LANDMANN JUNGMAN MEMORIAL HOSPITAL CORPORATION: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- LANDMANN JUNGMAN MEMORIAL HOSPITAL CORPORATION (EIN 46-6015787)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-07-15
- IRS object ID
- 201311979349300311
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-07-15T11:42:17-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450250958 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EIDE BAILLY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 EAST 10TH ST PO BOX 5125 | AddressLine1 |
| City | SIOUX FALLS | City |
| State | SD | State |
| ZIP Code | 571175125 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 466015787 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LANDMANN-JUNGMAN MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | LAND | NameControl |
| Phone | 6055832226 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 BILLARS STREET | AddressLine1 |
| City | SCOTLAND | City |
| State | SD | State |
| ZIP Code | 570592026 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DARCY KEPPLINGER | Name |
| Title | INTERIM CEO | Title |
| Phone | 6055862226 | Phone |
| Date Signed | 2013-07-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LAURIE HANSON | Name |
| PTIN | P00851848 | PTIN |
| Phone | 6053391999 | Phone |
| Date Prepared | 2013-07-15 | DatePrepared |
| Self Employed | X | SelfEmployed |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DARCY KEPPLINGER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 BILLARS STREET | AddressLine1 |
| City | SCOTLAND | City |
| State | SD | State |
| ZIP Code | 570592026 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 3763456 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.LJMH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1969 | YearFormation |
| State Legal Domicile | SD | StateLegalDomicile |
| Activity Or Mission Description | OPERATION OF A COMMUNITY CRITICAL ACCESS HOSPITAL. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 49 | TotalNbrEmployees |
| Total Nbr Volunteers | 10 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 15583 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 54808 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 3539996 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 3696534 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 9165 | InvestmentIncomePriorYear |
| Investment Income Current Year | 10314 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 700 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1800 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 3565444 | TotalRevenuePriorYear |
| Total Revenue Current Year | 3763456 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 1436150 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 1353574 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 2552591 | OtherExpensePriorYear |
| Other Expenses Current Year | 2546220 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 3988741 | TotalExpensesPriorYear |
| Total Expenses Current Year | 3899794 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -423297 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -136338 | RevenuesLessExpensesCY |
| Total Assets BOY | 4153875 | TotalAssetsBOY |
| Total Assets EOY | 4116606 | TotalAssetsEOY |
| Total Liabilities BOY | 2419454 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2505614 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1734421 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1610992 | NetAssetsOrFundBalancesEOY |
| Mission Description | LANDMANN-JUNGMAN MEMORIAL HOSPITAL IS COMMITTED TO PROVIDING THE HIGHEST QUALITY HEALTHCARE WITH COMPASSION AND RESPECT. OUR COMMITMENT SHALL BE TO THE ETHICAL TREATMENT OF ALL PEOPLE THROUGHOUT THE CONTINUUM OF LIFE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 3478738 | Expense |
| Revenue | 3672173 | Revenue |
| Description | LANDMANN-JUNGMAN MEMORIAL HOSPITAL (LJMH) IS A LICENSED CRITICAL ACCESS HOSPITAL WITH 25 ACUTE CARE BEDS AND 10 SWING BEDS. THE FACILITY OFFERS INPATIENT, OUTPATIENT AND PHYSICIAN CLINIC SERVICES TO RESIDENTS IN AND AROUND THE CITY OF SCOTLAND, SD. SEVERAL VISITING SPECIALISTS SPEND TIME AT LJMH CONDUCTING OUTREACH CLINICS ON A REGULAR BASIS WHICH INCLUDE AREAS OF CARDIOLOGY, GENERAL SURGERY, OB/GYN, MOBILE MRI, CT, NUCLEAR MEDICINE AND MAMMOGRAPHY. WEST WINDS APARTMENTS IS ALSO PART OF LJMH AND SERVES AS A 16 UNIT SENIOR HOUSING APARTMENT BUILDING. LJMH IS PROUD OF THE EXCELLENT CARE IT PROVIDES FOR PATIENTS OF THE SERVICE AREA. THE FACILITY IS ALSO NOTED FOR ITS COMMUNITY SERVICE, WHICH INCLUDES AN ANNUAL HEALTH FAIR AND BI-MONTHLY BLOOD DRIVES. | Description |
| Total Program Service Expense | 3478738 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 12 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 49 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DARCY KEPPLINGER | NamePerson |
| Telephone Number | 6055832226 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 BILLARS STREET | AddressLine1 |
| City | SCOTLAND | City |
| State | SD | State |
| ZIP Code | 57059 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (12 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| KENT LEHR | ||||||
| PRESIDENT | 1.00 | X | X | 0 | 0 | 0 |
| GREG GEMAR | ||||||
| VICE PRESIDENT | 1.00 | X | X | 0 | 0 | 0 |
| SHIRLEY HERRBOLDT | ||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 |
| DAVID BAKER | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| RICK MEYER | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JENNIFER SEDLACEK | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| CHARLES MOGCK | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| STEVE FLETT | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| DENNIS BIETZ | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JARAD SCHORTZMAN | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| LEE BALDWIN | ||||||
| CEO | 50.00 | X | 73865 | 0 | 7379 | |
| DARCY KEPPLINGER | ||||||
| CFO | 40.00 | X | 54263 | 0 | 1085 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 128128 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 8464 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 1 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AVERA MCKENNAN | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1325 S CLIFF AVE PO BOX 5045 | AddressLine1 |
| City | SIOUX FALLS | City |
| State | SD | State |
| ZIP Code | 571175045 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | MANAGEMENT, IT, EDUCATION | DescriptionOfServices |
| Compensation | 273501 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| All Other Contributions | 54808 | AllOtherContributions |
| Total Contributions | 54808 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SERVICE RE | 621110 | 2719356 | 2719356 |
| SCOTLAND PHARMACY | 446110 | 844119 | 844119 |
| WEST WINDS REVENUE | 623990 | 93349 | 93349 |
| CHANGE IN AVERA FOUNDA | 900099 | 15349 | 15349 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 24361 | TotalRevenueColumn |
| Exclusion | $24,361 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 3696534 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 10314 | TotalRevenueColumn |
| Exclusion | $10,314 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1800 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1800 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1800 | TotalRevenueColumn |
| Exclusion | $1,800 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3763456 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3672173 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $36,475 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 148516 | Total |
| Management And General | 148516 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1025928 | Total |
| Program Services | 952157 | ProgramServices |
| Management And General | 73771 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10111 | Total |
| Program Services | 9869 | ProgramServices |
| Management And General | 242 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 90737 | Total |
| Program Services | 85537 | ProgramServices |
| Management And General | 5200 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 78282 | Total |
| Program Services | 69003 | ProgramServices |
| Management And General | 9279 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 39365 | Total |
| Management And General | 39365 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 731268 | Total |
| Program Services | 701165 | ProgramServices |
| Management And General | 30103 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10262 | Total |
| Program Services | 85 | ProgramServices |
| Management And General | 10177 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 146040 | Total |
| Program Services | 89638 | ProgramServices |
| Management And General | 56402 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72762 | Total |
| Program Services | 72762 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4791 | Total |
| Program Services | 4714 | ProgramServices |
| Management And General | 77 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 102013 | Total |
| Program Services | 102013 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 350385 | Total |
| Program Services | 350385 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28453 | Total |
| Program Services | 9000 | ProgramServices |
| Management And General | 19453 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 932077 | 932077 | |
| BAD DEBT | 86931 | 86931 | |
| COMMUNITY & EMPLOYEE RE | 25350 | 25350 | |
| CONTINUING EDUCATION | 14515 | 13251 | 1264 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2008 | Total |
| Program Services | 151 | ProgramServices |
| Management And General | 1857 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3899794 | Total |
| Program Services | 3478738 | ProgramServices |
| Management And General | 421056 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 84048 | BOY |
| EOY | 175231 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 112728 | BOY |
| EOY | 40173 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 516996 | BOY |
| EOY | 668256 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 163947 | BOY |
| EOY | 157018 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7075 | BOY |
| EOY | 20022 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 7150291 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 4660115 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2682064 | BOY |
| EOY | 2490176 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 466764 | BOY |
| EOY | 496747 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 120253 | BOY |
| EOY | 68983 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4153875 | BOY |
| EOY | 4116606 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 323642 | BOY |
| EOY | 646218 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1925314 | BOY |
| EOY | 1737042 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 170498 | BOY |
| EOY | 122354 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2419454 | BOY |
| EOY | 2505614 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1621693 | BOY |
| EOY | 1567928 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 112728 | BOY |
| EOY | 43064 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1734421 | BOY |
| EOY | 1610992 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4153875 | BOY |
| EOY | 4116606 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -136338 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 12909 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 0 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 36163 | OtherCostOrOtherBasis |
| Book Value | 36163 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4461668 | OtherCostOrOtherBasis |
| Depreciation | 2219248 | Depreciation |
| Book Value | 2242420 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2567184 | OtherCostOrOtherBasis |
| Depreciation | 2408518 | Depreciation |
| Book Value | 158666 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 85276 | OtherCostOrOtherBasis |
| Depreciation | 32349 | Depreciation |
| Book Value | 52927 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2490176 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (3 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| DEBT RESERVE FUNDS | 46524 | C |
| INTEREST IN NET ASSETS OF AVERA HEALTH FOUNDATION | 102019 | F |
| CAPITAL EXPENDITURES AND DEBT REDEMPTION | 348204 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 496747 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| LJM APARTMENT RESIDENT FEE PAYABLE | $52,000 |
| CONDITIONAL ASSET RETIREMENT OBLIGATION | $63,371 |
| DAMAGE DEPOSITS PAYABLE | $6,983 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 122354 | TotalOfAmounts |
| Total Revenue | 3763456 | TotalRevenue |
| Total Expenses | 3899794 | TotalExpenses |
| Excess Or Deficit For Year | -136338 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 12909 | NetUnrealizedGLOnInvestments |
| Total Adjustments | 12909 | TotalAdjustments |
| Excess Or Deficit Per FS | -123429 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 3667995 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 12909 | NetUnrealizedGainsInvestments |
| Other Revenues | -86931 | OtherRevenues |
| Revenue Not Rptd F990 | -74022 | RevenueNotRptdF990 |
| Revenue Subtotal | 3742017 | RevenueSubtotal |
| Other Revenues Not Included | 21439 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 21439 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 3763456 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 3812863 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 3812863 | ExpensesSubtotal |
| Other Expenses Not Included | 86931 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 86931 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 3899794 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | THE HOSPITAL BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE HOSPITAL WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | PROVISION FOR BAD DEBTS REPORTED IN REVENUE ON FINANCIAL STATEMENTS -86,931. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | CONTRIBUTIONS REPORTED IN FUND BALANCE FOR FINANCIAL STATEMENTS 21,439. | |
| PART XIII, LINE 4B - OTHER ADJUSTMENTS: | PROVISION FOR BAD DEBTS REPORTED IN REVENUE ON FINANCIAL STATEMENTS 86,931. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 150.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 231 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 231 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 127436 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 70988 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 56448 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01480 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 127667 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 70988 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 56679 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01490 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 784949 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 300622 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 484327 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12700 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 784949 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 300622 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 484327 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12700 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 912616 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 371610 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 541006 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.14190 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $86,931 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 1317493 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 1304448 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 13045 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 0 | WrittenDebtCollectionPolicy |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LANDMANN-JUNGMAN MEMORIAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 BILLARS STREET | AddressLine1 |
| City | SCOTLAND | City |
| State | SD | State |
| ZIP Code | 57059 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LANDMANN-JUNGMAN MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 0 | CHNAConducted |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 0 | UsesFPGFree |
| Uses FPG Discounted | 0 | UsesFPGDiscounted |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 0 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 1 | AmountsGenerallyBilled |
| Gross Charges | 1 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 2 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| WEST WINDS APARTMENTS | ||||
| 600 BILLARS STREET | SCOTLAND | SD | 57059 | SENIOR LIVING |
| LANDMANN-JUNGMAN MEMORIAL CLINIC | ||||
| 600 BILLARS STREET | SCOTLAND | SD | 57059 | PROVIDER BASED CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| PART I, LINE 6A: LJMH PREPARES A COMMUNITY BENEFIT REPORT THAT IS SUBMITTED TO AVERA HEALTH. THE INFORMATION IS MADE AVAILABLE TO THE PUBLIC THROUGH AVERA HEALTH'S COMMUNITY BENEFIT REPORT. | |
| PART I, LINE 7: CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7 BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. LINES 7B AND 7G WERE OBTAINED UTILIZING THE MEDICARE COST REPORT. | |
| PART I, L7 COL(F): BAD DEBT EXPENSE OF $86,931 WAS SUBTRACTED FROM TOTAL OPERATING EXPENSE. | |
| PART III, LINE 4: A) THE AMOUNT REPORTED ON LINE 2 REPRESENTS THE BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS.B) LJMH BAD DEBT SYSTEM TAKES INTO ACCOUNT CONTRACTUAL ALLOWANCES AND/OR DISCOUNTS. IF AN ACCOUNT IS WRITTEN OFF TO BAD DEBTS, PAYMENTS RECEIVED AFTER THE WRITE OFF FOR THAT ACCOUNT ARE POSTED TO THE BAD DEBT RECOVERY ACCOUNT. C) THE AMOUNT OF BAD DEBT THAT MAY BE ATTRIBUTABLE TO CHARITY CARE IS UNKNOWN. D) FOOTNOTE FROM FINANCIAL STATEMENT: PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY).FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL 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.THE HOSPITAL'S PROCESS FOR CALCULATING THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS HAS NOT SIGNIFICANTLY CHANGED FROM SEPTEMBER 30, 2011 TO SEPTEMBER 30, 2012. THE HOSPITAL DOES NOT MAINTAIN A MATERIAL ALLOWANCE FOR DOUBTFUL ACCOUNTS FROM THIRD-PARTY PAYORS, NOR DID IT HAVE SIGNIFICANT WRITE OFFS FROM THIRD-PARTY PAYORS. THE HOSPITAL HAS NOT SIGNIFICANTLY CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING FISCAL YEARS 2011 OR 2012. | |
| PART III, LINE 8: MEDICARE ALLOWABLE COST OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR THE FISCAL YEAR ENDING 9/30/2012. | |
| PART V, SECTION B, LINE 9: LJMH USED A SLIDING SCALE TO DETERMINE ELIGIBILITY FOR FREE CARE, HOWEVER,THE POLICY DOES NOT INCLUDE THE STATED FPG INCOME LIMIT. THE FPG LIMIT USED DURING THE YEAR WAS 150%. | LANDMANN-JUNGMAN MEMORIAL HOSPITAL |
| PART V, SECTION B, LINE 10: LJMH USES A SLIDING SCALE TO DETERMINE ELIGIBILITY FOR DISCOUNTED CARE, HOWEVER, THE POLICY DOES NOT INCLUDE THE STATED FPG INCOME LIMIT. DURING THE YEAR ENDED 9/30/12, THE HOSPITAL DID NOT PROVIDE DISCOUNTED CARE (ONLY FREE CARE). | LANDMANN-JUNGMAN MEMORIAL HOSPITAL |
| PART V, SECTION B, LINE 15E: BILLS ARE DUE WITHIN 30 DAYS OF THE BILLING DATE. A 10 DAY NOTICE IS SENT AFTER THE 30 DAY PERIOD HAS PASSED. IF THERE IS NO RESPONSE TO EITHER BILL, THE ACCOUNT IS SENT TO COLLECTIONS. THE HOSPITAL IS IN THE PROCESS OF REVIEWING THEIR PROCEDURES TO ENSURE THEY ARE IN COMPLIANCE WITH 501(R). | LANDMANN-JUNGMAN MEMORIAL HOSPITAL |
| PART V, SECTION B, LINE 19D: PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE ARE CHARGED THE STANDARD CHARGEMASTER RATE LESS THE APPLICABLE PERCENTAGE DISCOUNT AS DETERMINED BASED ON A SLIDING SCALE. THE HOSPITAL WILL REVIEW THE PROPOSED METHODS FOR AMOUNTS GENERALLY BILLED TO ENSURE ITS DISCOUNT UNDER THE FINANCIAL ASSISTANCE POLICY MEETS THE REQUIREMENTS OF 501(R). | LANDMANN-JUNGMAN MEMORIAL HOSPITAL |
| PART V, SECTION B, LINE 20: LJMH CHARGED ALL PATIENTS THE STANDARD CHARGEMASTER RATE, REGARDLESS OF THEIR ABILITY TO PAY. DISCOUNTS WERE APPLIED DIRECTLY AGAINST THE CHARGEMASTER RATE. DISCOUNTS PROVIDED UNDER THE FINANCIAL ASSISTANCE POLICY DURING THE YEAR ENDED 9/30/12 RESULTED SOLELY IN FREE CARE. LJMH IS IN THE PROCESS OF DEVELOPING A FORMULA FOR CALCULATING AMOUNTS GENERALLY BILLED TO BE IN COMPLIANCE WITH 501(R). | LANDMANN-JUNGMAN MEMORIAL HOSPITAL |
| PART V, SECTION B, LINE 21: LJMH CHARGED ALL PATIENTS THE STANDARD CHARGEMASTER RATE, REGARDLESS OF THEIR ABILITY TO PAY. DISCOUNTS WERE APPLIED DIRECTLY AGAINST THE CHARGEMASTER RATE. LJMH IS IN THE PROCESS OF DEVELOPING A FORMULA FOR CALCULATING AMOUNTS GENERALLY BILLED TO BE IN COMPLIANCE WITH 501(R). | LANDMANN-JUNGMAN MEMORIAL HOSPITAL |
| PART VI, LINE 2: LANDMANN-JUNGMAN MEMORIAL HOSPITAL (LJMH) CONDUCTS PATIENT SATISFACTION SURVEYS WHICH CAN LEAD TO INFORMATION REGARDING NEEDED SERVICES. IN ADDITION WHILE CONDUCTING THE HEALTH SCREENINGS, INTERACTIVE QUESTIONS ARE ASKED ABOUT SERVICES AND THE RESULTS ARE REPORTED BACK TO THE OFFICERS AND BOARD. | |
| PART VI, LINE 3: PATIENTS ARE EDUCATED ABOUT ELIGIBILITY AS THEY INQUIRE ABOUT ASSISTANCE. IN ADDITION, THE POLICY IS POSTED IN THE EMERGENCY ROOM, WAITING ROOMS, AND IN THE ADMISSIONS OFFICE. | |
| PART VI, LINE 4: LJMH IS LOCATED IN SCOTLAND, SD, AND PRIMARILY SERVES THE COUNTIES OF BON HOMME AND HUTCHINSON. THE POPULATION OF THE SERVICE AREA IS ROUGHLY 14,413 PEOPLE, AND SCOTLAND HAS A POPULATION OF 841 PEOPLE. OF THE 14,413 PEOPLE RESIDING IN BOTH COUNTIES, AN AVERAGE OF 22.05% ARE 65 YEARS OLD AND OVER WHICH IS ATTRIBUTABLE TO THE AVERAGE OF 78.60% OF INPATIENT DAYS BEING PROVIDED TO PATIENTS 65 YEARS OLD AND OVER. IF ONE LOOKS AT THE COUNTIES AS A WHOLE, THE AVERAGE MEDIAN HOUSEHOLD INCOME IS $40,208 WITH THE MEDIAN FAMILY INCOME BEING $50,428. BOTH COUNTIES ARE CONSIDERED MEDICALLY UNDERSERVED BY HRSA AND THE SD DEPARTMENT OF HEALTH. | |
| PART VI, LINE 5: LANDMANN JUNGMAN COMMUNITY HOSPITAL IS FOCUSED ON SERVING THE NEEDS OF THE COMMUNITY. THE GOVERNING BODY OF THE HOSPITAL IS MADE UP ENTIRELY OF VOLUNTEERS FROM THE COMMUNITY. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO QUALIFIED PHYSICIANS IN ITS COMMUNITY. EXCESS FUNDS ARE USED FOR THE IMPROVEMENT OF PATIENT CARE AND FACILITIES. THE HOSPITAL IS USED BY THE UNIVERSITY OF SOUTH DAKOTA FOR NURSING CLINICALS, AS WELL AS BY THE PHARMACY AND HIM PROGRAMS. IT IS OPEN TO ANYONE WHO WANTS TO LEARN ABOUT CAREERS IN THE HEALTH CARE INDUSTRY.THE HOSPITAL OPERATES AN EMERGENCY ROOM THAT IS AVAILABLE TO ALL REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL ADMINISTRATION IS VERY RECEPTIVE TO INPUT FROM THE COMMUNITY. AN AUXILLIARY SUPPORTS THE HOSPITAL AND PROVIDES THE HOSPITAL WITH FEEDBACK ON AN INFORMAL BASIS. THE HOSPITAL IS THE ONLY HEALTHCARE FACILITY IN TOWN, WITH THE EXCEPTION OF A CLINIC WHICH IS NOT AFFILIATED WITH THE HOSPITAL. | |
| PART VI, LINE 6: LJMH IS A MANAGED FACILITY OF AVERA HEALTH. AVERA HEALTH AND THE HOSPITAL WORK COOPERATIVELY TO ENHANCE HEALTHCARE THROUGHOUT THE COMMUNITY SERVED BY LJMH. AS A MANAGED FACILITY, LJMH IS ABLE TO PARTICIPATE IN AVERA E-CARE SERVICES. THESE SERVICES INCLUDE AVERA E-ICU, E-EMERGENCY, E-PHARMACY AND E-CONSULT. THESE SERVICES ALLOW RURAL PATIENTS TO BE CARED FOR AT THEIR LOCAL HOSPITALS, PROVIDE RURAL HOSPITALS ACCESS TO IMMEDIATE SPECIALTY CARE AND SUPPORT, AND HELP REDUCE HEALTH CARE COSTS AND TRAVEL.LJMH ALSO HAS ACCESS TO "BACK OFFICE" SUPPORT SERVICES, SUCH AS LEGAL CONSULTATION, QUALITY BENCHMARKING, CODING, COMPUTER SERVICES, CONTRACT NEGOTIATIONS, ADMINISTRATIVE CONSULTATION, GROUP PURCHASING, HUMAN RESOURCE ASSISTANCE AND MANY OTHER SERVICES. AVERA HEALTH IS ABLE TO PROVIDE THESE SERVICES TO LJMH AT A COST BELOW THAT WHICH THE HOSPITAL COULD OTHERWISE ACHIEVE. IN TURN, LOCAL CAREGIVERS ARE ABLE TO DEVOTE MORE RESOURCES TO PATIENT AND RESIDENT CARE. AVERA HEALTH AND LJMH DEDICATE RESOURCES TO ENDEAVORS THAT MAKE A POSITIVE DIFFERENCE TO IMPROVE THE HEALTH OF THE COMMUNITIES THEY SERVE. THESE ACTIVITIES INCLUDE LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS, ECONOMIC DEVELOPMENT, PHYSICAL IMPROVEMENTS IN THE COMMUNITY, CONTRIBUTIONS TO NONPROFIT COMMUNITY ORGANIZATIONS, NONPROFIT EVENT SPONSORSHIPS, DONATED MEDICAL SUPPLIES, COMMUNITY HEALTH EDUCATION AND SUPPORT GROUPS, HEALTH SCREENINGS, FLU-SHOT CLINICS, COMMUNITY HEALTH EDUCATION AND VARIOUS OTHER ACTIVITIES. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | LEE BALDWIN | NamePerson |
| Base Compensation Filing Org | 73708 | BaseCompensationFilingOrg |
| Comp Based On Related Orgs | 0 | CompBasedOnRelatedOrgs |
| Bonus Filing Org | 0 | BonusFilingOrg |
| Bonus Related Orgs | 0 | BonusRelatedOrgs |
| Other Compensation Filing Org | 157 | OtherCompensationFilingOrg |
| Other Compensation Related Orgs | 0 | OtherCompensationRelatedOrgs |
| Deferred Comp Filing Org | 769 | DeferredCompFilingOrg |
| Deferred Comp Related Orgs | 0 | DeferredCompRelatedOrgs |
| Nontaxable Benefits Filing Org | 6796 | NontaxableBenefitsFilingOrg |
| Nontaxable Benefits Related Orgs | 0 | NontaxableBenefitsRelatedOrgs |
| Total Compensation Filing Org | 81430 | TotalCompensationFilingOrg |
| Total Compensation Related Orgs | 0 | TotalCompensationRelatedOrgs |
| Comp Report Prior990 Filing Org | 0 | CompReportPrior990FilingOrg |
| Comp Report Prior990 Related Orgs | 0 | CompReportPrior990RelatedOrgs |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SUPPLEMENTAL INFORMATION | Identifier |
| Return Reference | PART III | ReturnReference |
| Explanation | PART I, QUESTION 3: THE CEO IS COMPENSATED THROUGH A MANAGEMENT AGREEMENT WITH AVERA MCKENNAN, 800 E 21ST STREET, SIOUX FALLS, SD 57105. AVERA MCKENNAN UTILIZES A STUDY OF COMPARABLE FACILITIES OF SIMILAR SIZE TO DETERMINE THE COMPENSATION APPLICABLE FOR THE CEO POSITION TO THE HOSPITAL. THE STUDY IS PROVIDED BY AVERA HEALTH. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE IS COMPOSED OF THE PRESIDENT AND THREE BOARD MEMBERS. THE EXECUTIVE COMMITTEE SHALL HAVE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE FACILITY DURING THE INTERIM BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED ANY ACTION TAKEN SHALL NOT CONFLICT WITH THE POLICIES AND EXPRESSED WISHES OF THE BOARD OF DIRECTORS AND THAT IT SHALL REFER ALL MATTERS OF MAJOR IMPORTANCE TO THE BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION A, LINE 3 | THE ORGANIZATION PAYS A MANAGEMENT COMPANY FOR THE CEO'S SERVICES. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE CEO AND CFO REVIEW THE 990 IN DETAIL. A COPY OF THE 990 IS GIVEN TO THE BOARD MEMBERS BEFORE IT IS FILED WITH THE IRS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY APPLIES TO ALL BOARD MEMBERS AND MANAGEMENT. BOARD MEMBERS ARE RESPONSIBLE FOR DETERMINING WHETHER A POTENTIAL CONFLICT EXISTS WITH THE CEO AND BOARD MEMBERS. THE CEO IS RESPONSIBLE FOR DETERMINING IF THERE ARE POTENTIAL CONFLICTS OF INTEREST AMONGST MANAGEMENT. THE BOARD IS ULTIMATELY RESPONSIBLE FOR DETERMINING WHETHER AN ACTUAL CONFLICT EXISTS. ANY BOARD MEMBER WITH A CONFLICT IS REQUIRED TO ABSTAIN FROM VOTING ON THE MATTER OF CONFLICT. | |
| FORM 990, PART VI, SECTION B, LINE 15A | THE ORGANIZATION DOES NOT PAY ITS CEO DIRECTLY, RATHER THE HOSPITAL IS PAYING THE CEO THROUGH AN INDEPENDENT CONTRACTOR ARRANGEMENT WITH AVERA MCKENNAN. THE PROCESS USED TO SET THE TOP MANAGEMENT'S ANNUAL SALARY IS BASED ON A COMBINATION OF FACTORS WHICH INCLUDES THE ORGANIZATION'S AND AVERA MCKENNAN'S REVIEW OF SALARY SURVEYS ON A YEARLY BASIS COMPARING THE ORGANIZATIONS TO OTHERS OF SIMILAR SIZE. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC DURING ITS ANNUAL BOARD MEETING AND UPON REQUEST. THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED GAINS ON INVESTMENTS: 12,909. | CHANGES IN NET ASSETS OR FUND BALANCES: |
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