2024-11-14T16:57:26-06:00 2023-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2023-01-01 454165628 United Hospital District UNIT 5075263273 515 S Moore St Blue Earth MN 560132158 Richard Ash CEO 5075263273 2024-11-14 1 1 Kim Hunwardsen CPA P00484560 6122536500 2024-11-13 2023 2024-10-15 13:58:12Z X Richard Ash 515 S Moore St Blue Earth MN 560132158 46909253 0 X www.uhd.org X 2011 MN Provision of health care services 13 11 291 11 0 0 375419 355887 41759723 44368470 130150 1665068 535906 519828 42801198 46909253 0 0 0 0 22274448 24317852 0 0 0 18656563 21374673 40931011 45692525 1870187 1216728 53529743 53169752 12958664 11381945 40571079 41787807 At United Hospital District, we exist to provide and promote appropriate health care services to the communities we serve, doing so in a safe and healing environment which supports our patient-centered care philosophy. 0 0 39662383 44368470 United Hospital District, Inc. operates a 25-bed critical access hospital in Blue Earth, Minnesota. The Hospital also operates medical clinics in Blue Earth, Wells and Fairmont, Minnesota. The Hospital provides health care services to patients who meet certain criteria under its charity care policy without charge or at amounts less than established rates. The estimated cost of providing these services was $367,000 for the year ended December 31, 2023, calculated by multiplying the ratio of cost to gross charges for the Hospital by the gross uncompensated charges associated with providing charity care to its patients. 39662383 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 98 0 1 291 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 11 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 MN X Jeanette Kruckeberg 5075267949 515 S Moore St Blue Earth MN 560132158 Bob Karp MD Physician/Board Member 40.00 X 505117 0 49386 Aaron Johnson MD Physician & CMO/Board Member 40.00 X 433005 0 45023 Ryan Milbrandt Chairman 1.00 X X 650 0 0 Melanie Humburg Secretary 1.00 X X 666 0 0 Douglas Johanson Treasurer 1.00 X X 700 0 0 Larry Anderson Board Member 1.00 X 600 0 0 Richard Barke Board Member 1.00 X 1069 0 0 Chase Brandt Board Member 1.00 X 650 0 0 Joanne Hoffman Board Member 1.00 X 650 0 0 Justin Miller Board Member 1.00 X 600 0 0 Wyatt Rollenhagen Board Member 1.00 X 1127 0 0 Michael McCarty PA-C Board Member 1.00 X 473 0 0 Krista Blair Board Member 1.00 X 550 0 0 Richard Ash CEO 40.00 X 273599 0 47585 Patrick Justin CFO 40.00 X 182645 0 19352 Alex Wong MD Physician 40.00 X 553160 0 49853 Christopher Gran MD Physician 40.00 X 493609 0 30716 Jia-Shyuan Su MD Physician 40.00 X 392821 0 39647 David Krusemark CRNA 40.00 X 274291 0 20085 Laraine Klunder CRNA 40.00 X 273865 0 46914 3389847 0 348561 36 0 1 0 FEP 22029 N 51st St Phoenix AZ 85054 ED MD Coverage 1811763 Aureus Nursing 1010 N 102nd Street Suite 300 Omaha NE 68114 Healthcare Staffing Service 1166324 Robert W Carlstrom Co Inc 1901 Excel Dr Mankato MN 56001 Construction 769544 Orthopaedic & Fracture Clinic 1431 Premier Drive Mankato MN 56001 Ortho MD's 500311 Shared Medical Services 209 Limestone Pass PO Box 330 Cottage Grove MN 53527 CT Services 406470 15 263913 91974 25000 355887 Patient Service Revenue 621110 43333472 43333472 340B Program Revenue 621110 722512 722512 Equity earnings in CDMI 621110 186034 186034 Supporting Revenue 621110 126452 126452 44368470 276618 276618 519828 0 519828 519828 519828 1385185 3265 0 0 1385185 3265 1388450 1388450 46909253 44368470 0 2184896 X 1570324 1016594 553730 17302494 15637545 1664949 974993 882228 92765 3227748 2886727 341021 1242293 1101552 140741 25429 25429 77882 77882 8135768 7457811 677957 302371 1900 300471 1116252 679498 436754 801934 116999 684935 984166 864538 119628 209609 172326 37283 70910 50768 20142 246918 206604 40314 2217270 1855255 362015 307585 307585 Medical Supplies 4940769 4940270 499 Equipment Rental/Repair 1034078 960521 73557 MN Care Tax 499167 499167 Licenses/Dues 120210 65683 54527 284355 266397 17958 45692525 39662383 6030142 0 20947812 19720916 3739802 5037311 18269 42308 728301 834435 1104104 1200788 369609 90441 55845700 33381706 21808269 22463994 3600000 2688180 438809 510957 774768 580422 53529743 53169752 3175303 4043384 7193996 6927927 368953 219300 2220412 191334 12958664 11381945 X 40571079 41787807 40571079 41787807 53529743 53169752 1216728 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 612000 612000 37933215 21023500 16909715 1004353 787608 216745 14396876 11570598 2826278 1899256 1899256 22463994 Third Party Payor Settlements 191334 191334 X 46909253 0 46909253 0 46909253 45692525 0 45692525 0 45692525 Part X, Line 2: The Hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. 1 1 X 1 X 225.000000000000 1 X 275.000000000000 0 1 1 0 0 367000 367000 0.00800 8768237 5387937 3380300 0.07400 9135237 5387937 3747300 0.08200 5805062 2289515 3515547 0.07690 5805062 2289515 3515547 0.07690 14940299 7677452 7262847 0.15890 1 488091 55642 8075099 8113399 -38300 X 1 1 1 1 United Hospital District 515 S Moore Street Blue Earth MN 56013 www.uhd.org 375736 X X X 2 Provider based clinics, 1 Fee for service clinic United Hospital District 1 0 0 1 X X X X X X X X X 23 1 0 0 1 X See Part V, Page 8 X 1 23 1 See Part V, Page 8 0 1 X 225.000000000000 275.000000000000 X 1 1 X X X X X 1 X http://www.uhd.org/index.php/forms X http://www.uhd.org/index.php/forms X http://www.uhd.org/index.php/forms X X X X X 1 X 0 X X X X 1 X 0 0 United Hospital District Part V, Section B, Line 5: Four focus groups were scheduled to occur between November 8-10, 2023, to obtain information from community residents for UHD's CHNA. The UHD leadership team initially provided names, demographics, and contact information for 87 potential attendees. Each focus group included a mix of attendees representing their community. All four focus groups were originally scheduled to be held in person but one was held remote to accomodate more people. Attendees included seniors, representatives from businesses, health care consumers, active health care providers, parents, school representatives, and lifelong residents. United Hospital District Part V, Section B, Line 11: In 2023, United Hospital District (UHD) commissioned a community health needs assessment to evaluate the healthcare needs of its service area: Faribault, Freeborn, Martin, and Blue Earth Counties in Minnesota, and Kossuth and Winnebago Counties in Iowa.The CHNA was completed in December 2023. In 2020, UHD identified three strategies on which to focus from 2021 through 2023. Secondary data, focus groups, and key stakeholder interviews confirmed that these strategies remain relevant again from the 2023 CHNA. The priorities identified by the 2020 and 2023 CHNA teams are as follows: **Goal 1: Provide and Promote Education Opportunities to the Communities We Serve. **Goal 2: Match the Scope of Services with the Needs of the Communities We Serve**Goal 3: Promote, Partner, and Enhance Mental Health ServicesThe following actions were taken in the current year to address the needs identified above: **Goal 1: Provide and Promote Education Opportunities to the Communities We Serve. 1. Survey responses indicate there is an opportunity to better communicate about services or available preventive support. 2. Some focus group respondents indicated that they were not sure what services UHD offers. 3. Leverage all modes of communication that will reach the senior population as well as younger community members. **Action Item A: The community education team met to brainstorm about how best to promote better education regarding the varied services available at UHD. The team also explored the methods to disseminate the information, i.e., via YouTube, podcasts, radio, and other outlets to reach the various demographic segments of UHD's service area. **Action Item B: Worked with senior center for good exercises, limit trip/fall hazards in the home.**Action Item C: Provided education for large 25-44 population and COPD/stroke population.**Goal 2: Match the Scope of Services with the Needs of the Communities We Serve:1. The CHNA results encouraged UHD to continue developing partnerships with businesses, faith groups, and schools (including schools in within the counties but not located in Blue Earth).**Action Item A: Educated Wells and Fairmont communities on what services are available. Free blood test assessments are offered to the communities in February of each year at a cost of approximately $100K to organization.**Goal 3: Promote, Partner, and Enhance Mental Health Services1. As in many communities, there is an opportunity to address issues related to mental illness. Following best practice recommendations, this is not something the hospital can do alone. **Action Item A: UHD is working with Mason City Clinic to provide telepsychiatry appointments.**Action Item B: 50-page Mental Health booklet was completed and printed. MH Providers have put it into use and has been well received.**Action Item C: MH Access Expanded (location and/or provider): MH PhD is up and running in the Fairmont location 3 days/week, currently limiting to 1 new referral per day due to current caseload.**Action Item D: Outreach is planned to the local school district staff. United Hospital District Part V, Section B, Line 13h: Documents that may be reviewed include completed application, recent tax statements, bank denial and MA denial. The Organization also follows the state agreement. United Hospital District Part V, Section B, Line 15e: We have certified staff who assist with the MN State Exchange and MA. They also provide guidance with every patient's insurance carrier where needed. Schedule H, Part V, Line 9: The hospital completed their most recent Community Health Needs Assessment in December of 2023, but it was not approved by the board and posted to the website until after the board meeting on Januay 8th of 2024. The Implementation Strategy was started in early 2024, but due to a transition in the CFO postion in March, the Implementation Strategy was not completed, approved and posted to the website until November 2024. All the needs identified were continuations of needs from the prior implementation plan, so the hospital had continued to address the needs even without the formal implementation plan. There was no negative impact to the community of the error as the plan was being implemented even though it was not fully approved or posted on the website. The error has been corrected. Schedule H, Part V, Line 7a and 11: https://uhd.org/index.php/community-needs-assessment 1 1 - UHD Home Health and Hospice 125 South Main Street Blue Earth MN 56013 Comprehensive Home Care & Hospice Program Part I, Line 3c: In addition to the Federal Poverty Guidelines, documents that may be reviewed include completed application, recent tax statements, bank denial and MA denial. The Organization also follows the state agreement. Part I, Line 7: Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b and subsidized health services on line 7g were determined using the costing methods to prepare the cost reports. Part III, Line 2: The amount reported on line 2 represents implicit price concessions. The Hospital determines its estimate of implicit price concessions based on its historical collection experience with this class of patients. Part III, Line 3: 11.4% of the residents living in Faribault County are living below the federal poverty guidelines. The Organization estimates that 11.4% of its implicit price concessions are attributable to patients eligible for financial assistance under the financial assistance policy based on this percentage. Part III, Line 4: The footnote to the organization's financial statements addressing implicit price concessions may be found on pages 11 and 12 of the attached audited financial statements. Part III, Line 8: Medicare allowable costs were obtained from the 2023 Medicare cost report. The Medicare Cost Report is completed based on the rules and regulations set forth by the Centers for Medicare and Medicaid Services.The Organization reported a shortfall in 2023. Even though Medicare was at a loss, the Hospital provides services to these patients because access to healthcare and individual's health is important to the Hospital. Therefore, the Medicare shortfall is considered a community benefit. Part III, Line 9b: Within 7 days after an insurance payment, the patient will start receiving monthly billings. Statements are sent on a monthly cycle basis. If no payment is received 30 days after the statement went out, the patient is contacted by phone. If no payment is received for 90 days, the patient is contacted by letter to advise him or her of further collection actions to be taken. When agreed upon amounts are not paid off, arrangements can be made for a series of payments to fulfill a patient's obligation. Each account is reviewed by a business office staff member before placing with a collection agency. A financial assistance application submitted by a patient will be processed for at least 240 days following their first post discharge billing statement. If an individual submits a financial assistance application after collection actions have started, collection actions will be suspended until financial assistance eligibility is determined. If an individual is determined to be eligible for financial assistance, no further collection actions will be taken. If an individual is determined to be eligible for financial assistance after collection actions have started, the collection actions will be reversed. Part VI, Line 2: UHD has standing advisory committees with representation from our communities for Home Health/Hospice. Input from the members helps set the strategies and initiatives for improvement. We've also had Focus Groups to address Obstetrical services and another for Orthopedic services. Our patient satisfaction survey incorporates a comments section which gives our patients a voice to make suggestions. Part VI, Line 3: UHD provides the following information for financial assistance: (1) posts its charity care policy, or a summary thereof, and financial assistance contact information in admissions areas, emergency rooms, and other areas of the organization's facilities in which eligible patients are likely to be present; (2) provides a copy of the policy, or a summary thereof, and financial assistance contact information to patients as part of the intake process; (3) provides a copy of the policy, or a summary thereof, and financial assistance contact information to patients with discharge materials; (4) includes the policy, or a summary thereof, along with financial assistance contact information, in patient bills; and/or (5) discusses with the patient the availability of various government benefits, such as Medicaid or state programs, and assists the patient with qualification for such programs, where applicable. In addition, the Business Office has several certified individuals to assist with applications for both State and Federal insurance plans. The financial assistance application and a copy of the financial assistance policy are also posted to the Organization's website. Part VI, Line 4: UHD is located in Blue Earth, Minnesota, a community of approximately 3,400 situated in the west central end of Faribault County. The county borders Martin County to the west, Freeborn County to the east, Blue Earth County to the north, and two Iowa counties, Kossuth and Winnebago, to the south.UHD is the only hospital serving Faribault County and the northern Iowa adjacent counties. Faribault County comprises 82% of UHD outpatient admissions while the remaining adjacent counties comprises 95% of all outpatient encounters. The population within a 10-mile radius of Blue Earth is about 9,000 and within a 20-mile radius is about 30,000.The closet full-service hospitals are in:Fairmont, MN - Mayo Clinic Health Systems - 22 miles westMankato, MN - Mayo Clinic Health Systems - 45 miles northEmmetsburg, IA - Palo Alto County Hospital - 66 miles southwest Part VI, Line 5: United Hospital District's current board members reside in the service area. Medical staff privileges for physicians are provided to all qualified care providers who also primarily reside in the service area. The Hospital also has relationships for certain specialists who provide their medical care in our clinics and hospital. All surplus funds are reinvested in the program areas for the hospital and clinics. X X 0 0 0 0 0 0 0 0 0 Alex Wong MD Physician 552955 0 205 0 0 0 16500 0 36070 0 605730 0 0 0 Bob Karp MD Physician/Board Member 504912 0 205 0 0 0 16500 0 35425 0 557042 0 0 0 Christopher Gran MD Physician 493404 0 205 0 0 0 16500 0 16244 0 526353 0 0 0 Aaron Johnson MD Physician & CMO/Board Member 432800 0 205 0 0 0 16500 0 30794 0 480299 0 0 0 Jia-Shyuan Su MD Physician 392616 0 205 0 0 0 14207 0 27082 0 434110 0 0 0 Laraine Klunder CRNA 273660 0 205 0 0 0 13727 0 34870 0 322462 0 0 0 Richard Ash CEO 273599 0 0 0 0 0 14250 0 34537 0 322386 0 0 0 David Krusemark CRNA 274086 0 205 0 0 0 13779 0 7510 0 295580 0 0 0 Patrick Justin CFO 181630 0 1015 0 0 0 9177 0 11040 0 202862 0 0 0 A City of Frost Minnesota 416005176 2018-10-18 9428450 Refinance District's debt and remodel ER, lobby and other spaces 0 0 0 A 2395466 9428450 188569 3053221 2019 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 0 0 0 0 0 1 A 1 Aaron Johnson MD Medical Provider Signing Incentive X 100000 42308 0 1 1 42308 Form 990, Part VI, Section A, line 1a The Organization has an Executive Committee consisting of the Chair, Vice Chair, Secretary and Treasurer. In addition, the CEO is an ex-officio, non-voting member of the Executive Committee. The Chair of the Board of Directors is the Chair of the Executive Committee. The Executive Committee has the authority of the Board of Directors in the management of the business of the Organization in intervals between meetings of the Board of Directors. Form 990, Part VI, Section A, line 7a The Board of Directors consists of no fewer than seven and no more than fifteen members. Three "District Directors" are appointed by the United Hospital District Board of Directors. There can be up to two "At-Large Directors" who are elected by the Board of Directors but need not be residents of the Geographic Service Area. There is one Ex Officio director, who is the physician serving as the Chief of Medical Staff of the hospital. The remaining members of the Board of Directors are "Area Directors" who are elected by the Board of Directors of this corporation and must be residents of the Geographic Service Area. The Geographic Service Area means all of the cities and townships comprising the District, plus any additional area contained within the lowest number of contiguous zip codes from which the hospital drew at least 75 percent of its inpatients during the previous fiscal year. Form 990, Part VI, Section B, line 11b The CFO reviews the Form 990 and a copy is provided to the board members prior to filing with the IRS. Form 990, Part VI, Section B, line 12c The organization has a conflict of interest policy in place which covers the officers and board members of the organization. Potential conflicts are reviewed and determined by the CEO and board chair. If an individual has a conflict of interest, they are asked to abstain from voting on the conflicting issue. Form 990, Part VI, Section B, line 15a CEO: The Executive Committee of the Board reviews salary surveys from the Minnesota Hospital Association in determining the salary for the CEO. Other officers: Similarly to the CEO, the results of the salary survey from the Minnesota Hospital Association is used in determining the salary for the remaining officers. The CEO approves these increases in compensation. Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest policy and financial statements are not made available to the public. Form 990, Part IX, line 11g Outside Consultants/Purchased Srvcs: Program service expenses 7,288,749. Management and general expenses 214,622. Fundraising expenses 0. Total expenses 7,503,371. Other Fees: Program service expenses 169,062. Management and general expenses 463,335. Fundraising expenses 0. Total expenses 632,397.