LAKEWOOD HEALTH SYSTEM: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- LAKEWOOD HEALTH SYSTEM (EIN 41-1842965)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-07-06
- IRS object ID
- 202131879349300413
- Schema version
- 2020v4.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-07-06T08:10:48-05:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 LONDON ROAD SUITE 200 | AddressLine1Txt |
| City | DULUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55812 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411842965 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKEWOOD HEALTH SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LAKE | BusinessNameControlTxt |
| Phone | 2188941515 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 49725 COUNTY 83 | AddressLine1Txt |
| City | STAPLES | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56479 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LISA BJERGA | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 2188941515 | PhoneNum |
| Signature | 2021-06-25 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | LISA | PersonFirstNm |
| Person Last | BJERGA | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL J PETERSON CPA | PreparerPersonNm |
| PTIN | P01833529 | PTIN |
| Phone | 2187224705 | PhoneNum |
| Preparation | 2021-06-18 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TIM RICE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 49725 COUNTY 83 | AddressLine1Txt |
| City | STAPLES | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56479 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $115,114,108 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.LAKEWOODHEALTHSYSTEM.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1996 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE QUALITY, PERSONALIZED HEALTHCARE FOR A LIFETIME. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 1011 | TotalEmployeeCnt |
| Total Volunteers | 42 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $729,010 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,802,397 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $107,665,930 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $107,923,755 | CYProgramServiceRevenueAmt |
| PY Investment Income | $549,760 | PYInvestmentIncomeAmt |
| CY Investment Income | $618,300 | CYInvestmentIncomeAmt |
| PY Other Revenue | $769,252 | PYOtherRevenueAmt |
| CY Other Revenue | $677,699 | CYOtherRevenueAmt |
| PY Total Revenue | $109,713,952 | PYTotalRevenueAmt |
| CY Total Revenue | $115,022,151 | 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 | $52,582,613 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $51,596,138 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $53,624,850 | PYOtherExpensesAmt |
| CY Other Expenses | $55,563,926 | CYOtherExpensesAmt |
| PY Total Expenses | $106,207,463 | PYTotalExpensesAmt |
| CY Total Expenses | $107,160,064 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,506,489 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $7,862,087 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $127,472,858 | TotalAssetsBOYAmt |
| Total Assets EOY | $153,437,720 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $57,563,035 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $74,066,639 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $69,909,823 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $79,371,081 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF LAKEWOOD HEALTH SYSTEM IS TO PROVIDE QUALITY, PERSONALIZED HEALTHCARE FOR A LIFETIME. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $76,052,143 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $92,663,618 | RevenueAmt |
| Desc | HOSPITAL AND CLINICS -LAKEWOOD HEALTH SYSTEM (THE ORGANIZATION) OPERATES A 25-BED CRITICAL ACCESS HOSPITAL PROVIDING INPATIENT, OUTPATIENT, EMERGENCY, AND OTHER SPECIALTY HEALTH CARE SERVICES, INCLUDING A 10-BED GERIATRIC BEHAVIORAL HEALTH UNIT IN STAPLES, MINNESOTA. THE ORGANIZATION ALSO OPERATES RURAL HEALTH CLINICS LOCATED IN STAPLES, MOTLEY, PILLAGER, EAGLE BEND, AND BROWERVILLE, MINNESOTA. PHYSICIANS, PHYSICIAN'S ASSISTANTS, AND NURSE PRACTITIONERS PROVIDE CLINIC PATIENTS WITH PRIMARY CARE AND OTHER HEALTH CARE SERVICES. IN ADDITION, THE ORGANIZATION OPERATES A DERMATOLOGY CLINIC IN SARTELL, MINNESOTA.THE ORGANIZATION PROVIDED FOR 3,760 INPATIENT HOSPITAL AND SWING-BED DAYS, 2,835 INPATIENT GERIATRIC BEHAVIORAL HEALTH UNIT DAYS, 75,664 MEDICAL AND MENTAL HEALTH RURAL HEALTH CLINIC VISITS AND 8,465 DERMATOLOGY CLINIC VISITS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $10,601,268 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $15,401,936 | RevenueAmt |
| Desc | SENIOR SERVICES -THE ORGANIZATION OPERATES A 100-BED, MEDICARE-CERTIFIED SKILLED NURSING FACILITY IN STAPLES, MINNESOTA, THAT PROVIDES LONG-TERM AND REHABILITATIVE CARE TO RESIDENTS. IN ADDITION TO SKILLED NURSING CARE, THE ORGANIZATION ALSO OPERATES HOME HEALTH CARE AND HOSPICE PROGRAMS TO PROVIDE NURSING CARE AND ASSISTANCE AT THE PATIENT'S RESIDENCE. ASSISTED LIVING AND INDEPENDENT LIVING FACILITIES OPERATED BY THE ORGANIZATION, LOCATED IN STAPLES, MINNESOTA, PROVIDE COMBINATIONS OF HEALTH-RELATED AND SUPPORTIVE SERVICES FOR TENANTS. THE ORGANIZATION PROVIDED FOR 29,277 RESIDENT DAYS IN THE NURSING HOME AND 750 ASSISTED LIVING UNIT RENTED MONTHS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $86,653,411 | 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 | Yes (1) | 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 | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | 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 | Yes (1) | 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 | 58 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1011 | 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 | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| 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 | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | 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 | LISA BJERGA CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2188941515 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 49725 COUNTY 83 | AddressLine1Txt |
| City | STAPLES | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56479 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| CAROL CAMPBELL | ||||||||
| CRNA | 40.00 | Yes (X) | $313,046 | $0 | $25,544 | |||
| SHERREE ENGEN | ||||||||
| CRNA | 40.00 | Yes (X) | $303,928 | $0 | $25,103 | |||
| RENEE PETERSON | ||||||||
| CRNA | 40.00 | Yes (X) | $251,059 | $0 | $28,368 | |||
| KATHLEEN DOBSON | ||||||||
| VP OF SENIOR SERVICES | 40.00 | Yes (X) | $196,593 | $0 | $37,246 | |||
| TRACY HUNTINGTON | ||||||||
| CRNA | 40.00 | Yes (X) | $191,701 | $0 | $6,110 | |||
| CRAIG WOLHOWE | ||||||||
| VP OF HOSPITAL & CLINIC SERVICES | 40.00 | $274,945 | $0 | $44,286 | Yes (X) | |||
| LYNN RICE | ||||||||
| VP OF SUPPORT SERVICES | 40.00 | $263,809 | $0 | $22,203 | Yes (X) | |||
| CORRINE NEISESS | ||||||||
| VP OF NURSING | 40.00 | $180,412 | $0 | $30,387 | Yes (X) | |||
| CHRISTINE ALBRECHT | ||||||||
| CHIEF MEDICAL OFFICER | 40.00 | $0 | $0 | $0 | Yes (X) | |||
| JOHN HALFEN | ||||||||
| CHIEF MEDICAL OFFICER (THRU MAY) | 40.00 | $9,865 | $0 | $0 | Yes (X) | |||
| LISA BJERGA | ||||||||
| CFO | 40.00 | $293,280 | $0 | $5,776 | Yes (X) | |||
| TIM RICE | ||||||||
| PRESIDENT | 40.00 | $548,880 | $0 | $67,748 | Yes (X) | Yes (X) | ||
| JIM HOFER | ||||||||
| CHAIRMAN | 1.00 | $2,490 | $0 | $0 | Yes (X) | Yes (X) | ||
| JEF CICHOS | ||||||||
| VICE CHAIRMAN | 1.00 | $2,652 | $0 | $0 | Yes (X) | Yes (X) | ||
| CURT MCILRAVY | ||||||||
| CHAIR-ELECT | 1.00 | $2,548 | $0 | $0 | Yes (X) | Yes (X) | ||
| MARY THEURER | ||||||||
| SECRETARY | 1.00 | $3,172 | $0 | $0 | Yes (X) | Yes (X) | ||
| KEVIN NELSON | ||||||||
| TREASURER | 1.00 | $1,456 | $0 | $0 | Yes (X) | Yes (X) | ||
| ARDEN BEACHY MD | ||||||||
| BOARD MEMBER | 1.00 | $468 | $0 | $0 | Yes (X) | |||
| LANA HANSEN | ||||||||
| BOARD MEMBER | 1.00 | $1,820 | $0 | $0 | Yes (X) | |||
| MICHAEL HUDALLA MD | ||||||||
| BOARD MEMBER | 1.00 | $1,040 | $0 | $0 | Yes (X) | |||
| NORMAN KRAUSE | ||||||||
| BOARD MEMBER | 1.00 | $1,560 | $0 | $0 | Yes (X) | |||
| JORDAN MOE MD | ||||||||
| BOARD MEMBER | 1.00 | $1,092 | $0 | $0 | Yes (X) | |||
| KAITLYN SCHOECK MD | ||||||||
| BOARD MEMBER | 1.00 | $520 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,846,336 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $292,771 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 58 | 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 |
|---|---|---|---|---|---|
| LAKEWOOD CLINIC PA | |||||
| 49725 COUNTY 83 | STAPLES | MN | 56479 | PHYSICIAN SERVICES | $11,619,868 |
| BIG STONE THERAPIES | |||||
| 309 WASHINGTON AVE | ORTONVILLE | MN | 56278 | THERAPY SERVICES | $2,411,481 |
| QUEST DIAGNOSTICS | |||||
| PO BOX 775460 | CHICAGO | IL | 606775460 | LAB READINGS | $1,232,666 |
| CENTRAL MN DIAGNOSTIC INC | |||||
| 150 10TH ST NW | MILACA | MN | 56353 | MRI, CT & NUC MED SERVICES | $1,144,815 |
| ESSENTIA HEALTH | |||||
| 532 EAST FIRST STREET | DULUTH | MN | 55805 | ONCOLOGY & ORTHO PROVIDER SERVICES | $1,007,204 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 20 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $16,317 | FundraisingAmt |
| Government Grants | $5,719,107 | GovernmentGrantsAmt |
| All Other Contributions | $66,973 | AllOtherContributionsAmt |
| Total Contributions | $5,802,397 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT AND RESIDENT SERVICE | 621110 | $104,229,699 | $104,229,699 |
| 340B PHARMACY | 621300 | $2,276,930 | $2,276,930 |
| OCCUPATIONAL HEALTH | 621300 | $356,324 | $356,324 |
| RENT REVENUE | 531120 | $293,924 | $293,924 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $766,878 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $766,878 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $107,923,755 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $635,302 | TotalRevenueColumnAmt |
| Exclusion | $635,302 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $3,675 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $20,677 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$17,002 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$17,002 | TotalRevenueColumnAmt |
| Exclusion | -$17,002 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $16,317 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $7,601 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$7,601 | TotalRevenueColumnAmt |
| Exclusion | -$7,601 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $112,950 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $63,679 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $49,271 | TotalRevenueColumnAmt |
| Exclusion | $49,271 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| FOOD SERVICE | 900099 | $494,230 | $494,230 | |
| EHR INCENTIVE | 900099 | $141,799 | $141,799 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $636,029 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $115,022,151 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $108,065,554 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,154,200 | 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 | $2,668,000 | TotalAmt |
| Management And General | $2,668,000 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,261,920 | TotalAmt |
| Program Services | $30,162,255 | ProgramServicesAmt |
| Management And General | $8,099,665 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,183,813 | TotalAmt |
| Program Services | $938,612 | ProgramServicesAmt |
| Management And General | $245,201 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,672,940 | TotalAmt |
| Program Services | $4,973,034 | ProgramServicesAmt |
| Management And General | $1,699,906 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,809,465 | TotalAmt |
| Program Services | $2,052,988 | ProgramServicesAmt |
| Management And General | $756,477 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,522 | TotalAmt |
| Management And General | $85,522 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $136,218 | TotalAmt |
| Management And General | $136,218 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,143,137 | TotalAmt |
| Program Services | $21,698,538 | ProgramServicesAmt |
| Management And General | $1,444,599 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $336,901 | TotalAmt |
| Program Services | $30,620 | ProgramServicesAmt |
| Management And General | $306,281 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,351,479 | TotalAmt |
| Program Services | $9,780,885 | ProgramServicesAmt |
| Management And General | $1,570,594 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $797,683 | TotalAmt |
| Management And General | $797,683 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,711,539 | TotalAmt |
| Program Services | $2,341,836 | ProgramServicesAmt |
| Management And General | $1,369,703 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $349,106 | TotalAmt |
| Program Services | $283,346 | ProgramServicesAmt |
| Management And General | $65,760 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,100 | TotalAmt |
| Program Services | $122,504 | ProgramServicesAmt |
| Management And General | $46,596 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,296,055 | TotalAmt |
| Program Services | $1,171,186 | ProgramServicesAmt |
| Management And General | $124,869 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,979,387 | TotalAmt |
| Program Services | $5,840,180 | ProgramServicesAmt |
| Management And General | $139,207 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $373,389 | TotalAmt |
| Management And General | $373,389 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MN CARE TAX | $1,782,759 | $1,782,759 | |
| BAD DEBT EXPENSE | $1,762,082 | $1,762,082 | |
| OPERATING ROOM SUPPLIES | $1,754,090 | $1,754,090 | |
| DUES & SUBSCRIPTIONS | $761,530 | $367,895 | $393,635 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,773,949 | TotalAmt |
| Program Services | $1,590,601 | ProgramServicesAmt |
| Management And General | $183,348 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $107,160,064 | TotalAmt |
| Program Services | $86,653,411 | ProgramServicesAmt |
| Management And General | $20,506,653 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,815 | BOYAmt |
| EOY | $4,890 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,929,290 | BOYAmt |
| EOY | $42,630,921 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,445,859 | BOYAmt |
| EOY | $11,971,833 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,401 | BOYAmt |
| EOY | $15,391 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,649,634 | BOYAmt |
| EOY | $2,483,956 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,491,440 | BOYAmt |
| EOY | $1,414,757 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $125,815,238 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $70,794,989 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,813,215 | BOYAmt |
| EOY | $55,020,249 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,873,855 | BOYAmt |
| EOY | $38,619,449 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $934,647 | BOYAmt |
| EOY | $771,539 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,325,702 | BOYAmt |
| EOY | $504,735 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $127,472,858 | BOYAmt |
| EOY | $153,437,720 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,951,630 | BOYAmt |
| EOY | $9,712,107 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $200,372 | BOYAmt |
| EOY | $4,426,679 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,125,153 | BOYAmt |
| EOY | $2,968,810 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,609 | BOYAmt |
| EOY | $36,247 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,949,704 | BOYAmt |
| EOY | $42,147,471 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,298,567 | BOYAmt |
| EOY | $14,775,325 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,563,035 | BOYAmt |
| EOY | $74,066,639 | 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 | $68,777,328 | BOYAmt |
| EOY | $78,080,710 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,132,495 | BOYAmt |
| EOY | $1,290,371 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,909,823 | BOYAmt |
| EOY | $79,371,081 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $127,472,858 | BOYAmt |
| EOY | $153,437,720 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $7,862,087 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,665,169 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$65,998 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule 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 | $805 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $805 | 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 | THE ORGANIZATION IS A MEMBER OF MINNESOTA HOSPITAL ASSOCIATION AND 2.9% OF THE $27,751 MEMBERSHIP FEE WAS RELATED LOBBYING ACTIVITIES. MINNESOTA HOSPITAL ASSOCIATION (MHA) IS AN ORGANIZATION OF 142 MEMBER HOSPITALS AND HEALTH SYSTEMS. MHA ADVOCATES ON BEHALF OF ITS MEMBERS WITH LAWMAKERS, EDUCATING THEM ON COMPLEX ISSUES IN HEALTH CARE AND ENSURING THEY HAVE THE TOOLS THEY NEED TO MAKE INFORMED DECISIONS. THE MISSION OF MHA IS TO ADVOCATE SO THEIR MEMBERS CAN ACHIEVE THEIR MISSIONS BETTER. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $851,207 | OtherCostOrOtherBasisAmt |
| Book Value | $851,207 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $45,023,385 | OtherCostOrOtherBasisAmt |
| Depreciation | $22,028,049 | DepreciationAmt |
| Book Value | $22,995,336 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $79,096,963 | OtherCostOrOtherBasisAmt |
| Depreciation | $48,766,940 | DepreciationAmt |
| Book Value | $30,330,023 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $843,683 | OtherCostOrOtherBasisAmt |
| Book Value | $843,683 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $55,020,249 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO THIRD-PARTY REIMBURSEMENT PROGRAMS | $5,681,770 |
| CONTRACT LIABILITIES | $9,093,555 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $14,775,325 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $112,822,194 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $1,665,169 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $51,203 | OtherRevenueAmt |
| Revenue Not Reported | $1,716,372 | RevenueNotReportedAmt |
| Revenue Subtotal | $111,105,822 | RevenueSubtotalAmt |
| Other Revenues Not Included | $3,916,329 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $3,916,329 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $115,022,151 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $103,518,812 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $103,518,812 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $3,641,252 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $3,641,252 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $107,160,064 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | THE ORGANIZATION IS THE TRUSTEE OF VARIOUS RESIDENT FUNDS AND HAS A FIDUCIARY RESPONSIBILITY FOR THE ADMINISTRATION AND DISTRIBUTION OF THESE FUNDS FOR THE RESIDENTS. THE ORGANIZATION ALSO HOLDS TENANT SECURITY DEPOSITS FOR RESIDENTS OF LAKEWOOD PINES AND LAKEWOOD MANOR. THESE FUNDS ARE ON DEPOSIT IN SEPARATE BANK ACCOUNTS AND ARE REPORTED AS AN ASSET AND LIABILITY ON PART X OF THE 990. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | CHANGE IN CASH SURRENDER VALUE OF LIFE INSURANCE 12,055. CHANGE IN INVESTMENT IN UNCONSOLIDATED AFFILIATES 39,148. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 1,762,082. CONTRIBUTIONS TO RESTRICTED NET ASSETS 268,734. FUNDRAISING EVENT 6,343. EXPENSES RECORDED AS REVENUE 1,879,170. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 1,762,082. EXPENSES RECORDED AS REVENUE 1,879,170. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Events Total | 6 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $16,317 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $16,317 | CharitableContriOtherEventsAmt |
| Oth Direct Expnss Other Events | $7,601 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $16,317 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $16,317 | CharitableContributionsTotAmt |
| Oth Direct Expnss Total Events | $7,601 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $7,601 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$7,601 | NetIncomeSummaryAmt |
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 |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 240.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | $606,163 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $606,163 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00580 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,445,907 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,090,002 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,052,070 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,090,002 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $606,163 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00580 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $298,705 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,300 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $289,405 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $301,792 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $105,819 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $195,973 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $26,036 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $26,036 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $631,533 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $115,119 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $516,414 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00480 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,683,603 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,205,121 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,122,577 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01060 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,191 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,191 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,191 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,191 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,022,010 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $16,453,788 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $16,601,364 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$147,576 | 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 | LAKEWOOD HEALTH SYSTEM | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 49725 COUNTY ROAD 83 | AddressLine1Txt |
| City | STAPLES | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56479 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.LAKEWOODHEALTHSYSTEM.COM | WebsiteAddressTxt |
| State License | 1295726362 | 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 PROVIDER | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKEWOOD HEALTH SYSTEM | 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 | 19 | 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 SUPPLEMENTAL INFORMATION | 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 | 20 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SUPPLEMENTAL INFORMATION | 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 | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 240.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE SUPPLEMENTAL INFORMATION | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE SUPPLEMENTAL INFORMATION | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE SUPPLEMENTAL INFORMATION | 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 |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| LAKEWOOD HEALTH SYSTEM | PART V, SECTION B, LINE 5: THE CHNA PROCESS WAS CONDUCTED DURING 2018-2019. DATA WAS COLLECTED IN CONJUNCTION WITH TRI-COUNTY HEALTH CARE, CHI ST. GABRIEL'S HEALTH, CENTRACARE HEALTH LONG PRAIRIE, TODD COUNTY PUBLIC HEALTH, WADENA COUNTY PUBLIC HEALTH AND MORRISON COUNTY PUBLIC HEALTH. COMMUNITY STAKEHOLDER INTERVIEWS AND A COMMUNITY SURVEY IDENTIFIED COMMUNITY PERCEPTION OF HEALTH NEEDS AND WHAT MAKES A HEALTHY COMMUNITY IN MORRISON, TODD AND WADENA COUNTIES. FOR THE PURPOSES OF THIS ASSESSMENT, DATA GATHERED REFLECTS THE CORE SERVICE AREA OF LHS (ZIP CODES 56479 AND 56466) AND THE THREE COUNTIES MENTIONED PREVIOUSLY. |
| LAKEWOOD HEALTH SYSTEM | PART V, SECTION B, LINE 6B: THE DATA COLLECTED FOR THE CHNA WAS DONE IN CONJUNCTION WITH TODD-WADENA HEALTHY CONNECTIONS, WHICH HAS MEMBERS REPRESENTING LHS, TRI-COUNTY HEALTH CARE, TODD COUNTY HEALTH & HUMAN SERVICES, AND WADENA COUNTY PUBLIC HEALTH.PART V, SECTION B, LINE 7A:HTTPS://WWW.LAKEWOODHEALTHSYSTEM.COM/COMMUNITY-HEALTH/COMMUNITY-HEALTH-NEED |
| LAKEWOOD HEALTH SYSTEM | PART V, SECTION B, LINE 7D: COMMUNITY PRESENTATIONS OCCURRED AT AREA SERVICE CLUBS, TO OUR DISTRICT TOWNSHIP ANNUAL MEETINGS, AND KEY COMMUNITY STAKEHOLDER GROUPS (ROTARY, LIONS, SCHOOL DISTRICT, CITY OF STAPLES) JAN-FEB 2020. PART V, SECTION B, LINE 10:HTTPS://WWW.LAKEWOODHEALTHSYSTEM.COM/COMMUNITY-HEALTH/COMMUNITY-HEALTH-NEED |
| LAKEWOOD HEALTH SYSTEM | PART V, SECTION B, LINE 11: AN INTERNAL COMMUNITY HEALTH NEEDS ASSESSMENT TASK FORCE ANALYZED AND RANKED THE INDICATORS BASED ON COMMUNITY IMPACT, POTENTIAL FOR CHANGE, ECONOMIC FEASIBILITY AND ALIGNMENT TO THE MISSION OF LHS. TAKING INTO ACCOUNT WHAT OTHER COMMUNITY RESOURCES ARE CURRENTLY AVAILABLE TO MEET NEEDS IDENTIFIED, THE FOLLOWING HEALTH NEEDS WERE DETERMINED TO BETHE TOP PRIORITY FOR LHS:1. HEALTHY BODY WEIGHT ADULT & CHILD2. MENTAL WELLBEING 3. SOCIAL DETERMINANTSEACH OF THESE HEALTH NEEDS WILL BE ADDRESSED BY THE DEVELOPMENT AND IMPLEMENTATION OF INTERVENTIONS STARTING IN EARLY 2020. ALL IMPLEMENTED STRATEGIES WILL BE MEASURED AND EVALUATED OVER THE THREE-YEAR PERIOD TO DETERMINE IF HEALTH NEEDS ARE BEING MET AND IF THE INTERVENTIONS ARE EFFECTIVELY IMPACTING THE PRIORITIES IDENTIFIED. |
| LAKEWOOD HEALTH SYSTEM | PART V, SECTION B, LINE 13H: THE AMOUNT INVOICED DOES NOT CHANGE, HOWEVER A DISCOUNT AMOUNT IS DETERMINED BY INCOME LEVEL AND UNINSURED STATUS THAT WILL RESULT IN THE AMOUNT OF PAYMENT, IF ANY, FROM THE FAP-ELIGIBLE PATIENT. |
| LAKEWOOD HEALTH SYSTEM | PART V, SECTION B, LINE 16J: EACH APPLICABLE ADMISSION AREA HAS A POLICY AVAILABLE FOR THE PATIENT AS NEEDED AND UPON REQUEST.FAP:HTTPS://LAKEWOODHEALTHSYSTEM.COM/BILL-PAY/FAP APPLICATION:HTTPS://LAKEWOODHEALTHSYSTEM.COM/BILL-PAY/FAP PLAIN LANGUAGE SUMMARY:HTTPS://LAKEWOODHEALTHSYSTEM.COM/BILL-PAY/ |
| LAKEWOOD HEALTH SYSTEM | PART V, SECTION B, LINE 24: THERE ARE CHARGES THAT ARE EXEMPT FROM THE FAP DISCOUNTS, SO IN THIS CASE YES WE WOULD CHARGE THE AMOUNT EQUAL TO THE GROSS CHARGE. EXAMPLES WOULD BE A DOT PHYSICAL, A COPAY BALANCE THAT INSURANCE WOULD LEAVE FOR THE CLIENT AS WE CANNOT DISCOUNT COPAYS AND IN VITRO FERTILIZATION SERVICES. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 7 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - STAPLES CLINIC | ||||
| 49725 COUNTY ROAD 83 | STAPLES | MN | 56479 | CLINIC |
| 2 - LHS CARE CENTER | ||||
| 401 PRAIRIE AVE NE | STAPLES | MN | 56479 | SKILLED NURSING FACILITY |
| 3 - SARTELL DERMATOLOGY | ||||
| 161 19TH ST S SUITE 106 | SARTELL | MN | 56377 | CLINIC |
| 4 - PILLAGER CLINIC | ||||
| 653 PILLSBURY ST N STE 1 | PILLAGER | MN | 56473 | CLINIC |
| 5 - EAGLE VALLEY CLINIC | ||||
| 815 HWY 71 S | EAGLE BEND | MN | 56446 | CLINIC |
| 6 - BROWERVILLE CLINIC | ||||
| 30535 241ST AVE | BROWERVILLE | MN | 56438 | CLINIC |
| 7 - MOTLEY CLINIC | ||||
| 1233 HWY 10 | MOTLEY | MN | 56466 | CLINIC |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7G: | AMOUNTS USED FOR SUBSIDIZED SERVICES WERE CALCULATED USING DETAILED REPORT DATA KEPT BY THE ORGANIZATION. DATA INCLUDED THE TOTAL CHARGES, LESS ALLOWANCES AND DISCOUNTS, MEDICAID; AND ACTUAL COST OF SERVICES PROVIDED. SUBSIDIZED SERVICES INCLUDED TRANSPORTATION SERVICES FOR 2020. THERE ARE NO PHYSICIAN CLINICS. |
| 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 $ 1,762,082. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | LAKEWOOD HEALTH SYSTEM HAS SET ASIDE A SMALL AREA OF LAND ON WHICH A COMMUNITY PARK WAS ESTABLISHED. TO PROMOTE PHYSICAL ACTIVITY IN CHILDREN, LHS PURCHASED PLAYGROUND EQUIPMENT FOR THE PARK. THIS PARK IS THE ONE MOST OFTEN UTILIZED BY CHILDREN AND IS AFFECTIONATELY KNOWN AS THE "DINO PARK" DUE TO SOME OF THE EQUIPMENT HAVING A DINOSAUR THEME. |
| PART III, LINE 2: | THE AMOUNT IS CALCULATED BY MULTIPLYING THE TOTAL CHARGES FOR SERVICES WRITTEN OFF AS BAD DEBT BY THE COST-TO-CHARGE RATIO. |
| PART III, LINE 3: | THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY FINANCIAL ASSISTANCE POLICY IS NOT REASONABLE TO CALCULATE FOR THE ORGANIZATION. LAKEWOOD DOES NOT DO PRESUMPTIVE CHARITY CARE OR PARO (PAYMENT ASSISTANCE RANK ORDER) SCORING SO THERE IS NO ESTIMATE ELECTED.LAKEWOOD DOES HAVE A FINANCIAL ASSISTANCE POLICY THAT PROVIDES DISCOUNTED OR FREE CARE. LAKEWOOD IS ALSO COMMITTED TO PROVIDING OTHER COMMUNITY BENEFIT AND COMMUNITY BUILDING FUNCTIONS. THE OPPORTUNITY TO PROVIDE MORE DISCOUNTED OR FREE CARE OR PERFORM ADDITIONAL COMMUNITY BENEFIT AND COMMUNITY BUILDING ACTIVITIES IS LIMITED AS BAD DEBT COSTS INCREASE. |
| PART III, LINE 4: | MANAGEMENT PROVIDES FOR POTENTIALLY UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO VALUATION ALLOWANCE AND A CREDIT TO PATIENTS ACCOUNTS RECEIVABLE. |
| PART III, LINE 8: | THE MEDICARE ALLOWABLE COST OF CARE RELATING TO PAYMENTS ON LINE 5 WERE CALCULATED USING INFORMATION PREPARED FROM OUR FILED 2020 MEDICARE COST REPORT.A LARGE PERCENTAGE OF LAKEWOOD PATIENTS ARE MEDICARE ELIGIBLE AND LAKEWOOD WILL CONTINUE TO PROVIDE SERVICES DESPITE ANY SHORTFALL. |
| PART III, LINE 9B: | PATIENTS ARE REQUIRED TO APPLY FOR MEDICAL ASSISTANCE IN ORDER TO RECEIVE A 50% OR GREATER DISCOUNT PER LAKEWOOD'S CUSTOMER ASSISTANCE PROGRAM. |
| PART VI, LINE 2: | THE ORGANIZATION CONDUCTS COMMUNITY SURVEYS AND USES PATIENT FEEDBACK TO ASSESS THE NEEDS OF THE COMMUNITIES IT SERVES. |
| PART VI, LINE 3: | PATIENT FINANCIAL SERVICES (PFS) STAFF ARE AVAILABLE AND UTILIZED THROUGHOUT THE PATIENT EXPERIENCE. PFS STAFF EDUCATE PATIENTS ON MEANS-TESTED PROGRAMS AVAILABLE TO THE PATIENT AS WELL AS ASSIST THE PATIENT WITH THE CUSTOMER ASSISTANCE APPLICATION PROCESS. PAYMENT PLANS ARE ALSO ESTABLISHED TO ASSIST PATIENTS IN PAYING OFF OBLIGATIONS OWED TO THE ORGANIZATION. |
| PART VI, LINE 4: | LAKEWOOD HEALTH SYSTEM OFFERS A BROAD SPECTRUM OF CARE. OUR SYSTEM INCLUDES A STATE-OF-THE-ART MAIN CAMPUS WITH A 25-BED, CRITICAL ACCESS HOSPITAL AND CLINIC (STAPLES, MN); FOUR MODERN SATELLITE CLINICS (BROWERVILLE, PILLAGER, MOTLEY & EAGLE BEND, MN), SENIOR SERVICES CARE AND HOUSING, A SPECIALIZED SENIOR BEHAVIORAL HEALTH UNIT (STAPLES, MN), AND A DERMATOLOGY CLINIC (SARTELL, MN). WE ALSO HAVE ON-STAFF MEDICAL SPECIALISTS AND VISITING MEDICAL PARTNERS, WHICH ALLOWS US TO OFFER COMPREHENSIVE CARE IN THESE VARIOUS COMMUNITIES. ITS NEIGHBOR, MOTLEY, IS JUST A FEW MILES AWAY AND HAS ANOTHER 1,000 PEOPLE. THE TWO TOWNS COLLABORATE ON MANY COMMUNITY-WIDE INITIATIVES, INCLUDING THE LOCAL SCHOOL SYSTEM. STAPLES BOASTS MANY ATTRACTIVE STORE FRONTS AND BUSINESSES IN THE DOWNTOWN AREA, GIVING IT A "MAIN STREET USA" FEEL. STAPLES IS PROUD OF ITS RICH HISTORY AND ACCOMPLISHMENTS IN THE AREAS OF BUSINESS, EDUCATION, HEALTH CARE, ATHLETICS AND CULTURAL ACTIVITIES. COMMUNITY INVOLVEMENT, PASSION, AND LOYALTY IS ALIVE AND WELL IN STAPLES - FROM THE TOWN RALLYING AROUND LOCAL SPORTS TEAMS, TO ATTENDING CONCERTS AND OTHER FINE ARTS - RELATED EVENTS, TO SUPPORTING LOCAL PHILANTHROPIC EFFORTS, TO CULTURAL ACTIVITIES REPRESENTING THE STRONG SCANDINAVIAN & FINNISH ANCESTRIES IN THE AREA. |
| PART VI, LINE 5: | A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE WITHIN LAKEWOOD'S PRIMARY SERVICE AREA.LHS PROVIDES SPECIAL SERVICES INCLUDING PALLIATIVE CARE, MEDICAL HOME, AND HOME HEALTH, FOR THE COMMUNITY. LHS'S EMERGENCY ROOM IS AVAILABLE TO ALL DESPITE PATIENT FINANCIAL IMPLICATIONS. THERE ARE NO LIMITS IN REGARD TO THE AMOUNT OF CHARITY CARE OR CAP PROGRAM PARTICIPANTS. GOVERNMENT HEALTH SPONSORED PROGRAMS WOULD INCLUDE MEDICARE AND MEDICAID. LHS IS THE SOLE COMMUNITY PROVIDER IN THE STAPLES AREA. |
| PART VI, LINE 6: | N/A |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | 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 (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CAROL CAMPBELL | ||||||||||||||
| CRNA | $229,922 | $0 | $0 | $0 | $83,124 | $0 | $4,330 | $0 | $21,214 | $0 | $338,590 | $0 | $0 | $0 |
| SHERREE ENGEN | ||||||||||||||
| CRNA | $215,984 | $0 | $0 | $0 | $87,944 | $0 | $7,074 | $0 | $18,029 | $0 | $329,031 | $0 | $0 | $0 |
| RENEE PETERSON | ||||||||||||||
| CRNA | $182,741 | $0 | $0 | $0 | $68,318 | $0 | $6,289 | $0 | $22,079 | $0 | $279,427 | $0 | $0 | $0 |
| KATHLEEN DOBSON | ||||||||||||||
| VP OF SENIOR SERVICES | $164,313 | $0 | $20,398 | $0 | $11,882 | $0 | $5,401 | $0 | $31,845 | $0 | $233,839 | $0 | $0 | $0 |
| TRACY HUNTINGTON | ||||||||||||||
| CRNA | $191,201 | $0 | $500 | $0 | $0 | $0 | $5,483 | $0 | $627 | $0 | $197,811 | $0 | $0 | $0 |
| CRAIG WOLHOWE | ||||||||||||||
| VP OF HOSPITAL & CLINIC SERVICES | $231,597 | $0 | $28,799 | $0 | $14,549 | $0 | $7,422 | $0 | $36,864 | $0 | $319,231 | $0 | $0 | $0 |
| LYNN RICE | ||||||||||||||
| VP OF SUPPORT SERVICES | $219,370 | $0 | $26,748 | $0 | $17,691 | $0 | $7,072 | $0 | $15,131 | $0 | $286,012 | $0 | $0 | $0 |
| CORRINE NEISESS | ||||||||||||||
| VP OF NURSING | $152,256 | $0 | $18,534 | $0 | $9,622 | $0 | $4,881 | $0 | $25,506 | $0 | $210,799 | $0 | $0 | $0 |
| LISA BJERGA | ||||||||||||||
| CFO | $252,777 | $0 | $27,357 | $0 | $13,146 | $0 | $4,816 | $0 | $960 | $0 | $299,056 | $0 | $0 | $0 |
| TIM RICE | ||||||||||||||
| PRESIDENT | $416,609 | $0 | $94,071 | $0 | $38,200 | $0 | $66,494 | $0 | $1,254 | $0 | $616,628 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4A | FormAndLineReferenceDesc |
| Explanation | THE FOLLOWING HIGHEST COMPENSATED EMPLOYEES RECEIVED SEVERANCE PAYMENTS AND THEIR SEVERANCE PAYMENTS ARE INCLUDED IN SCH J PART II COLUMN B(II): CAROL CAMPBELL $72,916 SHERREE ENGEN $72,915 RENEE PETERSON $68,318 | ExplanationTxt |
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 | UNITED HOSPITAL DISTRICT TODD MORRISON CASS AND WADENA COUNTIES MN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 416005558 | BondIssuerEIN |
| CUSIP | 88903ACN8 | CUSIPNum |
| Bond Issued | 2016-11-15 | BondIssuedDt |
| Issue Price | $4,168,729 | IssuePriceAmt |
| Purpose | REFINANCING | 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 | $625,000 | RetiredAmt |
| Total Proceeds | $4,168,729 | TotalProceedsAmt |
| Refunding Escrow | $4,098,626 | RefundingEscrowAmt |
| Issuance Costs From Proceeds | $70,103 | IssuanceCostsFromProceedsAmt |
| Substantial Completion | 2004 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | Yes (1) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKEWOOD CLINIC PA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | BOARD MEMBERS HAVE OWNERSHIP INTEREST IN LAKEWOOD CLINIC, PA. | RelationshipDescriptionTxt |
| Transaction | $12,729,394 | TransactionAmt |
| Transaction | THE ORGANIZATION HAS A MEDICAL SERVICE AGREEMENT WITH LAKEWOOD CLINIC, PA FOR THE PROVISION OF PHYSICIAN AND OTHER PROFESSIONAL MEDICAL SERVICES. THE AGREEMENT EXPIRES IN 2022. LAKEWOOD CLINIC, PA IS PAID PER A NEGOTIATED PRICE OF RELATIVE VALUE UNIT (RVU). THE RVU IS DETERMINED BASED ON THIRD-PARTY COMPENSATION DATA. IN ADDITION, THERE ARE COMPENSATION AGREEMENTS FOR SERVICES THAT USE HOURLY RATES DETERMINED USING MARKET DATA TO ENSURE COMPENSATION IS REASONABLE. THERE ARE SPECIALIST POSITIONS THAT RECEIVE AN ANNUAL COMPENSATION THAT IS ALSO DETERMINED USING MARKET DATA. THE FOLLOWING LAKEWOOD HEALTH SYSTEM BOARD MEMBERS HAVE OWNERSHIP INTEREST IN OR ARE MEMBERS OF LAKEWOOD CLINIC, PA: - ARDEN BEACHY, MD - MICHAEL HUDALLA, MD - JORDAN MOE, MD - KAITLYN SCHOECK, MD - CHRISTINE ALBRECHT, MD - JOHN HALFEN, MD (THRU MAY) | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | TIM RICE, PRESIDENT/CEO, IS MARRIED TO LYNN NEWTON RICE, VP OF SUPPORT SERVICES. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE PREPARER OF FORM 990 EMAILS A COPY OF THE FINAL 990 TO THE ORGANIZATION'S CFO. THE CFO PERFORMS A DETAIL REVIEW OF FORM 990 AND PROVIDES EACH VOTING BOARD MEMBER WITH A COPY OF FORM 990 BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANY INTERESTS WHICH WERE IDENTIFIED AS PART OF THE ANNUAL CONFLICT OF INTEREST DISCLOSURE WOULD BE DOCUMENTED IN THE BOARD OF DIRECTOR MEETING MINUTES. THE OFFICERS, DIRECTORS, AND KEY EMPLOYEES COMPLETE A FORMAL CONFLICT OF INTEREST DISCLOSURE ANNUALLY. INTERESTS THAT ARISE BETWEEN COMPLETING FORMS MUST BE DISCLOSED BY THE INTERESTED MEMBER TO THE REST OF THE BOARD. FOR ANY BOARD ACTION THAT REQUIRED A VOTE AND COULD BE INFLUENCED BY A CONFLICT, THE AFFECTED BOARD MEMBER IS NOT PERMITTED TO VOTE ON THE ACTION. THE ORGANIZATION ALSO CONSIDERS WHETHER OTHER POTENTIAL CONFLICTS OF INTEREST COULD RESULT FOR ANY OF THESE INDIVIDUALS BASED ON POSSIBLE ACTIONS UNDER CONSIDERATION BY THE ORGANIZATION DURING THE YEAR. |
| FORM 990, PART VI, SECTION B, LINE 15 | FOR THE CEO, INITIAL COMPENSATION CONSIDERATION IS MADE BASED ON A REVIEW OF SALARY SURVEY DATA COMPILED BY THE MINNESOTA HOSPITAL ASSOCIATION. THIS DATA IS THEN REVIEWED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. AFTER THIS REVIEW, THE DATA IS SUBMITTED TO THE FULL FINANCE COMMITTEE OF THE BOARD OF DIRECTORS FOR REVIEW ALONG WITH THE ENTIRE ANNUAL BUDGET PACKET. FINALLY, THE FULL BUDGET PACKAGE, ALONG WITH ALL SPECIFIC SALARY PROPOSALS IS SUBMITTED TO THE FULL BOARD OF DIRECTORS FOR FINAL APPROVAL. AT ANY TIME IN THIS PROCESS, ANY OF THE COMMITTEES OR BOARD COULD REQUEST ADDITIONAL INDEPENDENT SALARY INFORMATION SUPPORTING THE PROPOSED SALARY. THIS COMPENSATION AMOUNT IS INCLUDED IN THE CEO EMPLOYMENT CONTRACT WHICH IS PREPARED EVERY OTHER YEAR WITH A TWO-YEAR TERM. FOR THE CFO, CMO AND VP'S, THE PROCESS STARTS WITH A COMPENSATION SURVEY PERFORMED BY INTEGRATED HEALTHCARE STRATEGIES (IHS). IHS IS CONTRACTED BIENNIALLY TO COMPLETE A COMPENSATION MARKET SURVEY FOR THESE POSITIONS. THIS DATA IS AGAIN THEN REVIEWED BY THE COMPENSATION COMMITTEE WITH THE REMAINING PROCESS BEING IDENTICAL TO THAT FOR THE CEO. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THESE DOCUMENTS CAN BE REQUESTED FROM THE ORGANIZATION'S CHIEF FINANCIAL OFFICER. |
| FORM 990, PART IX, LINE 11G | OPERATING ROOM PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 581,467. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 581,467. SURGICAL PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 876,289. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 876,289. TECHNICIAN PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,710,823. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,710,823. BEHAVIORAL HEALTH PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 887,445. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 887,445. EMERGENCY ROOM PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,058,738. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,058,738. REHAB/THERAPY PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,010,448. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,010,448. NURSING PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 982,436. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 982,436. PHYSICIAN PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 9,644,386. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,644,386. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 1,268,525. MANAGEMENT AND GENERAL EXPENSES 605,084. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,873,609. CLINIC & ADMIN FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 839,515. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 839,515. PHARMACY PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 677,981. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 677,981. |
| FORM 990, PART XI, LINE 9: | NET ASSETS RELEASED FROM RESTRICTIONS -117,201. CHANGE IN CASH SURRENDER VALUE OF LIFE INSURANCE 12,055. CHANGE IN INVESTMENTS IN UNCONSOLIDATED AFFILIATES 39,148. |
Schedule R IRS990ScheduleR
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKEWOOD-CENTRACARE LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 49725 CTY 83 | AddressLine1Txt |
| City | STAPLES | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56479 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411974939 | EIN |
| Primary Activities | CLINICAL SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | -$31,595 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $13,379 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | Yes (1) | GeneralOrManagingPartnerInd |
| Ownership | 0.50000 | OwnershipPct |
| 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 | 0 | 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 | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | 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 |