SCHEDULE O
(Form 990 or 990-EZ)

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
2017
Open to Public
Inspection
Name of the organization
Farmers Union Hospital Association
 
Employer identification number

73-0579295
Return Reference Explanation
Form 990, Part VI, Section A, line 1 The Executive Committee is composed of the officers of the Board; President, Vice President, Secretary and Treasurer. The Hospital's Board President serves as the Chair of the Executive Committee. Other members may be added if advisable. The Executive Committee directly represents the Board and possesses the power to act for the Board within limits set for it by the Board, on matters needing immediate attention, prior to regular board meetings, and such other powers as delegated to it by the Board. The Executive Committee reports to the Board of Directors at the next regular or at the next special meeting called for that purpose.
Form 990, Part VI, Section A, line 6 Members are individuals who have voting shares in Great Plains Regional Medical Center. Membership is obtained through transfers of existing memberships. Transfers normally result either through voluntary surrender of a membership from a current member who is no longer interested in retaining their membership or through the death of a member who has no immediate family interested in retaining the membership. Each individual is allowed only one membership and there is only one vote allowed per membership.
Form 990, Part VI, Section A, line 7a Governing Board members are appointed through nomination and a majority vote election by the membership at annual meetings.
Form 990, Part VI, Section A, line 7b Any amendments to the Governing Board Bylaws and Rules & Regulations have to be approved by a majority vote of the membership. Per the Organization's Bylaws, the members are the supreme authority of the Association in all its affairs.
Form 990, Part VI, Section B, line 11b The Form 990 is presented and reviewed at the governing Board's monthly meeting. The 990 is also posted on the governing Board's website prior to the meeting.
Form 990, Part VI, Section B, line 12c All members of the governing board, officers and key employees receive a copy of the Conflict of Interest Policy on an annual basis. The individuals are required to review the policy and complete and sign the questionnaire attesting to their understanding of the policy and that their answers are true and accurate. The board as a whole reviews the conflict of interest statements. Any potential conflicts are discussed and depending on the conflict the board decides the appropriate action to take.
Form 990, Part VI, Section B, line 15a When determining the CEO's compensation, Human Resources conducts a comparative analysis of compensation by position using state, multi-state, regional and national compensation data. Data is selected from hospitals with similar bed size, revenue and other similar area comparatives. Human Resources then submits a report to the Executive Committee. This is completed on an annual basis. The Executive Committee reviews the data, confirms the data with an independent auditor and recommends appropriate CEO compensation to the Board of Directors. All other positions within the Hospital are reviewed annually by Human Resources and approved by the CEO.
Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.
Form 990, Part IX, line 11g Consulting: Program service expenses 3,623,125. Management and general expenses 350,160. Fundraising expenses 0. Total expenses 3,973,285. Service contracts: Program service expenses 829,792. Management and general expenses 273,445. Fundraising expenses 0. Total expenses 1,103,237. Contract labor: Program service expenses 3,094,719. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,094,719. Purchased services: Program service expenses 89,246. Management and general expenses 649,854. Fundraising expenses 0. Total expenses 739,100.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2017


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