2017-03-02T10:56:20-06:00 2016-06-30 450250958 EIDE BAILLY LLP 4310 17TH AVE S PO BOX 2545 FARGO ND 581082545 990 2015-07-01 450231181 Lutheran Charity Association D/B/A Jamestown Regional Medical Center LUTH 7012521050 2422 20th Street SW Jamestown ND 584013360 Beverly Fiferlick CFO 7012521050 2017-02-23 1 LISA CHAFFEE CPA P00193453 7012398500 2017-02-23 2015 2021-01-29 14:40:06Z Jamestown Regional Medical Center Beverly Fiferlick 2422 20th Street SW Jamestown ND 584013360 45097532 0 X www.jrmcnd.com X 1927 ND Jamestown Regional Medical Center will be the best rural hospital in the country for patients to receive care, employees to work, and physicians to practice. 11 10 416 99 47075 -852 110775 64612 41687273 44112579 490652 822217 66782 48099 42355482 45047507 0 50 0 0 19841981 21262533 0 0 0 23324132 22662913 43166113 43925496 -810631 1122011 72369662 72221248 52721657 51313306 19648005 20907942 X Exceed expectations and be the difference in the lives of those we serve. 1 0 39702058 50 44072409 Jamestown Regional Medical Center is a 25 bed critical access hospital providing short-term acute inpatient, outpatient, swing bed, home health and hospice health care services. The nearest provider of health care services is more than 35 miles away and Jamestown Regional Medical Center is located 100 miles away from the nearest major health service centers in Fargo or Bismarck, North Dakota. Jamestown Regional Medical Center makes medical care accessible to the entire community it serves. In addition to the routine inpatient and outpatient health care services provided, during FYE June 30, 2016 the following were provided: *4,263 inpatient days of which 462 were swing bed and 18 hospice days of care *39% Medicare is the percentage of inpatient days *12% Medicaid is the percentage of inpatient days *8,701 emergency visits of which 723 resulted in inpatient admissions *32,501 total outpatient visits *2,308 outpatient surgical procedure visits including outpatient surgery and scopes *337 live births *2,051 orthopedic patients*753 urology patients *2,124 cardiac rehab visits *4,355 home health visits *4,928 hospice days of care *$461,538 in free care *99 volunteers We provide the following specialty services to the communities we serve:*Urology: Treatment of conditions associated with the kidney, bladder and urinary tract. *Wound Clinic: We offer advanced wound care solutions to patients dealing with the issue of wound healing.*Cardiac care and rehabilitation: In addition to emergency and intensive care units our cardiac services include cardiolite stress, adenoscan and adenowalk cardiolite imaging tests and spect imaging tests for accurate diagnosis, and monitored diet and exercise programs throughout the hospital stay and through outpatient care in our cardiac rehabilitation center.*3D Mammography: We have new 3D Mammography technology that detects cancer sooner than ever before*Emergency care: Our emergency center is staffed 24 hours a day throughout the year and handles everything from broken bones to heart attacks. *Home health services: Services provided to the home bound include nursing, physical, occupational, speech and social services.*Hospice: provide for the physical and psychological needs of the terminally ill and help accommodate their families through a full range of hospice services.*Nutritional counseling: Our registered dietitians provide nutritional assessments and personalized diet plans to optimize health and speed recovery through proper nutrition.*Physical and occupational therapy: Provide a full range of services to help patients recover from on-the-job, sports-related injuries and certain debilitating diseases.*Social services and support groups: Our facility provides a wide range of support in the coordination of services by our social service department and support groups to help our patients and their families cope with the emotional and financial effects of illness. *Podiatry services: Our licensed and credentialed doctor of podiatry medicine treats everything from flat feet to bunions with moderate therapeutic techniques.*Hearing services: We employ a licensed audiologist that can help correct hearing loss.*Surgery center: Our inpatient and outpatient surgery center is capable of handling a wide variety of general and specialized surgical procedures including laparoscopic and cataract procedures. *Other support services:-Laboratory, pathology and radiology services: Full range of services to provide accurate diagnosis for treatment -Care line: We operate an emergency response telephone based response center to enable the elderly to remain independent in their homes *Volunteers and volunteer services: We have, on the average, 99 community volunteers as follows:-Senior companions: Helping senior citizens maintain independence by reading to them, helping with shopping, etc. -Hospice: Assisting hospice patients and families cope with terminal illness -Children's TLC: Volunteers provide parents with a break with their children that are hospitalized -Telecare: Maintain contact with your friends or family member through telephone calls to their home -Gift Shoppe: Operated for the convenience of friends and family of hospital patients to obtain cards, flowers and small gifts for patients in our facility -Other services: Community members volunteer their services to help out in times of need in most service areas assisting patients and their families. 39702058 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 53 0 1 416 1 1 1 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Beverly Fiferlick 7012521050 2422 20th Street SW Jamestown ND 584013360 Connie Krapp Past Chairperson 1.00 0.00 X X 0 0 0 Dennis D Pozarnsky Chairperson 1.00 1.00 X X 0 0 0 Joanne H Ottmar Vice Chairperson 1.00 0.00 X X 0 0 0 Pat Nygaard Secretary/Treasurer 1.00 0.00 X X 0 0 0 Terry Anderson Sec/Treas (thru Nov 2015) 1.00 0.00 X X 0 0 0 Michael Dean MD Board Member/Orthopedic Surgeon 40.00 0.00 X 673128 0 63698 Sarah Schatz MD Board Member 1.00 0.00 X 0 0 0 Eric Monson Board Member 1.00 0.00 X 0 0 0 Casey Henderson Board Member 1.00 0.00 X 0 0 0 Myra Quanrud MD Board Member 1.00 0.00 X 0 0 0 Wanda Vining-Alber Board Member 1.00 0.00 X 0 0 0 Mark Anderson Board Member 1.00 0.00 X 0 0 0 KC DeBoer CEO 40.00 1.00 X 262701 0 44831 Brandon Vaughan CFO (thru Jan 2016) 40.00 1.00 X 127890 0 30463 Beverly Fiferlick CFO (as of Apr 2016) 40.00 1.00 X 0 0 0 Trisha Jungels CNO 40.00 0.00 X 116245 0 19110 Ricki Ramlo COO 40.00 0.00 X 117053 0 26701 Dr Manuel Harris Podiatrist 40.00 0.00 X 207692 0 50525 Dr Philip Jystad ER Physician 40.00 0.00 X 374503 0 63764 Dr Scott Goecke ER Physician 40.00 0.00 X 352485 0 33723 James Metzger CRNA 40.00 0.00 X 195366 0 37264 Lee Ellingson CRNA 40.00 0.00 X 218075 0 39259 2645138 0 409338 21 0 1 0 Gary Wade 484 Snider Dr Walla Walla WA 99362 Radiologist 900815 Huron Consulting Services LLC 550 W Van Buren St Chicago IL 60607 Healthcare Consulting 822855 2 48788 15824 64612 Net Patient Service Revenue 621400 43156365 43156365 Cafeteria 900099 270419 270419 Laundry Services 812300 47075 47075 Auxiliary Revenue 900099 44116 44116 594604 594604 44112579 350844 350844 41194 0 41194 41194 41194 456322 15051 0 0 456322 15051 471373 471373 56930 50025 6905 6905 45047507 44072409 47075 863411 X 50 50 1471573 752778 718795 14956106 13915475 1040631 977929 918292 59637 2827426 2571576 255850 1029499 917715 111784 56895 56895 65275 65275 5937417 4798602 1138815 182710 55737 126973 699719 471604 228115 12385 12385 982794 966154 16640 197911 136968 60943 85513 63506 22007 1999025 1999025 4471839 4471839 173887 54898 118989 Medical Supplies 4858985 4849939 9046 Lease and Rental 1218764 1218764 Provision for Bad Debts 1165396 1165396 Food 241192 241192 313206 120163 193043 43925496 39702058 4223438 0 4285902 3929262 6058569 5592933 498623 488113 145520 178163 64099114 22186635 45002469 41912479 14717516 18372056 1661063 1748242 72369662 72221248 3919883 3806837 618032 611577 45945021 44829927 2238721 2064965 52721657 51313306 X 19354893 20476628 293112 431314 19648005 20907942 72369662 72221248 X 1122011 -10885 148811 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 4131 4131 0 Part II-B, Line 1: The organization pays dues to various professional organizations. A portion of those dues are used towards lobbying expenses. These lobbying expenses go towards advocating for the organizations purpose and mission. 1 20070 44116 54725 9461 0 433429 433429 46083796 11270626 34813170 789268 155276 633992 16274460 10615155 5659305 518161 145578 372583 41912479 Estimated Third-Party Settlements 2064965 2064965 X 44015337 -10885 -1027194 -1038079 45053416 -5909 -5909 45047507 42755400 50025 50025 42705375 1220121 1220121 43925496 Part IV, Line 1b: There is an auxiliary which operates under the EIN of the Organization. Part X, Line 2: The Medical Center is organized as a North 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 Medical Center is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Organization is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Organization files an Exempt Organization Business Income Tax Return (Form 990T) with the IRS to report its unrelated business taxable income. The Organization 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 consolidated financial statements. The Organization 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 Included in Revenue on Financial Statements -1,165,396. Increase in Interest in Foundation 138,202. Part XI, Line 4b - Other Adjustments: Cost of Goods Sold Included in Expenses on Financial Statements -50,025. Auxiliary Revenues 44,116. Part XII, Line 2d - Other Adjustments: Cost of Goods Sold Included in Expenses on Financial Statements 50,025. Part XII, Line 4b - Other Adjustments: Provision for Bad Debts Included in Revenue on Financial Statements 1,165,396. Auxiliary Expenses 54,725. 1 1 X 1 X 1 X 1 1 0 0 364000 364000 0.00850 2467330 2274472 192858 0.00450 2831330 2274472 556858 0.01300 12876 12876 0.00030 4521553 2790075 1731478 0.04050 4534429 2790075 1744354 0.04080 7365759 5064547 2301212 0.05380 0 1165396 230748 12894443 13683599 -789156 X 1 1 1 1 Jamestown Regional Medical Center 2422 20th St SW Jamestown ND 58401 www.jrmcnd.com 5027 X X X X Lutheran Charity Association 1 0 0 1 X X X X X X X 14 1 1 1 1 X www.jrmcnd.com/about/community X http://centralvalleyhealth.org/HIP.html X 1 14 1 https://www.jrmcnd.com/about/community/ 0 0 1 X 100.000000000000 300.000000000000 X X X 1 1 X X X X 1 X https://www.jrmcnd.com/resource-center/patient-accounts/community-care/ X https://www.jrmcnd.com/resource-center/patient-accounts/community-care/ X https://www.jrmcnd.com/resource-center/patient-accounts/community-care/ X X X X 1 X 0 X X X X 1 X 0 0 Lutheran Charity Association Part V, Section B, Line 5: A public survey was conducted by the University of North Dakota Center for Rural Health (UND CRH) from February to March 2015. The survey was available in both paper and electronic versions; a variety of notices were provided to the general public. Approximately 300 surveys were completed. Analysis was provided by the UND CRH and results were shared at a community meeting in May 2015. Focus groups were also done in May - June 2015. Lutheran Charity Association Part V, Section B, Line 6a: Central Valley Health District and ND State Hospital Lutheran Charity Association Part V, Section B, Line 6b: The CHNA was conducted with Central Valley Health District. Lutheran Charity Association Part V, Section B, Line 11: Community members identified the following priority areas by using surveys and focus groups:* Physical Activity and Obesity: Enhance physical activity and obesity prevention efforts by monitoring progress at monthly Community Health Partnership meetings, increasing New Year New You participation by 10% each year, work with TRAC Executive Board to construct and open the TRAC.* Physical Environment - Not Enough Affordable Housing: Increase tenant-base rental assistance availability by working with HUD, USDA Rural Development, Federal and State officials, etc.* Access to Care - Cost and Adequacy of Health Insurance: Increase education and awareness of health choices and behaviors. * Employment - Workforce: Increase education and awareness of workforce challenges by engaging community partners to strengthen capacity.There were results accomplished in FYE16 on the priorities of the prior CHNA:Physical Activity and Obesity: * NYNY Results showed improvement in all 15 healthy lifestyle behaviors of which included:* Minimum exercise recommendation was reached by 41% pre-challenge and 63% post-challenge. 57% were aware of minimum number of minutes to accumulate of exercise weekly.* Average consumption of 3 or more servings of fruit increased from 36% pre-challenge to 74% post-challenge.* Average consumption of 3 or more servings of vegetables increased from 43% pre-challenge to 69% post-challenge.* Decrease from 68% to 53% for eating meals prepared outside the home each week.Improvement in the following self-reported areas:* How often do you feel overwhelmed or unable to cope with the pace of your life?57% responded Rarely or Never pre-challenge70% responded Rarely or Never post-challenge* Do you experience sleeplessness or interrupted sleep on a regular basis?48% responded Yes pre-challenge27% responded Yes post-challenge* Do you experience tension on a regular basis?39% responded Yes pre-challenge21% responded Yes post-challenge* How many hours of sleep do you average per night?69% received 7-9 hours pre-challenge90% received 7-9 hours post-challenge* 53% had a weight loss goal and 327 pounds were lost.* Busy work schedule (67%) and time demands of family members (49%) are the top obstacles to maintaining a healthier lifestyle.* Two Rivers Activity Center construction underway and is scheduled to open in 2017Physical Environment - Not Enough Affordable Housing:* In Jamestown, housing is up to a 4% vacancy rate from 2% (Spring 2016)Access to Care - Cost and Adequacy of Health Insurance: * JRMC providers/programs: - Urology (first time ever in the community) - No Excuses Campaign promotes breast health at no cost to the patient - a partnership with Central Valley Health and Women's Way sharps collection - SANE (sexual assault nurse examiner) services relocated to JRMC. In May three additional nurses trained as SANEs. SANE Coordinator hired. - Community Care - Health TracksEmployment - Workforce:* North Dakota Unemployment Rate 2.8% 1 1 - JRMC Clinic 2422 20th Street SW Jamestown ND 58401 Clinic Part I, Line 3c: The patient may be asked to provide additional information to help determine eligibility for financial assistance that is not based upon the federal poverty guidelines. Items the patient is asked to also provide include:-Medical Assistance eligibility/denial notice if applicable-Income tax returns for the 2 most recently filed years-Proof of income and adjusted gross income such as pay stubs from the past 6 pay periods, W-2 withholding statements, Social Security checks, receipts, or deposits, and bank statements-Notification of Benefit decision from the ND Department of Human Services 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. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. Health Professions education, line 7f, is reported based on actual expense amounts recorded in the general ledger. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report. Part I, Ln 7 Col(f): The amount of bad debt expense removed from the denominator of the calculations was $1,165,396. Part III, Line 2: In evaluating the collectability of patient accounts receivable, the organization analyzes past results and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts specifically, for receivables associated with services provided to patients who have third-party coverage. The organization analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts for expected uncollectible amounts for which the third-party payer has not yet paid, or for payers who are known to be having financial difficulties that make the realization of amounts due unlikely for receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill). The organization records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. Part III, Line 3: We used charity care as a percent of gross revenue to estimate bad debt expense attributable to patients eligible under the FAP. Part III, Line 4: The footnote to the Organization's financial statements can be found on page 8 and 9 of the attached audited financial statements. Part III, Line 8: IRS Rev. Rul. 69-545, which established the community benefit standard for nonprofit hospitals, states that if a hospital serves patients with government health benefits, including Medicare, then this is an indication that the hospital operates to promote the health of the community. In some communities, Medicare is the largest payer, and hospitals must accept these patients regardless of whether they make a surplus or deficit from providing such services. If the Medicare participation is premised on this fact, then providing Medicare services promotes access to healthcare services which is a community benefit. Also, the elderly are often an underserved population who experience issues with access to healthcare services. Without tax-exempt hospitals providing Medicare services, the government would bear the burden of directly providing services to the elderly. Medicare allowable costs are based on the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. Part III, Line 9b: No collections effort will be made by Jamestown Regional Medical Center or its collection agencies on the percentage of community care approved. However, patients must have completed the community care application process, establish their eligibility, and have been approved. Upon receipt of an incomplete application, the guarantor will have 30 days from notification of the incomplete application to complete the application thoroughly or the application will be void. Four billing statements will be sent to patients over the course of 120 days after the first statement is sent. The fourth statement will inform the patient of potential Extraordinary Collection Actions. Part VI, Line 2: The Community Health Partnership was formed in March 2013 after the completion of the 2012 Community Health Assessment and Community Health Improvement Plan. The Community Health Partnership is comprised of community members and numerous community agencies. The purpose of the Community Health Partnership is to provide effective, quality health and safety services in an environment that enables community members to reach their full potential through assessment, leadership and partnerships. The goals of the community health partnership are:-Enhance efficiency of community connections-Decrease duplication of efforts (and meetings)-Improve awareness and health within the community (Stutsman County)The organization also recently completed its 2nd Community Health Needs Assessment during the 6/30/15 fiscal year end. Part VI, Line 3: All patients receive a "Payment Guidelines" brochure at time of registration, which notifies the patients on how to apply for charity care as well as explains the claim filing process, responsible party, co-pays and payments. All private pay patients receive a letter which lists charity care as a payment alternative to those who qualify. Our website contains a charity care link which explains the program and allows forms to be downloaded and printed. Part VI, Line 4: Jamestown Regional Medical Center serves a nine county area of South Central North Dakota. The primary industry is agriculture. The population is 52,155 with 21% over the age of 65. The average age is 42. Male and female population is split evenly. Average income by household is $53,650. There are two colleges within Jamestown Regional Medical Center trade area. Jamestown Regional Medical Center is the only birthing center within a 90 mile radius. Part VI, Line 5: A majority of the Governing body is comprised of persons who reside in the organization's primary service area who are neither employees nor contractors of Jamestown Regional Medical Center, nor family members thereof. Jamestown Regional Medical Center extends medical staff privileges to all qualified physicians in the community. Jamestown Regional Medical Center recently moved into a new replacement hospital which has many upgrades in technology, most of which are related to improving patient care. Surplus funds, when available, are used to invest in both capital assets and medical equipment in order to improve patient care. X X X X 0 0 0 0 0 0 0 1 0 Michael Dean MD Board Member/Orthopedic Surgeon 672747 0 0 0 381 0 44042 0 20222 0 737392 0 0 0 KC DeBoer CEO 262340 0 0 0 361 0 23205 0 22512 0 308418 0 0 0 Brandon Vaughan CFO (thru Jan 2016) 127832 0 0 0 58 0 11448 0 19536 0 158874 0 0 0 Dr Manuel Harris Podiatrist 206175 0 0 0 1517 0 17694 0 33397 0 258783 0 0 0 Dr Philip Jystad ER Physician 373856 0 0 0 647 0 44042 0 20289 0 438834 0 0 0 Dr Scott Goecke ER Physician 352124 0 0 0 361 0 26042 0 8247 0 386774 0 0 0 James Metzger CRNA 195269 0 0 0 97 0 17737 0 20094 0 233197 0 0 0 Lee Ellingson CRNA 217714 0 0 0 361 0 17927 0 21898 0 257900 0 0 0 Part I, Line 7 There is an incentive plan specifically for the CEO. This plan is designed to encourage, recognize and reward superior job and organizational performance. Incentive awards that may be paid under the terms of this plan are determined by overall organizational and individual performance for the annual operating period. The Chair of the Board of Directors has the responsibility to implement this plan. The incentives for the CEO are expressed as a percentage of the participant's base salary at the end of the incentive plan year. The maximum award is approved by the Board for each plan year. There is a detailed criterion for the results of what the organization considers a superior job. The criteria uses goal driven measures that intend to incentivize important long term strategic objectives over short term efforts only. The CEO's performance is measured based on the following areas of focus: Service, Quality, Financial, People, Growth, and Personal Growth. There is a ranking system for sets of criterion, and the Board of Directors is to utilize this system in determining the level of incentive the CEO will receive. For FY 2016, the incentive plan for the CEO was 6.7% of his base salary. Form 990, Part III, line 2 The JRMC Urology Clinic, which opened November 2015, specializes in treating urological diseases. The Organization began providing outside laundry services under a contract to the Anne Carlsen Center on January 1st, 2016. Form 990, Part VI, Section A, line 1 The Governance Committee consists of the officers of the Board of Directors. A majority of the members of the Governance Committee constitutes a quorum. The Governance Committee: A. Reviews the performance of the President/Chief Executive Officer of the Jamestown Regional Medical Center on the anniversary date of employment and report the findings to the Board of Directors. B. Assists our board to fulfill its responsibilities for ensuring high levels of governance performance and contribution. C. Assists our board to appoint and re-appoint directors; and formulating policies regarding making decisions about and overseeing governance effectiveness, efficiency, creativity and adaptability. D. Takes action on behalf of our board in emergency situations when we cannot be convened; emergency actions taken by the Governance Committee must be reported to the, and discussed/ratified by, our board at its next regularly scheduled meeting. Form 990, Part VI, Section B, line 11 The preparer of the Form 990 provides an electronic copy of the final 990 to the organization's Chief Financial Officer. The Chief Financial Officer performs a detailed review of Form 990. The Chief Financial Officer provides each voting Board Member with a copy of the Form 990 prior to submitting to the Internal Revenue Service. Form 990, Part VI, Section B, line 12c The conflict of interest policy covers employees and board members. The Compliance Officer reviews all potential conflicts and determines if a conflict exists. Directors are asked at every board meeting whether or not anyone has a duality of interest or conflict of interest. Directors having a duality of interest or a possible conflict of interest on any matter which comes before the board shall not vote on the matter or use their personal influence on the matter. The minutes of the meeting shall reflect that a disclosure of duality or conflict of interest was made, and the director making such a disclosure shall not be counted in declaring a quorum for the determination of the matter. This provision shall not be construed as preventing the director from briefly stating a position on the matter nor from answering pertinent questions. Form 990, Part VI, Section B, line 15 For the CEO, the Board Chairman converses with an HR consultant on market wages and evaluation process. Evaluation forms are typically completed by board members and the Board Chairman conducts the actual evaluation. Comparability data was used by those without conflict and the decisions were documented. This process takes place annually. The CFO is evaluated and compensated based on the Employee Performance Assessment policy that is standard for the organization. Comparability data is also used to determine adjustments to compensation. Form 990, Part VI, Section C, line 19 The organization does not make its governing documents, conflict of interest policy and financial statements available to the public. Form 990, Part IX, line 11g Consulting Services: Program service expenses 143,221. Management and general expenses 373,576. Fundraising expenses 0. Total expenses 516,797. Maintenance and Repair: Program service expenses 895,747. Management and general expenses 0. Fundraising expenses 0. Total expenses 895,747. Other Purchased Services: Program service expenses 3,759,634. Management and general expenses 217,675. Fundraising expenses 0. Total expenses 3,977,309. Contracted Services: Program service expenses 0. Management and general expenses 547,564. Fundraising expenses 0. Total expenses 547,564. Form 990, Part XI, line 9: Increase in Interest in the Foundation 138,202. Change in Auxiliary Net Assets 10,609. Jamestown Regional Medical Center Foundation Inc 2422 20th St SW Jamestown ND 58401 363348763 Fundraising ND 501(c)(3) Line 11a, I Lutheran Charity Association 1 Nierling Jamestown Hospital Trust 2422 20th Street SW Jamestown ND 58401 912004888 Charitable Trust ND Lutheran Charity Association (DBA Jamestown Regional Medical Center) T 2629 85489 1.00000 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 0 0 Jamestown Regional Medical Center Foundation Inc Q 225258 cost