2023-08-14T11:04:03-05:00 2022-09-30 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2021-10-01 410730602 LAKE REGION HEALTHCARE CORPORATION LAKE 2187368000 712 SOUTH CASCADE STREET FERGUS FALLS MN 56538 CAMIE PATTERSON CFO 2187368000 2023-08-11 1 CAMIE PATTERSON 999009999 MACKENZIE MCNAUGHTON P02025805 6123764500 2023-08-11 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z KENT MATTSON 712 SOUTH CASCADE STREET FERGUS FALLS MN 56538 148030991 0 X WWW.LRHC.ORG X 1951 MN WE PARTNER TO ENRICH LIFE THROUGH HEALTH. 14 14 1015 59 248106 0 1013555 4329876 129751270 134539509 1665073 2562522 9891097 6521953 142320995 147953860 82163 87134 0 0 51091964 54363008 0 0 0 87820471 87748212 138994598 142198354 3326397 5755506 173065629 165940026 57174844 53897891 115890785 112042135 X WE PARTNER TO ENRICH LIFE THROUGH HEALTH. 0 0 92185448 87134 103105993 LAKE REGION HEALTHCARE CORPORATION IS A NOT-FOR-PROFIT PROVIDER OF HEALTH CARE SERVICES OPERATING A 108-BED HOSPITAL COMPRISED OF A 94-BED ACUTE HOSPITAL, A 14-BED PSYCHIATRIC UNIT, AND MULTIPLE CLINIC SITES. OUR PURPOSE IS TO MEET THE HEALTH CARE NEEDS OF THE PEOPLE IN WEST CENTRAL MINNESOTA. WE WILL CREATE AN EXCEPTIONAL, INNOVATIVE, AND PERSONAL HEALTHCARE EXPERIENCE THAT ALLOWS PEOPLE TO EXCEL AND OUR COMMUNITIES TO THRIVE. OUR CORE VALUES INCLUDE EXCELLENCE, PERSON-CENTERED, RESPECT, INTEGRITY, INNOVATION, COLLABORATION & STEWARDSHIP. LAKE REGION HEALTHCARE CORPORATION IS A PROVIDER OF QUALITY HEALTH CARE SERVICES, AS NOTED BY OUR ACCREDITATION BY THE JOINT COMMISSION. SERVICES THAT LAKE REGION HEALTHCARE PROVIDES INCLUDE MEDICAL/SURGICAL, PEDS, OB GYN, ICCU, RADIOLOGY/INTERVENTIONAL RADIOLOGY, OCCUPATIONAL THERAPY, PHYSICAL THERAPY, SPEECH THERAPY, RESPIRATORY CARE, SOCIAL WORK, SURGERY, ONCOLOGY, BIRTHING SUITES, CARDIAC REHAB/ECP, EMERGENCY SERVICES, COMMUNITY WELLNESS, AND LABORATORY. 27926205 0 31234421 LAKE REGION HEALTHCARE OFFERS CLINICAL SERVICES IN FOUR COMMUNITIES AND A WALK-IN CLINIC. SPECIALTIES OFFERED THROUGH CLINIC SERVICES INCLUDE CARDIOLOGY, OB GYN, PEDIATRICS, OPHTHALMOLOGY, FAMILY MEDICINE, INTERNAL MEDICINE, UROLOGY, DERMATOLOGY, ENT, ALLERGY, AUDIOLOGY, PODIATRY, PULMONOLOGY, SPORTS MEDICINE, SURGERY, AND ORTHOPEDICS. 120111653 1 1 0 1 0 0 0 0 0 0 1 1 0 1 0 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 110 0 1 1015 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 14 14 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X X LAKE REGION HEALTHCARE CORPORATION 2187368000 712 S CASCADE ST FERGUS FALLS MN 56537 CRYSTAL ADAMS TRUSTEE 4.00 1.50 X 0 0 0 JOHN ERICKSON BOARD CHAIR 8.00 0.00 X X 0 0 0 CARRIE BRIMHALL VICE CHAIR 5.00 0.00 X X 0 0 0 LAUREL NELSON SECRETARY 5.00 0.00 X X 0 0 0 SCOTT BAUER TRUSTEE 4.00 0.00 X 0 0 0 DEB FERGUSON TRUSTEE 4.00 0.00 X 0 0 0 CHUCK MCFARLANE TRUSTEE 4.00 0.00 X 0 0 0 MATTHEW MOUSER MD TRUSTEE 4.00 0.00 X 0 0 0 JERRY NESS TRUSTEE 4.00 0.00 X 0 0 0 ERIN PETERSON MD TRUSTEE 4.00 0.00 X 0 0 0 JUSTIN ANDERSON TRUSTEE 4.00 0.00 X 0 0 0 WADE SWENSON MD TRUSTEE 4.00 0.00 X 0 0 0 REBECCA BOESL TRUSTEE 4.00 0.00 X 0 0 0 JEANNE ENNEN TRUSTEE 4.00 1.50 X 0 0 0 KENT MATTSON CEO 40.00 0.00 X 452807 0 44161 ROBERTA YOUNG CNO 40.00 0.00 X 247761 0 17735 DANIELLE LESMEISTER PRAIRIE RIDGE CEO 0.00 40.00 X 0 149400 17425 WADE JYRKAS CIO 40.00 0.00 X 132559 0 16701 KATIE JOHNSON VP OF MARKETING & COMMUNICATIONS 40.00 0.00 X 107483 0 16598 LUKE DRAXTEN VP OF PHYSICIAN SERVICES 40.00 0.00 X 112330 0 13561 CAMIE PATTERSON CFO 40.00 0.00 X 359036 0 21510 KATHY BURVILLE VP OF AMBULATORY AND PROFESSIONAL SERVICES 40.00 0.00 X 25094 0 23 MICHAEL SIEMS MILL STREET RESIDENCE DIRECTOR 0.00 40.00 X 0 64159 0 FRITZ KARSNIA ANESTHESIA DIRECTOR 40.00 0.00 X 265675 0 13235 JASON ZOSEL CRNA 40.00 0.00 X 238965 0 13059 KYLE ELLISON CRNA 40.00 0.00 X 237152 0 12833 MARK SCHULZ CRNA 40.00 0.00 X 244877 0 12811 HENRIK BJORNDAHL CRNA 40.00 0.00 X 252883 0 12811 2676622 213559 212463 63 0 1 0 LAKE REGION MEDICAL GROUP 712 S CASCADE STREET FERGUS FALLS MN 56538 PHYSICIAN SERVICES 28802026 MEDICAL SOLUTIONS LLC 1010 NORTH 102ND STREET OMAHA NE 68114 CONTRACTED LABOR 2635673 MAYO COLLABORATIVE SERVICES PO BOX 9146 MINNEAPOLIS MN 58480 LAB SERVICES 814662 VIRTUAL RADIOLOGIC PROFESSIONALS 25983 NETWORK PL CHICAGO IL 60673 RADIOLOGY SERVICES 753800 CHANGE HEALTHCARE PO BOX 98347 CHICAGO IL 60693 IT SERVICES 736258 29 4130581 199295 4329876 PATIENT CARE SERVICES 623000 134539509 134340414 199095 134539509 2085823 2085823 896019 77131 818888 818888 818888 476560 139 0 0 476560 139 476699 476699 OUTSIDE SERVICE REVENUE 623000 5032083 5032083 OPTICAL SALES 446199 731813 49011 682802 CAFETERIA REVENUE 623000 445903 445903 -506734 -506734 5703065 147953860 134340414 248106 9035464 X 87134 87134 1292271 1292271 43093749 29731239 13362510 814855 562185 252670 5828197 4020990 1807207 3333936 2300149 1033787 147823 147823 149315 149315 140033 140033 39828773 39828773 495213 342071 153142 599819 599819 2376878 2081342 295536 115033 66382 48651 3689 3230 459 737397 608915 128482 4599133 2942078 1657055 871862 871862 SUPPLIES 27134136 27134136 REPAIRS AND MAINTENANCE 5987825 5243311 744514 MN HEALTH SURCHARGE 2362219 2362219 MISCELLANEOUS 2199064 1925637 273427 142198354 120111653 22086701 0 23271617 3681710 224505 44381 21862005 22514017 10105640 2019224 2568390 2593400 2095950 1530535 143956843 83364699 56901173 60592144 39538407 43274242 2314823 17883115 14183119 11807258 173065629 165940026 14097338 13421268 34642689 40476623 8434817 0 57174844 53897891 X 0 0 0 0 115890785 112042135 115890785 112042135 173065629 165940026 X 5755506 -12284671 2680515 X X 0 1 X 1 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 7044 0 0 0 7044 0 PART II-B, LINE 1: LAKE REGION HEALTHCARE PAID A PERCENT OF THEIR MHA DUES FOR LOBBYING PURPOSES. 3078849 3078849 91775781 49167266 42608515 161387 79393 81994 44748671 34118040 10630631 4192155 4192155 60592144 782424 C EMPLOYEE DEFERRED COMPENSATION INVESTMENT 94313 C FUNDS HELD BY TRUSTEE 17006378 C 17883115 FUNDED DEPRECIATION 11327564 WORKERS COMPENSATION INSURANCE DEPOSITS 148674 DUE FROM AFFILIATES 28049 THIRD PARTY PAYOR SETTLEMENTS 302971 11807258 X PART X, LINE 2: LRHC 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). THIS ENTITY IS REQUIRED ANNUALLY TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THIS ENTITY MAY BE SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. LRHC FILES AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990-T) WITH THE IRS TO REPORT ITS UNRELATED BUSINESS TAXABLE INCOME. MEDICAL BUILDING IS A MINNESOTA LIMITED LIABILITY COMPANY SOLELY OWNED BY LRHC AND RECOGNIZED BY THE IRS FOR U.S. FEDERAL INCOME TAX PURPOSES AS A PASS-THROUGH ENTITY AND IS TREATED AS A "DISREGARDED ENTITY" FOR TAX PURPOSES AND WILL BE INCLUDED IN SCHEDULE R OF LRHC'S IRS FORM 990. THE CORPORATION 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 CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION 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 1 0 0 442000 442000 0.00310 21313948 12613690 8700258 0.06120 21755948 12613690 9142258 0.06430 50733 50733 0.00040 473293 473293 0.00330 4320 4320 0.00000 528346 528346 0.00370 22284294 12613690 9670604 0.06800 2 18750 18750 0.00010 70770 70770 0.00050 2 89520 89520 0.00060 2900467 22687127 24653583 -1966456 X 1 1 1 LRH RAD ONC SERVICES RADIATION ONCOLOGY 0.50000 0.00000 0.50000 1 1 LAKE REGION HEALTHCARE CORPORATION 712 S CASCADE STREET FERGUS FALLS MN 56537 WWW.LRHC.ORG 00437 X X X 5 PROVIDER-BASED CLINICS AND 1 CANCER CENTER LAKE REGION HEALTHCARE CORPORATION 1 0 0 1 X X X X X X X X X 21 1 1 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 1 X HTTPS://WWW.LRHC.ORG/PATIENTS-VISITORS/PATIENTS/FINANCIAL-SERVICES/ X HTTP://WWW.LRHC.ORG/PATIENTS-VISITORS/PATIENTS/FINANCIAL-SERVICES/ X HTTP://WWW.LRHC.ORG/PATIENTS-VISITORS/PATIENTS/FINANCIAL-SERVICES/ X X X X X 1 X 0 X X X 1 X 0 1 LAKE REGION HEALTHCARE CORPORATION PART V, SECTION B, LINE 5: LAKE REGION HEALTHCARE CORPORATION - LAKEREGION REFERRED TO THE MOBILIZING FOR ACTION THROUGH PLANNING ANDPARTNERSHIP (MAPP) FRAMEWORK FOR GUIDANCE IN THE COMMUNITY HEALTH NEEDSASSESSMENT PROCESS. THIS COMMUNITY-WIDE PLANNING AND ACTION ORIENTEDPROCESS WAS DEVELOPED BY THE NATIONAL ASSOCIATION OF COUNTY AND CITYHEALTH OFFICIALS IN PARTNERSHIP WITH THE PUBLIC HEALTH PRACTICE PROGRAMOFFICE OF THE CENTERS FOR DISEASE CONTROL AND PREVENTION. MAPP IS ACOMMUNITY-DRIVEN PROCESS ROOTED ON PARTNERSHIP DEVELOPMENT. ASSESSMENT OFNEEDS AND ASSETS AND STRATEGIC PLANNING ON HOW TO EFFICIENTLY USEAVAILABLE RESOURCES TO ADDRESS THE PRIORITIZED HEALTH NEEDS. LRH COMPLETEDTWO ASSESSMENTS IN THE MAPP PROCESS: COMMUNITY THEMES AND STRENGTHS, ANDCOMMUNITY HEALTH STATUS. LRH ALSO HAD INPUT FROM COMMUNITY PARTNERS ANDSTAKEHOLDERS, ESPECIALLY PUBLIC HEALTH AND THOSE REPRESENTING THEUNDESERVED AND LOW-INCOME POPULATIONS. LAKE REGION HEALTHCARE CORPORATION PART V, SECTION B, LINE 6A: PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES LAKE REGION HEALTHCARE CORPORATION 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: 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.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. LAKE REGION HEALTHCARE CORPORATION CONTINUED TO REFER APPROPRIATE PRENATAL OR POSTPARTUM PATIENTS TO THE COUNTY'S HOME VISITING PROGRAM, ANDPROMOTE THRIVE AND PERSON-CENTERED ACTIVITIES AMONG STAFF, PROVIDERS,AND THE COMMUNITY. NUTRITION, PHYSICAL ACTIVITY, AND OBESITY - TO ENCOURAGE HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN THE SERVICE AREA, LRH 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. LAKE REGION HEALTHCARE ALONG WITH PARTNERSHIP4HEALTH AND OTHER MEMBERS OF LIVE WELL FERGUS FALLS WERE STILL ABLE TO WORK TO PROMOTE WORKSITE WELLNESS TO OTHER BUSINESSES IN THE COMMUNITY. IN ADDITION TO CREATING A HEALTHY ENVIRONMENT THROUGH COMMUNITY PROGRAMS,LRH WORKED TO IMPROVE ACCESS TO QUALITY PREVENTIVE SERVICES, THROUGH OFFERING "I CAN PREVENT DIABETES" CLASSES FOR FREE, GROWING THE LIFESTYLE MEDICINE PROGRAM, UTILIZING PRE-VISIT PLANNING.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 ABUSE - CHEMICAL DEPENDENCE WAS ONE OF THE CONCERNS FREQUENTLY BROUGHT UP IN OUR FOCUS GROUP SESSIONS. AS IS THE CASE ACROSS THE ENTIRE COUNTRY, ADDICTION TO OPIOIDS, HEROIN AND METHAMPHETAMINE IS ALSO A GROWING THREAT IN OUR COMMUNITY. AS PART OF OUR RESPONSE, LAKE REGIONHEALTHCARE IS ONE OF EIGHT PILOT SITES ACROSS THE STATE FOLLOWING THE TACKLING OPIOID USE WITH NETWORKS (TOWN) MODEL FUNDED THROUGH THE MINNESOTA DEPARTMENT OF HEALTH TO HELP PREVENT OPIOID MISUSE AND OVERDOSE. THE TOWN MODEL INTEGRATES PREVENTION AND TREATMENT STRATEGIES AT THE HEALTH CARE SYSTEM AND IN SURROUNDING COMMUNITY TO: (1) CREATE COORDINATED CLINICAL CARE TEAMS, (2) IMPROVE THE PRESCRIBING CULTURE BY PROVIDING EDUCATION TO PROVIDERS AND PHARMACISTS ON APPROPRIATE OPIOID AND NALOXONE PRESCRIBING AND DISPENSING, (3) INCREASE COORDINATION ACROSS COMMUNITY SECTORS AND REDUCE TREATMENT GAPS FOR INDIVIDUALS WITH OPIOID USE DISORDER BY STRENGTHENING PARTNERSHIPS WITH LAW ENFORCEMENT AND OTHER COMMUNITY SECTORS AND (4) INCREASE REFERRALS FOR NEEDED SERVICES BY BRINGING TOGETHER INTERDISCIPLINARY AND INTERAGENCY TEAMS TO BE REPRESENTED IN EACH COMMUNITY TASK FORCE. LAKE REGION HEALTHCARE ENGAGED AND EDUCATED ITS PROVIDERS ON MINNESOTA AND CDC OPIOID PRESCRIBING GUIDELINES, ENCOURAGED THE USE OF THE CONTROLLED SUSBTANCE CARE PLAN FOR PATIENTS ON CHRONIC OPIOID THERAPY OR WITH CONCOMITANT USE OF BENZODIAZEPINES, AND COLLABORATED WITH COMMUNITY PARTNERS TO IDENTIFY AND IMPLEMENT POTENTIAL EFFECTIVE ENVIRONMNETAL STRATEGIES TO ADDRESS OPIOID ABUSE/MISUSE THROUGH THE OTTER TAIL COUNTY OPIOID ABUSE PREVENTION TASK FORCE. ADDITIONALLY, LAKE REGION HEALTHCARE CORPORATION ESTABLISHED AN OPIOID SAFETY PROGRAM LED BY THE OPIOID SAFETY STEERING COMMITTEE IN NOVEMBER 2019 TO ENSURE RESPONSIBLE OPIOID PRESCRIBING AND SYSTEMATIC MONITORING. ANOTHER STRATEGY OF LAKE REGION HEALTHCARE IN FISCAL YEAR 2022 WAS TOEXPAND ACCESS TO NALOXONE THROUGH EDUCATING PROVIDERS ON RECOMMENDATIONS REGARDING WHEN TO PRESCRIBE OR CO-PRESCRIBE NALOXONE AND HOST COMMUNITY NARCAN TRAINING. RESOURCES FOR THESE PROGRAMS WERE DIVERTED TO RESPOND TO THE COVID-19 PANDEMIC AND WE WERE NOT ABLE TO PREPARE AND PRESENT PROVIDER EDUCATION ON NALOXONE PRESCRIBING GUIDELINES. WE ARE CURRENTLY WORKINGWITH OUR PHARMACY DEPARTMENT TO DEVELOP EDUCATION MATERIALS TO BE SHARED WITH ALL THE PROVIDERS AS PART OF THEIR ANNUAL EDUCATION IN 2022. SIMILARLY, WE WERE NOT ABLE TO HOST COMMUNITY TRAININGS ON NARCAN AND OPIOID AWARENESS. DEPENDING ON THE COVID SITUATION IN OUR COMMUNITY, WE HOPE TO BE ABLE TO WORK WITH COMMUNITY PARTNERS AND FACILITATE COMMUNITY EDUCATION SESSIONS IN CALENDAR YEAR 2022.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/ LAKE REGION HEALTHCARE CORPORATION PART V, SECTION B, LINE 24: THE FAP POLICY DOES NOT APPLY TO ELECTIVE SERVICES; THEREFORE, FAP ELIGIBLE INDIVIDUALS WERE CHARGED THE GROSS AMOUNT FOR ALL ELECTIVE SERVICES. 6 1 - ASHBY CLINIC 110 COUNTY ROAD 82 EAST ASHBY MN 56309 CLINIC 2 - BARNESVILLE AREA CLINIC 209 SECOND STREET SOUTHEAST BARNESVILLE MN 56514 CLINIC 3 - BATTLE LAKE CLINIC 410 LAKE AVENUE SOUTH BATTLE LAKE MN 56515 CLINIC 4 - MAIN FERGUS FALLS CLINIC 111 WEST VERNON AVENUE FERGUS FALLS MN 56537 CLINIC 5 - WALK-IN CLINIC 2311 WEST LINCOLN AVENUE FERGUS FALLS MN 56537 CLINIC 6 - CANCER CENTER 908 SOUTH CASCADE STREET FERGUS FALLS MN 56537 CANCER TREATMENT CENTER PART I, LINE 7: THE COST METHODOLOGY USED TO DETERMINE THE AMOUNTS IN LINE 7A-7D AND 7G IS THE ADJUSTED MEDICARE COST TO CHARGE RATIO ON THE 2021 COST REPORT. THE COST METHODOLOGY USED TO DETERMINE THE AMOUNTS IN LINE 7E, 7F, AND 7I ARE THE ACTUAL COSTS INCURRED AND RECORDED IN THE GENERAL LEDGER AND FINANCIAL STATEMENTS. PART II, COMMUNITY BUILDING ACTIVITIES: IN THE PAST YEAR, LRHC HAS PARTICIPATED IN A COMMUNITY GROUP FOCUSED ON DEVELOPING A COMMUNITY VISION AND ECONOMIC DEVELOPMENT. LRHC ALSO 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 AT CHARGES AS PRESENTED ON THE FINANCIAL STATEMENTS. PART III, LINE 4: THE FOOTNOTE TO THE FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE IS LOCATED IN FOOTNOTE 1 ON PAGE 11 OF THE ATTACHED 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 2021 COST REPORT. PART III, LINE 9B: THE COLLECTION POLICY STATES THAT CERTAIN INDIVIDUALS WITH VERY LIMITED MEANS MAY NOT BE ABLE TO MEET THE ACCEPTABLE PAYMENT GUIDELINES. WHEN THIS OCCURS, THE COLLECTION STAFF WILL EXHAUST EVERY CONSIDERATION TO RESOLVE THE ACCOUNTS, SUCH AS APPLICATIONS FROM MEDICAL AND GENERAL ASSISTANCE AND THE HOSPITAL CHARITY CARE PROGRAM. APPLICATIONS FOR CHARITY CARE ARE PROVIDED UPON REQUEST OR WHEN A PATIENT DEMONSTRATES THE NEED FOR THE CHARITY CARE PROGRAM ASSISTANCE. PART VI, LINE 2: ONE OF LAKE REGION HEALTHCARE'S GUIDING PRINCIPLES IS TO PROVIDE A HEALTHCARE SYSTEM THAT IS RESPECTFUL AND RESPONSIVE TO THEIR CUSTOMERS' NEEDS. IT IS ASSESSED ON A CONTINUAL BASIS. PERIODICALLY, LAKE REGION HEALTHCARE WORKS WITH OTTERTAIL COUNTY DEPARTMENT OF HEALTH TO PERFORM A FORMAL NEEDS ASSESSMENT OF THE COMMUNITY IT SERVES. PART VI, LINE 3: FOR THE UNINSURED AND SELF-PAY DISCOUNT, LAKE REGION HEALTHCARE FOLLOWS UP WITH A PHONE CALL TO SEE IF THEY RECEIVED THE LETTER AND DISCUSS THE PATIENTS' OPTIONS. ONCE IN THE COLLECTION PROCESS, PATIENTS WILL BE ASSESSED AS TO WHETHER OR NOT THEY WOULD BE ELIGIBLE FORTHE UNINSURED/SELF-PAY DISCOUNT. INPATIENTS ARE VISITED BY A PATIENTFINANCIAL SERVICES STAFF MEMBER TO EXPLAIN THE UNINSURED/SELF PAY DISCOUNTAN DIF ELIGIBLE, GIVEN AN APPLICATION FOR THE COMMUNITY CARE PROGRAM.FINANCIAL SERVICES PAMPHLETS EXPLAIN BOTH PROGRAMS AND ARE DISPERSEDAROUND THE FACILITY. PROGRAM INFORMATION CAN ALSO BE ACCESSED ON LAKEREGION HEALTHCARE'S WEBSITE. EMPLOYEES AMONGST THE PATIENT DEPARTMENTSWORK WITH THE BUSINESS OFFICE TO BE SURE THAT EVERYONE WHO MAY BE ELIGIBLERECEIVES THE APPROPRIATE INFORMATION. THE COLLECTION AGENCIES THAT ARECONTRACTED WITH LAKE REGION HEALTHCARE ARE ALSO AWARE AND OFFER EITHERPROGRAM IF APPROPRIATE. PART VI, LINE 4: LAKE REGION HEALTHCARE PROVIDES PRIMARY AND SECONDARY HEALTHCARE SERVICES IN A RURAL AREA OF WEST CENTRAL MINNESOTA WITH A POPULATION OF APPROXIMATELY 100,000 PEOPLE. THE AVERAGE AGE OF THE POPULATION IS OLDER THAN BOTH THE STATE AND NATIONAL AVERAGES, WHICH LEADS TO A HIGHER THAN NORMAL PERCENTAGE OF OLDER PATIENTS WHOM THE HOSPITAL SERVES. APPROXIMATELY TWO-THIRDS OF THE PATIENT DAYS AT LAKE REGION HEALTHCARE ARE USED BY MEDICARE-AGED PATIENTS. PART VI, LINE 5: THE MOST TANGIBLE WAY THAT LAKE REGION HEALTHCARE PROVIDES COMMUNITY BENEFITS IS THROUGH COMMUNITY PROGRAMS AND SERVICES. IT PROVIDES THESE SERVICES AS A RESPONSIBLE MEMBER OF THE COMMUNITY. EDUCATIONAL PROGRAMS, HEALTHCARE SCREENINGS, SUPPORT GROUPS, AND OTHER COMMUNITY SERVICES ARE PROVIDED BY LAKE REGION HEALTHCARE TO IMPROVE THE HEALTHCARE AND QUALITY OF LIFE FOR THE PEOPLE IN THE COMMUNITY. THE MAJORITY OF THE 15 VOTING MEMBERS OF THE BOARD IS COMPRISED OF PERSONS WHO RESIDE WITHIN THIS SERVICE AREA. THE BOARD CONSISTS OF HOMEMAKERS, FARMERS, AND BUSINESS OWNER. LAKE REGION HEALTHCARE ALSO HAS AN OPEN MEDICAL STAFF AVAILABLE FOR ALL QUALIFIED PHYSICIANS. LAKE REGION HEALTHCARE BUDGETS FOR PROGRAMS WHICH ENCOURAGE INDIVIDUALS TO PRACTICE HEALTHCARE LIFESTYLES, AS WELL AS PROVIDES SUPPORT PROGRAMS WHICH BENEFIT THE ECONOMIES AND COMMUNITIES OF THEIR SERVICE AREA. PART VI, LINE 6: THE LAKE REGION HEALTHCARE (LRH) ENTERPRISE IS AN INDEPENDENT, COMMUNITY OWNED AND GOVERNED, NON-PROFIT HEALTHCARE ORGANIZATION HEADQUARTERED IN FERGUS FALLS. WITH FACILITIES IN NINE COMMUNITIES, WE ARE A MIDSIZED RURAL HEALTH SYSTEM PRIMARILY THAT SERVES FIVE COUNTIES IN WEST CENTRAL MINNESOTA AND EASTERN NORTH DAKOTA. THE ENTERPRISE OPERATES TWO HOSPITALS (IN FERGUS FALLS AND ELBOW LAKE), 10 CLINICS, A CANCER CENTER, A SENIOR LIVING COMMUNITY (MILL STREET RESIDENCE), AND VARIOUS OTHER HEALTH AND WELLNESS RELATED VENTURES. WITH OVER 1,100 EMPLOYEES AND 120 PHYSICIANS AND ADVANCE PRACTICE PROVIDERS, WE ARE DEDICATED TO SERVING THE HEALTHCARE NEEDS OF OUR COMMUNITIES CLOSE TO HOME AND DELIVERING SPECIALTY AND SUB-SPECIALTY SERVICES AT OUR LOCATIONS IN FERGUS FALLS, ELBOW LAKE, ASHBY, BARNESVILLE, BATTLE LAKE, EVANSVILLE, HERMAN, HOFFMAN, AND MORRIS, MN. IN EACH OF THE COMMUNITIES WE SERVE AND THE GREATER SERVICE AREA IN TOTAL, WE PROMOTE THE HEALTH OF THE PEOPLE IN OUR REGION THROUGH THE DONATION OF FINANCIAL AND HUMAN RESOURCES AND PROGRAMMING SUPPORT TO ACTIVITIES THAT PROMOTE HEALTHY EATING, PHYSICAL ACTIVITY, AND MENTAL HEALTH RESILIENCE. THESE EVENTS INCLUDE LRH SPONSORED EVENTS LIKE THE LAKE REGION RUN AND THE PEBBLE LAKE YOUTH TRIATHLON AS WELL AS COMMUNITY-LED EVENTS LIKE THE ASHBY 10K, THE PRAIRIE PURSUIT AND THE CENTRAL LAKES CYCLE DUATHLON. ALL OF THE WORK WE DO AND ACTIVITIES WE SUPPORT ARE AIMED AT ACHIEVING OUR MISSION OF PARTNERING TO ENRICH LIFE THROUGH HEALTH. 1 FERGUS FALLS 544 EDUCATION FOUNDATION 518 FRIBERG AVENUE FERGUS FALLS MN 56537 411978590 501(C)(3) 7200 0 N/A N/A COMMUNITY BENEFIT GREATER FERGUS FALLS CORPORATION 403 SOUTH UNION AVENUE SUITE 10 FERGUS FALLS MN 56537 831284758 501(C)(3) 15000 0 N/A N/A COMMUNITY BENEFIT WEST CENTRAL INITIATIVE 1000 WESTERN AVE FERGUS FALLS MN 56537 833891315 501(C)(3) 20000 0 N/A N/A COMMUNITY BENEFIT PART I, LINE 2: THE LAKE REGION HEALTHCARE FINANCE TEAM MAINTAINS A RECORD OF ALL GRANTS ISSUED AND PLEDGES MADE. GRANT ELIGIBILITY AND SELECTION CRITERIA ARE DESCRIBED IN OUR DONATION POLICY AS FOLLOWS: TAX-EXEMPT, NONPROFIT ORGANIZATIONS ARE ELIGIBLE. CONTRIBUTIONS ARE NOT GENERALLY GIVEN FOR TRAVEL OR TRAVEL-RELATED EXPENSES; TO INDIVIDUALS; TO ORGANIZATIONS BASED OUTSIDE OF OUR REGION; TO ORGANIZATIONS OF PRIMARILY POLITICAL FOCUS OR ORGANIZATIONS THAT DISCRIMINATE ON THE BASIS OF AGE, SEX, RACE, COLOR, NATIONAL ORIGIN, RELIGION, CREED OR SEXUAL ORIENTATION. LAKE REGION HEALTHCARE BELIEVES IN BEING A GOOD COMMUNITY PARTNER BY SUPPORTING VARIOUS CHARITABLE CAUSES THROUGHOUT OUR SERVICE AREAS. WE REGARD PARTNERSHIPS WITH NONPROFIT ORGANIZATIONS AS AN IMPORTANT INVESTMENT IN THE FUTURE OF COMMUNITIES WE SERVE AND THE VITALITY OF OUR ORGANIZATION. OVER TIME, WE HAVE PARTICIPATED IN AND ASSISTED WITH MANY COMMUNITY PROJECTS AND FESTIVALS, EDUCATIONAL PROGRAMS, YOUTH SPORTS ACTIVITIES, LOCAL GOVERNMENT, HEALTH PROGRAMS, AND NONPROFIT ORGANIZATIONS. TO ACHIEVE THE GREATEST BENEFIT FROM AVAILABLE FUNDING, WE GENERALLY FOCUS ON EVENTS OR PROGRAMS THAT DIRECTLY IMPACT THE COMMUNITIES WE SERVE. IN ADDITION, BECAUSE OUR DOLLARS ARE LIMITED, WE NARROW OUR FOCUS FURTHER BY SUPPORTING MAINLY THOSE REQUESTS THAT IMPACT HEALTH AND WELLNESS, CHILDREN AND EDUCATION, AND THE ARTS. X X X X X X 0 0 0 0 0 1 0 0 0 KENT MATTSON CEO 452807 0 0 0 0 0 22500 0 21661 0 496968 0 0 0 CAMIE PATTERSON CFO 359036 0 0 0 0 0 0 0 21510 0 380546 0 0 0 FRITZ KARSNIA ANESTHESIA DIRECTOR 265675 0 0 0 0 0 0 0 13235 0 278910 0 0 0 HENRIK BJORNDAHL CRNA 252883 0 0 0 0 0 0 0 12811 0 265694 0 0 0 ROBERTA YOUNG CNO 247761 0 0 0 0 0 0 0 17735 0 265496 0 0 0 MARK SCHULZ CRNA 244877 0 0 0 0 0 0 0 12811 0 257688 0 0 0 JASON ZOSEL CRNA 238965 0 0 0 0 0 0 0 13059 0 252024 0 0 0 KYLE ELLISON CRNA 237152 0 0 0 0 0 0 0 12833 0 249985 0 0 0 DANIELLE LESMEISTER PRAIRIE RIDGE CEO 0 149400 0 0 0 0 0 0 0 17425 0 166825 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. A CITY OF FERGUS FALLS MN 2021-10-01 21000000 TO IMPLEMENT A NEW EHR AND PURCHASE MEDICAL EQUIPMENT 0 0 0 A 2565655 21000000 56000 4192155 6129000 10622845 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 0 0 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 1A THERE IS AN EXECUTIVE COMMITTEE LIMITED TO SEVEN TRUSTEES, AND THESE TRUSTEES SHALL BE: (1) THE PRESIDENT (2) THE VICE PRESIDENT (3) THE SECRETARY (4) THE TREASURER (5) THE PAST PRESIDENT AND (6 AND 7) THE BOARD WILL DESIGNATE TWO BOARD MEMBERS AT LARGE TO SERVE ON THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL MEET AT LEAST FOUR TIMES EACH YEAR, ONCE IN EACH CALENDAR QUARTER. ITS MEETINGS MAY BE JOINT MEETINGS WITH THE BOARD OF TRUSTEES. UNLESS ITS AUTHORITY IS EXPRESSLY LIMITED BY THE BOARD, THE EXECUTIVE COMMITTEE SHALL EXERCISE THE FULL POWER OF THE BOARD ON THE BASIS OF BYLAW PROVISIONS AND WITHOUT SPECIFIC DELEGATION OF SUCH AUTHORITY BY THE BOARD, BUT ONLY IN THE INTERVALS BETWEEN MEETINGS OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 2 MATTHEW MOUSER, MD, ERIN PETERSON, MD, AND WADE SWENSON, MD ARE AFFILIATED WITH COMPANIES THAT HAVE A BUSINESS RELATIONSHIP WITH LAKE REGION HEALTHCARE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B COPIES OF THE COMPLETED FORM 990, WITH SUPPORTING SCHEDULES AND FOOTNOTES, WERE DISTRIBUTED TO ALL LRHC BOARD MEMBERS SUFFICIENTLY IN ADVANCE OF THE FILING DEADLINE TO ENABLE DETAILED AND CONSCIENTIOUS REVIEW BY ALL BOARD MEMBERS AND OPPORTUNITY FOR FEEDBACK AND CORRECTION. ALL QUESTIONS, CONCERNS, OR OTHER FEEDBACK FROM BOARD MEMBERS WERE DIRECTED TO THE LRHC CHIEF FINANCIAL OFFICER AND INCORPORATED INTO THE FORM 990 AS APPROPRIATE, SUFFICIENTLY IN ADVANCE OF THE FILING DEADLINE TO ENABLE A DETAILED CONSCIENTIOUS REVIEW BY ALL EXECUTIVE OR FINANCE COMMITTEE MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST DISCLOSURES ARE COLLECTED FROM ALL INTERESTED PERSONS, OFFICERS, AND TRUSTEES ANNUALLY TO ASSESS WHETHER OR NOT THERE ARE ANY CONFLICTS OF INTEREST ACCORDING TO THE CONFLICTS OF INTEREST POLICY. IT IS CONSISTENTLY MONITORED DURING THE YEAR TO BE SURE THAT THE WRITTEN POLICY IS BEING FOLLOWED. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR THE OFFICERS OF LAKE REGION HEALTHCARE IS REVIEWED ANNUALLY, OUTSIDE INDEPENDENT COMPENSATION CONSULTANTS ARE ENGAGED FOR FAIR MARKET ASSESSMENTS, AS WELL AS MHA SALARY SURVEYS. COMPENSATION IS PRESENTED FOR APPROVAL TO THE EXECUTIVE COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 LAKE REGION HEALTHCARE'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC BY REQUEST. FORM 990, PART IX, LINE 11G OUTSIDE CONSULTING FEES: PROGRAM SERVICE EXPENSES 947,763. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 947,763. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 31,411,198. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 31,411,198. COLLECTION FEES: PROGRAM SERVICE EXPENSES 385,238. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 385,238. OUTSIDE LAUNDRY SERVICES: PROGRAM SERVICE EXPENSES 224,584. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 224,584. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 6,703,188. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,703,188. STUDENT PHARMACY SERVICES: PROGRAM SERVICE EXPENSES 156,802. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 156,802. FORM 990, PART XI, LINE 9: OTHER CHANGES -49,557. MEDICAL BUILDING RESTRUCTURING 16,147,341. MEDICAL BUILDING RESTRUCTURING -13,417,269. FORM 990, PART XII, LINE 3B: SINGLE AUDIT WILL BE COMPLETED BY 6/30/23 DEADLINE FORM 990, HEADER, LINE C: LAKE REGION HEATLHCARE ALSO DOES BUSINESS AS: LAKE REGION HEALTHCARE CLINIC SERVICES - ASHBY CLINIC, LAKE REGION HEALTHCARE CLINIC SERVICES - BATTLE LAKE, LAKE REGION HEALTHCARE CLINIC SERVICES - FERGUS FALLS, LAKE REGION HOSPITAL, AND LAKE REGION HEALTHCARE - WALK-IN CLINIC. 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 1 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 1 PRAIRIE RIDGE HOSPITAL & HEALTH SERVICES 1411 HIGHWAY 79 EAST ELBOW LAKE MN 56531 411763968 HEALTHCARE SERVICES MN 501(C)(3) LINE 3 LAKE REGION HEALTHCARE CORPORATION 1 PRAIRIE RIDGE FOUNDATION 1411 HIGHWAY 79 EAST ELBOW LAKE MN 56531 455092280 FUNDRAISING MN 501(C)(3) LINE 7 PRAIRIE RIDGE HOSPITAL & HEALTH SERVICES 1 LRH RAD ONC SERVICES 712 SOUTH CASCADE STREET FERGUS FALLS MN 56538 271322270 RADIATION & ONCOLOGY SERVICES MN LAKE REGION HEALTHCARE RELATED -1005528 1030206 0 1 0.50000 RURAL HEALTH ALLIANCE LLC 1210 BROADWAY STE 240 271 ALEXANDRIA MN 56308 020738699 EQUIPMENT SALES MN N/A 0 0 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 1 0 0 LRH RAD ONC SERVICES Q 1372709 PATIENT BILLING SERVICES LAKE REGION HEALTHCARE FOUNDATION Q 82025 OPERATING EXPENSES PRAIRIE RIDGE HOSPITAL & HEALTH SERVICES Q 4564304 OPERATING EXPENSES LRHC LONG-TERM CARE FACILITIES INC Q 516367 OPERATING EXPENSES