2023-10-26T14:20:28-05:00 2022-12-31 450250958 EIDE BAILLY LLP 18081 BURT ST STE 200 OMAHA NE 680224722 990 2022-01-01 470733773 VNA HOSPICE OF SOUTHWEST IOWA VNAH 4023425566 12565 WEST CENTER ROAD 100 OMAHA NE 68144 DAVID E VANLANDINGHAM VP FINANCE/CFO 4023425566 2023-10-24 1 DAVID VANLANDINGHAM 999009999 1 WENDY R COOLEY CPA P01523804 4023302660 2023-10-24 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z JAMES SUMMERFELT 12565 WEST CENTER ROAD 100 OMAHA NE 68144 2687 0 X WWW.VNATODAY.ORG X 1990 IA A COMMUNITY WHERE ALL INDIVIDUALS AND FAMILIES HAVE ACCESS TO IMPECCABLE END OF LIFE CARE. X 5 4 0 4 0 0 92702 10 517147 0 1279159 2677 1159 0 1890167 2687 0 0 0 0 221489 22 0 0 0 400282 9887 621771 9909 1268396 -7222 2449063 2441603 238 0 2448825 2441603 CHERISHING LIFE'S JOURNEY THROUGH AN EXTRAORDINARY COMMITMENT TO COMPASSION, COMFORT AND HOLISTIC CARE. 0 0 9909 0 DURING 2021, THE HOSPICE OPERATIONS OF VNA HOSPICE OF SOUTHWEST IOWA WERE SOLD. THE ORGANIZATION WILL CONTINUE TO OPERATE UNTIL THE REMAINING ASSETS ARE TRANSFERRED. 9909 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 5 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X X DAVID E VANLANDINGHAM VP FINANCECFO 4029304064 12565 WEST CENTER ROAD SUITE 100 OMAHA NE 68144 X JAMES SUMMERFELT PRESIDENT & CEO 5.00 50.00 X X 0 322046 30989 ELIZABETH MURPHY VICE CHAIR 1.00 5.00 X X 0 0 0 JASON HANSEN CHAIR 1.00 5.00 X X 0 0 0 RICHARD SECOR SECRETARY 1.00 5.00 X X 0 0 0 SEAN WINEKAUF TREASURER 1.00 5.00 X X 0 0 0 DAVID VANLANDINGHAM VP FINANCE/CFO 5.00 50.00 X 0 165941 17522 0 487987 48511 0 0 1 0 0 10 10 2677 2677 2687 0 0 2677 22 22 449 449 MEDICAID ADJUSTMENT 9438 9438 9909 0 9909 0 15183 0 1210358 481 1223522 2441122 2449063 2441603 238 0 238 0 X 2448825 2441603 0 2448825 2441603 2449063 2441603 -7222 0 X X 0 1 X 1 0 X 163450 9784 31097 92702 10 297043 972862 1442548 1647814 517147 0 4580371 1136312 1452332 1678911 609849 10 4877414 0 0 0 4877414 37 321 2677 3035 37 321 2677 3035 1159 1159 1136312 1452332 1678948 611329 2687 4881608 0.99910 0.99970 0.00060 0.00010 X 578904 21432 20054 1378 578904 578904 17921 16914 1007 578904 578904 14919 12840 2079 578904 578904 19158 16914 2244 578904 578904 19443 17054 2389 578904 0.00000 1.00000 0.00000 0 1 1 0 INTERCOMPANY RECEIVABLE 2441122 2441122 X PART V, LINE 4: THE ENDOWMENT IS HELD BY VISITING NURSE FOUNDATION, AN AFFILIATE THAT WAS FORMED TO FURTHER THE MISSION OF VISITING NURSE HEALTH SERVICES AND ITS AFFILIATES. THE ENDOWMENT IS MAINTAINED IN PERPETUITY TO GENERATE INCOME TO SUPPORT THE OPERATIONS OF VISITING NURSE FOUNDATION AND ITS AFFILIATED ENTITIES. PRIOR TO 2018, THIS ENDOWMENT WAS NOT BEING REPORTED BY THIS ORGANIZATION. THE BEGINNING BALANCE OF THE FOUNDATION'S ENDOWMENT IS SHOWN AS CONTRIBUTIONS ON PART V, LINE 1B, COLUMN (E). PART X, LINE 2: THE ASSOCIATION ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. THE ASSOCIATION RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT DECEMBER 31, 2022 AND 2021 THE ASSOCIATION HAD NO UNCERTAIN TAX POSITIONS ACCRUED. 0 0 0 0 0 0 0 0 0 JAMES SUMMERFELT PRESIDENT & CEO 0 281386 0 39115 0 1545 0 7371 0 23618 0 353035 0 0 DAVID VANLANDINGHAM VP FINANCE/CFO 0 164555 0 0 0 1386 0 5122 0 12400 0 183463 0 0 PART I, LINE 3 VNA HOSPICE OF SOUTHWEST IOWA DOES NOT PAY COMPENSATION TO A CEO OR EXECUTIVE DIRECTOR. VISITING NURSE ASSOCIATION OF THE MIDLANDS (VNAM) PAYS THE COMPENSATION OF JAMES SUMMERFELT WHO SERVES AS THE TOP MANAGEMENT OFFICIAL OF VNA HOSPICE OF SOUTHWEST IOWA. VNAM UTILIZED THE FOLLOWING FOR DETERMINING HIS COMPENSATION: FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY AND APPROVAL BY THE BOARD. CASH 2022-12-16 1212539 470690207 VISITING NURSE ASSOCIATION OF THE MIDLANDS 12565 W CENTER ST STE 100 OMAHA NE 68144 501(C)(3) 0 0 0 0 0 1 1 1 0 FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATE MEMBER OF VNA HOSPICE OF SOUTHWEST IOWA IS VISITING NURSE HEALTH SERVICES. FORM 990, PART VI, SECTION A, LINE 7A VNA HOSPICE OF SOUTHWEST IOWA'S BOARD MEMBERS ARE SELECTED BY VISITING NURSE HEALTH SERVICES' BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B PURSUANT TO THE ORGANIZATION'S ARTICLES OF INCORPORATION, CERTAIN ACTIVITIES AND DECISIONS OF THE BOARD "ARE SUBJECT TO AND REQUIRE THE APPROVAL AND CONSENT OF THE BOARD OF DIRECTORS OF THE VISITING NURSE HEALTH SERVICES", A RELATED ENTITY. ITEMS REQUIRING APPROVAL INCLUDE THE ORGANIZATION'S ANNUAL BUDGET, ANY CHANGES TO ITS ARTICLES OF INCORPORATION OR BYLAWS, AND CHANGE IN PURPOSE, MERGER, CONSOLIDATION OR DISSOLUTION, AMONG OTHERS. FORM 990, PART VI, SECTION B, LINE 11B VNA HOSPICE OF SOUTHWEST IOWA WILL SHARE THE FORM 990 WITH THE GOVERNING BODY PRIOR TO SUBMISSION. IF A REGULARLY SCHEDULED MEETING DOES NOT OCCUR BEFORE THE FORM 990 DEADLINE FOR SUBMISSION, THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS WILL MEET, REVIEW THE FORM 990, AND RELAY INFORMATION TO THE GOVERNING BODY AT THE NEXT REGULARLY SCHEDULED BOARD MEETING. THE VP FINANCE/CFO COORDINATES THE PREPARATION OF FORM 990 WITH AN OUTSIDE ACCOUNTING FIRM, AND REVIEWS A DRAFT COPY. THE PRESIDENT/CEO AND THE VP FINANCE/CFO WILL PROVIDE FORM 990 TO THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS, OFFICERS AND KEY EMPLOYEES COMPLETE AND SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY. ELECTRONIC COPIES ARE KEPT IN THE ADMINISTRATIVE OFFICE. MEMBERS OF THE BOARD OF DIRECTORS ARE AWARE OF THE POLICY AND EXCUSE THEMSELVES FROM THE VOTE WHEN APPROPRIATE. THE CONFLICT OF INTEREST POLICY STATEMENTS ARE REVIEWED BY THE PRESIDENT AND CEO, WHO MAKES HIMSELF AWARE OF ANY POTENTIAL CONFLICTS THAT MAY ARISE. ALL MEMBERS OF THE BOARD OF DIRECTORS AND LEADERSHIP TEAM COMPLETE AND SIGN CONFLICT OF INTEREST STATEMENTS. BOARD MEMBERS ARE REQUIRED BY THE ORGANIZATION'S BYLAWS TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST OR CONFLICT OF INTEREST TRANSACTIONS TO BE APPROVED BY BOARD VOTE. FORM 990, PART VI, SECTION B, LINE 15A THE CEO IS COMPENSATED THROUGH VISITING NURSE ASSOCIATION OF THE MIDLANDS (VNAM), AN AFFILIATE OF VNA HOSPICE OF SOUTHWEST IOWA. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS APPROVES THE COMPENSATION FOR THE CEO. SALARY COMPARISONS ARE CONDUCTED WHEN DETERMINED NECESSARY BY THE COMMITTEE; REVIEWS OF A PAID COMPARABILITY STUDY AND COMPARABLE COMPANY FORMS 990 HAVE BEEN COMPLETED IN THE PAST, THE MOST RECENT IN 2021. A PERFORMANCE EVALUATION PROCESS IS COMPLETED ANNUALLY BY THE BOARD OF DIRECTORS AND THE EXECUTIVE COMMITTEE MAKES THE FINAL DETERMINATION OF THE CEO'S SALARY BASED ON THE EVALUATION PROCESS. ALL DISCUSSIONS ARE RECORDED IN COMMITTEE MINUTES. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION B; FORM 990 PART VIII; AND FORM 990 PART IX: VNA HOSPICE OF SOUTHWEST IOWA SHARES ITS FACILITY, ITS EMPLOYEES AND OTHER EXPENSES WITH FIVE RELATED ORGANIZATIONS: VISITING NURSE ASSOCIATION OF THE MIDLANDS, VISITING NURSE FOUNDATION, VISITING NURSE HEALTH SERVICES, VISITING NURSE ASSOCIATION OF POTTAWATTAMIE COUNTY AND EASTER SEAL SOCIETY OF NEBRASKA, INC. VNA HOSPICE OF SOUTHWEST IOWA RECEIVES MANAGEMENT FEES AND EXPENSE SHARING FEES FROM THOSE ORGANIZATIONS AND ALSO PAYS MANAGEMENT FEES TO THOSE ORGANIZATIONS. FEES RECEIVED ARE REPORTED ON PART VIII, LINE 2 AND FEES PAID ARE REPORTED ON PART IX, LINE 11A. AS THE FEES ARE PAID TO A RELATED OPERATING CHARITABLE ENTITY, THE MANAGEMENT FEES PAID ARE NOT REPORTED AS AN INDEPENDENT CONTRACTOR PAYMENT ON PART VII, SECTION B. FORM 990, PART XI, LINE 2C: THE FINANCE AND AUDIT COMMITTEE IS RESPONSIBLE FOR EVALUATION AND OVERSIGHT OF THE FINANCIAL NEEDS AND STATUS OF THE VNA AND FOR THE ESTABLISHMENT AND REVIEW OF POLICIES DESIGNED TO MEET SUCH NEEDS. THE COMMITTEE REVIEWS AND RECOMMENDS APPROVAL OF THE ANNUAL OPERATING AND CAPITAL BUDGETS, REVIEWS AND RECOMMENDS APPROVAL TO THE VNA BOARD THE MONTHLY FINANCIAL PROGRESS TOWARD ANNUAL BUDGET PLANS AS REPORTED BY STAFF, ENSURES ACCURACY OF FINANCIAL REPORTING INCLUDING MONITORING OF INTERNAL CONTROLS, OVERSEES THE ACCOUNTING AND FINANCIAL REPORTING PROCESS AND THE INDEPENDENT AUDIT OF THE FINANCIAL STATEMENTS AND SELECTS, OVERSEES AND COMPENSATES THE EXTERNAL AUDITORS. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. VISITING NURSE ASSOCIATION OF THE MIDLANDS 12565 WEST CENTER ROAD STE 100 OMAHA NE 68144 470690207 HOMECARE, HOSPICE, PHARMACY NE 501(C)(3) LINE 7 VISITING NURSE HEALTH SERVICES 1 VISITING NURSE HEALTH SERVICES 12565 WEST CENTER ROAD STE 100 OMAHA NE 68144 470690286 HOMECARE, PUBLIC HEALTH NE 501(C)(3) LINE 7 N/A 0 VISITING NURSE FOUNDATION 12565 WEST CENTER ROAD STE 100 OMAHA NE 68144 470690846 FUNDRAISING, INVESTMENTS NE 501(C)(3) LINE 12A, I VISITING NURSE HEALTH SERVICES 1 EASTER SEAL SOCIETY OF NEBRASKA INC 12565 WEST CENTER ROAD STE 100 OMAHA NE 68144 470457872 DISABILITY ASSISTANCE NE 501(C)(3) LINE 7 VISITING NURSE HEALTH SERVICES 1 VISITING NURSE ASSOCIATION OF POTTAWATTAMIE COUNTY 822 S MAIN SUITE 102 COUNCIL BLUFFS IA 51503 420681048 HOMECARE, PUBLIC HEALTH IA 501(C)(3) LINE 7 VISITING NURSE HEALTH SERVICES 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 VISITING NURSE ASSOCIATION OF THE MIDLANDS D 1217600 FAIR MARKET VALUE SCHEDULE R, PAGE 3, PART V, LINE 2: VNA HOSPICE OF SOUTHWEST IOWA SHARES ITS FACILITY WITH FIVE AFFILIATES, EASTER SEAL SOCIETY OF NEBRASKA, INC., VISITING NURSE ASSOCIATION OF THE MIDLANDS, VISITING NURSE FOUNDATION, VISITING NURSE ASSOCIATION OF POTTAWATTAMIE COUNTY, AND VISITING NURSE HEALTH SERVICES. USE OF THE FACILITY BY THE FIVE ORGANIZATIONS OVERLAPS. THEREFORE, IT IS DIFFICULT TO QUANTIFY THE COST OF THE PORTION USED BY EACH ORGANIZATION.