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← LUTHERAN COMMUNITY HOSPITAL ASSOCIATION OF NORFOLK NEBRASKA

Form 990 for tax year 2023

Filed by LUTHERAN COMMUNITY HOSPITAL ASSOCIATION OF NORFOLK NEBRASKA.

Totals

Total revenue
$87,606
Total expenses
$5,634
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$0
Investment income
$87,606
Other revenue
$0
Total assets, end of year
$2,859,629
Total liabilities, end of year
$20,800
Net assets or fund balances, end of year
$2,838,829
Program services expenses (Part IX)
$0
Management and general expenses
$5,634
Fundraising expenses
$0
Program service expenses (Part III)
not reported

Program services were 0.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 3 · Investment income

    total $15,311 · excluded $15,311

  • 7a · Gross sales of assets other than inventory

    securities $72,295

  • 7b · Less cost or other basis and sales expenses

    securities $0

  • 7c · Gain or loss

    securities $72,295

  • 7d · Net gain or loss

    total $72,295 · excluded $72,295

Functional expenses

Part IX, the statement of functional expenses.

  • 11b · Fees: legal

    total $2,622 · management and general $2,622

  • 20 · Interest

    total $3,012 · management and general $3,012

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $192,746 · end of year $198,646

  • 11 · Investments: publicly traded securities

    beginning of year $2,219,622 · end of year $2,657,908

  • 15 · Other assets

    beginning of year $3,075 · end of year $3,075

  • 25 · Other liabilities

    beginning of year $96,872 · end of year $20,800

  • 27 · Net assets without donor restrictions

    beginning of year $1,613,783 · end of year $2,134,041

  • 28 · Net assets with donor restrictions

    beginning of year $704,788 · end of year $704,788

Mission and programs · 2023

Mission

TO SERVE CHRIST BY PROVIDING ALL PEOPLE WITH EXEMPLARY MEDICAL SERVICES IN AN ENVIRONMENT OF LOVE AND CARE.

Activities or mission (Part I)

TO SUPPORT FAITH REGIONAL HEALTH SERVICES.

  • LUTHERAN COMMUNITY HOSPITAL ASSOCIATION, SOLE MEMBER OF FAITH REGIONAL HEALTH SERVICES, SUPPORTS FAITH REGIONAL HEALTH SERVICES, WITH WHOM THEY OPERATE AN INTEGRATED HEALTHCARE SYSTEM.

As filed on the 2023 return.

Listed in Part VII

  • KELLY DRISCOLL

    CEO

    Total calculated
    $820,528
    From this org
    $0
    From related orgs
    $781,144
    Other
    $39,384
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $696,897 related
    Bonus
    $0 + $72,772 related
    Other
    $0 + $11,475 related
    Deferred
    $0 + $16,500 related
    Nontaxable benefits
    $0 + $25,083 related
    Filer's total
    $0 + $822,727 related

  • JANNA CLINE

    VP FINANCE

    Total calculated
    $302,707
    From this org
    $0
    From related orgs
    $272,156
    Other
    $30,551
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $272,106 related
    Bonus
    $0 + $50 related
    Other
    $0
    Deferred
    $0 + $8,317 related
    Nontaxable benefits
    $0 + $23,637 related
    Filer's total
    $0 + $304,110 related

  • PRESTON SUNDERMAN

    PRESIDENT

    Total calculated
    $0
    Hours/week
    2.5 + 1 related

  • JOHN ROBERTSON

    VICE PRESIDENT

    Total calculated
    $0
    Hours/week
    2.5 + 1.5 related

  • KAREN PETERSEN

    SECRETARY

    Total calculated
    $0
    Hours/week
    2.5

  • BRETT JACKSON

    TREASURER

    Total calculated
    $0
    Hours/week
    2.5 + 1.5 related

  • GAROLD KOLLMAR

    TREASURER THRU 12/23

    Total calculated
    $0
    Hours/week
    2.5

  • DR DAN BLOMENBERG

    MEMBER

    Total calculated
    $0
    Hours/week
    2.5

  • JENNIFER CARLISLE

    MEMBER

    Total calculated
    $0
    Hours/week
    2.5

  • JASON DOELE

    MEMBER

    Total calculated
    $0
    Hours/week
    2.5

  • MICHAEL SULLIVAN

    MEMBER

    Total calculated
    $0
    Hours/week
    2.5

  • REGINA BUSBOOM

    MEMBER

    Total calculated
    $0
    Hours/week
    2.5 + 1 related

  • LEON ROSENTHAL

    MEMBER

    Total calculated
    $0
    Hours/week
    2.5 + 1 related

  • CRAIG BOCHE

    MEMBER

    Total calculated
    $0
    Hours/week
    2.5

  • JOHN DINKEL

    MEMBER

    Total calculated
    $0
    Hours/week
    2.5

  • JERRELL DOLESH

    MEMBER

    Total calculated
    $0
    Hours/week
    2.5

  • DIANE BECKER

    MEMBER THRU 12/23

    Total calculated
    $0
    Hours/week
    2.5 + 1 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

None.

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3
LUTHERAN COMMUNITY HOSPITAL ASSOCIATION OF NORFOLK, NEBRASKA (LCHA) DOES NOT COMPENSATE ANY OFFICERS, DIRECTORS, OR KEY EMPLOYEES. THE COMPENSATION LISTED IN SCHEDULE J IS PAID BY FAITH REGIONAL HEALTH SERVICES (FRHS), A RELATED ENTITY. THEIR COMPENSATION IS DETERMINED BY GATHERING DATA FROM EXTERNAL SURVEYS AND FORM 990 DATA PROVIDED BY COMPARABLE FACILITIES. FACILITIES USED ARE SIMILAR IN BED SIZE, NET REVENUES AND NUMBER OF FTES. WAGES ARE GATHERED AND COMPARED BY TITLE, RESPONSIBILITIES AND YEARS OF EXPERIENCE. THE SALARY RECOMMENDATIONS ARE MADE BY THE FRHS HUMAN RESOURCES DEPARTMENT. THE FRHS GOVENING BOARD APPROVES THE SALARY RECOMMENDATIONS FOR THE CEO; THE CEO APPROVES THE RECOMMENDATIONS FOR THE OTHER OFFICERS AND VICE-PRESIDENTS; AND THE VICE-PRESIDENTS APPROVE THE RECOMMENDATIONS FOR THE DIRECTORS OF VARIOUS HOSPITAL DEPARTMENTS.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2023
Filed
15 January 2025
IRS schema version
2023v6.0
Source object
202540159349301494

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