2021-11-05T15:08:50-05:00 2020-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2020-01-01 454165628 United Hospital District Inc UNIT 5075263273 515 S Moore Street Blue Earth MN 56013 Richard Ash CEO 5075263273 2021-10-28 1 Richard Ash 999009999 Kim Hunwardsen CPA P00484560 6122536500 2021-10-28 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z Richard Ash 515 S Moore Street Blue Earth MN 56013 38674943 0 X www.uhd.org X 2011 MN Provision of health care services 10 8 279 9 0 0 139277 5221308 38638556 33093718 226673 -1221699 710 210 39005216 37093537 0 0 0 0 20341135 20007746 0 0 0 16537061 16102550 36878196 36110296 2127020 983241 44335314 50772048 12192052 17645545 32143262 33126503 X 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. 0 1 30003905 33093718 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. 30003905 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 72 0 1 279 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 8 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 MN X Patrick Justin 5075267908 515 S Moore Street Blue Earth MN 56013 Wyatt Rollenhagen Chairman 1.00 X X 1223 0 0 Ryan Milbrandt Vice Chair 1.00 X X 1050 0 0 Melanie Humburg Secretary 1.00 X X 1420 0 0 Doug Johanson Treasurer 1.00 X X 1284 0 0 Larry Anderson Board Member 1.00 X 1387 0 0 Chase Brandt Board Member 1.00 X 900 0 0 Joanne Hoffman Board Member 1.00 X 712 0 0 Aaron Johnson MD Board Member 40.00 X 266656 0 25300 Bob Karp MD Board Member 40.00 X 397055 0 45143 Justin Miller Board Member 1.00 X 700 0 0 Richard Ash CEO 40.00 X 243307 0 42870 Patrick Justin CFO 40.00 X 150045 0 18595 Alex Wong MD Surgeon 40.00 X 557956 0 43779 Christopher Gran MD Physician 40.00 X 472728 0 26848 Joseph Montanaro MD Physician 40.00 X 379669 0 36731 Laraine Klunder CRNA 40.00 X 243853 0 42410 Mary Trites MD Physician 40.00 X 225991 0 20599 2945936 0 302275 24 0 1 0 Acute Care Inc 1609 N Ankeny Blvd Ankeny IA 50023 ED MD Coverage 1515841 Orthopaedic & Fracture Clinic 1431 Premier Drive Mankato MN 56001 Ortho MD's 424862 CMDI 525 10th St NE Milaca MN 56353 CT Services 307234 Cloudwave 100 Crowley Dr Marlborough MA 01752 Computer host 203607 Kraus Anderson Construction 501 South Eighth Street Minneapolis MN 55404 Construction 202882 7 5022609 198699 25000 5221308 Patient Service Revenue 621110 31700525 31700525 340B Program Revenue 621110 1132459 1132459 Equity earnings in CDMI 900099 137196 137196 Supporting Revenue 900099 123538 123538 33093718 153830 153830 210 0 210 210 210 105877 100000 0 1581406 105877 -1481406 -1375529 -1375529 37093537 33093718 0 -1221489 X 1203356 723221 480135 14068379 12550353 1518026 821447 731805 89642 2923199 2568696 354503 991365 864042 127323 99320 99320 65207 65207 4555001 4010427 544574 188849 188849 1033974 599628 434346 833390 11417 821973 638534 513942 124592 183994 164990 19004 61961 44863 17098 350339 300077 50262 2247069 1924691 322378 180099 180099 Medical Supplies 3533764 3408670 125094 Equipment Rental/Repair 1199346 740224 459122 MN Care Tax 577601 577601 Licenses/Dues 104466 49401 55065 249636 219857 29779 36110296 30003905 6106391 0 6741217 17534080 7249617 4093779 93269 68269 420648 703251 787509 838100 27727 363633 49676670 28916420 23085140 20760250 5066005 4847170 333107 357380 531075 1206136 44335314 50772048 3040393 3190195 3690866 8710015 7908529 100683 58108 2797847 340961 0 12192052 17645545 X 32143262 33126503 32143262 33126503 44335314 50772048 983241 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 612000 612000 34104492 17205052 16899440 1004353 637192 367161 13924306 11074176 2850130 31519 31519 20760250 X 38578499 0 38578499 -1484962 -1484962 37093537 37595258 1484962 1484962 36110296 0 36110296 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. 1 1 X 1 X 225.000000000000 1 X 275.000000000000 0 1 1 0 0 398000 398000 0.01100 7120643 4182755 2937888 0.08140 7518643 4182755 3335888 0.09240 4874894 2514413 2360481 0.06540 4874894 2514413 2360481 0.06540 12393537 6697168 5696369 0.15780 1 1857112 464278 7202988 7157871 45117 X 1 1 1 1 United Hospital District 515 S Moore Street Blue Earth MN 56013 www.uhd.org 375736 X X X 3 Provider based clinics, 1 Fee for service clinic United Hospital District 1 0 0 1 X X X X X X X X X 20 1 0 0 1 X See Part V, Page 8 X 1 20 0 1 0 1 X 225.000000000000 275.000000000000 X 1 1 X X X X X 1 X http://www.uhd.org/index.php/forms X http://www.uhd.org/index.php/forms X http://www.uhd.org/index.php/forms X X X X X 1 X 0 X X X X 1 X 0 0 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 2 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 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. X X 0 0 0 0 0 0 0 0 0 Alex Wong MD Surgeon 557854 0 102 0 0 0 14250 0 31183 0 603389 0 0 0 Christopher Gran MD Physician 472626 0 102 0 0 0 14000 0 14796 0 501524 0 0 0 Bob Karp MD Board Member 368135 0 28920 0 0 0 14250 0 33053 0 444358 0 0 0 Joseph Montanaro MD Physician 379567 0 102 0 0 0 14250 0 24556 0 418475 0 0 0 Aaron Johnson MD Board Member 266554 0 102 0 0 0 0 0 26966 0 293622 0 0 0 Laraine Klunder CRNA 243751 0 102 0 0 0 12681 0 31336 0 287870 0 0 0 Richard Ash CEO 243205 0 102 0 0 0 12343 0 31655 0 287305 0 0 0 Mary Trites MD Physician 225889 0 102 0 0 0 11250 0 10375 0 247616 0 0 0 Patrick Justin CFO 149944 0 101 0 0 0 7625 0 11725 0 169395 0 0 0 A City of Frost Minnesota 416005176 2018-10-18 9428450 Refinance District's debt and remodel ER, lobby and other spaces 0 0 0 A 1328974 9428450 188569 3053221 2019 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 0 0 0 0 0 1 A 1 Bob Karp MD Medical Provider Signing Incentive X 125000 68269 0 1 1 68269 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.