STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

INTERNATIONAL FALLS MEMORIAL HOSPITAL ASSN: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
INTERNATIONAL FALLS MEMORIAL HOSPITAL ASSN (EIN 41-0726171)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-01
IRS object ID
201913059349300606
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)
Return2019-11-01T07:10:39-05:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Eide Bailly LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1800 Nicollet Mall Ste 1300AddressLine1Txt
CityMinneapolisCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554027033ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN410726171EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1International Falls Memorial HospitalBusinessNameLine1Txt
Business Name Line2AssociationBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlINTEBusinessNameControlTxt
Phone2182835401PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11400 Highway 71AddressLine1Txt
CityInternational FallsCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56649ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMelissa MarcottePersonNm
Person TitleCFOPersonTitleTxt
Phone2182835401PhoneNum
Signature2019-10-28SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKim Hunwardsen CPAPreparerPersonNm
PTINP00484560PTIN
Phone6122536500PhoneNum
Preparation2019-10-28PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address216.147.181.49IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-10-28IPDt
IP Tm11:07:57IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdD8A1E5117AA53286D53F57459EBB2DE5C7CA50FCAtSubmissionCreationDeviceId
At Submission Filing Device IdF9BEE9501A3B4F00F190E63700B8BF2BC70C7B96AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-01-14 16:20:31ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Rainy Lake Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerRobert Pastor IIPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11400 Highway 71AddressLine1Txt
CityInternational FallsCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56649ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$27,507,071GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.rainylakemedical.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1945FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionTo promote and provide health care and wellness services in our region that exceed expectations.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee215TotalEmployeeCnt
Total Volunteers32TotalVolunteersCnt
Total Gross UBI$120TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$99,973PYContributionsGrantsAmt
CY Contributions Grants$245,547CYContributionsGrantsAmt
PY Program Service Revenue$27,053,124PYProgramServiceRevenueAmt
CY Program Service Revenue$27,139,015CYProgramServiceRevenueAmt
PY Investment Income$58,460PYInvestmentIncomeAmt
CY Investment Income$53,823CYInvestmentIncomeAmt
PY Other Revenue$66,399PYOtherRevenueAmt
CY Other Revenue$65,943CYOtherRevenueAmt
PY Total Revenue$27,277,956PYTotalRevenueAmt
CY Total Revenue$27,504,328CYTotalRevenueAmt
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$12,716,939PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$12,577,721CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$14,488,963PYOtherExpensesAmt
CY Other Expenses$14,109,030CYOtherExpensesAmt
PY Total Expenses$27,205,902PYTotalExpensesAmt
CY Total Expenses$26,686,751CYTotalExpensesAmt
PY Revenues Less Expenses$72,054PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$817,577CYRevenuesLessExpensesAmt
Total Assets BOY$24,442,231TotalAssetsBOYAmt
Total Assets EOY$26,399,757TotalAssetsEOYAmt
Total Liabilities BOY$9,329,721TotalLiabilitiesBOYAmt
Total Liabilities EOY$10,382,860TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$15,112,510NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$16,016,897NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionProvide accessible quality healthcare to our communities using values of Respect, Integrity, Compassion and Excellence (RICE) in support of the vision comprised of the following elements: provider of choice for our communities, patient and family-centered care, expanding services, regional specialty relationships and preferred healthcare employer.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$23,116,929ExpenseAmt
Revenue$27,138,895RevenueAmt
DescProvided health care services to the community of International Falls and surrounding area. In addition to providing direct patient care and in furtherance of its charitable purpose, Rainy Lake Medical Center (RLMC) provides a wide variety of benefits to the community including offering various community based service programs, cash contributions to non-profit agencies, the donation of space for use by community groups, and staff time of mentoring/job shadowing. Additionally, a number of health related education programs are provided for the benefit of the community, including health enhancements and wellness, classes on specific conditions, and programs designed to improve the general standards of the health of the community. RLMC also actively promotes its community care program, which provides free or reduced cost healthcare to patients who are unable to pay fully for services received.Desc
Total Program Service Expenses$23,116,929TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
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 Bonds0TaxExemptBondsInd
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 Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document72IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee215EmployeeCnt
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 Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
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
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Melissa MarcotteBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2182835431PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11400 Highway 71AddressLine1Txt
CityInternational FallsCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56649ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Susan Congrave
Chair4.000.00Yes (X)Yes (X)$0$0$0
Jon Talsness MD
Vice Chair4.000.00Yes (X)Yes (X)$0$0$0
Brian Briggs
Secretary4.002.00Yes (X)Yes (X)$0$0$0
Don Billig
Treasurer4.000.00Yes (X)Yes (X)$0$0$0
Robert Anderson
Member4.000.00Yes (X)$0$0$0
Richard Peterson
Member4.002.00Yes (X)$0$0$0
Steven Lindberg
Member4.000.00Yes (X)$0$0$0
Robert Pastor II
CEO (as of Aug 2018)40.001.00Yes (X)$123,097$0$6,300
Bonnie Erickson
CEO (thru Aug 2018)40.001.00Yes (X)$164,520$0$0
Melissa Marcotte
CFO40.001.00Yes (X)$138,638$0$3,091
Jay Knaak
Physician40.000.00$280,309$0$35,440Yes (X)
Kimberly Versteeg
Physician40.000.00$242,940$0$30,055Yes (X)
Nancy Burmeister
Nurse Practioner40.000.00$145,996$0$15,534Yes (X)
Rio Silvernail
Physician Assistant40.000.00$135,528$0$14,539Yes (X)
Katie Chezick
Pharmacy Director40.000.00$131,145$0$23,641Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,362,173TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$128,600TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K17IndivRcvdGreaterThan100KCnt
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
Acute Care Inc
1609 N Ankeny Blvd Suite 200AnkenyIA50023Physician Fees$1,725,213
Kraus-Anderson Construction Co
206 Beltrami Ave NWBemidjiMN56601Construction Contractor$781,493
Central MN Diagnostic Inc
525 10th St NE/PO Box 158MilacaMN56353CT, Ultrasound, Mammography, MRI Lease$728,108
RC Shefland Anesthesia LTD
27040 Cty Road 9BemidjiMN56601Anesthesiologist Fees$485,406
Aureus Radiology LLC
CA Industries PO Box 3037OmahaNE68103Contract Labor$323,746
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K17CntrctRcvdGreaterThan100KCnt
Related Organizations$45,158RelatedOrganizationsAmt
Government Grants$184,617GovernmentGrantsAmt
All Other Contributions$15,772AllOtherContributionsAmt
Total Contributions$245,547TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient Service Revenue621990$26,858,826$26,858,826
Equity in Earnings of JV621990$187,727$187,727

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$92,462TotalRevenueColumnAmt
Related Or Exempt Func Income$92,342RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$120UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$27,139,015TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$51,609TotalRevenueColumnAmt
Exclusion$51,609ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$65,943RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$65,943RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$65,943TotalRevenueColumnAmt
Exclusion$65,943ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$2,757SecuritiesAmt
Other$2,200OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$2,743SecuritiesAmt
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$14SecuritiesAmt
Other$2,200OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,214TotalRevenueColumnAmt
Exclusion$2,214ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$27,504,328TotalRevenueColumnAmt
Related Or Exempt Func Income$27,138,895RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$120UnrelatedBusinessRevenueAmt
Exclusion$119,766ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$437,400TotalAmt
Management And General$437,400ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$10,044,793TotalAmt
Program Services$9,261,683ProgramServicesAmt
Management And General$783,110ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$184,808TotalAmt
Program Services$165,879ProgramServicesAmt
Management And General$18,929ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,159,312TotalAmt
Program Services$1,030,186ProgramServicesAmt
Management And General$129,126ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$751,408TotalAmt
Program Services$664,454ProgramServicesAmt
Management And General$86,954ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$23,637TotalAmt
Management And General$23,637ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$32,887TotalAmt
Management And General$32,887ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,711,827TotalAmt
Program Services$4,986,343ProgramServicesAmt
Management And General$725,484ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$128,228TotalAmt
Management And General$128,228ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$281,375TotalAmt
Program Services$124,671ProgramServicesAmt
Management And General$156,704ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$386,963TotalAmt
Program Services$386,963ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$26,799TotalAmt
Program Services$21,264ProgramServicesAmt
Management And General$5,535ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$60,948TotalAmt
Program Services$37,836ProgramServicesAmt
Management And General$23,112ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$267,316TotalAmt
Program Services$184,448ProgramServicesAmt
Management And General$82,868ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,490,401TotalAmt
Program Services$1,028,377ProgramServicesAmt
Management And General$462,024ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$109,800TotalAmt
Program Services$75,762ProgramServicesAmt
Management And General$34,038ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$3,371,369$3,371,227$142
Bad Debts$828,093$828,093
Repairs and Maintenance$592,917$295,374$297,543
MN Care Tax$224,755$224,755

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$571,715TotalAmt
Program Services$429,614ProgramServicesAmt
Management And General$142,101ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$26,686,751TotalAmt
Program Services$23,116,929ProgramServicesAmt
Management And General$3,569,822ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$4,376,027BOYAmt
EOY$5,126,303EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,897,856BOYAmt
EOY$3,779,088EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$511,421BOYAmt
EOY$566,603EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$193,830BOYAmt
EOY$158,032EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$26,565,110LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$12,363,735LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$13,970,873BOYAmt
EOY$14,201,375EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,902,207BOYAmt
EOY$1,925,592EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$590,017BOYAmt
EOY$642,764EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$24,442,231BOYAmt
EOY$26,399,757EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,464,489BOYAmt
EOY$2,495,135EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$5,623,070BOYAmt
EOY$6,757,011EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,242,162BOYAmt
EOY$1,130,714EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,329,721BOYAmt
EOY$10,382,860EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$15,041,165BOYAmt
EOY$16,002,814EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$71,345BOYAmt
EOY$14,083EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$15,112,510BOYAmt
EOY$16,016,897EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$24,442,231BOYAmt
EOY$26,399,757EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$817,577ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$12,673NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$99,483OtherChangesInNetAssetsAmt
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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other OrganizationsYes (1)GrantsOtherOrganizationsInd
Grants Other Organizations$443GrantsOtherOrganizationsAmt
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other Activities0OtherActivitiesInd
Total Lobbying Expenditures$443TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationThe organization pays dues to various professional organizations. A portion of these dues are used towards lobbying expenses. The lobbying expenses go towards advocating for the organization's purpose and mission.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$87,371OtherCostOrOtherBasisAmt
Book Value$87,371BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$17,001,383OtherCostOrOtherBasisAmt
Depreciation$5,111,042DepreciationAmt
Book Value$11,890,341BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$782,191OtherCostOrOtherBasisAmt
Depreciation$349,025DepreciationAmt
Book Value$433,166BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,642,305OtherCostOrOtherBasisAmt
Depreciation$6,903,668DepreciationAmt
Book Value$1,738,637BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$51,860OtherCostOrOtherBasisAmt
Book Value$51,860BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$14,201,375TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Asset Retirement Obligation$18,550
Estimated Third-Party Payor Settlements$1,112,164
FieldValueIRS element (for citing)
Total Liability$1,130,714TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$26,744,844TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$12,673NetUnrealizedGainsInvstAmt
Other Revenue-$744,611OtherRevenueAmt
Revenue Not Reported-$757,284RevenueNotReportedAmt
Revenue Subtotal$27,502,128RevenueSubtotalAmt
Other Revenues Not Included$2,200OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$2,200RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$27,504,328TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$25,856,458TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included-$2,200OtherExpensesIncludedAmt
Expenses Not Reported-$2,200ExpensesNotReportedAmt
Expenses Subtotal$25,858,658ExpensesSubtotalAmt
Other Expenses Not Included$828,093OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$828,093ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$26,686,751TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part X, Line 2:The Center is organized as a Minnesota nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Center is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Center is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Center files an Exempt Organization Business Income Tax Return (Form 990T) with the IRS to report its unrelated business taxable income. The Center believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Center would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred.
Part XI, Line 2d - Other Adjustments:Provision for Bad Debts included in revenue for financial statement -828,093. Change in unrecognized pension costs 99,483. Foundation net inc/(loss) recorded in temp. restricted contribution income -16,001.
Part XI, Line 4b - Other Adjustments:Gain on disposal of Equipment reported in Expenses for Financial Statement 2,200.
Part XII, Line 2d - Other Adjustments:Gain on disposal of Equipment reported in Expenses for Financial Statement -2,200.
Part XII, Line 4b - Other Adjustments:Provision for Bad Debts included in revenue for financial statement 828,093.

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
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
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$57,487TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$57,487NetCommunityBenefitExpnsAmt
Total Expense0.00220TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$57,487TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$57,487NetCommunityBenefitExpnsAmt
Total Expense0.00220TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$24,195TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,455DirectOffsettingRevenueAmt
Net Community Benefit Expns$21,740NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,111TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$9,111NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,474,587TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,033,052DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,441,535NetCommunityBenefitExpnsAmt
Total Expense0.17180TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,800TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,800NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,510,693TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,035,507DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,475,186NetCommunityBenefitExpnsAmt
Total Expense0.17310TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,568,180TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,035,507DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,532,673NetCommunityBenefitExpnsAmt
Total Expense0.17530TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,428TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$5,428NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$27,860TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$27,860NetCommunityBenefitExpnsAmt
Total Expense0.00110TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$20,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$20,000NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$53,288TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$53,288NetCommunityBenefitExpnsAmt
Total Expense0.00210TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$828,093BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$5,722,879ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$5,832,421CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$109,542MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
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 Line1Rainy Lake Medical CenterBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11400 Highway 71AddressLine1Txt
CityInternational FallsCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56649ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.rainylakemedical.comWebsiteAddressTxt
State License365894StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
Other2 Rural Health Clinics/Specialty Provider-Based ClinicOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Rainy Lake Medical CenterBusinessNameLine1Txt
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 Conducted16CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttps://www.rainylakemedical.comOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLhttps://www.rainylakemedical.comStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Other MethodYes (X)OtherMethodInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttp://rainylakemedical.com/patient-resources/FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttps://www.rainylakemedical.com/patient-resources/FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttp://rainylakemedical.com/patient-resources/FAPSummaryOnWebsiteURLTxt
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
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
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Rainy Lake Medical CenterPart V, Section B, Line 5: RLMC identified and surveyed 29 key community stakeholders representing a broad section of the community including local service providers, members of the religious community, business owners, and citizens from International Falls and the greater county. The agencies represented included those serving the medically underserved, low-income and minority populations of International Falls and Koochiching County. RLMC conducted two separate surveys: the first to obtain opinions regarding RLMC's success in implementing actions subsequent to its 2013 Community Needs Assessment, and the second survey asked for input on the current state of health in the community, what needs are unmet and which are of high priority.
Rainy Lake Medical CenterPart V, Section B, Line 6b: Quorum Health Resources assisted with the development of RLMC's Community Health Needs Assessment.
Rainy Lake Medical CenterPart V, Section B, Line 11: Actions taken during 2018 to address the identified needs for Accessibility and Affordability, Pre-existing conditions and improved Emergency Room Services include:-The expansion/improvement of the chemotherapy/infusion therapy department with a $1.5M renovation of their space.-The rollout of a Nurse Practitioner Hospitalist program which relieved the ER physicians from serving in a dual role and also improved RLMC's admit vs. transfer rate-Continued focus on enhancing the current EHR by installing the CPSI MUE bundle -Reaching agreement and establishing processes with Essentia Health to allow mutual access to viewing patient records through EpicCare Link.The following are community needs thatwere identified during the 2016 Community Health Needs Assessment but notaddressed by RLMC:1. Mental Health/Suicide (duplication of effort with local Essentia HealthClinic and other community Mental Health providers).2. Substance Abuse (outside of RLMC's mission)3. Alzheimer's (duplication of services with other community providers andoutside of RLMC's mission).
Rainy Lake Medical CenterPart V, Section B, Line 15e: The contact phone number is listed on the website and provided in all statements and letters mailed, and a business card is included in the application packet.
Rainy Lake Medical CenterPart V, Section B, Line 16j: Work closely with County services and community senior advocate.

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 6a:RLMC makes its community benefit data available to the public by including it in their audited financial statements and through the Minnesota Hospital Association Annual Report.
Part I, Line 7:Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Community health improvement services, line 7e, Health Professions Education, line 7f and Cash and in-kind contributions, line 7i, are reported based on actual expense amounts recorded in the general ledger. The cost for subsidized health services, line 7g, was determined using the Cost Report.
Part I, Line 7g:Costs of the Specialty Clinic included are $1,341,462 for salaries, supplies and overhead allocations
Part I, Ln 7 Col(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 $828,093.
Part II, Community Building Activities:RLMC invests resources towards emergency preparedness, particularly a "decontamination team" that conducts drills throughout the year. The team is skilled in setting up a portable decontamination tent, dressing in an appropriate level of PPE and practicing decontaminating patients. RLMC also supports efforts to have the safe removal and treatment of garbage and waste products. RLMC also provides support to an educational institution in the area to help train health professionals.
Part III, Line 2:For receivables associated with self-pay accounts, a provision for bad debts is recorded in the period of service based on past experience.
Part III, Line 4:The footnote that describes bad debt expense is found on page 10 of the attached audit report.
Part III, Line 8:RLMC is a critical access hospital. There was a shortfall for 2018due to sequestration. Even though Medicare was at a loss, the Hospitalprovides services to these patients because access to healthcare andindividual's health is important to the Hospital. Therefore, the Medicareshortfall is considered a community benefit.Medicare allowable costs were obtained from the 2018 Medicare cost report.The Medicare Cost Report is completed based on the rules and regulations set forth by the Centers for Medicare and Medicaid Services.
Part III, Line 9b:RLMC will not refer an account to a third party debt collection agency unless RLMC has given the patient reasonable opportunity to submit a community care application if the facts and circumstances suggest the patient may be eligible for community care, including for example, if the patient is uninsured or is on Minnesota Care, Medical Assistance, or other relief based on need. If a patient submits an application for community care after an account has been referred for collection activity, RLMC will suspend all collection activity until the patient's application has been processed and the patient has been notified of the decision.
Part VI, Line 2:In addition to the Community Health Needs Assessment completed every 3 years, community health fairs are held where community members can provide feedback on their health care needs. A Patient & Family Advisory Council (PFAC) has also been formed which provides a link between the community and the organization. RLMC also has representation at the quarterly Community Mental Health meeting, which also includes social services, local mental health providers and law enforcement. The goal of the group is to share resources and address the local mental health needs.
Part VI, Line 3:RLMC has staff that are Minnesota Community Application Agent (MNCAA) certified, which enables us to assist our patients with the Minnesota Care application process. RLMC communicates to patients our Community Care Program (Charity Care) in the following manner:1. Patients are given a Community Care brochure with a Minnesota Care insert at time of service.2. Statements and letters sent to patients offering Community Care.3. Phone calls are made to patients to discuss and offer Community Care and assistance with the Minnesota Care application process.4. All employees are educated annually about our Community Care program and three employees are educated to complete and submit Minnesota Care applications to the state for processing.5. Upon request, Community Care packets with applications for both our Community Care Program and the Minnesota Care Insurance are sent or given to patients.6. The RLMC website displays payment options where our Community Care Program is discussed. 7. One of the requirements for RLMC Community Care is a denial from the county in regards to financial assistance unless they are enrolled in the MN Senior Program. We offer to assist them with their Medical Assistance application.8. Signage communicating the Program to patients is displayed in many areas of the patient care area of the facility.9. Financial Counselors attend health fairs and other events in the community to promote the Program and answer any questions.
Part VI, Line 4:RLMC's primary service area (PSA) is Koochiching County, Minnesota. The county is large and sparsely populated (less than 4.3 persons per square mile) with most of the population centered in International Falls. Other nearby communities includes Littlefork, Big Falls, Ranier, Birchdale and Loman. The PSA has an estimated population of less than 13,000 and population decline is projected to continue while the number of persons over 65 is expected to rise even more.
Part VI, Line 5:Representation on the Board of Trustees is 100% local as all trustees are active and involved members of the local community. RLMC has in place an open medical staff model, and has specialists from several different health care systems providing care to patients. The organization has recently invested over $8 million in expansion and renovation of the current facility in order to provide better patient care and more local care, eliminating the need to travel 100+ miles to receive care. The organization also continues to expand the breadth of specialty services offered locally on an outreach basis.Emergency services are offered 24/7, 365 days a year to all needing care.Because of its remote location, if services of Chemotherapy and Labor/Delivery were not offered in the community, residents would have to travel 100+ miles to receive these critical services. The organization recently established a Patient & Family Advisory Council (PFAC) to allow for community input.
Part VI, Line 7, Reports Filed With StatesMN

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
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 (6 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Bonnie Erickson
CEO (thru Aug 2018)$142,308$0$0$0$22,212$0$0$0$0$0$164,520$0$0$0
Jay Knaak
Physician$273,309$0$5,000$0$2,000$0$5,400$0$31,444$0$317,153$0$0$0
Kimberly Versteeg
Physician$242,940$0$0$0$0$0$4,856$0$26,603$0$274,399$0$0$0
Nancy Burmeister
Nurse Practioner$126,668$0$19,328$0$0$0$2,967$0$13,971$0$162,934$0$0$0
Rio Silvernail
Physician Assistant$113,438$0$22,090$0$0$0$2,742$0$13,147$0$151,417$0$0$0
Katie Chezick
Pharmacy Director$125,881$0$0$0$5,264$0$2,833$0$22,211$0$156,189$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 1The Executive Committee will consist of the Chair, the Vice Chair, the Secretary and the Treasurer elected by the Board of Trustees at its first meeting after election. The Chair shall serve as chair of the Executive Committee. The Executive Committee will have the power to transact all regular business of the Medical Center, as authorized by the full Board, during the interim between meetings of the Board of Trustees, provided any action taken will not conflict with the policies and expressed wishes of the Board of Trustees, and that it will refer all matters of major importance to the Board of Trustees.
Form 990, Part VI, Section B, line 11bThe Form 990 is prepared by the same accounting firm which prepares the audit and then it is reviewed by the CFO and CEO. In addition, a copy of the return is provided to the Board of Trustees for review before it is filed with the IRS.
Form 990, Part VI, Section B, line 12cThe Organization's officers, directors, and key employees are reminded of the conflict of interest policy and must sign a conflict of interest statement annually. When a conflict of interest exists, the interested trustee may be present for discussion to answer questions, but may not advocate for the action to be taken and may be asked to leave the room while a vote is taken.
Form 990, Part VI, Section B, line 15The compensation for the CEO is set by the Board of Directors and is documented in the board minutes and CEO's written contract. To set the CEO's compensation, RLMC uses three external reports for determining and setting salary ranges. These include the Minnesota Hospital Association Salary Survey Report, the "HHRAM" (Healthcare Human Resources Association of Minnesota) Salary Survey Book, and the Medical Group Management Associate (MGMA) Physician Compensation Report Survey. The compensation for other officers and key employees is reviewed and approved by the CEO. HHRAM Salary Survey is used in determining these salaries as well as longevity and performance evaluations. These decisions are documented in the employee's personnel file. All reviews are performed as least annually.
Form 990, Part VI, Section C, line 19The governing documents, financial statements, and conflict of interest policy are not open to the public.
Form 990, Part IX, line 11gContracted Services: Program service expenses 885,543. Management and general expenses 3,240. Fundraising expenses 0. Total expenses 888,783. Purchased Services: Program service expenses 644,373. Management and general expenses 493,216. Fundraising expenses 0. Total expenses 1,137,589. Physician Fees: Program service expenses 2,389,724. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,389,724. Other Fees: Program service expenses 29,137. Management and general expenses 196,629. Fundraising expenses 0. Total expenses 225,766. Equipment Rent: Program service expenses 1,037,566. Management and general expenses 32,399. Fundraising expenses 0. Total expenses 1,069,965.
Form 990, Part XI, line 9:Change in unrecognized pension costs 99,483.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1Falls Memorial Hospital Foundation IncBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11400 Highway 71AddressLine1Txt
CityInternational FallsCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56649ZIPCd
FieldValueIRS element (for citing)
EIN204585807EIN
Primary ActivitiesSupportPrimaryActivitiesTxt
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 Line1Rainy Lake Medical CenterBusinessNameLine1Txt
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 Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd