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Nonprofiteer
← CHEYENNE COUNTY HOSPITAL ASSOCIATION INC

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

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.

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.

Provenance

Return type
form_990
Tax year
2024
Filed
13 November 2025
IRS schema version
2024v5.2
Source object
202543189349306639

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