STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

LAKE REGION HEALTHCARE CORPORATION: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
LAKE REGION HEALTHCARE CORPORATION (EIN 41-1763968)
Tax period
2016-10-01 to 2017-09-30
Filed
2018-08-15
IRS object ID
201812279349301331
Schema version
2016v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-08-15T10:10:26-05:00ReturnTs
Tax Period End2017-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14310 17TH AVE S PO BOX 2545AddressLine1Txt
CityFARGOCityNm
State AbbreviationNDStateAbbreviationCd
ZIP581082545ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN411763968EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Prairie Ridge Hospital and HealthBusinessNameLine1Txt
Business Name Line2Services IncBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlPRAIBusinessNameControlTxt
Phone2186857300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11411 Highway 79 EAddressLine1Txt
CityElbow LakeCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56531ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKyle RichardsPersonNm
Person TitleLake Region Healthcare CEOPersonTitleTxt
Phone2186857300PhoneNum
Signature2018-08-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLISA CHAFFEE CPAPreparerPersonNm
PTINP00193453PTIN
Phone7012398500PhoneNum
Preparation2018-08-15PreparationDt
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDanielle LesmeisterPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11411 Highway 79 EAddressLine1Txt
CityElbow LakeCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56531ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$20,120,736GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.prairiehealth.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1993FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionAn acute care hospital and ambulatory outpatient facility.ActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee172TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$128,886PYContributionsGrantsAmt
CY Contributions Grants$70,859CYContributionsGrantsAmt
PY Program Service Revenue$17,165,270PYProgramServiceRevenueAmt
CY Program Service Revenue$19,923,913CYProgramServiceRevenueAmt
PY Investment Income$34,570PYInvestmentIncomeAmt
CY Investment Income$125,164CYInvestmentIncomeAmt
PY Other Revenue$1,343PYOtherRevenueAmt
CY Other Revenue$800CYOtherRevenueAmt
PY Total Revenue$17,330,069PYTotalRevenueAmt
CY Total Revenue$20,120,736CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$5,794,990PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$5,673,438CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$12,297,272PYOtherExpensesAmt
CY Other Expenses$13,430,307CYOtherExpensesAmt
PY Total Expenses$18,092,262PYTotalExpensesAmt
CY Total Expenses$19,103,745CYTotalExpensesAmt
PY Revenues Less Expenses-$762,193PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,016,991CYRevenuesLessExpensesAmt
Total Assets BOY$31,451,284TotalAssetsBOYAmt
Total Assets EOY$32,953,193TotalAssetsEOYAmt
Total Liabilities BOY$24,321,710TotalLiabilitiesBOYAmt
Total Liabilities EOY$24,726,240TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$7,129,574NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$8,226,953NetAssetsOrFundBalancesEOYAmt
MissionServing the healthcare needs of the people.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$15,537,405ExpenseAmt
Revenue$19,923,913RevenueAmt
DescPrairie Ridge Hospital and Health Services (Medical Center) 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. The Medical Center operates various provider based clinics and a provider based surgery department. The Medical Center maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges foregone for services and supplies furnished under its charity care policy. The amount of charges foregone, based on established rates were $38,757 and $53,354 during the years ended September 30, 2017 and September 30, 2016.Desc
Total Program Service Expenses$15,537,405TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document36IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee172EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Krista GerberBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2186857337PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11411 Highway 79 EAddressLine1Txt
CityElbow LakeCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56531ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Gene Wenstrom
Chair2.504.20Yes (X)Yes (X)$600$0$0
David Bjork
Vice Chair (Oct-Feb)1.505.00Yes (X)Yes (X)$1,200$0$0
Sandy Alvstad
Secretary(Oct-Jul)1.500.00Yes (X)Yes (X)$1,200$0$0
Jay McNamar
VC & Sec (Apr-Sept)/Dir (Oct-Apr)1.500.00Yes (X)Yes (X)$1,200$0$0
Dustin Sperr
Director/Co-CMO2.400.00Yes (X)$9,874$0$0
Gary Spies
Director1.505.00Yes (X)$1,200$0$0
Richard Lambert
Director (Jun-Sept)1.500.00Yes (X)$0$0$0
Danielle Lesmeister
Director (Jun-Aug)1.500.00Yes (X)$0$0$0
Jim Gingerich
Interim CEO (Oct-Jul)40.000.00Yes (X)$0$10,986$0
Kyle Richards
Interim CEO (Aug-Sept)0.0040.00Yes (X)$0$0$0
Brett Longtin
CFO (Oct-Sept)/CEO (Oct-Nov)0.0040.00Yes (X)$0$259,665$17,303
Barbara Moore
Physical Therapist40.000.00$108,517$0$11,636Yes (X)
Renae Lien
Pharmacy Director40.000.00$125,840$0$4,253Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$249,631TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$270,651TotReportableCompRltdOrgAmt
Total Other Compensation$33,192TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Lake Region Healthcare Co
712 S Cascade StFergus FallsMN56538Professional/Physician Services$2,971,406
West Central Internal Medicine
PO Box 410MorrisMN56267Physician Services$421,232
CPSI
6600 Wall StreetMobileAL36695IT Support$269,712
DMS Imaging Inc
PO Box 670747DallasTX75267Radiology Services$252,524
Morris Electronics Inc
511 Atlantic AveMorrisMN56267IT Services$225,524
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K9CntrctRcvdGreaterThan100KCnt
Government Grants$8,536GovernmentGrantsAmt
All Other Contributions$62,323AllOtherContributionsAmt
Total Contributions$70,859TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Service Rev.622110$18,032,171$18,032,171
Pharmacy722320$1,673,703$1,673,703
Supporting Revenue900099$212,350$212,350
Rural Alliance Investment900099$5,689$5,689
FieldValueIRS element (for citing)
Total Program Service Revenue$19,923,913TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$76,756TotalRevenueColumnAmt
Exclusion$76,756ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$800RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$800RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$800TotalRevenueColumnAmt
Exclusion$800ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$40,408SecuritiesAmt
Other$8,000OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

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

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$40,408SecuritiesAmt
Other$8,000OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$48,408TotalRevenueColumnAmt
Exclusion$48,408ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$20,120,736TotalRevenueColumnAmt
Related Or Exempt Func Income$19,923,913RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$125,964ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$6,900TotalAmt
Management And General$6,900ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$4,838,113TotalAmt
Program Services$3,337,309ProgramServicesAmt
Management And General$1,500,804ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$101,980TotalAmt
Program Services$70,345ProgramServicesAmt
Management And General$31,635ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$371,503TotalAmt
Program Services$256,261ProgramServicesAmt
Management And General$115,242ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$354,942TotalAmt
Program Services$244,837ProgramServicesAmt
Management And General$110,105ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$60,000TotalAmt
Management And General$60,000ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$78,921TotalAmt
Management And General$78,921ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,196,873TotalAmt
Program Services$4,149,438ProgramServicesAmt
Management And General$1,047,435ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$23,054TotalAmt
Management And General$23,054ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$582,300TotalAmt
Program Services$471,752ProgramServicesAmt
Management And General$110,548ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$379,239TotalAmt
Program Services$40,409ProgramServicesAmt
Management And General$338,830ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$35,415TotalAmt
Program Services$28,114ProgramServicesAmt
Management And General$7,301ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$45,012TotalAmt
Program Services$30,425ProgramServicesAmt
Management And General$14,587ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$828,802TotalAmt
Program Services$828,802ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,963,371TotalAmt
Program Services$1,963,371ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$98,356TotalAmt
Program Services$98,356ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$3,002,195$3,002,195
Repairs and Maintenance$436,086$390,467$45,619
Bad Debt Expense$345,618$345,618
MN Health Tax$238,085$238,085

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$116,980TotalAmt
Program Services$41,621ProgramServicesAmt
Management And General$75,359ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$19,103,745TotalAmt
Program Services$15,537,405ProgramServicesAmt
Management And General$3,566,340ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,901,977BOYAmt
EOY$5,357,923EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,295,865BOYAmt
EOY$3,975,659EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$290,536BOYAmt
EOY$253,221EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$225,525BOYAmt
EOY$195,295EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$28,771,405LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$8,549,406LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$22,037,890BOYAmt
EOY$20,221,999EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$2,402,252BOYAmt
EOY$2,698,465EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$81,094BOYAmt
EOY$69,676EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$216,145BOYAmt
EOY$180,955EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$31,451,284BOYAmt
EOY$32,953,193EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,412,097BOYAmt
EOY$1,698,345EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$22,532,713BOYAmt
EOY$22,042,095EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$376,900BOYAmt
EOY$985,800EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$24,321,710BOYAmt
EOY$24,726,240EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$6,845,750BOYAmt
EOY$7,925,327EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$54,276BOYAmt
EOY$72,078EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$229,548BOYAmt
EOY$229,548EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$7,129,574BOYAmt
EOY$8,226,953EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$31,451,284BOYAmt
EOY$32,953,193EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,016,991ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$80,388NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$283,824BeginningYearBalanceAmt
Investment Earnings Or Losses$17,802InvestmentEarningsOrLossesAmt
End Year Balance$301,626EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$270,034BeginningYearBalanceAmt
Investment Earnings Or Losses$13,790InvestmentEarningsOrLossesAmt
End Year Balance$283,824EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$315,032BeginningYearBalanceAmt
Investment Earnings Or Losses-$4,998InvestmentEarningsOrLossesAmt
Other Expenditures$40,000OtherExpendituresAmt
End Year Balance$270,034EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$309,625BeginningYearBalanceAmt
Investment Earnings Or Losses$5,407InvestmentEarningsOrLossesAmt
End Year Balance$315,032EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$284,404BeginningYearBalanceAmt
Investment Earnings Or Losses$25,221InvestmentEarningsOrLossesAmt
End Year Balance$309,625EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.76100PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.23900TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$570,277OtherCostOrOtherBasisAmt
Book Value$570,277BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$21,445,141OtherCostOrOtherBasisAmt
Depreciation$4,025,241DepreciationAmt
Book Value$17,419,900BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,747,987OtherCostOrOtherBasisAmt
Depreciation$4,524,165DepreciationAmt
Book Value$2,223,822BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,000OtherCostOrOtherBasisAmt
Book Value$8,000BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$20,221,999TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDue to Third Party PayorDesc
Amt$985,800Amt
FieldValueIRS element (for citing)
Total Liability$985,800TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$19,855,506TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$80,388NetUnrealizedGainsInvstAmt
Other Revenue-$345,618OtherRevenueAmt
Revenue Not Reported-$265,230RevenueNotReportedAmt
Revenue Subtotal$20,120,736RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$20,120,736TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$18,758,127TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$18,758,127ExpensesSubtotalAmt
Other Expenses Not Included$345,618OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$345,618ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$19,103,745TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:Endowment funds are intended to earn investment income. The investment income is intended to be used for funding operational expenses.
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.
Part XI, Line 2d - Other Adjustments:Bad Debt Expense Included in Expenses in Financial Statements -345,618.
Part XII, Line 4b - Other Adjustments:Bad Debt Expense Included in Revenue in Financial Statements 345,618.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other175.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other215.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance Budget0FinancialAssistanceBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$29,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$29,000NetCommunityBenefitExpnsAmt
Total Expense0.00150TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,613,339TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,378,716DirectOffsettingRevenueAmt
Net Community Benefit Expns$234,623NetCommunityBenefitExpnsAmt
Total Expense0.01250TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,642,339TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,378,716DirectOffsettingRevenueAmt
Net Community Benefit Expns$263,623NetCommunityBenefitExpnsAmt
Total Expense0.01400TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$225,875TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$70,223DirectOffsettingRevenueAmt
Net Community Benefit Expns$155,652NetCommunityBenefitExpnsAmt
Total Expense0.00830TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,772,835TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,316,918DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,455,917NetCommunityBenefitExpnsAmt
Total Expense0.07760TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,998,710TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,387,141DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,611,569NetCommunityBenefitExpnsAmt
Total Expense0.08590TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,641,049TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,765,857DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,875,192NetCommunityBenefitExpnsAmt
Total Expense0.09990TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$345,618BadDebtExpenseAmt
Bad Debt Expense Attributable$42,856BadDebtExpenseAttributableAmt
Reimbursed By Medicare$7,562,984ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$7,604,145CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$41,161MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Prairie Ridge Hospital & Health ServicesBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11411 Highway 79 EAddressLine1Txt
CityElbow LakeCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56531ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.prairiehealth.orgWebsiteAddressTxt
State License00154StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
Other5 provider based clinicsOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Prairie Ridge Hospital and Health ServicBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Part V, Section B, Line 7dOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSee Part V, Section B, Line 7dStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care175.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care215.000000000000FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLwww.prairiehealth.org/patients-visitors/financial-assistance/FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLwww.prairiehealth.org/patients-visitors/financial-assistance/FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLwww.prairiehealth.org/patients-visitors/financial-assistance/FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Prairie Ridge Hospital and Health ServicePart V, Section B, Line 5: 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.
Prairie Ridge Hospital and Health ServicePart V, Section B, Line 7d: Line 7 Hospital Website:https://www.prairiehealth.org/about-us/community-health-needs-assessment/
Prairie Ridge Hospital and Health ServicePart V, Section B, Line 11: The Hospital is addressing the needs listed below which were identified in the 2015 tax year CHNA. The initiatives that were taken by year end are addressed below.1) Preventative CareCurrent activities * Prairie Ridge has a practitioner with an interest in diabetes. * We hold 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 Center 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 in order to identify potential issues early on. * Prairie Ridge operates a 24/7 fitness center that is open to the community. * We work with a wide variety of insurance programs in order to allow access to as many members of the community as we can. * Prairie Ridge contracts with 4 area school districts to provide school nursing. * Prairie Ridge has 6 locations in order to provide better access to care. A sixth location in Herman, MN was opened in March 2017. * Prairie Ridge has added a second evening clinic to allow better access to healthcare. 2) Aging PopulationCurrent activities * Prairie Ridge hired a nurse specifically to work with our aging population. * The services provided by the nurse include annual wellness visit reminders. * Chronic Care Management provides a care coordinator for patients with multiple diagnoses. * This nurse visits with 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. * Implemented Transitional Care Management which helps manage the care after discharge. * Prairie Ridge offers swing bed services.Conducted by others in collaboration with Prairie Ridge: * Prairie Ridge has partnered with the PAD PRAIRIE initiative. * Prairie Ridge promoted community awareness of PAD through community events * Prairie Ridge facilitated screening and identification of PAD * Nursing homes in Barrett and Evansville provide assisted living, but Prairie Ridge physicians provide care to the residents and lab services.3) Mental and Behavioral Health ServicesCurrent activities * The school district has providers who come in to meet with students. * Prairie Ridge has a contract with Bridgeway Behavioral Health at Lake Region Healthcare. * Prairie Ridge works with the Region 4 Mental Health Crisis team. * Prairie Ridge conducts continued education with staff in dealing with mental health and behavior health patients. * Prairie Ridge is working with LRH to implement and provide mental health services locally via telemedicine at PRHHS. The proposed implementation date is in FY 2018. Proposed activities * 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. This will help us to create a safe environment for our patients dealing with mental and/or behavioral health issues. * Prairie Ridge will continue to contract with 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. This will help practitioners to better serve and treat our patients. * Prairie Ridge will continue to educate patients about the services available to them. This will allow us to better serve our patients by connecting them with the correct services to best address their needs.4) Dental Care for Low Income Families and Transportation are two needs that were identified but will not be addressed specifically by Prairie Ridge due to funding. The community has organizations that serves the community with these needs. Prairie Ridge provides information to its patients on the resources available in these areas.
Prairie Ridge Hospital and Health ServicePart V, Section B, Line 16j: 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.
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line11 - Herman ClinicBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1204 5th St EAddressLine1Txt
CityHermanCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56248ZIPCd
FieldValueIRS element (for citing)
FacilityPhysician ClinicFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 6a:The annual community benefit report is available to the public upon request and on the PRHHS website.
Part I, Line 7:Charity care was converted to cost by multiplying the ratio of cost to charges for the Hospital 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.
Part I, Ln 7 Col(f):The amount of bad debt expense removed from the denominator of the calculation was $345,618.
Part III, Line 2:Bad debt expense on line 2 is reported at charges as presented on the financial statements. A payment on an account previously written off reduces bad debt expense in the current year.
Part III, Line 3:The estimated amount of bad debt expense attributable to patients eligible under the organization's charity care policy is calculated by using the ratio of the population in the service area that is below the FPG of 12.4% to the total population and multiplying that percentage times the bad debt expense at cost.
Part III, Line 4:The footnote to the Organization's financial statements can be found on page 9 of the attached audited financial statements.
Part III, Line 8:Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services.Even though Medicare was at a loss, the Hospital provides services to these patients because access to healthcare and individual's health is important to the Hospital. Therefore, the Medicare shortfall is considered a community benefit.
Part III, Line 9b:For patients unable to meet the collection guidelines of Prairie Ridge Hospital and Health Services, 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, the Hospital 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.
Part VI, Line 2:In addition to the CHNA process that took part in tax year 2015, the organization assesses the health care needs of the community based on feedback from physicians.
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.
Part VI, Line 4:Prairie Ridge Hospital and Health Services service area includes Grant County and surrounding counties in Minnesota. In 2015, the population for Grant County was estimated to be 5,903. In 2014, approximately 23.3% of the population is age 65 or older. The average per capita income is $27,195 and approximately in 2013 12.4% of the population is below the federal poverty level. The nearest hospital in the area is approximately 20 miles from Prairie Ridge Hospital and Health Services main campus.
Part VI, Line 5:The Organization's governing body is comprised of volunteer members who reside in the community. Medical staff privileges are extended to all qualified physicians in the community. Surplus funds are reinvested in facilities to improve patient care. The hospital operates an emergency room that is available to all, regardless of ability to pay.Prairie Ridge Hospital and Health Services (PRHHS) is the sole healthcare provider within the Elbow Lake Community. The satellite clinics located in Ashby, Evansville, Hoffman and Herman provide clinic and lab services. The Morris satellite clinic provides outpatient surgery, clinic, lab and radiology services to the Morris area.PRHHS supports the education and training of various healthcare professionals. Nurse Practitioner, Physician Assistant, Radiology, Physical Therapy and nursing professionals-in-training shadow PRHHS providers during their various internships.In keeping with the hospital's mission of "Serving the healthcare needs of the people" PRHHS provides:Support Groups - PRHHS provides free use of the facility for support groups on a monthly basis. Groups include: Grief Support and Diabetic SupportTransportation - To facilitate transportation for patients in Morris to the Prairie Ridge Morris facility, PRHHS pays a monthly stipend to a public transit that allows those patients to attend their appointments without paying transportation costs.Ambulance - PRHHS Ambulance and Emergency Staff are present in case of emergency at local school activities such as football, wrestling, etc. In addition they are present at county fairs and other local events.Blood Pressure Checks - Free blood pressure checks are available at all times in both the clinic and hospital setting at all PRHHS sites. These checks are at no cost to the patient whether or not they are an established patient.Expos - PRHHS participates in the Grant County and Stevens County Fairs where we provide various information.Sports Physicals - School sports physicals are performed at a reduced rate for the schools in our area.Spry - Spry is a publication sponsored by PRHHS that provides various health related information on various topics including a variety of conditions as well as information on maintaining good health.Community Pages - Listed through the community pages are the various support groups and any health related activities provided at various times for various occasions (i.e. Community Safety, Drug Education, etc.).
Part VI, Line 7, Reports Filed With StatesMN

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonBrett LongtinPersonNm
TitleCFO (Oct-Sept)/CEO (Oct-Nov)TitleTxt
Base Compensation Filing Org$0BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$232,915CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$26,750BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$17,303NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$0TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$276,968TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 3FormAndLineReferenceDesc
ExplanationThe CEO for PRHHS is a LRHC employee, therefore they establish the CEO's compensation pursuant to compensation studies performed by an independent party using market data. LRHC used all methods listed on line 3.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 2Jim Gingerich, Dr. Dustin Sperr, Brett Longtin, Gary Spies, Dr. David Bjorke and Gene Wenstrom all have a business relationship.
Form 990, Part VI, Section A, line 6Lake Region Healthcare Corporation ("Lake Region"), a Minnesota nonprofit corporation, is the sole corporate member of the Corporation.
Form 990, Part VI, Section A, line 7aLake 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 7bLake 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 to transfer 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 8bCurrently the organization does not have any committees with the authority to act on behalf of the governing body.
Form 990, Part VI, Section B, line 11bThe 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 12cThe 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 15The compensation for the CEO is determined annually by the related organization, Lake Region Healthcare.
Form 990, Part VI, Section C, line 19The Organization's governing documents, conflict of interest policy, and financial statements are available to the public upon request.
Form 990 Part VII CEO/CFO Officer HoursThe CFO and one of the Interim CEOs were employees of Lake Region Healthcare, a related organization. Due to their time being primarily at LRH, their hours cannot be reasonably allocated between the facilities. The compensation reflected on Part VII is for their services to both organizations.
Form 990, Part IX, line 11gConsulting Services: Program service expenses 16,400. Management and general expenses 0. Fundraising expenses 0. Total expenses 16,400. Physician Fees: Program service expenses 2,574,423. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,574,423. Purchased Services: Program service expenses 1,531,021. Management and general expenses 1,033,165. Fundraising expenses 0. Total expenses 2,564,186. Miscellaneous: Program service expenses 27,594. Management and general expenses 14,270. Fundraising expenses 0. Total expenses 41,864.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1Pharm Care LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11411 Highway 79 EAddressLine1Txt
CityElbow LakeCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56531ZIPCd
FieldValueIRS element (for citing)
EIN411763968EIN
Primary ActivitiesRetail PharmacyPrimaryActivitiesTxt
Legal Domicile StateMNLegalDomicileStateCd
Total Income$0TotalIncomeAmt
End Of Year Assets$0EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Prairie Ridge Hospital and Health Services IncBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
Prairie Ridge Foundation Inc
1411 Highway 79 EElbow LakeMN56531455092280Supporting OrganizationMN501(c)(3)Line 7Prairie Ridge Hospital and Health Services IncYes (1)
Lake Region Healthcare Corporation
712 S Cascade StFergus FallsMN565380728410730602HospitalMN501(c)(3)Line 30N/A
Lake Region Healthcare Foundation
712 S Cascade StFergus FallsMN565380728411677288FoundationMN501(c)(3)Line 12a, ILake Region Healthcare Corporation0
LRHC Long Term Care Facilities Inc
712 S Cascade StFergus FallsMN565380728411817549Assisted LivingMN501(c)(3)Line 10Lake Region Healthcare Corporation0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
LRH RAD ONC Services
712 S Cascade StFergus FallsMN565380728271322270Radiation Oncology ServicesMNN/A
Lake Region Home Medical Supply
712 S Cascade StFergus FallsMN565380728464182501Medical Equipment SalesMNN/A
Lakes Area Community Health Plan
712 S Cascade StFergus FallsMN565380728460952511Health Insurance ServicesMNN/A
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd