2024-11-08T13:15:26-06:00 2023-12-31 450250958 EIDE BAILLY LLP 18081 BURT ST STE 200 OMAHA NE 680224722 990 2023-01-01 421101835 SHENANDOAH MEDICAL CENTER SHEN 7122461230 300 PERSHING AVENUE SHENANDOAH IA 51601 MATTHEW SELLS CEO 7122461230 2024-11-08 1 1 MEGAN L KOZIOL CPA P01544037 4023302660 2024-11-08 2023 2024-10-15 13:58:12Z MATTHEW SELLS 300 PERSHING AVENUE SHENANDOAH IA 51601 60331660 0 X WWW.SMCHOSPITAL.COM X 1978 IA TO PROVIDE A COMPLETE CONTINUUM OF HEALTHCARE SERVICES TO THE PEOPLE OF SHENANDOAH. 9 8 407 223 0 0 1663987 2707562 49030959 56087519 148459 624784 249615 266200 51093020 59686065 0 0 0 0 25569481 29051655 0 0 0 23725360 24576292 49294841 53627947 1798179 6058118 65095594 79783296 33812631 41705627 31282963 38077669 TO MAKE A DIFFERENCE BY PROVIDING EXCEPTIONAL PATIENT CARE. 0 0 47184216 56281999 SHENANDOAH MEDICAL CENTER IS A CRITICAL ACCESS HOSPITAL WITH 25 ACUTE BEDS. THE HOSPITAL PROVIDES ACUTE AND ANCILLARY SERVICES TO INDIVIDUALS IN AN INPATIENT AND OUTPATIENT SETTING. IN JUNE OF 2020 THE SHENANDOAH MEDICAL CENTER ASSUMED RESPONSIBILITY FOR THE CANCER TREATMENT CENTER. IN 2023 THE CANCER CENTER PROVIDED 7,520 VISITS. SHENANDOAH MEDICAL CENTER CONTINUES TO LEASE SPACE TO THE DIALYSIS TREATMENT CENTER. DURING 2023 THE HOSPITAL PROVIDED 930 DAYS OF ACUTE CARE, 708 DAYS OF SKILLED CARE, 165 NURSERY DAYS AND 204,716 OUTPATIENT OCCASIONS OF SERVICE. 47184216 1 1 0 1 0 0 0 0 0 1 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 67 0 1 407 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 X KALEY NEAL CFO 7122461230 300 PERSHING AVENUE SHENANDOAH IA 51601 HEATHER BABE MD DIRECTOR 40.00 0.00 X 353416 0 19403 DENNIS GREBERT CHAIRMAN 3.00 10.00 X X 0 0 0 JOHN FINN VICE CHAIRMAN 3.00 0.00 X X 0 0 0 JON SKILLERN SECRETARY/TREASURER 3.00 0.00 X X 0 0 0 JILLIAN TRAVIS DIRECTOR 3.00 0.00 X 0 0 0 JAMES DOYLE DIRECTOR 3.00 0.00 X 0 0 0 BRUCE BALDWIN DIRECTOR 3.00 0.00 X 0 0 0 NICK BOSLEY DIRECTOR 3.00 0.00 X 0 0 0 AMY MILLER DIRECTOR 3.00 0.00 X 0 0 0 MATTHEW SELLS PRESIDENT & CEO 40.00 10.00 X 338608 0 39610 KALEY NEAL CFO 40.00 1.00 X 166528 0 11222 MOHAMED ABDI PHYSICIAN 40.00 0.00 X 421728 0 8231 REBECCA ROSE PHYSICIAN 40.00 0.00 X 494940 0 25523 MARTEE MACLEOD-KOZAL PHYSICIAN 40.00 0.00 X 443163 0 32200 CHASE BROWN PHYSICIAN 40.00 0.00 X 433304 0 31728 MICHAEL WOODS PHYSICIAN 40.00 0.00 X 427067 0 22462 3078754 0 190379 42 0 1 0 MEDEFIS CONSOLIDATED PO BOX 5068 NEW YORK NY 100875068 CONTRACT LABOR 2681953 MD WEST ONE 8005 FARNAM DRIVE OMAHA NE 68114 CONTRACT LABOR 966000 SHARED MEDICAL SERVICES INC 209 LIMESTONE PASS COTTAGE GROVE WI 53527 MRI AND PET SCANS 635005 ELEVATE HEATHCARE CONSULTANTS 3811 TRUTLE CREEK BLVD DALLAS TX 75219 CONTRACT LABOR 566928 BROWN'S MEDICAL IMAGING 14315 C CIRCLE OMAHA NE 68144 SERVICE CONTRACT 410486 20 2361774 63473 282315 6374 2707562 MEDICARE/MEDICAID PAYM 624100 36431525 36431525 NET PATIENT SERVICE RE 624100 15935590 15935590 340B REVENUE 624100 2449350 2449350 AMBULANCE SERVICES 621910 960253 960253 310801 310801 56087519 764372 764372 71720 0 71720 71720 71720 506007 645552 43 -139545 -43 -139588 -139588 CAFETERIA REVENUE 624200 189458 189458 INSURANCE PROCEEDS 900099 5022 5022 194480 59686065 56281999 0 696504 X 936479 375987 560492 96183 96183 22483702 19974374 2509328 771042 700184 70858 3207442 2845371 362071 1556807 1350941 205866 10284 10284 118875 118875 7389 7389 48827 48827 7918919 6970177 948742 925201 925201 2698046 2283689 414357 982256 969888 12368 173476 159632 13844 847102 819679 27423 3253445 3148121 105324 537871 520458 17413 MEDICAL SUPPLIES 6565691 6565691 FOOD 295006 281736 13270 LICENSES & FEES 135482 112054 23428 MEMBERSHIPS 58422 10051 48371 53627947 47184216 6443731 0 1619 1705 8334438 7632955 5711075 8079507 1308963 1717417 181901 421763 78934169 39200905 33172459 39733264 9415489 10193130 223213 223213 6746437 11780342 65095594 79783296 6480640 8041973 27331991 33663654 33812631 41705627 X 24803048 31532258 6479915 6545411 31282963 38077669 65095594 79783296 X 6058118 803156 -66568 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 7389 7389 0 PART II-B, LINE 1: PORTION OF DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION AND THE IOWA HOSPITAL ASSOCIATION ARE ALLOCABLE TO LOBBYING ACTIVITIES. 388820 49498 438318 440631 -51811 388820 404381 36250 440631 6023323 498337 238611 231663 6528608 5970820 133351 151032 231880 6023323 0.64966 0.35034 0 0 407142 407142 48196421 17794763 30401658 28968819 20461046 8507773 1361787 945096 416691 39733264 DUE - SHENANDOAH AMBULANCE SERVICE 453925 BENEFICIAL INTEREST-PERPETUAL TRST 5476097 PATIENT CUSTOMER CONTRACTS 358157 EST THIRD-PARTY PAYOR SETTLEMENTS 5492163 11780342 X PART V, LINE 4: THE ENDOWMENT FUNDS WERE DESIGNATED AS SUCH BY THE SHENANDOAH MEDICAL CENTER BOARD OF DIRECTORS AND ARE MEANT TO BE HELD BY THE HOSPITAL. THE INCOME IS TYPICALLY REINVESTED IN THE ENDOWMENT FUNDS ON AN ANNUAL BASIS, BUT THE BOARD OF DIRECTORS HAS THE ABILITY TO DETERMINE THAT THE INCOME COULD BE USED IN SUPPORT OF THE HOSPITAL'S PROGRAMS AND PROJECTS, INCLUDING PROPERTY AND EQUIPMENT PURCHASES. PART X, LINE 2: THE MEDICAL CENTER ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES. THE MEDICAL CENTER RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT DECEMBER 31, 2023 AND 2022, THE MEDICAL CENTER HAD NO UNCERTAIN TAX POSITIONS ACCRUED. PART V, LINE 1A, COLUMN C: THE BEGINNING BALANCE HAS BEEN ADJUSTED TO REMOVE FUNDS THAT WERE DETERMINED TO NOT BE CONSIDERED ENDOWMENTS. 1 1 X 1 X 1 X 0 1 0 1 1 77511 77511 0.00140 7732553 11238566 0 0.00000 7810064 11238566 77511 0.00140 805455 805455 0.01500 154 154 0.00000 805609 805609 0.01500 8615673 11238566 883120 0.01640 1 3012167 397606 17662765 17939198 -276433 X 1 1 1 1 SHENANDOAH MEDICAL CENTER 300 PERSHING AVE SHENANDOAH IA 51601 WWW.SMCHOSPITAL.COM 730065H X X X X SHENANDOAH MEDICAL CENTER 1 0 0 1 X X X X X X X X X 22 1 0 1 1 X SMCHOSPITAL.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ X 1 22 1 SMCHOSPITAL.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ 0 1 X 100.000000000000 200.000000000000 X X X X X X 1 1 X X X 1 X SMCHOSPITAL.COM/INSURANCE-FINANCIAL-ASSISTANCE/ X SMCHOSPITAL.COM/INSURANCE-FINANCIAL-ASSISTANCE/ X SMCHOSPITAL.COM/INSURANCE-FINANCIAL-ASSISTANCE/ X X X X X X 1 X 0 X X X X 1 X 0 0 SHENANDOAH MEDICAL CENTER PART V, SECTION B, LINE 5: THE CHNA TOWN HALL WAS HELD OVER LUNCH ON WEDNESDAY, FEBRUARY 18, 2022 AT THE SHENANDOAH MEDICAL CENTER HARTMAN ROOM IN SHENANDOAH, IA. VINCE VANDEHAAR, MBA, FACILITATED THIS 1-1/2 HOUR SESSION WITH THIRTY (30) COMMUNITY ATTENDEES. SMC CONSULTED WITH VVV RESEARCH & DEVELOPMENT, INC. TO COMPLETE THE NEEDS ASSESSMENT WHICH WAS FINALIZED IN 2022. SMC PARTNERED WITH PAGE COUNTY PUBLIC HEALTH TO COMPLETE THE ASSESSMENT. ONGOING MEETINGS WITH CHNA STAKEHOLDERS WERE HELD THURSDAY, APRIL 4, 2022 AND MAY 22, 2022 AT SHENANDOAH MEDICAL CENTER IN SHENANDOAH, IA TO COMPOSE AN IMPLEMENTATION PLAN. SHENANDOAH MEDICAL CENTER PART V, SECTION B, LINE 6B: PAGE COUNTY PUBLIC HEALTH SHENANDOAH MEDICAL CENTER PART V, SECTION B, LINE 11: NEEDS ADDRESSED IN THE MOST RECENT CHNA INCLUDE: MENTAL HEALTH, ECONOMIC DEVELOPMENT, SENIOR HEALTH, SUBSTANCE ABUSE, CANCER CARE, CHRONIC DISEASE MANAGEMENT, AND OBESITY.SHENANDOAH MEDICAL CENTER HAS WORKED TO EXPAND MENTAL HEALTH SERVICES IN PAGE COUNTY BY CONTINUING TO PARTNER WITH OTHER MENTAL HEALTH ORGANIZATIONS IN SHENANDOAH, AS WELL AS THROUGH THE RECRUITMENT OF ADDITIONAL BEHAVIORAL HEALTH ARNPS AND A LICENSED SOCIAL WORKER TO INCREASE ACCESS TO CARE. SMC HAS ALSO WORKED TO IMPLEMENT PEDIATRIC TELEHEALTH SERVICES THROUGH A PARTNERSHIP WITH CHILDREN'S HOSPITAL IN AN EFFORT TO GAIN ACCESS TO PSYCHIATRIC TELEHEALTH SERVICES FOR CHILDREN. ADDITIONALLY, TELEHEALTH PARTNERSHIPS WERE DEVELOPED TO GAIN ACCESS TO BEHAVIORAL HEALTH CARE IN THE EMERGENCY ROOM, WHICH HAS PROVIDED MUCH IMPROVED ACCESS TO CARE. RECRUITMENT OF TWO BEHAVIORAL HEALTH ARNPS AND A SOCIAL WORKER HAVE BEEN MAJOR INITIATIVES FOR THE ORGANIZATION OVER THE PAST TWELVE MONTHS. SMC FIGHTS DRUG ABUSE THROUGH USE OF SPECIFIC PAIN CONTRACTS ENTERED INTO BETWEEN PROVIDERS AND PATIENTS WITH DRUG ABUSE HISTORY. SMC ALSO PARTNERS WITH SEVERAL ORGANIZATIONS SUCH AS ZION RECOVERY SERVICES TO INCREASE THE ACCESS TO TREATMENT FOR DRUG ABUSE PATIENTS. SMC'S CEO HAS ALSO BECOME THE PRESIDENT OF THE SHENANDOAH CHAMBER AND INDUSTRY ASSOCIATION TO ADDRESS ECONOMIC DEVELOPMENT NEEDS AND HE ALSO SERVES AS CHAIR OF THE COMMUNITY'S HOUSING COMMITTEE, ALTHOUGH THESE AREAS MAY NOT BE CONSIDERED MISSION CRITICAL TO SMC. SMC PARTNERS WITH SEVERAL LOCAL SENIOR LIVING PROVIDERS TO PROVIDE THE NECESSARY CARE FOR THE COMMUNITY'S SENIORS. SMC HAS DEVELOPED A ROBUST POPULATION HEALTH TEAM THAT INCLUDES FIVE HEALTH COACHES THAT MANAGE THE CARE OF ACUTE DIABETIC PATIENTS AND OTHER CHRONIC DISEASES VIA PARTNERSHIP WITH IOWA MEDICAID AND PARTICIPATION IN MULTIPLE ACCOUNTABLE CARE ORGANIZATIONS TO IMPROVE CARE THROUGHOUT THE STATE OF IOWA. SMC IS ADDRESSING THE NEED OF CANCER CARE WITH A $13 MILLION DOLLAR INVESTMENT IN A REGIONAL CANCER CENTER THAT WILL PROVIDE BOTH MEDICAL AND RADIATION ONCOLOGY SERVICES. COMPLEX CHEMOTHERAPY AND RADIATION THERAPY WILL BE DELIVERED THROUGH THE ONBOARDING OF AN EMPLOYED MEDICAL ONCOLOGIST AND AN EMPLOYED RADIATION ONCOLOGIST. WHILE THESE ITEMS ARE SIGNIFICANT INVESTMENTS, SMC UNDERSTANDS THE IMPORTANCE OF PROVIDING CANCER CARE TO THIS REGION, AS CANCER PREVALENCE RATES ARE AMONG THE HIGHEST IN THE STATE OF IOWA IN SOUTHWEST IOWA. NEEDS THAT DID NOT GET DIRECTLY ADDRESSED BY SMC WERE THE IMPROVEMENT OF ACCESS TO DENTAL SERVICES FOR OUR MEDICAID PATIENTS AND AFFORADABLE HOUSING. THESE ITEMS WERE NOT CONSIDERED RELATED TO THE FACILITY'S MISSION CRITICAL OPERATIONS. AS A RESULT, SMC WILL CONTINUE TO HELP SUPPORT COMMUNITY PARTNERS IN ORDER TO ADDRESS THOSE NEEDS. SHENANDOAH MEDICAL CENTER PART V, SECTION B, LINE 13H: THE ELIGIBILITY OF EACH APPLICANT FOR FINANCIAL ASSISTANCE IS DETERMINED ON A CASE BY CASE BASIS THROUGH COORDINATION OF THE PATIENT FINANCIAL COUNSELOR, BUSINESS OFFICE MANAGER, AND CHIEF FINANICAL OFFICER. ELIGIBILITY IS BASED ON A REVIEW AND VERIFICATION OF INCOME OF AN INDIVIDUAL OR FAMILY, INCLUDING THE SIZE OF THE FAMILY. VERIFICATION INCLUDES BUT IS NOT LIMITED TO: TAX RETURNS, PAY STUBS, SOCIAL SECURITY CHECKS, DISABILITY CHECKS OR BANK STATEMENTS. AN UNINSURED DISCOUNT OF 35% IS GRANTED TO ALL PATIENTS WITH NO INSURANCE. FURTHER DISCOUNTING IS APPLIED BASED ON THE APPLICANT'S ABILITY TO MEET THE ELIGIBILITY CRITERIA. 3 1 - SHENANDOAH PHYSICIANS CLINIC - SIDNEY 802 ILLINOIS STREET SIDNEY IA 51652 SIDNEY CLINIC 2 - SHENANDOAH MEDICAL CENTER 2 JACK FOSTER DRIVE SHENANDOAH IA 51601 WELLNESS CENTER 4 - SHENANDOAH PHYSICIANS CLINIC - TABOR 713 MAIN STREET TABOR IA 51653 TABOR CLINIC PART I, LINE 3C: IN ADDITION TO FEDERAL POVERTY GUIDELINES, THE ORGANIZATION ALSO USED ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS, RESIDENCY AND FAMILY SIZE TO DETERMINE ELIGIBILITY FOR PROVIDING FREE OR DISCOUNTED CARE. PART I, LINE 6A: THE ANNUAL COMMUNITY BENEFIT REPORT WAS NOT PREPARED BY A RELATED ORGANIZATION. PART I, LINE 7: CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. UNREIMBURSED MEDICAID ON LINE 7B WAS CALCULATED USING THE COSTING METHODS TO PREPARE THE COST REPORTS. COMMUNITY HEALTH IMPROVEMENT SERVICES, LINE 7E, AND HEALTH PROFESSIONS EDUCATION, LINE 7F, ARE REPORTED BASED ON ACTUAL EXPENSES REPORTED IN THE GENERAL LEDGER. PART I, LINE 7G: THERE WERE NO SUBSIDIZED HEALTH SERVICES DURING THE YEAR. PART II, COMMUNITY BUILDING ACTIVITIES: THERE WERE NO COMMUNITY BUILDING ACTIVITIES REPORTED DURING THE YEAR. PART III, LINE 2: THE AMOUNT REPRTED ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE MEDICAL CENTER DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION EXPERIENCE WITH THIS CLASS OF PATIENTS. PART III, LINE 3: THE ESTIMATED AMOUNT OF THE ORGANIZATION'S IMPLICIT PRICE CONCESSIONS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS CALCULATED BASED ON AN APPROXIMATE 13.2% OF INDIVIDUALS LIVING BELOW THE POVERTY LEVEL IN THE SERVICE AREA. PART III, LINE 4: THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES IMPLICIT PRICE CONCESSIONS IS LOCATED IN FOOTNOTE 1 ON PAGES 9 AND 11 THROUGH 13 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: THE ENTIRE MEDICARE SHORTFALL IS CONSIDERED A COMMUNITY BENEFIT. SERVICES ARE PROVIDED TO PATIENTS UNDER THE MEDICARE PROGRAM EVEN THOUGH THE HOSPITAL KNOWS THEY WILL NOT RECOVER ALL OF THE COSTS FROM PROVIDING THE SERVICES. THIS PROGRAM IS CONSIDERED SUBSIDIZED BY THE HOSPITAL AND OTHER PAYORS. PATIENTS RELY ON THESE SERVICES FOR THEIR HEALTH AND WELL-BEING AND ARE ESSENTIAL FOR THEIR ACCESS TO HEALTHCARE. TOTAL REVENUE RECEIVED FROM MEDICARE IS THE GROSS REIMBURSEMENT PLUS SETTLEMENT. BOTH TOTAL REVENUE RECEIVED FROM MEDICARE AND THE MEDICARE ALLOWABLE COSTS ARE REPORTED FROM THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CENTERS FOR MEDICARE AND MEDICAID SERVICES. PART III, LINE 9B: ONCE A PATIENT HAS BEEN DEEMED ELIGIBLE FOR FINANCIAL ASSISTANCE, THE PATIENT'S ACCOUNT IS UPDATED WITH THE APPROPRIATE AMOUNT OF FINANCIAL ASSISTANCE. IF A PATIENT HAS HAD ALL ACCOUNTS GRANTED FULL FINANCIAL ASSISTANCE, THE PATIENT RECEIVES NOTICE THAT ALL OBLIGATIONS HAVE BEEN SATISFIED. IF THERE IS A REMAINING PATIENT BALANCE, SMC'S FINANCIAL COUNSELOR WORKS CLOSELY WITH THE PATIENT TO AGREE UPON A PAYMENT PLAN THAT IS FINANCIALLY FEASIBLE FOR THE PATIENT. PART VI, LINE 2: THE ORGANIZATION'S LEADERSHIP INFORMALLY MEETS WITH LEADERS IN THE COMMUNITY TO DISCUSS COMMUNITY ISSUES, AS WELL AS ATTEMPTS TO IDENTIFY AREAS WHERE SMC CAN BE OF SERVICE TO THE EMPLOYERS IN THE COMMUNITY. PART VI, LINE 3: THE FINANCIAL ASSISTANCE APPLICATION IS PROVIDED TO ALL PATIENTS ON THE WEBSITE. ADDITIONALLY, OUR THIRD PARTY SELF-PAY ORGANIZATION MAILS APPLICATIONS TO THOSE PATIENTS WHO INDICATE THAT THEY DO NOT HAVE THE MEANS TO PAY THEIR ACCOUNTS. UPON CONTACT AT SMC, OUR SOCIAL SERVICES REPRESENTATIVE AND PATIENT FINANCIAL COUNSELOR DISCUSS OPTIONS WITH PATIENTS AND ALSO ASSIST IN THE COMPLETION OF THE FINANCIAL ASSISTANCE APPLICATIONS, MEDICARE AND MEDICAID APPLICATIONS IF APPLICABLE, AND MAKING ANY OTHER ARRANGEMENTS NECESSARY TO ASSIST PATIENTS IN FINANCIALLY SATISFYING THEIR OBLIGATIONS. PATIENTS ARE ALSO NOTIFIED OF THE FINANCIAL ASSISTANCE POLICY AT ADMISSION AND DISCHARGE. PART VI, LINE 4: THE MEDIAN HOUSEHOLD INCOME WAS $51,867 AND $56,750 FOR PAGE AND FREMONT COUNTIES, RESPECTIVELY IN 2019, AS COMPARED TO THE STATE MEDIAN HOUSEHOLD INCOME OF $60,523. AS A BYPRODUCT OF THE MEDIAN HOUSEHOLD INCOME IN THE SERVICE AREA, SHENANDOAH MEDICAL CENTER TREATS A SIGNIFICANT NUMBER OF MEDICAID, UNINSURED, AND UNDERINSURED PATIENTS. THE AREA POPULATION IS PREDOMINATELY WHITE, NON-HISPANIC. PART VI, LINE 5: IN ADDITION TO ITS EFFORTS TO ADDRESS THE NEEDS IDENTIFIED BY ITS COMMUNITY HEALTH NEEDS ASSESSMENT, THE FACILITY ALSO HAS AN ACTIVE INTERNAL WELLNESS PROGRAM THAT IT IS CURRENTLY ROLLING OUT TO THE COMMUNITY. ADDITIONALLY, THE HOSPITAL OPERATES A WELLNESS CENTER THAT PROVIDES VERY AFFORDABLE MEMBERSHIP RATES AND PERSONAL TRAINING OPTIONS TO HELP PROMOTE WELLNESS IN THE COMMUNITY. PART VI, LINE 6: SMC IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. PART VI, LINE 7, REPORTS FILED WITH STATES IA X X X X 0 0 0 0 0 0 0 0 0 REBECCA ROSE PHYSICIAN 466650 0 25000 0 3290 0 24720 0 3971 0 523631 0 0 0 MARTEE MACLEOD-KOZAL PHYSICIAN 408665 0 34000 0 498 0 22500 0 12868 0 478531 0 0 0 CHASE BROWN PHYSICIAN 372917 0 59938 0 449 0 22328 0 12568 0 468200 0 0 0 MICHAEL WOODS PHYSICIAN 396844 0 26933 0 3290 0 12062 0 13568 0 452697 0 0 0 MOHAMED ABDI PHYSICIAN 310727 0 110870 0 131 0 0 0 11399 0 433127 0 0 0 MATTHEW SELLS PRESIDENT & CEO 308159 0 30000 0 449 0 16139 0 26265 0 381012 0 0 0 HEATHER BABE MD DIRECTOR 314920 0 37668 0 828 0 17753 0 4818 0 375987 0 0 0 KALEY NEAL CFO 161251 0 5000 0 277 0 8464 0 4487 0 179479 0 0 0 ALICIA SELLS EMPLOYEE OF ORGANIZATION AND WIFE OF MATTHEW SELLS, CEO 96183 EMPLOYEE'S COMPENSATION 0 FORM 990, PART VI, SECTION A, LINE 8B THERE IS NO COMMITTEE WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE CEO, CFO, AND GOVERNING BOARD PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS ENFORCED BY THE CEO AND COMPLIANCE OFFICER. ALL BOARD MEMBERS AND EXECUTIVES ARE REQUIRED TO DISCLOSE ANY CONFLICTS OF INTEREST THAT ARE PRESENTED. ON AN ANNUAL BASIS, A SUMMARY OF ALL CONFLICTS IDENTIFIED DURING THE YEAR ARE PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW AS PART OF THE ANNUAL COMPLIANCE SUMMARY. WHEN A CONFLICT OF INTEREST IS IDENTIFIED, THE INDIVIDUAL POSSESSING THE CONFLICT IS NOT ALLOWED TO PROVIDE INPUT ON THE SUBJECT AND IS REQUIRED TO ABSTAIN FROM ANY RELATED VOTING. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE ORGANIZATION'S CEO WAS REVIEWED AND AUTHORIZED BY THE BOARD OF DIRECTORS. SMC ALSO UTILITIZES THE IOWA HOSPITAL ASSOCIATION SALARY SURVEY DATA TO APPROPRIATELY SET COMPENSATION FOR ITS OFFICERS AND KEY EMPLOYEES. ADDITIONALLY, SALARY SURVEY DATA OBTAINED FROM MGMA AND MERRITT HAWKINS IS USED TO EVALUATE THE COMPENSATION OF ALL PROVIDERS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. FORM 990, PART IX, LINE 11G LAB FEES: PROGRAM SERVICE EXPENSES 323,732. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 323,732. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 2,510,583. MANAGEMENT AND GENERAL EXPENSES 85,055. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,595,638. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,872,023. MANAGEMENT AND GENERAL EXPENSES 474,479. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,346,502. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,152,839. MANAGEMENT AND GENERAL EXPENSES 389,208. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,542,047. CONSULTING FEES: PROGRAM SERVICE EXPENSES 111,000. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 111,000. FORM 990, PART XI, LINE 9: CHANGE IN PERPETUAL TRUST -66,568. FORM 990, PART XII, LINE 2C: THE BOARD OF DIRECTORS ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF SMC'S FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. SHENANDOAH MEDICAL CENTER FOUNDATION 300 PERSHING AVENUE SHENANDOAH IA 51601 421471184 SUPPORT SHENANDOAH MEDICAL CENTER IA 501(C)(3) LINE 12A, I SHENANDOAH MEDICAL CENTER 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 SHENANDOAH MEDICAL CENTER FOUNDATION C 2361774 FMV