2015-11-16T13:18:35-06:00 2014-12-31 135565207 KPMG LLP 1212 NORTH 96TH STREET SUITE 300 OMAHA NE 68114 990 2014-01-01 420680355 JENNIE EDMUNDSON MEMORIAL HOSPITAL JENN 4023544840 933 EAST PIERCE STREET COUNCIL BLUFFS IA 51503 LINDA BURT VICE PRES FINANCE, CFO 4023544000 2015-11-16 1 LORRAINE A EGGER P00223617 4023481450 2014 2016-02-25 16:41:14Z STEVEN BAUMERT 933 EAST PIERCE STREET COUNCIL BLUFFS IA 51503 114422974 0 X WWW.BESTCARE.ORG X 1894 IA TO PROVIDE AND MAINTAIN HOSPITAL AND AMBULATORY FACILITIES FOR THE CARE OF PATIENTS. 12 10 792 401 382331 0 291587 313357 93491013 102142506 875120 1052006 1491806 1364692 96149526 104872561 7838966 6012140 0 0 44540286 42020687 0 0 0 40103946 43890805 92483198 91923632 3666328 12948929 73399044 84366212 22263208 28990191 51135836 55376021 X THE MISSION OF JENNIE EDMUNDSON MEMORIAL HOSPITAL IS TO IMPROVE THE QUALITY OF LIFE BY CARING FOR THE BODY AND MIND. JENNIE EDMUNDSON SUPPORTS ITS MISSION OF CARING FOR PEOPLE THROUGH THE PROVISION OF INPATIENT AND OUTPATIENT HOSPITAL SERVICES ON ITS MAIN CAMPUS AT 933 EAST PIERCE STREET,COUNCIL BLUFFS, IOWA AND AT VARIOUS SATELLITE LOCATIONS THROUGHOUT SOUTHWEST IOWA. 0 0 5092444 564066 9229251 JENNIE EDMUNDSON CARDIAC SERVICES INCLUDE SOUTHWEST IOWA'S FIRST STATE-OF-THE-ART CARDIAC CATHETERIZATION LAB. OTHER CARDIAC SERVICES OFFERED AT JENNIE EDMUNDSON MEMORIAL HOSPITAL INCLUDE HEART FAILURE PROGRAM, CARDIAC REHABILITATION SERVICES AND INPATIENT CARE PROVIDED BY HIGHLY TRAINED CARDIAC CARE PROFESSIONALS. 4612381 468797 7669749 JENNIE EDMUNDSON'S CANCER CENTER IS THE ONLY CANCER CENTER IN SOUTHWEST IOWA ACCREDITED BY THE AMERICAN COLLEGE OF SURGEONS. ALL NEWLY DIAGNOSED CANCER PATIENTS' CASES ARE PRESENTED AND REVIEWED AT THE WEEKLY CANCER CONFERENCE FOR IN-DEPTH REVIEW BY SURGEONS, RADIOLOGISTS, PATHOLOGISTS, MEDICAL AND RADIATION ONCOLOGISTS AND OTHER SPECIALIZED CARE PROVIDERS. EVERY YEAR SINCE 1996, JENNIE EDMUNDSON HAS RECEIVED APPROVAL FROM THE COMMISSION ON CANCER INCLUDING MEETING PROGRAM STANDARDS, PROVIDING SUPPORT AND EDUCATION, AND DELIVERING QUALITY CARE TO ITS PATIENTS. 13624333 1083950 17737021 QUALITY, COMPREHENSIVE SURGICAL SERVICES ARE PROVIDED AT JENNIE EDMUNDSON HOSPITAL BY A TEAM OF CARING AND EXPERT PHYSICIANS, NURSES AND ANESTHESIOLOGISTS USING STATE OF THE ART TECHNOLOGY. PATIENTS ARE ENCOURAGED TO TAKE AN ACTIVE ROLE IN THEIR SURGICAL EXPERIENCE. HIGHLY PERSONALIZED PRE- AND POST-OPERATIVE CARE IS DELIVERED FROM ADMISSION TO DISCHARGE BY NURSES WHO SPECIALIZE IN SURGICAL CARE.CARE IS PROVIDED TO CHILDREN, ADOLESCENTS AND ADULTS IN GENERAL, GYNECOLOGY, NEUROSURGERY, OPHTHALMOLOGY, ORTHOPEDICS, OTOLARYNGOLOGY, RESPIRATORY/PULMONARY, UROLOGY,AND VASCULAR/CARDIAC/THORACIC SURGICAL SPECIALTIES. 58865470 3895327 68246908 JENNIE EDMUNDSON HOSPITAL IS THE OLDEST ENTITY IN THE NEBRASKA HEALTH SYSTEM FAMILY. IT IS A 232-BED REGIONAL HEALTH CARE CENTER SERVING SOUTHWESTERN IOWA. IT IS THE ONLY HOSPITAL IN THE REGION THAT OFFERS NATIONALLY ACCREDITED CANCER AND BREAST CANCER PROGRAMS WHILE ALSO FEATURING SOUTHWEST IOWA'S ONLY ADVANCED WOUND CENTER AS WELL AS A FULL-LINE OF WOMEN'S SERVICES INCLUDING A BIRTHING CENTER AND LEVEL II NURSERY.ADDITIONAL CORE SERVICES INCLUDE MEDICAL/SURGICAL SERVICES, AN EMERGENCY DEPARTMENT, DIAGNOSTIC AND IMAGING SERVICES. EMPHASIS IS PLACED ON EDUCATION FOR PATIENTS, THEIR FAMILIES AND THE COMMUNITY. 58865470 3895327 68246908 82194628 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 X 31 0 792 1 1 1 0 0 0 0 0 0 0 0 0 X 12 10 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IA X LINDA BURT 4023544840 8511 WEST DODGE ROAD OMAHA NE 68114 DAN KINNEY PHD CHAIRMAN 1.00 0.00 X X 0 0 0 EMMA CHANCE VICE CHAIRMAN 1.00 0.00 X X 0 0 0 DEB BASS DIRECTOR 1.00 0.00 X 0 0 0 JOHN NELSON SECRETARY 1.00 0.00 X X 0 0 0 KAREN COLLINS DIRECTOR 1.00 0.00 X 0 0 0 WILLIAM SHIFFERMILLER MD DIRECTOR 1.00 39.00 X 0 379224 107306 JOHN G SOUTHARD MD PHD DIRECTOR 1.00 0.00 X 0 0 0 SPENCER C STEVENS DIRECTOR 1.00 0.00 X 0 0 0 LAWRENCE F UEBNER DIRECTOR 1.00 0.00 X 0 0 0 RICK CROWL JR DIRECTOR 1.00 0.00 X 0 0 0 THOMAS D WHITSON DIRECTOR 1.00 0.00 X 0 0 0 MICHAEL ZLOMKE MD DIRECTOR 1.00 0.00 X 0 0 0 STEVEN BAUMERT PRESIDENT 35.00 5.00 X 0 301159 80930 LINDA BURT VICE PRES-FINANCE & CFO 6.00 34.00 X 0 464701 96352 MICHAEL ROMANO MD PHYSICIAN /EXEC MED AFFAIR 40.00 0.00 X 207306 0 44835 PEGGY HELGET EXEC. PATIENT SVCS 40.00 0.00 X 182825 0 25494 JAMES CHAMBERS EXEC. CLINICAL AFFAIRS 40.00 0.00 X 151081 0 36800 JULIE HINES NURSE 40.00 0.00 X 140048 0 29254 NGUYET TRAN MD PHYSICIAN 40.00 0.00 X 191137 0 31372 DONNA HUBBELL EXEC. QUALITY & PT SAFETY 40.00 0.00 X 153863 0 29444 EVELYN REHER PHYSICIAN 40.00 0.00 X 314566 0 40673 1340826 1145084 522460 34 0 1 0 PATHLAB LTD 933 EAST PIERCE STREET COUNCIL BLUFFS IA 51503 MEDICAL SERVICES 5822771 EMERGENCY PHYSICIANS WESTERN IOWA LLC 4950 SOUTH 177 CIRCLE OMAHA NE 68135 MEDICAL SERVICES 1761029 MCLMYERS-CARLISLE-LEAPLY 14124 INDUSTRIAL RD OMAHA NE 68144 CONSTRUCTION SERVICES 1738434 ACCELECARE WOUND CENTERS INC P O BOX 671242 DALLAS TX 75267 MEDICAL SERVICES 784084 HORIZON HEALTH MANAGEMENT P O BOX 840839 DALLAS TX 75284 MEDICAL SERVICES 682899 12 222962 90395 313357 NET PATIENT SVC REV. 621990 100334902 100334902 OTHER PATIENT REVENUE 621990 1807604 1807604 102142506 572027 572027 1603890 1432565 171325 171325 171325 8495325 1200 8016546 0 478779 1200 479979 479979 171915 101302 70613 70613 CAFETERIA 722210 740423 740423 LABORATORY 621500 382331 382331 1122754 104872561 102882929 382331 1293944 113068 113068 5899072 5899072 390131 390131 33277940 32972996 304944 1199998 1129909 70089 4918595 4847830 70765 2234023 2194928 39095 57208 57208 18923 18923 42643 42643 8707878 8707878 198996 198996 1294721 1294721 46540 46540 3811118 3811118 46983 46983 150489 150489 3217993 3217993 400510 305436 95074 MEDICAL SUPPLIES 14746637 14746637 ALLOCATIONS 8640132 8640132 MEDICAID PROVIDER TAX 862993 862993 DUES, LICENSES AND SUBS 252822 252822 1394219 1394219 91923632 82194628 9729004 0 9515646 10753300 11422341 13021704 130983 135061 2031122 1906288 498864 619790 127799666 92963625 33678777 34836041 14582852 22136974 189714 226692 1348745 730362 73399044 84366212 11748159 12001467 4605000 3540000 5910049 13448724 22263208 28990191 X 50498824 54736428 537012 539593 100000 100000 51135836 55376021 73399044 84366212 X 12948929 -335463 -8373281 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 18923 0 0 0 18923 0 PART II-B, LINE 1: A PORTION OF THE ANNUAL DUES PAID TO THE AMERICAN HOSPITAL AND IOWA HOSPITAL ASSOCIATIONS IS ATTRIBUTABLE TO LOBBYING ACTIVITIES. 218264 4954 10730 212488 213966 11523 7225 218264 199654 5053 12759 3500 213966 185484 10963 9207 6000 199654 183700 1784 185484 0.94830 0.05170 0 1 1 2807651 2807651 76438401 50530368 25908033 48553614 42433257 6120357 34836041 MINIMUM PENSION LIABILITY 12040581 COND. ASSET RETIREMENT OBLIGATION 1234398 ESTIMATED THIRD PARTY PAYABLE 173745 13448724 X PART V, LINE 4: PERMANENTLY RESTRICTED NET ASSETS INCLUDE ENDOWMENT FUNDS WHICH ARE INTENDED TO BE HELD IN PERPETUITY. THE INCOME ON SUCH FUNDS IS EXPENDABLE FOR THE BENEFIT OF JENNIE EDMUNDSON MEMORIAL HOSPITAL. PART X, LINE 2: JENNIE EDMUNDSON MEMORIAL HOSPITAL RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. IN 2014 AND 2013 MANAGEMENT DETERMINED THERE ARE NO INCOME TAX POSITIONS REQUIRING RECOGNITION OF THE FINANCIAL STATEMENTS. NO CHANGES WERE MADE TO THE FINANCIAL STATEMENTS DUE TO FIN 48. 1 1 X 1 X 1 X 1 1 0 1 1 3161792 173334 2988458 0.03250 14696615 14040923 655692 0.00710 17858407 14214257 3644150 0.03960 358706 358706 0.00390 1057338 1057338 0.01150 210536 210536 0.00230 348835 348835 0.00380 1975415 1975415 0.02150 19833822 14214257 5619565 0.06110 5770 5770 0.00010 5770 5770 0.00010 1 1299814 29836392 32204671 -2368279 X 1 1 1 1 JENNIE EDMUNDSON MEMORIAL HOSPITAL 933 EAST PIERCE STREET COUNCIL BLUFFS IA 51503 780039H X X X X JENNIE EDMUNDSON MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X 12 1 1 1 1 X METHODISTCOMMUNITYBENEFIT.COM/OUR-PLAN/COMMUNITY-HEALTH-NEEDS-ASSESSMENT X 1 12 1 WWW.METHODISTCOMMUNITYBENEFIT.COM/OUR-PLAN/ 0 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X X X X X X 1 X 0 X X X 1 X 0 0 JENNIE EDMUNDSON MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT (ASSESSMENT) WAS SPONSORED BY A COALITION OF LOCAL HEALTH SYSTEMS AND LOCAL HEALTH DEPARTMENTS. THE ASSESSMENT WAS CONDUCTED BY PROFESSIONAL RESEARCH CONSULTANTS INC. (PRC), A NATIONALLY-RECOGNIZED HEALTHCARE CONSULTING FIRM WITH EXTENSIVE EXPERIENCE CONDUCTING COMMUNITY HEALTH NEEDS ASSESSMENTS.THE ASSESSMENT INCORPORATED DATA FROM BOTH QUANTITATIVE AND QUALITATIVE SOURCES. QUANTITATIVE DATA INCLUDED PRIMARY DATA REPRESENTATION FROM TELEPHONE INTERVIEWS WHICH INCORPORATED BOTH LANDLINE AND CELL PHONE INTERVIEWS. IN ADDITION THERE WERE FIVE FOCUS GROUPS WHICH INCLUDED 88 KEY INFORMANTS INCLUDING PHYSICIANS, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, BUSINESS LEADERS AND OTHER COMMUNITY LEADERS. JENNIE EDMUNDSON MEMORIAL HOSPITAL PART V, SECTION B, LINE 6A: THE CHNA WAS A COLLABORATIVE EFFORT OF THREE OMAHA HEALTH SYSTEMS - METHODIST HEALTH SYSTEM, ALEGENT HEALTH SYSTEM AND THE NEBRASKA MEDICAL CENTER AS WELL AS LOCAL HEALTH DEPARTMENTS FROM DOUGLAS, SARPY/CASS COUNTIES, NEBRASKA AND POTTAWATTAMIE COUNTY, IOWA. JENNIE EDMUNDSON MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: JENNIE EDMUNDSON HOSPITAL DID NOT ADDRESS THE AREAS OF ORAL HEALTH AND SUBSTANCE ABUSE WHICH WERE OUTLINED IN THE CHNA. OTHER ORGANIZATIONS IN THE COMMUNITY HAVE THE RESOURCES AND QUALIFICATIONS TO PROVIDE FOR THESE AREAS OF COMMUNITY HEALTH.JENNIE EDMUNDSON MEMORIAL HOSPITAL WILL COLLABORATE WITH COMMUNITY ORGANIZATIONS THAT ARE ADDRESSING THESE NEEDS.2014 IMPLEMENTATION STRATEGY UPDATE:METHODIST JENNIE EDMUNDSON HOSPITAL (MJEH) IS COMMITTED TO ITS COMMUNITY, LIVING THE MISSION OF IMPROVING THE QUALITY OF LIFE THROUGH EXCELLENCE IN HEALTH CARE. COMMUNITY BENEFIT PROGRAMS ARE STRATEGICALLY FOCUSED TO IMPROVE ACCESS TO HEALTH CARE SERVICES, ENHANCE THE HEALTH OF THE COMMUNITY, ADVANCE MEDICAL OR HEALTH CARE KNOWLEDGE AND RELIEVE OR REDUCE THE BURDEN OF THE GOVERNMENT. MJEH CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2012 AND DEVELOPED PLANS TO ADDRESS THE IDENTIFIED NEEDS. TO ENSURE EFFECTIVE STRATEGIES WERE DEPLOYED, MEASURABLE OUTCOMES WERE ESTABLISHED AND MEASURED PERIODICALLY OVER THE THREE YEARS SINCE. THOUGH SEVERAL IDENTIFIED NEEDS GO BEYOND MJEH'S SCOPE OF EXPERTISE, MJEH CONTINUED ITS COMMITMENT BY COLLABORATING WITH OTHER HEALTH CARE ORGANIZATIONS TARGETING THOSE NEEDS.TO IMPROVE THE HEALTH OF THE ENTIRE COMMUNITY, RESOURCES FOR DISEASES, PREVENTION AND HEALTHY LIVING ARE PROVIDED BY THE FAMILY RESOURCE CENTER, A FREE CENTER LOCATED IN MJEH. MJEH ADDRESSES THE NATIONAL CRISIS OF MENTAL HEALTH BY PROVIDING SERVICES FOR THE COMMUNITY FOR A REDUCED FEE OR WITH AVAILABLE FINANCIAL ASSISTANCE. IN ADDITION TO BOTH THESE PROGRAMS, MJEH HAS ESTABLISHED A SEXUAL ASSAULT PROGRAM FOR SURVIVORS WORKING WITH LAW ENFORCEMENT TO PROVIDE THE BEST TREATMENT AND EMOTIONAL SUPPORT.MJEH IS PROUD TO BE A PART OF THE COMMUNITY AND REFLECTS ITS COMMITMENT BY SERVING PEOPLE THROUGH OUR PREVENTION ACTIVITIES, HEALTH PROMOTION, SOCIAL SERVICES, PASTORAL CARE, NUMEROUS VOLUNTEER EFFORTS, PROFESSIONAL EDUCATION, AND A STRONG LEADERSHIP FOR A HEALTHIER COMMUNITY. JENNIE EDMUNDSON MEMORIAL HOSPITAL PART V, SECTION B, LINE 13B: JENNIE EDMUNDSON MEMORIAL HOSPITAL CHARGES MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE FOR PATIENTS OR GUARANTORS WITH FAMILY INCOME GREATER THAN 400% OF THE FEDERAL POVERTY LEVEL WHEN CIRCUMSTANCES INDICATE SEVERE FINANCIAL HARDSHIP. PATIENTS, OR THEIR GUARANTORS, MAY BE ELIGIBLE FOR MEDICAL HARDSHIP ASSISTANCE IF THEY HAVE INCURRED OUT-OF-POCKET OBLIGATIONS RESULTING FROM MEDICAL SERVICES THAT EXCEED 25% OF FAMILY INCOME AND SUFFICIENT FAMILY ASSETS ARE NOT AVAILABLE TO MEET THE OBLIGATION. JENNIE EDMUNDSON MEMORIAL HOSPITAL PART V, SECTION B, LINE 13H: JENNIE EDMUNDSON MEMORIAL HOSPITAL UNDERSTANDS THAT NOT ALL PATIENTS ARE ABLE TO COMPLETE A FINANCIAL ASSISTANCE APPLICATION OR COMPLY WITH REQUESTS FOR DOCUMENTATION. THERE MAY BE INSTANCES UNDER WHICH A PATIENT'S QUALIFICATION FOR FINANCIAL ASSISTANCE IS ESTABLISHED WITHOUT COMPLETING THE FORMAL FINANCIAL ASSISTANCE APPLICATION. OTHER INFORMATION MAY BE UTILIZED TO TO MAKE AN INFORMED DECISION ON FINANCIAL NEED SUCH AS; HOMELESS, DECEASED - NO KNOWN ESTATE, WIC PROGRAM ELIGIBILITY OR SNAP BENEFITS.ADDITIONALLY, JENNIE EDMUNDSON MEMORIAL HOSPITAL UTILIZES A PRESUMPTIVE ELIGIBILITY ANALYTICS SOLUTION THAT EXAMINES HISTORICAL DATA COMBINED WITH HOUSEHOLD ECONOMIC INFORMATION. IT EVALUATES ACCOUNTS BASED ON THE FOLLOWING STANDARDS: AVAILABLE HOUSEHOLD INCOME, HOUSEHOLD SIZE, CAPACITY TO MAKE PAYMENT, AND OVER-EXTENSION COMPARED TO FEDERAL POVERTY GUIDELINES. THIS INFORMATION IS DERIVED FROM SOCIO-ECONOMIC DATA FROM NUMEROUS SOURCES, INCLUDING CENSUS DATA. USING THIS PRESUMPTIVE ELIGIBILITY APPROACH, A SCORE IS ASSIGNED AT THE INDIVIDUAL PATIENT LEVEL. THE SCORE ENABLES THE PATIENT FINANCIAL SERVICES TO MEET INTERNAL PROCESSING REQUIREMENTS WHILE PROVIDING A COMMUNITY BENEFIT THROUGH FORGIVING ACCOUNT BALANCES FOR THOSE IN NEED.THIS APPROACH ENABLES JENNIE EDMUNDSON MEMORIAL HOSPITAL TO EVALUATE ACCOUNTS FOR FINANCIAL ASSISTANCE EQUALLY, REGARDLESS OF THE PATIENT'S ABILITY TO COMPLETE AN APPLICATION FOR ASSISTANCE.WHEN THE PRESUMPTIVE ELIGIBILITY SOLUTION IS THE BASIS FOR DETERMINING ELIGIBILITY, A FULL FREE CARE DISCOUNT WILL BE GRANTED FOR ELIGIBLE SERVICES FOR RETROSPECTIVE DATES OF SERVICE ONLY. THESE ACCOUNTS WILL NOT BE SENT TO COLLECTION AND WILL NOT BE INCLUDED IN BAD DEBT EXPENSE. JENNIE EDMUNDSON MEMORIAL HOSPITAL PART V, SECTION B, LINE 16I: THE FINANCIAL ASSISTANCE APPLICATION IS PROVIDED WITH INPATIENT ADMISSION PACKETS. GUIDANCE TO THE POLICY IS REFERRED TO IN PATIENT STATEMENTS. JENNIE EDMUNDSON MEMORIAL HOSPITAL PART V, SECTION B, LINE 22D: THE AVERAGE COMMERCIAL INSURANCE RATE IS USED. PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY JENNIE EDMUNDSON MEMORIAL HOSPITAL PART V, SECTION B, LINE 16A WEBSITE: WWW.BESTCARE.ORG/TOOLS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE/ JENNIE EDMUNDSON MEMORIAL HOSPITAL PART V, SECTION B, LINE 16B WEBSITE: WWW.BESTCARE.ORG/TOOLS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE/ PART I, LINE 7: THE METHODS PRIMARILY USED ARE THE FINANCIAL INFORMATION FROM THE MEDICARE COST REPORT AND ACTUAL EXPENDITURES. PART I, LINE 7G: A SUBSIDIZED HEALTH BENEFIT IS CALCULATED FOR DEPARTMENTS AND SERVICES RECOGNIZING THESE AREAS OPERATE AT A NEGATIVE MARGIN. TRANSPORT SERVICES AND CLINICS IN UNDERSERVED AREAS, FOR EXAMPLE, ARE SERVICES THAT OPERATE AT NEGATIVE MARGINS. PART I, LN 7 COL(F): THE PERCENTAGE IS ARRIVED AT BY DIVIDING NET COMMUNITY BENEFIT EXPENSES IN COLUMN (E) BY THE AMOUNT ON FORM 990, PART IX, LINE 25, COLUMN (A). PART I, LINE 6A AND 6B: ANNUAL COMMUNITY BENEFIT REPORT:NEBRASKA METHODIST HEALTH SYSTEM PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT WHICH INCLUDES INFORMATION ON COMMUNITY BENEFITS ACTIVITIES FROM ALL AFFILIATES. IN ADDITION, A QUARTERLY PUBLICATION, "CHART" ADDRESSES ONGOING COMMUNITY BENEFIT ACTIVITIES. THE WEBSITE "METHODISTCHART.ORG" IS DEDICATED TO JENNIE EDMUNDSON MEMORIAL HOSPITAL AND NEBRASKA METHODIST HEALTH SYSTEM AFFILIATES' COMMUNITY WORKS. IT PROVIDES INFORMATION ABOUT THE SUCCESSES IN IMPACTING THE COMMUNITY'S OVERALL HEALTH.PART VI, LINE 7:NO DIRECT REPORT IS PROVIDED TO THE STATE OF IOWA. HOWEVER, INFORMATION FROM THE HOSPITAL'S COMMUNITY BENEFIT DATA IS INCLUDED IN A REPORT COMPILED BY THE IOWA HOSPITAL ASSOCIATION. IN ADDITION, A COPY OF THE FORM 990 IS PROVIDED TO THE IOWA LEGISLATIVE AGENCY AND THE IOWA DEPARTMENT OF PUBLIC HEALTH.PART I, LINE 7:INFORMATION ON PROGRAMS CONSTITUTING COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS, SUBSIDIZED HEALTH SERVICES AND IN-KIND DONATIONS IS COLLECTED THROUGHOUT THE YEAR USING THE COMMUNITY BENEFITS INVENTORY SOCIAL ACCOUNTABILITY SOFTWARE WHICH FOLLOWS CATHOLIC HEALTH ASSOCIATION (CHA) GUIDELINES FOR COMMUNITY BENEFIT REPORTING. AMOUNTS SHOWN AS COMMUNITY BENEFIT ARE AT COST LESS ANY REVENUE EXCLUSIVE OF ANY GRANTS. CASH AND IN-KIND DONATIONS THAT SUPPORT FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT ACTIVITIES ARE INCLUDED IN CONTRIBUTIONS.PART I, LINE 7E:JENNIE EDMUNDSON AND 20 OTHER ORGANIZATIONS IN THE COMMUNITY HAVE UNITED IN THE SHAKEN BABY TASK FORCE IN A COMMUNITY EFFORT TO PREVENT SHAKEN BABY SYNDROME. THE TASK FORCE, LED BY MEMBERS OF THE STAFF OF JENNIE EDMUNDSON HOSPITAL, DEVELOPED A COPYRIGHTED CURRICULUM, VIDEO AND SAFEBABY.ORG WEBSITE AND THE NATION'S ONLY 24-HOUR DEDICATED CRYING BABY HOTLINE. THE VIDEO "SHAKEN BABIES: SHATTERED LIVES" IS FREE ON REQUEST AND HAS BEEN SENT TO REQUESTERS IN THE UNITED STATES AND COUNTRIES OUTSIDE THE UNITED STATES.JENNIE EDMUNDSON'S COMMITMENT TO SOUTHWEST IOWA EXTENDS TO A WIDE VARIETY OF OTHER ANNUAL SCREENING PROGRAMS ON PROSTATE CANCER, COLORECTAL CANCER, BREAST CANCER AND CERVICAL CANCER. IN ADDITION, PHYSICIANS AND HOSPITAL STAFF PROVIDE EDUCATIONAL PROGRAMS TO ORGANIZATIONS AND AT COMMUNITY EVENTS. PART II, COMMUNITY BUILDING ACTIVITIES: AS A COMMUNITY LEADER, JENNIE EDMUNDSON EMPLOYEES ARE ACTIVE IN COMMUNITY ORGANIZATIONS, HOLDING LEADERSHIP ROLES ON BOARDS OF DIRECTORS, COMMITTEE CHAIRMANSHIPS AND MEMBERSHIPS. JENNIE EDMUNDSON PARTICIPATES IN THE CHAMBER OF COMMERCE, THE AMERICAN HEART ASSOCIATION AND OTHER ORGANIZATIONS TO STRENGTHEN THE INFRASTRUCTURE OF THE COMMUNITY. PART III, LINE 4: FOOTNOTE TO THE FINANCIAL STATEMENTS DESCRIBING BAD DEBT EXPENSE IS SHOWN IN THE ATTACHED AUDITED FINANCIAL STATEMENTS, PAGE 9.THE COST METHODOLOGY FOR THE BAD DEBT EXPENSE PRESENTED IN PART III, LINE 2, IS CONSISTENT WITH THAT OF THE 2014 FILED MEDICARE COST REPORT. PART III, LINE 8: SOURCE FOR MEDICARE REVENUE AND ALLOWABLE COSTS IS THE 2014 MEDICARE COST REPORT AS FILED. PART III, LINE 9B: COLLECTION PRACTICES FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE.JENNIE EDMUNDSON MEMORIAL HOSPITAL HAS ADOPTED A PROCEDURE FOR THOSE SITUATIONS WHERE A PATIENT POTENTIALLY MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAS NOT OR CANNOT COMPLETE THE APPLICATION. THIS PROCEDURE, REFERRED TO AS THE PRESUMPTIVE CHARITY PROCESS, IS FOLLOWED BY HOSPITAL PERSONNEL AS WELL AS THIRD-PARTY VENDORS ASSISTING WITH SELF-PAY COLLECTIONS.SOME OF THE INDIVIDUAL LIFE CIRCUMSTANCES THAT HAVE BEEN ESTABLISHED AS INDICATORS OF PRESUMPTIVE ELIGIBILITY INCLUDE:PARTICIPATION IN STATE-FUNDED PRESCRIPTION PROGRAMS; RECEIVING CARE FROM A HOMELESS PERSONS CLINIC; PARTICIPATION IN WOMEN, INFANTS AND CHILDREN (WIC) PROGRAMS; SNAP BENEFITS; ELIGIBILITY FOR SUBSIDIZED SCHOOL LUNCH PROGRAM; ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED (E.G. MEDICAID SPEND-DOWN); LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS VALID ADDRESS.THE HOSPITAL STAFF, AS WELL AS VENDORS UTILIZED FOR SELF-PAY COLLECTIONS, HAVE BEEN TRAINED TO IDENTIFY INDICATORS OF PRESUMPTIVE ELIGIBILITY AND DOCUMENT SUCH AS SUPPORT FOR A FINANCIAL ASSISTANCE DETERMINATION.THE HOSPITAL BILLS ALL THIRD PARTY RESOURCES THAT MAY BE ABLE TO PROVIDE REIMBURSEMENT FOR CARE PROVIDED TO PATIENTS. THIS INCLUDES, BUT IS NOT LIMITED TO, COMMERCIAL INSURANCE, MEDICARE, MEDICAID, COUNTY GOVERNMENT AND OTHER GOVERNMENT PROGRAMS, AND ANY OTHER POTENTIAL SOURCE OF REIMBURSEMENT.EVERY EFFORT IS MADE TO IDENTIFY PATIENTS THAT MAY QUALIFY FOR FINANCIAL ASSISTANCE PRIOR TO OR DURING THE TIME OF SERVICE. THOSE PATIENTS ARE ENCOURAGED TO COMPLETE AN APPLICATION FOR FINANCIAL ASSISTANCE. PART VI, LINE 2: BROAD-BASED COMMUNITY HEALTH AND OUTREACH INTIATIVES INCLUDE TARGETED PROGRAMS THAT ALIGN WITH KEY HEALTH NEEDS IDENTIFIED BY LIVEWELL OMAHA. LIVEWELL OMAHA IS A FORUM OF ORGANIZATIONS WORKING TOGETHER TO POSITIVELY IMPACT HEALTH OUTCOMES FOR ALL INDIVIDUALS AND FAMILIES IN THE COMMUNITY. PART VI, LINE 3: FINANCIAL ASSISTANCE BROCHURES ARE INCLUDED IN ALL INPATIENT ADMISSION PACKETS. JENNIE EDMUNDSON HOSPITAL CONTRACTS WITH AN ELIGIBILITY SERVICE TO ASSIST INDIVIDUALS IN DETERMINING ELIGIBILITY AND COMPLETING THE REQUIRED PAPERWORK TO PARTICIPATE IN MEDICAID OR GOVERNMENT MEANS-TESTED PROGRAMS. HOSPITAL FINANCIAL COUNSELORS AND ELIGIBILITY SERVICE PERSONNEL ARE CONVENIENTLY LOCATED AT THE HOSPITAL FOR PRIVATE CONSULTATION FOR BOTH INPATIENT AND OUTPATIENT COUNSELING. THE COUNSELORS ARE INCLUDED IN THE ADMISSION/DISCHARGE PROCESS TO ENSURE THAT THE PATIENT IS FULLY INFORMED ABOUT THE PROCESS AND TO HELP THE PATIENT DETERMINE WHAT ASSISTANCE MAY BE NEEDED AND WHAT IS AVAILABLE TO THEM. THE HOSPITAL CUSTOMER SERVICE UNIT IS ALSO TRAINED TO ASSIST PATIENTS WITH FINANCIAL NEED. PATIENTS WHO CONTACT THE UNIT EXPRESSING DIFFICULTY IN MEETING THEIR FINANCIAL OBLIGATION ARE ASSESSED FOR ELIGIBILITY FOR FINANCIAL ASSISTANCE.APPROPRIATE RESOURCES ARE USED TO PROVIDE EFFECTIVE COMMUNICATION WITH NON-ENGLISH SPEAKING PATIENTS INCLUDING CYRACOM LANGUAGE LINE SYSTEM THAT PROVIDES 24-HOUR ACCESS TO SEVERAL HUNDRED DIFFERENT LANGUAGE INTERPRETERS. OTHER RESOURCES INCLUDE HOPE MEDICAL OUTREACH AND ON-SITE STAFF OR CONTRACTED INTERPRETER SERVICES. THE HOSPITAL PROVIDES FOR INTERPRETATIVE SERVICES AT NO COST TO THE PATIENT.INFORMATION ON THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE TO THE PUBLIC ON THE BESTCARE.ORG WEBSITE. ADDITIONALLY, PATIENT STATEMENTS INCLUDE A STATEMENT ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE INCLUDING CONTACT INFORMATION. PART VI, LINE 4: JENNIE EDMUNDSON SERVES COUNCIL BLUFFS, IOWA AND SURROUNDING COMMUNITIES IN SOUTHWESTERN IOWA.JENNIE EDMUNDSON'S PROGRAMS ALIGN CLOSELY WITH THE KEY HEALTH NEEDS IDENTIFIED BY LIVEWELL OMAHA, A COLLABORATION OF LOCAL NON-PROFIT, GOVERNMENTAL AND FOR-PROFIT ORGANIZATIONS DEDICATED TO IMPROVING THE HEALTH OF THOSE WHO LIVE AND WORK IN THE AREA. PART VI, LINE 5: JENNIE EDMUNDSON'S BOARD OF DIRECTORS IS COMPOSED OF COMMUNITY LEADERS WITH DIVERSE BACKGROUNDS AND PROVIDES OVERSIGHT OF ALL OPERATIONS. THE COMPOSITION INCLUDES A COMBINATION OF THOSE WITH LONGEVITY ON THE BOARD AND THOSE WHO ARE NEWER MEMBERS. PHYSICIAN INVOLVEMENT ON THE BOARD ENHANCES THE HOSPITAL'S ABILITY TO BE A LEADER IN MEDICAL SERVICES.MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL PRACTITIONERS WHO CONTINUOUSLY MEET THE QUALIFICATIONS, STANDARDS AND REQUIREMENTS TO PROMOTE A UNIFORM STANDARD OF QUALITY PATIENT CARE, TREATMENT AND SERVICES. PART VI, LINE 6: THE NEBRASKA METHODIST HEALTH SYSTEM INCLUDES JENNIE EDMUNDSON MEMORIAL HOSPITAL AND JENNIE EDMUNDSON MEMORIAL HOSPITAL FOUNDATION, NEBRASKA METHODIST HOSPITAL, NEBRASKA METHODIST HEALTH SYSTEM, PHYSICIANS CLINIC INC., NEBRASKA METHODIST COLLEGE OF NURSING AND NEBRASKA METHODIST HOSPITAL FOUNDATION. AS A GROUP, THESE ENTITIES ARE COMMITTED TO CARING FOR THE PEOPLE OF THE COMMUNITY BY PROVIDING OUTSTANDING HEALTH CARE, EDUCATIONAL OPPORTUNITIES AND SUPPORT SERVICES. TO FULFILL OUR MISSION OF CARING FOR PEOPLE, AFFILIATES HAVE DEVELOPED A VARIETY OF WAYS TO CONTRIBUTE CARE AND HEALTH-RELATED EDUCATION TO THE POOR, TO MINORITIES, AND TO OTHER UNDERSERVED GROUPS AS WELL AS TO THE BROADER COMMUNITY. AS INDIVIDUAL AFFILIATES, A UNIFIED HEALTH SYSTEM AND AN ACTIVE PARTNER WITH OTHER COMMUNITY AND GOVERNMENTAL AGENCIES, JENNIE EDMUNDSON MEMORIAL HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH AND QUALIFY OF LIFE OF THE RESIDENTS OF THIS COMMUNITY. 0 IOWA WESTERN COMMUNITY COLLEGE FOUNDATION 2700 COLLEGE ROAD COUNCIL BLUFFS IA 51503 421224333 501(C)(3) 5250 EDUCATION / SCHOLARSHIPS POTTAWATTAMIE COUNTY MENTAL ABUSE NETWORK 515 5TH AVE COUNCIL BLUFFS IA 51503 260697957 501(C)(3) 10000 SUPPORT OF FOUNDATION PROGRAMS CONNECTIONS AREA AGENCY AGING 300 W BROADWAY STE 240 COUNCIL BLUFFS IA 51503 421146108 501(C)(3) 70079 PARTNERING TO REDUCE READMISSIONS COUNCIL BLUFFS AREA CHAMBER OF COMMERCE PO BOX 1565 COUNCIL BLUFFS IA 51502 420198270 501(C)(6) 13475 SUPPORT OF CHAMBER'S PROGRAMS 3 1 SCHOLARSHIPS 6 11000 FINANCIAL ASSISTANCE 9017 5888072 BOOK FINANCIAL ASSISTANCE TO PATIENTS PART I, LINE 2: JENNIE EDMUNDSON MEMORIAL HOSPITAL ONLY PROVIDES GRANTS TO IRC SECTION 501(C)(3) ORGANIZATIONS AND 501(C)(3) ACTIVITIES TO ENSURE THE FUNDS ARE USED FOR EXEMPT PURPOSES. 0 1 0 0 0 0 0 0 0 WILLIAM SHIFFERMILLER MD DIRECTOR 0 310534 0 6000 0 62690 0 89701 0 19703 0 488628 0 56076 STEVEN BAUMERT PRESIDENT 0 261421 0 0 0 39738 0 62538 0 19374 0 383071 0 0 LINDA BURT VICE PRES-FINANCE & CFO 0 373454 0 0 0 91247 0 82504 0 14830 0 562035 0 66637 MICHAEL ROMANO MD PHYSICIAN /EXEC MED AFFAIR 189806 0 0 0 17500 0 20338 0 25588 0 253232 0 0 0 PEGGY HELGET EXEC. PATIENT SVCS 161259 0 14804 0 6762 0 18074 0 8510 0 209409 0 0 0 JAMES CHAMBERS EXEC. CLINICAL AFFAIRS 151081 0 0 0 0 0 22075 0 15815 0 188971 0 0 0 JULIE HINES NURSE 129898 0 0 0 10150 0 14362 0 15802 0 170212 0 0 0 NGUYET TRAN MD PHYSICIAN 191137 0 0 0 0 0 6610 0 28672 0 226419 0 0 0 DONNA HUBBELL EXEC. QUALITY & PT SAFETY 125895 0 14804 0 13164 0 9682 0 20852 0 184397 0 0 0 EVELYN REHER PHYSICIAN 269958 0 44608 0 0 0 25948 0 15627 0 356141 0 0 0 PART I, LINE 3 JENNIE EDMUNDSON MEMORIAL HOSPITAL IS AN AFFILIATED MEMBER OF THE NEBRASKA METHODIST HEALTH SYSTEM. POLICIES ARE CENTRALIZED AT NEBRASKA METHODIST HEALTH SYSTEM INC. METHODIST HEALTH SYSTEM, WITH WHICH JENNIE EDMUNDSON IS AFFILIATED, RETAINS AN INDEPENDENT CONSULTANT TO REVIEW ALL OFFICER COMPENSATION FOR EACH AFFILIATE. UNDER THIS PROCESS, MARKET DATA ON COMPENSATION IS GATHERED AND ANALYZED AND COMPENSATION RANGES ARE SET. THE INFORMATION IS THEN PROVIDED TO THE COMPENSATION COMMITTEE OF THE BOARD OF NEBRASKA METHODIST HEALTH SYSTEM INC., A NEBRASKA NON-PROFIT CORPORATION AND A VOTING MEMBER OF JENNIE EDMUNDSON MEMORIAL HOSPITAL. ALL OFFICER COMPENSATION IS REVIEWED, EVALUATED AND APPROVED BY THIS COMMITTEE. PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NONQUALIFIED PLAN DURING 2014 AND RECEIVED CONTRIBUTIONS, PLAN ACCRUALS OR PLAN DISTRIBUTIONS IN THE FOLLOWING AMOUNTS: STEVEN BAUMERT $27,554 ACCRUAL LINDA BURT $59,336 ACCRUAL; $66,637 PLAN DISTRIBUTION WILLIAM SHIFFERMILLER MD $35,380 ACCRUAL;PLAN DISTRIBUTION $56,076 JOHN SOUTHARD MD MEMBER OF THE BOARD 460000 DR. SOUTHARD IS A 50% OWNER OF PULMONARY/INFECTIOUS DISEASE WHICH CONTRACTS WITH THE HOSPITAL TO PROVIDE SERVICES. 0 FORM 990, PART V, LINE 2B THE PAYROLL SYSTEM FOR JENNIE EDMUNDSON MEMORIAL HOSPITAL IS BEING HANDLED BY A COMMON PAYMASTER, NEBRASKA METHODIST HEALTH SYSTEM INC. ALL W-2 FORMS ARE ISSUED UNDER THE TAX IDENTIFICATION NUMBER OF NEBRASKA METHODIST HEALTH SYSTEM. ALL REQUIRED FEDERAL EMPLOYMENT TAX RETURNS WERE FILED BY NEBRASKA METHODIST HEALTH SYSTEM. WAGES AND BENEFITS SHOWN IN THIS FORM 990 ARE ACTUAL EXPENSES ASSOCIATED WITH JENNIE EDMONDSON MEMORIAL HOSPITAL PERSONNEL. FORM 990, PART VI, SECTION A, LINE 6 UNDER THE ARTICLES OF INCORPORATION OF JENNIE EDMUNDSON MEMORIAL HOSPITAL, AS RESTATED ON APRIL 29, 1994, THE WOMEN'S CHRISTIAN ASSOCIATION OF IOWA, AN IOWA NON-PROFIT CORPORATION IS A SPONSORING MEMBER OF JENNIE EDMUNDSON MEMORIAL HOSPITAL. UNDER THE SAME ARTICLES OF INCORPORATION, NEBRASKA METHODIST HEALTH SYSTEM INC.,A NEBRASKA NON-PROFIT CORPORATION, IS A CORPORATE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A UNDER THE ARTICLES OF INCORPORATION OF JENNIE EDMUNDSON MEMORIAL HOSPITAL, AS RESTATED ON APRIL 29 1994, THE WOMEN'S CHRISTIAN ASSOCIATION OF COUNCIL BLUFFS, IOWA, AN IOWA NON-PROFIT CORPORATION, IS A SPONSORING MEMBER OF THE ORGANIZATION AND HAS THE RIGHT TO NOMINATE TWO (2) OF ITS MEMBERS TO THE HOSPITAL'S BOARD OF DIRECTORS. LIKEWISE, THE NEBRASKA METHODIST HEALTH SYSTEM INC. HAS THE RIGHT TO NOMINATE TO THE HOSPITAL'S BOARD OF DIRECTORS THE NUMBER OF DIRECTORS THAT IS ONE (1) LESS THAN A MAJORITY OF THE SEATS ON THE BOARD OF DIRECTORS. NEBRASKA METHODIST HEALTH SYSTEM ALSO HAS THE RIGHT TO APPROVE ALL OF THE DIRECTORS NOMINATED. FORM 990, PART VI, SECTION B, LINE 11 PRIOR TO FILING THE FORM 990, A COPY IS PROVIDED TO THE AUDIT AND COMPLIANCE COMMITTEE OF NEBRASKA METHODIST HEALTH SYSTEM AND THE JENNIE EDMUNDSON MEMORIAL HOSPITAL BOARD OF DIRECTORS. THEY ARE GIVEN AN OPPORTUNITY TO ASK QUESTIONS OR REQUEST MORE INFORMATION. INFORMATION FOR THE FORM 990 IS GATHERED FROM APPROPRIATE RESPONSIBLE PARTIES THROUGHOUT THE ORGANIZATION, INCLUDING THE ORGANIZATION'S HUMAN RESOURCES, FINANCE, COMPLIANCE, AND COMMUNITY NETWORKING DEPARTMENTS; IS REVIEWED BY EXTERNAL TAX ADVISORS AND HAS A FINAL REVIEW BY THE CHIEF FINANCIAL OFFICER FOR NEBRASKA METHODIST HEALTH SYSTEM AND THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER. FORM 990, PART VI, SECTION B, LINE 12C AN ANNUAL QUESTIONNAIRE IS SENT TO ALL OFFICERS, DIRECTORS, COMMITTEE MEMBERS, MEDICAL DIRECTORS, AND KEY EMPLOYEES PURSUANT TO THE METHODIST HEALTH SYSTEM CONFLICTS OF INTEREST POLICY WHICH REQUIRES THE DISCLOSURE RELATIONSHIPS, NOT JUST FINANCIAL, THAT COULD GIVE RISE TO CONFLICTS WITH THE ORGANIZATION. A BOARD COMMITTEE MEETS ANNUALLY TO REVIEW ALL POTENTIAL CONFLICTS IDENTIFIED THROUGH THE SURVEYS. SHOULD A DECISION COME TO THE BOARD WITH AN IDENTIFIED CONFLICT, THE OFFICER, DIRECTOR OR KEY EMPLOYEE IS NOT PERMITTED TO VOTE OR USE PERSONAL INFLUENCE ON THE MATTER AND IS NOT COUNTED IN DETERMINING THE QUORUM FOR A MEETING AT WHICH THE MATTER IS DISCUSSED. A POTENTIAL CONFLICT OF INTEREST ONCE IDENTIFIED MUST BE EVALUATED ON A CASE BY CASE BASIS. IN ORDER TO APPROVE THE TRANSACTION WHICH INVOLVES A DIRECT CONFLICT OF INTEREST, THE BOARD MUST FIRST FIND, BY MAJORITY VOTE OF DIRECTORS FOR WHOM NO CONFLICT EXISTS, AT A MEETING AT WHICH A QUORUM IS PRESENT, THAT THE ARRANGEMENT OR TRANSACTION IS IN THE BEST INTERESTS OF JENNIE EDMUNDSON MEMORIAL HOSPITAL AND/OR ITS HEALTH SYSTEM AFFILIATES, IS FAIR AND REASONABLE AND, AFTER INVESTIGATION, THE DIRECTORS HAVE DETERMINED THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE OBTAINED WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. FORM 990, PART VI, SECTION B, LINE 15 JENNIE EDMUNDSON MEMORIAL HOSPITAL IS AN AFFILIATED MEMBER OF THE NEBRASKA METHODIST HEALTH SYSTEM. POLICIES ARE CENTRALIZED AT NEBRASKA METHODIST HEALTH SYSTEM INC. METHODIST HEALTH SYSTEM, WITH WHICH JENNIE EDMUNDSON IS AFFILIATED, RETAINS AN INDEPENDENT CONSULTANT TO REVIEW ALL OFFICER COMPENSATION FOR EACH AFFILIATE. UNDER THIS PROCESS, MARKET DATA ON COMPENSATION IS GATHERED AND ANALYZED AND COMPENSATION RANGES ARE SET. THE INFORMATION IS THEN PROVIDED TO THE COMPENSATION COMMITTEE OF THE BOARD OF NEBRASKA METHODIST HEALTH SYSTEM INC., A NEBRASKA NON-PROFIT CORPORATION AND THE VOTING MEMBER OF JENNIE EDMUNDSON MEMORIAL HOSPITAL. ALL OFFICER COMPENSATION IS REVIEWED, EVALUATED AND APPROVED BY THIS COMMITTEE. PHYSICIAN COMPENSATION IS COMPARED TO NATIONAL COMPENSATION SURVEY DATA FROM THE MEDICAL GROUP MANAGEMENT ASSOCIATION (MGMA) AND THE AMERICAN MEDICAL GROUP ASSOCIATION (AMGA). THE POLICY ON "PHYSICIAN COMPENSATION" IS FOLLOWED WHEN CONTRACTING WITH PHYSICIANS TO ENSURE APPROPRIATE APPROVALS, INCLUDING APPROVAL BY THE BOARD OF DIRECTORS, ARE OBTAINED WHEN WARRANTED. OPINIONS OF FAIR MARKET VALUE REGARDING A PARTICULAR COMPENSATION ARRANGEMENT OR TRANSACTION MAY ALSO BE OBTAINED FROM REPUTABLE, INDEPENDENT VALUATION CONSULTANTS. FORM 990, PART VI, SECTION C, LINE 18 THE FORM 1023 WAS FILED PRIOR TO 7/15/87 AND NEED NOT BE MADE PUBLICLY AVAILABLE. A COPY OF THE IRS LETTER 947 WILL BE PROVIDED UPON WRITTEN REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE THESE DOCUMENTS SEPARATELY AVAILABLE TO THE PUBLIC. HOWEVER, ARTICLES OF INCORPORATION FOR THE ORGANIZATION ARE AVAILABLE THROUGH THE IOWA SECRETARY OF STATE'S WEBSITE. THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED TO ALL MEMBERS OF THE BOARD OF DIRECTORS. FINANCIAL INFORMATION IS AVAILABLE TO THE PUBLIC THROUGH THE IRS FORM 990 AND FORM 990-T. THE ORGANIZATION ALSO CONTRIBUTES INFORMATION REGARDING THE COMMUNITY BENEFITS IT PROVIDES AS PART OF THE METHODIST HEALTH SYSTEM'S ANNUAL COMMUNITY BENEFIT REPORT. THIS REPORT IS AVAILABLE TO THE PUBLIC ON THE WEBSITE WWW.METHODISTCHART.ORG. FORM 990, PART XI, LINE 9: CHANGE IN MINIMUM PENSION LIABILITY -8,657,264. CAPITAL TRANSFERS FROM AFFILIATES 283,983. JENNIE EDMUNDSON MEMORIAL HOSPITAL FOUNDATION 933 EAST PIERCE STREET COUNCIL BLUFFS IA 51503 421439454 SUPPORT OF JENNIE EDMUNDSON HOSPITAL IA 501(C)(3) L7 JENNIE EDMUNDSON MEMORIAL HOSPITAL 1 WOMEN'S CHRISTIAN ASSOCIATION OF COUNCIL BLUFFS IOWA 933 EAST PIERCE STREET COUNCIL BLUFFS IA 51503 930957829 MEMBER OF JENNIE EDMUNDSON MEMORIAL HOSPITAL IA 501(C)(3) L11: III-O N/A 0 NEBRASKA METHODIST HEALTH SYSTEM INC 8511 W DODGE ROAD OMAHA NE 68114 470639839 ADMINISTRATIVE SUPPORT NE 501(C)(3) L11: III-FI N/A 0 NEBRASKA METHODIST HOSPITAL 8511 W DODGE ROAD OMAHA NE 68114 470376604 LICENSED HOSPITAL NE 501(C)(3) L3 NEBRASKA METHODIST HEALTH SYSTEM INC 0 NEBRASKA METHODIST COLLEGE OF NURSING & ALLIED HEALTH 8511 W DODGE ROAD OMAHA NE 68114 470724387 NURSING AND HEALTH EDUCATION FACILITY NE 501(C)(3) L2 NEBRASKA METHODIST HOSPITAL 0 NEBRASKA METHODIST HEALTH SYSTEM SELF INSURANCE TRUST FUND 8511 W DODGE ROAD OMAHA NE 68114 363699672 INSURANCE NE 501(C)(3) L11: III-FI NEBRASKA METHODIST HEALTH SYSTEM INC 0 REAL ESTATE HOLDINGS 8511 W DODGE ROAD OMAHA NE 68114 470649790 PROPERTY MANAGEMENT NE 501(C)(2) N/A NEBRASKA METHODIST HEALTH SYSTEM INC 0 PHYSICIANS CLINIC INC 8511 W DODGE ROAD OMAHA NE 68114 470687317 CLINICAL HEALTH CARE NE 501(C)(3) L9 NEBRASKA METHODIST HEALTH SYSTEM INC 0 NEBRASKA METHODIST HOSPITAL FOUNDATION 8511 W DODGE ROAD OMAHA NE 68114 470595345 SUPPORT OF NEBRASKA METHODIST HOSPITAL NE 501(C)(3) L7 NEBRASKA METHODIST HEALTH SYSTEM INC 0 SHARED SERVICE SYSTEMS INC 8511 W DODGE ROAD OMAHA NE 68114 470649534 MEDICAL SUPPLY DISTRIBUTION & LAUNDRY NE NEBRASKA METHODIST HEALTH SYSTEM INC C 0 METHODIST HEALTH PARTNERS 8511 W DODGE ROAD OMAHA NE 68114 470797563 MANAGED CARE CONTRACTING NE NEBRASKA METHODIST HEALTH SYSTEM INC C 0 0 1 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 JENNIE EDMUNDSON MEMORIAL HOSPITAL FOUNDATION C 222962 BOOK