2022-04-18T15:22:23-05:00 2021-05-31 450250958 EIDE BAILLY LLP 200 E 10TH ST STE 500 SIOUX FALLS SD 571046375 990 2020-06-01 410758512 MADELIA HEALTH MADE 5076423255 121 DREW AVE SE MADELIA MN 56062 BRUCE CRAVEN CFO 5076423255 2022-04-18 1 BRUCE CRAVEN 999009999 LAURIE HANSON CPA P00851848 6053391999 2022-04-16 0 AAL1 IAL1 2020 2022-09-23 18:48:47Z X JAKE REDDEN 121 DREW AVE SE MADELIA MN 56062 20430065 0 X WWW.MADELIAHEALTH.ORG X 1950 MN PROVIDE QUALITY HEALTHCARE SERVICES TO THE LOCAL COMMUNITY. 9 9 181 8 0 0 351370 5120627 12893755 15048993 228143 147439 117237 13035 13590505 20330094 0 0 0 0 6717055 8689306 0 0 0 7085658 7410664 13802713 16099970 -212208 4230124 20506821 20549984 10711092 5802689 9795729 14747295 THE MISSION OF MADELIA HEALTH IS TO PROVIDE SAFE AND QUALITY HEALTHCARE SERVICES TO THOSE WE SERVE IN AN ENVIRONMENT BASED ON RESPECT, DIGNITY, AND EXCELLENCE. 0 0 12969568 15048993 MADELIA HEALTH PROVIDES GENERAL MEDICAL/SURGICAL SERVICES FOR INPATIENTS, SWING BED PATIENTS, OUTPATIENTS AND HOME CARE CLIENTS. DURING THE FISCAL YEAR 2020-21 THERE WERE 118 ACUTE CARE ADMISSIONS WITH 401 PATIENT DAYS, 64 SWING BED ADMISSIONS WITH 533 PATIENT DAYS, 11,982 HOME CARE VISITS TO 1,101 PATIENT, AND 4,364 TOTAL OUTPATIENT VISITS. A VARIETY OF COMMUNITY BENEFIT SERVICES ARE DONE EACH YEAR BY VOLUNTEER HOSPITAL EMPLOYEES AND COMMUNITY VOLUNTEERS. 12969568 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 62 0 1 181 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 1 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 1 0 MN X BRUCE CRAVEN 5076423255 121 DREW AVENUE SOUTHEAST MADELIA MN 56062 DENNIS ARDUSER CHAIRMAN 1.00 0.20 X X 1800 0 0 BRIAN MCCABE VICE CHAIR 1.00 0.00 X X 1400 0 0 STEVE SORENSON TREASURER/SECRETARY 1.00 0.00 X X 1400 0 0 STEVE COOLING BOARD MEMBER 1.00 0.00 X 1600 0 0 KEN GRONEWOLD BOARD MEMBER 1.00 0.00 X 1200 0 0 LIZ SCHMIDT BOARD MEMBER 1.00 0.00 X 1200 0 0 NORMA KRUMIEDE BOARD MEMBER 1.00 0.00 X 1200 0 0 RYAN VISHER BOARD MEMBER 1.00 0.00 X 1200 0 0 ELIZABETH SCHMIDT BOARD MEMBER 1.00 0.00 X 0 0 0 BARBARA OVERLIE BOARD MEMBER UNTIL 9/2020 1.00 0.00 X 0 0 0 JEFF MENGENHAUSEN CEO 40.00 0.20 X 196286 0 21309 MONIQUE HOFFMANN-URBAN CFO UNTIL 4/2021 40.00 0.00 X 121421 0 10399 ROZ SNYDER INTERIM CEO; CCO BEG 1/2021 40.00 0.00 X 0 0 0 JANE MALMSKOG PHARMACIST 40.00 0.00 X 146767 0 14216 KARLA BOETTCHER NURSE PRACTITIONER 40.00 0.00 X 211823 0 15701 JENNIFER MCLAUGHLIN REGISTERED NURSE 40.00 0.00 X 120846 0 15393 ELIZABETH HOLMQUIST NURSE PRACTITIONER 40.00 0.00 X 119344 0 6257 DENNIS NELSON PHYSICIAN 40.00 0.00 X 153900 0 0 1081387 0 83275 15 1 1 0 MANKATO CLINIC LTD 1804 N RIVERFRONT DR MANKATO MN 56001 PROVIDERS 918304 WHITESELL MEDICAL STAFFING LTD PO BOX 997 ANNANDALE MN 55302 TRAVELING PROVIDERS 245292 PIETSCH CONSTRUCTION 28617 850TH AVE MADELIA MN 56062 CONSTRUCTION 199779 MARCO TECHNOLOGIES LLC PO BOX 1450 MINNEAPOLIS MN 55485 IT SUPPORT 132154 MEDICAL SOLUTIONS LLC PO BOX 850737 MINNEAPOLIS MN 55485 TRAVELING NURSE 130608 6 261946 4847382 11299 5120627 NET PATIENT REVENUE 624100 14415065 14415065 PHARMACY 446110 321315 321315 312613 312613 15048993 201760 201760 13035 13035 41616 4034 99971 0 -58355 4034 -54321 -54321 20330094 15048993 0 160474 476516 476516 6156553 5458244 698309 148510 133596 14914 1429605 1031214 398391 478122 399519 78603 392176 392176 18770 18770 466938 466938 240478 240478 63461 46743 16718 6007 6007 215254 188312 26942 821199 718413 102786 MEDICAL SUPPLIES 3295040 3232849 62191 OPERATING FEES 1575447 1362495 212952 REPAIR AND MAINTENANCE 261102 261102 54792 54792 16099970 12969568 3130402 0 2265800 7864846 1183780 84758 2222905 2568617 284869 415525 59688 92846 19123037 13194640 5215440 5928397 1891392 10308200 617123 52619 20506821 20549984 1152812 1214717 510000 4390158 3876207 1494360 33729 3673762 168036 10711092 5802689 X 9655729 14624113 140000 123182 9795729 14747295 20506821 20549984 4230124 721442 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 194207 194207 7510668 4588646 2922022 334564 231723 102841 11057327 8374271 2683056 26271 26271 5928397 THIRD PARTY PAYOR SETTLEMENTS 168036 168036 X PART X, LINE 2: THE HOSPITAL BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE HOSPITAL WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. 1 1 X 1 X 1 X 1 1 1 0 1 1 3000 3000 0.00020 263421 207902 55519 0.00340 266421 207902 58519 0.00360 31453 31453 0.00200 1536634 827573 709061 0.04400 1568087 827573 740514 0.04600 1834508 1035475 799033 0.04960 1 627573 71543 4416177 4379394 36783 X 1 1 1 1 MADELIA HEALTH 121 DREW AVE SE MADELIA MN 56062 WWW.MADELIAHEALTH.ORG 385015 X X X X MADELIA HEALTH 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X HTTPS://WWW.MADELIAHEALTH.ORG/CHNA/ X 1 18 0 1 0 1 X 100.000000000000 200.000000000000 X X 1 1 X X X X 1 X PART V SECTION C X PART V SECTION C X PART V SECTION C X X X X X X X 1 X 0 X X X X 1 X 0 0 MADELIA HEALTH PART V, SECTION B, LINE 5: PART V, SECTION B, LINE 5: FOR MADELIA HEALTH'S MAY 2019 COMMUNITY HEALTH NEEDS ASSESSMENT, THE HOSPITAL SOLICITED INPUT FROM THE COMMUNITY THROUGH A SURVEY THAT WAS MAILED TO EVERY HOME IN SIX ZIP CODES - 7,494 IN TOTAL. WE RECEIVED 253 RESPONSES, INCLUDING 43 FROM INDIVIDUALS WHO SELF-IDENTIFIED AS LOW-INCOME, SIX FROM INDIVIDUALS WHO IDENTIFIED AS LATINO, 130 FROM INDIVIDUALS WHO IDENTIFIED AS ELDERLY, AND 45 FROM MEDICAL PROFESSIONALS. MADELIA HEALTH PART V, SECTION B, LINE 11: NEEDS IDENTIFIED IN THE MOST RECENT CHNA IMPLEMENTATION STRATEGY INCLUDE CANCER, MENTAL HEALTH, DIABETES, HEART DISEASE AND OBESITY.IT IS UNDERSTOOD THAT IT WILL TAKE A NUMBER OF YEARS TO OBTAIN MEASURABLE DATA TO DEMONSTRATE ACTUAL EDUCATION IN OBESITY. THE CURRENT STRATEGY FOCUSES ON SHORT TERM GOALS. THE FOLLOWING SHORT TERM GOALS HAVE BEEN ESTABLISHED TO REMOVE THE BARRIERS TO HEALTHY EATING AND INCREASE PHYSICAL EXERCISE: DEVELOP PARTNERSHIPS WITH COMMUNITY AND COUNTY ORGANIZATIONS WHO SHARE THE SAME VISION TO IMPROVE THE ACCESS OF FRESH FRUITS AND VEGETABLES WITHIN THE COMMUNITY; DEVELOP OPPORTUNITIES TO PROVIDE LOW-COST OR NO-COST FRUITS AND VEGETABLES TO THOSE IN NEED; INCREASE COMMUNITY AWARENESS OF PROGRAMS THAT WILL ALLOW THEM TO OBTAIN FRESH FRUITS AND VEGETABLES AT LOW OR NO COST; EDUCATE CHILDREN ON HEALTHY EATING; EDUCATE CHILDREN ON THE RELATIONSHIP BETWEEN PHYSICAL ACTIVITY AND OVERALL HEALTH; PARTNER WITH MADELIA SCHOOL ON THE JUMP ROPE FOR HEARTS PROJECT; PROVIDE OPPORTUNITIES FOR THE COMMUNITY TO TASTE FRUITS AND VEGETABLES COMMON TO DIFFERENT CULTURES REPRESENTED IN THE COMMUNITY.DIABETES, HEART DISEASE, AND CANCER:MADELIA HEALTH RECOGNIZES THE IMPORTANCE OF RESOURCE UTILIZATION IS DONE IN A WAY THAT WILL HAVE THE GREATEST IMPACT ON THE COMMUNITY AS A WHOLE. BY FOCUSING ON OBESITY BY SETTING GOALS AND PROVIDING EDUCATION, REDUCING OBESITY WILL ALSO REDUCE THE RISK OF DIABETES, HEART DISEASE, AND CANCER.IN FISCAL YEAR 2021, MADELIA HEALTH STAFF OPENED A FARMERS MARKET IN A NEW LOCATION. THERE WERE OTHER INITIATIVES PLANNED BUT THEY WERE CANCELLED DUE TO COVID. MADELIA HEALTH PART V, SECTION B, LINE 13B: IF A PATIENT NEEDS CARE WITHIN ONE YEAR OF COMPLETION AND APPROVAL OF A FINANCIAL ASSISTANCE APPLICATION, THE ORGANIZATION WILL USE PRESUMPTIVE ELIGIBILITY BASED ON THE PREVIOUSLY COMPLETED APPLICATION. THE ORGANIZATION DOES NOT UTILIZE THIRD PARTY INFORMATION TO DETERMINE PRESUMPTIVE ELIGIBILITY FOR FINANCIAL ASSISTANCE. MADELIA HEALTH PART V, SECTION B, LINE 16J: THE FAP APPLICATION IS AUTOMATICALLY MAILED OUT TO UNINSURED AND UNDERINSURED PATIENTS. MADELIA HEALTH PART V, SECTION B, LINE 20E: PATIENTS ARE INFORMED OF THE STATUS OF THEIR ACCOUNT THROUGH BILLING STATEMENTS AND LETTERS INDICATING THE AGING OF THEIR ACCOUNT AND THE AVAILABILITY TO MAKE PAYMENT ARRANGEMENTS WITH SEVERAL OPTIONS OF RECEIVING A DISCOUNT. PART V, LINES 16A-16C THE FAP, FAP APPLICATION, AND FAP SUMMARY ARE AVAILABLE AT: HTTPS://WWW.MADELIAHEALTH.ORG/FINANCIAL-ASSISTANCE/ 3 1 - LAKE CRYSTAL CLINIC 221 S MURPHY ST LAKE CRYSTAL MN 56055 CLINIC 2 - LAKE CRYSTAL PHARMACY 210 S MAIN ST LAKE CRYSTAL MN 56055 PHARMACY 3 - LAKE CRYSTAL REHAB 621 W NATHAN ST LAKE CRYSTAL MN 56055 REHAB SERVICE SPACE WITHIN A COMMUNITY CENTER PART I, LINE 3C: THE METHODOLOGY USED TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE TAKES INTO CONSIDERATION INCOME, FAMILY SIZE AND ASSETS AVAILABLE TO PAY FOR CARE. IF A PATIENT NEEDS CARE WITHIN ONE YEAR OF COMPLETION AND APPROVAL OF A FINANCIAL ASSISTANCE APPLICATION, THE ORGANIZATION WILL USE PRESUMPTIVE ELIGIBILITY BASED ON THE PREVIOUSLY COMPLETED APPLICATION. THE ORGANIZATION DOES NOT UTILIZE THIRD PARTY INFORMATION TO DETERMINE PRESUMPTIVE ELIGIBILITY FOR FINANCIAL ASSISTANCE. PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT IS AVAILABLE UPON REQUEST. PART I, LINE 7: LINE 7A, CHARITY CARE EXPENSE WAS CONVERTED TO COST BASED ON AN OVERALL COST-TO-CHARGE RATIO WHICH ADDRESSES ALL PATIENT SEGMENTS. LINE 7B, UNREIMBURSED MEDICAID, WAS CALCULATED USING THE COSTING METHODS TO PREPARE THE COST REPORTS. LINE 7E WAS CACULATED AT COST. LINE 7G, SUBSIDIZED HEALTH SERVICES, WAS CALCULATED USING THE MEDICARE COST REPORT. PART III, LINE 2: THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE ORGANIZATION DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSION BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THIS CLASS OF PATIENTS. PART III, LINE 3: THE ESTIMATED AMOUNT OF THE ORGANIZATION'S IMPLICIT PRICE CONCESSIONS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS CALCULATED BASED ON THE PERCENTAGE OF INDIVIDUALS LIVING BELOW THE POVERTY LEVEL IN 2020. THEREFORE, 11.4% OF IMPLICIT PRICE CONCESSIONS CAN REASONABLY BE CONSIDERED A COMMUNITY BENEFIT AS IT WOULD HAVE BEEN WRITTEN OFF TO CHARITY CARE. PART III, LINE 4: THE FOOTNOTE THAT DESCRIBES IMPLICIT PRICE CONCESSION IS ON PAGE 12 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: MEDICARE ALLOWABLE COST OF CARE WAS CALCULATED FROM THE MEDICARE COST REPORT FOR FISCAL YEAR ENDING 06/30/2021. MEDICAL SERVICES ARE PROVIDED TO PATIENTS WITH MEDICARE COVERAGE REGARDLESS OF WHETHER OR NOT A SURPLUS OR DEFICIT IS REALIZED. PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES WHICH ARE VITALLY NEEDED BY OUR COMMUNITY.THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. PART III, LINE 9B: EACH WEEK, STATEMENTS ARE SENT OUT THROUGH OUR EDI PROCESS WITH STATEMENTS BEING MAILED TO THE PATIENT BY A CLEARINGHOUSE. PATIENTS ARE BILLED AFTER MEDICARE OR COMMERCIAL INSURANCE HAS BEEN FILED AND PAYMENT HAS BEEN RECEIVED WITHIN A SIX-WEEK PERIOD. PATIENTS WILL BE BILLED FOR THE REMAINING BALANCE MONTHLY. ACCOUNTS ARE VERIFIED INTERNALLY PRIOR TO COLLECTION LETTERS BEING SENT. IF NO PAYMENT IS RECEIVED WITHIN 2 MONTHS OF BILLINGS, THE STATEMENT IS SENT WITH A NOTICE LETTER REQUESTING PAYMENT. LETTERS WILL ALSO BE SENT SHOULD NO PAYMENT BE RECEIVED WITHIN 60 AND 90 DAYS. SHOULD NO RESPONSE BE RECEIVED WITHIN FIVE (5) DAYS OF THE LAST LETTER, A TELEPHONE CALL IS ISSUED TO NEGOTIATE A PAYMENT PLAN. IF ACCOUNT HOLDER MAY QUALIFY FOR OUR HEALTHCARE FINANCIAL PROGRAM, AN APPLICATION IS SENT TO BE COMPLETED AND RETURNED TO US. LACK OF RESPONSE TO THE TELEPHONE CALL WILL RESULT IN VERIFICATION OF THE ACCOUNT(S) BY THE INSURANCE BILLING CLERKS AND THEN REVIEWED BY THE BUSINESS OFFICE MANAGER FOR APPROVAL TO BEGIN FORMAL COLLECTION PROCESS. THESE ACCOUNTS ARE THEN TURNED OVER TO A PROFESSIONAL COLLECTION AGENCY. CHARITY CARE CONSIDERATIONS WILL BE MADE BY THE BUSINESS OFFICE MANAGER WHEN ALL NECESSARY DOCUMENTATION IS PRESENTED AND SHOULD IT BE EVIDENT THAT THE PATIENT'S LACK OF FINANCES WARRANT THIS AND CHARITY CARE IS THE BEST ETHICAL DECISION FOR THE PATIENT. PART VI, LINE 2: THROUGH THE COMMUNITY ASSESSMENT PROCESS, HEALTHCARE NEEDS AND SERVICES WERE IDENTIFIED AND PROGRAMS WERE DEVELOPED. STRATEGIC PLANNING ASSESSES THE NEEDS OF THE COMMUNITY AND PATIENTS THROUGH PATIENT SATISFACTION SURVEYS, COMMENT CARDS, COMMUNITY ASSESSMENTS, AND A DIVERSE MEMBERHIP OF COMMUNITY ELECTED GOVERNING BOARD MEMBERS THAT REPRESENT THE COMMUNITY AND BRINGS TO THE TABLE ISSUES, CONCERNS, AND RECOMMENDATIONS FOR HEALTH CARE SERVICES.MADELIA HEALTH COLLABORATES WITH OTHER LOCAL ORGANIZATIONS REFERRED TO AS THE MADELIA COMMUNITY BASED COLLABORATIVE (MCBC) WHICH INCLUDES THE FOLLOWING PARTICIPANT ORGANIZATIONS: MADELIA HEALTH AND CLINICS MINNESOTA STATE UNIVERSITY, MANKATO SCHOOL OF NURSING, GLEN TAYLOR NURSING INSTITUTE FOR FAMILY AND SOCIETY, WATONWAN COUNTY PUBLIC HEALTH DEPARTMENT, MADELIA SCHOOL SYSTEM, LUTHER MEMORIAL HOME, DOWNS FOOD GROUP INC, MADELIA CITY COUNCIL, AND MADELIA CHAMBER OF COMMERCE. THROUGH THIS COLLABORATION, MADELIA HEALTH IS ABLE TO PARTNER WITH OTHER ORGANIZATIONS THAT HAVE EXPRESSED AN INTEREST IN IMPROVING THE HEALTH OF THEIR EMPLOYEES. THE COMMUNITY HEALTH NEEDS ASSESSMENT COMPLETED BY MADELIA HEALTH HELPS MCBC DETERMINE WHAT AREAS THEY WILL FOCUS THEIR EFFORTS IN ORDER TO GAIN THE MOST BENEFIT FOR THE COMMUNITY. STAFF FROM MADELIA HEALTH HAVE A SIGNIFICANT ROLE IN THIS DEVELOPMENT AND CARRYING OUT THE ACTION PLANS. PART VI, LINE 3: PATIENTS ARE INFORMED OF FINANCIAL ASSISTANCE UPON ADMISSION TO THE HOSPITAL, THROUGH BILLING CLERKS ASSISTANCE WITH PATIENT ACCOUNTS, STATEMENTS ON THE BILLS, AND PERSONAL LETTERS SENT TO ACCOUNTS IDENTIFIED AS UNINSURED AND UNDERINSURED. PART VI, LINE 4: MADELIA HEALTH SERVES A 25 MILE RADIUS OF RURAL COMMUNITIES CONSISTING OF A CULTURALLY DIVERSE AND SENIOR POPULATION. PART VI, LINE 5: THE HOSPITAL SERVES ALL PERSONS IN THE COMMUNITY ON A NON-DISCRIMINATORY BASIS, AND OPERATES AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY. MADELIA HEALTH HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. THE GOVERNING BODY IS COMPRISED PRIMARILY OF INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY.STAFF PARTICIPATE IN COMMUNITY ORGANIZATIONS TO PROVIDE HEALTHCARE REPRESENTATION AND INFORMATION TO ENHANCE THOSE ORGANIZATION'S EVENTS, ETC. X 1 0 X X 0 0 0 0 0 0 0 0 0 KARLA BOETTCHER NURSE PRACTITIONER 134900 0 76923 0 0 0 6783 0 8919 0 227525 0 0 0 JEFF MENGENHAUSEN CEO 169242 0 27044 0 0 0 8082 0 13227 0 217595 0 0 0 JANE MALMSKOG PHARMACIST 146767 0 0 0 0 0 7481 0 6735 0 160983 0 0 0 DENNIS NELSON PHYSICIAN 153900 0 0 0 0 0 0 0 0 0 153900 0 0 0 PART I, LINE 1A HOUSING ALLOWANCE FOR CEO OF $5,000 LISTED ON THE 1099. A CITY OF MADELIA MN 466005334 2021-02-26 4118000 REVENUE REFUNDING BOND SERIES 2021 0 0 0 A 36703 4118000 81644 4036356 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 0 1 0 0 0 0 A 0 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE PRESIDENT, AS CHAIRPERSON, VICE PRESIDENT/TREASURER, SECRETARY, AND UP TWO (2) ADDITIONAL TRUSTEES. THE EXECUTIVE COMMITTEE SHALL HAVE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD OF TRUSTEES, SUBJECT TO ANY POWER LIMITATION IMPOSED BY THE BOARD OF TRUSTEES. A QUORUM FOR THE EXECUTIVE COMMITTEE CAN ONLY BE MADE UP OF EXECUTIVE COMMITTEE MEMBERS AND ONLY EXECUTIVE COMMITTEE MEMBERS MAY VOTE DURING EXECUTIVE COMMITTEE MEETINGS. MINUTES OF THE EXECUTIVE MEETINGS SHALL BE SUBMITTED TO THE BOARD OF TRUSTEES. THE EXECUTIVE COMMITTEE SHALL ANNUALLY EVALUATE THE CHIEF EXECUTIVE OFFICER'S PERFORMANCE AND RECOMMEND HIS/HER REMUNERATION TO THE FULL BOARD OF TRUSTEES BASED ON THE CHIEF EXECUTIVE OFFICER'S PERFORMANCE IN RELATION TO THE CORPORATION'S OBJECTIVES AND GOALS. THIS COMMITTEE SHALL MEET AS NECESSARY. FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION CHANGED ITS NAME FROM MADELIA COMMUNITY HOSPITAL, INC TO MADELIA HEALTH EFFECTIVE APRIL 19, 2021. FORM 990, PART VI, SECTION A, LINE 6 MEMBERSHIP OF THIS CORPORATION SHALL BE OPEN TO ANY NATURAL PERSON WHO MEETS THE FOLLOWING QUALIFICATIONS AT THE TIME OF APPLICATION: 1) IS OF LEGAL VOTING AGE IN MINNESOTA; 2) IS A VOTING RESIDENT WITHIN THE PRIMARY SERVICE AREA OF THE HOSPITAL, BEING DEFINED AS THE COUNTIES OF WATONWAN, BLUE EARTH, BROWN, MARTIN AND NICOLLET, STATE OF MINNESOTA; 3) IS A NATURAL PERSON AND NOT A CORPORATION, PARTNERSHIP OR OTHER ASSOCIATION; 4) SUBMITS A WRITTEN APPLICATION FOR MEMBERSHIP TO THE BOARD OF TRUSTEES ON A FORM APPROVED BY THE BOARD OF TRUSTEES; AND 5) SUBMITS A MEMBERSHIP FEE OF $25 OR MORE, WITH SAID APPLICATION. FORM 990, PART VI, SECTION A, LINE 7A ALL TRUSTEES ARE ELECTED BY THE CORPORATE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE CHIEF FINANCIAL OFFICER PRIOR TO FILING AND WILL BE PRESENTED TO THE GOVERNING BOARD OF TRUSTEES BY FINANCE COMMITTEE AT THE FIRST REGULAR MEETING OF THE BOARD OF TRUSTEES SUBSEQUENT TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS REVIEWED AT THE JANUARY BOARD MEETING BY THE GOVERNING BOARD AND DEPARTMENT MANAGERS. IF ANY CONFLICTS OF INTEREST ARISE, NOTIFICATION IS GIVEN TO ADMINISTRATION. A CONTRACT OR OTHER TRANSACTION THAT MAY INVOLVE A CONFLICT OF INTEREST IS NOT VOID OR VOIDABLE IF: 1) THE CONTRACT OR TRANSACTION WAS FAIR AND REASONABLE AS TO THE CORPORATION WHEN IT WAS AUTHORIZED, APPROVED, OR RATIFIED; 2) ALL MATERIAL FACTS ARE FULLY DISCLOSED TO THE MEMBERS AND THE CONTRACT OR TRANSACTION IS APPROVED BY TWO-THRIDS OF THE MEMBERS ENTITLED TO VOTE, OTHER THAN THE INTERESTED DIRECTOR OR TRUSTEE; AND 3) ALL MATERIAL FACTS ARE FULLY DISCLOSED TO THE BOARD OF TRUSTEES OR A COMMITTEE, AND THE BOARD OR COMMITTEE APPROVES THE CONTRACT OR TRANSACTION BY A MAJORITY VOTE, BUT THE INTERESTED TRUSTEE MAY NOT TAKE PART IN THE DISCUSSION, AND MAY NOT VOTE. FORM 990, PART VI, SECTION B, LINE 15 MADELIA HEALTH ENSURES THAT THE COMPENSATION PAID TO ITS CEO BE CONSISTENT WITH POLICY AND PROVIDE EQUITABLE STANDARDS FOR WAGE AND BENEFITS BASED ON ANNUAL REGIONAL SURVEY OF COMPARABLE ENTITIES. THE GOVERNING BOARD REVIEWS ANNUALLY THE CEO'S PERFORMANCE AND THE BASIS IS THE ANNUAL MN HOSPITAL ASSOCIATON SURVEY. THE BOARD DETERMINES THE CEO'S BASE SALARY, IN ITS SOLE DISCRETION. THE CEO EVALUATES COMPENSATION OF OTHER OFFICERS AND EMPLOYEES ANNUALLY BASED ON THEIR PERFORMANCE. ANNUAL INCREASES ARE BASED ON A REGIONAL SURVEY OF COMPARABLE ENTITIES WITH SIMILAR POSITIONS ALONG WITH YEARS OF SERVICE AND NUMBER SUPERVISED. THE SURVEY RESULTS AND THE EMPLOYEES PERFORMANCE ARE EVALUATED FOR AN INCREASE IF DEEMED APPROPRIATE. FORM 990, PART VI, SECTION C, LINE 19 MADELIA HEALTH MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AT THE ANNUAL CORPORATION MEETING AND UPON REQUEST. MADELIA COMMUNITY HOSPITAL FOUNDATION 121 DREW AVENUE SE MADELIA MN 56062 731719218 SOLICIT CONTRIBUTIONS ON BEHALF OF THE MADELIA COMMUNITY HOSPITAL MN 501(C)(3) LINE 12A, I MADELIA HEALTH 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 MADELIA HEALTH FOUNDATION C 261946 COST