UNITED HOSPITAL DISTRICT INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- UNITED HOSPITAL DISTRICT INC (EIN 45-4165628)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-05
- IRS object ID
- 202103099349303895
- Schema version
- 2020v4.1
- 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 D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-05T15:08:50-05:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Nicollet Mall Ste 1300 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554027033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 454165628 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | United Hospital District Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UNIT | BusinessNameControlTxt |
| Phone | 5075263273 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 515 S Moore Street | AddressLine1Txt |
| City | Blue Earth | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56013 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Richard Ash | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 5075263273 | PhoneNum |
| Signature | 2021-10-28 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Richard | PersonFirstNm |
| Person Last | Ash | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2021-10-28 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Richard Ash | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 515 S Moore Street | AddressLine1Txt |
| City | Blue Earth | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56013 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $38,674,943 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.uhd.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2011 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | Provision of health care services | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 279 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $139,277 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,221,308 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $38,638,556 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $33,093,718 | CYProgramServiceRevenueAmt |
| PY Investment Income | $226,673 | PYInvestmentIncomeAmt |
| CY Investment Income | -$1,221,699 | CYInvestmentIncomeAmt |
| PY Other Revenue | $710 | PYOtherRevenueAmt |
| CY Other Revenue | $210 | CYOtherRevenueAmt |
| PY Total Revenue | $39,005,216 | PYTotalRevenueAmt |
| CY Total Revenue | $37,093,537 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $20,341,135 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $20,007,746 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $16,537,061 | PYOtherExpensesAmt |
| CY Other Expenses | $16,102,550 | CYOtherExpensesAmt |
| PY Total Expenses | $36,878,196 | PYTotalExpensesAmt |
| CY Total Expenses | $36,110,296 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,127,020 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $983,241 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $44,335,314 | TotalAssetsBOYAmt |
| Total Assets EOY | $50,772,048 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $12,192,052 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $17,645,545 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $32,143,262 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $33,126,503 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | At United Hospital District, we exist to provide and promote appropriate health care services to the communities we serve, doing so in a safe and healing environment which supports our patient-centered care philosophy. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | Yes (1) | SignificantChangeInd |
| Expense | $30,003,905 | ExpenseAmt |
| Revenue | $33,093,718 | RevenueAmt |
| Desc | United Hospital District, Inc. operates a 25-bed critical access hospital in Blue Earth, Minnesota. The Hospital also operates medical clinics in Blue Earth, Wells, Winnebago and Fairmont, Minnesota. A 24-bed adolescent treatment center had been operated in Winnebago, Minnesota but ceased operations in April 2020. The building and grounds have also been sold. The Hospital provides health care services to patients who meet certain criteria under its charity care policy without charge or at amounts less than established rates. The estimated cost of providing these services was $398,000 for the year ended December 31, 2020, calculated by multiplying the ratio of cost to gross charges for the Hospital by the gross uncompensated charges associated with providing charity care to its patients. | Desc |
| Total Program Service Expenses | $30,003,905 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | 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 | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 72 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 279 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | 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 | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | 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 | Yes (1) | 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 | Patrick Justin | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5075267908 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 515 S Moore Street | AddressLine1Txt |
| City | Blue Earth | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56013 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| Wyatt Rollenhagen | |||||||
| Chairman | 1.00 | Yes (X) | Yes (X) | $1,223 | $0 | $0 | |
| Ryan Milbrandt | |||||||
| Vice Chair | 1.00 | Yes (X) | Yes (X) | $1,050 | $0 | $0 | |
| Melanie Humburg | |||||||
| Secretary | 1.00 | Yes (X) | Yes (X) | $1,420 | $0 | $0 | |
| Doug Johanson | |||||||
| Treasurer | 1.00 | Yes (X) | Yes (X) | $1,284 | $0 | $0 | |
| Larry Anderson | |||||||
| Board Member | 1.00 | Yes (X) | $1,387 | $0 | $0 | ||
| Chase Brandt | |||||||
| Board Member | 1.00 | Yes (X) | $900 | $0 | $0 | ||
| Joanne Hoffman | |||||||
| Board Member | 1.00 | Yes (X) | $712 | $0 | $0 | ||
| Aaron Johnson MD | |||||||
| Board Member | 40.00 | Yes (X) | $266,656 | $0 | $25,300 | ||
| Bob Karp MD | |||||||
| Board Member | 40.00 | Yes (X) | $397,055 | $0 | $45,143 | ||
| Justin Miller | |||||||
| Board Member | 1.00 | Yes (X) | $700 | $0 | $0 | ||
| Richard Ash | |||||||
| CEO | 40.00 | Yes (X) | $243,307 | $0 | $42,870 | ||
| Patrick Justin | |||||||
| CFO | 40.00 | Yes (X) | $150,045 | $0 | $18,595 | ||
| Alex Wong MD | |||||||
| Surgeon | 40.00 | $557,956 | $0 | $43,779 | Yes (X) | ||
| Christopher Gran MD | |||||||
| Physician | 40.00 | $472,728 | $0 | $26,848 | Yes (X) | ||
| Joseph Montanaro MD | |||||||
| Physician | 40.00 | $379,669 | $0 | $36,731 | Yes (X) | ||
| Laraine Klunder | |||||||
| CRNA | 40.00 | $243,853 | $0 | $42,410 | Yes (X) | ||
| Mary Trites MD | |||||||
| Physician | 40.00 | $225,991 | $0 | $20,599 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,945,936 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $302,275 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 24 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Acute Care Inc | |||||
| 1609 N Ankeny Blvd | Ankeny | IA | 50023 | ED MD Coverage | $1,515,841 |
| Orthopaedic & Fracture Clinic | |||||
| 1431 Premier Drive | Mankato | MN | 56001 | Ortho MD's | $424,862 |
| CMDI | |||||
| 525 10th St NE | Milaca | MN | 56353 | CT Services | $307,234 |
| Cloudwave | |||||
| 100 Crowley Dr | Marlborough | MA | 01752 | Computer host | $203,607 |
| Kraus Anderson Construction | |||||
| 501 South Eighth Street | Minneapolis | MN | 55404 | Construction | $202,882 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $5,022,609 | GovernmentGrantsAmt |
| All Other Contributions | $198,699 | AllOtherContributionsAmt |
| Noncash Contributions | $25,000 | NoncashContributionsAmt |
| Total Contributions | $5,221,308 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Service Revenue | 621110 | $31,700,525 | $31,700,525 |
| 340B Program Revenue | 621110 | $1,132,459 | $1,132,459 |
| Equity earnings in CDMI | 900099 | $137,196 | $137,196 |
| Supporting Revenue | 900099 | $123,538 | $123,538 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $33,093,718 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $153,830 | TotalRevenueColumnAmt |
| Exclusion | $153,830 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $210 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $210 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $210 | TotalRevenueColumnAmt |
| Exclusion | $210 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $105,877 | SecuritiesAmt |
| Other | $100,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $1,581,406 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $105,877 | SecuritiesAmt |
| Other | -$1,481,406 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,375,529 | TotalRevenueColumnAmt |
| Exclusion | -$1,375,529 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,093,537 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $33,093,718 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$1,221,489 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,203,356 | TotalAmt |
| Program Services | $723,221 | ProgramServicesAmt |
| Management And General | $480,135 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,068,379 | TotalAmt |
| Program Services | $12,550,353 | ProgramServicesAmt |
| Management And General | $1,518,026 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $821,447 | TotalAmt |
| Program Services | $731,805 | ProgramServicesAmt |
| Management And General | $89,642 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,923,199 | TotalAmt |
| Program Services | $2,568,696 | ProgramServicesAmt |
| Management And General | $354,503 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $991,365 | TotalAmt |
| Program Services | $864,042 | ProgramServicesAmt |
| Management And General | $127,323 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,320 | TotalAmt |
| Management And General | $99,320 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,207 | TotalAmt |
| Management And General | $65,207 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,555,001 | TotalAmt |
| Program Services | $4,010,427 | ProgramServicesAmt |
| Management And General | $544,574 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $188,849 | TotalAmt |
| Management And General | $188,849 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,033,974 | TotalAmt |
| Program Services | $599,628 | ProgramServicesAmt |
| Management And General | $434,346 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $833,390 | TotalAmt |
| Program Services | $11,417 | ProgramServicesAmt |
| Management And General | $821,973 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $638,534 | TotalAmt |
| Program Services | $513,942 | ProgramServicesAmt |
| Management And General | $124,592 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $183,994 | TotalAmt |
| Program Services | $164,990 | ProgramServicesAmt |
| Management And General | $19,004 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,961 | TotalAmt |
| Program Services | $44,863 | ProgramServicesAmt |
| Management And General | $17,098 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $350,339 | TotalAmt |
| Program Services | $300,077 | ProgramServicesAmt |
| Management And General | $50,262 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,247,069 | TotalAmt |
| Program Services | $1,924,691 | ProgramServicesAmt |
| Management And General | $322,378 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $180,099 | TotalAmt |
| Management And General | $180,099 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $3,533,764 | $3,408,670 | $125,094 |
| Equipment Rental/Repair | $1,199,346 | $740,224 | $459,122 |
| MN Care Tax | $577,601 | $577,601 | |
| Licenses/Dues | $104,466 | $49,401 | $55,065 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $249,636 | TotalAmt |
| Program Services | $219,857 | ProgramServicesAmt |
| Management And General | $29,779 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,110,296 | TotalAmt |
| Program Services | $30,003,905 | ProgramServicesAmt |
| Management And General | $6,106,391 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,741,217 | BOYAmt |
| EOY | $17,534,080 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,249,617 | BOYAmt |
| EOY | $4,093,779 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $93,269 | BOYAmt |
| EOY | $68,269 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $420,648 | BOYAmt |
| EOY | $703,251 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $787,509 | BOYAmt |
| EOY | $838,100 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,727 | BOYAmt |
| EOY | $363,633 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $49,676,670 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $28,916,420 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,085,140 | BOYAmt |
| EOY | $20,760,250 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,066,005 | BOYAmt |
| EOY | $4,847,170 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $333,107 | BOYAmt |
| EOY | $357,380 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $531,075 | BOYAmt |
| EOY | $1,206,136 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,335,314 | BOYAmt |
| EOY | $50,772,048 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,040,393 | BOYAmt |
| EOY | $3,190,195 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $3,690,866 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,710,015 | BOYAmt |
| EOY | $7,908,529 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,683 | BOYAmt |
| EOY | $58,108 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $2,797,847 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $340,961 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,192,052 | BOYAmt |
| EOY | $17,645,545 | 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 | $32,143,262 | BOYAmt |
| EOY | $33,126,503 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,143,262 | BOYAmt |
| EOY | $33,126,503 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,335,314 | BOYAmt |
| EOY | $50,772,048 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $983,241 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $612,000 | OtherCostOrOtherBasisAmt |
| Book Value | $612,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $34,104,492 | OtherCostOrOtherBasisAmt |
| Depreciation | $17,205,052 | DepreciationAmt |
| Book Value | $16,899,440 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,004,353 | OtherCostOrOtherBasisAmt |
| Depreciation | $637,192 | DepreciationAmt |
| Book Value | $367,161 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,924,306 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,074,176 | DepreciationAmt |
| Book Value | $2,850,130 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $31,519 | OtherCostOrOtherBasisAmt |
| Book Value | $31,519 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $20,760,250 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $38,578,499 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $38,578,499 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$1,484,962 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$1,484,962 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $37,093,537 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $37,595,258 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $1,484,962 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $1,484,962 | ExpensesNotReportedAmt |
| Expenses Subtotal | $36,110,296 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $36,110,296 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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. |
| Part XI, Line 4b - Other Adjustments: | Loss on Sale of Adolescent Treatment Center -1,484,962. |
| Part XII, Line 2d - Other Adjustments: | Loss on Sale of Adolescent Treatment Center 1,484,962. |
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 | 225.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 275.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | 0 | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $398,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $398,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01100 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,120,643 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,182,755 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,937,888 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08140 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,518,643 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,182,755 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,335,888 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09240 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,874,894 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,514,413 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,360,481 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06540 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,874,894 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,514,413 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,360,481 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06540 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,393,537 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,697,168 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,696,369 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.15780 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,857,112 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $464,278 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $7,202,988 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,157,871 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $45,117 | 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 | United Hospital District | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 515 S Moore Street | AddressLine1Txt |
| City | Blue Earth | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56013 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.uhd.org | WebsiteAddressTxt |
| State License | 375736 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | 3 Provider based clinics, 1 Fee for service clinic | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | United Hospital District | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 20 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Part V, Page 8 | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 20 | ImplementationStrategyAdptYr |
| Strategy Posted Website | 0 | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (1) | StrategyAttachedInd |
| 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 | 225.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 275.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| 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 |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | http://www.uhd.org/index.php/forms | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | http://www.uhd.org/index.php/forms | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | http://www.uhd.org/index.php/forms | 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 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 |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| United Hospital District | Part V, Section B, Line 5: In November 2020, the CHNA, a cover letter on UHD's letterhead, and a postage paid reply envelope were mailed first class to 800 randomly selected residents in the targeted region (fifteen zip codes). A press release was sent to local newspapers prior to the survey distribution announcing that UHD would conduct a CHNA throughout the region, in cooperation with The National Rural Health Resouce Center (The Center). The announcement was also shared on UHD's Facebook page. To assist with the assessment, UHD contracted with the National Rural Health Resource Center, headquartered in Duluth, Minnesota. The Center is a nonprofit organization dedicated to sustaining and improving health care in rural communities. The Center conducted demographic analysis and statistical research and surveys for the focus groups and key community stakeholder interviews were developed.Due to COVID-19 restrictions the focus groups were held virtually and included residents from several different communities in UHD's service area and represented young parents, seniors, veterans, schools, businesses, healthcare consumers, and social services. The key stakeholder meetings were one-on-one 60-minute interviews and included representatives of education, law enforcement, local business, faith leaders, and other community and elected leaders. |
| United Hospital District | Part V, Section B, Line 11: The priorities identified in the most recently conducted CHNA by the CHNA teams are as follows: 1. Provide and Promote Education Information and Opportunities to the Communities We Serve. *Goal-Provide Education on UHD service and education on wellness topics.2. Match the Scope of Services with the Needs of the Communities We Serve. *Goal-Investigate adding Community Paramedicine staff.3. Promote, Partner, and Enhance Mental Health Services *Goals-Increase MH service on UHD website, Collaborate with schools, nursing homes, veterans services to identify and connect to services; tele-psych out-patient servicesDue to the timing of the completion of the most recent CHNA, we have not been able to address these most recent goals. UHD continued to address the goals of the 2017 CHNA in the following ways:**Goal 1: Raise awareness of healthcare and healthcare-related services currently provided by UHD. We have been able to meet this goal in 2020.*Action Item A: Review and update existing print and online materials, both available to the public and distributed internally to UHD staff and partners***A communications position was created and filled in August of 2018. Responsibilities of the position include updating existing informational material and creating/distributing improved healthcare services information internally and more intensively externally to the communities we serve. The UHD website rebuild was started in early 2018 and it went live in early 2019. The site was redesigned to provide improved access to healthcare services information and availability. In 2020 the below activities were undertaken to meet our CHNA goal #1:-Staff continues to improve and update the website to provide the public with the most applicable and accurate healthcare information. -Advertising activities (billboards, newspaper, Facebook) are continually evaluated and updated to educate the communities we serve on what services are available to them. -Feedback cards were provided and encouraged at community events (County Fairs, Festival Parades) to learn from the community what services they know are available and the perception of those services.*Action Item B: Assess and expand public education and public information activities specifically related to:a) smoking cessation, specifically including smoking cessation options for pregnant womenb) weight loss/weight controlc) healthy dietsd) exercise/activitye) moderation in alcohol consumption***During 2020 action Item B was addressed in the following ways:-On the first Friday of each month at our local AM radio station, one of UHD's providers discussed one relevant health topic related to smoking cessation, weight loss/weight control, and healthy diets or other areas of public health concern. **Goal 2: Service collaboration and coordination with external community partners. We have been able to meet this goal in 2020.*Action Item A: Develop outreach activities based on the CHNA report of findings and other available resources to solicit interest in, and partners for, a more formalized system of multiorganizational community support for community residents. As the hospital's identified single point of contact for community relations and collaborations, the CEO should lead this effort.*Action Item B: Based on (A) above, UHD should actively participate in the implementation of a coordinated community support information and referral service. This includes participation in service coordination activities led by other agencies serving UHD's service area.***To help address Action Items A and B, UHD is part of the core leadership group of a newly formed Faribault and Martin Counties Community Health Collaborative. The representatives of the collaborative are from Mayo Clinic Hospital, Fairmont, United Hospital District, Blue Earth, Martin and Faribault county public health and human services, Blue Earth and Fairmont schools and several community-based organizations and service clubs. Three action planning teams have been created to address the following: Access to Care, Chronic Disease and Community Resiliency.1.) Highlights from Healthier Together Action Team:-Expediting assistance of community member meal deliveries during the COVID-19 response. The team was able to deliver 150-200 meals or packages per week at zero charge to the community.-Healthier Together has formed a partnership with USC (United South Central) High School and BEA (Blue Earth Area) High School to host WIC (Special Supplemental Nutrition Program for Women, Infants, Children) baby cafe sites. This program promotes and supports breastfeeding for pregnant and breastfeeding parents.-Affiliate with local substance abuse prevention coalitions to distribute substance cessation resources through meal delivery programs.-During COVID-19 pandemic resources have been shared with the community to promote an active school day at home and the importance of movement for mental health2.) Highlights from Access to Care Team-UHD and Fairmont - Mayo Clinic Health System have formed a tentative partnership to collaborate with Prairie Lakes Transit to provide free healthcare transportation within Faribault and Martin Counties. This transportation service would cover Medical, Dental, Mental, Vision, and Hearing services.**Goal 3: Operational feasibility planning to address potential service additions. We have been able to meet this goal in 2020.*Action Item A: Based on the information contained in the CHNA report of findings and other available information, develop an inventory of service gaps and personnel needs.-UHD has applied for and received approval of HPSA (Health Professional Shortage Area) which will allow UHD to apply to become a NHSC (National Health Service Corps) site.*Action Item B: Develop potential financial and operational plans to address the identified service gaps and personnel needs.-Becoming a NHSC site will allow UHD to apply to become a RHC (Rural Health Clinic) allowing for improved Medicare and Medicaid reimbursement. |
| United Hospital District | Part V, Section B, Line 13h: Documents that may be reviewed include completed application, recent tax statements, bank denial and MA denial. The Organization also follows the state agreement. |
| United Hospital District | Part V, Section B, Line 15e: We have certified staff who assist with the MN State Exchange and MA. They also provide guidance with every patient's insurance carrier where needed. |
| Schedule H, Part V, Line 7a: | https://uhd.org/media/attachments/2021/01/14/chna.pdf |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - UHD Home Health and Hospice | ||||
| 125 South Main Street | Blue Earth | MN | 56013 | Comprehensive Home Care & Hospice Program |
| 2 - Adolescent Treatment Center | ||||
| 620 1st Avenue SW | Winnebago | MN | 56098 | Children's Residential, Supervised Living, Chemical Dependency Treatment |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | In addition to the Federal Poverty Guidelines, documents that may be reviewed include completed application, recent tax statements, bank denial and MA denial. The Organization also follows the state agreement. |
| Part I, Line 7: | Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b and subsidized health services on line 7g were determined using the costing methods to prepare the cost reports. |
| Part III, Line 2: | The amount reported on line 2 represents implicit price concessions. The Hospital determines its estimate of implicit price concessions based on its historical collection experience with this class of patients. |
| Part III, Line 3: | The Organization estimates that 25% of its implicit price concessions are attributable to patients eligible for financial assistance under the financial assistance policy. We estimate that 25% of those who should have completed financial assistance forms and applications could have qualified for financial assistance had they applied. |
| Part III, Line 4: | The footnote to the organization's financial statements addressing implicit price concessions may be found on pages 11 and 12 of the attached audited financial statements. |
| Part III, Line 8: | Medicare allowable costs were obtained from the 2020 Medicare cost report. 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: | Within 7 days after an insurance payment, the patient will start receiving monthly billings. Statements are sent on a monthly cycle basis. If no payment is received 30 days after the statement went out, the patient is contacted by phone. If no payment is received for 90 days, the patient is contacted by letter to advise him or her of further collection actions to be taken. When agreed upon amounts are not paid off, arrangements can be made for a series of payments to fulfill a patient's obligation. Each account is reviewed by a business office staff member before placing with a collection agency. A financial assistance application submitted by a patient will be processed for at least 240 days following their first post discharge billing statement. If an individual submits a financial assistance application after collection actions have started, collection actions will be suspended until financial assistance eligibility is determined. If an individual is determined to be eligible for financial assistance, no further collection actions will be taken. If an individual is determined to be eligible for financial assistance after collection actions have started, the collection actions will be reversed. |
| Part VI, Line 2: | UHD has standing advisory committees with representation from our communities for Home Health/Hospice and ATCW. Input from the members helps set the strategies and initiatives for improvement. We've also had Focus Groups to address Obstetrical services and another for Orthopedic services. Our patient satisfaction survey incorporates a comments section which gives our patients a voice to make suggestions. |
| Part VI, Line 3: | Whether in person or on our web-site, UHD provides the following information for financial assistance: (1) posts its charity care policy, or a summary thereof, and financial assistance contact information in admissions areas, emergency rooms, and other areas of the organization's facilities in which eligible patients are likely to be present; (2) provides a copy of the policy, or a summary thereof, and financial assistance contact information to patients as part of the intake process; (3) provides a copy of the policy, or a summary thereof, and financial assistance contact information to patients with discharge materials; (4) includes the policy, or a summary thereof, along with financial assistance contact information, in patient bills; and/or (5) discusses with the patient the availability of various government benefits, such as Medicaid or state programs, and assists the patient with qualification for such programs, where applicable. In addition, the Business Office has several certified individuals to assist with applications for both State and Federal insurance plans. |
| Part VI, Line 4: | UHD is located in Blue Earth, Minnesota, a community of approximately 3,400 situated in the west central end of Faribault County. The county borders Martin County to the west, Freeborn County to the east, Blue Earth County to the north, and two Iowa counties, Kossuth and Winnebago, to the south.UHD is the only hospital serving Faribault County and the northern Iowa adjacent counties. Faribault County comprises 82% of UHD outpatient admissions while the remaining adjacent counties comprises 95% of all outpatient encounters. The population within a 10-mile radius of Blue Earth is about 9,000 and within a 20-mile radius is about 30,000.The closet full-service hospitals are in:Fairmont, MN - Mayo Clinic Health Systems - 22 miles westAlbert Lea, MN - Mayo Clinic Health Systems - 42 miles east (Albert Lea Hospital closed its inpatient services effective 10/30/19.)Mankato, MN - Mayo Clinic Health Systems - 45 miles northEmmetsburg, IA - Palo Alto County Hospital - 66 miles southwest |
| Part VI, Line 5: | United Hospital District's current board members reside in the service area. Medical staff privileges for physicians are provided to all qualified care providers who also primarily reside in the service area. The Hospital also has relationships for certain specialists who provide their medical care in our clinics and hospital. All surplus funds are reinvested in the program areas for the hospital and clinics. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Alex Wong MD | ||||||||||||||
| Surgeon | $557,854 | $0 | $102 | $0 | $0 | $0 | $14,250 | $0 | $31,183 | $0 | $603,389 | $0 | $0 | $0 |
| Christopher Gran MD | ||||||||||||||
| Physician | $472,626 | $0 | $102 | $0 | $0 | $0 | $14,000 | $0 | $14,796 | $0 | $501,524 | $0 | $0 | $0 |
| Bob Karp MD | ||||||||||||||
| Board Member | $368,135 | $0 | $28,920 | $0 | $0 | $0 | $14,250 | $0 | $33,053 | $0 | $444,358 | $0 | $0 | $0 |
| Joseph Montanaro MD | ||||||||||||||
| Physician | $379,567 | $0 | $102 | $0 | $0 | $0 | $14,250 | $0 | $24,556 | $0 | $418,475 | $0 | $0 | $0 |
| Aaron Johnson MD | ||||||||||||||
| Board Member | $266,554 | $0 | $102 | $0 | $0 | $0 | $0 | $0 | $26,966 | $0 | $293,622 | $0 | $0 | $0 |
| Laraine Klunder | ||||||||||||||
| CRNA | $243,751 | $0 | $102 | $0 | $0 | $0 | $12,681 | $0 | $31,336 | $0 | $287,870 | $0 | $0 | $0 |
| Richard Ash | ||||||||||||||
| CEO | $243,205 | $0 | $102 | $0 | $0 | $0 | $12,343 | $0 | $31,655 | $0 | $287,305 | $0 | $0 | $0 |
| Mary Trites MD | ||||||||||||||
| Physician | $225,889 | $0 | $102 | $0 | $0 | $0 | $11,250 | $0 | $10,375 | $0 | $247,616 | $0 | $0 | $0 |
| Patrick Justin | ||||||||||||||
| CFO | $149,944 | $0 | $101 | $0 | $0 | $0 | $7,625 | $0 | $11,725 | $0 | $169,395 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | City of Frost Minnesota | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 416005176 | BondIssuerEIN |
| Bond Issued | 2018-10-18 | BondIssuedDt |
| Issue Price | $9,428,450 | IssuePriceAmt |
| Purpose | Refinance District's debt and remodel ER, lobby and other spaces | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $1,328,974 | RetiredAmt |
| Total Proceeds | $9,428,450 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $188,569 | IssuanceCostsFromProceedsAmt |
| Working Capital Expenditures | $3,053,221 | WorkingCapitalExpendituresAmt |
| Substantial Completion | 2019 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | Yes (1) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Bob Karp MD | PersonNm |
| Relationship With Org | Medical Provider | RelationshipWithOrgTxt |
| Loan Purpose | Signing Incentive | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $125,000 | OriginalPrincipalAmt |
| Balance Due | $68,269 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $68,269 | TotalBalanceDueAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, line 3 | A 24-bed adolescent treatment center had been operated in Winnebago, Minnesota but ceased operations in April 2020. The building and grounds have also been sold. |
| Form 990, Part VI, Section A, line 1 | The Organization has an Executive Committee consisting of the Chair, Vice Chair, Secretary and Treasurer. In addition, the CEO is an ex-officio, non-voting member of the Executive Committee. The Chair of the Board of Directors is the Chair of the Executive Committee. The Executive Committee has the authority of the Board of Directors in the management of the business of the Organization in intervals between meetings of the Board of Directors. |
| Form 990, Part VI, Section A, line 7a | The Board of Directors consists of no fewer than seven and no more than fifteen members. Three "District Directors" are appointed by the United Hospital District Board of Directors. There can be up to two "At-Large Directors" who are elected by the Board of Directors but need not be residents of the Geographic Service Area. There is one Ex Officio director, who is the physician serving as the Chief of Medical Staff of the hospital. The remaining members of the Board of Directors are "Area Directors" who are elected by the Board of Directors of this corporation and must be residents of the Geographic Service Area. The Geographic Service Area means all of the cities and townships comprising the District, plus any additional area contained within the lowest number of contiguous zip codes from which the hospital drew at least 75 percent of its inpatients during the previous fiscal year. |
| Form 990, Part VI, Section B, line 11b | The CFO reviews the Form 990 and a copy is provided to the board members prior to filing with the IRS. |
| Form 990, Part VI, Section B, line 12c | The organization has a conflict of interest policy in place which covers the officers and board members of the organization. Potential conflicts are reviewed and determined by the CEO and board chair. If an individual has a conflict of interest, they are asked to abstain from voting on the conflicting issue. |
| Form 990, Part VI, Section B, line 15a | CEO: The Executive Committee of the Board reviews salary surveys from the Minnesota Hospital Association in determining the salary for the CEO. Other officers: Similarly to the CEO, the results of the salary survey from the Minnesota Hospital Association is used in determining the salary for the remaining officers. The CEO approves these increases in compensation. |
| Form 990, Part VI, Section C, line 19 | The governing documents, conflict of interest policy and financial statements are not made available to the public |
| Form 990, Part IX, line 11g | Outside Consultants/Purchased Srvcs: Program service expenses 3,780,127. Management and general expenses 206,038. Fundraising expenses 0. Total expenses 3,986,165. Other Fees: Program service expenses 230,300. Management and general expenses 338,536. Fundraising expenses 0. Total expenses 568,836. |