LAKE REGION HEALTHCARE CORPORATION: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- LAKE REGION HEALTHCARE CORPORATION (EIN 41-1763968)
- Tax period
- 2021-10-01 to 2022-09-30
- Filed
- 2023-08-14
- IRS object ID
- 202332269349301803
- Schema version
- 2021v4.2
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-08-14T12:10:13-05:00 | ReturnTs |
| Tax Period End | 2022-09-30 | 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 | 220 S 6TH STREET SUITE 300 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411763968 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRAIRIE RIDGE HOSPITAL AND HEALTH | BusinessNameLine1Txt |
| Business Name Line2 | SERVICES INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PRAI | BusinessNameControlTxt |
| Phone | 2186857300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1411 HIGHWAY 79 EAST | AddressLine1Txt |
| City | ELBOW LAKE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56531 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CAMIE PATTERSON | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 2186857300 | PhoneNum |
| Signature | 2023-08-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | CAMIE | PersonFirstNm |
| Person Last | PATTERSON | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DARRYN MCGARVEY | PreparerPersonNm |
| PTIN | P00958683 | PTIN |
| Phone | 6123764500 | PhoneNum |
| Preparation | 2023-08-13 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRAIRIE RIDGE HEALTHCARE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DANIELLE LESMEISTER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1411 HIGHWAY 79 EAST | AddressLine1Txt |
| City | ELBOW LAKE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56531 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $19,110,787 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PRAIRIEHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1993 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | WE PARTNER TO ENRICH LIFE THROUGH HEALTH. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 149 | TotalEmployeeCnt |
| Total Volunteers | 1 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $352,033 | PYContributionsGrantsAmt |
| CY Contributions Grants | $550,185 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $18,048,286 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $17,998,889 | CYProgramServiceRevenueAmt |
| PY Investment Income | $85,467 | PYInvestmentIncomeAmt |
| CY Investment Income | $196,392 | CYInvestmentIncomeAmt |
| PY Other Revenue | $272,676 | PYOtherRevenueAmt |
| CY Other Revenue | $353,428 | CYOtherRevenueAmt |
| PY Total Revenue | $18,758,462 | PYTotalRevenueAmt |
| CY Total Revenue | $19,098,894 | 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 | $6,060,197 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,230,655 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $13,450,435 | PYOtherExpensesAmt |
| CY Other Expenses | $12,771,604 | CYOtherExpensesAmt |
| PY Total Expenses | $19,510,632 | PYTotalExpensesAmt |
| CY Total Expenses | $19,002,259 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$752,170 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $96,635 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $34,170,156 | TotalAssetsBOYAmt |
| Total Assets EOY | $30,674,232 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $24,882,699 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $21,949,533 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,287,457 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,724,699 | NetAssetsOrFundBalancesEOYAmt |
| Mission | WE PARTNER TO ENRICH LIFE THROUGH HEALTH. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $15,239,295 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $17,998,889 | RevenueAmt |
| Desc | PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES (PRHHS) MAINTAINS AND OPERATES A HOSPITAL AND AMBULATORY OUTPATIENT FACILITY FOR THE CARE AND TREATMENT OF THE SICK, DISEASED, DISABLED, AGED, OR INDIGENT PERSONS AND PARTICIPATES IN VARIOUS ACTIVITIES TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY. PRHHS OPERATES VARIOUS PROVIDER-BASED CLINICS IN ELBOW LAKE, MORRIS, ASHBY, EVANSVILLE, HOFFMAN, A SEPARATE PHYSICIAN CLINIC IN HERMAN, AND A PROVIDER-BASED SURGERY DEPARTMENT IN MORRIS, MINNESOTA. | Desc |
| Total Program Service Expenses | $15,239,295 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | 0 | TaxExemptBondsInd |
| 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 | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 149 | 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 | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2186857300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1411 HIGHWAY 79 EAST | AddressLine1Txt |
| City | ELBOW LAKE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56531 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JAY MCNAMAR | ||||||||
| CHAIR AS OF OCT 2021 | 1.50 | 0.00 | Yes (X) | Yes (X) | $660 | $0 | $0 | |
| CRYSTAL ADAMS | ||||||||
| DIRECTOR | 1.50 | 6.00 | Yes (X) | $660 | $0 | $0 | ||
| JEFF DREIER | ||||||||
| DIRECTOR | 1.50 | 0.20 | Yes (X) | $660 | $0 | $0 | ||
| JEANNE ENNEN | ||||||||
| DIRECTOR | 1.50 | 0.00 | Yes (X) | $660 | $0 | $0 | ||
| RICHARD LAMBERT | ||||||||
| DIRECTOR | 1.50 | 4.00 | Yes (X) | $660 | $0 | $0 | ||
| DUSTIN SPERR | ||||||||
| VICE CHAIR/SECRETARY | 2.50 | 0.00 | Yes (X) | $660 | $0 | $0 | ||
| LARRY GOETZINGER | ||||||||
| DIRECTOR | 1.50 | 0.00 | Yes (X) | $660 | $0 | $0 | ||
| GENE WENSTROM | ||||||||
| CHAIR THROUGH OCT 2021 | 1.50 | 0.00 | Yes (X) | Yes (X) | $550 | $0 | $0 | |
| KENT MATTSON | ||||||||
| LRH CEO | 1.00 | 39.00 | Yes (X) | $0 | $452,807 | $44,161 | ||
| CAMIE PATTERSON | ||||||||
| CFO | 1.00 | 39.00 | Yes (X) | $0 | $359,036 | $21,510 | ||
| DANIELLE LESMEISTER | ||||||||
| CEO | 40.00 | 0.00 | Yes (X) | $149,400 | $0 | $17,425 | ||
| JAY THOMPSON | ||||||||
| PHARMICIST | 40.00 | 0.00 | $113,627 | $0 | $6,206 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $268,197 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $811,843 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $89,302 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | 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 |
|---|---|---|---|---|---|
| LAKE REGION HEALTHCARE CORPORATION | |||||
| 712 S CASCADE STREET | FERGUS FALLS | MN | 56538 | PROFESSIONAL/PHYSICIAN SERVICES | $4,073,505 |
| SONRISA MEDICAL CARE PA | |||||
| 19796 510TH AVENUE | MORRIS | MN | 56267 | PHYSICIAN SERVICES | $526,505 |
| MIDWEST SURGICARE LLC | |||||
| 24 EAST 7TH STREET | MORRIS | MN | 56267 | SURGICAL SERVICES | $487,000 |
| WEST CENTRAL INTERNAL MEDICINE | |||||
| PO BOX 410 | MORRIS | MN | 56267 | PHYSICIAN SERVICES | $397,852 |
| DMS IMAGING INC | |||||
| PO BOX 670747 | DALLAS | TX | 75267 | RADIOLOGY SERVICES | $363,344 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $5,575 | RelatedOrganizationsAmt |
| Government Grants | $458,758 | GovernmentGrantsAmt |
| All Other Contributions | $85,852 | AllOtherContributionsAmt |
| Total Contributions | $550,185 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 623000 | $17,834,023 | $17,834,023 |
| PHARMACY 340B REVENUE | 623000 | $164,866 | $164,866 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $17,998,889 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $163,004 | TotalRevenueColumnAmt |
| Exclusion | $163,004 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $45,281 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $11,893 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $45,281 | SecuritiesAmt |
| Other | -$11,893 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $33,388 | TotalRevenueColumnAmt |
| Exclusion | $33,388 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| MISCELLANEOUS REVENUE | 623000 | $166,358 | $166,358 |
| CAFETERIA REVENUE | 623000 | $123,515 | $123,515 |
| OUTSIDE SERVICES REVENUE | 623000 | $51,424 | $51,424 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,131 | TotalRevenueColumnAmt |
| Exclusion | $12,131 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $353,428 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,098,894 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,998,889 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $549,820 | 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 | $166,825 | TotalAmt |
| Management And General | $166,825 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,948,817 | TotalAmt |
| Program Services | $3,613,202 | ProgramServicesAmt |
| Management And General | $1,335,615 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,233 | TotalAmt |
| Program Services | $55,659 | ProgramServicesAmt |
| Management And General | $20,574 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $663,393 | TotalAmt |
| Program Services | $484,353 | ProgramServicesAmt |
| Management And General | $179,040 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $375,387 | TotalAmt |
| Program Services | $274,075 | ProgramServicesAmt |
| Management And General | $101,312 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,072 | TotalAmt |
| Management And General | $4,072 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,107 | TotalAmt |
| Management And General | $85,107 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,114,158 | TotalAmt |
| Program Services | $5,343,919 | ProgramServicesAmt |
| Management And General | $770,239 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,280 | TotalAmt |
| Program Services | $65,185 | ProgramServicesAmt |
| Management And General | $24,095 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $504,858 | TotalAmt |
| Management And General | $504,858 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $592,538 | TotalAmt |
| Program Services | $485,178 | ProgramServicesAmt |
| Management And General | $107,360 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,429 | TotalAmt |
| Program Services | $67,251 | ProgramServicesAmt |
| Management And General | $5,178 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $737,380 | TotalAmt |
| Program Services | $603,776 | ProgramServicesAmt |
| Management And General | $133,604 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,494,631 | TotalAmt |
| Program Services | $1,423,116 | ProgramServicesAmt |
| Management And General | $71,515 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,996 | TotalAmt |
| Program Services | $98,996 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $1,705,836 | $1,705,836 | |
| REPAIRS & MAINTENANCE | $552,277 | $452,211 | $100,066 |
| RENT EXPENSE | $250,219 | $204,882 | $45,337 |
| MN HEALTH TAX/SURCHARGE | $212,054 | $212,054 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $257,769 | TotalAmt |
| Program Services | $149,602 | ProgramServicesAmt |
| Management And General | $108,167 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,002,259 | TotalAmt |
| Program Services | $15,239,295 | ProgramServicesAmt |
| Management And General | $3,762,964 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,127,711 | BOYAmt |
| EOY | $6,115,902 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $569,515 | BOYAmt |
| EOY | $1,059,848 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,260,405 | BOYAmt |
| EOY | $3,645,430 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $200,511 | BOYAmt |
| EOY | $222,513 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $138,382 | BOYAmt |
| EOY | $133,081 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $31,500,710 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $16,425,644 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,600,567 | BOYAmt |
| EOY | $15,075,066 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,623,730 | BOYAmt |
| EOY | $2,553,149 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,946 | BOYAmt |
| EOY | $39,854 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,602,389 | BOYAmt |
| EOY | $1,829,389 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,170,156 | BOYAmt |
| EOY | $30,674,232 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,572,381 | BOYAmt |
| EOY | $2,771,286 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,814,422 | BOYAmt |
| EOY | $19,178,247 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,495,896 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,882,699 | BOYAmt |
| EOY | $21,949,533 | 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 | $8,942,307 | BOYAmt |
| EOY | $8,433,696 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $345,150 | BOYAmt |
| EOY | $291,003 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,287,457 | BOYAmt |
| EOY | $8,724,699 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,170,156 | BOYAmt |
| EOY | $30,674,232 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $96,635 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$730,246 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $70,853 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | 0 | 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 D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $345,150 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$54,147 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $291,003 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $288,938 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $56,212 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $345,150 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $262,506 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $26,432 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $288,938 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $253,400 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $9,106 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $262,506 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $301,626 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $26,774 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $75,000 | OtherExpendituresAmt |
| End Year Balance | $253,400 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $527,767 | OtherCostOrOtherBasisAmt |
| Book Value | $527,767 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $21,360,619 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,011,134 | DepreciationAmt |
| Book Value | $12,349,485 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $625,516 | OtherCostOrOtherBasisAmt |
| Depreciation | $544,760 | DepreciationAmt |
| Book Value | $80,756 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,580,314 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,869,750 | DepreciationAmt |
| Book Value | $1,710,564 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $406,494 | OtherCostOrOtherBasisAmt |
| Book Value | $406,494 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $15,075,066 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| FUNDED DEPRECIATION | $348,855 |
| FUNDS HELD BY TRUSTEE | $880,601 |
| DUE FROM AFFILIATES | $157,477 |
| PATRONAGE CREDIT ASSETS | $348,301 |
| THIRD PARTY RECEIVABLE | $94,155 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,829,389 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | ENDOWMENT FUNDS ARE INTENDED TO EARN INVESTMENT INCOME. THE INVESTMENT INCOME IS INTENDED TO BE USED FOR FUNDING CAPITAL EXPENDITURES. |
| PART X, LINE 2: | PRAIRIE RIDGE HOSPITAL & HEALTH SERVICES (PRHHS) IS ORGANIZED AS A MINNESOTA NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). PRHHS IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, PRHHS IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. PRHHS HAS DETERMINED THEY ARE NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAS NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990-T) WITH THE IRS. PRHHS BELIEVES 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 CONSOLIDATED FINANCIAL STATEMENTS. PRHHS 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. |
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 |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 175.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 215.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | 0 | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $88,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $88,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00460 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,130,833 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,671,176 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,459,657 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07680 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,218,833 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,671,176 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,547,657 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08140 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $88,117 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $36,102 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $52,015 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $31,400 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $31,400 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,885,594 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,652,414 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,233,180 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06490 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,005,111 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,688,516 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,316,595 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06930 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,223,944 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,359,692 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,864,252 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.15070 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,820 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,820 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $77 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $77 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,897 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,897 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $402,981 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $5,093,151 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $5,062,778 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $30,373 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| 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 | PRAIRIE RIDGE HOSPITAL & HEALTH SERVICES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1411 HIGHWAY 79 EAST | AddressLine1Txt |
| City | ELBOW LAKE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56531 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.PRAIRIEHEALTH.ORG | WebsiteAddressTxt |
| State License | 00154 | 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 |
| Other | 5 PROVIDER-BASED CLINICS | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRAIRIE RIDGE HOSPITAL & HEALTH SERVICES | 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 | 21 | 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 | HTTPS://WWW.LRHC.ORG/HEALTH-WELLNESS/LOCAL-HEALTH-RESOURCES/ | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://WWW.LRHC.ORG/HEALTH-WELLNESS/LOCAL-HEALTH-RESOURCES/ | StrategyWebsiteURLTxt |
| 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 | 175.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 215.000000000000 | 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 | HTTPS://WWW.LRHC.ORG/PATIENTS-VISITORS/PATIENTS/FINANCIAL-SERVICES/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.LRHC.ORG/PATIENTS-VISITORS/PATIENTS/FINANCIAL-SERVICES/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.LRHC.ORG/PATIENTS-VISITORS/PATIENTS/FINANCIAL-SERVICES/ | 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 |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PRAIRIE RIDGE HOSPITAL & HEALTH SERVICES | PART V, SECTION B, LINE 5: PRHHS REFERRED TO THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP (MAPP) FRAMEWORK FOR GUIDANCE IN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. THIS COMMUNITY-WIDE PLANNING AND ACTION-ORIENTED PROCESS WAS DEVELOPED BY THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS IN PARTNERSHIP WITH THE PUBLIC HEALTH PRACTICE PROGRAM OFFICE OF THE CENTERS OF DISEASE CONTROL AND PREVENTION. MAPP IS A COMMUNITY-DRIVEN PROCESS ROOTED ON PARTNERSHIP DEVELOPMENT, ASSESSMENT OF NEEDS AND ASSETS, AND STRATEGIC PLANNING ON HOW TO EFFICIENTLY USE AVAILABLE RESOURCES TO ADDRESS THE PRIORITIZED HEALTH NEEDS. PRHHS COMPLETED TWO ASSESSMENTS IN THE MAPP PROCESS: COMMUNITY THEMES AND STRENGTHS, AND COMMUNITY HEALTH STATUS. PRHHS ALSO HAD INPUT FROM COMMUNITY PARTNERS AND STAKEHOLDERS, ESPECIALLY PUBLIC HEALTH AND THOSE REPRESENTING THE UNDERSERVED AND LOW-INCOME POPULATIONS. |
| PRAIRIE RIDGE HOSPITAL & HEALTH SERVICES | PART V, SECTION B, LINE 11: IN THE MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, LAKE REGION HEALTHCARE CORPORATION IDENTIFIED THE FOLLOWING SIGNIFICANT NEEDS: MENTAL HEALTH, HEALTH EDUCATION AND PREVENTATIVE SERVICES; NUTRITION, PHYSICAL ACTIVITY, AND OBESITY; ACCESS TO HEALTH AND SOCIAL SERVICES; SUBSTANCE AND TOBACCO USE.MENTAL HEALTH - TO HELP US IMPROVE ACCESS TO MENTAL HEALTH EDUCATION, RESOURCES, AND SERVICES, WE ARE FOCUSING ON RECRUITING AND RETAINING MENTAL HEALTH PROVIDERS TO OUR COMMUNITY. WE CONTINUE TO UTILIZE THE DEPRESSION SCREENING PROTOCOL AND ARE COLLABORATING WITH COMMUNITY PARTNERS TO IDENTIFY GAPS AND OPPORTUNITIES IN THIS AREA. ANOTHER FOCUS IS IMPROVING EMPLOYEE ENGAGEMENT AND WELLNESS FOR OUR EMPLOYEES. CURRENTLY THESE DICUSSIONS ARE LED BY PRODUCTIVE ALTERNATIVES INC AND OTTER TAIL COUNTY DEPARTMENT OF HUMAN SERVICES AND INCLUDES REPRESENTATIVES FROM LAW ENFORCEMENT, OTHER HEALTH CARE SYSTEMS, SUBSTANCE ABUSE AND MENTAL HEALTH PROVIDERS AND OTHER INTERSESED STAEKHOLDERS. THE GROUP MET MONTHLY IN 2022 AND PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES PLANS ON CONTINUING TO BE PART OF THIS CONVERSATION AND HELP THE COMMUNITY HAVE IMPROVED ACCESS TO QUALITY MENTAL HEALTH CARE. PRAIRIE RIDGE HEALTHCARE ALONG WITH LAKE REGION HEALTHCARE ADOPTED AN ENTERPRISE-WIDE CENTERED ON YOU INITIATIVE IN 2020. CENTERED ON YOU AIMS TO UPHOLD THE ENTERPRISE'S COMMITMENT TO A PERSON-CENTERED APPROACH AND BEING THE BEST PLACE TO GIVE AND RECEIVE CARE. ONE COMPONENT OF THIS INITIATIVE IS TO CONDUCT AN EMPLOYEE ENGAGEMENT SURVEY PERIODICALLY TO ASSIST WITH GROWTH AND IMPROVEMENT FOR THE ORGANIZATION. THE RESULTS OF THE SURVEY WILL BE USED TO GUIDE FUTURE INITIATIVES AND ACTION PLANS TO PROMOTE AND SUPPORT EMPLOYEE ENGAGEMENT AND TO ENSURE THAT EACH EMPLOYEE FEELS LIKE A VALUED MEMBER OF THE ORGANIZATION.HEALTH EDUCATION AND PREVENTATIVE SERVICES BUILDING AWARENESS AND OFFERING CONVENIENT ACCESS TO SERVICES IN OUR COMMUNITY, TO IN TURN INCRESE UTILIZATION OF THE RECOMMENDED PREVENTATIVE CARE SERVICES. USED VARIOUS TOOLS TO FACILITATE PATIENT OUTREACH. PRHHS CONTINUED TO ENCOURAGE ANNUAL WELLNESS VISITS AND CANCER SCREENINGS AS PART OF THIS INITIATIVE.NUTRITION, PHYSICAL ACTIVITY, AND OBESITY - TO ENCOURAGE HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN THE SERVICE AREA, THE ENTERPRISE (LAKE REGION HEALTHCARE AND PRAIRIE RIDGE HEALTHCARE) WORKED TO CREATE A HEALTHY ENVIRONMENT BY CONTINUING TO LEAD THE ANNUAL COMMUNITY HEALTH EXPO, SUPPORT LIVE WELL FERGUS FALLS AND THEIR INITIATIVES, EXPAND SHOP WITH THE DOC PROGRAM TO IMPROVE ACCESS TO HEALTHY FOOD CHOICES, ESTABLISH WALK WITH THE DOC PROGRAM TO INCREASEACCESS TO PHYSICAL ACTIVITY OPPORTUNITIES, AND ADVOCATE FOR LOCAL BUSINESSES TO ADOPT WORKSITE WELLNESS INITIATIVES. THE ENTERPRISE ALONG WITH PARTNERSHIP4HEALTH AND OTHER MEMBERS OF LIVE WELL FERGUS FALLS WERE STILL ABLE TO WORK TO PROMOTE WORKSITE WELLNESS TO OTHER BUSINESSES IN THECOMMUNITY.IN ADDITION TO CREATING A HEALTHY ENVIRONMENT THROUGH COMMUNITY PROGRAMS, PRHHS WORKED TO IMPROVE ACCESS TO QUALITY PREVENTIVE SERVICES, THROUGH COUNSELING AND EDUCATION ON FOOD AND NUTRITION AND IMPROVING COMPREHENSIVE CARE FOR PATIENTS WITH DIABETES.ACCESS TO HEALTH AND SOCIAL SERVICES TO IMPROVE THE NUMBER OF PATIENTS CONNECTED TO APPROPRIATE HEALTH CARE AND COMMUNITY RESOURCES, WE EXPANDED CARE COORDINATION RESOURCES, IMPLEMENTED SOCIAL HEALTH NEEDS SCREENING, AND PROVIDED COMPREHENSIVE TRANSITIONAL CARE FROM INPATIENT TO OTHER SETTINGS. WE ALSO CONTINUED TO RECRUIT AND RETAIN PROVIDERS TO IMPROVE ACCESS TO HEALTH RESOURCES IN OUR COMMUNITY.SUBSTANCE AND TOBACCO USE:AN ENTERPRISE-WIDE (LAKE REGION HEALTHCARE AND PRAIRIE RIDGE HEALTHCARE) OPIOID SAFETY PROGRAM WAS ESTABLISHED IN NOVEMBER 2019 LED BY A MULTI-DISCIPLINARY OPIOID SAFETY STEERING COMMITTEE TO ENSURE RESPONSIBLE OPIOID PRESCRIBING AND SYSTEMATIC MONITORING. THE FOLLOWING SUBCOMMITTEES WERE FORMED, EACH TASKED WITH IDENTIFYING OPIOID PRACTICE PATTERNS AND DEVELOPING PROCEDURES AND PROGRAMMING TO ENHANCE PATIENT SAFETY AND MITIGATE OPIOID-RELATED RISKS IN THEIR PARTICULAR DOMAIN: (1) ACUTE PAIN MANAGEMENT, (2) AMBULATORY PAIN MANAGEMENT, (3) SUBSTANCE USE DISORDER SERVICES, (4) NON-PHARMACOLOGICAL PAIN MANAGEMENT, (5) CONTROLLED SUBSTANCE DIVERSION PREVENTION AND (6) OPPORTUNITIES, PERFORMANCE IMPROVEMENT AND EDUCATION. THE WORK OF THE STEERING COMMITTEE WAS PUT ON HOLD TO REALLOCATE RESOURCES TOWARDS COVID-19 RESPONSE, BUT BECAME OPERATIVE AGAIN IN CY 2022. EDUCATION AND COMMUNITY TRAININGS ON NARCAN AND OPIOD AWARENESS IS AN ACTIVITY TAKING PLACE TO INCREASE KNOWLEDGE AROUND OPIOID USE.MORE DETAIL ON THE IDENTIFIED SIGNIFICANT HEALTH NEEDS AS WELL AS THE STRATEGIES AND ACTIVITIES DEVELOPED TO ADDRESS THEM CAN BE FOUND ON LAKE REGION HEALTHCARE'S WEBSITE AT HTTPS://WWW.LRHC.ORG/HEALTH-WELLNESS/LOCAL-HEALTH-RESOURCES/ |
| PRAIRIE RIDGE HOSPITAL & HEALTH SERVICES | PART V, SECTION B, LINE 16J: THE HOSPITAL PROVIDED A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WITH THE PATIENT BILLING INVOICES, POSTED A SUMMARY IN THE EMERGENCY ROOMS AND WAITING ROOMS, AS WELL AS THE ADMISSION OFFICE AND THEIR WEBSITE. THE FULL POLICY IS AVAILABLE UPON REQUEST. |
| PRAIRIE RIDGE HOSPITAL & HEALTH SERVICES | PART V, SECTION B, LINE 24: THE FAP POLICY DOES NOT APPLY TO ELECTIVE SERVICES; THEREFORE, FAP ELIGIBLE INDIVIDUALS WERE CHARGED THE GROSS AMOUNT OF ALL ELECTIVE SERVICES. |
| 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 - HERMAN CLINIC | ||||
| 204 5TH STREET EAST | HERMAN | MN | 56248 | PHYSICIAN CLINIC |
| 2 - EVANSVILLE CLINIC | ||||
| 649 1/2 STATE STREET | EVANSVILLE | MN | 56326 | PHYSICIAN CLINIC |
| 3 - HOFFMAN CLINIC | ||||
| 114 MAIN AVENUE | HOFFMAN | MN | 56339 | PHYSICIAN CLINIC |
| 4 - MORRIS CLINIC | ||||
| 114 MAIN AVENUE | HOFFMAN | MN | 56339 | PHYSICIAN CLINIC |
| 5 - ELBOW LAKE CLINIC | ||||
| 1411 HIGHWAY 79 E | ELBOW LAKE | MN | 56531 | PHYSICIAN CLINIC |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | CHARITY CARE WAS CONVERTED TO COST BY MULTIPLYING THE RATIO OF COST TO CHARGES FOR PRHHS BY THE GROSS UNCOMPENSATED CHARGES ASSOCIATED WITH PROVIDING CHARITY CARE TO ITS PATIENTS. MEDICAID IS REPORTED AT COST ACCORDING TO THE AMOUNTS ON THE MEDICAID COST REPORT. COMMUNITY HEALTH IMPROVEMENT SERVICES AND DONATIONS ARE REPORTED BASED ON ACTUAL EXPENSES RECORDED TO THE GENERAL LEDGER. SUBSIDIZED HEALTH SERVICES ARE REPORTED ACCORDING TO COSTS ALLOCATED TO THE RELEVANT COST CENTERS ON THE MEDICARE COST REPORT. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | PRHHS HAS ALLOWED COMMUNITY GROUPS TO USE MEETING ROOMS FREE OF CHARGE TO ASSIST IN THEIR MISSIONS, ALONG WITH VARIOUS CASH DONATIONS GIVEN TO COMMUNITY ORGANIZATIONS. |
| PART III, LINE 2: | BAD DEBT EXPENSE ON LINE 2 IS REPORTED AS CHARGES AS PRESENTED ON THE FINANCIAL STATEMENTS. A PAYMENT ON ACCOUNT PREVIOUSLY WRITTEN OFF REDUCES BAD DEBT EXPENSE IN THE CURRENT YEAR. |
| PART III, LINE 4: | THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS CAN BE FOUND ON PAGE 9 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THE COSTING METHODOLOGY USED TO DETERMINE THE RELATED COSTS IS AN ADJUSTED MEDICARE COST TO CHARGE RATIO BASED ON THE FISCAL YEAR 2022 COST REPORT. |
| PART III, LINE 9B: | FOR PATIENTS UNABLE TO MEET THE COLLECTION GUIDELINES OF PRHHS, NOTICE OF THE CHARITY CARE PROGRAM AND APPROPRIATE FORMS (INCLUDING THE FINANCIAL DISCLOSURE STATEMENT) WILL BE SUPPLIED TO THE PATIENT FOR COMPLETION AND CONSIDERATION IN SATISFYING THE BALANCE REMAINING DUE. ONCE THE PATIENT BEGINS THE APPLICATION PROCESS, PRHHS CEASES ALL COLLECTION ACTION ON THE AMOUNTS BEING CONSIDERED FOR FINANCIAL ASSISTANCE. IF THERE IS A PAYMENT MADE ON THE ACCOUNT DURING THE APPLICATION PROCESS, THE PAYMENT IS APPLIED DIRECTLY TO THE ACCOUNT BALANCE. INDIVIDUALS ARE GIVEN 240 DAYS TO COMPLETE THE FAP APPLICATION. |
| PART VI, LINE 2: | IN ADDITION TO THE CHNA PROCESS THAT TOOK PLACE IN TAX YEARS 2015 AND 2018, THE ORGANIZATION ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITY BASED ON FEEDBACK FROM PHYSICIANS. |
| PART VI, LINE 3: | INFORMATION REGARDING CHARITY CARE IS AVAILABLE IN ADMISSION AREAS AND IN CLINIC PATIENT ROOMS. IF A PATIENT IS PAST DUE ON A BILL, AN ADDITIONAL NOTIFICATION IS GIVEN TO THE PATIENT TO CONTACT THE HOSPITAL TO DISCUSS PAYMENT OPTIONS, INCLUDING CHARITY CARE. THE HOSPITAL PROVIDES COUNSELING TO PATIENTS TO HELP THEM QUALIFY FOR MEDICAID. |
| PART VI, LINE 4: | PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES AREA INCLUDES GRANT COUNTY AND SURROUNDING COUNTIES IN MINNESOTA. THE AVERAGE AGE OF THE POPULATION IS OLDER THAN BOTH THE STATE AND NATIONAL AVERAGES, WHICH LEADS TO HIGHER THAN NORMAL PERCENTAGE OF OLDER PATIENTS WHOM THE HOSPITAL SERVES. THE NEAREST HOSPITAL IS APPROXIMATELY 20 MILES FROM PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES MAIN CAMPUS. |
| PART VI, LINE 5: | THE MOST TANGIBLE WAY PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES PROVIDES COMMUNITY BENEFITS IS THROUGH COMMUNITY PROGRAMS AND SERVICES. IT PROVIDES THESE SERVICES AS A RESPONSIBLE MEMBER OF THE COMMUNITY. EDUCATIONAL PROGRAMS, HEALTHCARE SCREENING, SUPPORT GROUPS, SCHOOL HEALTH SERVICES, AND OTHER COMMUNITY SERVICES ARE PROVIDED BY PRAIRIE RIDGE HOSPITAL TO IMPROVE THE HEALTHCARE AND QUALITY OF LIFE FOR THE PEOPLE IN THE COMMUNITY. |
| PART VI, LINE 6: | LAKE REGION HEALTHCARE FOUNDATION RECEIVES DONATIONS, MEMORIALS, PLEDGES, AND LEADS FUNDRAISING EVENTS. THE FUNDS RECEIVED ARE GRANTED TO LAKE REGION HEALTHCARE AND COMMUNITY ORGANIZATIONS TO SUPPORT PROVIDING QUALITY HEALTHCARE IN THE COMMUNITIES IN OUR SERVICE AREA. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | MN |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KENT MATTSON | ||||||||||||||
| LRH CEO | $0 | $452,807 | $0 | $0 | $0 | $0 | $0 | $22,500 | $0 | $21,661 | $0 | $496,968 | $0 | $0 |
| CAMIE PATTERSON | ||||||||||||||
| CFO | $0 | $359,036 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $21,510 | $0 | $380,546 | $0 | $0 |
| DANIELLE LESMEISTER | ||||||||||||||
| CEO | $149,400 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $17,425 | $0 | $166,825 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 6 | FormAndLineReferenceDesc |
| Explanation | LRHC HAS IMPLEMENTED AN INCENTIVE COMPENSATION PROGRAM FOR CERTAIN EXECUTIVE LEADERSHIP POSITIONS WITHIN THE ORGANIZATION. CERTAIN MEASURES AND GOALS NEED TO BE MET IN ORDER FOR THE COMPENSATION TO BE PAID OUT IN WHOLE, SUCH AS MEETING FINANCIAL PERFORMANCE EXPECTATIONS AND QUALITY METRICS AND SUCCESSFUL IMPLEMENTATION OF STRATEGIC GOALS. THE EXECUTIVE COMMITTEE OF THE BOARD REVIEWS PERFORMANCE ANNUALLY AND DETERMINES ANY AMOUNTS OF COMPENSATION THAT IS AWARDED. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | LAKE REGION HEALTHCARE CORPORATION ("LAKE REGION"), A MINNESOTA NONPROFIT CORPORATION, IS THE SOLE CORPORATE MEMBER OF THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | LAKE REGION HAS RESERVED EXCLUSIVELY TO ITSELF THE POWER TO APPOINT BOARD MEMBERS FROM A SLATE OF CANDIDATES NOMINATED BY THE CORPORATION'S BOARD. |
| FORM 990, PART VI, SECTION A, LINE 7B | LAKE REGION HAS RESERVED EXCLUSIVELY TO ITSELF THE FOLLOWING RESERVED POWERS: A) APPROVAL OF OPERATING AND CAPITAL BUDGET RECOMMENDED BY THE CORPORATION'S BOARD; B) APPROVAL OF STRATEGIC CAPITAL PLAN RECOMMENDED BY THE CORPORATION'S BOARD; C) APPROVAL OF ANY RECOMMENDATIONS BY THE CORPORATION'S BOARD TO SUBSTANTIALLY CHANGE ITS PURPOSE OR MISSION OR TRANSFER OF ASSETS; D) AMENDMENT OF ARTICLES OF INCORPORATION, BYLAWS, AND OTHER CORPORATE DOCUMENTS; E) APPROVAL OF CONTRACTS INVOLVING PHYSICIANS OR OTHER PROVIDERS, FOR COMPLIANCE PURPOSES ONLY; F) BOARD MEMBER APPOINTMENT, FOR A SLATE OF CANDIDATES NOMINATED BY THE CORPORATION'S BOARD; G) APPROVAL OF INCURRENCE OF DEBT IN EXCESS OF THRESHOLDS ESTABLISHED BY LAKE REGION POLICY; H) APPROVAL OF JOINT VENTURES OR PARTNERSHIPS PROPOSED TO BE ENTERED INTO BY THE CORPORATION; AND I) APPROVAL OF THE CREATION BY THE CORPORATION OF ANY NEW CORPORATION, LIMITED LIABILITY COMPANY, OR OTHER ENTITY. |
| FORM 990, PART VI, SECTION A, LINE 8B | CURRENTLY THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE RETURN WAS REVIEWED BY BOTH LRHC AND PRHHS CEOS, THEN FOLLOWED BY A REVIEW BY THE PRHHS BOARD OF DIRECTORS PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY IS REVIEWED ON AN ANNUAL BASIS BY THE BOARD OF DIRECTORS. BOARD MEMBERS, OFFICERS, AND MANAGEMENT PERSONNEL ARE ASKED TO DISCLOSE ANY POTENTIAL CONFLICTS. ANY POTENTIAL CONFLICTS ARE REVIEWED AT THAT TIME, AND ANY ACTUAL CONFLICTS ARE NOTED IN THE MEETING MINUTES. ANY PERSON WITH A CONFLICT IS RESTRICTED FROM VOTING ON ALL MATTERS RELATED TO THE CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PHYSICIAN SERVICE FEES: PROGRAM SERVICE EXPENSES 2,430,653. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,430,653. ON CALL PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 779,936. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 779,936. COLLECTION FEES: PROGRAM SERVICE EXPENSES 13,870. MANAGEMENT AND GENERAL EXPENSES 5,127. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,997. OUTSIDE LAUNDRY FEES: PROGRAM SERVICE EXPENSES 21,813. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,813. MISC PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,063,959. MANAGEMENT AND GENERAL EXPENSES 762,940. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,826,899. OUTSIDE CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 5,876. MANAGEMENT AND GENERAL EXPENSES 2,172. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,048. PHARMACY SERVICE FEES: PROGRAM SERVICE EXPENSES 27,812. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 27,812. |
| FORM 990, PART XI, LINE 9: | ENDOWMENT EARNINGS 18,913. NET ASSETS RELEASED FROM RESTRICTION 125,000. CHANGE IN UNREALIZED LOSSES ON INVESTMENTS -73,060. |
| FORM 990, PART XII, LINE 3B: | SINGLE AUDIT WILL BE COMPLETED BY 6/30/23 DEADLINE |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| PRAIRIE RIDGE FOUNDATION INC | |||||||||||
| 1411 HIGHWAY 79 EAST | ELBOW LAKE | MN | 56531 | 455092280 | FUNDRAISING | MN | 501(C)(3) | LINE 7 | PRAIRIE RIDGE HOSPITAL & HEALTH SERVICES | Yes (1) | |
| LAKE REGION HEALTHCARE CORPORATION | |||||||||||
| 712 SOUTH CASCADE STREET | FERGUS FALLS | MN | 56538 | 410730602 | HOSPITAL | MN | 501(C)(3) | LINE 3 | 0 | N/A | |
| LAKE REGION HEALTHCARE FOUNDATION | |||||||||||
| 712 SOUTH CASCADE STREET | FERGUS FALLS | MN | 56538 | 411677288 | FUNDRAISING | MN | 501(C)(3) | LINE 12A, I | LAKE REGION HEALTHCARE CORPORATION | 0 | |
| LRHC LONG-TERM CARE FACILITIES INC | |||||||||||
| 712 SOUTH CASCADE STREET | FERGUS FALLS | MN | 56538 | 411817549 | ASSISTED LIVING | MN | 501(C)(3) | LINE 10 | LAKE REGION HEALTHCARE CORPORATION | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LRH RAD ONC SERVICES | ||||||||||||||
| 712 SOUTH CASCADE STREET | FERGUS FALLS | MN | 56538 | 271322270 | RADIATION & ONCOLOGY SERVICES | MN | N/A | 0 | 0 | |||||
| RURAL HEALTH ALLIANCE LLC | ||||||||||||||
| 1210 BROADWAY STE 240 271 | ALEXANDRIA | MN | 56308 | 020738699 | EQUIPMENT SALES | MN | 0 | Yes (1) | PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES INC | RELATED | $17,826 | $69,819 | 0.10000 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |