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JEFFERSON COMMUNITY HEALTH CENTER INC: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization
JEFFERSON COMMUNITY HEALTH CENTER INC (EIN 47-0468078)
Tax period
2023-10-01 to 2024-09-30
Filed
2025-08-14
IRS object ID
202502269349301430
Schema version
2023v6.0
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)
Return2025-08-14T12:31:40-05:00ReturnTs
Tax Period End2024-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line118081 BURT ST STE 200AddressLine1Txt
CityOMAHACityNm
State AbbreviationNEStateAbbreviationCd
ZIP680224722ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2023-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN470468078EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JEFFERSON COMMUNITY HEALTH CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlJEFFBusinessNameControlTxt
Phone4027293351PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12200 H STAddressLine1Txt
CityFAIRBURYCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68352ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCHANCE KLASEKPersonNm
Person TitleCFOPersonTitleTxt
Phone4027293351PhoneNum
Signature2025-08-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMEGAN L KOZIOL CPAPreparerPersonNm
PTINP01544037PTIN
Phone4023302660PhoneNum
Preparation2025-08-13PreparationDt
FieldValueIRS element (for citing)
Tax2023TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1JEFFERSON COMMUNITY HEALTH & LIFEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerCHANCE KLASEKPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12200 H STAddressLine1Txt
CityFAIRBURYCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68352ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$35,668,785GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressHTTP://WWW.JCHEALTHANDLIFE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1960FormationYr
Legal Domicile StateNELegalDomicileStateCd
Activity Or MissionTO OPERATE AN ACUTE CARE CRITICAL ACCESS HOSPITAL IN FAIRBURY, NEBRASKA.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee290TotalEmployeeCnt
Total Volunteers8TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$4,444,716PYContributionsGrantsAmt
CY Contributions Grants$819,603CYContributionsGrantsAmt
PY Program Service Revenue$30,805,464PYProgramServiceRevenueAmt
CY Program Service Revenue$33,853,758CYProgramServiceRevenueAmt
PY Investment Income$596,086PYInvestmentIncomeAmt
CY Investment Income$770,490CYInvestmentIncomeAmt
PY Other Revenue$190,135PYOtherRevenueAmt
CY Other Revenue$219,655CYOtherRevenueAmt
PY Total Revenue$36,036,401PYTotalRevenueAmt
CY Total Revenue$35,663,506CYTotalRevenueAmt
PY Grants And Similar Paid$5,721PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$6,713CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$18,795,995PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$19,750,038CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$27,118CYTotalFundraisingExpenseAmt
PY Other Expenses$12,707,169PYOtherExpensesAmt
CY Other Expenses$13,591,420CYOtherExpensesAmt
PY Total Expenses$31,508,885PYTotalExpensesAmt
CY Total Expenses$33,348,171CYTotalExpensesAmt
PY Revenues Less Expenses$4,527,516PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,315,335CYRevenuesLessExpensesAmt
Total Assets BOY$48,660,085TotalAssetsBOYAmt
Total Assets EOY$51,704,257TotalAssetsEOYAmt
Total Liabilities BOY$19,681,828TotalLiabilitiesBOYAmt
Total Liabilities EOY$19,226,488TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$28,978,257NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$32,477,769NetAssetsOrFundBalancesEOYAmt
MissionINSPIRING HEALTHY LIVING BY PROVIDING EXCEPTIONAL HEALTH AND LIFE SERVICES FOR EVERY PERSON, EVERY TIME.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$27,731,320ExpenseAmt
Grant$6,713GrantAmt
Revenue$30,432,354RevenueAmt
DescJEFFERSON COMMUNITY HEALTH & LIFE OPERATES A 17 BED CRITICAL ACCESS ACUTE CARE HOSPITAL. JEFFERSON COMMUNITY HEALTH & LIFE ALSO OPERATES A FITNESS CENTER, RURAL HEALTH CLINICS, AND PROVIDES HOME HEALTH SERVICES.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$2,365,573ExpenseAmt
Revenue$3,421,404RevenueAmt
DescJEFFERSON COMMUNITY HEALTH & LIFE OPERATES A 40 BED LONG-TERM CARE FACILITY FOR THE RESIDENTS OF JEFFERSON COUNTY AND THE SURROUNDING AREA.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$30,096,893TotalProgramServiceExpensesAmt
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 ActivitiesYes (1)FundraisingActivitiesInd
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 BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
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 EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document7IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee290EmployeeCnt
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 ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
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 Members8GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
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 ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
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)
PersonCHANCE KLASEKPersonNm
Phone4027296856PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12200 H STREET PO BOX 277AddressLine1Txt
CityFAIRBURYCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68352ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
TREVOR STEINMEYER
PRESIDENT1.000.00Yes (X)Yes (X)$0$0$0
ROSS BOECKNER
VICE PRESIDENT1.001.00Yes (X)Yes (X)$0$0$0
GLENDA AUSTIN
SECRETARY/TREASURER1.000.00Yes (X)Yes (X)$0$0$0
CAROLYN SCHERBARTH
BOARD MEMBER1.000.00Yes (X)$0$0$0
STEVEN SNYDER
BOARD MEMBER1.001.00Yes (X)$0$0$0
DIANE WELLSANDT
BOARD MEMBER1.000.00Yes (X)$0$0$0
DALLAS CHRIST
BOARD MEMBER1.000.00Yes (X)$0$0$0
SARA STEWART
BOARD MEMBER1.000.00Yes (X)$0$0$0
DR BURKE KLINE
CEO (JAN'24 - AUG '24)40.001.00Yes (X)$214,296$0$34,663
BILL WELCH
INTERIM CEO (AUG'24 - DEC'24)40.001.00Yes (X)$0$0$0
CHANCE KLASEK
CFO40.001.00Yes (X)$165,880$0$41,951
CRAIG SHUMARD
PHYSICIAN40.000.00$421,450$0$48,400Yes (X)
MADHAV NARAYAN
PHYSICIAN40.000.00$322,680$0$10,848Yes (X)
SEAN FLOR
PHYSICIAN40.000.00$310,356$0$34,278Yes (X)
REBECCA STROKLUND
PHYSICIAN40.000.00$301,359$0$39,029Yes (X)
BRETT WERGIN
PHYSICIAN40.000.00$301,502$0$24,995Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,037,523TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$234,164TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K25IndivRcvdGreaterThan100KCnt
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
CERNER
2800 ROCK CREEK PKWYKANSAS CITYKS64117ELECTRONIC HEALTH RECORD SERVICES$780,284
HEARTLAND BUSINESS SYSTEMS
9140 WEST DODGE ROAD SUITE 200OMAHANE68114INFORMATION TECHNOLOGY SERVICES$377,453
RURALMED MANAGEMENT RESOURCES
511 WEST AVEHOLDREGENE68949REVENUE CYCLE SERVICES$253,055
BRYAN HEALTH
1600 S 48TH STLINCOLNNE68506MEDICAL SERVICES$251,035
HIGH PLAINS ANESTHESIA SERVICES
8426 W BIRCH RDCLATONIANE68238ANESTHESIA SERVICES$180,000
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K11CntrctRcvdGreaterThan100KCnt
Fundraising$15,424FundraisingAmt
Related Organizations$51,537RelatedOrganizationsAmt
Government Grants$607,192GovernmentGrantsAmt
All Other Contributions$145,450AllOtherContributionsAmt
Noncash Contributions$5,580NoncashContributionsAmt
Total Contributions$819,603TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE624100$30,877,172$30,877,172
340B DRUG PRICING PROGRAM624100$1,537,040$1,537,040
CEDARWOOD ASSISTED LIVING SVC FEE623000$895,409$895,409
CEDARWOOD: EQUITY IN JT VENTURE623000$190,055$190,055

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$354,082TotalRevenueColumnAmt
Related Or Exempt Func Income$354,082RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$33,853,758TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$770,490TotalRevenueColumnAmt
Exclusion$770,490ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$2,320FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$15,424ContriRptFundraisingEventAmt
Fundraising Direct Expenses$5,279FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$2,959TotalRevenueColumnAmt
Exclusion-$2,959ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescCAFETERIADesc
Business722210BusinessCd
Total Revenue Column$222,614TotalRevenueColumnAmt
Exclusion$222,614ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$222,614OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$35,663,506TotalRevenueColumnAmt
Related Or Exempt Func Income$33,853,758RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$990,145ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$6,713TotalAmt
Program Services$6,713ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$530,791TotalAmt
Management And General$530,791ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$84,139TotalAmt
Program Services$84,139ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$15,397,426TotalAmt
Program Services$14,731,734ProgramServicesAmt
Management And General$640,801ManagementAndGeneralAmt
Fundraising$24,891FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$464,706TotalAmt
Program Services$464,706ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,188,418TotalAmt
Program Services$2,044,334ProgramServicesAmt
Management And General$142,263ManagementAndGeneralAmt
Fundraising$1,821FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,084,558TotalAmt
Program Services$1,010,105ProgramServicesAmt
Management And General$74,453ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$82,032TotalAmt
Program Services$32,957ProgramServicesAmt
Management And General$49,075ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$129,342TotalAmt
Management And General$129,342ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,113,593TotalAmt
Program Services$2,385,225ProgramServicesAmt
Management And General$728,368ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$137,136TotalAmt
Program Services$20,822ProgramServicesAmt
Management And General$116,314ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,020,541TotalAmt
Program Services$912,818ProgramServicesAmt
Management And General$107,317ManagementAndGeneralAmt
Fundraising$406FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$554,017TotalAmt
Program Services$498,675ProgramServicesAmt
Management And General$55,342ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$78,528TotalAmt
Program Services$66,479ProgramServicesAmt
Management And General$12,049ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$157,164TotalAmt
Program Services$106,074ProgramServicesAmt
Management And General$51,090ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$489,241TotalAmt
Program Services$452,585ProgramServicesAmt
Management And General$36,656ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,431,506TotalAmt
Program Services$2,249,328ProgramServicesAmt
Management And General$182,178ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$242,036TotalAmt
Program Services$242,036ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$4,429,439$4,429,439
FOOD EXPENSE$451,310$202,927$248,383
DUES AND SUBSCRIPTIONS$187,382$69,885$117,497
MISCELLANEOUS EXPENSES$88,153$85,912$2,241

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$33,348,171TotalAmt
Program Services$30,096,893ProgramServicesAmt
Management And General$3,224,160ManagementAndGeneralAmt
Fundraising$27,118FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$10,871,578BOYAmt
EOY$12,078,530EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$8,600,479BOYAmt
EOY$8,925,672EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$562,966BOYAmt
EOY$586,307EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$512,900BOYAmt
EOY$681,175EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$38,682,742LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$19,841,094LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$19,615,173BOYAmt
EOY$18,841,648EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$6,520,699BOYAmt
EOY$8,770,393EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$1,348,011BOYAmt
EOY$1,532,030EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$628,279BOYAmt
EOY$288,502EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$48,660,085BOYAmt
EOY$51,704,257EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,951,201BOYAmt
EOY$3,251,089EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,214,019BOYAmt
EOY$6,982,715EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$8,515,754BOYAmt
EOY$8,414,622EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$854BOYAmt
EOY$578,062EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$19,681,828BOYAmt
EOY$19,226,488EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$28,652,760BOYAmt
EOY$32,114,646EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$325,497BOYAmt
EOY$363,123EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$28,978,257BOYAmt
EOY$32,477,769EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$48,660,085BOYAmt
EOY$51,704,257EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$2,315,335ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,184,177NetUnrlzdGainsLossesInvstAmt
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 Required0FederalGrantAuditRequiredInd

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 OrganizationsYes (1)GrantsOtherOrganizationsInd
Grants Other Organizations$2,799GrantsOtherOrganizationsAmt
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other Activities0OtherActivitiesInd
Total Lobbying Expenditures$2,799TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

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

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$50,754BeginningYearBalanceAmt
Contributions$335,309ContributionsAmt
Investment Earnings Or Losses$14,193InvestmentEarningsOrLossesAmt
Grants Or Scholarships$37,133GrantsOrScholarshipsAmt
End Year Balance$363,123EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$50,754BeginningYearBalanceAmt
End Year Balance$50,754EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$50,754BeginningYearBalanceAmt
End Year Balance$50,754EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$50,754BeginningYearBalanceAmt
End Year Balance$50,754EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$50,754BeginningYearBalanceAmt
End Year Balance$50,754EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.14010PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.85990TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$50,943OtherCostOrOtherBasisAmt
Book Value$50,943BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$28,167,064OtherCostOrOtherBasisAmt
Depreciation$13,519,746DepreciationAmt
Book Value$14,647,318BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,387,874OtherCostOrOtherBasisAmt
Depreciation$6,134,894DepreciationAmt
Book Value$3,252,980BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,076,861OtherCostOrOtherBasisAmt
Depreciation$186,454DepreciationAmt
Book Value$890,407BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$18,841,648TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
ACCRUED INTEREST$77,062
ESTIMATED THIRD-PARTY PAYOR SETTLEMENT$501,000
FieldValueIRS element (for citing)
Total Liability$578,062TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE INTENDED USE OF THE HOSPITAL'S ENDOWMENT FUNDS IS TO PROVIDE NURSING SCHOLARSHIPS AND CAPITAL IMPROVEMENTS.
PART X, LINE 2:THE HEALTH 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 HEALTH CENTER RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT SEPTEMBER 30, 2024 AND 2023, THE HEALTH CENTER HAD NO UNCERTAIN TAX POSITIONS ACCRUED
SCHEDULE D, PART V, LINE COLUMN A:PRIOR TO THE CURRENT YEAR, THE ENDOWMENT FUNDS REPORTED ON SCHEDULE D, PART V DID NOT INCLUDE TEMPORARY ENDOWMENTS. IN THE CURRENT YEAR, THE ORGANIZATION INCLUDED THE TEMPORARY ENDOWMENTS. THE CURRENT YEAR CONTRIBUTION AMOUNT REPORTED IN COLUMN A INCLUDES THE BEGINNING BALANCE OF THE TEMPORARY ENDOWMENTS.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GOLF TOURNAMENTEvent1Nm
Gross Receipts Event1$17,744GrossReceiptsEvent1Amt
Charitable Contri Event1$15,424CharitableContriEvent1Amt
Gross Revenue Event1$2,320GrossRevenueEvent1Amt
Cash Prizes Event1$1,440CashPrizesEvent1Amt
Non Cash Prizes Event1$820NonCashPrizesEvent1Amt
Rent Facility Costs Event1$1,880RentFacilityCostsEvent1Amt
Food And Beverage Event1$607FoodAndBeverageEvent1Amt
Other Direct Expenses Event1$532OtherDirectExpensesEvent1Amt
Gross Receipts Total$17,744GrossReceiptsTotalAmt
Charitable Contributions Tot$15,424CharitableContributionsTotAmt
Gross Revenue Total Events$2,320GrossRevenueTotalEventsAmt
Cash Prizes Total Events$1,440CashPrizesTotalEventsAmt
Non Cash Prizes Total Events$820NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$1,880RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$607FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events$532OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$5,279DirectExpenseSummaryEventsAmt
Net Income Summary-$2,959NetIncomeSummaryAmt

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
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
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$66,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$66,000NetCommunityBenefitExpnsAmt
Total Expense0.00200TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,756,040TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,514,094DirectOffsettingRevenueAmt
Net Community Benefit Expns$241,946NetCommunityBenefitExpnsAmt
Total Expense0.00730TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,822,040TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,514,094DirectOffsettingRevenueAmt
Net Community Benefit Expns$307,946NetCommunityBenefitExpnsAmt
Total Expense0.00930TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$74,323TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$74,323NetCommunityBenefitExpnsAmt
Total Expense0.00220TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$24,100TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$24,100NetCommunityBenefitExpnsAmt
Total Expense0.00070TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,519,123TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,575,513DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,943,610NetCommunityBenefitExpnsAmt
Total Expense0.08830TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,933TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$10,933NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,628,479TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,575,513DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,052,966NetCommunityBenefitExpnsAmt
Total Expense0.09150TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,450,519TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,089,607DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,360,912NetCommunityBenefitExpnsAmt
Total Expense0.10080TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$275TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$275NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$275TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$275NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$682,097BadDebtExpenseAmt
Bad Debt Expense Attributable$67,528BadDebtExpenseAttributableAmt
Reimbursed By Medicare$10,513,057ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$10,571,963CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$58,906MedicareSurplusOrShortfallAmt

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 Line1JEFFERSON COMMUNITY HEALTH CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12200 H STREETAddressLine1Txt
CityFAIRBURYCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68352ZIPCd
FieldValueIRS element (for citing)
Website AddressHTTP://WWW.JCHEALTHANDLIFE.ORGWebsiteAddressTxt
State License440001StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1JEFFERSON COMMUNITY HEALTH CENTER 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 Conducted21CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLJCHEALTHANDLIFE.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/OwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt21ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLJCHEALTHANDLIFE.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/StrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Other CriteriaYes (X)OtherCriteriaInd
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 URLHTTPS://WWW.JCHEALTHANDLIFE.ORG/CARE-SERVICES/PATIENT-RESOURCES/FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTPS://WWW.JCHEALTHANDLIFE.ORG/CARE-SERVICES/PATIENT-RESOURCES/FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTPS://WWW.JCHEALTHANDLIFE.ORG/CARE-SERVICES/PATIENT-RESOURCES/FAPSummaryOnWebsiteURLTxt
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 TranslatedYes (X)FAPTranslatedInd
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
Prospective Medicare MedicaidYes (X)ProspectiveMedicareMedicaidInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
JEFFERSON COMMUNITY HEALTH CENTER, INC.PART V, SECTION B, LINE 5: JEFFERSON COMMUNITY HEALTH & LIFE BEGAN ITS FOURTH COMMUNITY HEALTH NEEDS ASSESSMENT EARLY IN 2022. JCH&L CONDUCTED FOCUS GROUPS WITH LOCAL ORGANIZATIONS, HELD A COMMUNITY STAKEHOLDERS MEETING AND REVIEWED STATISTICS MADE AVAILABLE THROUGH PUBLIC HEALTH SOLUTIONS, THE STATE OF NEBRASKA, US CENSUS, HEALTHY PEOPLE 2030, AND WEBSITES SUCH AS COUNTY HEALTH RANKINGS AND WORLD LIFE EXPECTANCY.A COMMUNITY HEALTH NEEDS ASSESSMENT STAKEHOLDERS MEETING WAS HELD AT JCH&L WITH REPRESENTATIVES FROM AREA AGENCY PARTNERS, AND FOCUS GROUP MEETINGS WERE CONDUCTED WITH LOCAL COMMUNITY ORGANIZATIONS INCLUDING KIWANIS, ROTARY, OPTIMISTS, SENIOR DINERS AND JCH&L'S DEPARTMENT MANAGERS. A TOTAL OF 84 ATTENDED AND PARTICIPATED IN DISCUSSIONS OF COMMUNITY HEALTH NEEDS. HEALTH CARE PROVIDERS WERE ASKED TO SHARE THEIR CONCERNS AND WHAT THEY SEE AS THE COMMUNITY'S GREATEST NEEDS.
JEFFERSON COMMUNITY HEALTH CENTER, INC.PART V, SECTION B, LINE 11: PRIORITIZED NEEDS (AS DETERMINED BY COMMUNITY HEALTH NEEDS ASSESSMENT):1) OBESITY2) NUTRITION/SEDENTARY LIFESTYLE3) CHRONIC DISEASES AFFECTED BY OBESITY AND SEDENTARY LIFESTYLE, INCLUDING DIABETES, HEART DISEASE, STROKE, AND CANCERACTIONS TAKEN IN THIS TAX YEAR TO ADDRESS THESE NEEDS INCLUDE:1. PROMOTING HEALTHY LIFESTYLES AND PHYSICAL ACTIVITY- HOSTED KIDS COOKING CLASSES AND YOUTH SWIM EVENTS, PROMOTING HANDS-ON EDUCATION ABOUT NUTRITION AND FUN PHYSICAL ACTIVITY.- OFFERED FITNESS EDUCATION SESSIONS FOR STUDENTS AT MULTIPLE SCHOOL EVENTS, INCLUDING DILLER-ODELL, FAIRBURY PUBLIC, AND SIXTH GRADE ADVENTURE DAY.- HELD FITNESS IS FUN AND A FUN RUN IN PARTNERSHIP WITH JEFFS GONE MAD.- SPONSORED A WALKING CHALLENGE IN THE NEWLY RENOVATED FAIRBURY COMMUNITY BUILDING WITH PRIZES TIED TO THE SENIOR DINERS PROGRAM.- ADDED THE CIRCL FITNESS CLASS AT BURKLEY FITNESS CENTER AND HOSTED SENIOR HEALTH & FITNESS DAY FEATURING PRESENTATIONS ON NUTRITION AND EXERCISE.- SUPPORTED SAFE TRAVEL FOR ALL CHILDREN THROUGH OCCUPATIONAL THERAPIST TAYLOR ZIMMERMAN, HELPING FAMILIES WITH CHILDREN WHO HAVE SPECIAL MOBILITY NEEDS.- HOSTED COMMUNITY ACTIVITIES THAT ENCOURAGED MOVEMENT AND WELLNESS, SUCH AS THE REINDEER FUN WALK AND PROGRESSIVE AG SAFETY DAY, REACHING NEARLY 100 CHILDREN.2. ADDRESSING CHRONIC DISEASE EDUCATION, SCREENING, AND SUPPORT- OFFERED FREE MEDICARE PART D REVIEWS, WELCOME TO MEDICARE EDUCATION, AND DIABETES EDUCATION BY DR. BRETT WERGIN TO IMPROVE CHRONIC DISEASE MANAGEMENT AMONG SENIORS.- CONTINUED SMART MOVES PARTICIPATION AND CHRONIC CARE COORDINATION PROGRAMMING.- LAUNCHED A WOUND CARE CLINIC, A CRITICAL SERVICE FOR INDIVIDUALS WITH DIABETES AND VASCULAR CONDITIONS.- CONTINUED SUPPORT GROUPS INCLUDING ALZHEIMER'S CAREGIVER SESSIONS, EXPANDING SUPPORT FOR AGING AND CHRONICALLY ILL POPULATIONS.- HOSTED THE BRYAN MOBILE SCREENING UNIT, PROVIDING LOW-COST ACCESS TO SCREENINGS.- DISTRIBUTED GAS CARDS TO FAMILIES AFFECTED BY CANCER AND HOSTED AN EDUCATIONAL CANCER SESSION AT FAIRBURY HIGH SCHOOL.3. COMMUNITY ENGAGEMENT AND PARTNERSHIPS- MAINTAINED STRONG COMMUNITY PRESENCE THROUGH PARADES, FAIRS, PRESENTATIONS AT SENIOR DINERS, AND DONATIONS TO LOCAL YOUTH SPORTS PROGRAMS.- PARTNERED WITH FAIRBURY PUBLIC SCHOOLS ON THE HEALTHCARE HEROES LEAGUE FOR THIRD GRADERS AND CAREER DAYS TO FOSTER HEALTH EDUCATION EARLY.- PROVIDED EDUCATION ON VAPING PREVENTION, CPR, AND FIRST AID IN SCHOOLS.- SUPPORTED COMMUNITY WELL-BEING THROUGH EVENTS LIKE TRICK OR TREAT AT GARDENSIDE, CAR SHOWS, GRIEF SUPPORT GROUPS, AND BABYSITTING SAFETY CLASSES.4. ENHANCING ACCESS AND QUALITY OF CARE- EXPANDED CLINIC HOURS AND ADDED EARLY AND AFTERNOON APPOINTMENTS TO IMPROVE ACCESSIBILITY.- RECRUITED AND RETAINED PROVIDERS ACROSS SPECIALTIES INCLUDING BEHAVIORAL HEALTH, VASCULAR SURGERY, AND PAIN MANAGEMENT.- MAINTAINED 5-STAR CMS RATING AT GARDENSIDE AND EARNED MULTIPLE NATIONAL RECOGNITIONS FOR QUALITY, STROKE CARE, AND PATIENT EXPERIENCE.- RE-ACCREDITED THE SLEEP LAB, ADDED NEW DIAGNOSTIC EQUIPMENT, AND MADE FACILITY UPGRADES INCLUDING NEW PARKING, SIDEWALKS, AND ROOFTOP UNITS TO ENHANCE PATIENT CARE.THROUGH THESE INITIATIVES, JCH&L CONTINUED TO MAKE PROGRESS ON ITS 2022 CHNA PRIORITIES. THE CURRENT YEAR'S WORK DEMONSTRATED SUSTAINED COMMITMENT TO PROMOTING HEALTHIER LIFESTYLES, REDUCING CHRONIC DISEASE BURDENS, AND INCREASING ACCESS TO CARE.NEEDS JEFFERSON COMMUNITY HEALTH & LIFE WILL NOT ADDRESS:THERE WERE NEEDS IDENTIFIED THAT JCH&L DID NOT CHOOSE TO ADDRESS. WHILE THESE NEEDS ARE IMPORTANT TO THE COMMUNITY, THEY WERE NOT CHOSEN BASED ON THE PRIORITIZATION PROCESS.NEEDS WHICH WILL NOT BE ADDRESSED SPECIFICALLY BY JCH&L INCLUDE:*MENTAL HEALTH. WE WILL CONTINUE TO WORK TO BE GOOD COMMUNITY PARTNERS IN IMPROVING OUR COMMUNITY'S MENTAL HEALTH. WE CONTINUE TO OFFER A SPECIALTY CLINIC WITH GENESIS PSYCHIATRIC GROUP; WE CONTINUE TO SEEK OTHER POTENTIAL PROVIDERS WHO COULD OFFER SPECIALTY CLINICS AT OUR FACILITY; AND WE CONTINUE TO KEEP UP TO DATE ON WHAT SERVICES ARE AVAILABLE IN OUR COMMUNITY, SO OUR PROVIDERS CAN REFER AS APPROPRIATE. PRIMARY CARE IS OUR PRIME RESPONSIBILITY AND WE WILL CONTINUE TO FOCUS ON PRIMARY CARE FOR OUR AREA RESIDENTS. WE FEEL A MUCH BROADER COMMUNITY APPROACH WILL BE REQUIRED TO BE SUCCESSFUL IN IMPROVING OUR COMMUNITY'S MENTAL HEALTH STATUS.*SUBSTANCE ABUSE. WE WILL CONTINUE TO WORK TO BE GOOD COMMUNITY PARTNERS TO ALL AREA ENTITIES WORKING TO IMPROVE OUR COMMUNITY'S STATUS WITH SUBSTANCE ABUSE. THIS AREA IS ALSO NOT NAMED IN PRIORITIES BECAUSE WE BELIEVE A MUCH BROADER COMMUNITY APPROACH WILL BE REQUIRED TO BESUCCESSFUL IN IMPROVING OUR COMMUNITY'S STATUS WITH SUBSTANCE ABUSE. *SUICIDE. WE WILL CONTINUE TO WORK TO BE GOOD COMMUNITY PARTNERS TO ALL AREA ENTITIES WORKING TOWARD SUICIDE PREVENTION AND ASSISTANCE TO THOSE AFFECTED BY SUICIDE. THIS AREA IS NOT NAMED IN PRIORITIES, BECAUSE A MUCH BROADER COMMUNITY APPROACH WILL BE REQUIRED TO BE SUCCESSFUL IN REDUCING THE NUMBER OF SUICIDES.*ALZHEIMER'S DISEASE. WE WILL CONTINUE TO OFFER AN ALZHEIMER'S CAREGIVER'S SUPPORT GROUP AND WE WILL PROVIDE EDUCATIONAL RESOURCES TO OUR COMMUNITY THROUGH THE ALZHEIMER'S ASSOCIATION. THIS IS THE EXTENT OF WHAT WE FEEL OUR INVOLVEMENT CAN BE AT THIS TIME, SO WE DO NOT INTEND TO NAME THIS AS A MAJOR AREA OF ACTIVITY.*ADDITIONAL SPECIALTIES, ACCESS TO CARE, PREVENTATIVE CARE. JCH&L IS ALWAYS SEEKING POSSIBILITIES FOR ADDITIONAL SPECIALTIES, INCREASED ACCESS TO CARE AND INCREASED PREVENTATIVE CARE TO ADDRESS COMMUNITY NEEDS, AND WILL CONTINUE THIS PROCESS AS A PART OF OUR ONGOING STRATEGIC PLANNINGPROCESS. HOWEVER, IT IS NOT NAMED IN OUR PRIORITIES BECAUSE OF THE NEED FOR PERSONNEL AND RESOURCES TO ADDRESS PRIORITY AREAS, EXCEPT FOR A FEW SELECT AREAS WHICH DIRECTLY AFFECT OUR PRIORITY GOALS FOR THE NEXT THREE YEARS.*BULLYING, DENTAL HEALTH, CHRONIC PAIN. JCH&L WISHES TO BE A GOOD COMMUNITY PARTNER WITH ALL AREA AGENCIES AND PRACTICES WHICH PROVIDE SERVICES IN ALL OF THESE AREAS, WHICH ARE ALL OUTSIDE OF OUR CURRENT OFFERINGS. WE DO NOT INTEND TO NAME THESE AS PRIORITY AREAS AT THE PRESENT TIME.*ECONOMY, HOUSING. THESE ARE ONGOING SOCIETAL ISSUES WHICH AFFECT OUR BUSINESSES AND SERVICES. WE WILL CONTINUE TO BE A GOOD COMMUNITY PARTNER ON DEALING WITH THESE ISSUES IN OUR AREA, BUT WE DO NOT INTEND TO MAKE THESE AREAS OUR PRIORITY AREAS OF FOCUS.*INSURANCE/UNINSURED/UNDERINSURED. WE CONTINUE TO SEEK WAYS THAT WE AS AN ORGANIZATION CAN BEST SERVE THOSE WHO ARE UNINSURED OR UNDERINSURED, INCLUDING PROVIDING CHARITY CARE. THESE ARE NOT NAMED AS PRIORITY AREAS AT THIS TIME.
JEFFERSON COMMUNITY HEALTH CENTER, INC.PART V, SECTION B, LINE 13H: SOME INDIVIDUALS OR GUARANTORS MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE IN EXCESS OF WHAT WOULD HAVE BEEN GRANTED UNDER THE INCOME CRITERIA IF THEY HAD INCURRED CATASTROPHIC MEDICAL COSTS OR OTHER OBLIGATIONS (PRESENTLY OR ONGOING) THAT HAVE SUBSTANTIALLY REDUCED THEIR ABILITY TO PAY. IN SUCH CASES THE INDIVIDUAL OR GUARANTOR MAY BE DETERMINED BY JEFFERSON COMMUNITY HEALTH & LIFE TO BE MEDICALLY INDIGENT AND MAY, AT JEFFERSON COMMUNITY HEALTH & LIFE'S DISCRETION, BE ELIGIBLE FOR FINANCIAL ASSISTANCE IN THE FORM OF FREE OR DISCOUNTED LIABILITIES. THERE ARE INSTANCES WHEN A PATIENT WILL COMPLETE THE FINANCIAL ASSISTANCE APPLICATION, PROVIDES SUPPORTING DOCUMENTATION AND DOES NOT QUALIFY FOR ASSISTANCE. IF THE PATIENT'S BALANCE EXCEEDS MORE THAN 20% OF THEIR TOTAL INCOME, THIS WILL BE DEEMED A CATASTROPHIC BALANCE. IN THESE INSTANCES, THE CHIEF FINANCIAL OFFICER WILL HAVE THE AUTHORITY TO DETERMINE IF A PORTION OF THE BALANCE SHOULD BE FORGIVEN TO FINANCIAL ASSISTANCE. THIS WILL BE HANDLED ON A CASE-BY-CASE BASIS AND THE TOTALITY OF CIRCUMSTANCES WILL BE UTILIZED IN DETERMINING ELIGIBILITY. THE DISCOUNT SHALL NOT EXCEED 20% OF OUTSTANDING BALANCES.
FieldValueIRS element (for citing)
Facility2FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - GARDENSIDE
200 H STREETFAIRBURYNE68352LONG TERM CARE FACILITY
2 - FAIRBURY CLINIC
825 22ND STREETFAIRBURYNE68352RURAL HEALTH CLINIC

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:FEDERAL POVERTY GUIDELINES ARE USED TO DETERMINE ELIGIBILITY FOR PROVIDING FREE AND DISCOUNTED CARE TO LOW INCOME INDIVIDUALS. SOME INDIVIDUALS OR GUARANTORS MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE IN EXCESS OF WHAT WOULD HAVE BEEN GRANTED UNDER THE INCOME CRITERIA IF THEY HAD INCURRED CATASTROPHIC MEDICAL COSTS OR OTHER OBLIGATIONS (PRESENTLY OR ONGOING) THAT HAVE SUBSTANTIALLY REDUCED THEIR ABILITY TO PAY. IN SUCH CASES THE INDIVIDUAL OR GUARANTOR MAY BE DETERMINED BY JEFFERSON COMMUNITY HEALTH & LIFE TO BE MEDICALLY INDIGENT AND MAY, AT JEFFERSON COMMUNITY HEALTH & LIFE'S DISCRETION, BE ELIGIBLE FOR FINANCIAL ASSISTANCE IN THE FORM OF FREE OR DISCOUNTED LIABILITIES. THERE ARE INSTANCES WHEN A PATIENT WILL COMPLETE THE FINANCIAL ASSISTANCE APPLICATION, PROVIDES SUPPORTING DOCUMENTATION AND DOES NOT QUALIFY FOR ASSISTANCE. IF THE PATIENT'S BALANCE EXCEEDS MORE THAN 20% OF THEIR TOTAL INCOME, THIS WILL BE DEEMED A CATASTROPHIC BALANCE. IN THESE INSTANCES, THE CHIEF FINANCIAL OFFICER WILL HAVE THE AUTHORITY TO DETERMINE IF A PORTION OF THE BALANCE SHOULD BE FORGIVEN TO FINANCIAL ASSISTANCE. THIS WILL BE HANDLED ON A CASE-BY-CASE BASIS AND THE TOTALITY OF CIRCUMSTANCES WILL BE UTILIZED IN DETERMINING ELIGIBILITY. THE DISCOUNT SHALL NOT EXCEED 20% OF OUTSTANDING BALANCES.
PART I, LINE 6A:JCH&L'S COMMUNITY BENEFIT REPORT IS PREPARED BY THE STAFF OF THE HOSPITAL.
PART I, LINE 7:FINANCIAL ASSISTANCE AT COST, LINE 7A, UNREIMBURSED MEDICAID, LINE 7B, AND SUBSIDIZED HEALTH SERVICES, LINE 7G, ARE CALCULATED USING THE COSTING METHODS TO PREPARE THE COST REPORTS. COMMUNITY HEALTH IMPROVEMENT SERVICES, LINE 7E, HEALTH PROFESSIONS EDUCATION, LINE 7F, AND CASH AND IN-KIND CONTRIBUTIONS, LINE 7I, ARE REPORTED BASED ON ACTUAL EXPENSES REPORTED IN THE GENERAL LEDGER.
PART I, LINE 7G:THERE ARE COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC INCLUDED ON LINE 7G. TOTAL REVENUE RECEIVED FROM MEDICARE RELATED TO PHYSICIAN CLINICS INCLUDES $121,849 WITH MEDICARE ESTIMATED COSTS OF CARE RELATING TO PAYMENTS OF $182,066.
PART I, LINE 7:JCH&L REACHES OUT TO THE COMMUNITY IN A VARIETY OF WAYS INCLUDING, IN 2024:I. BENEFITS FOR THE POOR/PUBLIC PROGRAMS A. TRADITIONAL CHARITY CARE - JCH&L PROVIDED CHARITY CARE IN FISCAL 2024 FOR ALL JCH&L SERVICES TO THOSE WHO MEET THE FEDERAL POVERTY GUIDELINES. THE HOSPITAL BUSINESS OFFICE STAFF MEMBERS FILE INSURANCE CLAIMS FOR PATIENTS. PATIENTS ASSISTED: 52 VALUE: $66,000 B. IMPLICIT PRICE CONCESSIONS - BESIDES OFFICIAL CHARITY CARE, JCH&L WROTE OFF $682,097 IN IMPLICIT PRICE CONCESSIONS DURING FISCAL 2024. II. COMMUNITY BENEFIT SERVICESA. COMMUNITY HEALTH EDUCATION AND OUTREACH. - HEALTHCARE HEROES PIPELINE JEFFERSON COMMUNITY HEALTH & LIFE HAS PARTNERED WITH THE FAIRBURY PUBLIC SCHOOLS, NEBRASKA HOSPITAL ASSOCIATION AND NEBRASKA HEALTHCARE FOUNDATION TO BRING THE HEALTH CARE HEROES LEAGUE TO FAIRBURY THIRD GRADERS IN THE FALL OF FISCAL 2024. THE PROGRAM IS A COLLABORATIVE EFFORT TO PROVIDE FUN, ENGAGING, AND INNOVATIVE APPROACHES TO TEACH STUDENTS ABOUT A MULTITUDE OF DIFFERENT HEALTH CARE CAREER CHOICES. FOUR JCH&L STAFF MEMBERS WERE TRAINED FOR THE PROGRAM, AND ARE TAKING TURNS WORKING WITH A PE TEACHER IN THE SCHOOL TO OFFER THE PROGRAM. IN AUGUST AND SEPTEMBER 2024, STAFF MEMBERS RECEIVED TRAINING AND BEGAN MEETING WITH SCHOOL CLASSES ON A WEEKLY BASIS. TOTAL INDIVIDUALS REACHED: 69. ESTIMATED COST OF STAFF TIME: $1,650. - HEALTH FAIR JCH&L PROVIDES EDUCATIONAL BOOTHS, FREE HEALTH SCREENINGS, HANDOUTS, INFORMATION, ETC., AT COMMUNITY EVENTS. NO HEALTH FAIR WAS HELD IN 2024. - SPEAKERS BUREAU. JCH&L STAFF MEMBERS PROVIDE EDUCATIONAL PROGRAMS FOR COMMUNITY ORGANIZATIONS ON A VARIETY OF TOPICS. A TOTAL OF 21 PROGRAMS WERE DONE IN FISCAL 2024. TOTAL INDIVIDUALS REACHED: 1,063. ESTIMATED COST OF STAFF TIME: $1050. - SUPPORT GROUPS - ALZHEIMER'S ASSOCIATION CAREGIVERS SUPPORT GROUP RESUMED IN FISCAL 2023 AFTER BEING OFF BECAUSE OF COVID. JCH&L STAFF COORDINATE MEETINGS, OFFERING ASSISTANCE TO ANYONE INTERESTED IN MORE INFORMATION ABOUT ALZHEIMER'S AND BEING A CAREGIVER. JCH&L PROVIDES EDUCATIONAL PROGRAMS FOR THE GROUP -- INCLUDING SPEAKER'S FEES IF NEEDED, POSTAGE TO SEND OUT MEETING NOTICES, AND REFRESHMENTS. WE ALSO PROVIDE MEETING SPACE AND DRINKS FOR A GRIEF SUPPORT GROUP COORDINATED BY COTTONWOOD HOSPICE. TOTAL NUMBER REACHED: 60. APPROXIMATE COST OF STAFF TIME SPENT: $1,650. ESTIMATED COST OF POSTAGE: $200 (MEETING NOTICES) ESTIMATED OTHER COSTS (MATERIALS, SPEAKER FEES, REFRESHMENTS): $450. B. COMMUNITY-BASED CLINICAL SERVICES SCREENINGS AND ONE-TIME OR OCCASIONALLY HELD CLINICS. - COMPLETE BLOOD PROFILES IN THE FALL OF 2021, JCH&L BEGAN OFFERING WELLNESS WEDNESDAYS AND FASTING FRIDAYS, OFFERING PATIENT-REQUESTED BLOOD SCREENINGS FOR THOSE WITH HIGH DEDUCTIBLES OR WHO WOULD LIKE RESULTS MORE OFTEN THAN THEY CAN GET THEM THROUGH INSURANCE COVERAGE. THIS WAS TO TAKE THE PLACE OF COMPLETE BLOOD PROFILES PREVIOUSLY OFFERED TO OUR COMMUNITY AT A REDUCED RATE EACH SPRING. SEVERAL TYPES OF SCREENINGS ARE OFFERED WEEKLY AT A REDUCED RATE. DURING THE FISCAL YEAR WE DID 563 SCREENINGS, AND BROUGHT IN $10,250 IN PAYMENTS FOR THE SERVICE. WHEN COMPARED AGAINST TYPICAL CHARGES THE TOTAL COMMUNITY BENEFIT WAS MORE THAN $44,000. ESTIMATED NUMBER REACHED: 563 VALUE OF ESTIMATED STAFF TIME: $22,201.79. ESTIMATED VALUE OF COMMUNITY BENEFIT: $44,821. - IMMUNIZATION CLINICS. JCH&L COOPERATES WITH BLUE VALLEY COMMUNITY ACTION IN PROVIDING IMMUNIZATION CLINIC FOR CHILDREN TWICE EACH MONTH. JCHC PROVIDES SPACE WHERE IMMUNIZATIONS ARE DONE, NURSING STAFF, THE PATIENT WAITING AREAS, AND JANITORIAL AND SUPPORT SERVICES. NUMBER OF PATIENTS SERVED: 164. TOTAL OF 413 VACCINATIONS PROVIDED. ESTIMATED COST OF NURSES PROVIDED BY JCH&L TO GIVE SHOTS: $2,300.III. MEDICAL EDUCATION A. SCHOLARSHIP FUNDING FOR HEALTH PROFESSIONS. - PHYSICIAN/MEDICAL STUDENTS, NURSES/NURSING STUDENTS, TECHNICIANS AND OTHER HEALTH PROFESSIONALS. MEDICAL STUDENTS COME REGULARLY FOR RURAL ROTATIONS TO LEARN FROM LOCAL PHYSICIANS. JCH&L PROVIDES AN APARTMENT FOR THE MEDICAL STUDENTS TO STAY IN DURING THEIR TIME IN FAIRBURY, AND ALSO PROVIDES THEM USE OF OUR FITNESS CENTER DURING THEIR STAY. A TOTAL OF 7 PHYSICIAN STUDENTS, 5 PA STUDENTS, 3 NURSE PRACTITIONER STUDENTS, AND 1 PHARMACY STUDENT LEARNED AT OUR FACILITY IN FISCAL 2024. JCH&L IS A PARTNER IN OFFERING THE LILLIAN HANSEN REESMAN RN MEMORIAL NURSES SCHOLARSHIP FUND. SCHOLARSHIPS ARE OFFERED FROM THIS FUND, ESTABLISHED IN 1980. ONLY INTEREST IS USED FROM THIS $10,000 PERPETUAL FUND, DONATED BY THE REESMAN FAMILY, TO PROVIDE NURSING SCHOLARSHIPS. SCHOLARSHIPS ARE PROVIDED AS INTEREST FUNDS ARE AVAILABLE. ONE $500 SCHOLARSHIP WAS AWARDED IN FISCAL 2024. THE JCH&L AUXILIARY PROVIDES A SCHOLARSHIP FOR STUDENTS PURSUING AN EDUCATION IN MEDICAL FIELDS. THE $400 SCHOLARSHIP IS GIVEN FROM THE AUXILIARY'S FUNDS, AND THE NUMBER OF SCHOLARSHIPS GIVEN EACH YEAR IS BASED ON THE AUXILIARY'S FUNDING AVAILABILITY AND THE NUMBER OF REQUESTS. ONE SCHOLARSHIP WAS AWARDED IN 2024. ESTIMATED NUMBER REACHED: 16. JCH&L COST (APARTMENT RENT, STAFF TIME, ETC.): $20,000. B. OTHER - JOB SHADOWING. JCH&L TYPICALLY HOSTS JOB SHADOW STUDENTS THROUGH FAIRBURY HIGH SCHOOL'S ANATOMY AND PHYSIOLOGY CLASS, THROUGH THE SOUTHEAST COMMUNITY COLLEGE-FAIRBURY HIGH SCHOOL CAREER ACADEMY PROGRAM, AND FOR INTERESTED INDIVIDUALS. NUMBER REACHED: 41. ESTIMATED COST OF STAFF TIME: $4,100.IV. SUBDIZED HEALTH SERVICES - WELLNESS CENTER SUPPORT. JEFFERSON COMMUNITY HEALTH & LIFE HAS OPERATED THE BURKLEY FITNESS CENTER AS A COMMUNITY FITNESS/WELLNESS CENTER SINCE IT OPENED IN 1996. JCH&L PAYS THE WELLNESS CENTER'S OPERATING EXPENSES THAT EXCEED REVENUES. BECAUSE OF THE HEALTH CENTER'S SUPPORT OF THE FITNESS CENTER'S CASH FLOW, PRICES FOR MEMBERSHIPS AND SERVICES CAN REMAIN REASONABLE FOR COMMUNITY RESIDENTS. IF THE FITNESS CENTER WERE A STAND-ALONE OPERATION, PRICES WOULD HAVE TO RISE CONSIDERABLY TO PAY ALL EXPENSES. TOTAL VISITS FOR FISCAL 2024: 54,045. ESTIMATED AMOUNT OF WELLNESS CENTER SUPPORT: $49,156. - HOME HEALTH SUPPORT. JEFFERSON COMMUNITY HEALTH & LIFE HAS OPERATED A HOME HEALTH AGENCY SINCE 1984. JCH&L PAYS THE AGENCY'S OPERATING EXPENSES THAT EXCEED REVENUES. THE HEALTH CENTER'S SUPPORT MAKES IT POSSIBLE FOR THE HOME HEALTH AGENCY TO CONTINUE TO PROVIDE SKILLED CARE IN THE HOMES OF AREA RESIDENTS. INCOME: $189,237. EXPENSES: $506,157. NET LOSS: $316,920. - GARDENSIDE LONG-TERM CARE. JEFFERSON COMMUNITY HEALTH & LIFE HAS OPERATED GARDENSIDE LONG-TERM CARE SINCE OPENING IN 1963. GARDENSIDE PROVIDES A HOME (SHORT-TERM FOR SKILLED CARE OR LONG-TERM FOR THOSE UNABLE TO LIVE IN THEIR OWN HOME INDEPENDENTLY) FOR UP TO 40 INDIVIDUALS. MOST ARE FROM THIS AREA AND HAVING A LONG-TERM CARE FACILITY NEAR THEIR HOMES AND FAMILIES IS A GREAT BENEFIT TO OUR RESIDENTS, AS WELL AS TO THEIR FAMILIES. INCOME: $ 3,383,759. EXPENSES: $4,245,233. NET LOSS: $ 861,474.V. RESEARCH. NO RESEARCH DOLLARS EXPENDED.VI. CASH AND IN-KIND DONATIONS.A. CASH DONATIONS. JCH&L MAKES DONATIONS TO VARIOUS CHARITABLE CAUSES, INCLUDING GIRL SCOUTS, SOFTBALL, BASEBALL AND CHURCH CAMP FIRST AID KITS; SPONSORSHIP OF BASEBALL AND SOFTBALL TEAMS; GOLF TOURNAMENTS, AREA HIGH SCHOOL POST PROM ACTIVITIES; AREA COMMUNITY CELEBRATIONS; CHAMBER OF COMMERCE BANQUET, CHAMBER OF COMMERCE NEW TEACHER WELCOME, CHAMBER OF COMMERCE TEACHER RECOGNITION; AND DONATIONS TO TEAMMATES, LIGHT IT UP BLUE, FIVE STAR BIBLE CAMP; STATEBOUND ATHLETES FROM JEFFERSON COUNTY SCHOOLS; BONHAM THEATRE; ROTARY FUND-RAISERS; KGMT-KUTT ANNUAL THANKSGIVING MEAL; BLUE VALLEY COMMUNITY ACTION; BLUE RIVERS AREA AGENCY ON AGING; AND AREA SCHOOLS' WRESTLING PROGRAMS. THESE TOTALED $6,383. JCH&L ALSO CONTRIBUTES ITEMS -- SUCH AS FITNESS CENTER PASSES, JCH&L ITEMS, ETC., TO COMMUNITY EVENTS AS DOOR PRIZES. THESE TOTALED AN ESTIMATED $1,000. DONATIONS DURING FISCAL 2024 TOTALED $7,383. B. IN-KIND DONATIONS. - BLOOD DRIVE SUPPORT JCH&L ASSISTS NEBRASKA COMMUNITY BLOOD BANK BY SCHEDULING APPOINTMENTS FOR SIX BLOOD DRIVES EACH YEAR. THE BLOOD PRODUCTS ULTIMATELY HELP OUR COMMUNITY, AS NEBRASKA COMMUNITY BLOOD BANK IS JCH&L'S SUPPLIER OF BLOOD AND BLOOD PRODUCTS. ESTIMATED STAFF TIME: $500. - SAFETY DAY FOR KIDS. JCHL IS ONE OF THE COSPONSORS OF THE ANNUAL SAFETY DAY FOR KIDS IN JEFFERSON COUNTY. A TOTAL OF 98 KIDS -- AGES KINDERGARTEN THROUGH SIXTH GRADES ATTENDED THE AUGUST 2024 EVENT. STAFF MEMBERS ASSISTED IN PLANNING THE EVENT AND ASSISTED IN COORDINATING AND INSTRUCTING ON THE DAY OF THE CAMP. THE COST OF STAFF TIME DONATED IS ESTIMATED AT: $2,550. TOTAL COST OF SUPPLIES FURNISHED WAS $500.
PART II, COMMUNITY BUILDING ACTIVITIES:ECONOMIC DEVELOPMENT. JEFFERSON COMMUNITY HEALTH & LIFE IS ACTIVE IN LOCAL ECONOMIC DEVELOPMENT ACTIVITIES. JCH&L IS A MEMBER OF THE FAIRBURY CHAMBER OF COMMERCE. WE SEEK OPPORTUNITIES TO OFFER TOURS, HEALTH CARE INFORMATION ON COMMUNITY WEBSITES, ETC. COST OF CHAMBER MEMBERSHIP: $275. IN ADDITION TO THESE DIRECT PROGRAMS AND SERVICES, THE EMPLOYEES OF JEFFERSON COMMUNITY HEALTH & LIFE SERVE THEIR COMMUNITY IN MANY WAYS INCLUDING SERVING IN THEIR CHURCHES, AS GIRL AND BOY SCOUT LEADERS, 4-H LEADERS, AS LEADERS IN CIVIC ORGANIZATIONS, AS YOUTH GROUP LEADERS, AS CITY GOVERNMENT MEMBERS, ON COMMUNITY DEVELOPMENT BOARDS, FOR EMERGENCY RESPONSE ORGANIZATIONS, AND OTHERS. JCH&L STAFF MEMBERS ARE A RESOURCE AS COMMUNITY ROLE MODELS.JCH&L IS PROUD OF ITS CONTRIBUTIONS TO THE CITIZENS OF JEFFERSON COUNTY AND THE SURROUNDING AREA. THE CITIZENS OF THIS AREA ALSO HIGHLY REGARD JCH&L'S CONTRIBUTIONS TO THE COMMUNITY.THE GOAL OF THE JCH&L BOARD OF DIRECTORS, ADMINISTRATION AND STAFF IS TO EXPAND THAT PARTNERSHIP WITH AREA RESIDENTS AND FIND MORE WAYS TO SERVE AS A RESOURCE FOR HEALTH AND WELLNESS INFORMATION.
PART III, LINE 2:THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE ORGANIZATION DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSION BASED ON ITS 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 9.9% 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 12 AND 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:IF A PATIENT IS GRANTED FINANCIAL ASSISTANCE THAT IS FREE CARE, THE WRITTEN NOTICE TO THE PATIENT SHALL SO STATE AND REASONABLE MEASURES SHALL BE TAKEN TO ENSURE THAT ALL ECAS ARE REVERSED. IN ADDITION, ANY AMOUNTS PAID BY THE PATIENT IN EXCESS OF $5 SHALL BE REFUNDED. IF THE PATIENT IS GRANTED FINANCIAL ASSISTANCE THAT IS OTHER THAN FREE CARE,JCH&L WILL:1. PROVIDE THE PATIENT WITH A REVISED BILL SETTING FORTH: (I) THE AMOUNT THE PATIENT OWES FOR CARE PROVIDED AFTER FINANCIAL ASSISTANCE, (II) HOW THE REVISED AMOUNT WAS DETERMINED; AND (III) EITHER THE AGB FOR THE CARE PROVIDED OR INSTRUCTIONS ON HOW THE PATIENT CAN OBTAIN INFORMATION REGARDING THE AGB FOR THE CARE PROVIDED;2. PROVIDE THE PATIENT WITH A REFUND FOR ANY AMOUNT THE PATIENT HAS PAID IN EXCESS OF THE AMOUNT OWED TO JCH&L(UNLESS SUCH AMOUNT IS LESS THAN $5); AND3. TAKE REASONABLE MEASURES TO REVERSE ANY ECAS TAKEN AGAINST THE PATIENT.
PART VI, LINE 2:JCH&L ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY JCH&L SERVES IN SEVERAL WAYS. JCH&L UTILIZES SURVEYS BY PUBLIC HEALTH SOLUTIONS OF THE HEALTH CARE NEEDS FOR RESIDENTS OF JEFFERSON COUNTY AND THE SURROUNDING COMMUNITY. JCH&L VISITS LOCAL COMMUNITY SERVICE ORGANIZATIONS AND SEEKS INPUT ON NEEDS. JCH&L REVIEWS SURVEYS DONE BY THE STATE AND OTHER ORGANIZATIONS ON THE HEALTH CARE NEEDS FOR RESIDENTS OF JEFFERSON COUNTY AND THE SURROUNDING AREA.
PART VI, LINE 3:JCH&L INFORMS AND EDUCATES PATIENTS ABOUT ELIGIBILITY FOR ASSISTANCE ON AN INDIVIDUAL BASIS WHEN QUESTIONS ARISE. THE PATIENT BOOKLET PROVIDES BUSINESS OFFICE CONTACT INFORMATION FOR PATIENT QUESTIONS ABOUT THEIR BILL. THE SELF-PAY BILLING VENDOR ENGAGED BY JCH&L HAS A SET OF CRITERIA IT USES TO ASSESS WHETHER A PATIENT IS ELIGIBLE FOR ASSISTANCE PROGRAMS, OR IF THEY QUALIFY FOR JCH&L'S CHARITY CARE PROGRAM.
PART VI, LINE 4:JCH&L SERVES JEFFERSON COUNTY AND PARTS OF THAYER, FILLMORE, SALINE AND GAGE COUNTIES, ALL IN NEBRASKA; AND PARTS OF WASHINGTON AND MARSHALL COUNTIES IN KANSAS. THE POPULATION OF THE SERVICE AREA IS ESTIMATED AT ABOUT 18,000. REVENUE FROM MEDICARE PATIENTS AVERAGES APPROXIMATELY 50%, AND REVENUE FROM MEDICAID CLIENTS AVERAGES APPROXIMATELY 10%.
PART VI, LINE 5:JCH&L OPERATES IN JEFFERSON COUNTY WITH A COMMUNITY BOARD AND OPEN MEDICAL STAFF. ALL SURPLUS FUNDS ARE REINVESTED BACK INTO THE FACILITY THROUGH BUILDING CONSTRUCTION, EQUIPMENT PURCHASES, OR COMMUNITY PROGRAMS PROVIDED. JCH&L PROMOTES THE HEALTH OF THE COMMUNITY BY OFFERING A COMMUNITY FITNESS CENTER AT A REASONABLE RATE AND OFFERING SCHOLARSHIPS FOR THE COMMUNITY'S YOUTH WHO HAVE FINANCIAL NEED. THE NET COMMUNITY BENEFIT REPORTED IN PART I RELATING TO THE FITNESS CENTER WAS APPROXIMATELY $143,000. JCH&L PROMOTES THE HEALTH OF THE COMMUNITY BY PROMOTING COMMUNITY-WIDE PROGRAMS SUCH AS LIVE HEALTHY NEBRASKA AND STEP-2-IT (PROGRAMS WHICH ENCOURAGE INCREASING ACTIVITY AND LOSING WEIGHT.) JCH&L IS ALSO INVOLVED IN PROGRESSIVE AG SAFETY DAY AND WORKING WITH BLUE VALLEY COMMUNITY ACTION TO OFFER IMMUNIZATIONS TO AREA CHILDREN. JCH&L PROMOTES THE HEALTH OF THE COMMUNITY BY OFFERING PROGRAMS, TOURS, SPEAKERS, AND EDUCATION, INCLUDING SUPPORT GROUPS, EDUCATIONAL PROGRAMS AND PROGRAMS FOR LOCAL ORGANIZATIONS.
PART VI, LINE 6:JCH&L IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM BUT DOES WORK TO BE A LEADER IN PROMOTING THE HEALTH OF THE COMMUNITIES IT SERVES. JCH&L PARTNERS WITH MANY OTHER AREA ORGANIZATIONS, INCLUDING PUBLIC HEALTH SOLUTIONS, FARM SAFETY 4 JUST KIDS, NEBRASKA SAFE KIDS, JEFFERSON COUNTY EXTENSION, BLUE VALLEY COMMUNITY ACTION, FAIRBURY CHAMBER OF COMMERCE, FAIRBURY PUBLIC SCHOOLS, NEBRASKA COMMUNITY BLOOD BANK, RURAL COMPREHENSIVE CARE NETWORK, BLUE RIVER VALLEY NETWORK, HEARTLAND HEALTH ALLIANCE, AND OTHERS. DEPENDING ON THE ACTIVITY, JCH&L MAY BE THE LEAD ORGANIZATION, OR AN ORGANIZATION PROVIDING HELP AND ASSISTANCE.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgYes (1)CompBasedOnRevenueOfFlngOrgInd
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 (7 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
CRAIG SHUMARD
PHYSICIAN$299,558$0$121,892$0$0$0$24,263$0$24,137$0$469,850$0$0$0
SEAN FLOR
PHYSICIAN$270,746$0$39,610$0$0$0$20,720$0$13,558$0$344,634$0$0$0
REBECCA STROKLUND
PHYSICIAN$274,801$0$26,558$0$0$0$7,911$0$31,118$0$340,388$0$0$0
MADHAV NARAYAN
PHYSICIAN$271,780$0$50,900$0$0$0$720$0$10,128$0$333,528$0$0$0
BRETT WERGIN
PHYSICIAN$272,789$0$28,713$0$0$0$11,275$0$13,720$0$326,497$0$0$0
DR BURKE KLINE
CEO (JAN'24 - AUG '24)$213,130$0$1,166$0$0$0$5,655$0$29,008$0$248,959$0$0$0
CHANCE KLASEK
CFO$165,230$0$650$0$0$0$9,609$0$32,342$0$207,831$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 4ADURING THE YEAR, A SEVERANCE PAYMENT WAS MADE TO BURKE N. KLINE, A FORMER EMPLOYEE OF THE ORGANIZATION. UNDER A SEPARATION AGREEMENT AND RELEASE, THE ORGANIZATION AGREED TO PAY SEVERANCE COMPENSATION IN THE TOTAL GROSS AMOUNT OF $123,760, EQUIVALENT TO 26 WEEKS OF BASE SALARY, FOLLOWING HIS SEPARATION FROM EMPLOYMENT. IN ADDITION, IF THE EMPLOYEE ELECTED COBRA CONTINUATION COVERAGE, THE EMPLOYER AGREED TO CONTRIBUTE TO HEALTH INSURANCE PREMIUMS AT THE SAME LEVEL AS EXISTING EMPLOYEES THROUGH DECEMBER 2024. THE SEVERANCE PAYMENT WAS MADE IN ACCORDANCE WITH THE TERMS OUTLINED IN THE AGREEMENT AND WAS SUBJECT TO STANDARD PAYROLL DEDUCTIONS. THE AGREEMENT INCLUDED CONFIDENTIALITY, NON-DISPARAGEMENT, AND RELEASE OF CLAIMS PROVISIONS.
PART I, LINE 5THE ORGANIZATION PROVIDES INCENTIVE COMPENSATION TO CERTAIN EMPLOYED PHYSICIANS AND ADVANCED PRACTICE PROVIDERS BASED ON INDIVIDUAL PRODUCTIVITY AS MEASURED BY WORK RELATIVE VALUE UNITS (WRVUS). PROVIDERS RECEIVE A BASE SALARY AND ARE ELIGIBLE FOR ADDITIONAL INCENTIVE COMPENSATION FOR WRVUS PERFORMED IN EXCESS OF AN ESTABLISHED THRESHOLD. THE INCENTIVE COMPENSATION IS CALCULATED QUARTERLY AT A FIXED WRVU CONVERSION FACTOR AND RECONCILED AGAINST A BI-WEEKLY DRAW SYSTEM. THIS INCENTIVE STRUCTURE IS BASED ON INDIVIDUAL PHYSICIAN PRODUCTIVITY AND NOT DIRECTLY ON THE OVERALL REVENUES OF THE ORGANIZATION OR ANY RELATED ENTITY.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1HOSPITAL AUTHORITY NO 1 OF JEFFERSON COUNTY NEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN611683496BondIssuerEIN
Bond Issued2021-12-18BondIssuedDt
Issue Price$8,291,780IssuePriceAmt
PurposeRENOVATE FACILITY & REF BOND ISSUE (12/18/12)PurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$1,218,164RetiredAmt
Total Proceeds$8,291,780TotalProceedsAmt
Capital Expenditures$4,024,791CapitalExpendituresAmt
Other Spent Proceeds$4,266,989OtherSpentProceedsAmt
Substantial Completion2022SubstantialCompletionYr
Refunding Tax Exempt BondsYes (1)RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Use By Others0.00000PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00000PrivateBusConcerningUBIPct
Total Private Business Use0.00000TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd0ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate DueYes (1)NoRebateDueInd
Variable Rate IssueYes (1)VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
DATE THE REBATE COMPUTATION WAS PERFORMED:03/31/2022
NOTE REGARDING THE REBATE COMPUTATION:SINCE THE BOND PROCEEDS HAVE BEEN SPENT AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CALCULATIONS ARE NECESSARY.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonPATRICIA SNYDERPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionEMPLOYEE OF THE HOSPITAL AND SPOUSE OF STEVEN SNYDER, BOARD OF DIRECTORRelationshipDescriptionTxt
Transaction$84,139TransactionAmt
TransactionEMPLOYEE COMPENSATIONTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1ATHE EXECUTIVE COMMITTEE, COMPRISED OF THE BOARD PRESIDENT, VICE PRESIDENT, SECRETARY/TREASURER AND ONE OTHER APPOINTED MEMBER OF THE BOARD, HAS THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION A, LINE 6JEFFERSON COMMUNITY HEALTH & LIFE HAS MEMBERS. ANY PERSON, CORPORATION OR OTHER ENTITY MAY BECOME A LIFETIME MEMBER IF A CONTRIBUTION OF $100 OR MORE IS MADE TO THE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7AVACANCIES, OCCURRING ON THE BOARD BY EXPIRATION, SHALL BE FILLED THROUGH ELECTION BY THE MEMBERS AT THE ANNUAL MEETING OF THE MEMBERS. THE BOARD DEVELOPMENT COMMITTEE SHALL SUBMIT A SLATE OF PROSPECTIVE CANDIDATES TO THE BOARD OF DIRECTORS AT THEIR MEETING PRIOR TO THE ANNUAL MEETING WHICH WILL THEN BE PRESENTED AT THE ANNUAL MEETING FOR CONSIDERATION FOR ELECTION TO THE BOARD. IN ADDITION, MEMBERS OF THE CORPORATION MAY MAKE NOMINATIONS FROM THE FLOOR.
FORM 990, PART VI, SECTION A, LINE 7BEACH MEMBER SHALL BE ENTITLED TO ONE VOTE ON EACH MATTER SUBMITTED TO THE VOTE OF THE MEMBERS.
FORM 990, PART VI, SECTION B, LINE 11BTHE BOARD WILL REVIEW THE FORM 990 AT A REGULARLY SCHEDULED BOARD MEETING, WHICH DOES NOT NECESSARILY OCCUR PRIOR TO THE FILING OF FORM 990. FORM 990 IS REVIEWED BY MR. CHANCE KLASEK, CFO, PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CBOARD MEMBERS ARE REQUIRED, BY THE ARTICLES AND BYLAWS, TO REVIEW THE CONFLICT OF INTEREST POLICY ANNUALLY. A BOARD MEMBER WITH A CONFLICT OF INTEREST IS REQUIRED TO ABSTAIN FROM VOTING ON ANY MOTION FOR WHICH HE HAS A CONFLICT OF INTEREST. BOARD MEMBERS ARE WELL ACQUAINTED WITH EACH OTHER AND WOULD BE AWARE OF ANY PERSONAL CONFLICTS OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15THE HOSPITAL PARTICIPATES IN THE NEBRASKA COMPDATA SALARY SURVEYS FOR ALL POSITIONS. THE CEO SURVEY DATA IS GIVEN TO THE BOARD TO REVIEW, AND THE BOARD APPROVES THE CEO'S SALARY ON AN ANNUAL BASIS. OTHER OFFICER COMPENSATION IS REVIEWED AND APPROVED BY THE CEO AND HR DIRECTOR. THE BOARD OF DIRECTORS REVIEWS COMPENSATION RANGES PROPOSED BY OR THROUGH THE CEO FOR JCH&L'S OFFICERS AND KEY EMPLOYEES AND DETERMINES THAT SUCH COMPENSATION RANGES ARE REASONABLE AND CONSISTENT WITH FAIR MARKET VALUE.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PAGE 11, PART XI, LINE 2C:THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS SELECTS THE INDEPENDENT ACCOUNTANT AND HAS THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT. UPON CONCLUSION OF THE AUDIT, THE AUDITING FIRM PRESENTS THE RESULTS AND FINDINGS TO THE FINANCE COMMITTEE. THERE HAVE BEEN NO CHANGES TO THIS PROCESS FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1JCHC REAL ESTATE INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12200 H STREETAddressLine1Txt
CityFAIRBURYCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68352ZIPCd
FieldValueIRS element (for citing)
EIN881755265EIN
Primary ActivitiesREAL ESTATE HOLDINGSPrimaryActivitiesTxt
Legal Domicile StateNELegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 12C, III-FIPublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1JEFFERSON COMMUNITY HEALTH 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 OrgYes (1)GiftGrntCapContriFromOthOrgInd
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

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1JCHC REAL ESTATE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeCTransactionTypeTxt
Involved$51,537InvolvedAmt
Method Of Amount DeterminationFAIR MARKET VALUEMethodOfAmountDeterminationTxt