2026-03-03T14:00:21-06:00 2025-06-30 450250958 EIDE BAILLY LLP 18081 BURT ST STE 200 OMAHA NE 680224722 990 2024-07-01 470366569 HENDERSON HEALTH CARE SERVICES INC HEND 4027234512 1621 FRONT ST HENDERSON NE 683710217 CHERYL BROWN CHIEF EXECUTIVE OFFICER 4027234512 2026-02-23 1 1 MEGAN L KOZIOL CPA P01544037 4023302660 2026-02-20 2024 2025-03-06 01:10:19Z CHERYL BROWN 1621 FRONT ST HENDERSON NE 683710217 22679088 0 X WWW.HENDERSONHEALTHCARE.ORG X 1949 NE TO PROMOTE PROFESSIONAL, COMPETENT, ETHICAL AND COMPASSIONATE HEALTH CARE. 8 8 186 30 0 0 492632 341286 20946611 21329813 683353 704364 16691 12231 22139287 22387694 3720 1730 0 0 12344075 13404189 0 0 0 7741512 8931997 20089307 22337916 2049980 49778 47311850 49126628 12020852 13448310 35290998 35678318 X WE ARE A NONPROFIT, COMMUNITY BASED HEALTH CARE NETWORK WHOSE MISSION IS TO PROMOTE PROFESSIONAL, COMPETENT, ETHICAL AND COMPASSIONATE HEALTH CARE IN THE NAME OF CHRIST TO INDIVIDUALS, FAMILIES AND COMMUNITY. 0 0 12085030 1730 13179064 ANCILLARY SERVICES - HENDERSON HEALTH CARE SERVICES IS A 13-BED COMMUNITY-BASED HEALTH CARE NETWORK LOCATED IN THE HEART OF RURAL NEBRASKA. ANCILLARY SERVICES PROVIDED INCLUDE RADIOLOGY, LABORATORY, OPERATING AND RECOVERY ROOMS, PHYSICAL, RESPIRATORY, INTRAVENOUS, OCCUPATIONAL AND SPEECH THERAPIES, CENTRAL SERVICES, EMERGENCY ROOM, SPECIALTY CLINIC, ANESTHESIOLOGY, ELECTROCARDIOLOGY, CARDIAC AND PULMONARY REHABILITATION AND DIABETIC EDUCATION.IN FISCAL YEAR 2025, THE HOSPITAL PROVIDED 3,481 RADIOLOGY PROCEDURES AND 2,991 PHYSICAL THERAPY VISITS, SAW 769 VISITS TO THE EMERGENCY ROOM AND PERFORMED 304 OPERATIONS. HENDERSON PROVIDED 242 PATIENT DAYS OF ACUTE CARE AND 331 PATIENT DAYS OF SWING-BED CARE. 3416823 2977408 RURAL HEALTH CLINICS - THIS ENCOMPASSES TWO PROVIDER BASED RHCS, ONE LOCATED ADJACENT TO THE CAH AND ONE SATELLITE CLINIC IN SUTTON WHICH OFFERS EXPANDED LAB AND X-RAY. WE EMPLOY 3 MDS AND 4 PAS TO STAFF THESE CLINICS ALONG WITH NURSING AND ADMISSION STAFF. BEING LOCATED NEAR THE INTERSTATE WE ARE ABLE TO SERVE THOSE TRAVELING THROUGH WITH HEALTHCARE NEEDS, BUT OUR GENERAL SERVICE AREA INCLUDES HENDERSON, YORK, HAMPTON, BRADSHAW, MCCOOL, SUTTON, CLAY CENTER, AND AURORA. WE AVERAGE OVER 10,000 CLINIC VISITS BETWEEN THE TWO LOCATIONS AND WE PROVIDE FAMILY PRACTICE SERVICES INCLUDING OBSTETRIC CARE, GERIATRIC CARE, AND PEDIATRIC CARE. 2610854 3167651 LTC NURSING - WE ARE A 40-BED LTC NON-MEDICARE CERTIFIED FACILITY, WE SERVE A MIXTURE OF PRIVATE AND MEDICAID PATIENTS AND FOR FISCAL YEAR 2025 WE HAD 87% OCCUPANCY. THE LARGEST SINGLE COST WITHIN THIS DEPARTMENT IS SALARIES AS THEY CARRY 25.52 FTES IN THIS DEPARTMENT, WHICH INCLUDES AN ASSISTANT ADMINISTRATOR, DIRECTOR OF NURSING, AND ASSISTANT DIRECTOR OF NURSING. THE NEXT HIGHEST COSTS ARE THE EMPLOYEE BENEFITS FOR THE STAFF, INCLUDING HEALTH INSURANCE AND RETIREMENT PLAN. WE ALSO INCUR A QUARTERLY ASSESSMENT TAX FROM NE DHHS, ASSESSED AT $9.00 PER BED PER RESIDENT DAY SO APPROXIMATELY $114,000 PER YEAR. 2398338 2005690 PHARMACY/ONCOLOGY - SALARIES INCLUDE A FULL TIME PHARMACIST AND PART TIME PHARMACY TECHNICIAN THAT PERFORMS MEDICATION ORDER REVIEWS FOR ALL MEDICATIONS ORDERED FOR THE HHCS CAH, THIS PHARMACIST ALSO PERFORMS THE MONTHLY INTERNAL REVIEW OF PHARMACY/MEDICATION FOR THE CAH AND LTC. SUPPLIES EXPENSE IS MOSTLY COMPOSED OF MEDICATION COSTS FOR ALL THE MEDICATIONS ADMINISTERED TO THE ER, OP, IP, SK AND OPO PATIENTS AT HHCS. MEDICATIONS ARE PURCHASED MOSTLY THROUGH CARDINAL. 2398338 2005690 20511045 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 51 0 1 186 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X JILL MYERS 4027234512 1621 FRONT STREET HENDERSON NE 683710217 LOWELL HIEBNER VICE CHAIRMAN 1.00 X X 0 0 0 STACEY STARK SECRETARY 1.00 X X 0 0 0 ALAN JANZEN TREASURER 1.00 X X 0 0 0 RICK BOARDMAN MEMBER 1.00 X 0 0 0 BLAKE BURGESS MEMBER 1.00 X 0 0 0 BRAD FRIESEN MEMBER 1.00 X 0 0 0 HOLLY HERZBERG MEMBER 1.00 X 0 0 0 JOHN VAN KIRK MEMBER 1.00 X 0 0 0 CHERYL BROWN CEO 50.00 X 240700 0 9573 JILL MYERS CFO 50.00 X 209836 0 16877 CURTIS COGSWELL CHAIRMAN 1.00 X 0 0 0 JAMES OHRT PHYSICIAN 94.00 X 590206 0 29683 LINDSEY NELSON PHYSICIAN 77.00 X 321976 0 41552 CHRISTOPHER VANDERNECK PHYSICIAN 71.00 X 299569 0 21838 SHELLY AMACK PROFESSIONAL SERVICES OFFI 50.00 X 202285 0 7605 ALLISON BAUER PA 62.00 X 176816 0 47430 2041388 0 174558 24 0 1 0 SAMPSON CONSTRUCTION CO INC 5825 S 14TH STREET LINCOLN NE 68512 CONSTRUCTION SERVICES 2023008 HEALTH FACILITIES GROUP LLC 330 N MEAD STREET WICHITA KS 67202 ARCHITECTURE SERVICES 308878 T&T CONTRACTING 9409 SOUTHERN SKY ROAD LINCOLN NE 68505 CONSTRUCTION SERVICES 294922 HEALTHLAND CPSI PO BOX 11407 BIRMINGHAM AL 35246 EMR SERVICE PROVIDER 163382 4 27291 313995 341286 ANCILLARY SERVICES 621400 11444962 11444962 LONG-TERM-CARE NURSING 621400 3167651 3167651 RURAL HEALTH CLINICS 621400 2977408 2977408 PHARMACY/ONCOLOGY 621400 2005690 2005690 340B PROGRAM REVENUE 621400 1564849 1564849 169253 169253 21329813 709013 709013 285700 1045 277988 13406 7712 -12361 -4649 -4649 CAFETERIA SALES 900099 12231 12231 12231 22387694 21329813 0 716595 1730 1730 476986 476986 9807131 9308949 498182 297331 280836 16495 116886 113871 3015 2705855 2497414 208441 3091 3091 7959 7959 11819 11819 1637242 1201453 435789 19779 19779 1712933 1699138 13795 294408 264420 29988 346120 337172 8948 7427 4966 2461 20469 17335 3134 184173 180095 4078 2077848 2042403 35445 296866 290293 6573 MEDICAL SUPPLIES 2015645 2015645 LICENSES AND PERMITS 172629 165265 7364 DUES AND SUBSCRIPTIONS 82945 70463 12482 PRINTING AND POSTAGE 31049 19535 11514 9595 62 9533 22337916 20511045 1826871 0 9662451 10431114 3329110 3751929 409514 325169 116270 221106 39493539 13518802 27144073 25974737 5688513 6029837 931919 930067 30000 1462669 47311850 49126628 2668780 2326251 8555227 10166774 796845 955285 12020852 13448310 X 34167591 34392484 1123407 1285834 35290998 35678318 47311850 49126628 X 49778 339394 -1852 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 975 975 0 PART II-B, LINE 1: A PORTION OF THE DUES PAID TO THE NEBRASKA HOSPITAL ASSOCIATION (NHA) ARE USED BY THOSE ORGANIZATIONS FOR LOBBYING ACTIVITIES. 981825 981825 32201883 9534378 22667505 5862013 3886898 1975115 447818 97526 350292 25974737 DEFERRED COMPENSATION 955285 955285 X 22713417 339394 -1852 337542 22375875 11819 11819 22387694 22326097 0 22326097 11819 11819 22337916 PART X, LINE 2: HHCS ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. HHCS RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT JUNE 30, 2025 AND 2024, HHCS HAD NO UNCERTAIN TAX POSITIONS ACCRUED. PART XI, LINE 2D - OTHER ADJUSTMENTS: LOSS ON BENEFICIAL INTEREST IN TRUSTS -1,852. 1 1 X 1 X 1 X 1 1 0 0 6 15000 15000 0.00070 1658716 1658716 6 1673716 1658716 15000 0.00070 363 22266 22266 5816863 3902688 1914175 0.08570 100 5543 0 5543 0.00020 463 5844672 3924954 1919718 0.08590 469 7518388 5583670 1934718 0.08660 1 637154 59255 4743387 4773275 -29888 X 1 1 1 1 HENDERSON HEALTH CARE SERVICES 1621 FRONT ST HENDERSON NE 68371 WWW.HENDERSONHEALTHCARE.ORG 820001 X X X X HENDERSON HEALTH CARE SERVICES INC 1 0 0 1 X X X X X X X X 24 1 0 1 1 X HTTPS://HENDERSONHEALTHCARE.ORG/ABOUT/COMMUNITY-HEALTH.HTML X 1 24 1 HTTPS://HENDERSONHEALTHCARE.ORG/ABOUT/COMMUNITY-HEALTH.HTML 0 1 X 150.000000000000 300.000000000000 X X X 1 1 X X X 1 X WWW.HENDERSONHEALTHCARE.ORG/PATIENT-INFO/FINANCIAL-SERVICES/ASSISTANCE.HTML X WWW.HENDERSONHEALTHCARE.ORG/PATIENT-INFO/FINANCIAL-SERVICES/ASSISTANCE.HTML X WWW.HENDERSONHEALTHCARE.ORG/PATIENT-INFO/FINANCIAL-SERVICES/ASSISTANCE.HTML X X X X X X 1 X 0 X X X X 1 X 0 0 HENDERSON HEALTH CARE SERVICES INC PART V, SECTION B, LINE 5: THIS ASSESSMENT FOCUSES ON COLLECTING THE COMMUNITY'S PERSPECTIVE ON ISSUES SUCH AS HEALTH CARE, EDUCATION, CARE FOR OLDER ADULTS, JOBS, SUPPORT NETWORKS, HEALTH PROBLEMS, AND RISKY BEHAVIORS. THESE HEALTH CHALLENGES WERE IDENTIFIED THROUGH SURVEY RESULTS, DEMOGRAPHIC DATA, AND CONSULTATION WITH PUBLIC HEALTH PARTNERS. IN RESPONSE, HHCS DEVELOPED A COMMUNITY HEALTH IMPROVEMENT PLAN WITH ACTIONABLE STRATEGIES THAT EMPHASIZE EDUCATION, EARLY INTERVENTION, COLLABORATION, AND ACCESS TO CARE. HENDERSON HEALTH CARE SERVICES INC PART V, SECTION B, LINE 6B: FOUR CORNERS HEALTH DEPARTMENT HENDERSON HEALTH CARE SERVICES INC PART V, SECTION B, LINE 11: HENDERSON HEALTH CARE SERVICES, INC. CONTINUES TO PUT FORTH RESOURCES TO ADDRESS THE IDENTIFIED NEEDS AS FOLLOWS:1) OBESITY/NUTRITION/PHYSICAL ACTIVITY: HHCS PROMOTES HEALTHY LIFESTYLES BY PARTNERING WITH FOUR CORNERS HEALTH DEPARTMENT, OFFERING AN ANNUAL HEALTH FAIR TO EMPLOYEES AND MONTHLY HEALTH FAIR TO THE PUBLIC, OFFERING WELLNESS CENTER ACCESS TO EMPLOYEES AND THE PUBLIC, AND PROVIDING NUTRITIONAL COUNSELING AND DIABETIC EDUCATION TO PATIENTS. 2) CANCER: HHCS CONTINUES TO PROMOTE CANCER AWARENESS BY MAINTAINING AND EXPANDING ONCOLOGY AND SPECIALTY SERVICES, RELEASING MESSAGES TO THE PUBLIC ENCOURAGING EARLY SCREENING AND PREVENTATIVE HEALTH APPOINTMENTS IN THE LOCAL NEWSPAPER, WEBSITE OR QUARTERLY NEWSLETTER, DISTRIBUTING EDUCATIONAL MATERIALS, SUPPORTING TECHNICAL UPGRADES SUCH AS THE PURCHASE OF A NEW 3D MAMMOGRAM MACHINE, AND COLLABORATING WITH LOCAL PUBLIC HEALTH ON AWARENESS AND PREVENTION, ESPECIALLY PROMOTING BREAST CANCER AWARENESS IN OCTOBER.3) MENTAL HEALTH: HHCS PROMOTES MENTAL HEALTH BY MAKING APPROPRIATE MENTAL HEALTH REFERRALS WHEN DEEMED NECESSARY AND DEVELOPING A CLEAR AND CONSISTENT MESSAGE TO THE GENERAL PUBLIC AND PATIENTS OF HHCS. THIS INCLUDES SPONSORING A SPEAKER AT THE HEARTLAND COMMUNITY SCHOOL AND SUTTON PUBLIC SCHOOL FOCUSING ON SUICIDE PREVENTION/MENTAL HEALTH AMONGST TEENAGERS, CYBER BULLYING AND RISKY BEHAVIORS, AND THE USE OF EMERGENCY IN THE ER SETTING WHERE MENTAL HEALTH COORDINATION CAN BE INITIATED.4) ALCOHOL/DRUG ABUSE: HHCS PROVIDES SUPPORT FOR ALCOHOL/DRUG ABUSE BY COLLABORATING WITH THE LOCAL PUBLIC HEALTH SYSTEM TO EDUCATE AND BE A RESOURCE FOR MEMBERS OF THE COMMUNITY, PROVIDING CLINICAL SUPPORT AND REFERRALS, AND LAUNCHING PUBLIC MESSAGING CAMPAIGNS ABOUT SUBSTANCE ABUSE. OF THE NEEDS IDENTIFIED, THERE WERE NO SIGNIFICANT NEEDS THAT ARE NOT BEING ADDRESSED. 3 1 - HENDERSON FAMILY CARE 1621 FRONT STREET HENDERSON NE 68371 RURAL HEALTH CLINIC 2 - SUTTON FAMILY PRACTICE 1106 N SAUNDERS SUITE 2 SUTTON NE 68979 RURAL HEALTH CLINIC 3 - LEGACY SQUARE 1621 FRONT STREET HENDERSON NE 68371 LONG-TERM CARE PART I, LINE 3C: IN ADDITION TO FEDERAL POVERTY GUIDELINES; MEDICAL INDIGENCY, INSURANCE STATUS AND UNDERINSURANCE STATUS ARE USED TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. A SLIDING FEE SCALE BASED ON FAMILY SIZE AND FPL IS USED TO DETERMINE WHETHER THE COST OF CARE WILL BE FREE OR DISCOUNTED. 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, LINE 7B, AND SUBSIDIZED HEALTH SERVICES, LINE 7G, WERE CALCULATED USING THE COSTING METHODS TO PREPARE THE COST REPORTS. COMMUNITY HEALTH IMPROVEMENT SERVICES, LINE 7E, AND CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT, LINE 7I, ARE REPORTED BASED ON ACTUAL EXPENSES REPORTED IN THE GENERAL LEDGER. 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 VARIOUS CLASSES OF PATIENTS. PART III, LINE 3: THE ESTIMATED AMOUNT OF THE ORGANIZATION'S IMPLICIT PRICE CONCESSIONS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS CALCULATED BASED ON AN APPROXIMATE 9.30% OF INDIVIDUALS LIVING BELOW THE POVERTY LEVEL IN THE SERVICE AREA. PART III, LINE 4: THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES IMPLICIT PRICE CONCESSIONS IS LOCATED IN FOOTNOTE 1 ON PAGES 13 AND 14 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 RENDERED ON A FEE SCHEDULE ARE NOT INCLUDED IN THE MEDICARE CALCULATIONS PER THE 990 INSTRUCTIONS. HAD THIS BEEN REPORTED THE HOSPITAL WOULD HAVE HAD A GREATER LOSS FROM MEDICARE SERVICES OF $52,461.MEDICARE FEE SCHEDULE REVENUE $42,370MEDICARE ESTIMATED COSTS OF CARE RELATING TO PAYMENTS $94,831NET (SHORTAGE) $(52,461) PART III, LINE 9B: NO EXTRAORDINARY COLLECTION ACTIONS (ECA'S) WILL BE TAKEN AGAINST AN INDIVIDUAL BEFORE REASONABLE EFFORTS HAVE BEEN MADE TO DETERMINE WHETHER THE INDIVIDUAL IS ELIGIBLE FOR ASSISTANCE UNDER THE HHCS FINANCIAL ASSISTANCE POLICY (FAP).NO ACCOUNT WILL BE SUBJECT TO BAD DEBT COLLECTION ACTIONS WITHIN 120 DAYS OF ISSUING THE FIRST POST-DISCHARGE BILL AND WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE. THIS 120 DAY TIMEFRAME MAY BE SHORTENED IF A DETERMINATION HAS BEEN MADE ON FINANCIAL ASSISTANCE, A PAYMENT PLAN HAS BEEN ESTABLISHED AND AGREED TO BY THE PATIENT OR GUARANTOR, AND THE PATIENT OR GUARANTOR IS NO LONGER COMPLYING WITH THE PAYMENT PLAN. NO COLLECTION ACTIONS WILL BE PURSUED AGAINST A PATIENT IF THE PATIENT, OR GUARANTOR, HAS PROVIDED DOCUMENTATION SHOWING THAT HE OR SHE HAS APPLIED FOR COVERAGE UNDER MEDICAID, OR OTHER PUBLICLY SPONSORED HEALTH PROGRAMS, THAT MAY PAY THE OUTSTANDING CLAIM AND FOR WHICH AN ELIGIBILITY DETERMINATION IS STILL PENDING. WITHIN THE 240 DAYS FROM THE FIRST POST-DISCHARGE INVOICE, IF A PATIENT, OR GUARANTOR, APPLIES FOR FINANCIAL ASSISTANCE, COLLECTION ACTIONS WILL CEASE WHILE THE APPLICATION IS UNDER CONSIDERATION. IF THE APPLICANT IS APPROVED FOR FULL FREE CARE, NO FURTHER ACTIONS WILL BE TAKEN TO COLLECT ON THE ACCOUNT. IF THE APPLICANT IS DENIED FINANCIAL ASSISTANCE OR IS APPROVED FOR DISCOUNTED CARE, APPROPRIATE STEPS MUST BE TAKEN BY THE PATIENT, OR GUARANTOR, TO RESOLVE THE OUTSTANDING SELF-PAY BALANCE OR ADDITIONAL COLLECTION ACTIONS WILL BE PURSUED. APPLICANTS APPROVED FOR DISCOUNTED CARE WILL BE REFUNDED PAYMENTS IN EXCESS OF THE AMOUNT DETERMINED OWED BY THE PATIENT, OR PATIENT'S GUARANTOR, ON ACCOUNTS FOR WHICH THEY HAVE BEEN GRANTED ASSISTANCE UNDER THE HHCS FINANCIAL ASSISTANCE POLICY. PART VI, LINE 2: MEDICAL STAFF MEETINGS (INCLUDES ADMINISTRATION, DONS, ALL EMPLOYED PROVIDERS, PHARMACISTS) AND PROVIDER MEETINGS (INCLUDES ONLY EMPLOYED PROVIDERS, CEO AND DON) ARE HELD MONTHLY DURING WHICH OUR MEDICAL STAFF HAVE AN OPPORTUNITY TO SHARE WHAT THEY ARE SEEING FOR RECURRING CASES OF DISEASE MANAGEMENT IN THEIR PATIENTS. IF A TREND IS IDENTIFIED THROUGH THAT DISCUSSION THEN WE TRY TO DEVELOP AN OUTREACH TO THE COMMUNITY. FOR EXAMPLE, PATIENT EDUCATION IN THE NEWSLETTER OR PAMPHLETS IN THE CLINIC EXAM ROOMS, IT BECOMES A FOCUS POINT FOR ALL PROVIDERS WHEN SEEING THEIR PATIENTS. WE MAY ALSO TURN TO COMMUNITY OUTREACH EDUCATION SESSIONS WHERE OUR STAFF HOLD "TOWN HALL" MEETINGS TO EDUCATE THOSE INTERESTED IN ATTENDING. WE ALSO HOLD ANNUAL HEALTH FAIR LABS AND WE COLLECTIVELY LOOK AT RESULTS TO DETERMINE ANY TRENDS IN HEALTH MANAGEMENT THAT NEED TO BE A FOCUS FOR OUR PROVIDERS FOR THE NEXT YEAR. THIS CAN HELP US IDENTIFY ADDITIONAL LAB OR RADIOLOGY TESTS THAT WE NEED TO OFFER IN OUR FACILITY. IT CAN ALSO TELL US IF WE NEED TO FOCUS ON A SPECIALTY CLINIC THAT MAY NEED TO BE RECRUITED TO PROVIDE THE SERVICE IN-HOUSE. LASTLY, WE HAVE PURCHASED KPI NINJA SOFTWARE THAT WILL ALLOW US TO DATA MINE OUR CLAIMS AND DIAGNOSIS SO WE CAN ANALYZE TO SEE WHAT TYPES OF HEALTH MANAGEMENT ARE PREVALENT IN OUR COMMUNITIES. PART VI, LINE 3: IT IS NOTED THAT HENDERSON HEALTH CARE OFFERS CHARITY CARE IN THE ADMISSION FORMS THAT ALL PATIENTS SIGN WHEN THEY COME TO THE CLINIC AND HOSPITAL AND THE FAP IS POSTED IN THE HOSPITAL WAITING ROOMS. ALSO, IN COLLECTION LETTERS, PATIENTS ARE ENCOURAGED TO CONTACT THE HOSPITAL IF THEY ARE INTERESTED IN APPLYING FOR CHARITY CARE. LASTLY, CHARITY CARE IS VERBALLY EXPLAINED TO PATIENTS IF THEY CALL STATING THEY CAN'T PAY FOR THEIR MEDICAL BILL. HHCS ALSO PUBLISHES A NOTICE ANNUALLY IN A NEWSLETTER THAT WE OFFER CHARITY CARE, AND WE PROVIDE OUR POLICY AND APPLICATIONS TO THE CLAY COUNTY AND YORK COUNTY HEALTH DEPARTMENT IN AN EFFORT TO REACH THOSE IN NEED. ALL PATIENT STATEMENTS INCLUDE THE NOTICE THAT FINANCIAL ASSISTANCE IS OFFERED AND INCLUDES CONTACT INFORMATION TO OBTAIN THE APPLICATION. PART VI, LINE 4: HENDERSON HEALTH CARE SERVICES IS LOCATED IN HENDERSON, NEBRASKA PROVIDING HEALTH CARE SERVICES TO RURAL COMMUNITIES THAT PRIMARILY INCLUDE YORK COUNTY (POP. 14,125), CLAY COUNTY (POP. 6,104), AND HAMILTON COUNTY (POP. 9,429); APPROXIMATELY 30,000 PEOPLE IN TOTAL. HENDERSON HEALTH CARE PROVIDES HEALTH CARE SERVICES TO INFANTS, CHILDREN, ADOLESCENTS, ADULT MEN AND WOMEN, AND THE AGED. THERE IS AN AVERAGE OF 16.67 PERSONS PER SQUARE MILE IN THE SERVICE AREA COMPARED TO ABOUT 80 PER SQUARE MILE ACROSS THE UNITED STATES. THE RESIDENTS OF THESE COUNTIES ARE 97.44% WHITE WITH 17.64% OVER THE AGE OF 65 YEARS AND 9.30% BELOW POVERTY LEVEL. PART VI, LINE 5: HHCS OFFERS A FULL ARRAY OF HEALTH CARE SERVICES FROM BIRTH TO DEATH BY PROVIDING OBSTETRIC CARE ALL THE WAY TO LONG TERM CARE NEEDS AND RESPITE NEEDS. THE HOSPITAL BRINGS SPECIALISTS OF MANY AREAS TO THE LOCAL COMMUNITY BY PROVIDING SPECIALTY CLINICS WITHIN THE COMMUNITY. PHYSICIANS DO SPEAKING ENGAGEMENTS AT THE SUTTON AND HENDERSON SCHOOLS ON VARIOUS HEALTH TOPICS RELATED TO THEIR AGE GROUP. HHCS HOSTS MEDICAL STUDENTS FOR ROTATION AND STRIVES TO EDUCATE THESE STUDENTS AND RESIDENTS. A QUARTERLY NEWSLETTER IS ISSUED THAT SPOTLIGHTS OUR NEW SERVICES BUT ALSO OFFERS A QUESTION AND ANSWER SESSION FOR HOT TOPICS WITH THE PROVIDERS. HHCS OFFERS 24 HOUR ER CARE AND WORKS WITH AVERA EMERGENCY PROGRAM TO PROVIDE THE BEST TRAUMA AND CRITICAL CARE TO ER PATIENTS. THE HOSPITAL ALSO OFFERS A DIABETES PREVENTION CLASS TO THE PUBLIC WHICH MEETS WEEKLY TO PROVIDE EDUCATION AND SUPPORT FOR ATTENDEES. AN EMPLOYED PHYSICAL THERAPIST IS PROVIDED TO THREE AREA SCHOOLS TO SERVE ON A WEEKLY BASIS AS THEIR ATHLETIC TRAINER; AT NO COST TO THE SCHOOL OR STUDENT.HHCS IS THE LARGEST EMPLOYER IN THE COMMUNITY WITH APPROXIMATELY 160 EMPLOYEES FROM THE SURROUNDING COMMUNITIES. THE DIRECTOR OF NURSING STAFF AND HUMAN RESOURCES REGULARLY ATTENDS JOB FAIRS PROMOTING HEALTH CARE POSITIONS. HHCS ALSO HOSTS THE HENDERSON HEARTLAND SCHOOL JUNIOR HIGH FOR A CAREER DAY IN WHICH THEY COME FOR A TOUR OF THE FACILITY TO LEARN ABOUT THE VAST ARRAY OF JOBS OFFERED WITHIN THE HEALTHCARE INDUSTRY. THE HOSPITAL OFFERS A MONTHLY HEALTH FAIR LAB PROGRAM THAT PROVIDES REDUCED COST TESTS FOR THE PUBLIC, HHCS ALSO PROMOTES HEALTHCARE AT THE SUTTON AND HENDERSON ANNUAL HOME SHOWS. X X 0 0 0 0 0 0 0 1 0 JAMES OHRT PHYSICIAN 300000 0 290206 0 0 0 13683 0 16000 0 619889 0 0 0 LINDSEY NELSON PHYSICIAN 250000 0 71976 0 0 0 13333 0 28219 0 363528 0 0 0 CHRISTOPHER VANDERNECK PHYSICIAN 250000 0 49569 0 0 0 12607 0 9232 0 321408 0 0 0 CHERYL BROWN CEO 235484 0 5216 0 0 0 8850 0 723 0 250273 0 0 0 JILL MYERS CFO 205036 0 4800 0 0 0 8197 0 8680 0 226713 0 0 0 ALLISON BAUER PA 135000 0 41816 0 0 0 5200 0 42230 0 224246 0 0 0 SHELLY AMACK PROFESSIONAL SERVICES OFFI 191512 0 10773 0 0 0 7438 0 167 0 209890 0 0 0 PART I, LINE 7 PHYSICIAN BONUSES ARE DEPENDENT UPON THE INDIVIDUAL PHYSICIAN'S CHARGED FEES (ADJUSTED FOR CONTRACTUAL AGREEMENTS AND PHYSICIAN'S PERSONAL PROFESSIONAL SERVICES) AND ARE PAID OUT AS A PERCENTAGE OF REVENUE ABOVE A THRESHOLD, WHICH VARIES WITH PHYSICIAN'S PRODUCTIVITY. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE CONSISTS OF THE CHAIR, VICE CHAIR, SECRETARY, AND TREASURER. EXCEPT FOR POWER TO AMEND THE ARTICLES OF INCORPORATION AND BY-LAWS, THE EXECUTIVE COMMITTEE SHALL HAVE ALL OF THE POWERS AND AUTHORITY OF THE BOARD OF DIRECTORS IN THE INTERVALS BETWEEN REGULAR MEETINGS OF THE BOARD OF DIRECTORS, SUBJECT TO THE DIRECTION AND CONTROL OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 EVERY PERSON, SOCIETY, BUSINESS OR CONGREGATION WHO HAS DONATED ONE HUNDRED DOLLARS OR MORE FOR THE BENEFIT OF HENDERSON HEALTH CARE SERVICES, INC.(HHCS) DURING THEIR LIFETIME SHALL BE A MEMBER OF HHCS. NO PERSON, SOCIETY, BUSINESS OR CONGREGATION SHALL BE ENTITLED TO MORE THAN ONE VOTE REGARDLESS OF THE CONTRIBUTIONS IN EXCESS OF ONE HUNDRED DOLLARS, AND A PERSON MUST BE OF LEGAL AGE TO EXERCISE VOTING PRIVILEGES. ACCEPTANCE OF ANY DONATION OF $100.00 OR MORE CONSTITUTES APPROVAL OF A LIFETIME MEMBERSHIP. THE MEMBERSHIP IS NOT TRANSFERABLE OR ASSIGNABLE. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS ARE ELECTED BY THE MEMBERSHIP AT THE ANNUAL MEMBERSHIP MEETING. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND REVIEWED BY MANAGEMENT. A FINAL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR, OFFICER AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT THAT AFFIRMS THAT SUCH PERSON: 1) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, 2) HAS READ AND UNDERSTANDS THE POLICY, 3) HAS AGREED TO COMPLY WITH THE POLICY, AND 4) UNDERSTANDS THAT THE CORPORATION IS A TAX EXEMPT CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. ANY PERSON WITH A POSSIBLE CONFLICT OF INTEREST IN ANY MATTER SHOULD NOT VOTE OR USE HIS/HER PERSONAL INFLUENCE ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR THE CEO IS DETERMINED BY A FACILITY EVALUATION TOOL COMPLETED BY THE BOARD PRESIDENT AND REVIEWED WITH AND APPROVED BY THE BOARD OF DIRECTORS. THE CEO OVERSEES THE REMAINING OFFICERS AND COMPLETES THE FACILITY EVALUATION TOOL FOR THOSE OFFICERS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE FINANCIAL STATEMENTS ARE DISTRIBUTED AT THE ANNUAL MEETING TO THOSE IN ATTENDANCE AND ARE ALSO AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: LOSS ON BENEFICIAL INTEREST IN TRUSTS -1,852. FORM 990, PART XI, LINE 2C: THE BOARD OF DIRECTORS ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF HHCS'S FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR.