TY 2022 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) BRETT BONWELL...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(2) JEFF GOKIE...................................................................... CHAIRMAN	1.00 ................. 0.00	X	X	0	0
(3) JULIE HANEY...................................................................... VICE CHAIRMAN	1.00 ................. 0.00	X	X	0	0
(4) STAN EMERSON...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(5) JOHN PAVLIK...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(6) CRAIG PEKNY MD...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(7) SARAH PILLEN...................................................................... TREASURER	1.00 ................. 0.00	X	X	0	0
(8) ABBIE TESSENDORF...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(9) DANIEL ROSENQUIST MD...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(10) TIM TOOLEY...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(11) CHARLES SEADSCHLAG...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(12) MICHAEL HANSEN...................................................................... PRESIDENT/CEO/SECRETARY	40.00 ................. 0.00	X	X	585,154	120,449
(13) JOE CITTA III MD...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(14) DUSTIN VOLKMER MD...................................................................... DIRECTOR (END 9/2022)	1.00 ................. 0.00	X		0	0
(15) AMY BLASER...................................................................... VP BUSINESS DEVELOPMENT	40.00 ................. 0.00		X	233,198	67,925
(16) CHAD VAN CLEAVE...................................................................... VP FINANCE	40.00 ................. 0.00		X	268,202	68,657
(17) SCOTT MESSERSMITH...................................................................... VP OPERATIONS	40.00 ................. 0.00		X	230,609	67,203

(A) Name and business address	(B) Description of services	(C) Compensation
JE DUNN CONSTRUCTION COMPANY 1001 LOCUST ST KANSAS CITY,MO64106	CONSTRUCTION	29,528,245
AMERISOURCE BERGEN DRUG CORP 27550 NETWORK PLACE CHICAGO,IL60673	PHARMACEUTICALS	5,058,762
FOCUSONE SOLUTIONS LLC PO BOX 850861 MINNEAPOLIS,MN55485	CONTRACTED STAFFING	4,215,045
CARDIO SOLUTIONS PO BOX 639028 CINCINNATI,OH45263	CONTRACTED STAFFING	3,390,998
RURAL PARTNERS IN MEDICINE LLC 8181 ARISTA PLACE SUITE 100 BROOMFIELD,CO80021	CONTRACTED STAFFING	2,793,058
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 105

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public
Inspection

Name of the organization

COLUMBUS COMMUNITY HOSPITAL INC

Employer identification number

47-0542043

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2022

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2022 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2022. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2021. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990) 2022

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2022 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2021 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2022 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2021 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2022. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2021. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2022

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2022

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2022

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2022

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2022 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2022	(iii) Distributable Amount for 2022
1 Distributable amount for 2022 from Section C, line 6
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2022:
a From 2017.......
b From 2018.......
c From 2019.......
d From 2020.......
e From 2021.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2022 distributable amount
i Carryover from 2017 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2022 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2022 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2022, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2022. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2023. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2018.....
b Excess from 2019.....
c Excess from 2020.....
d Excess from 2021.....
e Excess from 2022.....

Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2022

Name of the organization

COLUMBUS COMMUNITY HOSPITAL INC

Employer identification number

47-0542043

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990) (2022)

Schedule B (Form 990) (2022) Page 2

Name of organization COLUMBUS COMMUNITY HOSPITAL INC

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2022)

Schedule B (Form 990) (2022)

Page 3

Name of organization COLUMBUS COMMUNITY HOSPITAL INC		Employer identification number 47-0542043

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2022)

Schedule B (Form 990) (2022)

Page 4


Name of organization COLUMBUS COMMUNITY HOSPITAL INC			Employer identification number 47-0542043
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2022)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

COLUMBUS COMMUNITY HOSPITAL INC

Employer identification number

47-0542043

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990) 2021

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2021

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Yes

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

9,482

Total. Add lines 1c through 1i ....................................................................................................

9,482

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	DIRECT CONTACT WITH STATE AND FEDERAL LEGISLATORS, THEIR STAFF AND OTHER GOVERNMENT OFFICIALS. WE HAVE ADVOCATED FOR RURAL HEALTHCARE LEGISLATION (E.G. RURAL HOSPITAL DEMONSTRATION PROGRAM). DUES PAID TO AMERICAN HOSPITAL ASSOCIATION ALLOCATED TO LOBBYING $3,969.44 AND DUES PAID TO NEBRASKA HOSPITAL ASSOCIATION ALLOCATED TO LOBBYING $5,512.85

Schedule C (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

COLUMBUS COMMUNITY HOSPITAL INC

Employer identification number

47-0542043

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2021

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	2,600,002	2,580,574	2,456,387	1,912,239	1,863,805
b	Contributions ...	18,508	19,428	124,187	544,148	48,434
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	2,618,510	2,600,002	2,580,574	2,456,387	1,912,239

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

100.000 %

Term endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

Yes

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	11,149,790		11,149,790
b	Buildings ....	106,720,429	49,213,604	57,506,825
c	Leasehold improvements
d	Equipment ....	58,919,772	33,081,242	25,838,530
e	Other .....	40,788,458	5,935,570	34,852,888
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				129,348,033

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2021

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

PART V, LINE 4:

ENDOWMENT FUNDS ARE HELD AND MAINTAINED BY COLUMBUS COMMUNITY HOSPITAL FOUNDATION. THE ENDOWMENT FUNDS EXIST IN SUPPORT OF IMPROVED HEALTH SERVICES BY COLUMBUS COMMUNITY HOSPITAL.

PART X, LINE 2:

THE HOSPITAL ADOPTED FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES - AN INTERPRETATION OF FASB STATEMENT NO, 109. FIN 48 PROVIDES SPECIFIC GUIDANCE ON HOW TO ADDRESS UNCERTAINTY IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES, PRESCRIBING RECOGNITION THRESHOLDS AND MEASUREMENT ATTRIBUTES. THE ADOPTION OF FIN 48 BY COLUMBUS COMMUNITY HOSPITAL DID NOT HAVE A MATERIAL IMPACT ON THE HOSPITAL'S FINANCIAL POSITION, RESULTS OF OPERATIONS, OR CASH FLOWS. IN FISCAL YEARS ENDING 2023 AND 2022, MANAGEMENT DETERMINED THAT THERE ARE NO INCOME TAX POSITIONS REQUIRING RECOGNITION IN THE FINANCIAL STATEMENTS.

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

COLUMBUS COMMUNITY HOSPITAL INC

Employer identification number

47-0542043

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 13000.0000000000 %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	0	0	382,759		382,759	0.270 %
b	Medicaid (from Worksheet 3, column a) . . . . .	0	0	15,047,259	8,802,276	6,244,983	4.440 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .			15,430,018	8,802,276	6,627,742	4.710 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).		34,339	152,216	12,615	139,601	0.100 %
f	Health professions education (from Worksheet 5) . . .		1,566	9,418	9,796	-378	0 %
g	Subsidized health services (from Worksheet 6) . . . .		117	4,523		4,523	0 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .		300	488		488	0 %
j	Total. Other Benefits . .		36,322	166,645	22,411	144,234	0.100 %
k	Total. Add lines 7d and 7j .		36,322	15,596,663	8,824,687	6,771,976	4.810 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022

Schedule H (Form 990) 2022

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing	854	15,551		15,551	0.010 %
2	Economic development
3	Community support	940	178,626	125,355	53,271	0.040 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	500	7,000		7,000	0 %
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	2,294	201,177	125,355	75,822	0.050 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

8,914,334

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

32,387,358

Enter Medicare allowable costs of care relating to payments on line 5.....

46,772,525

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-14,385,167

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
11 HEALTHPARK LLC	PROPERTY MANAGEMENT	22.920 %	0 %	77.080 %
22 ZARZ LLC	PROPERTY MANAGEMENT	0.880 %	0 %	99.120 %
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2022

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)					Other (describe)
1	COLUMBUS COMMUNITY HOSPITAL INC 4600 38TH STREET COLUMBUS,NE686011800 WWW.COLUMBUSHOSP.ORG 630001	X	X	X	47 BED ACUTE CARE HOSPITAL W/ 24 HR ER SERVICES

Schedule H (Form 990) 2022

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	COLUMBUS COMMUNITY HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SECTION C

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SECTION C

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2022

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	COLUMBUS COMMUNITY HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 130.000000000000%
and FPG family income limit for eligibility for discounted care of 200.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE SECTION C

The FAP application form was widely available on a website (list url):

SEE SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE SECTION C

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2022

Page 6

Part VFacility Information (continued)

Billing and Collections

	COLUMBUS COMMUNITY HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2022

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	COLUMBUS COMMUNITY HOSPITAL INC
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2022

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
COLUMBUS COMMUNITY HOSPITAL, INC	PART V, SECTION B, LINE 5: THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP (MAPP) PROCESS WAS DEVELOPED BY AND IS RECOMMENDED FOR COMMUNITY ASSESSMENT BY THE NATIONAL ASSOCIATION OF CITY AND COUNTY HEALTH OFFICIALS (NACCHO) AND THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC). THE NEBRASKA RURAL HEALTH ASSOCIATION ALSO RECOMMENDED MAPP AS A COMMUNITY ASESSMENT FOR NEBRASKA'S COMMUNITY, NON PROFIT HOSPITALS IN ITS COMMUNITY HEALTH ASSESSMENT COLLABORATIVE PRELIMINARY RECOMMENDATIONS. THIS WAS SO THE HOSPITALS COULD COMPLY WITH NEW REQUIREMENTS FOR TAX-EXEMPT STATUS ENACTED BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (SEPTEMBER 2011).MAPP ALLOWS FOR INPUT FROM PARTIES WHO REPRESENT BROAD INTERESTS IN THE COMMUNITIES. INPUT FROM DIVERSE SECTORS INCLUDING MEDICALY UNDERSERVED, LOW-INCOME, MINORITY POPULATIONS AND INDIVIDUALS FROM DIVERSE AGE GROUPS WAS OBTAINED THROUGH SURVEYS, TARGETED FOCUS GROUPS, OPEN PUBLIC MEETINGS AND TARGETED INVITATIONS TO COMMUNITY LEADERS AND AGENCIES.THE HOSPITAL'S PARTICIPATION IN THE CURRENT MAPP ASSESSMENT IS THE MOST THOROUGH TO DATE, WITH MORE THAN 100 INDIVIDUALS IN THE DISTRICT PARTICIPATING IN THE PROCESS. THIS DOES NOT COUNT THE 1,000 INDIVIDUAL SURVEYS OR FOCUS GROUP PARTICIPANTS.
COLUMBUS COMMUNITY HOSPITAL, INC	PART V, SECTION B, LINE 6A: - CHI HEALTH, SCHUYLER- GENOA COMMUNITY HOSPITAL- BOONE COUNTY HEALTH CENTER
COLUMBUS COMMUNITY HOSPITAL, INC	PART V, SECTION B, LINE 6B: - EAST CENTRAL DISTRICT HEALTH DEPARTMENT- GOOD NEIGHBOR COMMUNITY HEALTH CENTER
COLUMBUS COMMUNITY HOSPITAL, INC	PART V, SECTION B, LINE 7D: THE DETAILED ASSESSMENT AND RELATED COMPONENTS ARE AVAILABLE ON THE DISTRICT'S WEBSITE AT:HTTPS://WWW.COLUMBUSHOSP.ORG/FOR-THE-COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
SCHEDULE H, PART V, LINE 9	UNDER THE 501(R) REGULATIONS, THE IMPLEMENTATION STRATEGY FOR THE 2021 CHNA WAS SUPPOSED TO BE ADOPTED BY SEPTEMBER 15, 2022. DUE TO UNFORESEEN DELAYS, THE IMPLEMENTATION WAS NOT ADOPTED UNTIL FEBRUARY 6, 2023.
SCHEDULE H, PART V, LINE 10A	HTTPS://WWW.COLUMBUSHOSP.ORG/FOR-THE-COMMUNITY/CHIP-IMPLEMENTATION-PLAN-2021
SCHEDULE H, PART V, SECTION B, LINE 11	IN 2021, COLUMBUS COMMUNITY HOSPITAL (CCH) CONDUCTED - IN COLLABORATION WITH THE EAST CENTRAL DISTRICT HEALTH DEPARTMENT (ECDHD) AND OTHER HOSPITAL FACILITIES - A COMPREHENSIVE, JOINT CHNA FOR THE PARTICIPANTS' SHARED COMMUNITIES OF BOONE, COLFAX, NANCE, AND PLATTE COUNTIES. THE CHNA IDENTIFIED THE FIVE AREAS OF GREATEST CONCERN FOR RESIDENTS IN THESE AREAS: MENTAL HEALTH DRUG ABUSE AND MISUSEONGOING DISEASES SUCH AS HEART DISEASE, STROKE, HIGH BLOOD PRESSURE, DIABETES, CANCER AND RESPIRATORY PROBLEMSFINDING HOUSING THAT IS SAFE AND AFFORDABLE BULLYING.CCH HAS CHOSEN TO FOCUS ON ADDRESSING FOUR OF THE FIVE AREAS ON CONCERN. FOR HOUSING THAT IS SAFE AND AFFORDABLE, THE CITY OF COLUMBUS, COLUMBUS AREA CHAMBER OF COMMERCE AND HABITAT FOR HUMANITY ARE ALREADY WORKING ON THAT NEED, SO CCH IS FOCUSING ITS RESOURCES ELSEWHERE.THE HOSPITAL WILL WORK HAND IN HAND WITH THE ECDHD AND OTHER HEALTH-AND BUSINESS-RELATED AGENCIES TO ADDRESS THESE COMMUNITY NEEDS. SPECIFICALLY, CCH WILL TAKE THE LEAD IN ADDRESSING THE IDENTIFIED NEEDS OF ACCESS TO MENTAL HEALTH CARE, TREATMENT FOR DRUG ABUSE AND MISUSE, AND TREATMENT FOR ONGOING DISEASES.MENTAL HEALTH CAREPLATTE COUNTY AND THE SURROUNDING AREAS CONTINUE TO EXPERIENCE AN INCREASE IN MENTAL HEALTH CARE NEEDS-BOTH INPATIENT AND OUTPATIENT. CCH HAS TAKEN THE LEAD IN THE FOLLOWING:OBJECTIVE: ENHANCE AND EXPAND MENTAL HEALTH RESOURCES IN OUR COMMUNITY.ACTION STEP: CCH LED A COMMUNITY HEALTH INVENTORY OF WHAT EXISTS FOR MENTAL HEALTH CARE IN OUR AREA, COMMISSIONING A THIRD-PARTY CONSULTANT SURVEY OF ACCESS BEHAVIORAL HEALTH IN THE GENERAL AREA. THIS SURVEY QUANTIFIED THE MANPOWER IN THE AREA AND LOOKED AT LEAD TIME TO APPOINTMENTS.OBJECTIVE: RECRUIT TOP-LEVEL MENTAL HEALTH PHYSICIANS AND OTHER PROVIDERS TO THE AREA.ACTION STEP: CCH CONTINUED TO EXPAND COLUMBUS PSYCHIATRY CLINIC, WHICH OPENED IN 2019. THE CLINIC NOW HAS MULTIPLE PSYCHIATRISTS, NURSE PRACTITIONERS AND LICENSED INDEPENDENT MENTAL HEALTH PROVIDERS. CCH WORKED WITH BRYAN TELEHEALTH TO CREATE ACCESS TO A WIDE VARIETY OF MENTAL HEALTH EXPERTS.OBJECTIVE: CREATE AN OPTION FOR TOP-LEVEL MENTAL HEALTH CARE FOR THE GERIATRIC POPULATION.ACTION STEP: IN 2021, CCH OPENED A 10-BED SENIOR BEHAVIORAL HEALTH INPATIENT UNIT THAT EXCLUSIVELY SERVES OLDER ADULTS.OBJECTIVE: EXPAND OPTIONS FOR COMMUNITY EDUCATION ON MENTAL HELATH INITIATIVES.ACTION STEP: CCH CONTINUALLY USES EXPERTS FROM THE OUTPATIENT CLINIC TO DEVELOP EDUCATIONAL PROGRAMMING FOR THE COMMUNITY, INCLUDING SEMINARS ON ADHD, CHILDREN AND SCREEN TIME, STRESS IN CHILDREN.DRUG ABUSE AND MISUSECCH WILL WORK TO REDUCE SUBSTANCE ABUSE TO PROTECT THE HEALTH, SAFETY AND QUALITY OF LIFE FOR ALL.OBJECTIVE: CREATE AWARENESS ABOUT ANTIBIOTICS USE AND ABUSE.ACTION STEP: CCH HAS CONTINUED A PUBLIC EDUCATION CAMPAIGN THAT TEACHES OUR COMMUNITY ABOUT PROPER ANTIBIOTICS USE. WHILE ANTIBIOTICS ARE IMPORTANT HEALTH CARE TOOLS, THEY SHOULD ONLY BE USED FOR TREATING CERTAIN INFECTIONS CAUSED BY BACTERIA.OBJECTIVE: OFFER NON-ADDICTIVE OPTIONS FOR PAIN RELIEF.ACTION STEP: CCH CONTINUES TO EXPAND ITS USE OF NON-OPIOID PAIN MANAGEMENT. THE HOSPITAL'S ANESTHESIA DEPARTMENT WAS ONE OF THE FIRST IN THE STATE TO OFFER THE IOVERA TREATMENT. THIS CLINICALLY PROVEN, NON-OPIOID PAIN MANAGEMENT SOLUTION USES THE BODY'S NATURAL RESPONSE TO COLD TO RELIEVE PAIN.CCH CONTINUES TO DELIVER MATERIALS AND PROVIDE PRESENTATIONS FOR PROVIDERS ACROSS THE AREA RELATED TO OPIOID INTERVENTION.CCH CONTINUES TO OFFER TELEMEDICINE OPTIONS FOR OPIOID INTERVENTION.TREATMENT FOR ONGOING DISEASESDISEASES SUCH AS HEART DISEASE, DIABETES, STROKE, CANCER, HIGH BLOOD PRESSURE AND DIABETES CONTINUE TO TAKE LIVES AND REDUCE QUALITY OF LIFE. CCH HAS EMBARKED ON MANY COMMUNITY PARTNERSHIPS TO TACKLE THESE DISEASES HEAD-ON.OBJECTIVE: PREVENT DIABETES AND IMPROVE ADVANCED CARE FOR THOSE WITH THE DISEASE.ACTION STEP: CCH PROVIDES COMPREHENSIVE DIABETES EDUCATION FOR MEMBERS OF THE COMMUNITY. IT OFFERS SPECIALIZED CLASSES AND HOSTS DIABETES EVENTS FOR THE PUBLIC AT LEAST TWICE A YEAR.OBJECTIVE: DECREASE INCIDENCES OF HEART DISEASE IN THE COMMUNITY.ACTION STEP: IN 2022, CCH OPENED A CARDIAC CATHETERIZATION LAB AT THE HOSPITAL THAT ALLOWS DOCTORS TO PERFORM LIFESAVING CARDIAC PROCEDURES. IT ALSO OPENED COLUMBUS CARDIOLOGY CLINIC, WHICH EDUCATES THE COMMUNITY ABOUT SIGNS OF HEART DISEASE AND STEPS PEOPLE CAN TAKE TO IMPROVE THEIR HEART HEALTH.COLUMBUS CARDIOLOGY CLINIC WORKS WITH LOCAL EMPLOYERS TO OFFER FREE HEART-HEALTH SCREENINGS ON SITE, SO THAT EMPLOYEES CAN LEARN WHETHER THEY ARE AT RISK FOR A HEART EVENT.OBJECTIVE: DECREASE OBESITY AND PROVIDE OPTIONS FOR PHYSICAL ACTIVITY IN THE COMMUNITY.ACTION STEP: IN JANUARY 2024, THE HOSPITAL OPENED A 240,000-SQUARE-FOOT FIELDHOUSE, WHICH OFFERS THE COMMUNITY A PLETHORA OF INDOOR RECREATIONAL OPTIONS. IN AN AREA OF THE COUNTRY WHERE PEOPLE SPEND MUCH OF THEIR TIME INDOORS FOR HALF THE YEAR, THE COLUMBUS FIELDHOUSE ENCOURAGES PHYSICAL ACTIVITY NO MATTER THE WEATHER, WHICH DECREASES COMMUNITY MEMBERS' RISK FOR HEART DISEASE, STROKE AND OTHER CHRONIC DISEASES.UP UNTIL DECEMBER 2023, CCH OFFERED WALK WITH A DOC ON A MONTHLY BASIS. IT WAS A WALKING PROGRAM THAT TOOK PLACE AT VARIOUS LOCATIONS AROUND THE COMMUNITY. LOCAL HEALTH CARE PROVIDERS PRESENTED A HEALTH-BASED TOPIC TO THE GROUP, FOLLOWED BY A 45-50 MINUTE WALK WITH THE PROVIDER. THE PURPOSE OF THE WALK WAS TO ENCOURAGE PHYSICAL ACTIVITY AND ALLOW COMMUNITY MEMBERS TO MEET NEW AND ESTABLISHED PHYSICIANS AND HEALTH CARE PROVIDERS FROM AROUND THE COLUMBUS AREA.CCH CONTINUES TO WORK WITH LOCAL RESTAURANTS, ENCOURAGING THEM TO ADD HEALTHY FOODS TO THEIR MENUS SO MEMBERS OF THE COMMUNITY HAVE OPTIONS WHEN THEY GO OUT TO EAT.CCH CONTINUES TO WORK WITH LOCAL CHURCHES TO OFFER THE WALK TO BETHLEHEM AND THE WALK TO JERUSALEM, WALKING PROGRAMS THAT ENCOURAGE PARTICIPANTS TO WALK VIRTUALLY THE DISTANCE FROM COLUMBUS TO BETHLEHEM AND JERUSALEM, RESPECTIVELY.OBJECTIVE: PROVIDE COMPREHENSIVE CARE FOR CANCER PATIENTS.ACTION STEP: IN 2022, THE HOSPITAL ACQUIRED COLUMBUS CANCER CARE, AN OUTPATIENT CLINIC THAT PROVIDES RADIATION ONCOLOGY SERVICES. THIS IS THE FIRST STOP TOWARD CREATING A CANCER CENTER CONCEPT - A FACILITY WHERE COMMUNITY MEMBERS CAN RECEIVE ALL THE CANCER SERVICES THEY NEED IN ONE LOCATION.BULLYINGBULLYING - BOTH IN-PERSON AND ONLINE - IS AN ONGOING PROBLEM FOR CHILDREN OF ALL AGES. CCH HAS PARTNERED WITH SMART GEN SOCIETY TO SPECIFICALLY ADDRESS CHALLENGES FACING CHILDREN IN THE DIGITAL LANDSCAPE.OBJECTIVE: DECREASE SOCIAL MEDIA BULLYINGACTION STEP: CCH BROUGHT IN EXPERTS FROM SMART GEN SOCIETY, AN ORGANIZATION THAT OFFERS PREVENTIVE WORKSHOPS AND RESOURCES FOR PARENTS, TEACHERS, SPORTS TEAMS AND BUSINESSES. THESE EXPERTS PROVIDED EDUCATIONAL PROGRAMMING THAT FOCUSED ON DECREASING BULLYING IN THE DIGITAL LANDSCAPE.
SCHEDLE H, PART V, SECTION B, LINE 11 (CONT'D)	OTHER NEEDS ADDRESSED:ACCESS TO HEALTH CAREOBJECTIVE: UPDATE OUR FACILITIES TO OFFER OUR PATIENTS THE MOST COMPREHENSIVE, HIGH-QUALITY CAREACTION STEP: IN FALL 2021, CCH COMPLETED CONSTRUCTION ON A $35-MILLION RENOVATION PROJECT THAT STARTED IN APRIL 2019. THE LARGEST STRUCTURAL CHANGE AS PART OF THE PROJECT WAS A NEW, EXPANDED SURGICAL SERVICES AREA. IT INCLUDES OPERATING ROOMS, A PRE & POST-OP AREA, A NEW OP SURGERY DEPARTMENT AND A POST ANESTHESIA CARE UNIT. THE HOSPITAL'S MATERNAL CHILD HEALTH DEPARTMENT ALSO RECEIVED UPGRADES AS PART OF THE RENOVATION AND THE UPDATED UNIT OPENED IN MARCH 2021. IT NOW OCCUPIES 18,400 SQUARE FEET, WHICH IS NEARLY DOUBLE ITS PREVIOUS SIZE. THE SECURE UNIT INCLUDES 8 LDRP ROOMS; A SURGICAL SUITE; 4 POSTPARTUM ROOMS; AND A LARGER NICU. A SEPARATE ADDITION ON THE FIRST FLOOR HOUSES SEVERAL DEPARTMENTS THAT WERE RELOCATED, INCLUDING A RENOVATED CARDIOPULMONARY REHAB DEPARTMENT, WHICH NOW OFFERS MORE SPACE FOR THE DEPARTMENT'S EXERCISE EQUIPMENT. SEVERAL OTHER AREAS OF THE HOSPITAL WERE ALSO RENOVATED OR IMPROVED DURING THE PROJECT, INCLUDING THE RADIOLOGY DEPARTMENT. AS PART OF THE PROJECT, CCH OPENED A 10-BED SENIOR BEHAVIORAL HEALTH UNIT, WHICH OFFERS MENTAL HEALTH CARE FOR PATIENTS AGES 65 AND OLDER. SINCE THE UNIT OPENED IN SEPTEMBER 2021, IT HAS PROVIDED MUCH-NEEDED MENTAL HEALTH SERVICES TO THE COMMUNITY. IN SPRING 2022, CCH OPENED A NEW 1,150-SQUARE-FOOT CARDIAC CATH LAB, WHICH HAS THE LATEST IMAGING AND MONITORING TECHNOLOGY. IT WAS PART OF THE EXPANSION AND RENOVATION PROJECT. THE CATH LAB PUTS TIME ON A PATIENT'S SIDE. IT ALLOWS DOCTORS TO PERFORM MINIMALLY INVASIVE TESTS AND PROCEDURES TO DIAGNOSE AND TREAT HEART DISEASE ON-SITE, REDUCING THE TIME FROM DIAGNOSIS TO RESTORED BLOOD FLOW. IN THE PAST, MEDICAL PROFESSIONALS NEEDED TO TRANSPORT CRITICALLY ILL PATIENTS TO LARGE FACILITIES THAT HAD CARDIAC CATH LABS.OBJECTIVE: BRING IN NEW TECHNOLOGY TO OFFER INCREASED SERVICES IN OUR COMMUNITYACTION STEP: THE CONSTRUCTION PROJECT CCH STARTED IN 2019 AND COMPLETED IN 2021 HAS INTRODUCED NEW AND IMPROVED TECHNOLOGY AND EQUIPMENT THROUGHOUT THE HOSPITAL. FOR EXAMPLE, RENOVATIONS IN THE RADIOLOGY DEPARTMENT ALLOWED FOR THE ADDITION OF A NEW SYSTEM FOR INTERVENTIONAL RADIOLOGY AND CARDIOLOGY PROCEDURES, A NEW CT SCANNER THAT OFFERS SHORTER SCAN TIMES AND IMPROVED IMAGING, A NEW MRI MACHINE AND NEW EQUIPMENT FOR TOMOSYNTHESIS SCANS AND HIGH-DEFINITION BREAST BIOPSIES. IN AUGUST 2021, CCH BECAME ONE OF JUST 2 HOSPITALS IN THE STATE TO START OFFERING INSPIRE SURGERY, AN OPTION FOR PEOPLE WHO SUFFER FROM SLEEP APNEA. THE SURGERY IMPLANTS A SMALL DEVICE IN PATIENTS' CHEST THAT HELPS THEM BREATHE WHILE THEY SLEEP. IT IS AN EFFECTIVE ALTERNATIVE TO CPAP MACHINES. IN SEPTEMBER 2021, THE HOSPITAL BEGAN PERFORMING SURGERIES USING THE DA VINCI XI ROBOTIC SYSTEM. THE SYSTEM ALLOWS FOR GREATER CAPABILITIES IN THE OPERATING ROOM WHILE PROVIDING A MINIMALLY INVASIVE SURGERY OPTION FOR PATIENTS. OBJECTIVE: EXPAND CANCER CARE OFFERINGS IN THE COMMUNITYACTION STEP: TO BETTER SERVE AREA RESIDENTS WHO HAVE BEEN DIAGNOSED WITH CANCER, CCH DEVELOPED A PATIENT NAVIGATION PROGRAM & CREATED THE POSITIONS OF ONCOLOGY NURSE NAVIGATOR & ONCOLOGY SOCIAL WORKER. IN DECEMBER 2021, CCH ACQUIRED COLUMBUS CANCER CARE, A RADIATION ONCOLOGY PRACTICE. THIS IS A CRUCIAL FIRST STEP TOWARD CREATING A CANCER CENTER.OBJECTIVE: RECRUIT QUALITY PHYSICIANS TO MEET THE GROWING NEEDS OF THE COMMUNITIES WE SERVEACTION STEP: PHYSICIAN AND MIDLEVEL RECRUITMENT; 2021: GROSS 37, NET 30, 2022; GROSS 42, NET 42.OBJECTIVE: ENHANCE HEALTH CARE OFFERINGS BY EXPANDING TELEHEALTH SERVICESACTION STEP: CCH CONTINUED TO OFFER THE TELESTROKE PROGRAM, E-MENTAL HEALTH TRIAGE & THE TELESTEWARDSHIP PROGRAM. THESE PROGRAMS ALLOW CCH PATIENTS TO INTERACT WITH HEALTH SPECIALISTS IN LARGER COMMUNITIES. TELESTROKE ALLOWS CCH PATIENTS TO CONSULT WITH A NEBRASKA MEDICINE NEUROLOGIST WITHOUT HAVING TO LEAVE COLUMBUS. OBJECTIVE: INCREASE ACCESS TO CANCER SCREENINGSACTION STEP: CCH OFFERS LOW-DOSE CT LUNG SCREENINGS TO QUALIFYING PATIENTS WHO WERE REFERRED BY THEIR DOCTOR. CCH'S COLUMBUS ENT CLINIC HAS ALSO OFFERED ORAL, HEAD & NECK CANCER SCREENINGS.OBJECTIVE: MAKE THE EHEALTH LIBRARY ON THE CCH WEBSITE A GOOD RESOURCE FOR THE PUBLICACTION STEP: THE EHEALTH LIBRARY & THE CCH WEBSITE CONTINUE TO BE UPDATED WITH THE NEWEST INFORMATION ON SERVICE LINES & RESOURCES. IT CONTINUES TO BE A REPUTABLE RESOURCE FOR ALL.OBJECTIVE: EXPAND THE VISITING PHYSICIANS CLINIC TO INCREASE OFFICE HOURS AND PHYSICIAN RECRUITMENT FOR MULTIPLE SPECIALTIES AND LOCAL PRIMARY CARE CLINICS.ACTION STEP: THE HOSPITAL CONTINUES ITS PHYSICIAN RECRUITMENT AND OFFERS INCREASED ACCESS TO THE VISITING PHYSICIANS CLINIC.OBJECTIVE: BRING ADDITIONAL MEDICAL SERVICES TO THE COMMUNITY BY OPENING OR ACQUIRING NEW CLINICSACTION STEP: IN JUNE 2021, CCH ACQUIRED COLUMBUS SURGERY CENTER, A FACILITY THAT OFFERS OPHTHALMOLOGY, PAIN AND ENDOSCOPY PROCEDURES. DR. PETER DIEDRICHSEN, A GENERAL OPHTHALMOLOGIST WHO OPENED THE CENTER, WANTED TO TRANSITION OWNERSHIP. HOSPITAL LEADERSHIP FELT THAT PURCHASING THE PRACTICE WOULD ALLOW CONTINUED PATIENT CARE AT THE CENTER AND EXPAND THE HOSPITAL'S SERVICES LINES TO INCLUDE OPTHALMOLOGY. IN DECEMBER 2021, CCH ACQUIRED COLUMBUS CANCER CARE, A RADIATION ONCOLOGY PRACTICE. THIS IS A CRUCIAL FIRST STEP TOWARD CREATING A CANCER CENTER. IN SPRING 2022, THE HOSPITAL ANNOUNCED A PARTNERSHIP WITH THE LINDSAY AREA INVESTMENT CLUB TO BRING A PRIMARY CARE CLINIC TO LINDSAY, NE. THE LINDSAY MEDICAL CLINIC WOULD BE IN THE OLD 5FERS XPRESS BUILDING ON PINE STREET.OBJECTIVE: INCREASE ACCESS TO THE HOSPITAL FOR PATIENTS WHO HAVE TROUBLE WALKINGACTION STEP: CCH CONTINUES TO PROVIDE VIP: VERY IMPORTANT PATIENT VALET PARKING TO PATIENTS AND FAMILIES AT NO COST. THE SERVICE IS INTENDED TO PROVIDE PATIENTS AND OTHER VISITORS WITH A QUICK ENTRANCE TO THE HOSPITAL TO IMPROVE THEIR EXPERIENCE AT CCH.
SCHEDLE H, PART V, SECTION B, LINE 11 (CONT'D)	OBJECTIVE: INCREASE ACCESS TO HEALTH CARE TRAININGACTION STEP: CCH CONTINUES TO OFFER STOP THE BLEED, A NATIONAL PROGRAM THAT TEACHES MEMBERS OF THE PUBLIC HOW TO CONTROL MASSIVE BLEEDING USING DRESSINGS, TOURNIQUETS AND THEIR OWN HANDS. UNCONTROLLED BLEEDING CAN CAUSE DEATH WITHIN MINUTES. SO, IN SITUATIONS WHEN EMERGENCY RESPONSE IS DELAYED-SUCH AS NATURAL DISASTERS, ACTIVE SHOOTER SITUATIONS OR EXPLOSIVE EVENTS-IT BECOMES PARTICULARLY IMPORTANT FOR EVERYDAY CITIZENS TO KNOW HOW TO STOP BLEEDING.OBJECTIVE: WORK TO CONTINUALLY IMPROVE PATIENT'S ACCESS TO HEALTH CARE & THE QUALITY OF HEALTH CARE THEY RECEIVEACTION STEP: CCH CONTINUED TO USE A PATIENT-CENTERED METHODOLOGY CALLED LEAN HEALTHCARE. THE ULTIMATE GOAL BEHIND LEAN IS TO ELIMINATE WASTE, IMPROVE PROCESSES & INCREASE OVERALL PATIENT SATISFACTION. CCH HAS BEEN WORKING TO CREATE A CULTURE SURROUNDING THESE SIMPLE GOALS. EMPLOYEES ARE ENCOURAGED TO TAKE PART IN THE PRACTICE & SHARE ANY IDEAS THEY HAVE TO IMPROVE QUALITY OF CARE IN THE FACILITY. THE HOPE IS TO IMPROVE PATIENT CARE, PATIENT SATISFACTION, STAFF SATISFACTION & REGULATORY COMPLIANCE, AS WELL AS REDUCE INVENTORY, COSTS, MORTALITY RATES & MORBIDITY RATES.OBJECTIVE: INCREASE ACCESS TO HEALTH CARE INFORMATIONACTION STEP: CCH CONTINUES TO OFFER A LITTLE FREE LIBRARY ON ITS CAMPUS. THE LITTLE FREE LIBRARY, WHICH IS LOCATED NEAR THE CCH CHILD CARE CENTER AT 3970 HEALTH PARKWAY, IS ACCESSIBLE TO THE PUBLIC 24 HOURS A DAY, 7 DAYS A WEEK. THE PURPOSE OF THE LIBRARY IS TO ENCOURAGE READING IN COMMUNITY MEMBERS OF ALL AGES. CCH FILLED THE LIBRARY WITH BOOKS TO TEACH CHILDREN ABOUT HEALTH AND WELLNESS. SPANISH AND ENGLISH BOOKS ARE INCLUDED.OBJECTIVE: OFFER ADDITIONAL SUPPORT TO PATIENTS WITH PARKINSON'S DISEASEACTION STEP: CCH'S REHABILITATIVE SERVICES CONTINUED OFFERING ROCK STEADY BOXING CLASSES AT THE COLUMBUS WELLNESS CENTER. ROCK STEADY BOXING IS A NONPROFIT ORGANIZATION THAT GIVES PEOPLE WITH PARKINSON'S DISEASE HOPE BY IMPROVING THEIR QUALITY OF LIFE THROUGH A NONCONTACT, BOXING-BASED FITNESS CURRICULUM. THE INTERNATIONAL CLASSES, DELIVERED LOCALLY NOW, HAVE PROVEN THAT ANYONE, IN ANY STAGE OF PARKINSON'S, CAN LESSEN THEIR SYMPTOMS AND LEAD A HEALTHIER AND HAPPIER LIFE. SCIENCE IS SHOWING THAT INTENSIVE EXERCISES, LIKE THOSE PERFORMED IN ROCK STEADY BOXING, MAY BE NEURO-PROTECTIVE, ACTUALLY SLOWING DISEASE PROGRESSION AND LOSS OF FUNCTIONAL ABILITIES. IN SPRING 2021, 19 COLUMBUS COMMUNITY HOSPITAL REHABILITATIVE SERVICES STAFF MEMBERS BECAME CERTIFIED IN PWR!MOVES, A PARKINSON-SPECIFIC TRAINING PROGRAM THAT HELPS PATIENTS MAINTAIN OR RESTORE SKILLS THAT HAVE DETERIORATED AND INTERFERE WITH EVERYDAY MOVEMENTS.OBJECTIVE: TO OFFER LONG-TERM, RECURRING HEALTH EDUCATION EVENTS & ONE-TIME EVENTS THAT GIVE COMMUNITY MEMBERS AN OPPORTUNITY TO LEARN MORE ABOUT THEIR HEALTH & HOW TO MANAGE ITACTION STEP: CCH OFFERS A VARIETY OF LONG-TERM, RECURRING EVENTS THAT HELP COMMUNITY MEMBERS LEARN MORE ABOUT THEIR HEALTH, INCLUDING: LUNCH AND LEARN EVENTS THAT PROVIDE COMMUNITY MEMBERS WITH INFORMATION ABOUT TOPICS INCLUDING: FOOD TRENDS AND DEPARTMENT OF TRANSPORTATION GUILDLINES, BUMP AND BEYOND PREPARED CHILDBIRTH CLASSES THAT TEACH PARENTS ABOUT LABOR AND DELIVERY, COMFORT TECHNIQUES, NEWBORN CARE AND MORE.OBJECTIVE: OFFER PATIENT TRANSPORTATION FOR CCH PATIENTSACTION STEP: CCH CONTINUED TO CONTRACT WITH CHECKER CAB COMPANY TO PROVIDE 24/7 ACCESS CAB SERVICE AVAILABLE FOR PATIENTS UP TO A 150-MILE DISPOSITION RADIUS. CCH CONTINUED OFFERING THE VERY IMPORTANT PATIENT (VIP) TRANPORTATION SERVICE TO INCREASE ACCESS TO HEALTHCARE. THE CURB-TO-CURB SERVICE PROVIDES FREE TRANSPORTATION FOR NON-EMERGENCY PATIENTS WHO HAVE NO OTHER MEANS OF TRANSPORTATION. THE DRIVERS BRING THE PATIENTS TO THEIR APPOINTMENTS & TAKE THEM HOME AFTERWARD. WHILE THE MAJORITY OF RIDES ARE PROVIDED TO PATIENTS IN COLUMUBS, THE SERVICE HAS BEEN EXTENDED AS FAR AS CENTRAL CITY, WHICH IS ABOUT 40 MILES AWAY.OBJECTIVE: OFFER LONG-TERM PROGRAMS & SUPPORT TO COMMUNITY MEMBERS WITH CHRONIC HEALTH ISSUESACTION PLAN: CCH CONTINUED TO OFFER SUPPORT GROUPS AND ACTIVITIES, INCLUDING THE FOLLOWING: DIABETES ACTIVITY GROUP, COMPREHENSIVE DIABETES GROUP, ADVANCED CARBOHYDRATE COUNTING CLASS, CONTROL DIABETES FOR LIFE, LOUD CROWD EXERCISE GROUP, TBI/STROKE SUPPORT GROUP AND THE AMERICAN CANCER SOCIETY'S LOOK GOOD-FEEL BETTER PROGRAM.OBJECTIVE: PROVIDE THE NECESSARY RESOURCES TO PROTECT COMMUNITY MEMBERS FROM COVID-19ACTION STEP: IN SPRING 2020, CCH CREATED MARKETING CAMPAIGNS THAT URGED COMMUNITY MEMBERS TO STAY SAFE & STAY HOME & IMPLEMENTED INTERNAL SAFETY PRECAUTIONS SUCH AS VISITOR RESTRICTIONS COVID-19 SCREENINGS & MASK REQUIREMENTS. IT ALSO CANCELLED HOSPITAL EVENTS OR MOVED THEM ONLINE. IN MAY 2020, CCH HIRED & TRAINED MEDICAL SCREENERS WHO STARTED PERFORMING COVID-19 SCREENINGS AT LOCAL BUSINESSES OFFICES & MANUFACTURING PLANTS. IN JUNE 2020, CCH BECAME A TESTNEBRASKA SITE & STARTED OFFERING DRIVE-THRU COVID-19 TESTING. THE TESTNEBRASKA INITIATIVE WAS A PARTNERSHIP BETWEEN THE STATE GOVERNMENT & PRIVATE COMPANIES TO INCREASE COVID-19 TESTING & REDUCE THE VIRUS' SPREAD. IN JANUARY 2021, CCH BEGAN COLLABORATING WITH THE EAST CENTRAL DISTRICT HEALTH DEPARTMENT TO ADMINISTER COVID-19 VACCINES TO THE PUBLIC. IN APRIL 2021, CCH ANNOUNCED IT WAS CLOSING ITS TESTNEBRASKA SITE, EFFECTIVE AT THE END OF THE MONTH, AS MORE TESTING OPTIONS HAD BECOME AVAILABLE AT CLINICS AND RETAIL PHARMACIES. AT THE END OF APRIL 2021, CCH HAD LARGELY RESUMED ALL ITS USUAL OPERATIONS, EVEN AS IT MAINTAINED SEVERAL COVID-19 SAFETY PRECAUTIONS. THROUGHOUT THE COVID-19 PANDEMIC, CCH HAS WORKED HARD TO PROVIDE LOCAL RESIDENTS WITH RELIABLE HEATLH CARE INFORMATION THROUGH MARKETING CAMPAIGNS, ITS WEBSITE AND ITS SOCIAL MEDIA CHANNELS. IT ALSO POSTED A SERIES OF EDUCATIONAL VIDEOS ON ITS WEBSITE AND ITS SOCIAL MEDIA CHANNELS. IN THESE VIDEOS, LOCAL PUBLIC HEALTH EXPERTS, INCLUDING CCH PHYSICIANS, GIVE UP-TO-DATE INFORMATION ON THE VIRUS, HOSPITAL RECOURCE, VACCINES, SAFETY GUIDANCE, MASKS AND MORE.
SCHEDLE H, PART V, SECTION B, LINE 11 (CONT'D)	IMPLEMENTATION STRATEGYOBESITYOBJECTIVE: BUILD FACILITIES THAT INCREASE COMMUNITY MEMBERS' ACCESS TO EXERCISE AND WELLNESS OPPORTUNITIESACTION STEP: CCH IS CONTINUING WITH ITS PLANS TO BUILD A NEW FIELDHOUSE. THE MULTIPURPOSE FIELDHOUSE WILL BE AN INDOOR SPORTS AND FITNESS FACILITY THAT WILL PROVIDE EXERCISE AND WELLNESS OPPORTUNITIES FOR ALL AGES. INITIAL DESIGNS OF THE FACILITY ANTICIPATE IT WILL BE APPROXIMATELY 260,000 SQUARE FEET AND COST APPROXIMATELY $34 MILLION. THE HOSPITAL BROKE GROUND ON THE FIELDHOUSE IN FALL 2021, AND LEADERS EXPECT TO OPEN THE FACILITY IN EARLY 2024. THE FIELDHOUSE WILL OFFER A WIDE VARIETY OF FITNESS AND RECREATION AREAS, BOTH INDOOR AND OUTDOOR. IT ALSO WILL HAVE RUNNING AND WALKING TRACKS AND SPACE FOR SOME OF CCH'S PHYSICAL THERAPY AND REHABILITATION SERVICES. CCH WILL MANAGE AND OPERATE THE FACILITY, BUT THE YMCA ALSO WILL OFFER PROGRAMS AND ACTIVITIES THERE.OBJECTIVE: OFFER SPECIAL EVENTS TO ENCOURAGE COMMUNITY MEMBERS TO INCREASE THEIR PHYSICAL ACTIVITY, AND IMPROVE THEIR OVERALL HEALTHACTION STEP: PROMOTED INCREASED PHYSICAL ACTIVITY THROUGH A VARIETY OF PROGRAMS AND SPECIAL EVENTS, INCLUDING, THE PLATTE COUNTY LIFESTYLE COALITION, WHICH IS A PROGRAM OF CCH. CCH HAS SPONSORED MANY FITNESS-BASED PROGRAMS INCLUDING: PARK YOUR CHAIR AND WALK THE SQUARE, AN INITIATIVE DURING THE SUMMER LAWN CHAIRS ON THE SQUARE CONCERT SERIES IN WHICH SPECTATORS ARE ENCOURAGED TO WALK FOR A HALF HOUR PRIOR TO THE EVENT. WALK TO BETHLEHEM, A CHRISTMAS-TIME EVENT IN WHICH CONGREGATIONS AND INDIVIDUAL FAMILY MEMBERS WORK TOGETHER TO WALK THE SAME NUMBER OF MILES AS THEY WOULD IF THEY WERE WALKING TO JERUSALEM.OBJECTIVE: IMPROVE COMMUNITY MEMBERS' HEALTH & NUTRITION THROUGH THE USE OF EDUCATIONAL PROGRAMS & EVENTSACTION STEP: CCH OFFERED A VARIETY OF PROGRAMS AND EVENTS TO TEACH COMMUNITY MEMBERS HOW TO IMPROVE THEIR NUTRITION AND THEREFORE THEIR OVERALL HEALTH. CCH HAS OFFERED THE NATIONAL DIABETES PREVENTION PROGRAM SINCE 2017. IN THIS YEARLONG PROGRAM, PARTICIPANTS WORK WITH A TRAINED LIFESTYLE COACH TO MAKE HEALTHY CHANGES TO THEIR LIFESTYLE. CCH CONTINUED TO OFFER THE CHIP PROGRAM TO PROMOTE EVIDENCE-BASED MEDICAL GUIDELINES TO HELP COMMUNITY MEMBERS LIVE A HEALTHY LIFESTYLE. THE CHIP PROGRAM CONTINUES TO GROW AND EXPAND. THE PROGRAM IS OFFERED TO PHYSICIAN-REFERRED CLIENTS AND HAS BEEN EXPANDED TO THE GENERAL PUBLIC. PARTICIPANTS HAVE SEEN MARKED REDUCTIONS IN THEIR CHOLESTORAL LEVELS AND EXCESS WEIGHT. CCH ALSO CONTINUED TO OFFER CLUB CHIP, A SUPPORT GROUP FOR PEOPLE WHO HAVE SUCCESSFULLY COMPLETED THE CHIP PROGRAM. CLUB CHIP MEETINGS ARE HELD ONCE MONTH FROM 5:30-6:30 PM IN THE COLUMBUS WELLNESS CENTER'S MULTIPURPOSE ROOM. HEALTHY COOKING DEMONSTRATION CLASSES LED BY CCH DIETITIANS ARE OFFERED MONTHLY. IN THIS LOW-COST PROGRAM, COMMUNITY MEMBERS CAN SEE A DEMONSTARTION AND OBTAIN A COLLECTION OF EASY AND HEALTHY RECIPES. CCH DIETITIANS ALSO OFFER FOOD THOUGHT SESSIONS WEEKLY. THESE FREE, EDUCATIONAL EVENTS GIVE COMMUNITY MEMBERS THE OPPORTUNITY TO GET ONE-ON-ONE TIME WITH A DIETITIAN TO GET THEIR HEALTH AND NUTRITION QUESTIONS ANSWERED.OBJECTIVE: TO OFFER FITNESS PROGRAMS & CLASSES THAT HELP PEOPLE OF ALL LEVELS OF FITNESS GET MORE PHYSICAL ACTIVITYACTION STEP: CCH CONTINUED THE WALK WITH A DOC PROGRAM WHICH WAS DESIGNED TO GET COMMUNITY MEMBERS OUTSIDE & EXERCISING. IN THIS PROGRAM, HELD ONCE A MONTH IN VARIOUS LOCATIONS ACROSS COLUMBUS, CCH HEALTH CARE PROVIDERS SHARE INFORMATION ABOUT HEALTH & WELLNESS TOPICS WHILE THEY WALK WITH COMMUNITY MEMBERS. THESE WALKS ARE HELD IN THE EVENINGS FOR ABOUT AN HOUR. THE PROGRAM WAS DESIGNED TO PROMOTE PHYSICAL ACIVITY IN PEOPLE OF ALL AGES IN ORDER TO REVERSE THE CONSEQUENCES OF A SEDENTARY LIFESTYLE.OBJECTIVE: WORK WITH OTHER ORGANIZATIONS IN THE COMMUNITY TO INCREASE HEALTH & FITNESS OFFERINGSACTION STEP: CCH, ALONG WITH COLUMBUS IN ACTION INC. CONTINUED TO OFFER A BIKE-SHARE PROGRAM. THE PROGRAM LETS COMMUNITY MEMBERS RENT A BICYCLE FOR A SMALL FEE. THE BIKES ARE AVAILABLE AT THE RAMADA-RIVER'S EDGE CONVENTION CENTER, CCH & THE COLUMBUS WELLNESS CENTER. RIDERS CAN PICK & RETURN THE BIKES AT THESE LOCATIONS USING A FREE APP ON THEIR SMARTPHONES. THE BIKE-SHARE PROGRAM WAS CREATED TO PROVIDE A LOW-COST RECREATIONAL ACTIVITY TO COMMUNITY MEMBERS & PROMOTE HEALTH & WELLNESS THROUGHOUT THE COMMUNITYOBJECTIVE: INCREASE OPPORTUNITIES TO BE ACTIVE IN THE COMMUNITYACTION STEP: CCH WAS AWARDED A $1,500 COMMUNITY CHANGE GRANT FROM THE AMERICA WALKS ORGANIZATION. COLUMBUS WAS 1 OF 19 COMMUNITIES CHOSEN FROM MORE THAN 400 APPLICATIONS TO RECEIVE FUNDING & WORK WITH AMERICA WALKS THROUGHOUT 2020. AS PART OF THE GRANT, THE COMMUNITY WILL RECEIVE FUNDING TO HELP CREATE SAFE, ACCESSIBLE & ENJOYABLE PLACES TO WALK.OBJECTIVE: EDUCATE AREA CHILDREN ABOUT HEALTH & WELLNESSACTION STEP: IN 2020, CCH ADDED A NEW LITTLE FREE LIBRARY TO ITS CAMPUS. THE LITTLE FREE LIBRARY, LOCATED NEAR THE CHILD CARE CENTER IS ACCESSIBLE TO THE PUBLIC 24 HOURS A DAY, 7 DAYS A WEEK. THE PURPOSE OF THE LIBRARY IS TO ENCOURAGE READING IN COMMUNITY MEMBERS OF ALL AGES. CCH WILL INTIALLY FILL THE LIBRARY WITH BOOKS TO INFORM CHILDREN ABOUT HEALTH & WELLNESS. SPANISH AND ENGLISH BOOKS WILL BE INCLUDED.IMPLEMENTATION STRATEGYFAMILY SUPPORTCCH OPENED THE 13,000 SQUARE-FOOT CCH CHILD CARE CENTER IN FALL 2017. IT CONTINUES TO CARE FOR MORE THAN 100 CHILDREN FROM 6 WEEKS TO 13 YEARS OF AGE. CCH CONTINUED ITS HEALTHY FAMILIES NETWORK, A HOME VISITATION PROGRAM THAT WORKS WITH YOUNG, AT-RISK FAMILIES IN PLATTE, COLFAX, BOONE & NANCE COUNTIES. THE PROGRAM OFFERS SUPPORT TO MORE THAN 340 FAMILIES. IT HELPS YOUNG FAMILIES WHO NEED SUPPORT & EDUCATION & TEACHES PARENTS ABOUT THE IMPORTANCE OF THE FIRST 4 YEARS OF A CHILD'S LIFE. IT OFFERS HOME VISITS TO MOTHERS, STARTING IN THE 2ND TRIMESTER & CONTINUES UNTIL THE CHILDREN ARE 3 YEARS OLD. THE PROGRAM IS OFFERED TO THE COMMUNITY AT NO CHARGE TO THE FAMILIES. CCH ALSO CONTINUED ITS BABY CARE & BREASTFEEDING CLASSES & ITS BUMP & BEYOND SERIES OF CLASSES FOR EXPECTING PARENTS. CCH CONTINUES TO SUPPORT LOCAL FAMILIES WHOSE FIRST LANGUAGE IS NOT ENGLISH BY OFFERING FREE INTERPRETER SERVICES AT THE HOSPITAL. CCH CONTINUES TO PARTICIPATE IN KIDS SAFETY DAY, WHERE AREA FAMILIES CAN LEARN SAFETY TIPS FROM LOCAL EXPERTS. THE EVENT INCLUDES DEMONSTRATIONS AND DISPLAYS THAT ALLOW CHILDREN AND TEENS TO LEARN ABOUT FIRE, SEAT BELT AND POWERLINE SAFETY, AMONG OTHER IMPORTANT TOPICS. CCH CONTINUED TO OFFER SUPPORT FOR FAMILIES WHO HAD SUFFERED THE LOSS OF A PREGNANCY WITH THEIR PRECIOUS H.E.A.R.T.S. INTERFAITH MEMORIAL SERVICE. THIS ANNUAL MEMORIAL SERVICE IS HELD EACH OCTOBER TO COINCIDE WITH NATIONAL PREGNANCY LOSS & INFANT DEATH MONTH. INDIVIDUALS WHO HAVE EXPERIENCED A PREGNANCY LOSS ARE WELCOME TO ATTEND, ALONG WITH THEIR FAMILY & FRIENDS.
SCHEDLE H, PART V, SECTION B, LINE 11 (CONT'D)	IMPLEMENTATION STRATEGYSUBSTANCE ABUSETO DECREASE THE USE AND ABUSE OF OPIOIDS, CCH EXPLORED NON-OPIOID TREATMENT OPTIONS. THE CCH ANESTHESIA DEPARTMENT IS NOW DOING MORE THAN A DOZEN DIFFERENT NERVE BLOCKS TO HELP PROVIDE POSTOPERATIVE PAIN RELIEF. THIS INCLUDES NERVE BLOCKS FOR GENERAL, OBSTETRIC AND ORTHOPEDIC PATIENTS. CCH'S CRNAS ARE ALSO UTILIZING ENHANCE RECOVERY AFTER SURGERY. IOVERA WAS ANOTHER ONE OF THE NON-OPIOID OPTIONS USED TO TREAT PAIN. THE IOVERA TREATMENT IS A CLINCALLY PROVEN, NON-OPIOID, LONG-LASTING PAIN MANAGEMENT SOLUTION THAT USES THE BODY'S NATURAL RESPONSE TO COLD TO RELIEVE PAIN. THE IOVERA TREATMENT IS BASED UPON THE WELL-ESTABLISHED PRINCIPLES OF CRYONEUROLYSIS. THE IOVERA SYSTEM USED AN INNOVATIVE PROCESS TO FORM A TARGETED COLD ZONE SURROUNDING PERIPHERAL NERVE TISSUE TO IMMEDIATELY BLOCK THE NERVE FROM SENDING PAIN SIGNALS. THE SYSTEM IS SPECIFICALLY DESIGNED TO CREATE A TEMPORARY, REVERSIBLE NERVE BLOCK THROUGH A PROCESS CALLED WALLERIAN DEGENERATION, THAT IS FOLLOWED BY PREDICTABLE REGENERATION OF THE NERVES. CCH CONTINUES TO OFFER AN OPIOD INTERVENTION PROGRAM. THE PROGRAM IS OFFERED THROUGH BRYAN HEALTH'S BRYAN INDEPENDENCE CENTER, A SUBSTANCE USE TREATMENT CENTER WHICH OFFERS INPATIENT AND OUTPATIENT TREATMENT FOR SUBSTANCE ABUSE. CCH'S OPIOID INTERVENTION PROGRAM IS AN EXTENSION OF THE INDEPENDENCE CENTER'S INTERVENTION NURSE CONSULTATION PROGRAM. IN THE PROGRAM, CCH PHYSICIANS CAN REFER PATIENTS WHO ARE MISUSING OPIOIDS/OPIATES TO A TELEMEDICINE SUBSTANCE USE ASSESSMENT WITH ONE OF BRYAN'S SPECIALIZED INTERVENTION NURSES. THE NURSE WILL DO A FULL SUBSTANCE USE VALUATION ON THE PATIENT AND PROVIDE DIAGNOSES AND RECOMMENDED TREATMENT OPTIONS, IF APPLICABLE. FROM THERE, THE PATIENT'S EVALUATION CAN BE FORWARDED TO SUBSTANCE USE TREATMENT AGENCIES, IF THAT IS WHAT THE PATIENT WISHES TO DO. CCH CONTINUES TO USE THE SERVICES OF ITS FIRST CHAPLAIN, MARY JO "MITCH" SHEMEK. SHE PROVIDES SPIRITUAL CARE AND EMOTIONAL SUPPORT FOR STAFF, PATIENTS AND PATIENTS' FAMILIES; FACILITATES VISITS; AND CONNECTS PATIENTS WITH THEIR PASTORS, IF REQUESTED.IMPLEMENTATION STRATEGYBEHAVIORAL HEALTHOBJECTIVE: CONTINUE TO ENHANCE THE BEHAVIORAL HEALTH SERVICE LINE WITHIN THE COMMUNITYACTION STEPS: CCH CONTINUES TO OPERATE COLUMBUS PSYCHIATRY CLINIC, THE ONLY FULL-TIME LOCALLY BASED PSYCHIATRY CLINIC IN COLUMBUS. IN SEPTEMBER 2021, CCH OPENED A NEW SENIOR BEHAVIORAL HEALTH UNIT. THE INPATIENT GERIATRIC PSYCHIATRY PROGRAM TREATS OLDER ADULTS WHO HAVE MENTAL HEALTH CONDITIONS LIKE DEPRESSION, ANXIETY AND BIPOLAR DISORDER. THE 10-BED UNITY IS DESIGNED FOR SHORT-TERM STAYS OF 10 TO 14 DAYS. AN ADVANCED PRACTICE NURSE IN PSYCHIATRY WORKS IN THE UNITY FOR THE DAY-TO-DAY HANDLING OF PATIENTS. EACH DAY, PATIENTS HAVE ACTIVITIES AND 5 THERAPEUTIC GROUP SESSIONS. PATIENTS ARE ALSO EXPECTED TO EAT TOGETHER IN A COMMUNAL DINING/ACTIVITY AREA. THE PROGRAM IS OFFERED IN PARTNERSHIP WITH HORIZON HEALTH BEHAVIORAL HEALTH SERVICES, A TEXAS-BASED ORGANIZATION THAT FOCUSES ON HOSPITAL-BASED BEHAVIORAL HEALTH. HORIZON, WHICH HAS PARTNERSHIPS WITH ABOUT 100 HOSPITALS IN THE COUNTRY, HAS PROVIDED A DIRECTOR AND COMMUNITY OUTREACH PERSON TO MANAGE THE PROGRAM AT CCH. THE REST OF THE STAFF MEMBERS ON THE UNIT ARE CCH EMPLOYEES.
SCHEDULE H, PART V, LINE 16A	HTTPS://WWW.COLUMBUSHOSP.ORG/PATIENTS-VISITORS/PATIENT-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE-PROGRAMSCHEDULE H, PART V, LINE 16BHTTPS://WWW.COLUMBUSHOSP.ORG/PATIENTS-VISITORS/PATIENT-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE-PROGRAMSCHEDULE H, PART V, LINE 16CHTTPS://WWW.COLUMBUSHOSP.ORG/PATIENTS-VISITORS/PATIENT-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE-PROGRAM

Schedule H (Form 990) 2022

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?14
Name and address		Type of Facility (describe)
1	1 - PREMIER PHYSICAL THERAPY OF CCH US 30 CENTER BLDG 3100-23RD ST STE 15 COLUMBUS,NE686013161	OUTPATIENT PHYSICAL THERAPY
2	2 - WIGGLES & GIGGLES THERAPY FOR KIDS 3912 38TH STREET SUITE B COLUMBUS,NE686015100	PEDIATRIC THERAPY SERVICES
3	3 - OCCUPATIONAL HEALTH SERVICES OF CCH 3005-19TH ST SUITE 300 COLUMBUS,NE686014252	EMP HEALTH CARE SVCS TO PREVENT & TREAT WORK INJURIES
4	4 - WOUND HEALING CENTER 4600-38TH ST SUITE 165 COLUMBUS,NE68601	WOUND TREATMENT CENTER
5	5 - HUMPHREY CLINIC OF CCH 3003 MAIN STREET HUMPHREY,NE686423155	CLINIC IN SMALL TOWN TO OFFER MEDICAL SERVICES TO RESIDENTS
6	6 - HOSPICE OF COLUMBUS COMMUNITY HOSPITAL 3005-19TH ST SUITE 600 COLUMBUS,NE686014248	HOSPICE SERVICES
7	7 - COLUMBUS PSYCHIATRY CLINIC 4508 38TH ST SUITE 165 COLUMBUS,NE68601	FREE STANDING CLINIC
8	8 - HOME HEALTH OF COLUMBUS COMMUNITY HOSP 3005-16TH ST SUITE 600 COLUMBUS,NE686014248	HOME HEALTH SERVICES
9	9 - COLUMBUS ORTHOPEDIC & SPORTS MED CLINIC 4508 38TH ST SUITE 133 COLUMBUS,NE686011668	FREE STANDING CLINIC
10	10 - REHABILITATIVE SERVICES 3912 38TH STREET SUITE B COLUMBUS,NE686015100	OUTPATIENT PHYSICAL THERAPY, OCCUPATIONAL THERAPY AND SPEECH THERAPY
11	11 - COLUMBUS OTOLARYNGOLOGY CLINIC 4508 38TH ST SUITE 152 COLUMBUS,NE68601	FREE STANDING CLINIC
12	12 - COLUMBUS GENERAL SURGERY 4508 38TH ST SUITE 250 COLUMBUS,NE68601	FREE STANDING CLINIC
13	13 - COLUMBUS PLASTIC SURGERY 4508 38TH ST SUITE 165 COLUMBUS,NE68601	FREE STANDING CLINIC
14	15 - LINDSAY MEDICAL CLINIC 110 PINE STREET LINDSAY,NE68644	CLINIC IN SMALL TOWN TO OFFER MEDICAL SERVICES TO RESIDENTS

Schedule H (Form 990) 2022

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 6A:	A COMMUNITY BENEFIT REPORT IS INCLUDED EACH YEAR IN THE HOSPITAL'S QUARTERLY NEWSLETTER "HOUSECALL" WITH AN ELECTRONIC VERSION OF THE NEWSLETTER HOUSED ON THE HOSPITAL'S WEBSITE. A SEPARATE LANDING PAGE ON THE WEBSITE WAS ALSO CREATED FOR THE REPORT TO PROVIDE EASY ACCESS TO THE REPORT.
PART I, LINE 7B	THE REVENUE GENERATED BY MEDICAID PATIENTS IS MULTIPLIED BY THE COST TO CHARGE RATIO DEVELOPED IN WORKSHEET 2. THE REMAINING PRODUCT IS THE CALCULATED COST ASSOCIATED WITH THE CHARGES FROM MEDICAID PATIENTS. THESE COSTS ARE REDUCED BY THE REIMBURSEMENTS COLLECTED FOR THE MEDICAID CHARGES. THE REMAINING NUMBER IS THE NET COMMUNITY BENEFIT EXPENSE.PART I, LINE 7EEXPENSES REPRESENT WAGES ALONG WITH SERVICES AND SUPPLIES PURCHASED BY THE HOSPITAL. DIRECT OFFSETTING REVENUES REPRESENT CASH COLLECTED FOR THESE SERVICES.PART I, LINE 7ICASH DONATIONS MADE TO EAST CENTRAL HEALTH DEPARTMENT (ECHD) AND THE GOOD NEIGHBOR COMMUNITY HEALTH CENTER REPRESENT THE MAJORITY OF THESE DONATIONS.PART I, LINE 7, COLUMN (F)THE AMOUNT OF $140,597,125 USED AS THE DENOMINATOR TO COMPUTE COLUMN (F) IS CALCULATED BY TAKING TOTAL FUNCTIONAL EXPENSES OF $149,511,459 MINUS BAD DEBT EXPENSE OF $8,914,334.
PART II, COMMUNITY BUILDING ACTIVITIES:	COMMUNITY BUILDING ACTIVITIESCCH CONTINUES TO COLLABORATE WITH THE LOCAL CHAMBER OF COMMERCE TO RECRUIT SKILLED PROFESSIONALS TO FILL JOB OPENINGS IN THE COMMUNITY. THE HOSPITAL ALSO PROVIDES SUPPORT AND STAFF TIME TO ASSIST IN HIGHLIGHTING THE HEALTH CARE COMMUNITY, OFFERING SPECIFIC DEPARTMENT OR HOSPITAL TOURS IN ORDER TO RECRUIT SKILLED PROFESSIONALS TO LIVE AND WORK IN COLUMBUS.THE HOSPITAL CONTINUES TO PARTNER WITH OUR LOCAL PUBLIC HEALTH DEPARTMENT AND COMMUNITY HEALTH CENTER (CHC) ON SEVERAL PROJECTS AND COMMUNITY DISEASE PREVENTION INITIATIVES, PROVIDING FINANCIAL SUPPORT AND PROFESSIONAL STAFF TIME AS LIAISONS TO THESE COMMUNITY PARTNERSHIPS THROUGHOUT THE YEAR. WORKING TOGETHER WITH THESE AGENCIES, SOME OF THE CHRONIC DISEASE AND ACCIDENT PREVENTION STRATGEIS ADDRESSED INCLUDE: TYPE 2 DIABETES, HYPERTENSION AND HEART DISEASE, PRE-AND POST-NATAL NEWBORN CARE, PHYSICAL ACTIVITY AND EXERCISE, COLON CANCER PREVENTION AND EARLY DETECTION, AND COMMUNITY PREPAREDENSS FOR NATURAL AND MAN-MADE DISASTERS. THESE PROGRAMS REACH COUNTLESS MEMBERS OF THE COMMUNITY EACH YEAR, MAKING A DIFFERENCE IN THE LIVES OF PEOPLE LIVING WITH CHRONIC HEALTH ISSUES.OTHER HOSPITAL-DRIVEN COMMUNITY HEALTH INITIATIVES INCLUDE: FREE FLU SHOTS FOR RESIDENTS AT THE SHELTER FOR THE HOMELESS, AND PARTICIPATION IN NUMEROUS COMMUNITY HEALTH FAIRS/EVENTS EACH YEAR, PROVIDING MEDICAL SCREENINGS AND FREE HEALTH INFORMATION/EDUCATION.TO ENCOURAGE ENTRY INTO THE MEDICAL PROFESSION, CCH BEGAN OFFERING THE HEALTH SCIENCE PATHWAY PROGRAM. THE EDUCATIONAL PROGRAM IS A COLLABORATION BETWEEN AREA HIGH SCHOOLS, CENTRAL COMMUNITY COLLEGE AND THE HOSPITAL, ALLOWING STUDENTS TO LEARN ABOUT CAREERS IN THE MEDICAL FIELD. IT INCLUDES A SERIES OF CLASSES THAT MEET REQUIREMENTS FROM THE STATE OF NEBRASKA AND EXPLORES VARIOUS AREAS OF HEALTH CARE, INCLUDING PHLEBOTOMY, RADIOLOGY, PHARMACY, NURSING, RESPIRATORY THERAPY, HOUSEKEEPING AND FACILITIES. MANY STUDENTS HAVE BECOME CERTIFIED NURSING ASSISTANTS (CNAS) THROUGH THE PROGRAM AND STARTED WORKING AT THE HOSPITAL.
PART III, LINE 2:	THE METHODOLOGY USED TO ESTIMATE BAD DEBT EXPENSE IS TO TAKE THE PRIVATE PAY WRITE-OFFS FOR THE YEAR AND DIVIDE THEM BY THE TOTAL REVENUE GENERATED FROM SELF-PAY PATIENTS AND MULTIPLY THE PRODUCT BY THE SELF-PAY ACCOUNTS RECEIVABLE. THIS GIVES THE AMOUNT OF RESERVE NECESSARY TO COVER THE POTENTIAL BAD DEBT IN CURRENT SELF-PAY ACCOUNTS RECEIVABLE. BAD DEBT EXPENSE FOR THE FISCAL YEAR IS THE AMOUNT OF ADDITIONAL EXPENSE NECESSARY TO BRING THAT RESERVE ACCOUNT TO THE CALCULATED (ESTIMATED) BALANCE.
PART III, LINE 4:	FINANCIAL STATEMENTS DO NOT INCLUDE ANY TEXT FOR BAD DEBT. THE AMOUNT IN LINE 2 IS THE BOOK BAD DEBT AMOUNT.
PART III, LINE 8:	IN ACCORDANCE WITH 42 CFR 413.24, COLUMBUS COMMUNITY HOSPITAL USES THE STEP-DOWN METHOD AS ITS COSTING METHODOLOGY. DEPARTMENTS WITHIN A PROVIDER ARE USUALLY DIVIDED INTO TWO TYPES: 1) THOSE THAT PRODUCE PATIENT CARE REVENUE (E.G., ROUTING SERVICES, RADIOLOGY), AND 2) THOSE THAT DO NOT DIRECTLY GENERATE PATIENT CARE REVENUE, BUT ARE UTILIZED AS A SERVICE BY OTHER DEPARTMENTS (E.G., LAUNDRY AND LINEN, DIETARY). THE TWO TYPES OF DEPARTMENTS ARE COMMONLY REFERRED TO AS REVENUE-PRODUCING COST CENTERS AND NONREVENUE-PRODUCING COST CENTERS. ALTHOUGH NONREVENUE-PRODUCING COST CENTERS DO NOT DIRECTLY PRODUCE PATIENT CARE REVENUE, THEY CONTRIBUTE INDIRECTLY TO PATIENT CARE REVENUE GENERATED BY SERVING AS A SERVICE TO THE REVENUE-PRODUCING CENTERS AND ALSO TO OTHER NONREVENUE-PRODUCING CENTERS. THEREFORE, FOR THE PURPOSE OF PROPER MATCHING OF REVENUE AND EXPENSES, THE COST OF THE REVENUE-PRODUCING CENTERS SHOULD INCLUDE BOTH ITS DIRECT EXPENSES AND ITS PROPORTIONATE SHARE OF THE COSTS OF EACH NONREVENUE-PRODUCING CENTER (INDIRECT COSTS) BASED ON THE AMOUNT OF SERVICES RECEIVED. THE PROCESS OF ALLOCATING THE COST OF A PARTICULAR NONREVENUE-PRODUCING CENTER TO OTHER NONREVENUE-PRODUCING CENTERS AND REVENUE-PRODUCING CENTERS IS PERFORMED BY UTILIZING A SET OF STATISTICS (E.G. POUNDS OF LAUNDRY FOR ALLOCATING LAUNDRY AND LINEN COSTS, SQUARE FEET FOR ALLOCATING DEPRECIATION BUILDING COSTS).EVERY NONREVENUE-PRODUCING COST CENTER HAS THE POTENTIAL OF BEING ALLOCATED TO EVERY OTHER NONREVENUE-PRODUCING COST CENTER IN ADDITION TO THE REVENUE-PRODUCING COST CENTERS. THIS PRECLUDES A SIMPLE ALLOCATION OF THE DIRECT EXPENSE OF THE NONREVENUE-PRODUCING COST CENTER BECAUSE THE INDIRECT COSTS DERIVED FROM ALLOCATION OF OTHER NONREVENUE-PRODUCING COST CENTERS MUST BE COMPUTED IN DETERMINING THE FULL COST (DIRECT AND INDIRECT COSTS) OF THE NONREVENUE-PRODUCING COST CENTER BEING ALLOCATED. THE STEP-DOWN METHOD RECOGNIZES THAT SERVICES FURNISHED BY CERTAIN NONREVENUE-PRODUCING DEPARTMENTS ARE UTILIZED BY CERTAIN OTHER NONREVENUE-PRODUCING CENTERS AS WELL AS BY THE REVENUE-PRODUCING CENTERS. ALL COSTS OF NONREVENUE-PRODUCING CENTERS ARE ALLOCATED TO ALL CENTERS THAT THEY SERVE, REGARDLESS OF WHETHER OR NOT THESE CENTERS PRODUCE REVENUE. THE COST OF THE NONREVENUE-PRODUCING CENTER SERVICING THE GREATEST NUMBER OF OTHER CENTERS, WHILE RECEIVING BENEFITS FROM THE LEAST NUMBER OF CENTERS, IS APPORTIONED FIRST, FOLLOWING THE APPORTIONMENT OF THE COST OF THE NON-REVENUE-PRODUCING CENTER, THAT CENTER WILL BE CONSIDERED CLOSED AND NO FURTHER COSTS ARE APPORTIONED TO THAT CENTER. THIS APPLIES EVEN THOUGH IT MAY HAVE RECEIVED SOME SERVICE FROM A CENTER WHOSE COST IS APPORTIONED LATER. GENERALLY, IF TWO CENTERS FURNISH SERVICES TO AN EQUAL NUMBER OF CENTERS WHILE RECEIVING BENEFITS FROM AN EQUAL NUMBER, THAT CENTER WHICH HAS THE GREATEST AMOUNT OF EXPENSE SHOULD BE ALLOCATED FIRST.
PART III, LINE 9B:	THE PURPOSE OF OUR FINANCIAL ASSISTANCE/CHARITY PROGRAM IS TO FURTHER THE CHARITABLE MISSION OF CCH BY PROVIDING FINANCIALLY DISADVANTAGED AND OTHER QUALIFIED PATIENTS WITH AN AVENUE TO APPLY FOR AND RECEIVE FREE OR DISCOUNTED CARE CONSISTENT WITH THE REQUIREMENTS OF THE INTERNAL REVENUE CODE AND IMPLEMENTING REGULATIONS UNDER 501(R). CCH'S FINANCIAL ASSISTANCE POLICY REFLECTS THE MISSION, VISION AND VALUES OF CCH. IT IS INTENDED TO ASSIST LOW INCOME, UNINSURED AND UNDERINSURED INDIVIDUALS WHOSE FINANCIAL STATUS, UNDER THE HOSPITAL'S QUALIFICATION CRITERIA, MAKES IT IMPRACTICAL OR IMPOSSIBLE TO PAY FOR MEDICALLY NECESSARY AND EMERGENCY CARE. OUR FINANCIAL ASSISTANCE PROGRAM HAS AN IMPLIED AND PRESUMPTIVE AVENUE, AS WELL AS MEDICAL INDIGENCE. THE PROGRAM PROVIDES A FAIR AND COMPREHENSIVE SYSTEM OF DISTRIBUTING FREE OR DISCOUNTED MEDICAL CARE TO POOR AND FINANCIALLY DISADVANTAGED PATIENTS WITHIN THE AVAILABLE RESOURCES OF CCH.THIS POLICY ADDRESSES: ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE, THE EXTENT TO WHICH FINANCIAL ASSISTANCE INCLUDES FREE AND DISCOUNTED CARE, AND MEDICALLY INDIGENT CARE, THE BASIS FOR CALCULATING AMOUNTS CHARGED TO ELIGIBLE PATIENTS (THE CALCULATIONS OF AMOUNTS GENERALLY BILLED (AGB)); THE METHOD FOR APPLYING FOR ASSISTANCE AND APPLICATION PERIOD; ACTIONS THAT MAY BE TAKEN BY CCH IN THE EVENT OF NONPAYMENT; AND MEASURES TO WIDELY PUBLICIZE THE POLICY. CCH RECOGNIZES THE INDIVIDUAL'S RIGHT TO OBTAIN QUALITY HEALTH CARE REGARDLESS OF AGE, SEX, RACE, DISABILITY, NATIONAL ORIGIN, MARITAL STATUS, SEXUAL ORIENTATION, PERSONAL BELIEFS OR THEIR ABILITY TO PAY. CCH HAS A FIDUCIARY RESPONSIBILITY TO SEEK PAYMENT FOR SERVICES FROM THOSE WHO CAN PAY.
PART VI, LINE 2:	IN 2021, CCH UNDERWENT A COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH CAN BE FOUND ON THE HOSPITAL'S WEBSITE: HTTPS://WWW.COLUMBUSHOSP.ORG/FOR-THE-COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
PART VI, LINE 3:	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEFINANCIAL ASSISTANCE INFORMATION IS AVAILABLE ON THE HOSPITAL'S WEBSITE, INCLUDING LINKS TO ADDITIONAL, IN-DEPTH INFORMATION. CCH HAS TAKEN MEASURES TO WIDELY PUBLICIZE THE FINANCIAL ASSISTANCE POLICY.PATIENT CHARITY/FINANCIAL ASSISTANCE PROGRAM:A) MONTHLY PAYMENT OPTION1) IF YOU ARE UNABLE TO PAY YOUR BALANCE IN FULL, PLEASE CALL THE PATIENT ACCOUNTS DEPARTMENT TO SET UP AN ACCEPTABLE PAYMENT ARRANGEMENT.B) PATIENT CHARITY/FINANCIAL ASSISTANCE PROGRAM:1) IF PATIENTS FEEL THEIR INCOME IS NOT SUFFICIENT TO PAY FOR SERVICES AT COLUMBUS COMMUNITY HOSPITAL, THEY ARE ENCOURAGED TO CONTACT THE PATIENT ACCOUNTS DEPARTMENT AND/OR SOCIAL WORKERS FOR INFORMATION REGARDING CHARITY/FINANCIAL ASSISTANCE.2) FURTHER INFORMATION ABOUT MEDICARE/MEDICAID/CHARITY CARE IS PROVIDED IN BOTH ENGLISH AND SPANISH ON OUR WEBSITE. THE STATE HAS MEDICAID APPLICATIONS AVAILABLE ONLINE. OUR REGISTRATION, PATIENT ACCOUNTS AND SOCIAL SERVICES STAFF CAN PROVIDE PATIENTS WITH FINANCIAL/CHARITY APPLICATIONS IN EITHER ENGLISH OR SPANISH.3) ADDITIONALLY, SIGNAGE IS POSTED TO INCLUDE THE FINANCIAL ASSISTANCE POLICY SUMMARY IN ENGLISH AND SPANISH DIRECTING PATIENTS TO CALL OR COME IN AS NEEDED FOR FINANCIAL HELP AND EMPLOYEES ARE ENCOURAGED AT THE EARLIEST POSSIBLE POINT TO REFER INDIVIDUALS TO PATIENT ACCOUNTS OR SOCIAL SERVICES WHO WILL SEE PATIENTS INDIVIDUALLY AND COUNSEL ON SPECIFIC CIRCUMSTANCES. WE HAVE IMPLEMENTED MEASURES TO WIDELY PUBLICIZE THE FINANCIAL ASSISTANCE PROGRAM. 4) MONTHLY STATEMENTS INCLUDE THE FOLLOWING INFORMATION:A. PAYMENT PLANSB. CHARITY/FINANCIAL ASSISTANCE PROGRAMC. 24/7 ONLINE BUSINESS OFFICE ACCESS, WHICH INCLUDES INFORMATION ON PAYMENT PLANS, CHARITY/FINANCIAL ASSISTANCE AND APPLICATIONS FOR FINANCIAL/CHARITY ASSISTANT AVAILABLE IN BOTH ENGLISH AND SPANISH THAT CAN BE DOWNLOADED FROM OUR WEBSITE.D. THE PHONE NUMBER OF PATIENT ACCOUNTS AND THE ON-LINE HOSPITAL WEBSITE.5) ALL REGISTRATION AREAS HAVE SIGNAGE POSTED IN ENGLISH AND SPANISH OF THE FINANCIAL ASSISTANCE POLICY SUMMARY, BROCHURES WHICH ADDRESS FINANCIAL ASSISTANCE, CCH AFFILIATES AND NON-AFFILIATES (INDEPENDENT PHYSICIANS AND OTHER INDEPENDENTS).6) THE CCH WEBSITE IN ENGLISH AND SPANISH CHARITY/FINANCIAL ASSISTANCE APPLICATION, FINANCIAL ASSISTANCE POLICY SUMMARY, FINANCIAL AID/CHARITY PROGRAM POLICY, CALCULATIONS OF AMOUNTS GENERALLY BILLED (AGB) WHICH IS REVISED ANNUALLY, COLUMBUS COMMUNITY HOSPITAL AND CCH-EMPLOYED PHYSICIANS, PRACTITIONERS AND CLINICS AND INDEPENDENT COMMUNITY PHYSICIANS AND OTHER INDEPENDENTS (WHICH ARE REVISED QUARTERLY).
PART VI, LINE 4:	COMMUNITY INFORMATIONTHE LOCAL ECOMONYCOLUMBUS COMMUNITY HOSPITAL IS LOCATED IN COLUMBUS, NEBRASKA, WHICH HAS A POPULATION OF APPROXIMATELY 22,000. IT IS THE COUNTY SEAT AND THE LARGEST CITY IN PLATTE COUNTY, WHICH HAS A POPULATION OF APPROXIMATELY 33,500. ALMOST 70% OF PLATTE COUNTY'S RESIDENTS LIVE IN COLUMBUS.ACCORDING TO THE NEBRASKA DEPARTMENT OF LABOR, COLUMBUS IS CONSIDERED A MAJOR HUB FOR THE MANUFACTURING INDUSTRY, AND HAS A GREATER SHARE OF MANUFACTURING EMPLOYMENT THAN OTHER NEBRASKA METROPOLITAN AREAS. THE COLUMBUS AND AREA ECONOMY IS BASED ON AGRICULTURE AND MANUFACTURING, WITH MANY INDUSTRIAL COMPANIES ATTRACTED BY PLENTIFUL, LOW-PRICED HYDROELECTRIC POWER. A HARDOWRKING, WELL-EDUCATED WORKFORCE, LOW ENERGY COSTS AND A LOCAL ENVIRONMENT FRIENDLY TO BUSINESS PROVIDE ENCOURAGEMENT FOR STRONG ECONOMIC AND INDUSTRIAL DEVELOPMENT WITHIN OUR AREA. AMONG THE MAJOR EMPLOYERS ARE ARCHER DANIELS MIDLAND, AN ETHANOL MANUFACTURING COMPANY; FLEXCON; CENTRAL CONFIEMENT SERVICES; PILLEN FAMILY FARMS; VISHAY; TWO BD MEDICAL PLANTS, WHICH ARE MEDICAL EQUIPMENT COMPANIES; BEHLEN MANUFACTURING, WHICH MANUFACTURES STEEL BUILDINGS; AND NEBRASKA PUBLIC PWER, WHOSE HEADQUARTERS IN IN COLUMBUS.THESE BUSINESS OPPORTUNITIES HAVE LED TO AN INFLUX OF SINGLE PEOPLE AND YOUNG FAMILIES MOVING INTO THE COLUMBUS AREA SEEKING EMPLOYMENT.AS REPORTED IN THE 2022-23 CCH ANNUAL REPORT, THE HOSPITAL HAD ABOUT 2,200 INAPTIENT ADMISSIONS; NEARLY 12,000 EMERGENCY VISITS; 2,400 OUTPATIENT PROCEDURES AND 360 INPATIENT PROCEDURES IN THE PRECEING YEAR.SERVICE CAPACITYCOLUMBUS COMMUNITY HOSPITAL (CCH) IS A COMMUNITY-OWNED, NOT-FOR-PROFIT HOSPITAL, LOCATED ON 60 ACRES IN THE NORTHWEST PART OF COLUMBUS, NEBRASKA. IT IS A 50-BED ACUTE CARE FACILITY THAT IS CERTIFIED FOR SWING BEDS, WITH FOUR SKILLED NURSING BEDS AND 15 AMBULATORY OUTPATIENT BEDS.CCH OFFERS COMPREHENSIVE CARE, INCLUDING 24-HOUR EMERGENCY CARE; INTENSIVE CARE; MEDICAL-SURGICAL CARE; INPATIENT AND OUTPATIENT CARE; AND GENERAL, ENT, UROLOGY, PODIATRY AND ORTHOPEDIC SURGICAL PROCEDURES. OTHER ANCILLARY SERVICES INCLUDE: RESPIRATORY CARE, WOUND CARE, DIABETES EDUCATION , ENDOSCOPY, A CARDIAC CATHETERIZATION LAB AND CARDIOPULMONARY REHABILITATION. THE HOSPITAL ALSO OFFERS COMPREHENSIVE OUTPATIENT LABORATORY, RADIOLOGY AND REHABILITATIVE SERVICES, AS WELL AS FREE, 24/7 INTERPRETER SERVICES.THE HOSPITAL HAS MORE THAN 900 EMPLOYEES AND AN ACTIVE MEDICAL STAFF OF 50 PHYSICIANS WHO REPRESENT 16 MEDICAL SPECIALTIES. AN ADDITIONAL 15 SPECIALTY SERVICES ARE BROUGHT TO THE COMMUNITY ON AN INTERMITTENT BASIS BY VISITING PHYSICIANS
PART VI, LINE 5:	PROMOTION OF COMMUNITY HEALTHCCH'S MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES. EACH YEAR, THE HOSPITAL STRIVES TO PROVIDE THE BEST CARE TO ITS PATIENTS, WHILE ALSO PROVIDING WELLNESS EVENTS AND ACTIVITIES THAT ARE EASILY ACCESSIBLE TO COMMUNITY MEMBERS. THESE INCLUDE DIABETES WELLNESS EVENTS, HEALTHY COOKING CLASSES AND CAR SEAT SAFETY CHECKS FOR FAMILIES.
PART VI, LINE 6:	AFFILIATED HEALTH CARE SYSTEMN/A
PART VI, LINE 7	STATE FILING OF COMMUNITY BENEFIT REPORTTHE COMMUNITY BENEFIT INFORMATION FROM THE 2022-2023 ANNUAL REPORT CAN BE FOUND AT:HTTPS://WWW.COLUMBUSHOSP.ORG/NEWS_EVENTS/ANNUAL_REPORT.ASPX

Schedule H (Form 990) 2022

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2022

Open to Public
Inspection

Name of the organization
COLUMBUS COMMUNITY HOSPITAL INC

Employer identification number
47-0542043

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) COLUMBUS COMMUNITY HOSPITAL FOUNDATION 4600 38TH STREET COLUMBUS,NE68601	47-0836747	501(C)(3)	155,293	0	BOOK		CHARITY CARE TO PATIENTS

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2022

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference

Explanation

PART I, LINE 2:

COLUMBUS COMMUNITY HOSPITAL DOES NOT TYPICALLY GIVE OUT DONATIONS, BUT OCCASIONALLY A REQUEST IS BROUGHT FORWARD AND THE BOARD DETERMINES THAT IT IS IN THE BEST INTEREST OF THE COMMUNITY TO PROVIDE A PARTICULAR GRANT. PRIOR TO PROVIDING THE GRANT, THE HOSPITAL DETERMINES THAT THE ORGANIZATION IT GIVES TO IS A 501(C)(3) ORGANIZATION OR A GOVERNMENT AGENCY. THE HOSPITAL WILL ALSO MAKE GRANTS TO THESE RELATED ORGANIZATIONS AS NECESSARY TO SUPPORT THEIR EXEMPT PURPOSE.

Schedule I (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

COLUMBUS COMMUNITY HOSPITAL INC

Employer identification number

47-0542043

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Yes

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2022

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1SHAWN BRANDENBURG PHYSICIAN	(i) (ii)	653,009 ------------- 0	181,592 ------------- 0	19,500 ------------- 0	12,200 ------------- 0	30,031 ------------- 0	896,332 ------------- 0	0 ------------- 0
2MICHAEL HANSEN PRESIDENT/CEO/SECRETARY	(i) (ii)	501,279 ------------- 0	63,375 ------------- 0	20,500 ------------- 0	85,141 ------------- 0	39,313 ------------- 0	709,608 ------------- 0	0 ------------- 0
3MATTHEW PIEPER PHYSICIAN	(i) (ii)	504,833 ------------- 0	141,551 ------------- 0	20,500 ------------- 0	12,110 ------------- 0	30,031 ------------- 0	709,025 ------------- 0	0 ------------- 0
4ANTHONY KRUEGER PHYSICIAN	(i) (ii)	500,183 ------------- 0	131,170 ------------- 0	20,500 ------------- 0	12,200 ------------- 0	30,031 ------------- 0	694,084 ------------- 0	0 ------------- 0
5JOHN BEAUVAIS PHYSICIAN	(i) (ii)	621,457 ------------- 0	0 ------------- 0	19,500 ------------- 0	12,200 ------------- 0	30,031 ------------- 0	683,188 ------------- 0	0 ------------- 0
6ROBERT MILLER PHYSICIAN	(i) (ii)	383,464 ------------- 0	0 ------------- 0	0 ------------- 0	21,350 ------------- 0	0 ------------- 0	404,814 ------------- 0	0 ------------- 0
7CHAD VAN CLEAVE VP FINANCE	(i) (ii)	236,361 ------------- 0	23,718 ------------- 0	8,123 ------------- 0	33,349 ------------- 0	38,457 ------------- 0	340,008 ------------- 0	0 ------------- 0
8AMY BLASER VP BUSINESS DEVELOPMENT	(i) (ii)	206,043 ------------- 0	19,612 ------------- 0	7,543 ------------- 0	32,617 ------------- 0	38,006 ------------- 0	303,821 ------------- 0	0 ------------- 0
9SCOTT MESSERSMITH VP OPERATIONS	(i) (ii)	179,051 ------------- 0	19,359 ------------- 0	32,199 ------------- 0	31,895 ------------- 0	37,978 ------------- 0	300,482 ------------- 0	0 ------------- 0
10DOROTHY BYBEE VP NURSING	(i) (ii)	217,054 ------------- 0	20,736 ------------- 0	0 ------------- 0	9,392 ------------- 0	37,940 ------------- 0	285,122 ------------- 0	0 ------------- 0
11KEITH LUEDDERS VP ANCIALLARY SERVICES	(i) (ii)	175,411 ------------- 0	17,848 ------------- 0	10,163 ------------- 0	22,824 ------------- 0	37,812 ------------- 0	264,058 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2022

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
PART I, LINE 1A	THE ORGANIZATION PAID FOR SOCIAL AND HEALTH CLUB DUES AS PART OF THE CEO'S EMPLOYMENT AGREEMENT. THESE AMOUNTS WERE REFLECTED ON THE CEO'S W-2.
PART I, LINE 4B	THE FOLLOWING REPORTABLE INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN DURING THE 2022 CALENDAR YEAR. AMOUNTS DEFERRED FROM THE PLAN WERE INCLUDED IN COLUMN C OF THE SCHEDULE J: MICHAEL HANSEN - $69,891 AMY BLASER - $16,474 SCOTT MESSERSMITH - $16,261 CHAD VAN CLEAVE - $19,923 KEITH LUEDDERS - $14,993 PART I, LINE 4C: THE HOSPITAL'S EXECUTIVE COMPENSATION COMMITTEE, MADE UP OF INDEPENDENT HOSPITAL BOARD MEMBERS, REVIEWS THE CEO'S COMPENSATION ANNUALLY. THE WAGE RANGE IS COMPARED TO INFORMATION PROVIDED BY THIRD PARTY CONSULTANTS. DECISIONS ARE DOCUMENTED.
PART I, LINE 6	WITH THE ASSISTANCE OF TOWERS-WATSON, EXECUTIVE COMPENSATION CONSULTANTS, THE BOARD AUTHORIZED PAYING AN INCENTIVE TO THE EXECUTIVES FOR MEETING SPECIFIC BOARD-ESTABLISHED DIRECTIVES. THE BOARD AUTHORIZED PAYING UP TO 25% OF BASE COMPENSATION FOR MICHAEL HANSEN AND UP TO 20% FOR THE FOLLOWING VPS: - DOROTHY BYBEE - AMY BLASER - CHAD VAN CLEAVE - SCOTT MESSERSMITH - KEITH LUEDDERS THE INCENTIVE IS BASED ON GOALS ESTABLISHED BY THE BOARD WHICH ARE NOW REVIEWED ANNUALLY. ONE OF THE GOALS IS THE HOSPITAL'S OPERATING MARGIN. THE BOARD DETERMINES THE ASSOCIATED METRICS FOR EACH INDIVIDUAL GOAL. EACH OF THE GOALS IS THEN ASSIGNED A WEIGHT BASED ON THE LEVEL OF IMPORTANCE, AS DETERMINED BY THE BOARD. THE RESULTS ARE ENTERED AND THE METRIC IS TABULATED. THAT NUMBER IS MULTIPLIED BY THE CORRESPONDING WEIGHT. ONCE WEIGHTED, THE FIGURES ARE ADDED IN TOTAL TO ESTABLISH A SCORE BETWEEN 1 AND 5. NO INCENTIVE IS PAID IF THE HOSPITAL'S OPERATING MARGIN FALLS BELOW 5.0%, REGARDLESS OF THE OUTCOMES OF THE OTHER MEASURES. ANY PHYSICIAN BONUSES ARE BASED ON PRODUCTIVITY. THE INCENTIVES WERE PAID IN THIS FISCAL YEAR FOR WORK DONE IN THE PREVIOUS FISCAL YEAR. THE BONUSES PAID WERE: DOROTHY BYBEE - $20,735.52 CHAD VAN CLEAVE - $23,718.24 AMY BLASER - $19,612.32 SCOTT MESSERSMITH - $19,358.56 MICHAEL HANSEN - $63,375.00 KEITH LUEDDERS - $17,848.48 SHAWN BRANDENBURG - $181,592.36 MATTHEW PIEPER - $141,551.00 ANTHONY KRUEGER - $131,170.00

Schedule J (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

COLUMBUS COMMUNITY HOSPITAL INC

Employer identification number

47-0542043

Return Reference	Explanation
PART III, LINE 4A	COLUMBUS COMMUNITY HOSPITAL (CCH) IS A 47 BED ACUTE CARE HOSPITAL WHICH CURRENTLY EMPLOYS OVER 800 PEOPLE. IT IS A SIGNIFICANT, POSITIVE ECONOMIC FORCE FOR THE COLUMBUS AREA, RETURNING DOLLARS INTO THE ECONOMY THROUGH LOCAL PURCHASES BY THE ORGANIZATION AND SALARIES THAT RETURN TO THE COMMUNITY. IT IS AN ASSET FOR THE LOCAL COMMUNITIES WHERE PATIENTS CAN OBTAIN QUALITY HEALTH CARE WITHOUT THE NEED TO DRIVE OVER 50 MILES FOR CARE. CCH OFFERS A VARIETY OF SERVICES THAT PROVIDE NECESSARY CARE FOR AREA RESIDENTS. BELOW IS A BRIEF SUMMARY OF SERVICES OFFERED BY COLUMBUS COMMUNITY HOSPITAL. - ALL 47 BEDS OF THE HOSPITAL'S ACUTE CARE SERVICES ARE ALSO CERTIFIED AS SWING BEDS. - CCH PROVIDES CERTIFIED, DEDICATED MEDICAL INTERPRETERS TO ASSIST NON-ENGLISH SPEAKING PATIENTS. THE INTERPRETERS ARE AVAILABLE IN-HOUSE OR ON-CALL 24/7 AND SERVE AS A LIAISON BETWEEN THE CARE PROVIDERS AND THE PATIENT. - THE HOSPITAL PROVIDES ICU, MEDICAL SURGICAL, OB AND ORTHOPEDIC SERVICES, ALONG WITH A VARIETY OF COMPLIMENTARY ANCILLARY SERVICES. THESE ANCILLARY SERVICES INCLUDE WOUND CARE, DIABETIC EDUCATION AND CARDIAC REHAB AND ALSO INCLUDE CLINICAL PHARMACY SERVICES. TO ENHANCE PATIENT SAFETY, CCH USES BAR-CODED MEDICATION ADMINISTRATION, SMART PUMPS AND COMPUTERIZED PHYSICIAN ORDER ENTRY. - SO THAT AREA RESIDENTS CAN RECEIVE CARE CLOSE TO HOME, CCH OFFERS REHABILITATIVE SERVICES THAT INCLUDE PHYSICAL THERAPY, SPEECH THERAPY, OCCUPATIONAL THERAPY AS WELL AS SPECIALIZED MULTIDISCIPLINARY THERAPY PROGRAMS SUCH AS THRIVE CANCER REHABILIATION CARE, PARKINSON WELLNESS PROGRAM, ROCK STEADY BOXING, CONCUSSION MANAGEMENT TEAM, COMPLETE DECONGESTIVE LYMPHEDEMA THERAPY CLINIC, A DRIVER'S REHABILIATION PROGRAM, VISUAL AND VESTIBULAR REHAB, AQUATIC THERAPY PROGRAM, AND PELVIC FLOOR DYSFUNCTION (MALE/FEMALE URINARY INCONTINENCE AND PELVIC PAIN) PROGRAM. THE HOSPITAL'S WIGGLES AND GIGGLES THERAPY FOR KIDS OFFERS PEDIATRIC PHYSICAL, OCCUPATIONAL AND SPEECH FOR CHILDREN RANGING IN AGE FROM INFANTS TO ADOLESCENTS. IN NOVEMBER 2015, OUTPATIENT THERAPY SERVICES MOVED INTO FIRST FLOOR SPACE WITH GREATER ACCESS FOR PATIENTS AT THE NEW COLUMBUS WELLNESS CENTER AND NOW PATIENTS ARE INTEGRATED AND TRANSITIONED INTO MEDICAL WELLNESS PROGRAMS AFTER DISCHARGE SUCH AS THE PARKINSON'S EXERCISE GROUP, THE LOUD CROWD VOICE EXERCISE GROUP, TBI, & STROKE SUPPORT GROUP, SPINEFIT EXERCISE CLASSES, AI CHI EXERCISE CLASSES, AQUATIC EXERCISE CLASSES, AND TAI CHI FOR BETTER BALANCE CLASSES. - NURSES IN THE HOSPITAL'S SAME DAY SERVICES (SDS) DEPARTMENT PREPARE PATIENTS FOR SURGERY AND CARE FOR PATIENTS IN BOTH THE INPATIENT AND OUTPATIENT SETTING. THE DEPARTMENT OVERSEES SEVERAL OUTPATIENT PROCEDURES, INCLUDING 90 TO 100 ENDOSCOPY PROCEDURES EACH MONTH. SDS NURSES ALSO ADMINISTER BLOOD TRANSFUSIONS AND CHEMOTHERAPY INFUSIONS. - CCH OFFERS SOME OF THE MOST ADVANCED IMAGING SERVICES INCLUDING MRI, CT, DIGITAL MAMMOGRAPHY AND ULTRASOUND. RADIOLOGISTS ARE ON CAMPUS AND/OR AVAILABLE 24/7. ALL IMAGES ARE DIGITAL, AND THE DICTATION USED BY RADIOLOGISTS IS VOICE RECOGNIZED AND BECOMES PART OF THE DIGITAL IMAGE. - THE HOSPITAL'S LABORATORY PERFORMS AN AVERAGE OF OVER 13,000 TESTS PER MONTH FOR BOTH INPATIENTS AND OUTPATIENTS. - THE CCH EMERGENCY DEPARTMENT (ED) EMPLOYS HIGHLY TRAINED EMERGENCY PHYSICIANS AND NURSES, OFFERING 24/7 CARE. OTHER HOSPITAL DEPARTMENTS PROVIDING SUPPORT IN THE ED INCLUDE RESPIRATORY CARE, SOCIAL WORK, LABORATORY, MEDICAL INTERPRETERS AND DIAGNOSTIC IMAGING. IN MAY 2006, THE CCH EMERGENCY DEPARTMENT WAS DESIGNATED AS A LEVEL III TRAUMA CENTER. THE MEDICAL STAFF AND PERSONNEL IN THE TRAUMA CENTER HAVE RECEIVED SPECIALIZED TRAINING TO RESUSCITATE AND STABILIZE TRAUMA PATIENTS. THE TRAUMA PROGRAM PROVIDES SYSTEMATIC REVIEW OF TRAUMA CARE AND PARTICIPATES IN INJURY PREVENTION ACTIVITIES THROUGHOUT THE COMMUNITY. - CCH OPENED WOUND CARE SERVICES IN AUGUST 2008, OFFERING CLINIC HOURS ONE DAY PER WEEK. THE IDENTIFIED SERVICE AREA INCLUDES A 45-MILE RADIUS AROUND COLUMBUS. BY JANUARY 2009, A SECOND DAY WAS ADDED TO SUPPORT THE DEMAND. THE PROGRAM HAS EXCEEDED THE ANTICIPATED DEMAND AND PROVIDES A MUCH NEEDED SERVICE CLOSE TO HOME. THE CLINIC SEES ABOUT 100 PATIENTS PER MONTH FOR WOUND CARE.
PART III, LINE 4A (CONT)	- FOR SERVICES LOCATED IN FACILITIES OFF-SITE, THE LARGER SERVICES ARE HOME HEALTH AND HOSPICE. HOME HEALTH PROVIDES SKILLED HEALTH SERVICES FOR PATIENTS AT THEIR PLACE OF RESIDENCE. THE PROGRAM IS MEDICALLY DIRECTED AND MUST BE ORDERED BY THE ATTENDING PHYSICIAN. HOME HEALTH IS MEDICARE AND MEDICAID CERTIFIED AND MEETS THE REQUIREMENTS OF THE JOINT COMMISSION. SERVICES PROVIDED WITHIN THE PROGRAM ARE: O SUPERVISION AND ADMINISTRATION OF MEDICATIONS O INTRAVENOUS THERAPY O INSTRUCTING PATIENTS IN DIABETIC MANAGEMENT O NUTRITIONAL ASSESSMENTS O HOME HEALTH AIDES O PERSONAL CARE SERVICES O OCCUPATIONAL, SPEECH AND PHYSICAL THERAPIES - HOSPICE SERVICES ARE PROVIDED TO PERSONS WHO ARE NO LONGER RECEIVING CURATIVE TREATMENT AND WHOSE LIFE EXPECTANCY IS SIX MONTHS OR LESS. CARE IS PROVIDED BY AN INTERDISCIPLINARY TEAM WHICH CONSISTS OF THE PHYSICIAN, NURSE, SOCIAL WORKER, THERAPIST, HOME HEALTH AIDE, SPIRITUAL ADVISOR, VOLUNTEER AND OTHER HEALTH PROFESSIONALS. - OUR LOCAL HEALTHY FAMILY NEBRASKA PROGRAM (HFN) TARGETS YOUNG, PRIMARILY SINGLE, PREGNANT MOTHERS AND THEIR FAMILIES. OUR VOLUNTARY HFN HOME VISITATION PROGRAM TARGETS THE MOST VULNERABLE YOUNG WOMEN AND THEIR FAMILIES BY OFFERING THEM INTENSE, IN-HOME EDUCATION, SUPPORT AND RESOURCES. THIS HOME VISITING PROGRAM COVERS FAMILIES IN A FOUR COUNTY AREA. THE HFN REQUIRES EACH MOTHER/FAMILY TO ACTIVELY PARTICIPATE IN BUILDING AN INDIVIDUALIZED FAMILY PLAN. THIS STRENGTH-BASED APPROACH PROMOTES SELF-IMPROVEMENT AND ENHANCES SELF-ESTEEM AND INDEPENDENCE FOR OUR YOUNG PARENTS THAT WILL HELP THEM MAKE BETTER DECISIONS AND BREAK OUT OF DESTRUCTIVE CYCLES. - THE CCH SLEEP LAB OFFERS COMPLETE POLYSOMNOGRAPHIC SLEEP TESTING BY TRAINED AND LICENSED SLEEP TECHNICIANS FOR THE PURPOSE OF DIAGNOSING OBSTRUCTIVE/CENTRAL SLEEP APNEA. BOTH DAYTIME AND NIGHT SLEEP STUDIES ARE PERFORMED. - OCCUPATIONAL HEALTH SERVICES (OHS) OFFERS A MENU OF HEALTH CARE SERVICES DESIGNED TO PREVENT AND TREAT INJURIES IN THE WORKPLACE. PARTNERING WITH EMPLOYERS IN MORE THAN 800 COMPANIES AND WITH OTHER HEALTH CARE PROFESSIONS, OHS PROVIDES THE COLUMBUS AND REGIONAL AREA BUSINESSES AND INDUSTRY WITH A COMPREHENSIVE RANGE OF SERVICES DESIGNED TO SUPPORT AND MAINTAIN A HEALTHY, SAFE WORKFORCE WHILE ASSISTING THEM IN MEETING OSHA AND DOT COMPLIANCE REGULATIONS. THEIR FULL RANGE OF SERVICES INCLUDE: O A COMPREHENSIVE TESTING PROCEDURE CALLED PHYSICAL CAPACITY PROFILE (PCP) THAT MATCHES EMPLOYEES TO THE JOB AND IS DESIGNED TO ACCOMMODATE INDIVIDUALS WITH HANDICAPS. THE PCP SYSTEM WAS DEVELOPED BY AN ORTHOPEDIC PHYSICIAN. THROUGH USE OF THIS TESTING, MUSCULOSKELETAL IMBALANCES ARE DETECTED WHICH HELPS EMPLOYERS PLACE EMPLOYEES IN THE APPROPRIATE JOB TO MINIMIZE THE POTENTIAL OF INJURY. O 24/7 DRUG AND ALCOHOL TESTING SERVICES O PRE-EMPLOYMENT/POST JOB OFFER PHYSICAL ASSESSMENTS O ON-SITE NURSING SERVICES O HEARING/VISION TESTING O HEARING CONSERVATION PROGRAM MANAGEMENT O RESPIRATORY FIT TESTING O RESPIRATORY EVALUATION SERVICES O FLU SHOTS AND IMMUNIZATION PROGRAMS O WELLNESS PROGRAMS - LIFELINE, AN IN-HOME EMERGENCY RESPONSE PROGRAM, PROVIDES THE VITAL SAFETY NET THAT MANY PEOPLE NEED TO CONTINUE LIVING AT HOME IN FAMILIAR AND COMFORTING SURROUNDINGS. THE PROGRAM IS COMPLETELY FOCUSED ON ENSURING THE PATIENT'S INDEPENDENCE, SAFETY AND WELL-BEING IN THEIR HOME. IT OPERATES WITH A BRACELET WORN BY THE PATIENT WITH A BUTTON THAT CAN BE PRESSED IF HELP IS NEEDED. PRE-DETERMINED RESPONDERS ARE SUMMONED TO THEIR HOME OR EMERGENCY TRANSFER CAN BE CALL IF NEEDED. - MEALS ON WHEELS ARE PREPARED BY THE NUTRITION SERVICES DEPARTMENT AND ARE DELIVERED BY COMMUNITY VOLUNTEERS. SENIORS AND PHYSICALLY HANDICAPPED ADULTS QUALIFY FOR THE PROGRAM. SPECIAL DIETS CAN ALSO BE ACCOMMODATED. FINANCIAL ASSISTANCE IS AVAILABLE THROUGH THE NEBRASKA DEPARTMENT OF SOCIAL SERVICES. - THE HOSPITAL ALSO PARTICIPATES IN AND HAS HOSTED COUNTY-WIDE NATURAL DISASTER AND PANDEMIC DRILLS. AS A MEMBER OF A LARGER PREPAREDNESS TEAM, RROMRS, CCH CAN ASSIST OR RECEIVE ASSISTANCE FROM THIS REGION'S MEDICARE PROVIDERS. THROUGH THESE DRILLS AND EXERCISES, THE HOSPITAL IS WELL-PREPARED TO HANDLE A NATURAL DISASTER OR PANDEMIC SHOULD ONE ARISE. - TO BETTER SERVICE OUR COMMUNITY, COLUMBUS COMMUNITY HOSPITAL HAS PARTNERED WITH COLUMBUS CHILDREN'S HEALTHCARE TO CREATE THE COLUMBUS COMMUNITY HOSPITAL PEDIATRIC HOSPITALIST PROGRAM IN MAY OF 2017. THIS SERVICE IS APPLICABLE TO INPATIENT AND OBSERVATION CARE ONLY TO PATIENTS AGES NEWBORN TO AGE 18. PEDIATRIC HOSPITALISTS ROUTINELY COMPLETE ROUNDS IN MORNING AND EVENINGS, AND AS CENSUS AND ACUITY DEMANDS. PHYSICIANS FROM OTHER COMMUNITIES WHO ARE NOT CURRENTLY CREDENTIALED AT COLUMBUS COMMUNITY HOSPITAL MAY REFER TO THE PEDIATRIC HOSPITALIST GROUP FOR ADMISSION.
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 WILL BE AVAILABLE FOR ALL THE MEMBERS OF THE FINANCE COMMITTEE TO REVIEW. UPON COMMITTEE REVIEW, THE 990 WILL THEN BE SUBMITTED TO THE FULL BOARD FOR REVIEW AND THE BOARD WILL MAKE ANY CORRECTIONS IF APPLICABLE.
FORM 990, PART VI, SECTION B, LINE 12C	COLUMBUS COMMUNITY HOSPITAL MONITORS ANY CONFLICT OF INTEREST BASED ON THEIR CONFLICT OF INTEREST POLICY. EMPLOYEES AND VOLUNTEERS ARE REQUIRED TO FULLY DISCLOSE ANY CONFLICT OF INTEREST THAT MAY EXIST OR APPEARS TO EXIST. HOSPITAL REVIEWS ANY OF THESE CONFLICTS AND WORKS WITH THE VICE PRESIDENT OR CEO TO DETERMINE IF A CONFLICT EXISTS. IF ONE DOES EXIST, THE HOSPITAL INITIATES ACTIONS TO MANAGE, REDUCE, OR ELIMINATE THE CONFLICT.
FORM 990, PART VI, SECTION B, LINE 15	THE HOSPITAL'S EXECUTIVE COMPENSATION COMMITTEE, MADE UP OF INDEPENDENT HOSPITAL BOARD MEMBERS, REVIEWS THE CEO'S COMPENSATION ANNUALLY. THE WAGE RANGE IS COMPARED TO INFORMATION PROVIDED BY THIRD PARTY CONSULTANTS. DECISIONS ARE DOCUMENTED. THE HOSPITAL'S CEO AND DIRECTOR OF HUMAN RESOURCES, REVIEW THE VP'S AND OTHER HIGHLY COMPENSATED EMPLOYEE'S COMPENSATION ANNUALLY. THE WAGE RANGE IS COMPARED TO INFORMATION PROVIDED BY THIRD PARTY CONSULTANTS. DECISIONS ARE DOCUMENTED.
FORM 990, PART VI, SECTION C, LINE 19	AT COLUMBUS COMMUNITY HOSPITAL, A 3-RING BINDER EXISTS IN THE EXECUTIVE ASSISTANT'S OFFICE LABELED FOR PUBLIC DISCLOSURE WHICH INCLUDES THE MOST CURRENT OF THE FOLLOWING: A) GOVERNING DOCUMENTS WHICH ARE THE HOSPITAL'S BYLAWS B) CONFLICT OF INTEREST POLICY C) AUDITED FINANCIAL STATEMENTS D) FORMS 990 AND 990-T
FORM 990, PART XI, LINE 9:	NET ASSET CHANGE FOR HEALTHPARK AND ZARZ -376,704. OTHER CHANGES IN NET ASSETS -64,252.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

COLUMBUS COMMUNITY HOSPITAL INC

Employer identification number

47-0542043

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)COLUMBUS COMMUNITY HOSPITAL FOUNDATION 4600 38TH STREET COLUMBUS,NE68601 47-0836747	FUNDRAISING	NE	501(C)(3)	LINE 12, I	CCH	Yes
(2)HEALTHPARK TITLE COMPANY 4600 38TH STREET COLUMBUS,NE68601 47-0830945	HOLDING CO	NE	501(C)(2)	N/A	CCH	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2021

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) ZARZ LLC PO BOX 1800 COLUMBUS,NE68602 27-3676428	PROPERTY MGMT	NE	HLTHPK TITLE CO	1,255	18,700		No		Yes		0.890 %
(2) HEALTHPARK LLC PO BOX 1800 COLUMBUS,NE68602 47-0836733	PROPERTY MGMT	NE	HLTHPK TITLE CO	154,131	1,698,929		No		Yes		22.920 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No
(1) PLATTE VALLEY PHYSICIAN ORG PO BOX 1800 COLUMBUS,NE68602 47-0790385	HEALTH ADMIN	NE	CCH		7,720	21,305	100.000 %	Yes

Schedule R (Form 990) 2021

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

Yes

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) COLUMBUS COMMUNITY HOSPITAL FOUNDATION	B	155,293	CASH
(2) COLUMBUS COMMUNITY HOSPITAL FOUNDATION	C	2,646,156	CASH

Schedule R (Form 990) 2021

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2021

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2021

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: OUR MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	13
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	12
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	1,052
6	Total number of volunteers (estimate if necessary) .............	6	383
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	273,066
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	497,916	9,254,736
9	Program service revenue (Part VIII, line 2g) .........	131,318,499	146,739,020
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,671,152	1,270,322
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	5,568,796	2,932,865
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	139,056,363	160,196,943
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	107,572	155,293
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	66,795,234	75,675,681
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	62,333,076	73,680,485
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	129,235,882	149,511,459
19	Revenue less expenses. Subtract line 18 from line 12.......	9,820,481	10,685,484
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	199,011,973	208,645,655
21	Total liabilities (Part X, line 26).............	18,421,182	18,547,435
22	Net assets or fund balances. Subtract line 21 from line 20.....	180,590,791	190,098,220

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 145,743,906 including grants of $ 155,293 ) (Revenue $ 146,924,108 )
	SEE SCHEDULE O

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses145,743,906

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)			(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) DOROTHY BYBEE........................................................................ VP NURSING	39.00 .......................1.00	X		237,790	0	44,700
(19) KEITH LUEDDERS........................................................................ VP ANCIALLARY SERVICES	40.00 .......................0.00	X		203,422	0	58,132
(20) ROBERT MILLER........................................................................ PHYSICIAN	1.00 .......................0.00		X	383,464	0	21,350
(21) JOHN BEAUVAIS........................................................................ PHYSICIAN	40.00 .......................0.00		X	640,957	0	38,226
(22) ANTHONY KRUEGER........................................................................ PHYSICIAN	40.00 .......................0.00		X	651,853	0	38,226
(23) MATTHEW PIEPER........................................................................ PHYSICIAN	40.00 .......................0.00		X	666,884	0	38,136
(24) SHAWN BRANDENBURG........................................................................ PHYSICIAN	40.00 .......................0.00		X	854,101	0	38,226

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	4,955,634	0	601,230

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	2,646,156
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	6,608,580

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		9,254,736

		Business Code
2a	NET PATIENT SERVICE RE	621110	146,739,020	146,739,020
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		146,739,020

3 Investment income (including dividends, interest, and othersimilar amounts) ......			1,270,325			1,270,325
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		701,242	6a
b	Less: rental expenses		503,293	6b
c	Rental income or (loss)		197,949	6c
d	Net rental income or (loss).......			197,949			197,949
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses	3		7b
c	Gain or (loss)	-3		7c
d	Net gain or (loss).........			-3			-3
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	CAFETERIA		900099	449,175			449,175
b	MEALS ON WHEELS		900099	103,290	103,290
c	HEALTH WATCH		900099	81,798	81,798
d	All other revenue ....			2,100,653		273,066	1,827,587
e	Total. Add lines 11a–11d ......			2,734,916
12	Total revenue. See instructions.....			160,196,943	146,924,108	273,066	3,745,033

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	155,293	155,293
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	1,758,375		1,758,375
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	58,323,574	58,323,574
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	2,229,667	2,229,667
9	Other employee benefits .......	9,508,481	9,508,481
10	Payroll taxes ...........	3,855,584	3,855,584
11	Fees for services (non-employees):
a	Management ......
b	Legal .........
c	Accounting ...........	814,424		814,424
d	Lobbying ...........	9,482		9,482
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	30,000	30,000
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	9,410,675	9,410,675
12	Advertising and promotion ....	752,764		752,764
13	Office expenses .......	24,580,719	24,580,719
14	Information technology ......	2,021,548	2,021,548
15	Royalties ..
16	Occupancy ...........	2,212,620	2,212,620
17	Travel ............	279,457		279,457
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	153,051		153,051
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	10,720,799	10,720,799
23	Insurance ...	346,247	346,247
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	PROVISION FOR BAD DEBTS	8,914,334	8,914,334
b	MINOR EQUIP & FINANCING	6,230,930	6,230,930
c	PURCHASED SERVICES	3,539,224	3,539,224
d	RECRUITING	248,624	248,624
e	All other expenses	3,415,587	3,415,587
25	Total functional expenses. Add lines 1 through 24e	149,511,459	145,743,906	3,767,553	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			19,620,895	1	10,973,061
2	Savings and temporary cash investments .........			0	2	0
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			17,790,908	4	20,297,867
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........			447,891	7	652,777
8	Inventories for sale or use ............			3,512,914	8	4,047,596
9	Prepaid expenses and deferred charges ......			4,709,899	9	3,804,520
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	217,578,449
b	Less: accumulated depreciation	10b	88,230,416	97,915,329	10c	129,348,033
11	Investments—publicly traded securities .			54,454,266	11	38,898,988
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			559,871	15	622,813
16	Total assets. Add lines 1 through 15 (must equal line 33)...			199,011,973	16	208,645,655

17	Accounts payable and accrued expenses .....	18,421,182	17	18,547,435
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	0	25	0
26	Total liabilities. Add lines 17 through 25..	18,421,182	26	18,547,435

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	180,590,791	27	190,098,220
28	Net assets with donor restrictions ...........	0	28	0
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	180,590,791	32	190,098,220
33	Total liabilities and net assets/fund balances ........	199,011,973	33	208,645,655