COMMUNITY HOSPITAL ASSOCIATION: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HOSPITAL ASSOCIATION (EIN 47-0533373)
- Tax period
- 2024-07-01 to 2025-06-30
- Filed
- 2026-05-12
- IRS object ID
- 202611329349304431
- Schema version
- 2024v5.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2026-05-12T12:50:17-05:00 | ReturnTs |
| Tax Period End | 2025-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18081 BURT ST STE 200 | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 680224722 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470533373 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL ASSOCIATION OF MCCOOK | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 3083442650 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1301 EAST H STREET PO BOX 1328 | AddressLine1Txt |
| City | MCCOOK | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 69001 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SEAN WOLFE | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 3083442650 | PhoneNum |
| Signature | 2026-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | WENDY R COOLEY CPA | PreparerPersonNm |
| PTIN | P01523804 | PTIN |
| Phone | 4023302660 | PhoneNum |
| Preparation | 2026-05-07 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SEAN WOLFE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1301 EAST H STREET PO BOX 1328 | AddressLine1Txt |
| City | MCCOOK | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 69001 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $82,517,085 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CHMCCOOK.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1974 | FormationYr |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE FOR THE HEALTHCARE NEEDS OF OUR REGION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 381 | TotalEmployeeCnt |
| Total Volunteers | 40 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $667,289 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,653,570 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $63,188,048 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $79,080,538 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,268,951 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,087,579 | CYInvestmentIncomeAmt |
| PY Other Revenue | $964,016 | PYOtherRevenueAmt |
| CY Other Revenue | $695,398 | CYOtherRevenueAmt |
| PY Total Revenue | $66,088,304 | PYTotalRevenueAmt |
| CY Total Revenue | $82,517,085 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $416,376 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $468,477 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $33,053,335 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $36,611,372 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $297,315 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $32,478,343 | PYOtherExpensesAmt |
| CY Other Expenses | $43,716,201 | CYOtherExpensesAmt |
| PY Total Expenses | $65,948,054 | PYTotalExpensesAmt |
| CY Total Expenses | $80,796,050 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $140,250 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,721,035 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $91,587,690 | TotalAssetsBOYAmt |
| Total Assets EOY | $98,696,906 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $32,519,348 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $37,612,867 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $59,068,342 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $61,084,039 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | LEADING OUR REGION TO A HEALTHIER FUTURE. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $64,997,995 | ExpenseAmt |
| Grant | $468,477 | GrantAmt |
| Revenue | $79,775,936 | RevenueAmt |
| Desc | 25-BED CRITICAL ACCESS ACUTE CARE HOSPITAL PROVIDING INPATIENT AND OUTPATIENT CARE, DIAGNOSTIC, REHABILITATION, SURGICAL, NURSERY, VISITING MEDICAL SPECIALISTS, HOME HEALTH AND HOSPICE, TWO RURAL HEALTH CLINICS, A PRIMARY CARE CLINIC, AND HEALTH AND EDUCATION PROGRAMS. | Desc |
| Total Program Service Expenses | $64,997,995 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 76 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 381 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SEAN WOLFE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3083448306 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1301 EAST H - PO BOX 1328 | AddressLine1Txt |
| City | MCCOOK | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 69001 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| RICHARD LAWTON | ||||||||
| ORTHO PHYSICAN | 40.00 | 0.00 | Yes (X) | $728,996 | $0 | $73,868 | ||
| DOUGLAS TICE | ||||||||
| ORTHO PHYSICAN | 40.00 | 0.00 | Yes (X) | $701,358 | $0 | $30,301 | ||
| EVAN GEILENKIRCHEN | ||||||||
| CRNA | 40.00 | 0.00 | Yes (X) | $348,969 | $0 | $58,914 | ||
| TROY BRUNTZ | ||||||||
| PRESIDENT & CEO | 39.00 | 1.00 | $333,968 | $0 | $53,413 | Yes (X) | ||
| SEAN WOLFE | ||||||||
| CFO | 40.00 | 0.00 | $232,303 | $0 | $62,516 | Yes (X) | ||
| ANTHONY RODEWALD | ||||||||
| PHARMACIST | 40.00 | 0.00 | Yes (X) | $203,660 | $0 | $43,146 | ||
| BRUCE MIKESELL | ||||||||
| EMERGENCY PHYSICIAN | 40.00 | 0.00 | Yes (X) | $197,298 | $0 | $19,583 | ||
| MATTHEW NIELSEN | ||||||||
| CHAIR | 1.00 | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| KURT VOSBURG | ||||||||
| VICE CHAIR | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| MICHAEL LORD | ||||||||
| SECRETARY | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| MATTHEW DAVIDSON | ||||||||
| TREASURER | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| KAREN CRAW | ||||||||
| DIRECTOR | 0.50 | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| DARREN ESCH | ||||||||
| DIRECTOR | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| JANA KMOCH | ||||||||
| DIRECTOR | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| GRANT NORGAARD | ||||||||
| DIRECTOR | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| ASHLEY VONTZ | ||||||||
| DIRECTOR | 0.50 | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,746,552 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $341,741 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 47 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MCCOOK FAMILY MEDICINE | |||||
| 1301 E H ST | MCCOOK | NE | 69001 | PROVIDER SERVICES | $4,464,295 |
| RUTTS HEATING & AC | |||||
| 1001 W 1ST ST | HASTINGS | NE | 68901 | CONSTRUCTION | $2,268,359 |
| SOUTHWEST NEBRASKA PHYSICAL THERAPY | |||||
| PO BOX 789 | MCCOOK | NE | 69001 | PHYSICAL THERAPY SERVICES | $1,593,822 |
| KREWE ANESTHESIA | |||||
| 3915 N ARNOULT RD | METAIRE | LA | 70002 | ANESTHESIA SERVICES | $995,685 |
| PATHOLOGY SERVICES | |||||
| PO BOX 1289 | NORTH PLATTE | NE | 69103 | LAB SERVICES | $908,092 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 21 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $461,043 | RelatedOrganizationsAmt |
| Government Grants | $142,527 | GovernmentGrantsAmt |
| All Other Contributions | $1,050,000 | AllOtherContributionsAmt |
| Total Contributions | $1,653,570 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621400 | $77,905,212 | $77,905,212 |
| PHARMACY REVENUE | 621400 | $936,100 | $936,100 |
| OUT-SOURCE SERVICES | 621400 | $239,226 | $239,226 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $79,080,538 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,086,845 | TotalRevenueColumnAmt |
| Exclusion | $1,086,845 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $167,429 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $167,429 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $167,429 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $167,429 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $734 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $734 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $734 | TotalRevenueColumnAmt |
| Exclusion | $734 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CAFETERIA/MEALS | 900099 | $320,860 | $320,860 |
| HOUSEKEEPING INCOME | 900099 | $76,955 | $76,955 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $130,154 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $130,154 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $527,969 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $82,517,085 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $79,775,936 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,087,579 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $464,477 | TotalAmt |
| Program Services | $464,477 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,000 | TotalAmt |
| Program Services | $4,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $702,978 | TotalAmt |
| Management And General | $702,978 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,563,182 | TotalAmt |
| Program Services | $21,466,205 | ProgramServicesAmt |
| Management And General | $4,906,509 | ManagementAndGeneralAmt |
| Fundraising | $190,468 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,679,795 | TotalAmt |
| Program Services | $1,360,849 | ProgramServicesAmt |
| Management And General | $306,889 | ManagementAndGeneralAmt |
| Fundraising | $12,057 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,551,577 | TotalAmt |
| Program Services | $4,427,638 | ProgramServicesAmt |
| Management And General | $1,084,649 | ManagementAndGeneralAmt |
| Fundraising | $39,290 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,113,840 | TotalAmt |
| Program Services | $1,670,146 | ProgramServicesAmt |
| Management And General | $428,898 | ManagementAndGeneralAmt |
| Fundraising | $14,796 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $154,012 | TotalAmt |
| Management And General | $154,012 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,835 | TotalAmt |
| Management And General | $139,835 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,231,745 | TotalAmt |
| Program Services | $14,162,806 | ProgramServicesAmt |
| Management And General | $4,068,939 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $232,742 | TotalAmt |
| Management And General | $232,742 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $732,112 | TotalAmt |
| Program Services | $588,513 | ProgramServicesAmt |
| Management And General | $143,581 | ManagementAndGeneralAmt |
| Fundraising | $18 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,382,965 | TotalAmt |
| Program Services | $1,382,965 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,994 | TotalAmt |
| Program Services | $34,834 | ProgramServicesAmt |
| Management And General | $14,160 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $823,828 | TotalAmt |
| Program Services | $453,455 | ProgramServicesAmt |
| Management And General | $363,529 | ManagementAndGeneralAmt |
| Fundraising | $6,844 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,070,846 | TotalAmt |
| Program Services | $1,065,960 | ProgramServicesAmt |
| Management And General | $4,886 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,376,543 | TotalAmt |
| Program Services | $4,791,691 | ProgramServicesAmt |
| Management And General | $584,852 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $511,363 | TotalAmt |
| Program Services | $510,434 | ProgramServicesAmt |
| Management And General | $929 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $12,036,997 | $12,036,997 | ||
| MISCELLANEOUS | $2,480,467 | $171,774 | $2,274,851 | $33,842 |
| FOOD | $397,827 | $397,827 | ||
| MEMBERSHIPS & DUES | $95,925 | $7,424 | $88,501 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,796,050 | TotalAmt |
| Program Services | $64,997,995 | ProgramServicesAmt |
| Management And General | $15,500,740 | ManagementAndGeneralAmt |
| Fundraising | $297,315 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,600 | BOYAmt |
| EOY | $2,427 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,564,598 | BOYAmt |
| EOY | $18,475,019 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,586,319 | BOYAmt |
| EOY | $12,453,679 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,165,529 | BOYAmt |
| EOY | $2,597,002 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,895,604 | BOYAmt |
| EOY | $3,053,635 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $117,952,305 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $69,114,487 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,438,901 | BOYAmt |
| EOY | $48,837,818 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,596,728 | BOYAmt |
| EOY | $2,224,453 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $660,411 | BOYAmt |
| EOY | $705,401 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $571,958 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $678,000 | BOYAmt |
| EOY | $9,775,514 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,587,690 | BOYAmt |
| EOY | $98,696,906 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,262,501 | BOYAmt |
| EOY | $9,963,461 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $671,128 | BOYAmt |
| EOY | $886,021 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,574,730 | BOYAmt |
| EOY | $26,740,271 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,989 | BOYAmt |
| EOY | $23,114 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,519,348 | BOYAmt |
| EOY | $37,612,867 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,068,342 | BOYAmt |
| EOY | $61,084,039 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,068,342 | BOYAmt |
| EOY | $61,084,039 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,587,690 | BOYAmt |
| EOY | $98,696,906 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,721,035 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $294,662 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | Yes (1) | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $5,944 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $20,985 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $26,929 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | A PORTION OF DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND NEBRASKA HOSPITAL ASSOCIATION ARE USED FOR LOBBYING AND POLITICAL ACTIVITIES. MANAGEMENT IS ACTIVE IN NEBRASKA HOSPITAL ASSOCIATION'S PAC, AHA'S ADVOCACY DAY, AND OTHER INDUSTRY FUNCTIONS. IN THE CURRENT YEAR, THE ORGANIZATION ALSO SUPPORTED A LOCAL SCHOOL BOND ATTEMPT. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,945,219 | BeginningYearBalanceAmt |
| Contributions | $3,683 | ContributionsAmt |
| Investment Earnings Or Losses | $515,882 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $108,476 | AdministrativeExpensesAmt |
| End Year Balance | $4,356,308 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,660,864 | BeginningYearBalanceAmt |
| Contributions | $3,766 | ContributionsAmt |
| Investment Earnings Or Losses | $446,030 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $165,441 | AdministrativeExpensesAmt |
| End Year Balance | $3,945,219 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,482,371 | BeginningYearBalanceAmt |
| Contributions | $5,110 | ContributionsAmt |
| Investment Earnings Or Losses | $214,711 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $41,328 | AdministrativeExpensesAmt |
| End Year Balance | $3,660,864 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,811,948 | BeginningYearBalanceAmt |
| Contributions | $5,826 | ContributionsAmt |
| Investment Earnings Or Losses | -$260,507 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $74,896 | AdministrativeExpensesAmt |
| End Year Balance | $3,482,371 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,290,398 | BeginningYearBalanceAmt |
| Contributions | $12,744 | ContributionsAmt |
| Investment Earnings Or Losses | $508,806 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $3,811,948 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.63065 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.36935 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $101,803 | OtherCostOrOtherBasisAmt |
| Book Value | $101,803 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $49,846,215 | OtherCostOrOtherBasisAmt |
| Depreciation | $42,089,121 | DepreciationAmt |
| Book Value | $7,757,094 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $64,242,355 | OtherCostOrOtherBasisAmt |
| Depreciation | $23,761,644 | DepreciationAmt |
| Book Value | $40,480,711 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,761,932 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,263,722 | DepreciationAmt |
| Book Value | $498,210 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $48,837,818 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | Desc |
| Book Value | $9,775,514 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $9,775,514 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | REFUNDABLE ADVANCES | Desc |
| Amt | $23,114 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $23,114 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE ENDOWMENT FUNDS ARE HELD BY THE COMMUNITY HOSPITAL HEALTH FOUNDATION OF MCCOOK (A RELATED PARTY) AND ARE USED IN SUPPORT OF THE HOSPITAL'S PROGRAMS AND PROJECTS, INCLUDING PROPERTY AND EQUIPMENT PURCHASES, SCHOLARSHIPS, HOSPICE PROGRAMS, REHABILITATION SERVICES AND OTHERS. |
| PART X, LINE 2: | THE HOSPITAL AND FOUNDATION ACCOUNT FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. THE HOSPITAL AND FOUNDATION RECOGNIZE THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT JUNE 30, 2025 AND 2024, THE HOSPITAL AND FOUNDATION HAD NO UNCERTAIN TAX POSITIONS ACCRUED. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,186,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,186,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01470 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,563,920 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,563,920 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,749,920 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,563,920 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,186,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01470 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,391 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $18,391 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,535,474 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,725,690 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,809,784 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03480 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $404,922 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $404,922 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00500 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,958,787 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,725,690 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,233,097 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04000 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,708,707 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,289,610 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,419,097 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05470 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,918,652 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $437,798 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $27,985,555 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $28,111,021 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$125,466 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL ASSOCIATION OF MCCOOK | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1301 EAST H STREET - PO BOX 1328 | AddressLine1Txt |
| City | MCCOOK | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 69001 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.CHMCCOOK.ORG | WebsiteAddressTxt |
| State License | 320007 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL ASSOCIATION OF MCCOOK | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 24 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, PAGE 8 | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 24 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, PAGE 8 | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://CHMCCOOK.ORG/FOR-PATIENTS/FINANCIAL-ASSISTANCE.HTML | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://CHMCCOOK.ORG/FOR-PATIENTS/FINANCIAL-ASSISTANCE.HTML | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://CHMCCOOK.ORG/FOR-PATIENTS/FINANCIAL-ASSISTANCE.HTML | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| COMMUNITY HOSPITAL ASSOCIATION OF MCCOOK | PART V, SECTION B, LINE 5: COMMUNITY HOSPITAL WORKED WITH COMMUNITY HOSPITAL CONSULTING TO COLLECT DATA THAT WAS USED TO IDENTIFY THE NEEDS OF OUR REGION. ACCORDING TO THE CHNA PROCESS AND METHODOLOGY, "CHC CONSULTING CONDUCTED THE FOLLOWING RESEARCH: A DEMOGRAPHIC ANALYSIS OF THE STUDY AREA, UTILIZING DEMOGRAPHIC DATA FROM A VARIETY OF SOURCES, A STUDY OF THE MOST RECENT HEALTH DATA AVAILABLE, ONE-ON-ONE PHONE INTERVIEWS WITH INDIVIDUALS WHO HAVE SPECIAL KNOWLEDGE OF THE COMMUNITIES, AND ANALYZED THOSE RESULTS, FACILITATED THE PRIORITIZATION PROCESS UTILIZING A SURVEY OF THE CHNA TEAM. THE CHNA TEAM INCLUDED: TROY BRUNTZ, CEO, MOLLY HERZBERG, CNO, KAREN KLIMENT THOMPSON, VP ANCILLARY SERVICES, LORI BEEBY, VP SUPPORT SERVICES, JESSICA JOHNSON, DIRECTOR OF QUALITY & PATIENT INFORMATION, LEANNE MILLER, DIRECTOR OF HUMAN RESOURCES, KYLE TEEL, CORPORATE CONTROLLER & STRATEGY DIRECTOR, AND BALEIGH ABBOTT, POPULATION HEATH & OUTREACH COORDINATOR."RESOURCES FOR HEALTH DATA WERE COLLECTED FROM SOURCES SUCH AS: THE ROBERT WOOD JOHNSON FOUNDATION, NEBRASKA STATE DEPARTMENT OF HEALTH AND HUMAN SERVICES, THE CARES ENGAGEMENT NETWORK, UNITED STATES CENSUS BUREAU, AND THE CENTERS FOR DISEASE CONTROL AND PREVENTION. FOR THE ONE-ON-ONE INTERVIEWS, ACCORDING TO THE SAME DOCUMENT MENTIONED ABOVE: "CH PROVIDED CHC CONSULTING WITH A LIST OF PERSONS WITH SPECIAL KNOWLEDGE OF PUBLIC HEALTH IN RED WILLOW COUNTY, INCLUDING PUBLIC HEALTH REPRESENTATIVES AND OTHER INDIVIDUALS WHO FOCUS SPECIFICALLY ON UNDERREPRESENTED GROUPS. FROM THAT LIST, SEVENTEEN IN-DEPTH PHONE INTERVIEWS WERE CONDUCTED USING A STRUCTURED INTERVIEW GUIDE. EXTENSIVE NOTES WERE TAKEN DURING EACH INTERVIEW AND THEN QUANTIFIED BASED ON RESPONSES, COMMUNITIES AND POPULATIONS (MINORITY, ELDERLY, UN/UNDERINSURED, ETC.) SERVED, AND PRIORITIES IDENTIFIED BY RESPONDENTS. QUALITATIVE DATA FROM THE INTERVIEWS WAS ALSO ANALYZED AND REPORTED." |
| COMMUNITY HOSPITAL ASSOCIATION OF MCCOOK | PART V, SECTION B, LINE 11: THE LIST OF PRIORITIZED NEEDS, IN DESCENDING ORDER, IS LISTED BELOW: 1) CONTINUED EMPHASIS ON RECRUITMENT AND RETENTION OF HEALTHCARE WORKFORCE TO INCREASE ACCESS TO PRIMARY CARE AND SPECIALTY CARE 2) PREVENTION, EDUCATION AND SERVICES TO ADDRESS HIGH MORTALITY RATES, CHRONIC DISEASES, PREVENTABLE CONDITIONS AND UNHEALTHY LIFESTYLES 3) ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE SERVICES AND PROVIDERS 4) ACCESS TO AFFORDABLE CARE AND REDUCING HEALTH DISPARITIES AMONG SPECIFIC POPULATION. EACH PRIORITY AREA HAS ANYWHERE FROM FOUR TO EIGHT ACTION STEPS IDENTIFIED IN THE CHNA IMPLEMENTATION PLAN TRACKING DOCUMENT AND EACH ACTION STEP HAS AT LEAST ONE RESPONSIBLE LEADER (A CH REPRESENTATIVE WITH OWNERSHIP OF THE ACTION STEP).PRIORITY #1: CONTINUED EMPHASIS ON RECRUITMENT AND RETENTION OF HEALTHCARE WORKFORCE TO INCREASE ACCESS TO PRIMARY CARE AND SPECIALTY CARE:1.A. COMMUNITY HOSPITAL OFFERS SEVERAL MEDICAL CLINICS OFFERING A VARIETY OF SPECIALTY CARE SERVICES. THE COMMUNITIES OF TRENTON AND CURTIS ARE SERVED BY LOCAL RURAL CLINICS PROVIDED BY COMMUNITY HOSPITAL. ADDITIONALLY, COMMUNITY HOSPITAL WILL ASSESS INFORMATION FROM THE SEMI-ANNUAL MARKET ASSESSMENT AND WILL CONTINUE TO TRACK RECRUITING EFFORTS OF NEW SPECIALISTS THROUGH SERVICE SEED. AS OPPORTUNITIES FOR ADDITIONAL SERVICES ARE EVALUATED, COMMUNITY HOSPITAL WILL ALSO FOCUS ON APPROPRIATE STAFFING FOR THE ADDITION OF SUCH SERVICES.1.B. COMMUNITY HOSPITAL WILL CONTINUE TO OFFER VARIOUS MOBILE SERVICES ON A REGULAR BASIS, SUCH AS PET/CT, CARDIOVASCULAR SCREENINGS, AND NUCLEAR STUDIES.1.C. COMMUNITY HOSPITAL MAINTAINS AN UPDATED CALENDAR OF VISITING SPECIALISTS ON ITS WEBSITE FOR RESIDENTS TO ACCESS AND UTILIZE IN PLANNING HEALTH CARE APPOINTMENTS. ADDITIONALLY, COMMUNITY HOSPITAL WILL CONTINUE TO IMPLEMENT ROTATING FACEBOOK ADVERTISEMENTS FEATURING VISITING SPECIALISTS.1.D. COMMUNITY HOSPITAL WILL CONTINUE TO SERVE AS A TEACHING FACILITY AND ALLOW FOR STUDENTS PURSUING HEALTH-RELATED CAREERS TO ROTATE THROUGH THE FACILITY FOR A VARIETY OF PROGRAMS, INCLUDING, BUT NOT LIMITED TO, THERAPY, PHARMACY, NURSING, AND PUBLIC HEALTH.1.E. THROUGH THE CNA INITIATIVE, COMMUNITY HOSPITAL PARTNERS WITH NURSING HOMES, SCHOOLS AND OTHERS IN THE REGION TO SUPPORT AND ENCOURAGE INTERESTED INDIVIDUALS TO PURSUE OPPORTUNITIES AS A PRACTICING CNA OR RN IN THE COMMUNITY.PRIORITY #2: PREVENTION, EDUCATION AND SERVICES TO ADDRESS HIGH MORTALITY RATES, CHRONIC DISEASES, PREVENTABLE CONDITIONS AND UNHEALTHY LIFESTYLES:2.A. COMMUNITY HOSPITAL WILL CONTINUE TO INCREASE EDUCATIONAL OPPORTUNITIES FOR THE PUBLIC CONCERNING WELLNESS TOPICS AND HEALTH RISK CONCERNS. ADDITIONALLY, COMMUNITY HOSPITAL WILL CONTINUE TO INCREASE AWARENESS OF AND ACCESS TO ITS EDUCATIONAL OFFERINGS.2.B. COMMUNITY HOSPITAL WILL CONTINUE TO HOST AND/OR PARTICIPATE IN LOCAL HEALTH-RELATED EVENTS TO PROMOTE HOSPITAL SERVICES, OFFER A VARIETY OF HEALTH SCREENINGS TO THE COMMUNITY, AND/OR SUPPORT OR PARTNER WITH LOCAL ORGANIZATIONS THAT PROVIDE SERVICES TO VULNERABLE POPULATIONS.2.C. COMMUNITY HOSPITAL WILL CONTINUE TO HOST VARIOUS SUPPORT AND EDUCATIONAL GROUPS AT THE FACILITY.2.D. COMMUNITY HOSPITAL PERSONNEL WILL CONTINUE TO SERVE IN LEADERSHIP ROLES AND AS VOLUNTEERS WITH MANY AGENCIES AND COMMITTEES IN THE COMMUNITY. ADDITIONALLY, COMMUNITY HOSPITAL WILL CONTINUE TO PROVIDE STAFF REPRESENTATION AT VARIOUS CONFERENCES AND IN LOCAL CONSORTIUMS FOCUSED AROUND ITS PATIENT POPULATION'S NEEDS.2.E. COMMUNITY HOSPITAL WILL CONTINUE TO SERVE AS THE BACKBONE ORGANIZATION FOR THE MCCOOK ON THE MOVE INITIATIVE, INCLUDING WELLNESS MCCOOK, IN COLLABORATION WITH SEVERAL LOCAL PARTNER ORGANIZATIONS TO IMPROVE THE OVERALL QUALITY OF LIFE IN THE COMMUNITY.2.F. COMMUNITY HOSPITAL WILL CONTINUE TO INCENTIVIZE EMPLOYEES AND THEIR FAMILIES TO PARTICIPATE IN REGULAR PHYSICAL ACTIVITY THROUGH DISCOUNTED MEMBERSHIPS AT LOCAL GYMS AND RECREATION FACILITIES, AS WELL AS WELLNESS INCENTIVES TOWARDS EMPLOYEE HEALTH INSURANCE PREMIUMS.2.G. COMMUNITY HOSPITAL WILL FOCUS ON VARIOUS PREVENTIVE AND EDUCATION TOPICS IN THE COMMUNITY AS OPPORTUNITIES ARISE.PRIORITY #3: ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE SERVICES AND PROVIDERS:3.A. COMMUNITY HOSPITAL WILL CONTINUE TO GROW AND EXPAND MENTAL HEALTH SERVICES PROVIDED TO THE COMMUNITY.3.B. COMMUNITY HOSPITAL WILL CONTINUE TO SHARE AN ANNUALLY-UPDATED LIST OF AREA AND TELEHEALTH PROVIDERS FOR MENTAL HEALTH SUPPORT AND COUNSELING SERVICES.3.C. COMMUNITY HOSPITAL WILL CONTINUE TO ADVOCATE AND EXPLORE OPPORTUNITIES TO SUPPORT OTHER OUTLETS IN THE COMMUNITY AND CONNECT PATIENTS WITH MENTAL AND BEHAVIORAL HEALTH RESOURCES AS OPPORTUNITIES ARISE.3.D. COMMUNITY HOSPITAL WILL CONTINUE TO OFFER MENTAL HEALTH SUPPORT TO ITS EMPLOYEES THROUGH THE EMPLOYEE ASSISTANCE PROGRAM (EAP).PRIORITY #4: ACCESS TO AFFORDABLE CARE AND REDUCING HEALTH DISPARITIES AMONG SPECIFIC POPULATIONS:4.A. COMMUNITY HOSPITAL WILL CONTINUE TO HOST AND PARTICIPATE IN DONATION DRIVES AND FUNDRAISING EVENTS TO BENEFIT UNDERSERVED ORGANIZATIONS IN THE COMMUNITY, AS WELL AS EDUCATIONAL EVENTS.4.B. COMMUNITY HOSPITAL WILL CONTINUE TO PROVIDE A LANGUAGE LINE TO OFFER TRANSLATION SERVICES FOR NONENGLISH SPEAKING PATIENTS AND FAMILIES AS NEEDED.4.C. COMMUNITY HOSPITAL WILL CONTINUE TO OFFER FINANCIAL ASSISTANCE AND PAYMENT PLAN EDUCATION TO PATIENTS WHO HAVE AN ECONOMIC NEED AND MEET THE QUALIFICATIONS OF THE FINANCIAL ASSISTANCE POLICY. IF FINANCIAL ASSISTANCE IS NEEDED, COMMUNITY HOSPITAL ENCOURAGES PATIENTS TO COMPLETE AN APPLICATION TO SEE IF THEY QUALIFY.4.D. IN CONJUNCTION WITH THE COMMUNITIES OF EXCELLENCE PROGRAM, COMMUNITY HOSPITAL WILL EXPLORE INCREASING ACCESS TO TRANSPORTATION SERVICES IN THE COMMUNITY.4.E. COMMUNITY HOSPITAL WILL CONTINUE TO INCREASE ACCESS TO CARE THROUGH THE PROVISION OF TELEHEALTH SERVICES TO APPLICABLE PATIENTS AND EXPLORE EXPANSION OF TELEHEALTH SERVICES AS OPPORTUNITIES ARISE.4.F. COMMUNITY HOSPITAL WILL CONTINUE TO PROVIDE HOME HEALTH, HOSPICE, AND PALLIATIVE CARE SERVICES FOR APPLICABLE RESIDENTS. FURTHERMORE, COMMUNITY HOSPITAL WILL CONTINUE TO FOCUS ON THE PATIENT'S FAMILY WELLBEING BY PROVIDING RESPITE CARE IN ORDER TO REDUCE CAREGIVER BURNOUT.4.G. COMMUNITY HOSPITAL WILL CONTINUE TO MEET WITH LOCAL NURSING HOMES AND ASSISTED LIVING FACILITIES ON A QUARTERLY BASIS AND COMPREHENSIVELY DISCUSS ANY EMERGING ISSUES IN THE AREA AND HOW TO ADDRESS SUCH ISSUES TO IMPROVE QUALITY AND EFFICIENCY OF CARE FOR PATIENTS.4.H. COMMUNITY HOSPITAL STAFF MEMBERS REGULARLY VOLUNTEER AT THE LOCAL MEALS ON WHEELS AND SENIOR CENTER ORGANIZATIONS TO SUPPORT THE NEEDS OF ELDERLY RESIDENTS IN THE COMMUNITY.ALL IDENTIFIED COMMUNITY HEALTH NEEDS ARE INCLUDED AND ADDRESSED IN THE FOUR PRIORITY AREAS INCLUDED IN THE CHNA AND RELATED ACTION PLANS. ACCORDINGLY, THERE CURRENTLY ARE NOT ANY IDENTIFIED NEEDS THAT ARE NOT BEING ADDRESSED AS PART OF THE PLAN.THE HOSPITAL CONTINUES TO PARTICIPATE IN FUNDRAISING EFFORTS FOR VARIOUS COMMUNITY ORGANIZATIONS INCLUDING THE BACKPACK EVENT FOR SCHOOL CHILDREN AND JEANS DAY FUNDRAISERS FOR A ROTATING LIST OF COMMUNITY BENEFIT PROGRAMS (4A). OCT 1ST COMMUNITY HOSPITAL WENT LIVE WITH AN ONLINE SYSTEM FOR FINANCIAL ASSISTANCE PROGRAM APPLICATIONS, STREAMLINING THE PROCESS TO EASE THE BURDEN ON PATIENTS WITH ECONOMIC NEED (4C) AND HOSTED THE BRIDGES TO MENTAL HEALTH EDUCATIONAL EVENT ON THE HOSPITAL'S CAMPUS (3C).COMMUNITY HOSPITAL ALSO MAINTAINED ARRANGEMENTS WITH MULTIPLE MOBILE IMAGING SERVICES TO BOLSTER ACCESS TO CARE IN OUR RURAL COMMUNITY (1B). |
| COMMUNITY HOSPITAL ASSOCIATION OF MCCOOK | PART V, SECTION B, LINE 13B: DISCOUNTING OR 100% WRITE-OFF TO CHARITY CARE IS ALLOWED ABOVE 150% OF THE FEDERAL POVERTY GUIDELINE BASED ON AN ANALYSIS OF INDIVIDUAL NEED AND DETERMINATION OF THE PATIENT BEING MEDICALLY INDIGENT; THIS ANALYSIS INCLUDES FACTORS SUCH AS INCOME, ACCESSIBLE ASSETS, MEDICAL AND/OR OTHER DEBTS, THE LIKELIHOOD OF ONGOING MEDICAL CARE AND THE INDIVIDUAL'S OVERALL ABILITY TO PAY.PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE AS MEDICALLY INDIGENT WILL BE RESPONSIBLE FOR THEIR MEDICAL BILLS UP TO A PERCENT OF THE GREATER OF THEIR HOUSEHOLD INCOME OR NET WORTH BASED ON AMOUNTS PROVIDED IN THE FINANCIAL ASSISTANCE POLICY. THERE IS NO LIMIT TO THE FPG INCOME, BUT PATIENTS OVER 501% OF FEDERAL POVERTY GUIDELINES MAY RECEIVE A DISCOUNT IF THEIR FAMILY'S MEDICAL BILLS AND RELATED DEBT ARE NO MORE THAN THE GREATER OF 20% OF HOUSEHOLD INCOME OR 10% OF NET WORTH.THE HOSPITAL MAY USE PRESUMPTIVE ELIGIBILITY AND PREVIOUS FINANCIAL ASSISTANCE DETERMINATIONS TO PROVIDE FINANCIAL ASSISTANCE IN CERTAIN CIRCUMSTANCES WHEN A PATIENT FAILS TO SUPPLY SUFFICIENT INFORMATION TO SUPPORT ELIGIBILITY. |
| COMMUNITY HOSPITAL ASSOCIATION OF MCCOOK | PART V, SECTION B, LINE 16J: THE HOSPITAL PUBLICIZED THE FINANCIAL ASSISTANCE POLICY ON BILLING INVOICES, ON POSTERS IN THE ER AND WAITING ROOMS, AT THE ADMISSIONS DESKS, INCLUDING UPON ADMISSIONS WITH SUMMARY NOTICES OF THE POLICIES. THE COMPLETE POLICY WAS AVAILABLE ON THE HOSPITAL'S WEBSITE AND UPON REQUEST. THE HOSPITAL ALSO PUBLICIZED THE POLICY THROUGH REFERRALS BY CLINICAL, SOCIAL WORKERS, AND OTHER STAFF TO THE HOSPITAL'S FINANCIAL COUNSELORS. COMMUNITY HOSPITAL ASSOCIATION OF MCCOOK DOES NOT HAVE AN LEP POPULATION OF A SINGLE PRIMARY LANGUAGE THAT REACHES 1,000 INDIVIDUALS OR 5% OF THE COMMUNITY SERVED BY THE HOSPITAL. HOWEVER, WITH SPANISH AS THE PREDOMINANT NON-ENGLISH LANGUAGE WE HAVE OPTED TO OFFER A FAP APPLICATION FORM IN THAT LANGUAGE FOR OUR PATIENTS' CONVENIENCE. |
| SCHEDULE H, PART V, SECTION B, LINE 7A AND 10A: | COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY WEBSITE:HTTPS://CHMCCOOK.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.HTML |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - COMMUNITY HEALTHCARE & HOSPICE | ||||
| 407 WEST 5TH STREET | MCCOOK | NE | 69001 | HOME HEALTH AND HOSPICE SERVICES |
| 2 - CURTIS MEDICAL CENTER | ||||
| 302 EAST 6TH STREET | CURTIS | NE | 69025 | RURAL HEALTH CLINIC-OUTPATIENT SERVICES |
| 3 - TRENTON MEDICAL CLINIC | ||||
| 406 EAST 1ST STREET | TRENTON | NE | 69044 | RURAL HEALTH CLINIC-OUTPATIENT SERVICES |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | CHARITY CARE IS GRANTED TO ALL INDIVIDUALS WHOSE HOUSEHOLD INCOME IS BELOW 150% OF THE FEDERAL POVERTY GUIDELINE AT THE 100% WRITE-OFF LEVEL. DISCOUNTING OR 100% WRITE-OFF TO CHARITY CARE IS ALLOWED ABOVE 150% OF THE FEDERAL POVERTY GUIDELINE BASED ON AN ANALYSIS OF INDIVIDUAL NEED AND DETERMINATION OF THE PATIENT BEING MEDICALLY INDIGENT; THIS ANALYSIS INCLUDES FACTORS SUCH AS INCOME, ACCESSIBLE ASSETS, MEDICAL OR/AND OTHER DEBTS, THE LIKELIHOOD OF ONGOING MEDICAL CARE AND THE INDIVIDUAL'S OVERALL ABILITY TO PAY.PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE AS MEDICALLY INDIGENT WILL BE RESPONSIBLE FOR THEIR MEDICAL BILLS UP TO A PERCENT OF THE GREATER OF THEIR HOUSEHOLD INCOME OR NET WORTH BASED ON AMOUNTS PROVIDED IN THE FINANCIAL ASSISTANCE POLICY. THERE IS NO LIMIT TO THE FPG INCOME, BUT PATIENTS OVER 501% OF FEDERAL POVERTY GUIDELINES MAY RECEIVE A DISCOUNT IF THEIR FAMILY'S MEDICAL BILLS AND RELATED DEBT ARE NO MORE THAN THE GREATER OF 20% OF HOUSEHOLD INCOME OR 10% OF NET WORTH.THE HOSPITAL MAY USE PRESUMPTIVE ELIGIBILITY AND PREVIOUS FINANCIAL ASSISTANCE DETERMINATIONS TO PROVIDE FINANCIAL ASSISTANCE IN CERTAIN CIRCUMSTANCES WHEN A PATIENT FAILS TO SUPPLY SUFFICIENT INFORMATION TO SUPPORT ELIGIBILITY. |
| PART I, LINE 7: | CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. UNREIMBURSED MEDICAID ON LINE 7B WAS CALCULATED USING THE COSTING METHODS TO PREPARE THE COST REPORTS. COMMUNITY HEALTH IMPROVEMENT SERVICES, LINE 7E, AND CASH AND IN-KIND CONTRIBUTIONS, LINE 7I, ARE REPORTED BASED ON ACTUAL EXPENSES REPORTED IN THE GENERAL LEDGER. THE COST FOR SUBSIDIZED HEALTH SERVICES ON LINE 7G WAS DETERMINED USING THE MEDICARE COST REPORT. |
| PART III, LINE 2: | THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE ORGANIZATION DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSION BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THIS CLASS OF PATIENTS. FOR THE FISCAL YEAR, THE AMOUNT OF IMPLICIT PRICE CONCESSIONS REPORTED IS $2,918,652. |
| PART III, LINE 3: | BASED ON A COMBINATION OF PAST EXPERIENCE AND CENSUS DATA AVAILABLE, THE HOSPITAL ESTIMATES 15% OF THE PATIENT IMPLICIT PRICE CONCESSIONS IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. IN ACCORDANCE WITH ITS MISSION OBJECTIVES, THE HOSPITAL PROVIDES FINANCIAL ASSISTANCE TO PATIENTS WHO LACK FINANCIAL RESOURCES TO PAY FOR THE SERVICES THEY RECEIVE, AND THE HOSPITAL RECOGNIZES THE SPECIAL CONCERNS OF INDIVIDUALS AND HOUSEHOLDS WITH LIMITED FINANCIAL RESOURCES OR WHO ARE OTHERWISE VULNERABLE WITHIN THE COMMUNITY THE HOSPITAL SERVICES. |
| PART III, LINE 4: | THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES IMPLICIT PRICE CONCESSIONS IS LOCATED ON PAGES 14 AND 15 OF THE ATTACHED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THE ENTIRE MEDICARE SHORTFALL IS CONSIDERED A COMMUNITY BENEFIT. SERVICES ARE PROVIDED TO PATIENTS UNDER THE MEDICARE PROGRAM EVEN THOUGH THE HOSPITAL KNOWS THEY WILL NOT RECOVER ALL OF THE COSTS FROM PROVIDING THE SERVICES. THIS PROGRAM IS CONSIDERED SUBSIDIZED BY THE HOSPITAL AND OTHER PAYORS. PATIENTS RELY ON THESE SERVICES FOR THEIR HEALTH AND WELL-BEING AND ARE ESSENTIAL FOR THEIR ACCESS TO HEALTHCARE. TOTAL REVENUE RECEIVED FROM MEDICARE IS THE GROSS REIMBURSEMENT PLUS SETTLEMENT. BOTH TOTAL REVENUE RECEIVED FROM MEDICARE AND THE MEDICARE ALLOWABLE COSTS ARE REPORTED FROM THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CENTERS FOR MEDICARE AND MEDICAID SERVICES.HOSPITAL SERVICES REIMBURSED ON A FEE SCHEDULE ARE NOT INCLUDED IN THE MEDICARE CALCULATION PER THE 990 INSTRUCTIONS. HAD THIS BEEN REPORTED, THE TOTAL LOSS FROM MEDICARE SERVICES WOULD HAVE INCREASED BY $924,379. MEDICARE FEE SCHEDULE REVENUE WAS $1,157,225 AND THE MEDICARE ESTIMATED COSTS OF CARE RELATING TO PAYMENTS WAS $2,081,604 RESULTING IN A NET SHORTAGE OF $924,379. |
| PART III, LINE 9B: | THE HOSPITAL WILL NOT TAKE EXTRAORDINARY COLLECTION ACTIVITIES (ECAS) AGAINST A PATIENT OR ANY OTHER INDIVIDUAL WHO HAS ACCEPTED OR IS REQUIRED TO ACCEPT FINANCIAL RESPONSIBILITY FOR A PATIENT UNLESS AND UNTIL THE HOSPITAL HAS MADE "REASONABLE EFFORTS" TO DETERMINE WHETHER THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY. PATIENT FINANCIAL COUNSELING IS RESPONSIBLE TO DETERMINE WHETHER THE HOSPITAL HAS ENGAGED IN REASONABLE EFFORTS TO DETERMINE WHETHER A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE.THE HOSPITAL DOES NOT TAKE ECAS AGAINST THE PATIENTS FOR AT LEAST 120 DAYS FROM THE DATE THE HOSPITAL PROVIDES THE PATIENT WITH THE FIRST POST-DISCHARGE BILL FOR CARE. A WRITTEN NOTICE IS SENT TO THE PATIENT AT LEAST 30 DAYS PRIOR TO ANY ECAS. THE NOTICE CONTAINS THE FOLLOWING INFORMATION:1. NOTIFIES THE PATIENT OF THE AVAILABILITY OF FINANCIAL ASSISTANCE,2. IDENTIFIES THE SPECIFIC ECA(S) THE HOSPITAL INTENDS TO INITIATE AGAINST THE PATIENT,3. STATES A DEADLINE AFTER WHICH ECAS MAY BE INITIATED THAT IS NO EARLIER THAN 30 DAYS AFTER THE DATE THE NOTICE IS PROVIDED TO THE PATIENT;5. PROVIDES A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WITH THE AFOREMENTIONED NOTICE; ANDMAKES A REASONABLE EFFORT TO ORALLY NOTIFY THE PATIENT ABOUT THE POTENTIAL AVAILABILITY OF FINANCIAL ASSISTANCE AT LEAST 30 DAYS PRIOR TO INITIATING ECAS AGAINST THE PATIENT DESCRIBING HOW THE INDIVIDUAL MAY OBTAIN ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS. |
| PART VI, LINE 2: | IN ADDITION TO THE CHNA, COMMUNITY HOSPITAL CONTINUES TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY THROUGH A VARIETY OF WAYS, INCLUDING (BUT NOT LIMITED TO) THE FOLLOWING:1) COMMUNITY HOSPITAL IS A KEY MEMBER OF MCCOOK ON THE MOVE INITIATIVE. THIS INCLUDES FOUR KEY COMMUNITY GROUPS THAT MEET REGULARLY AND LEAD/COORDINATE ACTIVITIES WITHIN THE COMMUNITY, WHICH INCLUDE THE FAMILY, EDUCATION, HEALTH, AND ECONOMIC DEVELOPMENT PILLARS. THE HEALTH PILLAR ATTEMPTS TO BRING TOGETHER ALL THE MAJOR HEALTHCARE PROVIDERS AND PUBLIC HEALTH AGENCIES QUARTERLY TO MAINTAIN AWARENESS AND WORK WITH EACH OTHER TO ADDRESS ISSUES AS THEY EMERGE. THE HEALTH PILLAR ALSO FOCUSES ON PROJECTS THAT PROMOTE A HEALTHY LIFESTYLE. 2) COMMUNITY HOSPITAL REGULARLY SCREENS PATIENTS FOR SOCIAL DETERMINANTS OF HEALTH; INCLUDING FINANCIAL, TRANSPORTATION CONCERNS, ISSUES RELATED TO LIVING ALONE, AND OTHER SOCIAL AND FINANCIAL ISSUES THAT IMPACT THE PATIENT'S HEALTH. WE HAVE PUT VARIOUS PROCESSES IN PLACE TO HELP THESE PATIENTS ADDRESS THESE CONCERNS AND ISSUES AS THEY ARE IDENTIFIED.3) COMMUNITY HOSPITAL REGULARLY MEETS WITH OUR NURSING HOMES AND OTHER LONG TERM ASSISTED CARE FACILITIES AS WELL AS OTHER PROVIDERS IN THE REGION TO ASSURE THAT THE CONTINUUM OF CARE FOR PATIENTS ARE WELL MET AND THAT WE ARE AWARE OF AND CAN ADDRESS ANY CONCERNS AS THEY COME TO OUR ATTENTION. |
| PART VI, LINE 3: | IDENTIFICATION OF PATIENTS WITH A POTENTIAL NEED FOR FINANCIAL ASSISTANCE WILL BE ACCOMPLISHED BY BOTH AN OPEN AND PUBLICIZED APPLICATION PROCESS AND A VARIETY OF SCREENING OPPORTUNITIES INCLUDING:A. ADMISSIONS/REGISTRATION PERSONNEL BASED UPON INFORMATION RECEIVED DURING THE REGISTRATION PROCESS.B. SOCIAL SERVICES PERSONNEL BASED UPON INFORMATION DURING THE INITIAL VISIT AND DISCHARGE PLANNING.C. NURSING STAFF BASED UPON INFORMATION RECEIVED DURING DISCUSSIONS WITH FAMILY AND/OR PATIENT.D. BUSINESS OFFICE PERSONNEL BASED UPON STATUS OF ACCOUNTS AND DISCUSSIONS WITH RESPONSIBLE PARTY.E. ACCOUNTS RECEIVABLE REPORTS.HOSPITAL STAFF OR THE NOTIFIED PATIENT ADVOCATE WILL EDUCATE THE PATIENT OR GUARANTOR ABOUT THE FINANCIAL ASSISTANCE POLICY AND WILL PROVIDE THEM AN APPLICATION FOR FINANCIAL ASSISTANCE. IF NECESSARY, THE PATIENT FINANCIAL COUNSELOR OR OTHER HOSPITAL STAFF MAY ASSIST THE PATIENT IN COMPLETING THE APPLICATION; HOWEVER, THE COMPLETION OF AN APPLICATION AND PROVIDING ALL NECESSARY SUPPORTING DOCUMENTATION IS THE PATIENT'S RESPONSIBILITY. PATIENTS MAY ALSO REQUEST AN APPLICATION OR ADDITIONAL INFORMATION IN PERSON AT THE ADMISSIONS OFFICE OR BY CALLING OR WRITING THE PATIENT FINANCIAL COUNSELOR AND AN APPLICATION WILL BE MAILED.IF A PATIENT SUBMITS A COMPLETED FINANCIAL ASSISTANCE APPLICATION DURING THE APPLICATION PERIOD AND THE HOSPITAL DETERMINES THAT THE PATIENT MAY BE ELIGIBLE FOR PARTICIPATION IN MEDICAID, THE HOSPITAL WILL NOTIFY THE PATIENT IN WRITING OF SUCH POTENTIAL ELIGIBILITY AND REQUEST THAT THE PATIENT TAKE STEPS NECESSARY TO ENROLL IN SUCH PROGRAM. IN SUCH CIRCUMSTANCES THE HOSPITAL WILL DELAY THE PROCESSING OF THE PATIENT'S FINANCIAL ASSISTANCE APPLICATION UNTIL THE PATIENT'S APPLICATION FOR MEDICAID IS COMPLETED, SUBMITTED TO THE REQUISITE GOVERNMENTAL AUTHORITY, AND A DETERMINATION HAS BEEN MADE. |
| PART VI, LINE 4: | COMMUNITY HOSPITAL SERVES A PRIMARY MARKET OF RED WILLOW COUNTY, WHICH IS LOCATED ON THE SOUTHERN BORDER OF NEBRASKA. IT IS 717 SQUARE MILES AND HAS APPROXIMATELY 15.0 PEOPLE PER SQUARE MILE. MCCOOK IS THE COUNTY SEAT. COMMUNITY HOSPITAL ALSO SERVES A SECONDARY MARKET INCLUDING NORTHERN KANSAS AND SOUTHWEST NEBRASKA, WHICH CONSISTS OF FURNAS, NE, HITCHCOCK, NE, DECATUR, KS, CHEYENNE, KS, FRONTIER, NE, RAWLINS, KS AND HAYES, NE. THE TOTAL ESTIMATED POPULATION FOR COMMUNITY HOSPITAL'S SERVICE AREA IS APPROXIMATELY 30,348. RED WILLOW COUNTY HAS A POPULATION OF APPROXIMATELY 10,337. THE GROUP OF COUNTIES WHICH MAKE UP THE SECONDARY MARKET FOR COMMUNITY HOSPITAL HAVE A POPULATION OF APPROXIMATELY 19,601. THE HOUSEHOLD INCOME AVERAGES FOR THESE AREAS ARE AS FOLLOWS:17% $0 - 25K25% $25K - 50K30% $50K - 100K22% $100K - 200K6% $200K+ |
| PART VI, LINE 5: | COMMUNITY HOSPITAL IS THE LARGEST HOSPITAL WITHIN AN HOUR TRAVEL TIME FOR MOST OF THE COMMUNITY SERVED. THE HOSPITAL PROVIDES THE PHYSICIANS OF MCCOOK A HOSPITAL IN WHICH TO PRACTICE MEDICINE. WITHOUT THE HOSPITAL OUR PATIENTS WOULD HAVE EXTREMELY LONG DISTANCES TO TRAVEL FOR EVERYTHING FROM EMERGENCY TO ROUTINE CARE. OUR HOSPITAL IS OVERSEEN BY A NON-COMPENSATED BOARD OF INDEPENDENT COMMUNITY MEMBERS. ANY PROFITS FROM THE OPERATION OF THE HOSPITAL ARE REINVESTED BACK INTO THE FACILITIES, EQUIPMENT AND STAFF TO PROVIDE OUR COMMUNITY WITH CURRENT AND HIGH QUALITY MEDICAL SERVICES CLOSE TO HOME. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | NE |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| COMMUNITY HOSPITAL HEALTH FOUNDATION | ||||||||
| 1301 E H ST | MCCOOK | NE | 69001 | 470693261 | 501(C)(3) | $103,332 | $0 | TO SUPPORT THE MISSION OF THE FOUNDATION |
| MCCOOK COLLEGE FOUNDATION | ||||||||
| 1205 EAST 1ST ST | MCCOOK | NE | 69001 | 476089800 | 501(C)(3) | $55,000 | $0 | PLEDGE FOR HEALTH SCIENCES CENTER AND NURSE AID SCHOLARSHIPS |
| UNIVERSITY OF NEBRASKA FOUNDATION | ||||||||
| 1010 LINCOLN MALL SUITE 300 | LINCOLN | NE | 68508 | 470379839 | 501(C)(3) | $30,000 | $0 | DONATION TO SUPPORT THE HEALTH SCIENCES PROGRAM (KHOP) |
| YMCA OF MCCOOK | ||||||||
| PO BOX 408 | MCCOOK | NE | 69001 | 470377999 | 501(C)(3) | $152,625 | $0 | PLEDGE ON REMODEL CAMPAIGN AND VARIOUS TEAM SPONSORSHIPS |
| NORTH PLATTE COMMUNITY COLLEGE FOUNDATION | ||||||||
| 601 WEST STATE FARM RD | NORTH PLATTE | NE | 69101 | 202459157 | 501(C)(3) | $10,000 | $0 | PLEDGE FOR HEALTH SCIENCES BUILDING |
| MCCOOK ECONOMIC DEVELOPMENT CORP | ||||||||
| 402 NORRIS AVE SUITE 301 | MCCOOK | NE | 69001 | 470685662 | 501(C)(6) | $19,520 | $0 | SPONSORING VARIOUS COMMUNITY DEVELOPMENT PROJECTS |
| MCCOOK AREA CHAMBER OF COMMERCE | ||||||||
| 402 NORRIS AVE SUITE 316 | MCCOOK | NE | 69101 | 470233780 | 501(C)(6) | $9,000 | $0 | SPONSORSHIP |
| RED WILLOW CO FAIR BOARD | ||||||||
| PO BOX 876 | MCCOOK | NE | 69001 | GOVERNMENTAL | $15,000 | $0 | FAIR SPONSOR | |
| CITY OF MCCOOK | ||||||||
| 505 WEST C STREET | MCCOOK | NE | 69001 | GOVERNMENTAL | $70,000 | $0 | INCLUSIVE PLAYGROUND AND MATCHING FUNDS FOR CCCFF GRANT | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 7 | Total501c3OrgCnt |
| Total Other Org | 2 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | GRANTS ARE MADE ONLY TO SELECTED CHARITABLE OR OTHER EXEMPT ORGANIZATIONS. COMMUNITY HOSPITAL ASSOCIATION ENTERS INTO AGREEMENTS WITH GRANTEES THAT GRANT FUNDS WILL BE RESTRICTED TO SPECIFIED EXEMPT PURPOSES. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RICHARD LAWTON | ||||||||||||||
| ORTHO PHYSICAN | $725,257 | $0 | $175 | $0 | $3,564 | $0 | $24,150 | $0 | $50,780 | $0 | $803,926 | $0 | $0 | $0 |
| DOUGLAS TICE | ||||||||||||||
| ORTHO PHYSICAN | $698,566 | $0 | $50 | $0 | $2,742 | $0 | $0 | $0 | $31,839 | $0 | $733,197 | $0 | $0 | $0 |
| EVAN GEILENKIRCHEN | ||||||||||||||
| CRNA | $344,970 | $0 | $435 | $0 | $3,564 | $0 | $24,150 | $0 | $36,449 | $0 | $409,568 | $0 | $0 | $0 |
| TROY BRUNTZ | ||||||||||||||
| PRESIDENT & CEO | $331,396 | $0 | $250 | $0 | $2,322 | $0 | $23,945 | $0 | $31,153 | $0 | $389,066 | $0 | $0 | $0 |
| SEAN WOLFE | ||||||||||||||
| CFO | $231,513 | $0 | $250 | $0 | $540 | $0 | $17,202 | $0 | $47,255 | $0 | $296,760 | $0 | $0 | $0 |
| ANTHONY RODEWALD | ||||||||||||||
| PHARMACIST | $202,425 | $0 | $425 | $0 | $810 | $0 | $0 | $0 | $45,224 | $0 | $248,884 | $0 | $0 | $0 |
| BRUCE MIKESELL | ||||||||||||||
| EMERGENCY PHYSICIAN | $194,322 | $0 | $75 | $0 | $2,901 | $0 | $0 | $0 | $20,468 | $0 | $217,766 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 2 | ADDED A PRIMARY CARE CLINIC (MCCOOK CLINIC) AS OF JANUARY 1, 2025. |
| FORM 990, PART VI, SECTION A, LINE 8B | THERE IS NO COMMITTEE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11B | COMMUNITY HOSPITAL'S FORM 990 & 990-T ARE PREPARED BY THE PUBLIC ACCOUNTING FIRM EIDE BAILLY. MANAGEMENT RECEIVES DRAFT COPIES OF THE COMPLETED FORMS FOR REVIEW. AFTER HOSPITAL MANAGEMENT HAS REVIEWED THE RETURNS, COMPLETE COPIES ARE DISTRIBUTED TO ALL MEMBERS OF THE BOARD OF DIRECTORS OF THE COMMUNITY HOSPITAL ASSOCIATION. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE COMMUNITY HOSPITAL ASSOCIATION'S CODE OF CONDUCT REQUIRES ALL EMPLOYEES, CONTRACTORS, AND AGENTS TO REPORT ANY CONFLICTS OF INTEREST THAT ARISE. IN ADDITION, THE ASSOCIATION HAS A CONFLICT OF INTEREST POLICY APPLICABLE TO DIRECTORS, OFFICERS, MEMBERS OF COMMITTEES AND SUBCOMMITTEES WITH BOARD-DELEGATED POWERS, AND KEY EMPLOYEES THAT REQUIRES, AMONG OTHER THINGS, ALL APPLICABLE PERSONS DISCLOSE ANY RELATIONSHIPS THAT MAY CREATE A CONFLICT OF INTEREST AND ARE REQUIRED TO COMPLETE AN ANNUAL DISCLOSURE OF ALL SUCH RELATIONSHIPS. ALL SUCH RELATIONSHIPS ARE DISCLOSED TO THE ENTIRE BOARD AND SENIOR MANAGEMENT, AND ANY AND ALL CONFLICTS OR POTENTIAL CONFLICTS ARE MONITORED BY SENIOR MANAGEMENT AND THE ASSOCIATION'S COMPLIANCE FUNCTION. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMMUNITY HOSPITAL'S PROCESS FOR DETERMINING THE COMPENSATION OF THE CEO IS AS FOLLOWS: THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS IS RESPONSIBLE FOR SETTING THE SALARY OF THE CEO. ANNUALLY, THE COMMITTEE CONDUCTS A REVIEW OF THE CEO'S PERFORMANCE, ABILITIES, AND OVERALL EFFECTIVENESS. THE COMMITTEE IS PRESENTED WITH SALARY AND COMPENSATION SURVEY DATA THAT IS COMPILED BY THE CEO AND THE HUMAN RESOURCE DEPARTMENT AND THE ACCURACY OF WHICH IS ATTESTED TO BY THE CFO. MULTIPLE SOURCES OF SURVEY DATA ARE USED, INCLUDING INFORMATION FROM THE NEBRASKA AND IOWA HOSPITAL ASSOCIATIONS, WHICH IS BROKEN DOWN TO SIMILARLY QUALIFIED PERSONS IN COMPARABLE POSITIONS AT SIMILARLY SIZED AND SITUATED ORGANIZATIONS. ALL SOURCE DOCUMENTATION IS GIVEN TO THE COMMITTEE AS WELL AS SUMMARIES PROVIDED FOR EASE OF REFERENCE. THE EXECUTIVE COMMITTEE CONDUCTS THE PERFORMANCE REVIEW WITH THE CEO; THEN MEETS IN PRIVATE CHAMBERS TO DISCUSS THE REVIEW AND TO DELIBERATE ANY AND ALL CHANGES TO THE EMPLOYMENT AGREEMENT, INCLUDING COMPENSATION, AND GOALS FOR THE FOLLOWING YEAR. CONTEMPORANEOUS RECORDS ARE KEPT OF ALL SURVEY AND COMPARABILITY DATA USED, AND THE RESULTS AND DECISIONS OF THE EXECUTIVE COMMITTEES MEETING ON COMPENSATION. COMPENSATION OF EMPLOYEES BELOW THE ROLE OF CEO ARE DETERMINED THROUGH THE USE OF SURVEY INFORMATION OF SIMILARLY QUALIFIED PERSONS IN COMPARABLE POSITIONS AT SIMILARLY SIZED AND SITUATED ORGANIZATIONS. THE CEO SETS THE COMPENSATION OF SENIOR MANAGEMENT BASED ON THOSE SURVEYS, TAKING IN CONSIDERATION PERFORMANCE AND EXPERIENCE OF EACH INDIVIDUAL. COMPENSATION RANGES OF EMPLOYEES BELOW SENIOR MANAGEMENT ARE SET BY HUMAN RESOURCES BASED ON MARKET WAGE RATES FOR SIMILARLY QUALIFIED PERSONS IN COMPARABLE POSITIONS AT SIMILARLY SIZED AND SITUATED ORGANIZATIONS. ALL EMPLOYEES HAVE AN ANNUAL REVIEW BY THEIR SUPERVISOR, WHICH DETERMINE WHERE IN THE SALARY RANGE AN EMPLOYEE WILL FALL. ALL SALARY RANGES, INCLUDING THOSE OF SENIOR MANAGEMENT, ARE ULTIMATELY APPROVED BY THE BOARD OF DIRECTORS DURING THE APPROVAL OF THE ANNUAL OPERATING BUDGET. |
| FORM 990, PART VI, SECTION C, LINE 19 | COMMUNITY HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FORM 990 & 990-T (CURRENT AND PAST YEARS AS REQUIRED BY LAW) AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. ANY INDIVIDUAL WHO WOULD LIKE A COPY OF ANY OF THE ABOVE MENTIONED DOCUMENTS MAY INSPECT THOSE DOCUMENTS IN PERSON AT THE HOSPITAL DURING NORMAL BUSINESS HOURS, OR REQUEST A COPY OF ANY OF THE ABOVE INFORMATION IN PERSON, BY PHONE, OR BY MAIL, AND WE WILL PROVIDE A COPY FREE OF CHARGE. |
| FORM 990, PART IX, LINE 11G | MISCELLANEOUS FEES FOR SERVICE: PROGRAM SERVICE EXPENSES 2,323,122. MANAGEMENT AND GENERAL EXPENSES 574,937. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,898,059. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 7,249,225. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,249,225. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 3,142,881. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,142,881. PT CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 1,447,578. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,447,578. COLLECTION FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 148,648. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 148,648. MEDICAID PROVIDER ASSESSMENT: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 3,345,354. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,345,354. |
| FORM 990, PART XII, LINE 2C | COMMUNITY HOSPITAL HAS A STANDING BOARD COMMITTEE, THE BUDGET AND FINANCE COMMITTEE, WHICH HAS THE AUTHORITY AND ASSUMES THE RESPONSIBILITY FOR THE SELECTION OF THE INDEPENDENT ACCOUNTING FIRM AND ALL RELATED OVERSIGHT, COMMUNICATION, AND REPORTING. THIS COMMITTEE APPROVES ALL ENGAGEMENT LETTERS AND RECEIVES ALL BOARD DIRECTED COMMUNICATION FROM THE INDEPENDENT ACCOUNTING FIRM. COPIES OF RECEIVED LETTERS/COMMUNICATIONS AND REPORTS ARE DISTRIBUTED TO ALL MEMBERS OF THE BOARD OF DIRECTORS IN ADDITION TO THE COMMITTEE MEMBERS. WHILE THE MEMBERS OF THE COMMITTEE HAVE CHANGED, THE PROCESS DESCRIBED HAS NOT CHANGED FROM THE PREVIOUS YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL HEALTH FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 801 WEST C STREET PO BOX 1328 | AddressLine1Txt |
| City | MCCOOK | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 69001 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470693261 | EIN |
| Primary Activities | SUPPORTING ORGANIZATION PROVIDES FUNDRAISING FOR THE HOSPITAL | PrimaryActivitiesTxt |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12A, I | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HOSPITAL ASSOCIATION OF MCCOOK | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| COMMUNITY HOSPITAL HEALTH FOUNDATION | ||
| C | $461,043 | CASH TRANSFERRED EQUALS FMV |
| COMMUNITY HOSPITAL HEALTH FOUNDATION | ||
| B | $103,332 | CASH TRANSFERRED EQUALS FMV |
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