2024-11-13T15:54:22-06:00 2023-12-31 450250958 EIDE BAILLY LLP 18081 BURT ST STE 200 OMAHA NE 680224722 990 2023-01-01 391904975 REGIONAL WEST GARDEN COUNTY REGI 3087723283 4021 AVE B SCOTTSBLUFF NE 69361 JEANNE MCKERRIGAN CFO/TREASURER 3087723283 2024-11-13 1 1 WENDY R COOLEY CPA P01523804 4023302660 2024-11-13 2023 2024-10-15 13:58:12Z MEL MCNEA 4021 AVE B SCOTTSBLUFF NE 69361 10851257 0 X WWW.GCHEALTH.ORG X 1984 NE TO PROVIDE HIGH QUALITY HEALTH CARE BY COMBINING CLINICAL AND SERVICE EXCELLENCE. 7 4 131 4 0 0 209625 114922 9850456 10689967 22147 21457 41285 4184 10123513 10830530 0 0 0 0 6006654 7105339 0 0 0 4458575 3973609 10465229 11078948 -341716 -248418 6047276 5482735 9468333 9152210 -3421057 -3669475 X ADVANCE THE HEALTH AND WELLNESS OF THE INDIVIDUALS AND COMMUNITIES WE ARE HONORED TO SERVE. 0 0 4364623 6570947 REGIONAL WEST GARDEN COUNTY IS A NON-PROFIT FACILITY CRITICAL ACCESS HOSPITAL THAT INCLUDES A 10 BED ACUTE CARE UNIT DESIGNED TO PROVIDE SPECIAL CARE FOR ACUTELY ILL PATIENTS. THIS CRITICAL ACCESS HOSPITAL OFFERS A VARIETY OF ANCILLARY SERVICES. 2215453 2828551 REGIONAL WEST GARDEN COUNTY INCLUDES A 40 BED NURSING HOME INTERMEDIATE LONG TERM CARE FACILITY. ITS PURPOSE IS TO PROVIDE 24 HOUR LICENSED NURSING CARE THAT ASSISTS RESIDENTS IN MEETING THEIR DAILY NEEDS AND HELPS THEM MAINTAIN THEIR OPTIMUM FUNCTIONAL LEVEL WITHIN AN ATMOSPHERE OF COMFORT AND DIGNITY. REGIONAL WEST GARDEN COUNTY NURSING HOME ALSO OFFERS ADULT DAY CARE, RESPITE CARE, AND HOSPICE SERVICES. 1128957 1181497 REGIONAL WEST GARDEN COUNTY CLINIC IS A RURAL HEALTH CLINIC THAT PROVIDES PHYSICIAN APPOINTMENTS AND WALK IN CARE FOR RESIDENTS IN THE SOUTHEASTERN NEBRASKA PANHANDLE. 1998991 113156 REGIONAL WEST GARDEN COUNTY ALSO PROVIDES ADMINISTRATIVE SUPPORT SERVICES NECESSARY TO ACCOMPLISH THE PRIMARY PROGRAM SERVICES OF THE HOSPITAL. THESE SERVICES ARE ADMINISTRATIVE, TECHNOLOGY, HUMAN RESOURCES, BILLING, HOUSEKEEPING, MEDICAL RECORDS AND OTHER SERVICES NECESSARY TO KEEP OPERATIONS RUNNING. 1998991 113156 9708024 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 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 1 0 1 0 1 14 0 1 131 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X JEANNE MCKERRIGAN 3086302244 4021 AVENUE B SCOTTSBLUFF NE 69361 MEL MCNEA PRESIDENT/CEO 1.00 45.00 X X 0 419351 21572 MICHAEL ICKOWSKI TREASURER/CFO THRU 05/2023 1.00 45.00 X X 0 227368 44990 BRAD HOWELL CEO - RWGC/DIRECTOR 40.00 0.00 X X 177704 0 10239 ALAN TOWNSEND INTERIM TREASURER/CFO 1.00 45.00 X X 184211 0 0 BEV KRAJEWSKI DIRECTOR 1.00 0.00 X 0 0 0 HOD KOSMAN DIRECTOR 1.00 3.00 X 0 0 0 MARY MATHER DIRECTOR 1.00 0.00 X 0 0 0 CYNTHIA GREGG DIRECTOR 1.00 0.00 X 0 0 0 STEPHANIE TODD SECRETARY 1.00 40.00 X 0 94850 32627 LAURIE SOPER APRN 40.00 0.00 X 327277 0 13378 KEVAN GEIGER EMT 40.00 0.00 X 151223 0 21813 ROBERT NOVAK PHYSICIAN 40.00 0.00 X 148749 0 4698 TAMARA KOUBEK CT TECHNOLOGIST 40.00 0.00 X 103740 0 42890 APRIL TOEPFER CHIEF NURSING OFFICER 40.00 0.00 X 102751 0 33250 AMANDA VICK FORMER OFFICER 0.00 43.00 X 0 329424 38657 JOHN MENTGEN FORMER OFFICER 0.00 0.00 X 0 260392 38551 1195655 1331385 302665 7 1 1 1 PRIME TIME HEALTHCARE LLC C/O AMERICAN NATIONAL BANK PO BOX 3 OMAHA NE 68103 AGENCY STAFF 487468 1 95346 19576 114922 NET HOSPITAL PATIENT REVENUE 623000 6570947 6570947 NURSING HOME PATIENT REVENUE 623000 2828551 2828551 HEALTH CLINIC PATIENT REVENUE 621110 1181497 1181497 OTHER OPERATING REVENUE 623000 108972 108972 10689967 12178 12178 30006 20727 9279 9279 9279 OTHER NON-OPERATING REVENUE 900099 4184 4184 4184 10830530 10694151 0 21457 X 188563 188563 5257930 5051644 206286 159757 153158 6599 1127878 1086298 41580 371211 346762 24449 38322 38322 2353509 1922745 430764 9112 4559 4553 190782 132588 58194 11344 11344 185923 183290 2633 35404 34413 991 13506 1849 11657 161191 121094 40097 50352 50352 MEDICAL SUPPLIES 498103 498103 CORPORATE ALLOCATION 265332 265332 FOOD 99406 99406 MISCELLANEOUS 44618 44618 16705 16153 552 11078948 9708024 1370924 0 564533 710500 2727526 569705 1772306 3242383 186027 220244 157513 119866 2123329 1594996 614876 528333 24495 91704 6047276 5482735 215138 949442 279555 284369 510557 100851 8463083 7817548 9468333 9152210 X -3421057 -3669475 -3421057 -3669475 6047276 5482735 -248418 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5887872 544587 55824 67507 6420776 8807244 182428 -2055429 1046371 5887872 7307997 190018 1350185 40956 8807244 6188204 324798 824828 29833 7307997 4837335 719879 1352989 98684 623315 6188204 0.00000 0.19650 0.80350 0 1 1 2916 2916 190488 66366 124122 1776782 1512853 263929 153143 15777 137366 528333 DUE TO AFFILIATES 7384981 DUE TO THIRD PARTY PAYOR 154882 LEASEHOLD PAYABLE GCHS 277685 7817548 X PART V, LINE 4: THE ENDOWMENT FUNDS ARE RESTRICTED FOR HEALTHCARE RESEARCH, HEALTHCARE EDUCATIONAL SCHOLARSHIPS, AND CAPITAL PROJECTS. PART X, LINE 2: THE ORGANIZATION ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740 INCOME TAXES. REGIONAL WEST GARDEN COUNTY RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT DECEMBER 31, 2023 AND 2022, REGIONAL WEST GARDEN COUNTY HAD NO UNCERTAIN TAX POSITIONS ACCRUED. 1 1 X 1 X 1 X 1 1 0 0 78418 78418 0.00710 1558482 1504593 53889 0.00490 1636900 1504593 132307 0.01200 1636900 1504593 132307 0.01200 1 701299 60311 3394021 3430884 -36863 X 1 1 1 1 REGIONAL WEST GARDEN COUNTY 1100 WEST 2ND OSHKOSH NE 69154 8200000 X X X X REGIONAL WEST GARDEN COUNTY 1 0 0 1 X X X X X X X X 23 1 1 1 1 X WWW.GCHEALTH.ORG/OUR-ORGANIZATION/ X 1 23 1 WWW.GCHEALTH.ORG/OUR-ORGANIZATION/ 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X HTTPS://GCHEALTH.ORG/COSTS-AND-BILLING/ X HTTPS://GCHEALTH.ORG/COSTS-AND-BILLING/ X HTTPS://GCHEALTH.ORG/COSTS-AND-BILLING/ X X X X X X 1 X 0 X X X X 1 X 0 0 REGIONAL WEST GARDEN COUNTY PART V, SECTION B, LINE 5: REGIONAL WEST GARDEN COUNTY (RWGC) PARTICIPATED WITH OTHER HOSPITALS IN THE RURAL NEBRASKA HEALTHCARE NETWORK (RNHN) JOINT PLANNING PROCESS FACILITATED BY PANHANDLE PUBLIC HEALTH DISTRICT. MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP (MAPP) IS A PARTNERSHIP-BASED FRAMEWORK TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT AND DEVELOP A COMMUNITY HEALTH IMPROVEMENT PLAN. MAPP EMPHASIZES THE PARTNERSHIP WITH ALL SECTORS OF THE PUBLIC HEALTH SYSTEM TO EVALUATE THE HEALTH STATUS OF THE REGION IT SERVES, IDENTIFY PRIORITY AREAS, AND DEVELOP PLANS FOR IMPLEMENTATION. RWGC DISTRIBUTED THE COMMUNITY HEALTH SURVEY TO PANHANDLE RESIDENTS IN OCTOBER AND NOVEMBER OF 2023 VIA PAPER AND ELECTRONIC SURVEYS. A COPY OF THE SURVEY CAN BE FOUND IN THE REGIONAL CHA. PAPER COPIES OF THE SURVEY WERE DISTRIBUTED BY HOSPITALS AND COMMUNITY-BASED ORGANIZATIONS. THE ELECTRONIC COPY WAS ADMINISTERED USING QUALTRICS AND SHARED ONLINE BY WEBSITE, SOCIAL MEDIA, AND EMAIL BY PPHD, LOCAL HOSPITALS, AND OTHER COMMUNITY ORGANIZATIONS. COUNTS AND PERCENTAGES FROM THE SURVEY RESPONSES WERE CALCULATED USING MICROSOFT EXCEL. THE INFORMATION INCLUDES RESPONSES FROM GARDEN COUNTY RESIDENTS AND THOSE WHO INDICATED THAT REGIONAL WEST WAS THEIR PRIMARY HEALTHCARE FACILITY. REGIONAL WEST GARDEN COUNTY PART V, SECTION B, LINE 6A: - BOX BUTTE GENERAL HOSPITAL- CHADRON COMMUNITY HOSPITAL- GORDON MEMORIAL HOSPITAL- KIMBALL HEALTH SERVICES- MORRILL COUNTY COMMUNITY HOSPITAL- PERKINS COUNTY HEALTH SERVICES- REGIONAL WEST MEDICAL CENTER- SIDNEY REGIONAL MEDICAL CENTER REGIONAL WEST GARDEN COUNTY PART V, SECTION B, LINE 6B: - RURAL NEBRASKA HEALTHCARE NETWORK- SCOTTS BLUFF COUNTY HEALTH DEPARTMENT- PANHANDLE PARTNERSHIP- PANHANDLE AREA DEVELOPMENT DISTRICT- NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES REGIONAL WEST GARDEN COUNTY PART V, SECTION B, LINE 11: NEEDS WERE ADDRESSED USING A PRIORITIZATION MATRIX TO HELP IDENTIFY THE AREAS OF NEED THAT MAY BE BETTER ADDRESSED BY OTHER ORGANIZATIONS OR AGENCIES IN THE REGION WITH A PRIMARY FUNCTION THAT DIRECTLY FOCUSED ON THOSE AREAS, AND ALSO TO IDENTIFY THE NEEDS THAT MOST CLOSELY ALIGNED WITH BOTH THE PURPOSE AND MISSION OF THE HOSPITAL AND COULD BE ADDRESSED EFFECTIVELY WITH THE RESOURCES THAT THE HOSPITAL HAS CURRENTLY. NEEDS THAT WERE NOT ADDRESSED IN THE IMPLEMENTATION STRATEGY EITHER WERE BETTER ADDRESSED BY OTHER AGENCIES OR ORGANIZATIONS IN THE REGION, OR WERE OUTSIDE OF THE SPECIFIC PURPOSE AND MISSION OF THE HOSPITAL AND COULD NOT BE ADDRESSED USING THE CURRENT RESOURCES. THERE WERE NO NEEDS IDENTITIED IN THE CURRENT CHNA THAT ARE NOT BEING ADDRESSED. NEEDS IDENTIFIED INCLUDE THE FOLLOWING: CHRONIC CARE IMPROVEMENTS, MENTAL HEALTH RESOURCES, AND ACCESS TO CARE.THE HOSPITAL CONTRACTED THE INHOUSE MENTAL HEALTH COUNSELOR TO DO OUTREACH AT OUR LOCAL ELEMENTARY SCHOOL, JUNIOR HIGH AND HIGH SCHOOL. IN ADDITION, THE INHOUSE MENTAL HEALTH COUNSELOR PROVIDED SERVICES IN OUR RURAL HEALTH CLINIC. THE FACILITY WORKS CLOSELY WITH THE LOCAL GARDEN COUNTY TRANSPORTATION SO PATIENTS CAN GET TO APPOINTMENTS ON TIME. THE FACILITY CONTINUES TO PROMOTE THE WALKING PATH ON THE GROUNDS TO SUPPORT WELLNESS FOR OUR COMMUNITY AND OUR STAFF. THE FACILITY USES MEDICAL MINUTES IN OUR LOCAL PAPER TO HIGHLIGHT SERVICES THAT ARE AVAILABLE IN OSHKOSH OR ARE PROVIDED BY VISITING PROVIDERS THAT COME FROM NORTH PLATTE AND SCOTTSBLUFF. REGIONAL WEST GARDEN COUNTY PART V, SECTION B, LINE 13H: SOME ITEMS CONSIDERED IN THE DETERMINATION, ACCORDING TO THE RWGC POLICY, ARE: ABILITY TO PAY, EXHAUSTION OF MEDICARE OR MEDICAID BENEFITS COMBINED WITH INABILITY TO PAY, DISCOUNTED CARE FOR THOSE UNABLE TO PAY; ALL OTHER POSSIBLE SOURCES OF COLLECTION USING SOUND BUSINESS PRACTICES HAVE BEEN MADE TO ENABLE THE PATIENT TO PAY; CARE PROVIDED TO A DECEASED PATIENT WITH NO ESTATE; OR CARE PROVIDED TO A PATIENT AFTER WHICH A NEGOTIATED SETTLEMENT WAS MADE FOR THE PATIENT'S ACCOUNT. 2 1 - REGIONAL WEST GARDEN COUNTY NURSING HOME 1100 WEST 2ND OSHKOSH NE 69154 ASSISTED LIVING FACILITY 2 - REGIONAL WEST GARDEN COUNTY CLINIC 1100 WEST 2ND OSHKOSH NE 69154 RURAL HEALTH CLINIC PART I, LINE 3C: IN ADDITION TO FEDERAL POVERTY GUIDELINES, THE ORGANIZATION USES ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS, AND RESIDENCY TO DETERMINE ELIGIBILITY FOR PROVIDING FREE OR DISCOUNTED CARE. SOME ITEMS CONSIDERED IN THE DETERMINATION, ACCORDING TO THE RWGC POLICY, ARE: ABILITY TO PAY, EXHAUSTION OF MEDICARE OR MEDICAID BENEFITS COMBINED WITH INABILITY TO PAY, DISCOUNTED CARE FOR THOSE UNABLE TO PAY; ALL OTHER POSSIBLE SOURCES OF COLLECTION USING SOUND BUSINESS PRACTICES HAVE BEEN MADE TO ENABLE THE PATIENT TO PAY; CARE PROVIDED TO A DECEASED PATIENT WITH NO ESTATE; OR CARE PROVIDED TO A PATIENT AFTER WHICH A NEGOTIATED SETTLEMENT WAS MADE FOR THE PATIENT'S ACCOUNT. 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. PART III, LINE 2: THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. RWGC DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON 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 8.6% OF INDIVIDUALS LIVING BELOW THE POVERTY LEVEL IN THE SERVICE AREA. PART III, LINE 4: PAGES 16 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS INCLUDES A FOOTNOTE THAT DESCRIBES IMPLICIT PRICE CONCESSIONS. PART III, LINE 8: APPROXIMATELY 50% OF REVENUE IS FROM PATIENTS PARTICIPATING IN THE MEDICARE PROGRAM, THUS PROVIDING SERVICES TO MEDICARE PATIENTS IS A PROMOTION OF HEALTHCARE SERVICES TO A SIGNIFICANT PORTION OF THE POPULATION OF THE COMMUNITY AND REGION THAT RWGC SERVES. MEDICARE COSTS ARE THE ALLOWABLE COSTS AS REPORTED ON THE RWGC COST REPORT FOR 2023. THE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE THESE ARE COSTS OVER AND ABOVE THE AMOUNT THAT MEDICARE PAYS. THESE SERVICES ARE INTEGRAL TO THE COMMUNITY AND WOULD NOT BE AVAILABLE TO THE COMMUNITY IF THEY WERE NOT PROVIDED BY THIS FACILITY. PART III, LINE 9B: THE COLLECTION POLICY AND THE RELATED CHARITY CARE POLICY STATES THAT SINCE A PATIENT'S ABILITY TO PAY FOR HEALTHCARE CAN CHANGE, A CHARITY DETERMINATION CAN BE MADE PRIOR TO, DURING OR FOLLOWING TREATMENT AT RWGC. ONCE A PATIENT HAS DEMONSTRATED OR COMMUNICATED A NEED THROUGH NONPAYMENT, OR THROUGH A COMPLETED FINANCIAL ASSISTANCE APPLICATION, THE FINANCIAL ASSISTANCE TEAM OF RWGC WILL REVIEW THE ACCOUNT AND BASED ON FEDERAL POVERTY GUIDELINES WILL MAKE A DETERMINATION OF WHETHER THE ACCOUNT QUALIFIES FOR CHARITY CARE TREATMENT. PART VI, LINE 2: THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVCES THROUGH THE RURAL HEALTH CLINIC AND EMERENCY ROOOM VISITS. THE FACILITY IS NOW PART OF AN ACCOUNTABLE CARE ORGANIZATION WHERE SEVERAL PUBLICATIONS GO OUT TO MEDICARE RECIPIENTS EACH YEAR HIGHLIGHTING SPECIFIC SERVICES. MEDICARE RECIPIENTS ARE ONE OF THE HOSPITAL'S LARGEST POPULATIONS SERVED. PART VI, LINE 3: AT THE TIME OF PRE-REGISTRATION BY PHONE, OR REGISTRATION ON THE DATE OF SERVICE, THE REGISTRATION CLERK MAKES PAYMENT ARRANGEMENTS WITH THE PATIENT OR GUARANTOR. THE STAFF ARE ALL TRAINED TO EXPLAIN THE FINANCIAL ASSISTANCE POLICY AND HELP THE PATIENT OR GUARANTOR WITH THE APPLICATION. SOCIAL SERVICES IS ALSO CONSULTED FOR HELP WITH THIS PROCESS AND ALSO HELPS WITH APPLYING FOR GOVERNMENT PROGRAMS THAT CAN HELP PAY FOR THE SERVICES. PART VI, LINE 4: RWGC SERVES GARDEN COUNTY NEBRASKA AND PARTS OF SURROUNDING COUNTIES (PRIMARILY DEUEL COUNTY). TOTAL POPULATION IN THE SERVICE AREA IS LESS THAN 5,000. THE COUNTY POPULATION CONTAINED 19.2% UNDER THE AGE OF 19, 15.6% FROM 20 TO 39, 31.3% FROM 40 TO 59, 25.4% FROM 60 TO 79, AND 8.5% WHO WERE 80 YEARS OF AGE OR OLDER. THE PERCENT OF THE POPULATION BELOW THE POVERTY LINE IS SLIGHTLY LESS THAN THE STATEWIDE AVERAGE, AND THE POVERTY RATE FOR CHILDREN UNDER AGE 18 IS ONE OF THE LOWEST IN THE REGION. PART VI, LINE 5: RWGC HAS PRIMARY CARE AND SPECIALTY CARE AVAILABLE THROUGH A RURAL HEALTH CLINIC ON SITE. ADDITIONAL SERVICES ARE ADDED AS AVAILABLE PRIMARILY THROUGH TELEMEDICINE. SERVICES ADDED RECENTLY INCLUDED CHIROPRACTIC CARE ON-SITE AND BEHAVIORAL HEALTH COUNSELING SERVICES ON-SITE. WE ARE LOOKING TO ADD A PAIN MANAGEMENT SPECIALIST THROUGH TELEMEDICINE SOON. IN ADDITION OUTREACH SERVICES TO SURROUNDING COMMUNITIES AND SENIOR CENTERS PROVIDES BLOOD PRESSURE CHECKS AND LAB DRAWS. WE ALSO PROVIDE SEVERAL REMOTE AREAS THAT SURROUND US WITH FLU SHOT CLINICS IN THE COMMUNITIES. WE ALSO PROVIDE EDUCATION THROUGH NEWSPAPER ARTICLES IN THE LOCAL NEWSPAPER. WE PLAN ON ADDING A WALKING TRACK AROUND THE HOSPITAL FOR COMMUNITY USE FOR WELLNESS. PART VI, LINE 6: THE AFFILIATED HEALTH CARE SYSTEM INCLUDES:REGIONAL WEST GARDEN COUNTY - CRITICAL ACCESS HOSPITALREGIONAL WEST HEALTH SERVICES - STRATEGIC PLANNING AND MANAGEMENTREGIONAL WEST MEDICAL CENTER - 182-BED HOSPITAL, LEVEL II TRAUMA CENTER, AND REGIONAL REFERRAL CENTERREGIONAL WEST PHYSICIANS CLINIC - MULTI-SPECIALTY MEDICAL GROUPREGIONAL WEST VILLAGE - INDEPENDENT AND ASSISTED LIVING CENTERREGIONAL WEST FOUNDATION - RAISES FUNDS, MANAGES INVESTMENTS, AND ADMINISTERS SCHOLARSHIP PROGRAMREGIONAL WEST HEALTH SERVICES AND AFFILIATES - 501(C)(9) ORGANIZATION PROVIDING EMPLOYEE HEALTH CAREREGIONAL CARE, INC. - A FOR-PROFIT ORGANIZATION PROVIDING TPA SERVICES. 0 1 0 0 0 0 0 0 0 MEL MCNEA PRESIDENT/CEO 0 419351 0 0 0 0 0 7477 0 14646 0 441474 0 0 AMANDA VICK FORMER OFFICER 0 328074 0 0 0 1350 0 38657 0 754 0 368835 0 0 LAURIE SOPER APRN 327277 0 0 0 0 0 11600 0 1781 0 340658 0 0 0 JOHN MENTGEN FORMER OFFICER 0 258367 0 0 0 2025 0 29712 0 9042 0 299146 0 0 MICHAEL ICKOWSKI TREASURER/CFO THRU 05/2023 0 226018 0 0 0 1350 0 44990 0 348 0 272706 0 0 BRAD HOWELL CEO - RWGC/DIRECTOR 177704 0 0 0 0 0 7189 0 3669 0 188562 0 0 0 ALAN TOWNSEND INTERIM TREASURER/CFO 184211 0 0 0 0 0 0 0 0 0 184211 0 0 0 KEVAN GEIGER EMT 151023 0 200 0 0 0 6158 0 15838 0 173219 0 0 0 ROBERT NOVAK PHYSICIAN 148749 0 0 0 0 0 0 0 4792 0 153541 0 0 0 PART I, LINE 3 THE CEO AND CFO ARE COMPENSATED BY REGIONAL WEST HEALTH SERVICES, A RELATED ORGANIZATION. METHODS USED TO ESTABLISH COMPENSATION FOR THESE INDIVIDUALS INCLUDE THE FOLLOWING: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: MICHAEL ICKOWSKI 25,275 AMANDA VICK 22,051 JOHN MENTGEN 16,050 SCHEDULE J, PART II: REGIONAL WEST HEALTH SERVICES, A RELATED ORGANIZATION, PAID COMMUNITY HOSPITAL CONSULTING, AN UNRELATED ORGANIZATION, $184,211 FOR SERVICES PROVIDED BY ALAN TOWNSEND IN HIS ROLE AS INTERIM CFO. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE SHALL HAVE THE POWER TO ACT FOR AND ON BEHALF OF THE CORPORATION AND ITS BOARD OF DIRECTORS AS NECESSARY AND REQUIRED BETWEEN REGULAR OR SPECIAL MEETINGS OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 6 REGIONAL WEST HEALTH SERVICES IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A REGIONAL WEST HEALTH SERVICES (RWHS), THE SOLE MEMBER, HAS THE ABILITY TO APPOINT 7 PERSONS TO THE BOARD OF DIRECTORS. THE REMAINING DIRECTORS MUST BE APPROVED BY RWHS. FORM 990, PART VI, SECTION A, LINE 7B REGIONAL WEST HEALTH SERVICES (RWHS), THE SOLE MEMBER, MUST APPROVE ALL MATTERS PERTAINING TO THE MERGER, CONSOLIDATION, LIQUIDATION OR AMENDMENT TO THE ARTICLES OF INCORPORATE OR BYLAWS OF THE CORPORATION. THE ANNUAL BUDGET OF THE CORPORATION IS ALSO SUBJECT TO THE APPROVAL OF RWHS. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD WILL HAVE AN OPPORTUNITY TO REVIEW DRAFTS ELECTRONICALLY PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL DISCLOSURE BY BOARD MEMBERS OF ANY CONFLICT OF INTEREST, AS SET FORTH IN THE POLICIES, IS REQUIRED. FOR ANY POSSIBLE CONFLICT OF INTEREST IDENTIFIED, THE REMAINING BOARD DETERMINES IF IT ACTUALLY CONSTITUTES A CONFLICT OF INTEREST WITHOUT THE CONFLICTED BOARD MEMBER PRESENT. IF A CONFLICT OF INTEREST IS DETERMINED TO EXIST, THE BOARD, LESS THE CONFLICTED MEMBER, WILL THEN DECIDE THE LEVEL OF INVOLVEMENT OF THE MEMBER IN DECISION MAKING FOR THE ENTITY, IF THERE IS AN ALTERNATIVE ARRANGEMENT THAT WILL ELIMINATE THE CONFLICT OF INTEREST, AND THE APPROPRIATENESS OF THE CONFLICTED MEMBER CONTINUING AS A BOARD MEMBER. FAILURE TO DISCLOSE A CONFLICT OF INTEREST CAN RESULT IN DISCIPLINARY AND CORRECTIVE ACTION FOR THE CONFLICTED MEMBER. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION PROCESS FOR TOP OFFICIAL: COMPENSATION FOR THE CEO IS DETERMINED BY THE COMPENSATION COMMITTEE OF THE RWHS BOARD. THE DETERMINATION IS BASED ON MARKET DATA AND RECOMMENDATIONS FROM AN INDEPENDENT CONSULTING FIRM WHO COLLECTS THAT INFORMATION FOR COMPARISON PURPOSES. MINUTES ARE KEPT OF THESE MEETINGS. COMPENSATION PROCESS FOR OFFICERS: COMPENSATION FOR OTHER OFFICERS IS REVIEWED BY AN INDEPENDENT CONSULTANT ON AN ANNUAL BASIS TO ENSURE THE COMPENSATION PLAN MEETS REASONABLENESS TESTING COMPARED TO MGMA COMPENSATION SURVEY. THE COMPENSATION MODEL IS ALSO REVIEWED BY LEGAL COUNSEL FOR REASONABLENESS AND COMPLIANCE WITH IRS REQUIREMENTS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND THE CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,718,901. MANAGEMENT AND GENERAL EXPENSES 404,316. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,123,217. SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 182,377. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 182,377. CONSULTING: PROGRAM SERVICE EXPENSES 21,467. MANAGEMENT AND GENERAL EXPENSES 26,448. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 47,915. PART XII, LINE 2C THE CFO OF REGIONAL WEST HEALTH SERVICES, THE SOLE MEMBER OF THE ORGANIZATION, IS RESPONSIBLE FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT PUBLIC ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. REGIONAL WEST HEALTH SERVICES 4021 AVENUE B SCOTTSBLUFF NE 69361 363314157 ADMIN SUPPORT NE 501(C)(3) LINE 12B, II N/A 0 REGIONAL WEST MEDICAL CENTER 4021 AVENUE B SCOTTSBLUFF NE 69361 470385129 HOSPITAL NE 501(C)(3) LINE 3 REGIONAL WEST HEALTH SERVICES 0 REGIONAL WEST FOUNDATION 4021 AVENUE B SCOTTSBLUFF NE 69361 237171022 FUNDRAISING NE 501(C)(3) LINE 12A, I REGIONAL WEST HEALTH SERVICES 0 REGIONAL WEST VILLAGE 4021 AVENUE B SCOTTSBLUFF NE 69361 363314162 RETIREMENT FACILITY NE 501(C)(3) LINE 10 REGIONAL WEST HEALTH SERVICES 0 REGIONAL WEST PHYSICIANS CLINIC 4021 AVENUE B SCOTTSBLUFF NE 69361 363314159 DR. CLINICS NE 501(C)(3) LINE 10 REGIONAL WEST HEALTH SERVICES 0 REGIONAL WEST HEALTH SERVICES & AFFILIATES 4021 AVENUE B SCOTTSBLUFF NE 69361 470658690 HEALTH PLAN NE 501(C)(9) REGIONAL WEST HEALTH SERVICES 0 REGIONAL CARE INC 4201 AVENUE B SCOTTSBLUFF NE 69361 470760050 TPA NE N/A C 0 0 0 0 0 1 0 0 0 0 0 1 0 0 1 1 1 0 1 0 REGIONAL WEST HEALTH SERVICES & AFFILIATE R 980329 CASH