MILLE LACS HEALTH SYSTEM: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- MILLE LACS HEALTH SYSTEM (EIN 41-0785161)
- Tax period
- 2022-10-01 to 2023-09-30
- Filed
- 2024-08-13
- IRS object ID
- 202422269349300537
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-08-13T11:31:21-05:00 | ReturnTs |
| Tax Period End | 2023-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 121 WEST BRIDGE STREET | AddressLine1Txt |
| City | OWATONNA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55060 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410785161 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MILLE LACS HEALTH SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MILL | BusinessNameControlTxt |
| Phone | 3205322581 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 NORTH ELM STREET PO BOX A | AddressLine1Txt |
| City | ONAMIA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 563590800 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | WILLIAM NELSON | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 3205322581 | PhoneNum |
| Signature | 2024-08-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JUSTIN HARTERT | PreparerPersonNm |
| PTIN | P02236744 | PTIN |
| Phone | 5074467100 | PhoneNum |
| Preparation | 2024-08-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2024-08-08 14:25:15Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | WILLIAM NELSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 NORTH ELM STREET PO BOX A | AddressLine1Txt |
| City | ONAMIA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 563590800 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $57,395,041 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| All Affiliates Included | Yes (1) | AllAffiliatesIncludedInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MLHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1953 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE QUALITY HEALTH SERVICES TO RESIDENTS OF ONAMIA, MN AND THE SURROUNDING AREA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 512 | TotalEmployeeCnt |
| Total Volunteers | 40 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,684,162 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,587,778 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $44,949,281 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $53,605,633 | CYProgramServiceRevenueAmt |
| PY Investment Income | $105,820 | PYInvestmentIncomeAmt |
| CY Investment Income | $104,661 | CYInvestmentIncomeAmt |
| PY Other Revenue | $415,237 | PYOtherRevenueAmt |
| CY Other Revenue | $1,027,836 | CYOtherRevenueAmt |
| PY Total Revenue | $48,154,500 | PYTotalRevenueAmt |
| CY Total Revenue | $57,325,908 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $30,874,585 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $32,735,974 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $30,600 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $20,167,211 | PYOtherExpensesAmt |
| CY Other Expenses | $25,866,276 | CYOtherExpensesAmt |
| PY Total Expenses | $51,072,396 | PYTotalExpensesAmt |
| CY Total Expenses | $58,602,250 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,917,896 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,276,342 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $57,022,078 | TotalAssetsBOYAmt |
| Total Assets EOY | $58,728,748 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $36,104,811 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $40,477,870 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $20,917,267 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $18,250,878 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO ASSIST THOSE RESIDING IN AND VISITING THE MILLE LACS AREA IN ACHIEVING AND MANTAINING OPTIMAL HEALTH. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $51,148,947 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $53,605,633 | RevenueAmt |
| Desc | MILLE LACS HEALTH SYSTEM (MLHS) IS A RURAL HEALTH SYSTEM LOCATION IN ONAMIA, MN, 80 MILES NORTH OF THE TWIN CITIES AREA NEAR LAKE MILLE LACS. OUR SYSTEM INCLUDES A 18-BED ACUTE CARE HOSPITAL, A 57-BED LONG-TERM CARE FACILITY, A 10-BED SENIOR CARE FACILITY, HOME CARE, HOSPICE, A BLS AND ALS AMBULANCE SERVICE, AS WELL AS AN ATTACHED MEDICAL CLINIC. MLHS ALSO OPERATES MEDICAL CLINICS IN THE TOWNS OF ISLE, HILLMAN, GARRISON, AND MILACA. OUR MEDICAL STAFF ALSO PROVIDES COVERAGE TO THE NE-IA-SHING CLINIC ON THE NEARBY MILLE LACS RESERVATION. THE HEALTH SYSTEM IS ORGANIZED AS A 501(C)(3) NONPROFIT CORPORATION. DUE TO THE LACK OF AVAILABLE HEALTHCARE OPTIONS IN THIS CENTRAL MINNESOTA REGION, THE FEDERAL GOVERNMENT HAS DESIGNATED THIS COMMUNITY AS A MEDICALLY UNDERSERVED AREA IN TERMS OF PRIMARY CLINICS.THE REMOTENESS OF HEALTHCARE SERVICES TO THE MILLE LACS COMMUNITIES IN THE 1950'S PROMPTED AN AREA-WIDE COMMUNITY EFFORT TO BUILD A HOSPITAL. THE HOSPITAL WAS COMPLETED IN 1956 AND, FIVE YEARS LATER A NURSING HOME WAS BUILT ADJACENT TO IT. OVER THE YEARS, THE FACILITIES HAVE BEEN EXPANDED AND MODERNIZED AND RENAMED SEVERAL TIMES. IN 1995, AN AMBITIOUS BUILDING PROJECT AND INTEGRATION EFFORT, WHICH INCLUDED A NEW HOSPITAL EMERGENCY ROOM, REHABILITATION CENTER, AND CLINIC SPACE WERE COMPLETED. THIS BUILDING PROJECT WAS MADE POSSIBLE THROUGH NEARLY A HALF MILLION DOLLARS WHICH WERE RAISED LOCALLY. IN 2001, A MULTI-MILLION DOLLAR EXPANSION AND RENOVATION PROJECT WAS STARTED TO FURTHER UPGRADE THE HOSPITAL AND LONG-TERM CARE SERVICES AND POSITION US TO MEET THE GROWING HEALTHCARE NEEDS OF THE AREA.MILLE LACS HEALTH SYSTEM SERVES A PERMANENT POPULATION BETWEEN 15,000 AND 20,000, INCLUDING RESIDENTS OF THE MILLE LACS RESERVATION. BECAUSE OF THE RECREATIONAL FEATURES OF THE MILLE LACS AREA, MLHS ALSO SERVES A NUMBER OF SEASONAL RESIDENTS. IT IS ESTIMATED THAT DURING THE BUSY SUMMER AND HOLIDAY WEEKEND THERE ARE UP TO AN ADDITIONAL 25,000 PEOPLE IN THE AREA. THIS NUMBER IS BASED ON STATISTICS FROM LOCAL RESORTS, MOTELS, AND CAMPGROUNDS. THE CLOSEST ACUTE CARE FACILITY IS 28 MILES AWAY IN PRINCETON. THE CLOSEST TERTIARY CARE FACILITY IS 55 MILES AWAY IN ST. CLOUD. THE CLOSEST SECONDARY LEVEL IS 50 MILES AWAY IN BRAINERD. MLHS IS THE ONLY PROVIDER OF ACUTE CARE WITHIN OUR PRIMARY SERVICE AREA OF ONAMIA, HILLMAN, ISLE, GARRISON, AND WAHKON, WHICH INCLUDES THE MILLE LACS RESERVATION.MILLE LACS HEALTH SYSTEM ALSO SERVES PATIENTS OUTSIDE THE PRIMARY SERVICES AREA. THE SECONDARY SERVICE AREA INCLUDES MORA, BOCK, MILACA, AND OGILVIE. | Desc |
| Total Program Service Expenses | $51,148,947 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 130 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 512 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANDREW KNUTSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3205322581 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 ELM ST N | AddressLine1Txt |
| City | ONAMIA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56359 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| DR LYNNE STEINER | |||||||||
| DIRECTOR/PHYSICIAN (THRU 12/22) | 40.00 | 0.00 | Yes (X) | $210,024 | $0 | $49,321 | |||
| DR ARDEN VIRNIG | |||||||||
| DIRECTOR/PHYSICIAN | 40.00 | 0.00 | Yes (X) | $265,853 | $0 | $36,558 | |||
| BETSY LUNDQUIST | |||||||||
| SECRETARY | 2.00 | 0.00 | Yes (X) | $930 | $0 | $0 | Yes (X) | ||
| WENDY KAFKA | |||||||||
| SECRETARY (THRU 12/22) | 2.00 | 0.00 | Yes (X) | $750 | $0 | $0 | Yes (X) | ||
| ROB DUBBS | |||||||||
| TREASURER | 2.00 | 0.00 | Yes (X) | $1,110 | $0 | $0 | Yes (X) | ||
| DENNIS BURR | |||||||||
| BOARD VICE CHAIR | 2.00 | 0.00 | Yes (X) | $870 | $0 | $0 | Yes (X) | ||
| DARLA ROACH | |||||||||
| DIRECTOR (THRU 12/22) | 2.00 | 0.00 | Yes (X) | $210 | $0 | $0 | |||
| JOE NAYQUONABE | |||||||||
| DIRECTOR (THRU 12/22) | 2.00 | 0.00 | Yes (X) | $210 | $0 | $0 | |||
| PHIL GRAVEL | |||||||||
| BOARD CHAIR | 8.00 | 0.00 | Yes (X) | $3,720 | $0 | $0 | Yes (X) | ||
| JEAN STAFFORD | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $990 | $0 | $0 | |||
| ROGER TRAMM | |||||||||
| DIRECTOR (THRU 5/23) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| ANTHONY HASS | |||||||||
| DIRECTOR/CHIROPRACTOR | 40.00 | 0.00 | Yes (X) | $113,484 | $0 | $29,915 | |||
| WILLIAM NELSON | |||||||||
| CEO | 40.00 | 0.00 | $421,278 | $0 | $71,986 | Yes (X) | |||
| JACKIE ULSETH | |||||||||
| CNO | 40.00 | 0.00 | $174,491 | $0 | $39,604 | Yes (X) | |||
| JOHN UNZEN | |||||||||
| CFO (THRU 4/22) | 40.00 | 0.00 | $100,612 | $0 | $26,023 | Yes (X) | |||
| BECKY FOSSAND | |||||||||
| CAO | 40.00 | 0.00 | $163,930 | $0 | $44,262 | Yes (X) | |||
| DR PATTI HOOK-VIRNIG | |||||||||
| CHIEF OF STAFF | 40.00 | 0.00 | $268,712 | $0 | $37,876 | Yes (X) | |||
| ANDY KNUTSON | |||||||||
| CFO | 40.00 | 0.00 | $98,530 | $0 | $23,086 | Yes (X) | |||
| DR TOM BRACKEN | |||||||||
| VP MEDICAL AFFAIRS | 40.00 | 0.00 | $221,076 | $0 | $59,539 | Yes (X) | |||
| DAWN BACK | |||||||||
| PHYSICIAN ASSISTANT | 40.00 | 0.00 | $238,343 | $0 | $26,913 | Yes (X) | |||
| JAMES YOUNG | |||||||||
| HOSPITALIST | 40.00 | 0.00 | $327,002 | $0 | $9,129 | Yes (X) | |||
| EARLE MUNNS | |||||||||
| HOSPITALIST | 40.00 | 0.00 | $306,663 | $0 | $35,032 | Yes (X) | |||
| CATHY DONOVAN | |||||||||
| FAMILY MEDICINE PHYSICIAN | 40.00 | 0.00 | $265,981 | $0 | $61,507 | Yes (X) | |||
| AMY HUSEBY | |||||||||
| PHYSICIAN ASSISTANT | 40.00 | 0.00 | $226,495 | $0 | $26,248 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,411,264 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $576,999 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 41 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| DIAGNOSTIC IMAGING SPECIALISTS | |||||
| 23294 DUTCHMANS BLUFF | NISSWA | MN | 56448 | RADIOLOGY SERVICES | $668,213 |
| FOCUSONE SOLUTIONS LLC | |||||
| 13609 CALIFORNIA ST SUITE 420 | OMAHA | NE | 68154 | CONTRACT NURSING | $563,037 |
| CENTRAL MN ANESTHESIA SERVICES INC | |||||
| 9527 330TH ST | ONAMIA | MN | 56359 | ANESTHESIA SERVICES | $521,232 |
| CENTRAL MN DIAGNOSTICS INC | |||||
| PO BOX 64756 | ST PAUL | MN | 60693 | RADIOLOGY SERVICES | $364,033 |
| SOFT CHOICE CORPORATION | |||||
| 16609 COLLECTIONS CENTER DR | CHICAGO | IL | 60693 | COMPUTER SOFTWARE | $308,106 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $595,147 | GovernmentGrantsAmt |
| All Other Contributions | $1,992,631 | AllOtherContributionsAmt |
| Total Contributions | $2,587,778 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT REVENUE | 621110 | $47,931,430 | $47,931,430 |
| CLINIC REVENUE | 621110 | $4,403,129 | $4,403,129 |
| ASSISTED LIVING | 623000 | $910,105 | $910,105 |
| JOINT VENTURE INCOME | 621500 | $351,386 | $351,386 |
| THERAPY REVENUE | 621300 | $9,583 | $9,583 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $53,605,633 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $105,793 | TotalRevenueColumnAmt |
| Exclusion | $105,793 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $17,625 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $17,625 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,625 | TotalRevenueColumnAmt |
| Exclusion | $17,625 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $68,001 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $69,133 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$1,132 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,132 | TotalRevenueColumnAmt |
| Exclusion | -$1,132 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $39,330 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $39,330 | TotalRevenueColumnAmt |
| Exclusion | $39,330 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| JOINT VENTURE INCOME - OTHER | 621500 | $583,507 | $583,507 |
| MEALS REVENUE | 812900 | $364,376 | $364,376 |
| MISCELLANEOUS | 812900 | $17,231 | $17,231 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,767 | TotalRevenueColumnAmt |
| Exclusion | $5,767 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $970,881 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $57,325,908 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $53,605,633 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,132,497 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,065,423 | TotalAmt |
| Program Services | $554,769 | ProgramServicesAmt |
| Management And General | $1,510,654 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,715,005 | TotalAmt |
| Program Services | $23,487,461 | ProgramServicesAmt |
| Management And General | $1,227,544 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $696,210 | TotalAmt |
| Program Services | $631,809 | ProgramServicesAmt |
| Management And General | $64,401 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,384,374 | TotalAmt |
| Program Services | $3,071,313 | ProgramServicesAmt |
| Management And General | $313,061 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,874,962 | TotalAmt |
| Program Services | $1,719,895 | ProgramServicesAmt |
| Management And General | $155,067 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,427 | TotalAmt |
| Management And General | $59,427 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $165,767 | TotalAmt |
| Management And General | $165,767 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,930,840 | TotalAmt |
| Program Services | $7,039,790 | ProgramServicesAmt |
| Management And General | $1,891,050 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $243,412 | TotalAmt |
| Program Services | $107,254 | ProgramServicesAmt |
| Management And General | $136,158 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,435,404 | TotalAmt |
| Program Services | $823,532 | ProgramServicesAmt |
| Management And General | $611,872 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $222,611 | TotalAmt |
| Program Services | $46,632 | ProgramServicesAmt |
| Management And General | $175,979 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,014,620 | TotalAmt |
| Program Services | $990,990 | ProgramServicesAmt |
| Management And General | $23,630 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $226,381 | TotalAmt |
| Program Services | $203,861 | ProgramServicesAmt |
| Management And General | $22,520 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $638,519 | TotalAmt |
| Program Services | $599,771 | ProgramServicesAmt |
| Management And General | $38,748 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,981,282 | TotalAmt |
| Program Services | $2,788,774 | ProgramServicesAmt |
| Management And General | $192,508 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $417,902 | TotalAmt |
| Program Services | $206,602 | ProgramServicesAmt |
| Management And General | $211,300 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $6,423,786 | $6,423,786 | |
| BAD DEBT EXPENSE | $1,386,063 | $1,386,063 | |
| FOOD | $518,832 | $518,832 | |
| TAXES | $364,962 | $91,408 | $273,554 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $836,468 | TotalAmt |
| Program Services | $456,405 | ProgramServicesAmt |
| Management And General | $380,063 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,602,250 | TotalAmt |
| Program Services | $51,148,947 | ProgramServicesAmt |
| Management And General | $7,453,303 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,794,854 | BOYAmt |
| EOY | $2,200,954 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,579,544 | BOYAmt |
| EOY | $4,861,810 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,022,329 | BOYAmt |
| EOY | $8,633,098 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $412,000 | BOYAmt |
| EOY | $796,000 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $691,334 | BOYAmt |
| EOY | $756,138 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $838,471 | BOYAmt |
| EOY | $440,502 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $77,446,185 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $38,751,739 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,282,418 | BOYAmt |
| EOY | $38,694,446 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,082 | BOYAmt |
| EOY | $183,932 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,069,162 | BOYAmt |
| EOY | $1,128,315 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,261,884 | BOYAmt |
| EOY | $1,033,553 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,022,078 | BOYAmt |
| EOY | $58,728,748 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,656,929 | BOYAmt |
| EOY | $3,130,230 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,159,892 | BOYAmt |
| EOY | $6,181,813 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $106,467 | BOYAmt |
| EOY | $157,196 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,181,523 | BOYAmt |
| EOY | $30,420,244 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $588,387 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,104,811 | BOYAmt |
| EOY | $40,477,870 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,216,734 | BOYAmt |
| EOY | $18,096,419 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,700,533 | BOYAmt |
| EOY | $154,459 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,917,267 | BOYAmt |
| EOY | $18,250,878 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,022,078 | BOYAmt |
| EOY | $58,728,748 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,276,342 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $156,027 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$1,546,074 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Political Expenditures | $0 | PoliticalExpendituresAmt |
| Volunteer Hours | 0 | VolunteerHoursCnt |
| Section4955 Organization Tax | $0 | Section4955OrganizationTaxAmt |
| Section4955 Managers Tax | $0 | Section4955ManagersTaxAmt |
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $2,647 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,647 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PAYS ANNUAL DUES TO AHA/MHA/MHCA, OF WHICH, A PORTION IS SPENT ON LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,192,310 | OtherCostOrOtherBasisAmt |
| Book Value | $1,192,310 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $53,767,552 | OtherCostOrOtherBasisAmt |
| Depreciation | $23,506,193 | DepreciationAmt |
| Book Value | $30,261,359 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,797,231 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,223,025 | DepreciationAmt |
| Book Value | $2,574,206 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $18,551,760 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,909,058 | DepreciationAmt |
| Book Value | $4,642,702 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $137,332 | OtherCostOrOtherBasisAmt |
| Depreciation | $113,463 | DepreciationAmt |
| Book Value | $23,869 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $38,694,446 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO/FROM MEDICARE | $400,000 |
| ROU LIABILITY | $188,387 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $588,387 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $53,181,406 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $156,027 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $156,027 | RevenueNotReportedAmt |
| Revenue Subtotal | $53,025,379 | RevenueSubtotalAmt |
| Other Revenues Not Included | $4,300,529 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $4,300,529 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $57,325,908 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $57,216,187 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $57,216,187 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $1,386,063 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,386,063 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $58,602,250 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | THE HOSPITAL HOLDS FUNDS ON BEHALF OF THE NURSING HOME RESIDENTS IN A SEPARATE BANK ACCOUNT. |
| PART X, LINE 2: | THE ORGANIZATION IS A NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION FOLLOWS THE GUIDANCE IN THE ACCOUNTING STANDARDS REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE APPLICATION OF THIS STANDARD HAS NO EFFECT ON THE FINANCIAL STATEMENTS. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | GAIN ON DISPOSAL OF EQUIPMENT -1,132. INVESTMENT INCOME 304,638. GRANT INCOME 595,147. CONTRIBUTIONS AND OTHER INCOME 50,549. PROVISION FOR BAD DEBT 1,386,063. DONOR RESTRICTED CONTRIBUTIONS 1,965,264. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | PROVISION FOR BAD DEBT 1,386,063. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,920,456 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,468,251 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,452,205 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.18270 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,920,456 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,468,251 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,452,205 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.18270 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $476,167 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $476,167 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00830 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $51,376 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $48,838 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,538 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $670 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,773 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $528,213 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $50,611 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $478,705 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00830 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,448,669 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,518,862 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,930,910 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.19100 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,386,063 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $6,558,968 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,475,462 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,916,494 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MILLE LACS HEALTH SYSTEM | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 NORTH ELM STREET | AddressLine1Txt |
| City | ONAMIA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 563590800 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.MLHEALTH.ORG | WebsiteAddressTxt |
| State License | 8557484 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MILLE LACS HEALTH SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 22 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, PAGE 8 | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | 0 | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (1) | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, PAGE 8 | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, PAGE 8 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, PAGE 8 | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MILLE LACS HEALTH SYSTEM | PART V, SECTION B, LINE 5: WE GATHERED QUALITATIVE INFORMATION AND PERSPECTIVES ON COMMUNITY HEALTH NEEDS THROUGH ONE-ON-ONE AND SMALL GROUP INTERVIEWS WITH KEY COMMUNITY STAKEHOLDERS. THESE INTERVIEWS WERE CONDUCTED IN JULY 2022. THE PRIMARY GOAL OF THESE INTERVIEWS WAS TO ASCERTAIN A RANGE OF PERSPECTIVES ON THE COMMUNITY'S HEALTH NEEDS. WE GATHERED INFORMATION FROM THE FOLLOWING SPECIFIED GROUPS WITHIN OUR COMMUNITY: - PEOPLE WITH SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH; - GOVERNMENT HEALTH DEPARTMENTS AND OTHER GOVERNMENT AGENCIES; - LEADERS, REPRESENTATIVES OR MEMBERS OF MEDICALLY UNDERSERVED POPULATIONS; - LEADERS, REPRESENTATIVES OR MEMBERS OF LOW-INCOME POPULATIONS; AND - LEADERS, REPRESENTATIVES OR MEMBERS OF MINORITY POPULATIONS.THE FOLLOWING AGENCIES, ORGANIZATIONS AND BUSINESSES PARTICIPATED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS BY CONTRIBUTING THEIR PERSPECTIVES, OPINIONS AND OBSERVATIONS. - MILLE LACS COUNTY DEPARTMENT OF COMMUNITY & VETERANS SERVICES - MILLE LACS BAND OF OJIBWE - MILLE LACS COUNTY SHERIFF'S DEPARTMENT - CITY OF ONAMIA - ONAMIA POLICE DEPARTMENT - CITY OF MILACA - MILACA POLICE DEPARTMENT - CITY OF ISLE - ISLE POLICE DEPARTMENT - CROSIER FATHERS & BROTHERSWE BELIEVE EACH OF THESE ORGANIZATIONS IS A QUALIFIED REPRESENTATIVE OF THE IDENTIFIED GROUPS BECAUSE THE NATURE OF THEIR WORK BRINGS THEM INTO CONTACT WITH THOSE GROUPS ON A REGULAR BASIS. FOR MANY OF THE ORGANIZATIONS LISTED, THE NATURE OF THEIR MISSION AND PURPOSE REQUIRES THEM TO CONSIDER THE SPECIAL NEEDS OF THE GROUPS IDENTIFIED. |
| MILLE LACS HEALTH SYSTEM | PART V, SECTION B, LINE 11: THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR 2022, MILLE LACS HEALTH SYSTEM IDENTIFIED THE FOLLOWING SIGNIFICANT COMMUNITY HEALTH NEEDS AND PRIORITIZED THEM IN THE GIVEN ORDER:1A MENTAL HEALTH1B ELDER HEALTH2A SUBSTANCE ABUSE2B OBESITY2C ACCESS TO HEALTHCARECONSISTENT WITH THE REQUIREMENTS OF SECTION 501(R)(3), THIS IMPLEMENTATION STRATEGY IDENTIFIES MILLE LACS HEALTH SYSTEM'S PLANNED RESPONSE TO EACH SIGNIFICANT COMMUNITY HEALTH NEED. IF MILLE LACS HEALTH SYSTEM DOES NOT PLAN TO ADDRESS A HEALTH NEED, THIS IMPLEMENTATION STRATEGY EXPLAINS WHY.MENTAL HEALTH:- CONTINUE TO OFFER TELE-PSYCHIATRY AND ONSITE PSYCHOLOGIST- FAMILY MEDICINE PROVIDERS CONTINUE TO OFFER MENTAL HEALTH SERVICES- CONTINUE GERI-PSYCH INPATIENT UNIT- CONTINUE TO PROVIDE LOCKED MEMORY CARE UNIT IN LONG TERM CARE - CONTINUE SOCIAL WORKER SUPPORT SERVICES TO ACUTE CARE, EMERGENCY DEPARTMENT, LONG TERM CARE, GERI-PSYCH AND HOME CARE/HOSPICE- EMERGENCY DEPARTMENT CARE ONSITE- BEHAVIORAL HEALTH ROOMS IN EMERGENCY DEPARTMENT AND INPATIENT UNITELDER HEALTH:- CONTINUE GERI-PSYCH INPATIENT UNIT- CONTINUE TO PROVIDE SENIOR SERVICES IN LONG TERM CARE - CONTINUE SOCIAL WORKER SUPPORT SERVICES TO ACUTE CARE, EMERGENCY DEPARTMENT, LONG TERM CARE, GERI-PSYCH AND HOME CARE/HOSPICE- MEDICATION THERAPY MANAGEMENT THROUGH PHARMACY SERVICES- INR MANAGEMENT FOR MEDICATION EVALUATION AND THERAPY IN OUTPATIENT CLINICS AND PHARMACY SERVICES.- PROVIDE MANAGEMENT SERVICES FOR LOCAL ASSISTED LIVING ORGANIZATIONSUBSTANCE ABUSE: - REINVIGORATE MEDICATED ASSISTED THERAPY (MAT) PROGRAM- CONTINUE PARTNERSHIP WITH FREEDOM CENTER TREATMENT PROGRAM- CONTINUE MONTHLY PAIN COMMITTEE COLLABORATION- EXPLORE BARRIERS TO TRANSPORTATION FOR CARE AND TREATMENT- EXPLORE NARCAN DISTRIBUTION AND FENTANYL TESTING KIT OPPORTUNITIES OBESITY:- PROVIDE REGISTERED DIETICIAN SERVICES- CONTINUE TO PROVIDE GROUP WEIGHT LOSS SERVICES FOR PRE-DIABETICS- CONTINUE TO PROVIDE OUTPATIENT CDE SERVICES- FAMILY MEDICINE PROVIDERS CONTINUE TO OFFER SERVICES FOR OBESITY DIAGNOSES THROUGH A VARIETY OF METHODS- OPERATE COMMUNITY PHARMACY SERVICES WITH PHARMACIST AVAILABLE TO COUNSEL PATIENTS ACCESS TO HEALTH CARE:- OUTPATIENT SERVICES PROVIDED IN ONAMIA, ISLE, HILLMAN, GARRISON AND MILACA- AMBULANCE SERVICES PROVIDED IN ONAMIA AND ISLE- OUTPATIENT INFUSION THERAPY SERVICES- SURGERY ON-SITE- HOME CARE/HOSPICE- LONG TERM CARE WITH MEMORY CARE UNIT- CRITICAL ACCESS HOSPITAL SERVICES- REHABILITATION SERVICES AT THREE SITES- FINANCIAL ASSISTANCE FOR ELIGIBLE PATIENTS/RESIDENTS- COMMUNITY HEALTH EDUCATIONBECAUSE OF LIMITED RESOURCES, WE CANNOT RESPOND EFFECTIVELY TO EVERY IDENTIFIED HEALTH NEED. WE HAVE CHOSEN OUR RESPONSES BASED ON ANALYSES OF OUR RESOURCES, OUR MISSION, OUR EXISTING SPECIALTIES, COMMUNITY PRIORITIES, AND EXISTING COMMUNITY RESOURCES. |
| PART V, LINE 16B, FAP APPLICATION WEBSITE: | HTTPS://WWW.MLHEALTH.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE |
| PART V, LINE 16A, FAP WEBSITE: | HTTPS://WWW.MLHEALTH.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE |
| PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: | HTTPS://WWW.MLHEALTH.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE |
| PART V, LINE 7A, CHNA WEBSITE: | HTTPS://WWW.MLHEALTH.ORG/PATIENTS-VISITORS/PATIENT-RESOURCES |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - MLHS FAMILY CLINIC - ONAMIA | ||||
| 200 N ELM STREET | ONAMIA | MN | 56359 | MEDICAL CLINIC |
| 2 - MLHS FAMILY CLINIC - ISLE | ||||
| 375 W ISLE STREET | ISLE | MN | 56342 | MEDICAL CLINIC |
| 3 - MLHS FAMILY CLINIC - MILACA | ||||
| 1010 5TH STREET SE | MILACA | MN | 56353 | MEDICAL CLINIC |
| 4 - MLHS FAMILY CLINIC - GARRISON | ||||
| 27378 STATE HIGHWAY 18 | GARRISION | MN | 56450 | MEDICAL CLINIC |
| 5 - MLHS FAMILY CLINIC - HILLMAN | ||||
| 26362 370TH AVENUE | HILLMAN | MN | 56338 | MEDICAL CLINIC |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | THE FEDERAL POVERTY INCOME GUIDELINES PROVIDE THE INITIAL FRAMEWORK TO DETERMINE THE INDIVIDUAL'S ABILITY TO PAY. INDIVIDUALS WITH INCOME AND ASSETS EQUAL TO OR LESS THAN THE FEDERAL POVERTY INCOME GUIDELINES, WITH NO OTHER AVAILABLE ASSETS MUST BE EVALUATED TO SEE IF THE PATIENT FIRST QUALIFIES FOR ASSISTANCE FROM ANY FEDERAL, STATE, OR LOCAL COUNTY PROGRAMS. A REASONABLE PAYMENT SCHEDULE OVER A 1- OR 2-YEAR PERIOD WILL BE DETERMINED IN THE INTERVIEW PROCESS. THE PORTION THAT WILL BE WRITTEN OFF SHOULD THEN BE CLASSIFED AS A CHARITY DISCOUNT. INDIVIDUALS WITHIN TWO (2) TIMES THE FEDERAL POVERTY GUIDELINES MAY ALSO HAVE SOME MEDICAL INSURANCE COVERAGE. THE PATIENT DEDUCTABLE AND NONCOVERED SERVICES MAY BE LARGE ENOUGH THAT THE INDIVIDUAL IS INCAPABLE OF PAYING OFF WITHIN A 1-2 YEAR PERIOD. THEREFORE, THIS UNPAYABLE AMOUNT BY THE PATIENT MAY BE CLASSIFED AS A CHARITY DISCOUNT. |
| PART I, LINE 7: | THE COSTS INCLUDED IN PART 1, LINES 7A AND 7B WERE DERIVED BY USING THE COST-TO-CHARGE RATIO CALCULATED USING WORKSHEET 2 AND THEN APPLIED AGAINST INTERNALLY DEVELOPED NUMBERS. THE COSTS INCLUDED IN PART 1, LINES 7E, 7F AND 7I WERE ACTUAL COSTS TRACKED BY THE HEALTH SYSTEM IN THEIR FINANCIAL PROCESS. |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1,386,063. |
| PART III, LINE 2: | SEE THE "PATIENT AND RESIDENT ACCOUNTS RECEIVABLE" PARAGRAPHS ON PAGE 8 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS FOR INFORMATION ABOUT OUR BAD DEBT EXPENSE CALCULATION. |
| PART III, LINE 3: | MILLE LACS HEALTH SYSTEM IS REPORTING $0 BECAUSE WE DO NOT HAVE A METHOD TO REASONABLY ESTIMATE THE PORTION OF BAD DEBT EXPENSE THAT IS ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE BUT DIDN'T APPLY. |
| PART III, LINE 4: | SEE THE "PATIENT AND RESIDENT ACCOUNTS RECEIVABLE" PARAGRAPHS ON PAGE 8 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS FOR INFORMATION ABOUT OUR BAD DEBT EXPENSE CALCULATION. |
| PART III, LINE 8: | THE MEDICARE ALLOWABLE COSTS AND REVENUES WERE CALCULATED USING THE 9/30/2023 COST REPORT. THE SHORTFALL SHOULD BE CONSIDERED COMMUNITY BENEFIT AS IT REPRESENTS A FINANCIAL SACRIFICE BY MILLE LACS HEALTH SYSTEM IN SERVING THE ELDERLY MEMBERS OF OUR COMMUNITY WHO MAY OTHERWISE STRUGGLE TO AFFORD HEALTH CARE. |
| PART III, LINE 9B: | REASONABLE EFFORTS TO NOTIFY AN INDIVIDUAL ABOUT FINANCIAL ASSISTANCEAT LEAST 30 DAYS PRIOR TO TAKING ANY EXTRAORDINARY COLLECTION ACTION AGAINST AN INDIVIDUAL, THE HEALTH SYSTEM WILL PROVIDE THE INDIVIDUAL WITH A WRITTEN NOTICE THAT INCLUDES THE FOLLOWING INFORMATION: - THE HEALTH SYSTEM OFFERS FINANCIAL ASSISTANCE TO ELIGIBLE INDIVIDUALS. - IDENTIFY THE EXTRAORDINARY COLLECTION ACTIONS THAT MAY BE INITIATED AGAINST THE INDIVIDUAL TO OBTAIN PAYMENT FOR THE CARE. - PROVIDE A DEADLINE AFTER WHICH SUCH EXTRAORDINARY COLLECTION ACTIONS MAY BE INITIATED.THE WRITTEN NOTICE WILL INCLUDE A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. THE HEALTH SYSTEM WILL ALSO MAKE REASONABLE EFFORTS TO ORALLY NOTIFY THE RESPONSIBLE PARTY ABOUT THE FINANCIAL ASSISTANCE POLICY AND HOW THE INDIVIDUAL MAY OBTAIN ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS.BEFORE ENGAGING IN AN EXTRAORDINARY COLLECTION ACTION AGAINST AN INDIVIDUAL, THE BUSINESS OFFICE MANAGER WILL DETERMINE THAT REASONABLE EFFORTS HAVE BEEN MADE TO NOTIFY THE INDIVIDUAL ABOUT FINANCIAL ASSISTANCE.IF AN INDIVIDUAL SUBMITS A FINANCIAL ASSISTANCE APPLICATION, THE HEALTH SYSTEM WILL CEASE ALL COLLECTION EFFORTS UNTIL A DETERMINATION OF FINANCIAL ASSISTANCE ELIGIBILITY IS MADE. IF THE HEALTH SYSTEM OR ANOTHER AUTHORIZED PARTY HAS ALREADY BEGUN AN EXTRAORDINARY COLLECTION ACTION AGAINST AN INDIVIDUAL WHEN THAT INDIVIDUAL SUBMITS A COMPLETE FINANCIAL ASSISTANCE APPLICATION, THE EXTRAORDINARY COLLECTION ACTION WILL BE SUSPENDED. SUSPENDING AN ACTION MEANS THAT NO FURTHER STEPS ARE TAKEN ON THAT EXTRAORDINARY COLLECTION ACTION AND NO NEW EXTRAORDINARY COLLECTION ACTIONS ARE INITIATED. THIS SUSPENSION MAY BE LIFTED WHEN THE HEALTH SYSTEM DETERMINES THE INDIVIDUAL'S ELIGIBILITY FOR FINANCIAL ASSISTANCE AND NOTIFIES THE INDIVIDUAL OF THAT DECISION.IF THE HEALTH SYSTEM OR ANOTHER AUTHORIZED PARTY HAS ALREADY BEGUN AN EXTRAORDINARY COLLECTION ACTION AGAINST AN INDIVIDUAL WHEN THAT INDIVIDUAL IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, ALL REASONABLY AVAILABLE MEASURES WILL BE TAKEN TO REVERSE THE EXTRAORDINARY COLLECTION ACTION. SUCH STEPS INCLUDE, BUT ARE NOT LIMITED TO, VACATING A JUDGMENT AGAINST THE INDIVIDUAL, LIFTING A LEVY OR LIEN ON THE INDIVIDUAL'S PROPERTY, AND REMOVING FROM THE INDIVIDUAL'S CREDIT REPORT ANY ADVERSE INFORMATION THAT WAS REPORTED.IF AN INDIVIDUAL SUBMITS AN INCOMPLETE FINANCIAL ASSISTANCE APPLICATION, THE HEALTH SYSTEM WILL TAKE THE FOLLOWING STEPS TO ENCOURAGE THEM TO COMPLETE THE APPLICATION: - SUSPEND ANY EXTRAORDINARY COLLECTION ACTIONS TO OBTAIN PAYMENT FOR THE CARE. - PROVIDE A WRITTEN NOTICE TO THE RESPONSIBLE PARTY THAT INCLUDES THE ADDITIONAL INFORMATION AND/OR DOCUMENTATION THAT MUST BE SUBMITTED, AND THE PHYSICAL LOCATION AND PHONE NUMBER OF THE BUSINESS OFFICE MANAGER, WHO CAN ANSWER QUESTIONS ABOUT THE FINANCIAL ASSISTANCE POLICY AND/OR PROVIDE ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS. - ALLOW A REASONABLE AMOUNT OF TIME FOR THE RESPONSIBLE PARTY TO SUBMIT A COMPLETE FINANCIAL ASSISTANCE APPLICATION. SUCH PERIOD OF TIME WILL BE AT LEAST 30 DAYS FROM THE DATE THE WRITTEN NOTICE IS SENT TO THE RESPONSIBLE PARTY.IF THE INDIVIDUAL FAILS TO PROVIDE THE REQUESTED INFORMATION WITHIN THE STATED TIME, THE HEALTH SYSTEM MAY RENEW THE PREVIOUSLY INITIATED EXTRAORDINARY COLLECTION ACTIONS.IF AN INDIVIDUAL HAS MADE FULL OR PARTIAL PAYMENT, AND THE INDIVIDUAL IS SUBSEQUENTLY DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE, ANY PAYMENTS IN EXCESS OF THEIR NEWLY CALCULATED REMAINING LIABILITY WILL BE REFUNDED TO THE PATIENT WITHIN 30 DAYS OF THE FINANCIAL ASSISTANCE ELIGIBILITY DETERMINATION. IF THE REFUNDABLE AMOUNT IS LESS THAN $5.00, IT WILL NOT BE REFUNDED. |
| PART VI, LINE 2: | MILLE LACS HEALTH SYSTEM ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITY THROUGH THE ORGANIZATION OF COMMUNITY MEETINGS - FEEDBACK FORUMS. THE ORGANIZERS PROVIDE CONSTANT FEEDBACK OF COMMUNITY NEEDS. THERE ARE COMMUNITY FOCUS GROUPS AND HOSPITAL STAFF ATTENDANCE AT VARIOUS CLUB MEETINGS TO PROVIDE HEALTH INFORMATION AND GUIDANCE ON HOW TO ACCESS TO THE HOSPITAL'S SERVICES. |
| PART VI, LINE 3: | ELIGIBILITY FOR ASSISTANCE INFORMATION IS ON THE BILLING STATEMENTS. THE HEALTH SYSTEM ALSO PROVIDES NEWSLETTERS AND COMMUNITY OUTREACH PROGRAMS THAT INCLUDE INFORMATION ABOUT FINANCIAL ASSISTANCE. AN ASSISTANCE INFORMATION SHEET IS PROVIDED TO THE PATIENT OR REPRESENTATIVE AT THE TIME OF THE SERVICE OR AT A SCHEDULED MEETING FOR ELIGIBILITY. |
| PART VI, LINE 4: | MILLE LACS HEALTH SYSTEM IS LOCATED 80 MILES NORTH OF THE MINNEAPOLIS MN AREA IN CENTRAL MINNESOTA. THE HEALTH SYSTEM SERVES THE PREDOMINATELY RURAL AREA OF MILLE LACS COUNTRY AND PORTIONS OF MORRISON, AITKIN, CROW WING, AND KANABEC COUNTIES, PLUS THE MILLE LACS OJIBW INDIAN RESERVATION. THE MILLE LACS PRIMARY SERVICE AREA INCLUDES 15,000 TO 18,000 YEAR ROUND RESIDENTS WITH THE POPULATION DOUBLING DURING THE PEAK TOURIST SEASON. PERSONS LIVING BELOW THE POVERTY LEVEL IN MILLE LACS COUNTY IS 10.9% FROM THE US CENSUS. THE DEMOGRAPHIC AND SOCIOECONOMIC PROFILE COMMON TO OUR RURAL COMMUNITY ALSO INFLUENCES THE DEMANDS ON OUR HEALTHCARE SYSTEM. RURAL AREAS IN GENERAL HAVE GREATER CONCENTRATIONS OF ELDERLY PEOPLE THAN DO URBAN AREAS. AN OLDER POPULATION IS MORE LIKELY TO HAVE CHRONIC HEALTHCARE NEEDS, WHICH CAN PLACE A HEAVY BURDEN ON COMMUNITIES THAT ALREADY FACE SHORTAGES. |
| PART VI, LINE 5: | MILLE LACS HEALTH SYSTEM PROVIDES EDUCATIONAL HEALTH FAIRS, COMMUNITY MEETINGS ON HEALTH PROBLEMS, DIAGNOSIS AND PREVENTION METHODS. PART OF OUR MISSION STATEMENT IS TO ASSIST THOSE RESIDING IN AND VISITING THE MILLE LACS AREA IN ACHIEVING AND MAINTAINING OPTIMAL HEALTH. THE HEALTH SYSTEM PROVIDES PASTORAL CARE TO PATIENTS UPON REQUEST FROM OUR AREA CHURCHES CLERGY. WE SEND OUT QUARTERLY COMMUNITY HEALTH INFORMATION NEWS LETTERS. WE PROVIDE FREE BLOOD PRESSURE TESTING PROGRAMS. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | MN |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WILLIAM NELSON | ||||||||||||||
| CEO | $339,688 | $0 | $81,590 | $0 | $0 | $0 | $11,008 | $0 | $60,978 | $0 | $493,264 | $0 | $0 | $0 |
| EARLE MUNNS | ||||||||||||||
| HOSPITALIST | $304,670 | $0 | $1,993 | $0 | $0 | $0 | $3,096 | $0 | $31,936 | $0 | $341,695 | $0 | $0 | $0 |
| JAMES YOUNG | ||||||||||||||
| HOSPITALIST | $324,809 | $0 | $2,193 | $0 | $0 | $0 | $3,168 | $0 | $5,961 | $0 | $336,131 | $0 | $0 | $0 |
| CATHY DONOVAN | ||||||||||||||
| FAMILY MEDICINE PHYSICIAN | $263,589 | $0 | $2,392 | $0 | $0 | $0 | $10,009 | $0 | $51,498 | $0 | $327,488 | $0 | $0 | $0 |
| DR PATTI HOOK-VIRNIG | ||||||||||||||
| CHIEF OF STAFF | $266,320 | $0 | $2,392 | $0 | $0 | $0 | $10,740 | $0 | $27,136 | $0 | $306,588 | $0 | $0 | $0 |
| DR ARDEN VIRNIG | ||||||||||||||
| DIRECTOR/PHYSICIAN | $263,461 | $0 | $2,392 | $0 | $0 | $0 | $10,612 | $0 | $25,946 | $0 | $302,411 | $0 | $0 | $0 |
| DR TOM BRACKEN | ||||||||||||||
| VP MEDICAL AFFAIRS | $218,587 | $0 | $2,489 | $0 | $0 | $0 | $8,389 | $0 | $51,150 | $0 | $280,615 | $0 | $0 | $0 |
| DAWN BACK | ||||||||||||||
| PHYSICIAN ASSISTANT | $235,973 | $0 | $2,370 | $0 | $0 | $0 | $5,706 | $0 | $21,207 | $0 | $265,256 | $0 | $0 | $0 |
| DR LYNNE STEINER | ||||||||||||||
| DIRECTOR/PHYSICIAN (THRU 12/22) | $210,024 | $0 | $0 | $0 | $0 | $0 | $7,686 | $0 | $41,635 | $0 | $259,345 | $0 | $0 | $0 |
| AMY HUSEBY | ||||||||||||||
| PHYSICIAN ASSISTANT | $225,895 | $0 | $600 | $0 | $0 | $0 | $8,564 | $0 | $17,684 | $0 | $252,743 | $0 | $0 | $0 |
| JACKIE ULSETH | ||||||||||||||
| CNO | $172,564 | $0 | $1,927 | $0 | $0 | $0 | $6,874 | $0 | $32,730 | $0 | $214,095 | $0 | $0 | $0 |
| BECKY FOSSAND | ||||||||||||||
| CAO | $162,020 | $0 | $1,910 | $0 | $0 | $0 | $6,888 | $0 | $37,374 | $0 | $208,192 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF ONAMIA MN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 416005437 | BondIssuerEIN |
| Bond Issued | 2020-07-08 | BondIssuedDt |
| Issue Price | $6,990,000 | IssuePriceAmt |
| Purpose | REFUND SERIES 2001 AND 2003 DEBTS AND FACILITY CONSTRUCTION | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $600,706 | RetiredAmt |
| Total Proceeds | $6,990,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $72,435 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $586,691 | CapitalExpendituresAmt |
| Other Spent Proceeds | $6,330,874 | OtherSpentProceedsAmt |
| Refunding Tax Exempt Bonds | Yes (1) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | Yes (1) | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | THE EXECUTIVE COMMITTEE IS COMPRISED OF THE ELECTED OFFICERS OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE HAS THE AUTHORITY OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE BUSINESS OF THE ORGANIZATION IN THE INTERVALS BETWEEN MEETINGS OF THE BOARD OF DIRECTORS AND IS AT ALL TIMES SUBJECT TO THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 2 | DR. PATTI HOOK-VIRNIG AND DR. ARDEN VIRNIG ARE SPOUSES. |
| FORM 990, PART VI, SECTION A, LINE 7A | TWO MEMBERS OF THE BOARD OF DIRECTORS ARE PHYSICIANS OF MILLE LACS HEALTH SYSTEM. THESE DIRECTORS ARE ELECTED BY THE MEDICAL STAFF ANNUALLY. |
| FORM 990, PART VI, SECTION B, LINE 11B | PRIOR TO FILING THE 990 TAX FORM, IT WAS PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW AND APPROVAL. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH DIRECTOR/OFFICER OF MLHS SHALL COMPLETE AND SIGN A CONFLICT OF INTEREST QUESTIONNARIE UPON APPOINTMENT AND THEREAFTER AT THE TIME OF EACH ANNUAL MEETING. THE CONFLICT OF INTEREST POLICY IS MONITORED BY THE CEO AND COMPLIANCE OFFICER. EACH DIRECTOR/OFFICER OF MLHS SHALL FULLY DISCLOSE ANY CONFLICTS OF INTERESTS. IF A CONFLICT OF INTEREST EXISTS, THE BOARD MEMBER/OFFICER MAY BE ASKED TO STEP DOWN. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO AND OTHER OFFICERS' COMPENSATION IS EVALUATED BY THE BOARD OF DIRECTORS. COMPARABILITY DATA FROM OTHER AREA FACILITIES IS USED ALONG WITH AN EXECUTIVE SALARY SURVEY TO DETERMINE COMPENSATION FOR TOP MANAGEMENT OFFICIALS. THIS PROCESS LAST INCLUDED REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2023. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE HEALTH SYSTEM'S GOVERNING DOCUMENTS, CONFLICT OF INTERET POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONSULTANTS: PROGRAM SERVICE EXPENSES 249,982. MANAGEMENT AND GENERAL EXPENSES 69,739. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 319,721. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 3,654,713. MANAGEMENT AND GENERAL EXPENSES 1,445,634. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,100,347. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,135,095. MANAGEMENT AND GENERAL EXPENSES 375,677. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,510,772. |
| FORM 990, PART XI, LINE 9: | CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION -1,546,074. |