CENTRACARE HEALTH SYSTEM OF MELROSE: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- CENTRACARE HEALTH SYSTEM OF MELROSE (EIN 41-1865315)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-14
- IRS object ID
- 202201349349301720
- Schema version
- 2020v4.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-14T09:54:12-05:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 SOUTH SIXTH STREET | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411865315 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRACARE HEALTH SYSTEM - MELROSE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CENT | BusinessNameControlTxt |
| Phone | 3202564231 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 525 MAIN STREET WEST | AddressLine1Txt |
| City | MELROSE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56352 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOSEPH KALKMAN | PersonNm |
| Person Title | EVP, CAO & CHRO | PersonTitleTxt |
| Phone | 3202564231 | PhoneNum |
| Signature | 2022-05-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JOSEPH | PersonFirstNm |
| Person Last | KALKMAN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CHRIS MESKIMEN | PreparerPersonNm |
| PTIN | P01314196 | PTIN |
| Phone | 6123974000 | PhoneNum |
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 | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRACARE HEALTH - MELROSE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DR KENNETH HOLMEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 525 MAIN STREET WEST | AddressLine1Txt |
| City | MELROSE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56352 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $45,947,207 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CENTRACARE.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1997 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | WE'RE HERE FOR YOUR WHOLE LIFE TO LISTEN, THEN SERVE, TO GUIDE AND HEAL BECAUSE HEALTH MEANS EVERYTHING. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 110 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,232,234 | PYContributionsGrantsAmt |
| CY Contributions Grants | -$1,486,197 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $39,625,931 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $44,220,605 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,517,879 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,377,738 | CYInvestmentIncomeAmt |
| PY Other Revenue | $735,770 | PYOtherRevenueAmt |
| CY Other Revenue | $631,236 | CYOtherRevenueAmt |
| PY Total Revenue | $44,111,814 | PYTotalRevenueAmt |
| CY Total Revenue | $45,743,382 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $498,330 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $696,289 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $22,051,899 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $24,867,558 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $18,275,853 | PYOtherExpensesAmt |
| CY Other Expenses | $21,381,837 | CYOtherExpensesAmt |
| PY Total Expenses | $40,826,082 | PYTotalExpensesAmt |
| CY Total Expenses | $46,945,684 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,285,732 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,202,302 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $78,938,963 | TotalAssetsBOYAmt |
| Total Assets EOY | $87,022,550 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $30,256,317 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $34,228,169 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $48,682,646 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $52,794,381 | NetAssetsOrFundBalancesEOYAmt |
| Mission | WE'RE HERE FOR YOUR WHOLE LIFE TO LISTEN, THEN SERVE, TO GUIDE AND HEAL BECAUSE HEALTH MEANS EVERYTHING. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $22,561,084 | ExpenseAmt |
| Grant | $671,714 | GrantAmt |
| Revenue | $30,470,071 | RevenueAmt |
| Desc | CCH - MELROSE IS PART OF A LARGER INTEGRATED HEALTH CARE DELIVERY SYSTEM KNOWN AS CENTRACARE HEALTH, A SYSTEM RECOGNIZED FOR BEING A LEADER IN PROVIDING HIGH-QUALITY, COMPREHENSIVE CARE THROUGHOUT THE REGION. CCH - MELROSE IS A 14 BED CRITICAL ACCESS HOSPITAL THAT PROVIDES ACUTE CARE SERVICES IN THE AREAS OF MEDICAL, SURGICAL, DIAGNOSTIC AND OBSTETRICS ALONG WITH OTHER SERVICES OF 24 HOUR EMERGENCY ROOM, IMAGING, LABORATORY, REHABILITATION, AND CHEMOTHERAPY TO THE COMMUNITY OF STEARNS COUNTY. THERE WERE 559 INPATIENT VISITS, 2,269 INPATIENT DAYS WITH 30,152 OUTPATIENT VISITS IN FISCAL YEAR 2021. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $9,735,859 | ExpenseAmt |
| Grant | $24,575 | GrantAmt |
| Revenue | $7,934,458 | RevenueAmt |
| Desc | CCH - MELROSE OPERATES MELROSE PARK VIEW PLACE AND CENTRACARE - MELROSE CARE CENTER, WHICH ARE CONVENIENTLY CONNECTED TO THE MELROSE HOSPITAL FOR THE HEALTH NEEDS OF THE COMMUNITY. MELROSE PARK VIEW PLACE IS A 60-UNIT INDEPENDENT LIVING SENIOR HOUSING APARTMENT BUILDING THAT OFFERS RETIREMENT LIVING AT ITS FINEST. MELROSE PINE VILLA CARE CENTER IS A 75 BED SKILLED NURSING FACILITY THAT PROVIDES QUALITY, COMPASSIONATE CARE WITH AN EMPHASIS ON ENHANCING EACH RESIDENT'S PHYSICAL, SPIRITUAL, EMOTIONAL AND SOCIAL WELL BEING. THERE WERE 21,407 RESIDENT DAYS DURING FISCAL YEAR 2021. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $4,689,488 | ExpenseAmt |
| Revenue | $5,840,764 | RevenueAmt |
| Desc | CCH - MELROSE OPERATES THE MELROSE CLINIC, WHICH IS CONVENIENTLY CONNECTED TO THE MELROSE HOSPITAL FOR THE HEALTH NEEDS OF THE COMMUNITY. MELROSE CLINIC PROVIDES SERVICES OF GENERAL SURGERY, NEUROLOGY, OBSTETRICS/GYNECOLOGY, ONCOLOGY, ORTHOPEDICS, AND UROLOGY. THERE WERE 25,176 CLINIC VISITS DURING FISCAL YEAR 2021. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $36,986,431 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | 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 | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | 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 | Yes (1) | 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 | 0 | EmployeeCnt |
| 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 | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 | Yes (1) | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADAM PAULSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3202564231 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 525 MAIN STREET WEST | AddressLine1Txt |
| City | MELROSE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56352 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 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 | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| KENNETH D HOLMEN MD | |||||||||
| PRESIDENT/CEO | 6.50 | 33.50 | Yes (X) | Yes (X) | $0 | $1,423,120 | $42,559 | ||
| DONALD JURGENS MD | |||||||||
| DIRECTOR | 1.00 | 39.00 | Yes (X) | $0 | $863,168 | $20,730 | |||
| CHRISTIAN P SCHMIDT MD | |||||||||
| DIRECTOR | 1.00 | 39.00 | Yes (X) | $0 | $514,228 | $73,374 | |||
| RICHARD A WEHSELER MD | |||||||||
| DIRECTOR | 1.00 | 39.00 | Yes (X) | $0 | $403,754 | $58,681 | |||
| BRYAN ROLPH MD | |||||||||
| DIRECTOR | 1.00 | 39.00 | Yes (X) | $0 | $431,949 | $1,783 | |||
| SHARON J RUGGIERO MD | |||||||||
| DIRECTOR | 1.00 | 39.00 | Yes (X) | $0 | $260,991 | $57,886 | |||
| DAVID ANFINSON | |||||||||
| VICE CHAIR | 0.25 | 1.75 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| STEVE LARAWAY | |||||||||
| BOARD CHAIR | 0.25 | 1.75 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BOB THUERINGER | |||||||||
| DIRECTOR | 0.20 | 1.80 | Yes (X) | $0 | $0 | $0 | |||
| FATHER TOM KNOBLACH | |||||||||
| DIRECTOR | 0.25 | 1.75 | Yes (X) | $0 | $0 | $0 | |||
| JAMES HEBL | |||||||||
| DIRECTOR | 0.25 | 1.75 | Yes (X) | $0 | $0 | $0 | |||
| JEFF GAU | |||||||||
| DIRECTOR | 0.25 | 1.75 | Yes (X) | $0 | $0 | $0 | |||
| JOE UPHUS | |||||||||
| DIRECTOR | 0.25 | 1.75 | Yes (X) | $0 | $0 | $0 | |||
| TERESA BOHNEN | |||||||||
| DIRECTOR | 0.25 | 1.75 | Yes (X) | $0 | $0 | $0 | |||
| TIM WENSMAN | |||||||||
| DIRECTOR | 0.25 | 1.75 | Yes (X) | $0 | $0 | $0 | |||
| CRAIG BROMAN | |||||||||
| CHIEF OPERATING OFFICER/EVP | 6.50 | 33.50 | Yes (X) | $0 | $1,387,560 | $51,923 | |||
| MICHAEL BLAIR | |||||||||
| CHIEF FINANCIAL OFFICER/SR VP/TREASURER | 1.00 | 39.00 | Yes (X) | $0 | $544,396 | $73,619 | |||
| SANTO CRUZ | |||||||||
| CHIEF LEGAL OFFICER/SR VP/SECRETARY | 1.00 | 39.00 | Yes (X) | $0 | $363,379 | $45,019 | |||
| CINDY FIRKINS SMITH MD | |||||||||
| VICE PRESIDENT | 10.00 | 30.00 | $0 | $852,324 | $53,785 | Yes (X) | |||
| PATRICK J HELLER | |||||||||
| OPERATING COMMITTEE DIRECTOR | 40.00 | 0.00 | $0 | $490,006 | $42,548 | Yes (X) | |||
| LINDSEY R CHMIELEWSKI | |||||||||
| MEDICAL DIRECTOR | 40.00 | 0.00 | $0 | $343,420 | $67,282 | Yes (X) | |||
| MICHAEL J BESTE | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $0 | $409,786 | $49,805 | Yes (X) | |||
| KURT E SCHWIETERS | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $0 | $370,566 | $51,264 | Yes (X) | |||
| BRYAN J BAUCK | |||||||||
| EXECUTIVE DIRECTOR | 20.00 | 20.00 | $0 | $264,914 | $32,502 | Yes (X) | |||
| JULIE A KLASEN | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $0 | $234,570 | $47,007 | Yes (X) | |||
| ADAM M PAULSON | |||||||||
| FINANCE DIRECTOR | 13.00 | 27.00 | $0 | $132,117 | $26,788 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $9,290,248 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $796,555 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| AYA HEALTHCARE INC | |||||
| DEPT 3519 PO BOX 123519 | DALLAS | TX | 75312 | TEMPORARY STAFFING SERVICES | $2,055,950 |
| WEST CENTRAL ANESTHESIA PC | |||||
| 10382 AUGUSTA DRIVE | SAUK CENTRE | MN | 56378 | CRNA SERVICES | $531,811 |
| CONVERDIA HEALTH STAFFING | |||||
| 2108 S UNIVERSITY DR SUITE 106B | FARGO | ND | 58103 | PHYSICIAN SERVICES | $519,531 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Info In Schedule O Part VIII | Yes (X) | InfoInScheduleOPartVIIIInd |
| Related Organizations | $56,748 | RelatedOrganizationsAmt |
| Government Grants | -$1,544,167 | GovernmentGrantsAmt |
| All Other Contributions | $1,222 | AllOtherContributionsAmt |
| Total Contributions | -$1,486,197 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT & RESIDENT REV | 622110 | $42,680,063 | $42,680,063 |
| SENIOR HOUSING INCOME | 623311 | $1,215,886 | $1,215,886 |
| OTHER PROGRAM INCOME | 622110 | $324,656 | $324,656 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $44,220,605 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,377,738 | TotalRevenueColumnAmt |
| Exclusion | $2,377,738 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $810,373 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $203,825 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $606,548 | TotalRevenueColumnAmt |
| Exclusion | $606,548 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $24,688 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $24,688 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $24,688 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $45,743,382 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $44,245,293 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,984,286 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $675,964 | TotalAmt |
| Program Services | $675,964 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,325 | TotalAmt |
| Program Services | $20,325 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,518,853 | TotalAmt |
| Program Services | $14,200,158 | ProgramServicesAmt |
| Management And General | $5,318,695 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $645,000 | TotalAmt |
| Program Services | $470,602 | ProgramServicesAmt |
| Management And General | $174,398 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,780,957 | TotalAmt |
| Program Services | $2,448,326 | ProgramServicesAmt |
| Management And General | $1,332,631 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $922,748 | TotalAmt |
| Program Services | $673,606 | ProgramServicesAmt |
| Management And General | $249,142 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,205 | TotalAmt |
| Management And General | $4,205 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,989 | TotalAmt |
| Management And General | $55,989 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,524,055 | TotalAmt |
| Program Services | $5,511,586 | ProgramServicesAmt |
| Management And General | $1,012,469 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,716 | TotalAmt |
| Program Services | $13,716 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $156,042 | TotalAmt |
| Program Services | $49,411 | ProgramServicesAmt |
| Management And General | $106,631 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,194,570 | TotalAmt |
| Program Services | $1,426,470 | ProgramServicesAmt |
| Management And General | $768,100 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,936,032 | TotalAmt |
| Program Services | $1,313,278 | ProgramServicesAmt |
| Management And General | $622,754 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,709 | TotalAmt |
| Program Services | $90,272 | ProgramServicesAmt |
| Management And General | $1,437 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,380 | TotalAmt |
| Program Services | $29,044 | ProgramServicesAmt |
| Management And General | $2,336 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $786,462 | TotalAmt |
| Program Services | $786,462 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,344,848 | TotalAmt |
| Program Services | $3,307,854 | ProgramServicesAmt |
| Management And General | $36,994 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $176,909 | TotalAmt |
| Program Services | $38,364 | ProgramServicesAmt |
| Management And General | $138,545 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DRUGS/MEDICAL SUPPLIES | $4,363,660 | $4,245,211 | $118,449 |
| IMPLICIT PRICE CONCESS. | $974,620 | $974,620 | |
| MEDICAID/MN CARE | $677,674 | $677,674 | |
| DUES & AFFILIATIONS | $49,966 | $33,488 | $16,478 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,945,684 | TotalAmt |
| Program Services | $36,986,431 | ProgramServicesAmt |
| Management And General | $9,959,253 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,696,093 | BOYAmt |
| EOY | $10,883,087 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $82,350 | BOYAmt |
| EOY | $82,605 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,117,625 | BOYAmt |
| EOY | $6,518,190 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $338,695 | BOYAmt |
| EOY | $381,812 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,968 | BOYAmt |
| EOY | $130,052 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $64,368,412 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $30,613,655 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,684,513 | BOYAmt |
| EOY | $33,754,757 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,505,568 | BOYAmt |
| EOY | $33,187,006 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,469,151 | BOYAmt |
| EOY | $2,085,041 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,938,963 | BOYAmt |
| EOY | $87,022,550 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,921,669 | BOYAmt |
| EOY | $7,156,525 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,944,506 | BOYAmt |
| EOY | $20,055,885 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,390,142 | BOYAmt |
| EOY | $7,015,759 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,256,317 | BOYAmt |
| EOY | $34,228,169 | 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 | $48,676,157 | BOYAmt |
| EOY | $52,787,892 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,489 | BOYAmt |
| EOY | $6,489 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,682,646 | BOYAmt |
| EOY | $52,794,381 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,938,963 | BOYAmt |
| EOY | $87,022,550 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,202,302 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $5,712,025 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$397,988 | 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $756 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $756 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | CENTRACARE - MELROSE PAID $756 TO STATE AND NATIONAL ASSOCIATIONS TO CONDUCT LOBBYING ACTIVITIES ON ITS BEHALF, AS A MEMBER OF THE ASSOCIATIONS. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $517,250 | OtherCostOrOtherBasisAmt |
| Book Value | $517,250 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $47,894,747 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,014,083 | DepreciationAmt |
| Book Value | $28,880,664 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,956,415 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,599,572 | DepreciationAmt |
| Book Value | $4,356,843 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $33,754,757 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENTS HELD BY CENTRACARE IN POOLED INVESTMENTS | Desc |
| Book Value | $33,187,006 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $33,187,006 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| OTHER LIABILITIES | $3,415,885 |
| DUE TO AFFILIATES | $3,599,874 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $7,015,759 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | CENTRACARE, THE CORPORATION, THE CLINIC, CCH - MELROSE, CCH - LONG PRAIRIE, CCH - SAUK CENTRE, THE FOUNDATION AND CARRIS HEALTH FOUNDATION HAVE BEEN DETERMINED TO QUALIFY AS TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CCH - MONTICELLO, CCH - PAYNESVILLE AND CARRIS AND CARRIS HEALTH REDWOOD AND CENTRACARE SURGERY CENTER, AS DISREGARDED LIMITED LIABILITY COMPANIES (LLCS) UNDER INTERNAL REVENUE SERVICE REGULATIONS, ACHIEVE TAX-EXEMPT TREATMENT BASED ON THE EXEMPT STATUS OF THEIR PARENT, CENTRACARE HEALTH SYSTEM. AT JUNE 30, 2021 AND 2020, THERE WERE NO UNCERTAIN TAX POSITIONS. | ExplanationTxt |
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 |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $113,362 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $113,362 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00250 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,279,558 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,424,496 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,855,062 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08390 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,392,920 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,424,496 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,968,424 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08640 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $66,095 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $66,095 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,490 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $9,490 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,325 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $20,325 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $95,910 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $95,910 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00200 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,488,830 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,424,496 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,064,334 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08840 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,560 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,560 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,560 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,560 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $974,620 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $6,912,684 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $6,769,087 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $143,597 | 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 | CENTRACARE HEALTH - MELROSE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 525 MAIN STREET WEST | AddressLine1Txt |
| City | MELROSE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56352 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.CENTRACARE.COM/LOCATIONS/MELROSE/ | WebsiteAddressTxt |
| State License | 347139 | 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 | RURAL HEALTH CLINIC, NURSING HOME | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRACARE HEALTH - MELROSE | 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 |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, PAGE 8 | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, PAGE 8 | 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 | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| 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 |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE | 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 |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| CENTRACARE HEALTH - MELROSE | PART V, SECTION B, LINE 3J: CENTRACARE UTILIZED THE MAPP (MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS) PROCESS TO CONDUCT THE CHNA AND PREPARE THE IMPLEMENTATION STRATEGY WHICH WE CALLED THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). THE MAPP PROCESS INCLUDES A LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT, STAKEHOLDER INTERVIEWS, COMMUNITY HEALTH SURVEY JOINTLY FUNDED AND MANAGED WITH THREE COUNTY PUBLIC HEALTH DEPARTMENTS, AND SEVERAL COMMUNITY MEETINGS TO GATHER INFORMATION ON FORCES THAT CREATE HEALTH, TRENDS, FACTORS AND EVENTS AFFECTING HEALTH, AND STRATEGIES TO OVERCOME BARRIERS TO HEALTHY LIVING. THE CHNA INCLUDED A HEALTH EQUITY ASSESSMENT AND INFORMATION ON NATIONAL, STATE, AND OTHER LOCAL PLANNING PROCESSES RELATED TO HEALTH.AS A FOLLOW UP TO THE PRIOR CHNA PROCESS WHERE PUBLIC HEALTH DATA WAS A SIGNIFICANT GAP, THIS CHNA AND SUBSEQUENT CHIP WAS A COLLABORATIVE EFFORT EXECUTED WITH BENTON COUNTY PUBLIC HEALTH, SHERBURNE COUNTY PUBLIC HEALTH, AND STEARNS COUNTY PUBLIC HEALTH. THE RESULT WAS A JOINT CHNA AND CHIP. |
| CENTRACARE HEALTH - MELROSE | PART V, SECTION B, LINE 5: CENTRACARE POPULATION HEALTH CONDUCTED SPECIFIC AND COMPREHENSIVE EVALUATION OF ZIP CODE 56304 THAT HAS THE WORST HEALTH OUTCOMES IN THE THREE COUNTIES INCLUDED IN THE CHNA AND CHIP. THIS EVALUATION INCLUDED DATA EVALUATION, KEY INFORMANT INTERVIEWS, AND HEALTH INDICATORS FOR MINORITY GROUPS. THE CENTRAL MN ALLIANCE ALSO COMPLETED SEVERAL SURVEYS AND ASSESSMENTS TO GET INPUT FROM MULTIPLE SECTORS OF EACH COMMUNITY REPRESENTING DIFFERENT POPULATIONS IN ORDER TO COMPILE A LIST OF TOP PRIORITIES IN THE REGION:THE COMMUNITY HEALTH STATUS ASSESSMENT (CHSA) WAS DATA COLLECTED FROM THE COMMUNITY HEALTH ASSESSMENT COMPLETED IN 2016, CENTRACARE PATIENT DATA, MINNESOTA STUDENT SURVEY DATA, AND MINNESOTA PUBLIC HEALTH VITAL STATISTICS. THIS DATA WAS COMPARED TO DOCUMENTS AND DATASETS FROM THE MN STATEWIDE HEALTH ASSESSMENT (SHA), CENTRAL MN COMMUNITY HEALTH SURVEY DATA, PREVIOUS PLANNING PROCESS PRIORITY LISTS, HEALTH EQUITY DATA ANALYSES (HEDA) FROM EACH COUNTY, TYPES OF DATA REQUESTS OUR AGENCIES WERE GETTING FROM THE PUBLIC, AND THE MN DEPARTMENT OF HEALTH DATA INDICATOR LIST. A "COMMUNITY PRIORITY CATEGORY" WAS ASSIGNED TO EACH DATA POINT TO IDENTIFY A LIST OF COMMUNITY PRIORITIES.THE COMMUNITY THEMES AND STRENGTHS ASSESSMENT (CTSA) WAS CONDUCTED IN THE FORM OF KEY STAKEHOLDER INTERVIEWS VIA PHONE WITH A WIDE VARIETY OF COMMUNITY PARTNERS THROUGHOUT THE THREE COUNTIES. A TOTAL OF 50 STAKEHOLDERS WERE INTERVIEWED FROM 20 DIFFERENT SECTORS INCLUDING: 1. YOUTH, PARENT, SMALL BUSINESS OWNER, CORPORATE BUSINESS OWNER, MEDIA, SCHOOL/EDUCATION, YOUTH-SERVING ORGANIZATION, LAW ENFORCEMENT, RELIGIOUS OR FAITH-BASED ORGANIZATION, PRIMARY HEALTHCARE, BEHAVIORAL HEALTH, HOSPITAL-BASED HEALTHCARE, STATE/LOCAL GOVERNMENT- ELECTED, STATE/LOCAL GOVERNMENT- NON-ELECTED, NON-PROFIT, CIVIC/VOLUNTEER GROUP, VETERANS INTEREST GROUP, AGING POPULATION INTEREST GROUP, ENVIRONMENTAL INTEREST GROUP, MINORITY INTEREST GROUP.FOR THE LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT (LPHSA) BENTON, SHERBURNE, AND STEARNS COUNTY LPH AGENCIES PARTICIPATED IN A CAPACITY ASSESSMENT TO HELP DETERMINE THE EXTENT TO WHICH REQUIRED LOCAL PUBLIC HEALTH ACTIVITIES ARE IN PLACE STATEWIDE. THE ASSESSMENT QUESTIONS WERE THEN UTILIZED TO FORMULATE A SURVEY FOR THREE SECTORS OF THE LOCAL PUBLIC HEALTH SYSTEM: EMERGENCY PREPAREDNESS, ENVIRONMENTAL HEALTH, AND HEALTHCARE ACCESS/INFECTIOUS DISEASE. COMMUNITY PARTNERS WERE INVITED TO PARTICIPATE IN THE SURVEY VIA EMAIL. AFTER ANALYZING THE RESULTS, THE LPHSA SUBGROUP DEVELOPED A LIST OF THEIR TOP 10 RECOMMENDATIONS FROM ALL 3 SECTORS TO SUPPORT THE DEVELOPMENT OF THE COMMUNITY COMMUNITY HEALTH IMPROVEMENT PLAN.THE FORCES OF CHANGE (FOC) ASSESSMENT WAS COMPLETED IN THE FORM OF A COMUNITY MEETING IN AUGUST OF 2018 TO IDENTIFY FORCES THAT MAY AFFECT A COMMUNITY AND OPPORTUNITIES AND THREATS ASSOCIATED WITH THOSE FORCES. THE AGENDA INCLUDED A BRAINSTORMING ACTIVITY AND TIME IN SMALL GROUP AND LARGE GROUP DISCUSSION. A FLIER ADVERTISING THE MEETING WAS DISTRIBUTED TO COMMUNITY MEMBERS VIA EMAIL. THERE WERE 68 PEOPLE THAT ATTENDED REPRESENTING 27 ORGANIZATIONS AND TWO THAT IDENTIFIED THEIR AFFILIATION AS 'COMMUNITY MEMBER'. AS A FOLLOW UP TO THE FORCES OF CHANGE COMMUNITY MEETING, A WORLD CAFE WAS HELD IN JANUARY 2019 FOR MEMBERS OF THE COMMUNITY TO COME AND TALK ABOUT THEIR PERCEPTION OF NEEDS IN THE SURROUNDING COMMUNITIES. THERE WERE 94 PEOPLE THAT ATTENDED THE MEETING REPRESENTING 32 ORGANIZATIONS AND THREE THAT IDENTIFIED THEIR AFFILIATION AS 'COMMUNITY MEMBER'. ORGANIZATIONS THAT WERE REPRESENTED AT BOTH COMMUNITY MEETINGS INCLUDED LOCAL GOVERNMENT, HEALTHCARE, LOCAL NONPROFITS, EDUCATION, UNDERREPRESENTED COMMUNITIES, FAITH COMMUNITY, AND OTHERS.IN ORDER TO BETTER ENGAGE INDIVIDUALS OR ORGANIZATIONS WITH A PERSPECTIVE OF AT-RISK POPULATIONS, A HEALTH EQUITY ASSESSMENT WAS ALSO COMPLETED. FOCUS-GROUP MEETINGS WERE HELD ON THREE SEPARATE OCCASIONS AT THE GREAT RIVER REGIONAL LIBRARY IN ST. CLOUD, AND COMMUNITY INPUT WAS GATHERED AT THE BENTON, SHERBURNE, AND STEARNS COUNTY FAIRS TO REACH OUT TO A VARIETY OF COMMUNITIES. IN TOTAL, THERE WERE 30 SOMALI ADULTS WHO DISCUSSED POSITIVES, NEGATIVES, AND AREAS-TO-IMPROVE-ON WITHIN THE COMMUNITY. AT THE COUNTY FAIRS, INFORMATION WAS GATHERED FROM RESPONDENTS FROM THE 56304-ZIP CODE. |
| CENTRACARE HEALTH - MELROSE | PART V, SECTION B, LINE 6A: CENTRACARE HEALTH SYSTEMC - MELROSE CONDUCTED THE CHNA WITH CENTRACARE- PAYNESVILLE, CENTRACARE- SAUK CENTRE, AND ST. CLOUD HOSPITAL. |
| CENTRACARE HEALTH - MELROSE | PART V, SECTION B, LINE 6B: CENTRACARE HEALTH SYSTEMC - MELROSE CONDUCTED THE CHNA WITH BENTON COUNTRY PUBLIC HEALTH, SHERBURNE COUNTRY PUBLIC HEALTH AND STEARNS COUNTRY PUBLIC HEALTH. |
| CENTRACARE HEALTH - MELROSE | PART V, SECTION B, LINE 11: THE PRIORITIZATION PROCESS TOOK PLACE WHILE UTILIZING THE MAPP PROCESS. THE WORK OF EACH OF THE FOUR MAPP ASSESSMENT SUB-GROUPS RESULTED IN FOUR LISTS OF 10 COMMUNITY PRIORITIES. AS A REMINDER, THE FOUR ASSESSMENTS INCLUDE: COMMUNITY HEALTH STATUS ASSESSMENT, COMMUNITY THEMES AND STRENGTHS ASSESSMENT, LOCAL PUBLIC HEALTH STATUS ASSESSMENT, AND FORCES OF CHANGE ASSESSMENT. THOSE FOUR LISTS OF 10 ARE INCLUDED IN THE NARRATIVE EARLIER IN THIS DOCUMENT.THE CORE SUPPORT TEAM WAS PROVIDED THOSE FOUR LISTS OF TEN PRIORITIES. THEY TOOK THOSE LISTS AND TALKED WITH THEIR AGENCY STAFF TO IDENTIFY ANY THEMES OR COMMONALITIES AMONGST THE FOUR LISTS. THE CORE SUPPORT TEAM THEN CAME TOGETHER IN A MEETING AND WENT THROUGH A FACILITATED PROCESS USING THE CENTRAL MN ALLIANCE VISION AS A GUIDE TO COME UP WITH A TOP 10 LIST TO SEND ON TO THE DELEGATED AUTHORITIES.THE DELEGATED AUTHORITIES MET AND CONTINUED THE DISCUSSION ABOUT THE PRIORITY LIST. THE PRIORITIES PASSED ON BY THE CORE SUPPORT TEAM WERE RUN THROUGH TWO PRIORITIZATION EXERCISES. THE FIRST WAS A RANKING DISCUSSION WITH POINTS ASSIGNED FOR CERTAIN CRITERIA. RANKS INCLUDED 3 FOR HIGH, 2 FOR MEDIUM, AND 1 FOR LOW. THE CRITERIA INCLUDED: URGENCY: IS THIS A PRIORITY ISSUE THAT NEEDS TO BE ADDRESSED IN THE NEXT 1-3 YEARS? POTENTIAL IMPACT: IS IT LIKELY THAT ADDRESSING THIS CRITICAL ISSUE WILL HAVE A SIGNIFICANT IMPACT ON ONE OR MORE SPECIFIC POPULATIONS? DO YOU HAVE REASON TO BELIEVE YOU CAN BE SUCCESSFUL ON THIS ISSUE? ACTIONABLE/FEASIBLE: ARE THERE OPPORTUNITIES FOR ACTION TO ADDRESS THE CRITICAL ISSUE? IS THERE ROOM TO MAKE MEANINGFUL IMPROVEMENT ON THE ISSUE? RESOURCES: ARE RESOURCES (FUNDS, STAFF, & EXPERTISE) EITHER READILY AVAILABLE OR LIKELY RESOURCES CAN BE OBTAINED TO ADDRESS THE CRITICAL ISSUE? ARE THERE RESOURCES THROUGH THE STATE AND COMMUNITY MEMBERS TO WORK ON THE ISSUE? IF NOT, CAN RESOURCES BE ACQUIRED? COMMUNITY READINESS: IS THIS A CRITICAL ISSUE IDENTIFIED AS IMPORTANT BY THE COMMUNITY? ARE PEOPLE IN THE COMMUNITY INTERESTED IN THE ISSUE? IS THERE COMMUNITY MOMENTUM TO MOVE THIS INITIATIVE FORWARD? INTEGRATION: IS THERE OPPORTUNITY FOR COLLABORATION? IS THERE OPPORTUNITY TO BUILD ON EXISTING INITIATIVES? WILL THIS DUPLICATE EFFORTS? FINALLY, THE PRIORITIES WERE PLACED ON A CONTROL/INFLUENCE GRID.THE PRIORITIES IDENTIFIED WERE AS FOLLOWS IN COMMUNITY INFORMED RANKING: 1) BUILDING FAMILIES, 2) MENTAL HEALTH, 3) ENCOURAGING SOCIAL CONNECTION, 4) ADVERSE CHILDHOOD EXPERIENCES (ACES), 5) TOBACCO/NICOTINE USE, 6) HEALTH CARE, 7) RISKY YOUTH BEHAVIOR, 8) FINANCIAL STRESS, 9) TRAUMA, AND 10) EDUCATING POLICY MAKERS AND KEY COMMUNITY STAKEHOLDERS. DUE TO THE NEWNESS OF THE COLLABORATION ON THIS WORK, A DECISION WAS MADE TO FOCUS ON THE TOP TWO PRIORITIES FOR THE COMMUNITY HEALTH IMPROVEMENT PLAN. THE PRIORITIES THREE THROUGH TEN WILL NOT SPECIFICALLY BE ADDRESSED THROUGH ACTION PLANNING OR MEASUREMENT, HOWEVER, THERE ARE WAYS MANY OF THESE PRIORITIES ARE BEING ADDRESSED EITHER WITHIN THE TOP TWO PRIORITIES OR THE COMMUNITY. IN THE FUTURE, THE GROUP WILL ASSESS THE CAPACITY TO EXPAND THE NUMBER OF PRIORITIES BEING ADDRESSED AND MEASURED. ALTHOUGH NOT DIRECTLY ADDRESSED IN THE PLAN, CENTRACARE DOES ACTIVELY SUPPORT OTHER ORGANIZATIONS WITHIN THE COMMUNITY WHO ARE WORKING ON DETERMINANTS OF HEALTH IDENTIFIED DURING THE CHNA PROCESS LIKE ACES, TOBACCO, TRAUMA, EDUCATING POLICYMAKERS, ETC.THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) IS THE ACTION PLAN THAT USES GUIDING PRINCIPLES AND STRATEGIES TO ADDRESS THE COMMUNITY PRIORITIES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS. THE TOP PRIORITIES ARE BUILDING FAMILIES AND MENTAL HEALTH. WE WILL USE THE GUIDING PRINCIPLES OF COMMUNITY COLLABORATION, AWARENESS, RESILIENCE, EQUITY, EDUCATION, AND HEALTH ORGANIZATIONS TO DRIVE OUR STRATEGIES. IN THE CURRENT FISCAL YEAR THE ORGANIZATION LOOKED AT GRANTS FOR SCHOOLS TO TEACH IN THEIR CURRICULUM AND LOOKED AT PARTNERING WITH OTHER ORGANIZATIONS TO OFFER CLASSES/RESOURCES FOR THOSE IN NEED OF PARENTING SKILLS AND CAREGIVER RESOURCES. THEY ALSO LOOKED INTO CREATING SUPPORT GROUPS, MEDICATION ASSISTED TREATMENT AND ADDITIONAL AWARENESS WITHIN THE COMMUNITY REGARDING MENTAL HEALTH NEEDS.THE ST. CLOUD HOSPITAL, CENTRACARE- MELROSE HOSPITAL, CENTRACARE- SAUK CENTRE, AND CENTRACARE- PAYNESVILLE WILL MAINTAIN THEIR ENGAGEMENTS WITH THE CENTRAL MN ALLIANCE AND FOLLOW THE MAPP LEADERSHIP STRUCTURE TO CARRY OUT THE STRATEGIES OUTLINED IN THE CHIP. THERE WILL BE MEETINGS AS OUTLINED IN THE CHIP UNDER LEADERSHIP SYSTEM & PROCESS FOR MONITORING AND REVISION. TO SEE THE FULL CHIP GO TO THE CENTRACARE WEBSITE AT HTTPS://WWW.CENTRACARE.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/. |
| CENTRACARE HEALTH - MELROSE | PART V, SECTION B, LINE 13H: A NON-CITIZEN CAN BE DENIED CARE IF THEY CAME TO THE US SPECIFICALLY TO RECEIVE FREE CARE.PRESUMPTIVE ELIGIBILITY - IF PATIENTS FAIL TO SUPPLY SUFFICIENT INFORMATION TO SUPPORT FINANCIAL ASSISTANCE ELIGIBILITY, CENTRACARE HEALTH MAY REFER TO OR RELY ON EXTERNAL SOURCES AND/OR OTHER PROGRAM ENROLLMENT RESOURCES TO DETERMINE ELIGIBILITY WHEN:(A) PATIENT IS HOMELESS(B) PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS(C) PATIENT IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM(D) PATIENT IS ELIGIBLE FOR A STATE-FUNDED PRESCRIPTION MEDICATION PROGRAM(E) PATIENT'S VALID ADDRESS IS CONSIDERED LOW-INCOME OR SUBSIDIZED HOUSING(F) PATIENT RECEIVES FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO HOSPITAL FOR FURTHER TREATMENT |
| CENTRACARE HEALTH - MELROSE | PART V, SECTION B, LINE 16J: PATIENTS WHO ARE AT A SELF PAY STATUS RECEIVE FINANCIAL ASSISTANCE INFORMATION EITHER VIA A TELEPHONE CALL OR ON BILLING STATEMENTS. |
| CENTRACARE HEALTH - MELROSE | PART V, SECTION B, LINE 20E: OUR CREDIT COLLECTION AGENCIES ARE REQUIRED TO PROVIDE CHARITY INFORMATION AS PART OF THEIR COLLECTION PROCESS PRIOR TO ANY CONSIDERATION OF LEGAL ACTION AGAINST THE PATIENT. |
| CENTRACARE HEALTH - MELROSE: | PART V, SECTION B, LINES 7A:THE HOSPITAL'S CHNA CAN BE FOUND ON ITS WEBSITE AT WWW.CENTRACARE.COM/DOCUMENTS/ABOUT/CENTRAL-MN-ALLIANCE-CHIP_CHNA-2019-2022-VERSION-2-UPDATED-02.20.PDF.PART V, SECTION B, LINES 10A:THE HOSPITAL'S IMPLEMENTATION PLAN CAN BE FOUND ON ITS WEBSITE AT WWW.CENTRACARE.COM/DOCUMENTS/ABOUT/CENTRAL-MN-ALLIANCE-CHIP_CHNA-2019-2022-VERSION-2-UPDATED-02.20.PDF. |
| SCHEDULE H, PART V, SECTION B, LINE 22B | THE FOLLOWING DISCLOSURE IS IN ACCORDANCE WITH REV. PROC. 2015-21 SECTION 7 IN REGARDS TO SCHEDULE H, PART V, SECTION B, LINE 22B. DURING THE TAX PERIOD ENDED JUNE 30, 2021, THE FINANCIAL ASSISTANCE POLICY DID NOT INCLUDE THE PERCENTAGE CALCULATED FOR THE "AMOUNTS GENERALLY BILLED" USING THE LOOK BACK METHOD. CENTRACARE IDENTIFIED THIS ERROR IN MARCH 2022 DURING THE PREPARATION OF THE FORM 990 FOR THE TAX PERIOD ENDED JUNE 30, 2021 AND CORRECTED THIS ERROR IN APRIL 2022. THIS ERROR WAS MINOR AND INADVERTENT AND CORRECTIVE ACTIONS WERE TAKEN AFTER THE DISCOVERY OF THE ERROR. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - MELROSE PINE RILLA CARE CENTER | ||||
| 525 MAIN STREET WEST | MELROSE | MN | 56382 | SKILLED CARE AND MEMORY ASSISTANCE LIVING FACILITY |
| 2 - MELROSE PARK VIEW PLACE | ||||
| 125 5TH AVE NW | MELROSE | MN | 56352 | ASSISTED LIVING FACILITY |
| 3 - MELROSE CLINIC | ||||
| 525 MAIN STREET WEST | MELROSE | MN | 56352 | CLINIC |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | CENTRACARE HEALTH SYSTEM PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT THAT INCLUDES ALL RELATED ORGANIZATIONS. |
| PART I, LINE 7: | THE ORGANIZATIONS TOTAL EXPENSES WERE REDUCED BY THEIR NON-OPERATING REVENUE, MEDICAID SURCHARGE AND MN CARE TAX. THE NET TOTAL EXPENSES WERE THEN DIVIDED BY GROSS CHARGES TO DETERMINE THE COST TO CHARGE RATIO. |
| PART I, LN 7 COL(F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $974,620 |
| PART II, COMMUNITY BUILDING ACTIVITIES: | CENTRACARE - MELROSE PARTICIPATED IN NUMEROUS MEETINGS THROUGHOUT THE YEAR WITH SURROUNDING LIONS/JAYCEES AND ALSO COMPLETED BIOMETRIC SCREENINGS WHICH HELPED PROMOTE IMPROVED HEALTH IN THE COMMUNITY.THE HEALTH SYSTEM PROVIDED DRIVE THROUGH TEST SITES, FREE VACCINATION CLINICS, MANDATED EMPLOYEE VACCINATION, TRAINING, SCREENING, PRODUCTS TO ENSURE SAFE ENVIRONMENTS, AND OTHER VARIOUS SERVICES/PRODUCTS. |
| PART III, LINE 2: | THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. |
| PART III, LINE 4: | THE FOLLOWING IS FROM THE "ACCOUNTS RECEIVABLE" PARAGRAPH INCLUDED IN NOTE 2 ON PAGE 11 OF THE ORGANIZATION'S AUDITED FINANCIALS."CENTRACARE REPORTS PATIENT AND RESIDENT SERVICE REVENUE AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH CENTRACARE EXPECTS TO BE ENTITLED TO IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS AND THIRD-PARTY PAYORS (INCLUDING MEDICARE, MEDICAID, BLUE CROSS AND OTHER THIRD-PARTY PAYORS). CERTAIN REIMBURSEMENT ARRANGEMENTS INCLUDE VARIABLE CONSIDERATION FOR AMOUNTS SUBJECT TO RETROACTIVE AUDIT AND ADJUSTMENT. DIFFERENCES BETWEEN AMOUNTS ORIGINALLY RECORDED AND FINALLY SETTLED ARE INCLUDED IN OPERATIONS IN THE YEAR IN WHICH THE DIFFERENCES ARE KNOWN. REVENUE IS RECOGNIZED AS PERFORMANCE OBLIGATIONS ARE SATISFIED." |
| PART III, LINE 8: | THE AMOUNT ON LINE 7 OF PART III WAS DETERMINED BY UTILIZING KEY SECTIONS OF THE MEDICARE COST REPORT, PRIMARILY THE D SERIES AND E SERIES. |
| PART III, LINE 9B: | THE COLLECTION POLICIES AT THE ORGANIZATION REQUIRE COLLECTION STAFF TO OFFER CHARITY TO PATIENTS WHO INDICATE THAT PAYMENT MAY BE AN ISSUE. IF A PATIENT DOES QUALIFY FOR FULL CHARITY, ALL OTHER COLLECTION EFFORTS MUST CEASE. IF A PATIENT QUALIFIES FOR PARTIAL CHARITY, COLLECTION EFFORTS WILL CONTINUE ON THE BALANCE OF THE ACCOUNT. THESE PROVISIONS APPLY TO BOTH HOSPITAL EMPLOYED COLLECTION STAFF AND COLLECTION AGENCY STAFF. NO PATIENTS, WHETHER THEY QUALIFY FOR CHARITY OR NOT, ARE REPORTED TO CREDIT REPORTING AGENCIES. |
| PART VI, LINE 2: | THE ORGANIZATIONS' STRATEGIC PLANNING ASSESSES THE NEEDS OF THE COMMUNITY AND PATIENTS THROUGH PATIENT SATISFACTION SURVEYS, COMMENT CARDS, COMMUNITY ASSESSMENTS AND A DIVERSE OPERATING COMMITTEE THAT REPRESENTS THE COMMUNITY AND BRINGS TO THE TABLE ISSUES, CONCERNS AND RECOMMENDATIONS FOR HEALTH CARE SERVICES. |
| PART VI, LINE 3: | INPATIENTS WHO ARE SELF PAY ARE IDENTIFIED, AND A REPRESENTATIVE OF THE ORGANIZATION'S BILLING DEPARTMENT EXPLAINS THE CHARITY CARE POLICY TO PATIENTS. THEY ALSO EXPLAIN THE SELF PAY DISCOUNT AND SCREENS THE PATIENT FOR ELIGIBILITY FOR ANY STATE OR FEDERAL PROGRAMS. THEY ALSO ASSIST THE PATIENT WITH ANY PAPERWORK REQUIRED TO APPLY FOR SUCH PROGRAMS. OUTPATIENTS WHO ARE SELF PAY RECEIVE AN AUTOMATIC SELF PAY DISCOUNT. IF THE PATIENT DOES NOT REMIT PAYMENT, COLLECTION STAFF ATTEMPT TO REACH THE PATIENT BY PHONE. PATIENTS ARE TOLD ABOUT THE CHARITY PROGRAM. FOR BOTH INPATIENTS AND OUTPATIENTS, ALL STATEMENTS CONTAIN A LETTER REGARDING THE AVAILABILITY OF CHARITY CARE. ALSO ALL PRECOLLECTION LETTERS HAVE THIS SAME LANGUAGE INDICATING THE AVAILABILITY AND PROCESS OF OBTAINING CHARITY CARE. |
| PART VI, LINE 4: | MELROSE IS PREDOMINANTLY AN AGRICULTURAL COMMUNITY. THE ESTIMATED 2020 POPULATION SHOWS 6,330 RESIDENTS WITH AN ESTIMATED INCREASE TO 6,444 BY 2025. THIS AREA HAS SEEN AN INCREASE IN ITS POPULATION AND PROJECTIONS INDICATE THAT WILL CONTINUE. THE PROJECTED GROWTH BY AGE BRACKET FROM 2020 TO 2025 IS AS FOLLOWS: 0-17: 2.94%, 18-44: 6.94%, 45-64: -8.35%, 65+: 4.29%. THE ESTIMATED 2020 ETHNIC MIX IS AS FOLLOWS: CAUCASIAN: 79.38%, AFRICAN AMERICAN: 1.36%, ASIAN: .54%, HISPANIC: 18.15%, OTHER: .57%. |
| PART VI, LINE 5: | THE ORGANIZATION HAS A COMMUNITY BASED OPERATING COMMITTEE THAT MEETS ON A MONTHLY BASIS TO REVIEW VARIOUS ASPECTS OF THE FACILITY AND PROVIDE INPUT ON THOSE ASPECTS FROM A COMMUNITY PERSPECTIVE. THE ORGANIZATION PARTICIPATES IN THE COMMUNITY BLOOD DRIVES BY PROVIDING FOOD AND SUPPLIES FOR BOTH THE WORKERS AND BLOOD DONORS. THE FACILITY ALSO SPONSORS A HEALTH FAIR ON AN ANNUAL BASIS FOR THE LOCAL AND SURROUNDING COMMUNITIES. |
| PART VI, LINE 6: | THE ORGANIZATION IS PART OF CENTRACARE HEALTH SYSTEM (CCHS) WHICH PROVIDES A BROAD RANGE OF HEALTH CARE SERVICES TO THE PATIENTS OF CENTRAL MINNESOTA. CCHS IS DEDICATED TO IMPROVING THE HEALTH OF PEOPLE LIVING AND WORKING IN THE COMMUNITIES IT SERVES. TO ACCOMPLISH ITS GOALS IT WORKS ACTIVELY WITH ITS AFFILIATE HEALTH CARE ORGANIZATIONS. CCHS CONTINUES TO FOCUS ON PROVIDING THE BEST CARE POSSIBLE AND IN REINVESTING INTO THE COMMUNITY. CCHS ALSO PROMOTES WELLNESS BY SPONSORING PROGRAMS AND EVENTS IN LOCAL COMMUNITIES THAT FOCUS ON HEALTHY EATING AND EXERCISE, AND BY CONDUCTING SCREENINGS FOR CONDITIONS SUCH AS HIGH BLOOD PRESSURE. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | MN |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRACARE HEALTH FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1406 6TH AVENUE NORTH | AddressLine1Txt |
| City | ST CLOUD | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56303 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 411855173 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $36,111 | CashGrantAmt |
| Purpose Of Grant | PROGRAM SUPPORT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SCHOLARSHIPS FOR ADVANCING EDUCATION | GrantTypeTxt |
| Recipient | 30 | RecipientCnt |
| Cash Grant | $20,325 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE CLASSES ARE POSTED AS "POSITIONS" ON THE WEBSITE THAT PEOPLE CAN APPLY TO. THE APPLICATIONS ARE SCREENED BY RECRUITMENT AND IF SELECTED, SET UP FOR AN INTERVIEW WITH THE HIRING MANGER AT THE SITE. IF THE HIRING MANAGER WISHES TO PROCEED, THEY ARE OFFERED A POSITION BY THE RECRUITER TO TAKE THE CNA CLASS BUT THEN ALSO TO TAKE A PART TIME OR FULL TIMES POSITION AS A CNA IN ONE OF OUR ENTITIES ONCE THEY COMPLETE THE CLASS, SKILLS, AND TEST. ANYONE THAT APPLIES AND IS NOT SELECTED, THE RECRUITMENT TEAM WOULD HAVE NOTES AND TRACKING ITEMS FOR THIS IN ORACLE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KENNETH D HOLMEN MD | ||||||||||||||
| PRESIDENT/CEO | $0 | $1,025,380 | $0 | $0 | $0 | $397,740 | $0 | $14,981 | $0 | $27,578 | $0 | $1,465,679 | $0 | $0 |
| CRAIG BROMAN | ||||||||||||||
| CHIEF OPERATING OFFICER/EVP | $0 | $956,517 | $0 | $250,000 | $0 | $181,043 | $0 | $27,625 | $0 | $24,298 | $0 | $1,439,483 | $0 | $199,215 |
| CINDY FIRKINS SMITH MD | ||||||||||||||
| VICE PRESIDENT | $0 | $618,886 | $0 | $105,282 | $0 | $128,156 | $0 | $26,000 | $0 | $27,785 | $0 | $906,109 | $0 | $0 |
| DONALD JURGENS MD | ||||||||||||||
| DIRECTOR | $0 | $853,816 | $0 | $4,650 | $0 | $4,702 | $0 | $5,688 | $0 | $15,042 | $0 | $883,898 | $0 | $0 |
| MICHAEL BLAIR | ||||||||||||||
| CHIEF FINANCIAL OFFICER/SR VP/TREASU | $0 | $524,778 | $0 | $0 | $0 | $19,618 | $0 | $45,500 | $0 | $28,119 | $0 | $618,015 | $0 | $0 |
| CHRISTIAN P SCHMIDT MD | ||||||||||||||
| DIRECTOR | $0 | $500,526 | $0 | $8,549 | $0 | $5,153 | $0 | $45,500 | $0 | $27,874 | $0 | $587,602 | $0 | $0 |
| PATRICK J HELLER | ||||||||||||||
| OPERATING COMMITTEE DIRECTOR | $0 | $478,643 | $0 | $7,783 | $0 | $3,580 | $0 | $20,820 | $0 | $21,728 | $0 | $532,554 | $0 | $0 |
| RICHARD A WEHSELER MD | ||||||||||||||
| DIRECTOR | $0 | $319,512 | $0 | $79,432 | $0 | $4,810 | $0 | $26,000 | $0 | $32,681 | $0 | $462,435 | $0 | $0 |
| MICHAEL J BESTE | ||||||||||||||
| PHYSICIAN | $0 | $395,805 | $0 | $7,783 | $0 | $6,198 | $0 | $19,500 | $0 | $30,305 | $0 | $459,591 | $0 | $0 |
| BRYAN ROLPH MD | ||||||||||||||
| DIRECTOR | $0 | $414,480 | $0 | $11,503 | $0 | $5,966 | $0 | $0 | $0 | $1,783 | $0 | $433,732 | $0 | $0 |
| KURT E SCHWIETERS | ||||||||||||||
| PHYSICIAN | $0 | $354,599 | $0 | $7,783 | $0 | $8,184 | $0 | $26,000 | $0 | $25,264 | $0 | $421,830 | $0 | $0 |
| LINDSEY R CHMIELEWSKI | ||||||||||||||
| MEDICAL DIRECTOR | $0 | $327,580 | $0 | $7,506 | $0 | $8,334 | $0 | $39,000 | $0 | $28,282 | $0 | $410,702 | $0 | $0 |
| SANTO CRUZ | ||||||||||||||
| CHIEF LEGAL OFFICER/SR VP/SECRETARY | $0 | $336,391 | $0 | $0 | $0 | $26,988 | $0 | $19,500 | $0 | $25,519 | $0 | $408,398 | $0 | $0 |
| SHARON J RUGGIERO MD | ||||||||||||||
| DIRECTOR | $0 | $242,774 | $0 | $9,089 | $0 | $9,128 | $0 | $45,500 | $0 | $12,386 | $0 | $318,877 | $0 | $0 |
| BRYAN J BAUCK | ||||||||||||||
| EXECUTIVE DIRECTOR | $0 | $229,636 | $0 | $0 | $0 | $35,278 | $0 | $0 | $0 | $32,502 | $0 | $297,416 | $0 | $1,796 |
| JULIE A KLASEN | ||||||||||||||
| PHYSICIAN | $0 | $214,962 | $0 | $11,875 | $0 | $7,733 | $0 | $19,500 | $0 | $27,507 | $0 | $281,577 | $0 | $0 |
| ADAM M PAULSON | ||||||||||||||
| FINANCE DIRECTOR | $0 | $126,123 | $0 | $0 | $0 | $5,994 | $0 | $4,167 | $0 | $22,621 | $0 | $158,905 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE COMPENSATION PAID TO THE PRESIDENT AND VICE PRESIDENTS (NON-MEDICAL PROVIDERS) IS DETERMINED BY CENTRACARE HEALTH SYSTEM, A RELATED ORGANIZATION. CENTRACARE HEALTH SYSTEM USES THE FOLLOWING METHODS TO DETERMINE COMPENSATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| PART I, LINE 4B | THE CORPORATIONS' EXECUTIVES ARE ELIGIBLE TO PARTICIPATE IN BENEFIT PLANS WHICH INCLUDE TAX DEFERRED NON-QUALIFIED INVESTMENT ACCOUNTS. THESE PLANS MAY PROVIDE, BUT ARE NOT CERTAIN TO PROVIDE, FOR PAYMENT OF TAX DEFERRED COMPENSATION TO THESE EXECUTIVES AT SOME TIME IN THE FUTURE. THE EXECUTIVE HAS NO LEGAL RIGHT TO THESE DOLLARS UNTIL, AND UNLESS, CERTAIN FUTURE EVENTS OCCUR. IN ACCORDANCE WITH THE INSTRUCTIONS TO FORM 990, THE AMOUNTS LISTED IN PART VII AND SCHEDULE J, PART II, COLUMN C, REFLECT TAX DEFERRED COMPENSATION. THIS COMPENSATION IS POTENTIALLY REPORTED TWICE ON FORM 990 - ONCE WHEN THE COMPENSATION IS DEFERRED OR ACCRUED AND AGAIN IF AND WHEN IT IS PAID TO THE EXECUTIVE. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE NON-QUALIFIED PLAN: BRYAN BAUCK - PAID $1,796 CRAIG BROMAN - PAID $199,215 |
| PART I, LINE 7 | THE ORGANIZATION PROVIDES INCENTIVE COMPENSATION TO DESIGNATED INDIVIDUALS BASED ON FOUR DISCRETE AREAS: STEWARDSHIP, THROUGH A COMPARISON BETWEEN BUDGETED AND ACTUAL NET OPERATING INCOME FOR SAINT CLOUD HOSPITAL AND/OR CENTRACARE HEALTH SYSTEM AS WELL THROUGH ACHIEVING METRICS FOR AN IDENTIFIED COST REDUCTION PROGRAM; QUALITY, THROUGH ACHIEVING SAINT CLOUD HOSPITAL AND SYSTEM QUALITY METRICS; PATIENT EXPERIENCE, THROUGH ACHIEVEMENT OF PATIENT SATISFACTION GOALS AS COMPARED TO NATIONAL AND BASELINE RANKINGS; AND PEOPLE/EMPLOYEES, THROUGH ACHIEVEMENT OF SPECIFIED EMPLOYMENT SATISFACTION GOALS AND HIRING AND/OR RETENTION GOALS. THE INCENTIVE COMPENSATION PAID OUT IS NOT A PORTION OR PERCENTAGE OF ACTUAL NET EARNINGS OF ANY CENTRACARE HEALTH SYSTEM AFFILIATE, HOWEVER NET EARNINGS GOALS ARE REQUIRED TO BE MET BEFORE THE INCENTIVE COMPENSATION IS PAID. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER IS CENTRACARE HEALTH SYSTEM, A MINNESOTA NONPROFIT ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | ALL BOARD MEMBERS ARE APPOINTED BY CENTRACARE HEALTH SYSTEM, THE SOLE CORPORATE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING MATTERS ARE RESERVED FOR ACTION BY CENTRACARE HEALTH SYSTEM, THE SOLE MEMBER: 1. ADOPTION OF AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS. 2. APPOINTMENT OF DIRECTORS AND OFFICERS. 3. APPROVAL OF THE CORPORATION'S ANNUAL OPERATING AND CAPITAL BUDGETS AND ANY DEBTS TO BE INCURRED. 4. APPROVAL OF ALL STRATEGIC PLANS. 5. DETERMINATION OF THE DISSOLUTION OF OR THE DISCONTINUATION OF THE BUSINESS OF THE CORPORATION. 6. APPROVAL OF ANY TRANSACTION WHICH MAY AFFECT THE CORPORATION'S STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE BOARD OF DIRECTORS HAS DELEGATED THE APPROVAL AUTHORITY OF THE FORM 990 TO THE AUDIT COMMITTEE. ANNUALLY, AT THE AUDIT COMMITTEE MEETING, PRIOR TO FILING WITH THE IRS, THE AUDIT COMMITTEE REVIEWS AND APPROVES FORM 990. A COPY OF FORM 990 IS THEN PROVIDED FOR THE FULL BOARD TO REVIEW PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD MEMBERS ARE REQUIRED TO REVIEW AND SIGN A CONFLICT OF INTEREST QUESTIONNAIRE TWICE A YEAR. ALL STAFF SIGN CONFLICTS OF INTEREST FORMS ON AN ANNUAL BASIS. THE QUESTIONNAIRES ARE REVIEWED BY THE CORPORATE COMPLIANCE OFFICER AS WELL AS THE CORPORATE COMPLIANCE GROUP (A COMPLIANCE COMMITTEE WHICH INCLUDES INTERNAL MEMBERS AND OUTSIDE COUNSEL). THE RESPONSES TO THE QUESTIONNAIRES ARE THEN REVIEWED WITH THE EXECUTIVE COMMITTEE OF THE BOARD. THE CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING CONFLICTS OF INTERESTS RELATED TO BOARD AND STAFF AND TO ALERT AFFECTED PARTIES WHEN A CONFLICT ARISES. WHEN AN ACTUAL CONFLICT ARISES, THE AFFECTED PARTY IS ASKED TO RECUSE HIM/HER SELF FROM THE DECISION MAKING PROCESS. THE CORPORATE COMPLIANCE OFFICER ATTENDS BOARD MEETINGS AND SPECIFIED BOARD COMMITTEE MEETINGS WHERE CONFLICT ISSUES MAY ARISE. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION AND BENEFITS OF THE PRESIDENT ARE SUBJECT TO FULL COMPENSATION AND BENEFITS COMPARABILITY STUDIES CONDUCTED BIENNIALLY BY A THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT. HOWEVER, THE COMPENSATION PORTION OF THE STUDY IS REVIEWED ANNUALLY BY THE CONSULTANT AND UPDATED FOR COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REVIEW AND APPROVAL. THE MOST RECENT FULL REVIEW WAS DONE JUNE 2021. THE THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT IS RETAINED BY ST. COULD HOSPITAL TO PERFORM SERVICES. THE COMPENSATION AND BENEFITS OF THE VICE PRESIDENTS (NON-MEDICAL PROVIDERS) ARE SUBJECT TO FULL COMPENSATION AND BENEFITS COMPARABILITY STUDIES CONDUCTED BIENNIALLY BY A THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT. HOWEVER, THE COMPENSATION PORTION OF THE STUDY IS REVIEWED ANNUALLY BY THE CONSULTANT AND UPDATED FOR COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REVIEW AND APPROVAL. THE MOST RECENT FULL REVIEW WAS COMPLETED IN JUNE 2021. THE THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT IS RETAINED BY ST. CLOUD HOSPITAL TO PERFORM THESE SERVICES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE HOSPITAL/CENTRACARE HEALTH SYSTEM DOES NOT GENERALLY MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. THE HOSPITAL/CENTRACARE HEALTH SYSTEM DOES DO AN ANNUAL REPORT TO THE COMMUNITY IN WHICH FINANCIAL RESULTS ARE REPORTED TO AND DISCUSSED WITH THE PUBLIC. THIS REPORT IS AVAILABLE TO THE PUBLIC ON THE ORGANIZATION'S WEBSITE. |
| PART VIII, LINE 1E | NEGATIVE REVENUE IS ATTRIBUTABLE TO HHS REGULATION CHANGES RELATED TO POOLED FUNDING AND TARGETED FUNDING FOR COVID RELIEF. |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 57,670. MANAGEMENT AND GENERAL EXPENSES 62,109. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 119,779. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 1,617,155. MANAGEMENT AND GENERAL EXPENSES 833,694. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,450,849. LABORATORY FEES: PROGRAM SERVICE EXPENSES 1,905,952. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,905,952. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 523,773. MANAGEMENT AND GENERAL EXPENSES 77,731. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 601,504. MEDICAL FEES: PROGRAM SERVICE EXPENSES 1,407,036. MANAGEMENT AND GENERAL EXPENSES 38,935. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,445,971. |
| FORM 990, PART XI, LINE 9: | TRANSFERS TO AFFILIATED ORGANIZATIONS -397,988. |
| FORM 990, PART XII, LINE 3B: | DUE TO COVID-19 THE OFFICE OF MANAGEMENT AND BUDGET EXTENDED THE SINGLE AUDIT DUE DATE. DUE TO THIS THE SINGLE AUDIT REQUIRED TO BE COMPLETED IS IN PROCESS, HOWEVER THE JUNE 30, 2020 SINGLE AUDIT HAS BEEN COMPLETED. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CENTRACARE HEALTH SYSTEM | |||||||||||
| 1406 6TH AVENUE NORTH | ST CLOUD | MN | 56303 | 411813221 | INTEGRATED HEALTH SYSTEM | MN | 501(C)(3) | 3 | N/A | 0 | |
| ST CLOUD HOSPITAL | |||||||||||
| 1406 6TH AVENUE NORTH | ST CLOUD | MN | 56303 | 410695596 | ACUTE / LT CARE | MN | 501(C)(3) | 3 | 0 | CENTRACARE HEALTH SYSTEM | |
| CENTRACARE HEALTH - LONG PRAIRIE | |||||||||||
| 50 CENTRACARE DRIVE | LONG PRAIRIE | MN | 56347 | 411924645 | ACUTE / LT CARE | MN | 501(C)(3) | 3 | Yes (1) | CENTRACARE HEALTH SYSTEM | |
| CENTRACARE HEALTH - SAUK CENTRE | |||||||||||
| 425 NORTH ELM STREET | SAUK CENTRE | MN | 56378 | 452438973 | ACUTE / LT CARE | MN | 501(C)(3) | 3 | Yes (1) | CENTRACARE HEALTH SYSTEM | |
| CENTRACARE CLINIC | |||||||||||
| 1200 6TH AVENUE NORTH | ST CLOUD | MN | 56303 | 411806657 | MULTI-SPECIALTY | MN | 501(C)(3) | 3 | Yes (1) | CENTRACARE HEALTH SYSTEM | |
| CENTRACARE HEALTH FOUNDATION | |||||||||||
| 1406 6TH AVENUE NORTH | ST CLOUD | MN | 56303 | 411855173 | FUNDRAISING | MN | 501(C)(3) | 7 | 0 | CENTRACARE HEALTH SYSTEM | |
| CUSHMAN ALBERT RICE TRUST | |||||||||||
| 1100 WEST ST GERMAIN STREET | ST CLOUD | MN | 56303 | 416019335 | SUPPORT FOR CARRIS HEALTH | MN | 501(C)(3) | 12A, I | 0 | CARRIS HEALTH | |
| CARRIS HEALTH FOUNDATION | |||||||||||
| 301 BECKER AVENUE SOUTHWEST | WILLMAR | MN | 56303 | 411611555 | SUPPORT FOR CARRIS HEALTH | MN | 501(C)(3) | 7 | 0 | CENTRACARE HEALTH FOUNDATION | |
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 |
|---|---|---|---|---|---|---|---|---|---|
| MONTICELLO CANCER CENTER | |||||||||
| 1001 HART BOULEVARD SUITE 50 | MONTICELLO | MN | 55362 | 261909519 | RADIATION & ONCOLOGY SERVICES | MN | N/A | 0 | 0 |
| BENSON MEDICAL LLC | |||||||||
| 1228 ATLANTIC AVENUE | BENSON | MN | 56215 | 203149203 | HEALTHCARE | MN | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| CENTRACARE HOLDINGS INC | |||||||||
| 1406 6TH AVENUE NORTH | ST CLOUD | MN | 56303 | 472688595 | HOLDING COMPANY / PHARMACY | MN | N/A | C | 0 |
| AFFILIATED COMMUNITY MEDICAL CENTERS PA | |||||||||
| 301 BECKER AVENUE SOUTHWEST | WILLMAR | MN | 56201 | 410850702 | HEALTHCARE SYSTEM | MN | N/A | C | 0 |
| AFFILIATED COMMUNITY HEALTH NETWORK INC | |||||||||
| 101 WILLMAR AVENUE SOUTHWEST | WILLMAR | MN | 56201 | 411765606 | HEALTH NETWORK | MN | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | 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 | 0 | 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 | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CENTRACARE HEALTH SYSTEM | ||
| P | $33,330,970 | FMV |
| CENTRACARE HEALTH FOUNDATION | ||
| C | $56,748 | FMV |
| CENTRACARE HEALTH FOUNDATION | ||
| B | $36,111 | FMV |
| CENTRACARE HEALTH SYSTEM | ||
| N | $3,422,966 | FMV |
| CENTRACARE HEALTH SYSTEM | ||
| O | $5,375,835 | FMV |