Community Benefit Insight - Tax-exempt hospital

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Community Memorial Hospital Inc

Community Memorial Hospital

809 Jackson St
Burke, SD 57523

Bed count	16	Medicare provider number	431309	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 460219795

Display data for year:

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

10.13%

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	$ 28,000 0.40 %
Medicaid as % of operating expenses	$ 80,343 1.16 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 0 0 %
Subsidized health services as % of operating expenses	$ 566,826 8.18 %
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.	$ 26,663 0.38 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 0 0 %
Community building* as % of operating expenses	$ 0 0 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	Not available
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	$ 0 0 %
Physical improvements and housing as % of community building expenses	$ 0
Economic development as % of community building expenses	$ 0
Community support as % of community building expenses	$ 0
Environmental improvements as % of community building expenses	$ 0
Leadership development and training for community members as % of community building expenses	$ 0
Coalition building as % of community building expenses	$ 0
Community health improvement advocacy as % of community building expenses	$ 0
Workforce development as % of community building expenses	$ 0
Other as % of community building expenses	$ 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	$ 106,323 1.53 %
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	$ 518 0.49 %

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 $ 5277981 including grants of $ 19165) (Revenue $ 7025523)
COMMUNITY MEMORIAL HOSPITAL, INC., 16-BED ACUTE CARE HOSPITAL, PROMOTES HEALTH OF THE COMMUNITY BY PROVIDING A VARIETY OF HEALTH CARE SERVICES. DURING 2021, COMMUNITY MEMORIAL HOSPITAL HAD 3,688 CLINIC VISITS IN BURKE AND 541 CLINIC VISITS IN BONESTEEL. THE HOSPITAL HAD 176 ADMISSIONS, 375 ACUTE PATIENT DAYS, 497 SWINGBED DAYS AND 443 VISITS TO THE EMERGENCY ROOM.

Facility Information

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

COMMUNITY MEMORIAL HOSPITAL, INC
PART V, SECTION B, LINE 5: COMMUNITY MEMORIAL HOSPITAL (CMH) SURVEYED SEVERAL CROSS SECTIONS OF THE COMMUNITY INCLUDING THE CITY COUNCIL, STAFF OF BURKE SCHOOL DISTRICT, BURKE COMMUNITY CLUB, GREGORY COUNTY EMPLOYEES, CMH BOARD OF DIRECTORS, CMH EMPLOYEES AND FIRST FIDELITY BANK EMPLOYEES. IN ADDITION A SURVEY WEBSITE WAS PUBLISHED IN THE LOCAL NEWSPAPER FOR OTHER INTERESTED PARTIES TO COMPLETE.

COMMUNITY MEMORIAL HOSPITAL, INC
PART V, SECTION B, LINE 7D: THE CHNA AND IMPLEMENTATION STRATEGY CAN BE FOUND AT:HTTPS://WWW.CMHBURKE.ORG/ABOUT, ANDHTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT

COMMUNITY MEMORIAL HOSPITAL, INC
PART V, SECTION B, LINE 11: THE FOLLOWING NEEDS WERE IDENTIFIED BASED ON SURVEY DATA: ECONOMICS, CHILDREN AND YOUTH, HEALTH CARE AND WELLNESS, AGING, SAFETY AND MENTAL HEALTH/SUBSTANCE ABUSE. COMMUNITY MEMORIAL HOSPITAL IS ADDRESSING ALL OF THE ASSESSED NEEDS TO THE BEST OF OUR ABILITY AS A HEALTHCARE ORGANIZATION. IF THE NEED CANNOT BE ADDRESSED, INFORMATION IS SHARED WITH VARIOUS COMMUNITY ORGANIZATIONS AND LEADERS.THE NEEDS THAT WILL NOT BE ADDRESSED ARE AGING CONCERNS AROUND THE OVERALL COST OF LONG-TERM CARE THAT INCLUDE COST AND AVAILABILITY OF MEMORY CARE AND THE AVAILABILITY OF LONG-TERM CARE, ECONOMICS OF AFFORDABLE HOUSING AND SAFETY CONCERNS AROUND ABUSE OF PRESCRIPTION DRUGS AND EXCESSIVE BINGE DRINKING. COMMUNITY MEMORIAL HOSPITAL ADDRESSED THE AGING NEED BY REFERRING TO INSURANCE AGENCIES AND ATTORNEYS FOR ESTATE PLANNING. A LONG-TERM CARE FACILITY IN A NEIGHBORING COMMUNITY IS RELOCATING TO A NEW FACILITY THAT WILL ASSIST IN ADDRESSING AVAILABILITY. IN REGARD TO ECONOMICS, RESULTS WERE SHARED WITH SEVERAL LOCAL ORGANIZATIONS TO INCLUDE OUR LOCAL DEVELOPMENT GROUP. THE DEVELOPMENT GROUP USED THE DATA IN SEVERAL OF THEIR GRANT SUBMISSIONS AND WILL BE BUILDING A HOUSE NEXT YEAR. RESULTS WERE ALSO SHARED WITH LOCAL LAW ENFORCEMENT IN REGARD TO SAFETY DUE TO ABUSE OF PRESCRIPTION DRUGS AND EXCESSIVE BINGE DRINKING. IN FY 2021, COMMUNITY MEMORIAL HOSPITAL PERFORMED THE FOLLOWING ACTIONS WITH THE IMPLEMENTATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT: PRIORITY 1 MENTAL HEALTH- COMMUNITY MEMORIAL CONTINUED ITS FOCUS ON MENTAL HEALTH AWARENESS AND HAS MADE HUGE STRIDES HAVING MENTAL HEALTH SERVICES ON CAMPUS. THE HOSPITAL WAS ALSO A SPONSOR FOR THE FIRST ANNUAL COLORED IN HOPE AWARENESS WALK SPONSORED BY THE LOCAL COUNSELING SERVICE. THE RUN/WALK PROVIDED AWARENESS FOR SUICIDE AND MENTAL ILLNESS. THE EVENT HAD APPROXIMATELY 100 MEMBERS OF THE COMMUNITY AND SURROUNDING COMMUNITIES IN ATTENDANCE. STAFF ALSO FOCUSED ON THE FACILITY PHQ9S MAKING SIGNIFICANT IMPROVEMENTS IN COMPLETION OF THE DOCUMENTS.PRIORITY 2 HEALTHCARE AND WELLNESS- COMMUNITY MEMORIAL HOSPITAL CONTINUED ITS COMMITMENT TO PROMOTING A HEALTHY LIFESTYLE. THE HOSPITAL FUNDED FITNESS CLASSES AT THE LOCAL FITNESS CENTERS, FITNESS ON MAIN IN BURKE, SD AND POST 36 FITNESS IN BONESTEEL, SD. THE FUNDING ALLOWED FITNESS CLASSES TO BE OFFERED TO THE PUBLIC AT NO COST. THE FUNDING ELIMINATES FINANCIAL DETERRENCE FOR COMMUNITY MEMBERS AND INCREASES ATTENDANCE. IN JANUARY 2021, STAFF FROM COMMUNITY MEMORIAL HOSPITAL VISITED LOCAL ASSISTED LIVING FACILITIES TO ADMINISTER THE COVID-19 VACCINE TO RESIDENTS THAT CHOSE TO RECEIVE THE VACCINE.THE HOSPITAL SPONSORED SPRING AND FALL COMMUNITY HEALTH FAIRS THAT INCLUDED FREE LIPID PANELS AND A REDUCED COST WELLNESS PANEL CONSISTING OF FIVE LAB TESTS. THE HEALTH FAIRS HAD 140 PARTICIPANTS. HOSPITAL SPONSORED AN ANNUAL BLOOD DRIVE IN AUGUST.HOSPITAL HOSTED A DRIVE-THRU FLU SHOT CLINIC IN SEPTEMBER.SANFORD HEART AND VASCULAR SCREENINGS WERE OFFERED IN BOTH MARCH AND OCTOBER.HOSPITAL SPONSORED A BREAST CANCER AWARENESS WALK AT THE LOCAL LAKE. THE WALK WAS IN RECOGNITION OF THOSE WHO HAVE BATTLED THE DISEASE AS WELL AS PROMOTING ANNUAL MAMMOGRAMS.HOSPITAL ALSO DONATED TO THE ADDITION OF A SPLASH PAD TO THE CITY PARK. THE SPLASH PAD WILL MEET THE HEALTHCARE AND WELLNESS PRIORITY AS WELL AS THE CHILDREN AND YOUTH FINDING. THE GOAL IS TO PROVIDE A SAFE AND ACCESSIBLE WATER RECREATION OPTION IN THE COMMUNITY THAT CURRENTLY DOES NOT EXIST. IT IS A FUN WAY TO INCREASE PHYSICAL ACTIVITY AND DECREASE CHILDHOOD OBESITY. OUR LOCAL PHYSICIAN AND CHIEF EXECUTIVE OFFICER WERE KEY MEMBERS OF THE COMMITTEE THAT WORKED ON THE IMPLEMENTATION OF THE SPLASH PAD.

COMMUNITY MEMORIAL HOSPITAL, INC
PART V, SECTION B, LINE 13H: PATIENTS WHOSE FAMILY INCOME EXCEEDS 150% OF THE FPL MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE; HOWEVER, THE DISCOUNTED RATES SHALL NOT BE GREATER THAN THE AMOUNTS GENERALLY BILLED TO COMMERCIALLY INSURED PATIENTS. A DETERMINATION BASED ON PRESUMPTIVE ELIGIBILITY MAY BE MADE IF ALL OTHER AVENUES HAVE BEEN EXHAUSTED.

COMMUNITY MEMORIAL HOSPITAL, INC
PART V, SECTION B, LINE 15E: THE PHONE NUMBER FOR COMMUNITY MEMORIAL HOSPITAL IS LISTED ON THE APPLICATION. THE CMH EMPLOYEE ANSWERING THE PHONE WILL DIRECT THE PATIENT TO SOMEONE WHO CAN HELP WITH THE APPLICATION. CMH ALSO OFFERS INFORMATION REGARDING OTHER ORGANIZATIONS OR GOVERNMENT AGENCIES WHICH OFFER ASSISTANCE.

COMMUNITY MEMORIAL HOSPITAL, INC
PART V, SECTION B, LINE 16J: PART V, LINE 16A, 16B, & 16C:THE POLICY, PLAIN LANGUAGE SUMMARY AND APPLICATION ARE POSTED TO THE WEBSITE AT HTTPS://WWW.CMHBURKE.ORG/FINANCIALASSISTANCEPART V, LINE 16J: FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY AND APPLICATION ARE AVAILABLE IN THE ER AND NEAR THE ADMISSION DESK. A SIGN IS POSTED IN THE ADMISSIONS AREA TO INFORM PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE. THE HOSPITAL PROVIDES A COPY OF THE POLICY, SUMMARY AND APPLICATION TO PATIENTS WHO MAY QUALIFY UNDER THE FINANCIAL ASSISTANCE POLICY. THE FA POLICY, SUMMARY AND APPLICATION ARE ALSO LOCATED AT THE COUNTY WELFARE OFFICE. LESS THAN FIVE PERCENT OF THE POPULATION, AND FEWER THAN 1,000 INDIVIDUALS IN THE SERVICE AREA SPEAK A LANGUAGE OTHER THAN ENGLISH AS THEIR PRIMARY LANGUAGE. HOWEVER, A TRANSLATION SERVICE IS AVAILABLE IF NEEDED.

COMMUNITY MEMORIAL HOSPITAL, INC
PART V, SECTION B, LINE 24: THE HOSPITAL FACILITY MAY HAVE CHARGED FAP ELIGIBLE INDIVIDUALS AN AMOUNT EQUAL TO GROSS CHARGES FOR ELECTIVE SERVICES THAT ARE NOT COVERED UNDER THE FINANCIAL ASSISTANCE POLICY.

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 3C:
INDIVIDUALS WILL NOT BE DENIED CHARITY CARE BASED ON RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, AGE OR ABILITY TO PAY. BUSINESS OFFICE STAFF TRY TO IDENTIFY ELIGIBLE INDIVIDUALS AT THE TIME OF ADMISSION, HOWEVER INDIVIDUALS CAN BECOME ELIGIBLE FOR CHARITY CARE AT ANY POINT DURING OR AFTER THEIR MEDICAL ENCOUNTER. ONCE AN INDIVIDUAL IS IDENTIFIED AS A POTENTIAL CHARITY CARE RECIPIENT, COMMUNITY MEMORIAL HOSPITAL UTILIZES BOTH AN INCOME AND AN ASSET TEST TO EVALUATE ELIGIBILITY FOR CHARITY CARE. THE HOSPITAL REVIEWS A SCHEDULE OF THE PATIENT'S CURRENT INCOME AND EXPENSES AND ASSET LEVELS TO DETERMINE IF THE PATIENT CAN REASONABLY BE EXPECTED TO MAKE PAYMENT OF MEDICAL EXPENSES. CATASTROPHIC ILLNESS AND OTHER FACTORS MAY BE CONSIDERED. A DETERMINATION BASED ON PRESUMPTIVE ELIGIBILITY MAY BE MADE IF ALL OTHER AVENUES HAVE BEEN EXHAUSTED.

PART I, LINE 7:
CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A BASED ON AN OVERALL COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. LINE 7E WAS OBTAINED UTILIZING THE ACTUAL GENERAL LEDGER SYSTEM. LINES 7B AND 7G WAS OBTAINED FROM THE MEDICAID AND MEDICARE COST REPORTS, RESPECTIVELY.RURAL HEALTH CLINIC NET REVENUES OF $774,061 AND COSTS OF $1,128,331 WERE INCLUDED ON LINE 7G FOR A NET COMMUNITY SHORTFALL OF $354,270.

PART III, LINE 2:
THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE ORGANIZATION DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSION BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THIS CLASS OF PATIENTS.

PART III, LINE 3:
THE ORGANIZATION BELIEVES A SMALL AMOUNT OF THE IMPLICIT PRICE CONCESSIONS AMOUNT MAY BE ATTRIBUTABLE TO CHARITY CARE. A PERCENTAGE OF CHARITY CARE TO NET PATIENT REVENUE WAS USED TO DETERMINE THE AMOUNT OF IMPLICIT PRICE CONCESSION THAT MAY HAVE BEEN ELIGIBLE FOR FINANCIAL ASSISTANCE.

PART III, LINE 4:
FOOTNOTE FROM FINANCIAL STATEMENTS: PLEASE SEE NOTE 1, FINANCIAL STATEMENT, PATIENT SERVICE REVENUE ON PAGES 13-14.

PART III, LINE 8:
MEDICARE ALLOWABLE COSTS OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR FISCAL YEAR ENDING 12/31/2021. MEDICAL SERVICES ARE PROVIDED TO PATIENTS WITH MEDICARE COVERAGE REGARDLESS OF WHETHER OR NOT A SURPLUS OR DEFICIT IS REALIZED. PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES WHICH ARE VITALLY NEEDED BY OUR COMMUNITY.

PART III, LINE 9B:
ONCE A DECISION HAS BEEN MADE GRANTING FINANCIAL ASSISTANCE AND THE PATIENT/GUARANTOR HAS BEEN NOTIFIED, CMH WILL NO LONGER ATTEMPT TO COLLECT THE DISCOUNTED AMOUNT. IF, DURING THE COLLECTION PROCESS, IT IS DETERMINED THAT SOMEONE MAY QUALIFY FOR FINANCIAL ASSISTANCE, THE COLLECTION PROCESS STOPS AND THE FINANCIAL ASSISTANCE APPLICATION PROCESS BEGINS. COLLECTION IS HALTED UNTIL THE FINANCIAL ASSISTANCE APPLICATION IS REVIEWED AND QUALIFICATION IS DETERMINED. APPROVED FINANCIAL ASSISTANCE REQUESTS WILL BE WRITTEN OFF WITHIN TEN DAYS FROM THE DATE APPROVED. THE DECISION TO WRITE OFF THE ACCOUNT IS PERMANENT.

PART VI, LINE 2:
COMMUNITY MEMORIAL HOSPITAL CONDUCTED A FORMAL COMMUNITY NEEDS ANALYSIS DURING 2019. IN ADDITION TO CONDUCTING THE NEEDS ASSESSMENT EVERY THREE YEARS, ADMINISTRATION MEETS WITH PROVIDERS AND CLINIC MANAGERS MONTHLY AND WITH THE MEDICAL STAFF GROUP BI-MONTHLY. DURING THESE MEETINGS, TOPICS FROM PATIENT INTERACTIONS ARE DISCUSSED TO IDENTIFY ANY COMMUNITY HEALTH NEEDS.

PART VI, LINE 3:
INDIVIDUALS ARE MADE AWARE OF FINANCIAL ASSISTANCE THROUGH POSTING OF THE POLICY AND APPLICATION IN THE ER, CLINIC, AND ADMISSIONS OFFICE. STAFF IN THE ADMISSIONS OFFICE PROVIDE INFORMATION TO INDIVIDUALS WHO MAY QUALIFY FOR MEDICARE, MEDICAID, OR OTHER FINANCIAL ASSISTANCE.THE FINANCIAL ASSISTANCE POLICY AND APPLICATION ARE ALSO AVAILABLE ON THE FACILITY WEBSITE AND AT THE COUNTY WELFARE OFFICE.

PART VI, LINE 4:
COMMUNITY MEMORIAL HOSPITAL SERVES SEVERAL COMMUNITIES IN SOUTH CENTRAL SOUTH DAKOTA AND NORTH CENTRAL NEBRASKA. WE SERVE A RURAL POPULATION THAT IS VERY HOMOGENEOUS IN COMPOSITION. THE AREAS SERVED ARE PRIMARILY FARMING/RANCHING AND RETIREMENT COMMUNITIES. WE HAVE A VERY LOW PERCENTAGE OF UNINSURED RESIDENTS IN OUR AREA. WE ARE LOCATED IN A FEDERAL HEALTH PROFESSIONAL SHORTAGE AREA. 68% OF THE ORGANIZATION'S REVENUE WAS FROM SERVING THE MEDICARE POPULATION, 6% WAS FROM TITLE 19, 19% FROM COMMERCIAL INSURANCE, 3% FROM GOVERNMENT PAYERS/OTHERS, AND 4% SELF-PAY.

PART VI, LINE 5:
THE GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION. FAMILY MEMBERS OF SOME OF THE MEMBERS OF THE GOVERNING BODY ARE EMPLOYED BY THE ORGANIZATION DUE TO THE SMALL POPULATION OF THE COMMUNITY. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY. SURPLUS FUNDS, IF ANY, ARE REINVESTED FOR FACILITY AND EQUIPMENT UPGRADES, AND IMPROVING TECHNICAL SKILLS OF EMPLOYEES. COMMUNITY MEMORIAL HOSPITAL PROVIDES THE FOLLOWING TYPES OF COMMUNITY EDUCATION:A HEALTH FAIR IS PROVIDED SEMI-ANNUALLY FOR THE COMMUNITY WITH MANY DIFFERENT ASPECTS OF HEALTH CARE REPRESENTED. BLOOD DRAWS, BLOOD PRESSURES, GLUCOSE TESTING, AND DIFFERENT SCREENING TESTS ARE JUST A FEW OF THE SERVICES OFFERED BY THE HEALTH FAIR. IN ADDITION, EDUCATION FOR ALL SCHOOL AGES IS PROVIDED DURING A WEEK OF ACTIVITIES AT THE HOSPITAL. ACTIVITIES INCLUDE: TOURS OF DIFFERENT DEPARTMENTS, HAND WASHING TECHNIQUES, POISON CONTROL EDUCATION, AND A TEDDY BEAR CLINIC WHICH ENTAILS A TRIP TO THE EMERGENCY DEPARTMENT WITH THE TEDDY BEAR BEING THE PATIENT AND THE STUDENT BEING THE PARENT DESCRIBING THE COMPLAINTS. COMMUNITY MEMORIAL HOSPITAL ALSO PROVIDES CPR TRAINING TO BOTH THE STAFF AND COMMUNITY MEMBERS. DISASTER PREPAREDNESS TRAINING IS PROVIDED TO THE LOCAL FIRE DEPARTMENT. ADVANCED CARDIAC LIFE SUPPORT (ACLS) CLASSES AND TRAUMA NURSE CURRICULUM COURSES (TNCC) ARE PROVIDED TO STAFF AS WELL AS NURSES FROM SURROUNDING COMMUNITIES. COMMUNITY MEMORIAL HOSPITAL SPONSORS DIFFERENT ACTIVITIES IN THE COMMUNITY AS WELL AS PARTICIPATES IN COMMUNITY PROJECTS, INCLUDING SCHOOL YEAR BOOK, AFTER PROM PARTY, PARADES AND OTHER COMMUNITY EVENTS. A GREAT DEAL OF PRIDE IS TAKEN IN THE COMMUNITY WITH THE COMMUNITY GIVING AS MUCH TO THE HOSPITAL AS THE HOSPITAL GIVES BACK TO THE COMMUNITY.

Operating expenses	$ 6,930,820
Total amount spent on community benefits as % of operating expenses	$ 701,832 10.13 %