REGIONAL WEST MEDICAL CENTER: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
REGIONAL WEST MEDICAL CENTER (EIN 47-0385129)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-14
IRS object ID
201123189349306412
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

FieldValueIRS element (for citing)
Timestamp2011-11-14T15:14:52-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CONTRYMAN ASSOCIATES PC CPA'SBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 2246AddressLine1
CitySCOTTSBLUFFCity
StateNEState
ZIP Code69363ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN470385129EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1REGIONAL WEST MEDICAL CNTRBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlREGINameControl
Phone3086353711Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line14021 AVENUE BAddressLine1
CitySCOTTSBLUFFCity
StateNEState
ZIP Code693614602ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDAVID GRIFFITHSName
TitleCFO & VP OF FINANCETitle
Phone3086353711Phone
Date Signed2011-11-15DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameDAN W CHARRON CPA CMAName
Phone3086357705Phone
Date Prepared2011-11-14DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts183656392GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.RWHS.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Activity Or Mission DescriptionPROVIDING MEDICAL CAREActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees1518TotalNbrEmployees
Total Gross UBI15127665TotalGrossUBI
Net Unrelated Business Txbl Income-1879567NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year57750ContributionsGrantsPriorYear
Contributions Grants Current Year21423ContributionsGrantsCurrentYear
Program Service Revenue Prior Year133367134ProgramServiceRevenuePriorYear
Program Service Revenue CY156098838ProgramServiceRevenueCY
Investment Income Prior Year1131843InvestmentIncomePriorYear
Investment Income Current Year1845207InvestmentIncomeCurrentYear
Other Revenue Prior Year21678011OtherRevenuePriorYear
Other Revenue Current Year23974298OtherRevenueCurrentYear
Total Revenue Prior Year156234738TotalRevenuePriorYear
Total Revenue Current Year181939766TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1712040GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY8050000GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year71469762SalariesEtcPriorYear
Salaries Etc Current Year75623749SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year75507338OtherExpensePriorYear
Other Expenses Current Year83001268OtherExpensesCurrentYear
Total Expenses Prior Year148689140TotalExpensesPriorYear
Total Expenses Current Year166675017TotalExpensesCurrentYear
Revenues Less Expenses Prior Year7545598RevenuesLessExpensesPriorYear
Revenues Less Expenses CY15264749RevenuesLessExpensesCY
Total Assets BOY145479201TotalAssetsBOY
Total Assets EOY155804021TotalAssetsEOY
Total Liabilities BOY86021905TotalLiabilitiesBOY
Total Liabilities EOY80348009TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY59457296NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY75456012NetAssetsOrFundBalancesEOY
Mission DescriptionPROVIDING MEDICAL CAREMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense130942774Expense
Grants8050000Grants
Revenue165477559Revenue
DescriptionREGIONAL WEST MEDICAL CENTER PROVIDED 34,372 DAYS OF INPATIENT CARE TO 6,715 PATIENTS AND REGISTERED APPROXIMATELY 54,737 OUTPATIENTS. REGIONAL WEST MEDICAL CENTER PROVIDED 20,304,353 IN BENEFITS TO THE COMMUNITY, EXCLUDING MEDICARE SHORTFALL, AND 46,265,366 OF COMMUNITY BENEFITS INCLUDING THE MEDICARE SHORTFALL.Description
Total Program Service Expense130942774TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedfalseFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccounttrueEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096107NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees1518NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDAVID GRIFFITHSNamePerson
Telephone Number3086301111TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14021 AVENUE BAddressLine1
CitySCOTTSBLUFFCity
StateNEState
ZIP Code693614602ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
TODD S SORENSEN
CEO55.00XX048187174874
TOM HOLYOKE
1.00X8402100
H HOD KOSMAN
CHAIRMAN1.00XX000
GLEN FORNEY MD
1.00X000
JANE HUNTER
1.00XX000
ROBERT KELLEY
1.00X000
MARK HARTMAN MD
1.00X000
JIM TRUMBULL
1.00X000
JEFFREY HOLLOWAY MD
1.00X000
REV LAUREN EKDAHL
1.00X000
DORA OLIVARES
1.00X000
JIM DARNELL
1.00X000
DAVID GRIFFITHS
CFO55.00X022710633983
JENNIFER BROOKER
SECRETARY40.00X03362716840
SHIRLEY KNODEL
CHIEF NURSIN55.00174212032943X
JAN TAYLOR
VP OF ANCILL55.00161851042091X
RALPH PHELPS
CRNA40.00202677023155X
THOMAS DREDLA IV
CRNA40.00202169024363X
JANET HANSON
CRNA40.00201895039607X
THOMAS DREDLA III
CRNA40.00199114042480X
CINDY BRAMAN
CRNA40.00199013041940X
JAMES MCHUGH
VP OF MED55.00179308010708XX
LISA BEWLEY
CHIEF INFORM55.00017519130894XX
STEVE HODGES
VP OF HR55.00014954635642XX
STUART FULKS
VP OF MKTING55.00014359525981XX
FieldValueIRS element (for citing)
Total Reportable Comp From Org1604260TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1210936TotalReportableCompFrmRltdOrgs
Total Other Compensation475501TotalOtherCompensation
Number Individuals GT100 K13NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MCKESSON INFORMATION SYSTEMS
PO BOX 98347CHICAGOIL606938347SVC MTN & EQUIP2771484
MAYO MEDICAL LABORATORIES
PO BOX 9146MINNEAPOLISMN55480REFERENCE LAB813604
WESTERN PATHOLOGY CONSULTANTS PC
LABORATORY774102
MAGNET SOLUTIONS
PO BOX 1826SCOTTSBLUFFNE69361A/R COLLECTIONS659982
PHILIPS MEDICAL SYSTEMS
PO BOX 406629ATLANTAGA303843262SVC CONTRACTS627944
FieldValueIRS element (for citing)
Number Of Contractors GT100 K112NumberOfContractorsGT100K
All Other Contributions21423AllOtherContributions
Total Contributions21423TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICE REVENUEDescription
Total Revenue Column156098838TotalRevenueColumn
Related Or Exempt Function Income156098838RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue156098838TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1153118TotalRevenueColumn
Exclusion$1,153,118ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities2408715Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1716626Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities692089Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column692089TotalRevenueColumn
Related Or Exempt Function Income692089RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
REFERENCE LABORATORY6215001106386011063860
PHARMACY SALES44611040638054063805
ADMINISTRATIVE & MISC3822061$3,822,061

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column5024572TotalRevenueColumn
Related Or Exempt Function Income1290526RelatedOrExemptFunctionIncome
Exclusion$3,734,046ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue23974298TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column181939766TotalRevenueColumn
Related Or Exempt Function Income158081453RelatedOrExemptFunctionIncome
Unrelated Business Revenue15127665UnrelatedBusinessRevenue
Exclusion$8,709,225ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total8050000Total
Program Services8050000ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total336062Total
Program Services336062ProgramServices

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total179308Total
Program Services179308ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total56544601Total
Program Services46027281ProgramServices
Management And General10517320ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2443036Total
Program Services2014247ProgramServices
Management And General428789ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total12148679Total
Program Services9338592ProgramServices
Management And General2810087ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3972063Total
Program Services3250141ProgramServices
Management And General721922ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total360591Total
Management And General360591ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total58992Total
Management And General58992ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total4683840Total
Program Services4655443ProgramServices
Management And General28397ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1000852Total
Program Services699651ProgramServices
Management And General301201ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1642512Total
Program Services1140674ProgramServices
Management And General501838ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total530092Total
Program Services275876ProgramServices
Management And General254216ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total370162Total
Program Services304987ProgramServices
Management And General65175ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total3174065Total
Program Services2589020ProgramServices
Management And General585045ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total10238716Total
Program Services6849548ProgramServices
Management And General3389168ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total796397Total
Program Services565251ProgramServices
Management And General231146ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
SUPPLIES3036856329939062429501
OTHER PURCHASED SERVICES18477146837147610105670
EQUIPMENT RENTAL & MAINT710223638133223288914
MISCELLANEOUS1569586769572800014
MINOR EQUIPMENT889024469661419363

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1738494Total
Program Services1303600ProgramServices
Management And General434894ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total166675017Total
Program Services130942774ProgramServices
Management And General35732243ManagementAndGeneral
Fundraising0Fundraising
FieldValueIRS element (for citing)
Joint CostsXJointCosts

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY67248BOY
EOY71732EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY11554857BOY
EOY12216496EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY24247096BOY
EOY30580238EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY1220232BOY
EOY1698478EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY4583398BOY
EOY4702846EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1712817BOY
EOY2315455EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis174171847LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec118049807LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY58270063BOY
EOY56122040EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY42517495BOY
EOY46970621EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1305995BOY
EOY1126115EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY145479201BOY
EOY155804021EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY19681479BOY
EOY17177043EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY63693597BOY
EOY59303631EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2646829BOY
EOY3867335EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY86021905BOY
EOY80348009EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY59457296BOY
EOY75456012EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY59457296BOY
EOY75456012EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY145479201BOY
EOY155804021EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses15264749ReconcilationRevenueExpenses
Reconcilation Other Changes733967ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewtrueAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis2783590OtherCostOrOtherBasis
Book Value2783590BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis168030958OtherCostOrOtherBasis
Depreciation118049807Depreciation
Book Value49981151BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3357299OtherCostOrOtherBasis
Book Value3357299BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings56122040TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionMARKET VALUE OF INTEREST RATE SWAPDescription
Amount$3,867,335Amount
FieldValueIRS element (for citing)
Total Of Amounts3867335TotalOfAmounts
Total Revenue181939766TotalRevenue
Total Expenses166675017TotalExpenses
Excess Or Deficit For Year15264749ExcessOrDeficitForYear
Net Unrealized GL On Investments3080292NetUnrealizedGLOnInvestments
Other-$2,346,325OtherAmount
Total Adjustments733967TotalAdjustments
Excess Or Deficit Per FS15998716ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt186939769TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments3080292NetUnrealizedGainsInvestments
Other Revenues1924177OtherRevenues
Revenue Not Rptd F9905004469RevenueNotRptdF990
Revenue Subtotal181935300RevenueSubtotal
Other Revenues Not Included4466OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt4466RevenueNotRptdOnFinStmt
Total Revenue Per Form990181939766TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt170941053TotExpensesEtcAuditedFinclStmt
Other Expenses Included4270506OtherExpensesIncluded
Expenses Not Rptd F9904270506ExpensesNotRptdF990
Expenses Subtotal166670547ExpensesSubtotal
Other Expenses Not Included4470OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt4470ExpensesNotRptdOnFinStmt
Total Expenses Per Form990166675017TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
RECONCILIATION OF CHANGES - OTHERSCHEDULE D, PAGE 4, PART XI, LINE 8PENSION RELATED CHANGES OTHER THAN NET PERIODIC COSTS 1,924,177 FRIENDS OF REGIONAL WEST -4,466 FUND BALANCE TRANSFERS TO AFFILIATES -3,050,000 CHANGE IN FMV OF INTEREST RATE SWAP -1,220,506 FRIENDS OF REGIONAL WEST 4,470
REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHERSCHEDULE D, PAGE 4, PART XII, LINE 2DPENSION RELATED CHANGES OTHER THAN NET PERIODIC COSTS 1,924,177
REVENUE AMOUNTS INCLUDED ON RETURN - OTHERSCHEDULE D, PAGE 4, PART XII, LINE 4BFRIENDS OF REGIONAL WEST 4,466
EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHERSCHEDULE D, PAGE 4, PART XIII, LINE 2DFUND BALANCE TRANSFERS TO AFFILIATES 3,050,000 CHANGE IN FMV OF INTEREST RATE SWAP 1,220,506
EXPENSE AMOUNTS INCLUDED ON RETURN - OTHERSCHEDULE D, PAGE 4, PART XIII, LINE 4BFRIENDS OF REGIONAL WEST 4,470

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense7333252TotalCommunityBenefitExpense
Net Community Benefit Expense7333252NetCommunityBenefitExpense
Percent Of Total Expense0.04400PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense5751053TotalCommunityBenefitExpense
Net Community Benefit Expense5751053NetCommunityBenefitExpense
Percent Of Total Expense0.03450PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense13084305TotalCommunityBenefitExpense
Net Community Benefit Expense13084305NetCommunityBenefitExpense
Percent Of Total Expense0.07850PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense516685TotalCommunityBenefitExpense
Direct Offsetting Revenue33920DirectOffsettingRevenue
Net Community Benefit Expense482765NetCommunityBenefitExpense
Percent Of Total Expense0.00290PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense1424392TotalCommunityBenefitExpense
Direct Offsetting Revenue29649DirectOffsettingRevenue
Net Community Benefit Expense1394743NetCommunityBenefitExpense
Percent Of Total Expense0.00840PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense429404TotalCommunityBenefitExpense
Net Community Benefit Expense429404NetCommunityBenefitExpense
Percent Of Total Expense0.00260PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense5628982TotalCommunityBenefitExpense
Net Community Benefit Expense5628982NetCommunityBenefitExpense
Percent Of Total Expense0.03380PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense7999463TotalCommunityBenefitExpense
Direct Offsetting Revenue63569DirectOffsettingRevenue
Net Community Benefit Expense7935894NetCommunityBenefitExpense
Percent Of Total Expense0.04760PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense21083768TotalCommunityBenefitExpense
Direct Offsetting Revenue63569DirectOffsettingRevenue
Net Community Benefit Expense21020199NetCommunityBenefitExpense
Percent Of Total Expense0.12610PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense9937TotalCommunityBuildingExpense
Net Community Building Expense9937NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense1114773TotalCommunityBuildingExpense
Net Community Building Expense1114773NetCommunityBuildingExpense
Percent Of Total Expense0.00670PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense1124710TotalCommunityBuildingExpense
Net Community Building Expense1124710NetCommunityBuildingExpense
Percent Of Total Expense0.00670PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$4,404,434BadDebtExpenseAmount
Amount Reimbursed By Medicare35969912AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare61930925CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-25961013MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1REGIONAL WEST MEDICAL CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line14021 AVENUE BAddressLine1
CitySCOTTSBLUFFCity
StateNEState
ZIP Code69361ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1REGIONAL WEST MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedfalseCHNAConducted
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent100.0FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent250.0FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Collection ActivitiesfalseCollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
COMMUNITY BUILDING ACTIVITIESPART IIRWMCS MAJOR COMMUNITY BUILDING ACTIVITIES INCLUDE DISASTER READINESS SUPPORT SYSTEM ENHANCEMENT FOR THE IMMEDIATE COMMUNITY AND SCOTTS BLUFF COUNTY ADOPTASCHOOL INVOLVMENT AND PHYSICIAN RECRUITMENT THE DISASTER READINESS SUPPORT INCLUDES COMMUNITY WIDE DRILLS COMMUNITY DISEASE AWARENESS MEETINGS COUNTY LEVEL DISASTER MEETINGS AND COOPERATION WITH THE LOCAL POLICE DEPARTMENT TO PROVIDE DISASTER SUPPORT FOR THE COMMUNITY RWMC REPRESENTATIVES ALSO VISIT LOCAL BUSINESSES AND SCHOOLS TO PROVIDE INFORMATION ON ANY VIRUS OUTBREAKS OR ALERTS SUCH AS THE H1N1 CRISIS IN 2009 RWMC IS INVOLVED WITH THE VARIOUS COMMUNITYWIDE SCHOOL PROGRAMS THEREBY PROVIDING SUPPORT TO A LOCAL SCHOOLS THROUGH PROMOTING ACTIVITIES RAISING FUNDS AND HELPING TO SERVE LUNCHES ETC RWMC AS A HOSPITAL THAT PROVIDES SERVICE TO A MEDICALLY UNDERSERVED AREA IS ACTIVELY INVOLVED IN RECRUITING QUALITY PHYSICIANS AND MEDICAL SPECIALISTS TO THE AREA TO PROVIDE NEEDED MEDICAL SERVICES THIS ONGOING RECRUITMENT ACTIVITY IS ESSENTIAL TO THE COMMUNITY AND REGION IN ORDER TO ENSURE THAT RESIDENTS HAVE REGIONAL ACCESSIBILITY TO NEEDED MEDICAL SERVICES
BAD DEBT EXPENSE EXPLANATIONPART III LINE 4THE PORTION OF THE NOTES TO THE FINANCIAL STATEMENTS OF THE AUDIT REPORT THAT ADDRESSES BAD DEBT IS UNDER THE PATIENT RECEIVABLES NET PARAGRAPH IN NOTE 1 DESCRIPTION OF ORGANIZATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES IN THIS SECTION THE NOTES STATE ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT IT IS IMPORTANT TO NOTE THAT THE BAD DEBT EXPENSE ON THE FINANCIAL STATEMENTS IS STATED IN TERMS OF UNREALIZABLE REVENUE RATHER THAN AT THE ACTUAL COSTS ASSOCIATED WITH THE BAD DEBT RWMC HAS COST ACCOUNTING SOFTWARE FROM WHICH THE ACTUAL COSTS OF THE BAD DEBT AS REPORTED ABOVE WERE OBTAINED THE COST OF BAD DEBT EXPENSE USING THIS SOFTWARE IS CALCULATED BY ADDING THE DIRECT COSTS OF THE MEDICAL SERVICES PROVIDED ALONG WITH A COMBINATION OF AN ALLOCATION OF OVERHEAD BASED ON COST ACCOUNTING METHODOLGY AND COST TO RATIO CHARGES FOR NEW SERVICE CODES RWMC USES A METHOD SIMILAR TO THE METHOD OF CALCULATING CHARITY CARE COST TO CALCULATE BAD DEBT AT COST THE TOTAL COST OF THE BAD DEBT OBTAINED FROM THE COST ACCOUNTING SYSTEM IS REDUCED BY PAYMENTS THAT WERE MADE AND ANY RECOVERIES THAT WERE REALIZED ON THE ACCOUNTS AFTER ELIMINATING ANY CREDIT BALANCES THE REMAINING COST IS DETERMINED TO BE A REASONABLE ESTIMATE OF THE COST OF BAD DEBT AT THIS TIME THE COMMUNITY BENEFIT DOES NOT INCLUDE ANY BAD DEBT AMOUNTS
MEDICARE EXPLANATIONPART III LINE 8APPROXIMATED 47 OF THE NET PATIENT SERVICES REVENUE IS FROM PATIENTS PARTICIPATING IN THE MEDICARE PROGRAM THUS PROVIDING SERVICES TO MEDICARE PATIENTS IS A PROMOTION OF HEALTHCARE SERVICES TO A SIGNIFICANT PORTION OF THE POPULATION OF THE COMMUNITY AND REGION THAT RWMC SERVES MEDICARE COST IS THE ALLOWABLE COSTS AS REPORTED ON THE REGIONAL WEST MEDICAL CENTER COST REPORT FOR 2010
COLLECTION PRACTICES EXPLANATIONPART III LINE 9BTHE COLLECTION POLICY OF RWMC AND THE RELATED CHARITY CARE POLICY STATES THAT SINCE A PATIENTS ABILITY TO PAY FOR HEALTHCARE SERVICES CAN CHANGE A CHARITY DETERMINATION CAN BE MADE PRIOR TO DURING OR FOLLOWING TREATMENT AT RWMC ONCE A PATIENT HAS DEMONSTRATED OR COMMUNICATED A NEED THROUGH NONPAYMENT OR THROUGH A COMPLETED FINANCIAL ASSISTANCE APPLICATION THE FINANCIAL ASSISTANCE TEAM OF RWMC WILL REVIEW THE ACCOUNT AND BASED ON FEDERAL POVERTY GUIDELINES WILL MAKE A DETERMINATION OF WHETHER THE ACCOUNT QUALIFIES FOR CHARITY CARE TREATMENT SOME ITEMS CONSIDERED IN THE DETERMINATION ACCORDING TO RWMC POLICY ARE ABILITY TO PAY EXHAUSTION OF MEDICARE OR MEDICAID BENEFITS COMBINED WITH INABILITY TO PAY DISCOUNTED CARE FOR THOSE UNABLE TO PAYALL OTHER POSSIBLE SOURCES OF COLLECTION USING SOUND BUSINESS PRACTICES HAVE BEEN MADE TO ENABLE THE PATIENT TO PAY CARE PROVIDED TO A DECEASED PATIENT WITH NO ESTATE OR CARE PROVIDED TO PATIENT AFTER WHICH A NEGOTIATED SETTLEMENT WAS MADE FOR THE PATIENTS ACCOUNT
NEEDS ASSESSMENTPART VICOMMUNITY NEEDS ARE ASSESSED BY USING UNRELATED DATA COLLECTION SOURCES AND THROUGH THE ACTIVE OBSERVATION AND INVOLVEMENT OF THE ENTITIES EMPLOYEES THROUGHOUT THE COMMUNITIES AND REGION SERVED ONE OF THE MAIN DATA COLLECTION SOURCES USED IS THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM BFRSS THIS ANNUAL SURVEY COLLECTS DATA ON THE PREVALENCE OF MAJOR HEALTH RISK FACTORS AMONG ADULTS RESIDING THE THE STATE THIS INFORMATION IS USED TO TARGET HEALTH EDUCATION AND RISK REDUCTION ACTIVITIES THROUGHOUT THE STATE AND GIVES RWMC A STARTING POINT FOR PROGRAM IDEAS RWMC IS ALSO INVOLVED WITH THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS MAPP PROCESS WITH PANHANDLE PUBLIC HEALTH DISTRICT THIS IS A COMMUNITY WIDE STRATEGIC PLANNING TOOL FOR IMPROVING COMMUNITY HEALTH WHICH IS FACILITATED BY PUBLIC HEALTH LEADERSHIP AND HELPS COMMUNITIES PRIORITIZE PUBLIC HEALTH ISSUES AND IDENTIFY RESOURCES FOR ADDRESSING THEM THE NEBRASKA STATE DEPARTMENT OF HEALTH IS A MAJOR RESOURCE FOR DATA USED IN NEEDS ASSESSMENT AN ASSESSMENT IS DONE OF THE GRANTS OFFERRED BY THE STATE TO DETERMINE IF THE GRANT COULD BE USED TO ADDRESS A NEED IN THE COMMUNITIES SERVED AND IF THE PROGRAM WOULD BE SUSTAINABLE ONCE STARTED COMMUNICATION WITH OTHER GROUPS IN THE REGION IS ONGOING SO THAT SERVICES ARE NOT DUPLICATED THE STATE DEPARTMENT OF HEALTH PROVIDES RWMC WITH MONTHLY CALLS ON REPORTABLE DISEASE SURVEILLANCE WHICH HELPS RWMC DIRECT EDUCATION PROGRAMS AND RESOURCES TOWARDS AREAS OF CONCERN
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPART VIPATIENTS ARE NOTIFIED AT ONE OR MORE TIMES THROUGHOUT THE PROCESS OF SCHEDULING INHOUSE THROUGH STATEMENTS LETTERSAT THE POINT OF DISCHARGE IN THE ADMISSIONS PACKET AND OCCASIONALLY BY THIER PHYSICIAN ABOUT THE FINANCIAL ASSISTANCE AND THE PAYMENT POLICIES OF RWMC RWMC HAS A TIME OF SERVICE TOSCOLLECTION POLICY THAT IS COMMUNICATED TO THE PATIENT OR THE PATIENTS FAMILY PRIOR TO OR FOLLOWING TREATMENT AT THE FACILITY DURING THIS CONFERENCE THE PATIENT IS ALSO GIVEN MATERIALS EXPLAINING THE FINANCIAL ASSISTANCE AVAILABLE THE VERBAL COMMUNICATION OF THIS POLICY PROVIDES RWMC AN OPPORTUNITY TO ASSESS IF PATIENTS HAVE A FINANCIAL NEED SO THAT THE FINANCIAL LIASIONS OF RWMC WILL BE ABLE TO PROACTIVELY WORK WITH THE PATIENTS TO DETERMINE IF THEY QUALIFY FOR FINANCIAL ASSISTANCE AT THIS TIME PAYMENT OPTIONS ARE COMMUNICATED AND DISCUSSED WITH THE PATIENTPATIENTS FAMILY A FINANCIAL ASSISTANCE APPLICATION IF APPLICABLE IS PROVIDED FOR THE PATIENT TO FILL OUT THAT IS THEN EVALUATED TO DETERMINE THE PATIENTS ABILITY OR INABILITY TO PAY USING A MEASUREMENT OF INCOME BASED ON THE MOST RECENTLY PUBLISHED POVERTY GUIDELINES FROM THE FEDERAL REGISTER DECISIONS REGARDING FINANCIAL ASSISTANCE ARE THEN COMMUNICATED TO THE PATIENT IN A LETTER
COMMUNITY INFORMATIONPART VIRWMC SERVES THE REGIONAL AREA INCLUDING THE PANHANDLE OF NEBRASKA EASTERN WYOMING SOUTHWESTERN SOUTH DAKOTA AND NORTHERN COLORADO THIS AREA IS MAINLY RURAL WITH AGRICULTURE BEING THE BIGGEST INDUSTRY THE AVERAGE ANNUAL INCOME FOR THE IMMEDIATE SCOTTS BLUFF COUNTY AREA IS APPROXIMATELY 44900 FOR A FAMILY OF 4 THE 2000 CENSUS PROJECTED THE POPULATION OF THE AREA TO BE 39000 IN 2010 OF THIS POPUATION 50 IS ESTIMATED TO BE OVER THE AGE OF 54 IN THE REGION THERE ARE 5 OTHER SMALLER HOSPITALS BUT RWMC IS THE ONLY HOSPITAL IN THE PANHANDLE OF NEBRASKA TO BE DESIGNATED A TRAUMA CENTER AND AS THE LARGEST FACILITY PROVIDES SUPPORT SERVICES TO THE SMALLER HOSPITALS IN THE REGION RWMC ESTIMATES THAT 47 OF ITS REVENUE IS DERIVED FROM MEDICAL TREATMENT OF PATIENTS COVERED BY MEDICARE 13 OF REVENUE IS DERIVED FROM PATIENTS COVERED BY MEDICAID

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedfalseRecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1REGIONAL WEST PHYSICIANS CLINICBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14021 AVE BAddressLine1
CitySCOTTSBLUFFCity
StateNEState
ZIP Code69361ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient363314159EINOfRecipient
IRC Section3IRCSection
Amount Of Cash Grant8050000AmountOfCashGrant

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgBase Compensation Filing OrgBaseCompensationFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
TODD S SORENSEN
465105167665754817326556745554933
DAVID GRIFFITHS
2170431006333068915261089239600
SHIRLEY KNODEL
20582516307611136236139330207155
JAN TAYLOR
199529149771120802523216859203942
RALPH PHELPS
230884201755922825114904225832
THOMAS DREDLA IV
2338502000922077662217741226532
JANET HANSON
23284919894829472464314964241502
THOMAS DREDLA III
23299019489442202523917241241594
CINDY BRAMAN
23326619494640672419917741240953
JAMES MCHUGH
212928173321598741216587190016
LISA BEWLEY
16497010221258705024206085209067
STEVE HODGES
1495462016915473185188181004
STUART FULKS
143595182967685169576167510

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTSIdentifier
Return ReferenceSCHEDULE J, PAGE 1, PART I, LINE 4ReturnReference
ExplanationTODD S SORENSEN 0 164,980 0 DAVID GRIFFITHS 0 20,445 0 SHIRLEY KNODEL 0 21,283 0 JAN TAYLOR 0 20,217 0 JAMES MCHUGH 0 575 0 LISA BEWLEY 0 17,564 0 STEVE HODGES 0 17,797 0 STUART FULKS 0 16,470 0Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Business Name Line2IssuerName/BusinessNameLine2Issuer EINIssuerEINDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
HOSP AUTH NO1 OF SB CO NE
2008 BONDS4706767862008-12-2310000000BUILDING IMPROVEMENT AND PROPERTY ACQUISITIONfalsefalsefalse
HOSP AUTH NO1 OF SB CO NE
2009 BONDS4706767862009-01-2110000000BUILDING IMPROVEMENT AND PROPERTY ACQUISITIONfalsefalsefalse
HOSP AUTH NO1 OF SB CO NE
2009A BONDS4706767862009-12-0220000000PROVIDE FUNDS TO REFUND 12/15/2005 BONDSfalsefalsefalse
HOSPITAL REVENUE BONDS SERIES 2010
2010 BONDS4706767862010-03-0110500000ADVANCE REFUNDING OF SERIES 2005 BONDSfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Year Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindTotal ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceeds
2008falsefalsetruetrue
2009falsefalsetruetrue
2009truefalsetruetrue
truefalsetruetrue1050000040500

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsefalsefalsefalsefalsetrue
falsefalsefalsefalsefalsetrue
falsefalsefalsefalsefalsetrue
falsefalsefalsefalsefalsefalse

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
falsefalsefalsefalsefalsefalse
falsefalsefalsefalsefalsefalse
falsetruefalsefalsefalsefalse
falsefalsefalsefalsefalsefalse

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Business Name Line2IssuerName/BusinessNameLine2Issuer EINIssuerEINDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
HOSP AUTH NO1 OF SB CO NE
2008 BONDS4706767862008-12-2310000000BUILDING IMPROVEMENT AND PROPERTY ACQUISITIONfalsefalsefalse
HOSP AUTH NO1 OF SB CO NE
2009 BONDS4706767862009-01-2110000000BUILDING IMPROVEMENT AND PROPERTY ACQUISITIONfalsefalsefalse
HOSP AUTH NO1 OF SB CO NE
2009A BONDS4706767862009-12-0220000000PROVIDE FUNDS TO REFUND 12/15/2005 BONDSfalsefalsefalse
HOSPITAL REVENUE BONDS SERIES 2010
2010 BONDS4706767862010-03-0110500000ADVANCE REFUNDING OF SERIES 2005 BONDSfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Year Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindTotal ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceeds
2008falsefalsetruetrue
2009falsefalsetruetrue
2009truefalsetruetrue
truefalsetruetrue1050000040500

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsefalsefalsefalsefalsetrue
falsefalsefalsefalsefalsetrue
falsefalsefalsefalsefalsetrue
falsefalsefalsefalsefalsefalse

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
falsefalsefalsefalsefalsefalse
falsefalsefalsefalsefalsefalse
falsetruefalsefalsefalsefalse
falsefalsefalsefalsefalsefalse

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CHALOUPKA HOLYOKE HOFMEISTERBusinessNameLine1
FieldValueIRS element (for citing)
RelationshipDIRECTORRelationship
Amount Of Transaction84021AmountOfTransaction
Description Of TransactionLEGAL SERVICESDescriptionOfTransaction
Sharing Of RevenuesfalseSharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BFORM IS PRESENTED TO AND REVIEWED BY THE BOARD IN THE MONTH PRIOR TO THE FILING DEADLINE.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CANNUAL 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.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ACOMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE OF THE RWHS BOARD FOR THE CEO AND EXECUTIVE TEAM BASED ON MARKET DATA AND RECOMMENDATIONS FROM AN INDEPENDENT CONSULTING FIRM WHO COLLECTS THAT DATA FOR COMPARISON PURPOSES. MINUTES ARE KEPT OF THESE MEETINGS.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BSEE COMPENSATION PROCESS FOR CEO.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19GOVERNING DOCUMENTS AND POLICIES ARE MADE AVAILABLE TO THE PUBLIC THROUGH POSTING ON THE ORGANIZATION'S WEBSITE.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
REGIONAL WEST HEALTH SERVICES
4021 AVENUE BSCOTTSBLUFFNE69361363314157HEALTH SVCNE501C311AN/Afalse
REGIONAL WEST FOUNDATIONS
4021 AVENUE BSCOTTSBLUFFNE69361237171022SUPPORTNE501C311AN/Afalse
REGIONAL WEST VILLAGE
4021 AVENUE BSCOTTSBLUFFNE69361363314162ASSIS LIVNE501C39N/Afalse
PANHANDLE HEALTH PROPERTIES
4021 AVENUE BSCOTTSBLUFFNE69361363314161MED RENTALNE501C2N/Afalse
REGIONAL WEST HEALTH SERVICES EMPLO
4021 AVENUE BSCOTTSBLUFFNE69361470658690HEALTH PLANE501C9N/Afalse
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1REGIONAL WEST HEALTH SERVICESBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeQTransactionType
Amount Involved3050000AmountInvolved

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