2023-08-14T12:10:13-05:00 2022-09-30 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2021-10-01 411763968 PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES INC PRAI 2186857300 1411 HIGHWAY 79 EAST ELBOW LAKE MN 56531 CAMIE PATTERSON CFO 2186857300 2023-08-13 1 CAMIE PATTERSON 999009999 DARRYN MCGARVEY P00958683 6123764500 2023-08-13 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z PRAIRIE RIDGE HEALTHCARE DANIELLE LESMEISTER 1411 HIGHWAY 79 EAST ELBOW LAKE MN 56531 19110787 0 X WWW.PRAIRIEHEALTH.ORG X 1993 MN WE PARTNER TO ENRICH LIFE THROUGH HEALTH. 7 7 149 1 0 0 352033 550185 18048286 17998889 85467 196392 272676 353428 18758462 19098894 0 0 0 0 6060197 6230655 0 0 0 13450435 12771604 19510632 19002259 -752170 96635 34170156 30674232 24882699 21949533 9287457 8724699 WE PARTNER TO ENRICH LIFE THROUGH HEALTH. 0 0 15239295 0 17998889 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. 15239295 1 1 0 0 0 0 0 0 0 1 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 149 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 MN X X PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES 2186857300 1411 HIGHWAY 79 EAST ELBOW LAKE MN 56531 JAY MCNAMAR CHAIR AS OF OCT 2021 1.50 0.00 X X 660 0 0 CRYSTAL ADAMS DIRECTOR 1.50 6.00 X 660 0 0 JEFF DREIER DIRECTOR 1.50 0.20 X 660 0 0 JEANNE ENNEN DIRECTOR 1.50 0.00 X 660 0 0 RICHARD LAMBERT DIRECTOR 1.50 4.00 X 660 0 0 DUSTIN SPERR VICE CHAIR/SECRETARY 2.50 0.00 X 660 0 0 LARRY GOETZINGER DIRECTOR 1.50 0.00 X 660 0 0 GENE WENSTROM CHAIR THROUGH OCT 2021 1.50 0.00 X X 550 0 0 KENT MATTSON LRH CEO 1.00 39.00 X 0 452807 44161 CAMIE PATTERSON CFO 1.00 39.00 X 0 359036 21510 DANIELLE LESMEISTER CEO 40.00 0.00 X 149400 0 17425 JAY THOMPSON PHARMICIST 40.00 0.00 X 113627 0 6206 268197 811843 89302 2 0 1 0 LAKE REGION HEALTHCARE CORPORATION 712 S CASCADE STREET FERGUS FALLS MN 56538 PROFESSIONAL/PHYSICIAN SERVICES 4073505 SONRISA MEDICAL CARE PA 19796 510TH AVENUE MORRIS MN 56267 PHYSICIAN SERVICES 526505 MIDWEST SURGICARE LLC 24 EAST 7TH STREET MORRIS MN 56267 SURGICAL SERVICES 487000 WEST CENTRAL INTERNAL MEDICINE PO BOX 410 MORRIS MN 56267 PHYSICIAN SERVICES 397852 DMS IMAGING INC PO BOX 670747 DALLAS TX 75267 RADIOLOGY SERVICES 363344 7 5575 458758 85852 550185 PATIENT SERVICE REVENUE 623000 17834023 17834023 PHARMACY 340B REVENUE 623000 164866 164866 17998889 163004 163004 45281 0 11893 45281 -11893 33388 33388 MISCELLANEOUS REVENUE 623000 166358 166358 CAFETERIA REVENUE 623000 123515 123515 OUTSIDE SERVICES REVENUE 623000 51424 51424 12131 12131 353428 19098894 17998889 0 549820 X 166825 166825 4948817 3613202 1335615 76233 55659 20574 663393 484353 179040 375387 274075 101312 4072 4072 85107 85107 6114158 5343919 770239 89280 65185 24095 504858 504858 592538 485178 107360 72429 67251 5178 737380 603776 133604 1494631 1423116 71515 98996 98996 MEDICAL SUPPLIES 1705836 1705836 REPAIRS & MAINTENANCE 552277 452211 100066 RENT EXPENSE 250219 204882 45337 MN HEALTH TAX/SURCHARGE 212054 212054 257769 149602 108167 19002259 15239295 3762964 0 8127711 6115902 569515 1059848 4260405 3645430 200511 222513 138382 133081 31500710 16425644 15600567 15075066 3623730 2553149 46946 39854 1602389 1829389 34170156 30674232 2572381 2771286 19814422 19178247 2495896 0 24882699 21949533 X 8942307 8433696 345150 291003 9287457 8724699 34170156 30674232 X 96635 -730246 70853 X X 0 1 X 1 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 345150 -54147 291003 288938 56212 345150 262506 26432 288938 253400 9106 262506 301626 26774 75000 253400 0.00000 1.00000 0.00000 0 0 527767 527767 21360619 9011134 12349485 625516 544760 80756 8580314 6869750 1710564 406494 406494 15075066 FUNDED DEPRECIATION 348855 FUNDS HELD BY TRUSTEE 880601 DUE FROM AFFILIATES 157477 PATRONAGE CREDIT ASSETS 348301 THIRD PARTY RECEIVABLE 94155 1829389 X 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. 1 1 X 1 X 175.000000000000 1 X 215.000000000000 1 0 0 88000 88000 0.00460 3130833 1671176 1459657 0.07680 3218833 1671176 1547657 0.08140 88117 36102 52015 0.00270 31400 31400 0.00170 2885594 1652414 1233180 0.06490 3005111 1688516 1316595 0.06930 6223944 3359692 2864252 0.15070 1820 1820 0.00010 77 77 0.00000 1897 1897 0.00010 1 402981 5093151 5062778 30373 X 1 1 1 1 PRAIRIE RIDGE HOSPITAL & HEALTH SERVICES 1411 HIGHWAY 79 EAST ELBOW LAKE MN 56531 WWW.PRAIRIEHEALTH.ORG 00154 X X X X 5 PROVIDER-BASED CLINICS PRAIRIE RIDGE HOSPITAL & HEALTH SERVICES 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X HTTPS://WWW.LRHC.ORG/HEALTH-WELLNESS/LOCAL-HEALTH-RESOURCES/ 1 21 1 HTTPS://WWW.LRHC.ORG/HEALTH-WELLNESS/LOCAL-HEALTH-RESOURCES/ 0 1 X 175.000000000000 215.000000000000 X X X 1 1 X X X X 1 X HTTPS://WWW.LRHC.ORG/PATIENTS-VISITORS/PATIENTS/FINANCIAL-SERVICES/ X HTTPS://WWW.LRHC.ORG/PATIENTS-VISITORS/PATIENTS/FINANCIAL-SERVICES/ X HTTPS://WWW.LRHC.ORG/PATIENTS-VISITORS/PATIENTS/FINANCIAL-SERVICES/ X X X X X X 1 X 0 X X X 1 X 0 1 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. 5 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 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 0 0 0 0 0 0 1 0 0 KENT MATTSON LRH CEO 0 452807 0 0 0 0 0 22500 0 21661 0 496968 0 0 CAMIE PATTERSON CFO 0 359036 0 0 0 0 0 0 0 21510 0 380546 0 0 DANIELLE LESMEISTER CEO 149400 0 0 0 0 0 0 0 17425 0 166825 0 0 0 PART I, LINE 6 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. 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 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 1 LAKE REGION HEALTHCARE CORPORATION 712 SOUTH CASCADE STREET FERGUS FALLS MN 56538 410730602 HOSPITAL MN 501(C)(3) LINE 3 N/A 0 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 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 PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES INC RELATED 17826 69819 0 1 0.10000 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0