Community Benefit Insight - Tax-exempt hospital

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Jefferson Community Health Center Inc

Jefferson Community Health Center

2200 North H Street
Fairbury, NE 68352

Bed count	17	Medicare provider number	281319	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 470468078

Display data for year:

Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

6.45%

Spending by Community Benefit Category- 2021
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2021

Additional data

Community Benefit Expenditures: 2021

All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.
Amount spent in the following IRS community benefit categories:

Financial Assistance at cost as % of operating expenses	$ 122,321 0.40 %
Medicaid as % of operating expenses	$ 281,162 0.93 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 14,000 0.05 %
Subsidized health services as % of operating expenses	$ 1,508,312 4.98 %
Research as % of operating expenses	$ 0 0 %
Community health improvement services and community benefit operations* as % of operating expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 24,274 0.08 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 4,144 0.01 %
Community building* as % of operating expenses	$ 250 0.00 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	YES
Number of activities or programs (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Persons served (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Community building expense as % of operating expenses	$ 250 0.00 %
Physical improvements and housing as % of community building expenses	$ 0 0 %
Economic development as % of community building expenses	$ 250 100 %
Community support as % of community building expenses	$ 0 0 %
Environmental improvements as % of community building expenses	$ 0 0 %
Leadership development and training for community members as % of community building expenses	$ 0 0 %
Coalition building as % of community building expenses	$ 0 0 %
Community health improvement advocacy as % of community building expenses	$ 0 0 %
Workforce development as % of community building expenses	$ 0 0 %
Other as % of community building expenses	$ 0 0 %
Direct offsetting revenue	$ 0
Physical improvements and housing	$ 0
Economic development	$ 0
Community support	$ 0
Environmental improvements	$ 0
Leadership development and training for community members	$ 0
Coalition building	$ 0
Community health improvement advocacy	$ 0
Workforce development	$ 0
Other	$ 0

Other Useful Tax-exempt Hospital Information: 2021

In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt as % of operating expenses	$ 374,799 1.24 %
Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?	NO

Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy
The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2022 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

Does the organization have a written financial assistance (charity care) policy?	YES
Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?	YES
Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy as % of operating expenses	$ 50,973 13.60 %

Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.
The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.
In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

Community Health Needs Assessment Activities: 2021

The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

Did the tax-exempt hospital report that they had conducted a CHNA?	YES
Did the CHNA define the community served by the tax-exempt hospital?	YES
Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?	YES
Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?	YES
Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?	YES

Supplemental Information: 2021

This section presents qualitative information submitted by the hospital, verbatim from the 990H record.

Statement of Program Service Accomplishments
Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4A (Expenses $ 25662173 including grants of $ 6092) (Revenue $ 27593710)
JEFFERSON 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.

4B (Expenses $ 1899578 including grants of $ 0) (Revenue $ 2473382)
JEFFERSON COMMUNITY HEALTH & LIFE OPERATES A 40 BED LONG-TERM CARE FACILITY FOR THE RESIDENTS OF JEFFERSON COUNTY AND THE SURROUNDING AREA.

Facility Information

Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.

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 HAS 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, HEALTH 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 CANCERTHE HOSPITAL IS DOING THE FOLLOWING TO ADDRESS THESE NEEDS:* THE SMART MOVES PROGRAM OFFERS A YEAR-LONG CLASS TO TEACH THOSE AT RISK FOR DEVELOPING PRE-DIABETES TO MAKE HEALTHY LIFESTYLE CHOICES. CONTINUE TO EXPAND, PROMOTE, AND INCREASE UTILIZATION OF SMART MOVES LIFESTYLE CHANGE PROGRAM (A PROGRAM OF THE NATIONAL DIABETES PREVENTION PROGRAM).*RESTART KIDS COOKING CLASSES AS SOON AS POSSIBLE*CONTINUE TO BE AN ACTIVE PART OF COMMUNITY PARTNERSHIPS WORKING TO ESTABLISH WALKABLE COMMUNITY AND WALKING/BIKE TRAILS IN FAIRBURY. ENHANCE COMMUNITY'S SIDEWALKS AND SAFE WALKING/BIKING ROUTES. ENCOURAGE ACTIVITY LIFESTYLES FOR THOSE OF ALL AGES. WORK WITH CITY TO ESTABLISH WALKING AREA IN FAIRBURY COMMUNITY BUILDING, ACCESSIBLE TO SENIOR DINERS AND COMMUNITY IN GENERAL*CONTINUE TO PARTNER WITH SCHOOLS AND OTHER YOUTH ORGANIZATIONS, OFFER SIDELINES SERVICES FOR ATHLETES, AND OFFER YOUTH EVENTS AT THE BURKLEY FITNESS CENTER, AND PROVIDE EDUCATION AND INFORMATION AS NEEDED BY AREA SCHOOLS.*CONTINUE MEN'S AND WOMEN'S HEALTH ACTIVITIES. OFFER INCENTIVES FOR MEN AND WOMEN WHO HAVE PHYSICALS. PLAN A MEN'S HEALTH EVENT. CONTINUE TO OFFER AND PROMOTE WOMEN'S HEALTH DAYS.*RESTART OFFERING COMMUNITY HEALTH EDUCATION PROGRAMS INCLUDING COMMUNITY PROGRAMS ON NUTRITION, OBESITY, HEALTHY LIFESTYLES, CHRONIC DISEASES, MENTAL HEALTH AND SUBSTANCE ABUSE.*ENHANCE USE OF MEDICARE WELLNESS VISIT PROGRAM.*CONTINUE DEVELOPMENT AND EXPANSION OF CHRONIC CARE COORDINATION PROGRAM.*CONSIDER ADDITION OF TELEHEALTH SERVICES FOR PULMONOLOGY.*ADD CERTIFIED PERSONAL TRAINERS TO FITNESS CENTER STAFF.*CONTINUE TO PROVIDE FINANCIAL SUPPORT FOR BURKLEY FITNESS CENTER.*CONSIDER ADDING QUALITY INCENTIVES TO PHYSICIAN CONTRACTS TO ADDRESS PRIORITIZED COMMUNITY NEEDS.*INCREASE MENTAL HEALTH SERVICES BEING OFFERED TO THE COMMUNITY.*BECOME INVOLVED IN LOCAL COALITIONS WORKING TO IMPROVE MENTAL HEALTH AND SUBSTANCE ABUSE.*CONTINUE INVOLVEMENT WITH FAIRBURY SENIOR DINERS. HELP TO PROMOTE SENIOR DINERS, WHICH OFFERS NUTRITIOUS MEALS AND SOCIAL INTERACTION TO THOSE WHO ARE 60 AND OLDER. CONTINUE TO OFFER MONTHLY HEALTH EDUCATION PROGRAM.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 BE SUCCESSFUL 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 PLANNING PROCESS. 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.

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 3C:
FEDERAL POVERTY GUIDELINES ARE USED TO DETERMINE ELIGIBILITY FOR PROVIDING FREE AND DISCOUNTED CARE TO LOW INCOME INDIVIDUALS.

PART I, LINE 6A:
JEFFERSON COMMUNITY HEALTH & LIFE PREPARES ITS OWN COMMUNITY BENEFIT REPORT.

PART I, LINE 7:
THE HOSPITAL USED THE WORKSHEETS PROVIDED IN THE FORM 990 INSTRUCTIONS TO HELP CALCULATE THE FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST.

PART I, LN 7 COL(F):
THE IMPLICIT PRICE CONCESSION EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $374,799.

PART I, LINE 7 (CONTINUED):
VI. CASH AND IN-KIND DONATIONSA. 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-RAISER; KGMT-KUTT ANNUAL THANKSGIVING MEAL; BLUE VALLEY COMMUNITY ACTION; BLUE RIVERS AREA AGENCY ON AGING; AND AREA SCHOOLS' WRESTLING PROGRAMS. THESE TOTALED $6,092. 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 2022 TOTALED $7,092. 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: $250.SAFETY DAY FOR KIDS - JCH&L IS ONE OF THE COSPONSORS OF THE ANNUAL SAFETY DAY FOR KIDS IN JEFFERSON COUNTY. A TOTAL OF 95 KIDS -- AGES KINDERGARTEN THROUGH SIXTH GRADES ATTENDED THE AUGUST 2022 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 HEALTH CENTER DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION EXPERIENCE WITH VARIOUS CLASSES OF PATIENTS.

PART III, LINE 3:
AS PART OF OUR COMMUNITY NEEDS ASSESSMENT, WE GATHERED INFORMATION ON THE INCOME CHARACTERISTICS OF THE UNINSURED POPULATION. USING THAT DATA, WE ANALYZED WHAT PORTION OF UNINSURED INDIVIDUALS IN THE HOSPITAL'S SERVICE AREA WOULD BE ELIGIBLE FOR THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. THIS PERCENTAGE WAS APPLIED TO THE TOTAL AMOUNT OF IMPLICIT PRICE CONCESSIONS FOR SELF-PAY PATIENTS TO ESTIMATE THE PORTION OF SELF-PAY IMPLICIT PRICE CONCESSIONS THAT WERE LIKELY ATTRIBUTABLE TO INDIVIDUALS ELIGIBLE FOR THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.

PART III, LINE 4:
"JCH&L'S FINANCIAL STATEMENTS DO NOT CONTAIN A SPECIFIC FOOTNOTE DESCRIBING BAD DEBT EXPENSE. HOWEVER, PAGES 8, 10 AND 11 OF THE ATTACHED FINANCIAL STATEMENTS INCLUDE FOOTNOTES TITLED ""PATIENT RECEIVABLE,"" ""PATIENT SERVICE REVENUE AND ""FINANCIAL ASSISTANCE/CHARITY CARE""."

PART III, LINE 8:
THE HOSPITAL CALCULATED THE MEDICARE ALLOWABLE COSTS BY ADDING THE INPATIENT, SWING BED AND OUTPATIENT COSTS AS FOUND ON THE MEDICARE COST REPORT FOR SEPTEMBER 30, 2022. THE SHORTFALL IS TREATED AS AN ADDITIONAL COMPONENT OF COMMUNITY BENEFIT, AS CARE IS PROVIDED REGARDLESS IF THE HOSPITAL WILL GET PAID THE ENTIRE AMOUNT.

PART III, LINE 9B:
ONCE IT IS DETERMINED THAT A PATIENT MAY NOT HAVE THE MEANS TO PAY, AN ASSISTANCE APPLICATION IS PROVIDED. JCH&L STAFF WILL APPLY THE RECOMMENDED PERCENTAGE DISCOUNT TO THE PATIENT'S ACCOUNT.

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 CONDUCTED A COMMUNITY PERCEPTION SURVEY IN 2015, WHICH INCLUDED QUESTIONS ON COMMUNITY HEALTH 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 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.

PART VI, LINE 7:
JCH&L DOES NOT FILE A COMMUNITY BENEFIT REPORT WITH ANY STATES.

PART I, LINE 7:
JCH&L REACHED OUT TO THE COMMUNITY IN A VARIETY OF WAYS IN FISCAL YEAR 2022, INCLUDING:I. BENEFITS FOR THE POOR/PUBLIC PROGRAMSA. JCH&L PROVIDED CHARITY CARE IN FISCAL 2022 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: 55 VALUE: $140,000B. . UNPAID COSTS OF PUBLIC PROGRAMS. MEDICAID SHORTFALL - SHORTFALL BASED ON COSTS: $284,292C. BAD DEBT: BESIDES OFFICIAL CHARITY CARE, JCH&L WROTE OFF $386,850 IN BAD DEBT DURING FISCAL 2022. II. COMMUNITY BENEFIT SERVICESA. COMMUNITY HEALTH EDUCATION AND OUTREACH: HEALTH FAIR - JCH&L PROVIDES EDUCATIONAL BOOTHS, FREE HEALTH SCREENINGS, HANDOUTS, INFORMATION, ETC., AT COMMUNITY EVENTS. WE STILL DID NOT GET BACK TO HAVING A HEALTH FAIR IN 2022.SPEAKERS BUREAU - JCH&L STAFF MEMBERS PROVIDE EDUCATIONAL PROGRAMS FOR COMMUNITY ORGANIZATIONS ON A VARIETY OF TOPICS. A TOTAL OF 23 PROGRAMS WERE DONE IN FISCAL 2022. TOTAL INDIVIDUALS REACHED: 678. ESTIMATED COST OF STAFF TIME: $775.SUPPORT GROUPS - JCH&L'S PARKINSON'S SUPPORT GROUP AND ALZHEIMER'S CAREGIVER'S SUPPORT GROUP WERE PUT ON HOLD IN 2020 BECAUSE OF COVID AND WERE NOT RESTARTED PRIOR TO THE END OF FISCAL 2022. IN PREVIOUS YEARS, JCH&L STAFF MEMBERS COORDINATED MEETINGS OF THESE SUPPORT GROUPS, OFFERING ASSISTANCE TO ANYONE INTERESTED IN MORE INFORMATION ABOUT THE DISEASES. JCH&L PROVIDES EDUCATIONAL PROGRAMS FOR EACH OF THESE GROUPS -- INCLUDING SPEAKER'S FEES OR VIDEO TAPE RENTAL FEES, POSTAGE TO SEND OUT MEETING NOTICES, AND REFRESHMENTS. TOTAL NUMBER REACHED: 0. APPROXIMATE COST OF STAFF TIME SPENT: $0. ESTIMATED COST OF POSTAGE: $25 (TO NOTIFY THOSE INTERESTED THAT MEETINGS WERE STILL SUSPENDED.) ESTIMATED OTHER COSTS (MATERIALS, SPEAKER FEES): $0B. 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 598 SCREENINGS, WITH CHARGES OF $62,000. WHEN COMPARED AGAINST TYPICAL CHARGES THE TOTAL COMMUNITY BENEFIT WAS MORE THAN $50,000. ESTIMATED NUMBER REACHED: 598 VALUE OF ESTIMATED STAFF TIME: $21,174. ESTIMATED VALUE OF COMMUNITY BENEFIT: $50,859.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, JANITORIAL AND SUPPORT SERVICES, AND STORAGE OF VACCINES IN OUR PHARMACY. NUMBER OF PATIENTS SERVED: 222. TOTAL OF 630 VACCINATIONS PROVIDED. ESTIMATED COST OF NURSES PROVIDED BY JCH&L TO GIVE SHOTS: $2,300. C. HEALTH CARE SUPPORT SERVICESCOVID CLINICS AND BOOSTER CLINICS - JCH&L OFFERED COVID VACCINE CLINICS 3 TIMES IN NOVEMBER 2021. WE GAVE 450 COVID BOOSTERS. WE RECEIVED AN ADMINISTRATION FEE THROUGH INSURANCE FOR MOST OF THE VACCINES GIVEN. COST OF STAFF TIME AFTER ADMINISTRATION FEES: $0III. MEDICAL EDUCATIONA. 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 5 PHYSICIAN STUDENTS AND 2 PA STUDENTS UTILIZED OUR FACILITY IN FISCAL 2022. 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 2022. 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. NO SCHOLARSHIPS WERE AWARDED IN 2022. ESTIMATED NUMBER REACHED: 7. JCH&L COST (APARTMENT RENT, STAFF TIME, ETC.): $12,000.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. DURING FISCAL 2022 WE HAD A REQUIREMENT THAT ALL STUDENTS BE VACCINATED FOR COVID (PER CMS REQUIREMENTS.) NUMBER REACHED: 14. ESTIMATED COST OF STAFF TIME: $1,400.CAREER ACADEMY HANDS ON - THROUGH THE SCC CAREER ACADEMY, JCH&L HOSTED 28 STUDENTS FROM AREA SCHOOLS FOR A HANDS-ON CAREER DAY IN SEPTEMBER 2022. THE STUDENTS WERE ABLE TO LEARN TO TAKE BLOOD PRESSURES, SUTURE SIMULATED WOUNDS, DO A SIMULATED LAPROSCOPIC EXERCISE, TAKING SHOTS, TAKING BLOOD SAMPLES, AND VIEWING RADIOLOGY PROCEDURES. NUMBER REACHED: 28. ESTIMATED COST OF SUPPLIES AND FOOD: $750. ESTIMATED COST OF STAFF TIME: $600.IV. SUBSIDIZED HEALTH SERVICESWELLNESS 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 2022: 42,421. ESTIMATED AMOUNT OF WELLNESS CENTER SUPPORT: $237,173. 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: $207,949. EXPENSES: $483,654. NET LOSS: $275,705.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: $ 2,473,382. EXPENSES: $3,516,492. NET LOSS: $ 1,043,110.V. RESEARCH.NO RESEARCH DOLLARS EXPENDED.

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 $237,000. 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.

Operating expenses	$ 30,301,395
Total amount spent on community benefits as % of operating expenses	$ 1,954,213 6.45 %