2016-04-18T00:00:00-05:00 2015-06-30 450250958 EIDE BAILLY LLP 200 EAST 10TH ST PO BOX 5125 SIOUX FALLS SD 571175125 990 2014-07-01 466015787 Landmann-Jungman Memorial Hospital LAND 6055832226 600 Billars Street Scotland SD 570592026 Darcy Permann CFO 6055832226 2016-03-26 1 Laurie Hanson P00851848 6053391999 2016-03-26 X 2014 2016-08-17 19:52:53Z Darcy Permann 600 Billars Street Scotland SD 570592026 3987732 0 X www.ljmh.org X 1969 SD Operation of a community critical access hospital. 9 9 44 9 0 0 8289 12058 2792147 3960056 12633 13868 1050 1750 2814119 3987732 0 0 0 0 1081080 1799918 0 0 0 1879138 2207732 2960218 4007650 -146099 -19918 4072088 4062214 2577685 2596963 1494403 1465251 Landmann-Jungman Memorial Hospital is committed to providing the highest quality healthcare with compassion and respect. Our commitment shall be to the ethical treatment of all people throughout the continuum of life. 0 0 3499165 3960056 Landmann-Jungman Memorial Hospital (LJMH) is a licensed critical access hospital with 25 acute care beds, of which 10 may be used as swing beds. The facility offers inpatient, outpatient and physician clinic services to residents in and around the city of Scotland, SD. Several visiting specialists spend time at LJMH conducting outreach clinics on a regular basis which include areas of cardiology, general surgery, OB/GYN, mobile MRI, CT, nuclear medicine and mammography. West Winds Apartments is also part of LJMH and serves as a 16 unit senior housing apartment building. LJMH is proud of the excellent care it provides for patients of the service area. The facility is also noted for its community service, which includes an annual health fair and bi-monthly blood drives. 3499165 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 15 0 1 44 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 1 0 0 X Darcy Permann 6055832226 600 Billars Street Scotland SD 57059 Kent Lehr Co-Chair 1.00 X X 0 0 0 Greg Gemar Co-Chair 1.00 X X 0 0 0 Jarad Schortzman Secretary 1.00 X X 0 0 0 David Baker Director 1.00 X 0 0 0 Charles Mogck Director 1.00 X 0 0 0 Jerry Nelson Director 1.00 X 0 0 0 Doreen Schlechter Director 1.00 X 0 0 0 Devin Lubinus Director 1.00 X 0 0 0 Carol Hofer Director 1.00 X 0 0 0 Jonathan Moe Administrator 50.00 X 0 0 0 Darcy Permann CFO 50.00 X 55884 0 8255 55884 0 8255 0 0 0 0 Avera McKennan 1325 S Cliff Ave PO Box 5045 Sioux Falls SD 571175045 Management, IT, Education 672130 1 12058 12058 Net Patient Service Re 621110 3100699 3100699 Scotland Pharmacy 446110 606133 606133 West Winds Revenue 623990 95237 95237 Change in Avera Founda 900099 2914 2914 155073 155073 3960056 629 629 1750 0 1750 1750 1750 7906 5333 0 0 7906 5333 13239 13239 3987732 3960056 0 15618 X 65405 65405 1542963 1441081 101882 14481 14092 389 87683 57578 30105 89386 78200 11186 117773 117773 36750 36750 457856 454375 3481 6084 6084 169513 92116 77397 73376 73376 1280 1280 89842 89842 333638 333638 41258 41258 Medical Supplies 807630 807630 Bad Debt 31499 31499 Continuing Education 17961 16745 1216 Community & Employee Re 2789 2789 20483 8993 11490 4007650 3499165 508485 0 305829 358907 22486 0 483480 420874 179540 183576 22021 27475 6847338 4463875 2476326 2383463 512963 615441 69443 72478 4072088 4062214 453898 411745 9685 16968 1985750 1905075 128352 263175 2577685 2596963 X 1494403 1465251 0 0 1494403 1465251 4072088 4062214 -19918 -9234 0 X 0 1 X 1 0 X 36163 36163 4865281 3017906 1847375 1862592 1363444 499148 83302 82525 777 2383463 Debt Reserve Funds 46524 C Interest in Net Assets of Avera Health Foundation 132859 F Capital Expenditures and Debt Redemption 436058 F 615441 Conditional Asset Retirement Obligation 71225 Damage Deposits Payable 8083 Capital Lease 183867 263175 X 3934941 -9234 -31499 -40733 3975674 12058 12058 3987732 3976151 0 3976151 31499 31499 4007650 Part X, Line 2: The Hospital is organized as a South Dakota nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Hospital is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Hospital is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Hospital has determined it is not subject to unrelated business income tax and has not filed an Exempt Organization Business Income Tax Return (Form 990T) with the IRS. The Hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Part XI, Line 2d - Other Adjustments: Provision for Bad Debt -31,499. Part XI, Line 4b - Other Adjustments: Net assets released from restrictions for capital expenditures 12,058. Part XII, Line 4b - Other Adjustments: Provision for Bad Debt 31,499. 1 1 X 1 X 1 X 1 1 0 1 1 33200 33200 0.00830 53751 48823 4928 0.00120 86951 48823 38128 0.00950 964334 632558 331776 0.08340 964334 632558 331776 0.08340 1051285 681381 369904 0.09290 0 31499 0 1565646 1571071 -5425 X 1 1 1 1 Landmann-Jungman Memorial Hospital 600 Billars Street Scotland SD 57059 www.avera.org/scotland 10561 X X X X Landmann-Jungman Memorial Hospital 1 0 0 1 X X X X X X 12 1 0 0 1 X http://www.avera.org/scotland X X 1 13 1 http://www.avera.org/scotland 0 0 1 X 150.000000000000 300.000000000000 X X X X 1 1 X X X 1 X X X X 1 X 0 X X 1 X 0 0 Landmann-Jungman Memorial Hospital Part V, Section B, Line 5: LJMH began the Community Health Needs Assessment by gathering the most recent statistics regarding the public health of the community from county, state and national resources. LJMH held focus groups to seek the input of the general public, key community leaders, city and county government including law enforcement, school nursing and administration, church officials, and individuals with special knowledge in public health. The Bon Homme county health nurse was also interviewed to provide input on what the needs are for the county. Landmann-Jungman Memorial Hospital Part V, Section B, Line 7d: The CHNA report is also available at http://www.avera.org/experience/shared/community-needs-health-assessments. Landmann-Jungman Memorial Hospital Part V, Section B, Line 11: Pursuant to the implementation strategy adopted by LJMH, all identified needs will be addressed. During the current year, continued discussions with Scotland EMS about EMT shortages have taken place. LJMH worked with state legislators and was successful in assisting in postponing proposed state wide ambulance legislation that would have negatively affected Scotland EMS services and worsened EMT shortages. LJMH continued to offer two outreach specialties as a result of the Community Health Needs Assessment. LJMH is working with the local school district on building a secondary fitness center as part of an auxiliary gym that would be open to the community. Landmann-Jungman Memorial Hospital Part V, Section B, Line 16i: A notice is posted in the hospital facility's emergency rooms or waiting rooms and in the facility's admissions office alerting patients of the availability of financial assistance and instructions for obtaining a copy of the full policy. 2 West Winds Apartments 600 Billars Street Scotland SD 57059 Senior Living Landmann-Jungman Memorial Clinic 600 Billars Street Scotland SD 57059 Provider Based Clinic Part I, Line 3c: Please refer to Part V, Line 13 for additional factors used in determining free or discounted care eligibility. Part I, Line 7: Lines 7b and 7g were obtained utilizing the Medicaid and Medicare cost reports, respectively. Part I, Ln 7 Col(f): Bad debt expense of $31,499 was subtracted from total operating expense. Part I, Line 6b: LJMH prepares a community benefit report. The report is available to the public upon request. Part III, Line 2: The amount reported on line 2 represents the bad debt expense per the audited financial statements.LJMH bad debt system takes into account contractual allowances and/or discounts. If an account is written off to bad debts, payments received after the write off for that account are posted to the Bad Debt Recovery account. Part III, Line 3: The amount of bad debt that may be attributable to charity care is unknown. LJMH is not confident that it could appropriately allocate any of the organization's bad debt expense to specific individuals that would be eligible for financial assistance. Part III, Line 4: The footnote that describes bad debt is on page 6 of the attached financial statments. Part III, Line 8: The entire amount of the shortfall on line 7 should be treated as community benefit. The shortfall is a direct result of sequestration enactments put in place by the federal government.Medicare allowable cost of care was calculated from the Medicare cost report for the fiscal year ending 6/30/15. Part III, Line 9b: Financial arrangements will be made on accounts meeting financial need and having a remaining balance on their account. Arrangements may be altered according to need at the discretion of the Administrator. Part VI, Line 2: Landmann-Jungman Memorial Hospital (LJMH) conducted a Community Health Needs Assessment during the fiscal year ended September 30, 2013. Please refer to Part V, Line 5 for more information concerning this process.LJMH regularly conducts patient satisfaction surveys which can lead to information regarding needed services. Additionally, interactive questions are asked about services during health screenings. Results of the questionnaire are reported back to the officers and board. Part VI, Line 3: Please refer to Part V, Line 16. Part VI, Line 4: LJMH is located in Scotland, SD, and primarily serves the counties of Bon Homme and Hutchinson. The population of the service area is roughly 14,413 people, and Scotland has a population of 841 people. Of the 14,413 people residing in both counties, an average of 22.05% are 65 years old and over which is attributable to the average of 78.60% of inpatient days being provided to patients 65 years old and over. If one looks at the counties as a whole, the average median household income is $40,208 with the median family income being $50,428. Both counties are considered medically underserved by HRSA and the SD Department of Health. Part VI, Line 5: Landmann Jungman Community Hospital is focused on serving the needs of the community. The governing body of the Hospital is made up entirely of volunteers from the community. The Hospital extends medical staff privileges to qualified physicians in its community. Excess funds are used for the improvement of patient care and facilities. The Hospital is used by the University of South Dakota for nursing clinicals, as well as by the pharmacy and HIM programs. It is open to anyone who wants to learn about careers in the health care industry.The Hospital operates an emergency room that is available to all regardless of their ability to pay. The Hospital administration is very receptive to input from the community. An Auxilliary supports the hospital and provides the hospital with feedback on an informal basis. In addition to LJMH's healthcare facility, there is one other clinic in town which is not affiliated with the hospital. Part VI, Line 6: LJMH is a managed facility of Avera Health. Avera Health and the Hospital work cooperatively to enhance healthcare throughout the community served by LJMH. As a managed facility, LJMH is able to participate in Avera e-CARE services. These services include Avera e-ICU, e-Emergency, e-Pharmacy and e-Consult. These services allow rural patients to be cared for at their local hospitals, provide rural hospitals access to immediate specialty care and support, and help reduce health care costs and travel.LJMH also has access to "back office" support services, such as legal consultation, quality benchmarking, coding, computer services, contract negotiations, administrative consultation, group purchasing, human resource assistance and many other services. Avera Health is able to provide these services to LJMH at a cost below that which the Hospital could otherwise achieve. In turn, local caregivers are able to devote more resources to patient and resident care. Avera Health and LJMH dedicate resources to endeavors that make a positive difference to improve the health of the communities they serve. These activities include leadership development and training for community members, economic development, physical improvements in the community, contributions to nonprofit community organizations, nonprofit event sponsorships, donated medical supplies, community health education and support groups, health screenings, flu-shot clinics, community health education and various other activities. Form 990, Part VI, Section A, line 1 The Executive Committee is composed of the President and three board members. The Executive Committee shall have power to transact all regular business of the facility during the interim between the meetings of the Board of Directors, provided any action taken shall not conflict with the policies and expressed wishes of the Board of Directors and that it shall refer all matters of major importance to the Board of Directors. Form 990, Part VI, Section A, line 3 Avera McKennan acts as a management company in providing the services of Jonathan Moe, Administrator, to Landmann-Jungman Memorial Hospital. During the tax year ended June 30, 2015, Jonathan received compensation of $93,061 and employer paid benefits of $4,333 for his services in the capacity of Administrator at LJMH. Avera McKennan is located at 1325 S Cliff Ave, Sioux Falls, SD. Form 990, Part VI, Section B, line 11 The Administrator and CFO review the 990 in detail. A copy of the 990 is given to the board members before it is filed with the IRS. Form 990, Part VI, Section B, line 12c The conflict of interest policy applies to all board members and management. Board members are responsible for determining whether a potential conflict exists with the Administrator and board members. The Administrator is responsible for determining if there are potential conflicts of interest amongst management. The board is ultimately responsible for determining whether an actual conflict exists. Any board member with a conflict is required to abstain from voting on the matter of conflict. Form 990, Part VI, Section B, line 15a The organization does not pay its Administrator directly, rather the hospital is paying the Administrator through an independent contractor arrangement with Avera McKennan. The process used to set the top management's annual salary is based on a combination of factors which includes the organization's and Avera McKennan's review of salary surveys on a yearly basis comparing the organization to others of similar size. Form 990, Part VI, Section C, line 19 The organization makes its financial statements available to the public during its annual board meeting and upon request. The organization does not make its governing documents and conflict of interest policy available to the public. Form 990, Part IX, line 11g Temporary and contract labor: Program service expenses 56,069. Management and general expenses 0. Fundraising expenses 0. Total expenses 56,069. Phyisician professional fees: Program service expenses 287,131. Management and general expenses 0. Fundraising expenses 0. Total expenses 287,131. Other fees: Program service expenses 111,176. Management and general expenses 0. Fundraising expenses 0. Total expenses 111,176. Temporary and contract labor: Program service expenses 0. Management and general expenses 3,220. Fundraising expenses 0. Total expenses 3,220. Other fees: Program service expenses 0. Management and general expenses 261. Fundraising expenses 0. Total expenses 261.