STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

SHENANDOAH MEDICAL CENTER: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
SHENANDOAH MEDICAL CENTER (EIN 42-1101835)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-11-15
IRS object ID
201643209349302759
Schema version
2015v2.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2016-11-15T08:53:31-06:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN476097913PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1SEIM JOHNSON 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 Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN421101835EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SHENANDOAH MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSHENBusinessNameControlTxt
Phone7122461230PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 PERSHING AVENUEAddressLine1Txt
CitySHENANDOAHCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51601ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMATTHEW SELLSPersonNm
Person TitleCFOPersonTitleTxt
Phone7122461230PhoneNum
Signature2016-11-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonWENDY R COOLEYPreparerPersonNm
PTINP01523804PTIN
Phone4023302660PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKAREN COLEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 PERSHING AVENUEAddressLine1Txt
CitySHENANDOAHCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51601ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$42,141,371GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.SMCHOSPITAL.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1978FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionTO PROVIDE A COMPLETE CONTINUUM OF HEALTHCARE SERVICES TO THE PEOPLE OF SHENANDOAH & SURROUNDING COMMUNITIES WITHOUT REGARD FOR ABILITY TO PAY AND WITHOUT DISCRIMINATION.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee441TotalEmployeeCnt
Total Volunteers50TotalVolunteersCnt
Total Gross UBI$50TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$145,231PYContributionsGrantsAmt
CY Contributions Grants$209,245CYContributionsGrantsAmt
PY Program Service Revenue$35,895,816PYProgramServiceRevenueAmt
CY Program Service Revenue$40,939,000CYProgramServiceRevenueAmt
PY Investment Income$590,492PYInvestmentIncomeAmt
CY Investment Income$481,617CYInvestmentIncomeAmt
PY Other Revenue$320,432PYOtherRevenueAmt
CY Other Revenue$321,617CYOtherRevenueAmt
PY Total Revenue$36,951,971PYTotalRevenueAmt
CY Total Revenue$41,951,479CYTotalRevenueAmt
PY Grants And Similar Paid$69,130PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$19,351,591PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$21,586,785CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$15,832,576PYOtherExpensesAmt
CY Other Expenses$19,349,247CYOtherExpensesAmt
PY Total Expenses$35,253,297PYTotalExpensesAmt
CY Total Expenses$40,936,032CYTotalExpensesAmt
PY Revenues Less Expenses$1,698,674PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,015,447CYRevenuesLessExpensesAmt
Total Assets BOY$36,601,106TotalAssetsBOYAmt
Total Assets EOY$67,750,733TotalAssetsEOYAmt
Total Liabilities BOY$6,608,413TotalLiabilitiesBOYAmt
Total Liabilities EOY$37,478,759TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$29,992,693NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$30,271,974NetAssetsOrFundBalancesEOYAmt
MissionTO MAKE A DIFFERENCE BY PROVIDING EXCEPTIONAL PATIENT CARE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$32,892,495ExpenseAmt
Revenue$40,939,000RevenueAmt
DescSHENANDOAH MEDICAL CENTER IS A CRITICAL ACCESS HOSPITAL WITH 25 ACUTE BEDS AND A 50 BED INTERMEDIATE CARE NURSING FACILITY. THE HOSPITAL PROVIDES ACUTE AND ANCILLARY SERVICES TO INDIVIDUALS IN AN INPATIENT AND OUTPATIENT SETTING. IN ADDITION, THE HOSPITAL PROVIDES RENTAL SPACE FOR A CANCER AND DIALYSIS TREATMENT CENTER. DURING 2015, THE HOSPITAL PROVIDED 1,309 DAYS OF ACUTE CARE, 768 DAYS OF SKILLED NURSING CARE, 203 NURSERY DAYS, AND 103,629 OUTPATIENT OCCASIONS OF SERVICE. THE NURSING FACILITY PROVIDED 15,074 INTERMEDIATE CARE DAYS AND 553 SKILLED NURSING CARE DAYS OF SERVICE.Desc
Total Program Service Expenses$32,892,495TotalProgramServiceExpensesAmt
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
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
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 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 With Officer Ent0BusinessRlnWithOfficerEntInd
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 Document24IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee441EmployeeCnt
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
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
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

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MATTHEW SELLS CFOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7122461230PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 PERSHING AVENUEAddressLine1Txt
CitySHENANDOAHCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51601ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
ED KLOBERDANZ
CHAIRMAN3.000.00Yes (X)Yes (X)$0$0$0
ALISSA MCGINNIS
VICE CHAIRMAN3.000.00Yes (X)Yes (X)$0$0$0
GREG RITCHEY
SECRETARY/TREASURER3.000.00Yes (X)Yes (X)$0$0$0
TIM AUGUSTINE
DIRECTOR3.000.00Yes (X)$0$0$0
MARY JO CARRELL
DIRECTOR3.000.00Yes (X)$0$0$0
DEB ISTAS
DIRECTOR3.000.00Yes (X)$0$0$0
FLOYD JONES DO
DIRECTOR3.000.00Yes (X)$0$0$0
ROGER JONES
DIRECTOR3.000.00Yes (X)$0$0$0
DAVE LASHIER
DIRECTOR3.001.00Yes (X)$0$0$0
LINDA LAUGHLIN
DIRECTOR3.000.00Yes (X)$0$0$0
KAREN COLE
CEO40.001.00Yes (X)$309,740$0$29,811
MATTHEW SELLS
CFO40.000.00Yes (X)$132,308$0$27,877
REBECCA ROSE
PHYSICIAN40.000.00$494,563$0$21,657Yes (X)
SCOTT R KING
PHYSICIAN40.000.00$433,860$0$28,188Yes (X)
SANTOSH KUMAR
PHYSICIAN40.000.00$366,203$0$36,785Yes (X)
MICHAEL WOODS
PHYSICIAN40.000.00$322,030$0$38,511Yes (X)
SATYA THIPPAREDDI
PHYSICIAN40.000.00$195,539$0$14,471Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,254,243TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$197,300TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K23IndivRcvdGreaterThan100KCnt
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
ALTUS ARCHITECTURAL STUDIOS
12925 WEST DODGE RDOMAHANE68154CONSULTING$723,566
GRAHAM CONSTRUCTION
421 GRAND AVENUEDES MOINESIA51601CONSTRUCTION ON NEW ADDITION$474,864
UNMC PHYSICIANS LAB REF
PO BOX 30014-1114OMAHANE68103LAB REFERENCE FEES$452,352
MEDEFIS CONSOLIDATED
PO BOX 5068NEW YORKNY10087COVERAGE FOR OB, MED SURG,LAB AND SURGER$370,900
DENNIS CUMMINGS
DEPARTMENT 300KANSAS CITYMO64121ANESTHESIOLOGIST$139,209
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt
Related Organizations$78,797RelatedOrganizationsAmt
Government Grants$12,318GovernmentGrantsAmt
All Other Contributions$118,130AllOtherContributionsAmt
Total Contributions$209,245TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEDICARE/MEDICAID PAYM624100$18,780,574$18,780,574
NET PATIENT SERVICE RE624100$17,757,284$17,757,284
340B REVENUE624100$2,035,882$2,035,882
MEANINGFUL USE INCENTI624100$1,650,919$1,650,919
AMBULANCE SERVICES621910$559,062$559,062

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$155,279TotalRevenueColumnAmt
Related Or Exempt Func Income$155,279RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$40,939,000TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$423,566TotalRevenueColumnAmt
Exclusion$423,566ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$152,387RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$152,387RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$152,387TotalRevenueColumnAmt
Exclusion$152,387ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$235,803SecuritiesAmt
Other$12,140OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$189,892SecuritiesAmt
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$45,911SecuritiesAmt
Other$12,140OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$58,051TotalRevenueColumnAmt
Exclusion$58,051ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
CAFETERIA REVENUE624200$169,180$169,180
CATERING722320$50$50
FieldValueIRS element (for citing)
Other Revenue Total$169,230OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$41,951,479TotalRevenueColumnAmt
Related Or Exempt Func Income$40,939,000RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$50UnrelatedBusinessRevenueAmt
Exclusion$803,184ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$499,736TotalAmt
Management And General$499,736ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$92,871TotalAmt
Program Services$92,871ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$17,625,714TotalAmt
Program Services$14,190,843ProgramServicesAmt
Management And General$3,434,871ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$390,821TotalAmt
Program Services$321,173ProgramServicesAmt
Management And General$69,648ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,799,560TotalAmt
Program Services$1,446,791ProgramServicesAmt
Management And General$352,769ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,178,083TotalAmt
Program Services$990,189ProgramServicesAmt
Management And General$187,894ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$58,228TotalAmt
Management And General$58,228ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$85,186TotalAmt
Management And General$85,186ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,173,212TotalAmt
Program Services$3,229,052ProgramServicesAmt
Management And General$1,944,160ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$185,625TotalAmt
Program Services$27,055ProgramServicesAmt
Management And General$158,570ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,257,114TotalAmt
Program Services$864,349ProgramServicesAmt
Management And General$392,765ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$399,999TotalAmt
Program Services$364,741ProgramServicesAmt
Management And General$35,258ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$171,192TotalAmt
Program Services$121,965ProgramServicesAmt
Management And General$49,227ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$108,308TotalAmt
Management And General$108,308ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,575,224TotalAmt
Program Services$2,348,234ProgramServicesAmt
Management And General$226,990ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$198,607TotalAmt
Program Services$181,101ProgramServicesAmt
Management And General$17,506ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$4,998,244$4,998,244
BAD DEBT EXPENSE$3,248,531$3,248,531
FOOD$300,240$300,240
EMPLOYEE RECRUITMENT$277,474$50,513$226,961

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$312,063TotalAmt
Program Services$116,603ProgramServicesAmt
Management And General$195,460ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$40,936,032TotalAmt
Program Services$32,892,495ProgramServicesAmt
Management And General$8,043,537ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,028,593BOYAmt
EOY$1,382EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,875,107BOYAmt
EOY$23,831,263EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$7,016,049BOYAmt
EOY$10,206,784EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$801,328BOYAmt
EOY$1,040,538EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$215,346BOYAmt
EOY$262,578EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$38,225,705LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$22,555,728LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$11,173,093BOYAmt
EOY$15,669,977EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$7,852,376BOYAmt
EOY$7,364,792EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$339,146BOYAmt
EOY$378,181EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$5,300,068BOYAmt
EOY$8,995,238EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$36,601,106BOYAmt
EOY$67,750,733EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,449,688BOYAmt
EOY$6,067,824EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$331,071BOYAmt
EOY$1,910,399EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
EOY$25,350,000EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$2,305,914BOYAmt
EOY$4,150,536EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$521,740BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,608,413BOYAmt
EOY$37,478,759EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$23,779,747BOYAmt
EOY$24,578,643EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,118,564BOYAmt
EOY$1,023,321EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$5,094,382BOYAmt
EOY$4,670,010EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$29,992,693BOYAmt
EOY$30,271,974EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$36,601,106BOYAmt
EOY$67,750,733EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$1,015,447ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$580,642NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$155,524OtherChangesInNetAssetsAmt
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$6,068OtherActivitiesAmt
Total Lobbying Expenditures$6,068TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationPORTION OF DUES PAID TO THE AMERICAN ACADEMY OF FAMILY PHYSICIANS, THE AMERICAN HOSPITAL ASSOCIATION AND THE IOWA HOSPITAL ASSOCATION ARE ALLOCABLE TO LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$9,342,606BeginningYearBalanceAmt
Contributions$5,632ContributionsAmt
Investment Earnings Or Losses-$1,413,381InvestmentEarningsOrLossesAmt
Other Expenditures$184,503OtherExpendituresAmt
End Year Balance$7,750,354EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$9,273,345BeginningYearBalanceAmt
Contributions$36,330ContributionsAmt
Investment Earnings Or Losses$147,606InvestmentEarningsOrLossesAmt
Other Expenditures$114,675OtherExpendituresAmt
End Year Balance$9,342,606EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$9,734,922BeginningYearBalanceAmt
Contributions$30,006ContributionsAmt
Investment Earnings Or Losses$498,003InvestmentEarningsOrLossesAmt
Other Expenditures$989,586OtherExpendituresAmt
End Year Balance$9,273,345EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,578,451BeginningYearBalanceAmt
Contributions$2,877,629ContributionsAmt
Investment Earnings Or Losses$565,340InvestmentEarningsOrLossesAmt
Other Expenditures$1,286,498OtherExpendituresAmt
End Year Balance$9,734,922EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$8,688,964BeginningYearBalanceAmt
Investment Earnings Or Losses$58,208InvestmentEarningsOrLossesAmt
Other Expenditures$1,168,721OtherExpendituresAmt
End Year Balance$7,578,451EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.86130BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.00670PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.13200TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$92,822OtherCostOrOtherBasisAmt
Book Value$92,822BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,435,940OtherCostOrOtherBasisAmt
Depreciation$9,310,084DepreciationAmt
Book Value$3,125,856BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$20,725,309OtherCostOrOtherBasisAmt
Depreciation$12,430,374DepreciationAmt
Book Value$8,294,935BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,971,634OtherCostOrOtherBasisAmt
Depreciation$815,270DepreciationAmt
Book Value$4,156,364BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$15,669,977TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (6 entries)

DescDescBook ValueBookValueAmt
INVESTMENT IN HOSPITAL LLC$1,742
DUE FROM SHENANDOAH AMBULANCE SERVICE$53,019
BENEFICIAL INTEREST IN PERPETUAL TRUSTS$4,618,010
DUE FROM SHENANDOAH MEDICAL CENTER FOUNDATION$73,309
OTHER RECEIVABLES$3,840,288
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS$408,870
FieldValueIRS element (for citing)
Total Book Value Other Assets$8,995,238TotalBookValueOtherAssetsAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE ENDOWMENT FUNDS WERE DESIGNATED AS SUCH BY THE SHENANDOAH MEDICAL CENTER BOARD OF DIRECTORS AND ARE MEANT TO BE HELD BY THE HOSPITAL. THE INCOME IS TYPICALLY REINVESTED IN THE ENDOWMENT FUNDS ON AN ANNUAL BASIS, BUT THE BOARD OF DIRECTORS HAS THE ABILITY TO DETERMINE THAT THE INCOME COULD BE USED IN SUPPORT OF THE HOSPITAL'S PROGRAMS AND PROJECTS, INCLUDING PROPERTY AND EQUIPMENT PURCHASES.
PART X, LINE 2:SHENANDOAH MEDICAL CENTER(SMC) AND THE FOUNDATION ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND 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 MEDICAL CENTER'S TAX EXEMPT STATUS. IN GENERAL, SUCH STANDARDS REQUIRE THE MEDICAL CENTER 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 FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES. THE MEDICAL CENTER RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT DECEMBER 31, 2015 AND 2014, 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
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
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$419,690TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$419,690NetCommunityBenefitExpnsAmt
Total Expense0.01110TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,466,857TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,440,702DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,026,155NetCommunityBenefitExpnsAmt
Total Expense0.02720TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,886,547TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,440,702DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,445,845NetCommunityBenefitExpnsAmt
Total Expense0.03830TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,332TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$13,332NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$442,683TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$126,812DirectOffsettingRevenueAmt
Net Community Benefit Expns$315,871NetCommunityBenefitExpnsAmt
Total Expense0.00840TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,858,818TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,572,025DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,286,793NetCommunityBenefitExpnsAmt
Total Expense0.06070TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$23,294TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$23,294NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,338,127TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,698,837DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,639,290NetCommunityBenefitExpnsAmt
Total Expense0.07010TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$16,224,674TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$12,139,539DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,085,135NetCommunityBenefitExpnsAmt
Total Expense0.10840TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$58,883TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$58,883NetCommunityBenefitExpnsAmt
Total Expense0.00160TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$748TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$748NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$59,631TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$59,631NetCommunityBenefitExpnsAmt
Total Expense0.00160TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$3,248,531BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$10,959,184ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$11,522,417CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$563,233MedicareSurplusOrShortfallAmt

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 Line1SHENANDOAH MEDICAL CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 PERSHING AVEAddressLine1Txt
CitySHENANDOAHCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51601ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.SMCHOSPITAL.COMWebsiteAddressTxt
State License730065HStateLicenseNum
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 Line1SHENANDOAH MEDICAL CENTERBusinessNameLine1Txt
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
Information GapsYes (X)InformationGapsInd
OtherYes (X)OtherInd
CHNA Conducted13CHNAConductedYr
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 URLWWW.SMCHOSPITAL.COMOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt14ImplementationStrategyAdptYr
Strategy Posted Website0StrategyPostedWebsiteInd
Strategy AttachedYes (1)StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care200.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
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 URLWWW.SMCHOSPITAL.COMFAPAvailableOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Average Negotiated RatesYes (X)AverageNegotiatedRatesInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SHENANDOAH MEDICAL CENTERPART V, SECTION B, LINE 3J: THE NEEDS ASSESSMENT INDICATED THAT AREAS FOR IMPROVEMENT WERE AS FOLLOWS: CHILD AND INFANT IMMUNIZATION, TRANSPORTATION, INTERNET/TELECOMMUNICATIONS INFRASTRUCTURE, UNINSURED/UNDERINSURED, TELEMEDICINE, EYE CARE FOR VETERANS, CARDIOVASCULAR ACCESS, MEDICAL TECHNOLOGY, CATASTROPHIC PLANNING, MEDICARE FRAUD, MAMMOGRAPHY, PRIMARY CARE ACCESS IN FREMONT COUNTY, DRUG ASSISTANCE, ECONOMIC DEVELOPMENT, SENIOR CARE, SUICIDE PREVENTION IN SCHOOL, PHYSICIAN RETENTION, NURSES, PARAMEDICS, DOMESTIC AND SEXUAL ABUSE, EDUCATION OF EXISTING SERVICES, LAYOUT OF SMC, PSYCHIATRIST, PEDIATRICIAN, COLLABORATION BETWEEN SMC AND CLARINDA REGIONAL MEDICAL CENTER, EDUCATION OF EXISTING FACILITIES, OBESITY, TEEN PREGNANCY, SIDEWALKS AROUND SCHOOLS, SAFE WALKING AND BIKING PATH, AND HEALTHY FOOD.
SHENANDOAH MEDICAL CENTERPART V, SECTION B, LINE 5: PAGE COUNTY'S TOWN HALL WAS HELD OVER DINNER ON THURSDAY SEPT 6, 2012 AT THE SHENANDOAH CHAMBER AND INDUSTRY, 100 S MAPLE STREET, SHENANDOAH, IA. EXTERNAL CONSULTANTS FACILITATED THIS HOUR AND A HALF SESSION WITH FORTY THREE (43) COMMUNITY ATTENDEES. SMC CONSULTED WITH VVV RESEARCH & DEVELOPMENT, INC. FOR THIS NEEDS ASSESSMENT.
SHENANDOAH MEDICAL CENTERPART V, SECTION B, LINE 11: SHENANDOAH MEDICAL CENTER ASSISTED IN EDUCATING ITS COMMUNITY ON HEALTH REFORM LAW INSURANCE OPTIONS BY UTILIZING ITS PATIENT FINANCIAL COUNSELOR AND MEMBERS OF ITS SOCIAL SERVICES DEPARTMENT TO PROVIDE INSURANCE INFORMATION TO PATIENTS AND ASSIST THEM IN ENROLLMENT IN MEDICAID AND MEDICARE IN ORDER TO THE LOWER UNINSURED AND UNDERINSURED POPULATION. ADDITIONALLY, THE FACILITY INVESTED IN A CONNECTION WITH THE IHIN, WHICH ALLOWS PATIENTS TO ACCESS THEIR MEDICAL INFORMATION TO NUMEROUS FACILITIES IN IOWA. FURTHERMORE, AN INVESTMENT IN A PATIENT PORTAL THAT IS COMPATIBLE WITH SMC'S ELECTRONIC MEDICAL RECORD SYSTEM ALSO OCCURRED IN ORDER TO FURTHER ALONG THE BUILDING OF THE HEALTH INTERNET INFRASTRUCTURE. ANOTHER ITEM OF IMPORTANCE IDENTIFIED WITHIN THE ASSESSMENT WAS THE NEED TO IMPROVE CHILDREN'S ACCESS TO IMMUNIZATIONS. SMC NOW PARTICIPATES IN THE PROGRAM TO PROVIDE FREE AND REDUCED PRICE VACCINATIONS FOR CHILDREN AND INFANTS. IN ORDER TO RETAIN AND RECRUIT PROVIDERS, SMC HAS INVESTED NUMEROUS DOLLARS TO ADD AN ORTHOPEDIC SURGEON AND FOUR ADVANCED REGISTERED NURSE PRACTITIONERS DURING 2015. IN ORDER TO SUPPORT VETERAN CARE DELIVERY, THE FACILITY CONTINUES TO BE A PREFERRED PROVIDER TO CONDUCT VETERAN'S DISABILITY EXAMS AND ALSO EXPANDED ITS HOME HEALTH AND HOSPICE COVERAGE TO VETERANS THROUGH THE WE HONOR VETERANS PROGRAM. ADDITIONAL EDUCATION IN WORKING WITH MENTAL HEALTH PATIENTS HAS BEEN PROVIDED TO STAFF MEMBERS IN THE EMERGENCY ROOM AND PRIMARY CARE CLINICS IN ORDER TO HELP EXPAND THE MENTAL HEALTH DELIVERY IN PAGE AND FREMONT COUNTIES. IN ORDER TO FIGHT DRUG ABUSE, NUMEROUS EDUCATIONAL SESSIONS WERE HELD WITH PROVIDERS IN THE APPROPRIATE MAINTENANCE OF PATIENTS WITH OPIATES PRESCRIPTIONS. THE HOSPITAL ALSO FACILITATED EXPANDED TESTING OF SEXUALLY TRANSMITTED DISEASES FOR TEENAGERS IN THE AREA.NEEDS THAT DID NOT GET DIRECTLY ADDRESSED INCLUDE SUPPORTING COMMUNITY ECONOMIC DEVELOPMENT OUTSIDE OF THE NUMBER OF JOBS ADDED AT SHENANDOAH MEDICAL CENTER IN 2015. ADDITIONALLY, SMC DID NOT WORK ON BUILDING A SAFE WALKING/BIKING PATH IN THE COMMUNITY OR REDUCING TEEN PREGNANCY IN OUR SERVICE AREA. OTHER ITEMS THAT DID NOT GET ADDRESSED BY SMC THIS YEAR WAS THE BUILDING OF A SCHOOL SUICIDE PREVENTION PROGRAM AND FIGHTING DOMESTIC AND SEXUAL ABUSE. ALL ITEMS NOT ADDRESSED WERE NOT CONSIDERED RELATED TO THE FACILITY'S MISSION CRITICAL OPERATIONS. AS A RESULT, SMC WILL CONTINUE TO HELP SUPPORT COMMUNITY PARTNERS IN ORDER TO ADDRESS THOSE NEEDS.
SHENANDOAH MEDICAL CENTERPART V, SECTION B, LINE 13H: THE ELIGIBILITY OF EACH APPLICANT FOR FINANCIAL ASSISTANCE IS DETERMINED ON A CASE BY CASE BASIS THROUGH COORDINATION OF THE PATIENT FINANCIAL COUNSELOR, BUSINESS OFFICE MANAGER, AND REVENUE CYCLE DIRECTOR. ELIGIBILITY IS BASED ON A REVIEW AND VERIFICATION OF INCOME OF AN INDIVIDUAL OR FAMILY, INCLUDING THE SIZE OF THE FAMILY. VERIFICATION INCLUDES BUT IS NOT LIMITED TO: TAX RETURNS, PAY STUBS, SOCIAL SECURITY CHECKS, DISABILITY CHECKS OR BANK STATEMENTS. DETERMINATION IS BASED UPON INCOME DATA DIRECTLY RELATED TO FEDERAL POVERTY LEVELS AFTER APPLYING ALL OTHER RESOURCES. CHARITY CARE IS BASED ON 200% OF POVERTY LEVEL. AN UNINSURED DISCOUNT OF 30% IS GRANTED TO ALL PATIENTS WITH NO INSURANCE. AN ADDITIONAL 20% DISCOUNT IS AUTOMATICALLY GRANTED TO THESE INDIVIDUALS ONCE THEY COMPLETE THE FINANCIAL ASSISTANCE APPLICATION. FURTHER DISCOUNTING IS APPLIED BASED ON THE APPLICANT'S ABILITY TO MEET THE ELIGIBILITY CRITERIA.
SHENANDOAH MEDICAL CENTERPART V, SECTION B, LINE 22D: THE INDIVIDUALS WHO DID NOT HAVE INSURANCE ARE GIVEN A 30% UNINSURED DISCOUNT. ANY INDIVIDUAL COMPLETING THE FINANCIAL ASSISTANCE APPLICATION ALSO RECEIVED AN AUTOMATIC ADDITIONAL 20% DISCOUNT TO ENSURE THAT THE HOSPITAL WAS CHARGING NO MORE THAN THE AVERAGE OF ITS THREE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES.
FieldValueIRS element (for citing)
Facility5FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - ELM HEIGHTS CARE CENTER
1204 SOUTH ELM STREETSHENANDOAHIA51601SKILLED NURSING
2 - SHENANDOAH MEDICAL CENTER
300 PARK AVENUESHENANDOAHIA51601MEDICAL CLINIC
3 - SHENANDOAH PHYSICIANS CLINIC - SIDNEY
802 ILLINOIS STREETFREMONTIA52561SIDNEY CLINIC
4 - SHENANDOAH MEDICAL CENTER
2 JACK FOSTER DRIVESHENANDOAHIA51601WELLNESS CENTER
5 - SHENANDOAH PHYSICIANS CLINIC - ESSEX
527 IOWA AVENUEESSEXIA51638ESSEX CLINIC

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:NOT APPLICABLE
PART I, LINE 6A:THE ANNUAL COMMUNITY BENEFIT REPORT WAS NOT PREPARED BY A RELATED ORGANIZATION.
PART I, LN 7 COL(F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $3,248,531.
PART II, COMMUNITY BUILDING ACTIVITIES:SHENANDOAH MEDICAL CENTER PROVIDES JOB SHADOWING TO STUDENTS OF SHENANDOAH, PHLEBOTOMY STUDENT ROTATIONS, CLARKSON/METHODIST STUDENTS JOB SHADOWING, CNA CLASSES FOR SHENANDOAH HIGH SCHOOL STUDENTS, MENTORING OF STUDENTS BY SMC STAFF, AND IS INVOLVED IN THE FREMONT/PAGE COUNTY PREVENT CHILD ABUSE GROUP AND BREAST CANCER AWARENESS. THESE ACTIVITIES HELP TO FURTHER THE EDUCATION OF THE COMMUNITY ON HEALTH IMPROVEMENT AND MAINTENANCE AND ALSO ASSIST IN THE DEVELOPMENT OF LOCAL INDIVIDUALS IN BECOMING HEALTH CARE PROFESSIONALS.
PART III, LINE 2:IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE MEDICAL CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE MEDICAL CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR THOSE ACCOUNTS OVER A CERTAIN AGE BASED ON DISCHARGE THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE MEDICAL CENTER RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.
PART III, LINE 3:THE MEDICAL CENTER PROVIDES CHARITY CARE 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 PATIENT SERVICE REVENUE OR IN THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.
PART III, LINE 4:THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT CONTAIN A SPECIFIC FOOTNOTE DESCRIBING BAD DEBT. HOWEVER, THE FOOTNOTES TITLED "PATIENT ACCOUNTS RECEIVABLE," "NET PATIENT SERVICE REVENUE, AND "CHARITY CARE" CAN BE FOUND ON PAGES 8, 10 AND 11 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8:THE MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT BECAUSE IT REPRESENTS UNCOMPENSATED CARE PROVIDED TO INDIVIDUALS IN THE SHENANDOAH AND SURROUNDING COMMUNITIES. IT HAS BEEN DETERMINED BASED ON THE OVERALL MEDICARE ALLOWABLE COST AS A PERCENT OF TOTAL CHARGES, APPLIED TO THE TOTAL MEDICARE CHARGES.
PART III, LINE 9B:ONCE A PATIENT HAS BEEN DEEMED ELIGIBLE FOR FINANCIAL ASSISTANCE, THE PATIENT'S ACCOUNT IS UPDATED WITH THE APPROPRIATE AMOUNT OF FINANCIAL ASSISTANCE. IF A PATIENT HAS HAD ALL ACCOUNTS GRANTED FULL FINANCIAL ASSISTANCE, THE PATIENT RECEIVES NOTICE THAT ALL OBLIGATIONS HAVE BEEN SATISFIED. IF THERE IS A REMAINING PATIENT BALANCE, SMC'S FINANCIAL COUNSELOR WORKS CLOSELY WITH THE PATIENT TO AGREE UPON A PAYMENT PLAN THAT IS FINANCIALLY FEASIBLE FOR THE PATIENT.
PART VI, LINE 2:THE ORGANIZATION'S LEADERSHIP INFORMALLY MEETS WITH LEADERS IN THE COMMUNITY TO DISCUSS COMMUNITY ISSUES, AS WELL AS ATTEMPTS TO IDENTIFY AREAS WHERE SMC CAN BE OF SERVICE TO THE EMPLOYERS IN THE COMMUNITY.
PART VI, LINE 3:THE FINANCIAL ASSISTANCE APPLICATION IS PROVIDED TO ALL PATIENTS ON THE WEBSITE. ADDITIONALLY, OUR THIRD PARTY SELF-PAY ORGANIZATION MAILS APPLICATIONS TO THOSE PATIENTS WHO INDICATE THAT THEY DO NOT HAVE THE MEANS TO PAY THEIR ACCOUNTS. UPON CONTACT AT SMC, OUR SOCIAL SERVICES REPRESENTATIVE AND PATIENT ACCOUNT COUNSELOR DISCUSS OPTIONS WITH PATIENTS AND ALSO ASSIST IN THE COMPLETION OF THE FINANCIAL ASSISTANCE APPLICATIONS, MEDICARE AND MEDICAID APPLICATIONS IF APPLICABLE, AND MAKING ANY OTHER ARRANGEMENTS NECESSARY TO ASSIST PATIENTS IN FINANCIALLY SATISFYING THEIR OBLIGATIONS. PATIENTS ARE ALSO NOTIFIED OF THE FINANCIAL ASSISTANCE POLICY AT ADMISSION AND DISCHARGE.
PART VI, LINE 4:THE MEDIAN HOUSEHOLD INCOME WAS $44,786 AND $52,221 FOR PAGE AND FREMONT COUNTIES, RESPECTIVELY IN 2014, AS COMPARED TO THE STATE MEDIAN HOUSEHOLD INCOME OF $53,712. AS A BYPRODUCT OF THE MEDIAN HOUSEHOLD INCOME IN THE SERVICE AREA, SHENANDOAH MEDICAL CENTER TREATS A SIGNIFICANT NUMBER OF MEDICAID, UNINSURED, AND UNDERINSURED PATIENTS. THE AREA POPULATION IS PREDOMINATELY WHITE, NON-HISPANIC.
PART VI, LINE 5:IN ADDITION TO ITS EFFORTS TO ADDRESS THE NEEDS IDENTIFIED BY ITS COMMUNITY HEALTH NEEDS ASSESSMENT, THE FACILITY ALSO HAS AN ACTIVE INTERNAL WELLNESS PROGRAM THAT IT IS ATTEMPTING TO ROLL-OUT IN ITS COMMUNITY. ADDITIONALLY, THE HOSPITAL OPERATES A WELLNESS CENTER THAT PROVIDES VERY AFFORDABLE MEMBERSHIP RATES AND PERSONAL TRAINING OPTIONS TO HELP PROMOTE WELLNESS IN THE COMMUNITY.
PART VI, LINE 6:SMC IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractYes (X)WrittenEmploymentContractInd
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 (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
KAREN COLE
CEO$219,132$0$82,355$0$8,253$0$13,250$0$16,561$0$339,551$0$0$0
MATTHEW SELLS
CFO$117,189$0$15,000$0$119$0$4,319$0$23,558$0$160,185$0$0$0
REBECCA ROSE
PHYSICIAN$462,418$0$30,060$0$2,085$0$7,207$0$14,450$0$516,220$0$0$0
SCOTT R KING
PHYSICIAN$375,832$0$55,561$0$2,467$0$13,250$0$14,938$0$462,048$0$0$0
SANTOSH KUMAR
PHYSICIAN$303,799$0$62,100$0$304$0$13,250$0$23,535$0$402,988$0$0$0
MICHAEL WOODS
PHYSICIAN$320,212$0$0$0$1,818$0$9,465$0$29,046$0$360,541$0$0$0
SATYA THIPPAREDDI
PHYSICIAN$182,851$0$12,000$0$688$0$11,054$0$3,417$0$210,010$0$0$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1IOWA FINANCE AUTHORITYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN521699886BondIssuerEIN
CUSIP46246NHT6CUSIPNum
Bond Issued2015-12-08BondIssuedDt
Issue Price$25,350,000IssuePriceAmt
PurposeCONSTRUCT AND REMODEL HOSPITAL AND CLINICPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds$25,350,000TotalProceedsAmt
Capitalized Interest$1,096,354CapitalizedInterestAmt
Issuance Costs From Proceeds$294,375IssuanceCostsFromProceedsAmt
Capital Expenditures$2,728,090CapitalExpendituresAmt
Unspent$22,621,910UnspentAmt
Current Refunding0CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation Made0FinalAllocationMadeInd
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 RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due YetYes (1)RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
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

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
ALICIA SELLS
EMPLOYEE OF ORGANIZATION AND WIFE OF MATTHEW SELLS, CFO$66,356EMPLOYEE'S COMPENSATION0
CODY AUGUSTINE
EMPLOYEE OF ORGANIZATION AND SON OF TIM AUGUSTINE, BOARD MEMBER$26,515EMPLOYEE'S COMPENSATION0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6THE CORPORATION SHALL HAVE TWO CLASSES OF MEMBERS, DESIGNATED CLASS A MEMBERS AND CLASS B MEMBERS. THE CLASS A MEMBERS SHALL BE ALL OF THOSE INDIVIDUALS THEN SERVING AS DULY ELECTED MEMBERS OF THE BOARD OF DIRECTORS OF THE CORPORATION, EXCEPT FOR THAT PERSON NOMINATED TO THE BOARD OF DIRECTORS BY THE CLASS B MEMBER. THE CLASS B MEMBER SHALL BE SHENANDOAH/NHS REGIONAL VENTURES, LLC, AN IOWA LIMITED LIABILITY COMPANY.
FORM 990, PART VI, SECTION A, LINE 7ATHE CLASS B MEMBER SHALL HAVE THE RIGHT TO NOMINATE ONE PERSON TO SERVE ON THE BOARD OF DIRECTORS OF THE CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 IS REVIEWED BY THE CEO, CFO, AND GOVERNING BOARD PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS ENFORCED BY THE CEO AND COMPLIANCE OFFICER. ALL BOARD MEMBERS AND EXECUTIVES ARE REQUIRED TO DISCLOSE ANY CONFLICTS OF INTEREST THAT ARE PRESENTED. ON AN ANNUAL BASIS, A SUMMARY OF ALL CONFLICTS IDENTIFIED DURING THE YEAR ARE PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW AS PART OF THE ANNUAL COMPLIANCE SUMMARY. WHEN A CONFLICT OF INTEREST IS IDENTIFIED, THE INDIVIDUAL POSSESSING THE CONFLICT IS NOT ALLOWED TO PROVIDE INPUT ON THE SUBJECT AND IS REQUIRED TO ABSTAIN FROM ANY RELATED VOTING.
FORM 990, PART VI, SECTION B, LINE 15THE COMPENSATION OF THE ORGANIZATION'S CEO WAS REVIEWED AND AUTHORIZED BY THE BOARD OF DIRECTORS. SMC ALSO UTILITIZES THE IOWA HOSPITAL ASSOCIATION SALARY SURVEY DATA TO APPROPRIATELY SET COMPENSATION FOR ITS OFFICERS AND KEY EMPLOYEES. ADDITIONALLY, SALARY SURVEY DATA OBTAINED FROM MGMA AND MERRITT HAWKINS IS USED TO EVALUATE THE COMPENSATION OF ALL PROVIDERS.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST.
FORM 990, PART IX, LINE 11GLAB FEES: PROGRAM SERVICE EXPENSES 370,507. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 370,507. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 1,195,658. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,195,658. CONSULTING FEES: PROGRAM SERVICE EXPENSES 56,460. MANAGEMENT AND GENERAL EXPENSES 160,352. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 216,812. OTHER FEES FOR SERVICE: PROGRAM SERVICE EXPENSES 1,606,427. MANAGEMENT AND GENERAL EXPENSES 1,783,808. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,390,235.
FORM 990, PART XI, LINE 9:CHANGE IN VALUE OF BENEFICIAL INTEREST IN PERPETUAL TRUST -194,559. GAIN ON EQUITY IN SHENANDOAH AMBULANCE SERVICE 39,035.
FORM 990, PART XII, LINE 2C:THE BOARD OF DIRECTORS ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF SMC'S FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1SHENANDOAH MEDICAL CENTER FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1300 PERSHING AVENUEAddressLine1Txt
CitySHENANDOAHCityNm
State AbbreviationIAStateAbbreviationCd
ZIP51601ZIPCd
FieldValueIRS element (for citing)
EIN421471184EIN
Primary ActivitiesSUPPORT SHENANDOAH MEDICAL CENTERPrimaryActivitiesTxt
Legal Domicile StateIALegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 11A, IPublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SHENANDOAH MEDICAL CENTERBusinessNameLine1Txt
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 Line1SHENANDOAH MEDICAL CENTER FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeCTransactionTypeTxt
Involved$78,797InvolvedAmt
Method Of Amount DeterminationFAIR MARKET VALUEMethodOfAmountDeterminationTxt