Form 990 for tax year 2024
Filed by CHEYENNE COUNTY HOSPITAL ASSOCIATION INC.
Totals
- Total revenue
- $88,488,589
- Total expenses
- $87,136,958
- Contributions and grants received
- $1,008,404
- Grants paid
- $49,500
- Program service revenue
- $86,526,851
- Investment income
- $722,210
- Other revenue
- $231,124
- Total assets, end of year
- $121,972,149
- Total liabilities, end of year
- $60,805,763
- Net assets or fund balances, end of year
- $61,166,386
- Program services expenses (Part IX)
- $76,404,986
- Management and general expenses
- $10,731,972
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $76,404,986
Program services were 87.7% 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.
-
1d · Related organizations
$304,480
-
1e · Government grants (contributions)
$703,861
-
1f · All other contributions, gifts and grants
$63
-
2a · Program service revenue: NET PATIENT SERVICE REVENUE
total $84,876,287 · related or exempt $84,876,287
-
2b · Program service revenue: 340B REVENUE
total $486,298 · related or exempt $486,298
-
2c · Program service revenue: SCHOOL REHAB REVENUE
total $168,476 · related or exempt $168,476
-
2f · All other program service revenue
total $995,790 · related or exempt $995,790
-
3 · Investment income
total $821,296 · excluded $821,296
-
7b · Less cost or other basis and sales expenses
other assets $99,086
-
7c · Gain or loss
other assets -$99,086
-
7d · Net gain or loss
total -$99,086 · excluded -$99,086
-
11a · Other revenue: CAFETERIA
total $231,124 · excluded $231,124
-
11e · Other revenue, total
$231,124
Functional expenses
Part IX, the statement of functional expenses.
-
1 · Grants to domestic organizations and governments
total $49,500 · program services $49,500
-
5 · Compensation of officers, directors and key employees
total $1,656,390 · program services $1,383,911 · management and general $272,479
-
6 · Compensation of disqualified persons
total $195,586 · program services $195,586
-
7 · Other salaries and wages
total $34,719,458 · program services $30,736,922 · management and general $3,982,536
-
8 · Pension plan contributions
total $1,002,292 · program services $899,400 · management and general $102,892
-
9 · Other employee benefits
total $8,189,686 · program services $6,178,371 · management and general $2,011,315
-
10 · Payroll taxes
total $2,304,087 · program services $1,689,555 · management and general $614,532
-
11a · Fees: management
total $413,730 · management and general $413,730
-
11b · Fees: legal
total $99,344 · program services $102 · management and general $99,242
-
11c · Fees: accounting
total $66,095 · management and general $66,095
-
11g · Fees: other
total $10,946,963 · program services $10,511,576 · management and general $435,387
-
12 · Advertising and promotion
total $281,288 · program services $262,007 · management and general $19,281
-
13 · Office expenses
total $3,867,591 · program services $3,300,216 · management and general $567,375
-
14 · Information technology
total $133,610 · program services $75,109 · management and general $58,501
-
16 · Occupancy
total $1,074,365 · program services $957,677 · management and general $116,688
-
17 · Travel
total $1,183,068 · program services $1,168,289 · management and general $14,779
-
19 · Conferences, conventions and meetings
total $214,516 · program services $116,023 · management and general $98,493
-
20 · Interest
total $1,253,873 · program services $1,137,096 · management and general $116,777
-
22 · Depreciation, depletion and amortization
total $4,723,791 · program services $4,399,869 · management and general $323,922
-
23 · Insurance
total $1,162,149 · program services $127,015 · management and general $1,035,134
-
24a · Other expenses: MEDICAL SUPPLIES
total $11,529,000 · program services $11,529,000
-
24b · Other expenses: RECRUITING FEES
total $917,185 · program services $885,675 · management and general $31,510
-
24c · Other expenses: FOOD PRODUCTS
total $497,934 · program services $497,934
-
24d · Other expenses: MISCELLANEOUS
total $306,704 · program services $47,055 · management and general $259,649
-
24e · All other expenses
total $348,753 · program services $257,098 · management and general $91,655
Balance sheet
Part X, book values.
-
1 · Cash, non-interest-bearing
beginning of year $571,758 · end of year $13,029,617
-
2 · Savings and temporary cash investments
beginning of year $28,386,443 · end of year $13,227,112
-
4 · Accounts receivable
beginning of year $12,073,997 · end of year $25,058,845
-
7 · Other notes and loans receivable
beginning of year $968,288 · end of year $0
-
8 · Inventories for sale or use
beginning of year $2,019,859 · end of year $2,215,907
-
9 · Prepaid expenses and deferred charges
beginning of year $1,048,856 · end of year $1,429,203
-
10a · Land, buildings and equipment: cost or other basis
$97,098,786
-
10b · Land, buildings and equipment: accumulated depreciation
$43,056,071
-
10c · Land, buildings and equipment, net
beginning of year $42,834,005 · end of year $54,042,715
-
11 · Investments: publicly traded securities
beginning of year $8,617,321 · end of year $9,314,384
-
12 · Investments: other securities
end of year $268,382
-
14 · Intangible assets
beginning of year $1,090,156
-
15 · Other assets
beginning of year $9,645,203 · end of year $3,385,984
-
17 · Accounts payable and accrued expenses
beginning of year $9,732,154 · end of year $8,857,214
-
19 · Deferred revenue
beginning of year $0 · end of year $75,000
-
20 · Tax-exempt bond liabilities
beginning of year $7,000,596 · end of year $6,532,333
-
23 · Secured mortgages and notes payable
beginning of year $28,536,399 · end of year $39,861,190
-
25 · Other liabilities
beginning of year $2,689,267 · end of year $5,480,026
-
27 · Net assets without donor restrictions
beginning of year $59,297,470 · end of year $61,166,386
Mission and programs · 2024
Mission
TO REVOLUTIONIZE HEALTHCARE SERVICES IN THE REGION.
-
SIDNEY REGIONAL MEDICAL CENTER IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL WHICH PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY ROOM CARE SERVICE TO PATIENTS IN AND AROUND SIDNEY, NEBRASKA AND THE REGION. IT ALSO OPERATES LONG-TERM CARE FACILITIES AND TWO PROVIDER-BASED RURAL HEALTH CLINICS IN SIDNEY, NEBRASKA. DURING THE CURRENT YEAR, SRMC ALSO BEGAN PROVIDING GROUND AMBULANCE SERVICES UPON EXIT OF THE FORMER SERVICE PROVIDER.
Expenses $66,623,985 · Grants $49,500 · Revenue $65,705,832
-
THE EXTENDED CARE UNIT PROVIDED CARE FOR AN AVERAGE OF 48 PATIENTS DAILY DURING 2024. SRMC PROVIDED 17,661 RESIDENT DAYS OF CARE FOR IT'S RESIDENTS FROM THE CHEYENNE, DEUEL, KIMBALL AND SURROUNDING AREAS.
Expenses $5,180,010 · Revenue $5,644,368
-
IN 2024, THE HOSPITAL NURSING DEPARTMENT PROVIDED 2,048 PATIENT DAYS OF CARE, INCLUDING GENERAL INPATIENT, ICU PATIENTS AND SWING BED PATIENTS, AND DELIVERED 71 NEWBORNS FOR THE SEVEN COUNTY AREA THAT SIDNEY REGIONAL MEDICAL CENTER (SRMC) SERVES. SRMC HAD 4,436 PATIENTS SEEK CARE IN THE EMERGENCY DEPARTMENT DURING 2024 AND CARED FOR 351 OSERVATION PATIENTS WHO NEEDED CARE BUT DID NOT QUALIFY FOR INPATIENT SERVICES UNDER CMS RULES.
Expenses $4,600,991 · Revenue $15,176,651
As filed on the 2024 return. The filer continues this part on Schedule O, which is not shown here.
Listed in Part VII
-
JAMES POPOVICH MD
PHYSICIAN AT LARGE
- Total calculated
- $726,414
- From this org
- $667,835
- From related orgs
- $0
- Other
- $58,579
- Hours/week
- 39 + 1 related
Schedule J breakdown matched by us
- Base
- $637,835
- Bonus
- $30,000
- Other
- $0
- Deferred
- $23,000
- Nontaxable benefits
- $35,723
- Filer's total
- $726,558
-
APRIL SMITH MD
CHIEF OF MEDICAL STAFF
- Total calculated
- $657,209
- From this org
- $606,380
- From related orgs
- $0
- Other
- $50,829
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $556,380
- Bonus
- $50,000
- Other
- $0
- Deferred
- $15,250
- Nontaxable benefits
- $35,723
- Filer's total
- $657,353
-
WILLIAM PILE
CHAIRMAN
- Total calculated
- $0
- Hours/week
- 4
-
TIM MILLER
VICE CHAIRMAN
- Total calculated
- $0
- Hours/week
- 4
-
KATHY NARJES
SECRETARY
- Total calculated
- $0
- Hours/week
- 4
-
JEFF ELLWANGER
TREASURER
- Total calculated
- $0
- Hours/week
- 4
-
STAN BELIEU
MEMBER
- Total calculated
- $0
- Hours/week
- 4 + 1 related
-
NANCI MCCASLIN
MEMBER
- Total calculated
- $0
- Hours/week
- 4 + 1 related
-
CLEM SCHUMACHER
MEMBER
- Total calculated
- $0
- Hours/week
- 4
-
JEFF HELLER
MEMBER
- Total calculated
- $0
- Hours/week
- 4
-
WILLIAM ROBINSON
MEMBER
- Total calculated
- $0
- Hours/week
- 4
-
KELLY UTLEY
CFO
- Total calculated
- $272,334
- From this org
- $236,322
- From related orgs
- $0
- Other
- $36,012
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $235,530
- Bonus
- $0
- Other
- $792
- Deferred
- $12,278
- Nontaxable benefits
- $23,878
- Filer's total
- $272,478
-
JASON PETIK
CEO
- Total calculated
- $413,730
- From this org
- $413,730
- From related orgs
- $0
- Other
- $0
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $413,730
- Bonus
- $0
- Other
- $0
- Deferred
- $0
- Nontaxable benefits
- $0
- Filer's total
- $413,730
-
KELLY CASEY MD
SURGEON
- Total calculated
- $965,397
- From this org
- $913,997
- From related orgs
- $0
- Other
- $51,400
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $629,966
- Bonus
- $284,031
- Other
- $0
- Deferred
- $14,453
- Nontaxable benefits
- $37,097
- Filer's total
- $965,547
-
REBECCA L ALLARD MD
PHYSICIAN
- Total calculated
- $855,277
- From this org
- $800,348
- From related orgs
- $0
- Other
- $54,929
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $800,348
- Bonus
- $0
- Other
- $0
- Deferred
- $15,250
- Nontaxable benefits
- $39,823
- Filer's total
- $855,421
-
SARA SHOLAR MD
PHYSICIAN
- Total calculated
- $706,927
- From this org
- $656,189
- From related orgs
- $0
- Other
- $50,738
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $626,189
- Bonus
- $30,000
- Other
- $0
- Deferred
- $15,250
- Nontaxable benefits
- $35,632
- Filer's total
- $707,071
-
ARIEL SORIANO
PHYSICIAN
- Total calculated
- $722,536
- From this org
- $685,555
- From related orgs
- $0
- Other
- $36,981
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $640,555
- Bonus
- $45,000
- Other
- $0
- Deferred
- $19,483
- Nontaxable benefits
- $17,642
- Filer's total
- $722,680
-
JOSHUA CALDWELL
UROLOGIST
- Total calculated
- $739,162
- From this org
- $715,163
- From related orgs
- $0
- Other
- $23,999
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $539,407
- Bonus
- $175,756
- Other
- $0
- Deferred
- $15,250
- Nontaxable benefits
- $8,876
- Filer's total
- $739,289
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
- 1a · First-class or charter travel
- 1a · Housing allowance or residence for personal use
- 1b · Written policy on the line-1a expenses
- 2 · Substantiation required before reimbursing expenses
- 3 · Compensation committee
- 3 · Compensation survey or study
- 3 · Approval by the board or compensation committee
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 1A
- CHARTER AIRFAIRE, WHICH WAS ONLY FOR BUSINESS TRAVEL AND REIMBURSED UNDER AN ACCOUNTABLE PLAN, AND PAID HOUSING, PROVIDED BY THE HOSPITAL AND REQUIRED AS A CONDITION OF EMPLOYMENT FOR THE EMPLOYER'S CONVENIENCE, WAS PROVIDED FOR AERIEL SORIANO, PHYSICIAN, AND WAS NOT INCLUDED IN TAXABLE INCOME.
- SCHEDULE J, PART III:
- JASON PETIK, CEO, RECEIVES COMPENSATION FROM POUDRE VALLEY MEDICAL GROUP, AN UNRELATED ENTITY. POUDRE VALLEY MEDICAL GROUP PROVIDES MANAGEMENT SERVICES TO ITS CLIENTS, INCLUDING THE SIDNEY REGIONAL MEDICAL CENTER. THE SIDNEY REGIONAL MEDICAL CENTER'S BOARD OF DIRECTORS SETS THE COMPENSATION FOR MR. PETIK. MR. PETIK RECEIVED TOTAL COMPENSATION OF $413,730. MR. PETIK'S COMPENSATION IS REFLECTED IN PART IX, LINE 11A.
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
-
$21,000
ANNUAL DONATION
-
$10,000
SIDNEY HS PARTNERSHIP AGREEMENT
-
YOUTH LIVESTOCK SPONSORSHIP
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.
-
CHEYENNE COUNTY HOSPITAL AND HEALTH CENTER FOUNDATION
501(C)(3) · SUPPORT SIDNEY REGIONAL MEDICAL CENTER · NE
Taxable family on this return
Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.
Disregarded entities
Part I: entities that legally are the filer and file no return of their own.
-
SIDNEY REGIONAL MEDICAL CENTER LONG TERM CARE LLC
LONG-TERM CARE & ASSISTED LIVING · NE · income $6,091,185 · assets $3,120,780
Directly controlled by CHEYENNE COUNTY HOSPITAL ASSOCIATION INC
-
SIDNEY REGIONAL MEDICAL CENTER EMS LLC
EMERGENCY MEDICAL SERVICES · NE · income $325,269 · assets $277,718
Directly controlled by CHEYENNE COUNTY HOSPITAL ASSOCIATION INC
Provenance
- Return type
- form_990
- Tax year
- 2024
- Filed
- 13 November 2025
- IRS schema version
- 2024v5.2
- Source object
- 202543189349306639
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