JEFFERSON COMMUNITY HEALTH CENTER INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization: JEFFERSON COMMUNITY HEALTH CENTER INC (EIN 47-0468078)
Tax period: 2013-10-01 to 2014-09-30
Filed: 2015-04-03
IRS object ID: 201500939349300620
Schema version: 2013v4.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule J
Schedule K
Schedule L
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2015-04-03T15:11:47-05:00	ReturnTs
Tax Period End	2014-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	476097913	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	SEIM JOHNSON LLP	BusinessNameLine1

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	18081 BURT STREET SUITE 200	AddressLine1
City	OMAHA	City
State	NE	State
ZIP Code	680224722	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2013-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	470468078	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JEFFERSON COMMUNITY HEALTH CENTER INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Business Name Control	JEFF	BusinessNameControlTxt
Phone	4027293351	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2200 H STREET PO BOX 277	AddressLine1
City	FAIRBURY	City
State	NE	State
ZIP Code	68352	ZIPCode

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	CHANCE KLASEK	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	4027293351	PhoneNum
Signature	2015-04-03	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	BARBARA J FAJEN	PreparerPersonNm
PTIN	P00400874	PTIN
Phone	4023302660	PhoneNum

Field	Value	IRS element (for citing)
Tax	2013	TaxYr
Build TS	2016-03-07 17:11:31Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	CHANCE KLASEK	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2200 H STREET PO BOX 277	AddressLine1
City	FAIRBURY	City
State	NE	State
ZIP Code	68352	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	$17,265,202	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	HTTP://JCHC.US	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1960	FormationYr
Legal Domicile State	NE	LegalDomicileStateCd
Activity Or Mission	JCHC WILL PROVIDE AN EXCEPTIONAL HEALTHCARE EXPERIENCE FOR EVERY PATIENT, EVERY TIME.	ActivityOrMissionDesc
Voting Members Governing Body	9	VotingMembersGoverningBodyCnt
Voting Members Independent	3	VotingMembersIndependentCnt
Total Employee	241	TotalEmployeeCnt
Total Volunteers	15	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$69,131	PYContributionsGrantsAmt
CY Contributions Grants	$122,707	CYContributionsGrantsAmt
PY Program Service Revenue	$14,958,633	PYProgramServiceRevenueAmt
CY Program Service Revenue	$16,849,719	CYProgramServiceRevenueAmt
PY Investment Income	$68,301	PYInvestmentIncomeAmt
CY Investment Income	$80,652	CYInvestmentIncomeAmt
PY Other Revenue	$274,965	PYOtherRevenueAmt
CY Other Revenue	$112,227	CYOtherRevenueAmt
PY Total Revenue	$15,371,030	PYTotalRevenueAmt
CY Total Revenue	$17,165,305	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$8,194,442	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$8,435,125	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$27,942	CYTotalFundraisingExpenseAmt
PY Other Expenses	$7,160,145	PYOtherExpensesAmt
CY Other Expenses	$7,927,061	CYOtherExpensesAmt
PY Total Expenses	$15,354,587	PYTotalExpensesAmt
CY Total Expenses	$16,362,186	CYTotalExpensesAmt
PY Revenues Less Expenses	$16,443	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$803,119	CYRevenuesLessExpensesAmt
Total Assets BOY	$18,395,033	TotalAssetsBOYAmt
Total Assets EOY	$24,138,736	TotalAssetsEOYAmt
Total Liabilities BOY	$2,386,539	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$7,298,657	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$16,008,494	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$16,840,079	NetAssetsOrFundBalancesEOYAmt
Mission	JCHC WILL PROVIDE AN EXCEPTIONAL HEALTHCARE EXPERIENCE FOR EVERY PATIENT, EVERY TIME.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$13,539,719	ExpenseAmt
Revenue	$14,465,301	RevenueAmt
Desc	JEFFERSON COMMUNITY HEALTH CENTER OPERATES A 25 BED ACUTE CARE HOSPITAL. JEFFERSON COMMUNITY HEALTH CENTER ALSO OPERATES A WELLNESS CENTER AND PROVIDES HOME HEALTH SERVICES.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$1,414,336	ExpenseAmt
Revenue	$2,384,418	RevenueAmt
Desc	JEFFERSON COMMUNITY HEALTH CENTER OPERATES A 40 BED LONG-TERM CARE FACILITY FOR THE RESIDENTS OF JEFFERSON COUNTY AND THE SURROUNDING AREA.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$14,954,055	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	Yes (1)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	Yes (1)	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	Yes (1)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	0	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	6	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	241	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	9	GoverningBodyVotingMembersCnt
Independent Voting Member	3	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CHANCE KLASEK	BusinessNameLine1

Field	Value	IRS element (for citing)
Phone	4027296856	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2200 H STREET PO BOX 277	AddressLine1
City	FAIRBURY	City
State	NE	State
ZIP Code	68352	ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
DICK HOPPE
CHAIRMAN	1.00	Yes (X)	Yes (X)	$0	$0	$0
BRIAN SCHEELE
VICE CHAIRMAN	1.00	Yes (X)	Yes (X)	$0	$0	$0
DR CRAIG SHUMARD
VICE CHAIRMAN (10/1/13 - 12/31/13)	1.00	Yes (X)	Yes (X)	$0	$0	$0
LYMON HAMM
SECRETARY/TREASURER	1.00	Yes (X)	Yes (X)	$0	$0	$0
LINDA BAUER
MEMBER (1/1/14 - PRESENT)	1.00	Yes (X)		$0	$0	$0
BRIAN BLOBAUM
MEMBER (1/1/14 - PRESENT)	1.00	Yes (X)		$0	$0	$0
MARY GLENN
MEMBER	1.00	Yes (X)		$0	$0	$0
JULIE KNIGGE
MEMBER (10/1/13 - 12/31/13)	1.00	Yes (X)		$0	$0	$0
RYAN PARKER
MEMBER (10/1/13 - 12/31/13)	1.00	Yes (X)		$0	$0	$0
MIKE STEELE
MEMBER	1.00	Yes (X)		$0	$0	$0
DR TED TUCKER
MEMBER (1/1/14 - PRESENT)	1.00	Yes (X)		$0	$0	$0
JACK WESCH
MEMBER	1.00	Yes (X)		$0	$0	$0
CHAD JURGENS
CEO	40.00		Yes (X)	$143,712	$0	$22,068
CHANCE KLASEK
CFO	40.00		Yes (X)	$34,240	$0	$5,338
GARY MITCHELL
DIRECTOR OF PHARMACY	40.00			$142,681	$0	$20,825	Yes (X)
DENNIS RUSSEL
PHARMACIST	40.00			$105,038	$0	$19,202	Yes (X)
BILL WELCH
FORMER CEO	0.00			$112,844	$0	$14,758		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$538,515	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$82,191	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	3	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1	CityContractorAddress/USAddress/City	StateContractorAddress/USAddress/State	ZIP CodeContractorAddress/USAddress/ZIPCode	ServicesServicesDesc	CompensationCompensationAmt
BECKENHAUER CONSTRUCTION
1901 RIVERSIDE BLVD	NORFOLK	NE	68702	CONSTRUCTION	$2,580,721
FAIRBURY CLINIC PC
825 22ND STREET	FAIRBURY	NE	68352	ER COVERAGE	$601,115
MEDHOST OF TENNESSEE
2739 MOMENTUM PLACE	CHICAGO	IL	60689	IT CONSULTING	$430,494
HUSKER REHAB
2320 N 6TH STREET	BEATRICE	NE	68310	THERAPY SERVICES	$361,942
SOUTHEAST ANESTHESIA SERVICES
8426 W BIRCH	CLATONIA	NE	68328	CRNA SERVICES	$360,000

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	11	CntrctRcvdGreaterThan100KCnt
All Other Contributions	$122,707	AllOtherContributionsAmt
Noncash Contributions	$20,468	NoncashContributionsAmt
Total Contributions	$122,707	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEDICARE/MEDICAID PAYMENTS	624100	$8,951,268	$8,951,268
PATIENT SERVICE REVENUE	624100	$7,253,720	$7,253,720
CEDARWOOD ASSISTED LIVING FEES	623000	$413,940	$413,940
EHR INCENTIVE PAYMENTS	624100	$165,634	$165,634
GAIN ON EQUITY IN JOINT VENTURE	623000	$52,362	$52,362

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$12,795	TotalRevenueColumnAmt
Related Or Exempt Func Income	$12,795	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$16,849,719	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$78,936	TotalRevenueColumnAmt
Exclusion	$78,936	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$101,613	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$99,897	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$1,716	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,716	TotalRevenueColumnAmt
Exclusion	$1,716	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	CAFETERIA	Desc
Business	722210	BusinessCd
Total Revenue Column	$112,227	TotalRevenueColumnAmt
Exclusion	$112,227	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$112,227	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$17,165,305	TotalRevenueColumnAmt
Related Or Exempt Func Income	$16,849,719	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$192,879	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$205,359	TotalAmt
Management And General	$205,359	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$266,522	TotalAmt
Program Services	$266,522	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$6,466,455	TotalAmt
Program Services	$5,977,247	ProgramServicesAmt
Management And General	$472,862	ManagementAndGeneralAmt
Fundraising	$16,346	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$214,766	TotalAmt
Program Services	$201,235	ProgramServicesAmt
Management And General	$13,531	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$786,793	TotalAmt
Program Services	$730,831	ProgramServicesAmt
Management And General	$55,962	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$495,230	TotalAmt
Program Services	$451,249	ProgramServicesAmt
Management And General	$42,914	ManagementAndGeneralAmt
Fundraising	$1,067	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$6,178	TotalAmt
Management And General	$6,178	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$44,000	TotalAmt
Management And General	$44,000	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$15,051	TotalAmt
Management And General	$15,051	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$1,881,771	TotalAmt
Program Services	$1,724,196	ProgramServicesAmt
Management And General	$157,094	ManagementAndGeneralAmt
Fundraising	$481	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$60,361	TotalAmt
Program Services	$58,313	ProgramServicesAmt
Management And General	$1,478	ManagementAndGeneralAmt
Fundraising	$570	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,262,275	TotalAmt
Program Services	$1,065,534	ProgramServicesAmt
Management And General	$194,189	ManagementAndGeneralAmt
Fundraising	$2,552	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$7,330	TotalAmt
Program Services	$7,330	ProgramServicesAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$351,413	TotalAmt
Program Services	$319,699	ProgramServicesAmt
Management And General	$31,714	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$33,250	TotalAmt
Program Services	$26,976	ProgramServicesAmt
Management And General	$6,274	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$51,869	TotalAmt
Program Services	$44,871	ProgramServicesAmt
Management And General	$6,998	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$3,044	TotalAmt
Program Services	$3,044	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$1,273,355	TotalAmt
Program Services	$1,273,355	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$87,847	TotalAmt
Management And General	$87,847	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$2,022,368	$2,022,368
BAD DEBTS EXPENSE	$373,584	$373,584
FOOD EXPENSE	$370,865	$370,865
DUES AND SUBSCRIPTIONS	$61,237	$22,534	$38,703

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$21,263	TotalAmt
Program Services	$14,302	ProgramServicesAmt
Management And General	$35	ManagementAndGeneralAmt
Fundraising	$6,926	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$16,362,186	TotalAmt
Program Services	$14,954,055	ProgramServicesAmt
Management And General	$1,380,189	ManagementAndGeneralAmt
Fundraising	$27,942	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$3,758,444	BOYAmt
EOY	$450	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$5,265,213	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$2,175,713	BOYAmt
EOY	$2,106,663	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$287,419	BOYAmt
EOY	$347,415	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$160,644	BOYAmt
EOY	$95,038	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$23,314,963	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$10,232,670	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$9,531,619	BOYAmt
EOY	$13,082,293	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$2,054,053	BOYAmt
EOY	$2,769,345	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$220,317	BOYAmt
EOY	$272,679	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$206,824	BOYAmt
EOY	$199,640	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$18,395,033	BOYAmt
EOY	$24,138,736	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$2,001,762	BOYAmt
EOY	$1,912,338	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$4,209,501	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$384,777	BOYAmt
EOY	$265,720	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$911,098	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$2,386,539	BOYAmt
EOY	$7,298,657	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$15,871,588	BOYAmt
EOY	$16,704,973	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$86,152	BOYAmt
EOY	$84,352	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$50,754	BOYAmt
EOY	$50,754	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$16,008,494	BOYAmt
EOY	$16,840,079	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$18,395,033	BOYAmt
EOY	$24,138,736	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$803,119	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$28,466	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Separate Basis Fincl Stmt	Yes (X)	SeparateBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$1,572	OtherActivitiesAmt
Total Lobbying Expenditures	$1,572	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	JCHC PAID DUES TO THE NEBRASKA HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. A PORTION OF THE DUES WERE USED FOR LOBBYING ACTIVITIES.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$50,754	BeginningYearBalanceAmt
End Year Balance	$50,754	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$50,754	BeginningYearBalanceAmt
End Year Balance	$50,754	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$50,754	BeginningYearBalanceAmt
End Year Balance	$50,754	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$50,754	BeginningYearBalanceAmt
End Year Balance	$50,754	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Contributions	$50,754	ContributionsAmt
Investment Earnings Or Losses	$250	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$250	GrantsOrScholarshipsAmt
End Year Balance	$50,754	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.00000	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	1.00000	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.00000	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$13,943	OtherCostOrOtherBasisAmt
Book Value	$13,943	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$16,047,936	OtherCostOrOtherBasisAmt
Depreciation	$6,113,071	DepreciationAmt
Book Value	$9,934,865	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,072,995	OtherCostOrOtherBasisAmt
Depreciation	$4,044,118	DepreciationAmt
Book Value	$2,028,877	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,180,089	OtherCostOrOtherBasisAmt
Depreciation	$75,481	DepreciationAmt
Book Value	$1,104,608	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$13,082,293	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	ESTIMATED THIRD-PARTY PAYOR SETTLEMENT	Desc
Amt	$911,098	Amt

Field	Value	IRS element (for citing)
Total Liability	$911,098	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$16,805,136	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	$28,466	NetUnrealizedGainsInvstAmt
Revenue Not Reported	$28,466	RevenueNotReportedAmt
Revenue Subtotal	$16,776,670	RevenueSubtotalAmt
Investment Expenses Not Incld	$15,051	InvestmentExpensesNotIncldAmt
Other Revenues Not Included	$373,584	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$388,635	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$17,165,305	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$15,973,551	TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported	$0	ExpensesNotReportedAmt
Expenses Subtotal	$15,973,551	ExpensesSubtotalAmt
Investment Expenses Not Incld2	$15,051	InvestmentExpensesNotIncld2Amt
Other Expenses Not Included	$373,584	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$388,635	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$16,362,186	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, LINE 4:	THE INTENDED USE OF THE HOSPITAL'S ENDOWMENT FUNDS IS TO PROVIDE NURSING SCHOLARSHIPS AND CAPITAL IMPROVEMENTS.
PART X, LINE 2:	THE HEALTH CENTER IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN THE HEALTH CENTER'S TAX EXEMPT STATUS. IN GENERAL, SUCH STANDARDS REQUIRE THE HEALTH CENTER TO MEET A COMMUNITY BENEFITS STANDARD AND COMPLY WITH VARIOUS LAWS AND REGULATIONS. THE HEALTH CENTER ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. THE HEALTH CENTER RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT SEPTEMBER 30, 2014, THE HEALTH CENTER HAD NO UNCERTAIN TAX POSITIONS ACCRUED. THE HEALTH CENTER IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR FISCAL YEARS ENDED PRIOR TO SEPTEMBER 30, 2011.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	PROVISION FOR BAD DEBTS 373,584.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	PROVISION FOR BAD DEBTS 373,584.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent150	Yes (X)	Percent150Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$77,099	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$77,099	NetCommunityBenefitExpnsAmt
Total Expense	0.00480	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,470,211	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,661,596	DirectOffsettingRevenueAmt
Net Community Benefit Expns	-$191,385	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,547,310	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,661,596	DirectOffsettingRevenueAmt
Net Community Benefit Expns	-$114,286	NetCommunityBenefitExpnsAmt
Total Expense	0.00480	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$12,945	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$12,945	NetCommunityBenefitExpnsAmt
Total Expense	0.00080	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$8,450	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,450	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$448,690	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$211,398	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$237,292	NetCommunityBenefitExpnsAmt
Total Expense	0.01480	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,213	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,213	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$476,298	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$211,398	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$264,900	NetCommunityBenefitExpnsAmt
Total Expense	0.01650	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,023,608	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,872,994	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$150,614	NetCommunityBenefitExpnsAmt
Total Expense	0.02130	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$373,584	BadDebtExpenseAmt
Bad Debt Expense Attributable	$50,000	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$6,553,096	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$6,488,213	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$64,883	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JEFFERSON COMMUNITY HEALTH CENTER	BusinessNameLine1

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2200 H STREET	AddressLine1
City	FAIRBURY	City
State	NE	State
ZIP Code	68352	ZIPCode

Field	Value	IRS element (for citing)
Website Address	HTTP://JCHC.US	WebsiteAddressTxt
State License	440001	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	JEFFERSON COMMUNITY HEALTH CENTER INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Other	Yes (X)	OtherInd
CHNA Conducted	12	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	0	CHNAConductedWithOtherFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	HTTP://JCHC.US	OwnWebsiteURLTxt
Rpt Available Upon Request	Yes (X)	RptAvailableUponRequestInd
Adopt Implementation Strategy	Yes (X)	AdoptImplementationStrategyInd
Exec Implementation Strategy	Yes (X)	ExecImplementationStrategyInd
Include Operational Plan	Yes (X)	IncludeOperationalPlanInd
Prioritize Health Needs	Yes (X)	PrioritizeHealthNeedsInd
Prioritize Services	Yes (X)	PrioritizeServicesInd
All Needs Addressed	0	AllNeedsAddressedInd
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Used Deter Elig Free Care	Yes (1)	FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care	150.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt Care	Yes (1)	FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care	300.000000000000	FPGFamilyIncmLmtDscntCarePct
Explained Basis	Yes (1)	ExplainedBasisInd
Income Level	Yes (X)	IncomeLevelInd
Asset Level	Yes (X)	AssetLevelInd
Medical Indigency	Yes (X)	MedicalIndigencyInd
Uninsured Discount	Yes (X)	UninsuredDiscountInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
Posted On Website	Yes (X)	PostedOnWebsiteInd
Posted In Emergency Room	Yes (X)	PostedInEmergencyRoomInd
Posted In Admission Office	Yes (X)	PostedInAdmissionOfficeInd
Available On Request	Yes (X)	AvailableOnRequestInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Collection Activities	0	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Average Negotiated Rates	Yes (X)	AverageNegotiatedRatesInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
JEFFERSON COMMUNITY HEALTH CENTER, INC.	PART V, SECTION B, LINE 1J: OTHER ITEMS ADDRESSED IN THE NEEDS ASSESSMENT ARE IMPLEMENTATION STRATEGY AND NEEDS THAT WILL NOT BE ADDRESSED BY JCHC.
JEFFERSON COMMUNITY HEALTH CENTER, INC.	PART V, SECTION B, LINE 3: JEFFERSON COMMUNITY HEALTH CENTER (JCHC) BEGAN ITS HEALTH NEEDS ASSESSMENT IN DECEMBER 2012. JCHC WORKED WITH PUBLIC HEALTH SOLUTIONS DISTRICT HEALTH DEPARTMENT, REVIEWED INTERVIEWS CONDUCTED BY PUBLIC HEALTH SOLUTIONS, CONDUCTED INTERVIEWS WITH LOCAL ORGANIZATIONS, CONDUCTED INTERVIEWS WITH JCHC STAFF AND REVIEWED STATISTICS MADE AVAILABLE THROUGH PUBLIC HEALTH SOLUTIONS AND THE STATE OF NEBRASKA. MEETINGS WERE CONDUCTED WITH LOCAL COMMUNITY ORGANIZATIONS INCLUDING KIWANIS, ROTARY, AGRICULTURE REPRESENTATIVES AND SENIOR DINERS. A TOTAL OF 83 ATTENDED AND PARTICIPATED. IN ADDITION, MEETINGS WERE HELD WITH JEFFERSON COMMUNITY HEALTH CENTER STAFF WHO ALSO REPRESENT THE AREA IN WHICH THEY LIVE. A TOTAL OF 71 JCHC STAFF MEMBERS PARTICIPATED.PUBLIC HEALTH SOLUTIONS DISTRICT HEALTH DEPARTMENT CONDUCTED ITS COMMUNITY HEALTH IMPROVEMENT PLAN STUDY OF A FIVE COUNTY AREA WITH THE ASSISTANCE OF LANE GEWECKE CONSULTING IN NOVEMBER 2012.
JEFFERSON COMMUNITY HEALTH CENTER, INC.	PART V, SECTION B, LINE 7: THERE WERE NEEDS IDENTIFIED THAT JCHC DID NOT ADDRESS. WHILE THESE NEEDS ARE IMPORTANT TO THE COMMUNITY, THEY WERE NOT CHOSEN BASED ON THE PRIORITIZATION PROCESS. THESE NEEDS INCLUDE: ALZHEIMER'S DISEASE, UNINTENTIONAL INJURIES, HEALTH CARE PROVIDER COVERAGE WHEN EXISTING PHYSICIANS RETIRE, FUTURE OF HEALTH CARE, WEAKENING FAMILY STRUCTURE/PARENTING, LACK OF DOCTORS/HEALTH CARE, DRUG/ALCOHOL USE AND THE AGING POPULATION.

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	GARDENSIDE	BusinessNameLine1

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	200 H STREET	AddressLine1
City	FAIRBURY	City
State	NE	State
ZIP Code	68352	ZIPCode

Field	Value	IRS element (for citing)
Facility	LONG TERM CARE FACILITY	FacilityTxt

Supplemental Information Detail SupplementalInformationDetail (19 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C:	FEDERAL POVERTY GUIDELINES ARE USED TO DETERMINE ELIGIBILITY FOR PROVIDING FREE AND DISCOUNTED CARE TO LOW INCOME INDIVIDUALS.
PART I, LINE 6A:	JEFFERSON COMMUNITY HEALTH CENTER PREPARES ITS OWN COMMUNITY BENEFIT REPORT.
PART I, LINE 7:	THE HOSPITAL USED THE WORKSHEETS PROVIDED IN THE FORM 990 INSTRUCTIONS TO HELP CALCULATE THE FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST.
PART I, LINE 7G:	THERE ARE NO COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC INCLUDED ON LINE 7G.
PART I, LN 7 COL(F):	THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $373,584.
PART I, LINE 7:	JCHC REACHED OUT TO THE COMMUNITY IN A VARIETY OF WAYS IN FISCAL YEAR 2014, INCLUDING:I. BENEFITS FOR THE POOR/PUBLIC PROGRAMS A. TRADITIONAL CHARITY CARE CHARITY CARE - JCHC PROVIDED CHARITY CARE IN FISCAL 2014 TO THOSE WHO MEET THE FEDERAL POVERTY GUIDELINES. THE BUSINESS OFFICE STAFF MEMBERS FILE INSURANCE CLAIMS FOR PATIENTS.PATIENTS ASSISTED: 120. VALUE: $127,264. B. UNPAID COSTS OF PUBLIC PROGRAMS. MEDICAID SHORTFALL - SHORTFALL BASED ON COSTS: 0. C. BAD DEBT. BESIDES OFFICIAL CHARITY CARE, JCHC WROTE OFF $373,584 IN BAD DEBT DURING FISCAL 2014. II. COMMUNITY BENEFIT SERVICESA.COMMUNITY HEALTH EDUCATION AND OUTREACH.CHILD SAFETY SEAT PROGRAM - JCHC IS A PART OF A CHILD SAFETY SEAT COALITION AND HOLDS CHILD SAFETY SEAT CHECK UP EVENTS DURING THE YEAR, AS WELL AS OFFERS INDIVIDUAL INSTRUCTION IN PROPER USE OF SEATS. A TOTAL OF 46 SEATS WERE CHECKED AT CHECK-UP EVENTS OR INDIVIDUAL APPOINTMENTS. GRANTS ARE RECEIVED TO PURCHASE SEATS TO HAVE AVAILABLE, BUT STAFF TIME IS DONATED BY JEFFERSON COMMUNITY HEALTH CENTER. ESTIMATED VALUE OF STAFF TIME: $925.HEALTH FAIR - JCHC PROVIDES EDUCATIONAL BOOTHS, FREE HEALTH SCREENINGS, HANDOUTS, INFORMATION, ETC. AT THE JEFFERSON COUNTY SPRING EXPO AND THE JEFFERSON COUNTY FAIR. AN ESTIMATED 700+ TOOK PART IN OFFERINGS FROM JCHC AT THESE EVENTS. FOR 2014, THE COST OF BOOTHS, GIVEAWAYS, STAFF TIME, ETC. ARE ESTIMATED AT $2,500. ESTIMATED NUMBER REACHED: 700.SPEAKERS BUREAU - JCHC STAFF MEMBERS PROVIDE EDUCATIONAL PROGRAMS FOR COMMUNITY ORGANIZATIONS ON A VARIETY OF TOPICS. A TOTAL OF 26 PROGRAMS WERE PRESENTED IN FISCAL 2014. TOTAL INDIVIDUALS REACHED: 1150. ESTIMATED COST OF STAFF TIME: $800.SUPPORT GROUPS - IN 2014, JCHC COORDINATED A PARKINSON'S SUPPORT GROUP AND ALZHEIMER'S CAREGIVERS SUPPORT GROUP. JCHC STAFF MEMBERS COORDINATED MEETINGS OF THESE SUPPORT GROUPS, AND OFFERED ASSISTANCE TO ANYONE INTERESTED IN MORE INFORMATION ABOUT THE DISEASES. THE PARKINSON'S SUPPORT GROUP MEETS MONTHLY. TOTAL ATTENDANCE DURING FISCAL 2014 WAS 40. A SUPPORT GROUP FOR CAREGIVERS OF ALZHEIMER'S PATIENTS MEETS MONTHLY AND HAD ATTENDANCE OF 28 THROUGHOUT THE YEAR. JCHC PROVIDES EDUCATIONAL PROGRAMS FOR EACH OF THESE GROUPS -- INCLUDING SPEAKER'S FEES OR VIDEO TAPE RENTAL FEES, POSTAGE TO SEND OUT MEETING NOTICES, AND REFRESHMENTS. TOTAL NUMBER REACHED: 68. APPROXIMATE COST OF STAFF TIME SPENT: $1,000. ESTIMATED COST OF POSTAGE: $325. ESTIMATED OTHER COSTS (MATERIALS, SPEAKER FEES): $100. HEALTH PROMOTION PROGRAMS. JCHC OFFERS SMOKING CESSATION INFORMATION TO PATIENTS AND THE PUBLIC. EACH INPATIENT WHO IS A SMOKER IS PROVIDED INFORMATION ON SMOKING CESSATION. ESTIMATED NUMBER REACHED: 93; ESTIMATED COST OF PROMOTIONAL MATERIALS PROVIDED: $475. B. COMMUNITY-BASED CLINICAL SERVICES SCREENINGS AND ONE-TIME OR OCCASIONALLY HELD CLINICS. COMPLETE BLOOD PROFILES - COMPLETE BLOOD PROFILES WERE OFFERED IN THE SPRING AT A REDUCED RATE. A TOTAL OF 50 BLOOD PROFILES WERE OFFERED. PARTICIPANTS PAID $45, WHICH IS A FRACTION OF THE ESTIMATED VALUE OF THE TESTING. ESTIMATED STAFF TIME: $1,200. IMMUNIZATION CLINICS. JCHC COOPERATES WITH BLUE VALLEY COMMUNITY ACTION AND PUBLIC HEALTH SOLUTIONS IN PROVIDING AN IMMUNIZATION CLINIC FOR CHILDREN TWICE EACH MONTH. JCHC PROVIDES SPACE WHERE IMMUNIZATIONS ARE GIVEN, NURSING STAFF, PATIENT WAITING AREAS, JANITORIAL AND SUPPORT SERVICES, AND STORAGE OF VACCINES IN OUR PHARMACY. NUMBER OF CHILDREN SERVED: 203 BY BLUE VALLEY COMMUNITY ACTION. TOTAL OF 686 VACCINATIONS PROVIDED (375 PUBLIC, 311 PRIVATE.) ESTIMATED COST OF NURSES PROVIDED BY JCHC TO GIVE SHOTS: $1,620. TOTAL CHILDREN IMMUNIZED: 203. C. HEALTH CARE SUPPORT SERVICESENROLLMENT ASSISTANCE IN PUBLIC PROGRAMS - JCHC OFFERED A COMMUNITY EDUCATION EVENT ON THE MEDICARE PART D DRUG PROGRAM. THE PROGRAM WAS PROVIDED BY JCHC EMPLOYEES TRAINED AS SHIIP VOLUNTEERS (250). JCHC ALSO OFFERED PRENATAL CLASSES (10). ESTIMATED NUMBER OF PEOPLE REACHED: 260. ESTIMATED COST OF PROGRAMS, FOOD, AND STAFF TIME: $4,000. III. MEDICAL EDUCATION A. SCHOLARSHIP FUNDING FOR HEALTH PROFESSIONS. SCHOLARSHIPS ARE PROVIDED FOR PHYSICIAN/MEDICAL STUDENTS, NURSES/NURSING STUDENTS, TECHNICIANS AND OTHER HEALTH PROFESSIONALS. JCHC WORKS WITH SOUTHEAST COMMUNITY COLLEGE IN BEATRICE AS A SITE FOR LPN PRACTICAL NURSING TRAINING. AN ESTIMATED 60 STUDENTS LEARNED IN OUR FACILITY IN 2014. NURSING STUDENTS UTILIZE MEETING ROOM SPACE AT JCHC, AS WELL AS TAKE PART IN CLINICAL PRACTICE. MEDICAL STUDENTS COME REGULARLY FOR RURAL ROTATIONS TO LEARN FROM LOCAL PHYSICIANS. JCHC PROVIDES LODGING FOR THE MEDICAL STUDENTS DURING THEIR TIME IN FAIRBURY, AND ALSO PROVIDES THE STUDENTS USE OF THE WELLNESS CENTER DURING THEIR STAY. FIVE MEDICAL STUDENTS UTILIZED OUR FACILITY IN 2014. JCHC OFFERS THE LILLIAN HANSEN REESMAN RN MEMORIAL NURSES SCHOLARSHIP FUND, ESTABLISHED IN 1980. ONLY INTEREST IS USED FROM THIS $10,000 PERPETUAL FUND, DONATED BY THE REESMAN FAMILY, TO PROVIDE NURSING SCHOLARSHIPS. SCHOLARSHIPS ARE PROVIDED AS INTEREST FUNDS ARE AVAILABLE. ONE $500 SCHOLARSHIP WAS AWARDED IN FISCAL 2014. THE JCHC AUXILIARY PROVIDES A SCHOLARSHIP FOR A STUDENT PURSUING AN EDUCATION IN A MEDICAL FIELD. THE $400 SCHOLARSHIP IS GIVEN FROM THE AUXILIARY'S FUNDS, AND THE NUMBER OF SCHOLARSHIPS GIVEN EACH YEAR IS BASED ON THE AUXILIARY'S FUNDING AVAILABILITY AND THE NUMBER OF REQUESTS. ONE SCHOLARSHIP WAS AWARDED IN 2014. ESTIMATED NUMBER REACHED: 66. JCHC COST (APARTMENT RENT, STAFF TIME, ETC.): $4,600. B. OTHER JOB SHADOWING. JCHC HOSTS JOB SHADOW STUDENTS FROM FAIRBURY HIGH SCHOOL'S ANATOMY AND PHYSIOLOGY CLASSES, THROUGH THE SOUTHEAST COMMUNITY COLLEGE-FAIRBURY HIGH SCHOOL CAREER ACADEMY PROGRAM, AND FOR INTERESTED INDIVIDUALS. THIS YEAR, SHADOWING OPPORTUNITIES WERE ALSO ARRANGED FOR STUDENTS AS A PART OF THE SCC CAREER ACADEMY, AND FOR OTHER INTERESTED INDIVIDUALS. A TOTAL OF 34 STUDENTS PARTICIPATED IN SHADOWING OPPORTUNITIES IN FISCAL 2014. NUMBER REACHED: 34. ESTIMATED COST OF STAFF TIME: $2,650. VIDEOCONFERENCE. CONTINUED OFFERING VIDEOCONFERENCING CAPABILITIES, INCLUDING POSSIBLE PROGRAMS FOR PROFESSIONALS IN THE COMMUNITY. AVAILABILITY COSTS $100 PER MONTH. A TOTAL OF 56 EDUCATIONAL AND ADMINISTRATIVE PROGRAMS WERE OFFERED IN 2014. THIS INCLUDED A NUMBER OF OPPORTUNITIES FOR STAFF AND COMMUNITY EDUCATION, MEETINGS, AND CLINICAL VISITS. ESTIMATED NUMBER REACHED: 80. COST FOR 2014: $1,200.IV. SUBDIZED HEALTH SERVICES WELLNESS CENTER SUPPORT. JEFFERSON COMMUNITY HEALTH CENTER HAS OPERATED THE BOB AND WAUNETA BURKLEY WELLNESS CENTER AS A COMMUNITY WELLNESS CENTER SINCE IT OPENED IN 1996. JCHC PAYS THE WELLNESS CENTER'S OPERATING EXPENSES THAT EXCEED REVENUES. BECAUSE OF THE HEALTH CENTER'S SUPPORT OF THE WELLNESS CENTER'S CASH FLOW, PRICES FOR MEMBERSHIPS AND SERVICES CAN REMAIN REASONABLE FOR COMMUNITY RESIDENTS. IF THE WELLNESS CENTER WERE A STAND-ALONE OPERATION, PRICES WOULD HAVE TO RISE CONSIDERABLY TO PAY ALL EXPENSES. NUMBER OF PERSONS SERVED: 1,116 (MEMBERS AS OF FISCAL YEAR-END 2013.) ESTIMATED AMOUNT OF WELLNESS CENTER SUPPORT: $237,000. V. RESEARCH. NO RESEARCH DOLLARS EXPENDED.VI. CASH AND IN-KIND DONATIONS.A. CASH DONATIONS. JCHC MAKES DONATIONS TO VARIOUS CHARITABLE CAUSES, INCLUDING GIRL SCOUT AND BOY SCOUT FIRST AID KITS, FREE LOAN OF HOME BILLIRUBEN BLANKET, SPONSORSHIP OF BASEBALL AND SOFTBALL TEAMS, AREA HIGH SCHOOL POST-PROM ACTIVITIES, AN AREA COMMUNITY PICNIC, A LOCAL DANCE RECITAL, AN AREA RODEO, EMT TRAINING CONFERENCE, CHAMBER OF COMMERCE BANQUET, CHAMBER OF COMMERCE NEW TEACHER WELCOME, CHAMBER OF COMMERCE TEACHER RECOGNITION, LOANING OUT CPR MANNEQUINS, ETC. THESE TOTALED $574. JCHC ALSO CONTRIBUTES ITEMS -- SUCH AS MATTRESS COVERS TO CAMP JEFFERSON ($297), WELLNESS CENTER PASSES, JCHC GLASSES AND DUFFLE BAGS, ETC., TO COMMUNITY EVENTS AS DOOR PRIZES. THESE TOTALED AN ESTIMATED $450. USE OF A BILIBLANKET WAS DONATED FOR NEWBORNS WITH JAUNDICE FOR 4 FAMILIES FOR 28 DAYS OF IN-KIND USE, FOR A VALUE OF $3,080. DONATIONS DURING FISCAL 2014 TOTALED $4,400. B. IN-KIND DONATIONS. WALK TO END ALZHEIMER'S - JEFFERSON COMMUNITY HEALTH CENTER SUPPORTS THE ANNUAL WALK TO END ALZHEIMER'S BY PROVIDING STAFF TIME AND POSTAGE TO SEND OUT SPONSORSHIP LETTERS AND NEWS RELEASES PROMOTING THE EVENT, STAFF TIME TO ASSIST IN PLANNING THE EVENT, AND STAFF TIME THE DAY OF THE EVENT. A TOTAL OF 35 WALKERS PARTICIPATED AND THE EVENT RAISED $4,800 FOR THE ALZHEIMER'S ASSOCIATION. ESTIMATED POSTAGE: $22. ESTIMATED STAFF TIME: $240.SAFE KIDS CHAPTER -JEFFERSON COMMUNITY HEALTH CENTER IS A MEMBER OF THE SAFE KIDS COALITION. THREE JCHC STAFF MEMBERS PARTICIPATE IN THE ORGANIZATION. THEY ARE JOINED BY A VARIETY OF OUTSIDE AGENCIES IN THE COMMUNITY WHO BELIEVE STRONGLY IN CHILDHOOD SAFETY. IN ADDITION TO SAFETY SEAT CHECK UP EVENTS, OTHER SAFETY PROMOTIONS WERE OFFERED. ESTIMATED STAFF TIME: $1,200.
PART I, LINE 7 (CONTINUED):	BLOOD DRIVE SUPPORT - JCHC ASSISTS NEBRASKA COMMUNITY BLOOD BANK BY SCHEDULING APPOINTMENTS FOR SIX BLOOD DRIVES EACH YEAR. THE BLOOD PRODUCTS ULTIMATELY HELP OUR COMMUNITY, AS NEBRASKA COMMUNITY BLOOD BANK IS JCHC'S SUPPLIER OF BLOOD AND BLOOD PRODUCTS. ESTIMATED STAFF TIME: $100.SAFETY DAY FOR KIDS. JCHC WAS ONE OF THE CO-SPONSORS FOR THE ANNUAL SAFETY DAY FOR KIDS IN JEFFERSON COUNTY. A TOTAL OF 98 KIDS, AGES KINDERGARTEN THROUGH SIXTH GRADES ATTENDED. STAFF MEMBERS ASSISTED IN PLANNING THE EVENT AND ASSISTED IN COORDINATING AND INSTRUCTING ON THE DAY OF THE CAMP. THE COST OF STAFF TIME DONATED IS ESTIMATED AT: $1,150. TOTAL COST OF SUPPLIES FURNISHED WAS $250.
PART II, COMMUNITY BUILDING ACTIVITIES:	JEFFERSON COMMUNITY HEALTH CENTER IS ACTIVE IN LOCAL ECONOMIC DEVELOPMENT ACTIVITIES. JCHC IS A MEMBER OF THE FAIRBURY CHAMBER OF COMMERCE. JCHC SEEKS OPPORTUNITIES TO OFFER TOURS, HEALTH CARE INFORMATION ON COMMUNITY WEBSITES, ETC. IN ADDITION TO THESE DIRECT PROGRAMS AND SERVICES, THE EMPLOYEES OF JEFFERSON COMMUNITY HEALTH CENTER SERVE THEIR COMMUNITY IN MANY WAYS INCLUDING SERVING IN THEIR CHURCHES AS GIRL AND BOY SCOUT LEADERS, AS 4-H LEADERS, AS LEADERS IN CIVIC ORGANIZATIONS, AS YOUTH GROUP LEADERS, AS CITY GOVERNMENT MEMBERS, ON COMMUNITY DEVELOPMENT BOARDS, FOR EMERGENCY RESPONSE ORGANIZATIONS AND OTHERS. JCHC STAFF MEMBERS ARE A RESOURCE AS COMMUNITY ROLE MODELS.JCHC IS PROUD OF ITS CONTRIBUTIONS TO THE CITIZENS OF JEFFERSON COUNTY AND THE SURROUNDING AREA. THE CITIZENS OF THIS AREA ALSO HIGHLY REGARD JCHC'S CONTRIBUTIONS TO THE COMMUNITY.THE GOAL OF THE JCHC BOARD OF DIRECTORS, ADMINISTRATION AND STAFF IS TO EXPAND THAT PARTNERSHIP WITH AREA RESIDENTS AND FIND MORE WAYS TO SERVE AS A RESOURCE FOR HEALTH AND WELLNESS INFORMATION.
PART III, LINE 2:	IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HEALTH CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HEALTH CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR THOSE ACCOUNTS OVER A CERTAIN AGE BASED ON DISCHARGE 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 HEALTH CENTER 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:	THE HEALTH CENTER PROVIDES CHARITY CARE TO PATIENTS WHO ARE FINANCIALLY UNABLE TO PAY FOR THE HEALTHCARE SERVICES THEY RECEIVE. IT IS THE POLICY OF THE HEALTH CENTER NOT TO PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. ACCORDINGLY, THE HEALTH CENTER DOES NOT REPORT THESE AMOUNTS IN NET OPERATING REVENUE OR IN THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE HEALTH CENTER DETERMINES THE COSTS ASSOCIATED WITH PROVIDING CHARITY CARE BY AGGREGATING THE DIRECT AND INDIRECT COSTS, INCLUDING SALARIES, BENEFITS, SUPPLIES, AND OTHER OPERATING EXPENSES, BASED ON AN OVERALL COST TO CHARGE RATIO. THE AMOUNT REPORTED ON LINE 3 WAS DETERMINED USING PAST EXPERIENCE BY THE EXECUTIVE STAFF OF JEFFERSON COMMUNITY HEALTH CENTER.
PART III, LINE 4:	JCHC'S FINANCIAL STATEMENTS DO NOT CONTAIN A SPECIFIC FOOTNOTE DESCRIBING BAD DEBT EXPENSE. HOWEVER, THE FOLLOWING IS TEXT OF THE FOOTNOTES TITLED "PATIENT ACCOUNTS RECEIVABLE," "NET PATIENT SERVICE REVENUE" AND "CHARITY CARE":PATIENT ACCOUNTS RECEIVABLE:THE HEALTH CENTER REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS, AND OTHERS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HEALTH CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HEALTH CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR THOSE ACCOUNTS OVER A CERTAIN AGE BASED ON DISCHARGE 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 HEALTH CENTER 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.NET PATIENT SERVICE REVENUE:THE HEALTH CENTER HAS AGREEMENTS WITH THIRD-PARTY PAYORS THAT PROVIDE FOR PAYMENTS TO THE HEALTH CENTER AT AMOUNTS DIFFERENT FROM ITS ESTABLISHED RATES. PAYMENT ARRANGEMENTS INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES AND PER DIEM PAYMENTS. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE DETERMINED.CHARITY CARE:THE HEALTH CENTER PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE HEALTH CENTER DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. THE HEALTH CENTER IS DEDICATED TO PROVIDING COMPREHENSIVE HEALTHCARE SERVICES TO ALL SEGMENTS OF SOCIETY, INCLUDING THE AGED AND OTHERWISE ECONOMICALLY DISADVANTAGED. IN ADDITION, THE HEALTH CENTER PROVIDES A VARIETY OF COMMUNITY HEALTH SERVICES AT OR BELOW COST.
PART III, LINE 8:	THE HOSPITAL CALCULATED THE MEDICARE ALLOWABLE COSTS BY ADDING THE INPATIENT, SWING BED AND OUTPATIENT COSTS AS FOUND ON THE MEDICARE COST REPORT FOR SEPTEMBER 30, 2014. NO SHORTFALL IS TREATED AS COMMUNITY BENEFIT.
PART III, LINE 9B:	ONCE IT IS DETERMINED THAT A PATIENT MAY NOT HAVE THE MEANS TO PAY, AN ASSISTANCE APPLICATION IS PROVIDED. IN ADDITION, ALL ACCOUNTS THAT OUR SELF-PAY RECEIVABLE VENDOR DID NOT RECEIVE PAYMENT ON AFTER 75 DAYS WILL BE RUN THROUGH A PRESUMPTIVE CHARITY CRITERIA PROCESS. THIS PROCESS ASSISTS IN THE DETERMINATION OF FINANCIAL ASSISTANCE ELIGIBILITY. JCHC STAFF WILL APPLY THE RECOMMENDED PERCENTAGE DISCOUNT TO THE PATIENT'S ACCOUNT.
PART VI, LINE 2:	JCHC ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY JCHC SERVES IN SEVERAL WAYS. JCHC UTILIZES SURVEYS BY PUBLIC HEALTH SOLUTIONS OF THE HEALTH CARE NEEDS FOR RESIDENTS OF JEFFERSON COUNTY AND THE SURROUNDING COMMUNITY. JCHC VISITS LOCAL COMMUNITY SERVICE ORGANIZATIONS AND SEEKS INPUT ON NEEDS. JCHC CONDUCTED A COMMUNITY PERCEPTION SURVEY IN 2006, WHICH INCLUDES QUESTIONS ON COMMUNITY HEALTH NEEDS. JCHC REVIEWS SURVEYS DONE BY THE STATE AND OTHER ORGANIZATIONS ON THE HEALTH CARE NEEDS FOR RESIDENTS OF JEFFERSON COUNTY AND THE SURROUNDING AREA.
PART VI, LINE 3:	JCHC INFORMS AND EDUCATES PATIENTS ABOUT ELIGIBILITY FOR ASSISTANCE ON AN INDIVIDUAL BASIS WHEN QUESTIONS ARISE. THE PATIENT BOOKLET PROVIDES BUSINESS OFFICE CONTACT INFORMATION FOR PATIENT QUESTIONS ABOUT THEIR BILL. THE SELF-PAY BILLING VENDOR ENGAGED BY JCHC HAS A SET OF CRITERIA IT USES TO ASSESS WHETHER A PATIENT IS ELIGIBLE FOR ASSISTANCE PROGRAMS, OR IF THEY QUALIFY FOR JCHC'S CHARITY CARE PROGRAM.
PART VI, LINE 4:	JCHC SERVES JEFFERSON COUNTY AND PARTS OF THAYER, FILLMORE, SALINE AND GAGE COUNTIES, ALL IN NEBRASKA; AND PARTS OF WASHINGTON AND MARSHALL COUNTIES IN KANSAS. THE POPULATION OF THE SERVICE AREA IS ESTIMATED AT ABOUT 18,000. REVENUE FROM MEDICARE PATIENTS AVERAGES APPROXIMATELY 50%, AND REVENUE FROM MEDICAID CLIENTS AVERAGES APPROXIMATELY 10%.
PART VI, LINE 5:	JCHC OPERATES IN JEFFERSON COUNTY WITH A COMMUNITY BOARD AND OPEN MEDICAL STAFF. ALL SURPLUS FUNDS ARE REINVESTED BACK INTO THE FACILITY THROUGH BUILDING CONSTRUCTION, EQUIPMENT PURCHASES, OR COMMUNITY PROGRAMS PROVIDED. JCHC PROMOTES THE HEALTH OF THE COMMUNITY BY OFFERING A COMMUNITY WELLNESS CENTER AT A REASONABLE RATE AND OFFERING SCHOLARSHIPS FOR THE COMMUNITY'S YOUTH WHO HAVE FINANCIAL NEED. THE NET COMMUNITY BENEFIT REPORTED IN PART I RELATING TO THE WELLNESS CENTER WAS $237,000. JCHC PROMOTES THE HEALTH OF THE COMMUNITY BY PROMOTING COMMUNITY-WIDE PROGRAMS SUCH AS LIVE HEALTHY NEBRASKA AND STEP-2-IT (PROGRAMS WHICH ENCOURAGE INCREASING ACTIVITY AND LOSING WEIGHT.) JCHC IS ALSO INVOLVED IN CAR SAFETY SEAT CHECKS, PROGRESSIVE AG SAFETY DAY, AND WORKING WITH BLUE VALLEY COMMUNITY ACTION TO OFFER IMMUNIZATIONS TO AREA CHILDREN. JCHC PROMOTES THE HEALTH OF THE COMMUNITY BY OFFERING PROGRAMS, TOURS, SPEAKERS, AND EDUCATION, INCLUDING SUPPORT GROUPS, EDUCATIONAL PROGRAMS AND PROGRAMS FOR LOCAL ORGANIZATIONS.
PART VI, LINE 6:	JCHC IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM BUT DOES WORK TO BE A LEADER IN PROMOTING THE HEALTH OF THE COMMUNITIES IT SERVES. JCHC PARTNERS WITH MANY OTHER AREA ORGANIZATIONS, INCLUDING PUBLIC HEALTH SOLUTIONS, FARM SAFETY 4 JUST KIDS, NEBRASKA SAFE KIDS, JEFFERSON COUNTY EXTENSION, BLUE VALLEY COMMUNITY ACTION, FAIRBURY CHAMBER OF COMMERCE, FAIRBURY PUBLIC SCHOOLS, FAIRBURY CLINIC, NEBRASKA COMMUNITY BLOOD BANK, RURAL COMPREHENSIVE CARE NETWORK, BLUE RIVER VALLEY NETWORK, HEARTLAND HEALTH ALLIANCE, AND OTHERS. DEPENDING ON THE ACTIVITY, JCHC MAY BE THE LEAD ORGANIZATION, OR AN ORGANIZATION PROVIDING HELP AND ASSISTANCE.
PART VI, LINE 7:	JCHC DOES NOT FILE A COMMUNITY BENEFIT REPORT WITH ANY STATES.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	0	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	0	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
CHAD JURGENS
CEO	$143,674	$0	$0	$0	$38	$0	$7,390	$0	$14,678	$0	$165,780	$0	$0	$0
GARY MITCHELL
DIRECTOR OF PHARMACY	$142,656	$0	$0	$0	$25	$0	$7,383	$0	$13,442	$0	$163,506	$0	$0	$0
BILL WELCH
FORMER CEO	$112,822	$0	$0	$0	$22	$0	$5,711	$0	$9,047	$0	$127,602	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 1A	FormAndLineReferenceDesc
Explanation	JCHC PROVIDES DISCOUNTED OR FREE WELLNESS CENTER MEMBERSHIPS TO ITS EMPLOYEES AND PHYSICIANS.	ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	HOSPITAL AUTHORITY NO 1 OF JEFFERSON COUNTY NE	BusinessNameLine1

Field	Value	IRS element (for citing)
Bond Issuer EIN	611683496	BondIssuerEIN
Bond Issued	2012-12-18	BondIssuedDt
Issue Price	$5,800,000	IssuePriceAmt
Purpose	CONSTRUCTION AND RENOVATION OF FACILITIES	PurposeDesc
Defeased	0	DefeasedInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Pool Financing	0	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Total Proceeds	$4,005,373	TotalProceedsAmt
Issuance Costs From Proceeds	$50,001	IssuanceCostsFromProceedsAmt
Capital Expenditures	$3,995,372	CapitalExpendituresAmt
Current Refunding	0	CurrentRefundingInd
Advance Refunding	0	AdvanceRefundingInd
Final Allocation Made	0	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (1)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	0	OwningBondFinancedPropertyInd
Any Lease Arrangements	0	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	0	MgmtContractBondFincdPropInd
Any Research Agreements	0	AnyResearchAgreementsInd
Private Bus Use By Others	0.00000	PrivateBusUseByOthersPct
Private Bus Concerning UBI	0.00000	PrivateBusConcerningUBIPct
Total Private Business Use	0.00000	TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test	0	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	0	ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd	0	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	0	Form8038TFiledInd
Rebate Not Due Yet	Yes (1)	RebateNotDueYetInd
Exception To Rebate	0	ExceptionToRebateInd
No Rebate Due	0	NoRebateDueInd
Variable Rate Issue	0	VariableRateIssueInd
Hedge Identified In Bks And Rec	0	HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGICInd
Gross Proceeds Invested	0	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	Yes (1)	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	Yes (1)	ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II, COLUMN A, LINE 3:	FormAndLineReferenceDesc
Explanation	THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) AS THIS DEBT WAS ISSUED ON A DRAW-DOWN BASIS AND THE TOTAL PRINCIPAL AVAILABLE HAS NOT YET BEEN DRAWN.	ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (7 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
FAIRBURY CLINIC PC
DR. CRAIG SHUMARD, BOARD MEMBER, OWNS MORE THAN 5% OF FAIRBURY CLINIC P.C.	$601,115	FAIRBURY CLINIC P.C. PROVIDED EMERGENCY ROOM COVERAGE SERVICES TO JEFFERSON COMMUNITY HEALTH CENTER.	0
MARY HOPPE
EMPLOYEE OF THE HOSPITAL AND SPOUSE OF DICK HOPPE, CHAIRMAN OF THE BOARD	$85,596	EMPLOYEE'S W-2 WAGES	0
STACY SHUMARD
EMPLOYEE OF THE HOSPITAL AND SPOUSE OF DR. CRAIG SHUMARD, BOARD MEMBER	$42,153	EMPLOYEE'S W-2 WAGES	0
CAROL BLOBAUM
EMPLOYEE OF THE HOSPITAL AND SPOUSE OF BRIAN BLOBAUM, BOARD MEMBER	$72,957	EMPLOYEE'S W-2 WAGES	0
JANET STEELE
EMPLOYEE OF THE HOSPITAL AND SPOUSE OF MIKE STEELE, BOARD MEMBER	$35,541	EMPLOYEE'S W-2 WAGES	0
JACQUELINE WESCH
EMPLOYEE OF THE HOSPITAL AND SPOUSE OF JACK WESCH, BOARD MEMBER	$30,275	EMPLOYEE'S W-2 WAGES	0
FAIRBURY CLINIC PC
DR. TED TUCKER, BOARD MEMBER, OWNS MORE THAN 5% OF FAIRBURY CLINIC P.C.	$601,115	FAIRBURY CLINIC P.C. PROVIDED EMERGENCY ROOM COVERAGE SERVICES TO JEFFERSON COMMUNITY HEALTH CENTER.	0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6	JEFFERSON COMMUNITY HEALTH CENTER HAS MEMBERS. ANY PERSON, CORPORATION OR OTHER ENTITY MAY BECOME A LIFETIME MEMBER IF A CONTRIBUTION OF $100 OR MORE IS MADE TO THE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7A	VACANCIES, OCCURRING ON THE BOARD BY EXPIRATION, SHALL BE FILLED THROUGH ELECTION BY THE MEMBERS AT THE ANNUAL MEETING OF THE MEMBERS. THE BOARD DEVELOPMENT COMMITTEE SHALL SUBMIT A SLATE OF PROSPECTIVE CANDIDATES TO THE BOARD OF DIRECTORS AT THEIR MEETING PRIOR TO THE ANNUAL MEETING WHICH WILL THEN BE PRESENTED AT THE ANNUAL MEETING FOR CONSIDERATION FOR ELECTION TO THE BOARD. IN ADDITION, MEMBERS OF THE CORPORATION MAY MAKE NOMINATIONS FROM THE FLOOR.
FORM 990, PART VI, SECTION A, LINE 7B	EACH MEMBER SHALL BE ENTITLED TO ONE VOTE ON EACH MATTER SUBMITTED TO THE VOTE OF THE MEMBERS.
FORM 990, PART VI, SECTION B, LINE 11	THE 990 IS REVIEWED AT THE REGULAR BOARD MEETING PRIOR TO SUBMISSION TO THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	BOARD MEMBERS ARE REQUIRED, BY THE ARTICLES AND BYLAWS, TO REVIEW THE CONFLICT OF INTEREST POLICY ANNUALLY. A BOARD MEMBER WITH A CONFLICT OF INTEREST IS REQUIRED TO ABSTAIN FROM VOTING ON ANY MOTION FOR WHICH HE HAS A CONFLICT OF INTEREST. BOARD MEMBERS ARE WELL ACQUAINTED WITH EACH OTHER AND WOULD BE AWARE OF ANY PERSONAL CONFLICTS OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15	THE HOSPITAL PARTICIPATES IN THE NEBRASKA COMPDATA SALARY SURVEYS FOR ALL POSITIONS. THE CEO SURVEY DATA IS GIVEN TO THE BOARD TO REVIEW, AND THE BOARD APPROVES THE CEO'S SALARY ON AN ANNUAL BASIS.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11G	PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,636,657. MANAGEMENT AND GENERAL EXPENSES 148,254. FUNDRAISING EXPENSES 481. TOTAL EXPENSES 1,785,392. FEES FOR SERVICE: PROGRAM SERVICE EXPENSES 44,167. MANAGEMENT AND GENERAL EXPENSES 2,110. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 46,277. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 43,372. MANAGEMENT AND GENERAL EXPENSES 6,730. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 50,102.
FORM 990, PAGE 11, PART XI, LINE 2C:	THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS SELECTS THE INDEPENDENT ACCOUNTANT AND HAS THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT. UPON CONCLUSION OF THE AUDIT, THE AUDITING FIRM PRESENTS THE RESULTS AND FINDINGS TO THE FINANCE COMMITTEE. THERE HAVE BEEN NO CHANGES TO THIS PROCESS FROM THE PRIOR YEAR.