2019-10-09T16:29:50-07:00 2018-09-30 990 2017-10-01 411763968 PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES INC PRAI 2186857300 1411 HIGHWAY 79 EAST ELBOW LAKE MN 56531 Danielle Lesmeister CEO 2186857337 2019-10-10 206.183.181.183 2017 2019-02-21 02:37:17Z DANIELLE LESMEISTER CEO 1411 HIGHWAY 79 EAST ELBOW LAKE MN 56531 17980113 0 X www.prairiehealth.org X 1993 MN An acute care hospital and ambulatory outpatient facility. 7 6 156 0 0 0 70859 163681 19923913 17440494 125164 119854 800 256084 20120736 17980113 0 0 0 0 5673438 6300635 0 0 0 13430307 12169956 19103745 18470591 1016991 -490478 32955197 31327904 24701469 23539375 8253728 7788529 Serving the healthcare needs of the people. 0 0 15808836 0 17440494 Prairie Ridge Hospital and Health Services (PRHHS) maintains and operates a hospital and an ambulatory outpatient facility for the care and treatment of the sick, diseased, disabled, aged or indigent persons and participates in various activities to promote the general health of the community. PRHHS operates various provider based clinics in Elbow Lake, Morris, Ashby, Evansville, Hoffman and Herman and a provider based surgery department in Morris, Minnesota. 0 0 0 15808836 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 23 0 1 156 1 0 0 0 0 0 0 0 0 0 0 X 7 6 1 0 0 0 1 1 1 1 0 1 0 1 1 1 1 1 1 0 0 0 MN X X X PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES 2186857300 1411 HIGHWAY 79 EAST ELBOW LAKE MN 56531 Gene Wenstrom Chair 2.5 6 X X 1110 0 0 Jay McNamar Vice Chair & Secretary 1.5 0 X X 1110 0 0 Dustin Sperr Director 2.4 0 X 1110 0 0 Gary Spies Director 1.5 7.00 X 1110 0 0 Richard Lambert Director 1.5 4.00 X 0 0 0 Jeff Dreier Director 1.50 0.2 X 0 0 0 Jeanne Ennen Director 1.5 0 X 0 0 0 Danielle Lesmeister CEO 40 0 X 0 0 0 Brett Longtin Former CFO 0 40 X X 0 274192 13368 Barbara Moore Physical Therapist 40 0 X 109301 0 3895 Renae Lien Pharmacy Director 40 0 X 127531 11442 9529 241272 285634 26792 2 1 1 0 Lake Region Healthcare Co 712 S Cascade St Fergus Falls MN 56538 Professional/Physician Services 3148761 West Central Internal Medicine PO Box 410 Morris MN 56267 Physician Services 494306 Morris Electronics Inc 511 Atlantic Ave Morris MN 56267 IT Services 272128 DMS Imaging Inc PO Box 670747 Dallas TX 75267 Radiology Services 263498 Technical Life Care Medical Co 2720 Mounds View Blvd Suite 100 Mounds View MN 55112 Biomedical Services 215755 10 0 0 0 0 9918 153763 0 163681 Net Patient Service Revenue 622110 15996482 15996482 0 0 Pharmacy 340B Services 446110 1444012 1444012 0 0 0 0 0 0 17440494 112944 112944 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6910 0 0 0 6910 6910 6910 0 0 0 MISCELLANEOUS REVENUE 622000 130759 130759 0 0 CAFETERIA REVENUE 622000 97490 97490 0 0 MEDICAL COPIES REVENUE 622000 9574 9574 0 0 18261 18261 0 0 256084 17980113 17816432 0 0 X 0 0 0 0 0 0 0 0 0 0 0 0 4085 0 4085 0 5428388 4336106 1092282 0 107641 85982 21659 0 398647 318433 80214 0 361874 281178 80696 0 0 0 0 0 -66486 0 -66486 0 95253 0 95253 0 0 0 0 0 0 0 0 0 0 0 5069302 4021960 1047342 0 58474 0 58474 0 496574 450031 46543 0 0 0 0 0 0 0 0 0 396089 314176 81913 0 29225 29225 0 0 0 0 0 0 77078 61006 16072 0 811484 811484 0 0 0 0 0 0 1822289 1822289 0 0 116218 116218 0 0 Medical Supplies 2224058 2224046 12 0 Repairs & Maintenance 423931 423106 825 0 Bad Debt Expense 294592 294592 0 0 MN Health Tax 165762 165762 0 0 156113 53242 102871 0 18470591 15808836 2661755 0 4792212 3258032 565711 566576 0 0 4131843 3747717 0 0 0 0 0 0 253221 212034 195295 206880 29179466 10288268 20221999 18891198 2017491 3637554 48452 44574 0 0 0 0 728973 763339 32955197 31327904 1673574 2031458 0 0 0 0 0 0 0 0 0 0 22042095 21507917 0 0 985800 0 24701469 23539375 X 7952102 7535128 72078 23853 229548 229548 8253728 7788529 32955197 31327904 -490478 25279 0 0 0 0 X 0 1 X 1 0 X 301626 0 26774 0 75000 0 253400 283824 0 17802 0 0 0 301626 270034 0 13790 0 0 0 283824 315032 0 -4998 0 40000 0 270034 309625 0 5407 0 0 0 315032 0 0.906 0.094 0 0 0 570277 570277 0 21673431 5143842 16529589 0 0 0 0 0 6927938 5144426 1783512 0 7820 0 7820 18891198 Assets Limited to Use 763339 763339 0 0 X 17560364 25279 0 0 -294592 -269313 17829677 0 150436 150436 17980113 18175999 0 0 0 0 0 18175999 0 294592 294592 18470591 Schedule D, Part V, Line 4 Endowment funds are intended to earn investment income. The investment income is intended to be used for funding capital expenditures. Schedule D, Part X, Line 2 PRHHS 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). PRHHS is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, PRHHS is subject to income tax on net income that is derived from business activities that are unrelated to their exempt purpose. PRHHS has determined they are not subject to unrelated business income tax and has not filed an Exempt Organization Business Income Tax Return (Form 990T) with the IRS. PRHHS 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. PRHHS 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. Schedule D, Part XI, Line 2d Bad Debt Expense is included in Revenue on the Financial Statements of $294,592. Schedule D, Part XI, Line 4b There was a grant received of $125,157 and a Release from Restricted Net Assets of $75,000 that is reported as Revenue on the 990 but are considered a change in net assets on the audited financial statements. Schedule D, Part XII, Line 4b Bad Debt Expense Included in Expenses on the Financial Statements of $294,592. 1 1 X 1 X 1.75 1 X 2.15 1 0 1 1 0 0 37000 0 37000 0.002 0 0 2412205 1853059 559146 0.033 0 0 0 0 0 0 0 0 2449205 1853059 596146 0.035 0 0 14372 0 14372 0.0008 0 0 96076 0 96076 0.0053 0 0 5950238 4076763 1873475 0.1031 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6060686 4076763 1983923 0.1092 0 0 8509891 5929822 2580069 0.1442 0 0 0 0 0 0 0 0 4810 0 4810 0.0003 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 330 0 0 0 5140 0 5140 0.0003 0 294592 36529 7462876 7472301 -9425 X 1 1 1 1 Prairie Ridge Hospital & Health Services 1411 Highway 79 East Elbow Lake MN 56531 www.prairiehealth.org 00154 X X X X 5 provider based clinics Prairie Ridge Hospital & Health Services 1 0 0 1 X X X X X X X X X 15 1 0 0 1 X https://www.prairiehealth.org/about-us/community-health-needs-assessment/ X 1 15 1 https://www.prairiehealth.org/about-us/community-health-needs-assessment/ 0 0 1 X 175 215 X X X 1 1 X X X X 1 X https://www.prairiehealth.org/patients-visitors/financial-assistance/ X https://www.prairiehealth.org/patients-visitors/financial-assistance/ X https://www.prairiehealth.org/patients-visitors/financial-assistance/ X X X X X X 1 X 0 X X X 1 X 0 1 Schedule H, Part V, Section B, Line 5-Prairie Ridge Hospital & Health Services We put together a committee of community members comprised of: A Prairie Ridge board member, area director of public health, a licensed social worker with an area nursing home, a branch manager with a home healthcare agency, the facilitator with a child and youth council, the counselor for the area school district, a former teacher, the county social services director, and the dean of students for the local school district. We met several times in order to identify what needs our area has. We also conducted a public survey via handout and the internet in order to get outside feedback. Schedule H, Part V, Section B, Line 7a-Prairie Ridge Hospital & Health Services https://www.prairiehealth.org/about-us/community-health-needs-assessment/ Schedule H, Part V, Section B, Line 7d-Prairie Ridge Hospital & Health Services https://www.prairiehealth.org/about-us/community-health-needs-assessment/ Schedule H, Part V, Section B, Line 11-Prairie Ridge Hospital & Health Services The Hospital is addressing the needs listed below which were identified in the 2015 tax year CHNA. 1) Preventative Care - Prairie Ridges holds a free monthly diabetic education support group that covers a variety of topics for those who have diabetes and their loved ones. Through the diabetic education program, we offer a free membership to the Prairie Ridge Fitness to qualifying members. Prairie Ridge works with Lake Region Healthcare dieticians on addressing dietary issues in the community and with our patients. Prairie Ridge has put into place additional screening for well child exams to identify potential issues early on. Prairie Ridge contracts with 5 area school districts to provide school nursing. 2) Aging Population - Prairie Ridge hired a nurse specifically to work with our aging population to provide annual wellness visit reminders. Chronic Care Management provides a care coordinator for patients with multiple diagnoses who visits area senior groups to educate them on services available to them. Prairie Ridge has partnered with the PAD PRAIRIE initiative and has received training to perform screenings on patients to better diagnose PAD. Prairie Ridge has promoted awareness of the PAD program through community events and facilitated screenings for identification of PAD in patients. We have implemented Transitional Care Management which helps manage the care of patients after discharge. Prairie Ridge offers swing bed services. Prairie Ridge does not plan to engage in any additional programs related to elderly care during the current period as it is not currently in a financial position to address this issue. In addition, as noted above, others in the community currently are addressing it. 3) Mental and Behavioral Health Services - Prairie Ridge conducts continued education with staff in dealing with mental health and behavior health patients. Prairie Ridge partnered with Lake Region Healthcare to implement and provide mental health services locally via telemedicine at Prairie Ridge in Elbow Lake. Prairie Ridge is working on policies and procedures to turn one of our hospital rooms into a safe room for mental health and behavior health patients to help create a safe environment for our patients dealing with mental and/or behavioral health issues. Prairie Ridge will continue to contract with Lake Region Healthcare Bridgeway Behavioral Health to provide services for patients with mental/behavioral health issues. Prairie Ridge will continue to ensure practitioners are aware of the signs of mental health issues and encourage them to refer to specialists. Prairie Ridge will continue to educate patients about the services available to them. 4) Transportation - Prairie Ridge educates patients as to what services are available to them to help them with transportation. Prairie Ridge does not plan to engage in any additional programs related to transportation during the current period as it is not currently in a financial position to address this issue. In addition, as noted above, others in the community currently are addressing it. 5) Dental Care for Low Income Families Current activities - Prairie Ridge helps promote the free dental services that are offered for area families. Prairie Ridge does not plan to engage in any additional programs related to Dental Care during the current period as it is not currently in a financial position to address this issue. Schedule H, Part V, Section B, Line 16a-Prairie Ridge Hospital & Health Services https://www.prairiehealth.org/patients-visitors/financial-assistance/ Schedule H, Part V, Section B, Line 16b-Prairie Ridge Hospital & Health Services https://www.prairiehealth.org/patients-visitors/financial-assistance/ Schedule H, Part V, Section B, Line 16c-Prairie Ridge Hospital & Health Services https://www.prairiehealth.org/patients-visitors/financial-assistance/ Schedule H, Part V, Section B, Line 16j-Prairie Ridge Hospital & Health Services The Hospital provided a summary of the financial assistance policy with the patient billing invoices, posted a summary in the emergency rooms and waiting rooms, as well as the admissions office and their website. The full policy was available upon request. Schedule H, Part V, Section B, Line 24-Prairie Ridge Hospital & Health Services The FAP policy does not apply to elective services therefore FAP eligible individuals were charged the gross amount for all elective services. 1 Herman Clinic 204 5th St E Herman MN 56248 Physician Clinic Schedule H, Part I, Line 7 Charity care was converted to cost by multiplying the ratio of cost to charges for PRHHS by the gross uncompensated charges associated with providing charity care to its patients. Medicaid is reported at cost according to the amounts on the Medicaid Cost Report. Community health improvement services and donations are reported based on actual expenses recorded to the general ledger. Subsidized health services are reported according to costs allocated to the relevant cost centers on the Medicare Cost Report. Schedule H, Part I, Line 7, Column f Bad Debt expense of $294,592 in included on Form 990, Part IX Line 25, but excluded in the calculation of the percentage of total expense. Schedule H, Part II PRHHS has allowed community groups to use meeting rooms free of charge to assist in their missions, along with various cash donations given to community organizations. Schedule H, Part III, Section A, Line 2 Bad debt expense on line 2 is reported as charges as presented on the financial statements. A payment on an account previously written off reduces bad debt expense in the current year. Schedule H, Part III, Section A, Line 4 The footnote to the Organization's financial statements can be found on page 9 of the attached audited financial statements. Schedule H, Part III, Section B, Line 8 The costing methodology used to determine the related costs is an adjusted Medicare cost to charge ratio based on the 2018 cost report. Schedule H, Part III, Section C, Line 9b For patients unable to meet the collection guidelines of PRHHS, notice of the Charity Care Program and appropriate forms (including the financial disclosure statement) will be supplied to the patient for completion and consideration in satisfying the balance remaining due. Once the patient begins the application process, PRHHS ceases all collection action on the amounts being considered for financial assistance. If there is a payment made on the account during the application process, the payment is applied directly to the account balance. Individuals are given 240 days to complete the FAP application. Schedule H, Part VI, Line 2 In addition to the CHNA process that took place in tax year 2015, the organization assesses the health care needs of the community based on feedback from physicians. Schedule H, Part VI, Line 3 Information regarding charity care is available in admission areas and in clinic patient rooms. If a patient is past due on a bill, an additional notification is given to the patient to contact the hospital to discuss payment options, including charity care. The hospital provides counseling to patients to help them qualify for Medicaid. Schedule H, Part VI, Line 4 Prairie Ridge Hospital and Health Services service area includes Grant County and surrounding counties in Minnesota. The average age of the population is older than both the state and national averages which leads to a higher than normal percentage of older patients whom the hospital serves. The nearest hospital in the area is approximately 20 miles from Prairie Ridge Hospital and Health Services main campus. Schedule H, Part VI, Line 5 The most tangible wat the Prairie Ridge Hospital and Health Services provides community benefits is through community programs and services. It provides these services as a responsible member of the community. Educational programs, healthcare screenings, support groups, school health services and other community services are provided by Prairie Ridge Hospital to improve the healthcare and quality of life for the people in the community. X X X X X X 0 0 0 0 0 0 0 0 0 Danielle Lesmeister CEO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Brett Longtin Former CFO 0 274192 0 0 0 0 0 0 0 13368 0 287560 0 0 Barbara Moore Physical Therapist 109301 0 0 0 0 0 0 0 3895 0 113196 0 0 0 Renae Lien Pharmacy Director 127531 11442 0 0 0 0 0 0 9529 0 137060 11442 0 0 Form 990, Part VI, Section A, Line 2 Dustin Sperr has a business relationship with PRHHS. Form 990, Part VI, Section A, Line 6 Lake Region Healthcare Corporation ("Lake Region"), a Minnesota nonprofit corporation, is the sole corporate member of the Corporation. Form 990, Part VI, Section A, Line 7a Lake Region has reserved exclusively to itself the power to appoint board members from a slate of candidates nominated by the Corporation's Board. Form 990, Part VI, Section A, Line 7b Lake Region has reserved exclusively to itself the following reserved powers: a. Approval of Operating and Capital Budget recommended by the Corporation's Board; b. Approval of Strategic Plan recommended by the Corporation's Board; c. Approval of any recommendation by the Corporation's Board to substantially change its purpose or mission or transfer of assets; d. Amendment of Articles of Incorporation, Bylaws, and other Corporate Documents; e. Approval of Contracts involving Physicians or other Providers, for compliance purposes only; f. Board member appointment, for a slate of candidates nominated by the Corporation's Board; g. Approval of incurrence of debt in excess of thresholds established by Lake Region policy; h. Approval of joint ventures or partnerships proposed to be entered into by the Corporation; and i. Approval of the creation by the Corporation of any new corporation, limited liability company, or other entity. Form 990, Part VI, Section A, Line 8b Currently the organization does no have any committees with the authority to act on behalf of the governing body. Form 990, Part VI, Section A, Line 9 Gene Wenstrom, 720 Starlight Drive, Sartell, MN 56377; Jay McNamar, 212 8th Ave SE, Elbow Lake, MN 56531; Dustin Sperr, 317 7th Ave SE, Elbow Lake, MN 56531; Gary Spies, 2806 Lakewood Dr, Fergus Falls, MN 56537; Richard Lambert, 106 Riley's River Road, Morris, MN 56267; Jeff Dreier, 26899 Oak Point Road, Elbow Lake, MN 56531; Jeanne Ennen, 51188 150th Street, Donnelly, MN 56235. Form 990, Part VI, Section B, Line 11b The return is to be reviewed by both LRHC and PRHHS CEOs, then followed by a review by the PRHHS Board of Directors prior to filing. Form 990, Part VI, Section B, Line 12c The conflict of interest policy is reviewed on an annual basis by the Board of Directors. Board members, officers, and management personnel are asked to disclose any potential conflicts. Any potential conflicts are reviewed at that time, and any actual conflicts are noted in the meeting minutes. Any person with a conflict is restricted from voting on related matters. Form 990, Part VI, Section B, Line 15 The compensation for the CEO is determined annually by the related organization, Lake Region Healthcare. Independent compensation consultants are engaged for fair market assessments, as well as MHA Salary surveys. Compensation is presented for approval to the Executive Committee of Lake Region Healthcare. Form 990, Part VI, Section C, Line 19 The Organization's governing documents, conflict of interest policy, and financial statements are available to the public upon request. Form 990, Part IX, Line 11g Physician Service Fees $2,271,798, On Call Physician Fees $489,332, Collection Fees $11,309, Outside Laundry Fees $16,089, and Misc Purchased Services $2,280,774. Pharm Care LLC 1411 Highway 79 E Elbow Lake MN 56531 411763968 Retail Pharmacy MN 0 0 Prairie Ridge Hospital and Health Services Inc Prairie Ridge Foundation Inc 1411 Highway 79 E Elbow Lake MN 56531 455092280 Supporting Organization MN 501c3 Line 7 Prairie Ridge Hospital and Health Services Inc 1 Lake Region Healthcare Corporation 712 S Cascade St Fergus Falls MN 56538 410730602 Hospital MN 501c3 Line 3 N/A 0 Lake Region Healthcare Foundation 712 S Cascade St Fergus Falls MN 56538 411677288 Foundation MN 501c3 Line 12a, I Lake Region Healthcare Corporation 0 LRHC Long Term Care Facilities Inc 712 S Cascade St Fergus Falls MN 56538 411817549 Assisted Living MN 501c3 Line 10 Lake Region Healthcare Corporation 0 LRH RAD ONC Services 712 S Cascade St Fergus Falls MN 56538 271322270 Radiation Oncology Services MN N/A Excluded 0 0 0 0 Lake Region Home Medical 712 S Cascade St Fergus Falls MN 56538 464182501 Medical Equipment Sales MN N/A Excluded 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 Lake Region Healthcare Corporation p 3049501 Operating Expenses Prairie Ridge Foundation Inc c 75621 Contribution Amount Given Prairie Ridge Foundation Inc m 75621 Fundraising Contributions Received