2024-11-11T13:15:32-06:00 2023-12-31 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-01-01 411842965 LAKEWOOD HEALTH SYSTEM LAKE 2188941515 49725 COUNTY 83 STAPLES MN 56479 JOE REYCRAFT CFO 2188941515 2024-11-08 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2024-11-08 2023 2024-10-15 13:58:12Z LISA BJERGA 49725 COUNTY 83 STAPLES MN 56479 148182087 0 X WWW.LAKEWOODHEALTHSYSTEM.COM X 1996 MN TO PROVIDE QUALITY, PERSONALIZED HEALTHCARE FOR A LIFETIME. 10 9 1094 34 0 0 6055621 1594226 128995985 144739988 391578 650250 913262 1059423 136356446 148043887 0 0 0 0 61488165 66613506 0 0 0 64164272 78046654 125652437 144660160 10704009 3383727 163284076 162825284 65990838 58426912 97293238 104398372 X THE MISSION OF LAKEWOOD HEALTH SYSTEM IS TO PROVIDE QUALITY, PERSONALIZED HEALTHCARE FOR A LIFETIME. 0 0 107899450 0 126915585 HOSPITAL AND CLINICS -LAKEWOOD HEALTH SYSTEM (THE ORGANIZATION) OPERATES A 25-BED CRITICAL ACCESS HOSPITAL PROVIDING INPATIENT, OUTPATIENT, EMERGENCY, AND OTHER SPECIALTY HEALTH CARE SERVICES, INCLUDING A 10-BED GERIATRIC BEHAVIORAL HEALTH UNIT IN STAPLES, MINNESOTA. THE ORGANIZATION ALSO OPERATES RURAL HEALTH CLINICS LOCATED IN STAPLES, MOTLEY, PILLAGER, EAGLE BEND, AND BROWERVILLE, MINNESOTA. PHYSICIANS, PHYSICIAN'S ASSISTANTS, AND NURSE PRACTITIONERS PROVIDE CLINIC PATIENTS WITH PRIMARY CARE AND OTHER HEALTH CARE SERVICES. IN ADDITION, THE ORGANIZATION OPERATES A DERMATOLOGY CLINIC IN SARTELL, MINNESOTA.THE ORGANIZATION PROVIDED FOR 3,554 INPATIENT HOSPITAL AND SWING-BED DAYS, 178 ICU DAYS, 2,352 INPATIENT GERIATRIC BEHAVIORAL HEALTH UNIT DAYS, 97,886 MEDICAL AND MENTAL HEALTH RURAL HEALTH CLINIC VISITS AND 10,705 DERMATOLOGY CLINIC VISITS. 13167197 0 18224138 SENIOR SERVICES -THE ORGANIZATION OPERATES A 100-BED, MEDICARE-CERTIFIED SKILLED NURSING FACILITY IN STAPLES, MINNESOTA, THAT PROVIDES LONG-TERM AND REHABILITATIVE CARE TO RESIDENTS. IN SEPTEMBER 2021, 13 BEDS WERE PUT ON LAYAWAY STATUS, REDUCING THE TOTAL SKILLED NURSING BEDS IN SERVICE FROM 100 TO 87. IN ADDITION TO SKILLED NURSING CARE, THE ORGANIZATION ALSO OPERATES HOME HEALTH CARE AND HOSPICE PROGRAMS TO PROVIDE NURSING CARE AND ASSISTANCE AT THE PATIENT'S RESIDENCE. ASSISTED LIVING AND INDEPENDENT LIVING FACILITIES OPERATED BY THE ORGANIZATION, LOCATED IN STAPLES, MINNESOTA, PROVIDE COMBINATIONS OF HEALTH-RELATED AND SUPPORTIVE SERVICES FOR TENANTS. THE ORGANIZATION PROVIDED FOR 27,403 RESIDENT DAYS IN THE NURSING HOME AND 812 ASSISTED LIVING UNIT RENTED MONTHS. 121066647 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 1 1 1 1 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 168 0 1094 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 10 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 MN X JOE REYCRAFT CFO 2188941515 49725 COUNTY 83 STAPLES MN 56479 LISA BJERGA CEO & PRESIDENT 40.00 X X 486257 0 8072 CURT MCILRAVY CHAIRMAN 1.00 X X 5408 0 0 JEF CICHOS VICE CHAIRMAN 1.00 X X 3796 0 0 KEVIN NELSON TREASURER 1.00 X X 1872 0 0 MARY THEURER SECRETARY 1.00 X X 4004 0 0 MICHAEL HUDALLA MD BOARD MEMBER (THRU 06/23) 1.00 X 624 0 0 STEPHANIE JORDAHL BOARD MEMBER 1.00 X 1144 0 0 NORMAN KRAUSE BOARD MEMBER 1.00 X 2756 0 0 RYAN KRAY MD BOARD MEMBER 1.00 X 624 0 0 ROBERT MUELLER BOARD MEMBER 1.00 X 1612 0 0 KAITLYN SCHOECK MD BOARD MEMBER 1.00 X 676 0 0 JOSEPH REYCRAFT CFO 40.00 X 242160 0 13859 CHRISTINE ALBRECHT CHIEF MEDICAL OFFICER 40.00 X 579850 0 0 LYNN RICE VP OF SUPPORT SERVICES 40.00 X 296416 0 21610 CORRINE NEISESS VP OF NURSING 40.00 X 205173 0 17614 CRAIG WOLHOWE VP OF HOSPITAL & CLINIC SERVICES 40.00 X 295992 0 42772 KIMERLY HUSCHLE CRNA 40.00 X 224885 0 27695 SCOTT MANEY CRNA 40.00 X 350398 0 26838 DANIEL LUND CRNA 40.00 X 318732 0 42641 JASON ALEXANDER CRNA 40.00 X 345339 0 23333 MATTHEW SINGH CRNA 40.00 X 341892 0 25953 TIM RICE CEO (FORMER) 0.00 X 157454 0 0 3867064 0 250387 101 1 1 1 LAKEWOOD CLINIC PA 49725 COUNTY 83 STAPLES MN 56479 PHYSICIAN SERVICES 15961240 OCHIN PO BOX 5426 PORTLAND OR 972285426 SOFTWARE BUILD SERVICES 3914941 BIG STONE THERAPIES 309 WASHINGTON AVE ORTONVILLE MN 56278 THERAPY SERVICES 2970252 INFINITE HEALTH COLLABORATIVE TCO 4200 DAHLBERG DRIVE GOLDEN VALLEY MN 55422 ORTHOPEDIC SERVICES 1465791 HPM SERVICES LLC 3780 N GARFILED AVENUE 101 LOVELAND CO 80538 PAIN MANAGEMENT SERVICES 1135860 20 46373 1442054 105799 1594226 NET PATIENT AND RESIDENT SERVICE 621110 141798050 141798050 340B PHARMACY 621300 1040371 1040371 OCCUPATIONAL HEALTH 621300 506083 506083 RENT REVENUE 531120 327208 327208 1068276 1068276 144739988 666012 666012 6711 22473 -15762 -15762 -15762 35927 46373 26234 9693 9693 27850 25465 2385 2385 113650 64028 49622 49622 FOOD SERVICE 900099 597988 597988 EHR INCENTIVE 621110 399735 399735 997723 148043887 145139723 0 1309938 X 2232291 2232291 48716036 39073088 9642948 2011356 1557265 454091 10092457 7751833 2340624 3561366 2715744 845622 73060 73060 166908 166908 1091 1091 30693741 29222608 1471133 509340 37635 471705 20700324 18688203 2012121 774573 774573 5293870 3592002 1701868 522289 404313 117976 182699 138889 43810 1215580 1097194 118386 7250443 7214777 35666 544335 544335 OPERATING ROOM SUPPLIES 3231685 3231685 MN CARE TAX 2168663 2168663 BAD DEBT EXPENSE 1302501 1302501 DUES & SUBSCRIPTIONS 876497 467195 409302 2539055 2403052 136003 144660160 121066647 23593513 0 5132 5112 33087770 16916606 16726954 28864729 180102 277077 3233945 3130833 1882144 3531878 151645200 81292961 60372234 70352239 46545025 38206204 1250770 1540606 163284076 162825284 11610599 12728513 5631448 630373 2641123 2469779 35421 33094 40477153 39607702 5595094 2957451 65990838 58426912 X 95985989 102831763 1307249 1566609 97293238 104398372 163284076 162825284 X 3383727 3603955 117452 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1091 1091 0 PART II-B, LINE 1: THE ORGANIZATION IS A MEMBER OF MINNESOTA HOSPITAL ASSOCIATION AND 3.96% OF THE $27,546 MEMBERSHIP FEE WAS RELATED LOBBYING ACTIVITIES. MINNESOTA HOSPITAL ASSOCIATION (MHA) IS AN ORGANIZATION OF 142 MEMBER HOSPITALS AND HEALTH SYSTEMS. MHA ADVOCATES ON BEHALF OF ITS MEMBERS WITH LAWMAKERS, EDUCATING THEM ON COMPLEX ISSUES IN HEALTH CARE AND ENSURING THEY HAVE THE TOOLS THEY NEED TO MAKE INFORMED DECISIONS. THE MISSION OF MHA IS TO ADVOCATE SO THEIR MEMBERS CAN ACHIEVE THEIR MISSIONS BETTER. 0 1 X 1208430 1208430 45292253 25389374 19902879 83227021 55903587 27323434 21917496 21917496 70352239 DUE TO THIRD-PARTY REIMBURSEMENT PROGRAMS 606171 LEASE OBLIGATIONS 2351280 2957451 148404344 3603955 -2935492 668463 147735881 308006 308006 148043887 141558570 0 141558570 3101590 3101590 144660160 PART IV, LINE 2B: THE ORGANIZATION IS THE TRUSTEE OF VARIOUS RESIDENT FUNDS AND HAS A FIDUCIARY RESPONSIBILITY FOR THE ADMINISTRATION AND DISTRIBUTION OF THESE FUNDS FOR THE RESIDENTS. THE ORGANIZATION ALSO HOLDS TENANT SECURITY DEPOSITS FOR RESIDENTS OF LAKEWOOD PINES AND LAKEWOOD MANOR. THESE FUNDS ARE ON DEPOSIT IN SEPARATE BANK ACCOUNTS AND ARE REPORTED AS AN ASSET AND LIABILITY ON PART X OF THE 990. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN INVESTMENT IN AFFILIATES 166,098. BAD DEBT EXPENSE -1,302,501. EXPENSES RECORDED AS REVENUE -1,799,089. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTIONS TO RESTRICTED NET ASSETS 310,545. FUNDRAISING EVENT -2,539. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 1,302,501. EXPENSES RECORDED AS REVENUE 1,799,089. DINNER AUCTION 47302 24375 22927 7305 1200 GOLF TOURNAMENT 34998 21998 13000 300 9028 4100 4301 82300 46373 35927 300 9028 4100 11606 1200 26234 9693 27850 25000 465 0 27850 25000 465 25465 2385 MN 1 0 0 0 1.00000 0.00000 JOE REYCRAFT 49725 COUNTY 83 STAPLES MN 56479 0 LISA BJERGA 0 GENERAL OVERSIGHT OF GAMING ACTIVITIES. X 0 1 1 X 1 X 1 X 240.000000000000 1 1 1 0 1 1 450253 450253 0.00310 26457877 23424675 3033202 0.02120 26908130 23424675 3483455 0.02430 513658 76745 436913 0.00300 17918 17918 0.00010 6801789 5050028 1751761 0.01220 38772 38772 0.00030 7372137 5126773 2245364 0.01560 34280267 28551448 5728819 0.03990 7313 7313 0.00010 240000 240000 0.00170 247313 247313 0.00180 1 778424 17979934 18479858 -499924 X 1 1 1 1 LAKEWOOD HEALTH SYSTEM 49725 COUNTY ROAD 83 STAPLES MN 56479 WWW.LAKEWOODHEALTHSYSTEM.COM 1295726362 X X X X RURAL PROVIDER LAKEWOOD HEALTH SYSTEM 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X SEE PART V, SECTION C, LINE 7D X X 1 22 1 SEE PART V, SECTION C, LINE 7D 0 1 X 100.000000000000 240.000000000000 X X X X X 1 1 X X X X 1 X HTTPS://WWW.LAKEWOODHEALTHSYSTEM.COM/PATIENTS-VISITORS/BILLING-PAYMENTS/ X HTTPS://WWW.LAKEWOODHEALTHSYSTEM.COM/PATIENTS-VISITORS/BILLING-PAYMENTS/ X HTTPS://WWW.LAKEWOODHEALTHSYSTEM.COM/PATIENTS-VISITORS/BILLING-PAYMENTS/ X X X X X X X 1 X 0 X X X X 1 X 0 1 LAKEWOOD HEALTH SYSTEM PART V, SECTION B, LINE 5: IN ITS MOST RECENT CHNA, LAKEWOOD HEALTH SYSTEM (LAKEWOOD) TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY SERVED. THE "COMMUNITY" SERVED IS DEFINED AS THE ZIP CODE TABULATION AREAS OF STAPLES (56479) AND MOTLEY (56466), AND THE HOSPITAL'S PRIMARY SERVICE AREA OF MORRISON, TODD, AND WADENA COUNTY.FOR MORE THAN A DECADE, LAKEWOOD HAS BEEN AN ACTIVE MEMBER OF THE CHNA COLLABORATIVE - A COMMITTEE ESTABLISHED IN 2012 AND MADE UP OF HOSPITALS AND PUBLIC HEALTH AGENCIES FROM THE THREE-COUNTY SERVICE AREA - WHICH FACILITATES AN EVIDENCE-BASED PROCESS TO CHARACTERIZE THE HEALTH AND HEALTH NEEDS OF THE COMMUNITY. THE LARGEST SOURCE OF PRIMARY DATA WAS GENERATED BY THE MAILED HEALTH4LIFE SURVEY AND A WEB-BASED SURVEY. THE 2022 CHNA CONVENED IN AUGUST 2021 TO PLAN AND EXECUTE PROJECT ACTIVITIES, AND ENSURE THE ASSESSMENT PROCESS WAS INCLUSIVE, COMPREHENSIVE AND OBJECTIVE. BETWEEN OCTOBER - DECEMBER 2021, THE CHNA COLLABORATIVE CONDUCTED A MAIL-BASED AND RANDOM HOUSEHOLD SURVEY, WHICH CAPTURED INFORMATION DIRECTLY FROM COMMUNITY RESIDENTS WHO WERE AT LEAST 18 YEARS OLD, SUCH AS HEALTH STATUS AND OVERALL WELL-BEING, HEALTH SERVICE UTILIZATION, BARRIERS TO CARE, AND HEALTH-RELATED SOCIAL NEEDS. TO GENERATE THE SURVEY SAMPLE, A 47-QUESTION HEALTH4LIFE SURVEY INSTRUMENT WAS DISTRIBUTED TO MORE THAN 6,400 RANDOMLY SAMPLED HOUSEHOLDS IN THE THREE-COUNTY SERVICE AREA. A TOTAL OF 1,270 ADULT RESIDENTS COMPLETED THE HARD COPY SURVEY, REPRESENTING A SURVEY RESPONSE RATE OF 19.8%. FOR THE FIRST TIME, THE CHNA COLLABORATIVE DEVELOPED AND CONDUCTED A WEB-BASED SURVEY TO SOLICIT ADDITIONAL INPUT AND TO ENSURE RESPONSES FROM HOUSEHOLDS WITH YOUNGER ADULTS AND FROM UNDER-REPRESENTED POPULATIONS WERE CAPTURED. THE SURVEY WAS MADE AVAILABLE THROUGH THE ARCGIS SURVEY123 PLATFORM, AND IN MULTIPLE LANGUAGES (ENGLISH AND SPANISH). THE CHNA COLLABORATIVE POSTED THE ONLINE SURVEY ON WEB PAGES, SOCIAL MEDIA PLATFORMS, AND IN LOCAL NEWSPAPERS TO DIRECT COMMUNITY RESIDENTS TO THE LINK. THE SURVEY WAS OPEN BETWEEN NOVEMBER - DECEMBER 2021 AND GENERATED A TOTAL 928 COMMUNITY ADULT RESIDENTS' RESPONSES.THE CHNA ALSO UTILIZED SECONDARY PUBLIC HEALTH DATA FROM VARIOUS PUBLICLY AVAILABLE SOURCES, INCLUDING: UNITED STATES CENSUS BUREAU, CENTERS FOR DISEASE CONTROL AND PREVENTION, HEALTHY PEOPLE 2030, COUNTY HEALTH RANKINGS, MINNESOTA DEPARTMENT OF HEALTH, MINNESOTA DEPARTMENT OF HUMAN SERVICES, AND INTERNAL HEALTHCARE DATA. BOTH SECONDARY AND PRIMARY DATA WERE REVIEWED BY THE LAKEWOOD'S INTERNAL CHNA TEAM TO IDENTIFY AND PRIORITIZE THE TOP ISSUES FACING RESIDENTS IN THE COMMUNITY. LAKEWOOD HEALTH SYSTEM PART V, SECTION B, LINE 6A: LAKEWOOD CONDUCTED ITS NEEDS ASSESSMENT WITH THE FOLLOWING THREE (3) FACILITIES: ASTERA HEALTH (FORMERLY TRI-COUNTY HEALTH CARE) CENTRACARE - LONG PRAIRIE, AND CHI ST. GABRIEL'S HEALTH. LAKEWOOD HEALTH SYSTEM PART V, SECTION B, LINE 6B: LAKEWOOD CONDUCTED ITS NEEDS ASSESSMENT WITH THE FOLLOWING THREE (3) ORGANIZATIONS: MORRISON COUNTY PUBLIC HEALTH AND HUMAN SERVICES, TODD COUNTY HEALTH AND HUMAN SERVICES, AND WADENA COUNTY PUBLIC HEALTH. THE CHNA COLLABORATIVE HIRED A RESEARCH SCIENTIST FROM THE MINNESOTA DEPARTMENT OF HEALTH'S CENTER FOR HEALTH STATISTICS TO PROVIDE TECHNICAL ASSISTANCE AND CONDUCT A WEIGHTED ANALYSIS OF THE SURVEY DATA. LAKEWOOD HEALTH SYSTEM PART V, SECTION B, LINE 7D: COMMUNITY PRESENTATIONS OCCURRED AT AREA SERVICE CLUBS, TO OUR DISTRICT TOWNSHIP ANNUAL MEETINGS, AND KEY COMMUNITY STAKEHOLDER GROUPS (ROTARY, LIONS, SCHOOL DISTRICT, CITY OF STAPLES) JAN-FEB 2020.PART V, SECTION B, LINE 7A & 10A:HTTPS://WWW.LAKEWOODHEALTHSYSTEM.COM/COMMUNITY-HEALTH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ LAKEWOOD HEALTH SYSTEM PART V, SECTION B, LINE 11: THE TOP COMMUNITY HEALTH NEEDS THAT EMERGED FROM THE 2022 CHNA WERE IDENTIFIED BY THE HOSPITAL'S CHNA TEAM. THE CHNA TEAM EXAMINED EACH DOCUMENTED NEED AND USED A SET OF CRITERIA TO RANK AND DISTINGUISH THE TOP PRIORITIES THE HOSPITAL FACILITY WOULD UNDERTAKE, SUCH AS THE ALIGNMENT WITH LAKEWOOD'S MISSION, VISION, GOALS, AND KEY STRENGTHS; THE POTENTIAL FOR THE ORGANIZATION TO MAKE AN IMPACT ON THE NEEDS; AND THE COMMITMENT FROM REGIONAL PARTNERS TO COLLECTIVELY ADDRESS THE NEEDS. FURTHER, THE CHNA TEAM IDENTIFIED MULTIPLE DEMOGRAPHICS AND SOCIO-ECONOMIC SEGMENTS OF THE POPULATION WHO CONTINUE TO BE DISPROPORTIONATELY AFFECTED BY HEALTH INEQUITIES, INCLUDING OLDER ADULTS, RACIAL AND ETHNIC MINORITIES, AND LOW-INCOME INDIVIDUALS AND FAMILIES.SUBSEQUENT TO THE ADOPTION OF LAKEWOOD'S 2022 CHNA, THE COMMUNITY HEALTH IMPLEMENTATION STRATEGY PLAN WAS APPROVED BY THE SYSTEM BOARD OF DIRECTORS ON FEBRUARY 23, 2023. THE COMMUNITY HEALTH IMPLEMENTATION STRATEGY PLAN OUTLINES THE PRIORITY AREAS THE HOSPITAL FACILITY WILL UNDERTAKE TO MEET THE HEALTH NEEDS OF ITS COMMUNITY, REACH THE TARGETED POPULATION, AND IMPROVE THE QUALITY AND VALUE OF THE CARE PROVIDED TO PATIENTS.BETWEEN 2023-2025, LAKEWOOD COMMITTED TO IMPLEMENTING ACTIVITIES WITHIN THE FOLLOWING THREE (3) PRIORITY AREAS: 1. IMPROVING QUALITY OF LIFE2. PROMOTING ACCESS TO RESOURCES AND CARE3. ENHANCING THE BUILT ENVIRONMENTSIN ITS FIRST YEAR OF EXECUTING THE 2023-2025 IMPLEMENTATION STRATEGY PLAN, LAKEWOOD CONTINUED TO SCREEN FOR AND ADDRESS THE HEALTH-RELATED SOCIAL NEEDS (HRSNS) AND COMMUNITY-LEVEL SOCIAL DETERMINANTS OF HEALTH (SDOH) THAT AFFECT AN INDIVIDUAL'S ABILITY TO MAINTAIN OPTIMAL HEALTH AND WELL-BEING. IN FACT, LAKEWOOD INTENSIFIED ITS SCREENING PRACTICES, OPTIMIZED AND GREW MANY OF ITS TARGETED INTERVENTIONS, AND STRENGTHENED ITS COLLABORATIVE PARTNERSHIP BASE. - LAKEWOOD INVESTED IN A NEW ELECTRONIC HEALTH RECORDS SYSTEM THAT ALLOWED PROVIDERS AND CARE TEAMS TO CONDUCT MORE COMPREHENSIVE SCREENINGS FOR HRSNS/SDOHS AND EASILY MAKE REFERRALS TO ITS INTERNAL COMMUNITY HEALTH DEPARTMENT WHEN A POSITIVE SCREEN WAS DOCUMENTED. UPON REFERRALS, THE COMMUNITY HEALTH DEPARTMENT PROVIDED SUPPORT TO PATIENTS AND THEIR FAMILIES, AND/OR ENROLLED THEM IN ONE OF MANY FOOD SECURITY INTERVENTIONS.- LAKEWOOD ENHANCED AND EXPANDED ITS RECOVERY MEAL PROGRAM TO ADDRESS THE GROWING NUMBER OF POSTPARTUM MOTHERS WHO SCREENED POSITIVE FOR FOOD INSECURITY DURING DISCHARGE PLANNING. IN 2023, NEARLY 24 PERCENT OF NEW MOTHERS WERE FOOD INSECURE. THE MEALS AT BABY (OB) PROGRAM PROVIDED THREE (3) PREPARED AND NUTRITIOUS MEALS FOR NEW MOMS UPON DISCHARGE AND ADDITIONAL MEALS FOR EACH HOUSEHOLD MEMBER. - IN JUNE 2023, LAKEWOOD LAUNCHED THE TODD COUNTY PROMOTORES PROJECT TO ADDRESS THE HRSNS AND HEALTH DISPARITIES EXPERIENCED BY PERIPARTUM HISPANIC-LATINO WOMEN. LAKEWOOD'S COMMUNITY HEALTH WORKER (PROMOTORA) SCREENED WOMEN AND FAMILIES FOR HRSNS AND THEN CONNECTED THEM TO RESOURCES OR SERVICE PROVIDERS WHO COULD FURTHER ADDRESS THEIR UNMET HEALTH, ECONOMIC AND SOCIAL NEEDS.- LAKEWOOD'S COMMUNITY HEALTH COORDINATOR IS A CERTIFIED MNSURE NAVIGATOR AND PROVIDED FREE ASSISTANCE TO 131 INDIVIDUALS AND FAMILIES WHO NEEDED HEALTHCARE COVERAGE OR NEEDED ASSISTANCE WITH RENEWING THEIR COVERAGE.- LAKEWOOD FORMED NEW PARTNERSHIPS WITH PAYERS, GOVERNMENT/COUNTY AGENCIES AND COMMUNITY ENTITIES TO CONNECT RESOURCES TO PATIENTS WHO FACED CHALLENGES OUTSIDE THE CLINICAL SETTING. FOR EXAMPLE, LAKEWOOD RECEIVED A GRANT FROM BLUE CROSS BLUE SHIELD OF MINNESOTA THAT FOSTERED COLLABORATION WITH THE WAVE/SALUDOS WELCOME CENTER, TODD COUNTY HEALTH AND HUMAN SERVICES, LONG PRAIRIE CHAMBER OF COMMERCE, AND MANY LOCAL/REGIONAL NON-PROFITS. THESE PARTNERSHIPS HELPED TO ALIGN EFFORTS, REDUCE DUPLICATION, OPTIMIZE FINANCIAL RESOURCES, AND ULTIMATELY WORKING TO IMPROVE THE OVERALL HEALTH AND WELL-BEING OF THE HISPANIC-LATINO COMMUNITY IN TODD COUNTY. THERE WERE HEALTH NEEDS THAT EMERGED FROM THE 2022 CHNA THAT WERE NOT INCLUDED IN THE COMMUNITY HEALTH IMPLEMENTATION STRATEGY PLAN, SUCH AS DENTAL WORK, CANCER, AND TOBACCO USE. WHILE SOME HEALTH NEEDS MAY BE INDIRECTLY ADDRESSED THROUGH THE ACTIVITIES AND STRATEGIES OUTLINED IN THE IMPLEMENTATION STRATEGY PLAN, LAKEWOOD RECOGNIZED CERTAIN NEEDS WERE DEEMED TO ALREADY BE IN PLACE BY TRADITIONAL HEALTHCARE OR BY COLLABORATIVE PARTNERS WHO POSSESSED THE SCOPE OF SERVICES AND SKILL SET TO EFFECTIVELY ADDRESS THEM.FOR MORE DETAILED INFORMATION, INCLUDING GOALS, OBJECTIVES AND STRATEGIES, COMMUNITY PARTNERS, AND EVALUATION FRAMEWORK, REFER TO THE PUBLICLY AVAILABLE COMMUNITY HEALTH IMPLEMENTATION PLAN AVAILABLE ON THE LAKEWOOD'S WEBSITE; REFER TO THE URL GIVEN PREVIOUSLY FOR THE POSTING OF THE PLAN. LAKEWOOD HEALTH SYSTEM PART V, SECTION B, LINE 13H: THE AMOUNT INVOICED DOES NOT CHANGE, HOWEVER A DISCOUNT AMOUNT IS DETERMINED BY INCOME LEVEL AND UNINSURED STATUS THAT WILL RESULT IN THE AMOUNT OF PAYMENT, IF ANY, FROM THE FAP-ELIGIBLE PATIENT. LAKEWOOD HEALTH SYSTEM PART V, SECTION B, LINE 16J: EACH APPLICABLE ADMISSION AREA HAS A POLICY AVAILABLE FOR THE PATIENT AS NEEDED AND UPON REQUEST. LAKEWOOD HEALTH SYSTEM PART V, SECTION B, LINE 24: THERE ARE CHARGES THAT ARE EXEMPT FROM THE FAP DISCOUNTS, SO IN THIS CASE YES WE WOULD CHARGE THE AMOUNT EQUAL TO THE GROSS CHARGE. EXAMPLES WOULD BE A DOT PHYSICAL, A COPAY BALANCE THAT INSURANCE WOULD LEAVE FOR THE CLIENT AS WE CANNOT DISCOUNT COPAYS AND IN VITRO FERTILIZATION SERVICES. 7 1 - STAPLES CLINIC 49725 COUNTY ROAD 83 STAPLES MN 56479 CLINIC 2 - LHS CARE CENTER 401 PRAIRIE AVE NE STAPLES MN 56479 SKILLED NURSING FACILITY 3 - SARTELL DERMATOLOGY 161 19TH ST S SUITE 106 SARTELL MN 56377 CLINIC 4 - PILLAGER CLINIC 653 PILLSBURY ST N STE 1 PILLAGER MN 56473 CLINIC 5 - BROWERVILLE CLINIC 30535 241ST AVE BROWERVILLE MN 56438 CLINIC 6 - MOTLEY CLINIC 1233 HWY 10 MOTLEY MN 56466 CLINIC 7 - EAGLE VALLEY CLINIC 815 HWY 71 S EAGLE BEND MN 56446 CLINIC PART I, LINE 7: THE ORGANIZATION USES THE COST-TO-CHARGE RATIO RECOMMENDED BY WORKSHEET 2 OF THE IRS FORM 990, SCHEDULE H INSTRUCTIONS. PART I, LINE 7G: AMOUNTS USED FOR SUBSIDIZED SERVICES WERE CALCULATED USING DETAILED REPORT DATA KEPT BY THE ORGANIZATION. DATA INCLUDED THE TOTAL CHARGES, LESS ALLOWANCES AND DISCOUNTS, MEDICAID; AND ACTUAL COST OF SERVICES PROVIDED. SUBSIDIZED SERVICES INCLUDED THE TRANSPORTATION, CARE CENTER, AND INPATIENT BEHAVIORAL HEALTH UNITS IN 2023. 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 $ 1,302,501. PART II, COMMUNITY BUILDING ACTIVITIES: - DINO PARK: IN 2001, LAKEWOOD WORKED WITH THE CITY OF STAPLES-PARK AND RECREATION DEPARTMENT TO FUND AND CONSTRUCT A COMMUNITY PARK ON A SMALL PARCEL OF LAND OWNED BY THE ORGANIZATION. THE COMMUNITY PARK, AFFECTIONATELY KNOWN AS DINO PARK BECAUSE OF THE DINOSAUR-THEMED PLAY EQUIPMENT, IS MOST OFTEN USED BY NEIGHBORHOOD CHILDREN AND A LOCAL CHILDCARE CENTER. IN 2018, LAKEWOOD INSTALLED MULTIGENERATIONAL FITNESS EQUIPMENT TO GIVE CHILDREN AND ADULTS ENHANCED OPPORTUNITIES TO PLAY AND PARTICIPATE IN PHYSICAL ACTIVITY WHILE AT THE PARK. IN 2021, CONCRETE WALKWAYS WERE ADDED INSIDE AND OUTSIDE THE PERIMETER FENCING TO ENSURE VISITORS COULD EASILY ACCESS AND SAFELY NAVIGATE DINO PARK.- DESPITE DINO PARK BEING LISTED ON THE CITY OF STAPLES' WEBSITE AS ONE OF SIX COMMUNITY PARKS, LAKEWOOD EXCLUSIVELY MAINTAINS THE PARK AND ITS MANY AMENITIES, INCLUDING A PAVILION WITH RESTROOMS, UTILITIES, AND WALKWAYS. THE ORGANIZATION'S MAINTENANCE AND HOUSEKEEPING DEPARTMENTS ARE RESPONSIBLE FOR PRESERVING THE AESTHETICS AND CLEANLINESS OF DINO PARK DURING THE 28-WEEK COMMUNITY PARK SEASON. THE COST OF STAFF TIME AND OTHER EXPENSES ASSOCIATED WITH MAINTENANCE WERE CALCULATED USING DETAILED REPORT DATA KEPT BY THE ORGANIZATION.- THE NEST: IN 2022, LAKEWOOD COMMITTED TO INVESTING $6 MILLION TO HELP THE STAPLES-MOTLEY INDEPENDENT SCHOOL DISTRICT EXPAND A GYMNASIUM PROJECT TO A MULTI-PURPOSE WELLNESS AND RECREATION FACILITY ON THE SCHOOL CAMPUS. THE NEST, NAMED AFTER THE SCHOOL'S CARDINAL MASCOT, WILL HAVE A WALKING TRACK AND DEDICATED ROOMS TO HOST WELLNESS CLASSES AND WORKSHOPS. THE PARTNERSHIP BETWEEN THE ORGANIZATION AND A LOCAL SCHOOL DISTRICT ENHANCES THE DEVELOPMENT OF A VARIETY OF COMMUNITY HEALTH PROGRAMS AND REVITALIZES ITS RURAL COMMUNITY. LAKEWOOD INTENDS TO PRESCRIBE PATIENT PASSES FOR THOSE RECEIVING CARE AT ITS HOSPITAL FACILITY, PROVIDE EVIDENCE-BASED PROGRAMS, AND OFFER SOCIAL OPPORTUNITIES FOR THE COMMUNITY. MORE INFORMATION ABOUT THE NEST CAN BE OBTAINED ON THE ORGANIZATION'S WEBSITE AT THE FOLLOWING URL: HTTPS://WWW.LAKEWOODHEALTHSYSTEM.COM/LAKEWOOD-HEALTH-SYSTEM-PLEDGES-INVESTMENTS-FOR-A-HEALTHIER-COMMUNITY/ - ECONOMIC DEVELOPMENT ACTIVITIES: LAKEWOOD'S PRESIDENT AND CEO IS A MEMBER OF THE STAPLES ECONOMIC DEVELOPMENT AUTHORITY (SEDA) BOARD OF COMMISSIONERS. SEDA'S MISSION IS "TO PROMOTE THE STAPLES COMMUNITY AS A GROWING DESTINATION, WHERE PEOPLE LIVE, WORK, PLAY AND SUCCEED, AND ACTIVELY WORKS TO ATTRACT, DEVELOP, AND SUPPORT ECONOMIC GROWTH WITHIN THE COMMUNITY. SEDA MET ON THE FOURTH TUESDAY OF EACH MONTH IN 2023. PARTICIPATION ON SEDA INITIATED THE FOLLOWING INVESTMENTS IN THE CITY OF STAPLES. - THE PLAZA: IN 2022, LAKEWOOD PURCHASED A VACANT 1.789-ACRE PROPERTY IN THE CITY OF STAPLES AND BEGAN CONSTRUCTING "THE PLAZA", A MIXED-USE BUILDING COMPRISED OF 16,786 SQ. FT. OF COMMERCIAL AND RETAIL SPACE ON THE FIRST FLOOR, AND ELEVEN RESIDENTIAL APARTMENTS AVAILABLE FOR LEASE ON THE SECOND FLOOR. THE PLAZA REPRESENTS LAKEWOOD'S COMMITMENT TO THE COMMUNITY AND TO ITS MEDICAL AND CITY STAKEHOLDERS WHO ARE WORKING TO INCREASE ACCESS TO DIVERSE HEALTHCARE SERVICES, ADDRESS THE LACK OF NEWER AND/OR AFFORDABLE HOUSING OPTIONS, AND PROVIDE HIGH VISIBILITY SPACE FOR ENTREPRENEURS AND NEW BUSINESSES TO GENERATE ECONOMIC ACTIVITY FOR THE CITY OF STAPLES. CONSTRUCTION OF THE PLAZA WAS COMPLETED IN DECEMBER 2023. THE COMMERCIAL SPACE IS NOW HOME TO TWIN CITIES ORTHOPEDICS (TCO) STAPLES THERAPY AND LONGBELLA DRUG BY LAKEWOOD HEALTH SYSTEM. THE COST OF STAFF TIME AND OTHER EXPENSES ASSOCIATED WITH THE CONSTRUCTION AND DEVELOPMENT OF THE PLAZA, SUCH AS ECONOMIC DEVELOPMENT ACTIVITIES, SMALL BUSINESS DEVELOPMENT, AND SUPPORTING HOUSING NEEDS, WERE CALCULATED USING DETAILED REPORT DATA KEPT BY THE ORGANIZATION.MORE INFORMATION ABOUT THE PLAZA CAN BE OBTAINED ON THE ORGANIZATION'S WEBSITE AT THE FOLLOWING URL: HTTPS://WWW.LAKEWOODHEALTHSYSTEM.COM/THE-PLAZA/ - LAKEWOOD IS A MEMBER OF THE STAPLES-MOTLEY HOUSING GROUP, LLC, A COLLABORATIVE OF COMMUNITY-BASED ORGANIZATIONS AND BUSINESSES WHO SHARE A COLLECTIVE INTEREST IN ENHANCING HOUSING OPTIONS WITHIN THE COMMUNITY. THE STAPLES HOUSING GROUP PURCHASED SEVEN (7) VACANT PARCELS OF LAND FROM THE CITY OF STAPLES IN 2022, WITH THE INTENT TO CONSTRUCT SEVEN (7) SINGLE-FAMILY HOMES BY THE END OF 2023. THE EFFORTS TO BUILD SINGLE-FAMILY HOMES HAS ECONOMIC AND COMMUNITY BENEFITS, WHICH INCLUDES GENERATING LOCAL ECONOMIC ACTIVITY AND TAX REVENUE FOR THE CITY OF STAPLES, INCREASING LOCAL SCHOOL DISTRICT ENROLLMENT, AND GROWING AND RETAINING A DIVERSE WORKFORCE. LAKEWOOD INVESTED $210,000 IN 2022 TO SUPPORT THE HOUSING PROJECT. PART III, LINE 2: THE AMOUNT IS CALCULATED BY MULTIPLYING THE TOTAL CHARGES FOR SERVICES WRITTEN OFF AS BAD DEBT BY THE COST-TO-CHARGE RATIO. PART III, LINE 3: THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY FINANCIAL ASSISTANCE POLICY IS NOT REASONABLE TO CALCULATE FOR THE ORGANIZATION. LAKEWOOD DOES NOT DO PRESUMPTIVE CHARITY CARE OR PARO (PAYMENT ASSISTANCE RANK ORDER) SCORING SO THERE IS NO ESTIMATE ELECTED.LAKEWOOD DOES HAVE A FINANCIAL ASSISTANCE POLICY THAT PROVIDES DISCOUNTED OR FREE CARE. LAKEWOOD IS ALSO COMMITTED TO PROVIDING OTHER COMMUNITY BENEFIT AND COMMUNITY BUILDING FUNCTIONS. THE OPPORTUNITY TO PROVIDE MORE DISCOUNTED OR FREE CARE OR PERFORM ADDITIONAL COMMUNITY BENEFIT AND COMMUNITY BUILDING ACTIVITIES IS LIMITED AS BAD DEBT COSTS INCREASE. PART III, LINE 4: MANAGEMENT PROVIDES FOR POTENTIALLY UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO VALUATION ALLOWANCE AND A CREDIT TO PATIENTS ACCOUNTS RECEIVABLE. THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE DESCRIBING HOW THE ORGANIZATION ACCOUNTS FOR BAD DEBT EXPENSE. PART III, LINE 8: THE MEDICARE ALLOWABLE COST OF CARE RELATING TO PAYMENTS ON LINE 5 WERE CALCULATED USING INFORMATION PREPARED FROM OUR FILED 2023 MEDICARE COST REPORT.A LARGE PERCENTAGE OF LAKEWOOD PATIENTS ARE MEDICARE ELIGIBLE AND LAKEWOOD WILL CONTINUE TO PROVIDE SERVICES DESPITE ANY SHORTFALL. PART III, LINE 9B: WHEN COLLECTIONS ARE UNDERWAY WITH PATIENTS AND IT IS IDENTIFIED THAT THEY ARE ELIGIBLE, THE CUSTOMER ASSISTANCE PROGRAM IS EXTENDED TO THE PATIENT AND WE WILL SEND AN APPLICATION DIRECTLY TO THEM VIA EMAIL, FAX, MAILING ETC. OR DIRECT THEM TO THE APPLICATION ON OUR WEBSITE FOR CONVENIENT AND TIMELY COMPLETION. PATIENTS ARE REQUIRED TO APPLY FOR MEDICAL ASSISTANCE IN ORDER TO RECEIVE A 50% OR GREATER DISCOUNT PER LAKEWOOD'S CUSTOMER ASSISTANCE PROGRAM. PART VI, LINE 2: IN ADDITION TO THE CHNA, LAKEWOOD ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES THROUGH THE CHNA COLLABORATIVE MEMBERSHIP. THE MORRISON-TODD-WADENA COMMUNITY HEALTH BOARD PUBLISHES A COLLECTIVE AND COMPREHENSIVE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) DESCRIBING HOW LOCAL PUBLIC HEALTH, COMMUNITY PARTNERS AND STAKEHOLDERS IN THE THREE-COUNTIES WILL PRIORITIZE AND ADDRESS HEALTH ISSUES DETERMINED BY THE HEALTH NEEDS ASSESSMENTS. REGULAR MEETINGS ALLOW ALL PARTIES TO DISCUSS PROGRESS WITH CURRENT AND NEW PRIORITY HEALTH NEEDS INITIATIVES.LAKEWOOD ALSO REVIEWS PATIENT-LEVEL DATA, PAYOR AND CLAIMS DATA, AND PATIENT SATISFACTION AND EXPERIENCE SURVEY RESPONSES TO ASSESS PATIENT HEALTH NEEDS AND TO IDENTIFY WHERE GAPS IN ACCESS TO HEALTHCARE MAY EXIST. THE ORGANIZATION CONCURRENTLY LISTENS TO ITS WORKFORCE AND SEEKS PROVIDER AND CLINICIAN FEEDBACK TO IMPROVE THE HEALTHCARE NEEDS OF THE COMMUNITY. LAKEWOOD USES ITS SOCIAL MEDIA PLATFORMS AND ITS WEBSITE TO ACTIVELY ENGAGE AND EXCHANGE INFORMATION WITH PATIENTS, COMMUNITY MEMBERS, AND STAKEHOLDERS. PATIENT AND FAMILY ADVISORY GROUPS, CONSISTING OF PATIENTS, FAMILY AND COMMUNITY MEMBERS FROM ALL AGE GROUPS AND COMMUNITIES, ALSO GIVES THE ORGANIZATION REAL-TIME OPPORTUNITIES TO LISTEN TO SHARED HEALTHCARE-RELATED STORIES, EXPERIENCES AND IDEAS. PATIENT ADVISORY GROUP INFORMATION MAY BE OBTAINED ON THE ORGANIZATION'S WEBSITE AT THE FOLLOWING URL: HTTPS://WWW.LAKEWOODHEALTHSYSTEM.COM/LAKEWOOD-HEALTH-SYSTEM-LAUNCHES-PATIENT-ADVISORY-GROUPS/ LASTLY, LAKEWOOD SEEKS TO UNDERSTAND THE NEEDS OF THE COMMUNITY THROUGH THE PARTICIPATION IN LOCAL, REGIONAL, STATE AND FEDERAL COLLABORATIVES, ASSOCIATIONS AND COALITIONS, SUCH AS LEADERSHIP, ENGAGEMENT, ADVOCACY, AND POSITIVENESS (LEAP); STAPLES-MOTLEY INDEPENDENT SCHOOL DISTRICT BOARD; STAPLES-MOTLEY BEYOND POVERTY; WAVE/SALUDOS WELCOME CENTER; TODD COUNTY FAMILY SERVICES COLLABORATIVE; CENTRAL MINNESOTA COUNCIL ON AGING; MINNESOTA HOSPITAL ASSOCIATION; AND THE MEDICAID SERVICES ADVISORY COMMITTEE. PART VI, LINE 3: LAKEWOOD EFFECTIVELY INFORMS AND EDUCATES PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. THE ORGANIZATION WIDELY PUBLICIZES THE AVAILABILITY AND UTILIZATION OF FINANCIAL ASSISTANCE, IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 501 (R) (4), TO ENSURE THE COMMUNITY SERVED IS AWARE OF THE SERVICES AND SUPPORT. LAKEWOOD OFFERS FINANCIAL ASSISTANCE AND COUNSELING TO PATIENTS WITH LIMITED MEANS, AND TO PATIENTS WHO ARE UNINSURED OR UNDERINSURED BUT DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE.INFORMATION ABOUT FINANCIAL ASSISTANCE AND MEANS-TESTED PUBLIC PROGRAMS ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESS, AND THROUGH COMMUNICATION WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE.INFORMATION ON FINANCIAL ASSISTANCE IS AVAILABLE ONLINE, IN BROCHURES, MESSAGES ON PATIENTS' BILLS, AND POSTED NOTICES IN PUBLIC AREAS (E.G., EMERGENCY DEPARTMENT, ADMITTING AND REGISTRATION AREAS, AND PATIENT FINANCIAL SERVICES OFFICES). SUMMARIES OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM IS MADE AVAILABLE TO APPROPRIATE HEALTH AND HUMAN SERVICES AGENCIES AND OTHER COMMUNITY ORGANIZATIONS IN THE REGION THAT ASSIST PEOPLE IN NEED.LAKEWOOD ALSO HAS A WRITTEN POLICY FOR BILLING AND COLLECTIONS AND FOR ITS CUSTOMER ASSISTANCE PROGRAM. PAYMENT ARRANGEMENT IS AVAILABLE TO ASSIST PATIENTS IN PAYING OFF OBLIGATIONS OWED TO THE ORGANIZATION.MORE INFORMATION ABOUT LAKEWOOD'S FINANCIAL ASSISTANCE PROGRAM AND RESPECTIVE POLICIES CAN BE OBTAINED ON THE ORGANIZATION'S WEBSITE AT THE FOLLOWING URL: HTTPS://WWW.LAKEWOODHEALTHSYSTEM.COM/PATIENTS-VISITORS/BILLING-PAYMENTS/FINANCIAL-ASSISTANCE-PROGRAM/ PART VI, LINE 4: LAKEWOOD PROVIDES A BROAD SPECTRUM OF INPATIENT AND OUTPATIENT CARE SERVICES AT ITS STATE-OF-THE-ART MAIN CAMPUS FACILITY WHICH INCLUDES A 25-BED CRITICAL ACCESS HOSPITAL AND CLINIC (STAPLES, MN); FOUR MODERN SATELLITE CLINICS (BROWERVILLE, PILLAGER, MOTLEY & EAGLE BEND, MN), SENIOR SERVICES CARE AND HOUSING, A SPECIALIZED SENIOR BEHAVIORAL HEALTH UNIT (STAPLES, MN), AND A DERMATOLOGY CLINIC (SARTELL, MN). WHILE LAKEWOOD'S PRIMARY AND SECONDARY SERVICE AREA CONSISTS OF CASS, CROW WING, MORRISON, TODD, AND WADENA COUNTY, ITS FACILITIES AND SPECIALTY SERVICES DRAW FROM PORTIONS OF THE SURROUNDING COUNTIES, INCLUDING HUBBARD, AND OTTER TAIL. THE FIVE-COUNTY SERVICE AREA IS PRIMARILY AGRICULTURALLY BASED WITH LOW POPULATION DENSITIES WHICH HOUSE 165,640 RESIDENTS OVER 6,246 SQUARE MILES (26.5 PEOPLE PER SQUARE MILE). THE POPULATION DISTRIBUTION BY AGE ARE AS FOLLOWS: 22.5% ARE INFANTS, CHILDREN OR ADOLESCENTS AGES 0-17; ANOTHER 55.3% ARE AGES 18 TO 64; WHILE 22.2% ARE AGES 65 AND OLDER. THE PERCENTAGE OF THE TOTAL POPULATION IS MOSTLY WHITE, NON-HISPANIC AT 91.3%, BUT PORTIONS OF THE SERVICE AREA HAVE A HIGHER POPULATION OF HISPANIC OR LATINO INDIVIDUALS. HISPANIC OR LATINO AMERICANS MAKE UP THE LARGEST ETHNIC MINORITY GROUP IN THE REGION AT NEARLY 7.2%.THE PERCENTAGE OF THE POPULATION WHO LIVE IN POVERTY IS 11.5% AMONG ALL AGES, AND 16.3% AMONG CHILDREN AGES 0 TO 17 YEARS OLD. THE ABOVE-MENTIONED DATA ARE BASED ON THE U.S. CENSUS BUREAU, 2016-2020 AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES.THE PERCENTAGE OF THE POPULATION WHO LACK ADEQUATE ACCESS TO FOOD IS SLIGHTLY MORE THAN 8% ACROSS THE FIVE-COUNTY REGION. HOWEVER, THE NUMBER EQUATES TO MORE THAN 13,560 INDIVIDUALS WHO DO NOT HAVE ACCESS, AT TIMES, TO A RELIABLE SOURCE OF FOOD FOR AN ACTIVE, HEALTHY LIFE. PART VI, LINE 5: LAKEWOOD FURTHERS ITS EXEMPT PURPOSES BY PROMOTING THE HEALTH OF COMMUNITY, AND BY: 1. OPERATING A FULL-TIME EMERGENCY DEPARTMENT OPEN TO ALL, REGARDLESS OF THE PATIENT'S ABILITY TO PAY. 2. MAINTAINING A VOLUNTARY BOARD OF DIRECTORS WHO REPRESENT AND ARE DRAWN FROM THE COMMUNITIES OR GEOGRAPHICAL AREAS WITHIN THE SERVICE AREA. LAKEWOOD'S BOARD OF DIRECTORS HAS A GROUP OF SEVEN (7) PUBLIC TRUSTEES, ALONG WITH THE CEO AND FOUR (4) CLINIC PROVIDERS, WHO GOVERNS THE CHARITABLE ORGANIZATION AND ENSURES THE HOSPITAL IS OPERATING FOR THE BENEFIT OF THE COMMUNITY. 3. MAINTAINING AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS. 4. PROVIDING CARE FOR ALL PATIENTS ABLE TO PAY AND REMAINING CERTIFIED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES TO PROVIDE CARE TO THOSE WHO PAY THEIR BILLS THROUGH MEDICARE, MEDICAID, AND OTHER GOVERNMENT PAYMENT PROGRAMS.5. USING SURPLUS FUNDS TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES, PURCHASE EQUIPMENT, AND ADVANCE MEDICAL TRAINING AND EDUCATION.6. COLLABORATING WITH BUSINESSES, A SCHOOL DISTRICT, LOCAL FARMERS AND COMMUNITY-BASED ORGANIZATIONS TO IMPROVE COMMUNITY INFRASTRUCTURE AND SOCIAL CONNECTIONS, SUCH AS RESIDENTIAL HOUSING, COMMUNITY WELLNESS CENTER, A LOCAL FARMERS MARKET. 7. IMPLEMENTING EIGHT TARGETED INTERVENTIONS TO ADDRESS FOOD INSECURITY FOR NEARLY 1,500 PATIENTS AND HOUSEHOLD MEMBERS ANNUALLY. ALL ENROLLED PARTICIPANTS ARE FURTHER ASSESSED FOR HEALTH-RELATED SOCIAL NEEDS AND CONNECTED TO RESOURCES IF THEY DEMONSTRATE A NEED, SUCH AS HOUSING INSTABILITY AND CHRONIC STRESS ASSOCIATED WITH EXPERIENCING INTERPERSONAL VIOLENCE, POVERTY, AND GAPS IN HEALTH INSURANCE. 8. OFFERING SUPPORT GROUPS AND EDUCATIONAL CLASSES FACILITATED BY VARIOUS LAKEWOOD HEALTH PROFESSIONALS AND OFFERED AT NO COST TO PATIENTS AND COMMUNITY MEMBERS. 9. PROVIDING A RENTAL SPACE FOR A LOCAL DAYCARE CENTER, MAGIC FOREST, AND HAS RECENTLY SUPPORTED A BUILDING EXPANSION ALLOWING THE CENTER TO DOUBLE THE FACILITY SPACE TO ACCOMMODATE DOUBLING OF ENROLLMENT. WITH THE SUPPORT OF LHS, MAGIC FOREST IS ABLE TO SERVE 42 AREA CHILDREN WITHIN THEIR CHILDCARE ENVIRONMENT. PART VI, LINE 6: N/A X X X 0 1 0 0 0 0 0 0 0 CHRISTINE ALBRECHT CHIEF MEDICAL OFFICER 579850 0 0 0 0 0 0 0 0 0 579850 0 0 0 LISA BJERGA CEO & PRESIDENT 411700 0 49580 0 24977 0 6818 0 1254 0 494329 0 0 0 SCOTT MANEY CRNA 349898 0 500 0 0 0 880 0 25958 0 377236 0 0 0 JASON ALEXANDER CRNA 339839 0 5500 0 0 0 2625 0 20708 0 368672 0 0 0 MATTHEW SINGH CRNA 336392 0 5500 0 0 0 4950 0 21003 0 367845 0 0 0 DANIEL LUND CRNA 318226 0 506 0 0 0 9900 0 32741 0 361373 0 0 0 CRAIG WOLHOWE VP OF HOSPITAL & CLINIC SERVICES 259485 0 23130 0 13377 0 5853 0 36919 0 338764 0 0 0 LYNN RICE VP OF SUPPORT SERVICES 254288 0 21914 0 20214 0 9086 0 12524 0 318026 0 0 0 JOSEPH REYCRAFT CFO 230683 0 11287 0 190 0 2822 0 11037 0 256019 0 0 0 KIMERLY HUSCHLE CRNA 219510 0 5375 0 0 0 6798 0 20897 0 252580 0 0 0 CORRINE NEISESS VP OF NURSING 184434 0 15338 0 5401 0 6226 0 11388 0 222787 0 0 0 TIM RICE CEO (FORMER) 0 0 0 0 157454 0 0 0 0 0 157454 0 0 0 SCHEDULE J, PART II & FORM 990, PART VII, SECTION A, LINE 5 CHRISTINE ALBRECHT IS THE HOSPITAL'S CHIEF MEDICAL OFFICER. SHE ALSO PRACTICES AS AN EMPLOYEE OF LAKEWOOD CLINIC PA WHICH IS AN UNRELATED ORGANIZATION (SEE RELATIONSHIP FURTHER DESCRIBED ON SCHEDULE L) . THE COMPENSATION REPORTED ON PART VII OF THE 990 AND SCHEDULE J, PART II IS REPRESENTATIVE OF HER REPORTED COMPENSATION IN TOTAL FROM LAKEWOOD CLINIC WHICH INCLUDES HER CONTRIBUTIONS TO LAKEWOOD AS CHIEF MEDICAL OFFICER. A UNITED HOSPITAL DISTRICT TODD MORRISON CASS AND WADENA COUNTIES MN 416005558 88903ACN8 2016-11-15 4168729 REFINANCING 0 0 0 A 1135000 4168729 4098626 70103 2004 1 0 1 1 A 0 0 0 0 0 0 1 A 0 1 0 1 1 0 0 0 1 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: UNITED HOSPITAL DISTRICT, TODD, MORRISON, CASS AND WADENA COUN DATE THE REBATE COMPUTATION WAS PERFORMED: 12/01/2020 LAKEWOOD CLINIC PA BOARD MEMBERS HAVE OWNERSHIP INTEREST IN LAKEWOOD CLINIC, PA. 16882102 THE ORGANIZATION HAS A MEDICAL SERVICE AGREEMENT WITH LAKEWOOD CLINIC, PA FOR THE PROVISION OF PHYSICIAN AND OTHER PROFESSIONAL MEDICAL SERVICES. THE AGREEMENT EXPIRES IN 2022. LAKEWOOD CLINIC, PA IS PAID PER A NEGOTIATED PRICE OF RELATIVE VALUE UNIT (RVU). THE RVU IS DETERMINED BASED ON THIRD-PARTY COMPENSATION DATA. IN ADDITION, THERE ARE COMPENSATION AGREEMENTS FOR SERVICES THAT USE HOURLY RATES DETERMINED USING MARKET DATA TO ENSURE COMPENSATION IS REASONABLE. THERE ARE SPECIALIST POSITIONS THAT RECEIVE AN ANNUAL COMPENSATION THAT IS ALSO DETERMINED USING MARKET DATA. THE FOLLOWING LAKEWOOD HEALTH SYSTEM BOARD MEMBERS HAVE OWNERSHIP INTEREST IN OR ARE MEMBERS OF LAKEWOOD CLINIC, PA: - MICHAEL HUDALLA, MD (BOARD MEMBER THRU JUNE) - KAITLYN SCHOECK, MD - RYAN KRAY, MD 0 FORM 990, PART VI, SECTION B, LINE 11B THE PREPARER OF FORM 990 EMAILS A COPY OF THE FINAL 990 TO THE ORGANIZATION'S CFO. THE CFO PERFORMS A DETAIL REVIEW OF FORM 990 AND PROVIDES EACH VOTING BOARD MEMBER WITH A COPY OF FORM 990 BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C ANY INTERESTS WHICH WERE IDENTIFIED AS PART OF THE ANNUAL CONFLICT OF INTEREST DISCLOSURE WOULD BE DOCUMENTED IN THE BOARD OF DIRECTOR MEETING MINUTES. THE OFFICERS, DIRECTORS, AND KEY EMPLOYEES COMPLETE A FORMAL CONFLICT OF INTEREST DISCLOSURE ANNUALLY. INTERESTS THAT ARISE BETWEEN COMPLETING FORMS MUST BE DISCLOSED BY THE INTERESTED MEMBER TO THE REST OF THE BOARD. FOR ANY BOARD ACTION THAT REQUIRED A VOTE AND COULD BE INFLUENCED BY A CONFLICT, THE AFFECTED BOARD MEMBER IS NOT PERMITTED TO VOTE ON THE ACTION. THE ORGANIZATION ALSO CONSIDERS WHETHER OTHER POTENTIAL CONFLICTS OF INTEREST COULD RESULT FOR ANY OF THESE INDIVIDUALS BASED ON POSSIBLE ACTIONS UNDER CONSIDERATION BY THE ORGANIZATION DURING THE YEAR. FORM 990, PART VI, SECTION B, LINE 15 FOR THE CEO, INITIAL COMPENSATION CONSIDERATION IS MADE BASED ON A REVIEW OF SALARY SURVEY DATA COMPILED BY GALLAGHER. ADDITIONALLY, THE COMMITTEE MAY CONSIDER OTHER DATA SOURCES FOR CONTEXT INCLUDING DATA COMPILED BY THE MINNESOTA HOSPITAL ASSOCIATION (MHA), AND HEALTHCARE HUMAN RESOURCES ASSOCIATION OF MINNESOTA (HHRAM). THIS DATA IS THEN REVIEWED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. AFTER THIS REVIEW, A RECOMMENDATION IS SUBMITTED TO THE BOARD OF DIRECTORS FOR REVIEW ALONG WITH THE ENTIRE ANNUAL BUDGET PACKAGE. FINALLY, THE FULL BUDGET PACKAGE, ALONG WITH ALL SPECIFIC SALARY PROPOSALS IS SUBMITTED TO THE FULL BOARD OF DIRECTORS FOR FINAL APPROVAL. AT ANY TIME IN THIS PROCESS, ANY OF THE COMMITTEES OR BOARD COULD REQUEST ADDITIONAL INDEPENDENT SALARY INFORMATION SUPPORTING THE PROPOSED SALARY. THIS COMPENSATION AMOUNT IS INCLUDED IN THE CEO EMPLOYMENT CONTRACT WHICH IS PREPARED EVERY OTHER YEAR WITH A TWO-YEAR TERM. FOR THE CFO, CMO, AND VP'S, THE PROCESS STARTS WITH A COMPENSATION SURVEY PERFORMED BY INTEGRATED HEALTHCARE STRATEGIES (IHS) OR SIMILAR FIRM. IHS IS CONTRACTED BIENNIALLY TO COMPLETE A COMPENSATION MARKET SURVEY FOR THESE POSITIONS. THE COMMITTEE MAY CONSIDER OTHER DATA SOURCES FOR CONTEXT INCLUDING BUT NOT LIMITED TO DATA COMPILED BY THE MINNESOTA HOSPITAL ASSOCIATION (MHA), AND HEALTHCARE HUMAN RESOURCES ASSOCIATION OF MINNESOTA (HHRAM). THIS DATA IS REVIEWED BY THE COMPENSATION COMMITTEE WITH THE REMAINING PROCESS BEING IDENTICAL TO THAT FOR THE CEO WITH ALL RECOMMENDATIONS AND COMMITTEE MEETING MINUTES SENT TO THE BOARD FOR APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THESE DOCUMENTS CAN BE REQUESTED FROM THE ORGANIZATION'S CHIEF FINANCIAL OFFICER. FORM 990, PART IX, LINE 11G OPERATING ROOM PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,078,560. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,078,560. REHAB/THERAPY PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,420,383. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,420,383. PHYSICIAN PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 15,639,634. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,639,634. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 3,994,540. MANAGEMENT AND GENERAL EXPENSES 766,846. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,761,386. CLINIC & ADMIN FEES: PROGRAM SERVICE EXPENSES 2,904,998. MANAGEMENT AND GENERAL EXPENSES 704,287. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,609,285. PHARMACY PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 417,525. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 417,525. LAB PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,766,968. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,766,968. FORM 990, PART XI, LINE 9: NET ASSETS RELEASED FROM RESTRICTIONS 166,098. CHANGE IN INVESTMENTS IN AFFILIATES -48,646. STAPLESMOTLEY HOUSING GROUP LLC 49725 COUNTY ROAD 83 STAPLES MN 56479 882108733 HOME & ECONOMIC DEVELOPMENT MN LAKEWOOD HEALTH SYSTEM RELATED -38505 411495 0 1 0.70000 LHS-TCO HOUSING LLC 49725 COUNTY ROAD 83 STAPLES MN 56479 882084265 HOUSING MN LAKEWOOD HEALTH SYSTEM RELATED -9065 158944 0 1 0.50000 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 STAPLESMOTLEY HOUSING GROUP LLC B 240000 CASH LHS-TCO HOUSING LLC B 158944 CASH