||||||
| X | 0 | 0 | 0 | 1.00 | ||||
| MARK HARTMAN MD | ||||||||
| X | 0 | 0 | 0 | 1.00 | ||||
| JIM TRUMBULL | ||||||||
| X | 0 | 0 | 0 | 1.00 | ||||
| DENNIS HADDEN | ||||||||
| X | 0 | 0 | 0 | 1.00 | ||||
| JENNIFER BROOKER | ||||||||
| 33327 | 0 | 16840 | 40.00 | SECRETARY | X | |||
| LISA BEWLEY | ||||||||
| 175191 | 0 | 30894 | X | |||||
| LISA M STEELE | ||||||||
| 67194 | 0 | 29612 | 1.00 | SECRETARY | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 984690 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1689738 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 270304 | TotalOtherCompensation |
| Number Individuals GT100 K | 8 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | CONSULTING REVENUE | Description |
| Total Revenue Column | 6073759 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6073759 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 6073759 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3617862 | TotalRevenueColumn |
| Exclusion | $3,617,862 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER REVENUE | Description |
| Total Revenue Column | 195600 | TotalRevenueColumn |
| Related Or Exempt Function Income | 195600 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 195600 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9887221 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6269359 | RelatedOrExemptFunctionIncome |
| Exclusion | $3,617,862 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1177310 | Total |
| Program Services | 1177310 | ProgramServices |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 67194 | Total |
| Program Services | 67194 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3938504 | Total |
| Program Services | 3938504 | ProgramServices |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 157342 | Total |
| Program Services | 157342 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 937652 | Total |
| Program Services | 937652 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 329621 | Total |
| Program Services | 329621 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4288 | Total |
| Program Services | 4288 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54 | Total |
| Program Services | 54 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 420 | Total |
| Management And General | 420 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8313 | Total |
| Program Services | 8313 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21066 | Total |
| Management And General | 21066 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1074 | Total |
| Program Services | 1074 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 83114 | Total |
| Program Services | 83114 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2299234 | Total |
| Program Services | 2299234 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 139 | Total |
| Program Services | 139 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| PHYSICIAN RECRUITMENT | 809201 | 809201 |
| OTHER PURCHASED SERVICES | 10152 | 10152 |
| TELEPHONE | 2107 | 2107 |
| LICENSES AND FEES | 330 | 330 |
| MISCELLANEOUS | 84 | 84 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9847199 | Total |
| Program Services | 9825713 | ProgramServices |
| Management And General | 21486 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 620256 | BOY |
| EOY | 169429 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41130 | BOY |
| EOY | 3719 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1730991 | BOY |
| EOY | 2610662 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5593133 | BOY |
| EOY | 8922593 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3908288 | BOY |
| EOY | 1609197 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1957213 | BOY |
| EOY | 1779142 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13851011 | BOY |
| EOY | 15094742 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1838593 | BOY |
| EOY | 147092 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2077913 | BOY |
| EOY | 2640594 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3916506 | BOY |
| EOY | 2787686 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9934505 | BOY |
| EOY | 12307056 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9934505 | BOY |
| EOY | 12307056 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13851011 | BOY |
| EOY | 15094742 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 40022 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 2332529 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Written IRS Determination | X | WrittenIRSDetermination |
| Contrib By Controlling Individual | false | ContribByControllingIndividual |
| Contribution By Related Party | false | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | false | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REGIONAL WEST PHYSICIANS CLINIC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363314159 | EIN |
| Type Of Organization | 3 | TypeOfOrganization |
| Listed In Governing Doc | true | ListedInGoverningDoc |
| Supported Organization Notified | true | SupportedOrganizationNotified |
| Organized In US | true | OrganizedInUS |
| Amount | $1,050,000 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 3 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 9352485 | SumOfAmounts |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disclosed Orgs Legal Control | false | DisclosedOrgsLegalControl |
| Disclosed For Charitable Purposes | false | DisclosedForCharitablePurposes |
| Written Policy Monitoring | false | WrittenPolicyMonitoring |
| Sect170h Requirements Satisfied | false | Sect170hRequirementsSatisfied |
| Solicited Assets For Sale | false | SolicitedAssetsForSale |
| Agent Trustee Etc | false | AgentTrusteeEtc |
| Included On FS | false | IncludedOnFS |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | false | AreRelatedOrgsListedScheduleR |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| SELF FUNDED HEALTH PLAN | 1605889 |
| DUE FROM AFFILIATES | 132884 |
| ACCRUED INTEREST - NOTES RECEIVABLE | 40369 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 1779142 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| SELF FUNDED HEALTH PLAN PAYABLE | $1,605,889 |
| ACCRUED EXPENSES | $857,767 |
| DUE TO AFFILIATES | $176,938 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2640594 | TotalOfAmounts |
| Total Revenue | 9887221 | TotalRevenue |
| Total Expenses | 9847199 | TotalExpenses |
| Excess Or Deficit For Year | 40022 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 90043 | NetUnrealizedGLOnInvestments |
| Other | $2,242,486 | OtherAmount |
| Total Adjustments | 2332529 | TotalAdjustments |
| Excess Or Deficit Per FS | 2372551 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 12219750 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 90043 | NetUnrealizedGainsInvestments |
| Other Revenues | 2242486 | OtherRevenues |
| Revenue Not Rptd F990 | 2332529 | RevenueNotRptdF990 |
| Revenue Subtotal | 9887221 | RevenueSubtotal |
| Total Revenue Per Form990 | 9887221 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 9847199 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 9847199 | ExpensesSubtotal |
| Total Expenses Per Form990 | 9847199 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| RECONCILIATION OF CHANGES - OTHER | SCHEDULE D, PAGE 4, PART XI, LINE 8 | FUND TRANSFERS FROM AFFILIATES 2,242,486 |
| REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHER | SCHEDULE D, PAGE 4, PART XII, LINE 2D | FUND TRANSFERS FROM AFFILIATES 2,242,486 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | false | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)
| Comp Based On Related OrgsCompBasedOnRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs | Base Compensation Filing OrgBaseCompensationFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| DAVID HOLDT MD | ||||||||||
| 541617 | 3139 | 9800 | 18947 | 573503 | ||||||
| GLEN FORNEY MD | ||||||||||
| 527684 | 5011 | 9800 | 17627 | 560122 | 591975 | |||||
| JEFFREY HOLLOWAY MD | ||||||||||
| 527726 | 540 | 9800 | 18127 | 556193 | ||||||
| TODD S SORENSEN MD | ||||||||||
| 554933 | 465106 | 16766 | 57548 | 17326 | 556746 | |||||
| DAVID GRIFFITHS | ||||||||||
| 239600 | 217043 | 10063 | 33068 | 915 | 261089 | |||||
| LISA BEWLEY | ||||||||||
| 164970 | 10221 | 25870 | 5024 | 206085 | ||||||
| LISA M STEELE | ||||||||||
| 96950 | 67194 | 11980 | 17632 | 96806 | ||||||
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS | Identifier |
| Return Reference | SCHEDULE J, PAGE 1, PART I, LINE 4 | ReturnReference |
| Explanation | TODD S SORENSEN, MD 0 164,980 0 DAVID GRIFFITHS 0 20,445 0 LISA BEWLEY 0 17,564 0 | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | FROM WAS PRESENTED TO AND REVIEWED BY THE BOARD IN THE MONTH PRIOR TO THE FILING DEADLINE. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | ANNUAL DISCLOSURE BY BOARD MEMBERS OF ANY CONFLICT OF INTEREST, AS SET FORTH IN THE POLICIES, IS REQUIRED. FOR ANY POSSIBLE CONFLICT OF INTEREST IDENTIFIED, THE REMAINING BOARD DETERMINES IF IT ACTUALLY CONSTITUTES A CONFLICT OF INTEREST WITHOUT THE CONFLICTED BOARD MEMBER PRESENT. IF A CONFLICT OF INTEREST IS DETERMINED TO EXIST, THE BOARD, LESS THE CONFLICTED MEMBER, WILL THEN DECIDE THE LEVEL OF INVOLVEMENT OF THE MEMBER IN DECISION MAKING FOR THE ENTITY, IF THERE IS AN ALTERNATIVE ARRANGEMENT THAT WILL ELIMINATE THE CONFLICT OF INTEREST, AND THE APPROPRIATENESS OF THE CONFLICTED MEMBER CONTINUING AS A BOARD MEMBER. FAILURE TO DISCLOSE A CONFLICT OF INTEREST CAN RESULT IN DISCIPLINARY AND CORRECTIVE ACTION FOR THE CONFLICTED MEMBER. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS AND POLICY STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC BY BEING POSTED ON THE ORGANIZATION'S WEBSITE. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)
| Business Name Line2NameOfDisregardedEntity/BusinessNameLine2 | Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Public Charity StatusPublicCharityStatus |
|---|---|---|---|---|---|---|---|---|---|---|---|
| RWHS & AFFILIATES | |||||||||||
| EMPLOYEE BENEFIT TRUST | 4021 AVENUE B | SCOTTSBLUFF | NE | 69361 | 470658690 | BENEFIT PL | NE | 501C9 | N/A | false | |
| PANHANDLE HEALTH PROPERTIES | |||||||||||
| 4021 AVENUE B | SCOTTSBLUFF | NE | 69361 | 363314161 | RENTALS | NE | 501C2 | N/A | false | ||
| PRAIRIE HAVEN HOSPICE | |||||||||||
| 4021 AVENUE B | SCOTTSBLUFF | NE | 69361 | 391904975 | HOSPICE | NE | 501C3 | N/A | false | 3 | |
| REGIONAL WEST FOUNDATION | |||||||||||
| 4021 AVENUE B | SCOTTSBLUFF | NE | 69361 | 237171022 | SUPPORT | NE | 501C3 | N/A | false | 9 | |
| REGIONAL WEST PHYSICIANS CLINIC | |||||||||||
| 4021 AVENUE B | SCOTTSBLUFF | NE | 69361 | 363314159 | HEALTH CAR | NE | 501C3 | N/A | false | 3 | |
| REGIONAL WEST VILLAGE | |||||||||||
| 4021 AVENUE B | SCOTTSBLUFF | NE | 69361 | 363314162 | RET FACILI | NE | 501C3 | N/A | false | 9 | |
| REGIONAL WEST MEDICAL CENTER | |||||||||||
| 4021 AVENUE B | SCOTTSBLUFF | NE | 69361 | 470385129 | HOSPITAL | NE | 501C3 | N/A | false | 3 | |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REGIONAL CARE INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4021 AVENUE B | AddressLine1 |
| City | SCOTTSBLUFF | City |
| State | NE | State |
| ZIP Code | 69361 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470760050 | EIN |
| Primary Activity | TPA | PrimaryActivity |
| Legal Domicile State | NE | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| REGIONAL WEST PHYSICIANS CLINIC | |
| Q | 1050000 |
| REGIONAL WEST MEDICAL CENTER | |
| R | 8060000 |
| REGIONAL WEST FOUNDATION | |
| R | 242485 |
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