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JENNIE M MELHAM MEMORIAL MEDICAL CENTER INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
JENNIE M MELHAM MEMORIAL MEDICAL CENTER INC (EIN 47-0426530)
Tax period
2020-10-01 to 2021-09-30
Filed
2022-08-08
IRS object ID
202202209349301270
Schema version
2020v4.2
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-08-08T12:36:18-05:00ReturnTs
Tax Period End2021-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN476097913PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line118081 BURT STREET SUITE 200AddressLine1Txt
CityOMAHACityNm
State AbbreviationNEStateAbbreviationCd
ZIP680224722ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN470426530EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JENNIE M MELHAM MEMORIAL MEDICALBusinessNameLine1Txt
Business Name Line2CENTER INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlJENNBusinessNameControlTxt
Phone3088724180PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 250AddressLine1Txt
CityBROKEN BOWCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68822ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJEREMY M CLINGENPEELPersonNm
Person TitleCEOPersonTitleTxt
Phone3088724180PhoneNum
Signature2022-08-05SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJEREMYPersonFirstNm
Person LastCLINGENPEELPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMEGAN L KOZIOLPreparerPersonNm
PTINP01544037PTIN
Phone4023302660PhoneNum
Preparation2022-08-05PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJEREMY M CLINGENPEELPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 250AddressLine1Txt
CityBROKEN BOWCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68822ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$24,083,287GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MELHAM.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1962FormationYr
Legal Domicile StateNELegalDomicileStateCd
Activity Or MissionTHE PRIMARY MISSION AND PURPOSE OF THE JENNIE M. MELHAM MEMORIAL MEDICAL CENTER IS TO IMPROVE THE QUALITY OF LIFE IN ITS SURROUNDING SERVICE AREA BY PROVIDING AN ENVIRONMENT WHICH PROMOTES THE BEST POSSIBLE DELIVERY OF EMERGENCY, INPATIENT, SNF/SWING BED, OUTPATIENT, AMBULATORY CARE, AND INDEPENDENT LIVING APARTMENT SERVICES.ActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee128TotalEmployeeCnt
Total Volunteers10TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,757,490PYContributionsGrantsAmt
CY Contributions Grants$3,665,644CYContributionsGrantsAmt
PY Program Service Revenue$17,034,136PYProgramServiceRevenueAmt
CY Program Service Revenue$19,686,439CYProgramServiceRevenueAmt
PY Investment Income$422,847PYInvestmentIncomeAmt
CY Investment Income$505,577CYInvestmentIncomeAmt
PY Other Revenue-$131,110PYOtherRevenueAmt
CY Other Revenue-$114,279CYOtherRevenueAmt
PY Total Revenue$19,083,363PYTotalRevenueAmt
CY Total Revenue$23,743,381CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$7,575,614PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$7,701,995CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$3,293PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$2,912CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$2,912CYTotalFundraisingExpenseAmt
PY Other Expenses$9,134,876PYOtherExpensesAmt
CY Other Expenses$10,295,737CYOtherExpensesAmt
PY Total Expenses$16,713,783PYTotalExpensesAmt
CY Total Expenses$18,000,644CYTotalExpensesAmt
PY Revenues Less Expenses$2,369,580PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,742,737CYRevenuesLessExpensesAmt
Total Assets BOY$54,769,453TotalAssetsBOYAmt
Total Assets EOY$58,643,276TotalAssetsEOYAmt
Total Liabilities BOY$5,540,762TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,999,541TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$49,228,691NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$54,643,735NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionPARTNERING WITH YOU TO INSPIRE HEALTHY LIVING THROUGH QUALITY CARE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$10,374,826ExpenseAmt
Revenue$8,006,248RevenueAmt
DescJENNIE MELHAM MEMORIAL MEDICAL CENTER (JMMMC) OPERATES A 23-BED CRITICAL ACCESS HOSPITAL. IN ADDITION, THERE ARE 20 APARTMENTS DESIGNATED FOR THE ELDERLY. JMMMC PROVIDES OUTPATIENT SPECIALTY CLINICS AND SURGERY SERVICES.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$3,065,262ExpenseAmt
Revenue$3,255,958RevenueAmt
DescJMMMC PROVIDES HIGH QUALITY, LOW COST ACUTE CARE TO OUR LOCAL COMMUNITY. THE ACUTE CARE DEPARTMENT EXPERIENCED 1,751 DAYS OF CARE. THIS INCLUDES SWING BED, INPATIENT AND OUTPATIENT OBSERVATION. THIS PROVIDES LOCAL ACCESS FOR OUR RESIDENTS TO OBTAIN QUALITY CARE.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$1,962,760ExpenseAmt
Revenue$2,260,193RevenueAmt
DescJMMMC PROVIDES 24/7 EMERGENCY SERVICES TO OUR COMMUNITY. WE ENCOUNTERED 2,015 EMERGENCY ROOM VISITS.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$693,364ExpenseAmt
Revenue$6,164,040RevenueAmt
DescJMMMC PROVIDES RADIOLOGY SERVICES WHICH INCLUDES MOBILE MRI SERVICES, X-RAY, DIGITAL MAMMOGRAPHY, BONE DENSITOMETRY AND CT.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$693,364TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$6,164,040TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$16,096,212TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document20IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee128EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonCARLA BAZYN VPCFOPersonNm
Phone3088724180PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 250AddressLine1Txt
CityBROKEN BOWCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68822ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
DON CANTRELL
CHAIRMAN2.002.00Yes (X)Yes (X)$0$0$0
JOHN SMITH
VICE CHAIRMAN2.002.00Yes (X)Yes (X)$0$0$0
JOYCE RICHARDSON
SECRETARY2.002.00Yes (X)Yes (X)$0$0$0
MIKE BORDERS
TREASURER2.002.00Yes (X)Yes (X)$0$0$0
COREY STAPLES
MEMBER2.002.00Yes (X)$0$0$0
VERONICA L SCHMIDT
PRESIDENT/CEO THRU 09/15/2140.002.00Yes (X)$239,372$0$70,126
CARLA BAZYN
VP/CFO40.002.00Yes (X)$134,341$0$46,916
VICTOR LEE
INTERIM CEO40.002.00Yes (X)$0$0$0
DARCI SHEA
RN40.000.00$133,865$0$37,462Yes (X)
JENNIFER SCHAAF
PHARMACIST40.000.00$156,066$0$4,354Yes (X)
NICKIE LEEPER
CIO40.000.00$125,126$0$18,774Yes (X)
KRISTIN BAILEY
RN/DIRECTOR OF QUALITY/RISK/INFECTION CONTROL40.000.00$101,884$0$28,957Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$890,654TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$206,589TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K6IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CENTRAL NEBRASKA MEDICAL CLINIC
PO BOX 690BROKEN BOWNE68822ER DOCTOR SERVICES$1,398,928
SANDHILLS ANESTHESIA SERVICES LLC
79568 SUMNER ROADBROKEN BOWNE68822ANESTHESIA SERVICES$609,795
ATLAS HEALTHCARE LLC
PO BOX 41047BATON ROUGELA70835CONTRACT NURSING SERVICES$242,382
FOCUSONE SOLUTIONS LLC
PO BOX 850861MINNEAPOLISMN55485CONTRACT NURSING SERVICES$236,483
4 COUNTY HEATING & AIR LLC
314 SOUTH 7TH AVEBROKEN BOWNE68822HEATING & AIR SERVICES$207,718
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K9CntrctRcvdGreaterThan100KCnt
Government Grants$3,649,284GovernmentGrantsAmt
All Other Contributions$16,360AllOtherContributionsAmt
Total Contributions$3,665,644TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE - MEDICARE/MEDICA621110$10,791,051$10,791,051
PATIENT SERVICE - PRIVATE PAY621110$8,822,138$8,822,138
WELLNESS CENTER REVENUE624100$60,207$60,207

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$13,043TotalRevenueColumnAmt
Related Or Exempt Func Income$13,043RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$19,686,439TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$510,385TotalRevenueColumnAmt
Exclusion$510,385ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$155,980RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$329,772RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$173,792RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$173,792TotalRevenueColumnAmt
Exclusion-$173,792ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$5,326OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$10,134OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$4,808OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$4,808TotalRevenueColumnAmt
Exclusion-$4,808ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescCAFETERIA SALESDesc
Business722210BusinessCd
Total Revenue Column$59,513TotalRevenueColumnAmt
Exclusion$59,513ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$59,513OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$23,743,381TotalRevenueColumnAmt
Related Or Exempt Func Income$19,686,439RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$391,298ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$490,755TotalAmt
Management And General$490,755ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,471,247TotalAmt
Program Services$5,077,038ProgramServicesAmt
Management And General$394,209ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$143,889TotalAmt
Program Services$127,718ProgramServicesAmt
Management And General$16,171ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,149,673TotalAmt
Program Services$1,083,984ProgramServicesAmt
Management And General$65,689ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$446,431TotalAmt
Program Services$391,532ProgramServicesAmt
Management And General$54,899ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$11,702TotalAmt
Management And General$11,702ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$55,199TotalAmt
Management And General$55,199ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$2,912TotalAmt
Fundraising$2,912FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,820,936TotalAmt
Program Services$3,654,442ProgramServicesAmt
Management And General$166,494ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,377,561TotalAmt
Program Services$2,270,957ProgramServicesAmt
Management And General$106,604ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$624,751TotalAmt
Program Services$612,277ProgramServicesAmt
Management And General$12,474ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$304,194TotalAmt
Program Services$299,785ProgramServicesAmt
Management And General$4,409ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$4,248TotalAmt
Program Services$1,275ProgramServicesAmt
Management And General$2,973ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$50,745TotalAmt
Program Services$24,159ProgramServicesAmt
Management And General$26,586ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,393,268TotalAmt
Program Services$1,365,949ProgramServicesAmt
Management And General$27,319ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$157,391TotalAmt
Program Services$136,581ProgramServicesAmt
Management And General$20,810ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BAD DEBT$318,101$318,101
MINOR EQUIPMENT$236,852$229,033$7,819
DUES AND SUBSCRIPTIONS$105,229$53,685$51,544

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$835,560TotalAmt
Program Services$449,696ProgramServicesAmt
Management And General$385,864ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$18,000,644TotalAmt
Program Services$16,096,212ProgramServicesAmt
Management And General$1,901,520ManagementAndGeneralAmt
Fundraising$2,912FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$145BOYAmt
EOY$145EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$24,251,978BOYAmt
EOY$24,192,915EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,730,912BOYAmt
EOY$3,737,131EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$289,906BOYAmt
EOY$111,720EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$446,066BOYAmt
EOY$397,312EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$210,049BOYAmt
EOY$189,801EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$39,527,401LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$22,400,029LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$17,494,107BOYAmt
EOY$17,127,372EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$8,961,057BOYAmt
EOY$12,633,364EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$385,233BOYAmt
EOY$253,516EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$54,769,453BOYAmt
EOY$58,643,276EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,821,706BOYAmt
EOY$1,820,431EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,316,600BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,402,456BOYAmt
EOY$2,179,110EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,540,762BOYAmt
EOY$3,999,541EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$49,207,249BOYAmt
EOY$54,643,735EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$21,442BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$49,228,691BOYAmt
EOY$54,643,735EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$54,769,453BOYAmt
EOY$58,643,276EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$5,742,737ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$327,693NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$3,595OtherActivitiesAmt
Total Lobbying Expenditures$3,595TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationJMMMC PAID DUES TO THE AMERICAN HOSPITAL ASSOCIATION AND THE NEBRASKA HOSPITAL ASSOCIATION. A PORTION OF THE DUES FOR EACH ORGANIZATION WERE USED FOR LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$41,192BeginningYearBalanceAmt
Contributions$1,250ContributionsAmt
End Year Balance$42,442EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$39,942BeginningYearBalanceAmt
Contributions$1,250ContributionsAmt
End Year Balance$41,192EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$38,692BeginningYearBalanceAmt
Contributions$1,250ContributionsAmt
End Year Balance$39,942EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$37,400BeginningYearBalanceAmt
Contributions$1,260ContributionsAmt
Investment Earnings Or Losses$32InvestmentEarningsOrLossesAmt
End Year Balance$38,692EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$35,050BeginningYearBalanceAmt
Contributions$2,350ContributionsAmt
End Year Balance$37,400EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$369,594OtherCostOrOtherBasisAmt
Book Value$369,594BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$17,733,761OtherCostOrOtherBasisAmt
Depreciation$11,221,792DepreciationAmt
Book Value$6,511,969BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,254,344OtherCostOrOtherBasisAmt
Depreciation$6,619,957DepreciationAmt
Book Value$1,634,387BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,169,702OtherCostOrOtherBasisAmt
Depreciation$4,558,280DepreciationAmt
Book Value$8,611,422BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$17,127,372TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
457 PENSION LIABILITIES$183,672
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS$1,995,438
FieldValueIRS element (for citing)
Total Liability$2,179,110TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:PROVIDE SUPPORT TO ENSURE CONTINUED OPERATION OF JENNIE M. MELHAM MEMORIAL MEDICAL CENTER.
PART X, LINE 2:THE HOSPITAL AND FOUNDATION ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE CODE AND HAVE RECEIVED DETERMINATION LETTERS THAT THEY ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE INTERNAL REVENUE SERVICE HAS ESTABLISHED STANDARDS TO BE MET TO MAINTAIN THE HOSPITAL'S TAX EXEMPT STATUS. IN GENERAL, SUCH STANDARDS REQUIRE THE HOSPITAL TO MEET A COMMUNITY BENEFITS STANDARD AND COMPLY WITH VARIOUS LAWS AND REGULATIONS. THE MEDICAL CENTER ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB 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 SEPTEMBER 30, 2021 AND 2020, THE MEDICAL CENTER HAD NO UNCERTAIN TAX POSITIONS ACCRUED.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent200 DYes (X)Percent200DInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$37,982TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$37,982NetCommunityBenefitExpnsAmt
Total Expense0.00210TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,288,717TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,152,654DirectOffsettingRevenueAmt
Net Community Benefit Expns$136,063NetCommunityBenefitExpnsAmt
Total Expense0.00770TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,326,699TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,152,654DirectOffsettingRevenueAmt
Net Community Benefit Expns$174,045NetCommunityBenefitExpnsAmt
Total Expense0.00980TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$45,510TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$45,510NetCommunityBenefitExpnsAmt
Total Expense0.00260TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$226,211TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$226,211NetCommunityBenefitExpnsAmt
Total Expense0.01280TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$271,721TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$271,721NetCommunityBenefitExpnsAmt
Total Expense0.01540TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,598,420TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,152,654DirectOffsettingRevenueAmt
Net Community Benefit Expns$445,766NetCommunityBenefitExpnsAmt
Total Expense0.02520TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,316TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,316NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,587TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$12,587NetCommunityBenefitExpnsAmt
Total Expense0.00070TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,214TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,214NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,606TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,606NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,948TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$8,948NetCommunityBenefitExpnsAmt
Total Expense0.00050TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$32,671TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$32,671NetCommunityBenefitExpnsAmt
Total Expense0.00180TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$318,101BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$9,491,818ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$9,397,840CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$93,978MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JENNIE M MELHAM MEMORIAL MEDICAL CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 250AddressLine1Txt
CityBROKEN BOWCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68822ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.MELHAM.ORGWebsiteAddressTxt
State License100004StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherAPARTMENTSOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1JENNIE M MELHAM MEMORIAL MED CTR INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.MELHAM.ORG/DOWNLOADSOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt19ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLWWW.MELHAM.ORG/DOWNLOADSStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care200.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.MELHAM.ORG/FINANCIAL-ASSISTANCE-PROGRAMFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.MELHAM.ORG/FINANCIAL-ASSISTANCE-PROGRAMFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.MELHAM.ORG/FINANCIAL-ASSISTANCE-PROGRAMFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
JENNIE M. MELHAM MEMORIAL MED. CTR. INC.PART V, SECTION B, LINE 5: IN ORDER TO UPDATE THE 2019 CHNA THE MEDICAL CENTER'S ADMINISTRATION COLLECTED AND ANALYZED THE MOST CURRENT STATE, FEDERAL AND COMMUNITY DATABASES TO UNDERSTAND THE DEMOGRAPHIC MAKEUP AND TRENDS IN THE SERVICE AREA. THIS INFORMATION WAS USED TO BETTER UNDERSTAND HOW THESE TRENDS AFFECT THE MEDICAL CENTER'S CURRENT AND FUTURE PROVISION OF HEALTHCARE TO MEET THE COMMUNITY AND COUNTY'S HEALTH NEEDS. THE MEDICAL CENTER PARTNERED WITH THE LOUP BASIN PUBLIC HEALTH DEPARTMENT (LBPHD) IN DEVELOPMENT AND ADMINISTRATION OF A 2019 COMMUNITY THEMES AND STRENGTHS ASSESSMENT SURVEY OF RESIDENTS HEALTHCARE STATUS AND NEEDS IN THE LBPHD'S NINE COUNTY SERVICE AREA.THE RESULTS OF THE SURVEY WERE SEGREGATED OUT BY CITY/COUNTY SO THAT THIS INFORMATION COULD BE BROKEN DOWN AND USED BY EACH OF THE HOSPITALS IN THE REGION FOR PLANNING PURPOSES. THE MEDICAL CENTER USED THE BROKEN BOW AND CUSTER COUNTY SURVEY RESULTS IN THE 2019 CHNA PLANNING PROCESS.
JENNIE M. MELHAM MEMORIAL MED. CTR. INC.PART V, SECTION B, LINE 6B: LOUP BASIN PUBLIC HEALTH DEPARTMENT
JENNIE M. MELHAM MEMORIAL MED. CTR. INC.PART V, SECTION B, LINE 11: THE ASSESSMENT SURVEY IDENTIFIED THE FOLLOWING KEY NEED AREAS: 1. ADEQUATE NUTRITION PROGRAMS AND PHYSICAL ACTIVITY2. OBESITY AND ASSOCIATED CHRONIC ILLNESS3. ACCESS TO MENTAL HEALTH SERVICESTHE MEDICAL CENTER USED THE INFORMATION FROM THE LBPHD SURVEY AND MAPP PROCESS TO ASSIST IN UPDATING PLANS FOR HEALTH SCREENING, HEALTH EDUCATION AND WELLNESS ACTIVITIES IN THE COMMUNITY. FEEDBACK ON THE CHNA AND CHIP WAS SOUGHT FROM THE PBPHD, MEDICAL CENTER BOARD OF DIRECTORS, AND LOCAL MEDICAL STAFF. ALL FEEDBACK WAS USED TO REFINE THE 2019 CHNA AND CHIP FOR THE MEDICAL CENTER'S SERVICE AREA. SOME OF THE ACTIVITIES THAT WERE DEVELOPED AND IMPLEMENTED BY THE MEDICAL CENTER AS A RESULT OF THE 2019 CHNA AND CHIP FOR OUR SERVICE AREA:THE MEDICAL CENTER IS THE SITE FOR THE LOCAL WEIGHT WATCHERS PROGRAM AND PROMOTED THIS PROGRAM AMONG MEDICAL CENTER STAFF AND THE PUBLIC.MELHAM MEDICAL CENTER HAS PARTNERED WITH AND CONTINUES TO PARTNER WITH AREA SERVICE CLUBS, THE SCHOOL DISTRICT, AND OTHER HEALTHCARE PROVIDERS TO PROVIDE WELLNESS EVENTS SUCH AS 5K FUN RUNS AND WALKS, COMMUNITY EDUCATION, AND HEALTH FAIRS.THE MEDICAL CENTER HAS PARTNERED WITH THE BROKEN BOW POLICE DEPARTMENT TO CHARTER A CUSTER COUNTY MENTAL HEALTH TASK FORCE COMPRISED OF COUNTY SCHOOL DISTRICTS, LOCAL MENTAL HEALTH THERAPISTS, CUSTER COUNTY SHERIFF, NEBRASKA HIGHWAY PATROL, CALLAWAY DISTRICT HOSPITAL, AND CONSUMERS OF MENTAL HEALTH SERVICES. THE TASK FORCE EXISTS TO IDENTIFY MENTAL HEALTH NEEDS AND RESOURCES, REDUCE FRAGMENTATION OF SERVICES AMONG PROVIDERS, AND DEVELOP PLANS FOR COMMUNITY RESPONSE TO MENTAL HEALTH NEEDS. THE TASK FORCE RECENTLY PARTNERED WITH CUSTER AREA ROTARY AND RECEIVED A GRANT TO BRING THE WELLNESS RECOVERY ACTION PLAN (WRAP) TOOL TO THE COUNTY. LOCAL TRAINERS WILL WORK WITH LOCAL THERAPISTS, EMPLOYERS, AND SCHOOLS TO COORDINATE WRAP COMPLETION BY COMMUNITY MEMBERS TO PROACTIVELY ADDRESS WELLNESS, RECOVERY, STRESSORS, AND SUPPORT SYSTEMS. THE PLAN WILL THEN BE AVAILABLE TO LOCAL LAW ENFORCEMENT AND FIRST RESPONDERS IN A STANDARDIZED FORMAT TO ASSIST THEM IN ADDRESSING INDIVIDUALS IN CRISIS WITH THE GOAL OF AVOIDING ESCALATION OF CRISIS SITUATIONS.MELHAM MEDICAL CENTER CURRENTLY PARTNERS WITH RICHARD YOUNG BEHAVIOR HEALTH TO PROVIDE INDIVIDUAL PSYCHOLOGICAL SERVICES VIA TELEHEALTH IN THE SPECIALTY CLINIC.MELHAM MEDICAL CENTER CURRENTLY OPERATES A WELLNESS CENTER WITH COMPREHENSIVE STRENGTH AND CONDITIONING FITNESS EQUIPMENT AND A TENNIS COURT. THE MEDICAL CENTER IS CURRENTLY A CORE ORGANIZATION IN PARTNERSHIP WITH THE SCHOOL DISTRICT, MAJOR COMMUNITY EMPLOYERS, AND THE CITY OF BROKEN BOW IN AN EFFORT TO DEVELOP A COMMUNITY WELLNESS CENTER AND SUPPORT A WELLNESS CENTER PROGRAM AND WELLNESS DIRECTOR TO PROMOTE ACTIVE LIFESTYLES AND ACCESS TO WELLNESS ACTIVITIES FOR ALL AGES IN CUSTER COUNTY.ACCESS TO MENTAL HEALTH SERVICES WAS NOTED BY SURVEY PARTICIPANTS AS A NEED. THE MEDICAL CENTER HAS MANY OTHER FINANCIAL COMMITMENTS TO ENSURE PROVISION OF OTHER KEY MEDICAL CARE NEEDS IN THE COMMUNITY. THERE ARE EXISTING PROVIDERS IN THE COMMUNITY WHO ADDRESS MENTAL HEALTH ISSUES FOR ALL AGES WITH WHOM THE MEDICAL CENTER CAN PARTNER TO AVOID DUPLICATION OF SERVICES AND UNNECESSARY COMPETITION. THERE IS LIMITED GRANT FUNDING BASED ON UTILIZATION ON WHICH THESE NON-PROFIT AGENCIES RELY.ADEQUATE NUTRITION PROGRAMS FOR RESIDENTS OF THE COMMUNITY WAS ALSO NOTED BY THE PARTICIPANTS IN THE ASSESSMENT PROCESS AS A NEED. THIS IS NOT AN AREA OF EXPERTISE FOR THE MEDICAL CENTER. THERE ARE A NUMBER OF SERVICES IN THE COMMUNITY ALREADY WORKING ON NUTRITION ISSUES IN THE COMMUNITY THAT THE MEDICAL CENTER CAN PARTNER WITH OR SUPPORT, SUCH AS THE SENIOR CENTERS, THE BACKPACK PROGRAM, AND MEALS ON WHEELS PROGRAMS.
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line11 - LIBERTY SQUARE APARTMENTSBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 250AddressLine1Txt
CityBROKEN BOWCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68822ZIPCd
FieldValueIRS element (for citing)
FacilitySENIOR INDEPENDENT LIVING APARTMENT COMPLEXFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:ELIGIBILITY IS MAINLY BASED UPON FEDERAL POVERTY GUIDELINES, HOWEVER, OTHER FACTORS WILL COME INTO THE DECISION MAKING PROCESS. THESE FACTORS INCLUDE AGE, EXISTING MEDICAL DEBT, EXISTING NON-MEDICAL DEBT, ASSET OWNERSHIP, INVESTMENTS AND ANY OTHER PERTINENT INFORMATION. THE INCOME GUIDELINES ALLOW FOR ASSISTANCE, BASED UPON A SLIDING SCALE, WHERE INCOME IS FROM ANYWHERE FROM 100% TO 200% OF FEDERAL POVERTY GUIDLINES.
PART I, LINE 6A:JMMMC'S COMMUNITY BENEFIT REPORT IS NOT PREPARED BY A RELATED ORGANIZATION.
PART I, LINE 7:JMMMC USED THE SEPTEMBER 30, 2021 COST REPORT AND AUDITED FINANCIAL STATEMENTS TO CALCULATE THE AMOUNT REPORTED ON PART I, LINE 7. JMMMC TOOK CHARITY CARE CHARGES FROM THE AUDITED FINANCIAL STATMENTS THEN REDUCED THOSE NUMBER TO A COST BASIS USING A COST-TO-CHARGE RATIO.
PART I, LN 7 COL(F):THE BAD DEBT THAT HAS BEEN SUBTRACTED FROM TOTAL EXPENSES TO DETERMINE THE DENOMINATOR IN THE PERCENTAGES FOR COLUMN (F) IS $318,101.
PART II, COMMUNITY BUILDING ACTIVITIES:JMMMC'S COMMUNITY BUILDING ACTIVITIES INCLUDE DISASTER TRAINING ACTIVITIES EXPENSES. JMMMC HAS WORKED WITH COMMUNITY AND REGIONAL ORGANIZATIONS TO DEVELOP DISASTER PLANS AND TRAIN BOTH OUR STAFF AND OTHER EXTERNAL ORGANIZATION'S STAFF FOR ANY POTENTIAL DISASTER RESPONSE. MEETING ROOMS, INCLUDING SOME WITH TELE VIDEO CAPABILITIES ARE AVAILABLE AND USED BY AREA ORGANIZATIONS FREE OF CHARGE. THIS SAVES THESE ORGANIZATIONS SIGNIFICANT SUMS OF MONEY, KEEPING THEIR STAFF AND VOLUNTEERS HERE LOCALLY AS OPPOSED TO COMMUTING UPWARDS OF 200 MILES OR MORE FOR CERTAIN TRAINING EVENTS. WEIGHTWATCHERS MEETS AT JMMMC TO PROVIDE THE COMMUNITY THE OPPORTUNITY TO LEARN HEALTHY EATING LIFESTYLES.
PART III, LINE 2:GENERALLY, PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR RELATED DEDUCTIBLES AND COINSURANCE, WHICH VARY IN AMOUNT. THE MEDICAL CENTER PROVIDES SERVICES TO UNINSURED PATIENTS, AND OFFERS THOSE UNINSURED PATIENTS A DISCOUNT, EITHER BY POLICY OR LAW, FROM STANDARD CHARGES. THE MEDICAL CENTER ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS AND IMPLICIT PRICE CONCESSIONS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF CHANGE. FOR THE YEARS ENDED SEPTEMBER 30, 2021 AND 2020, NO SIGNIFICANT ADJUSTMENTS TO REVENUE WERE RECOGNIZED DUE TO CHANGES IN ESTIMATES OF IMPLICIT PRICE CONCESSIONS FOR PERFORMANCE OBLIGATIONS SATISFIED IN PRIOR YEARS. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE.
PART III, LINE 3:THE MEDICAL CENTER PROVIDES FINANCIAL ASSISTANCE TO PATIENTS WHO ARE FINANCIALLY UNABLE TO PAY FOR THE HEALTHCARE SERVICES THEY RECEIVE. IT IS THE POLICY OF THE MEDICAL CENTER NOT TO PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. ACCORDINGLY, THE MEDICAL CENTER DOES NOT REPORT THESE AMOUNTS IN NET OPERATING REVENUE OR IN THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE MEDICAL CENTER DETERMINES THE COSTS ASSOCIATED WITH PROVIDING CHARITY CARE BY AGGREGATING THE DIRECT AND INDIRECT COSTS, INCLUDING SALARIES, BENEFITS, SUPPLIES, AND OTHER OPERATING EXPENSES, BASED ON AN OVERALL COST TO CHARGE RATIO. THE COSTS FOR CARING FOR THESE PATIENTS FOR THE YEARS ENDED SEPTEMBER 30, 2021 AND 2020 WERE APPROXIMATELY $42,000 AND $98,000, RESPECTIVELY. ALL OF THIS AMOUNT IS CONSIDERED A COMMUNITY BENEFIT.
PART III, LINE 4:THERE IS NO FOOTNOTE TO JMMMC'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT. HOWEVER, PAGES 8, 10, 11 AND 12 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS INCLUDE FOOTNOTES TITLED "PATIENT RECEIVABLES AND "PATIENT SERVICE REVENUE", AND "PATIENT FINANCIAL ASSISTANCE".
PART III, LINE 8:JMMMC USED THE SEPTEMBER 30, 2021 COST REPORT TO CALCULATE THE AMOUNT REPORTED ON PART III, LINE 6. NO MEDICARE SHORTFALL IS TREATED AS COMMUNITY BENEFITS.
PART III, LINE 9B:IF A PATIENT IS IDENTIFIED THAT IS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE, EFFORTS TO REACH OUT TO THIS INDIVIDUAL OR THE INDIVIDUAL'S FAMILY ARE MADE. THE PATIENT OR FAMILY IS REQUESTED TO COMPLETE A CHARITY CARE APPLICATION TO FORMALIZE THE PROCESS. AT THE TIME A COMPLETED APPLICATION IS RECEIVED, ALL COLLECTION EFFORTS ARE CEASED UNTIL A DETERMINATION IS MADE TO THE QUALIFICATION OF THE INDIVIDUAL.
PART VI, LINE 2:THERE IS NO FORMAL POLICY TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY JMMMC SERVES OTHER THAN THE NEEDS ASSESSMENT THAT WAS CONDUCTED DURING THE 2018 TAX YEAR.
PART VI, LINE 3:ALL PRIVATE PAY PATIENT ACCOUNTS ARE REVIEWED BY THE BILLING STAFF. DURING THE REVIEW PROCESS, PATIENTS THAT ARE IDENTIFIED AS POTENTIAL CANDIDATES FOR ELIGIBILTY AND ASSISTANCE ARE CONTACTED BY THE BILLING STAFF. THE BILLING STAFF ENCOURAGES THE PATIENTS TO CONTACT THE APPROPRIATE AGENCY, MAINLY THE STATE MEDICAID PROGRAM, IN ORDER FOR THEM TO ASCERTAIN THEIR ELIGIBILITY. KNOWN INDIGENT PATIENTS ARE ENCOURAGED TO COMPLETE A CHARITY CARE APPLICATION. A FINANCIAL ASSISTANCE POLICY SUMMARY IS INCLUDED WITH ALL FIRST BILLINGS. INFORMATION REGARDING THE FINANCIAL ASSISTANCE POLICY IS INCLUDED ON ALL STATEMENTS SENT OUT.
PART VI, LINE 4:JENNIE M. MELHAM MEMORIAL MEDICAL CENTER SERVES THE PEOPLE OF CENTRAL NEBRASKA. LOCATED IN BROKEN BOW, THE COUNTY SEAT, THE PRIMARY SERVICE AREA ENCOMPASSES CUSTER COUNTY, BLAINE COUNTY, THOMAS COUNTY, LOUP COUNTY AND PARTS OF SHERMAN COUNTY. THE SERVICE AREA IS A VERY RURAL AREA. SOME COUNTIES OR PARTS THEREOF SERVED ARE AMONG THE SPARCEST POPULATED AREAS IN THE UNITED STATES. THE PRIMARY SERVICE AREA CONSISTS OF A POPULATION BASIS OF APPROXIMATELY 12,000. A LARGE PORTION OF THE POPULATION SERVED IS OVER AGE 65, RESULTING IN A LARGE NUMBER OF PATIENTS SEEN AT THE MEDICAL CENTER BEING COVERED BY THE MEDICARE PROGRAM. OVER 60% OF GROSS PATIENT REVENUE GENERATED AT THE MEDICAL CENTER IS MEDICARE. ADDITIONALLY, 5% OF GROSS PATIENT REVENUE IS RECEIVED FROM THE MEDICAID PROGRAM.
PART VI, LINE 5:JMMMC FURTHER PROMOTES THE HEALTH OF THE COMMUNITY BY THE FOLLOWING ACTIONS AND INITIATIVES:JMMMC PARTICIPATES WITH AREA COMMUNITY COLLEGES BY SERVING AS A CLINICAL ROTATION SITE FOR PHYSICIAN, PHYSICIAN ASSISTANT, PHARMACY, MEDICAL TECHNOLOGY, LPN, RN, MEDICAL TRANSCRIPTIONIST, PHYSICAL THERAPIST AND RADIOLOGY TECHNOLOGY STUDENTS. SPACE AND STAFF OVERSIGHT IS PROVIDED AT NO COST TO THE COLLEGE OR THE STUDENT. JMMMC ALSO OWNS A RESIDENTIAL HOUSE THAT IS USED TO MAKE FREE HOUSING AVAILABLE TO MANY OF THE STUDENTS WHO COME FROM OUT OF TOWN TO PARTICIPATE IN THE ABOVE STATED TRAINING PROGRAMS. JMMMC COVERS THE COSTS RELATED TO MAINTENANCE, HEATING, COOLING, LIGHTING, LAUNDRY/LINEN, INTERNET, AND OTHER COSTS FOR THIS HOUSE.JMMMC ASSISTS WITH LOCAL ECONOMIC DEVELOPMENT CORPORATION PROGRAMS DESIGNED TO PROMOTE INTEREST IN HEALTH CARE CAREERS. IT IS JMMMC'S HOPE THAT BY CREATING LOCAL INTEREST IN HEALTH CARE CAREERS JMMMC WILL INSPIRE LOCAL RESIDENTS TO SEEK OUT TRAINING AND RETURN TO THE COMMUNITY TO PURSUE A CAREER IN HEALTH CARE. JMMMC PARTNERS WITH LOCAL HIGH SCHOOLS TO PROMOTE HEALTHCARE CAREERS TO LOCAL STUDENTS. THROUGH HOSA (HEALTH OCCUPATIONS STUDENTS OF AMERICA), A FUTURE HEALTH CARE PROFESSIONALS CHAPTER AT BROKEN BOW HIGH SCHOOL, SPEARHEADED BY JMMMC, THE MEDICAL CENTER PROVIDES SPEAKERS, MENTORSHIP, AND JOB SHADOW EXPERIENCES TO STUDENTS. THE MEDICAL CENTER PARTNERS WITH THE LOCAL HIGH SCHOOL AND COMMUNITY COLLEGE TO PROVIDE CERTIFIED NURSING ASSISTANT CLASSES TO HIGH SCHOOL STUDENTS.NOT ALL PATIENTS HAVE AN ABILITY TO PAY AT TIME OF SERVICE. JMMMC HAS DEVELOPED GUIDELINES THAT DO NOT REQUIRE PAYMENT IN FULL AT TIME OF SERVICE FOR EMERGENT, URGENT OR ELECTIVE SERVICES AND ALLOWS FOR EXTENDED PERIODS OF TIME FOR PAYMENT OF THE DEBT AND NO INTEREST CHARGES ARE INCURRED. EVERY EFFORT IS MADE BY JMMMC TO KEEP HEALTHCARE AFFORDABLE FOR AREA PATIENTS.MEDICAL CENTER MEETING ROOMS ARE PROVIDED FREE OF CHARGE TO OUTSIDE COMMUNITY SERVICE ORGANIZATIONS WHO ARE PROMOTING HEALTHY LIFESTYLES AND WELLNESS PROMOTION.FREE BROADBAND ACCESS AND COMPUTER RESOURCES ARE PROVIDED FREE OF CHARGE TO LOCAL EMT VOLUNTEERS ALLOWING THEM TO BE MORE EFFICIENT IN THEIR DUTIES. THIS ALLOWS FOR BETTER PARTICIPATION IN THE EMT PROGRAM, THUS EXTENDING EMERGENCY TRANSFER SERVICES TO LOCAL RESIDENTS AND VISITORS. TELEVIDEO EQUIPMENT IS PROVIDED FREE OF CHARGE TO AREA EMT VOLUNTEERS. THIS ALLOWS FOR QUARTERLY TRAINING TO BE PROVIDED LOCALLY THAT IS REQUIRED TO MEET THEIR CONTINUING EDUCATION REQUIREMENTS AND MAINTAIN THEIR CERTIFICATION. THE AVAILABILITY OF THIS SERVICE FOR THE EMTS RESULTS IN SIGNIFICANT SAVINGS IN TERMS OF TRAVEL COSTS AND TRAVEL TIME, HELPING BOOST MORALE AND ENCOURAGING PARTICIPATION OF THIS EXTREMELY IMPORTANT SERVICE. IN THIS RURAL COMMUNITY, THERE IS NO OTHER EMERGENCY AMBULANCE SERVICE OTHER THAN THE LOCAL VOLUNTEERS. LOCAL LAW ENFORCEMENT, THE COUNTY ATTORNEY AND HEALTH DEPARTMENTS ALSO MAKE USE OF THE TELEVIDEO EQUIPMENT TO PROMOTE HEALTH AND SAFETY IN THE COMMUNITY. JMMMC PROVIDES SPACE FREE OF CHARGE TO THE CUSTER COUNTY COMMUNICATIONS DEPARTMENT. THIS COMMUNICATION CENTER HANDLES ALL RADIO COMMUNICATION BETWEEN THE LAW ENFORCEMENT AGENCIES, FIRE DEPARTMENTS AND EMERGENCY RESPONDERS FOR CUSTER COUNTY. THIS SPACE HOUSES EQUIPMENT THAT SERVES AS A BACKUP TO THEIR PRIMARY COMMUNICATION EQUIPMENT. IN SITUATIONS WHERE THE PRIMARY EQUIPMENT FAILS, THIS ALLOWS THE CUSTER COUNTY COMMUNICATIONS DEPARTMENT TO HAVE EMERGENCY BACKUP EQUIPMENT TO CONTINUE TO PROVIDE THE CRITICAL COMMUNICATION NEEDS OF CUSTER COUNTY.JMMMC'S EMERGENCY ROOM SERVICES ARE PROVIDED 24 HOURS PER DAY, 7 DAYS PER WEEK. THIS DEPARTMENT OPERATES AT A SIGNIFICANT LOSS BUT ENSURES THAT PATIENTS HAVE ACCESS TO EMERGENCY HEALTHCARE AT ALL TIMES. THE ER IS CERTIFIED AS A LEVEL IV TRAUMA CENTER AND THE SERVICE AREA EXTENDS APPROXIMATELY 100 MILES EAST TO WEST ALONG THE HIGHWAY 2 CORRIDOR. THIS IS THE MAIN HIGHWAY HORIZONTALLY BISECTING NEBRASKA AND IS USED BY MANY TRAVELERS AND VACATIONERS, GIVING THEM ACCESS TO EMERGENCY AND TRAUMA CARE. JMMMC'S EMERGENCY ROOM PROVIDES AROUND 2,500 EMERGENCY ROOM VISITS PER YEAR. THE MEDICAL CENTER PAYS LOCAL PHYSICIANS TO BE AVAILABLE TO PROVIDE EMERGENCY ROOM SERVICES 24 HOURS PER DAY, 365 DAYS PER YEAR.
PART VI, LINE 6:JMMMC IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
VERONICA L SCHMIDT
PRESIDENT/CEO THRU 09/15/21$207,262$0$31,840$0$270$0$8,451$0$61,675$0$309,498$0$0$0
CARLA BAZYN
VP/CFO$134,341$0$0$0$0$0$5,225$0$41,691$0$181,257$0$0$0
DARCI SHEA
RN$133,865$0$0$0$0$0$4,871$0$32,591$0$171,327$0$0$0
JENNIFER SCHAAF
PHARMACIST$156,066$0$0$0$0$0$3,131$0$1,223$0$160,420$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6THE MEMBERS CONSIST OF ALL PERSONS WHO CONTRIBUTE TO THE CORPORATION THE SUM OF NOT LESS THAN $25 AT ANY TIME DURING THE EXISTENCE OF THE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7ATHE MEMBERS ELECT THE BOARD OF DIRECTORS AT THE ANNUAL MEETING EACH YEAR.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 WILL BE PRESENTED TO THE BOARD OF DIRECTORS ELECTRONICALLY PRIOR TO FILING THE FORM 990.
FORM 990, PART VI, SECTION B, LINE 12CTHE CONFLICT OF INTEREST POLICY IS PRESENTED ANNUALLY TO THE BOARD OF DIRECTORS. THIS FORM IS REVIEWED AND DISCUSSED WITH THEM. THE BOARD MEMBERS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST DISCLOSURE FORM. THE CHAIRMAN CAN POINT OUT ANY KNOWN CONFLICTS OF INTEREST. INDIVIDUAL BOARD MEMBERS ARE ALSO RESPONSIBLE FOR DECLARING CONFLICTS AND UPON A CONFLICT, THEY ARE EXCLUDED FROM THE VOTE BUT NOT FROM THE DISCUSSION.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD OF DIRECTORS IS PRESENTED WITH COMPARATIVE INFORMATION FROM WAGE STUDIES PERFORMED BY THE NEBRASKA HOSPITAL ASSOCIATION. NHA GATHERS THE WAGE INFORMATION ANNUALY FROM MOST, IF NOT ALL, OF THE HOSPITALS IN THE STATE. THE DATA CAN BE ANALYZED IN A VARIETY OF FORMATS, ALLOWING FOR EXCELLENT WAGE COMPARISON. THE BOARD SETS THE CEO SALARY BASED UPON THIS INFORMATION.
FORM 990, PART VI, SECTION C, LINE 19JENNIE M. MELHAM MEMORIAL MEDICAL CENTER DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
FORM 990, PART IX, LINE 11GPATIENT TEST FEES: PROGRAM SERVICE EXPENSES 373,572. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 373,572. PHYSICAL/OCCUPATIONAL THERAPY: PROGRAM SERVICE EXPENSES 89,497. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 89,497. LAB TEST FEES: PROGRAM SERVICE EXPENSES 143,778. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 143,778. OTHER FEES FOR SERVICE: PROGRAM SERVICE EXPENSES 1,408,599. MANAGEMENT AND GENERAL EXPENSES 166,494. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,575,093. PHYSICIAN ER CALL PAYMENTS: PROGRAM SERVICE EXPENSES 1,292,133. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,292,133. SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 346,863. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 346,863.
FORM 990, PART XII, LINE 2C:THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1THE MELHAM MEDICAL CENTER FOUNDATION INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 250AddressLine1Txt
CityBROKEN BOWCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68822ZIPCd
FieldValueIRS element (for citing)
EIN470795995EIN
Primary ActivitiesSUPPORTING THE OPERATIONS OF A CRITICAL ACCESS HOSPITALPrimaryActivitiesTxt
Legal Domicile StateNELegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 12B, IIPublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1JENNIE M MELHAM MEMORIAL MEDICAL CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd