2023-04-17T14:53:30-05:00 2022-05-31 450250958 EIDE BAILLY LLP 200 E 10TH ST STE 500 SIOUX FALLS SD 571046375 990 2021-06-01 410758512 MADELIA HEALTH MADE 5076423255 121 DREW AVE SE MADELIA MN 56062 BRUCE CRAVEN CFO 5076423255 2023-04-15 1 BRUCE CRAVEN 999009999 LAURIE HANSON CPA P00851848 6053391999 2023-04-05 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z DAVID WALZ 121 DREW AVE SE MADELIA MN 56062 18536384 0 X WWW.MADELIAHEALTH.ORG X 1950 MN PROVIDE QUALITY HEALTHCARE SERVICES TO THE LOCAL COMMUNITY. 9 9 198 0 0 0 5120627 602387 15048993 17695546 147439 201437 13035 32183 20330094 18531553 0 0 0 0 8689306 10980834 0 0 0 7410664 8176132 16099970 19156966 4230124 -625413 20549984 18855648 5802689 5477668 14747295 13377980 THE MISSION OF MADELIA HEALTH IS TO PROVIDE SAFE AND QUALITY HEALTHCARE SERVICES TO THOSE WE SERVE IN AN ENVIRONMENT BASED ON RESPECT, DIGNITY, AND EXCELLENCE. 0 0 15658438 17629372 MADELIA HEALTH PROVIDES GENERAL MEDICAL/SURGICAL SERVICES FOR INPATIENT, SWING BED PATIENTS, OUTPATIENTS, AND HOME CARE CLIENTS. DURING THE FISCAL YEAR 2021-2022 THERE WERE 145 ACUTE CARE ADMISSIONS WITH 509 PATIENT DAYS, 61 SWING BED PATIENTS WITH 516 PATIENT DAYS, 11,365 HOME CARE VISITS AND 1,601 PATIENTS, AND 7,853 TOTAL OUTPATIENT VISITS. DURING THE FISCAL YEAR MADELIA HEALTH PROVIDED $181,000 IN CHARITY CARE. A VARIETY OF COMMUNITY BENEFIT SERVICES ARE DONE EACH YEAR BY VOLUNTEER HOSPITAL EMPLOYEES AND COMMUNITY VOLUNTEERS. 15658438 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 46 0 1 198 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 1 0 MN X BRUCE CRAVEN 5076423255 121 DREW AVENUE SOUTHEAST MADELIA MN 56062 DENNIS ARDUSER VICE CHAIR 1.00 0.20 X X 1800 0 0 BRIAN MCCABE CHAIR 1.00 0.00 X X 1800 0 0 STEVE SORENSON TREASURER/SECRETARY 1.00 0.00 X X 1800 0 0 STEVE COOLING BOARD MEMBER 1.00 0.00 X 1200 0 0 KEN GRONEWOLD BOARD MEMBER 1.00 0.00 X 1200 0 0 RYAN VISHER BOARD MEMBER 1.00 0.00 X 1200 0 0 NORMA KRUMIEDE BOARD MEMBER 1.00 0.00 X 1200 0 0 WENDY HENNAGER BOARD MEMBER 1.00 0.00 X 1200 0 0 ELIZABETH SCHMIDT BOARD MEMBER 1.00 0.00 X 1200 0 0 JEFF MENGENHAUSEN CEO UNTIL 09/2021 40.00 0.20 X 207486 0 22915 ROZ SNYDER CCO 40.00 0.00 X 129147 0 6644 BRUCE CARVEN CFO FROM 10/2021 40.00 0.20 X 32402 0 2364 JAKE REDDEN CEO FROM 10/2021 40.00 0.20 X 52876 0 2345 SARAH DRYDEN PHYSICIAN 40.00 0.00 X 259873 0 23141 KARLA BOETTCHER NURSE PRACTITIONER 40.00 0.00 X 184286 0 12859 JANE MALMSKOG PHARMACIST 40.00 0.00 X 165402 0 14544 BRUCE ROREM PHYSICIAN 40.00 0.00 X 210722 0 0 MITCHELL CHERNEY PHARMACIST 40.00 0.00 X 135487 0 10521 1390281 0 95333 15 1 1 0 MANKATO CLINIC LTD 1230 E MAIN ST MANKATO MN 56001 PROVIDERS 908937 PRAIRIEVIEW ANESTHESIA AND PAI 41130 620TH AVE BUTTERFIELD MN 56120 PAIN MGMT/ANESTESIA 178910 WOLD ARCHITECTS AND ENGINEERS 332 MINNESOTA ST SUITE 2000 SAINT PAUL MN 55101 ARCHITECT/ENGINEERS 178667 3 66173 533114 3100 602387 NET PATIENT REVENUE 624100 17086750 17086750 PHARMACY 446110 326153 326153 282643 282643 17695546 206268 206268 32183 32183 4831 -4831 -4831 -4831 18531553 17695546 0 233620 533444 533444 7803848 6904962 898886 191486 182714 8772 1867836 1369985 497851 584220 497816 86404 399906 399906 19597 19597 626648 102600 524048 236028 236028 75046 40526 34520 170 170 117189 102521 14668 877637 767788 109849 MEDICAL SUPPLIES 3464276 3464276 0 OPERATING FEES 1832855 1825174 7681 REPAIR AND MAINTENANCE 394768 394768 132012 132012 19156966 15658438 3498528 0 1183780 98921 2568617 3453314 415525 248342 92846 34894 20257072 14021305 5928397 6235767 10308200 8493590 52619 290820 20549984 18855648 1214717 1553831 510000 260257 3876207 3658324 33729 5256 168036 0 5802689 5477668 X 14624113 13256798 123182 121182 14747295 13377980 20549984 18855648 X -625413 -677729 -66173 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 194207 194207 8267696 4807756 3459940 11245856 8972209 2273647 549313 241340 307973 6235767 X 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 1 X 1 1 1 0 1 1 181000 181000 0.00940 379216 210748 168468 0.00880 560216 210748 349468 0.01820 23600 23600 0.00120 73824 73824 0.00390 6717055 4194475 2522580 0.13170 6814479 4194475 2620004 0.13680 7374695 4405223 2969472 0.15500 1 588784 68299 4409774 4383938 25836 X 1 1 1 1 MADELIA HEALTH 121 DREW AVE SE MADELIA MN 56062 WWW.MADELIAHEALTH.ORG 385015 X X X X 1 PROVIDER BASED CLINIC MADELIA HEALTH 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X HTTPS://WWW.MADELIAHEALTH.ORG/CHNA/ X 1 21 0 0 0 1 X 100.000000000000 200.000000000000 X X 1 1 X X X X 1 X PART V SECTION C X PART V SECTION C X PART V SECTION C X X X X X X X 1 X 0 X X X X 1 X 0 0 MADELIA HEALTH PART V, SECTION B, LINE 5: PART V, SECTION B, LINE 5: FOR MADELIA HEALTH'S MAY 2022 COMMUNITY HEALTH NEEDS ASSESSMENT, THE HOSPITAL SOLICITED INPUT THROUGH COMMUNITY FOCUS GROUPS AND SURVEYS, AND REVIEWED COUNTY HEALTH RANKINGS. INPUT RECEIVED INCLUDES QUALITATIVE AND QUANTITATIVE INFOMRATION FROM LOCAL, STATE AND FEDERAL SOURCES. IN ADDITION, INPUT WAS RECEIVED FROM PERSONS THAT REPRESENTATED A BROAD RANGE OF INTEREST IN THE COMMUNITY, PERSONS WITH PUBLIC HEALTH KNOWLEDGE AND EXPERTISE, AND PERSONS REPRESENTING MEDICALLY UNDERSERVED AND VULNERABLE POPULATIONS. MADELIA HEALTH PART V, SECTION B, LINE 11: NEEDS IDENTIFIED IN THE MOST RECENT CHNA IMPLEMENTATION STRATEGY INCLUDE : MENTAL AND BEHAVIORAL HEALTH, OBESITY AND NUTRITION AND STROKE AWARENESS AND PREVENTION.SOME HEALTH ISSUES OR NEEDS THAT WERE IDENTIFIED THROUGH THE CHNA PROCESS ARE NOT PRIORITIZED AT THIS TIME DUE TO BEING OUTSIDE THE SCOPE/ABILITIES OF MADELIA HEALTH AND/OR THE ISSUE IS BEING ADDRESSED BY OTHER COMMUNITY RESOURCES OR ORGANIZATIONS. IN OTHER INSTANCES, THERE ARE ALREADY INITIATIVES IN PLACE AT MADELIA HEALTH TO ADDRESS SOME NEEDS. MADELIA HEALTH IS NOT IGNORING THESE ISSUES BUT INTENDS TO COLLABORATE (WITHIN ITS ABILITY) WITH OTHER ORGANIZATIONS TO ADDRESS AND MAKE PROGRESS TOWARD THE NEEDS NOT SPECIFICALLY ADDRESSED IN THE IMPLEMENTATION STRATEGY: TOBACCO USE, BULLYING, HOUSING SHORTAGE, DAYCARE SHORTAGE, STAFFING SHORTAGE, ETC.DURING FISCAL YEAR 2022, WE CREATED TEAMS TO ADDRESS MENTAL HEALTH AND MENTAL WELL-BEING, NUTRITION AND HEALTHY EATING AND STROKE AWARENESS. THE TEAMS INCLUDE COMMUNITY AND COUNTY MEMBERS AS WELL AS MADELIA HEALTH STAFF. THESE TEAMS WILL WORK TOWARD MEETING THE IDENTIFIED NEEDS. MADELIA HEALTH PART V, SECTION B, LINE 13B: IF A PATIENT NEEDS CARE WITHIN ONE YEAR OF COMPLETION AND APPROVAL OF A FINANCIAL ASSISTANCE APPLICATION, THE ORGANIZATION WILL USE PRESUMPTIVE ELIGIBILITY BASED ON THE PREVIOUSLY COMPLETED APPLICATION. THE ORGANIZATION DOES NOT UTILIZE THIRD PARTY INFORMATION TO DETERMINE PRESUMPTIVE ELIGIBILITY FOR FINANCIAL ASSISTANCE. MADELIA HEALTH PART V, SECTION B, LINE 16J: THE FAP APPLICATION IS AUTOMATICALLY MAILED OUT TO UNINSURED AND UNDERINSURED PATIENTS. MADELIA HEALTH PART V, SECTION B, LINE 20E: PATIENTS ARE INFORMED OF THE STATUS OF THEIR ACCOUNT THROUGH BILLING STATEMENTS AND LETTERS INDICATING THE AGING OF THEIR ACCOUNT AND THE AVAILABILITY TO MAKE PAYMENT ARRANGEMENTS WITH SEVERAL OPTIONS OF RECEIVING A DISCOUNT. PART V, LINES 16A-16C THE FAP, FAP APPLICATION, AND FAP SUMMARY ARE AVAILABLE AT: HTTPS://WWW.MADELIAHEALTH.ORG/FINANCIAL-ASSISTANCE/ 4 1 - LAKE CRYSTAL CLINIC 221 S MURPHY ST LAKE CRYSTAL MN 56055 CLINIC 2 - LAKE CRYSTAL PHARMACY 210 S MAIN ST LAKE CRYSTAL MN 56055 PHARMACY 3 - LAKE CRYSTAL REHAB 621 W NATHAN ST LAKE CRYSTAL MN 56055 REHAB SERVICE SPACE WITHIN A COMMUNITY CENTER 4 - TRUMAN CLINIC 401 N 4TH AVE E TRUMAN MN 56088 CLINIC PART I, LINE 3C: THE METHODOLOGY USED TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE TAKES INTO CONSIDERATION INCOME, FAMILY SIZE AND ASSETS AVAILABLE TO PAY FOR CARE. IF A PATIENT NEEDS CARE WITHIN ONE YEAR OF COMPLETION AND APPROVAL OF A FINANCIAL ASSISTANCE APPLICATION, THE ORGANIZATION WILL USE PRESUMPTIVE ELIGIBILITY BASED ON THE PREVIOUSLY COMPLETED APPLICATION. THE ORGANIZATION DOES NOT UTILIZE THIRD PARTY INFORMATION TO DETERMINE PRESUMPTIVE ELIGIBILITY FOR FINANCIAL ASSISTANCE. PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT IS AVAILABLE UPON REQUEST. PART I, LINE 7: LINE 7A, CHARITY CARE EXPENSE WAS CONVERTED TO COST BASED ON AN OVERALL COST-TO-CHARGE RATIO WHICH ADDRESSES ALL PATIENT SEGMENTS. LINE 7B, UNREIMBURSED MEDICAID, WAS CALCULATED USING THE COSTING METHODS TO PREPARE THE COST REPORTS. LINES 7E AND 7F WERE TAKEN FROM THE GENERAL LEDGER. LINE 7G, SUBSIDIZED HEALTH SERVICES, WAS CALCULATED USING THE MEDICARE COST REPORT. PART I, LINE 7G: THE PROVIDER BASED CLINIC COSTS INCLUDED ON LINE 7G: REVENUE $1,675,480, EXPENSE $3,232,173, NET COMMUNITY BENEFIT $1,556,693. PART III, LINE 2: THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE ORGANIZATION DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSION BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THIS CLASS OF PATIENTS. PART III, LINE 3: THE ESTIMATED AMOUNT OF THE ORGANIZATION'S IMPLICIT PRICE CONCESSIONS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS CALCULATED BASED ON THE PERCENTAGE OF INDIVIDUALS LIVING BELOW THE POVERTY LEVEL IN 2021. THEREFORE, 11.6% OF IMPLICIT PRICE CONCESSIONS CAN REASONABLY BE CONSIDERED A COMMUNITY BENEFIT AS IT WOULD HAVE BEEN WRITTEN OFF TO CHARITY CARE. PART III, LINE 4: THE FOOTNOTE THAT DESCRIBES IMPLICIT PRICE CONCESSION IS ON PAGE 13-14 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: MEDICARE ALLOWABLE COST OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR FISCAL YEAR ENDING 06/30/2022. MEDICAL SERVICES ARE PROVIDED TO PATIENTS WITH MEDICARE COVERAGE REGARDLESS OF WHETHER OR NOT A SURPLUS OR DEFICIT IS REALIZED. PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES WHICH ARE VITALLY NEEDED BY OUR COMMUNITY.THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. PART III, LINE 9B: EACH WEEK, STATEMENTS ARE SENT OUT THROUGH OUR EDI PROCESS WITH STATEMENTS BEING MAILED TO THE PATIENT BY A CLEARINGHOUSE. PATIENTS ARE BILLED AFTER MEDICARE OR COMMERCIAL INSURANCE HAS BEEN FILED AND PAYMENT HAS BEEN RECEIVED WITHIN A SIX-WEEK PERIOD. PATIENTS WILL BE BILLED FOR THE REMAINING BALANCE MONTHLY. ACCOUNTS ARE VERIFIED INTERNALLY PRIOR TO COLLECTION LETTERS BEING SENT. IF NO PAYMENT IS RECEIVED WITHIN 2 MONTHS OF BILLINGS, THE STATEMENT IS SENT WITH A NOTICE LETTER REQUESTING PAYMENT. LETTERS WILL ALSO BE SENT SHOULD NO PAYMENT BE RECEIVED WITHIN 60 AND 90 DAYS. SHOULD NO RESPONSE BE RECEIVED WITHIN FIVE (5) DAYS OF THE LAST LETTER, A TELEPHONE CALL IS ISSUED TO NEGOTIATE A PAYMENT PLAN. IF ACCOUNT HOLDER MAY QUALIFY FOR OUR HEALTHCARE FINANCIAL PROGRAM, AN APPLICATION IS SENT TO BE COMPLETED AND RETURNED TO US. LACK OF RESPONSE TO THE TELEPHONE CALL WILL RESULT IN VERIFICATION OF THE ACCOUNT(S) BY THE INSURANCE BILLING CLERKS AND THEN REVIEWED BY THE BUSINESS OFFICE MANAGER FOR APPROVAL TO BEGIN FORMAL COLLECTION PROCESS. THESE ACCOUNTS ARE THEN TURNED OVER TO A PROFESSIONAL COLLECTION AGENCY. CHARITY CARE CONSIDERATIONS WILL BE MADE BY THE BUSINESS OFFICE MANAGER WHEN ALL NECESSARY DOCUMENTATION IS PRESENTED AND SHOULD IT BE EVIDENT THAT THE PATIENT'S LACK OF FINANCES WARRANT THIS AND CHARITY CARE IS THE BEST ETHICAL DECISION FOR THE PATIENT. PART VI, LINE 2: THROUGH THE COMMUNITY ASSESSMENT PROCESS, HEALTHCARE NEEDS AND SERVICES WERE IDENTIFIED AND PROGRAMS WERE DEVELOPED. STRATEGIC PLANNING ASSESSES THE NEEDS OF THE COMMUNITY AND PATIENTS THROUGH PATIENT SATISFACTION SURVEYS, COMMENT CARDS, COMMUNITY ASSESSMENTS, AND A DIVERSE MEMBERHIP OF COMMUNITY ELECTED GOVERNING BOARD MEMBERS THAT REPRESENT THE COMMUNITY AND BRINGS TO THE TABLE ISSUES, CONCERNS, AND RECOMMENDATIONS FOR HEALTH CARE SERVICES.MADELIA HEALTH COLLABORATES WITH OTHER LOCAL ORGANIZATIONS REFERRED TO AS THE MADELIA COMMUNITY BASED COLLABORATIVE (MCBC) WHICH INCLUDES THE FOLLOWING PARTICIPANT ORGANIZATIONS: MADELIA HEALTH AND CLINICS, MINNESOTA STATE UNIVERSITY, MANKATO SCHOOL OF NURSING, GLEN TAYLOR NURSING INSTITUTE FOR FAMILY AND SOCIETY, WATONWAN COUNTY PUBLIC HEALTH DEPARTMENT, MADELIA SCHOOL SYSTEM, LUTHER MEMORIAL HOME, DOWNS FOOD GROUP INC, MADELIA CITY COUNCIL, AND MADELIA CHAMBER OF COMMERCE. THROUGH THIS COLLABORATION, MADELIA HEALTH IS ABLE TO PARTNER WITH OTHER ORGANIZATIONS THAT HAVE EXPRESSED AN INTEREST IN IMPROVING THE HEALTH OF THEIR EMPLOYEES. THE COMMUNITY HEALTH NEEDS ASSESSMENT COMPLETED BY MADELIA HEALTH HELPS MCBC DETERMINE WHAT AREAS THEY WILL FOCUS THEIR EFFORTS IN ORDER TO GAIN THE MOST BENEFIT FOR THE COMMUNITY. STAFF FROM MADELIA HEALTH HAVE A SIGNIFICANT ROLE IN THIS DEVELOPMENT AND CARRYING OUT OF THE ACTION PLANS. PART VI, LINE 3: PATIENTS ARE INFORMED OF FINANCIAL ASSISTANCE UPON ADMISSION TO THE HOSPITAL, THROUGH BILLING CLERKS ASSISTANCE WITH PATIENT ACCOUNTS, STATEMENTS ON THE BILLS, AND PERSONAL LETTERS SENT TO ACCOUNTS IDENTIFIED AS UNINSURED AND UNDERINSURED. PART VI, LINE 4: MADELIA HEALTH SERVES A 30 MILE RADIUS OF RURAL COMMUNITIES CONSISTING OF CULTURALLY DIVERSE AND SENIOR POPULATIONS. THE MAJORITY OF THE SERVICE AREA IS IN WATONWAN COUNTY, MINNESOTA. FOR THE ESTIMATED 6,811 HOUSEHOLDS IN THE COMMUNITY, THE MEDIAN HOUSEHOLD INCOME IS $64,253. THIS IS ABOUT $17,000 BELOW THAT OF THE STATE OF MINNESOTA. THE POVERTY RATE FOR WATONWAN COUNTY IS 9.7%, AS COMPARED TO 8.3% FOR THE STATE OF MINNESOTA. THE UNEMPLOYMENT RATE FOR THE COUNTY IS 3.2% FOR 2021. APPROXIMATELY 28% OF INDIVIDUALS ARE OVER THE AGE OF 60. THE POPULATION IS 70% CAUCASIAN, 27% HISPANIC, AND 3% OTHER. PART VI, LINE 5: THE HOSPITAL SERVES ALL PERSONS IN THE COMMUNITY ON A NON-DISCRIMINATORY BASIS, AND OPERATES AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY. MADELIA HEALTH HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. THE GOVERNING BODY IS COMPRISED PRIMARILY OF INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY.STAFF PARTICIPATE IN COMMUNITY ORGANIZATIONS TO PROVIDE HEALTHCARE REPRESENTATION AND INFORMATION TO ENHANCE THOSE ORGANIZATION'S EVENTS, ETC. X 1 0 X X 0 0 0 0 0 0 0 0 0 SARAH DRYDEN PHYSICIAN 209215 0 50658 0 0 0 1707 0 22355 0 283935 0 0 0 JEFF MENGENHAUSEN CEO UNTIL 09/2021 207486 0 0 0 0 0 14463 0 9190 0 231139 0 0 0 BRUCE ROREM PHYSICIAN 189824 0 20898 0 0 0 0 0 922 0 211644 0 0 0 KARLA BOETTCHER NURSE PRACTITIONER 146837 0 37449 0 0 0 6675 0 7290 0 198251 0 0 0 JANE MALMSKOG PHARMACIST 162162 0 3240 0 0 0 8256 0 7393 0 181051 0 0 0 PART I, LINE 1A HOUSING ALLOWANCE FOR CEO OF $5,000 WAS INCLUDED ON W-2. A CITY OF MADELIA MN 466005334 2021-02-26 4118000 REVENUE REFUNDING BOND SERIES 2021 0 0 0 A 268413 4118000 81644 4036356 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 0 1 0 0 0 0 A 0 FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE PRESIDENT, AS CHAIRPERSON, VICE PRESIDENT/TREASURER, SECRETARY, AND UP TWO (2) ADDITIONAL TRUSTEES. THE EXECUTIVE COMMITTEE SHALL HAVE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD OF TRUSTEES, SUBJECT TO ANY POWER LIMITATION IMPOSED BY THE BOARD OF TRUSTEES. A QUORUM FOR THE EXECUTIVE COMMITTEE CAN ONLY BE MADE UP OF EXECUTIVE COMMITTEE MEMBERS AND ONLY EXECUTIVE COMMITTEE MEMBERS MAY VOTE DURING EXECUTIVE COMMITTEE MEETINGS. MINUTES OF THE EXECUTIVE MEETINGS SHALL BE SUBMITTED TO THE BOARD OF TRUSTEES. THE EXECUTIVE COMMITTEE SHALL ANNUALLY EVALUATE THE CHIEF EXECUTIVE OFFICER'S PERFORMANCE AND RECOMMEND HIS/HER REMUNERATION TO THE FULL BOARD OF TRUSTEES BASED ON THE CHIEF EXECUTIVE OFFICER'S PERFORMANCE IN RELATION TO THE CORPORATION'S OBJECTIVES AND GOALS. THIS COMMITTEE SHALL MEET AS NECESSARY. FORM 990, PART VI, SECTION A, LINE 6 MEMBERSHIP OF THIS CORPORATION SHALL BE OPEN TO ANY NATURAL PERSON WHO MEETS THE FOLLOWING QUALIFICATIONS AT THE TIME OF APPLICATION: 1) IS OF LEGAL VOTING AGE IN MINNESOTA; 2) IS A VOTING RESIDENT WITHIN THE PRIMARY SERVICE AREA OF THE HOSPITAL, BEING DEFINED AS THE COUNTIES OF WATONWAN, BLUE EARTH, BROWN, MARTIN AND NICOLLET, STATE OF MINNESOTA; 3) IS A NATURAL PERSON AND NOT A CORPORATION, PARTNERSHIP OR OTHER ASSOCIATION; 4) SUBMITS A WRITTEN APPLICATION FOR MEMBERSHIP TO THE BOARD OF TRUSTEES ON A FORM APPROVED BY THE BOARD OF TRUSTEES; AND 5) SUBMITS A MEMBERSHIP FEE OF $25 OR MORE, WITH SAID APPLICATION. FORM 990, PART VI, SECTION A, LINE 7A ALL TRUSTEES ARE ELECTED BY THE CORPORATE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE CHIEF FINANCIAL OFFICER PRIOR TO FILING AND WILL BE PRESENTED TO THE GOVERNING BOARD OF TRUSTEES BY FINANCE COMMITTEE AT THE FIRST REGULAR MEETING OF THE BOARD OF TRUSTEES SUBSEQUENT TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS REVIEWED AT THE JANUARY BOARD MEETING BY THE GOVERNING BOARD AND DEPARTMENT MANAGERS. IF ANY CONFLICTS OF INTEREST ARISE, NOTIFICATION IS GIVEN TO ADMINISTRATION. A CONTRACT OR OTHER TRANSACTION THAT MAY INVOLVE A CONFLICT OF INTEREST IS NOT VOID OR VOIDABLE IF: 1) THE CONTRACT OR TRANSACTION WAS FAIR AND REASONABLE AS TO THE CORPORATION WHEN IT WAS AUTHORIZED, APPROVED, OR RATIFIED; 2) ALL MATERIAL FACTS ARE FULLY DISCLOSED TO THE MEMBERS AND THE CONTRACT OR TRANSACTION IS APPROVED BY TWO-THRIDS OF THE MEMBERS ENTITLED TO VOTE, OTHER THAN THE INTERESTED DIRECTOR OR TRUSTEE; AND 3) ALL MATERIAL FACTS ARE FULLY DISCLOSED TO THE BOARD OF TRUSTEES OR A COMMITTEE, AND THE BOARD OR COMMITTEE APPROVES THE CONTRACT OR TRANSACTION BY A MAJORITY VOTE, BUT THE INTERESTED TRUSTEE MAY NOT TAKE PART IN THE DISCUSSION, AND MAY NOT VOTE. FORM 990, PART VI, SECTION B, LINE 15 MADELIA HEALTH ENSURES THAT THE COMPENSATION PAID TO ITS CEO BE CONSISTENT WITH POLICY AND PROVIDE EQUITABLE STANDARDS FOR WAGE AND BENEFITS BASED ON ANNUAL REGIONAL SURVEY OF COMPARABLE ENTITIES. THE GOVERNING BOARD REVIEWS ANNUALLY THE CEO'S PERFORMANCE AND THE BASIS IS THE ANNUAL MN HOSPITAL ASSOCIATON SURVEY. THE BOARD DETERMINES THE CEO'S BASE SALARY, IN ITS SOLE DISCRETION. THE CEO EVALUATES COMPENSATION OF OTHER OFFICERS AND EMPLOYEES ANNUALLY BASED ON THEIR PERFORMANCE. ANNUAL INCREASES ARE BASED ON A REGIONAL SURVEY OF COMPARABLE ENTITIES WITH SIMILAR POSITIONS ALONG WITH YEARS OF SERVICE AND NUMBER SUPERVISED. THE SURVEY RESULTS AND THE EMPLOYEES PERFORMANCE ARE EVALUATED FOR AN INCREASE IF DEEMED APPROPRIATE. FORM 990, PART VI, SECTION C, LINE 19 MADELIA HEALTH MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AT THE ANNUAL CORPORATION MEETING AND UPON REQUEST. FORM 990, PART XI, LINE 9: TRANSFER FROM FOUNDATION -66,173. MADELIA HEALTH FOUNDATION 121 DREW AVENUE SE MADELIA MN 56062 731719218 SOLICIT CONTRIBUTIONS ON BEHALF OF THE MADELIA COMMUNITY HOSPITAL MN 501(C)(3) LINE 12A, I MADELIA HEALTH 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 MADELIA HEALTH FOUNDATION C 66173 COST