MINNESOTA VALLEY HEALTH CENTER INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- MINNESOTA VALLEY HEALTH CENTER INC (EIN 41-0837659)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-15
- IRS object ID
- 201803199349315165
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-15T15:59:42-06:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 217 | AddressLine1Txt |
| City | AUSTIN | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55912 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410837659 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MINNESOTA VALLEY HEALTH CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MINN | BusinessNameControlTxt |
| Phone | 5076653375 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 621 SOUTH 4TH STREET | AddressLine1Txt |
| City | LE SUEUR | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56058 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRENT WORDELMAN | PersonNm |
| Person Title | DIRECTOR OF FINANCE | PersonTitleTxt |
| Phone | 5076653375 | PhoneNum |
| Signature | 2018-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DARRYN MCGARVEY | PreparerPersonNm |
| PTIN | P00958683 | PTIN |
| Phone | 5074347000 | PhoneNum |
| Preparation | 2018-11-15 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.137.57.251 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-11-15 | IPDt |
| IP Tm | 08:33:29 | IPTm |
| IP Timezone | PS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 05EFB997E327CD6BF4CE43E24B4C22289AFA48CE | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 9C3E08EBF53FA5FA3C7B2B5BD0B3E335DF999A73 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RIDGEVIEW LE SUEUR MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHAEL PHELPS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 621 SOUTH 4TH STREET | AddressLine1Txt |
| City | LE SUEUR | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56058 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $12,975,725 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MVHC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1959 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | OUR MISSION IS TO PROVIDE COMMUNITY-BASED HEALTHCARE IN AN ENVIRONMENT THAT FOSTERS DIGNITY, RESPECT AND EXCELLENCE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 189 | TotalEmployeeCnt |
| Total Volunteers | 30 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $46,743 | PYContributionsGrantsAmt |
| CY Contributions Grants | $187,598 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,764,430 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $12,619,961 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,762 | PYInvestmentIncomeAmt |
| CY Investment Income | $14,589 | CYInvestmentIncomeAmt |
| PY Other Revenue | $71,606 | PYOtherRevenueAmt |
| CY Other Revenue | $153,577 | CYOtherRevenueAmt |
| PY Total Revenue | $5,887,541 | PYTotalRevenueAmt |
| CY Total Revenue | $12,975,725 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,125,522 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,336,065 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,337,643 | PYOtherExpensesAmt |
| CY Other Expenses | $6,386,646 | CYOtherExpensesAmt |
| PY Total Expenses | $6,463,165 | PYTotalExpensesAmt |
| CY Total Expenses | $12,722,711 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$575,624 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $253,014 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $12,182,462 | TotalAssetsBOYAmt |
| Total Assets EOY | $12,329,834 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,397,845 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,808,800 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,784,617 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,521,034 | NetAssetsOrFundBalancesEOYAmt |
| Mission | OUR MISSION IS TO PROVIDE COMMUNITY-BASED HEALTHCARE IN AN ENVIRONMENT THAT FOSTERS DIGNITY, RESPECT, AND EXCELLENCE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $10,683,226 | ExpenseAmt |
| Revenue | $12,751,351 | RevenueAmt |
| Desc | MINNESOTA VALLEY HEALTH CENTER, INC. IS CREATED & ORGANIZED EXCLUSIVELY FOR CHARITABLE AND EDUCATIONAL PURPOSES. MINNESOTA VALLEY HEALTH CENTER, INC. IS CREATED AND ORGANIZED TO OWN, MAINTAIN, OPERATE AND CONDUCT, DIRECTLY OR INDIRECTLY, AND TO ASSIST AND COORDINATE ACTIVITIES OF FACILITIES FOR HEALTH CARE, EDUCATION, CARE FOR THE AGED AND SOCIAL SERVICES. MINNESOTA VALLEY HEALTH CENTER, INC. INCLUDES A HOSPITAL, OUTPATIENT SPECIALTY CLINICS, COMPLETE LAB AND RADIOLOGY DEPARTMENTS, A COMPREHENSIVE PHYSICAL OCCUPATIONAL AND SPEECH THERAPY DEPARTMENT, EXTENDED CARE NURSING FACILITIES, AN ADULT DAY HEALTH CENTER, AND INDEPENDENT LIVING SENIOR HOUSING. | Desc |
| Total Program Service Expenses | $10,683,226 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 13 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 189 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PATRICIA SCHLEGEL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5076658683 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 621 SOUTH 4TH STREET | AddressLine1Txt |
| City | LE SUEUR | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56058 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| RANDY BAUM | |||||||
| BOARD PRESIDENT | 10.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ROBERT BROEDER | |||||||
| BOARD SECRETARY/TREASURER | 5.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| STEVE SMITH | |||||||
| BOARD DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| DAVE JOHNSON | |||||||
| BOARD DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| IRENE MANKE | |||||||
| BOARD DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| DAVID BRAUN | |||||||
| BOARD DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JEFF NELSON | |||||||
| BOARD DIRECTOR | 3.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| ROBERT STEVENS | |||||||
| CEO - PART YEAR | 0.50 | 49.50 | Yes (X) | Yes (X) | $0 | $1,656,460 | $32,826 |
| PATRICIA SCHLEGEL | |||||||
| EXECUTIVE DIRECTOR OF FINANCE | 50.00 | 0.00 | Yes (X) | $105,115 | $0 | $14,186 | |
| PAMELA WILLIAMS | |||||||
| VICE PRESIDENT | 60.00 | 0.00 | Yes (X) | $143,394 | $0 | $22,357 | |
| GORDON GABLENZ | |||||||
| CFO | 0.50 | 49.50 | Yes (X) | $0 | $663,997 | $45,865 | |
| MICHAEL PHELPS | |||||||
| CEO | 0.50 | 49.50 | Yes (X) | $0 | $1,450,467 | $37,854 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $248,509 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,770,924 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $153,088 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PREMIER STAFFING | |||||
| 243 WINKLER WAY | COLOGNE | MN | 55322 | ER PHYSICIAN SERVICES | $1,157,693 |
| AEGIS THERAPIES INC | |||||
| PO BOX 8103 | FORT SMITH | AR | 72902 | THERAPY SERVICES | $539,759 |
| OMNICARE PHARMACY | |||||
| PO BOX 715268 | COLUMBUS | OH | 43271 | PHARMACY SERVICES | $278,815 |
| ESSENTIA CORPORATE | |||||
| 502 E SECOND STREET | DULUTH | MN | 55805 | SUPPORT FEE FOR EPIC | $150,997 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $34,664 | RelatedOrganizationsAmt |
| All Other Contributions | $152,934 | AllOtherContributionsAmt |
| Total Contributions | $187,598 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT/RESIDENT REVENUE | 621110 | $12,342,139 | $12,342,139 |
| APARTMENT PROJECT REVENUES | 623000 | $277,822 | $277,822 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $12,619,961 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,089 | TotalRevenueColumnAmt |
| Exclusion | $10,089 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $22,187 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $22,187 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $22,187 | TotalRevenueColumnAmt |
| Exclusion | $22,187 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $4,500 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $4,500 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,500 | TotalRevenueColumnAmt |
| Exclusion | $4,500 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MISCELLANEOUS INCOME | 900099 | $103,552 | $103,552 |
| DIETARY INCOME | 900099 | $27,838 | $27,838 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $131,390 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,975,725 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,751,351 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $36,776 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $285,052 | TotalAmt |
| Management And General | $285,052 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,561,960 | TotalAmt |
| Program Services | $4,034,877 | ProgramServicesAmt |
| Management And General | $527,083 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,154,777 | TotalAmt |
| Program Services | $900,951 | ProgramServicesAmt |
| Management And General | $253,826 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $334,276 | TotalAmt |
| Program Services | $334,276 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,033 | TotalAmt |
| Management And General | $1,033 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,100 | TotalAmt |
| Management And General | $75,100 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,680 | TotalAmt |
| Program Services | $75,680 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,614 | TotalAmt |
| Management And General | $24,614 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,791 | TotalAmt |
| Program Services | $15,791 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $349,231 | TotalAmt |
| Program Services | $349,231 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $341,687 | TotalAmt |
| Program Services | $341,687 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $793,131 | TotalAmt |
| Program Services | $793,131 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,908 | TotalAmt |
| Program Services | $1,908 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $3,759,285 | $2,977,211 | $782,074 |
| BAD DEBT | $622,441 | $622,441 | |
| REPAIRS AND MAINTENANCE | $217,039 | $217,039 | |
| TAXES AND LICENSES | $102,864 | $12,660 | $90,204 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,842 | TotalAmt |
| Program Services | $6,343 | ProgramServicesAmt |
| Management And General | $499 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,722,711 | TotalAmt |
| Program Services | $10,683,226 | ProgramServicesAmt |
| Management And General | $2,039,485 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $171,678 | BOYAmt |
| EOY | $163,580 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,074,689 | BOYAmt |
| EOY | $3,186,092 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,205,605 | BOYAmt |
| EOY | $2,084,580 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,036 | BOYAmt |
| EOY | $41,682 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,126 | BOYAmt |
| EOY | $19,462 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $14,396,135 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $8,487,577 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,962,151 | BOYAmt |
| EOY | $5,908,558 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $744,177 | BOYAmt |
| EOY | $925,880 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,182,462 | BOYAmt |
| EOY | $12,329,834 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,520,216 | BOYAmt |
| EOY | $987,294 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,680 | BOYAmt |
| EOY | $7,545 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,857,949 | BOYAmt |
| EOY | $5,585,674 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $228,287 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,397,845 | BOYAmt |
| EOY | $6,808,800 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,024,645 | BOYAmt |
| EOY | $4,726,342 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,683 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $711,289 | BOYAmt |
| EOY | $794,692 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,784,617 | BOYAmt |
| EOY | $5,521,034 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,182,462 | BOYAmt |
| EOY | $12,329,834 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $253,014 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $483,403 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $108 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $108 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | MINNESOTA VALLEY HEALTH CENTER, INC PAY DUES TO A CERTAIN ORGANIZATION RELATED TO THE INDUSTRY WHICH HAS LOBBYING EXPENSES. THE AMOUNT LISTED IS THE PERCENTAGE OF THE DUES PAID THAT WERE USED FOR LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $711,289 | BeginningYearBalanceAmt |
| Contributions | $5,050 | ContributionsAmt |
| Investment Earnings Or Losses | $115,650 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $27,879 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $9,417 | AdministrativeExpensesAmt |
| End Year Balance | $794,693 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $704,595 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $6,694 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $711,289 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $755,050 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$12,834 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $28,436 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $9,185 | AdministrativeExpensesAmt |
| End Year Balance | $704,595 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $766,834 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $24,787 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $28,393 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $8,178 | AdministrativeExpensesAmt |
| End Year Balance | $755,050 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $684,685 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $113,698 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $28,341 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $3,208 | AdministrativeExpensesAmt |
| End Year Balance | $766,834 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $46,482 | OtherCostOrOtherBasisAmt |
| Book Value | $46,482 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,456,540 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,511,732 | DepreciationAmt |
| Book Value | $944,808 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,583,673 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,941,239 | DepreciationAmt |
| Book Value | $1,642,434 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,309,440 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,034,606 | DepreciationAmt |
| Book Value | $3,274,834 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,908,558 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| BENEFICIAL INTEREST IN MINNESOTA FO | $794,692 |
| MC COST REPORT EST SETTLEMENT | $131,188 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $925,880 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO RIDGEVIEW | Desc |
| Amt | $228,287 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $228,287 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $12,353,284 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $12,353,284 | RevenueSubtotalAmt |
| Other Revenues Not Included | $622,441 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $622,441 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $12,975,725 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $12,100,270 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $12,100,270 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $622,441 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $622,441 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $12,722,711 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | MINNESOTA VALLEY HEALTH CENTER, INC ACTS AS CUSTODIAN FOR THE FUNDS OF THE RESIDENTS. RESIDENT TRUST FUNDS TOTALED $7,545 AT DECEMBER 31, 2017. DURING THAT SAME TIME MINNESOTA VALLEY HEALTH CENTER, IN HOLDS $15,655 IN A SEPARATE ACCOUNT FOR TENANT SECURITY DEPOSITS. |
| PART X, LINE 2: | THE HEALTH CENTER IS OPERATED AS A TAX-EXEMPT CORPORATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS NOT SUBJECT TO FEDERAL OR STATE INCOME TAX RELATED TO BUSINESS INCOME. THE HEALTH CENTER FOLLOWS THE ACCOUNTING STANDARD FOR RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE HEALTH CENTER'S TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT 622,441. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT 622,441. |
| SCHEDULE D, PART V, LINE 4 | MINNESOTA VALLEY HEALTH CENTER, INC'S INTENDED USE OF ITS ENDOWMENT FUNDS IS FOR CAPITAL AND OTHER IMPROVEMENTS THAT FURTHER MINNESOTA VALLEY HEALTH CENTER, INC'S MISSION. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 160.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 310.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $27,322 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $27,322 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00230 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,420,290 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,078,864 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $655,477 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $572,672 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $82,805 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00680 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,103,089 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,651,536 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $110,127 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00910 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $110,556 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $63,298 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $47,258 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $110,556 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $63,298 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $47,258 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,213,645 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,714,834 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $157,385 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01300 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $622,441 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $156,300 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $4,003,169 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $4,071,195 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$68,026 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MINNESOTA VALLEY HEALTH CENTER INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 621 SOUTH 4TH STREET | AddressLine1Txt |
| City | LE SUEUR | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56058 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.MVHC.ORG | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MINNESOTA VALLEY HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://MVHC.ORG/FILES/9314/8615/3079/MVHC_CHNA_2015_REPORT.PDF | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://MVHC.ORG/FILES/9314/8615/3079/MVHC_CHNA_2015_REPORT.PDF | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 160.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 310.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.MVHC.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://WWW.MVHC.ORG/FILES/5114/0206/1137/FINANCIAL_ASSISTANCE_APP_MAY_2014_ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://WWW.ESSENTIAHEALTH.ORG/MAIN/FINANCIAL-ASSISTANCE-PROGRAM.ASPX | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MINNESOTA VALLEY HEALTH CENTER | PART V, SECTION B, LINE 5: IN SEPTEMBER-OCTOBER 2015, MN VALLEY HEALTH CENTER CONVENED A GROUP OF COMMUNITY MEMBERS AND PARTNERS TO 1)DEVELOP A VISION OF A HEALTHY COMMUNITY, 2)COME TO A COMMON UNDERSTANDING OF THE CURRENT HEALTH STATUS OF THE COMMUNITY, AND 3)IDENTIFY KEY OPPORTUNITIES TO HELP MOVE THE COMMUNITY FROM THE CURRENT STATUS TO THE VISION. ORGANIZATIONS THAT PARTICIPATED IN THE COMMUNITY MEETINGS: MN VALLEY HEALTH CENTER, PUBLIC HEALTH AGENCIES FROM LE SUEUR AND SIBLEY COUNTIES, AND MAYO CLINIC HEALTH SYSTEM - LE SUEUR CLINIC. ALSO INCLUDED IN THE PLANNING WORK WAS THE COMMUNITY CENTER AND SCHOOL DISTRICT. |
| MINNESOTA VALLEY HEALTH CENTER | PART V, SECTION B, LINE 11: AT THE TOP OF THE HEALTH IMPROVEMENT PRIORITIES WERE PHYSICAL ACTIVITY AND HEART HEALTH BASED ON NUMBER OF VOTES RECEIVED. THE COMMITTEE IMPLEMENTED THE STEP UP PROGRAM OVER THE SUMMER MONTHS. THIS PROGRAM ENCOURAGED COMMUNITY MEMBERS TO JOIN THE GROUP FOR AN EVENING WALK ON A PRE-SET COURSE. RESTING BENCHES WERE INSTALLED ALONG THE PAVED PATHWAY FOR THOSE THAT MIGHT NEED IT. LOCAL BUSINESSES TOOK TURNS TO DONATE A PRIZE FOR EACH NIGHT OF WALKING. THE PARTICIPANTS IN THE WALK WE ENCOURAGED TO ENTER THEIR NAME FOR THE DRAWING.EMOTIONAL SUPPORT FOR YOUTH AND CHILDREN AND NUTRITION WERE OTHER NEEDS IDENTIFED THAT MVHC ARE NOT ADDRESSING AT THIS TIME DUE TO THE LACK OF PROFESSIONALS IN THE AREA TO HELP WITH THIS. THE SCHOOL WAS GOING TO RESEARCH THEIR RESOURCES FOR ASSISTANCE RELATED TO THESE NEEDS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - MINNESOTA VALLEY CARE CENTER | ||||
| 621 SOUTH 4TH STREET | LE SUEUR | MN | 56058 | SKILLED NURSING FACILITY |
| 2 - SUNRIZE PLAZA | ||||
| 600 SOUTH 5TH STREET | LE SUEUR | MN | 56058 | SENIOR APARTMENTS |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | ASSETS WILL BE CONSIDERED ALONG WITH THE PATIENTS INCOME TO DETERMINE ELIGIBILITY FOR THE FINANCIAL ASSISTANCE PROGRAM. TO BE ELIGIBLE, REPORTABLE ASSETS MAY NOT EXCEED $15,000 FOR A HOUSEHOLD OF ONE (1), OR $25,000 FOR A HOUSE OF TWO (2) OR MORE. ASSETS MAY INCLUDE, BUT ARE NOT LIMITED TO, SUCH ITEMS AS CHECKING AND SAVINGS ACCOUNTS, IRAS, 401(K)S, VALUE OF ADDITIONAL CARS THAT EXCEED THE NUMBER OF WORKING MEMBERS IN THE HOUSEHOLD, EQUITY IN RECREATIONAL VEHICLES AND ADDITIONAL PROPERTY, ETC. |
| PART I, LINE 7: | THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 OF THE IRS INSTRUCTIONS, RATIO OF PATIENT CARE COST-TO-CHARGES WAS USED TO CALCULATE THE COSTS FOR THE FOLLOWING COMMUNITY BENEFITS: CHARITY CARE, UNREIMBURSED MEDICAID AND COSTS FROM OTHER MEANS-TESTED GOVERNMENT PROGRAMS. ACTUAL COSTS WERE USED FOR THE REMAINDER OF THE COMMUNITY BENEFITS REPORTED. |
| 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 $ 622,441. |
| PART III, LINE 2: | DISCOUNTS, CHARITY CARE, AND BAD DEBT EXPENSE ARE ACCOUNTED FOR AS REDUCTIONS TO REVENUE. BAD DEBT EXPENSE ON PATIENT ACCOUNTS WOULD BE IDENTIFIED AS ANY BALANCE ON THE ACCOUNT, LESS ANY PREVIOUS PAYMENTS AND DISCOUNTS, THAT HAS AGED AND IS ABSENT OF ANY PAYMENTS. IF, DURING THE COLLECTION PROCESS, IT BECOMES KNOWN THAT THE PATIENT QUALIFIES FOR CHARITY CARE, THE AMOUNTS INCLUDED WITHIN THE BAD DEBT EXPENSE WOULD BE RECLASSIFIED TO CHARITY CARE. |
| PART III, LINE 3: | AS A TAX EXEMPT HOSPITAL, MEDICAL NECESSARY SERVICES ARE PROVIDED REGARDLESS OF THE PATIENTS ABILITY TO PAY FOR THAT CARE. MINNESOTA VALLEY HEALTH CENTER, INC. APPLIED A HIGH-LEVEL CONSERVATIVE ANALYTIC REVIEW BY MULTIPLYING THE RATIO OF CHARITABLE ALLOWANCES TO GROSS PATIENT REVENUE AGAINST BAD DEBT EXPENSE TO ARRIVE AT AN APPROXIMATION OF CHAIRTY CARE THAT RESIDES IN BAD DEBT. |
| PART III, LINE 4: | REFER TO THE "PATIENT AND RESIDENT RECEIVABLES" FOOTNOTE INCLUDED ON PAGE 7 OF THE CONSOLIDATED FINANCIAL STATEMENTS FOR A DESCRIPTION OF BAD DEBT EXPENSE. |
| PART III, LINE 8: | THE RATIONALE FOR CONSIDERING THE MEDICARE SHORTFALL AS A COMMUNITY BENEFIT IS THAT PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE AND IT IS LIKELY TO GET WORSE. MANY MEDICARE BENEFICIARIES ARE POOR AND ARE ELIGIBLE FOR MEDICAID IN ADDITION TO MEDICARE. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL AND NURSING HOME IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY. |
| PART III, LINE 9B: | THE POLICIES AND PROCEDRUES FOR INTERNAL AND EXTERNAL COLLECTION PRACTICES TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE POLICY (FAP) AND FINANCIAL ASSISTANCE, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR FINANCIAL ASSISTANCE FROM MINNESOTA VALLEY HEALTH CENTER, INC., AND THE PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS/HER PAYMENT AGREEMENTS. MINNESOTA VALLEY HEALTH CENTER, INC. OFFERS EXTENDED PAYMENT PLANS TO ELIGIBLE PATIENTS AND WILL NOT IMPOSE LIENS ON PRIMARY RESIDENCES NOR WILL WE REPROT PATIENTS TO A CREDIT RATING AGENCY FOR OUTSTANDING PATIENT BILLS. MINNESOTA VALLEY HEALTH CENTER, INC. WILL NOT CHARGE A PATIENT GROSS AMOUNT OF CHARGES FOR ANY UNINSURED TREATMENT. UNINSURED DISCOUNTS WILL BE APPLIED TO THE GROSS CHARGES PRIOR TO ANY FAP OR OTHER DISCOUNTS. AT ANY TIME MINNESOTA VALLEY HEALTH CENTER, INC. RECOGNIZES THAT A PATIENT MAY BE ELIGIBLE FOR STATE OR FEDERAL PROGRAMS, A REPRESENTATIVE WILL ASSIST THE PATIENT IN OBTAINING INFORMATION ABOUT THOSE PROGRAMS OR PROVIDE CONTACT INFORMATION FOR THOSE PROGRAMS. MINNESOTA VALLEY HEALTH CENTER, INC. CONTRACTS WITH AN OUTSIDE PATIENT ADVOCACY AGENCY, WHICH MAY PROVIDE ASSISTANCE TO THE UNINSURED PATIENT IN APPLYING TO CERTAIN STATE AND FEDERAL PROGRAMS. AT ANY STATE OF THE PATIENT EXPERIENCE AND UP THROUGH THE COLLECTION PROCESS, THE PATIENT MAY EXPRESS A CONCERN THAT THEY ARE UNABLE TO PAY THEIR BILL IN FULL OR MEET THE PAYMENT PLAN REQUIREMENTS. AT THAT TIME, THE PATIENT WILL BE GIVEN EVERY OPPORTUNITY TO COMPLETE AND SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE. MINNESOTA VALLEY HEALTH CENTER, INC. TRAINS ITS OUTSIDE DEBT COLLECTION AGENCIES AND ATTORNEYS ABOUT THE FINANCIAL ASSISTANCE POLICY AND HOW A PATIENT MAY OBTAIN MORE INFORMATION ABOUT THE FAP OR SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE. MINNEOSTA VALLEY HEALTH CENTER, INC. REQUIRES ITS OUTSIDE COLLECTION AGENCIES AND ATTORNEYS TO REFER PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE TO MINNESOTA VALLEY HEALTH CENTER, INC. IF A PATIENT HAS SUBMITTED AN APPLICATION FOR FINANCIAL ASSISTANCE AFTER AN ACCOUNT HAS BEEN REFERRED FOR COLLECTION ACTIVITY, MINNESOTA VALLEY HEALTH CENTER, INC. AND ITS OUTSIDE DEBT COLLECTION AGENCIES SUSPEND ALL COLLECTION ACTIVITY UNTIL THE PATIENT'S FINANCIAL ASSISTANCE APPLICATION HAS BEEN PROCESSED AND MINNESOTA VALLEY HEALTH CENTER, INC. HAS NOTIFIED THE PATIENT OF ITS DECISION. |
| PART VI, LINE 2: | MINNESOTA VALLEY HEALTH CENTER, INC. (MVHC) IS A LICENSED 15 BED CRITICAL ACCESS HOSPITAL IN LE SUEUR, MN AND IS THE ONLY HOSPITAL IN LE SUEUR COUNTY. MVHC WORKS WITH THE ONLY LOCAL PRIMARY CARE PHYSICIAN CLINIC IN LE SUEUR, SIBLEY COUNTY PUBLIC HEALTH, NICOLLET COUNTY PUBLIC HEALTH AND LE SUEUR COUNTY PUBLIC HEALTH AGENCIES FOR ASSESSING THE NEEDS OF THE RURAL COMMUNITIES IN OUR AREA. THESE NEEDS ARE DETERMINED BY SEVERAL DIFFERENT METHODS, BUT MOSTLY BASED ON WHAT THESE AGENCIES ARE ACTUALLY SEEING WHEN THEY ARE WORKING WITH THEIR CLIENTS. THIS COMMUNICATION IS ONGOING THROUGHOUT THE YEAR. MINNESOTA VALLEY HEALTH CENTER, INC. IS A MEMBER OF A LOCAL NON-PROFIT GROUP CALLED COMMUNITY WELLNESS COLLABORATION. THE MISSION OF THIS GROUP IS TO ADDRESS DEPRESSION, BULLYING AND SUICIDE PREVENTION IN OUR COMMUNITY. OTHER MEMBERS OF THIS COLLABORATION ARE LE SUEUR COUNTY PUBLIC HEALTH AND SOCIAL SERVICES, A LOCAL FAMILY PRACTICE CLINIC, LAW ENFORCEMENT AGENCIES AND A LOCAL SCHOOL. THE COLLABORATION WAS FORMED IN THE LAST TWO YEARS AND IS BASED ON WHAT THESE AGENCIES WERE SEEING EITHER IN THE EMERGENCY ROOM, CLINIC VISITS, AMBULANCE CALLS, INCIDENTS AT SCHOOL AND CALLS TO LAW ENFORCEMENT. THE COLLABORATION WAS DEEMED NECESSARY AS THE NUMBER OF THESE EVENTS HAVE BEEN INCREASING. |
| PART VI, LINE 3: | MINNESOTA VALLEY HEALTH CENTER, INC MAKES INFORMATION ON ITS FINANCIAL ASSISTANCE POLICY (FAP) READILY AVAILABLE TO THE PATIENT. INFORMATION ABOUT FINANCIAL ASSISTANCE PROGRAMS, THAT WERE IN PLACE THROUGH JUNE 30, 2018, IS AVAILABLE ON THE WEB SITE WWW.MVHC.ORG WHERE THE INFORMATION AND APPLICATION WERE EASILY ACCESSIBLE TO BE VIEWED, DOWNLOADED AND PRINTED AT NO CHARGE TO THE PATIENT. NOTICES ON THE AVAILABILITY OF FINANCIAL ASSISTANCE ARE CONSPICUOUSLY POSTED IN EMERGENCY ROOM DEPARTMENTS AND IN WAITING ROOMS. FINANCIAL ASSISTANCE INFORMATION IS AVAILABLE DURING THE PRE-ADMISSION FINANCIAL SCREENING, AT THE TIME OF REGISTRATION AND PRIOR TO A HOSPITAL DISCHARGE. INFORMATION ABOUT THE FAP IS IN ALL COLLECTION LETTERS AND PATIENT STATEMENTS. MINNESOTA VALLEY HEALTH CENTER, INC. EDUCATES STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS PROVIDING DIRECT PATIENT TREATMENT AND WHO WORK IN ADMISSIONS, BILLING AND COLLECTIONS, ABOUT THE EXISTENCE OF THE FAP AND HOW A PATIENT MAY OBTAIN MORE INFORMATION. ANNUAL EDUCATION/AWARENESS OF THE FAP IS PROVIDED TO ENSURE ALL EMPLOYEES WITH PATIENT CONTACT ARE AWARE OF THE PROGRAM AND HOW PATIENTS CAN OBTAIN ADDITIONAL INFORMATION. CLINICAL AND HOSPITAL STAFF WHO PROVIDE DIRECT PATIENT CARE HAVE KNOWLEDGE OF THE FAP AND KNOW TO DIRECT PATIENTS TO A REGISTRATION INTERVIEWER OR BUSINESS OFFICE REPRESENTATIVE. REGISTRATION STAFF HAVE AN UNDERSTANDING OF THE POLICY, KNOWLEDGE OF WHERE THE RELATED DOCUMENTS ARE LOCATED AND WHERE TO DIRECT THE PATIENT FOR MORE INFORMATION ON THE FAP. DESIGNATED EMPLOYEES HAVE A THOROUGH UNDERSTANDING OF THE FAP AND OFFER THE INFORMATION ON THE FAP TO THOSE PATIENTS WHO MAKE AN INQUIRY ABOUT THE PROGRAM OR ARE DETERMINED THROUGH A FINANCIAL SCREENING THAT THE PATIENT MAY BE ELIGIBLE FOR THIS PROGRAM. A REQUEST FOR FINANCIAL ASSISTANCE MAY BE MADE BY THE PATIENT, A PATIENT'S GUARANTOR, A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. MINNESOTA VALLEY HEALTH CENTER, INC. RESPONDS TO ANY ORAL OR WRITTEN REQUESTS FOR MORE GENERAL INFORMATION ON THE FAP MADE BY A PATIENT OR ANY INTERESTED PARTY. |
| PART VI, LINE 4: | MINNESOTA VALLEY HEALTH CENTER, INC. IS LOCATED IN LE SUEUR, MN. MINNESOTA VALLEY HEALTH CENTER, INC. OPERATES A CRITICAL ACCESS HOSPITAL, A LONG-TERM CARE FACILITY, AND A 37 UNIT HUD-SUBSIDIZED LOW INCOME HOUSING FOR SENIORS THAT SERVE THE COMMUNITIES OF LE SUEUR, NICOLLET AND SIBLEY COUNTIES. THE OVERALL COMMUNITY IS CLASSIFIED AS RURAL. MINNESOTA VALLEY HEALTH CENTER, INC. AND ITS RELATED FACILITIES COVER A SERVICE REGION OF APPROXIMATELY 28,000 PEOPLE. THE SERVICE REGION AGE DISTRIBUTION IS 25% UNDER THE AGE OF 18, 54% BETWEEN THE AGES OF 18 AND 65, AND 16% OVER THE AGE OF 65. THE RACIAL MAKEUP OF THE SERVICE REGION IS 91% WHITE, NON-HISPANIC, 6% HISPANIC OR LATINO, 1% BLACK OR AFRICAN AMERICAN, 1% AMERICAN INDIAN AND 1% ASIAN. THE GENDER SLPIT RATIO IS 50% WOMEN AND 50% MEN. THE AVERAGE INCOME FOR THE SERVICE AREA IS APPROXIMATELY $60,632. APPROXIMATELY 8.5% OF THE POPULATION FALLS BELOW THE FEDREAL POVERTY GUIDELINES. MINNESOTA VALLEY HEALTH CENTER, INC. IS COMMITTED TO SERVE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. 28% NET REVENUE DOLLARS WERE FROM SELF PAY PATIENTS. IN ADDITION, APPROXIMATELY 14% OF THEIR NET REVENUE DOLLARS WERE MEDICAID RECIPIENTS FOR THE HOSPITAL. APPROXIMATELY 69% NET REVENUE DOLLARS WERE FROM MEDICAL ASSISTANCE RESIDENTS IN THE NURSING HOME. MINNESOTA VALLEY HEALTH CENTER HAS AN OUTREACH PROGRAM THAT BRINGS SPECIALISTS LIKE ONCOLOGISTS, CARDIOLOGISTS, NEUROLOGISTS, AND OTHERS INTO ITS SMALLER COMMUNITY. THIS ELIMINATES BARRIERS TO CARE FOR MANY PATIENTS, PARTICULARLY THOSE WHO ARE EDERLY, LIVING ON LOW INCOMES, OR ARE FACED WITH OTHER CHALLENGES THAT MAKE IT DIFFICULT TO TRAVEL LONG DISTANCES FOR CARE. |
| PART VI, LINE 5: | MINNESOTA VALLEY HEALTH CENTER, INC'S BOARD OF DIRECTORS IS A VOLUNTEER BOARD CONSISTING OF LOCAL COMMUNITY MEMBERS WITH A CROSS SECTION OF OCCUPATIONS. ONE OF THE REPRESENTATIVES IS APPOINTED BY THE LE SUEUR CITY COUNCIL. NONE OF THE BOARD MEMBERS ARE EMPLOYEES, RELATED TO EMPLOYEES OR ARE INDEPENDENT CONTRACTORS OF THE ORGANIZATION. GIVEN THAT WE ARE A SMALL COMMUNITY IF A VOTE COMES UP FOR SOMETHING THAT COULD APPEAR TO BE A CONFLICT OF INTEREST THE BOARD MEMBER WILL ABSTAIN FROM VOTING. OUR MEDICAL STAFF CONSISTS OF OUR EMERGENCY ROOM DIRECTOR AND THE PROVIDERS FROM THE MAYO CLINIC HEATLH SYSTEM - MANKATO. MINNESOTA VALLEY HEALTH CENTER, INC. IS AN OPEN MEDICAL STAFF, THEREFORE ANY QUALIFIED PHYSICAN OF THE COMMUNITY IS ALLOWED TO APPLY. ALL APPLICANTS THAT APPLY MUST MEET THE CREDENTIALING STANDARDS AND BE APPROVED BY OUR GOVERNING BOARD IN ORDER TO PROVIDE SERVICES IN OUR SYSTEM. ANY SURPLUS CASH IS USED TO UPDATE MEDICAL EQUIPMENT FOR BOTH THE HOSPITAL AND NURSING HOME. ANY AND ALL EMERGENCY REPAIRS OR EQUIPMENT NEEDS THAT ARISE ARE TAKEN CARE OF IMMEDIATLEY. THE ADULT DAY HEALTH SERVICES PROGRAM IS ASSISTED BY THE HOSPITAL SERVICES. MOST OF THE CLIENTS IN THE ADULT DAY HEALTH SERVICES PROGRAM ARE ON THE ELDERLY WAIVER PROGRAM AND PAYMENT FROM THIS PROGRAM DOESN'T COVER ALL OF THE STAFF TIME OR THE COST TO TRANSPORT THE CLIENT FROM HOME TO OUR SITE AND BACK HOME AGAIN, YET IS IS A MUCH NEEDED SERVICE IN OUR COMMUNITY. WE OFFER A MEALS ON WHEELS PROGRAM FOR HOME BOUND RESIDENTS AND MOST OF THOSE MEALS ARE PAID FOR THROUGH AN ELDERLY WAIVER PGORAM THROUGH THE COUNTY, WHICH JUST COVERS THE COST OF THE FOOD. VOLUNTEERS DELIVER MEALS TO HOME BOUND CLIENTS MONDAYS - FRIDAYS, THIS PAST YEAR 3,972 MEALS WERE PREPARED AND DELIVERED. WE HAVE EVENING EVENTS FOR THE COMMUNITY SUCH AS "LINED IN PINK" FOR BREAST CANCER AWARENESS AND FLU SHOT CLINICS. WE PARTICIPATE IN LOCAL COMMUNITY EVENTS SUCH AS SUPER SATURDAY KIDS EVENTS, YOUTH SAFETY CAMP, SCHOOL SUPPLIES AND WINTER CLOTHING DRIVES FOR THE SCHOOL, FOOD SHELF DRIVE AND 5K WALK/RUN EVENT TWO TIMES A YEAR. WE ALSO PARTICIPATE WITH THE COMMUNITY'S SENIOR EXPO EACH YEAR THAT HIGHLIGHTS SERVICES TO SENIORS. WE HAVE THE EMERGENCY HELICOPTER HERE FOR EVENTS FOR THE COMMUNITY TO COME AND MEET THEM AND BE AWARE OF THESE SERVICES. MN VALLEY HAD A BOOTH AT THE ANNUAL RETAIL AND BUSINESS EXPO THAT WAS HELD AT THE LOCAL MALL TO EDUCATE THE COMMUNITY ON SERVICES AVAILABLE AT THE HEALTH CENTER. THE OUTPATIENT CLINIC WING PROVIDES SPACE FOR VISITING SPECIALISTS (CARDIOLOGY, PODIATRY, ORTHOPEDICS, UROLOGY, GENERAL SURGERY) FROM OTHER HEALTH CARE SYSTEMS TO SEE PATIENTS LOCALLY AND TO PERFORM OUTPATIENT PROCEDURES LOCALLY. MOST OF OUR POPULATION IS ELDERLY AND ARE UNABLE TO DRIVE GREAT DISTANCES SO THEY ARE ABLE TO RECEIVE CARE FROM SPECIALISTS LOCALLY. WE STRIVE TO PROVIDE HIGH-QUALITY, PATIENT-CENTERED CARE CLOSE TO HOME FOR THE COMMUNITIES WE SERVE. WE CONTINUE TO UPGRADE FACILITIES AND TECHNOLOGY TO ENSURE PATIENTS IN RURAL COMMUNITIES HAVE NEARBY ACCESS TO THESE SERVICES. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | MN |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT STEVENS | ||||||||||||||
| CEO - PART YEAR | $0 | $443,042 | $0 | $71,627 | $0 | $1,141,791 | $0 | $10,800 | $0 | $22,026 | $0 | $1,689,286 | $0 | $0 |
| PAMELA WILLIAMS | ||||||||||||||
| VICE PRESIDENT | $143,394 | $0 | $0 | $0 | $0 | $0 | $1,743 | $0 | $20,614 | $0 | $165,751 | $0 | $0 | $0 |
| GORDON GABLENZ | ||||||||||||||
| CFO | $0 | $303,834 | $0 | $53,085 | $0 | $307,078 | $0 | $10,800 | $0 | $35,065 | $0 | $709,862 | $0 | $0 |
| MICHAEL PHELPS | ||||||||||||||
| CEO | $0 | $368,738 | $0 | $52,130 | $0 | $1,029,599 | $0 | $10,800 | $0 | $27,054 | $0 | $1,488,321 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE CEO IS COMPENSATED BY RIDGEVIEW MEDICAL CENTER, THE SOLE MEMBER. THE FOLLOWING WERE USED BY RIDGEVIEW MEDICIAL CENTER TO DETERMINE THE CEO'S COMPENSATION: 1) COMPENSATION COMMITTEE (EXECUTIVE COMMITTEE) 2) INDEPENDENT COMPENSATION CONSULTANT 3) FORM 990 OF OTHER ORGANIZATIONS 4) WRITTEN EMPLOYEMENT CONTRACT 5) COMPENSATION SURVEY OR STUDY 6) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE (EXECUTIVE COMMITTEE) |
| PART I, LINE 4B | ROBERT STEVENS PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT SPLIT-DOLLAR WHOLE LIFE PLAN AT RIDGEVIEW MEDICAL CENTER. DURING 2017, $1,143,151 WAS CONTRIBUTED TO THE PLAN, $19,816 ACCRUED WITHIN THE PLAN, AND $592,724 WAS PAID OUT OF THE PLAN. MICHAEL PHELPS PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT SPLIT-DOLLAR WHOLE LIFE PLAN AT RIDGEVIEW MEDICAL CENTER. DURING 2017, $1,038,790 WAS CONTRIBUTED TO THE PLAN AND $500,177 WAS PAID OUT OF THE PLAN. GORDON GABLENZ PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT SPLIT-DOLLAR WHOLE LIFE PLAN AT RIDGEVIEW MEDICAL CENTER. DURING 2017, $315,740 WAS CONTRIBUTED TO THE PLAN, $7,874 ACCRUED WITHIN THE PLAN, AND $161,027 WAS PAID OUT OF THE PLAN. THESE DEFERRED COMPENSATION AMOUNTS ARE REPORTED ON A PRO-RATA BASIS WITHOUT REGARD TO THE INDIVIDUAL'S VESTING SCHEDULE. CURRENTLY, THE MAJORITY OF DEFERRED COMPENSATION IS NOT VESTED. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | MINNESOTA VALLEY HEALTH CENTER AMENDED THEIR ARTICLES OF INCORPORATION AND BYLAWS DUE TO THEIR AGREED UPON AFFILIATION WITH RIDGEVIEW MEDICAL CENTER. AMENDMENTS INCLUDED NAMING RIDGEVIEW MEDICAL CENTER AS THE SOLE CORPORATE MEMBER AND PROVIDING RIDGEVIEW MEDICAL CENTER WITH RESERVED POWERS IN SUCH AREAS AS FINAL APPOINTMENT OF BOARD MEMBERS, CAPITAL, BUDGET, DEBT, AMENDMENT OF GOVERNING DOCUMENTS AND GERNERAL OPERATION DECISIONS. |
| FORM 990, PART VI, SECTION A, LINE 6 | RIDGEVIEW MEDICAL CENTER IS THE SOLE MEMBER OF THE FILING ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE FILING ORGANIZATION'S BOARD SHALL CONSIST TWO PERSONS APPOINTED BY THE SOLE MEMBER. OTHER MEMBERS OF THE FILING ORGANIZATION'S BOARD ARE SELECTED BY A NOMINATING COMMITTEE AND MUST BE APPROVED BY THE SOLE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE ARTICLES AND BYLAWS PROVIDE THE SOLE MEMBER CERTAIN RESERVED POWERS IN AREAS SUCH AS CAPITAL, BUDGET, DEBT, AMENDMENT OF THE ARTICLES & BYLAWS AND GENERAL OPERATION DECISIONS. |
| FORM 990, PART VI, SECTION A, LINE 8B | FILING ORGANIZATION HAS NO EXECUTIVE COMMITTEE OR SIMILAR COMMITTEE WITH BOARD DELEGATED AUTHORITY. |
| FORM 990, PART VI, SECTION B, LINE 11B | MANAGEMENT REVIEWED THE FORM 990 AND PROVIDED COPIES TO THE BOARD OF DIRECTORS PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD MEMBERS ANNUALLY REVIEW AND SIGN THE STATEMENTS FOR POTENTIAL CONFLICTES OF INTEREST POLICY. EACH MEMBER IS EXPECTED TO DISCLOSE ANY CONFLICT OF INTEREST THAT MAY ARISE DURING THE YEAR. IF IT IS DETERMINED THAT CONFLICT OF INTEREST EXISTS, THE SITUATION WILL BE EXAMINED AND HANDLED APPROPRIATELY BY THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO & CFO ARE PAID BY RIDGEVIEW MEDICAL CENTER, THE SOLE CORPORATE MEMBER, WHICH PERFORMS THE REVIEW AND APPROVAL OF THE COMPENSATION FOR THE CEO AND CFO. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFILICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | CAPITAL GRANT AND CONTRIBUTIONS 400,000. CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATION 83,403. |
| FORM 990, PART XII, LINE 2C | THE PROCESS REGARDING OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MINNESOTA VALLEY MEMORIAL HOSPITAL FOUNDATION | |||||||||||
| 621 SOUTH FOURTH STREET | LE SUEUR | MN | 56058 | 411754182 | RAISING FUNDS FOR MINNESOTA VALLEY HEALTH CENTER, INC. | MN | 501(C)(3) | LINE 12A, I | N/A | 0 | |
| RIDGEVIEW MEDICAL CENTER | |||||||||||
| 500 S MAPLE ST | WACONIA | MN | 55387 | 311667875 | HEALTH CARE SERVICES | MN | 501(C)(3) | LINE 3 | N/A | 0 | |
| RIDGEVIEW FOUNDATION | |||||||||||
| 500 S MAPLE ST | WACONIA | MN | 55387 | 411328097 | RAISING FUNDS FOR RIDGEVIEW MEDICAL CENTER | MN | 501(C)(3) | LINE 7 | 0 | RIDGEVIEW MEDICAL CENTER | |
| RIDGEVIEW CLINICS | |||||||||||
| 500 S MAPLE ST | WACONIA | MN | 55387 | 411651783 | HEALTH CARE SERVICES | MN | 501(C)(3) | LINE 3 | 0 | RIDGEVIEW MEDICAL CENTER | |
| RIDGEVIEW INSURANCE CO | |||||||||||
| 60 E SOUTH TEMPLE STE 1800 | SALT LAKE CITY | UT | 84111 | 454109041 | CAPTIVE INSURANCE COMPANY | UT | 501(C)(3) | LINE 12A, I | 0 | RIDGEVIEW MEDICAL CENTER | |
| SIBLEY MEDICAL CENTER | |||||||||||
| 601 W CHANDLER ST | ARLINGTON | MN | 55307 | 411801967 | CRITICAL ACCESS HOSPITAL | MN | 501(C)(3) | LINE 3 | 0 | RIDGEVIEW MEDICAL CENTER | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| MINNEAPOLIS HEART INSTITITUE AT RIDGEVIEW HEART CENTER LLC | |||||||
| 500 S MAPLE ST | WACONIA | MN | 55387 | 205785920 | CARDIOLOGY | MN | N/A |
| CHASKA PLAZA SURGERY CENTER | |||||||
| 3000 HUNDERTMARK ROAD | CHASKA | MN | 55318 | 450975783 | SURGERY SERVICES | MN | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| EXECUTIVE HEALTH MANAGEMENT SERVICES | |||||||||
| 500 SOUTH MAPLE ST | WACONIA | MN | 55387 | 411760239 | MANAGEMENT SERVICES | MN | N/A | C | 0 |
| CHARITABLE REMAINDER UNITRUST (1) | |||||||||
| CHARITABLE TRUST | MN | N/A | 0 | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |