JENNIE EDMUNDSON MEMORIAL HOSPITAL: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
JENNIE EDMUNDSON MEMORIAL HOSPITAL (EIN 42-0680355)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-14
IRS object ID
201713189349309671
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

FieldValueIRS element (for citing)
Return2017-11-14T15:46:53-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN135565207PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11212 NORTH 96TH STREET SUITE 300AddressLine1Txt
CityOMAHACityNm
State AbbreviationNEStateAbbreviationCd
ZIP68114ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN420680355EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JENNIE EDMUNDSON MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlJENNBusinessNameControlTxt
Phone4023544840PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1933 EAST PIERCE STREETAddressLine1Txt
CityCOUNCIL BLUFFSCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51503ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJEFFREY E FRANCISPersonNm
Person TitleVICE PRES FINANCE, CFOPersonTitleTxt
Phone4023544000PhoneNum
Signature2017-11-14SignatureDt

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDONALD NEAL JRPreparerPersonNm
PTINP00798244PTIN
Phone4023481450PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address66.37.233.51IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-11-14IPDt
IP Tm14:54:16IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id81564C9D3205C28B4CD95701F47E5E56005E659FAtSubmissionCreationDeviceId
At Submission Filing Device Id81564C9D3205C28B4CD95701F47E5E56005E659FAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSTEVEN BAUMERTPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1933 EAST PIERCE STREETAddressLine1Txt
CityCOUNCIL BLUFFSCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51503ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$116,538,109GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.BESTCARE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1894FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionTO PROVIDE AND MAINTAIN HOSPITAL AND AMBULATORY FACILITIES FOR THE CARE OF PATIENTS.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee854TotalEmployeeCnt
Total Volunteers288TotalVolunteersCnt
Total Gross UBI$387,634TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,251,762PYContributionsGrantsAmt
CY Contributions Grants$1,955,293CYContributionsGrantsAmt
PY Program Service Revenue$105,633,607PYProgramServiceRevenueAmt
CY Program Service Revenue$107,647,825CYProgramServiceRevenueAmt
PY Investment Income$1,261,623PYInvestmentIncomeAmt
CY Investment Income$1,321,685CYInvestmentIncomeAmt
PY Other Revenue$835,567PYOtherRevenueAmt
CY Other Revenue$1,039,567CYOtherRevenueAmt
PY Total Revenue$108,982,559PYTotalRevenueAmt
CY Total Revenue$111,964,370CYTotalRevenueAmt
PY Grants And Similar Paid$4,870,091PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$4,531,118CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$46,293,622PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$47,841,044CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$46,162,958PYOtherExpensesAmt
CY Other Expenses$48,050,156CYOtherExpensesAmt
PY Total Expenses$97,326,671PYTotalExpensesAmt
CY Total Expenses$100,422,318CYTotalExpensesAmt
PY Revenues Less Expenses$11,655,888PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$11,542,052CYRevenuesLessExpensesAmt
Total Assets BOY$93,756,169TotalAssetsBOYAmt
Total Assets EOY$104,336,718TotalAssetsEOYAmt
Total Liabilities BOY$29,471,017TotalLiabilitiesBOYAmt
Total Liabilities EOY$27,203,286TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$64,285,152NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$77,133,432NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE MISSION OF JENNIE EDMUNDSON MEMORIAL HOSPITAL IS TO IMPROVE THE QUALITY OF LIFE BY CARING FOR THE BODY AND MIND. JENNIE EDMUNDSON SUPPORTS ITS MISSION OF CARING FOR PEOPLE THROUGH THE PROVISION OF INPATIENT AND OUTPATIENT HOSPITAL SERVICES ON ITS MAIN CAMPUS AT 933 EAST PIERCE STREET, COUNCIL BLUFFS, IOWA AND AT VARIOUS SATELLITE LOCATIONS THROUGHOUT SOUTHWEST IOWA.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$5,531,021ExpenseAmt
Grant$452,439GrantAmt
Revenue$10,581,908RevenueAmt
DescJENNIE EDMUNDSON CARDIAC SERVICES INCLUDE SOUTHWEST IOWA'S FIRST STATE-OF-THE-ART CARDIAC CATHETERIZATION LAB. OTHER CARDIAC SERVICES OFFERED AT JENNIE EDMUNDSON MEMORIAL HOSPITAL INCLUDE HEART FAILURE PROGRAM, CARDIAC REHABILITATION SERVICES AND INPATIENT CARE PROVIDED BY HIGHLY TRAINED CARDIAC CARE PROFESSIONALS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$5,750,219ExpenseAmt
Grant$357,785GrantAmt
Revenue$8,366,565RevenueAmt
DescJENNIE EDMUNDSON'S CANCER CENTER IS THE ONLY CANCER CENTER IN SOUTHWEST IOWA ACCREDITED BY THE AMERICAN COLLEGE OF SURGEONS. ALL NEWLY DIAGNOSED CANCER PATIENTS' CASES ARE PRESENTED AND REVIEWED AT THE WEEKLY CANCER CONFERENCE FOR IN-DEPTH REVIEW BY SURGEONS, RADIOLOGISTS, PATHOLOGISTS, MEDICAL AND RADIATION ONCOLOGISTS AND OTHER SPECIALIZED CARE PROVIDERS. EVERY YEAR SINCE 1996, JENNIE EDMUNDSON HAS RECEIVED APPROVAL FROM THE COMMISSION ON CANCER INCLUDING MEETING PROGRAM STANDARDS, PROVIDING SUPPORT AND EDUCATION, AND DELIVERING QUALITY CARE TO ITS PATIENTS.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$15,494,218ExpenseAmt
Grant$792,994GrantAmt
Revenue$18,543,877RevenueAmt
DescQUALITY, COMPREHENSIVE SURGICAL SERVICES ARE PROVIDED AT JENNIE EDMUNDSON HOSPITAL BY A TEAM OF CARING AND EXPERT PHYSICIANS, NURSES AND ANESTHESIOLOGISTS USING STATE OF THE ART TECHNOLOGY. PATIENTS ARE ENCOURAGED TO TAKE AN ACTIVE ROLE IN THEIR SURGICAL EXPERIENCE. HIGHLY PERSONALIZED PRE- AND POST-OPERATIVE CARE IS DELIVERED FROM ADMISSION TO DISCHARGE BY NURSES WHO SPECIALIZE IN SURGICAL CARE.CARE IS PROVIDED TO CHILDREN, ADOLESCENTS AND ADULTS IN GENERAL, GYNECOLOGY, NEUROSURGERY, OPHTHALMOLOGY, ORTHOPEDICS, OTOLARYNGOLOGY, RESPIRATORY/PULMONARY, UROLOGY, AND VASCULAR/CARDIAC/THORACIC SURGICAL SPECIALTIES.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$62,055,103ExpenseAmt
Grant$2,927,900GrantAmt
Revenue$70,791,880RevenueAmt
DescJENNIE EDMUNDSON HOSPITAL IS THE OLDEST ENTITY IN THE NEBRASKA HEALTH SYSTEM FAMILY. IT IS A 232-BED REGIONAL HEALTH CARE CENTER SERVING SOUTHWESTERN IOWA. IT IS THE ONLY HOSPITAL IN THE REGION THAT OFFERS NATIONALLY ACCREDITED CANCER AND BREAST CANCER PROGRAMS WHILE ALSO FEATURING SOUTHWEST IOWA'S ONLY ADVANCED WOUND CENTER AS WELL AS A FULL-LINE OF WOMEN'S SERVICES INCLUDING A BIRTHING CENTER AND LEVEL II NURSERY.ADDITIONAL CORE SERVICES INCLUDE MEDICAL/SURGICAL SERVICES, AN EMERGENCY DEPARTMENT, DIAGNOSTIC AND IMAGING SERVICES. EMPHASIS IS PLACED ON EDUCATION FOR PATIENTS, THEIR FAMILIES AND THE COMMUNITY.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$62,055,103TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$2,927,900TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$70,791,880TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$88,830,561TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document35IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee854EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JEFFREY E FRANCISBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4023544840PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line18511 WEST DODGE ROADAddressLine1Txt
CityOMAHACityNm
State AbbreviationNEStateAbbreviationCd
ZIP68114ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
DAN KINNEY PHD
CHAIRMAN1.000.00Yes (X)Yes (X)$0$0$0
EMMA CHANCE
VICE CHAIRMAN1.000.00Yes (X)Yes (X)$0$0$0
DEB BASS
DIRECTOR1.000.00Yes (X)$0$0$0
JOHN NELSON
SECRETARY1.000.00Yes (X)Yes (X)$0$0$0
KAREN COLLINS
DIRECTOR1.000.00Yes (X)$0$0$0
WILLIAM SHIFFERMILLER MD
DIRECTOR1.0039.00Yes (X)$0$477,178$74,493
JOHN G SOUTHARD MD PHD
DIRECTOR1.000.00Yes (X)$0$0$0
SPENCER C STEVENS
DIRECTOR1.000.00Yes (X)$0$0$0
LAWRENCE F UEBNER
DIRECTOR1.000.00Yes (X)$0$0$0
RICK CROWL JR
DIRECTOR1.000.00Yes (X)$0$0$0
THOMAS D WHITSON
TREASURER1.000.00Yes (X)Yes (X)$0$0$0
MICHAEL ZLOMKE MD
DIRECTOR1.000.00Yes (X)$0$0$0
STEVEN BAUMERT
PRESIDENT35.005.00Yes (X)$0$432,779$100,288
JEFFREY FRANCIS
CFO EFFECTIVE 3/7/166.0034.00Yes (X)$0$385,379$79,276
LINDA BURT
CFO THROUGH 3/6/166.0034.00Yes (X)$0$332,176$67,107
MICHAEL ROMANO MD
PHYSICIAN /EXEC MED AFFAIR40.000.00$298,419$0$74,102Yes (X)
PEGGY HELGET
EXEC. PATIENT SVCS40.000.00$186,694$0$33,450Yes (X)
JAMES CHAMBERS
VICE PRESIDENT CLINICAL AFFAIRS40.000.00$153,954$0$38,789Yes (X)
SCOTT BOMGAARS
VICE PRES - MED. AFFAIRS40.000.00$138,750$0$15,561Yes (X)
NGUYET TRAN MD
PHYSICIAN40.000.00$193,873$0$33,286Yes (X)
EVELYN REHER
PHYSICIAN40.000.00$332,742$0$46,427Yes (X)
BECKY KRAUL-HENKEL
EMPLOYEE HEALTH NURSE40.000.00$139,028$0$24,544Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,443,460TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,627,512TotReportableCompRltdOrgAmt
Total Other Compensation$587,323TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K38IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
PATHLAB LTD
933 EAST PIERCE STREETCOUNCIL BLUFFSIA51503MEDICAL SERVICES$6,628,475
EMERGENCY PHYSICIANS WESTERN IOWA LLC
4950 SOUTH 177 CIRCLEOMAHANE68135MEDICAL SERVICES$1,766,454
MCLMYERS-CARLISLE-LEAPLY
14124 INDUSTRIAL RDOMAHANE68144CONSTRUCTION SERVICES$1,491,067
HORIZON HEALTH MANAGEMENT
P O BOX 840839DALLASTX75284MEDICAL SERVICES$613,878
PULMONARY INFECTIOUS DISEASE ASSOCIATES
1 EDMUNDSON PLACECOUNCIL BLUFFSIA51503MEDICAL SERVICES$535,000
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K11CntrctRcvdGreaterThan100KCnt
Related Organizations$1,955,293RelatedOrganizationsAmt
Total Contributions$1,955,293TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SVC REV.621990$107,088,529$107,088,529
OTHER PATIENT REVENUE621990$559,296$559,296
FieldValueIRS element (for citing)
Total Program Service Revenue$107,647,825TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$922,175TotalRevenueColumnAmt
Exclusion$922,175ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$1,901,989RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$1,966,310RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$64,321RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$64,321TotalRevenueColumnAmt
Exclusion-$64,321ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$2,826,273SecuritiesAmt
Other$49,712OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$2,431,195SecuritiesAmt
Other$45,280OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$395,078SecuritiesAmt
Other$4,432OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$399,510TotalRevenueColumnAmt
Exclusion$399,510ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$210,803GrossSalesOfInventoryAmt
Cost Of Goods Sold$130,954CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$79,849TotalRevenueColumnAmt
Exclusion$79,849ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
CAFETERIA722210$636,405$636,405
LABORATORY621500$387,634$387,634
FieldValueIRS element (for citing)
Other Revenue Total$1,024,039OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$111,964,370TotalRevenueColumnAmt
Related Or Exempt Func Income$108,284,230RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$387,634UnrelatedBusinessRevenueAmt
Exclusion$1,337,213ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$123,379TotalAmt
Program Services$123,379ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$4,407,739TotalAmt
Program Services$4,407,739ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$485,113TotalAmt
Management And General$485,113ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$37,107,057TotalAmt
Program Services$36,953,103ProgramServicesAmt
Management And General$153,954ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,128,574TotalAmt
Program Services$2,028,738ProgramServicesAmt
Management And General$99,836ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,654,452TotalAmt
Program Services$5,605,085ProgramServicesAmt
Management And General$49,367ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,465,848TotalAmt
Program Services$2,434,541ProgramServicesAmt
Management And General$31,307ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$43,597TotalAmt
Management And General$43,597ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$18,431TotalAmt
Management And General$18,431ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$88,004TotalAmt
Management And General$88,004ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$9,321,355TotalAmt
Program Services$9,321,355ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$191,775TotalAmt
Program Services$191,775ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,383,460TotalAmt
Program Services$1,383,460ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$130,166TotalAmt
Program Services$130,166ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$3,684,906TotalAmt
Program Services$3,684,906ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$66,321TotalAmt
Program Services$66,321ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$118,947TotalAmt
Program Services$118,947ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,633,526TotalAmt
Program Services$3,633,526ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$324,919TotalAmt
Program Services$214,618ProgramServicesAmt
Management And General$110,301ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$16,199,730$16,199,730
ALLOCATIONS$10,511,847$10,511,847
MEDICAID PROVIDER TAX$859,002$859,002
DUES, LICENSES AND SUBS$250,892$250,892

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,223,278TotalAmt
Program Services$1,223,278ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$100,422,318TotalAmt
Program Services$88,830,561ProgramServicesAmt
Management And General$11,591,757ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$9,956,342BOYAmt
EOY$9,267,148EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$12,552,507BOYAmt
EOY$13,450,498EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$1,075,652BOYAmt
EOY$553,302EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,929,628BOYAmt
EOY$2,000,641EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$518,444BOYAmt
EOY$591,717EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$138,909,811LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$99,344,346LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$34,382,928BOYAmt
EOY$39,565,465EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$30,691,488BOYAmt
EOY$37,568,841EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$223,045BOYAmt
EOY$197,290EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,426,135BOYAmt
EOY$1,141,816EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$93,756,169BOYAmt
EOY$104,336,718EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$12,164,799BOYAmt
EOY$11,429,732EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,420,000BOYAmt
EOY$1,240,000EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$14,886,218BOYAmt
EOY$14,533,554EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$29,471,017BOYAmt
EOY$27,203,286EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$63,701,094BOYAmt
EOY$76,567,324EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$484,058BOYAmt
EOY$466,108EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$100,000BOYAmt
EOY$100,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$64,285,152BOYAmt
EOY$77,133,432EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$93,756,169BOYAmt
EOY$104,336,718EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$11,542,052ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,038,197NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$268,031OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other OrganizationsYes (1)GrantsOtherOrganizationsInd
Grants Other Organizations$18,431GrantsOtherOrganizationsAmt
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other Activities0OtherActivitiesInd
Total Lobbying Expenditures$18,431TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationA PORTION OF THE ANNUAL DUES PAID TO THE AMERICAN HOSPITAL AND IOWA HOSPITAL ASSOCIATIONS IS ATTRIBUTABLE TO LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$203,643BeginningYearBalanceAmt
Investment Earnings Or Losses$9,659InvestmentEarningsOrLossesAmt
Other Expenditures$6,437OtherExpendituresAmt
End Year Balance$206,865EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$212,488BeginningYearBalanceAmt
Investment Earnings Or Losses-$391InvestmentEarningsOrLossesAmt
Other Expenditures$8,454OtherExpendituresAmt
End Year Balance$203,643EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$218,264BeginningYearBalanceAmt
Investment Earnings Or Losses$4,954InvestmentEarningsOrLossesAmt
Other Expenditures$10,730OtherExpendituresAmt
End Year Balance$212,488EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$213,966BeginningYearBalanceAmt
Investment Earnings Or Losses$11,523InvestmentEarningsOrLossesAmt
Other Expenditures$7,225OtherExpendituresAmt
End Year Balance$218,264EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$199,654BeginningYearBalanceAmt
Contributions$5,053ContributionsAmt
Investment Earnings Or Losses$12,759InvestmentEarningsOrLossesAmt
Other Expenditures$3,500OtherExpendituresAmt
End Year Balance$213,966EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.97410PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.02590TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,039,282OtherCostOrOtherBasisAmt
Book Value$3,039,282BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$81,650,455OtherCostOrOtherBasisAmt
Depreciation$54,447,255DepreciationAmt
Book Value$27,203,200BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$54,220,074OtherCostOrOtherBasisAmt
Depreciation$44,897,091DepreciationAmt
Book Value$9,322,983BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$39,565,465TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
MINIMUM PENSION LIABILITY$12,972,611
COND. ASSET RETIREMENT OBLIGATION$1,250,212
ESTIMATED THIRD PARTY PAYABLE$310,731
FieldValueIRS element (for citing)
Total Liability$14,533,554TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:PERMANENTLY RESTRICTED NET ASSETS INCLUDE ENDOWMENT FUNDS WHICH ARE INTENDED TO BE HELD IN PERPETUITY. THE INCOME ON SUCH FUNDS IS EXPENDABLE FOR THE BENEFIT OF JENNIE EDMUNDSON MEMORIAL HOSPITAL.
PART X, LINE 2:JENNIE EDMUNDSON MEMORIAL HOSPITAL RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. IN 2016 AND 2015 MANAGEMENT DETERMINED THERE ARE NO INCOME TAX POSITIONS REQUIRING RECOGNITION OF THE FINANCIAL STATEMENTS. NO CHANGES WERE MADE TO THE FINANCIAL STATEMENTS DUE TO FIN 48.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$946,545TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$165,993DirectOffsettingRevenueAmt
Net Community Benefit Expns$780,552NetCommunityBenefitExpnsAmt
Total Expense0.00780TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$18,099,222TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$18,674,268DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,045,767TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$18,840,261DirectOffsettingRevenueAmt
Net Community Benefit Expns$780,552NetCommunityBenefitExpnsAmt
Total Expense0.00780TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$471,857TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$471,857NetCommunityBenefitExpnsAmt
Total Expense0.00470TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,778,029TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,778,029NetCommunityBenefitExpnsAmt
Total Expense0.01770TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$531,717TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$531,717NetCommunityBenefitExpnsAmt
Total Expense0.00530TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$659,706TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$659,706NetCommunityBenefitExpnsAmt
Total Expense0.00660TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,441,309TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,441,309NetCommunityBenefitExpnsAmt
Total Expense0.03430TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$22,487,076TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$18,840,261DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,221,861NetCommunityBenefitExpnsAmt
Total Expense0.04210TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$367TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$367NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$43,144TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$43,144NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$43,511TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$43,511NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$1,695,928BadDebtExpenseAmt
Reimbursed By Medicare$31,834,968ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$33,791,888CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$1,956,920MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JENNIE EDMUNDSON MEMORIAL HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1933 EAST PIERCE STREETAddressLine1Txt
CityCOUNCIL BLUFFSCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51503ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.BESTCARE.ORGWebsiteAddressTxt
State License780039HStateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Teaching HospitalYes (X)TeachingHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1JENNIE EDMUNDSON MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLMETHODISTCOMMUNITYBENEFIT.COM/OUR-PLAN/COMMUNITY-HEALTH-NEEDS-ASSESSMENTOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLWWW.METHODISTCOMMUNITYBENEFIT.COM/OUR-PLAN/StrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.BESTCARE.ORG/TOOLS/FINANCIAL-ASSISTANCE/FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.BESTCARE.ORG/TOOLS/FINANCIAL-ASSISTANCE/FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.BESTCARE.ORG/TOOLS/FINANCIAL-ASSISTANCE/FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
JENNIE EDMUNDSON MEMORIAL HOSPITALPART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT (ASSESSMENT) WAS SPONSORED BY A COALITION OF LOCAL HEALTH SYSTEMS AND LOCAL HEALTH DEPARTMENTS. THE ASSESSMENT WAS CONDUCTED BY PROFESSIONAL RESEARCH CONSULTANTS INC. (PRC), A NATIONALLY-RECOGNIZED HEALTHCARE CONSULTING FIRM WITH EXTENSIVE EXPERIENCE CONDUCTING COMMUNITY HEALTH NEEDS ASSESSMENTS.THE ASSESSMENT INCORPORATED DATA FROM BOTH QUANTITATIVE AND QUALITATIVE SOURCES. QUANTITATIVE DATA INCLUDED PRIMARY DATA REPRESENTATION FROM TELEPHONE INTERVIEWS WHICH INCORPORATED BOTH LANDLINE AND CELL PHONE INTERVIEWS. THIS TELEPHONE SURVEY CONSISTED OF AN INITIAL STRATIFIED RANDOM SAMPLE OF INDIVIDUALS AGE 18 AND OLDER IN THE METRO AREA. OVERSAMPLING WAS THEN UTILIZED, WHICH RESULTED IN CONTACT WITH 2,622 METRO AREA RESIDENTS. IN ADDITION THERE WERE FIVE GROUPS WHICH INCLUDED 138 COMMUNITY STAKEHOLDERS TAKING PART IN AN ONLINE KEY INFORMANT SURVEY, INCLUDING PHYSICIANS, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, BUSINESS LEADERS AND OTHER COMMUNITY LEADERS.
JENNIE EDMUNDSON MEMORIAL HOSPITALPART V, SECTION B, LINE 6A: THE CHNA WAS A COLLABORATIVE EFFORT OF THREE OMAHA HEALTH SYSTEMS - METHODIST HEALTH SYSTEM, CHI HEALTH SYSTEM AND NEBRASKA MEDICINE AS WELL AS LOCAL HEALTH DEPARTMENTS FROM DOUGLAS, SARPY/CASS COUNTIES, NEBRASKA AND POTTAWATTAMIE COUNTY, IOWA.
JENNIE EDMUNDSON MEMORIAL HOSPITALPART V, SECTION B, LINE 6B: IN ADDITION TO THE THREE OMAHA HEALTH SYSTEMS, AND LOCAL HEALTH DEPARTMENTS IDENTIFIED ABOVE, THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS A COLLABORATE EFFORT WITH LIVE WELL OMAHA. LIVE WELL OMAHA IS A NON-PROFIT ORGANIZATION WHICH STRIVES TO IMPROVE THE OVERALL HEALTH OF AREA RESIDENTS.
JENNIE EDMUNDSON MEMORIAL HOSPITALPART V, SECTION B, LINE 11: JENNIE EDMUNDSON HOSPITAL DID NOT ADDRESS THE AREAS OF INJURY AND VIOLENCE, SEXUALLY TRANSMITTED DISEASES, DEMENTIA, AND RESPIRATORY DISEASES WHICH WERE OUTLINED IN THE CHNA. OTHER ORGANIZATIONS IN THE COMMUNITY HAVE THE RESOURCES AND QUALIFICATIONS TO PROVIDE FOR THESE AREAS OF COMMUNITY HEALTH.JENNIE EDMUNDSON MEMORIAL HOSPITAL WILL COLLABORATE WITH COMMUNITY ORGANIZATIONS THAT ARE ADDRESSING THESE NEEDS.JENNIE EDMUNDSON MEMORIAL HOSPITAL DEVELOPED AN IMPLEMENTATION STRATEGY TO ADDRESS NEEDS IDENTIFIED IN THE 2015 COMMUNITY HEALTH NEEDS ASSESSMENT IN 2015-2016. THIS IMPLEMENTATION STRATEGY WAS NOT ADOPTED UNTIL APRIL 2016.2016 IMPLEMENTATION STRATEGY UPDATE:METHODIST JENNIE EDMUNDSON HOSPITAL (MJEH) IS COMMITTED TO ITS COMMUNITY, LIVING THE MISSION OF BEING COMMITTED TO CARING FOR PEOPLE. ALL LEADERSHIP SUPPORT THE IMPORTANCE OF WORKING IN THE COMMUNITY WITH OVER 220+ PARTNERS TO ADDRESS THOSE NEEDS MOST CURRENTLY IDENTIFIED IN THE 2015 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). MANAGEMENT AND BOARD MEMBERS APPROVED THE CURRENT PLAN TO STRATEGICALLY FOCUS ON THE NEEDS IDENTIFIED IN THE CHNA. THE GUIDING FOCUS FOR ALL PROGRAMS INCLUDES AT LEAST ONE OF THE FOLLOWING: ADDRESSING ACCESS TO HEALTH CARE SERVICES, ENHANCING THE HEALTH OF THE COMMUNITY, ADVANCING MEDICAL OR HEALTH CARE KNOWLEDGE AND RELIEVING OR REDUCE THE BURDEN OF THE GOVERNMENT.ALL COMMUNITY OUTREACH PROGRAMS ARE DONE IN PARTNERSHIP WITH THOSE ORGANIZATIONS THAT ARE CURRENTLY WORKING IN THE TARGETED COMMUNITY ON IDENTIFIED NEEDS. OFTEN PROGRAMS OR SERVICES ARE NOT EASILY QUANTIFIABLE UNTIL CURRENT CENTER FOR DISEASE CONTROL (CDC) REPORTS ARE UPDATED. EACH YEAR EVERY PROGRAM/SERVICE IS EVALUATED FOR EFFECTIVENESS AND UPDATED WITH THE MOST CURRENT EDUCATION MATERIALS AND SCREENINGS. TO CONTINUE TO IMPROVE THE HEALTH OF THE ENTIRE COMMUNITY, RESOURCES FOR DISEASE, PREVENTION AND HEALTHY LIVING ARE PROVIDED BY THE FAMILY RESOURCE CENTER, A FREE CENTER LOCATED WITHIN THE HOSPITAL. ONE OF THE MANY FOCUSES FOR THIS COMMUNITY IS TO PROVIDE EDUCATION FOR SHAKEN BABY SYNDROME. THIS DESIGNATED TASK FORCE EDUCATED OVER 1,900 HIGH SCHOOL STUDENTS IN 2016 ON CHILD ABUSE, TRAUMA AND DEVELOPMENT.MJEH ADDRESSES THE NATIONAL CRISIS OF MENTAL HEALTH BY PROVIDING SERVICES FOR THE COMMUNITY FOR A REDUCED FEE OR WITH AVAILABLE FINANCIAL ASSISTANCE. IN ADDITION, MJEH EMERGENCY DEPARTMENT CONTINUES TO OFFER SANE/SART (SEXUAL ASSAULT NURSE EXAMINER/SEXUAL ASSAULT RESPONSE TEAM) PROGRAM. THIS SEXUAL ASSAULT PROGRAM IS FOR SURVIVORS, AND WORKING WITH LAW ENFORCEMENT, PROVIDES THE BEST TREATMENT AND EMOTIONAL SUPPORT. OUR SANE/SART PROGRAM IN 2016 ASSISTED 400 VICTIMS.IN 2016, MJEH WAS ABLE TO ASSIST OVER 7,200 INDIVIDUALS WITH FINANCIAL ASSISTANCE. THIS PROGRAM HAS SUPPORTED FAMILIES AND INDIVIDUALS THAT WERE UNABLE TO TAKE CARE OF THEIR BILLS. OUR FINANCIAL ASSISTANCE PROGRAM IS EXPLAINED TO ALL PATIENTS UPON ADMISSION AND OUR PROVIDERS ARE KNOWLEDGEABLE REGARDING HOW THEIR PATIENTS CAN APPLY FOR THIS PROGRAM.MJEH CONTINUES TO WORK WITH OVER 220 ORGANIZATIONS WORKING THROUGH PREVENTION ACTIVITIES, HEALTH PROMOTION, SOCIAL SERVICES, PASTORAL CARE, NUMEROUS VOLUNTEER EFFORTS, PROFESSIONAL EDUCATION AND A STRONG LEADERSHIP FOR A HEALTHIER COMMUNITY.
JENNIE EDMUNDSON MEMORIAL HOSPITALPART V, SECTION B, LINE 13B: JENNIE EDMUNDSON MEMORIAL HOSPITAL CHARGES MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE FOR PATIENTS OR GUARANTORS WITH FAMILY INCOME GREATER THAN 400% OF THE FEDERAL POVERTY LEVEL WHEN CIRCUMSTANCES INDICATE SEVERE FINANCIAL HARDSHIP. PATIENTS, OR THEIR GUARANTORS, MAY BE ELIGIBLE FOR MEDICAL HARDSHIP ASSISTANCE IF THEY HAVE INCURRED OUT-OF-POCKET OBLIGATIONS RESULTING FROM MEDICAL SERVICES THAT EXCEED 25% OF FAMILY INCOME AND SUFFICIENT FAMILY ASSETS ARE NOT AVAILABLE TO MEET THE OBLIGATION.
JENNIE EDMUNDSON MEMORIAL HOSPITALPART V, SECTION B, LINE 13H: JENNIE EDMUNDSON MEMORIAL HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE FORMAL FINANCIAL ASSISTANCE APPLICATION. OTHER INFORMATION MAY BE UTILIZED TO MAKE AN INFORMED DECISION ON FINANCIAL NEED SUCH AS; HOMELESS, DECEASED - NO KNOWN ESTATE, WIC PROGRAM ELIGIBILITY OR SNAP BENEFITS.ADDITIONALLY, JENNIE EDMUNDSON MEMORIAL HOSPITAL UTILIZES A PRESUMPTIVE ELIGIBILITY ANALYTICS SOLUTION THAT EXAMINES HISTORICAL DATA COMBINED WITH HOUSEHOLD ECONOMIC INFORMATION. IT EVALUATES ACCOUNTS BASED ON THE FOLLOWING STANDARDS: AVAILABLE HOUSEHOLD INCOME, HOUSEHOLD SIZE, CAPACITY TO MAKE PAYMENT, AND OVER-EXTENSION COMPARED TO FEDERAL POVERTY GUIDELINES. THIS INFORMATION IS DERIVED FROM SOCIO-ECONOMIC DATA FROM NUMEROUS SOURCES, INCLUDING CENSUS DATA. USING THIS PRESUMPTIVE ELIGIBILITY APPROACH, A SCORE IS ASSIGNED AT THE INDIVIDUAL PATIENT LEVEL. THE SCORE ENABLES THE PATIENT FINANCIAL SERVICES TO MEET INTERNAL PROCESSING REQUIREMENTS WHILE PROVIDING A COMMUNITY BENEFIT THROUGH FORGIVING ACCOUNT BALANCES FOR THOSE IN NEED.THIS APPROACH ENABLES JENNIE EDMUNDSON MEMORIAL HOSPITAL TO EVALUATE ACCOUNTS FOR FINANCIAL ASSISTANCE EQUALLY, REGARDLESS OF THE PATIENT'S ABILITY TO COMPLETE AN APPLICATION FOR ASSISTANCE.WHEN THE PRESUMPTIVE ELIGIBILITY SOLUTION IS THE BASIS FOR DETERMINING ELIGIBILITY, A FULL FREE CARE DISCOUNT WILL BE GRANTED FOR ELIGIBLE SERVICES FOR RETROSPECTIVE DATES OF SERVICE ONLY. THESE ACCOUNTS WILL NOT BE SENT TO COLLECTION AND WILL NOT BE INCLUDED IN BAD DEBT EXPENSE.
JENNIE EDMUNDSON MEMORIAL HOSPITALPART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE APPLICATION IS PROVIDED WITH INPATIENT ADMISSION PACKETS. GUIDANCE TO THE POLICY IS REFERRED TO IN PATIENT STATEMENTS.

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7:THE METHODS PRIMARILY USED ARE THE FINANCIAL INFORMATION FROM THE MEDICARE COST REPORT AND ACTUAL EXPENDITURES.
PART I, LINE 7G:A SUBSIDIZED HEALTH BENEFIT IS CALCULATED FOR DEPARTMENTS AND SERVICES RECOGNIZING THESE AREAS OPERATE AT A NEGATIVE MARGIN. TRANSPORT SERVICES AND CLINICS IN UNDERSERVED AREAS, FOR EXAMPLE, ARE SERVICES THAT OPERATE AT NEGATIVE MARGINS.
PART I, LN 7 COL(F):THE PERCENTAGE IS ARRIVED AT BY DIVIDING NET COMMUNITY BENEFIT EXPENSES IN COLUMN (E) BY THE AMOUNT ON FORM 990, PART IX, LINE 25, COLUMN (A).
PART I, LINE 6A AND 6B:ANNUAL COMMUNITY BENEFIT REPORT:NEBRASKA METHODIST HEALTH SYSTEM PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT WHICH INCLUDES INFORMATION ON COMMUNITY BENEFITS ACTIVITIES FROM ALL AFFILIATES. IN ADDITION, A QUARTERLY PUBLICATION, "CHART" ADDRESSES ONGOING COMMUNITY BENEFIT ACTIVITIES. THE WEBSITE "METHODISTCHART.ORG" IS DEDICATED TO JENNIE EDMUNDSON MEMORIAL HOSPITAL AND NEBRASKA METHODIST HEALTH SYSTEM AFFILIATES' COMMUNITY WORKS. IT PROVIDES INFORMATION ABOUT THE SUCCESSES IN IMPACTING THE COMMUNITY'S OVERALL HEALTH.PART VI, LINE 7:NO DIRECT REPORT IS PROVIDED TO THE STATE OF IOWA. HOWEVER, INFORMATION FROM THE HOSPITAL'S COMMUNITY BENEFIT DATA IS INCLUDED IN A REPORT COMPILED BY THE IOWA HOSPITAL ASSOCIATION.PART I, LINE 7:INFORMATION ON PROGRAMS CONSTITUTING COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS, SUBSIDIZED HEALTH SERVICES AND IN-KIND DONATIONS IS COLLECTED THROUGHOUT THE YEAR USING THE COMMUNITY BENEFITS INVENTORY SOCIAL ACCOUNTABILITY SOFTWARE WHICH FOLLOWS CATHOLIC HEALTH ASSOCIATION (CHA) GUIDELINES FOR COMMUNITY BENEFIT REPORTING. AMOUNTS SHOWN AS COMMUNITY BENEFIT ARE AT COST LESS ANY REVENUE EXCLUSIVE OF ANY GRANTS. CASH AND IN-KIND DONATIONS THAT SUPPORT FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT ACTIVITIES ARE INCLUDED IN CONTRIBUTIONS.PART I, LINE 7E:JENNIE EDMUNDSON AND 20 OTHER ORGANIZATIONS IN THE COMMUNITY HAVE UNITED IN THE SHAKEN BABY TASK FORCE IN A COMMUNITY EFFORT TO PREVENT SHAKEN BABY SYNDROME. THE TASK FORCE, LED BY MEMBERS OF THE STAFF OF JENNIE EDMUNDSON HOSPITAL, DEVELOPED A COPYRIGHTED CURRICULUM, VIDEO AND SAFEBABY.ORG WEBSITE AND THE NATION'S ONLY 24-HOUR DEDICATED CRYING BABY HOTLINE. THE VIDEO "SHAKEN BABIES: SHATTERED LIVES" IS FREE ON REQUEST AND HAS BEEN SENT TO REQUESTERS IN THE UNITED STATES AND COUNTRIES OUTSIDE THE UNITED STATES. IN 2014, THE TASK FORCE EXPANDED THEIR MISSION TO INCLUDE KEEPING BABIES SAFE FROM SUDDEN INFANT DEATH SYNDROME (SIDS), CO-SLEEPING, AND SECOND AND THIRD-HAND SMOKE EXPOSURE.JENNIE EDMUNDSON'S COMMITMENT TO SOUTHWEST IOWA EXTENDS TO A WIDE VARIETY OF OTHER ANNUAL SCREENING PROGRAMS ON PROSTATE CANCER, COLORECTAL CANCER, BREAST CANCER AND CERVICAL CANCER. IN ADDITION, PHYSICIANS AND HOSPITAL STAFF PROVIDE EDUCATIONAL PROGRAMS TO ORGANIZATIONS AND AT COMMUNITY EVENTS.
PART II, COMMUNITY BUILDING ACTIVITIES:AS A COMMUNITY LEADER, JENNIE EDMUNDSON EMPLOYEES ARE ACTIVE IN COMMUNITY ORGANIZATIONS, HOLDING LEADERSHIP ROLES ON BOARDS OF DIRECTORS, COMMITTEE CHAIRMANSHIPS AND MEMBERSHIPS. JENNIE EDMUNDSON PARTICIPATES IN THE CHAMBER OF COMMERCE, THE AMERICAN HEART ASSOCIATION AND OTHER ORGANIZATIONS TO STRENGTHEN THE INFRASTRUCTURE OF THE COMMUNITY.
PART III, LINE 4:FOOTNOTE TO THE FINANCIAL STATEMENTS DESCRIBING BAD DEBT EXPENSE IS SHOWN IN THE ATTACHED AUDITED FINANCIAL STATEMENTS, PAGE 11.THE COST METHODOLOGY FOR THE BAD DEBT EXPENSE PRESENTED IN PART III, LINE 2, IS CONSISTENT WITH THAT OF THE 2016 FILED MEDICARE COST REPORT.
PART III, LINE 8:SOURCE FOR MEDICARE REVENUE AND ALLOWABLE COSTS IS THE 2016 MEDICARE COST REPORT AS FILED.
PART III, LINE 9B:COLLECTION PRACTICES FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE.JENNIE EDMUNDSON MEMORIAL HOSPITAL HAS ADOPTED A PROCEDURE FOR THOSE SITUATIONS WHERE A PATIENT POTENTIALLY MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAS NOT OR CANNOT COMPLETE THE APPLICATION. THIS PROCEDURE, REFERRED TO AS THE PRESUMPTIVE CHARITY PROCESS, IS FOLLOWED BY HOSPITAL PERSONNEL AS WELL AS THIRD-PARTY VENDORS ASSISTING WITH SELF-PAY COLLECTIONS.SOME OF THE INDIVIDUAL LIFE CIRCUMSTANCES THAT HAVE BEEN ESTABLISHED AS INDICATORS OF PRESUMPTIVE ELIGIBILITY INCLUDE:PARTICIPATION IN STATE-FUNDED PRESCRIPTION PROGRAMS; RECEIVING CARE FROM A HOMELESS PERSONS CLINIC; PARTICIPATION IN WOMEN, INFANTS AND CHILDREN (WIC) PROGRAMS; SNAP BENEFITS; ELIGIBILITY FOR SUBSIDIZED SCHOOL LUNCH PROGRAM; ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED (E.G. MEDICAID SPEND-DOWN); LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS VALID ADDRESS.THE HOSPITAL STAFF, AS WELL AS VENDORS UTILIZED FOR SELF-PAY COLLECTIONS, HAVE BEEN TRAINED TO IDENTIFY INDICATORS OF PRESUMPTIVE ELIGIBILITY AND DOCUMENT SUCH AS SUPPORT FOR A FINANCIAL ASSISTANCE DETERMINATION.THE HOSPITAL BILLS ALL THIRD PARTY RESOURCES THAT MAY BE ABLE TO PROVIDE REIMBURSEMENT FOR CARE PROVIDED TO PATIENTS. THIS INCLUDES, BUT IS NOT LIMITED TO, COMMERCIAL INSURANCE, MEDICARE, MEDICAID, COUNTY GOVERNMENT AND OTHER GOVERNMENT PROGRAMS, AND ANY OTHER POTENTIAL SOURCE OF REIMBURSEMENT.EVERY EFFORT IS MADE TO IDENTIFY PATIENTS THAT MAY QUALIFY FOR FINANCIAL ASSISTANCE PRIOR TO OR DURING THE TIME OF SERVICE. THOSE PATIENTS ARE ENCOURAGED TO COMPLETE AN APPLICATION FOR FINANCIAL ASSISTANCE.
PART VI, LINE 2:BROAD-BASED COMMUNITY HEALTH AND OUTREACH INTIATIVES INCLUDE TARGETED PROGRAMS THAT ALIGN WITH KEY HEALTH NEEDS IDENTIFIED BY LIVE WELL OMAHA. LIVE WELL OMAHA IS A FORUM OF ORGANIZATIONS WORKING TOGETHER TO POSITIVELY IMPACT HEALTH OUTCOMES FOR ALL INDIVIDUALS AND FAMILIES IN THE COMMUNITY.
PART VI, LINE 3:FINANCIAL ASSISTANCE APPLICATIONS ARE INCLUDED IN ALL INPATIENT ADMISSION PACKETS. JENNIE EDMUNDSON HOSPITAL CONTRACTS WITH AN ELIGIBILITY SERVICE TO ASSIST INDIVIDUALS IN DETERMINING ELIGIBILITY AND COMPLETING THE REQUIRED PAPERWORK TO PARTICIPATE IN MEDICAID OR GOVERNMENT MEANS-TESTED PROGRAMS. HOSPITAL FINANCIAL COUNSELORS AND ELIGIBILITY SERVICE PERSONNEL ARE CONVENIENTLY LOCATED AT THE HOSPITAL FOR PRIVATE CONSULTATION FOR BOTH INPATIENT AND OUTPATIENT COUNSELING. THE COUNSELORS ARE INCLUDED IN THE ADMISSION/DISCHARGE PROCESS TO ENSURE THAT THE PATIENT IS FULLY INFORMED ABOUT THE PROCESS AND TO HELP THE PATIENT DETERMINE WHAT ASSISTANCE MAY BE NEEDED AND WHAT IS AVAILABLE TO THEM. THE HOSPITAL CUSTOMER SERVICE UNIT IS ALSO TRAINED TO ASSIST PATIENTS WITH FINANCIAL NEED. PATIENTS WHO CONTACT THE UNIT EXPRESSING DIFFICULTY IN MEETING THEIR FINANCIAL OBLIGATION ARE PROVIDED WITH APPLICATIONS AND ARE ASSESSED FOR ELIGIBILITY FOR FINANCIAL ASSISTANCE.APPROPRIATE RESOURCES ARE USED TO PROVIDE EFFECTIVE COMMUNICATION WITH NON-ENGLISH SPEAKING PATIENTS INCLUDING CYRACOM LANGUAGE LINE SYSTEM THAT PROVIDES 24-HOUR ACCESS TO SEVERAL HUNDRED DIFFERENT LANGUAGE INTERPRETERS. OTHER RESOURCES INCLUDE HOPE MEDICAL OUTREACH AND ON-SITE STAFF OR CONTRACTED INTERPRETER SERVICES. THE HOSPITAL PROVIDES FOR INTERPRETATIVE SERVICES AT NO COST TO THE PATIENT.INFORMATION ON THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE TO THE PUBLIC ON THE BESTCARE.ORG WEBSITE IN BOTH ENGLISH AND SPANISH. ADDITIONALLY, PATIENT STATEMENTS INCLUDE A STATEMENT ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE INCLUDING CONTACT INFORMATION. PLAIN LANGUAGE SUMMARIES AND APPLICATIONS ARE AVAILABLE AT ALL REGISTRATION DESKS WITHIN THE HOSPITAL.
PART VI, LINE 4:JENNIE EDMUNDSON SERVES COUNCIL BLUFFS, IOWA AND SURROUNDING COMMUNITIES IN SOUTHWESTERN IOWA.JENNIE EDMUNDSON'S PROGRAMS ALIGN CLOSELY WITH THE KEY HEALTH NEEDS IDENTIFIED BY LIVE WELL OMAHA, A COLLABORATION OF LOCAL NON-PROFIT, GOVERNMENTAL AND FOR-PROFIT ORGANIZATIONS DEDICATED TO IMPROVING THE HEALTH OF THOSE WHO LIVE AND WORK IN THE AREA.
PART VI, LINE 5:JENNIE EDMUNDSON'S BOARD OF DIRECTORS IS COMPOSED OF COMMUNITY LEADERS WITH DIVERSE BACKGROUNDS AND PROVIDES OVERSIGHT OF ALL OPERATIONS. THE COMPOSITION INCLUDES A COMBINATION OF THOSE WITH LONGEVITY ON THE BOARD AND THOSE WHO ARE NEWER MEMBERS. PHYSICIAN INVOLVEMENT ON THE BOARD ENHANCES THE HOSPITAL'S ABILITY TO BE A LEADER IN MEDICAL SERVICES.MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL PRACTITIONERS WHO CONTINUOUSLY MEET THE QUALIFICATIONS, STANDARDS AND REQUIREMENTS TO PROMOTE A UNIFORM STANDARD OF QUALITY PATIENT CARE, TREATMENT AND SERVICES.
PART VI, LINE 6:THE NEBRASKA METHODIST HEALTH SYSTEM INCLUDES JENNIE EDMUNDSON MEMORIAL HOSPITAL AND JENNIE EDMUNDSON MEMORIAL HOSPITAL FOUNDATION, NEBRASKA METHODIST HOSPITAL, NEBRASKA METHODIST HEALTH SYSTEM, PHYSICIANS CLINIC INC., NEBRASKA METHODIST COLLEGE OF NURSING AND NEBRASKA METHODIST HOSPITAL FOUNDATION. AS A GROUP, THESE ENTITIES ARE COMMITTED TO CARING FOR THE PEOPLE OF THE COMMUNITY BY PROVIDING OUTSTANDING HEALTH CARE, EDUCATIONAL OPPORTUNITIES AND SUPPORT SERVICES. TO FULFILL OUR MISSION OF CARING FOR PEOPLE, AFFILIATES HAVE DEVELOPED A VARIETY OF WAYS TO CONTRIBUTE CARE AND HEALTH-RELATED EDUCATION TO THE POOR, TO MINORITIES, AND TO OTHER UNDERSERVED GROUPS AS WELL AS TO THE BROADER COMMUNITY. AS INDIVIDUAL AFFILIATES, A UNIFIED HEALTH SYSTEM AND AN ACTIVE PARTNER WITH OTHER COMMUNITY AND GOVERNMENTAL AGENCIES, JENNIE EDMUNDSON MEMORIAL HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH AND QUALITY OF LIFE OF THE RESIDENTS OF THIS COMMUNITY.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records Maintained0GrantRecordsMaintainedInd

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
JENNIE EDMUNDSON MEMORIAL HOSPITAL FOUNDATION
933 EAST PIERCE STCOUNCIL BLUFFSIA51503421439454501(C)(3)$109,275SUPPORT OF FOUNDATION PROGRAMS
(no name)
SUPPORT OF FOUNDATION PROGRAMS
(no name)
SUPPORT OF CHAMBER'S PROGRAMS
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)

Grant TypeGrantTypeTxtRecipientRecipientCntCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtValuation Method UsedValuationMethodUsedDescNon Cash AssistanceNonCashAssistanceDesc
SCHOLARSHIPS14$18,000
FINANCIAL ASSISTANCE7260$4,389,739BOOKFINANCIAL ASSISTANCE TO PATIENTS

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationJENNIE EDMUNDSON MEMORIAL HOSPITAL ONLY PROVIDES GRANTS TO IRC SECTION 501(C)(3) ORGANIZATIONS AND 501(C)(3) ACTIVITIES TO ENSURE THE FUNDS ARE USED FOR EXEMPT PURPOSES.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
WILLIAM SHIFFERMILLER MD
DIRECTOR$0$335,607$0$14,782$0$126,789$0$56,526$0$19,525$0$553,229$0$78,034
STEVEN BAUMERT
PRESIDENT$0$320,984$0$66,893$0$44,902$0$85,091$0$15,819$0$533,689$0$0
JEFFREY FRANCIS
CFO EFFECTIVE 3/7/16$0$384,281$0$0$0$1,098$0$63,656$0$15,620$0$464,655$0$0
LINDA BURT
CFO THROUGH 3/6/16$0$110,275$0$66,519$0$155,382$0$66,537$0$570$0$399,283$0$112,367
MICHAEL ROMANO MD
PHYSICIAN /EXEC MED AFFAIR$276,783$0$0$0$21,636$0$48,361$0$27,299$0$374,079$0$0$0
PEGGY HELGET
EXEC. PATIENT SVCS$168,239$0$16,300$0$2,155$0$27,458$0$6,524$0$220,676$0$0$0
JAMES CHAMBERS
VICE PRESIDENT CLINICAL AFFAIRS$153,553$0$401$0$0$0$24,017$0$15,544$0$193,515$0$0$0
SCOTT BOMGAARS
VICE PRES - MED. AFFAIRS$130,600$0$8,150$0$0$0$15,561$0$595$0$154,906$0$0$0
NGUYET TRAN MD
PHYSICIAN$193,873$0$0$0$0$0$8,614$0$25,294$0$227,781$0$0$0
EVELYN REHER
PHYSICIAN$332,341$0$401$0$0$0$31,488$0$15,561$0$379,791$0$0$0
BECKY KRAUL-HENKEL
EMPLOYEE HEALTH NURSE$49,586$0$8,150$0$81,292$0$20,864$0$4,326$0$164,218$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3JENNIE EDMUNDSON MEMORIAL HOSPITAL IS AN AFFILIATED MEMBER OF THE NEBRASKA METHODIST HEALTH SYSTEM. POLICIES ARE CENTRALIZED AT NEBRASKA METHODIST HEALTH SYSTEM INC. METHODIST HEALTH SYSTEM, WITH WHICH JENNIE EDMUNDSON IS AFFILIATED, RETAINS AN INDEPENDENT CONSULTANT TO REVIEW ALL OFFICER COMPENSATION FOR EACH AFFILIATE. UNDER THIS PROCESS, MARKET DATA ON COMPENSATION IS GATHERED AND ANALYZED AND COMPENSATION RANGES ARE SET. THE INFORMATION IS THEN PROVIDED TO THE COMPENSATION COMMITTEE OF THE BOARD OF NEBRASKA METHODIST HEALTH SYSTEM INC., A NEBRASKA NON-PROFIT CORPORATION AND A VOTING MEMBER OF JENNIE EDMUNDSON MEMORIAL HOSPITAL. ALL OFFICER COMPENSATION IS REVIEWED, EVALUATED AND APPROVED BY THIS COMMITTEE.
PART I, LINE 4BTHE FOLLOWING INDIVIDUALS PARTICIPATED IN A NONQUALIFIED PLAN DURING 2016 AND RECEIVED CONTRIBUTIONS, PLAN ACCRUALS OR PLAN DISTRIBUTIONS IN THE FOLLOWING AMOUNTS: STEVEN BAUMERT $50,138 ACCRUAL JEFFREY FRANCIS $60,655 ACCRUAL LINDA BURT $53,804 ACCRUAL; $112,367 PLAN DISTRIBUTION WILLIAM SHIFFERMILLER MD PLAN DISTRIBUTION $78,034 MICHAEL ROMANO MD $24,446 ACCRUAL PEGGY HELGET $16,120 ACCRUAL

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonJOHN G SOUTHARD MD PHDPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionMEMBER OF THE BOARDRelationshipDescriptionTxt
Transaction$535,000TransactionAmt
TransactionDR. SOUTHARD IS A 50% OWNER OF PULMONARY/INFECTIOUS DISEASE WHICH CONTRACTS WITH THE HOSPITAL TO PROVIDE SERVICES.TransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART V, LINE 2BTHE PAYROLL SYSTEM FOR JENNIE EDMUNDSON MEMORIAL HOSPITAL IS BEING HANDLED BY A COMMON PAYMASTER, NEBRASKA METHODIST HEALTH SYSTEM INC. ALL W-2 FORMS ARE ISSUED UNDER THE TAX IDENTIFICATION NUMBER OF NEBRASKA METHODIST HEALTH SYSTEM. ALL REQUIRED FEDERAL EMPLOYMENT TAX RETURNS WERE FILED BY NEBRASKA METHODIST HEALTH SYSTEM. WAGES AND BENEFITS SHOWN IN THIS FORM 990 ARE ACTUAL EXPENSES ASSOCIATED WITH JENNIE EDMONDSON MEMORIAL HOSPITAL PERSONNEL.
FORM 990, PART VI, SECTION A, LINE 6UNDER THE ARTICLES OF INCORPORATION OF JENNIE EDMUNDSON MEMORIAL HOSPITAL, AS RESTATED ON APRIL 29, 1994, THE WOMEN'S CHRISTIAN ASSOCIATION OF IOWA, AN IOWA NON-PROFIT CORPORATION IS A SPONSORING MEMBER OF JENNIE EDMUNDSON MEMORIAL HOSPITAL. UNDER THE SAME ARTICLES OF INCORPORATION, NEBRASKA METHODIST HEALTH SYSTEM INC., A NEBRASKA NON-PROFIT CORPORATION, IS A CORPORATE MEMBER OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7AUNDER THE ARTICLES OF INCORPORATION OF JENNIE EDMUNDSON MEMORIAL HOSPITAL, AS RESTATED ON APRIL 29 1994, THE WOMEN'S CHRISTIAN ASSOCIATION OF COUNCIL BLUFFS, IOWA, AN IOWA NON-PROFIT CORPORATION, IS A SPONSORING MEMBER OF THE ORGANIZATION AND HAS THE RIGHT TO NOMINATE TWO (2) OF ITS MEMBERS TO THE HOSPITAL'S BOARD OF DIRECTORS. LIKEWISE, THE NEBRASKA METHODIST HEALTH SYSTEM INC. HAS THE RIGHT TO NOMINATE TO THE HOSPITAL'S BOARD OF DIRECTORS THE NUMBER OF DIRECTORS THAT IS ONE (1) LESS THAN A MAJORITY OF THE SEATS ON THE BOARD OF DIRECTORS. NEBRASKA METHODIST HEALTH SYSTEM ALSO HAS THE RIGHT TO APPROVE ALL OF THE DIRECTORS NOMINATED.
FORM 990, PART VI, SECTION B, LINE 11BPRIOR TO FILING THE FORM 990, A COPY IS PROVIDED TO THE AUDIT AND COMPLIANCE COMMITTEE OF NEBRASKA METHODIST HEALTH SYSTEM AND THE JENNIE EDMUNDSON MEMORIAL HOSPITAL BOARD OF DIRECTORS. THEY ARE GIVEN AN OPPORTUNITY TO ASK QUESTIONS OR REQUEST MORE INFORMATION. INFORMATION FOR THE FORM 990 IS GATHERED FROM APPROPRIATE RESPONSIBLE PARTIES THROUGHOUT THE ORGANIZATION, INCLUDING THE ORGANIZATION'S HUMAN RESOURCES, FINANCE, COMPLIANCE, AND COMMUNITY NETWORKING DEPARTMENTS; IS REVIEWED BY EXTERNAL TAX ADVISORS AND HAS A FINAL REVIEW BY THE CHIEF FINANCIAL OFFICER FOR NEBRASKA METHODIST HEALTH SYSTEM AND THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER.
FORM 990, PART VI, SECTION B, LINE 12CAN ANNUAL QUESTIONNAIRE IS SENT TO ALL OFFICERS, DIRECTORS, COMMITTEE MEMBERS, MEDICAL DIRECTORS, AND KEY EMPLOYEES PURSUANT TO THE METHODIST HEALTH SYSTEM CONFLICTS OF INTEREST POLICY WHICH REQUIRES THE DISCLOSURE OF RELATIONSHIPS, NOT JUST FINANCIAL, THAT COULD GIVE RISE TO CONFLICTS WITH THE ORGANIZATION. A BOARD COMMITTEE MEETS ANNUALLY TO REVIEW ALL POTENTIAL CONFLICTS IDENTIFIED THROUGH THE SURVEYS. SHOULD A DECISION COME TO THE BOARD WITH AN IDENTIFIED CONFLICT, THE OFFICER, DIRECTOR OR KEY EMPLOYEE IS NOT PERMITTED TO VOTE OR USE PERSONAL INFLUENCE ON THE MATTER AND IS NOT COUNTED IN DETERMINING THE QUORUM FOR A MEETING AT WHICH THE MATTER IS DISCUSSED. A POTENTIAL CONFLICT OF INTEREST ONCE IDENTIFIED MUST BE EVALUATED ON A CASE BY CASE BASIS. IN ORDER TO APPROVE THE TRANSACTION WHICH INVOLVES A DIRECT CONFLICT OF INTEREST, THE BOARD MUST FIRST FIND, BY MAJORITY VOTE OF DIRECTORS FOR WHOM NO CONFLICT EXISTS, AT A MEETING AT WHICH A QUORUM IS PRESENT, THAT THE ARRANGEMENT OR TRANSACTION IS IN THE BEST INTERESTS OF JENNIE EDMUNDSON MEMORIAL HOSPITAL AND/OR ITS HEALTH SYSTEM AFFILIATES, IS FAIR AND REASONABLE AND, AFTER INVESTIGATION, THE DIRECTORS HAVE DETERMINED THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE OBTAINED WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES.
FORM 990, PART VI, SECTION B, LINE 15JENNIE EDMUNDSON MEMORIAL HOSPITAL IS AN AFFILIATED MEMBER OF THE NEBRASKA METHODIST HEALTH SYSTEM. POLICIES ARE CENTRALIZED AT NEBRASKA METHODIST HEALTH SYSTEM INC. METHODIST HEALTH SYSTEM, WITH WHICH JENNIE EDMUNDSON IS AFFILIATED, RETAINS AN INDEPENDENT CONSULTANT TO REVIEW ALL OFFICER COMPENSATION FOR EACH AFFILIATE. UNDER THIS PROCESS, MARKET DATA ON COMPENSATION IS GATHERED AND ANALYZED AND COMPENSATION RANGES ARE SET. THE INFORMATION IS THEN PROVIDED TO THE COMPENSATION COMMITTEE OF THE BOARD OF NEBRASKA METHODIST HEALTH SYSTEM INC., A NEBRASKA NON-PROFIT CORPORATION AND THE VOTING MEMBER OF JENNIE EDMUNDSON MEMORIAL HOSPITAL. ALL OFFICER COMPENSATION IS REVIEWED, EVALUATED AND APPROVED BY THIS COMMITTEE. PHYSICIAN COMPENSATION IS COMPARED TO NATIONAL COMPENSATION SURVEY DATA FROM THE MEDICAL GROUP MANAGEMENT ASSOCIATION (MGMA) AND THE AMERICAN MEDICAL GROUP ASSOCIATION (AMGA). THE POLICY ON "PHYSICIAN COMPENSATION" IS FOLLOWED WHEN CONTRACTING WITH PHYSICIANS TO ENSURE APPROPRIATE APPROVALS, INCLUDING APPROVAL BY THE BOARD OF DIRECTORS, ARE OBTAINED WHEN WARRANTED. OPINIONS OF FAIR MARKET VALUE REGARDING A PARTICULAR COMPENSATION ARRANGEMENT OR TRANSACTION MAY ALSO BE OBTAINED FROM REPUTABLE, INDEPENDENT VALUATION CONSULTANTS.
FORM 990, PART VI, SECTION C, LINE 18THE FORM 1023 WAS FILED PRIOR TO 7/15/87 AND NEED NOT BE MADE PUBLICLY AVAILABLE. A COPY OF THE IRS LETTER 947 WILL BE PROVIDED UPON WRITTEN REQUEST.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION DOES NOT MAKE THESE DOCUMENTS SEPARATELY AVAILABLE TO THE PUBLIC. HOWEVER, ARTICLES OF INCORPORATION FOR THE ORGANIZATION ARE AVAILABLE THROUGH THE IOWA SECRETARY OF STATE'S WEBSITE. THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED TO ALL MEMBERS OF THE BOARD OF DIRECTORS. FINANCIAL INFORMATION IS AVAILABLE TO THE PUBLIC THROUGH THE IRS FORM 990 AND FORM 990-T. THE ORGANIZATION ALSO CONTRIBUTES INFORMATION REGARDING THE COMMUNITY BENEFITS IT PROVIDES AS PART OF THE METHODIST HEALTH SYSTEM'S ANNUAL COMMUNITY BENEFIT REPORT. THIS REPORT IS AVAILABLE TO THE PUBLIC ON THE WEBSITE WWW.METHODISTCHART.ORG.
FORM 990, PART XI, LINE 9:CHANGE IN MINIMUM PENSION LIABILITY 268,031.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1LOESS HILLS PROPERTIES LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line18511 W DODGE RDAddressLine1Txt
CityOMAHACityNm
State AbbreviationNEStateAbbreviationCd
ZIP68114ZIPCd
FieldValueIRS element (for citing)
EIN475070644EIN
Primary ActivitiesRENTAL INCOMEPrimaryActivitiesTxt
Legal Domicile StateIALegalDomicileStateCd
Total Income$98,494TotalIncomeAmt
End Of Year Assets$1,398,645EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1JENNIE EDMUNDSON MEMORIAL HOSPITALBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
JENNIE EDMUNDSON MEMORIAL HOSPITAL FOUNDATION
933 EAST PIERCE STREETCOUNCIL BLUFFSIA51503421439454SUPPORT OF JENNIE EDMUNDSON HOSPITALIA501(C)(3)L7JENNIE EDMUNDSON MEMORIAL HOSPITALYes (1)
WOMEN'S CHRISTIAN ASSOCIATION OF COUNCIL BLUFFS IOWA
933 EAST PIERCE STREETCOUNCIL BLUFFSIA51503930957829MEMBER OF JENNIE EDMUNDSON MEMORIAL HOSPITALIA501(C)(3)L12: III-O0N/A
NEBRASKA METHODIST HEALTH SYSTEM INC
8511 W DODGE ROADOMAHANE68114470639839ADMINISTRATIVE SUPPORTNE501(C)(3)L12: III-FI0N/A
NEBRASKA METHODIST HOSPITAL
8511 W DODGE ROADOMAHANE68114470376604LICENSED HOSPITALNE501(C)(3)L3NEBRASKA METHODIST HEALTH SYSTEM INC0
NEBRASKA METHODIST COLLEGE OF NURSING & ALLIED HEALTH
8511 W DODGE ROADOMAHANE68114470724387NURSING AND HEALTH EDUCATION FACILITYNE501(C)(3)L2NEBRASKA METHODIST HOSPITAL0
NEBRASKA METHODIST HEALTH SYSTEM SELF INSURANCE TRUST FUND
8511 W DODGE ROADOMAHANE68114363699672INSURANCENE501(C)(3)L11: III-FINEBRASKA METHODIST HEALTH SYSTEM INC0
REAL ESTATE HOLDINGS
8511 W DODGE ROADOMAHANE68114470649790PROPERTY MANAGEMENTNE501(C)(2)N/ANEBRASKA METHODIST HEALTH SYSTEM INC0
PHYSICIANS CLINIC INC
8511 W DODGE ROADOMAHANE68114470687317CLINICAL HEALTH CARENE501(C)(3)L10NEBRASKA METHODIST HEALTH SYSTEM INC0
NEBRASKA METHODIST HOSPITAL FOUNDATION
8511 W DODGE ROADOMAHANE68114470595345SUPPORT OF NEBRASKA METHODIST HOSPITALNE501(C)(3)L7NEBRASKA METHODIST HEALTH SYSTEM INC0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
SHARED SERVICE SYSTEMS INC & SUBSIDIARY
8511 W DODGE ROADOMAHANE68114470649534MEDICAL SUPPLY DISTRIBUTION & LAUNDRYNENEBRASKA METHODIST HEALTH SYSTEM INCC0
METHODIST HEALTH PARTNERS
8511 W DODGE ROADOMAHANE68114470797563MANAGED CARE CONTRACTINGNENEBRASKA METHODIST HEALTH SYSTEM INCC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
JENNIE EDMUNDSON MEMORIAL HOSPITAL FOUNDATION
C$1,955,293BOOK
JENNIE EDMUNDSON MEMORIAL HOSPITAL FOUNDATION
B$109,275BOOK

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