2018-07-26T09:44:29-05:00 2017-09-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2016-10-01 411804205 LifeCare Medical Center LIFE 2184632500 715 Delmore Drive Roseau MN 56751 Keith Okeson CEO/President 2184632500 2018-07-24 1 Kim Hunwardsen CPA P00484560 6122536500 2018-07-04 2016 2022-09-23 18:48:47Z Keith Okeson 715 Delmore Drive Roseau MN 56751 47522243 0 X www.lifecaremedicalcenter.org X 1995 MN Promotion of Health 12 12 544 280 0 0 219635 343414 46188219 46413211 402019 381165 115925 120824 46925798 47258614 185258 37758 0 0 23462378 25520538 0 0 0 18099798 18400111 41747434 43958407 5178364 3300207 69618039 71264401 9346220 7518193 60271819 63746208 X To provide care for a healthy life. 0 0 37463859 37758 46413211 LifeCare Medical Center operates a 25-bed acute care hospital, including a 50-bed nursing facility, home health, hospice, and public health in Roseau, Minnesota. The organization also operates a 40-bed nursing home and 12 apartments of assisted living in Greenbush, Minnesota. The purpose of the organization is to own, maintain, and operate a hospital, nursing homes, furnish medical and surgical care to the sick, infirmed, or injured.Acute Care Hospital (Inpatient and Outpatient)Inpatient days: 1,917Outpatient visits: 42,514Long Term CareLifeCare Roseau Manor Resident Days: 17,194LifeCare Greenbush Manor Resident Days: 14,340Home Health/Public Health Visits: 6,895Hospice Clients Served: 32To fulfill its mission of community service, LifeCare Medical Center provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. The amount of charges foregone, based on established rates, was $395,238 for the year ended September 30, 2017. 37463859 1 1 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 69 0 1 544 1 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X Cathy Huss 2184634763 715 Delmore Drive Roseau MN 56751 Corwin Vatnsdal Chair 1.00 X X 2450 0 0 Brenda Sather Vice Chair 1.00 X X 1450 0 0 Mark Wilson Secretary 1.00 X X 1425 0 0 Therese McBride Treasurer 1.00 X X 1375 0 0 Ralph Herseth MD Trustee 1.00 X 1425 0 0 Chuck Lindner Trtu 1.00 X 1300 0 0 Shayne Isane Trustee 1.00 X 1025 0 0 Matthew Ulwelling Trustee 1.00 X 800 0 0 Beth Johnson Trustee 1.00 X 1500 0 0 Jessica Foss Trustee 1.00 X 1250 0 0 Dan Urness Trustee 1.00 X 425 0 0 Mark Karl Trustee 1.00 X 250 0 0 Keith Okeson CEO/President 40.00 X 319737 0 73415 Cathy Huss CFO 40.00 X 210970 0 70456 Gordon Streiff Pharmacy Director 40.00 X 161605 0 43468 Susan Lisell Senior Leader 40.00 X 180838 0 50247 Shannon D Carlson Senior Leader 40.00 X 151985 0 48974 Judy K Mattson Pharmacist 40.00 X 134052 0 69655 Kevin L Schumacher Information Systems Direct 40.00 X 124885 0 41817 1298747 0 398032 15 0 1 0 Comstock Construction Inc PO Box 396 Fergus Falls MN 565380396 Contractor/Construction 1866525 Wapiti Medical Group 107 Flynn Drive Suite 600 Milbank SD 57252 Locum Physician 1505273 Central Minnesota Diagnostic 150 10th St NW Milaca MN 56353 Imaging CT SCAN Service 710400 R & Q Trucking 302 3rd St SW Roseau MN 56751 Contractor/Construction 566992 Siemens Medical Solutions USA Dept CH 14195 Palatine IL 600554195 Imaging/Lab Services 439663 27 146992 196422 343414 Net Patient Service Revenue 622110 45580205 45580205 Other Revenue 621500 833006 833006 46413211 387377 387377 378241 257417 120824 120824 120824 6212 -6212 -6212 -6212 47258614 46413211 0 501989 X 31258 31258 6500 6500 699236 699236 19191449 16379317 2812132 626262 534496 91766 3595445 3068603 526842 1408146 1163977 244169 24077 24077 71958 71958 4945500 4691616 253884 129694 129694 1439696 849748 589948 912293 904184 8109 334096 314798 19298 59924 13595 46329 88482 88482 2776925 2776925 177298 177298 Medical Supplies 4063551 4063551 Bad Debt Expense 830157 830157 Surcharge Fees 586700 586700 MN Care Tax 401430 401430 1558330 581224 977106 43958407 37463859 6494548 0 4586497 5205580 6252142 6480456 926426 923292 219713 202689 55780683 29410149 26221876 26370534 30804292 31534696 508127 422520 98966 124634 69618039 71264401 4672564 3915164 3935000 3330172 259545 272857 479111 0 9346220 7518193 X 60271819 63746208 60271819 63746208 69618039 71264401 3300207 174182 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 7740 7740 39302447 18417447 20885000 14742002 10424975 4317027 1728494 567727 1160767 26370534 X 46828798 174182 -861415 -687233 47516031 -257417 -257417 47258614 43354409 257417 257417 43096992 861415 861415 43958407 Part IV, Line 2b: The Medical Center acts as custodian for the funds of the residents, holds resident security deposits, and holds employee voluntary withholdings. Funds for residents and others totaled $272,857 and $259,545 at September 30, 2017 and 2016. Part X, Line 2: The Medical Center is organized as a Minnesota nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Medical Center is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Medical Center has determined it is not subject to unrelated business income tax and has not filed an Exempt Organization Business Income Tax Return (Form 990T) with the IRS. The Medical Center believes that is 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 financial statements. The Medical Center would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Part XI, Line 2d - Other Adjustments: Provision for Bad Debts Recorded in Revenue for Financial Statements -830,157. Grant Expense Recorded in Revenue for Financial Statements -31,258. Part XI, Line 4b - Other Adjustments: Rental Expense Recorded in Expense for Financial Statements -257,417. Part XII, Line 2d - Other Adjustments: Rental Expense Recorded in Expense for Financial Statements 257,417. Part XII, Line 4b - Other Adjustments: Provision for Bad Debts Recorded in Revenue for Financial Statements 830,157. Grant Expense Recorded in Revenue for Financial Statements 31,258. 1 1 X 1 X 1 X 1 1 0 1 1 251000 251000 0.00580 7858166 6969546 888620 0.02060 8109166 6969546 1139620 0.02640 308141 1260 306881 0.00710 194932 194932 0.00450 5107885 3284324 1823561 0.04230 43353 1640 41713 0.00100 5654311 3287224 2367087 0.05490 13763477 10256770 3506707 0.08130 206146 1640 204506 0.00470 540631 145442 395189 0.00920 145348 1260 144088 0.00330 194932 194932 0.00450 1087057 148342 938715 0.02170 0 830157 5702 9314008 9459202 -145194 X 1 1 1 1 LifeCare Medical Center 715 Delmore Drive Roseau MN 56751 www.lifecaremedicalcenter.org 00579 X X X X X Urgent Care LifeCare Medical Center 1 0 0 1 X X X X X X X X X 15 1 0 1 1 X www.lifecaremedicalcenter.org/about X X 1 15 1 www.lifecaremedicalcenter.org/about 0 1 X 200.000000000000 250.000000000000 X X 1 1 X X X X 1 X https://lifecaremedicalcenter.org/financialassist/ X https://lifecaremedicalcenter.org/financialassist/ X https://lifecaremedicalcenter.org/financialassist/ X X X X X X 1 X 0 X X X 1 X 0 0 LifeCare Medical Center Part V, Section B, Line 5: Representatives from both LifeCare Medical Center and LifeCare Public Health conducted meetings with organizations and individuals who represent all geographic and age levels in our service area. These included: Roseau Ministerial Association, Warroad School District, Roseau School District, Badger/Greenbush School District, Roseau County Court system, Warroad Chamber of Commerce, Altru Physicians, Marvin Windows and Doors, Central Boiler and Polaris Industries (3 largest employers in service area). In addition, those who serve low-income and minority populations were represented by Roseau County Social Services, LifeCare Public Health, Northwest Community Action and HeadStart. LifeCare Medical Center Part V, Section B, Line 6b: LifeCare Public Health (public health agency for Roseau County). LifeCare Medical Center Part V, Section B, Line 7d: The CHNA was mailed to all city offices, county leadership and those who participated in the needs assessment. LifeCare Medical Center Part V, Section B, Line 11: LifeCare Medical Center's response to Community Health Needs identified in the most recent Community Health Needs Assessment for the most current tax period is as follows. Mental Health -We have begun to create community awareness of mental health issues and available resources. Research was done on Mental Health First Aid trainings. Planning is underway to offer Mental Health First Aid classes to our staff and community partners in 2018 utilizing an outside trainer. We have increased our marketing strategies through social media outlets and community events. A community wellness speaker event was held in September 2017. Linda Larsen, Wellness & Inspirational speaker, presented "Staying Right Side Up When Everything Seems Upside Down".-First point of access of mental health services will be part of the education provided through Mental Health First Aid training to staff and community members.-We will establish roadmap/logistics on coordinating care of mental health patients. Research is underway to determine the benefits of having a Community Health Worker or In Reach Worker to help coordinate the care of behavioral health clients. Development of a Behavioral Health Community Care Team is underway. A Universal HIPPA Release is also being developed. -We will develop care plans for individuals with identified mental health needs.Drug Abuse and Alcohol Abuse-We continue to work with Roseau County on a 5 year Drug-Free Communities grant that was awarded by the US Department of Health and Human Services. LifeCare continues to work with community partners and the youth of Roseau County to decrease the use of alcohol and drugs.Obesity-LifeCare offers 24-hour on-site wellness centers in Roseau, Warroad and Greenbush.-Trained staff are available for health fairs at local employers and community events to provide nutrition and exercise related topics.-Matter of Balance classes are available in each community to enable older adults to remain active.-Planning is underway to offer Tai Ji Quan classes in the community. Two staff members will be trained in the Fall 2017.-LifeCare continues to partner with the Roseau Diabetes Center to provide the I Can Prevent Diabetes class.-Annual Walk/Run event was held in partnership with the Diabetes Center.-Community trail maps with exercise and fitness trails are now available.-Working in partnership with the City of Roseau Parks and Recreation will continue to look for grant opportunities to provide fitness stations along the newly built walking trail.-We have 2 staff members working on becoming certified health coaches through Wellcoaches.-Registered Dietician is available through Rehab services for Nutrition Consultations.Healthy Parenting-LifeCare offers Prenatal classes, 1:1 prenatal education, and in home well baby checkups.-Family Home visiting services are available for high-risk families with young children.-Lactation Educators are available for lactation counseling and/or visits.-Continued partnership with the SAFE KIDS Coalition of Grand Forks to increase resources for the safety of children from birth to high school. Activities this year included: Bike Safety event, Head injury/concussion education in schools, car seat check up event, and BLAST Babysitting classes were offered.-The Drug-Free Communities Grant, mentioned above, will include resources on positive parenting.Tobacco Use-Working with Roseau county commissioners regarding stricter tobacco ordinances.-LifeCare has increased the number of Freedom from Smoking facilitators to 4 and provides multiple sessions of this class in the community. -Plans for a tobacco cessation support group are underway. LifeCare Medical Center Part V, Section B, Line 16j: In addition to providing the full policy upon request, the Hospital also summarizes the policy on its website, billing invoices, as well as brochures summarizing the policy in the emergency rooms and admissions office. 3 1 - LifeCare Roseau Manor 715 Delmore Drive Roseau MN 56751 Skilled Nursing Facility 2 - LifeCare Greenbush Manor 19120 290th Street Greenbush MN 56726 Skilled Nursing Facility and Assisted Living Facility 3 - LifeCare Home Care and Hospice 715 Delmore Drive Roseau MN 56751 Home Health and Hospice Part I, Line 7: Charity care was converted to cost by multiplying the ratio of cost to gross charges by the gross uncompensated charges associated with providing charity care to its patients. Community health improvements and cash and in-kind contributions are calculated at actual costs recorded in the general ledger. Education costs are based on estimated time and wages to manage students and interns at the facilities. Subsidized health services is converted to cost 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 total expenses to determine the percentage was $830,157. Part II, Community Building Activities: Community support includes donations to local community organizations and employee staff time donated to local community committees. Community support includes employee staff time spent on disaster preparedness beyond legal requirements.Coalition building includes EMT and CPR training for area First Responders and Fire Departments, as well as time donated to the Roseau Area Diabetes Center.Community health improvement advocacy includes staff time on healthcare related boards that advocate for healthcare, as well as time spent on discussions on proper prescription drug disposals, med alerts, chronic disease management, time spent in local correctional facilities on prescription drug abuse and on the Roseau County Committee on Aging. By being involved in the community through the above activities, we are able to increase health awareness.Roseau County is considered a Health Professional Shortage Area and therefore is including the costs of recruitment in workforce development. This promotes better care for our patients. The costs include physician recruitment, career fairs and workforce development committees. Part III, Line 2: Bad debt expense is reported net of discounts and contractual allowances. 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 gross charity care at charges as a percentage of total gross hospital revenue. It is reasonable to assume that charity care as a percentage of gross revenue can also be applied to bad debt. Part III, Line 4: The footnote to the organization's financial statements that describes bad debt expense can be found on page seven and eight of the audited financial statement. Part III, Line 8: Services are provided to patients under the Medicare program knowing that not all costs associated with providing these services will be recovered. Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, the entire Medicare shortfall is considered a community benefit.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. Part III, Line 9b: If a patient is known to qualify for financial assistance, or if the patient begins the financial assistance process, all collection actions cease until the application is completed. Part VI, Line 2: LifeCare provides the Public Health functions for Roseau County. Part VI, Line 3: We have financial counselors who have phone conversations with patients during our collections process. We guide patients to other financial programs as well as our own charity care program. Brochures are available in the admitting area which is in the same location as the Emergency Room. Information is also sent to our patients via patient bills. Our website has the charity care application and brochure, as well as the contact information for our financial counselors, available to patients. Part VI, Line 4: Roseau County is a rural area with a population of approximately 17,000 people. We are the sole hospital located in Roseau County and the nearest tertiary hospital is two hours away. We are a federally-designated medically underserved area. In 2009, approximately 12.7% of the population was age 65 or older. The average per capita income is 23,061 and approximately 9.7% of the population is below the federal poverty level. 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.As a not-for-profit organization, LifeCare Medical Center has made a promise to give back to its community. As a regional healthcare leader, LifeCare strives to respond to healthcare needs by partnering with local leaders, educators, government officials and others.The community benefit report summarizes how this leadership role has made a difference to the people of the area. Included are highlights describing how LifeCare has played an integral role in enhancing the health and overall well-being of the community.Trusted PartnershipsLifeCare's commitment to quality care extends beyond its walls and into the community where strong partnerships have been built to maintain and improve the health and overall well-being of its neighbors. LifeCare EMS personnel are proud of their trusted relationships with regional emergency response groups. Area fire fighters, police, and others participate in disaster training sessions where a disaster is staged and responded to as if it were a real life situation. This type of training helps prepare all groups involved.Education for a Healthy FuturePart of LifeCare's mission is to help educate the next generation of health care professionals. LifeCare Directors work closely with many regional high school and post-secondary educational facilities to bring students into our organization through job shadowing, internships, rural scholar and other programs. Through these programs, students get a firsthand look at specific health care careers as they learn from our staff for a day, week, month or several months based on their program. Students often times focus on rural healthcare employment opportunities that may be available to them once they have completed their education.Charity CareLifeCare recognizes that circumstances arise where a patient is simply unable to pay a hospital bill. In these situations, LifeCare offers a program called Charity Care, in which LifeCare forgives the bills of deserving families and individuals who meet set income guidelines. Great appreciation has been voiced by many who received a helping hand from this program. In fiscal year 2017, LifeCare granted over $395,000 in Charity Care based on charges foregone.A Healthy Awareness and Community OutreachLifeCare employees know the importance of educating the public about a healthy lifestyle. And sometimes the best way to provide awareness is to venture outside the facility. That's why LifeCare is involved with many initiatives throughout our communities. By reaching out to the public through nutrition and exercise programs, civic projects, health and safety awareness, health fairs, and other methods, they are able to educate and strengthen the community.Fifth grade tours have become a favorite for students throughout Roseau County. A hospital tour is coupled with a mini health fair where students learn their blood type. The goal of this program is to influence young students into making healthy lifestyle decisions, in addition to introducing them to careers in healthcare.Funding Essential ServicesLifeCare's commitment to community needs is exemplified by its contribution to subsidized services. In fiscal year 2017, LifeCare absorbed over $2,675,000 in costs in order to sustain services that rely on funding from other sources, in particular the Medicaid program. These departments include Home Health Care, Public Health, Ambulance, Clinic space and LifeCare's two nursing homes (Roseau Manor and Greenbush Manor).LifeCare Medical Center distributed almost $4.6 million based on cost in Community Benefits in fiscal year 2017 as reported on Schedule H Part I, II and III. Part VI, Line 7, Reports Filed With States MN 1 Roseau County 606 5th Ave SW Roseau MN 56751 416005889 Roseau County 31258 Valley Med Flight: pay for half of the expense to cover all costs not paid by insurance for each person that lives in Roseau County that needs to take a flight to another hospital. 1 0 Scholarships 9 6500 Part I, Line 2: The Medical Center does not specifically monitor the use of funds once the funds are provided to the individual or entity. They provide funds to Roseau based on their application for grants. The Organization provides scholarships to both high school students and students currently enrolled in a higher education program. The student must be pursueing a health care related field. If the recipient is a high school student the Organization pays the scholarships directly to the college or university they are attending. If the recipient is currently attending college they will pay the funds to the recipient or the college. X X 0 0 0 0 0 0 0 0 0 Keith Okeson CEO/President 285922 0 31699 0 2116 0 36830 0 38355 0 394922 0 0 0 Cathy Huss CFO 194428 0 14794 0 1748 0 37710 0 34487 0 283167 0 0 0 Gordon Streiff Pharmacy Director 156615 0 3638 0 1352 0 10799 0 34160 0 206564 0 0 0 Susan Lisell Senior Leader 172459 0 4293 0 4086 0 35586 0 16239 0 232663 0 0 0 Shannon D Carlson Senior Leader 146874 0 3852 0 1259 0 18558 0 31851 0 202394 0 0 0 Judy K Mattson Pharmacist 132590 0 200 0 1262 0 33070 0 37673 0 204795 0 0 0 Kevin L Schumacher Information Systems Direct 123251 0 500 0 1134 0 11778 0 31282 0 167945 0 0 0 A Roseau Area Hospital District 410785143 777187CW3 2012-11-15 5860000 Refund Series 1998 Bonds Issued 12/01/1998 0 0 0 A 2445000 5860000 586000 117200 5156800 2012 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 0 0 0 0 0 1 A 1 Schedule K, Part II, Line 4, Gross Proceeds in Reserve Fund The filing organization does not report the $586,000 reserve funds on their audited financials due to the issuer of the tax exempt bonds holding these funds. The issuer of the tax exempt bonds has included this amount on their financial statements. Form 990, Part VI, Section A, line 1 The Executive Committee consists of the Chair, Vice-Chair, Treasurer, Secretary, and at least one other director (who shall be selected annually.) The President/CEO will be a non-voting member of the committee. The President/CEO will be excused for matters relating to compensation and evaluation. The Executive Committee shall meet as often as necessary at the call of the Chair, Vice-Chair, or at the request of any two of its members. A majority of the Executive Committee shall constitute a quorum. The Executive Committee's specific responsibilities are to: * Exercise the authority of the board in the management of the business of the corporation between regularly scheduled meetings. * Report to the board any official actions it has taken at the next board meeting. * Review and approve the compensation program for the senior leaders of the organization that is designed to allow the organization to recruit and retain superior talent. * Responsible for conducting on an annual basis the process of establishing goals, evaluating the performance and establishing the compensation of the President/CEO. Form 990, Part VI, Section B, line 11b The return is reviewed initially by the CFO. The return is made available to the Board of Trustees before it is filed. Form 990, Part VI, Section B, line 12c All officers, trustees, and key employees are required to complete a conflict of interest form annually. The form is reviewed by the Board of Trustees to determine if any conflicts exist. If there are any conflicts, the Board of Trustees will discuss the restrictions that should be placed on the person with the conflict. Restrictions are typically related to voting and discussion of matters related to the conflict. Form 990, Part VI, Section B, line 15 The compensation for the CEO and CFO is approved by the Executive Committee based on comparability data. The CEO and CFO both have employment contracts. The deliberation and discussion of compensation is documented in the board meeting minutes. This process takes place on an annual basis. Form 990, Part VI, Section C, line 19 The organization's governing documents, conflict of interest policy, and financial statements are available upon request. Form 990, Part IX, line 11g Physician Fees: Program service expenses 1,984,322. Management and general expenses 16,000. Fundraising expenses 0. Total expenses 2,000,322. Service Related Fees: Program service expenses 2,484,444. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,484,444. Other Professional Fees: Program service expenses 222,850. Management and general expenses 237,884. Fundraising expenses 0. Total expenses 460,734.