2025-12-22T14:26:36-06:00 2025-02-28 450250958 EIDE BAILLY LLP 18081 BURT ST STE 200 OMAHA NE 680224722 990 2024-03-01 470396139 LUTHERAN COMMUNITY HOSPITAL ASSOCIATION OF NORFOLK NEBRASKA LUTH 4026447301 2700 W NORFOLK AVE NORFOLK NE 68701 BRENDA BAKER CFO - FRHS 4026447301 2025-12-15 1 1 MEGAN L KOZIOL CPA P01544037 4023302660 2025-12-15 2024 2025-03-06 01:10:19Z BRENDA BAKER 2700 W NORFOLK AVE NORFOLK NE 68701 790 0 X WWW.FRHS.ORG X 1926 NE TO SUPPORT FAITH REGIONAL HEALTH SERVICES. 13 13 0 13 0 0 0 0 0 0 87606 790 0 0 87606 790 0 0 0 0 0 0 0 0 0 5634 4915 5634 4915 81972 -4125 2859629 3175216 20800 15714 2838829 3159502 TO SERVE CHRIST BY PROVIDING ALL PEOPLE WITH EXEMPLARY MEDICAL SERVICES IN AN ENVIRONMENT OF LOVE AND CARE. 0 0 LUTHERAN COMMUNITY HOSPITAL ASSOCIATION, SOLE MEMBER OF FAITH REGIONAL HEALTH SERVICES, SUPPORTS FAITH REGIONAL HEALTH SERVICES, WITH WHOM THEY OPERATE AN INTEGRATED HEALTHCARE SYSTEM. 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 0 0 0 0 X BRENDA BAKER 4026447249 1500 KOENIGSTEIN AVE NORFOLK NE 68701 PRESTON SUNDERMAN PRESIDENT 2.50 1.00 X X 0 0 0 JOHN ROBERTSON VICE PRESIDENT 2.50 1.50 X X 0 0 0 KAREN PETERSEN SECRETARY 2.50 0.00 X X 0 0 0 BRETT JACKSON TREASURER 2.50 1.50 X X 0 0 0 DR DAN BLOMENBERG MEMBER 2.50 0.00 X 0 0 0 JENNIFER CARLISLE MEMBER 2.50 0.00 X 0 0 0 JASON DOELE MEMBER 2.50 0.00 X 0 0 0 MICHAEL SULLIVAN MEMBER 2.50 0.00 X 0 0 0 REGINA BUSBOOM MEMBER 2.50 1.00 X 0 0 0 LEON ROSENTHAL MEMBER 2.50 1.00 X 0 0 0 CRAIG BOCHE MEMBER 2.50 0.00 X 0 0 0 JOHN DINKEL MEMBER 2.50 0.00 X 0 0 0 JERRELL DOLESH MEMBER 2.50 0.00 X 0 0 0 KELLY DRISCOLL CEO 1.00 41.00 X 0 791760 40222 JANNA CLINE VP FINANCE THRU 04/24 1.00 41.00 X 0 159578 13089 BRENDA BAKER VP OF FINANCE 1.00 41.00 X 0 117628 3431 0 1068966 56742 0 0 1 0 0 790 790 790 0 0 790 3161 3161 1754 1754 4915 0 4915 0 198646 34815 2657908 3140401 3075 0 2859629 3175216 20800 15714 20800 15714 X 2134041 2454714 704788 704788 2838829 3159502 2859629 3175216 -4125 324798 0 X 0 0 0 X 704788 188 188 704788 704788 4501 4501 704788 704788 3402 3402 704788 704788 2822 2822 704788 704763 25 4518 4518 704788 0.14200 0.85800 0.00000 0 0 0 ANNUITIES PAYABLE 15714 15714 PART V, LINE 4: BOARD DESIGNATED ENDOWMENT FUNDS ARE TO BE USED FOR WOMEN'S AND CHILDREN'S HEALTH. PROJECTS MEETING THE CRITERIA FOR WOMEN'S AND CHILDREN'S HEALTH ARE FUNDED BY LCHA VIA ITS CONTRIBUTIONS TO FAITH REGIONAL HEALTH SERVICES TO BE USED FOR THESE PROGRAMS. PERMANENT ENDOWMENTS ARE CONTRIBUTIONS WHOSE PRINCIPAL IS PERMANENTLY SET ASIDE TO GENERATE INVESTMENT EARNINGS. INVESTMENT EARNINGS, INCLUDING MARKET VALUE GAINS (LOSSES), ON THESE FUNDS ARE NOT RESTRICTED AS TO USE. DONORS CAN SPECIFY A CONTRIBUTION TO THIS FUND IN ANY AMOUNT AT ANY TIME. PART V, LINE 1E: THE AMOUNT LISTED IS NOT AN ACTUAL EXPENDITURE BUT RATHER A RECLASSIFICATION OF INCOME. THE INCOME RECEIVED FROM THE ENDOWMENTS IS UNRESTRICTED AND ALLOWED TO BE SPENT ON ANY EXPENSES THAT LCHA INCURS. 0 0 0 0 0 0 0 0 0 KELLY DRISCOLL CEO 0 707070 0 73640 0 11050 0 17250 0 25172 0 834182 0 0 JANNA CLINE VP FINANCE THRU 04/24 0 145736 0 13842 0 0 0 5675 0 7892 0 173145 0 0 PART I, LINE 3 KELLY DRISCOLL, CEO OF FAITH REGIONAL HEALTH SERVICES (FRHS), IS COMPENSATED BY FRHS, A RELATED ORGANIZATION. FRHS USES ONE OR MORE OF THE METHODS ON LINE 3 TO DETERMINE THE CEO'S COMPENSATION. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE PRESIDENT, PAST PRESIDENT, VICE PRESIDENT, SECRETARY AND TREASURER. THE EXECUTIVE COMMITTEE SHALL HAVE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD OF DIRECTORS. ITS ACTIONS SHALL BE SUBJECT TO APPROVAL OR DISAPPROVAL AT THE NEXT REGULAR BOARD OF DIRECTORS MEETING. FORM 990, PART VI, SECTION A, LINE 6 ANY PERSON TWENTY-ONE (21) YEARS OF AGE OR OLDER WHO IS A MEMBER IN GOOD STANDING OF, AND AFFILIATED WITH, A LUTHERAN CONGREGATION, MAY BECOME A MEMBER OF LCHA UPON MEETING THE TERMS AND CONDITIONS OF MEMBERSHIP IN THE BYLAWS AND APPROVAL BY A MAJORITY OF THE MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS SHALL ELECT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS MUST APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION AND ANY MERGER, CONSOLIDATION AND/OR DISSOLUTION. FORM 990, PART VI, SECTION B, LINE 11B INFORMATION FOR THE FORM 990 AND ALL APPLICABLE SCHEDULES WERE COMPLETED IN-HOUSE AND REVIEWED BY THE CONTROLLER. COPIES OF THE COMPLETED RETURN WERE DISTRIBUTED TO THE BOARD MEMBERS FOR REVIEW PRIOR TO SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS SHALL IN NO WAY PERMIT THEIR POSITIONS ON THE BOARD, IN RELATION TO THEIR PERSONAL BUSINESS, TO CONFLICT WITH LCHA'S ACTIVITIES, AND EACH DIRECTOR SHALL, AT LCHA'S REQUEST, SIGN A STATEMENT, IN A FORM TO BE ADOPTED BY THE BOARD OF DIRECTORS, WHEREBY HE OR SHE SHALL AGREE TO DISCLOSE, AT ANY TIME AND FROM TIME TO TIME, ALL SUCH CONFLICTS. WHERE A CONFLICT OF INTEREST EXISTS OR CAN BE REASONABLY CONSTRUED, SUCH PERSON SHALL NOT VOTE ON, NOR USE HIS OR HER PERSONAL INFLUENCE ON, NOR PARTICIPATE IN THE DELIBERATIONS WITH RESPECT TO, OR BE PRESENT FOR DELIBERATION OR VOTE ON, SUCH CONTRACT OR TRANSACTION. SUCH PERSON MAY BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM AT ANY MEETING WHERE THE CONTRACT OR TRANSACTION IS UNDER DISCUSSION OR IS BEING VOTED UPON. THE MINUTES OF THE MEETING SHALL REFLECT THE DISCLOSURE MADE AND THE ABSTENTION FROM VOTING AND PARTICIPATING. FORM 990, PART VI, SECTION C, LINE 19 LCHA DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART VI, SECTION B, LINE 15: LCHA DOES NOT PAY COMPENSATION TO A CEO, EXECUTIVE DIRECTOR, TOP MANAGEMENT OFFICIAL, OFFICERS, OR EMPLOYEES. THEREFORE, THERE IS NOT A PROCESS IN PLACE FOR DETERMINING COMPENSATION. FORM 990, PART X: IN 1996, LUTHERAN COMMUNITY HOSPITAL ASSOCIATION (LCHA) ENTERED INTO A LEASE AGREEMENT WITH FAITH REGIONAL HEALTH SERVICES (FRHS) FOR ALL OF LCHA'S FIXED ASSETS AND RELATED DEBT. THE LEASE IS A 99-YEAR LEASE. LCHA IS THE SOLE MEMBER OF FRHS, AND IS IN CONTROL OF FRHS THROUGH SELECTION OF FRHS' BOARD MEMBERS PURSUANT TO FRHS' BYLAWS. FOR FINANCIAL ACCOUNTING PURPOSES, THE FIXED ASSETS AND RELATED DEBT ARE RECORDED ON THE BALANCE SHEET OF FRHS, AND ARE INCLUDED ON FRHS' FORM 990, PART X. LCHA'S BALANCE SHEET, AS PRESENTED IN THIS FORM 990, IS CONSISTENT WITH THE FINANCIAL STATEMENTS. THE FIXED ASSETS LEASED TO FRHS AND RELATED DEBT ARE OMITTED FROM THE BALANCE SHEET IN THIS FORM 990, PART X. FAITH REGIONAL HEALTH SERVICES 2700 W NORFOLK AVE NORFOLK NE 68701 470796875 HOSPITAL NE 501(C)(3) LINE 3 LUTHERAN COMMUNITY HOSP ASSOC 1 FAITH REGIONAL HEALTH SERVICES FOUNDATION 1500 KOENIGSTEIN AVE NORFOLK NE 68701 911772474 SUPPORT FAITH REGIONAL HEALTH SERVICES NE 501(C)(3) LINE 12A, I FAITH REGIONAL HEALTH SERVICES 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 FORM 990, SCHEDULE R, PART V, LINE 1J: LUTHERAN COMMUNITY HOSPITAL ASSOCIATION (LCHA) ENTERED INTO A LEASE AGREEMENT WITH FAITH REGIONAL HEALTH SERVICES (FRHS) FOR ALL OF LCHA'S FIXED ASSETS AND RELATED DEBT. THE LEASE IS A 99-YEAR LEASE. NO LEASE PAYMENTS ARE MADE BETWEEN THE ORGANIZATIONS.