JENNIE M MELHAM MEMORIAL MEDICAL CENTER INC: Form 990, tax year 2022
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- Organization
- JENNIE M MELHAM MEMORIAL MEDICAL CENTER INC (EIN 47-0426530)
- Tax period
- 2022-10-01 to 2023-09-30
- Filed
- 2024-08-09
- IRS object ID
- 202412229349301231
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-08-09T12:44:48-05:00 | ReturnTs |
| Tax Period End | 2023-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 476097913 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18081 BURT ST STE 200 | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 680224722 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470426530 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JENNIE M MELHAM MEMORIAL MEDICAL | BusinessNameLine1Txt |
| Business Name Line2 | CENTER INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | JENN | BusinessNameControlTxt |
| Phone | 3088724180 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 250 | AddressLine1Txt |
| City | BROKEN BOW | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68822 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KYLE D KELLUM | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 3088724180 | PhoneNum |
| Signature | 2024-08-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | WENDY R COOLEY CPA | PreparerPersonNm |
| PTIN | P01523804 | PTIN |
| Phone | 4023302660 | PhoneNum |
| Preparation | 2024-08-05 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2024-08-08 14:25:15Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KYLE D KELLUM | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 250 | AddressLine1Txt |
| City | BROKEN BOW | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68822 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $21,600,217 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MELHAM.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1962 | FormationYr |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Activity Or Mission | THE PRIMARY MISSION AND PURPOSE OF THE JENNIE M. MELHAM MEMORIAL MEDICAL CENTER IS TO IMPROVE THE QUALITY OF LIFE IN ITS SURROUNDING SERVICE AREA BY PROVIDING AN ENVIRONMENT WHICH PROMOTES THE BEST POSSIBLE DELIVERY OF EMERGENCY, INPATIENT, SNF/SWING BED, OUTPATIENT, AMBULATORY CARE, AND INDEPENDENT LIVING APARTMENT SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 132 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $74,827 | PYContributionsGrantsAmt |
| CY Contributions Grants | $125,511 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $18,917,672 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $20,405,599 | CYProgramServiceRevenueAmt |
| PY Investment Income | $692,227 | PYInvestmentIncomeAmt |
| CY Investment Income | $839,433 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$109,839 | PYOtherRevenueAmt |
| CY Other Revenue | -$90,817 | CYOtherRevenueAmt |
| PY Total Revenue | $19,574,887 | PYTotalRevenueAmt |
| CY Total Revenue | $21,279,726 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,252,227 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,260,684 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $10,136 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,463,565 | PYOtherExpensesAmt |
| CY Other Expenses | $10,355,624 | CYOtherExpensesAmt |
| PY Total Expenses | $17,715,792 | PYTotalExpensesAmt |
| CY Total Expenses | $19,616,308 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,859,095 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,663,418 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $55,083,378 | TotalAssetsBOYAmt |
| Total Assets EOY | $56,729,684 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,978,448 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,183,463 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $53,104,930 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $54,546,221 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | PARTNERING WITH YOU TO INSPIRE HEALTHY LIVING THROUGH QUALITY CARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $12,548,118 | ExpenseAmt |
| Revenue | $8,513,518 | RevenueAmt |
| Desc | JENNIE MELHAM MEMORIAL MEDICAL CENTER (JMMMC) OPERATES A 23-BED CRITICAL ACCESS HOSPITAL. IN ADDITION, THERE ARE 20 APARTMENTS DESIGNATED FOR THE ELDERLY. JMMMC PROVIDES OUTPATIENT SPECIALTY CLINICS AND SURGERY SERVICES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,394,071 | ExpenseAmt |
| Revenue | $2,404,823 | RevenueAmt |
| Desc | JMMMC PROVIDES 24/7 EMERGENCY SERVICES TO OUR COMMUNITY. WE ENCOUNTERED 2,249 EMERGENCY ROOM VISITS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,932,950 | ExpenseAmt |
| Revenue | $2,358,695 | RevenueAmt |
| Desc | JMMMC PROVIDES HIGH QUALITY, LOW COST ACUTE CARE TO OUR LOCAL COMMUNITY. THE ACUTE CARE DEPARTMENT EXPERIENCED 1,454 DAYS OF CARE. THIS INCLUDES SWING BED, INPATIENT AND OUTPATIENT OBSERVATION. THIS PROVIDES LOCAL ACCESS FOR OUR RESIDENTS TO OBTAIN QUALITY CARE. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $874,549 | ExpenseAmt |
| Revenue | $7,128,563 | RevenueAmt |
| Desc | JMMMC PROVIDES RADIOLOGY SERVICES WHICH INCLUDES MOBILE MRI SERVICES, X-RAY, DIGITAL MAMMOGRAPHY, BONE DENSITOMETRY AND CT. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $874,549 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $7,128,563 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $17,749,688 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 25 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 132 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CARLA BAZYN VPCFO | PersonNm |
| Phone | 3088724180 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 250 | AddressLine1Txt |
| City | BROKEN BOW | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68822 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| JEREMY CLINGEPEEL | ||||||||
| PRESIDENT/CEO THRU 1/23 | 40.00 | 2.00 | Yes (X) | $234,813 | $0 | $45,312 | ||
| DARCI SHEA | ||||||||
| RN | 40.00 | 0.00 | $190,392 | $0 | $51,711 | Yes (X) | ||
| CARLA BAZYN | ||||||||
| VP/CFO | 40.00 | 2.00 | Yes (X) | $154,978 | $0 | $53,235 | ||
| KATHRYN DECKER | ||||||||
| CNO | 40.00 | 0.00 | $187,040 | $0 | $7,872 | Yes (X) | ||
| JENNIFER SCHAAF | ||||||||
| PHARMACIST | 40.00 | 0.00 | $157,988 | $0 | $6,414 | Yes (X) | ||
| MARY HARVEY | ||||||||
| DIRECTOR OUTPATIENT SERVIC | 40.00 | 0.00 | $116,697 | $0 | $21,881 | Yes (X) | ||
| BEVERLY TREW | ||||||||
| NURSE | 40.00 | 0.00 | $109,024 | $0 | $22,526 | Yes (X) | ||
| JOHN SMITH | ||||||||
| CHAIRMAN | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| DON CANTRELL | ||||||||
| CHAIRMAN THRU 1/23 | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MIKE BORDERS | ||||||||
| VICE CHAIRMAN | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JOYCE RICHARDSON | ||||||||
| SECRETARY | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| COREY STAPLES | ||||||||
| TREASURER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| NORVAL L BOOKS | ||||||||
| MEMBER | 2.00 | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| STEPHANIE BOLDT | ||||||||
| INTERIM CEO 1/23 THRU 8/23 | 40.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| KYLE D KELLUM | ||||||||
| PRESIDENT/CEO FROM 8/23 | 40.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,150,932 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $208,951 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 11 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CENTRAL NEBRASKA MEDICAL CLINIC | |||||
| PO BOX 690 | BROKEN BOW | NE | 68822 | ER DOCTOR SERVICES | $1,108,682 |
| SANDHILLS ANESTHESIA SERVICES LLC | |||||
| 79568 SUMNER ROAD | BROKEN BOW | NE | 68822 | ANESTHESIA SERVICES | $717,983 |
| BRYAN MEDICAL CENTER | |||||
| PO BOX 82557 | LINCOLN | NE | 68501 | MOBILE PATIENT SERVICES | $169,332 |
| FIVE NINES TECHNOLOGY GROUP INC | |||||
| PO BOX 744821 | LOS ANGELES | CA | 90074 | IT SERVICES | $142,183 |
| DOCS WHO CARE INC | |||||
| 800 WEST FRONTIER LANE | OLATHE | KS | 66061 | ER DOCTOR SERVICES | $139,945 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $113,011 | GovernmentGrantsAmt |
| All Other Contributions | $12,500 | AllOtherContributionsAmt |
| Total Contributions | $125,511 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE - MEDICARE/MEDICA | 621110 | $13,165,650 | $13,165,650 |
| PATIENT SERVICE - PRIVATE PAY | 621110 | $7,103,058 | $7,103,058 |
| WELLNESS CENTER REVENUE | 624100 | $91,153 | $91,153 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $45,738 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $45,738 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $20,405,599 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $822,708 | TotalRevenueColumnAmt |
| Exclusion | $822,708 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $155,980 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $320,491 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$164,511 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$164,511 | TotalRevenueColumnAmt |
| Exclusion | -$164,511 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $16,725 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $16,725 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,725 | TotalRevenueColumnAmt |
| Exclusion | $16,725 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CAFETERIA SALES | Desc |
| Business | 722210 | BusinessCd |
| Total Revenue Column | $73,694 | TotalRevenueColumnAmt |
| Exclusion | $73,694 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $73,694 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,279,726 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,405,599 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $748,616 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $468,517 | TotalAmt |
| Management And General | $468,517 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,386,599 | TotalAmt |
| Program Services | $5,974,836 | ProgramServicesAmt |
| Management And General | $411,763 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $183,071 | TotalAmt |
| Program Services | $160,679 | ProgramServicesAmt |
| Management And General | $22,392 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,700,352 | TotalAmt |
| Program Services | $1,577,893 | ProgramServicesAmt |
| Management And General | $122,459 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $522,145 | TotalAmt |
| Program Services | $456,893 | ProgramServicesAmt |
| Management And General | $65,252 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,561 | TotalAmt |
| Management And General | $19,561 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,205 | TotalAmt |
| Management And General | $63,205 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,106,902 | TotalAmt |
| Program Services | $3,993,896 | ProgramServicesAmt |
| Management And General | $110,245 | ManagementAndGeneralAmt |
| Fundraising | $2,761 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,561,797 | TotalAmt |
| Program Services | $2,497,120 | ProgramServicesAmt |
| Management And General | $64,677 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $772,119 | TotalAmt |
| Program Services | $756,703 | ProgramServicesAmt |
| Management And General | $15,416 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $321,432 | TotalAmt |
| Program Services | $316,716 | ProgramServicesAmt |
| Management And General | $4,716 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,401 | TotalAmt |
| Program Services | $3,839 | ProgramServicesAmt |
| Management And General | $3,562 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,607 | TotalAmt |
| Program Services | $22,481 | ProgramServicesAmt |
| Management And General | $55,126 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,428,546 | TotalAmt |
| Program Services | $1,400,490 | ProgramServicesAmt |
| Management And General | $28,056 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $175,919 | TotalAmt |
| Program Services | $155,207 | ProgramServicesAmt |
| Management And General | $20,712 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| OTHER EXPENSE | $562,102 | $256,411 | $305,691 | |
| MINOR EQUIPMENT | $132,752 | $121,168 | $4,209 | $7,375 |
| DUES AND SUBSCRIPTIONS | $126,281 | $55,356 | $70,925 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,616,308 | TotalAmt |
| Program Services | $17,749,688 | ProgramServicesAmt |
| Management And General | $1,856,484 | ManagementAndGeneralAmt |
| Fundraising | $10,136 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $145 | BOYAmt |
| EOY | $145 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,524,351 | BOYAmt |
| EOY | $13,019,366 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,255,217 | BOYAmt |
| EOY | $2,480,310 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $172,752 | BOYAmt |
| EOY | $196,656 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $456,646 | BOYAmt |
| EOY | $458,868 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $189,346 | BOYAmt |
| EOY | $321,239 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $40,501,936 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $25,351,837 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,339,217 | BOYAmt |
| EOY | $15,150,099 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,354,464 | BOYAmt |
| EOY | $23,132,337 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $630,671 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $791,240 | BOYAmt |
| EOY | $1,339,993 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,083,378 | BOYAmt |
| EOY | $56,729,684 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,805,336 | BOYAmt |
| EOY | $1,930,534 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $173,112 | BOYAmt |
| EOY | $252,929 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,978,448 | BOYAmt |
| EOY | $2,183,463 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,104,930 | BOYAmt |
| EOY | $54,546,221 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,104,930 | BOYAmt |
| EOY | $54,546,221 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,083,378 | BOYAmt |
| EOY | $56,729,684 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,663,418 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$222,127 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $3,894 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $3,894 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | JMMMC PAID DUES TO THE AMERICAN HOSPITAL ASSOCIATION AND THE NEBRASKA HOSPITAL ASSOCIATION. A PORTION OF THE DUES FOR EACH ORGANIZATION WERE USED FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $42,942 | BeginningYearBalanceAmt |
| Contributions | $750 | ContributionsAmt |
| End Year Balance | $43,692 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $42,442 | BeginningYearBalanceAmt |
| Contributions | $500 | ContributionsAmt |
| End Year Balance | $42,942 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $41,192 | BeginningYearBalanceAmt |
| Contributions | $1,250 | ContributionsAmt |
| End Year Balance | $42,442 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $39,942 | BeginningYearBalanceAmt |
| Contributions | $1,250 | ContributionsAmt |
| End Year Balance | $41,192 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $38,692 | BeginningYearBalanceAmt |
| Contributions | $1,250 | ContributionsAmt |
| End Year Balance | $39,942 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $374,644 | OtherCostOrOtherBasisAmt |
| Book Value | $374,644 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,733,761 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,277,277 | DepreciationAmt |
| Book Value | $5,456,484 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,095,865 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,242,369 | DepreciationAmt |
| Book Value | $1,853,496 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,297,666 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,832,191 | DepreciationAmt |
| Book Value | $7,465,475 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $15,150,099 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| 457 PENSION LIABILITIES | $176,670 |
| RIGHT TO USE LEASE LIABILITY | $76,259 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $252,929 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | PROVIDE SUPPORT TO ENSURE CONTINUED OPERATION OF JENNIE M. MELHAM MEMORIAL MEDICAL CENTER. |
| PART X, LINE 2: | THE MEDICAL CENTER ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES. THE MEDICAL CENTER RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT SEPTEMBER 30, 2023, THE MEDICAL CENTER HAD NO UNCERTAIN TAX POSITIONS ACCRUED. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,244 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $25,244 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,470,999 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,470,999 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,496,243 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,470,999 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $25,244 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $45,509 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $45,509 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00230 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $295,598 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $295,598 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01510 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $341,107 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $341,107 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01740 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,837,350 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,470,999 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $366,351 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01870 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,992 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,992 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,704 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,704 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,912 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,912 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,830 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,830 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,293 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $17,293 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $32,731 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $32,731 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $322,662 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $9,769,515 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,828,752 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$59,237 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JENNIE M MELHAM MEMORIAL MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 250 | AddressLine1Txt |
| City | BROKEN BOW | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68822 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.MELHAM.ORG | WebsiteAddressTxt |
| State License | 100004 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JENNIE M MELHAM MEMORIAL MED CTR INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.MELHAM.ORG/DOWNLOADS | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.MELHAM.ORG/DOWNLOADS | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.MELHAM.ORG/FINANCIAL-ASSISTANCE-PROGRAM | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.MELHAM.ORG/FINANCIAL-ASSISTANCE-PROGRAM | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.MELHAM.ORG/FINANCIAL-ASSISTANCE-PROGRAM | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| JENNIE M. MELHAM MEMORIAL MED. CTR. INC. | PART V, SECTION B, LINE 5: IN ORDER TO UPDATE THE FISCAL YEAR 2022 CHNA THE MEDICAL CENTER'S ADMINISTRATION ALONG WITH VVV CONSULTANTS, LLC COLLECTED AND ANALYZED THE MOST CURRENT STATE, FEDERAL AND COMMUNITY DATABASES TO UNDERSTAND THE DEMOGRAPHIC MAKEUP AND TRENDS IN THE SERVICE AREA. THIS INFORMATION WAS USED TO BETTER UNDERSTAND HOW THESE TRENDS AFFECT THE MEDICAL CENTER'S CURRENT AND FUTURE PROVISION OF HEALTHCARE TO MEET THE COMMUNITY AND COUNTY'S HEALTH NEEDS. THE MEDICAL CENTER PARTNERED WITH VVV CONSULTANTS, LLC AND THE LOUP BASIN PUBLIC HEALTH DEPARTMENT (LBPHD) IN DEVELOPMENT AND ADMINISTRATION OF A 2022 COMMUNITY THEMES AND STRENGTHS ASSESSMENT SURVEY OF RESIDENTS HEALTHCARE STATUS AND NEEDS IN THE LBPHD'S NINE COUNTY SERVICE AREA.THE RESULTS OF THE SURVEY WERE SEGREGATED OUT BY CITY/COUNTY SO THAT THIS INFORMATION COULD BE BROKEN DOWN AND USED BY EACH OF THE HOSPITALS IN THE REGION FOR PLANNING PURPOSES. THE MEDICAL CENTER USED THE BROKEN BOW AND CUSTER COUNTY SURVEY RESULTS IN THE 2022 CHNA PLANNING PROCESS. |
| JENNIE M. MELHAM MEMORIAL MED. CTR. INC. | PART V, SECTION B, LINE 6B: LOUP BASIN PUBLIC HEALTH DEPARTMENT |
| JENNIE M. MELHAM MEMORIAL MED. CTR. INC. | PART V, SECTION B, LINE 11: THE ASSESSMENT SURVEY IDENTIFIED THE FOLLOWING KEY NEED AREAS: 1. ACCESS TO MENTAL HEALTH SERVICES2. HOUSING AVAILABILITY3. ACCESS TO PRIMARY CARETHE MEDICAL CENTER USED THE INFORMATION FROM THE COMMUNITY INSIGHT VIA AN ONLINE PERCEPTION SURVEY AND MAPP PROCESS TO ASSIST IN UPDATING PLANS FOR HEALTH SCREENING, HEALTH EDUCATION AND WELLNESS ACTIVITIES IN THE COMMUNITY. FEEDBACK ON THE CHNA AND CHIP WAS SOUGHT FROM THE LBPHD, MEDICAL CENTER BOARD OF DIRECTORS, AND LOCAL MEDICAL STAFF. ALL FEEDBACK WAS USED TO REFINE THE 2022 CHNA AND CHIP FOR THE MEDICAL CENTER'S SERVICE AREA. SOME OF THE ACTIVITIES THAT WERE DEVELOPED AND IMPLEMENTED BY THE MEDICAL CENTER AS A RESULT OF THE 2022 CHNA AND CHIP FOR OUR SERVICE AREA:ACCESS TO MENTAL HEALTH SERVICES WAS NOTED BY SURVEY PARTICIPANTS AS A NEED. THE MEDICAL CENTER HAS MANY OTHER FINANCIAL COMMITMENTS TO ENSURE PROVISION OF OTHER KEY MEDICAL CARE NEEDS IN THE COMMUNITY. THERE ARE EXISTING PROVIDERS IN THE COMMUNITY WHO ADDRESS MENTAL HEALTH ISSUES FOR ALL AGES WITH WHOM THE MEDICAL CENTER CAN PARTNER TO AVOID DUPLICATION OF SERVICES AND UNNECESSARY COMPETITION. THERE IS LIMITED GRANT FUNDING BASED ON UTILIZATION ON WHICH THESE NON-PROFIT AGENCIES RELY.THE MEDICAL CENTER COLLABORATED WITH THE SANDHILLS COMMUNITY INITIATIVE TO IDENTIFY AND PUBLISH AVAILABLE COMMUNITY CRISIS RESOURCES INCLUDING THE PROMOTION OF THE STATE 988 24-HOUR CRISIS HOTLINE.THE MEDICAL CENTER CONTINUES TO EDUCATE EMERGENCY DEPARTMENT STAFF REGARDING MENTAL HEALTH DELIVERY ISSUES AND HOW TO ADDRESS THEM. THE MEDICAL CENTER ALSO PROVIDES CONTINUING EDUCATION COURSES AND LUNCH AND LEARN PRESENTATIONS TO KEEP EVERYONE CURRENT IN TERMS OF TREATING MENTAL HEALTH ISSUES. THE MEDICAL CENTER HAS PARTNERED WITH THE BROKEN BOW POLICE DEPARTMENT TO CHARTER A CUSTER COUNTY MENTAL HEALTH TASK FORCE COMPRISED OF COUNTY SCHOOL DISTRICTS, LOCAL MENTAL HEALTH THERAPISTS, CUSTER COUNTY SHERIFF, NEBRASKA HIGHWAY PATROL, CALLAWAY DISTRICT HOSPITAL, AND CONSUMERS OF MENTAL HEALTH SERVICES. THE TASK FORCE EXISTS TO IDENTIFY MENTAL HEALTH NEEDS AND RESOURCES, REDUCE FRAGMENTATION OF SERVICES AMONG PROVIDERS, AND DEVELOP PLANS FOR COMMUNITY RESPONSE TO MENTAL HEALTH NEEDS. THE TASK FORCE RECENTLY PARTNERED WITH CUSTER AREA ROTARY AND RECEIVED A GRANT TO BRING THE WELLNESS RECOVERY ACTION PLAN (WRAP) TOOL TO THE COUNTY. LOCAL TRAINERS WILL WORK WITH LOCAL THERAPISTS, EMPLOYERS, AND SCHOOLS TO COORDINATE WRAP COMPLETION BY COMMUNITY MEMBERS TO PROACTIVELY ADDRESS WELLNESS, RECOVERY, STRESSORS, AND SUPPORT SYSTEMS. THE PLAN WILL THEN BE AVAILABLE TO LOCAL LAW ENFORCEMENT AND FIRST RESPONDERS IN A STANDARDIZED FORMAT TO ASSIST THEM IN ADDRESSING INDIVIDUALS IN CRISIS WITH THE GOAL OF AVOIDING ESCALATION OF CRISIS SITUATIONS.THE MEDICAL CENTER CURRENTLY PARTNERS WITH RICHARD YOUNG BEHAVIOR HEALTH TO PROVIDE INDIVIDUAL PSYCHOLOGICAL SERVICES VIA TELEHEALTH IN THE SPECIALTY CLINIC.THE MEDICAL CENTER HAS BEEN AN ACTIVE PART OF THE CUSTER ECONOMIC DEVELOPMENT CORPORATION (CEDC). THE CEDC HAS BEEN DEVELOPING THE COUNTYWIDE HOUSING DEVELOPMENT PLAN THAT WILL ADDRESS AFFORDABLE/SAFE HOUSING FOR RESIDENTS. THE CEDC IS ALSO WORKING TO SEEK ADDITIONAL GRANT MONEY TO ALLOW FOR LOCAL CONTRACTORS TO BID HOUSING DEVELOPMENT PROJECTS.THE MEDICAL CENTER IS EVALUATING DIFFERENT AVENUES THAT MAY HELP WITH THE NEED OF ACCESS TO PRIMARY CARE. THE IDEAS RANGE FROM CONDUCTING A FORMAL PHYSICIAN MANPOWER ASSESSMENT TO DOCUMENT THE NUMBER OF PCP AND STAFF NEEDED TO THE FEASIBILITY OF EXPANDING THE CLINIC'S AFTER-HOUR CARE PROGRAM TO ALLOW FORM MORE WALK-INS.THERE WERE NO SIGNIFICANT NEEDS IDENTIFIED THAT ARE NOT BEING ADDRESSED.DURING THE FISCAL YEAR ENDING 9/30/23, THE MEDICAL CENTER STARTED EXPLORING TELEHEALTH OPTIONS FOR CHILD PSYCHIATRY. THIS HAS LED TO IDENTIFYING A PHYSICIAN AND DISCUSSING CONTRACTING TERMS TO PROVIDE SAID SERVICE.THE MEDICAL CENTER HAS HAD MULTIPLE DISCUSSIONS RELATED TO THE EXPANSION OF PRIMARY CARE. IT WAS DECIDED TO PLACE THOSE DISCUSSIONS INTO THE CURRENT 3-YEAR STRATEGIC PLAN. OPTIONS INCLUDE A FREESTANDING URGENT CARE, AND POTENTIAL WALK-IN CLINIC(S) OUTSIDE OF BROKEN BOW. ADDITIONALLY, COLLABORATIVE DISCUSSIONS WITH THE INDEPENDENT PRIMARY CARE OFFICE IN BROKEN BOW HAVE OCCURRED RELATIVE TO PROVIDER SUCCESSION PLANNING. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - LIBERTY SQUARE APARTMENTS | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 250 | AddressLine1Txt |
| City | BROKEN BOW | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68822 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | SENIOR INDEPENDENT LIVING APARTMENT COMPLEX | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | ELIGIBILITY IS MAINLY BASED UPON FEDERAL POVERTY GUIDELINES, HOWEVER, OTHER FACTORS WILL COME INTO THE DECISION MAKING PROCESS. THESE FACTORS INCLUDE AGE, EXISTING MEDICAL DEBT, EXISTING NON-MEDICAL DEBT, ASSET OWNERSHIP, INVESTMENTS AND ANY OTHER PERTINENT INFORMATION. THE INCOME GUIDELINES ALLOW FOR ASSISTANCE, BASED UPON A SLIDING SCALE, WHERE INCOME IS FROM ANYWHERE FROM 100% TO 200% OF FEDERAL POVERTY GUIDLINES. |
| PART I, LINE 6A: | JMMMC'S COMMUNITY BENEFIT REPORT IS NOT PREPARED BY A RELATED ORGANIZATION. |
| PART I, LINE 7: | JMMMC USED THE SEPTEMBER 30, 2023 COST REPORT AND AUDITED FINANCIAL STATEMENTS TO CALCULATE THE AMOUNT REPORTED ON PART I, LINE 7. JMMMC TOOK CHARGES FROM THE COST REPORT AND TEH AUDITED FINANCIAL STATMENTS THEN REDUCED THOSE NUMBER TO A COST BASIS USING A COST-TO-CHARGE RATIO. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | JMMMC'S COMMUNITY BUILDING ACTIVITIES INCLUDE DISASTER TRAINING ACTIVITIES EXPENSES. JMMMC HAS WORKED WITH COMMUNITY AND REGIONAL ORGANIZATIONS TO DEVELOP DISASTER PLANS AND TRAIN BOTH OUR STAFF AND OTHER EXTERNAL ORGANIZATION'S STAFF FOR ANY POTENTIAL DISASTER RESPONSE. MEETING ROOMS, INCLUDING SOME WITH TELE VIDEO CAPABILITIES ARE AVAILABLE AND USED BY AREA ORGANIZATIONS FREE OF CHARGE. THIS SAVES THESE ORGANIZATIONS SIGNIFICANT SUMS OF MONEY, KEEPING THEIR STAFF AND VOLUNTEERS HERE LOCALLY AS OPPOSED TO COMMUTING UPWARDS OF 200 MILES OR MORE FOR CERTAIN TRAINING EVENTS. WEIGHTWATCHERS MEETS AT JMMMC TO PROVIDE THE COMMUNITY THE OPPORTUNITY TO LEARN HEALTHY EATING LIFESTYLES. |
| PART III, LINE 2: | THE MEDICAL CENTER DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION EXPERIENCE WITH VARIOUS CLASSES OF PATIENTS. THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. |
| PART III, LINE 4: | PAGES 9, 11 AND 13 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS INCLUDE FOOTNOTES TITLED "PATIENT RECEIVABLES", "PATIENT SERVICE REVENUE", AND "PATIENT FINANCIAL ASSISTANCE" THAT PROVIDE DESCRIPTIONS OF IMPLICIT PRICE CONCESSIONS. |
| PART III, LINE 8: | JMMMC USED THE SEPTEMBER 30, 2023 COST REPORT TO CALCULATE THE AMOUNT REPORTED ON PART III, LINE 6. ALL MEDICARE SHORTFALL IS TREATED AS COMMUNITY BENEFITS AS PROVIDING SERVICES TO MEDICARE IS REQUIRED AND THE ELDERLY IS A CHARITABLE CLASS. |
| PART III, LINE 9B: | IF A PATIENT IS IDENTIFIED THAT IS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE, EFFORTS TO REACH OUT TO THIS INDIVIDUAL OR THE INDIVIDUAL'S FAMILY ARE MADE. THE PATIENT OR FAMILY IS REQUESTED TO COMPLETE A CHARITY CARE APPLICATION TO FORMALIZE THE PROCESS. AT THE TIME A COMPLETED APPLICATION IS RECEIVED, ALL COLLECTION EFFORTS ARE CEASED UNTIL A DETERMINATION IS MADE TO THE QUALIFICATION OF THE INDIVIDUAL. |
| PART VI, LINE 2: | THERE IS NO FORMAL POLICY TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY JMMMC SERVES OTHER THAN THE NEEDS ASSESSMENT THAT WAS CONDUCTED DURING THE 2021 TAX YEAR. |
| PART VI, LINE 3: | ALL PRIVATE PAY PATIENT ACCOUNTS ARE REVIEWED BY THE BILLING STAFF. DURING THE REVIEW PROCESS, PATIENTS THAT ARE IDENTIFIED AS POTENTIAL CANDIDATES FOR ELIGIBILTY AND ASSISTANCE ARE CONTACTED BY THE BILLING STAFF. THE BILLING STAFF ENCOURAGES THE PATIENTS TO CONTACT THE APPROPRIATE AGENCY, MAINLY THE STATE MEDICAID PROGRAM, IN ORDER FOR THEM TO ASCERTAIN THEIR ELIGIBILITY. KNOWN INDIGENT PATIENTS ARE ENCOURAGED TO COMPLETE A CHARITY CARE APPLICATION. A FINANCIAL ASSISTANCE POLICY SUMMARY IS INCLUDED WITH ALL FIRST BILLINGS. INFORMATION REGARDING THE FINANCIAL ASSISTANCE POLICY IS INCLUDED ON ALL STATEMENTS SENT OUT. |
| PART VI, LINE 4: | JENNIE M. MELHAM MEMORIAL MEDICAL CENTER SERVES THE PEOPLE OF CENTRAL NEBRASKA. LOCATED IN BROKEN BOW, THE COUNTY SEAT, THE PRIMARY SERVICE AREA ENCOMPASSES CUSTER COUNTY, BLAINE COUNTY, THOMAS COUNTY, LOUP COUNTY AND PARTS OF SHERMAN COUNTY. THE SERVICE AREA IS A VERY RURAL AREA. SOME COUNTIES OR PARTS THEREOF SERVED ARE AMONG THE SPARCEST POPULATED AREAS IN THE UNITED STATES. THE PRIMARY SERVICE AREA CONSISTS OF A POPULATION BASIS OF APPROXIMATELY 12,000. A LARGE PORTION OF THE POPULATION SERVED IS OVER AGE 65, RESULTING IN A LARGE NUMBER OF PATIENTS SEEN AT THE MEDICAL CENTER BEING COVERED BY THE MEDICARE PROGRAM. OVER 50% OF GROSS PATIENT REVENUE GENERATED AT THE MEDICAL CENTER IS MEDICARE. THE MEDICARE ADVANTAGE GROSS PATIENT REVENUE IS 7%. ADDITIONALLY, 8% OF GROSS PATIENT REVENUE IS RECEIVED FROM THE MEDICAID PROGRAM. |
| PART VI, LINE 5: | JMMMC FURTHER PROMOTES THE HEALTH OF THE COMMUNITY BY THE FOLLOWING ACTIONS AND INITIATIVES:JMMMC PARTICIPATES WITH AREA COMMUNITY COLLEGES BY SERVING AS A CLINICAL ROTATION SITE FOR PHYSICIAN, PHYSICIAN ASSISTANT, PHARMACY, MEDICAL TECHNOLOGY, LPN, RN, MEDICAL TRANSCRIPTIONIST, PHYSICAL THERAPIST AND RADIOLOGY TECHNOLOGY STUDENTS. SPACE AND STAFF OVERSIGHT IS PROVIDED AT NO COST TO THE COLLEGE OR THE STUDENT. JMMMC ALSO OWNS A RESIDENTIAL HOUSE THAT IS USED TO MAKE FREE HOUSING AVAILABLE TO MANY OF THE STUDENTS WHO COME FROM OUT OF TOWN TO PARTICIPATE IN THE ABOVE STATED TRAINING PROGRAMS. JMMMC COVERS THE COSTS RELATED TO MAINTENANCE, HEATING, COOLING, LIGHTING, LAUNDRY/LINEN, INTERNET, AND OTHER COSTS FOR THIS HOUSE.JMMMC ASSISTS WITH LOCAL ECONOMIC DEVELOPMENT CORPORATION PROGRAMS DESIGNED TO PROMOTE INTEREST IN HEALTH CARE CAREERS. IT IS JMMMC'S HOPE THAT BY CREATING LOCAL INTEREST IN HEALTH CARE CAREERS JMMMC WILL INSPIRE LOCAL RESIDENTS TO SEEK OUT TRAINING AND RETURN TO THE COMMUNITY TO PURSUE A CAREER IN HEALTH CARE. JMMMC PARTNERS WITH LOCAL HIGH SCHOOLS TO PROMOTE HEALTHCARE CAREERS TO LOCAL STUDENTS. THROUGH HOSA (HEALTH OCCUPATIONS STUDENTS OF AMERICA), A FUTURE HEALTH CARE PROFESSIONALS CHAPTER AT BROKEN BOW HIGH SCHOOL, SPEARHEADED BY JMMMC, THE MEDICAL CENTER PROVIDES SPEAKERS, MENTORSHIP, AND JOB SHADOW EXPERIENCES TO STUDENTS. THE MEDICAL CENTER PARTNERS WITH THE LOCAL HIGH SCHOOL AND COMMUNITY COLLEGE TO PROVIDE CERTIFIED NURSING ASSISTANT CLASSES TO HIGH SCHOOL STUDENTS.NOT ALL PATIENTS HAVE AN ABILITY TO PAY AT TIME OF SERVICE. JMMMC HAS DEVELOPED GUIDELINES THAT DO NOT REQUIRE PAYMENT IN FULL AT TIME OF SERVICE FOR EMERGENT, URGENT OR ELECTIVE SERVICES AND ALLOWS FOR EXTENDED PERIODS OF TIME FOR PAYMENT OF THE DEBT AND NO INTEREST CHARGES ARE INCURRED. EVERY EFFORT IS MADE BY JMMMC TO KEEP HEALTHCARE AFFORDABLE FOR AREA PATIENTS.MEDICAL CENTER MEETING ROOMS ARE PROVIDED FREE OF CHARGE TO OUTSIDE COMMUNITY SERVICE ORGANIZATIONS WHO ARE PROMOTING HEALTHY LIFESTYLES AND WELLNESS PROMOTION.FREE BROADBAND ACCESS AND COMPUTER RESOURCES ARE PROVIDED FREE OF CHARGE TO LOCAL EMT VOLUNTEERS ALLOWING THEM TO BE MORE EFFICIENT IN THEIR DUTIES. THIS ALLOWS FOR BETTER PARTICIPATION IN THE EMT PROGRAM, THUS EXTENDING EMERGENCY TRANSFER SERVICES TO LOCAL RESIDENTS AND VISITORS. TELEVIDEO EQUIPMENT IS PROVIDED FREE OF CHARGE TO AREA EMT VOLUNTEERS. THIS ALLOWS FOR QUARTERLY TRAINING TO BE PROVIDED LOCALLY THAT IS REQUIRED TO MEET THEIR CONTINUING EDUCATION REQUIREMENTS AND MAINTAIN THEIR CERTIFICATION. THE AVAILABILITY OF THIS SERVICE FOR THE EMTS RESULTS IN SIGNIFICANT SAVINGS IN TERMS OF TRAVEL COSTS AND TRAVEL TIME, HELPING BOOST MORALE AND ENCOURAGING PARTICIPATION OF THIS EXTREMELY IMPORTANT SERVICE. IN THIS RURAL COMMUNITY, THERE IS NO OTHER EMERGENCY AMBULANCE SERVICE OTHER THAN THE LOCAL VOLUNTEERS. LOCAL LAW ENFORCEMENT, THE COUNTY ATTORNEY AND HEALTH DEPARTMENTS ALSO MAKE USE OF THE TELEVIDEO EQUIPMENT TO PROMOTE HEALTH AND SAFETY IN THE COMMUNITY. JMMMC PROVIDES SPACE FREE OF CHARGE TO THE CUSTER COUNTY COMMUNICATIONS DEPARTMENT. THIS COMMUNICATION CENTER HANDLES ALL RADIO COMMUNICATION BETWEEN THE LAW ENFORCEMENT AGENCIES, FIRE DEPARTMENTS AND EMERGENCY RESPONDERS FOR CUSTER COUNTY. THIS SPACE HOUSES EQUIPMENT THAT SERVES AS A BACKUP TO THEIR PRIMARY COMMUNICATION EQUIPMENT. IN SITUATIONS WHERE THE PRIMARY EQUIPMENT FAILS, THIS ALLOWS THE CUSTER COUNTY COMMUNICATIONS DEPARTMENT TO HAVE EMERGENCY BACKUP EQUIPMENT TO CONTINUE TO PROVIDE THE CRITICAL COMMUNICATION NEEDS OF CUSTER COUNTY.JMMMC'S EMERGENCY ROOM SERVICES ARE PROVIDED 24 HOURS PER DAY, 7 DAYS PER WEEK. THIS DEPARTMENT OPERATES AT A SIGNIFICANT LOSS BUT ENSURES THAT PATIENTS HAVE ACCESS TO EMERGENCY HEALTHCARE AT ALL TIMES. THE ER IS CERTIFIED AS A LEVEL IV TRAUMA CENTER AND THE SERVICE AREA EXTENDS APPROXIMATELY 100 MILES EAST TO WEST ALONG THE HIGHWAY 2 CORRIDOR. THIS IS THE MAIN HIGHWAY HORIZONTALLY BISECTING NEBRASKA AND IS USED BY MANY TRAVELERS AND VACATIONERS, GIVING THEM ACCESS TO EMERGENCY AND TRAUMA CARE. JMMMC'S EMERGENCY ROOM PROVIDES AROUND 2,500 EMERGENCY ROOM VISITS PER YEAR. THE MEDICAL CENTER PAYS LOCAL PHYSICIANS TO BE AVAILABLE TO PROVIDE EMERGENCY ROOM SERVICES 24 HOURS PER DAY, 365 DAYS PER YEAR. |
| PART VI, LINE 6: | JMMMC IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JEREMY CLINGEPEEL | ||||||||||||||
| PRESIDENT/CEO THRU 1/23 | $214,813 | $0 | $20,000 | $0 | $0 | $0 | $0 | $0 | $45,312 | $0 | $280,125 | $0 | $0 | $0 |
| DARCI SHEA | ||||||||||||||
| RN | $190,392 | $0 | $0 | $0 | $0 | $0 | $7,187 | $0 | $44,524 | $0 | $242,103 | $0 | $0 | $0 |
| CARLA BAZYN | ||||||||||||||
| VP/CFO | $154,978 | $0 | $0 | $0 | $0 | $0 | $6,026 | $0 | $47,209 | $0 | $208,213 | $0 | $0 | $0 |
| KATHRYN DECKER | ||||||||||||||
| CNO | $187,040 | $0 | $0 | $0 | $0 | $0 | $5,842 | $0 | $2,030 | $0 | $194,912 | $0 | $0 | $0 |
| JENNIFER SCHAAF | ||||||||||||||
| PHARMACIST | $152,988 | $0 | $5,000 | $0 | $0 | $0 | $5,128 | $0 | $1,286 | $0 | $164,402 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | STEPHANIE BOLDT WAS PAID BY AN UNRELATED ORGANIZATION, BRYAN HEALTH, FOR HER POSITION AS INTERIM CEO. BRYAN HEALTH USES APPROVAL BY THE BOARD IN DETERMINING HER COMPENSATION. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE MEMBERS CONSIST OF ALL PERSONS WHO CONTRIBUTE TO THE CORPORATION THE SUM OF NOT LESS THAN $25 AT ANY TIME DURING THE EXISTENCE OF THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBERS ELECT THE BOARD OF DIRECTORS AT THE ANNUAL MEETING EACH YEAR. |
| FORM 990, PART VI, SECTION A, LINE 8B | THERE IS NO COMMITTEE WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 WILL BE PRESENTED TO THE BOARD OF DIRECTORS ELECTRONICALLY PRIOR TO FILING THE FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY IS PRESENTED ANNUALLY TO THE BOARD OF DIRECTORS. THIS FORM IS REVIEWED AND DISCUSSED WITH THEM. THE BOARD MEMBERS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST DISCLOSURE FORM. THE CHAIRMAN CAN POINT OUT ANY KNOWN CONFLICTS OF INTEREST. INDIVIDUAL BOARD MEMBERS ARE ALSO RESPONSIBLE FOR DECLARING CONFLICTS AND UPON A CONFLICT, THEY ARE EXCLUDED FROM THE VOTE BUT NOT FROM THE DISCUSSION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OF DIRECTORS IS PRESENTED WITH COMPARATIVE INFORMATION FROM WAGE STUDIES PERFORMED BY THE NEBRASKA HOSPITAL ASSOCIATION. NHA GATHERS THE WAGE INFORMATION ANNUALY FROM MOST, IF NOT ALL, OF THE HOSPITALS IN THE STATE. THE DATA CAN BE ANALYZED IN A VARIETY OF FORMATS, ALLOWING FOR EXCELLENT WAGE COMPARISON. THE BOARD SETS THE CEO SALARY BASED UPON THIS INFORMATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | JENNIE M. MELHAM MEMORIAL MEDICAL CENTER DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | PATIENT TEST FEES: PROGRAM SERVICE EXPENSES 342,541. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 342,541. PHYSICAL/OCCUPATIONAL THERAPY: PROGRAM SERVICE EXPENSES 99,387. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 99,387. LAB TEST FEES: PROGRAM SERVICE EXPENSES 130,001. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 130,001. OTHER FEES FOR SERVICE: PROGRAM SERVICE EXPENSES 1,526,414. MANAGEMENT AND GENERAL EXPENSES 110,245. FUNDRAISING EXPENSES 2,761. TOTAL EXPENSES 1,639,420. PHYSICIAN ER CALL PAYMENTS: PROGRAM SERVICE EXPENSES 1,473,704. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,473,704. SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 421,849. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 421,849. |
| FORM 990, PART XII, LINE 2C: | THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE MELHAM MEDICAL CENTER FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 250 | AddressLine1Txt |
| City | BROKEN BOW | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 68822 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 470795995 | EIN |
| Primary Activities | SUPPORTING THE OPERATIONS OF A CRITICAL ACCESS HOSPITAL | PrimaryActivitiesTxt |
| Legal Domicile State | NE | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12B, II | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JENNIE M MELHAM MEMORIAL MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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