CENTRACARE HEALTH SYSTEM-LONG PRAIRIE: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- CENTRACARE HEALTH SYSTEM-LONG PRAIRIE (EIN 41-1924645)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-05-13
- IRS object ID
- 202131339349304578
- 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 C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-05-13T15:16:28-05:00 | ReturnTs |
| Tax Period End | 2020-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 420714325 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RSM US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 801 NICOLLET MALL WEST TOWER STE | AddressLine1Txt |
| Address Line2 | 1200 | AddressLine2Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554022526 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411924645 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRACARE HEALTH SYSTEM - LONG PRAIRIE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CENT | BusinessNameControlTxt |
| Phone | 3207322141 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 CENTRACARE DRIVE | AddressLine1Txt |
| City | LONG PRAIRIE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56347 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOSEPH KALKMAN | PersonNm |
| Person Title | EVP, CAO & CHRO | PersonTitleTxt |
| Phone | 3207322141 | PhoneNum |
| Signature | 2021-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KACIE MCEWEN | PreparerPersonNm |
| PTIN | P01599614 | PTIN |
| Phone | 6123324300 | PhoneNum |
| Preparation | 2021-05-11 | 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 | CENTRACARE HEALTH - LONG PRAIRIE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DR KENNETH D HOLMEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 CENTRACARE DRIVE | AddressLine1Txt |
| City | LONG PRAIRIE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56347 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $42,330,456 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CENTRACARE.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1999 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | WE'RE HERE FOR YOUR WHOLE LIFE TO LISTEN, THEN SERVE, TO GUIDE AND HEAL BECAUSE HEALTH MEANS EVERYTHING. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 358 | TotalEmployeeCnt |
| Total Volunteers | 50 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,042,102 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,153,297 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $35,743,201 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $34,976,973 | CYProgramServiceRevenueAmt |
| PY Investment Income | $285,589 | PYInvestmentIncomeAmt |
| CY Investment Income | $206,077 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,515,012 | PYOtherRevenueAmt |
| CY Other Revenue | $1,756,061 | CYOtherRevenueAmt |
| PY Total Revenue | $38,585,904 | PYTotalRevenueAmt |
| CY Total Revenue | $42,092,408 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $141,176 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $142,439 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $21,408,161 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $21,788,243 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $18,590,640 | PYOtherExpensesAmt |
| CY Other Expenses | $18,839,364 | CYOtherExpensesAmt |
| PY Total Expenses | $40,139,977 | PYTotalExpensesAmt |
| CY Total Expenses | $40,770,046 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,554,073 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,322,362 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $61,531,480 | TotalAssetsBOYAmt |
| Total Assets EOY | $61,590,751 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $43,789,990 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $43,155,424 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $17,741,490 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $18,435,327 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | WE'RE HERE FOR YOUR WHOLE LIFE TO LISTEN, THEN SERVE, TO GUIDE AND HEAL BECAUSE HEALTH MEANS EVERYTHING. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $22,250,033 | ExpenseAmt |
| Grant | $142,439 | GrantAmt |
| Revenue | $21,551,831 | RevenueAmt |
| Desc | CCH - LONG PRAIRIE IS PART OF A LARGER INTEGRATED HEALTH CARE DELIVERY SYSTEM KNOWN AS CENTRACARE HEALTH, A SYSTEM RECOGNIZED FOR BEING A LEADER IN PROVIDING HIGH-QUALITY, COMPREHENSIVE CARE THROUGHOUT THE REGION. CCH - LONG PRAIRIE IS A 25 BED CRITICAL ACCESS HOSPITAL THAT PROVIDES ACUTE CARE SERVICES IN THE AREAS OF MEDICAL, SURGICAL, DIAGNOSTIC, AND OBSTETRICS ALONG WITH OTHER SERVICES OF 24 HOUR EMERGENCY ROOM, IMAGING, LABORATORY, REHABILITATION, AND CHEMOTHERAPY TO THE COMMUNITY OF LONG PRAIRIE AND THE SURROUNDING AREA. THERE WERE 539 ADMISSIONS, 2,529 INPATIENT DAYS, AND 28,431 OUTPATIENT VISITS DURING FISCAL YEAR 2020. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $6,340,225 | ExpenseAmt |
| Revenue | $5,680,139 | RevenueAmt |
| Desc | CCH - LONG PRAIRIE OPERATES THE LONG PRAIRIE CLINIC WHICH IS CONVENIENTLY CONNECTED TO THE LONG PRAIRIE HOSPITAL FOR THE HEALTH CARE NEEDS OF THE COMMUNITY. LONG PRAIRIE CLINIC PROVIDES HEALTH CARE THROUGH A MIXTURE OF PHYSICIANS AND MIDLEVEL PROVIDERS. THERE WERE 17,921 CLINIC VISITS DURING FISCAL YEAR 2020. ALSO 48 SURGEON CLINIC VISITS.CCH - LONG PRAIRIE ALSO OPERATES THE EAGLE VALLEY CLINIC IN EAGLE BEND, MN WHICH PROVIDES HEALTH CARE FOR BOTH THE CLARISSA AND EAGLE BEND COMMUNITIES AND SURROUNDING AREAS. THE EAGLE VALLEY CLINIC PROVIDES HEALTH CARE THROUGH THE USE OF MIDLEVEL PROVIDERS WITH OVERSIGHT OF THE PHYSICIANS FROM THE LONG PRAIRIE CLINIC. THERE WERE 238 CLINIC VISITS DURING FISCAL YEAR 2020. THIS CLINIC WAS SHUT DOWN AS OF 10/31/19. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $6,608,821 | ExpenseAmt |
| Revenue | $6,382,307 | RevenueAmt |
| Desc | THE CCH - LONG PRAIRIE CARE CENTER IS AN ATTACHED 70 BED SKILLED NURSING FACILITY THAT PROVIDES QUALITY, COMPASSIONATE CARE WITH AN EMPHASIS ON ENHANCING EACH RESIDENT'S PHYSICAL, SPIRITUAL, EMOTIONAL, AND SOCIAL WELL-BEING. THERE WERE 20,587 RESIDENT DAYS DURING FISCAL YEAR 2020. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,830,159 | ExpenseAmt |
| Revenue | $1,362,696 | RevenueAmt |
| Desc | CCH - LONG PRAIRIE BUILT AN ASSISTED LIVING BUILDING AND OPENED IT FOR SERVICES IN MID AUGUST 2017. THE BUILDING CONSISTS OF 24 ASSISTED LIVING APARTMENTS AND 16 MEMORY CARE APARTMENTS. THERE WERE 6,254 ASSISTED LIVING OCCUPIED UNIT DAYS AND 2,262 MEMORY CARE OCCUPIED UNIT DAYS FOR FISCAL YEAR 2020. THERE WERE 7,140 ASSISTED LIVING TENANT DAYS AND 2,262 MEMORY CARE TENANT DAYS FOR FISCAL YEAR 2020. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $2,830,159 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $1,362,696 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $38,029,238 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 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 | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 13 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 358 | 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 | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LARRY KNUTSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3207327240 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 CENTRACARE DRIVE | AddressLine1Txt |
| City | LONG PRAIRIE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56347 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| KENNETH D HOLMEN MD | |||||||||
| PRESIDENT/CEO | 1.00 | 39.00 | Yes (X) | Yes (X) | $0 | $1,279,307 | $35,898 | ||
| CRAIG J BROMAN | |||||||||
| CHIEF OPERATING OFFICER | 1.00 | 39.00 | Yes (X) | Yes (X) | $0 | $1,109,826 | $40,748 | ||
| GREGORY R KLUGHERZ | |||||||||
| TREASURER/CFO, CCH(UNTIL 7/1/2019) | 1.00 | 39.00 | Yes (X) | Yes (X) | $0 | $709,157 | $39,650 | ||
| PAUL R HARRIS ESQ | |||||||||
| CORPORATE SECRETARY(UNTIL 3/1/2020) | 2.00 | 38.00 | Yes (X) | Yes (X) | $0 | $505,355 | $131,200 | ||
| THOMAS G SCHRUP MD | |||||||||
| VICE PRESIDENT | 1.00 | 39.00 | Yes (X) | Yes (X) | $0 | $498,952 | $81,057 | ||
| RENE ELDIDY MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $0 | $331,755 | $37,947 | Yes (X) | |||
| JAY-SHEREE P ALLEN MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $0 | $375,041 | $15,500 | Yes (X) | |||
| DANIEL J SWENSON | |||||||||
| ADMINISTRATOR - LONG PRAIRIE | 39.50 | 0.50 | $0 | $266,807 | $62,849 | Yes (X) | |||
| SANTO CRUZ | |||||||||
| CORPORATE SECRETARY(AS OF 6/28/2020) | 2.00 | 38.00 | Yes (X) | Yes (X) | $0 | $262,606 | $22,337 | ||
| DEBORAH P RASMUSSEN MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $0 | $241,222 | $24,996 | Yes (X) | |||
| WAYNE A JORGENSEN PA | |||||||||
| PHYSICIAN ASSISTANT | 40.00 | 0.00 | $171,339 | $0 | $38,377 | Yes (X) | |||
| CHRISTOPHER A HAGEN | |||||||||
| PHARMACY | 40.00 | 0.00 | $163,928 | $0 | $33,526 | Yes (X) | |||
| MICHAEL BLAIR | |||||||||
| TREASURER/CFO(AS OF 9/30/2019) | 1.00 | 39.00 | Yes (X) | Yes (X) | $0 | $97,957 | $757 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $335,267 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $5,677,985 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $564,842 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 20 | 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 |
|---|---|---|---|---|---|
| WHITESELL MEDICAL STAFFING | |||||
| 360 LAKE DRIVE EAST | ANNANDALE | MN | 55302 | PHYSICIAN SERVICES | $953,618 |
| AYA HEALTHCARE INC | |||||
| DEPT 3519 | DALLAS | TX | 75312 | TEMPORARY STAFFING SERVICES | $866,908 |
| CENTRAL MN DIAGNOSTIC INC | |||||
| 525 10TH ST NE | MILACA | MN | 56353 | MRI/CT SERVICES | $740,200 |
| WEST CENTRAL ANESTHESIA PC | |||||
| 10382 AUGUSTA DRIVE | SAUK CENTRE | MN | 56378 | CRNA SERVICES | $480,457 |
| DENNIS FAITH | |||||
| 4 REYNARD ROAD | MALVERN | PA | 19355 | PHYSICIAN SERVICES | $304,458 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,393,007 | RelatedOrganizationsAmt |
| Government Grants | $3,536,327 | GovernmentGrantsAmt |
| All Other Contributions | $223,963 | AllOtherContributionsAmt |
| Total Contributions | $5,153,297 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT AND RESIDENT SERVICE REVE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $34,579,940 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $34,579,940 | RelatedOrExemptFuncIncomeAmt |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $397,033 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $397,033 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $34,976,973 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $145,375 | TotalRevenueColumnAmt |
| Exclusion | $145,375 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $927,606 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $927,606 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $927,606 | TotalRevenueColumnAmt |
| Exclusion | $927,606 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $60,702 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $60,702 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $60,702 | TotalRevenueColumnAmt |
| Exclusion | $60,702 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $1,066,503 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $238,048 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $828,455 | TotalRevenueColumnAmt |
| Exclusion | $828,455 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $42,092,408 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $34,976,973 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,962,138 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $130,880 | TotalAmt |
| Program Services | $130,880 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,559 | TotalAmt |
| Program Services | $11,559 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,512,657 | TotalAmt |
| Program Services | $15,402,576 | ProgramServicesAmt |
| Management And General | $1,110,081 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $633,367 | TotalAmt |
| Program Services | $590,788 | ProgramServicesAmt |
| Management And General | $42,579 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,771,052 | TotalAmt |
| Program Services | $3,517,539 | ProgramServicesAmt |
| Management And General | $253,513 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $871,167 | TotalAmt |
| Program Services | $812,602 | ProgramServicesAmt |
| Management And General | $58,565 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,263 | TotalAmt |
| Management And General | $22,263 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,292 | TotalAmt |
| Management And General | $1,292 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,988,369 | TotalAmt |
| Program Services | $4,675,232 | ProgramServicesAmt |
| Management And General | $313,137 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,744 | TotalAmt |
| Program Services | $30,543 | ProgramServicesAmt |
| Management And General | $2,201 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,386 | TotalAmt |
| Program Services | $87,108 | ProgramServicesAmt |
| Management And General | $6,278 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,777 | TotalAmt |
| Program Services | $38,036 | ProgramServicesAmt |
| Management And General | $2,741 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $928,076 | TotalAmt |
| Program Services | $865,685 | ProgramServicesAmt |
| Management And General | $62,391 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,259 | TotalAmt |
| Program Services | $29,158 | ProgramServicesAmt |
| Management And General | $2,101 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,321,726 | TotalAmt |
| Program Services | $1,232,872 | ProgramServicesAmt |
| Management And General | $88,854 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,760,565 | TotalAmt |
| Program Services | $3,507,757 | ProgramServicesAmt |
| Management And General | $252,808 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $144,659 | TotalAmt |
| Program Services | $134,934 | ProgramServicesAmt |
| Management And General | $9,725 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MEDICAL SUPPLIES/DRUGS | $4,012,770 | $4,012,770 |
| IMPLICIT PRICE CONCESSI | $1,617,758 | $1,617,758 |
| MEDICAID/MN CARE | $660,978 | $660,978 |
| MEDICAL EQUIPMENT RENTA | $628,049 | $628,049 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $554,693 | TotalAmt |
| Program Services | $42,414 | ProgramServicesAmt |
| Management And General | $512,279 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,770,046 | TotalAmt |
| Program Services | $38,029,238 | ProgramServicesAmt |
| Management And General | $2,740,808 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,337,801 | BOYAmt |
| EOY | $6,210,578 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,888,202 | BOYAmt |
| EOY | $4,626,883 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $275,282 | BOYAmt |
| EOY | $380,078 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,099 | BOYAmt |
| EOY | $46,349 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $64,714,459 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $18,407,212 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,930,106 | BOYAmt |
| EOY | $46,307,247 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,525,827 | BOYAmt |
| EOY | $2,013,346 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $510,163 | BOYAmt |
| EOY | $468,725 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,537,545 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,531,480 | BOYAmt |
| EOY | $61,590,751 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,714,247 | BOYAmt |
| EOY | $3,126,136 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,376 | BOYAmt |
| EOY | $25,326 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,065,367 | BOYAmt |
| EOY | $40,003,962 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,789,990 | BOYAmt |
| EOY | $43,155,424 | 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 | $17,673,670 | BOYAmt |
| EOY | $18,360,329 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $67,820 | BOYAmt |
| EOY | $74,998 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,741,490 | BOYAmt |
| EOY | $18,435,327 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,531,480 | BOYAmt |
| EOY | $61,590,751 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,322,362 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$123,709 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$504,816 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $1,292 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,292 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | CENTRACARE - LONG PRAIRIE PAID $1,292 TO STATE AND NATIONAL ASSOCIATIONS TO CONDUCT LOBBYING ON ITS BEHALF, AS A MEMBER OF THE ASSOCIATIONS. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $282,427 | OtherCostOrOtherBasisAmt |
| Book Value | $282,427 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $51,675,154 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,887,034 | DepreciationAmt |
| Book Value | $40,788,120 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,951,631 | OtherCostOrOtherBasisAmt |
| Depreciation | $883,918 | DepreciationAmt |
| Book Value | $1,067,713 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,805,247 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,636,260 | DepreciationAmt |
| Book Value | $4,168,987 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $46,307,247 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| ASSET RETIREMENT OBLIGATION | $570,552 |
| BOND PREMIUM | $32,403,371 |
| DUE TO AFFILIATES | $4,361,550 |
| THIRD PARTY SETTLEMENTS | $1,179,583 |
| OPERATING LIABILITIES | $1,488,906 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $40,003,962 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | CENTRACARE, THE CORPORATION, THE CLINIC, CCH-MELROSE, CCH-LONG PRAIRIE, CCH-SAUK CENTRE AND THE FOUNDATION HAVE BEEN DETERMINED TO QUALIFY AS TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CCH-MONTICELLO, CCH-PAYNESVILLE AND CARRIS HEALTH, AS DISREGARDED LIMITED LIABILITY COMPANIES (LLCS) UNDER INTERNAL REVENUE SERVICE REGULATIONS, ACHIEVE TAX-EXEMPT TREATMENT BASED ON THE EXEMPT STATUS OF THEIR PARENT, CENTRACARE HEALTH SYSTEM. AT JUNE 30, 2020 AND 2019, THERE WERE NO UNCERTAIN TAX POSITIONS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 175.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $353,244 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $353,244 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00900 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,698,936 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,309,241 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,389,695 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06100 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,052,180 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,309,241 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,742,939 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07000 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,461 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,461 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,461 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,461 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,054,641 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,309,241 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,745,400 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07010 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,461 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,461 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,461 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,461 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,617,758 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $7,428,281 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,404,956 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $23,325 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRACARE HEALTH - LONG PRAIRIE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 CENTRACARE DRIVE | AddressLine1Txt |
| City | LONG PRAIRIE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56347 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.CENTRACARE.COM/LOCATIONS/CENTRACAR | WebsiteAddressTxt |
| State License | 331051 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | RURAL HEALTH CLINIC, NURSING HOME | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRACARE HEALTH - LONG PRAIRIE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SECTION C SUPPLEMENTAL INFORMATION FOR PART V, SECTION B | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SECTION C SUPPLEMENTAL INFORMATION FOR PART V, SECTION B | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 175.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| CENTRACARE HEALTH - LONG PRAIRIE | PART V, SECTION B, LINE 3J: CENTRACARE UTILIZED THE MAPP (MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS) PROCESS TO CONDUCT THE CHNA AND PREPARE THE IMPLEMENTATION STRATEGY WHICH WE CALLED THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). THE MAPP PROCESS INCLUDES A LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT, STAKEHOLDER INTERVIEWS, COMMUNITY HEALTH SURVEY JOINTLY FUNDED AND MANAGED WITH THREE COUNTY PUBLIC HEALTH DEPARTMENTS, AND SEVERAL COMMUNITY MEETINGS TO GATHER INFORMATION ON FORCES THAT CREATE HEALTH, TRENDS, FACTORS AND EVENTS AFFECTING HEALTH, AND STRATEGIES TO OVERCOME BARRIERS TO HEALTHY LIVING. THE CHNA INCLUDED A HEALTH EQUITY ASSESSMENT AND INFORMATION ON NATIONAL, STATE, AND OTHER LOCAL PLANNING PROCESSES RELATED TO HEALTH. AS A FOLLOW UP TO THE PRIOR CHNA PROCESS WHERE PUBLIC HEALTH DATA WAS A SIGNIFICANT GAP, THIS CHNA AND SUBSEQUENT CHIP WAS A COLLABORATIVE EFFORT EXECUTED WITH TODD COUNTY HEALTH AND HUMAN SERVICES, MORRISON COUNTY PUBLIC HEALTH, AND WADENA COUNTY PUBLIC HEALTH. THE RESULT WAS A JOINT CHNA AND CHIP. |
| CENTRACARE HEALTH - LONG PRAIRIE | PART V, SECTION B, LINE 5: TODD-MORRISON-WADENA CHNA COLLABORATIVE (MTW CHB) AGREED TO UTILIZE THE MAPP (MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS) PROCESS TO CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENT AND PREPARE THE IMPLEMENTATION STRATEGY. THIS GROUP MEETS BI-MONTHLY TO DEDICATE TIME IN COMPLETING THE MAPP PROCESS. IN ADDITION TO THE COLLABORATIVE GROUP'S EFFORTS OF COMPLETING A FORCES OF CHANGE ASSESSMENT, COMMUNITY INPUT WILL BE REPRESENTED THROUGH A COMMUNITY HEALTH SURVEY (GOAL IS 400 COMPLETED SURVEYS PER COUNTY), COMMUNITY STAKEHOLDER INTERVIEWS (FOLLOWING THE 12 SECTOR MODEL, EACH COUNTY WILL SELECT 20-30 NAMES FOR INTERVIEWS), AND ANECDOTAL SELF-REPORTED DATA COLLECTION WITHIN OUR TARGETED POPULATION (IDENTIFIED THROUGH ASSESSMENT IN OUR PMAP). OTHER SOURCES OF DATA COLLECTION INCLUDE LOCAL ELECTRONIC MEDICAL RECORD DATA, IHP AND HEALTH EQUITY DATA, COUNTY DATA TABLES, MINNESOTA STUDENT SURVEYS AND RESULTS FROM THE 2013 AND 2016 REGIONAL COMMUNITY HEALTH SURVEY DATA.EACH ORGANIZATION WILL WORK ON THE 2019 COMMUNITY HEALTH PRIORITIES INDEPENDENTLY, AS WELL AS COLLECTIVELY WHEN POSSIBLE. IDENTIFYING PRIORITIES TOGETHER ALLOWS THE OPPORTUNITY TO MAKE GREATER STRIDES THROUGHOUT OUR AREA, CREATING A REGIONAL APPROACH RATHER THAN ORGANIZATIONAL APPROACH. EACH ORGANIZATION HAS THE FREEDOM TO DECIDE HOW THEY CAN MOST AFFECT EACH PRIORITY BASED ON THEIR RESOURCES ALLOTTED TO THIS WORK. THE COLLABORATIVE GROUP WILL CONTINUE TO MEET TO REVIEW GOALS AND STRATEGIES AND UPDATE CURRENT EFFORTS AND MEASURES OF SUCCESS OVER THE DESIGNATED COMMUNITY HEALTH NEEDS ASSESSMENT PERIOD.THE ASSESSMENTS GATHER QUALITATIVE AND QUANTITATIVE DATA TO DRIVE THE PRIORITY SELECTION PROCESS. TO COMPLETE THE ASSESSMENTS, TODD AND WADENA COUNTIES FOLLOWED THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS PROCESS (MAPP). THE MAPP PROCESS IS A COMMUNITY-DRIVEN STRATEGIC PLANNING TOOL THAT INCLUDES COMMUNITY VISIONING, CONDUCTING FOUR ASSESSMENTS (COMMUNITY THEMES AND STRENGTHS, ORGANIZATION CAPACITY AND PERFORMANCE, COMMUNITY HEALTH, AND FORCES OF CHANGE), PRIORITIZING ISSUES, SELECTING GOALS AND STRATEGIES, AND DEVELOPING AN ACTION PLAN. THE CHB'S COMMUNITY HEALTH ASSESSMENT RESULTS INCLUDE SIX AREAS: WRITTEN/EMAIL SURVEY, FACE-TO-FACE INTERVIEWS, SECONDARY DATA SOURCES, DIRECTORY LISTING OF HEALTH SYSTEM CAPABILITIES, SUMMARY AND CONCLUSIONS, AND THREE-YEAR ACTION PLAN.THE SURVEY INSTRUMENT CONTENT WAS LARGELY TAKEN FROM A SIMILAR SURVEY CONDUCTED BY THESE SAME COUNTIES IN 2016. MODIFICATIONS TO THE SURVEY QUESTIONS WERE MADE BY LOCAL PUBLIC HEALTH STAFF WITH TECHNICAL ASSISTANCE FROM THE MINNESOTA DEPARTMENT OF HEALTH CENTER FOR HEALTH STATISTICS. A TWO-STAGE SAMPLING STRATEGY WAS USED FOR OBTAINING PROBABILITY SAMPLES OF ADULTS LIVING IN EACH OF THE THREE COUNTIES. A SEPARATE SAMPLE WAS DRAWN FOR EACH COUNTY. ADDITIONAL SAMPLES WERE DRAWN IN EACH OF FOUR CITIES IN THE REGION (LITTLE FALLS, LONG PRAIRIE, STAPLES AND WADENA). THE COMMUNITY THEMES AND STRENGTHS ASSESSMENT (CTSA): COMMUNITY STAKEHOLDER INTERVIEWS WERE CONDUCTED WITH 54 INDIVIDUALS ACROSS MORRISON, TODD, AND WADENA COUNTIES. INTERVIEWS WERE CONDUCTED BY PUBLIC HEALTH AND HEALTH CARE STAFF UTILIZING THE COMMUNITY STAKEHOLDER QUESTIONNAIRE. INTERVIEWS WERE CONDUCTED IN PERSON AND VIA PHONE AND TYPICALLY LASTED 45 MINUTES TO 1 HOUR. 22 INTERVIEWS WERE CONDUCT IN MORRISON COUNTY, 15 INTERVIEWS WERE CONDUCTED IN TODD COUNTY, AND 17 INTERVIEWS WERE CONDUCTED IN WADENA COUNTY. COMMUNITY STAKEHOLDERS WERE SELECTED FROM A VARIETY OF SECTORS. THE FORCES OF CHANGE (FOC) ASSESSMENT IDENTIFIES FORCES THAT MAY AFFECT A COMMUNITY AND OPPORTUNITIES AND THREATS ASSOCIATED WITH THOSE FORCES. THE FOC TEAM FACILITATED A CONVERSATION ON WHAT CREATES HEALTH, FORCES, TRENDS, FACTORS AND EVENTS AFFECTING HEALTH, AND STRATEGIES TO OVERCOME BARRIERS TO HEALTHY LIVING. |
| CENTRACARE HEALTH - LONG PRAIRIE | PART V, SECTION B, LINE 6A: CENTRACARE CONDUCTED THREE DIFFERENT CHNA GROUPS. THE TODD MORRISON WADENA COLLABORATIVE INCLUDED CENTRACARE LONG PRAIRIE ALONG WITH LAKEWOOD HEALTH SYSTEM, TRI-COUNTY HEALTHCARE, CHI ST. GABRIEL'S HEALTH, AND THE MORRISON TODD WADENA COMMUNITY HEALTH BOARD (MORRISON, TODD, AND WADENA COUNTY PUBLIC HEALTH DEPARTMENTS). |
| CENTRACARE HEALTH - LONG PRAIRIE | PART V, SECTION B, LINE 6B: CENTRACARE CONDUCTED THREE DIFFERENT CHNA GROUPS. THE TODD MORRISON WADENA COLLABORATIVE INCLUDED CENTRACARE LONG PRAIRIE ALONG WITH LAKEWOOD HEALTH SYSTEM, TRI-COUNTY HEALTHCARE, CHI ST. GABRIEL'S HEALTH, AND THE MORRISON TODD WADENA COMMUNITY HEALTH BOARD (MORRISON, TODD, AND WADENA COUNTY PUBLIC HEALTH DEPARTMENTS). |
| CENTRACARE HEALTH - LONG PRAIRIE | PART V, SECTION B, LINE 7D: PAPER COPY AVAILABLE UPON REQUEST AT NO CHARGE. |
| CENTRACARE HEALTH - LONG PRAIRIE | PART V, SECTION B, LINE 11: AFTER COMPLETING THE 2019 MORRISON-TODD-WADENA COMMUNITY HEALTH SURVEY AND THE INTERVIEWS WITH 22 COMMUNITY STAKEHOLDERS, AND AFTER REVIEWING ADDITIONAL DATA SOURCES FROM EMERGENCY ROOM STATISTICS TO THE STATE'S STUDENT SURVEY TO THE U.S. CENSUS BUREAU INFORMATION, AND MANY OTHER SOURCES, THE COMMUNITY HEALTH NEEDS ASSESSMENT TEAM AT CENTRACARE LONG PRAIRIE BEGAN THE WORK TO DEVELOP GOALS, INITIATIVES AND STRATEGIES TO ADDRESS TODD COUNTY'S THREE TOP HEALTH NEEDS AS IDENTIFIED BY THESE INVESTIGATIONS.WITH DATA IN HAND, KATIE GRUBER, SUPERVISOR COMMUNITY HEALTH AND WELL-BEING AND JODI HILLMER, DIRECTOR OF PATIENT CARE SERVICES, WHO LED THE 2019 CHNA WORK, CONVENED A SERIES OF MEETINGS WITH A STRATEGY TEAM TO, FIRST, DISCUSS THE ISSUES THAT SEEMED OF GREATEST CONCERN TO THE PEOPLE OF TODD COUNTY, AND THEN TO FOCUS ON EACH OF THE TOP THREE TO EXPLORE WAYS TO ADDRESS THOSE NEEDS AND TO IMPROVE THE HEALTH OF THEIR COMMUNITY. THE STRATEGY TEAM SHE INVITED TO ATTEND INCLUDED REPRESENTATIVES OF ORGANIZATIONS WHO, ON A DAILY BASIS, ADDRESS THE HEALTH CONCERNS OF THE PEOPLE WHO CALL TODD COUNTY HOME. THE TEAM INCLUDES REPRESENTATIVES FROM THE COUNTY'S PUBLIC HEALTH OFFICE, CITY COUNCIL, SCHOOLS, ELDERLY COMMUNITIES, THE COUNTY EXTENSION OFFICE, AND CENTRACARE LONG PRAIRIE ITSELF.PREPARED WITH INFORMATION ON THE RESULTS OF THE 2019 COMMUNITY NEEDS SURVEY AND THE STAKEHOLDER INTERVIEWS, THEY BEGAN ADDRESSING THE ISSUES FROM THEIR PROFESSIONAL PERSPECTIVES, QUICKLY FOCUSING ON OBESITY AND MENTAL HEALTH AS TOP CONCERNS, AS THEY HAD BEEN IN THE 2016 CHNA. DISCUSSION OF THESE TWO ISSUES LED THE TEAM TO CONCLUDE THAT OTHER ISSUES IDENTIFIED IN THE SURVEY, SUCH AS PARENTING SKILLS, AND FOOD INSECURITY WERE RELATED AND THAT THE ISSUES OF MENTAL HEALTH AND SOCIAL DETERMINANTS OF HEALTH ARE INTERTWINED. THE TEAM ACKNOWLEDGED AND ADDRESSED THE FACT THAT THE LIST OF ISSUES FROM WHICH SURVEY RESPONDENTS HAD TO CHOOSE WAS DEVELOPED BY THE MTW HEALTH BOARD TEAM AND WERE, THUS, NOT SELF-REPORTED ISSUES. THE TEAM MEMBERS, HOWEVER, AGREED THAT OBESITY, CAUSES MAJOR HEALTH CONCERNS FACED BY TODD COUNTY RESIDENTS. OBESITY ROSE TO THE TOP OF THEIR LIST OF HEALTH CONCERNS FOR 2019, FOLLOWED BY MENTAL HEALTH AND SOCIAL DETERMINANTS OF HEALTH. |
| CENTRACARE HEALTH - LONG PRAIRIE | PART V, SECTION B, LINE 13H: A NON-CITIZEN CAN BE DENIED CARE IF THEY CAME TO THE US SPECIFICALLY TO RECEIVE FREE CARE. PRESUMPTIVE ELIGIBILITY - IF PATIENTS FAIL TO SUPPLY SUFFICIENT INFORMATION TO SUPPORT FINANCIAL ASSISTANCE ELIGIBILITY, CENTRACARE HEALTH MAY REFER TO OR RELY ON EXTERNAL SOURCES AND/OR OTHER PROGRAM ENROLLMENT RESOURCES TO DETERMINE ELIGIBILITY WHEN:(A) PATIENT IS HOMELESS(B) PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS(C) PATIENT IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM(D) PATIENT IS ELIGIBLE FOR A STATE-FUNDED PRESCRIPTION MEDICATION PROGRAM(E) PATIENT'S VALID ADDRESS IS CONSIDERED LOW-INCOME OR SUBSIDIZED HOUSING(F) PATIENT RECEIVES FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO HOSPITAL FOR FURTHER TREATMENT |
| CENTRACARE HEALTH - LONG PRAIRIE | PART V, SECTION B, LINE 16J: PATIENTS WHO ARE AT A SELF PAY STATUS RECEIVE FINANCIAL ASSISTANCE INFORMATION EITHER VIA A TELEPHONE CALL OR ON BILLING STATEMENTS. |
| CENTRACARE HEALTH - LONG PRAIRIE | PART V, SECTION B, LINE 20E: OUR CREDIT COLLECTION AGENCIES ARE REQUIRED TO PROVIDE CHARITY INFORMATION AS PART OF THEIR COLLECTION PROCESS PRIOR TO ANY CONSIDERATION OF LEGAL ACTION AGAINST THE PATIENT. |
| CENTRACARE HEALTH - LONG PRAIRIE: | PART V, SECTION B, LINES 7A AND 10A: THE HOSPITAL'S CHNA AND STRATEGY AND IMPLEMENTATION PLAN CAN BE FOUND ON ITS WEBSITE AT WWW.CENTRACARE.COM/DOCUMENTS/ABOUT/CENTRACARE-LONG-PRAIRIE-CHNA-AND-IMPLEMENTATION-STRATEGY-VERSION-1-UPDATED-8.19.PDF |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 4 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - LONG PRAIRIE CARE CENTER | ||||
| 20 NINTH STREET SE | LONG PRAIRIE | MN | 56347 | NURSING HOME |
| 2 - LONG PRAIRIE CLINIC | ||||
| 50 CENTRACARE DRIVE | LONG PRAIRIE | MN | 56347 | CLINIC |
| 3 - EAGLE VALLEY CLINIC (CLOSED 103119) | ||||
| 815 HWY 71 SOUTH | EAGLE BEND | MN | 56446 | CLINIC |
| 4 - LONG PRAIRIE MEADOW PLACE | ||||
| 220 CENTRACARE DRIVE | LONG PRAIRIE | MN | 56347 | ASSISTED LIVING |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | CENTRACARE HEALTH SYSTEM PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT THAT INCLUDES ALL RELATED ORGANIZATIONS. |
| PART I, LINE 7: | THE ORGANIZATIONS TOTAL EXPENSES WERE REDUCED BY THEIR NON-OPERATING REVENUE, MEDICAID SURCHARGE AND MN CARE TAX. THE NET TOTAL EXPENSES WERE THEN DIVIDED BY GROSS CHARGES TO DETERMINE THE COST TO CHARGE RATIO. |
| PART I, 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 $ 1,617,758. |
| PART III, LINE 2: | THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. |
| PART III, LINE 4: | THE FOLLOWING IS FROM THE "ACCOUNTS RECEIVABLE" PARAGRAPH INCLUDED IN NOTE 2 OF THE ORGANIZATION'S AUDITED FINANCIALS."CENTRACARE REPORTS PATIENT AND RESIDENT SERVICE REVENUE AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH CENTRACARE EXPECTS TO BE ENTITLED TO IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS AND THIRD-PARTY PAYORS (INCLUDING MEDICARE, MEDICAID, BLUE CROSS AND OTHER THIRD-PARTY PAYORS). CERTAIN REIMBURSEMENT ARRANGEMENTS INCLUDE VARIABLE CONSIDERATION FOR AMOUNTS SUBJECT TO RETROACTIVE AUDIT AND ADJUSTMENT. DIFFERENCES BETWEEN AMOUNTS ORIGINALLY RECORDED AND FINALLY SETTLED ARE INCLUDED IN OPERATIONS IN THE YEAR IN WHICH THE DIFFERENCES ARE KNOWN. REVENUE IS RECOGNIZED AS PERFORMANCE OBLIGATIONS ARE SATISFIED." |
| PART III, LINE 8: | THE AMOUNT ON LINE 7 OF PART III WAS DETERMINED BY UTILIZING THE MEDICARE COST REPORT UTILIZING KEY SECTION OF THAT REPORT, PRIMARILY THE D SERIES AND E SERIES. |
| PART III, LINE 9B: | THE COLLECTION POLICIES AT THE ORGANIZATION REQUIRE COLLECTION STAFF TO OFFER CHARITY TO PATIENTS WHO INDICATE THAT PAYMENT MAY BE AN ISSUE. IF A PATIENT DOES QUALIFY FOR FULL CHARITY, ALL OTHER COLLECTION EFFORTS MUST CEASE. IF A PATIENT QUALIFIES FOR PARTIAL CHARITY, COLLECTION EFFORTS WILL CONTINUE ON THE BALANCE OF THE ACCOUNT. THESE PROVISIONS APPLY TO BOTH HOSPITAL EMPLOYED COLLECTION STAFF AND COLLECTION AGENCY STAFF. NO PATIENTS, WHETHER THEY QUALIFY FOR CHARITY OR NOT, ARE REPORTED TO CREDIT REPORTING AGENCIES. |
| PART VI, LINE 2: | THE ORGANIZATIONS' STRATEGIC PLANNING ASSESSES THE NEEDS OF THE COMMUNITY AND PATIENTS THROUGH PATIENT SATISFACTION SURVEYS, COMMENT CARDS, COMMUNITY ASSESSMENTS AND A DIVERSE OPERATING COMMITTEE THAT REPRESENTS THE COMMUNITY AND BRINGS TO THE TABLE ISSUES, CONCERNS AND RECOMMENDATIONS FOR HEALTH CARE SERVICES. |
| PART VI, LINE 3: | INPATIENTS WHO ARE SELF PAY ARE IDENTIFIED, AND A REPRESENTATIVE OF THE ORGANIZATION'S BILLING DEPARTMENT EXPLAINS THE CHARITY CARE POLICY TO PATIENTS. THEY ALSO EXPLAIN THE SELF PAY DISCOUNT AND SCREENS THE PATIENT FOR ELIGIBILITY FOR ANY STATE OR FEDERAL PROGRAMS. THEY ALSO ASSIST THE PATIENT WITH ANY PAPERWORK REQUIRED TO APPLY FOR SUCH PROGRAMS. OUTPATIENTS WHO ARE SELF PAY RECEIVE AN AUTOMATIC SELF PAY DISCOUNT. IF THE PATIENT DOES NOT REMIT PAYMENT, COLLECTION STAFF ATTEMPT TO REACH THE PATIENT BY PHONE. PATIENTS ARE TOLD ABOUT THE CHARITY PROGRAM. FOR BOTH INPATIENTS AND OUTPATIENTS, ALL STATEMENTS CONTAIN A LETTER REGARDING THE AVAILABILITY OF CHARITY CARE. ALSO ALL PRECOLLECTION LETTERS HAVE THIS SAME LANGUAGE INDICATING THE AVAILABILITY AND PROCESS OF OBTAINING CHARITY CARE. |
| PART VI, LINE 4: | LONG PRAIRIE IS LOCATED IN TODD COUNTY, MINNESOTA. THE ESTIMATED 2020 POPULATION SHOWS 6,865 RESIDENTS WITH AN ESTIMATED SLIGHT INCREASE TO 6,920 BY 2025. THE PROJECTED GROWTH BY AGE BRACKET FROM 2020 TO 2025 IS AS FOLLOWS: 0-17: 2.03%, 18-44: 3.02%, 45-64: -8.04%, 65+: 6.50%. THE ESTIMATED 2020 ETHNIC MIX IS AS FOLLOWS: CAUCASIAN: 76.45%, AFRICAN AMERICAN: .60%, ASIAN: 1.41%, HISPANIC: 19.58%, OTHER: 1.97%. |
| PART VI, LINE 5: | THE ORGANIZATION HAS A COMMUNITY BASED OPERATING COMMITTEE THAT MEETS ON A MONTHLY BASIS TO REVIEW VARIOUS ASPECTS OF THE FACILITY AND PROVIDE INPUT ON THOSE ASPECTS FROM A COMMUNITY PERSPECTIVE. THE ORGANIZATION PARTICIPATES IN THE COMMUNITY BLOOD DRIVES BY PROVIDING FOOD AND SUPPLIES FOR BOTH THE WORKERS AND BLOOD DONORS. THE FACILITY ALSO SPONSORS A HEALTH FAIR ON AN ANNUAL BASIS FOR THE LOCAL AND SURROUNDING COMMUNITIES. |
| PART VI, LINE 6: | THE ORGANIZATION IS PART OF CENTRACARE HEALTH SYSTEM (CCHS) WHICH PROVIDES A BROAD RANGE OF HEALTH CARE SERVICES TO THE PATIENTS OF CENTRAL MINNESOTA. CCHS IS DEDICATED TO IMPROVING THE HEALTH OF PEOPLE LIVING AND WORKING IN THE COMMUNITIES IT SERVES. TO ACCOMPLISH ITS GOALS IT WORKS ACTIVELY WITH ITS AFFILIATE HEALTH CARE ORGANIZATIONS. CCHS CONTINUES TO FOCUS ON PROVIDING THE BEST CARE POSSIBLE AND IN REINVESTING INTO THE COMMUNITY. CCHS ALSO PROMOTES WELLNESS BY SPONSORING PROGRAMS AND EVENTS IN LOCAL COMMUNITIES THAT FOCUS ON HEALTHY EATING AND EXERCISE, AND BY CONDUCTING SCREENINGS FOR CONDITIONS SUCH AS HIGH BLOOD PRESSURE. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | MN |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRACARE HEALTH FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1406 6TH AVE N | AddressLine1Txt |
| City | ST CLOUD | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56303 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 411855173 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $129,960 | CashGrantAmt |
| Purpose Of Grant | PROGRAM SUPPORT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | EDUCATION SCHOLARSHIPS | GrantTypeTxt |
| Recipient | 11 | RecipientCnt |
| Cash Grant | $11,538 | CashGrantAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KENNETH D HOLMEN MD | ||||||||||||||
| PRESIDENT/CEO | $0 | $1,256,282 | $0 | $0 | $0 | $23,025 | $0 | $14,000 | $0 | $22,738 | $0 | $1,316,045 | $0 | $0 |
| CRAIG J BROMAN | ||||||||||||||
| CHIEF OPERATING OFFICER | $0 | $872,329 | $0 | $0 | $0 | $237,497 | $0 | $21,000 | $0 | $20,546 | $0 | $1,151,372 | $0 | $0 |
| GREGORY R KLUGHERZ | ||||||||||||||
| TREASURER/CFO, CCH(UNTIL 7/1/2019) | $0 | $636,563 | $0 | $0 | $0 | $72,594 | $0 | $18,403 | $0 | $22,088 | $0 | $749,648 | $0 | $0 |
| PAUL R HARRIS ESQ | ||||||||||||||
| CORPORATE SECRETARY(UNTIL 3/1/2020) | $0 | $414,352 | $0 | $0 | $0 | $91,003 | $0 | $106,487 | $0 | $25,591 | $0 | $637,433 | $0 | $68,871 |
| THOMAS G SCHRUP MD | ||||||||||||||
| VICE PRESIDENT | $0 | $460,466 | $0 | $0 | $0 | $38,486 | $0 | $61,343 | $0 | $22,422 | $0 | $582,717 | $0 | $36,642 |
| RENE ELDIDY MD | ||||||||||||||
| PHYSICIAN | $0 | $304,631 | $0 | $19,461 | $0 | $7,663 | $0 | $19,233 | $0 | $20,832 | $0 | $371,820 | $0 | $0 |
| JAY-SHEREE P ALLEN MD | ||||||||||||||
| PHYSICIAN | $0 | $303,637 | $0 | $0 | $0 | $71,404 | $0 | $0 | $0 | $16,915 | $0 | $391,956 | $0 | $0 |
| DANIEL J SWENSON | ||||||||||||||
| ADMINISTRATOR - LONG PRAIRIE | $0 | $227,828 | $0 | $0 | $0 | $38,979 | $0 | $41,335 | $0 | $22,391 | $0 | $330,533 | $0 | $0 |
| SANTO CRUZ | ||||||||||||||
| CORPORATE SECRETARY(AS OF 6/28/2020) | $0 | $262,444 | $0 | $0 | $0 | $162 | $0 | $0 | $0 | $23,330 | $0 | $285,936 | $0 | $0 |
| DEBORAH P RASMUSSEN MD | ||||||||||||||
| PHYSICIAN | $0 | $219,429 | $0 | $14,596 | $0 | $7,197 | $0 | $16,766 | $0 | $10,433 | $0 | $268,421 | $0 | $0 |
| WAYNE A JORGENSEN PA | ||||||||||||||
| PHYSICIAN ASSISTANT | $159,365 | $0 | $0 | $0 | $11,974 | $0 | $13,340 | $0 | $27,050 | $0 | $211,729 | $0 | $0 | $0 |
| CHRISTOPHER A HAGEN | ||||||||||||||
| PHARMACY | $163,710 | $0 | $0 | $0 | $218 | $0 | $10,149 | $0 | $23,809 | $0 | $197,886 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE COMPENSATION PAID TO THE PRESIDENT AND VICE-PRESIDENTS (NON-MEDICAL PROVIDERS) IS DETERMINED BY CENTRACARE HEALTH SYSTEM, A RELATED ORGANIZATION. CENTRACARE HEALTH SYSTEM USES THE FOLLOWING METHODS TO DETERMINE COMPENSATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| PART I, LINE 4B | THE CORPORATIONS' EXECUTIVES ARE ELIGIBLE TO PARTICIPATE IN BENEFIT PLANS WHICH INCLUDE TAX DEFERRED NON-QUALIFIED INVESTMENT ACCOUNTS. THESE PLANS MAY PROVIDE, BUT ARE NOT CERTAIN TO PROVIDE, FOR PAYMENT OF TAX DEFERRED COMPENSATION TO THESE EXECUTIVES AT SOME TIME IN THE FUTURE. THE EXECUTIVE HAS NO LEGAL RIGHT TO THESE DOLLARS UNTIL, AND UNLESS, CERTAIN FUTURE EVENTS OCCUR. IN ACCORDANCE WITH THE INSTRUCTIONS TO FORM 990, THE AMOUNTS LISTED IN PART VII AND SCHEDULE J, PART II, COLUMN C, REFLECT TAX DEFERRED COMPENSATION. THIS COMPENSATION IS POTENTIALLY REPORTED TWICE ON FORM 990 - ONCE WHEN THE COMPENSATION IS DEFERRED OR ACCRUED AND AGAIN IF AND WHEN IT IS PAID TO THE EXECUTIVE. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE NON-QUALIFIED PLAN: KENNETH D HOLMEN - PAID $0; ACCRUED $0 CRAIG J BROMAN - PAID $199,497; ACCRUED $0 PAUL R HARRIS - PAID $68,871; ACCRUED $88,628 GREGORY R KLUGHERZ - PAID $0; ACCRUED $0 DANIEL J SWENSON - PAID $20,632; ACCRUED $27,159 THOMAS G SCHRUP - PAID $36,642; ACCRUED $42,705 |
| PART I, LINE 6 | THE ORGANIZATION PROVIDES INCENTIVE COMPENSATION TO DESIGNATED INDIVIDUALS BASED ON FOUR DISCRETE AREAS: STEWARDSHIP, THROUGH A COMPARISON BETWEEN BUDGETED AND ACTUAL NET OPERATING INCOME FOR SAINT CLOUD HOSPITAL AND/OR CENTRACARE HEALTH SYSTEM AS WELL THROUGH ACHIEVING METRICS FOR AN IDENTIFIED COST REDUCTION PROGRAM; QUALITY, THROUGH ACHIEVING SAINT CLOUD HOSPITAL AND SYSTEM QUALITY METRICS; PATIENT EXPERIENCE, THROUGH ACHIEVEMENT OF PATIENT SATISFACTION GOALS AS COMPARED TO NATIONAL AND BASELINE RANKINGS; AND PEOPLE/EMPLOYEES, THROUGH ACHIEVEMENT OF SPECIFIED EMPLOYMENT SATISFACTION GOALS AND HIRING AND/OR RETENTION GOALS. THE INCENTIVE COMPENSATION PAID OUT IS NOT A PORTION OR PERCENTAGE OF ACTUAL NET EARNINGS OF ANY CENTRACARE HEALTH SYSTEM AFFILIATE, HOWEVER NET EARNINGS GOALS ARE REQUIRED TO BE MET BEFORE THE INCENTIVE COMPENSATION IS PAID. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | CENTRACARE HEALTH SYSTEM, A MINNESOTA NONPROFIT ASSOCIATION, IS THE SOLE MEMBER OF CENTRACARE HEALTH SYSTEM - LONG PRAIRIE. |
| FORM 990, PART VI, SECTION A, LINE 7A | ALL BOARD MEMBERS ARE APPOINTED BY CENTRACARE HEALTH SYSTEM, THE SOLE CORPORATE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING MATTERS ARE RESERVED FOR ACTION BY CENTRACARE HEALTH SYSTEM, THE SOLE MEMBER: 1. ADOPTION OF AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS. 2. APPOINTMENT OF DIRECTORS AND OFFICERS. 3. APPROVAL OF THE CORPORATION'S ANNUAL OPERATING AND CAPITAL BUDGETS AND ANY DEBTS TO BE INCURRED. 4. APPROVAL OF ALL STRATEGIC PLANS. 5. DETERMINATION OF THE DISSOLUTION OF OR THE DISCONTINUATION OF THE BUSINESS OF THE CORPORATION. 6. APPROVAL OF ANY TRANSACTION WHICH MAY AFFECT THE CORPORATION'S STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE BOARD OF DIRECTORS HAS DELEGATED THE APPROVAL AUTHORITY OF THE FORM 990 TO THE AUDIT COMMITTEE. ANNUALLY, AT THE AUDIT COMMITTEE MEETING, PRIOR TO FILING WITH THE IRS, THE AUDIT COMMITTEE REVIEWS AND APPROVES FORM 990. A COPY OF FORM 990 IS THEN PROVIDED FOR THE FULL BOARD TO REVIEW PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD MEMBERS ARE REQUIRED TO REVIEW AND SIGN A CONFLICT OF INTEREST QUESTIONNAIRE TWICE A YEAR. ALL STAFF SIGN CONFLICTS OF INTEREST FORMS ON AN ANNUAL BASIS. THE QUESTIONNAIRES ARE REVIEWED BY THE CORPORATE COMPLIANCE OFFICER AS WELL AS THE CORPORATE COMPLIANCE GROUP (A COMPLIANCE COMMITTEE WHICH INCLUDES INTERNAL MEMBERS AND OUTSIDE COUNSEL). THE RESPONSES TO THE QUESTIONNAIRES ARE THEN REVIEWED WITH THE EXECUTIVE COMMITTEE OF THE BOARD. THE CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING CONFLICTS OF INTERESTS RELATED TO BOARD AND STAFF AND TO ALERT AFFECTED PARTIES WHEN A CONFLICT ARISES. WHEN AN ACTUAL CONFLICT ARISES, THE AFFECTED PARTY IS ASKED TO RECUSE HIM/HER SELF FROM THE DECISION MAKING PROCESS. THE CORPORATE COMPLIANCE OFFICER ATTENDS BOARD MEETINGS AND SPECIFIED BOARD COMMITTEE MEETINGS WHERE CONFLICT ISSUES MAY ARISE. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION AND BENEFITS OF THE PRESIDENT ARE SUBJECT TO FULL COMPENSATION AND BENEFITS COMPARABILITY STUDIES CONDUCTED BIENNIALLY BY A THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT. HOWEVER, THE COMPENSATION PORTION OF THE STUDY IS REVIEWED ANNUALLY BY THE CONSULTANT AND UPDATED FOR COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REVIEW AND APPROVAL. THE MOST RECENT FULL REVIEW WAS DONE JUNE 2019. THE THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT IS RETAINED BY ST. COULD HOSPITAL TO PERFORM SERVICES. FORM 990, PART VI, QUESTION 15B: THE COMPENSATION AND BENEFITS OF THE VICE PRESIDENTS (NON-MEDICAL PROVIDERS) ARE SUBJECT TO FULL COMPENSATION AND BENEFITS COMPARABILITY STUDIES CONDUCTED BIENNIALLY BY A THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT. HOWEVER, THE COMPENSATION PORTION OF THE STUDY IS REVIEWED ANNUALLY BY THE CONSULTANT AND UPDATED FOR COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REVIEW AND APPROVAL. THE MOST RECENT FULL REVIEW WAS COMPLETED IN JUNE 2019. THE THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT IS RETAINED BY ST. CLOUD HOSPITAL TO PERFORM THESE SERVICES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE HOSPITAL/CENTRACARE HEALTH SYSTEM DOES NOT GENERALLY MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. THE HOSPITAL/CENTRACARE HEALTH SYSTEM DOES DO AN ANNUAL REPORT TO THE COMMUNITY IN WHICH FINANCIAL RESULTS ARE REPORTED TO AND DISCUSSED WITH THE PUBLIC. THIS REPORT IS AVAILABLE TO THE PUBLIC ON THE ORGANIZATION'S WEBSITE. |
| FORM 990, PART IX, LINE 11G | MEDICAL FEES: PROGRAM SERVICE EXPENSES 2,414,209. MANAGEMENT AND GENERAL EXPENSES 173,995. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,588,204. CONTRACTED/PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,261,023. MANAGEMENT AND GENERAL EXPENSES 139,142. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,400,165. |
| FORM 990, PART XI, LINE 9: | EQUITY TRANSFERS TO AFFILIATED ORGANIZATIONS -504,816. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CENTRACARE HEALTH SYSTEM | |||||||||||
| 1406 6TH AVENUE NORTH | ST CLOUD | MN | 56303 | 411813221 | INTEGRATED HEALTH SYSTEM | MN | 501(C)(3) | LINE 3 | N/A | 0 | |
| ST CLOUD HOSPITAL | |||||||||||
| 1406 6TH AVE N | ST CLOUD | MN | 56303 | 410695596 | ACUTE/LT CARE | MN | 501(C)(3) | LINE 3 | 0 | CENTRACARE HEALTH SYSTEM | |
| CENTRACARE HEALTH-MELROSE | |||||||||||
| 11 NORTH 5TH AVE WEST | MELROSE | MN | 56352 | 411865315 | ACUTE/LT CARE | MN | 501(C)(3) | LINE 3 | Yes (1) | CENTRACARE HEALTH SYSTEM | |
| CENTRACARE HEALTH-SAUK CENTRE | |||||||||||
| 425 ELM STREET NORTH | SAUK CENTRE | MN | 56378 | 452438973 | ACUTE/LT CARE | MN | 501(C)(3) | LINE 3 | Yes (1) | CENTRACARE HEALTH SYSTEM | |
| CENTRACARE CLINIC | |||||||||||
| 1200 6TH AVE NORTH | ST CLOUD | MN | 56303 | 411806657 | MULTI-SPECIALTY | MN | 501(C)(3) | LINE 3 | Yes (1) | CENTRACARE HEALTH SYSTEM | |
| CENTRACARE HEALTH FOUNDATION | |||||||||||
| 1406 6TH AVE N | ST CLOUD | MN | 56303 | 411855173 | FUNDRAISING | MN | 501(C)(3) | LINE 7 | 0 | CENTRACARE HEALTH SYSTEM | |
| CUSHMAN ALBERT RICE TRUST | |||||||||||
| 1100 WEST ST GERMAIN STREET | ST CLOUD | MN | 56303 | 416019335 | SUPPORT FOR CARRIS HEALTH | MN | 501(C)(3) | LINE 12A, I | 0 | CARRIS HEALTH | |
| CARRIS HEALTH FOUNDATION | |||||||||||
| 301 BECKER AVE SW | WILLMAR | MN | 56303 | 411611555 | SUPPORT FOR CARRIS HEALTH | MN | 501(C)(3) | LINE 7 | 0 | CENTRACARE HEALTH FOUNDATION | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| MONTICELLO CANCER CENTER | |||||||
| 1001 HART BLVD STE 50 | MONTICELLO | MN | 55362 | 261909519 | RADIATION & ONCOLOGY SERVICES | MN | N/A |
| MONTICELLO SURGERY CENTER | |||||||
| 1013 HART BLVD | MONTICELLO | MN | 55362 | 813593057 | AMBULATORY SURGERY CENTER | MN | N/A |
| BENSON MEDICAL LLC | |||||||
| 1228 ATLANTIC AVENUE | BENSON | MN | 56215 | 203149203 | HEALTHCARE | MN | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| CENTRACARE HOLDINGS INC | |||||||||
| 1406 6TH AVE N | ST CLOUD | MN | 56303 | 472688595 | HOLDING COMPANY/PHARMACY | MN | N/A | C | 0 |
| AFFILIATED COMMUNITY MEDICAL CENTERS PA | |||||||||
| 301 BECKER AVE SW | WILLMAR | MN | 56201 | 410850702 | HEALTH CARE SYSTEM | MN | N/A | C | 0 |
| AFFILIATED COMMUNITY HEALTH NETWORK INC | |||||||||
| 101 WILLMAR AVE SW | WILLMAR | MN | 56201 | HEALTH NETWORK | MN | N/A | C | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | 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 | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRACARE CLINIC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | O | TransactionTypeTxt |
| Involved | $1,511,694 | InvolvedAmt |
| Method Of Amount Determination | ACTUAL AMOUNT | MethodOfAmountDeterminationTxt |