ASTERA HEALTH: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- ASTERA HEALTH (EIN 41-0713913)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-02
- IRS object ID
- 202133069349302723
- 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 I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-02T14:49:25-05:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 SOUTH 6TH STREET SUITE 300 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410713913 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRI-COUNTY HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | TRI- | BusinessNameControlTxt |
| Phone | 2186313510 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 415 JEFFERSON STREET NORTH | AddressLine1Txt |
| City | WADENA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56482 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOEL BEISWENGER | PersonNm |
| Person Title | PRESIDENT & CEO | PersonTitleTxt |
| Phone | 2186313510 | PhoneNum |
| Signature | 2021-10-26 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JOEL | PersonFirstNm |
| Person Last | BEISWENGER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DARRYN MCGARVEY | PreparerPersonNm |
| PTIN | P00958683 | PTIN |
| Phone | 6123764500 | PhoneNum |
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
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRI-COUNTY HEALTH CARE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOEL BEISWENGER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 415 JEFFERSON STREET NORTH | AddressLine1Txt |
| City | WADENA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56482 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $77,780,720 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.TCHC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1940 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 535 | TotalEmployeeCnt |
| Total Volunteers | 94 | TotalVolunteersCnt |
| Total Gross UBI | $31,468 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $668,972 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,442,721 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $70,486,300 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $68,954,817 | CYProgramServiceRevenueAmt |
| PY Investment Income | $421,466 | PYInvestmentIncomeAmt |
| CY Investment Income | $323,683 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,043,280 | PYOtherRevenueAmt |
| CY Other Revenue | $880,153 | CYOtherRevenueAmt |
| PY Total Revenue | $72,620,018 | PYTotalRevenueAmt |
| CY Total Revenue | $76,601,374 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $69,884 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $47,270 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $37,244,823 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $38,508,622 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $39,200 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $57,000 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $227,368 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $29,688,595 | PYOtherExpensesAmt |
| CY Other Expenses | $30,535,373 | CYOtherExpensesAmt |
| PY Total Expenses | $67,042,502 | PYTotalExpensesAmt |
| CY Total Expenses | $69,148,265 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,577,516 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $7,453,109 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $46,719,641 | TotalAssetsBOYAmt |
| Total Assets EOY | $67,419,895 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $19,148,563 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $32,063,973 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $27,571,078 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $35,355,922 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $57,383,963 | ExpenseAmt |
| Grant | $47,270 | GrantAmt |
| Revenue | $68,922,140 | RevenueAmt |
| Desc | TRI COUNTY HOSPITAL (TCH) LEADS DELIVERY OF HEALTHCARE TO ITS SERVICE AREA THROUGH THE EFFORTS OF 535 EMPLOYEES WHO COORDINATE THESE EFFORTS TO DELIVER QUALITY PATIENT CARE. ALL OF THE TCH FACILITIES OPERATE IN FEDERALLY DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREAS. OUR SERVICE AREAS GENERALLY RANK AMONGST THE MOST ECONOMICALLY AND SOCIALLY CHALLENGED IN THE STATE OF MINNESOTA. THE ACCOMPLISHMENTS WHICH FOLLOW HIGHLIGHT THE COMMITMENT OF TCH TO ITS COMMUNITIES. REQUIREMENTS OF THE IRS COMMUNITY BENEFIT STANDARD FOR TAX-EXEMPT ORGANIZATIONS ARE INTEGRAL TO TCH'S LARGER CHARITABLE MISSION OF "IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE." TCH IS GOVERNED BY AN INDEPENDENT BOARD INCLUDING COMMUNITY LEADERS, BUSINESS EXPERTS, AND CLINICAL HEALTHCARE EXPERTS AND HAS BEEN PROACTIVELY EVALUATING OPPORTUNITIES TO VOLUNTARILY ADOPT GOVERNANCE BEST PRACTICES TO ENSURE THE ORGANIZATION CONTINUES TO OPERATE WITH THE HIGHEST INTEGRITY FOR THE BENEFIT OF THE COMMUNITY. TRI COUNTY HOSPITAL, A CERTIFIED CRITICAL ACCESS HOSPITAL, OPERATES 25 BEDS AND PROVIDES NEEDED MEDICAL SERVICES AND PATIENT CARE TO ALL PATIENTS REGARDLESS OF ABILITY TO PAY. SERVICES INCLUDE INPATIENT, OUTPATIENT, EMERGENCY, SURGICAL, INTENSIVE, OBSTETRICAL, AND PEDIATRIC NURSING CARE. ANCILLARY SERVICES INCLUDE LABORATORY, RADIOLOGICAL, THERAPY SERVICES, REHABILITATIVE, AND PHARMACY. TRI-COUNTY HOSPITAL IS THE LARGEST EMPLOYER IN THE COMMUNITY, EMPLOYING 535 STAFF DURING 2020. TRI COUNTY HOSPITAL'S UNCOMPENSATED CARE (CHARITY CARE) PROGRAM PROVIDES DISCOUNTED AND FREE SERVICES TO PATIENTS WHO LACK THE RESOURCES TO BE FULLY RESPONSIBLE FOR THE HEALTH CARE THEY RECEIVE. THE UNCOMPENSATED CARE PROGRAM IS DESIGNED TO ENSURE THE ENTIRE COMMUNITY SERVED BY TCH HAS ACCESS TO NEEDED HEALTHCARE SERVICES. IN 2020, $703,267 OF REVENUES WAS DESIGNATED AS CHARITABLE SERVICES. TRI-COUNTY HOSPITAL CARED FOR 787 INPATIENTS FOR A TOTAL 1,798 DAYS OF CARE. ADDITIONALLY, TRI-COUNTY HOSPITAL OPERATES SIX CERTIFIED RURAL HEALTH CLINICS IN AREAS IDENTIFIED BY STATE AND FEDERAL AGENCIES AS HEALTH PROFESSIONAL SHORTAGE AREAS. THESE CLINICS EXAMINED AND/OR TREATED 10,945 PATIENTS IN 2020. TOTAL OUTPATIENT ENCOUNTERS FOR 2020 (INCLUDING THE CLINICS) WERE 45,533. TRI-COUNTY HOSPITAL OPERATES A FULL-TIME EMERGENCY DEPARTMENT AND ACCEPTS ALL PATIENTS WHO PRESENT THEMSELVES FOR EMERGENCY SERVICES AT THE FACILITY, SEEING 4,398 PATIENTS IN THE EMERGENCY DEPARTMENT IN 2020. TRI-COUNTY HOSPITAL OPERATES AN AMBULANCE SERVICE WHERE PATIENTS RECEIVE EMERGENT CARE AND TRANSPORTATION BY EMERGENCY MEDICAL TECHNICIANS THAT PROVIDE ADVANCED LIFE SUPPORT SERVICES. TCH ALSO OFFERS EMS EDUCATION COURSES FOR THE PURPOSE OF INCREASING SURVIVAL, IMPROVING COMMUNITY AWARENESS, AND INCREASING INDIVIDUAL CONFIDENCE AS A PART OF ITS CHARITABLE MISSION. COURSES OFFERED INCLUDE EMERGENCY MEDICAL TECHNICIAN BASIC, FIRST RESPONDER, CPR, AND FIRST AID. TRI-COUNTY HOSPITAL PROVIDES A COMMUNITY PARAMEDIC PROGRAM. COMMUNITY PARAMEDIC IS A PROVISION OF OUTREACH TO PATIENTS AT RISK FOR USING THE EMERGENCY MEDICAL OR INPATIENT HEALTHCARE SYSTEM FOR PRIMARY CARE SERVICES, AND HELPING THEM FIND MORE APPROPRIATE RESOURCES FOR THEIR MEDICAL NEEDS. THE COMMUNITY PARAMEDIC PROGRAM HAD 536 VISITS DURING 2020. TCH ALSO PROVIDES OR PARTICIPATES IN OTHER PROGRAMS WHICH CONTRIBUTE TO ITS CHARITABLE MISSION. EDUCATIONAL PROGRAMMING IS A PRIORITY INCLUDING BUT NOT LIMITED TO THE HIGH SCHOOL SUMMER INTERNSHIP PROGRAM; PROVIDING A CLINICAL ROTATION SITE FOR NURSING STUDENTS, PHYSICAL THERAPY STUDENTS AND FOR RADIOLOGY AND LABORATORY TECHNICIANS FROM AREA TECHNICAL COLLEGES, PARTICIPATING AS PRECEPTOR SITES FOR MEDICAL SCHOOLS INCLUDING THE RURAL PHYSICIAN ASSOCIATE PROGRAM AND SUMMER INTERNSHIP IN MEDICINE AS WELL AS PROVIDING CAMPUS-BASED PRECEPTOR PHYSICIANS TO THE UNIVERSITY OF MINNESOTA-DULUTH AND ST. CLOUD RESIDENCY PROGRAMS, AND HEALTH FAIRS WITH SCREENING OPPORTUNITIES IN ITS SERVICE AREA. TRI-COUNTY HOSPITAL ALSO OPERATES AN ADJUNCT ORGANIZATION (TRI COUNTY HOSPITAL FOUNDATION) WHICH HAS DEVELOPED A LOCAL SCHOLARSHIP FUND AND GRANT DOLLARS FOR WORTHY CAUSES, AND PROVIDES COMMUNITY HEALTH EDUCATION PROGRAMS, WHICH ARE CONSISTENT WITH IMPROVING THE COMMUNITIES' HEALTH STATUS. TCH ALSO PROVIDES ORGANIZATIONAL AND ADMINISTRATIVE SUPPORT TO VARIOUS COMMUNITY BASED GROUPS OFFERING PEER SUPPORT PROGRAMS. THESE INCLUDE AREAS SUCH AS CANCER, BREAST CANCER, ARTHRITIS, DIABETES, AND OTHERS. TCH PROVIDES SEVERAL AVENUES FOR LOCAL INDIVIDUALS TO CONTRIBUTE TO THE COMMUNITY THROUGH OUR VOLUNTEER PROGRAMS. INCLUDED ARE THE HOSPITAL INPATIENT AND OUTPATIENT VOLUNTEER SUPPORT PROGRAM, AND VARIOUS ADVISORY COMMITTEES. WE ARE CONTINUALLY THANKED BY THESE INDIVIDUALS FOR THE OPPORTUNITY FOR THEM TO FEEL NEEDED AND OFFER A PRODUCTIVE OUTLET FOR THEIR TALENTS. DURING 2020, TRI-COUNTY HOSPITAL HAD 94 VOLUNTEERS. | Desc |
| Total Program Service Expenses | $57,383,963 | 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 | 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 | Yes (1) | 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 | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | Yes (1) | 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 | 109 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 535 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | 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 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOEL BEISWENGER PRESIDENT CEO | PersonNm |
| Phone | 2186317489 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 415 JEFFERSON ST N | AddressLine1Txt |
| City | WADENA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56482 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| MATTHEW VAN BRUGGEN | |||||||||
| BOARD MEMBER | 4.00 | 0.00 | Yes (X) | $4,000 | $0 | $0 | |||
| TERRY DAVIS | |||||||||
| CHAIR | 4.00 | 0.00 | Yes (X) | $2,061 | $0 | $0 | Yes (X) | ||
| RYAN ANDERSON | |||||||||
| VICE CHAIR | 4.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| DOUG BJORKLUND | |||||||||
| BOARD MEMBER | 4.00 | 0.00 | Yes (X) | $4,499 | $0 | $0 | |||
| PAUL DRANGE | |||||||||
| SECRETARY | 4.00 | 0.00 | Yes (X) | $4,000 | $0 | $0 | Yes (X) | ||
| DAVE FJELDHEIM | |||||||||
| BOARD MEMBER | 4.00 | 0.00 | Yes (X) | $2,637 | $0 | $0 | |||
| JOLENE JOHANNES | |||||||||
| BOARD MEMBER | 4.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| GERALD MCCULLOUGH MD | |||||||||
| BOARD MEMBER | 4.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHN PATE MD | |||||||||
| BOARD MEMBER | 4.00 | 0.00 | Yes (X) | $3,065 | $0 | $0 | |||
| DAVE QUINCER | |||||||||
| BOARD MEMBER | 4.00 | 0.00 | Yes (X) | $1,253 | $0 | $0 | |||
| SHANEEN SCHMIDT MD | |||||||||
| BOARD MEMBER | 4.00 | 0.00 | Yes (X) | $3,014 | $0 | $0 | |||
| JOEL BEISWENGER | |||||||||
| PRESIDENT & CEO | 40.00 | 0.00 | $365,692 | $0 | $39,404 | Yes (X) | |||
| KIM AAGARD | |||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | 0.00 | $193,260 | $0 | $26,912 | Yes (X) | |||
| JOSE ALBA | |||||||||
| CAO | 40.00 | 0.00 | $157,616 | $0 | $6,193 | Yes (X) | |||
| THOMAS PINT | |||||||||
| CNO | 40.00 | 0.00 | $171,771 | $0 | $6,734 | Yes (X) | |||
| TERESA JOHNSON | |||||||||
| CHRO | 40.00 | 0.00 | $183,961 | $0 | $31,252 | Yes (X) | |||
| TIMOTHY MONSON MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $510,194 | $0 | $37,902 | Yes (X) | |||
| RACHEL REDIG MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $596,834 | $0 | $18,317 | Yes (X) | |||
| BENJAMIN ROBERTSON MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $1,245,601 | $0 | $44,997 | Yes (X) | |||
| NATHANIEL RONNING MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $685,570 | $0 | $22,225 | Yes (X) | |||
| ROSS ANDERSON MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $516,989 | $0 | $36,228 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,652,017 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $270,164 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | 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 |
|---|---|---|---|---|---|
| WADENA MEDICAL CENTER LTD | |||||
| 4 DEERWOOD NW | WADENA | MN | 56482 | PHYSICIAN SERVICES | $4,408,009 |
| HAMMEL GREEN AND ABRAHAMSON INC | |||||
| 420 N 5TH ST STE 100 | MINNEAPOLIS | MN | 55401 | ARCHITECT | $1,140,413 |
| CENTRACARE HEALTH SYSTEM | |||||
| 1406 6TH AVENUE N | ST CLOUD | MN | 56303 | MEDICAL SERVICES/EPIC LICENSING | $1,098,982 |
| RURAL RADIOLOGY INC | |||||
| 29697 510TH AVENUE | HENNING | MN | 56551 | RADIOLOGY SERVICES | $982,440 |
| REGIONAL DIAGNOSTIC RADIOLOGY | |||||
| 1990 CONNECTICUT AVENUE | SARTELL | MN | 56377 | RADIOLOGY READING FEES | $508,988 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 40 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $5,404,483 | GovernmentGrantsAmt |
| All Other Contributions | $1,038,238 | AllOtherContributionsAmt |
| Total Contributions | $6,442,721 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| PROGRAM SERVICE REVENUE | 621400 | $63,439,191 | $63,439,191 | |
| PHARMACY | 446110 | $5,092,496 | $5,092,496 | |
| CENTRAL MN DIAGNOSTIC | 900099 | $390,453 | $390,453 | |
| INDUSTRIAL BILLING | 900099 | $32,677 | $32,677 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $68,954,817 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $233,589 | TotalRevenueColumnAmt |
| Exclusion | $233,589 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $659,489 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $193,873 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $465,616 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $465,616 | TotalRevenueColumnAmt |
| Exclusion | $465,616 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,016,587 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $920,151 | SecuritiesAmt |
| Other | $6,342 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $96,436 | SecuritiesAmt |
| Other | -$6,342 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $90,094 | TotalRevenueColumnAmt |
| Exclusion | $90,094 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $46,889 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $58,980 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$12,091 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | -$1,209 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$10,882 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CLINIC REVENUE | 900099 | $127,110 | $127,110 |
| EMPLOYEE/GUEST MEALS | 722210 | $122,038 | $122,038 |
| MISCELLANEOUS | 900099 | $109,135 | $109,135 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $68,345 | TotalRevenueColumnAmt |
| Exclusion | $68,345 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $426,628 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $76,601,374 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $68,922,140 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $31,468 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,205,045 | 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 | $5,070 | TotalAmt |
| Program Services | $5,070 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,200 | TotalAmt |
| Program Services | $42,200 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,207,322 | TotalAmt |
| Management And General | $1,207,322 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,113,372 | TotalAmt |
| Program Services | $25,021,164 | ProgramServicesAmt |
| Management And General | $4,017,194 | ManagementAndGeneralAmt |
| Fundraising | $75,014 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $947,743 | TotalAmt |
| Program Services | $784,034 | ProgramServicesAmt |
| Management And General | $163,709 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,344,351 | TotalAmt |
| Program Services | $4,421,190 | ProgramServicesAmt |
| Management And General | $923,161 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,895,834 | TotalAmt |
| Program Services | $1,568,355 | ProgramServicesAmt |
| Management And General | $327,479 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,982 | TotalAmt |
| Management And General | $74,982 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,000 | TotalAmt |
| Fundraising | $57,000 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,293,858 | TotalAmt |
| Program Services | $10,484,151 | ProgramServicesAmt |
| Management And General | $807,616 | ManagementAndGeneralAmt |
| Fundraising | $2,091 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $216,638 | TotalAmt |
| Management And General | $216,638 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,410,953 | TotalAmt |
| Program Services | $168,099 | ProgramServicesAmt |
| Management And General | $1,151,446 | ManagementAndGeneralAmt |
| Fundraising | $91,408 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,517 | TotalAmt |
| Management And General | $9,517 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $991,748 | TotalAmt |
| Program Services | $795,458 | ProgramServicesAmt |
| Management And General | $196,290 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,599 | TotalAmt |
| Program Services | $60,295 | ProgramServicesAmt |
| Management And General | $30,449 | ManagementAndGeneralAmt |
| Fundraising | $1,855 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $350,667 | TotalAmt |
| Program Services | $350,667 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,177,540 | TotalAmt |
| Program Services | $2,094,674 | ProgramServicesAmt |
| Management And General | $82,866 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $340,240 | TotalAmt |
| Management And General | $340,240 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $8,965,348 | $8,965,348 | |
| RENTAL & MAINTENANCE | $2,890,487 | $2,363,805 | $526,682 |
| TAXES | $744,412 | $744,412 | |
| MA SURCHARGE | $375,742 | $375,742 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $600,642 | TotalAmt |
| Program Services | $259,453 | ProgramServicesAmt |
| Management And General | $341,189 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,148,265 | TotalAmt |
| Program Services | $57,383,963 | ProgramServicesAmt |
| Management And General | $11,536,934 | ManagementAndGeneralAmt |
| Fundraising | $227,368 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $726,767 | BOYAmt |
| EOY | $254,839 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,174,841 | BOYAmt |
| EOY | $27,412,541 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $466,390 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,899,158 | BOYAmt |
| EOY | $9,497,609 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $970,223 | BOYAmt |
| EOY | $569,620 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $792,110 | BOYAmt |
| EOY | $796,915 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $405,747 | BOYAmt |
| EOY | $514,412 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $61,409,737 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $43,614,236 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,916,724 | BOYAmt |
| EOY | $17,795,501 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,947,050 | BOYAmt |
| EOY | $8,596,577 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,630,946 | BOYAmt |
| EOY | $1,515,491 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,256,075 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,719,641 | BOYAmt |
| EOY | $67,419,895 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,494,984 | BOYAmt |
| EOY | $8,133,937 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,976,521 | BOYAmt |
| EOY | $10,317,947 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $5,692,000 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $677,058 | BOYAmt |
| EOY | $7,920,089 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,148,563 | BOYAmt |
| EOY | $32,063,973 | 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 | $27,369,593 | BOYAmt |
| EOY | $35,126,103 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $201,485 | BOYAmt |
| EOY | $229,819 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,571,078 | BOYAmt |
| EOY | $35,355,922 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,719,641 | BOYAmt |
| EOY | $67,419,895 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $7,453,109 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $331,735 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule 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 | $6,354 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $6,354 | 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 | A PORTION OF MEMBERSHIP DUES PAID TO AMERICAN HOSPITAL ASSOCIATION AND MINNESOTA HOSPITAL ASSOCIATION ARE USED FOR LOBBYING PURPOSES. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | Yes (1) | AgentTrusteeEtcInd |
| Beginning Balance | $3,762 | BeginningBalanceAmt |
| Additions During Year | $3 | AdditionsDuringYearAmt |
| Distributions During Year | $2,000 | DistributionsDuringYearAmt |
| Ending Balance | $1,765 | EndingBalanceAmt |
| Incl Escrow Custodial Acct Liab | 0 | InclEscrowCustodialAcctLiabInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $433,225 | OtherCostOrOtherBasisAmt |
| Book Value | $433,225 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $34,277,656 | OtherCostOrOtherBasisAmt |
| Depreciation | $25,745,526 | DepreciationAmt |
| Book Value | $8,532,130 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,844,890 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,571,271 | DepreciationAmt |
| Book Value | $273,619 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $19,602,488 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,297,439 | DepreciationAmt |
| Book Value | $3,305,049 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,251,478 | OtherCostOrOtherBasisAmt |
| Book Value | $5,251,478 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $17,795,501 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| ASSET RETIREMENT OBLIGATION | $686,543 |
| ESTIMATED THIRD PARTY SETTLEMENTS | $521,298 |
| PRF PAYABLES | $6,712,248 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $7,920,089 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $75,898,973 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $100,906 | OtherRevenueAmt |
| Revenue Not Reported | $100,906 | RevenueNotReportedAmt |
| Revenue Subtotal | $75,798,067 | RevenueSubtotalAmt |
| Other Revenues Not Included | $803,307 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $803,307 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $76,601,374 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $69,338,313 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $193,873 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $193,873 | ExpensesNotReportedAmt |
| Expenses Subtotal | $69,144,440 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $3,825 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $3,825 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $69,148,265 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 1B: | THE HOSPITAL MAINTAINS THE EMPLOYEE SCHOLARSHIP FUND. DONATIONS ARE TAKEN FROM VENDING/PHONE COMMISSION AND POP CAN SALVAGE WHICH ARE THEN USED FOR SCHOLARSHIPS FOR CHILDREN OF EMPLOYEES. |
| PART X, LINE 2: | THE SYSTEM FOLLOWS THE PROVISION OF THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE APPLICATION OF THESE PROVISIONS HAS NO IMPACT ON THE SYSTEM'S FINANCIAL STATEMENTS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | EXPENSES INCLUDED IN REVENUES IN THE FINANCIAL STATEMENTS -3,825. NET ASSETS RELEASED FROM RESTRICTION 104,731. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | REALIZED GAIN ON INVESTMENTS 96,436. INTEREST INCOME 233,589. RENTAL EXPENSE -193,873. TEMPORARILY RESTRICTED CONTRIBUTIONS 133,065. CAPITAL CONTRIBUTIONS 534,090. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 193,873. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | EXPENSES INCLUDED IN REVENUES IN THE FINANCIAL STATEMENTS 3,825. |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | Yes (X) | MailSolicitationsInd |
| Email Solicitations | Yes (X) | EmailSolicitationsInd |
| Phone Solicitations | Yes (X) | PhoneSolicitationsInd |
| In Person Solicitations | Yes (X) | InPersonSolicitationsInd |
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Solicitation Of Govt Grants | Yes (X) | SolicitationOfGovtGrantsInd |
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | Yes (1) | AgrmtProfFundraisingActyInd |
Fundraiser Activity Info FundraiserActivityInfoGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | ActivityActivityTxt | Fundraiser Control Of FundsFundraiserControlOfFundsInd | Gross ReceiptsGrossReceiptsAmt | Retained By ContractorRetainedByContractorAmt | Net To OrganizationNetToOrganizationAmt |
|---|---|---|---|---|---|---|---|---|
| BOUTS VENTURES LLC | ||||||||
| PO BOX 99 | DIAMONDALE | MI | 48821 | COMMUNITY RELATIONS COUNSELING SERVICE | 0 | $0 | $57,000 | $0 |
| KATRINA LYNN LLC | ||||||||
| 132 E SUPERIOR ST 3B | DULUTH | MN | 55802 | MARKETING AND FEASBILITY STUDY | 0 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Retained By Contractors | $57,000 | TotalRetainedByContractorsAmt |
| Licensed States | MN | LicensedStatesCd |
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 |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | 0 | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $425,470 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $425,470 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00620 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,293,168 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,812,911 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $480,257 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00690 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,949,663 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,453,038 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $496,625 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00720 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,668,301 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,265,949 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,402,352 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02030 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $291,875 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $76,580 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $215,295 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00310 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $127,152 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $127,152 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,267,520 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,038,803 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,228,717 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10450 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $96,452 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $96,452 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,782,999 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,115,383 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,667,616 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11080 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $32,451,300 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $23,381,332 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,069,968 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13110 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,124 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,124 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,621 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,621 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $127,490 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $127,490 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $137,235 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $137,235 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $0 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $14,914,309 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $14,601,036 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $313,273 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRI-COUNTY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 415 JEFFERSON STREET N | AddressLine1Txt |
| City | WADENA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56482 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.TCHC.ORG | WebsiteAddressTxt |
| State License | 365897 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRI-COUNTY HOSPITAL INC | 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 | 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 | WWW.TCHC.ORG/QUALITY-OF-CARE | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.TCHC.ORG/QUALITY-OF-CARE | 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 | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| 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 | WWW.TCHC.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-INFORMATION | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.TCHC.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-INFORMATION | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.TCHC.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-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 Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| TRI-COUNTY HOSPITAL, INC. | PART V, SECTION B, LINE 5: TRI-COUNTY HEALTH CARE CONDUCTED THE COMMUNITY HEALTH NEEDS ASSESSMENT WITH THE COLLABORATION OF TODD, WADENA AND MORRISON COUNTY PUBLIC HEALTH AGENCIES; CENTRACARE HEALTH SYSTEM; CHI ST. GABRIEL'S HOSPITAL; AND LAKEWOOD HEALTH SYSTEM TO ENSURE THE MOST COMPREHENSIVE ASSESSMENT OF THE SERVICE AREA COMMUNITY. THE MAPP PROCESS (MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS) WAS USED AS A "COMMUNITY-DRIVEN STRATEGIC PLANNING PROCESS FOR IMPROVING COMMUNITY HEALTH AND PROVIDED THE FRAMEWORK FOR DATA COLLECTION AND PRIORITIZING PUBLIC HEALTH NEEDS. DATA WAS COLLECTED FROM A VARIETY OF SOURCES INCLUDING INFORMATION FROM QUESTIONNAIRES FOR KEY STAKEHOLDERS, A COMMUNITY HEALTH SURVEY, AND QUANTITATIVE STATISTICS FROM LOCAL, COUNTY AND STATE PUBLIC HEALTH SOURCES. THE COMMUNITY HEALTH SURVEY WAS DISSEMINATED AND ANALYZED DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS IN THE TRI-COUNTY HEALTH CARE SERVICE AREA. SURVEYS WERE SENT OUT IN JANUARY 2019 TO A RANDOM SAMPLE OF 6,400 HOUSEHOLDS. COMPLETED SURVEYS WERE RECEIVED FROM 1,553 ADULT RESIDENTS OF THE THREE COUNTIES. |
| TRI-COUNTY HOSPITAL, INC. | PART V, SECTION B, LINE 6A: TRI-COUNTY HEALTH CARE CONDUCTED THE COMMUNITY HEALTH NEEDS ASSESSMENT WITH THE COLLABORATION OF CENTRACARE HEALTH SYSTEM, CHI ST. GABRIEL'S HOSPITAL AND LAKEWOOD HEALTH SYSTEM. |
| TRI-COUNTY HOSPITAL, INC. | PART V, SECTION B, LINE 6B: TRI-COUNTY HEALTH CARE CONDUCTED THE COMMUNITY HEALTH NEEDS ASSESSMENT WITH THE COLLABORATION OF TODD, WADENA AND MORRISON COUNTY PUBLIC HEALTH AGENCIES. |
| TRI-COUNTY HOSPITAL, INC. | PART V, SECTION B, LINE 11: IN 2016, TCHC CONDUCTED A CHNA THAT PRIORITIZED UNHEALTHY BEHAVIORS, OBESITY, CHRONIC DISEASE, AND MENTAL HEALTH. TCHC HAS ADDRESSED THESE ISSUES AS FOLLOWS:UNHEALTHY BEHAVIORS - THIS ITEM WAS IDENTIFIED AS A FIRST PRIORITY AS SUCCESSFUL RESULTS IN THIS AREA MAY ALSO HAVE POSITIVE IMPACTS ON OTHER SIGNIFICANT HEALTH ISSUES INCLUDING OBESITY, HEART DISEASE, STROKE, DIABETES, HIGH CHOLESTEROL, HIGH BLOOD PRESSURE, CANCER, ETC. HEALTHY BEHAVIOR PROMOTION ADDRESSES EXERCISE, DIET, SMOKING, ALCOHOL USE, DRUG USE AND HEALTH CARE COMPLIANCE. AS PART OF THE MASLOWSKI RESEARCH STUDY, TCHC IS PARTNERING WITH WADENA REGIONAL WELLNESS CENTER, CITY OF WADENA, JOLENE JOHANNES STATE FARM AGENCY, TODD WADENA ELECTRIC ASSOCIATION, WADENA DEER CREEK SCHOOLS, WADENA STATE BANK AND WEST CENTRAL TELEPHONE WITH PLANS TO EXPAND SEVERAL OTHER KEY COMMUNITY EMPLOYER GROUPS TO CREATE A RESULTS-ORIENTED WELLNESS INITIATIVE FOR THE WADENA COMMUNITY AND SURROUNDING AREA. WITH THE AID OF THE FRANK AND ELEANOR MASLOWSKI CHARITABLE TRUST AND THE WADENA REGIONAL WELLNESS CENTER, TCHC IS CONDUCTING A RESEARCH STUDY TO IDENTIFY FACTORS THAT MAY BE PREDICTIVE OR EXPLANATORY OF HEALTH RISK STATUS IN THE TCHC SERVICE AREA POPULATION. THE FIRST PHASE OF THE RESEARCH STUDY BEGAN IN 2013 WITH TCHC COMPILING BASELINE HEALTH CARE DATA FROM THE TCHC EMPLOYEE GROUP AND HAS EXPANDED THIS TO THE EMPLOYER GROUPS IDENTIFIED IN THE PREVIOUS PARAGRAPH. PLEASE REFER TO EXHIBIT 1 FOR A MORE DETAILED EXPLANATION AND RESULTS OF THIS STUDY. THE NEXT PHASE OF THIS PROJECT IS TO CONDUCT THIS SAME ACTIVITY WITH GROUPS FROM WADENA AND BERTHA COMMUNITIES. HEALTH CARE COMPLIANCE AND PREVENTION WILL BE ADDRESSED THROUGH OUR CARE COORDINATION PROGRAM. OBESITY - THIS CAN BE ADDRESSED WITH THE INITIATIVES BEING UNDERTAKEN FOR UNHEALTHY BEHAVIORS.CHRONIC DISEASE - INCLUDES DIABETES, HEART DISEASE, STROKE, HIGH CHOLESTEROL, HIGH BLOOD PRESSURE, CANCER, ETC. IN ADDITION TO THE WELLNESS INITIATIVES BEING UNDERTAKEN FOR UNHEALTHY BEHAVIORS, TCHC HAS IMPLEMENTED A MEDICAL HOME PROGRAM IN PARTNERSHIP WITH COMMUNITY PARAMEDICS TO AID PERSONS WITH CHRONIC ILLNESSES AND HELP THEM MANAGE THESE CONDITIONS TO REMAIN COMPLIANT WITH THEIR CARE AND ACHIEVE POSITIVE OUTCOMES. TCHC HAS ALSO IMPLEMENTED CARE COORDINATION PROGRAM TO IDENTIFY AND MONITOR PATIENTS DUE FOR PREVENTIVE CARE AND CONTACTING THOSE PATIENTS IN AN EFFORT TO IDENTIFY PATIENTS AT RISK EARLIER IN THE DISEASE PROCESS. TCHC WILL CONTINUE TO OFFER THE DIABETIC EDUCATION AND DIABETIC SUPPORT GROUP.MENTAL HEALTH - IN NOVEMBER OF 2012, TCHC HIRED DR. AARON LARSON, PSYCHIATRIST, AND ANDREA CRAIG, FNP, TO PROVIDE FULL-TIME PSYCHIATRIC SERVICES IN THE WADENA CLINIC. DR. LARSON ALSO CONDUCTS VISITS AT AREA GROUP HOMES IN AN EFFORT TO SEE TO THE NEEDS OF PERSONS UNABLE TO LIVE INDEPENDENTLY. TCHC IS CONTINUING TO RECRUIT PROVIDERS TO MEET INCREASING DEMANDS FOR PSYCHIATRIC SERVICES. TCHC OFFERS GRIEF AND MEMORY LOSS SUPPORT GROUPS. IN 2019, TCHC CONDUCTED A NEW CHNA THAT CONTINUED TO IDENTIFY THOSE SAME NEEDS, BUT ALSO IDENTIFIED SOCIAL DETERMINANTS OF HEALTH, COMMUNITY INFRASTRUCTURE, DRUG ADDICTION, CANCER, ACCESS TO HEALTH CARE SERVICES, PHI DATA EXCHANGE AND DECREASED FUNDING. TCHC HAS ADDRESSED THESE ISSUES AS FOLLOWS:SOCIAL DETERMINANTS OF HEALTH - INCLUDES HEALTH EQUITY, HOUSING, EMPLOYMENT, ENVIRONMENT AND TRANSPORTATION. TCHC LACKS RESOURCES TO FULLY ADDRESS THIS ISSUE BUT PLANS TO PARTNER WITH LOCAL GOVERNMENT AND BUSINESS LEADERS TO COLLABORATE ON COMMUNITY BUILDING IN AN EFFORT TO INCREASE POPULATION, IMPROVE SOCIO-ECONOMIC STATUS AND BUILD/ENHANCE THE COMMUNITY REPUTATION. TCHC WILL CONTINUE TO PROVIDE UNCOMPENSATED CARE FOR THOSE WHO LACK THE ABILITY TO PAY FOR HEALTH CARE SERVICES. TCHC ALSO PARTICIPATES IN HELPING PAY FOR CAR SEATS AND BIKE HELMETS FOR SAFE TRANSPORTATION OF INFANTS AND CHILDREN. TCHC WILL CONTINUE SUBSIDIZE FARE FOR INDIVIDUALS UTILIZING FRIENDLY RIDER PUBLIC TRANSPORTATION SERVICES TO GET TO THEIR APPOINTMENTS AT TCHC. TCHC ENTERED INTO AN AGREEMENT WITH THE STATE OF MINNESOTA AS PART OF THEIR INTEGRATED HEALTHCARE PARTNERSHIP IN 2018. AS PART OF THIS PROGRAM, THE HEALTH EQUITY GOAL IS TO ADDRESS ISSUES WITH OPIOID ADDICTION. THE ORGANIZATION HAS IMPLEMENTED AN OPIOID PROGRAM TO ASSIST WITH ADDICTION MANAGEMENT AND PROVIDE MEDICATION-ASSISTED TREATMENT. THE ORGANIZATION INTENDS TO CONTINUE THIS PROGRAM WITH ANOTHER THREE-YEAR AGREEMENT, BEGINNING IN 2022, WITH THE STATE TO ADDRESS THIS ISSUE.CANCER - TCHC'S INITIATIVES TO INCREASE PREVENTIVE VISITS AND DIAGNOSTIC SCREENING EXAMS WILL AID WITH EARLY DETECTION OF CANCER. IN ADDITION, TCHC'S PARTNERSHIP WITH LAKE REGION HEALTH CARE IN FERGUS FALLS, MN, ALLOWS US TO PROVIDE ONCOLOGY SERVICES FOR CANCER PATIENTS IN ADDITION OFFERING OUTPATIENT CHEMOTHERAPY SERVICES. ACCESS TO HEALTH CARE - TCHC OFFERS AN UNCOMPENSATED CARE PLAN FOR PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY. THIS PLAN IS OFFERED TO PERSONS WITH ANNUAL INCOME AT 200% PERCENT OF FEDERAL POVERTY GUIDELINES. TCHC IS LOCATED IN A HEALTH CARE PROFESSIONAL SHORTAGE AREA WHERE ACCESS TO A PROVIDER MAY BE LIMITED AT TIMES AND RECRUITING PROVIDERS TO RURAL AREAS CONTINUES TO BE A CHALLENGE. IN ADDITION, TCHC HAS DEVELOPED A MODEL THAT UTILIZES NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS TO PRACTICE ALONGSIDE THE PHYSICIAN TO PROVIDE NECESSARY SERVICES IN A MORE COST-EFFECTIVE MANNER. IN AN EFFORT TO IMPROVE ACCESS TO HEALTH CARE, TCHC HAS IMPLEMENTED A WALK-IN CLINIC EXTENDING HOURS MONDAY THROUGH THURSDAY AND SATURDAY MORNINGS. AS PART OF OUR CARE COORDINATION PLAN, TCHC IS COLLABORATING WITH PAYOR PLANS TO IMPLEMENT NECESSARY HEALTH SCREENINGS FOR SPECIFIC DISEASES IN AN EFFORT TO PREVENT/DETECT SPECIFIC ISSUES SUCH AS DIABETES, CANCER SCREENINGS, ETC. WITH THE COVID PANDEMIC, THE ORGANIZATION HAS EXPANDED SERVICES TO INCLUDE TELEHEALTH VISITS. THE ORGANIZATION PROVIDED COVID VACCINES TO PATIENTS IN THE COMMUNITY AT NO CHARGE. POPULATION HEALTH INFRASTRUCTURE - TCHC HAS BEEN ESTABLISHING RELATIONSHIPS AND PARTNERING WITH OTHER FACILITIES AND PROVIDERS TO ESTABLISH A MODEL FOR MANAGING POPULATION HEALTH. CURRENTLY, TCHC IS PARTNERING WITH CENTRACARE HOSPITALS AND SEVERAL OTHER AFFILIATES INCLUDING DOUGLAS COUNTY HOSPITAL AND RICE MEMORIAL HOSPITAL ON A CLINICALLY INTEGRATED NETWORK. TCHC, ALONG WITH THESE FACILITIES, UTILIZES THE EPIC ELECTRONIC MEDICAL RECORDS SYSTEM WITH A GOAL TO IMPLEMENT THE "HEALTHY PLANET" MODULE AS A TOOL TO AID WITH POPULATION HEALTH MANAGEMENT. DATA EXCHANGE - TCHC'S PARTNERSHIP WITH CENTRACARE HOSPITALS AND OTHER CENTRACARE AFFILIATES AS PART OF THE EPIC ELECTRONIC MEDICAL RECORDS SYSTEM ALLOWS US TO MEET FEDERAL MEANINGFUL USE REQUIREMENTS. THIS SYSTEM ALLOWS COMMUNICATION BETWEEN HOSPITALS BY UTILIZING THE "CARE EVERYWHERE" FEATURE OF THIS SYSTEM. DECREASED FUNDING - THIS IS A CONTINUED CHALLENGE FOR OUR ORGANIZATION AS THE FUNDS FOR HEALTH CARE DECREASE WHILE THE DEMAND CONTINUES TO RISE. TCHC COLLABORATES WITH THE MINNESOTA HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION FOR ADVOCACY EFFORTS FOR RURAL HEALTH CARE. |
| TRI-COUNTY HOSPITAL, INC. | PART V, SECTION B, LINE 20E: THE ORGANIZATION WRITES OFF SELF ADMINISTERED DRUGS FOR MEDICARE PATIENTS AS APPROVED BY THE OIG. |
| 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 | Address Line2USAddress/AddressLine2Txt |
|---|---|---|---|---|---|
| 1 - TCHC - WADENA CLINIC | |||||
| 4 DEERWOOD AVENUE | WADENA | MN | 56482 | RURAL HEALTH CLINIC | |
| 2 - TCHC - BERTHA CLINIC | |||||
| 214 1ST STREET NW | BERTHA | MN | 56437 | RURAL HEALTH CLINIC | |
| 3 - TCHC - HENNING CLINIC | |||||
| 4010 DOUGLAS AVENUE | HENNING | MN | 56551 | RURAL HEALTH CLINIC | |
| 4 - TCHC - OTTERTAIL CLIN | |||||
| 232 MINNESOTA HIGHWAY 78 N PO BOX | OTTERTAIL | MN | 56571 | RURAL HEALTH CLINIC | 129 |
| 5 - TCHC - SEBEKA CLINIC | |||||
| 106 MINNESOTA AVENUE | SEBEKA | MN | 56477 | RURAL HEALTH CLINIC | |
| 6 - TCHC - VERNDALE CLINIC | |||||
| 102 FARWELL STREET SOUTH | VERNDALE | MN | 56481 | RURAL HEALTH CLINIC | |
| 7 - TCHC - HENNING PHYSICAL THERAPY CLINIC | |||||
| 801 INMAN STREET | HENNING | MN | 56551 | PHYSICAL THERAPY CLINIC | |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | TRI-COUNTY HOSPITAL DETERMINES ELIGIBILITY BASED ON AN INDIVIDUAL'S INCOME, NET ASSETS, INSURANCE COVERAGE, AND APPLICATION FOR FEDERAL AND/OR STATE-PROVIDED ASSISTANCE. SEE OUR WEBSITE, WWW.TCHC.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-INFORMATION, FOR DETAILED INFORMATION ABOUT ELIGIBILITY CRITERIA. |
| PART I, LINE 7: | IN ORDER TO DETERMINE THE AMOUNTS INCLUDED IN PART I, LINE 7, TCH GENERALLY USED THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 OF THE IRS FORM 990 INSTRUCTIONS. TO CALCULATE THE COSTS OF COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFITS OPERATIONS, HEALTH PROFESSIONS EDUCATION, AND SUBSIDIZED HEALTH SERVICES, TCH USED THE COST-TO-CHARGE RATIO SPECIFIC TO THOSE SERVICES. |
| PART I, LINE 7G: | SUBSIDIZED HEALTH SERVICES INCLUDE REVENUES AND COSTS ASSOCIATED WITH ER AND THE FOLLOWING SIX PROVIDER-BASED CLINICS:- TRI-COUNTY HEALTH CARE - WADENDA CLINIC- TRI-COUNTY HEALTH CARE - BERTHA CLINIC- TRI-COUNTY HEALTH CARE - HENNING CLINIC- TRI-COUNTY HEALTH CARE - OTTERTAIL CLINIC- TRI-COUNTY HEALTH CARE - SEBEKA CLINIC- TRI-COUNTY HEALTH CARE - VERNDALE CLINICCOMMUNITY BENEFIT EXPENSES RELATED TO THESE CLINICS IS $12,553,147. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THROUGH OUR HOSPITAL AND FOUNDATION, COMMUNITY EDUCATION, COMMUNITY SUPPORT AND MANY OTHER EFFORTS, WE ARE ABLE TO SUPPORT SEVERAL HEALTH INITIATIVES THROUGHOUT THE COMMUNITIES WE SERVE SUCH AS CONTINUING HEALTH EDUCATION, HEALTH EQUIPMENT IN THE SCHOOLS, PRENATAL EDUCATION, CONTINUING COMMUNITY HEALTH EDUCATION, CAR SEAT SAFETY EDUCATION, HEALTH CARE SCHOLARSHIPS, ETC. |
| PART III, LINE 3: | IN 2014 TRI-COUNTY HOSPITAL ADDED THE PRESUMPTIVE UNCOMPENSATED CARE POLICY. IF AN ACCOUNT IS READY TO BE SENT TO BAD DEBT BUT HAS MEDICAID NOW OR THERE IS OTHER PROOF THAT THE PATIENT WOULD QUALIFY, THE AMOUNT IS WRITTEN OFF AS UNCOMPENSATED CARE. THEREFORE, ACCOUNTS ARE NOT BEING SENT TO COLLECTIONS THAT MEET THIS NEW UNCOMPENSATED CARE GUIDELINE. |
| PART III, LINE 4: | SEE THE 'PATIENT RECEIVABLES, NET' PARAGRAPH ON PAGE 9 OF THE ATTACHED FINANCIAL STATEMENTS FOR INFORMATION ABOUT BAD DEBT EXPENSE. |
| PART III, LINE 8: | THE TOTAL ALLOWABLE COST REPORTED TO MEDICARE WAS BASED ON THE 2020 FILED MEDICARE COST REPORT. AS A CRITICAL ACCESS HOSPITAL, TRI-COUNTY HOSPITALIS REIMBUSED AT 101% (LESS SEQUESTRATION WHEN IN EFFECT) OF COST WHEN SERVING MEDICARE BENEFICIARIES, RESULTING IN A SURPLUS. |
| PART III, LINE 9B: | IT IS THE EXPECTATION THAT ALL PATIENTS RECEIVING SERVICES ARE FINANCIALLY RESPONSIBLE FOR THE TIMELY PAYMENT OF ALL CHARGES INCURRED. HOWEVER, NO PATIENT WILL BE REFUSED NECESSARY OR EMERGENCY CARE IF UNABLE TO MEET THE FINANCIAL REQUIREMENTS. INFORMATION GATHERED AT REGISTRATION IS THE KEY TO SUCCESSFUL COLLECTION EFFORTS. ACCURATE NAME, ADDRESS, PHONE NUMBERS, EMPLOYMENT AND CONTACT NAMES ARE REQUIRED. ALL CLIENTS PROVIDE A COPY OF THEIR DRIVER'S LICENSE AS IDENTIFICATION. IF THE PATIENT IS UNABLE TO PAY THE TOTAL AMOUNT, A PAYMENT PLAN WILL BE SET UP ACCORDING TO THE ATTACHED PAYMENT SCHEDULE. OTHER MEANS TO RESOLVE THE DEBT SUCH AS ASSISTANCE WITH MEDICAID FORMS AND UNCOMPENSATED CARE WILL BE DISCUSSED WITH THE PATIENT. ACCOUNT REPRESENTATIVES ARE RESPONSIBLE FOR PATIENT AND INSURANCE CONTACTS NECESSARY TO SECURE PAYMENT FOR SERVICES. IF PAYMENT HAS NOT BEEN RECEIVED AT THE TIME OF SERVICE, THE FOLLOWING INTERNAL COLLECTION GUIDELINE WILLBEGIN. SOME STEPS IN THE POLICY COULD BE ELIMINATED, OR TIMING CHANGED, DUE TO THE STATUS OF PREVIOUS ACCOUNTS FOR GUARANTOR.- 1ST STATEMENT - AFTER ALL INSURANCE AND ADJUSTMENTS ARE PROCESSED ON AN ACCOUNT, AND THE ACCOUNT IS SELF-PAY, THE FIRST STATEMENT WILL BE PRODUCED AND SENT TO THE PATIENT.- 2ND STATEMENT - A 2ND INVOICE IS GENERATED IF THE ACCOUNT HAS NOT BEEN PAID IN FULL. THIS IS APPROXIMATELY 30 DAYS FROM THE 1ST INVOICE DATE, BUT DOES VARY BASED ON THE TIMING OF STATEMENT CYCLES. - A TCHC CREDIT POLICY LETTER IS MAILED TO THE PATIENT AFTER THE 2ND STATEMENT IS GENERATED.- 3RD STATEMENT - A 3RD INVOICE IS GENERATED IF THE ACCOUNT HAS NOT BEEN PAID IN FULL. THIS IS APPROXIMATELY 30 DAYS FROM THE 2ND INVOICE DATE. AT THIS TIME A PATIENT RESOURCE REPRESENTATIVE FOLLOWS UP WITH A PHONE CALL AND A PAST DUE LETTER #1 IS MAILED TO THE PATIENT.- 4TH STATEMENT - A 4TH INVOICE IS GENERATED IF THE ACCOUNT HAS NOT BEEN PAID IN FULL. THIS IS APPROXIMATELY 30 DAYS FROM THE 3RD INVOICE DATE. AT THIS TIME A PAST DUE LETTER #2 IS MAILED TO THE PATIENT ALONG WITH A PLAIN LANGUAGE SUMMARY OF TCHC'S UNCOMPENSATED CARE POLICY.- 5TH STATEMENT - A 5TH INVOICE IS GENERATED IF THE ACCOUNT HAS NOT BEEN PAID IN FULL. THIS IS APPROXIMATELY 30 DAYS FROM THE 4TH INVOICE DATE. AT THIS TIME A PATIENT RESOURCE REPRESENTATIVE FOLLOWS UP WITH A PHONE CALL AND A FINAL DEMAND NOTICE IS MAILED TO THE PATIENT.- 30 DAYS AFTER FINAL NOTICE HAS BEEN GIVEN, ACCOUNTS ARE REVIEWED BY PATIENT RESOURCES STAFF FOR SUBMISSION TO THIRD-PARTY COLLECTION AGENCIES. PATIENTS MAY ALSO RECEIVE A 6TH INVOICE DEPENDING ON THE TIMING OF STATEMENT CYCLES.- MISSED PAYMENT LETTERS ARE SENT WHEN A PAYMENT IS NOT RECEIVED FROM A PATIENT WHO HAS SET UP A PAYMENT PLAN AND HAS MADE PRIOR INSTALLMENTS ON TIME. |
| PART VI, LINE 2: | TRI-COUNTY HEALTH CARE (TCHC) ANTICIPATES THE NEEDS OF THE COMMUNITY BY USING BOTH INTERNAL AND EXTERNAL DATA. FOR INTERNAL MEANS, TCHC CAN GAUGE THE NEEDS OF THE COMMUNITY BASED ON WHAT IS PRESENTING IN OUR E/R, EMS CALLS, AND IDENTIFIED HEALTH PROBLEMS FOR OUR CLINIC PATIENTS. FOR EXTERNAL SOURCES OF DATA, TCHC ALSO WORKS CLOSELY WITH LOCAL LAW ENFORCEMENT, SOCIAL SERVICES, AND OTHER PUBLIC AGENCIES TO ASSESS THE NEEDS OF THE COMMUNITY. TCHC IS INVOLVED WITH THE CHILD PROTECTION TEAM, TCHC LEADERSHIP IS INVOLVED WITH OTHER CIVIC GROUPS TO HELP IDENTIFY NEEDS, AND TCHC CLINIC ADVISORY GROUPS INCLUDE COMMUNITY LEADERS AND SCHOOL OFFICIALS TO PROVIDE INPUT TO IDENTIFY HEALTH NEEDS IN ALL SIX OF THE COMMUNITIES WHERE TCHC HAS A CLINIC. THE ORGANIZATION ALSO PROVIDES FREE EDUCATIONAL OPPORTUNITIES FOR COMMUNITY MEMBERS THROUGH COMMUNITY EVENTS WHICH INCLUDE FREE LAB SCREENINGS FOR ALL WHO WISH TO ATTEND. THESE EVENTS ARE NOT LIMITED TO TCHC PATIENTS AND LAB RESULTS ARE FORWARDED TO THE PATIENT'S DESIGNATED PROVIDER. TCHC ALSO TOOK ON A LEAD ROLE THAT LED TO A COMMUNITY-BASED HEALTH STATUS AND WELLNESS RESEARCH STUDY IN CONJUNCTION WITH THE DEVELOPMENT OF THE MASLOWSKI WELLNESS AND RESEARCH CENTER. TCHC IS PARTICIPATING IN THIS STUDY AND IS WORKING TO INCLUDE OTHER LOCAL EMPLOYER GROUPS AS PART OF THIS ENDEAVOR. |
| PART VI, LINE 3: | WE MAKE INFORMATION AVAILABLE REGARDING OUR UNCOMPENSATED CARE PROGRAM ON OUR WEBSITE, IN BROCHURES, AND DURING COLLECTION CONTACTS WITH PATIENTS. |
| PART VI, LINE 4: | THE TRI-COUNTY HEALTH CARE COMMUNITY IS LOCATED IN WEST CENTRAL MINNESOTA AND INCLUDES EASTERN/CENTRAL OTTER TAIL, TODD AND WADENA COUNTIES. THE TOTAL POPULATION OF ALL THREE COUNTIES IS ESTIMATED AT 95,839; THE PRIMARY SERVICE AREA POPULATION OF TCHC IS ESTIMATED AT 38,184 BECAUSE IT MORE SPECIFICALLY FOCUSES ON THE CITIES OF WADENDA, SEBEKA, NEW YORK MILLS, BERTHA, DEER CREEK, HEWITT, ALDRICH, VERNDALE, BLUFFTON, HENNING, MENAHGA AND OTTERTAIL. THE TRI-COUNTY HEALTH CARE SERVICE AREA CONSISTS OF PRIMARILY WHITE/CAUCASIANS AT 95.7 PERCENT WITH 4.3 PERCENT MINORITY. THE STATE OF MINNESOTA IS ALSO PRIMARILY WHITE/CAUCASIANS AT 83.7 PERCENT BUT HAS A GREATER MINORITY POPULATION OF 16.3 PERCENT. |
| PART VI, LINE 5: | TRI COUNTY HOSPITAL'S UNCOMPENSATED CARE (CHARITY CARE) PROGRAM PROVIDES DISCOUNTED AND FREE SERVICES TO PATIENTS WHO LACK THE RESOURCES TO BE FULLY RESPONSIBLE FOR THE HEALTH CARE THEY RECEIVE. THE UNCOMPENSATED CARE PROGRAM IS DESIGNED TO ENSURE THE ENTIRE COMMUNITY SERVED BY TCH HAS ACCESS TO NEEDED HEALTHCARE SERVICES. TRI-COUNTY HOSPITAL OPERATES A FULL-TIME EMERGENCY ROOM AND ACCEPTS ALL PATIENTS WHO PRESENT THEMSELVES FOR EMERGENCY SERVICES AT THE FACILITY. TCH ALSO PROVIDES OR PARTICIPATES IN OTHER PROGRAMS WHICH CONTRIBUTE TO ITS CHARITABLE MISSION, INCLUDING THE HIGH SCHOOL SUMMER INTERNSHIP PROGRAM, PROVIDES A CLINICAL ROTATION SITE FOR LPN/LVN NURSING STUDENTS FROM THE LOCAL TECHNICAL COLLEGE, AND HEALTH FAIRS WITH SCREENING OPPORTUNITIES IN IT'S SERVICE AREA. TRI-COUNTY HOSPITAL ALSO OPERATES AN ADJUNCT ORGANIZATION (TRI COUNTY HOSPITAL FOUNDATION) WHICH HAS DEVELOPED A LOCAL SCHOLARSHIP FUND AND GRANT DOLLARS FOR WORTHY CAUSES, AND PROVIDES COMMUNITY HEALTH EDUCATION PROGRAMS, WHICH ARE CONSISTENT WITH IMPROVING THE COMMUNITIES' HEALTH STATUS. TCH ALSO PROVIDES ORGANIZATIONAL AND ADMINISTRATIVE SUPPORT TO VARIOUS COMMUNITY BASED GROUPS OFFERING PEER SUPPORT PROGRAMS. THESE INCLUDE AREAS SUCH AS CANCER, BREAST CANCER, ARTHRITIS, DIABETES, AND OTHERS. TCH PROVIDES SEVERAL AVENUES FOR LOCAL INDIVIDUALS TO CONTRIBUTE TO THE COMMUNITY THROUGH OUR VOLUNTEER PROGRAMS. INCLUDED ARE THE HOSPITAL INPATIENT AND OUTPATIENT VOLUNTEER SUPPORT PROGRAM, VOLUNTEER PROGRAMS. HOSPICE VOLUNTEERS, VOLUNTEERS, AND VARIOUS ADVISORY COMMITTEES. WE ARE CONTINUALLY THANKED BY THESE INDIVIDUALS FOR THE OPPORTUNITY FOR THEM TO FEEL NEEDED AND OFFER A PRODUCTIVE OUTLET FOR THEIR TALENTS. |
| PART VI, LINE 6: | TRI-COUNTY HOSPITAL IS PART OF AN INTEGRATED HEALTH SYSTEM (TRI-COUNTY HEALTH CARE). THE SYSTEM OPERATES A 25-BED CRITICAL ACCESS HOSPITAL (TRI-COUNTY HOSPITAL) AND ALSO OPERATES SEVERAL CLINICS IN THE SURROUNDING AREA. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | MN |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WDC PUBLIC SCHOOLS | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 COLFAX AVE SW | AddressLine1Txt |
| City | WADENA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56482 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 411750966 | RecipientEIN |
| IRC Section | GOVERNMENTAL | IRCSectionDesc |
| Cash Grant | $5,070 | CashGrantAmt |
| Valuation Method Used | N/A | ValuationMethodUsedDesc |
| Non Cash Assistance | N/A | NonCashAssistanceDesc |
| Purpose Of Grant | GRANT TO SUPPORT THE SCHOOL'S EMOTIONAL LIBRARY AND STUDENT ATHLETES RECOVERING FROM INJURIES. | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (3 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc |
|---|---|---|---|---|
| SCHOLARSHIPS/GRANTS | 20 | $28,700 | N/A | N/A |
| MEALS ON WHEELS | 1 | $1,000 | N/A | N/A |
| DAVIS FAMILY NURSING | 5 | $12,500 | N/A | N/A |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | GRANT REQUESTS WILL BE GENERATED THROUGH MEETINGS OF TRI-COUNTY HOSPITAL'S FOUNDATION BOARD, GOVERNING BOARD, SATELLITE CLINIC ADVISORY BOARDS, EXECUTIVE COMMITTEE, AND DEPARTMENT MANAGERS, OR THROUGH A DIRECT MAIL SOLICITATION TO COMMUNITY ORGANIZATIONS. ALL SCHOLARSHIPS HAVE SPECIFIC CRITERIA SET-UP AND ALL APPLICANTS ARE SCREENED TO MEET THAT CRITERIA. WINNERS ARE SELECTED USING A BLIND SELECTION PROCESS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BENJAMIN ROBERTSON MD | ||||||||||||||
| PHYSICIAN | $1,149,856 | $0 | $5,030 | $0 | $90,715 | $0 | $13,627 | $0 | $31,370 | $0 | $1,290,598 | $0 | $0 | $0 |
| NATHANIEL RONNING MD | ||||||||||||||
| PHYSICIAN | $617,273 | $0 | $5,030 | $0 | $63,267 | $0 | $22,225 | $0 | $0 | $0 | $707,795 | $0 | $0 | $0 |
| RACHEL REDIG MD | ||||||||||||||
| PHYSICIAN | $513,859 | $0 | $5,030 | $0 | $77,945 | $0 | $18,317 | $0 | $0 | $0 | $615,151 | $0 | $0 | $0 |
| ROSS ANDERSON MD | ||||||||||||||
| PHYSICIAN | $459,083 | $0 | $5,030 | $0 | $52,876 | $0 | $9,875 | $0 | $26,353 | $0 | $553,217 | $0 | $0 | $0 |
| TIMOTHY MONSON MD | ||||||||||||||
| PHYSICIAN | $419,193 | $0 | $40,030 | $0 | $50,971 | $0 | $13,628 | $0 | $24,274 | $0 | $548,096 | $0 | $0 | $0 |
| JOEL BEISWENGER | ||||||||||||||
| PRESIDENT & CEO | $303,712 | $0 | $30,030 | $0 | $31,950 | $0 | $14,070 | $0 | $25,334 | $0 | $405,096 | $0 | $0 | $0 |
| KIM AAGARD | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $137,661 | $0 | $16,667 | $0 | $38,932 | $0 | $7,747 | $0 | $19,165 | $0 | $220,172 | $0 | $0 | $0 |
| TERESA JOHNSON | ||||||||||||||
| CHRO | $131,801 | $0 | $21,255 | $0 | $30,905 | $0 | $7,406 | $0 | $23,846 | $0 | $215,213 | $0 | $0 | $0 |
| THOMAS PINT | ||||||||||||||
| CNO | $143,732 | $0 | $3,361 | $0 | $24,678 | $0 | $6,734 | $0 | $0 | $0 | $178,505 | $0 | $0 | $0 |
| JOSE ALBA | ||||||||||||||
| CAO | $123,578 | $0 | $3,092 | $0 | $30,946 | $0 | $6,193 | $0 | $0 | $0 | $163,809 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION'S CHIEF OFFICERS MAY RECEIVE NON-FIXED PAYMENTS DEPENDING ON VARIOUS MEASURES THAT INCLUDE: 1) THE EMPLOYEE ENGAGEMENT SURVEY, 2) QUALITY & SERVICE MEASURES, INPATIENT AND CLINIC SATISFACTION, 3) PRODUCTIVITY MANAGEMENT, AND 4) 360-DEGREE EVALUATION RESULTS. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|
| CITY OF BERTHA MINNESOTA | |||||||
| A | 416004976 | 2017-04-18 | $7,200,000 | TO REFINANCE 2005 SERIES DEBT, OTHER DEBT & FINANCE CAPITAL EXPENDITURES | 0 | 0 | 0 |
| CITY OF VERNDALE MINNESOTA | |||||||
| B | 416005591 | 2017-04-18 | $7,200,000 | TO REFINANCE 2005 SERIES DEBT, OTHER DEBT & FINANCE CAPITAL EXPENDITURES | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | $2,512,858 | $7,200,000 | $144,000 | $1,708,765 | $5,347,235 | 2018 | Yes (1) | 0 | 0 | Yes (1) |
| B | $1,310,419 | $7,200,000 | $144,000 | $1,708,765 | $5,347,235 | 2018 | Yes (1) | 0 | 0 | Yes (1) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Engage Bond Counsel ContractsEngageBondCounselContractsInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | Yes (1) | Yes (1) | 0 | 0 | 0.01450 | 0.00460 | 0.01910 | 0 | 0 | Yes (1) |
| B | 0 | Yes (1) | Yes (1) | 0 | 0 | 0.01450 | 0.00460 | 0.01910 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | Yes (1) | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | Yes (1) | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| WADENA MEDICAL CENTER LTD | |||
| DR. PATE AND DR. SCHMIDT ARE PARTNERS OF WMC LTD. | $4,408,009 | PHYSICIAN SERVICES | 0 |
| RURAL RADIOLOGY INC | |||
| DR. GERALD MCCULLOUGH, BOARD MEMBER, OWNS RURAL RADIOLOGY INC. | $982,440 | RADIOLOGY SERVICES | 0 |
| MATTHEW VAN BRUGGEN | |||
| MATTHEW VAN BRUGGEN IS A PARTNER AT PEMBERTON SORLIE RUFER & KERSHNER, PLLP | $48,647 | PROFESSIONAL SERVICES | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE RETIREMENT COMMITTEE HAS AUTHORITY TO ACT ON BEHALF OF THE BOARD BETWEEN MEETINGS OF THE BOARD. THE RETIREMENT COMMITTEE CONSISTS OF ONE BOARD MEMBER AS WELL AS THE ORGANIZATION'S CEO, CFO AND VP OF HR. |
| FORM 990, PART VI, SECTION A, LINE 2 | BOARD MEMBERS DR. PATE AND DR. SCHMIDT ARE BOTH PARTNERS OF WADENA MEDICAL CENTER LTD. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 WAS REVIEWED IN DETAIL BY THE OFFICERS OF TRI-COUNTY HOSPITAL (TCH). THE FORM 990 WAS THEN PRESENTED AT A REGULAR SCHEDULED BOARD MEETING FOR REVIEW AND APPROVAL BY THE FULL BOARD PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD OF DIRECTORS AND MANAGEMENT PERSONNEL ARE THE INDIVIDUALS COVERED UNDER THIS POLICY. IT IS THE CONTINUING RESPONSIBILITY OF THE BOARD AND MANAGEMENT TO SCRUTINIZE TRANSACTIONS AND MAKE IMMEDIATE DISCLOSURE OF ANY POTENTIAL CONFLICTS OF INTEREST TO THE CHIEF EXECUTIVE OFFICER OR THE BOARD CHAIR. EACH POTENTIAL CONFLICT IS SCRUTINIZED BY THE BOARD (WITH THE PERSON WITH A POTENTIAL CONFLICT OF INTEREST BEING EXCLUDED) TO DETERMINE IF THE CONTEMPLATED TRANSACTION IS JUST, FAIR AND IN THE BEST INTEREST OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 15A | EACH YEAR DURING THE PREPARATION OF THE ANNUAL BUDGET, HUMAN RESOURCES ACCESSES TWO TO THREE REGIONAL, STATE AND NATIONAL WAGE SURVEYS DEPENDING ON THE POSITION. THIS DATA IS USED BY MANAGEMENT AND THE BOARD TO ESTABLISH FAIR AND EQUITABLE COMPENSATION FOR TOP MANAGEMENT AND OTHER KEY EMPLOYEES WITHIN THE ORGANIZATION. THE BOARD DETERMINES THE CEO'S COMPENSATION AND THE CEO DETERMINES OTHER MANAGEMENT'S COMPENSATION. THIS WAS LAST DONE IN 2020. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | OTHER SERVICES: PROGRAM SERVICE EXPENSES 10,484,151. MANAGEMENT AND GENERAL EXPENSES 807,616. FUNDRAISING EXPENSES 2,091. TOTAL EXPENSES 11,293,858. |
| FORM 990, PART XII, LINE 2C | THE PROCESS FOR SELECTION AND OVERSIGHT OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| FAIR OAKS LODGE | ||||||||||
| 415 JEFFERSON STREET N | WADENA | MN | 56482 | 200439862 | ACTIVITY SUSPENDED AS OF 12-31-13 | MN | 501(C)(3) | LINE 11 | TRI-COUNTY HOSPITAL | Yes (1) |
| TRI-COUNTY COMMUNITY HEALTH SERVICES | ||||||||||
| 415 JEFFERSON STREET N | WADENA | MN | 56482 | 261504250 | ACTIVITY SUSPENDED AS OF 12-31-13 | MN | 501(C)(3) | LINE 11 | TRI-COUNTY HOSPITAL | Yes (1) |
| TRI-COUNTY HEALTH CARE | ||||||||||
| 415 JEFFERSON STREET N | WADENA | MN | 56482 | 261504304 | ACTIVITY SUSPENDED AS OF 12-31-13 | MN | 501(C)(3) | LINE 12A, I | TRI-COUNTY HOSPITAL | Yes (1) |
| 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 | 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 | 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 |