2011-11-10T12:42:21-06:00 2011-06-30 Wendling Noe Nelson & Johnson LLC 534 S Kansas Ave Suite 1500 Topeka KS 666033491 990 2010-07-01 480764456 Nemaha Valley Community Hospital NEMA 7853366181 1600 Community Drive Seneca KS 66538 Stan Regehr 7853366181 2011-11-09 1 Eric L Otting 7852334226 2011-11-09 2010 2016-03-07 17:11:31Z Stan Regehr 1600 Community Drive Seneca KS 66538 10786387 0 X N/A X 1969 KS The Nemaha Valley Community Hospital provides an acute care hospital to the surrounding area. 9 8 155 0 0 0 50234 304617 9741488 10293997 31652 52205 99530 65968 9922904 10716787 0 0 0 0 5669531 5814945 0 0 829 4043012 4651666 9712543 10466611 210361 250176 14405762 14304366 9825983 9456398 4579779 4847968 The Nemaha Valley Community Hospital is dedicated to providing quality health care and other related services in a compassionate manner sufficient to meet the primary health care needs of its patrons within the scope of its resources and staff. 0 0 9392977 10345222 Nemaha Valley Community Hospital provides healthcare treatment to its patients. 9392977 1 1 0 0 0 0 0 0 0 1 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 19 0 1 155 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 1 1 1 0 X Connie Ingwerson 7853366181 1600 Community Drive Seneca KS 66538 Mark Heiniger 4.00 X 0 0 0 Steven Kramer 4.00 X X 0 0 0 Joyce Schmitz 4.00 X X 0 0 0 Ron Johnson 4.00 X 0 0 0 Connie Ronnebaum 4.00 X 0 0 0 Judy Deters 4.00 X 0 0 0 Kathy Brinker 4.00 X X 0 0 0 Dr Angela Stueve 40.00 X X 212375 0 25844 Jim Runnebaum 4.00 X 0 0 0 Steve Haverkamp 4.00 X 0 0 0 Stan Regehr 40.00 X 151423 0 6514 Connie Ingwerson 40.00 X 67256 0 4432 Dr Jody Bieker 40.00 X 202304 0 26774 Dr James Lueger 40.00 X 212344 0 14049 Dr William Bartkoski 40.00 X 220161 0 14827 Karen Hynek 40.00 X 103633 0 9135 1169496 0 101575 6 0 1 0 Harry Stewart PO Box 147 Seneca KS 66538 Anesthesia Services 310800 Healthcare Management Services 2739 Momemtum Place Chicago IL 60689 IT Maintenance 238775 Stormont Vail Healthcare 1500 SW 10th Avenue Topeka KS 66604 Lab Services 144726 3 18222 286395 304617 Patient service 621990 10293997 10293997 10293997 40365 40365 81440 69600 11840 11840 11840 Miscellaneous 621990 39385 39385 Dietary Income 621990 26583 26583 65968 10716787 10345222 0 66948 228821 228821 4628507 4232222 396285 119610 110192 9418 549018 485508 63510 288989 252484 35676 829 2178 2178 19502 10585 8917 44175 43876 299 189292 189292 45309 31756 13553 594806 594806 855728 781602 74126 106569 106569 Supplies 1148641 1111528 37113 Professional fees 895378 792100 103278 Equipment rental and ma 390624 315067 75557 Collection fees and bad 226684 226684 Miscellanous 76653 75583 1070 56127 33123 23004 10466611 9392977 1072805 829 233654 235366 3701836 2703173 91261 18420 1199853 1245016 210599 244632 229184 249202 16690799 7848637 8728915 8842162 10460 766395 14405762 14304366 1116761 906285 44222 10113 8665000 8540000 9825983 9456398 X 4579078 4847267 701 701 4579779 4847968 14405762 14304366 X 250176 18013 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 54681 54681 9368171 2122552 7245619 7267947 5726085 1541862 8842162 Contribution receivables 240182 Estimated settlements due from third party payors 525324 Advances to physicians & medical students 889 766395 10716787 10466611 250176 18013 18013 268189 10716787 0 10716787 0 10716787 10466611 0 10466611 0 10466611 Description of Uncertain Tax Positions Under FIN 48: Part X: Not applicable. Part XI, Line 8 - Other Adjustments: Net assets released from restrictions used for operations -18,222. Temporarily restricted contributions and grants 36,235. Temp restricted net assets released for purchase of property and equipment -18,013. Unrestricted net assets used for purchase of property and equipment 18,013. 1 1 1 X 1 X 1 1 0 0 45787 45787 0.00450 416416 264554 151862 0.01480 462203 264554 197649 0.01930 112036 12865 99171 0.00970 1577 1577 0.00020 113613 12865 100748 0.00990 575816 277419 298397 0.02920 154290 61716 5553181 5756779 -203598 X 1 1 1 1 Nemaha Valley Community Hospital

1600 Community Drive Seneca KS 66538

X X X X Nemaha Valley Community Hospital 1 0 1 1 100.000000000000 1 200.000000000000 1 X X 1 1 X X X 1 X X X 1 X X X X X 1 X 0 1 Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 226684. Part II: N/A Part III, Line 4: Nemaha Valley Community Hospital provides for accounts receivable that could become uncollectible in the future by establishing an allowance to reduce the carrying value of such receivables to their estimated net realizable value. Nemaha Valley Community Hospital estimates this allowance based on the aging of its accounts receivable and its historical collection experience for each type of payor. Part III, Line 8: The Hospital provides service to all patients in their service area, regardless of the patient's ability to pay, and any shortfall absorbed by the Hospital is a benefit to the community. Part III, Line 9b: Nemaha Valley Community Hospital will make every effort to get correct financial and billing information and educate patients on charity programs and payment options. Nemaha Valley Community Hospital Part V, Section B, Line 19d: The Hospital reviews and updates its charges annually and all patients are charged the same. Part VI, Line 2: The Hospital receives feedback from community members regarding services currently offered and potential availability of services not offered. The Hospital also discusses the service needs of the community with the medical staff and board of trustees, who are in tune with the needs of the patients. Part VI, Line 3: Notification associated with patient encounter. Part VI, Line 4: The community being served consists of approximately 2,000 residents. The median family income is $40,819. 7.1% of the community residents live below federal poverty level, and 1.9% of the community residents live below 50% of the federal poverty level. Neighboring hospitals are located in Sabetha, Pawnee County, NE, and Hiawatha. They are approximately 15, 20, and 28 miles away respectively. Part VI, Line 6: The Hospital notifies the public in quarterly newsletters about services available at the hospital. The Hospital offers periodic diabetic educational programs and education programs for expectant mothers. The Hospital uses all excess funds to maintain and improve Hospital facilities and patient services. Part VI, Line 7: N/A X X 0 0 0 0 0 0 0 0 0 Dr Angela Stueve 193775 0 0 0 18600 0 8712 0 17132 0 238219 0 199787 0 Stan Regehr 151423 0 0 0 0 0 6514 0 0 0 157937 0 148512 0 Dr Jody Bieker 201505 0 0 0 799 0 9642 0 17132 0 229078 0 192694 0 Dr James Lueger 212344 0 0 0 0 0 9617 0 4432 0 226393 0 219019 0 Dr William Bartkoski 220161 0 0 0 0 0 10395 0 4432 0 234988 0 227666 0 City of Seneca Kansas 486026237 81712RAP4 2008-12-01 8835000 To refund notes payable and construction costs for an addition to Hospital 0 0 0 170000 8746650 1358153 73122 498789 6816586 2011 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 Dr Stueve Assist with transition from medical school X 16000 889 0 0 1 889 Sara Kramer Daughter of Board Member 38803 Employed by Nemaha Valley Community Hospital as the Director of the dietary department. 0 Tina Palic Daughter of Board Member 72095 Employed by Nemaha Valley Community Hospital as the Director of the occupational/physical therapy department. 0 Form 990, Part VI, Section B, line 11 The 990 is not formally presented to the board. The document is made available upon request. Form 990, Part VI, Section B, line 12c The board in required to annually sign conflict of interest statements. Form 990, Part VI, Section B, line 15 The CEO salary and compensation is approved by the hospital's board. Form 990, Part VI, Section C, line 19 Documents are available upon request. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net assets released from restrictions used for operations -18,222. Temporarily restricted contributions and grants 36,235. Temp restricted net assets released for purchase of property and equipment -18,013. Unrestricted net assets used for purchase of property and equipment 18,013. Total to Form 990, Part XI, Line 5: 18,013. FORM 990 PART VII LINE 12C The board in required to annually sign conflict of interest statements. Nemaha Valley Health Care Foundation 1600 Community Drive Seneca KS 66538 481097250 Fundraising for the benefit of Nemaha Valley Community Hospital KS 501(c)(3) 509(a) Nemaha Valley Community Hospital 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Nemaha Valley Health Care Foundation C 25000