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MADELIA HEALTH: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
MADELIA HEALTH (EIN 41-0758512)
Tax period
2018-06-01 to 2019-05-31
Filed
2020-04-13
IRS object ID
202021049349301037
Schema version
2018v3.1
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 ReturnHeader

FieldValueIRS element (for citing)
Return2020-04-13T14:24:07-05:00ReturnTs
Tax Period End2019-05-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1220 SOUTH SIXTH STREET SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-06-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN410758512EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MADELIA COMMUNITY HOSPITAL INCORPORATEDBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMADEBusinessNameControlTxt
Phone5076423255PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1121 DREW AVENUE SOUTHEASTAddressLine1Txt
CityMADELIACityNm
State AbbreviationMNStateAbbreviationCd
ZIP56062ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJEFF MENGENHAUSENPersonNm
Person TitleCEOPersonTitleTxt
Phone5076423255PhoneNum
Signature2020-04-10SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonRYAN ENGEBRETSONPreparerPersonNm
PTINP01585625PTIN
Phone6123764500PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address67.137.57.251IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-04-10IPDt
IP Tm10:31:39IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdF7E35B63400230345D2F018ED440CE5992BA784BAtSubmissionCreationDeviceId
At Submission Filing Device Id3F449F054D48A8326DD42E3CAE2ABA233D1F16C9AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-09-23 17:36:50ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1MADELIA COMMUNITY HOSPITAL & CLINICBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerJEFF MENGENHAUSENPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1121 DREW AVENUE SOUTHEASTAddressLine1Txt
CityMADELIACityNm
State AbbreviationMNStateAbbreviationCd
ZIP56062ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$13,213,489GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MCHOSPITAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1950FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionPROVIDE QUALITY HEALTHCARE SERVICES TO THE LOCAL COMMUNITY.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee140TotalEmployeeCnt
Total Volunteers60TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$182,834PYContributionsGrantsAmt
CY Contributions Grants$392,430CYContributionsGrantsAmt
PY Program Service Revenue$10,694,815PYProgramServiceRevenueAmt
CY Program Service Revenue$11,118,862CYProgramServiceRevenueAmt
PY Investment Income$136,089PYInvestmentIncomeAmt
CY Investment Income$133,118CYInvestmentIncomeAmt
PY Other Revenue$96,134PYOtherRevenueAmt
CY Other Revenue$91,580CYOtherRevenueAmt
PY Total Revenue$11,109,872PYTotalRevenueAmt
CY Total Revenue$11,735,990CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$7,212,414PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$7,806,127CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$4,600,173PYOtherExpensesAmt
CY Other Expenses$5,019,556CYOtherExpensesAmt
PY Total Expenses$11,812,587PYTotalExpensesAmt
CY Total Expenses$12,825,683CYTotalExpensesAmt
PY Revenues Less Expenses-$702,715PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,089,693CYRevenuesLessExpensesAmt
Total Assets BOY$17,445,824TotalAssetsBOYAmt
Total Assets EOY$16,110,240TotalAssetsEOYAmt
Total Liabilities BOY$6,171,605TotalLiabilitiesBOYAmt
Total Liabilities EOY$6,077,361TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$11,274,219NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$10,032,879NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE MISSION OF MADELIA COMMUNITY HOSPITAL IS TO PROVIDE SAFE AND QUALITY HEALTHCARE SERVICES TO THOSE WE SERVE IN AN ENVIRONMENT BASED ON RESPECT, DIGNITY, AND EXCELLENCE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$9,282,476ExpenseAmt
Revenue$11,118,862RevenueAmt
DescMADELIA COMMUNITY HOSPITAL & CLINIC PROVIDES GENERAL MEDICAL/SURGICAL SERVICES ON INPATIENTS, SWING BED PATIENTS, OUTPATIENTS AND HOME CARE CLIENTS. DURING THE FISCAL YEAR 2019 THERE WERE 86 ACUTE CARE ADMISSIONS, 70 SWING BED ADMISSIONS, 12,519 HOME CARE VISITS TO 1,156 HOME CARE CLIENTS, AND 4,453 TOTAL OUTPATIENT VISITS. DURING OUR FISCAL YEAR 2019, MADELIA COMMUNITY HOSPITAL AND CLINIC PROVIDED $28,872 IN CHARITY CARE. A VARIETY OF COMMUNITY BENEFIT SERVICES ARE DONE EACH YEAR BY VOLUNTEER HOSPITAL EMPLOYEES AND COMMUNITY VOLUNTEERS. COMMUNITY BENEFIT ACTIVITIES INCLUDED:COORDINATION OF DRIVERS FOR THE WATONWAN COUNTY SENIOR DRIVER PROGRAM, A NONPROFIT GROUP FURNISHING TRANSPORTATION FOR THE ELDERLY SENIOR POPULATION.DELIVERY OF 2,261 HOSPITAL-PREPARED MEALS FOR THE MEALS ON WHEELS PROGRAM IN MADELIAINTERPRETIVE AND TRANSLATION FROM ENGLISH TO SPANISH FOR PATIENTS AT MCHCCOLLABORATIVE HISPANIC OUTREACH SERVICES INCLUDING POPULATION HEALTH EDUCATIONAL SERVICES FOR THE PREVENTION OF DIABETES, OBESITY, HEART DISEASE, AND HYPERTENSIONHOSPICE ADVISORY COMMITTEEFREE HEEL SCANS TO DETECT OSTEOPOROSISFREE BLOOD PRESSURE CHECKS AT THE MADELIA COMMUNITY HOSPITAL & CLINIC AND AT HEALTH FAIRS IN THE AREA AND AT CHURCH EVENTSWORKING SIDE BY WITH STUDENTS FROM AREA UNIVERSITIES AND COLLEGES FOR STUDENTS IN THE NURSE PRACTITIONER, CLINIC, NURSING, LABORATORY TECHNICIAN AND PHYSICAL THERAPY PROGRAMS.INDUSTRY SPONSORS FOR THE HIGH STEP HEALTH SCIENCE ACADEMY, A PROGRAM FOR MADELIA HIGH SCHOOL STUDENTS THAT INTRODUCES THEM TO CAREER OPPORTUNITIES IN THE HEALTH CARE FIELD. PROVIDED MEETING FACILITIES FOR STUDENTS AND INSTRUCTION ONE HOUR PER WEEK DURING THE SCHOOL YEAR.DELIVERY OF PHARMACEUTICALS FOR HOME BOUND PATIENTSPHYSICIAN PROVIDING SKIN CHECKS FOR THE MADELIA HIGH SCHOOL WRESTLING TEAM.HIGH SCHOOL ATHLETE TRAINING AND CARE FOR SMALL AND NONLIFE THREATENING INJURIES. "IMPACT" (CONCUSSION) EVALUATION FOR MADELIA STUDENTS.PHYSICAL THERAPY DEPARTMENT HOSTED TWO FREE BALANCE AND FALL SCREENING SESSIONS - ONE IN LAKE CRYSTAL AND ONE IN MADELIA.HOSTED AG RESPIRATOR SESSIONS SO FARMERS COULD BE FITTED FOR APPROPRIATE FACEMASKS FREE OF CHARGE.HELD A SPECIAL HEALTH CARE CLINIC FOR AREA HUNTERS AT A REDUCED FEE. PEOPLE THAT ATTENDED HAD THEIR HEIGHT AND WEIGHT RECORDED, THEIR BLOOD PRESSURE CHECKED, AND THEIR VISION SCREENED. THEY ALSO HAD BLOOD TESTS TO SCREEN FOR HIGH CHOLESTEROL, DIABETES, PROSTATE CANCER/THYROID FUNCTION, AND AN EKG. TESTING WAS PRICED UNDER MCHC COST. SPONSORED AND HOSTED AN EDUCATIONAL EVENT ON THE CHANGES IN MEDICARE FOR 2019 WITH A SPEAKER FROM THE SENIOR LINKAGE LINE.COMMUNITY AND SCHOOL HEALTH FAIR PARTICIPATIONSMALL FEE FOOT AND NAIL CLINIC (SOAKING FEET, TRIMMING TOENAILS AND MASSAGING FEET OF ELDERLY PATIENTS). AN AVERAGE OF 60 PATIENTS PER MONTH PARTAKE IN THIS SERVICE.HOSTED THREE ART & HEALTH CLASSES TO ENHANCE THE HEALTH OF MIND AND BODY. EVENTS WERE SPONSORED BY RADIOLOGY, CLINIC AND HOME CARE DEPARTMENTS. ACTIVE AND CHARTER MEMBERS OF THE MADELIA COMMUNITY BASED COLLABORATIVE (MCBC). THIS GROUP IS COMPRISED OF HOSPITAL STAFF, NURSING PROFESSORS FROM MINNESOTA STATE UNIVERSITY - MANKATO, MEMBERS OF THE MANKATO GLEN TAYLOR NURSING INSTITUTE FOR FAMILY AND SOCIETY, WATONWAN COUNTY PUBLIC HEALTH REPRESENTATIVES, STATEWIDE HEALTH INITIATIVE PROGRAM (SHIP) REPRESENTATIVE, UNIVERSITY OF MINNESOTA EXTENSION EDUCATOR, ADMINISTRATIVE STAFF FROM THE LOCAL SCHOOL DISTRICT, AND COMMUNITY MEMBERS. MEMBERS OF MCBC, INCLUDING HOSPITAL STAFF, ALSO PARTNER WITH THE WATONWAN COMMUNITY FOOD PARTNERSHIP WHICH FOCUSES ON BRINGING FRESH FRUITS AND VEGETABLES INTO THE COMMUNITIES OF WATONWAN COUNTY.THE VISION OF MCBC IS WORKING TOGETHER TO ACHIEVE A HEALTHIER COMMUNITY. ITS MISSION IS TO PROMOTE THE WELL-BEING OF MADELIA RESIDENTS THROUGH COMMUNITY-BASED PARTNERSHIPS AND THE VALUES ARE EQUITY, COLLABORATION, COMMUNITY ENGAGEMENT, HEALTH & WELL-BEING.USING DATA FROM THE 2015 - 2016 COMMUNITY HEALTH NEEDS ASSESSMENT, THIS GROUP DECIDED ON TWO STRATEGIC FOCUSED AREAS, 1) OBESITY AND 2) MENTAL HEALTH WELL-BEING. OBESITY CONTINUES TO BE THE NUMBER ONE HEALTH CONCERN IN THE COMMUNITY. RECOGNIZING THAT MENTAL HEALTH WELL-BEING PLAYS A ROLE IN OBESITY AND WAS ALSO IDENTIFIED AS A SIGNIFICANT CONCERN IN THE NEEDS ASSESSMENT, MCBC DECIDED TO WORK COLLABORATIVELY ON A PROJECT THAT WOULD ADDRESS PHYSICAL AND MENTAL HEALTH. THE PROJECT THEME WAS "OH THE THINGS YOU CAN DO THAT ARE GOOD FOR YOU: ALL ABOUT STAYING HEALTHY," WITH A FOCUS ON THE IMPORTANCE OF EATING WELL, STAYING ACTIVE, AND GETTING GOOD SLEEP. THE GOAL IS TO DEMONSTRATE HOW THESE AREAS AFFECT YOUR PHYSICAL HEALTH AS WELL AS YOUR MENTAL HEALTH. IN ADDITION, MCBC IS PLANNING WORK IN THE FOCUS AREA OF OBESITY THAT WILL BRING FRESH FRUITS AND VEGETABLES TO THOSE IN NEED. IN THE FOCUS AREA OF MENTAL HEALTH WELL-BEING, THE GROUP IS PLANNING TRAINING AND EDUCATION THAT WILL TOUCH PEOPLE OF ALL AGES. THE ACCOMPLISHMENTS THIS YEAR INCLUDE: 1. EDUCATION PROVIDED TO 3RD AND 4TH GRADE STUDENTS ON, "OH THE THINGS YOU CAN DO THAT ARE GOOD FOR YOU: ALL ABOUT STAYING HEALTHY." THIS WAS FOLLOWED BY A POSTER CONTEST. THE POSTER CONTEST INCLUDED PRIZES OF "A BUCKETS OF THINGS THAT ARE GOOD FOR YOU AND A GRAND PRIZE OF A FAMILY POOL PASS.2. LET IT GROW BARRELS WERE AGAIN USED IN THE MADELIA MOBILE HOME PARK TO PROVIDE RESIDENTS WITH ACCESS TO FREE FRESH TOMATOES, PEPPERS, AND HERBS. MOST RESIDENTS ARE LOW-INCOME. 3. MCHC BECAME A REFERRAL SOURCE FOR THE MADELIA FOOD SHELF.4. EDUCATION WAS PROVIDED DURING THE COMMUNITY CELEBRATION WHICH INCLUDED:A. RETHINK YOUR DRINK DISPLAY WITH VEGETABLE AND FRUIT INFUSED WATER SAMPLESB. FRUIT AND VEGETABLE DISPLAYS C. MENTAL HEALTH DISPLAY ADDRESSING FEELINGS WITH TAKE HOME PACKETS FOR KIDS, PARENTS, AND GRANDPARENTS5. HOSTED MENTAL HEALTH MONDAY EVENTS IN NOVEMBER AND JANUARY, FOCUSING ON VARIOUS MENTAL HEALTH TOPICS.6. PROVIDED MONTHLY FARE FOR ALL DISTRIBUTION IN MADELIA AT THE LUTHER MEMORIAL HOME. FARE FOR ALL IS A FOOD PROGRAM AVAILABLE TO ALL COMMUNITY MEMBERS THAT OFFERS FRESH PRODUCE AND FROZEN MEATS FOR A SUBSTANTIALLY LOWER PRICE THAN CAN BE FOUND AT LOCAL GROCERS.Desc
Total Program Service Expenses$9,282,476TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document68IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee140EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MONIQUE HOFFMANN-URBANBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5076423255PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1121 DREW AVENUE SOUTHEASTAddressLine1Txt
CityMADELIACityNm
State AbbreviationMNStateAbbreviationCd
ZIP56062ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
DENNIS ARDUSER
BOARD PRESIDENT1.000.00Yes (X)Yes (X)$1,800$0$0
STEVEN COOLING
BOARD VP & TREASURER1.000.00Yes (X)Yes (X)$1,800$0$0
BARBARA OVERLIE
BOARD SECRETARY1.000.00Yes (X)Yes (X)$1,800$0$0
KENNETH GRONEWOLD
BOARD MEMBER1.000.00Yes (X)$1,200$0$0
NORMA KRUMWIEDE
BOARD MEMBER1.000.00Yes (X)$1,200$0$0
BRIAN MCCABE
BOARD MEMBER1.000.00Yes (X)$1,200$0$0
ELIZABETH SCHMIDT
BOARD MEMBER1.000.00Yes (X)$1,200$0$0
STEVEN SORENSEN
BOARD MEMBER1.000.00Yes (X)$1,200$0$0
RYAN VISHER
BOARD MEMBER1.000.00Yes (X)$1,200$0$0
JEFF MENGENHAUSEN
CEO40.000.20Yes (X)$144,475$0$28,449
MONIQUE HOFFMANN-URBAN
CFO40.000.20Yes (X)$100,782$0$16,298
JANE MALMSKOG
MEDICATION THERAPY MANAGEMENT40.000.00$127,026$0$18,086Yes (X)
JENNIFER MCLAUGHLIN
OR/ER MANAGER40.000.00$114,909$0$11,303Yes (X)
MICHAEL NELSON
EMERGENCY MEDICINE36.000.00$124,313$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$624,105TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$74,136TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K5IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
MANKATO CLINIC LTD
1230 E MAIN STMANKATOMN56002PHYSICIAN CLINIC PROVIDERS$815,024
WHITESELL MEDICAL STAFFING
PO BOX 997ANNADALEMN55302MEDICAL STAFFING$810,881
WMG LYFJABERG LLC
107 FLYNN DRIVE SUITE 600MILBANKSD57252MEDICAL STAFFING$414,394
CARDINAL HEALTH
3900 W AVERA DRIVE SUITE 301SIOUX FALLSSD57108AVERA CARE-EPHARMACY & EEMERGENCY$371,866
MARCO TECHNOLOGIES
4510 HEATHERWOOD ROADSAINT CLOUDMN56301IT SUPPORT$143,362
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K12CntrctRcvdGreaterThan100KCnt
Related Organizations$146,426RelatedOrganizationsAmt
Government Grants$245,734GovernmentGrantsAmt
All Other Contributions$270AllOtherContributionsAmt
Total Contributions$392,430TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT REVENUE624100$11,036,045$11,036,045
PHYSICAL THERAPY624310$68,526$68,526
LABORATORY621500$11,967$11,967
PHARMACY446110$2,324$2,324
FieldValueIRS element (for citing)
Total Program Service Revenue$11,118,862TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$192,337TotalRevenueColumnAmt
Exclusion$192,337ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$30,434TotalRevenueColumnAmt
Exclusion$30,434ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$59,133RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$38,113RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$21,020RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$21,020TotalRevenueColumnAmt
Exclusion$21,020ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,380,167SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,371,514SecuritiesAmt
Other$67,872OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$8,653SecuritiesAmt
Other-$67,872OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$59,219TotalRevenueColumnAmt
Exclusion-$59,219ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
EMPLOYEE MEALS900099$21,129$21,129
MISC INCOME900099$16,236$16,236
MEDICAL RECORDS900099$2,761$2,761
FieldValueIRS element (for citing)
Other Revenue Total$40,126OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,735,990TotalRevenueColumnAmt
Related Or Exempt Func Income$11,118,862RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$224,698ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$227,252TotalAmt
Management And General$227,252ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$6,305,530TotalAmt
Program Services$5,198,603ProgramServicesAmt
Management And General$1,106,927ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$171,802TotalAmt
Program Services$129,296ProgramServicesAmt
Management And General$42,506ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$761,665TotalAmt
Program Services$615,102ProgramServicesAmt
Management And General$146,563ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$339,878TotalAmt
Program Services$243,164ProgramServicesAmt
Management And General$96,714ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$309,465TotalAmt
Program Services$79,377ProgramServicesAmt
Management And General$230,088ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$22,219TotalAmt
Management And General$22,219ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$547,801TotalAmt
Management And General$547,801ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$187,920TotalAmt
Management And General$187,920ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$97,504TotalAmt
Program Services$64,280ProgramServicesAmt
Management And General$33,224ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$275,649TotalAmt
Management And General$275,649ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$779,074TotalAmt
Program Services$779,074ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$1,608,053$1,608,053
REPAIRS/MAINTENANCE$442,404$442,404
BAD DEBTS$354,812$354,812
CLINIC EXPENSES$210,715$210,715

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$183,940TotalAmt
Management And General$183,940ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$12,825,683TotalAmt
Program Services$9,282,476ProgramServicesAmt
Management And General$3,543,207ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,451,307BOYAmt
EOY$1,344,333EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$4,493,012BOYAmt
EOY$4,634,974EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$13,051BOYAmt
EOY$9,717EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,857,821BOYAmt
EOY$2,087,316EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$299,621BOYAmt
EOY$284,805EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$138,197BOYAmt
EOY$188,275EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$17,610,867LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$11,882,877LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$6,354,275BOYAmt
EOY$5,727,990EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,158,029BOYAmt
EOY$1,158,462EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$680,511BOYAmt
EOY$674,368EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$17,445,824BOYAmt
EOY$16,110,240EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,201,251BOYAmt
EOY$1,299,241EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,825,000BOYAmt
EOY$4,660,000EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$105,354BOYAmt
EOY$78,120EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$40,000BOYAmt
EOY$40,000EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,171,605BOYAmt
EOY$6,077,361EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$11,274,219BOYAmt
EOY$9,894,879EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
EOY$138,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,274,219BOYAmt
EOY$10,032,879EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$17,445,824BOYAmt
EOY$16,110,240EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$1,089,693ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$5,221NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$146,426OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$194,207OtherCostOrOtherBasisAmt
Book Value$194,207BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,936,493OtherCostOrOtherBasisAmt
Depreciation$4,208,270DepreciationAmt
Book Value$2,728,223BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,822,396OtherCostOrOtherBasisAmt
Depreciation$3,234,614DepreciationAmt
Book Value$1,587,782BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,657,771OtherCostOrOtherBasisAmt
Depreciation$4,439,993DepreciationAmt
Book Value$1,217,778BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$5,727,990TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescASSET RETIREMENT OBLIGATIONDesc
Amt$40,000Amt
FieldValueIRS element (for citing)
Total Liability$40,000TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE HOSPITAL IS CLASSIFIED BY THE IRS AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE IRC AND IS SUBJECTED TO FEDERAL INCOME TAX ONLY ON NET UNRELATED BUSINESS INCOME. THE HOSPITAL FOLLOWS THE GUIDANCE IN THE INCOME TAX STANDARD REGARDING RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE APPLICATION OF THIS STANDARD HAS NO EFFECT ON THE FINANCIAL STATEMENTS.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent200 DYes (X)Percent200DInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$23,869TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$23,869NetCommunityBenefitExpnsAmt
Total Expense0.00190TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,630,588TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,017,903DirectOffsettingRevenueAmt
Net Community Benefit Expns$612,685NetCommunityBenefitExpnsAmt
Total Expense0.04910TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,654,457TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,017,903DirectOffsettingRevenueAmt
Net Community Benefit Expns$636,554NetCommunityBenefitExpnsAmt
Total Expense0.05100TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$76,817TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$76,817NetCommunityBenefitExpnsAmt
Total Expense0.00620TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$367TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$367NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$77,184TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$77,184NetCommunityBenefitExpnsAmt
Total Expense0.00620TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,731,641TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,017,903DirectOffsettingRevenueAmt
Net Community Benefit Expns$713,738NetCommunityBenefitExpnsAmt
Total Expense0.05720TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,291TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,291NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$16,845TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$16,845NetCommunityBenefitExpnsAmt
Total Expense0.00140TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,020TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,020NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,049TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,049NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$27,205TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$27,205NetCommunityBenefitExpnsAmt
Total Expense0.00220TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$354,812BadDebtExpenseAmt
Bad Debt Expense Attributable$70,962BadDebtExpenseAttributableAmt
Reimbursed By Medicare$3,660,600ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$4,328,816CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$668,216MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MADELIA COMMUNITY HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1121 DREW AVE SEAddressLine1Txt
CityMADELIACityNm
State AbbreviationMNStateAbbreviationCd
ZIP56062ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.MCHOSPITAL.ORGWebsiteAddressTxt
State License385015StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MADELIA COMMUNITY HOSPITAL INCORPORATEDBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.MCHOSPITAL.ORG/COMMUNITY-NEEDS-ASSESSMENTOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted Website0StrategyPostedWebsiteInd
Strategy AttachedYes (1)StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care200.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Other MethodYes (X)OtherMethodInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTPS://WWW.MCHOSPITAL.ORG/FINANCIAL-ASSISTANCEFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTPS://WWW.MCHOSPITAL.ORG/FINANCIAL-ASSISTANCEFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTPS://WWW.MCHOSPITAL.ORG/FINANCIAL-ASSISTANCEFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
MADELIA COMMUNITY HOSPITAL, INCORPORATEDPART V, SECTION B, LINE 5: FOR MADELIA COMMUNITY HOSPITAL'S MAY 2019 COMMUNITY HEALTH NEEDS ASSESSMENT, THE HOSPITAL SOLICITED INPUT FROM THE COMMUNITY THROUGH A SURVEY THAT WAS MAILED TO EVERY HOME IN SIX ZIP CODES - 7,494 IN TOTAL. WE RECEIVED 253 RESPONSES, INCLUDING 43 FROM INDIVIDUALS WHO SELF-IDENTIFIED AS LOW-INCOME, SIX FROM INDIVIDUALS WHO IDENTIFIED AS LATINO, 130 FROM INDIVIDUALS WHO IDENTIFIED AS ELDERLY, AND 45 FROM MEDICAL PROFESSIONALS.
MADELIA COMMUNITY HOSPITAL, INCORPORATEDPART V, SECTION B, LINE 11: IT IS UNDERSTOOD THAT IT WILL TAKE A NUMBER OF YEARS TO OBTAIN MEASURABLE DATA TO DEMONSTRATE ACTUAL EDUCATION IN OBESITY. THE CURRENT STRATEGY FOCUSES ON SHORT TERM GOALS. THE FOLLOWING SHORT TERM GOALS HAVE BEEN ESTABLISHED TO REMOVE THE BARRIERS TO HEALTHY EATING AND INCREASE PHYSICAL EXERCISE: DEVELOP PARTNERSHIPS WITH COMMUNITY & COUNTY ORGANIZATIONS WHO SHARE THE SAME VISION TO IMPROVE THE ACCESS OF FRESH FRUITS AND VEGETABLES WITHIN THE COMMUNITY. DEVELOP OPPORTUNITIES TO PROVIDE LOW-COST OR NO-COST FRUITS AND VEGETABLES TO THOSE IN NEED. INCREASE COMMUNITY AWARENESS OF PROGRAMS THAT WILL ALLOW THEM TO OBTAIN FRESH FRUITS AND VEGETABLES AT LOW AND NO COST. EDUCATE CHILDREN ON HEALTHY EATING. EDUCATE CHILDREN ON THE RELATIONSHIP BETWEEN PHYSICAL ACTIVITY AND OVERALL HEALTH. PARTNER WITH MCHC ON THE JUMP ROPE FOR HEARTS PROJECT. PROVIDE OPPORTUNITIES FOR THE COMMUNITY TO TASTE FRUITS AND VEGETABLES COMMON TO DIFFERENT CULTURES REPRESENTED IN THE COMMUNITY.DIABETES, HEART DISEASE, AND CANCER. MCHC RECOGNIZES THE IMPORTANCE OF RESOURCE UTILIZATION IS DONE IN A WAY THAT WILL HAVE THE GREATEST IMPACT ON THE COMMUNITY AS A WHOLE. BY FOCUSING ON OBESITY BY SETTING GOALS AND PROVIDING EDUCATION, REDUCING OBESITY WILL ALSO REDUCE THE RISK OF DIABETES AND CANCER.
MADELIA COMMUNITY HOSPITAL, INCORPORATEDPART V, SECTION B, LINE 13H: ALL PATIENTS ARE CHARGED THE SAME FOR SERVICES RENDERED AT MCH NO MATTER WHAT THE PATIENT'S FINANCIAL STATUS CONSISTS OF.
MADELIA COMMUNITY HOSPITAL, INCORPORATEDPART V, SECTION B, LINE 15E: PATIENT BILLS CONTAIN A STATEMENT REGARDING THE FAP AVAILABILITY FOR FURTHER INQUIRY OF ASSISTANCE.
MADELIA COMMUNITY HOSPITAL, INCORPORATEDPART V, SECTION B, LINE 16J: THE FAP APPLICATION IS AUTOMATICALLY MAILED OUT TO UNINSURED AND UNDERINSURED PATIENTS.
MADELIA COMMUNITY HOSPITAL, INCORPORATEDPART V, SECTION B, LINE 20E: PATIENTS ARE INFORMED OF THE STATUS OF THEIR ACCOUNT THROUGH BILLING STATEMENTS AND LETTERS INDICATING THE AGING OF THEIR ACCOUNT AND THE AVAILABILITY TO MAKE PAYMENT ARRANGEMENTS WITH SEVERAL OPTIONS OF RECEIVING A DISCOUNT.

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:AGI UNDER 100% OF FPG RECEIVED FULL DISCOUNT, AGI BETWEEN 100%-200% FPG RECEIVED A DISCOUNT BASED ON FORMULARY CALCULATION. AN AGI OVER 200% DOES NOT QUALIFY FOR ASSISTANCE.
PART I, LINE 7:THE FINANCIAL ASSISTANCE AT COST AND MEDICAID AMOUNTS REPORTED IN PART I, LINES 7A AND 7B, RESPECTIVELY, WERE COMPUTED USING A RATIO OF COST TO CHARGES THAT WAS DERIVED FROM WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS AND HEALTH PROFESSIONS EDUCATION AMOUNTS REPORTED IN PART I, LINES 7E AND 7F, RESPECTIVELY, WERE AT COST.
PART I, LINE 7, COLUMN (F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 354,812.
PART II, COMMUNITY BUILDING ACTIVITIES:STAFF PARTICIPATE IN COMMUNITY ORGANIZATIONS TO PROVIDE HEALTHCARE REPRESENTATION AND INFORMATION TO ENHANCE THOSE ORGANIZATIONS EVENTS, ETC. MADELIA COMMUNITY BASED COLLABORATIVE (MCBC) IS A COMMUNITY BASED PROJECT THAT MADELIA COMMUNITY HOSPITAL PARTICIPATES IN TO SUPPORT HEALTHY LIFE STYLES. THROUGH THIS COLLABORATION, MADELIA COMMUNITY HOSPITAL IS ABLE TO PARTNER WITH OTHER AREA HEALTH BASED COMMUNITY EMPLOYERS AND EDUCATORS, AS WELL AS NON-HEALTH BASED EMPLOYERS THAT HAVE EXPRESSED AN INTEREST IN IMPROVING THE HEALTH OF THEIR EMPLOYEES. THE COMMUNITY HEALTH NEEDS ASSESSMENT COMPLETED BY MADELIA COMMUNITY HOSPITAL HELPS MCBC DETERMINE WHAT AREAS THEY WILL FOCUS THEIR EFFORTS IN ORDER TO GAIN THE MOST BENEFIT FOR THE COMMUNITY. STAFF FROM MADELIA COMMUNITY HOSPITAL HAVE A SIGNIFICANT ROLE IN THIS DEVELOPMENT AND CARRYING OUT THE ACTION PLANS.
PART III, LINE 2:PAYMENT FOR SERVICES IS REQUIRED UPON RECEIPT OF A BILL, AFTER PAYMENT BY INSURANCE, IF ANY. SELF-PAY ACCOUNTS ARE ANALYZED FOR COLLECTIBILITY BASED ON THE MONTHS PAST DUE AND PAYMENT HISTORY. AN ALLOWANCE IS ESTIMATED FOR THESE ACCOUNTS BASED ON THE HISTORICAL EXPERIENCE OF THE HOSPITAL. ACCOUNTS THAT ARE DETERMINED TO BE UNCOLLECTIBLE ARE SENT TO A COLLECTION AGENCY AND WRITTEN OFF AT THAT TIME.THE AMOUNT OF BAD DEBT EXPENSE REPORTED IN PART III, LINE 2 IS CALCULATED AS FOLLOWS: PAYMENT ARRANGEMENT INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES AND PER DIEM PAYMENTS. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS.
PART III, LINE 4:THE FOLLOWING IS FROM THE "PATIENT RECEIVABLES" PARAGRAPH IN NOTE 1 TO THE HOSPITAL'S FINANCIAL STATEMENTS:"PATIENT RECEIVABLES ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. PATIENTS ARE NOT REQUIRED TO PROVIDE COLLATERAL FOR SERVICES RENDERED. PAYMENT FOR SERVICES IS REQUIRED UPON RECEIPT OF AN INVOICE, AFTER PAYMENT BY INSURANCE, IF ANY. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. ACCOUNTS THAT ARE DETERMINED TO BE UNCOLLECTIBLE ARE SENT TO A COLLECTION AGENCY AND WRITTEN OFF AT THAT TIME."
PART III, LINE 8:THE REVENUE RECEIVED AND ALLOWABLE COSTS WERE BASED ON THE 2019 FILED MEDICARE COST REPORT.THE MEDICARE SHORTFALL ON PART III, LINE 7 IS NOT TREATED AS A COMMUNITY BENEFIT.
PART III, LINE 9B:EACH WEEK, STATEMENTS ARE SENT OUT THROUGH OUR EDI PROCESS WITH STATEMENTS BEING MAILED OUT TO THE PATIENT BY A CLEARINGHOUSE. PATIENTS ARE BILLED AFTER MEDICARE OR COMMERCIAL INSURANCE HAS BEEN FILED AND PAYMENT HAS BEEN RECEIVED WITHIN A SIX-WEEK PERIOD. PATIENTS WILL BE BILLED FOR THE REMAINING BALANCE MONTHLY. ACCOUNTS ARE VERIFIED INTERNALLY PRIOR TO COLLECTION LETTERS BEING SENT.IF NO PAYMENT IS RECEIVED WITHIN 2 MONTHS OF BILLINGS, THE STATEMENT IS SENT WITH A NOTICE LETTER REQUESTING PAYMENT. LETTERS WILL ALSO BE SENT SHOULD NO PAYMENT BE RECEIVED WITHIN 60 AND 90 DAYS.SHOULD NO RESPONSE BE RECEIVED WITHIN FIVE (5) DAYS OF THE LAST LETTER, A TELEPHONE CALL IS ISSUED TO NEGOTIATE A PAYMENT PLAN. IF ACCOUNT HOLDER MAY QUALIFY FOR OUR HEALTHCARE FINANCIAL PROGRAM, AN APPLICATION IS SENT TO BE COMPLETED AND RETURNED TO US.LACK OF RESPONSE TO THE TELEPHONE CALL WILL RESULT IN VERIFICATION OF THE ACCOUNT(S) BY THE INSURANCE BILLING CLERKS AND THEN REVIEWED BY THE BUSINESS OFFICE MANAGER FOR APPROVAL TO BEGIN FORMAL COLLECTION PROCESS. THESE ACCOUNTS ARE THEN TURNED IN TO A PROFESSIONAL COLLECTION AGENCY.CHARITY CARE CONSIDERATIONS WILL BE MADE BY BUSINESS OFFICE MANAGER WHEN ALL NECESSARY DOCUMENTATION IS PRESENTED AND SHOULD IT BE EVIDENT THAT THE PATIENT'S LACK OF FINANCES WARRANT THIS AND CHARITY CARE THE BEST ETHICAL DECISION FOR THE PATIENT.
PART VI, LINE 2:THRU THE COMMUNITY ASSESSMENT PROCESS, HEALTHCARE NEEDS & SERVICES WERE IDENTIFIED AND PROGRAMS WERE DEVELOPED (SEE MCH WEBSITE FOR THE 2016 COMMUNITY HEALTH DIALOGUE). STRATEGIC PLANNING ASSESSES THE NEEDS OF THE COMMUNITY AND PATIENTS THROUGH PATIENT SATISFACTION SURVEYS, COMMENT CARDS, COMMUNITY ASSESSMENTS, AND A DIVERSE MEMBERSHIP OF COMMUNITY ELECTED GOVERNING BOARD THAT REPRESENTS THE COMMUNITY AND BRINGS TO THE TABLE ISSUES, CONCERNS, AND RECCOMMENDATIONS FOR HEALTH CARE SERVICES.
PART VI, LINE 3:PATIENTS ARE INFORMED OF FINANCIAL ASSISTANCE UPON ADMISSION TO THE HOSPITAL, THROUGH BILLING CLERKS ASSISTANCE WITH PATIENT ACCOUNTS, STATEMENTS ON THE BILLS, AND PERSONAL LETTERS SENT TO ACCOUNTS IDENTIFIED AS UNINSURED AND UNDERINSURED.
PART VI, LINE 4:MADELIA COMMUNITY HOSPITAL SERVES A 25 MILE RADIUS OF RURAL COMMUNITIES CONSISTING MAJORLY OF A CULTURALLY DIVERSE AND SENIOR POPULATION.
PART VI, LINE 5:THERE WERE PUBLIC MEETINGS INFORMING THE COMMUNITY OF THE ASSESSMENT PROCESS AND ENCOURAGING THEIR PARTICIPATION. THIS WAS COMMUNICATED THRU THE NEWS MEDIA AND DIRECT CLIENT/FAMILY CONTACTS THRU MCH SERVICES. MADELIA COMMUNITY HOSPITAL (MCH) PARTNERED WITH THE MINNESOTA UNIVERSITY, MANKATO, NURSING STUDENTS TO DEVELOP AND CONDUCT A COMMUNITY-WIDE HEATHCARE ASSESSMENT. THIS WILL BE AN ONGOING PROCESS WHICH STARTED IN THE FALL OF 2011 AND WILL BE A CONTINUATION OF FOLLOWUP TO MEASURE THE PROGRESS OF COMMUNITY WELLNESS PROGRAMS THAT HAVE BEEN IMPLEMENTED AND TO IDENTIFY AWARENESS OF ANY NEW COMMUNITY HEALTH NEEDS.IN ADDITION TO THE ABOVE, MCH COLLABORATED WITH OTHER LOCAL ORGANIZATIONS REFERRED TO AS THE MADELIA COMMUNITY BASED COLLABORATIVE (MCBC) WHICH INCLUDED THE FOLLOWING PARTICIPANT ORGANIZATIONS: MADELIA COMMUNITY HOSPITAL AND CLINICSMINNESOTA STATE UNIVERSITY, MANKATO SCHOOL OF NURSINGGLEN TAYLOR NURSING INSTITUTE FOR FAMILY AND SOCIETYWATONWAN COUNTY PUBLIC HEALTH DEPARTMENTMADELIA SCHOOL SYSTEMLUTHER MEMORIAL HOMEDOWNS FOOD GROUP (MAJOR INDUSTRY IN MADELIA AND WATONWAN COUNTY)MADELIA CITY COUNCILMADELIA CHAMBER OF COMMERCE
PART VI, LINE 7, REPORTS FILED WITH STATESMN

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonJEFF MENGENHAUSENPersonNm
TitleCEOTitleTxt
Base Compensation Filing Org$144,475BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$0CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$28,449NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$172,924TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$0TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1CITY OF MADELIABusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN416005334BondIssuerEIN
CUSIP556401AR8CUSIPNum
Bond Issued2006-10-31BondIssuedDt
Issue Price$6,495,000IssuePriceAmt
PurposeCONSTRUCT HOSPITAL ADDITIONPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$1,835,000RetiredAmt
Total Proceeds$6,495,000TotalProceedsAmt
Capitalized Interest$161,893CapitalizedInterestAmt
Issuance Costs From Proceeds$16,238IssuanceCostsFromProceedsAmt
Credit Enhancement$113,662CreditEnhancementAmt
Capital Expenditures$6,203,207CapitalExpendituresAmt
Substantial Completion2008SubstantialCompletionYr
Refunding Tax Exempt Bonds0RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd0ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To RebateYes (1)ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE PRESIDENT, AS CHAIRPERSON, VICE PRESIDENT/TREASURER, SECRETARY, AND UP TWO (2) ADDITIONAL TRUSTEES. THE EXECUTIVE COMMITTEE SHALL HAVE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD OF TRUSTEES, SUBJECT TO ANY POWER LIMITATION IMPOSED BY THE BOARD OF TRUSTEES. A QUORUM FOR THE EXECUTIVE COMMITTEE CAN ONLY BE MADE UP OF EXECUTIVE COMMITTEE MEMBERS AND ONLY EXECUTIVE COMMITTEE MEMBERS MAY VOTE DURING EXECUTIVE COMMITTEE MEETINGS. MINUTES OF THE EXECUTIVE MEETINGS SHALL BE SUBMITTED TO THE BOARD OF TRUSTEES. THE EXECUTIVE COMMITTEE SHALL ANNUALLY EVALUATE THE CHIEF EXECUTIVE OFFICER'S PERFORMANCE AND RECOMMEND HIS/HER REMUNERATION TO THE FULL BOARD OF TRUSTEES BASED ON THE CHIEF EXECUTIVE OFFICER'S PERFORMANCE IN RELATION TO THE CORPORATION'S OBJECTIVES AND GOALS. THIS COMMITTEE SHALL MEET AS NECESSARY.
FORM 990, PART VI, SECTION A, LINE 6MEMBERSHIP OF THIS CORPORATION SHALL BE OPEN TO ANY NATURAL PERSON WHO MEETS THE FOLLOWING QUALIFICATIONS AT THE TIME OF APPLICATION: 1) IS OF LEGAL VOTING AGE IN MINNESOTA; 2) IS A VOTING RESIDENT WITHIN THE PRIMARY SERVICE AREA OF THE HOSPITAL, BEING DEFINED AS THE COUNTIES OF WATONWAN, BLUE EARTH, BROWN, MARTIN AND NICOLLET, STATE OF MINNESOTA; 3) IS A NATURAL PERSON AND NOT A CORPORATION, PARTNERSHIP OR OTHER ASSOCIATION; 4) SUBMITS A WRITTEN APPLICATION FOR MEMBERSHIP TO THE BOARD OF TRUSTEES ON A FORM APPROVED BY THE BOARD OF TRUSTEES; AND 5) SUBMITS A MEMBERSHIP FEE OF $25 OR MORE, WITH SAID APPLICATION.
FORM 990, PART VI, SECTION A, LINE 7AALL TRUSTEES ARE ELECTED BY THE CORPORATE MEMBERS.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS REVIEWED BY THE GOVERNING BOARD OF TRUSTEES SUBSEQUENT TO FILING THE FORM 990 WITH THE IRS. THE FORM 990 WILL BE PRESENTED BY FINANCE AT THE REGULAR MEETING OF THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 12CTHE CONFLICT OF INTEREST POLICY IS REVIEWED AT THE JANUARY BOARD MEETING BY THE GOVERNING BOARD AND DEPARTMENT MANAGERS. IF ANY CONFLICTS OF INTEREST ARISE, NOTIFICATION IS GIVEN TO ADMINISTRATION. A CONTRACT OR OTHER TRANSACTION THAT MAY INVOLVE A CONFLICT OF INTEREST IS NOT VOID OR VOIDABLE IF: 1) THE CONTRACT OR TRANSACTION WAS FAIR AND REASONABLE AS TO THE CORPORATION WHEN IT WAS AUTHORIZED, APPROVED, OR RATIFIED; 2) ALL MATERIAL FACTS ARE FULLY DISCLOSED TO THE MEMBERS AND THE CONTRACT OR TRANSACTION IS APPORVED BY TWO-THIRDS OF THE MEMBERS ENTITLED TO VOTE, OTHER THAN THE INTERESTED DIRECTOR OR TRUSTEE; AND 3) ALL MATERIAL FACTS ARE FULLLY DISCLOSED TO THE BOARD OF TRUSTEES OR A COMMITTEE, AND THE BOARD OR COMMITTEE APPROVES THE CONTRACT OR TRANSACTION BY A MAJORITY VOTE, BUT THE INTERESTED TRUSTEE MAY NOT TAKE PART IN THE DISCUSSION, AND MAY NOT VOTE.
FORM 990, PART VI, SECTION B, LINE 15MADELIA COMMUNITY HOSPITAL ENSURES THAT THE COMPENSATION PAID TO ITS CEO BE CONSISTENT WITH POLICY AND PROVIDE EQUITABLE STANDARDS FOR WAGE AND BENEFITS BASED ON ANNUAL REGIONAL SURVEY OF COMPARABLE ENTITIES. THE GOVERNING BOARD REVIEWS ANNUALLY THE CEO'S PERFORMANCE AND THE BASIS IS ANNUAL MN HOSPITAL ASSOCIATION SURVEY . THE BOARD DETERMINES THE CEO'S BASE SALARY, IN ITS SOLE DISCRETION. THIS WAS MOST RECENTLY COMPLETED IN 2019. COMPENSATION OF THE OFFICER AND KEY EMPLOYEES IS EVALUATED AND INCREASED ANNUALLY BASED ON PERFORMANCE BY THE CEO. ANNUAL INCREASES ARE BASED ON A REGIONAL SURVERY OF COMPARABLE ENTITIES WITH SIMILAR POSITIONS ALONG WITH YEARS OF SERVICE AND NUMBER SUPERVISED. THE SURVEY RESULTS AND THE EMPLOYEES PERFORMANCE ARE EVALUATED FOR AN INCREASE IF DEEMED APPROPRIATE. THIS WAS MOST RECENTLY COMPLETED IN 2019.
FORM 990, PART VI, SECTION C, LINE 19MADELIA COMMUNITY HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AT THE ANNUAL CORPORATION MEETING AND UPON REQUEST.
FORM 990, PART XI, LINE 9:RECONCILIATION FOR CONTRIBUTION FROM RELATED ENTITY -146,426.
FORM 990, PART XII, LINE 2CTHE ORGANIZATIONS BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF ITS INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEARS.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1MADELIA COMMUNITY HOSPITAL FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1121 DREW AVENUE SEAddressLine1Txt
CityMADELIACityNm
State AbbreviationMNStateAbbreviationCd
ZIP56062ZIPCd
FieldValueIRS element (for citing)
EIN731719218EIN
Primary ActivitiesSOLICIT CONTRIBUTIONS ON BEHALF OF THE MADELIA COMMUNITY HOSPITAL.PrimaryActivitiesTxt
Legal Domicile StateMNLegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 12A, IPublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1MADELIA COMMUNITY HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1MADELIA COMMUNITY HOSPITAL FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeCTransactionTypeTxt
Involved$146,426InvolvedAmt
Method Of Amount DeterminationFMVMethodOfAmountDeterminationTxt