LANDMANN JUNGMAN MEMORIAL HOSPITAL CORPORATION: Form 990, tax year 2016
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- Organization
- LANDMANN JUNGMAN MEMORIAL HOSPITAL CORPORATION (EIN 46-6015787)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-05-10
- IRS object ID
- 201841309349301674
- Schema version
- 2016v3.0
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-05-10T09:51:18-05:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | 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 | 200 EAST 10TH ST PO BOX 5125 | AddressLine1Txt |
| City | SIOUX FALLS | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 571175125 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 466015787 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Landmann-Jungman Memorial Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LAND | BusinessNameControlTxt |
| Phone | 6055832226 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 Billars Street | AddressLine1Txt |
| City | Scotland | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 570592026 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Melissa Gale | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6055832226 | PhoneNum |
| Signature | 2018-05-03 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Laurie Hanson | PreparerPersonNm |
| PTIN | P00851848 | PTIN |
| Phone | 6053391999 | PhoneNum |
| Preparation | 2018-05-03 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Melissa Gale | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 Billars Street | AddressLine1Txt |
| City | Scotland | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 570592026 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,394,509 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.ljmh.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1969 | FormationYr |
| Legal Domicile State | SD | LegalDomicileStateCd |
| Activity Or Mission | Operation of a community critical access hospital. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 48 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $28,443 | PYContributionsGrantsAmt |
| CY Contributions Grants | $13,500 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,092,847 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,355,226 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,116 | PYInvestmentIncomeAmt |
| CY Investment Income | $25,083 | CYInvestmentIncomeAmt |
| PY Other Revenue | $850 | PYOtherRevenueAmt |
| CY Other Revenue | $700 | CYOtherRevenueAmt |
| PY Total Revenue | $4,126,256 | PYTotalRevenueAmt |
| CY Total Revenue | $4,394,509 | 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 | $1,912,576 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,002,390 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,206,427 | PYOtherExpensesAmt |
| CY Other Expenses | $2,335,546 | CYOtherExpensesAmt |
| PY Total Expenses | $4,119,003 | PYTotalExpensesAmt |
| CY Total Expenses | $4,337,936 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $7,253 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $56,573 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,753,698 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,982,815 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,285,338 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,458,037 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,468,360 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,524,778 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Landmann-Jungman Memorial Hospital is committed to providing the highest quality healthcare with compassion and respect. Our commitment shall be to the ethical treatment of all people throughout the continuum of life. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,772,229 | ExpenseAmt |
| Revenue | $4,355,226 | RevenueAmt |
| Desc | Landmann-Jungman Memorial Hospital (LJMH) is a licensed critical access hospital with 25 acute care beds, of which 10 may be used as swing beds. The facility offers inpatient, outpatient and physician clinic services to residents in and around the city of Scotland, SD. Several visiting specialists spend time at LJMH conducting outreach clinics on a regular basis which include areas of cardiology, general surgery, OB/GYN, mobile MRI, CT, nuclear medicine and mammography. West Winds Apartments is also part of LJMH and serves as a 16 unit senior housing apartment building. LJMH is proud of the excellent care it provides for patients of the service area. The facility is also noted for its community service, which includes an annual health fair and bi-monthly blood drives. | Desc |
| Total Program Service Expenses | $3,772,229 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | 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 | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 11 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 48 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | 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 | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Darcy Permann | PersonNm |
| Phone | 6055832226 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 Billars Street | AddressLine1Txt |
| City | Scotland | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57059 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| Greg Gemar | ||||||
| President | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Jerry Nelson | ||||||
| Vice President(Until Jan 2017) | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Charles Mogck | ||||||
| Director/VP(Began Feb 2017) | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Jared Schortzman | ||||||
| Secretary | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| David Baker | ||||||
| Co-Secretary(Until Jan 2017) | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Carol Hofer | ||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Devin Lubinus | ||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Rhonda Bouza | ||||||
| Director(Began Jan 2017) | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Tanya Bult | ||||||
| Director(Began Jan 2017) | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Doreen Schlechter | ||||||
| Director(Until Jan 2017) | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Craig Winckler | ||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Gary Pepper | ||||||
| Director(Began Jan 2017) | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Melissa Gale | ||||||
| CEO (Began Nov 2016) | 50.00 | Yes (X) | $6,772 | $0 | $1,626 | |
| Darcy Permann | ||||||
| CFO | 50.00 | Yes (X) | $65,994 | $0 | $7,771 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $72,766 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $9,397 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Avera McKennan | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1325 S Cliff Ave PO Box 5045 | AddressLine1Txt |
| City | Sioux Falls | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 571175045 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | Management, IT, Education | ServicesDesc |
| Compensation | $710,345 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $13,500 | AllOtherContributionsAmt |
| Total Contributions | $13,500 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net Patient Service Re | 621110 | $3,324,335 | $3,324,335 |
| Pharmacy Revenue | 446110 | $857,738 | $857,738 |
| West Winds Revenue | 623990 | $102,859 | $102,859 |
| Change in Avera Founda | 900099 | $16,784 | $16,784 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $53,510 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $53,510 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,355,226 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,660 | TotalRevenueColumnAmt |
| Exclusion | $6,660 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $700 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $700 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $700 | TotalRevenueColumnAmt |
| Exclusion | $700 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $18,423 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $18,423 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,423 | TotalRevenueColumnAmt |
| Exclusion | $18,423 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,394,509 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,355,226 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $25,783 | 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 | $156,310 | TotalAmt |
| Management And General | $156,310 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,664,020 | TotalAmt |
| Program Services | $1,588,516 | ProgramServicesAmt |
| Management And General | $75,504 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,069 | TotalAmt |
| Program Services | $9,069 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,678 | TotalAmt |
| Program Services | $54,243 | ProgramServicesAmt |
| Management And General | $24,435 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,313 | TotalAmt |
| Program Services | $83,842 | ProgramServicesAmt |
| Management And General | $10,471 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,591 | TotalAmt |
| Management And General | $105,591 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,373 | TotalAmt |
| Management And General | $37,373 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $530,715 | TotalAmt |
| Program Services | $514,256 | ProgramServicesAmt |
| Management And General | $16,459 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,735 | TotalAmt |
| Management And General | $5,735 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $181,725 | TotalAmt |
| Program Services | $93,815 | ProgramServicesAmt |
| Management And General | $87,910 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,854 | TotalAmt |
| Program Services | $76,854 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,167 | TotalAmt |
| Program Services | $824 | ProgramServicesAmt |
| Management And General | $2,343 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,585 | TotalAmt |
| Program Services | $78,585 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $335,066 | TotalAmt |
| Program Services | $335,066 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,473 | TotalAmt |
| Management And General | $33,473 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $893,995 | $893,995 | |
| Continuing Education | $26,027 | $25,623 | $404 |
| Bad Debt | $7,595 | $7,595 | |
| Community & Employee Re | $2,073 | $2,073 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,572 | TotalAmt |
| Program Services | $9,946 | ProgramServicesAmt |
| Management And General | $7,626 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,337,936 | TotalAmt |
| Program Services | $3,772,229 | ProgramServicesAmt |
| Management And General | $565,707 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $320,011 | BOYAmt |
| EOY | $553,430 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $490,061 | BOYAmt |
| EOY | $623,426 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $187,863 | BOYAmt |
| EOY | $166,747 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,097 | BOYAmt |
| EOY | $17,064 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $6,947,010 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,977,975 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,112,160 | BOYAmt |
| EOY | $1,969,035 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $617,036 | BOYAmt |
| EOY | $653,113 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,470 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,753,698 | BOYAmt |
| EOY | $3,982,815 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $376,898 | BOYAmt |
| EOY | $474,161 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,652,355 | BOYAmt |
| EOY | $1,711,336 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $256,085 | BOYAmt |
| EOY | $272,540 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,285,338 | BOYAmt |
| EOY | $2,458,037 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,468,360 | BOYAmt |
| EOY | $1,524,778 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,468,360 | BOYAmt |
| EOY | $1,524,778 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,753,698 | BOYAmt |
| EOY | $3,982,815 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $56,573 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$155 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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 D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $36,163 | OtherCostOrOtherBasisAmt |
| Book Value | $36,163 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,865,281 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,370,538 | DepreciationAmt |
| Book Value | $1,494,743 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,919,444 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,523,140 | DepreciationAmt |
| Book Value | $396,304 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $126,122 | OtherCostOrOtherBasisAmt |
| Depreciation | $84,297 | DepreciationAmt |
| Book Value | $41,825 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,969,035 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| Interest in Net Assets of Avera Health Foundation | $150,733 | F |
| Assets Limited as to Use | $502,380 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $653,113 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| Conditional Asset Retirement Obligation | $74,795 |
| Damage Deposits Payable | $8,583 |
| Capital Lease | $159,162 |
| Estimated Third Party Payor Settlements | $30,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $272,540 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $4,386,759 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$155 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$7,595 | OtherRevenueAmt |
| Revenue Not Reported | -$7,750 | RevenueNotReportedAmt |
| Revenue Subtotal | $4,394,509 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $4,394,509 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $4,330,341 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $4,330,341 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $7,595 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $7,595 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $4,337,936 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part X, Line 2: | The Hospital is organized as a South Dakota nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Hospital is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Hospital is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Hospital has determined it is not subject to unrelated business income tax and has not filed an Exempt Organization Business Income Tax Return (Form 990T) with the IRS. The Hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. |
| Part XI, Line 2d - Other Adjustments: | Provision for Bad Debts -7,595. |
| Part XII, Line 4b - Other Adjustments: | Provision for Bad Debts 7,595. |
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 |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| 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 | $15,400 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $15,400 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00360 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $97,175 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $73,809 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $23,366 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00540 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $112,575 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $73,809 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $38,766 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00900 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,873 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $575 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,298 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,015,086 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $644,181 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $370,905 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08570 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,021,959 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $644,756 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $377,203 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08720 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,134,534 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $718,565 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $415,969 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09620 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $7,595 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,086 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $1,625,471 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $1,635,904 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$10,433 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| 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 | Landmann-Jungman Memorial Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 Billars Street | AddressLine1Txt |
| City | Scotland | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57059 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.avera.org/scotland | WebsiteAddressTxt |
| State License | 10561 | 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 | Landmann-Jungman Memorial Hospital | 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 | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Part V, line 7d | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Part V, line 7d | 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 | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| 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 |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See 16j narrative | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See 16j narrative | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See 16j narrative | 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 |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| 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 |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Landmann-Jungman Memorial Hospital | Part V, Section B, Line 5: LJMH began the Community Health Needs Assessment by gathering the most recent statistics regarding the public health of the community from county, state and national resources. LJMH held focus groups to seek the input of the general public, key community leaders, city and county government including law enforcement, school nursing and administration, church officials, and individuals with special knowledge in public health. The Bon Homme county health nurse was also interviewed to provide input on what the needs are for the county. |
| Landmann-Jungman Memorial Hospital | Part V, Section B, Line 7d: https://www.avera.org/about/community-health-needs-assessments/ orhttps://www.avera.org/about/community-health-needs-assessments/#landmann |
| Landmann-Jungman Memorial Hospital | Part V, Section B, Line 11: The needs identified and action plans include the following:Blood Pressure Screenings - LJMH provides free blood pressure screenings on a daily basis in the clinic. LJMH nursing staff holds blood pressure screenings at an Educational booth that focuses on hypertension and heart health. This is done in conjunction with Meals on Wheels, senior citizen events, a high school basketball game, and other community happenings. The screening includes education on nutrition, exercise and stress management, all key elements to keeping blood pressure under control.Shortages of EMTs for the Ambulance - The hospital has partnered with the EMT's in the community of Scotland to provide EMT education and training for EMT staff. The staff is better educated and feels more community support. The result includes that additional EMT's have been added to the all-volunteer crew. Diabetic Education Sessions - Some diabetic education classes were provided to the community via medical providers and a contracted dietician. LJMH is working toward conducting monthly diabetic education classes. Expansion on this is scheduled to take place in 2018.Health and Wellness Information - Multiple newspaper articles on health related topics have been published in the Scotland Journal, the local newspaper. Additional health related topics for education are posted to the hospital FaceBook page.LJMH will continue to utilize the local newspaper and FaceBook to communicate health related information and upcoming health events. The staff will be provided resources to educate our community on farm safety, breast cancer, diabetes, and pharmacy program changes. The hospital's goal is to have a more informed and educated community on a variety of health related topics to improve overall health and well-being. |
| Landmann-Jungman Memorial Hospital | Part V, Section B, Line 16j: Part V, Section B, Lines 16a and 16c: The financial assistance policy and plain language summary are available at:https://www.avera.org/locations/profile/landmann-jungman-memorial-hospital-avera/Part V, Section B, Line 16b: The financial assistance application form is available at http://www.avera.org/patients-visitors/charity-patient-assistance-programs/financial-assistance-forms/Part V, Section B, Line 16j: A notice is posted in the hospital facility's emergency rooms or waiting rooms and in the facility's admissions office alerting patients of the availability of financial assistance and instructions for obtaining a copy of the full policy. |
| Landmann-Jungman Memorial Hospital | Part V, Section B, Line 23: LJMH calculated amounts generally billed by taking the average of the three lowest paying, fully insured payors calculated annually at the most recent fiscal yearend. This method resulted in a lower amount generally billed than would have been calculated using the look-back method which is the method the hospital adopted during the fiscal year ending June 30, 2018. |
| Landmann-Jungman Memorial Hospital | Part V, Section B, Line 24: Elective services and non-emergent services are billed at gross charges. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - West Winds Apartments | ||||
| 1140 Washington Street | Scotland | SD | 57059 | Senior Living |
| 2 - Scotland Pharmacy | ||||
| 620 Billards Street | Scotland | SD | 57059 | Retail Pharmacy |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | In addition to using FPG to determine eligibility for free or discounted care, the facility also considers asset level and insurance status, and may provide presumptive care if warranted.Part I, Line 6:LJMH prepares a community benefit report. The report is available to the public upon request. |
| Part I, Line 7: | Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Lines 7b and 7g were obtained utilizing the Medicaid and Medicare cost reports, respectively. |
| Part I, Ln 7 Col(f): | Bad debt expense of $7,595 was subtracted from total operating expense. |
| Part III, Line 2: | The amount reported on line 2 represents the bad debt expense per the audited financial statements.LJMH bad debt system takes into account contractual allowances and/or discounts. If an account is written off to bad debts, payments received after the write off for that account are posted to the Bad Debt Recovery account. |
| Part III, Line 3: | The estimated amount of the Organization's bad debt expense attributable to patients eligible under the Organization's charity care policy is calculated based on the percentage of individuals living below the poverty level in 2016. The 14.3% can reasonably be considered a community benefit as it would have been written off to charity care. |
| Part III, Line 4: | The footnote that describes bad debt is on page 5 and 6 of the attached financial statements. |
| Part III, Line 8: | Medicare allowable cost of care was calculated from the Medicare cost report for fiscal year ending 6/30/17. Medical services are provided to patients with Medicare coverage regardless of whether or not a surplus or deficit is realized. Providing Medicare services promotes access to healthcare services which are vitally needed by our community. The Medicare cost report is completed based on the rules and regulations set forth by the Centers for Medicare and Medicaid Services. |
| Part III, Line 9b: | Financial arrangements will be made on accounts meeting financial need and having a remaining balance on their account. Arrangements may be altered according to need at the discretion of the Administrator. |
| Part V, Lines 22-23 Limitation on Charges | LJMH failed to use an allowable method under IRC 501(r)(5) in calculating amounts generally billed to patients under its financial assistance policy. LJMH had used a method that was allowable under the proposed Regulations, but failed to update its financial assistance policy in accordance with the final Regulations. The failure occurred during the fiscal year ended June 30, 2017. The failure involved two patients. On February 23, 2018, LJMH updated its financial assistance policy and procedures by adopting the limitation on charges look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that paid claims to the hospital facility during the prior 12-month period. LJMH determined the patients received a greater discount under the method utilized than they would have if the look-back method been used. Therefore, the patients were not charged more than allowed. The updated policy was posted to LJMH's website on March 23, 2018. |
| Part VI, Line 2: | Landmann-Jungman Memorial Hospital (LJMH) conducted a Community Health Needs Assessment during the fiscal year ended June 30, 2016.LJMH regularly conducts patient satisfaction surveys which can lead to information regarding needed services. Additionally, interactive questions are asked about services during health screenings. Results of the questionnaire are reported back to the officers and board. |
| Part VI, Line 3: | Patients are informed of the financial assistance/charity care policy with a document explaining the procedure. The document is at the registration desk and is given to patients at time of registration. The staff registering the patient can identify on the front end that the patient is able to pay through insurance or otherwise. If they identify on the front end that the patient needs assistance, the patient is given a financial packet to complete to see if they qualify for benefits. If there is no option for an outside assistance program, the patient is informed and encouraged to complete the application that utilizes a combination of income, assets, and expenses to determine what percentage of charity care they would qualify for. |
| Part VI, Line 4: | LJMH is located in Scotland, SD, and primarily serves the counties of Bon Homme and Hutchinson. The population of the service area is roughly 14,286 people, and Scotland has a population of 841 people. Of the 14,286 people residing in both counties, an average of 21.95% are 65 years old and over which is attributable to the average of 87% of acute and swing bed days being provided to patients 65 years old and over. If one looks at the counties as a whole, the average median household income is $49,229. Both counties are considered medically underserved by HRSA and the SD Department of Health. Both counties have uninsured patients of 13% per the 2017 County Health Rankings. Bon Homme and Hutchinson Counties are rural agriculture areas. |
| Part VI, Line 5: | Landmann Jungman Memorial Hospital is focused on serving the needs of the community. The governing body of the Hospital is made up entirely of volunteers from the community. The Hospital extends medical staff privileges to qualified physicians in its community. Excess funds are used for the improvement of patient care and facilities. The Hospital is used by the University of South Dakota for nursing clinicals, as well as by the pharmacy and HIM programs. It is open to anyone who wants to learn about careers in the health care industry.The Hospital operates an emergency room that is available to all regardless of their ability to pay. The Hospital administration is very receptive to input from the community.Avera Health and LJMH dedicate resources to endeavors that make a positive difference to improve the health of the communities they serve. These activities include leadership development and training for community members, economic development, physical improvements in the community, contributions to nonprofit community organizations, nonprofit event sponsorships, donated medical supplies, community health education and support groups, health screenings, flu-shot clinics, community health education and various other activities. We also have a fitness center so patients can maintain a healthy lifestyle. Additional information on community benefits are available in the annual community benefits report. |
| Part VI, Line 6: | LJMH is a managed facility of Avera Health. Avera Health and the Hospital work cooperatively to enhance healthcare throughout the community served by LJMH. As a managed facility, LJMH is able to participate in Avera e-CARE services. These services include Avera,e-Emergency, e-Pharmacy and e-Consult. These services allow rural patients to be cared for at their local hospitals, provide rural hospitals access to immediate specialty care and support, and help reduce health care costs and travel.LJMH also has access to "back office" support services, such as legal consultation, quality benchmarking, coding, computer services, contract negotiations, administrative consultation, group purchasing, human resource assistance and many other services. Avera Health is able to provide these services to LJMH at a cost below that which the Hospital could otherwise achieve. In turn, local caregivers are able to devote more resources to patient and resident care. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Melissa Gale | PersonNm |
| Title | CEO (Began Nov 2016) | TitleTxt |
| Base Compensation Filing Org | $6,764 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $8 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $1,704 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $8,476 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Form 990 Part VII, Line 5 | FormAndLineReferenceDesc |
| Explanation | Melissa Gale, CEO, was compensated through an arrangement with Avera McKennan, 1325 S Cliff Ave, Sioux Falls, SD 57108. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 1 | The Executive Committee is composed of the board President and three board members. The Executive Committee shall have power to transact all regular business of the facility during the interim between the meetings of the Board of Directors, provided any action taken shall not conflict with the policies and expressed wishes of the Board of Directors and that it shall refer all matters of major importance to the Board of Directors. |
| Form 990, Part VI, Section B, line 11b | The CEO will review the 990 in detail. A copy of the 990 is given to the board members before it is filed with the IRS. |
| Form 990, Part VI, Section B, line 12c | The conflict of interest policy applies to all board members and management. Board members are responsible for determining whether a potential conflict exists with the Administrator and board members. The Administrator is responsible for determining if there are potential conflicts of interest amongst management. The board is ultimately responsible for determining whether an actual conflict exists. Any board member with a conflict is required to abstain from voting on the matter of conflict. |
| Form 990, Part VI, Section B, line 15a | Avera McKennan and Landmann-Jungman Memorial Hospital use comparability data to determine appropriate compensation of the Administrator based on experience and performance. The compensation amount is approved annually by the Board of Directors. For other key employees Avera McKennan does a salary survey that is then approved by the Board of Directors. |
| Form 990, Part VI, Section C, line 19 | The organization makes its financial statements available to the public during its annual board meeting and upon request. The organization does not make its governing documents and conflict of interest policy available to the public. |
| Form 990, Part IX, line 11g | Temporary and contract labor : Program service expenses 102,564. Management and general expenses 0. Fundraising expenses 0. Total expenses 102,564. Phyisician professional fees : Program service expenses 292,409. Management and general expenses 0. Fundraising expenses 0. Total expenses 292,409. Other fees : Program service expenses 119,283. Management and general expenses 0. Fundraising expenses 0. Total expenses 119,283. Temporary and contract labor : Program service expenses 0. Management and general expenses 2,540. Fundraising expenses 0. Total expenses 2,540. Other fees : Program service expenses 0. Management and general expenses 13,919. Fundraising expenses 0. Total expenses 13,919. |
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