JENNIE EDMUNDSON MEMORIAL HOSPITAL: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- JENNIE EDMUNDSON MEMORIAL HOSPITAL (EIN 42-0680355)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-13
- IRS object ID
- 201343179349302334
- Schema version
- 2012v2.1
- 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 I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-13T13:19:01-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 135565207 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2 CENTRAL PARK PLAZA SUITE 1501 | AddressLine1 |
| City | OMAHA | City |
| State | NE | State |
| ZIP Code | 68102 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420680355 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JENNIE EDMUNDSON MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | JENN | NameControl |
| Phone | 4023544851 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 933 EAST PIERCE STREET | AddressLine1 |
| City | COUNCIL BLUFFS | City |
| State | IA | State |
| ZIP Code | 51503 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LINDA BURT | Name |
| Title | VICE PRES FINANCE, CFO | Title |
| Phone | 4023544000 | Phone |
| Date Signed | 2013-11-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| PTIN | P00223617 | PTIN |
| Phone | 4023481450 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | STEVEN BAUMERT | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 933 EAST PIERCE STREET | AddressLine1 |
| City | COUNCIL BLUFFS | City |
| State | IA | State |
| ZIP Code | 51503 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 95509486 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.BESTCARE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1894 | YearFormation |
| State Legal Domicile | IA | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE AND MAINTAIN HOSPITAL AND AMBULATORY FACILITIES FOR THE CARE OF PATIENTS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 834 | TotalNbrEmployees |
| Total Nbr Volunteers | 488 | TotalNbrVolunteers |
| Total Gross UBI | 181737 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -62696 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 606424 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 764810 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 91832269 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 91491298 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 243395 | InvestmentIncomePriorYear |
| Investment Income Current Year | 722054 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1239485 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1505649 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 93921573 | TotalRevenuePriorYear |
| Total Revenue Current Year | 94483811 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 5065862 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 6136409 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 41597668 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 45649437 | 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 | 44805982 | OtherExpensePriorYear |
| Other Expenses Current Year | 38861215 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 91469512 | TotalExpensesPriorYear |
| Total Expenses Current Year | 90647061 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2452061 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 3836750 | RevenuesLessExpensesCY |
| Total Assets BOY | 64622876 | TotalAssetsBOY |
| Total Assets EOY | 69207656 | TotalAssetsEOY |
| Total Liabilities BOY | 33580903 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 33768860 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 31041973 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 35438796 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 4592339 | Expense |
| Grants | 464817 | Grants |
| Revenue | 7038016 | Revenue |
| Description | 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. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 4155542 | Expense |
| Grants | 420277 | Grants |
| Revenue | 6357552 | Revenue |
| Description | 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. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 13021230 | Expense |
| Grants | 1003568 | Grants |
| Revenue | 15181087 | Revenue |
| Description | 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. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 60816547 | Expense |
| Grants | 4247747 | Grants |
| Revenue | 63603287 | Revenue |
| Description | 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. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 60816547 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 4247747 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 63603287 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 82585658 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | 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 | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | 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 | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | 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 | 1 | GrantsToOrganizations |
| Grants To Individuals | 1 | 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 | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 38 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 834 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| 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 | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | 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 | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | IA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LINDA BURT | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4023544851 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8511 WEST DODGE ROAD | AddressLine1 |
| City | OMAHA | City |
| State | NE | State |
| ZIP Code | 68114 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| 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 | ||
| ALLAN G LOZIER | |||||||||
| TREASURER | 1.00 | 0.00 | X | 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 | 348330 | 106327 | |||
| 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 | |||
| VELDA WEEKS | |||||||||
| 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 | 281801 | 78022 | |||
| LINDA BURT | |||||||||
| VICE PRES-FINANCE & CFO | 6.00 | 34.00 | X | 0 | 446423 | 89779 | |||
| MICHAEL ROMANO MD | |||||||||
| PHYSICIAN /EXEC MED AFFAIR | 40.00 | 0.00 | 218182 | 0 | 43299 | X | |||
| PEGGY HELGET | |||||||||
| EXEC. PATIENT SVCS | 40.00 | 0.00 | 154900 | 0 | 21552 | X | |||
| JAMES CHAMBERS | |||||||||
| EXEC. CLINICAL AFFAIRS | 40.00 | 0.00 | 164879 | 0 | 34015 | X | |||
| ALAN FISHER MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | 197037 | 0 | 36123 | X | |||
| NGUYET TRAN MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | 225285 | 0 | 7495 | X | |||
| DONNA HUBBELL | |||||||||
| EXEC. QUALITY & PT SAFETY | 40.00 | 0.00 | 127467 | 0 | 32610 | X | |||
| SAMUEL OAKES | |||||||||
| PHARMACIST | 40.00 | 0.00 | 139428 | 0 | 17928 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1227178 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1076554 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 467150 | TotalOtherCompensation |
| Number Individuals GT100 K | 24 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| PATHLAB LTD | |||||
| 933 EAST PIERCE STREET | COUNCIL BLUFFS | IA | 51503 | MEDICAL SERVICES | 6078198 |
| EMERGENCY PHYSICIANS WESTERN IOWA LLC | |||||
| 4950 SOUTH 177 CIRCLE | OMAHA | NE | 68135 | MEDICAL SERVICES | 1716563 |
| ACCELECARE WOUND CENTERS INC | |||||
| P O BOX 671242 | DALLAS | TX | 75267 | MEDICAL SERVICES | 882286 |
| HORIZON HEALTH MANAGEMENT | |||||
| P O BOX 840839 | DALLAS | TX | 75284 | MEDICAL SERVICES | 628795 |
| PSYCHIATRIC SERVICES OF WESTERN IOWA PC | |||||
| 933 EAST PIERCE STREET | COUNCIL BLUFFS | IA | 51503 | MEDICAL SERVICES | 341537 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 10 | NumberOfContractorsGT100K |
| Related Organizations | 740810 | RelatedOrganizations |
| All Other Contributions | 24000 | AllOtherContributions |
| Total Contributions | 764810 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SVC REV. | 621990 | 90841307 | 90841307 |
| OTHER PATIENT REVENUE | 621990 | 649991 | 649991 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 91491298 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 705164 | TotalRevenueColumn |
| Exclusion | $705,164 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1430653 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 889860 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 540793 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 540793 | TotalRevenueColumn |
| Exclusion | $540,793 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 41122 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 24232 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 16890 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 16890 | TotalRevenueColumn |
| Exclusion | $16,890 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 206058 | GrossSalesOfInventory |
| Cost Of Goods Sold | 111583 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 94475 | TotalRevenueColumn |
| Exclusion | $94,475 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| CAFETERIA | 722210 | 662249 | 662249 | |
| LABORATORY | 621500 | 181737 | 181737 | |
| TUITION REVENUE | 611600 | 26395 | 26395 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 870381 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 94483811 | TotalRevenueColumn |
| Related Or Exempt Function Income | 92179942 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 181737 | UnrelatedBusinessRevenue |
| Exclusion | $1,357,322 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46075 | Total |
| Program Services | 46075 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6090334 | Total |
| Program Services | 6090334 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 373082 | Total |
| Management And General | 373082 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33891865 | Total |
| Program Services | 33599519 | ProgramServices |
| Management And General | 292346 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2399105 | Total |
| Program Services | 2365286 | ProgramServices |
| Management And General | 33819 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6659849 | Total |
| Program Services | 6636012 | ProgramServices |
| Management And General | 23837 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2325536 | Total |
| Program Services | 2306474 | ProgramServices |
| Management And General | 19062 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 89974 | Total |
| Management And General | 89974 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18724 | Total |
| Management And General | 18724 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10621 | Total |
| Management And General | 10621 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6527476 | Total |
| Program Services | 6527476 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 199645 | Total |
| Program Services | 199645 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4663144 | Total |
| Program Services | 4663144 | ProgramServices |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17028 | Total |
| Program Services | 17028 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1225749 | Total |
| Program Services | 1225749 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71969 | Total |
| Program Services | 71969 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 411597 | Total |
| Program Services | 411597 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3861735 | Total |
| Program Services | 3861735 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 649365 | Total |
| Program Services | 519671 | ProgramServices |
| Management And General | 129694 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 11799090 | 11799090 | |
| ALLOCATIONS | 7070244 | 7070244 | |
| MEDICAID PROVIDER TAX | 859101 | 859101 | |
| DUES, LICENSES AND SUBS | 205595 | 205595 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1180158 | Total |
| Program Services | 1180158 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 90647061 | Total |
| Program Services | 82585658 | ProgramServices |
| Management And General | 8061403 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8367375 | BOY |
| EOY | 6800640 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13469274 | BOY |
| EOY | 13844973 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 715195 | BOY |
| EOY | 215752 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1101679 | BOY |
| EOY | 2034410 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 611743 | BOY |
| EOY | 474406 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 123624490 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 88349941 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37117530 | BOY |
| EOY | 35274549 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2294330 | BOY |
| EOY | 6917090 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 843139 | BOY |
| EOY | 3195659 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 102611 | BOY |
| EOY | 450177 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 64622876 | BOY |
| EOY | 69207656 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11228950 | BOY |
| EOY | 10125218 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6585000 | BOY |
| EOY | 5620000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15766953 | BOY |
| EOY | 18023642 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33580903 | BOY |
| EOY | 33768860 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30407127 | BOY |
| EOY | 34815950 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 534846 | BOY |
| EOY | 522846 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100000 | BOY |
| EOY | 100000 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31041973 | BOY |
| EOY | 35438796 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 64622876 | BOY |
| EOY | 69207656 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 3836750 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 176531 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 383542 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 1 | GrantsOtherOrganizations |
| Grants Other Organizations | $18,724 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 0 | OtherActivities |
| Total Lobbying Expenditures IIB | 18724 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | A PORTION OF THE ANNUAL DUES PAID TO THE AMERICAN HOSPITAL AND IOWA HOSPITAL ASSOCIATIONS IS ATTRIBUTABLE TO LOBBYING ACTIVITIES. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 199654 | BeginningOfYearBalance |
| Contributions | 5053 | Contributions |
| Investment Earnings Or Losses | 12759 | InvestmentEarningsOrLosses |
| Other Expenditures | 3500 | OtherExpenditures |
| End Of Year Balance | 213966 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 185484 | BeginningOfYearBalance |
| Contributions | 10963 | Contributions |
| Investment Earnings Or Losses | 9207 | InvestmentEarningsOrLosses |
| Other Expenditures | 6000 | OtherExpenditures |
| End Of Year Balance | 199654 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 183700 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 1784 | InvestmentEarningsOrLosses |
| End Of Year Balance | 185484 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 257776 | BeginningOfYearBalance |
| Contributions | 83700 | Contributions |
| Administrative Expenses | 157776 | AdministrativeExpenses |
| End Of Year Balance | 183700 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 257776 | BeginningOfYearBalance |
| End Of Year Balance | 257776 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.94200 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.05800 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2807651 | OtherCostOrOtherBasis |
| Book Value | 2807651 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 72931982 | OtherCostOrOtherBasis |
| Depreciation | 46826358 | Depreciation |
| Book Value | 26105624 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 47884857 | OtherCostOrOtherBasis |
| Depreciation | 41523583 | Depreciation |
| Book Value | 6361274 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 35274549 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| MINIMUM PENSION LIABILITY | $15,247,290 |
| COND. ASSET RETIREMENT OBLIGATION | $1,525,752 |
| ESTIMATED THIRD PARTY PAYABLE | $1,250,600 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 18023642 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | 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. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | 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 2012 AND 2011 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. |
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 |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 600.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| 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 | 3770334 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 735988 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3034346 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03350 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 11442877 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10510117 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 932760 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01030 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15213211 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11246105 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3967106 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04380 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 543954 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 543954 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00600 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 306929 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 306929 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00340 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 173224 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 173224 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00190 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 55976 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 55976 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1080083 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1080083 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01190 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 16293294 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11246105 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5047189 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05570 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 8288 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 8288 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 8288 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 8288 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $3,621,517 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 26772173 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 30272579 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -3500406 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| 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 | JENNIE EDMUNDSON MEMORIAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 933 EAST PIERCE STREET | AddressLine1 |
| City | COUNCIL BLUFFS | City |
| State | IA | State |
| ZIP Code | 51503 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.BESTCARE.ORG | WebsiteAddress |
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Teaching Hospital | X | TeachingHospital |
| 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 | JENNIE EDMUNDSON MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 1 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 0 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 600.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| Other Factors | X | OtherFactors |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (18 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| 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. EMERGENCY ROOM, TRANSPORT SERVICES, AND CLINICS IN UNDERSERVED AREAS ARE SERVICES THAT OPERATE AT NEGATIVE MARGINS. | |
| PART I, L7 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 FOLLOW 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: 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 STATEMENT, PAGE 9. | |
| PART III, LINE 8: SOURCE FOR MEDICARE REVENUE AND ALLOWABLE COSTS IS THE 2012 MEDICARE COST REPORT AS FILED. | |
| PART III, LINE 9B: COLLECTION PRACTICES FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE.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.JENNIE EDMUNDSON 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; FOOD STAMP ELIGIBILITY; 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. | |
| PART V, SECTION B, LINE 3: THE COMMUNITY NEEDS HEALTH 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 4: 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 7: JENNIE EDMUNDSON HOSPITAL DID NOT ADDRESS THE AREAS OF ORAL HEALTH AND SUBSTANCE ABUSE WHICH WERE OUTLINED IN THE CHNA. OTHER RESOURES IN THE COMMUNITY HAVE THE RESOURCES AND QUALIFICATIONS TO PROVIDE FOR THESE AREAS OF COMMUNITY HEALTH.JENNIE EDMUNDSON HOSPITAL WILL COLLABORATE WITH COMMUNITY ORGANIZATIONS THAT ARE ADDRESSING THESE NEEDS. | JENNIE EDMUNDSON MEMORIAL HOSPITAL |
| PART V, SECTION B, LINE 12H: JENNIE EDMUNDSON MEMORIAL HOSPITAL HAS ADOPTED A PROCEDURE FOR THOSE SITUATIONS IN WHICH A PATIENT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAS NOT OR CANNOT COMPLETE AN APPLICATION. THIS PROCEDURE, REFERRED TO AS PRESUMPTIVE CHARITY PROCESS, IS FOLLOWED BY HOSPITAL PERSONNEL AS WELL AS THIRD-PARTY VENDORS WHO HAVE BEEN ENGAGED TO ASSIST WITH SELF-PAY COLLECTIONS. | JENNIE EDMUNDSON MEMORIAL HOSPITAL |
| PART V, SECTION B, LINE 20D: THE AVERAGE COMMERCIAL INSURANCE RATE IS USED. | JENNIE EDMUNDSON MEMORIAL HOSPITAL |
| 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 INSURE 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 NEEDS. 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. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 0 | RecordsMaintained |
Recipient Table RecipientTable (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| IOWA WESTERN COMMUNITY COLLEGE FOUNDATION | |||||||
| 2700 COLLEGE ROAD | COUNCIL BLUFFS | IA | 51503 | 421224333 | 501(C)(3) | 17250 | EDUCATION / SCHOLARSHIPS |
| IOWA LEGAL AID SOCIETY | |||||||
| 532 FIRST AVENUE SUITE 300 | COUNCIL BLUFFS | IA | 51503 | 421079227 | 501(C)(3) | 10000 | LEGAL ASSISTANCE TO LOW INCOME INDIVIDUALS |
| UNIVERSITY OF IOWA FOUNDATION | |||||||
| P O BOX 4550 | IOWA CITY | IA | 52242 | 426004813 | 501(C)(3) | 15000 | EDUCATION |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 3 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII (2 entries)
| Type Of GrantTypeOfGrant | Number Of RecipientsNumberOfRecipients | Amount Of Cash GrantAmountOfCashGrant | Method Of ValuationMethodOfValuation | Amount Of Non Cash AssistanceAmountOfNonCashAssistance | Description Of Non Cash AssistanceDescriptionOfNonCashAssistance |
|---|---|---|---|---|---|
| SCHOLARSHIPS | 25 | 24000 | CASH | ||
| FINANCIAL ASSISTANCE | 10094 | BOOK | 6066334 | FINANCIAL ASSISTANCE TO PATIENTS |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: JENNIE EDMUNDSON MEMORIAL HOSPITAL ONLY PROVIDES GRANTS TO IRC SECTION 501(C)(3) ORGANIZATIONS TO ENSURE THE FUNDS ARE USED FOR EXEMPT PURPOSES. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | 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 (10 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WILLIAM SHIFFERMILLER MD | ||||||||||||||
| DIRECTOR | 0 | 294061 | 0 | 1074 | 0 | 53195 | 0 | 88901 | 0 | 19531 | 0 | 456762 | 0 | 41466 |
| STEVEN BAUMERT | ||||||||||||||
| PRESIDENT | 0 | 243901 | 0 | 0 | 0 | 37900 | 0 | 58411 | 0 | 20688 | 0 | 360900 | 0 | 0 |
| LINDA BURT | ||||||||||||||
| VICE PRES-FINANCE & CFO | 0 | 351687 | 0 | 0 | 0 | 94736 | 0 | 76099 | 0 | 14757 | 0 | 537279 | 0 | 72560 |
| MICHAEL ROMANO MD | ||||||||||||||
| PHYSICIAN /EXEC MED AFFAIR | 175490 | 0 | 0 | 0 | 42692 | 0 | 19632 | 0 | 24851 | 0 | 262665 | 0 | 0 | 0 |
| PEGGY HELGET | ||||||||||||||
| EXEC. PATIENT SVCS | 147739 | 0 | 0 | 0 | 7161 | 0 | 14187 | 0 | 8549 | 0 | 177636 | 0 | 0 | 0 |
| JAMES CHAMBERS | ||||||||||||||
| EXEC. CLINICAL AFFAIRS | 146627 | 0 | 0 | 0 | 18252 | 0 | 21341 | 0 | 13858 | 0 | 200078 | 0 | 0 | 0 |
| ALAN FISHER MD | ||||||||||||||
| PHYSICIAN | 197037 | 0 | 0 | 0 | 0 | 0 | 22723 | 0 | 14374 | 0 | 234134 | 0 | 0 | 0 |
| NGUYET TRAN MD | ||||||||||||||
| PHYSICIAN | 225285 | 0 | 0 | 0 | 0 | 0 | 7495 | 0 | 974 | 0 | 233754 | 0 | 0 | 0 |
| DONNA HUBBELL | ||||||||||||||
| EXEC. QUALITY & PT SAFETY | 115361 | 0 | 0 | 0 | 12106 | 0 | 13284 | 0 | 19326 | 0 | 160077 | 0 | 0 | 0 |
| SAMUEL OAKES | ||||||||||||||
| PHARMACIST | 139428 | 0 | 0 | 0 | 0 | 0 | 1325 | 0 | 17576 | 0 | 158329 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| 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 2012 AND RECEIVED CONTRIBUTIONS, PLAN ACCRUALS OR PLAN DISTRIBUTIONS IN THE FOLLOWING AMOUNTS: STEVEN BAUMERT $26,220 ACCRUAL LINDA BURT $58,333 ACCRUAL; $72,560 PLAN DISTRIBUTION WILLIAM SHIFFERMILLER MD $39,374 ACCRUAL;PLAN DISTRIBUTION $41,466 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| 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 COMMITTEE OF NEBRASKA METHODIST HEALTH SYSTEM AND THE JENNIE EDMUNDSON HOSPITAL BOARD OF DIRECTORS. THEY ARE GIVEN AN OPPORTUNITY TO ASK QUESTIONS OR REQUEST MORE INFORMATION AT A SUBSEQUENT MEETING. INFORMATION FOR THE FORM 990 IS GATHERED FROM APPROPRIATE RESPONSIBLE PARTIES THROUGHOUT THE ORGANIZATION, INCLUDING THE ORGANIZATION'S HUMAN RESOURCES, FINANCE AND COMPLIANCE DEPARTMENTS. THE RETURN GETS A DETAIL TIE-OUT AND DIRECTOR OF ACCOUNTING REVIEW. IT 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 AND KEY EMPLOYEES PURSUANT TO THE METHODIST HEALTH SYSTEM CONFLICTS OF INTEREST POLICY WHICH REQUIRES THE DISCLOSURE OF ALL CONFLICTS OF INTEREST, NOT JUST FINANCIAL, THAT COULD GIVE RISE TO CONFLICTS WITH THE ORGANIZATION. SHOULD A CONFLICT BE IDENTIFIED, 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 A 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 AND EMPLOYEES. 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 VII, SECTION A | STEVEN BAUMERT IS A KEY EMPLOYEE FOR NEBRASKA METHODIST HEALTH SYSTEM. HE HAS ASSIGNED LEADERSHIP RESPONSIBILITIES AT JENNIE EDMUNDSON MEMORIAL HOSPITAL. | |
| FORM 990, PART XI, LINE 9: | CHANGE IN MINIMUM PENSION LIABILITY -1,639,239. NET ASSETS RELEASED FOR OPERATIONS -18,000. ACCUM EFFECTIVE ACCTG CHANGES 2,040,781. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| JENNIE EDMUNDSON MEMORIAL HOSPITAL FOUNDATION | |||||||||||
| 933 EAST PIERCE STREET | COUNCIL BLUFFS | IA | 51503 | 421439454 | SUPPORT OF JENNIE EDMUNDSON HOSPITAL | IA | 501(C)(3) | L11: I | 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 | 0 | N/A | |
| NEBRASKA METHODIST HEALTH SYSTEM INC | |||||||||||
| 8511 W DODGE ROAD | OMAHA | NE | 68114 | 470639839 | ADMINISTRATIVE SUPPORT | NE | 501(C)(3) | L11: III-FI | 0 | N/A | |
| 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) | 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 | |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 1 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JENNIE EDMUNDSON MEMORIAL HOSPITAL FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionType |
| Amount Involved | 740810 | AmountInvolved |
| Method Of Amt Determination | CASH | MethodOfAmtDetermination |