MADELIA HEALTH: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- MADELIA HEALTH (EIN 41-0758512)
- Tax period
- 2019-06-01 to 2020-05-31
- Filed
- 2021-04-14
- IRS object ID
- 202131049349301003
- Schema version
- 2019v5.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-04-14T07:34:52-05:00 | ReturnTs |
| Tax Period End | 2020-05-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 S 6TH STREET SUITE 300 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-06-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410758512 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADELIA COMMUNITY HOSPITAL INCORPORATED | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MADE | BusinessNameControlTxt |
| Phone | 5076423255 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 121 DREW AVENUE SOUTHEAST | AddressLine1Txt |
| City | MADELIA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56062 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEFF MENGENHAUSEN | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 5076423255 | PhoneNum |
| Signature | 2021-04-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RYAN ENGEBRETSON | PreparerPersonNm |
| PTIN | P01585625 | PTIN |
| Phone | 6123764500 | PhoneNum |
| Preparation | 2021-04-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADELIA COMMUNITY HOSPITAL & CLINIC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JEFF MENGENHAUSEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 121 DREW AVENUE SOUTHEAST | AddressLine1Txt |
| City | MADELIA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56062 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $15,403,254 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MCHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1950 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE QUALITY HEALTHCARE SERVICES TO THE LOCAL COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 115 | TotalEmployeeCnt |
| Total Volunteers | 66 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $392,430 | PYContributionsGrantsAmt |
| CY Contributions Grants | $351,370 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $11,118,862 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $12,893,755 | CYProgramServiceRevenueAmt |
| PY Investment Income | $133,118 | PYInvestmentIncomeAmt |
| CY Investment Income | $228,143 | CYInvestmentIncomeAmt |
| PY Other Revenue | $91,580 | PYOtherRevenueAmt |
| CY Other Revenue | $117,237 | CYOtherRevenueAmt |
| PY Total Revenue | $11,735,990 | PYTotalRevenueAmt |
| CY Total Revenue | $13,590,505 | 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 | $7,806,127 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,717,055 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,019,556 | PYOtherExpensesAmt |
| CY Other Expenses | $7,085,658 | CYOtherExpensesAmt |
| PY Total Expenses | $12,825,683 | PYTotalExpensesAmt |
| CY Total Expenses | $13,802,713 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,089,693 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$212,208 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $16,003,558 | TotalAssetsBOYAmt |
| Total Assets EOY | $20,506,821 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,970,679 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,711,092 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $10,032,879 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,795,729 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF MADELIA COMMUNITY HOSPITAL IS TO PROVIDE SAFE AND QUALITY HEALTHCARE SERVICES TO THOSE WE SERVE IN AN ENVIRONMENT BASED ON RESPECT, DIGNITY, AND EXCELLENCE. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $9,981,735 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $12,893,755 | RevenueAmt |
| Desc | MADELIA COMMUNITY HOSPITAL & CLINIC PROVIDES GENERAL MEDICAL/SURGICAL SERVICES ON INPATIENTS, SWING BED PATIENTS, OUTPATIENTS AND HOME CARE CLIENTS. DURING THE FISCAL YEAR 2019-20 THERE WERE 70 ACUTE CARE ADMISSIONS WITH 267 PATIENT DAYS, 67 SWING BED ADMISSIONS WITH 786 PATIENT DAYS, 12,076 HOME CARE VISITS TO 1,091 PATIENT, AND 4.364 TOTAL OUTPATIENT VISITS. DURING OUR FISCAL YEAR 2020, MADELIA COMMUNITY HOSPITAL AND CLINIC PROVIDED $14,432 IN CHARITY CARE. A VARIETY OF COMMUNITY BENEFIT SERVICES ARE DONE EACH YEAR BY VOLUNTEER HOSPITAL EMPLOYEES AND COMMUNITY VOLUNTEERS. COMMUNITY BENEFIT ACTIVITIES INCLUDED:COORDINATION OF DRIVERS FOR THE WATONWAN COUNTY SENIOR DRIVER PROGRAM, A NONPROFIT GROUP FURNISHING TRANSPORTATION FOR THE ELDERLY SENIOR POPULATION.DELIVERY OF 1,616 HOSPITAL-PREPARED MEALS FOR THE MEALS ON WHEELS PROGRAM IN MADELIA INTERPRETIVE AND TRANSLATION FROM ENGLISH TO SPANISH FOR PATIENTS AT MCHCFREE SPORTS PHYSICALS OFFERED TO AREA ATHLETES IN MADELIA, LAKE CRYSTAL, ST. JAMES AND TRUMAN HIGH SCHOOLS.MCHC CO-SPONSORED A STOCK THE SHELF CAMPAIGN TO BENEFIT THE MADELIA COMMUNITY FOOD SHELF DURING THE MADELIA PARK DAYS CELEBRATION. WE COLLECTED 600 LBS. OF FOOD AND $265 FOR THE FOOD SHELF.MCHC CONTINUES TO BE A REFERRAL SOURCE FOR THE MADELIA COMMUNITY FOOD SHELF AND COLLECTED FOOD AND DONATIONS FOR STAFF THROUGHOUT THE YEAR.THE MADELIA COMMUNITY HOSPITAL FOUNDATION HELD A FREE EDUCATIONAL FORUM TO EDUCATE ATTENDEES ON ESTATE PLANNING, WEALTH MANAGEMENT AND ADVANCE DIRECTIVES.COORDINATES, HOSTS AND PROMOTES THE MADELIA FARMERS MARKET BEGINNING IN JUNE AND ENDING IN OCTOBER EACH YEAR. THE MADELIA FARMERS MARKET PROVIDES FRESH PRODUCE AND CANNED GOODS TO BE PURCHASED BY AREA RESIDENTS.ALL STAFF MEMBERS WERE TRAINED IN GIVING CPR.MCHC PARTNERED WITH AN AREA RESTAURANT TO RAISE AWARENESS ABOUT BREAST CANCER AND MAMMOGRAPHY, AND TO RAISE MONEY FOR THE AMERICAN CANCER SOCIETY.A PSYCHIATRIC, MENTAL HEALTH NURSE PRACTITIONER WAS HIRED TO MCHC CLINIC STAFF TO PROVIDE MENTAL HEALTH SERVICES TO AREA RESIDENTS. MCHC OPENED A FULL-SERVICE PHARMACY IN LAKE CRYSTAL, MN. A PHARMACY HAD NOT BEEN LOCATED IN THAT COMMUNITY FOR MANY YEARS. MCHC TOOK OVER THE MANKATO CLINIC PRACTICE IN LAKE CRYSTAL. MAYO CLINIC HEALTH SYSTEMS HAD CLOSED THEIR CLINIC OFFICE IN LAKE CRYSTAL TOO, SO THE NEED FOR HEALTH CARE IN THE COMMUNITY WAS EVIDENT.FREE BLOOD PRESSURE CHECKS AT THE MADELIA COMMUNITY HOSPITAL & CLINIC AND AT HEALTH FAIRS IN THE AREA AND AT CHURCH EVENTS. MCHC TOOK OVER THE MANAGEMENT OF THE MADELIA COMMUNITY AMBULANCE SERVICE. AN ADDITIONAL PARAMEDIC AND EMT WERE HIRED BY MCHC TO HELP COVER DAY SHIFTS WHEN VOLUNTEERS AREN'T AS AVAILABLE. THE AMBULANCE SERVICE WAS UPGRADED FROM A BASIC LIFE SUPPORT SERVICE TO PART-TIME ADVANCED LIFE SUPPORT. THIS ALLOWED THE SERVICE TO ADD MORE TRANSFERS TO AND FROM VARIOUS HOSPITALS. MCHC ALSO PROVIDES THE MEDICAL DIRECTOR FOR THE AMBULANCE SERVICE.OUR STAFF WORKS SIDE BY SIDE WITH STUDENTS FROM AREA UNIVERSITIES AND COLLEGES FOR STUDENTS IN THE NURSE PRACTITIONER, CLINIC, NURSING, LABORATORY TECHNICIAN AND PHYSICAL THERAPY PROGRAMS.INDUSTRY SPONSORS FOR THE HIGH STEP HEALTH SCIENCE ACADEMY, A PROGRAM FOR MADELIA HIGH SCHOOL STUDENTS THAT INTRODUCES THEM TO CAREER OPPORTUNITIES IN THE HEALTH CARE FIELD. PROVIDED MEETING FACILITIES FOR STUDENTS AND INSTRUCTION ONE HOUR PER WEEK DURING THE SCHOOL YEAR.DELIVERY OF PHARMACEUTICALS FOR HOME BOUND PATIENTSPHYSICIAN PROVIDING SKIN CHECKS FOR THE MADELIA HIGH SCHOOL WRESTLING TEAM.HIGH SCHOOL ATHLETIC TRAINING AND CARE FOR SMALL AND NONLIFE THREATENING INJURIES. "IMPACT" (CONCUSSION) EVALUATION FOR MADELIA STUDENTS.PHYSICAL THERAPY DEPARTMENT HOSTED DIZZINESS SCREENING EVENT.A SPECIAL HEALTH CARE CLINIC WAS HELD FOR AREA HUNTERS AT A REDUCED FEE. PEOPLE THAT ATTENDED HAD THEIR HEIGHT AND WEIGHT RECORDED, THEIR BLOOD PRESSURE CHECKED, AND THEIR VISION SCREENED. THEY ALSO HAD BLOOD TESTS TO SCREEN FOR HIGH CHOLESTEROL, DIABETES, PROSTATE CANCER/THYROID FUNCTION, AND AN EKG. TESTING WAS PRICED UNDER MCHC COST. SMALL FEE FOOT AND NAIL CLINIC (SOAKING FEET, TRIMMING TOENAILS AND MASSAGING FEET OF ELDERLY PATIENTS). AN AVERAGE OF 60 PATIENTS PER MONTH PARTAKE IN THIS SERVICE.ACTIVE AND CHARTER MEMBERS OF THE MADELIA COMMUNITY BASED COLLABORATIVE (MCBC). THIS GROUP IS COMPRISED OF HOSPITAL STAFF, NURSING PROFESSORS FROM MINNESOTA STATE UNIVERSITY MANKATO, MEMBERS OF THE MANKATO GLEN TAYLOR NURSING INSTITUTE FOR FAMILY AND SOCIETY, WATONWAN COUNTY PUBLIC HEALTH REPRESENTATIVES, STATEWIDE HEALTH INITIATIVE PROGRAM (SHIP) REPRESENTATIVE, UNIVERSITY OF MINNESOTA EXTENSION EDUCATOR, ADMINISTRATIVE STAFF FROM THE LOCAL SCHOOL DISTRICT, AND COMMUNITY MEMBERS. MEMBERS OF MCBC, INCLUDING HOSPITAL STAFF, ALSO PARTNER WITH THE WATONWAN COMMUNITY FOOD PARTNERSHIP WHICH FOCUSES ON BRINGING FRESH FRUITS AND VEGETABLES INTO THE COMMUNITIES OF WATONWAN COUNTY.THE VISION OF MCBC IS WORKING TOGETHER TO ACHIEVE A HEALTHIER COMMUNITY. ITS MISSION IS TO PROMOTE THE WELL-BEING OF MADELIA RESIDENTS THROUGH COMMUNITY-BASED PARTNERSHIPS AND THE VALUES ARE EQUITY, COLLABORATION, COMMUNITY ENGAGEMENT, HEALTH & WELL-BEING.THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT DETERMINED THAT CANCER, MENTAL HEALTH, DIABETES, HEART DISEASE AND OBESITY WERE THE PRIMARY HEALTH NEEDS IN THE COMMUNITY. THESE NEEDS WERE GIVEN HIGHEST PRIORITY BY MCBC BASED ON THE OVERWHELMING COMMUNITY RESPONSE, THEIR IDENTIFICATION AS AREAS OF CONCERN IN THE WATONWAN COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT, AND THEIR COST AND IMPACT ON QUALITY OF LIFE. THE INCLUSION OF OBESITY, CANCER, HEART DISEASE AND DIABETES IS STRENGTHENED BY THE FACT THAT THESE WERE ALSO THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS IN THE LAST COMMUNITY HEALTH NEEDS ASSESSMENT. MENTAL HEALTH WAS ACKNOWLEDGED AS AN AREA OF CONCERN IN THE MAY 2016 COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND WAS RANKED AS THE SECOND-HIGHEST AREA OF CONCERN BY COMMUNITY PARTICIPANTS IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT.MCBC WORKS COLLABORATIVELY ON PROJECTS THAT ADDRESS PHYSICAL AND MENTAL HEALTH. NORMALLY WE HOST A POSTER CONTEST FOR THIRD AND FOURTH GRADE STUDENTS IN THE SPRING, BUT THIS YEAR IT WAS CANCELLED DUE TO THE COVID-19 OUTBREAK. THE ACCOMPLISHMENTS THIS YEAR INCLUDE: 1. LET IT GROW BARRELS WERE AGAIN USED IN THE MADELIA MOBILE HOME PARK TO PROVIDE RESIDENTS WITH ACCESS TO FREE FRESH TOMATOES, PEPPERS, AND HERBS. MOST RESIDENTS ARE LOW-INCOME. 2. MCBC HELD A KID'S DAY AT THE MADELIA FARMERS MARKET IN SEPTEMBER, 2019. SEVERAL KIDS WERE IN ATTENDANCE AND LEARNED ABOUT HEALTHY FOOD AND EATING.3. MCBC HELPED TO COLLECT FOOD FOR THE MADELIA FOOD SHELF DURING THE PARK DAYS.4. COLLABORATED WITH STUDENTS FROM THE COLLEGE OF ALLIED HEALTH & NURSING AT MINNESOTA STATE UNIVERSITY TO EDUCATE MADELIA 7TH THROUGH 10TH GRADE STUDENTS ON THE DANGERS OF VAPING.5. ASSISTED IN MONTHLY FARE FOR ALL DISTRIBUTION IN MADELIA AT THE LUTHER MEMORIAL HOME AND AT HARSHORN MANOR. FARE FOR ALL IS A FOOD PROGRAM AVAILABLE TO ALL COMMUNITY MEMBERS THAT OFFERS FRESH PRODUCE AND FROZEN MEATS FOR A SUBSTANTIALLY LOWER PRICE THAN CAN BE FOUND AT LOCAL GROCERS. | Desc |
| Total Program Service Expenses | $9,981,735 | 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 | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 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 | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 64 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 115 | 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 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 | 0 | 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 | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONIQUE HOFFMANN-URBAN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5076423255 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 121 DREW AVENUE SOUTHEAST | AddressLine1Txt |
| City | MADELIA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56062 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| JEFF MENGENHAUSEN | ||||||||
| CEO | 40.00 | 0.20 | Yes (X) | $172,925 | $0 | $3,212 | ||
| JANE MALMSKOG | ||||||||
| PHARMD | 40.00 | 0.00 | $145,112 | $0 | $8,006 | Yes (X) | ||
| MONIQUE HOFFMANN-URBAN | ||||||||
| CFO | 40.00 | 0.20 | Yes (X) | $117,080 | $0 | $7,842 | ||
| MICHAEL NELSON | ||||||||
| PHYSICIAN-ER DIRECTOR | 34.00 | 0.00 | $124,313 | $0 | $0 | Yes (X) | ||
| KARLA BOETTCHER | ||||||||
| APP-ER NURSE PRACTITIONER | 22.00 | 0.00 | $112,691 | $0 | $0 | Yes (X) | ||
| MEGAN GOSSMAN | ||||||||
| RN-INFECTION CONTROL | 40.00 | 0.00 | $102,276 | $0 | $5,864 | Yes (X) | ||
| JAMIE HITCHCOCK | ||||||||
| PT-PHYSICAL THERAPY MANAGER | 40.00 | 0.00 | $102,175 | $0 | $5,859 | Yes (X) | ||
| DENNIS ARDUSER | ||||||||
| BOARD PRESIDENT | 1.00 | 0.00 | Yes (X) | $1,800 | $0 | $0 | Yes (X) | |
| STEVEN COOLING | ||||||||
| BOARD VP & TREASURER | 1.00 | 0.00 | Yes (X) | $1,800 | $0 | $0 | Yes (X) | |
| BARBARA OVERLIE | ||||||||
| BOARD SECRETARY | 1.00 | 0.00 | Yes (X) | $1,800 | $0 | $0 | Yes (X) | |
| KENNETH GRONEWOLD | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | $1,200 | $0 | $0 | Yes (X) | ||
| NORMA KRUMWIEDE | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | $1,200 | $0 | $0 | Yes (X) | ||
| BRIAN MCCABE | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | $1,200 | $0 | $0 | Yes (X) | ||
| ELIZABETH SCHMIDT | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | $1,200 | $0 | $0 | Yes (X) | ||
| STEVEN SORENSEN | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | $1,200 | $0 | $0 | Yes (X) | ||
| RYAN VISHER | ||||||||
| BOARD MEMBER | 1.00 | 0.00 | $1,200 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $889,172 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $30,783 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | 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 |
|---|---|---|---|---|---|
| MANKATO CLINIC LTD | |||||
| 1230 E MAIN ST | MANKATO | MN | 56002 | PHYSICIAN CLINIC PROVIDERS | $918,304 |
| CARDINAL HEALTH | |||||
| 3900 W AVERA DRIVE SUITE 301 | SIOUX FALLS | SD | 57108 | PHARMACY | $629,347 |
| WHITESELL MEDICAL STAFFING | |||||
| PO BOX 997 | ANNADALE | MN | 55302 | MEDICAL STAFFING | $245,292 |
| TRUBRIDGE | |||||
| PO BOX 850309 | MOBILE | AL | 36685 | CONSULTING SERVICES | $202,078 |
| MEDLINE INDUSTRIES INC | |||||
| ONE MEDLINE PLACE | MUNDELEIN | IL | 60060 | CONSULTING SERVICES | $137,871 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 14 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $187,000 | RelatedOrganizationsAmt |
| Government Grants | $137,057 | GovernmentGrantsAmt |
| All Other Contributions | $27,313 | AllOtherContributionsAmt |
| Total Contributions | $351,370 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 624100 | $12,823,951 | $12,823,951 |
| PHYSICAL THERAPY | 624310 | $49,230 | $49,230 |
| LABORATORY | 621500 | $20,562 | $20,562 |
| PHARMACY | 446110 | $12 | $12 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $12,893,755 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $220,530 | TotalRevenueColumnAmt |
| Exclusion | $220,530 | ExclusionAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,112 | TotalRevenueColumnAmt |
| Exclusion | $15,112 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $50,174 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $40,435 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $9,739 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,739 | TotalRevenueColumnAmt |
| Exclusion | $9,739 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,779,927 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,772,314 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,613 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,613 | TotalRevenueColumnAmt |
| Exclusion | $7,613 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| MISC INCOME | 900099 | $66,918 | $66,918 |
| EMPLOYEE MEALS | 900099 | $21,152 | $21,152 |
| MEDICAL RECORDS | 900099 | $4,316 | $4,316 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $92,386 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,590,505 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,893,755 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $345,380 | 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 | $308,717 | TotalAmt |
| Management And General | $308,717 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,025,990 | TotalAmt |
| Program Services | $3,936,153 | ProgramServicesAmt |
| Management And General | $1,089,837 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $157,287 | TotalAmt |
| Program Services | $112,101 | ProgramServicesAmt |
| Management And General | $45,186 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $816,972 | TotalAmt |
| Program Services | $604,773 | ProgramServicesAmt |
| Management And General | $212,199 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $408,089 | TotalAmt |
| Program Services | $312,174 | ProgramServicesAmt |
| Management And General | $95,915 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,918,471 | TotalAmt |
| Program Services | $1,710,899 | ProgramServicesAmt |
| Management And General | $207,572 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,158 | TotalAmt |
| Management And General | $23,158 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $579,210 | TotalAmt |
| Management And General | $579,210 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $241,016 | TotalAmt |
| Management And General | $241,016 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,695 | TotalAmt |
| Program Services | $59,025 | ProgramServicesAmt |
| Management And General | $20,670 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $262,943 | TotalAmt |
| Management And General | $262,943 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $747,997 | TotalAmt |
| Program Services | $747,997 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $1,936,744 | $1,936,744 | |
| REPAIRS/MAINTENANCE | $437,658 | $437,658 | |
| BAD DEBTS | $377,671 | $377,671 | |
| CLINIC EXPENSES | $184,198 | $184,198 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $296,897 | TotalAmt |
| Management And General | $296,897 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,802,713 | TotalAmt |
| Program Services | $9,981,735 | ProgramServicesAmt |
| Management And General | $3,820,978 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,344,333 | BOYAmt |
| EOY | $2,265,800 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,634,974 | BOYAmt |
| EOY | $7,864,846 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,717 | BOYAmt |
| EOY | $84,758 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,087,316 | BOYAmt |
| EOY | $2,222,905 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $284,805 | BOYAmt |
| EOY | $284,869 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $188,275 | BOYAmt |
| EOY | $59,688 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $17,588,881 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $12,373,441 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,727,990 | BOYAmt |
| EOY | $5,215,440 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,158,462 | BOYAmt |
| EOY | $1,891,392 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $567,686 | BOYAmt |
| EOY | $617,123 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,003,558 | BOYAmt |
| EOY | $20,506,821 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,299,241 | BOYAmt |
| EOY | $1,152,812 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,553,318 | BOYAmt |
| EOY | $4,390,158 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,120 | BOYAmt |
| EOY | $1,494,360 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,000 | BOYAmt |
| EOY | $3,673,762 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,970,679 | BOYAmt |
| EOY | $10,711,092 | 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 | $9,894,879 | BOYAmt |
| EOY | $9,655,729 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $138,000 | BOYAmt |
| EOY | $140,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,032,879 | BOYAmt |
| EOY | $9,795,729 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,003,558 | BOYAmt |
| EOY | $20,506,821 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$212,208 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $22,058 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$47,000 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 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 | $194,207 | OtherCostOrOtherBasisAmt |
| Book Value | $194,207 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,936,493 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,406,816 | DepreciationAmt |
| Book Value | $2,529,677 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,822,396 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,471,735 | DepreciationAmt |
| Book Value | $1,350,661 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,502,372 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,494,890 | DepreciationAmt |
| Book Value | $1,007,482 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $133,413 | OtherCostOrOtherBasisAmt |
| Book Value | $133,413 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,215,440 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ASSET RETIREMENT OBLIGATION | $40,000 |
| HHS COVID-19 EMERGENCY GRANT | $3,633,762 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,673,762 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL IS CLASSIFIED BY THE IRS AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE IRC AND IS SUBJECTED TO FEDERAL INCOME TAX ONLY ON NET UNRELATED BUSINESS INCOME. THE HOSPITAL FOLLOWS THE GUIDANCE IN THE INCOME TAX STANDARD REGARDING RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE APPLICATION OF THIS STANDARD HAS NO EFFECT ON THE FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,342 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,342 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,778,456 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,089,899 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $688,557 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05130 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,792,798 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,089,899 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $702,899 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05240 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $88,385 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $88,385 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00660 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $811 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $811 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $89,196 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $89,196 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00670 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,881,994 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,089,899 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $792,095 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05910 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,620 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $9,620 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,306 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $16,306 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,234 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,234 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,149 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,149 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $30,309 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $30,309 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $377,671 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $75,534 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $3,991,565 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $4,330,135 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$338,570 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| 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 | MADELIA COMMUNITY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 121 DREW AVE SE | AddressLine1Txt |
| City | MADELIA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56062 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.MCHOSPITAL.ORG | WebsiteAddressTxt |
| State License | 385015 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADELIA COMMUNITY HOSPITAL INCORPORATED | 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 | 18 | 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 VI | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | 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 | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| 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 | HTTPS://WWW.MCHOSPITAL.ORG/FINANCIAL-ASSISTANCE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.MCHOSPITAL.ORG/FINANCIAL-ASSISTANCE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.MCHOSPITAL.ORG/FINANCIAL-ASSISTANCE | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MADELIA COMMUNITY HOSPITAL, INCORPORATED | PART V, SECTION B, LINE 5: FOR MADELIA COMMUNITY HOSPITAL'S MAY 2019 COMMUNITY HEALTH NEEDS ASSESSMENT, THE HOSPITAL SOLICITED INPUT FROM THE COMMUNITY THROUGH A SURVEY THAT WAS MAILED TO EVERY HOME IN SIX ZIP CODES - 7,494 IN TOTAL. WE RECEIVED 253 RESPONSES, INCLUDING 43 FROM INDIVIDUALS WHO SELF-IDENTIFIED AS LOW-INCOME, SIX FROM INDIVIDUALS WHO IDENTIFIED AS LATINO, 130 FROM INDIVIDUALS WHO IDENTIFIED AS ELDERLY, AND 45 FROM MEDICAL PROFESSIONALS. |
| MADELIA COMMUNITY HOSPITAL, INCORPORATED | PART V, SECTION B, LINE 11: IT IS UNDERSTOOD THAT IT WILL TAKE A NUMBER OF YEARS TO OBTAIN MEASURABLE DATA TO DEMONSTRATE ACTUAL EDUCATION IN OBESITY. THE CURRENT STRATEGY FOCUSES ON SHORT TERM GOALS. THE FOLLOWING SHORT TERM GOALS HAVE BEEN ESTABLISHED TO REMOVE THE BARRIERS TO HEALTHY EATING AND INCREASE PHYSICAL EXERCISE: DEVELOP PARTNERSHIPS WITH COMMUNITY & COUNTY ORGANIZATIONS WHO SHARE THE SAME VISION TO IMPROVE THE ACCESS OF FRESH FRUITS AND VEGETABLES WITHIN THE COMMUNITY. DEVELOP OPPORTUNITIES TO PROVIDE LOW-COST OR NO-COST FRUITS AND VEGETABLES TO THOSE IN NEED. INCREASE COMMUNITY AWARENESS OF PROGRAMS THAT WILL ALLOW THEM TO OBTAIN FRESH FRUITS AND VEGETABLES AT LOW AND NO COST. EDUCATE CHILDREN ON HEALTHY EATING. EDUCATE CHILDREN ON THE RELATIONSHIP BETWEEN PHYSICAL ACTIVITY AND OVERALL HEALTH. PARTNER WITH MCHC ON THE JUMP ROPE FOR HEARTS PROJECT. PROVIDE OPPORTUNITIES FOR THE COMMUNITY TO TASTE FRUITS AND VEGETABLES COMMON TO DIFFERENT CULTURES REPRESENTED IN THE COMMUNITY.DIABETES, HEART DISEASE, AND CANCER. MCHC RECOGNIZES THE IMPORTANCE OF RESOURCE UTILIZATION IS DONE IN A WAY THAT WILL HAVE THE GREATEST IMPACT ON THE COMMUNITY AS A WHOLE. BY FOCUSING ON OBESITY BY SETTING GOALS AND PROVIDING EDUCATION, REDUCING OBESITY WILL ALSO REDUCE THE RISK OF DIABETES AND CANCER. |
| MADELIA COMMUNITY HOSPITAL, INCORPORATED | PART V, SECTION B, LINE 13H: ALL PATIENTS ARE CHARGED THE SAME FOR SERVICES RENDERED AT MCH NO MATTER WHAT THE PATIENT'S FINANCIAL STATUS CONSISTS OF. |
| MADELIA COMMUNITY HOSPITAL, INCORPORATED | PART V, SECTION B, LINE 15E: PATIENT BILLS CONTAIN A STATEMENT REGARDING THE FAP AVAILABILITY FOR FURTHER INQUIRY OF ASSISTANCE. |
| MADELIA COMMUNITY HOSPITAL, INCORPORATED | PART V, SECTION B, LINE 16J: THE FAP APPLICATION IS AUTOMATICALLY MAILED OUT TO UNINSURED AND UNDERINSURED PATIENTS. |
| MADELIA COMMUNITY HOSPITAL, INCORPORATED | PART V, SECTION B, LINE 20E: PATIENTS ARE INFORMED OF THE STATUS OF THEIR ACCOUNT THROUGH BILLING STATEMENTS AND LETTERS INDICATING THE AGING OF THEIR ACCOUNT AND THE AVAILABILITY TO MAKE PAYMENT ARRANGEMENTS WITH SEVERAL OPTIONS OF RECEIVING A DISCOUNT. |
| SCHEDULE H, PART V, SECTION B, LINE 7A: | WWW.MCHOSPITAL.ORG/COMMUNITY-NEEDS-ASSESSMENT |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | AGI UNDER 100% OF FPG RECEIVED FULL DISCOUNT, AGI BETWEEN 100%-200% FPG RECEIVED A DISCOUNT BASED ON FORMULARY CALCULATION. AN AGI OVER 200% DOES NOT QUALIFY FOR ASSISTANCE. |
| PART I, LINE 7: | THE FINANCIAL ASSISTANCE AT COST AND MEDICAID AMOUNTS REPORTED IN PART I, LINES 7A AND 7B, RESPECTIVELY, WERE COMPUTED USING A RATIO OF COST TO CHARGES THAT WAS DERIVED FROM WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS AND HEALTH PROFESSIONS EDUCATION AMOUNTS REPORTED IN PART I, LINES 7E AND 7F, RESPECTIVELY, WERE AT COST. |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 377,671. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | STAFF PARTICIPATE IN COMMUNITY ORGANIZATIONS TO PROVIDE HEALTHCARE REPRESENTATION AND INFORMATION TO ENHANCE THOSE ORGANIZATIONS EVENTS, ETC. MADELIA COMMUNITY BASED COLLABORATIVE (MCBC) IS A COMMUNITY BASED PROJECT THAT MADELIA COMMUNITY HOSPITAL PARTICIPATES IN TO SUPPORT HEALTHY LIFE STYLES. THROUGH THIS COLLABORATION, MADELIA COMMUNITY HOSPITAL IS ABLE TO PARTNER WITH OTHER AREA HEALTH BASED COMMUNITY EMPLOYERS AND EDUCATORS, AS WELL AS NON-HEALTH BASED EMPLOYERS THAT HAVE EXPRESSED AN INTEREST IN IMPROVING THE HEALTH OF THEIR EMPLOYEES. THE COMMUNITY HEALTH NEEDS ASSESSMENT COMPLETED BY MADELIA COMMUNITY HOSPITAL HELPS MCBC DETERMINE WHAT AREAS THEY WILL FOCUS THEIR EFFORTS IN ORDER TO GAIN THE MOST BENEFIT FOR THE COMMUNITY. STAFF FROM MADELIA COMMUNITY HOSPITAL HAVE A SIGNIFICANT ROLE IN THIS DEVELOPMENT AND CARRYING OUT THE ACTION PLANS. |
| PART III, LINE 2: | PAYMENT FOR SERVICES IS REQUIRED UPON RECEIPT OF A BILL, AFTER PAYMENT BY INSURANCE, IF ANY. SELF-PAY ACCOUNTS ARE ANALYZED FOR COLLECTIBILITY BASED ON THE MONTHS PAST DUE AND PAYMENT HISTORY. AN ALLOWANCE IS ESTIMATED FOR THESE ACCOUNTS BASED ON THE HISTORICAL EXPERIENCE OF THE HOSPITAL. ACCOUNTS THAT ARE DETERMINED TO BE UNCOLLECTIBLE ARE SENT TO A COLLECTION AGENCY AND WRITTEN OFF AT THAT TIME.THE AMOUNT OF BAD DEBT EXPENSE REPORTED IN PART III, LINE 2 IS CALCULATED AS FOLLOWS: PAYMENT ARRANGEMENT INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES AND PER DIEM PAYMENTS. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS. |
| PART III, LINE 4: | THE FOLLOWING IS FROM THE "PATIENT RECEIVABLES" PARAGRAPH IN NOTE 1 TO THE HOSPITAL'S FINANCIAL STATEMENTS:"PATIENT RECEIVABLES ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. PATIENTS ARE NOT REQUIRED TO PROVIDE COLLATERAL FOR SERVICES RENDERED. PAYMENT FOR SERVICES IS REQUIRED UPON RECEIPT OF AN INVOICE, AFTER PAYMENT BY INSURANCE, IF ANY. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. ACCOUNTS THAT ARE DETERMINED TO BE UNCOLLECTIBLE ARE SENT TO A COLLECTION AGENCY AND WRITTEN OFF AT THAT TIME." |
| PART III, LINE 8: | THE REVENUE RECEIVED AND ALLOWABLE COSTS WERE BASED ON THE 2020 FILED MEDICARE COST REPORT.THE MEDICARE SHORTFALL ON PART III, LINE 7 IS NOT TREATED AS A COMMUNITY BENEFIT. |
| PART III, LINE 9B: | EACH WEEK, STATEMENTS ARE SENT OUT THROUGH OUR EDI PROCESS WITH STATEMENTS BEING MAILED OUT TO THE PATIENT BY A CLEARINGHOUSE. PATIENTS ARE BILLED AFTER MEDICARE OR COMMERCIAL INSURANCE HAS BEEN FILED AND PAYMENT HAS BEEN RECEIVED WITHIN A SIX-WEEK PERIOD. PATIENTS WILL BE BILLED FOR THE REMAINING BALANCE MONTHLY. ACCOUNTS ARE VERIFIED INTERNALLY PRIOR TO COLLECTION LETTERS BEING SENT.IF NO PAYMENT IS RECEIVED WITHIN 2 MONTHS OF BILLINGS, THE STATEMENT IS SENT WITH A NOTICE LETTER REQUESTING PAYMENT. LETTERS WILL ALSO BE SENT SHOULD NO PAYMENT BE RECEIVED WITHIN 60 AND 90 DAYS.SHOULD NO RESPONSE BE RECEIVED WITHIN FIVE (5) DAYS OF THE LAST LETTER, A TELEPHONE CALL IS ISSUED TO NEGOTIATE A PAYMENT PLAN. IF ACCOUNT HOLDER MAY QUALIFY FOR OUR HEALTHCARE FINANCIAL PROGRAM, AN APPLICATION IS SENT TO BE COMPLETED AND RETURNED TO US.LACK OF RESPONSE TO THE TELEPHONE CALL WILL RESULT IN VERIFICATION OF THE ACCOUNT(S) BY THE INSURANCE BILLING CLERKS AND THEN REVIEWED BY THE BUSINESS OFFICE MANAGER FOR APPROVAL TO BEGIN FORMAL COLLECTION PROCESS. THESE ACCOUNTS ARE THEN TURNED IN TO A PROFESSIONAL COLLECTION AGENCY.CHARITY CARE CONSIDERATIONS WILL BE MADE BY BUSINESS OFFICE MANAGER WHEN ALL NECESSARY DOCUMENTATION IS PRESENTED AND SHOULD IT BE EVIDENT THAT THE PATIENT'S LACK OF FINANCES WARRANT THIS AND CHARITY CARE THE BEST ETHICAL DECISION FOR THE PATIENT. |
| PART VI, LINE 2: | THRU THE COMMUNITY ASSESSMENT PROCESS, HEALTHCARE NEEDS & SERVICES WERE IDENTIFIED AND PROGRAMS WERE DEVELOPED (SEE MCH WEBSITE FOR THE 2016 COMMUNITY HEALTH DIALOGUE). STRATEGIC PLANNING ASSESSES THE NEEDS OF THE COMMUNITY AND PATIENTS THROUGH PATIENT SATISFACTION SURVEYS, COMMENT CARDS, COMMUNITY ASSESSMENTS, AND A DIVERSE MEMBERSHIP OF COMMUNITY ELECTED GOVERNING BOARD THAT REPRESENTS THE COMMUNITY AND BRINGS TO THE TABLE ISSUES, CONCERNS, AND RECCOMMENDATIONS FOR HEALTH CARE SERVICES. |
| PART VI, LINE 3: | PATIENTS ARE INFORMED OF FINANCIAL ASSISTANCE UPON ADMISSION TO THE HOSPITAL, THROUGH BILLING CLERKS ASSISTANCE WITH PATIENT ACCOUNTS, STATEMENTS ON THE BILLS, AND PERSONAL LETTERS SENT TO ACCOUNTS IDENTIFIED AS UNINSURED AND UNDERINSURED. |
| PART VI, LINE 4: | MADELIA COMMUNITY HOSPITAL SERVES A 25 MILE RADIUS OF RURAL COMMUNITIES CONSISTING MAJORLY OF A CULTURALLY DIVERSE AND SENIOR POPULATION. |
| PART VI, LINE 5: | THERE WERE PUBLIC MEETINGS INFORMING THE COMMUNITY OF THE ASSESSMENT PROCESS AND ENCOURAGING THEIR PARTICIPATION. THIS WAS COMMUNICATED THRU THE NEWS MEDIA AND DIRECT CLIENT/FAMILY CONTACTS THRU MCH SERVICES. MADELIA COMMUNITY HOSPITAL (MCH) PARTNERED WITH THE MINNESOTA UNIVERSITY, MANKATO, NURSING STUDENTS TO DEVELOP AND CONDUCT A COMMUNITY-WIDE HEATHCARE ASSESSMENT. THIS WILL BE AN ONGOING PROCESS WHICH STARTED IN THE FALL OF 2011 AND WILL BE A CONTINUATION OF FOLLOWUP TO MEASURE THE PROGRESS OF COMMUNITY WELLNESS PROGRAMS THAT HAVE BEEN IMPLEMENTED AND TO IDENTIFY AWARENESS OF ANY NEW COMMUNITY HEALTH NEEDS.IN ADDITION TO THE ABOVE, MCH COLLABORATED WITH OTHER LOCAL ORGANIZATIONS REFERRED TO AS THE MADELIA COMMUNITY BASED COLLABORATIVE (MCBC) WHICH INCLUDED THE FOLLOWING PARTICIPANT ORGANIZATIONS: MADELIA COMMUNITY HOSPITAL AND CLINICSMINNESOTA STATE UNIVERSITY, MANKATO SCHOOL OF NURSINGGLEN TAYLOR NURSING INSTITUTE FOR FAMILY AND SOCIETYWATONWAN COUNTY PUBLIC HEALTH DEPARTMENTMADELIA SCHOOL SYSTEMLUTHER MEMORIAL HOMEDOWNS FOOD GROUP (MAJOR INDUSTRY IN MADELIA AND WATONWAN COUNTY)MADELIA CITY COUNCILMADELIA CHAMBER OF COMMERCE |
| PART VI, LINE 7, REPORTS FILED WITH STATES | MN |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JEFF MENGENHAUSEN | ||||||||||||||
| CEO | $159,994 | $0 | $12,931 | $0 | $0 | $0 | $0 | $0 | $3,212 | $0 | $176,137 | $0 | $0 | $0 |
| JANE MALMSKOG | ||||||||||||||
| PHARMD | $145,112 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $8,006 | $0 | $153,118 | $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 MADELIA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 416005334 | BondIssuerEIN |
| CUSIP | 556401AR8 | CUSIPNum |
| Bond Issued | 2006-10-31 | BondIssuedDt |
| Issue Price | $6,495,000 | IssuePriceAmt |
| Purpose | CONSTRUCT HOSPITAL ADDITION | 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 | $2,005,000 | RetiredAmt |
| Total Proceeds | $6,495,000 | TotalProceedsAmt |
| Capitalized Interest | $161,893 | CapitalizedInterestAmt |
| Issuance Costs From Proceeds | $129,900 | IssuanceCostsFromProceedsAmt |
| Credit Enhancement | $113,663 | CreditEnhancementAmt |
| Capital Expenditures | $6,203,207 | CapitalExpendituresAmt |
| Other Spent Proceeds | $48,230 | OtherSpentProceedsAmt |
| Substantial Completion | 2008 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | 0 | 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 | Yes (1) | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | Yes (1) | MgmtContractBondFincdPropInd |
| Engage Bond Counsel Contracts | Yes (1) | EngageBondCounselContractsInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | 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 | Yes (1) | 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 | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 2 | MADELIA COMMUNITY HOSPITAL ADDED MENTAL HEALTH SERVICES IN JULY 2019. ADDITIONALLY, AMBULANCE SERVICES BEGAN IN DECEMBER 2019, PROVIDING BLS AND TRANSFER SERVICES FOR THE COMMUNITY AND SURROUNDING AREA. |
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE PRESIDENT, AS CHAIRPERSON, VICE PRESIDENT/TREASURER, SECRETARY, AND UP TWO (2) ADDITIONAL TRUSTEES. THE EXECUTIVE COMMITTEE SHALL HAVE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD OF TRUSTEES, SUBJECT TO ANY POWER LIMITATION IMPOSED BY THE BOARD OF TRUSTEES. A QUORUM FOR THE EXECUTIVE COMMITTEE CAN ONLY BE MADE UP OF EXECUTIVE COMMITTEE MEMBERS AND ONLY EXECUTIVE COMMITTEE MEMBERS MAY VOTE DURING EXECUTIVE COMMITTEE MEETINGS. MINUTES OF THE EXECUTIVE MEETINGS SHALL BE SUBMITTED TO THE BOARD OF TRUSTEES. THE EXECUTIVE COMMITTEE SHALL ANNUALLY EVALUATE THE CHIEF EXECUTIVE OFFICER'S PERFORMANCE AND RECOMMEND HIS/HER REMUNERATION TO THE FULL BOARD OF TRUSTEES BASED ON THE CHIEF EXECUTIVE OFFICER'S PERFORMANCE IN RELATION TO THE CORPORATION'S OBJECTIVES AND GOALS. THIS COMMITTEE SHALL MEET AS NECESSARY. |
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERSHIP OF THIS CORPORATION SHALL BE OPEN TO ANY NATURAL PERSON WHO MEETS THE FOLLOWING QUALIFICATIONS AT THE TIME OF APPLICATION: 1) IS OF LEGAL VOTING AGE IN MINNESOTA; 2) IS A VOTING RESIDENT WITHIN THE PRIMARY SERVICE AREA OF THE HOSPITAL, BEING DEFINED AS THE COUNTIES OF WATONWAN, BLUE EARTH, BROWN, MARTIN AND NICOLLET, STATE OF MINNESOTA; 3) IS A NATURAL PERSON AND NOT A CORPORATION, PARTNERSHIP OR OTHER ASSOCIATION; 4) SUBMITS A WRITTEN APPLICATION FOR MEMBERSHIP TO THE BOARD OF TRUSTEES ON A FORM APPROVED BY THE BOARD OF TRUSTEES; AND 5) SUBMITS A MEMBERSHIP FEE OF $25 OR MORE, WITH SAID APPLICATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | ALL TRUSTEES ARE ELECTED BY THE CORPORATE MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 WAS REVIEWED BY THE CHIEF FINANCIAL OFFICER PRIOR TO FILING AND WILL BE PRESENTED TO THE GOVERNING BOARD OF TRUSTEES BY FINANCE COMMITTEE AT THE FIRST REGULAR MEETING OF THE BOARD OF TRUSTEES SUBSEQUENT TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY IS REVIEWED AT THE JANUARY BOARD MEETING BY THE GOVERNING BOARD AND DEPARTMENT MANAGERS. IF ANY CONFLICTS OF INTEREST ARISE, NOTIFICATION IS GIVEN TO ADMINISTRATION. A CONTRACT OR OTHER TRANSACTION THAT MAY INVOLVE A CONFLICT OF INTEREST IS NOT VOID OR VOIDABLE IF: 1) THE CONTRACT OR TRANSACTION WAS FAIR AND REASONABLE AS TO THE CORPORATION WHEN IT WAS AUTHORIZED, APPROVED, OR RATIFIED; 2) ALL MATERIAL FACTS ARE FULLY DISCLOSED TO THE MEMBERS AND THE CONTRACT OR TRANSACTION IS APPORVED BY TWO-THIRDS OF THE MEMBERS ENTITLED TO VOTE, OTHER THAN THE INTERESTED DIRECTOR OR TRUSTEE; AND 3) ALL MATERIAL FACTS ARE FULLLY DISCLOSED TO THE BOARD OF TRUSTEES OR A COMMITTEE, AND THE BOARD OR COMMITTEE APPROVES THE CONTRACT OR TRANSACTION BY A MAJORITY VOTE, BUT THE INTERESTED TRUSTEE MAY NOT TAKE PART IN THE DISCUSSION, AND MAY NOT VOTE. |
| FORM 990, PART VI, SECTION B, LINE 15 | MADELIA COMMUNITY HOSPITAL ENSURES THAT THE COMPENSATION PAID TO ITS CEO BE CONSISTENT WITH POLICY AND PROVIDE EQUITABLE STANDARDS FOR WAGE AND BENEFITS BASED ON ANNUAL REGIONAL SURVEY OF COMPARABLE ENTITIES. THE GOVERNING BOARD REVIEWS ANNUALLY THE CEO'S PERFORMANCE AND THE BASIS IS ANNUAL MN HOSPITAL ASSOCIATION SURVEY . THE BOARD DETERMINES THE CEO'S BASE SALARY, IN ITS SOLE DISCRETION. THIS WAS MOST RECENTLY COMPLETED IN 2020. COMPENSATION OF THE OFFICER AND KEY EMPLOYEES IS EVALUATED AND INCREASED ANNUALLY BASED ON PERFORMANCE BY THE CEO. ANNUAL INCREASES ARE BASED ON A REGIONAL SURVERY OF COMPARABLE ENTITIES WITH SIMILAR POSITIONS ALONG WITH YEARS OF SERVICE AND NUMBER SUPERVISED. THE SURVEY RESULTS AND THE EMPLOYEES PERFORMANCE ARE EVALUATED FOR AN INCREASE IF DEEMED APPROPRIATE. THIS WAS MOST RECENTLY COMPLETED IN 2020. |
| FORM 990, PART VI, SECTION C, LINE 19 | MADELIA COMMUNITY HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AT THE ANNUAL CORPORATION MEETING AND UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | ANESTHESIA FEES: PROGRAM SERVICE EXPENSES 49,224. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 49,224. PAIN MANAGEMENT CRNA FEES: PROGRAM SERVICE EXPENSES 52,957. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 52,957. 340B PROGRAM FEES: PROGRAM SERVICE EXPENSES 29,174. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,174. PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 142,411. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 142,411. DIETICIAN FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 10,755. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,755. ADVERTISING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 54,406. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 54,406. NURSING CONTRACTED STAFF: PROGRAM SERVICE EXPENSES 198,176. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 198,176. ER PHYSICIAN LOCUMS: PROGRAM SERVICE EXPENSES 637,816. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 637,816. CLINIC PHYSICIAN LOCUMS: PROGRAM SERVICE EXPENSES 738,844. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 738,844. SPEECH THERAPY FEES: PROGRAM SERVICE EXPENSES 218. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 218. PHARMACY LEGEND DRUG FEES: PROGRAM SERVICE EXPENSES 4,490. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,490. |
| FORM 990, PART XI, LINE 9: | RECONCILIATION FOR CONTRIBUTION FROM RELATED ENTITY -47,000. |
| FORM 990, PART XII, LINE 2C | THE ORGANIZATIONS BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF ITS INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEARS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADELIA COMMUNITY HOSPITAL FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 121 DREW AVENUE SE | AddressLine1Txt |
| City | MADELIA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56062 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 731719218 | EIN |
| Primary Activities | SOLICIT CONTRIBUTIONS ON BEHALF OF THE MADELIA COMMUNITY HOSPITAL. | PrimaryActivitiesTxt |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12A, I | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADELIA COMMUNITY HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADELIA COMMUNITY HOSPITAL FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionTypeTxt |
| Involved | $187,000 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |