CENTRACARE HEALTH SYSTEM-LONG PRAIRIE: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- CENTRACARE HEALTH SYSTEM-LONG PRAIRIE (EIN 41-1924645)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-05-15
- IRS object ID
- 201831359349301938
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-05-15T08:24:22-05:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 420714325 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RSM US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 801 NICOLLET MALL SUITE 1100 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411924645 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRACARE HEALTH SYSTEM - LONG PRAIRIE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CENT | BusinessNameControlTxt |
| Phone | 3207322141 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20 SE NINTH STREET | AddressLine1Txt |
| City | LONG PRAIRIE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56347 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CRAIG BROMAN | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 3207322141 | PhoneNum |
| Signature | 2018-05-01 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TODD A JACKSON | PreparerPersonNm |
| PTIN | P00092672 | PTIN |
| Phone | 6123324300 | PhoneNum |
| Preparation | 2018-05-01 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRACARE HEALTH - LONG PRAIRIE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DR KENNETH D HOLMEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20 SE NINTH STREET | AddressLine1Txt |
| City | LONG PRAIRIE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56347 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $32,847,504 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CENTRACARE.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1999 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | CENTRACARE HEALTH SYSTEM WORKS TO IMPROVE THE HEALTH OF EVERY PATIENT, EVERY DAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 326 | TotalEmployeeCnt |
| Total Volunteers | 50 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $192,503 | PYContributionsGrantsAmt |
| CY Contributions Grants | $218,547 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $29,339,862 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $31,097,020 | CYProgramServiceRevenueAmt |
| PY Investment Income | $273,056 | PYInvestmentIncomeAmt |
| CY Investment Income | $559,147 | CYInvestmentIncomeAmt |
| PY Other Revenue | $566,048 | PYOtherRevenueAmt |
| CY Other Revenue | $630,898 | CYOtherRevenueAmt |
| PY Total Revenue | $30,371,469 | PYTotalRevenueAmt |
| CY Total Revenue | $32,505,612 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $51,900 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $77,074 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $18,129,564 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $18,347,104 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $10,881,573 | PYOtherExpensesAmt |
| CY Other Expenses | $11,632,703 | CYOtherExpensesAmt |
| PY Total Expenses | $29,063,037 | PYTotalExpensesAmt |
| CY Total Expenses | $30,056,881 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,308,432 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,448,731 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $56,767,875 | TotalAssetsBOYAmt |
| Total Assets EOY | $74,944,386 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $38,666,151 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $55,228,511 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $18,101,724 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $19,715,875 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | CENTRACARE HEALTH WORKS TO IMPROVE THE HEALTH OF EVERY PATIENT, EVERY DAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $15,649,850 | ExpenseAmt |
| Grant | $77,074 | GrantAmt |
| Revenue | $19,775,657 | RevenueAmt |
| Desc | CCH - LONG PRAIRIE IS PART OF A LARGER INTEGRATED HEALTH CARE DELIVERY SYSTEM KNOWN AS CENTRACARE HEALTH, A SYSTEM RECOGNIZED FOR BEING A LEADER IN PROVIDING HIGH-QUALITY, COMPREHENSIVE CARE THROUGHOUT THE REGION. CCH - LONG PRAIRIE IS A 25 BED CRITICAL ACCESS HOSPITAL THAT PROVIDES ACUTE CARE SERVICES IN THE AREAS OF MEDICAL, SURGICAL, DIAGNOSTIC, AND OBSTETRICS ALONG WITH OTHER SERVICES OF 24 HOUR EMERGENCY ROOM, IMAGING, LABORATORY, REHABILITATION, AND CHEMOTHERAPY TO THE COMMUNITY OF LONG PRAIRIE AND THE SURROUNDING AREA. THERE WERE 562 ADMITS, 2,235 INPATIENT DAYS, AND 30,336 OUTPATIENT VISITS DURING FISCAL YEAR 2017. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $4,864,895 | ExpenseAmt |
| Revenue | $6,216,145 | RevenueAmt |
| Desc | CCH - LONG PRAIRIE OPERATES THE LONG PRAIRIE CLINIC WHICH IS CONVENIENTLY CONNECTED TO THE LONG PRAIRIE HOSPITAL FOR THE HEALTH CARE NEEDS OF THE COMMUNITY. LONG PRAIRIE CLINIC PROVIDES HEALTH CARE THROUGH A MIXTURE OF PHYSICIANS AND MIDLEVEL PROVIDERS. THERE WERE 20,301 CLINIC VISITS, 705 SURGEON CLINIC VISITS, AND 413 OPTHALMOLOGIST CLINIC VISITS DURING FISCAL YEAR 2017.CCH - LONG PRAIRIE ALSO OPERATES THE EAGLE VALLEY CLINIC IN EAGLE BEND, MN WHICH PROVIDES HEALTH CARE FOR BOTH THE CLARISSA AND EAGLE BEND COMMUNITIES AND SURROUNDING AREAS. THE EAGLE VALLEY CLINIC PROVIDES HEALTH CARE THROUGH THE USE OF MIDLEVEL PROVIDERS WITH OVERSIGHT OF THE PHYSICIANS FROM THE LONG PRAIRIE CLINIC. THERE WERE 1,213 CLINIC VISITS DURING FISCAL YEAR 2017. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $4,696,448 | ExpenseAmt |
| Revenue | $5,702,171 | RevenueAmt |
| Desc | THE CCH - LONG PRAIRIE CARE CENTER IS AN ATTACHED 70 BED SKILLED NURSING FACILITY THAT PROVIDES QUALITY, COMPASSIONATE CARE WITH AN EMPHASIS ON ENHANCING EACH RESIDENT'S PHYSICAL, SPIRITUAL, EMOTIONAL, AND SOCIAL WELL-BEING. THERE WERE 23,527 RESIDENT DAYS DURING FISCAL YEAR 2017. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $25,211,193 | 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 | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | 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 | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 49 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 326 | 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 | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | 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 | Yes (1) | 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 | LARRY KNUTSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3207327240 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20 SOUTHEAST NINTH STREET | AddressLine1Txt |
| City | LONG PRAIRIE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56347 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (11 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 | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| KENNETH D HOLMEN MD | |||||||||
| CEO | 1.00 | 39.00 | Yes (X) | Yes (X) | $0 | $1,293,753 | $26,581 | ||
| CRAIG J BROMAN | |||||||||
| PRESIDENT | 1.00 | 39.00 | Yes (X) | Yes (X) | $0 | $1,082,537 | $52,031 | ||
| DAVID TILSTRA MD CPE | |||||||||
| VICE PRESIDENT | 1.00 | 39.00 | Yes (X) | Yes (X) | $0 | $563,499 | $90,054 | ||
| PAUL R HARRIS ESQ | |||||||||
| CORPORATE SECRETARY | 2.00 | 38.00 | Yes (X) | Yes (X) | $0 | $504,874 | $83,489 | ||
| GREGORY R KLUGHERZ | |||||||||
| TREASURER/CFO, CCHS | 1.00 | 39.00 | Yes (X) | Yes (X) | $0 | $798,201 | $43,401 | ||
| DANIEL J SWENSON | |||||||||
| ADMINISTRATOR - LONG PRAIRIE | 39.50 | 0.50 | $0 | $268,930 | $47,670 | Yes (X) | |||
| WINN H GREGORY MD | |||||||||
| PHYSICIAN | 40.00 | $0 | $384,298 | $33,185 | Yes (X) | ||||
| RYAN C SCOTT DO | |||||||||
| PHYSICIAN | 40.00 | $0 | $369,344 | $40,135 | Yes (X) | ||||
| RENE ELDIDY MD | |||||||||
| PHYSICIAN | 40.00 | $0 | $328,781 | $45,468 | Yes (X) | ||||
| DEBORAH P RASMUSSEN MD | |||||||||
| PHYSICIAN | 40.00 | $0 | $321,031 | $43,479 | Yes (X) | ||||
| YUN CHAU B LEE MD | |||||||||
| PHYSICIAN | 40.00 | $0 | $592,812 | $45,336 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $6,508,060 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $550,829 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 8 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| WHITESELL MEDICAL STAFFING | |||||
| 1630 ANDERSON AVE SUITE 100 | BUFFALO | MN | 55303 | PHYSICIAN SERVICES | $524,278 |
| CENTRAL MN DIAGNOSTIC INC | |||||
| 150 10TH ST NW | MILACA | MN | 56353 | MRI/CT SERVICES | $509,495 |
| JOHNSON CONTROLS INC | |||||
| 402 GREAT OAK DRIVE BLDG B | WAITE PARK | MN | 56387 | BUILDING EFFICIENCY | $406,160 |
| HAMMEL GREEN AND ABRAHAMSON | |||||
| PO BOX 86 | MINNEAPOLIS | MN | 55486 | ARCHITECT SERVICES | $402,720 |
| WEST CENTRAL ANESTHESIA PC | |||||
| 520 COUNTRY OAK DRIVE | SAUK CENTRE | MN | 56370 | CRNA SERVICES | $357,343 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $218,547 | AllOtherContributionsAmt |
| Total Contributions | $218,547 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT AND RESIDENT SERVICE REVE | 900099 | $30,703,350 | $30,703,350 |
| OTHER PROGRAM REVENUE | 900099 | $393,670 | $393,670 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $31,097,020 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $530,538 | TotalRevenueColumnAmt |
| Exclusion | $530,538 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $33,945 | 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 | $33,945 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $33,945 | TotalRevenueColumnAmt |
| Exclusion | $33,945 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $28,609 | 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 | $28,609 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,609 | TotalRevenueColumnAmt |
| Exclusion | $28,609 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $938,845 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $341,892 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $596,953 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $596,953 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $32,505,612 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $31,693,973 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $593,092 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,250 | TotalAmt |
| Program Services | $74,250 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,824 | TotalAmt |
| Program Services | $2,824 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,016,047 | TotalAmt |
| Program Services | $11,257,499 | ProgramServicesAmt |
| Management And General | $2,758,548 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $588,012 | TotalAmt |
| Program Services | $472,283 | ProgramServicesAmt |
| Management And General | $115,729 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,950,631 | TotalAmt |
| Program Services | $2,369,907 | ProgramServicesAmt |
| Management And General | $580,724 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $792,414 | TotalAmt |
| Program Services | $636,456 | ProgramServicesAmt |
| Management And General | $155,958 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,194 | TotalAmt |
| Program Services | $3,369 | ProgramServicesAmt |
| Management And General | $825 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,530 | TotalAmt |
| Program Services | $17,293 | ProgramServicesAmt |
| Management And General | $4,237 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,273 | TotalAmt |
| Program Services | $1,273 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,573 | TotalAmt |
| Management And General | $21,573 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,112,404 | TotalAmt |
| Program Services | $3,303,027 | ProgramServicesAmt |
| Management And General | $809,377 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,182 | TotalAmt |
| Program Services | $43,518 | ProgramServicesAmt |
| Management And General | $10,664 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,937 | TotalAmt |
| Program Services | $67,417 | ProgramServicesAmt |
| Management And General | $16,520 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $381,602 | TotalAmt |
| Program Services | $306,498 | ProgramServicesAmt |
| Management And General | $75,104 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,413 | TotalAmt |
| Program Services | $36,475 | ProgramServicesAmt |
| Management And General | $8,938 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,499 | TotalAmt |
| Program Services | $42,970 | ProgramServicesAmt |
| Management And General | $10,529 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $726,616 | TotalAmt |
| Program Services | $583,608 | ProgramServicesAmt |
| Management And General | $143,008 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $187,827 | TotalAmt |
| Program Services | $150,860 | ProgramServicesAmt |
| Management And General | $36,967 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| SUPPLIES | $3,563,131 | $3,563,131 |
| BAD DEBT | $834,418 | $834,418 |
| MEDICAID/MN CARE | $647,481 | $647,481 |
| MEDICAL EQUIPMENT RENTA | $400,837 | $400,837 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $492,786 | TotalAmt |
| Program Services | $395,799 | ProgramServicesAmt |
| Management And General | $96,987 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,056,881 | TotalAmt |
| Program Services | $25,211,193 | ProgramServicesAmt |
| Management And General | $4,845,688 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,738,685 | BOYAmt |
| EOY | $3,147,485 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,948,640 | BOYAmt |
| EOY | $4,814,055 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $314,512 | BOYAmt |
| EOY | $327,806 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $136,026 | BOYAmt |
| EOY | $84,477 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $52,542,169 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $10,855,124 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,494,843 | BOYAmt |
| EOY | $41,687,045 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,357,393 | BOYAmt |
| EOY | $13,650,389 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $428,120 | BOYAmt |
| EOY | $428,850 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $349,656 | BOYAmt |
| EOY | $10,804,279 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,767,875 | BOYAmt |
| EOY | $74,944,386 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,052,104 | BOYAmt |
| EOY | $2,420,581 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,325 | BOYAmt |
| EOY | $9,185 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,212,608 | BOYAmt |
| EOY | $2,090,355 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,387,114 | BOYAmt |
| EOY | $50,708,390 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,666,151 | BOYAmt |
| EOY | $55,228,511 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,052,574 | BOYAmt |
| EOY | $19,659,180 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,150 | BOYAmt |
| EOY | $56,695 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,101,724 | BOYAmt |
| EOY | $19,715,875 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,767,875 | BOYAmt |
| EOY | $74,944,386 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $2,448,731 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $471,983 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$1,306,563 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
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 | $1,273 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,273 | 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 | CENTRACARE - LONG PRAIRIE PAID $1,273 TO SATE AND NATIONAL ASSOCIATIONS TO CONDUCT LOBBYING ACTIVITIES ON ITS BEHALF, AS A MEMBER OF THE ASSOCIATIONS. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | 0 | InclEscrowCustodialAcctLiabInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $312,427 | OtherCostOrOtherBasisAmt |
| Book Value | $312,427 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,909,654 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,956,205 | DepreciationAmt |
| Book Value | $3,953,449 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $35,316,942 | OtherCostOrOtherBasisAmt |
| Depreciation | $220,535 | DepreciationAmt |
| Book Value | $35,096,407 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,003,146 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,678,384 | DepreciationAmt |
| Book Value | $2,324,762 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $41,687,045 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| ASSETS INTERNALLY DESIGNATED FOR CAPITAL ACQUISITIONS | $6,469,494 | C |
| FUNDS HELD WITH TRUST - UNDER BOND INDENTURE | $7,180,895 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $13,650,389 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DEFERRED DEBT ACQUISITION | $265,167 |
| DUE FROM AFFILIATES | $10,539,112 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $10,804,279 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| ASSET RETIREMENT OBLIGATION | $131,202 |
| BOND PREMIUM | $33,106,877 |
| THIRD PARTY PAYOR SETTLEMENTS | $172,000 |
| CAPITAL LEASES | $38,815 |
| DUE TO AFFILIATES | $17,259,496 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $50,708,390 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | CENTRACARE, THE CORPORATION, THE CLINIC, CCH - MELROSE, CCH - LONG PRAIRIE, CCH - SAUK CENTRE, AND THE FOUNDATION HAVE BEEN DETERMINED TO QUALIFY AS TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CCH - MONTICELLO AND CCH - PAYNESVILLE, AS DISREGARDED LLCS UNDER INTERNAL REVENUE SERVICE REGULATIONS, ACHIEVE TAX-EXEMPT TREATMENT BASED ON THE EXEMPT STATUS OF THEIR PARENT, CENTRACARE HEALTH SYSTEM. AT JUNE 30, 2017 AND 2016, THERE WERE NO UNCERTAIN TAX POSITIONS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| 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 | 175.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| 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 | $320,824 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $320,824 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01100 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,665,562 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,957,509 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,708,053 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05850 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,986,386 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,957,509 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,028,877 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06950 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,020 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $19,020 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $396 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $396 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,416 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $19,416 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,005,802 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,957,509 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,048,293 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07020 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $834,418 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $8,181,745 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $8,178,090 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $3,655 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| 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 | CENTRACARE HEALTH - LONG PRAIRIE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20 NINTH STRET SOUTHEAST | AddressLine1Txt |
| City | LONG PRAIRIE | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56347 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | RURAL HEALTH CLINIC, SKILLED LONG-TERM CARE FACILITY | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRACARE HEALTH - LONG PRAIRIE | 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 |
| 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 |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | 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 | WWW.CENTRACARE.COM | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.CENTRACARE.COM | 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 | 175.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| 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 |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE | 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 Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Legal Judicial Process | Yes (X) | PermitLegalJudicialProcessInd |
| Permit Other Actions | Yes (X) | PermitOtherActionsInd |
| Collection Activities | Yes (1) | CollectionActivitiesInd |
| Engaged Legal Judicial Process | Yes (X) | EngagedLegalJudicialProcessInd |
| Other Actions | Yes (X) | OtherActionsInd |
| 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 |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| CENTRACARE HEALTH - LONG PRAIRIE | PART V, SECTION B, LINE 3J: CENTRACARE HEALTH'S (CCH) CHNA PRIMARY NEEDS WERE IDENTIFIED USING THE CENTER FOR DISEASE CONTROL'S COMMUNITY HEALTH STATUS INDICATORS (CHSI). THE PROCESS ALSO CONSIDERED SECONDARY DATA FROM THE DARTMOUTH ATLAS, ROBERT WOOD JOHNSON, MINNESOTA DEPARTMENT OF HEALTH, US CENSUS BUREAU, MINNESOTA HOSPITAL ASSOCIATION, AND PUBLIC HEALTH DEPARTMENTS FROM APPROPRIATE COUNTIES AND ADDITIONAL FEDERAL AND STATE ENTITIES. THE CHNA WAS INFORMED BY A COLLABORATIVE AND ONGOING COMMUNITY HEALTH SURVEY JOINTLY FUNDED AND MANAGED WITH A NUMBER OF AREA COUNTIES WHO WERE JOINTLY CONDUCTING COMMUNITY SURVEYS TO INFORM THEIR COMMUNITY HEALTH ASSESSMENTS IN SUPPORT OF DEVELOPMENT OF THEIR COMMUNITY HEALTH IMPROVEMENT PLANS.LACK OF CURRENT PUBLIC HEALTH DATA WAS A SIGNIFICANT INFORMATION GAP IN THE CHNA AS THE SURVEY COULD NOT BE COMPLETED IN TIME TO INCLUDE ITS DATA IN THE CCH CHNA. CCH HAS COMMITTED TO A CONTINUING EFFORT WITH PUBLIC HEALTH OFFICIALS TO JOINTLY DEVELOP PRIORITIES WITH THE COUNTIES AS A PART OF ITS ACTION PLANS. |
| CENTRACARE HEALTH - LONG PRAIRIE | PART V, SECTION B, LINE 5: DATA WAS OBTAINED FROM LOCAL COUNTY PUBLIC HEALTH DEPARTMENTS, INCLUDING THEIR MOST RECENT HEALTH ASSESSMENTS AND COMMUNITY REPORTS. IN ADDITION, HEALTH-RELATED INFORMATION WAS COLLECTED FROM AREA NONPROFIT ORGANIZATIONS THAT REGULARLY CONDUCT ASSESSMENTS AND EVALUATIONS OF THE SERVICES THEY PROVIDE AND THEIR TARGETED DEMOGRAPHICS. USEFUL MATERIAL WAS GATHERED FROM THE LOCAL UNITED WAY, CATHOLIC CHARITIES, THE CENTRAL MINNESOTA COUNCIL ON AGING, AND THE TRI-COUNTY ACTION PROGRAM (TRI-CAP). THESE ORGANIZATIONS SUPPORT A BROAD RANGE OF CONSTITUENTS WITH DIVERSE HEALTH-RELATED NEEDS; THEY REPRESENT DEMOGRAPHICS THAT ARE STATISTICALLY MORE LIKELY TO ENCOUNTER HEALTH-RELATED BARRIERS. CCH ALSO CONDUCTED A SERIES OF FOCUS GROUPS THAT INFORMED ITS CHNA. SPECIFICALLY, THE FOCUS GROUPS REPRESENTED POPULATIONS OF COLOR, RECENT IMMIGRANT POPULATIONS, CULTURAL MINORITIES, THOSE WHO WERE AUDIBLY CHALLENGED AND OTHERS WHO WERE DEEMED TO BE UNDER-REPRESENTED OR UNDER-SERVED. |
| CENTRACARE HEALTH - LONG PRAIRIE | PART V, SECTION B, LINE 6A: CCH CONDUCTED ITS CHNA JOINTLY WITH ALL OF ITS 501(C)(3) HOSPITALS AS OF THE BEGINNING OF ITS FISCAL YEAR 2016. THOSE FACILITIES INCLUDED ST. CLOUD HOSPITAL, CENTRACARE HEALTH - MELROSE, CENTRACARE HEALTH - LONG PRAIRIE, CENTRACARE HEALTH - SAUK CENTRE, CENTRACARE HEALTH - MONTICELLO AND CENTRACARE HEALTH - PAYNESVILLE.EACH HOSPITAL PREPARED INDIVIDUAL ACTION PLANS TO THE CHNA BASED ON SPECIFIC INPUT FROM THOSE COMMUNITIES. |
| CENTRACARE HEALTH - LONG PRAIRIE | PART V, SECTION B, LINE 11: THE NEEDS IDENTIFIED BY THE CHNA ARE CURRENTLY IN ORGANIZATIONAL WORK PLANS AND ARE UNDER IMPLEMENTATION. TO PRIORITIZE IDENTIFIED NEEDS, CHNA ADVISORY TASK FORCE MEMBERS DEVISED A SET OF CRITERIA. THE CRITERIA USED WERE: COMMUNITY IMPACT, POTENTIAL FOR CHANGE, ECONOMIC FEASIBILITY, COMMUNITY ASSETS, AND VALUE AND MISSION. THE PRIORITIZATION PROCESS IDENTIFIED THE FOLLOWING SIX, BROAD COMMUNITY HEALTH ISSUES: 1 - ADULT OBESITY2 - ADULT DIABETES3 - OLDER ADULT PREVENTABLE HOSPITALIZATIONS4 - STROKE DEATHS5 - CORONARY HEART DISEASE DEATHS6 - CANCER DEATHSST. CLOUD HOSPITAL WILL MAINTAIN ITS ENGAGEMENTS WITH THE CHNA ADVISORY TASK FORCE TO ENSURE EFFECTIVE COLLABORATION AND COMMUNICATION WITH THE OTHER CENTRACARE HOSPITALS. THE CHNA ADVISORY TASK FORCE WILL CONTINUE TO MEET DURING THE THREE-YEAR PERIOD IN WHICH THE IMPLEMENTATION STRATEGY WILL UNFOLD. DURING THIS TIME THE GROUP WILL:- IDENTIFY WHAT OTHER COMMUNITY ORGANIZATION ARE DOING IN REGARD TO HEALTH PRIORITY AREAS;- DEVELOP SPECIFIC GOALS AND METRICS TO MONITOR AND MEASURE PROGRESS AND OUTCOMES;- COMMUNICATE SHORT-TERM AND LONG-TERM RESULTS OF ACTION PLANS WITHIN THE COMMUNITY.BASED ON THE FINDINGS AND PRIORITIES ESTABLISHED BY THE CHNA, AND AFTER HAVING REVIEWED THE COMMUNITY BENEFITS ACTIVITIES THAT CURRENTLY EXIST, ST. CLOUD HOSPITAL WILL CONTINUE TO SUPPORT THE SYSTEM-WIDE INITIATIVES OUTLINED BELOW AND WILL PARTICIPATE IN LOCALIZED ADAPTIONS (AS DESCRIBED IN THE ACTION STEPS) OF THESE PROGRAMS WITH REGARD TO THE SPECIFIC NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL. TO SEE THE SPECIFIC ACTION PLAN FOR EACH OF THE SIX PRIORITY HEALTH AREAS SEE THE FULL IMPLEMENTATION STRATEGY FOR FISCAL YEAR 2016 - 2018 LOCATED ON THE WEBSITE AT:HTTP://WWW.CENTRACARE.COM/APP/FILES/PUBLIC/5221/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-CENTRACARE-HEALTH-SYSTEM.PDFPER GUIDANCE FROM THE IRS, REGULATION 1.501(R)-3(C), THE CHNA FOR CCH ELECTED NOT TO DIRECTLY ADDRESS SEVERAL DETERMINANTS OF HEALTH THAT IT IDENTIFIED IN ITS PROCESS WHICH WERE NOT WITHIN THE ORGANIZATION'S CAPABILITIES OR CORE COMPETENCIES. EXAMPLES OF ISSUES NOT SPECIFICALLY ADDRESSED IN THE CHNA ACTION PLANS INCLUDE HIGH SCHOOL GRADUATION RATES, AFFORDABLE HOUSING OR SUPPORTED HOUSING. CCH DID SUPPORT AN EFFORT OF THE CITY OF ST. CLOUD TO CONDUCT A HOUSING ASSESSMENT AS A RESULT OF THE CHNA PROCESS AND IS ALREADY THE LARGEST AREA PROVIDER OF SUPPORTED HOUSING DUE TO ITS EXTENSIVE CHEMICAL DEPENDENCY PROGRAMS AND SENIOR HOUSING PROGRAMS. |
| CENTRACARE HEALTH - LONG PRAIRIE | PART V, SECTION B, LINE 16J: PATIENTS WHO ARE AT A SELF PAY STATUS RECEIVE FINANCIAL ASSISTANCE INFORMATION EITHER VIA A TELEPHONE CALL OR ON BILLING STATEMENTS. |
| CENTRACARE HEALTH - LONG PRAIRIE | PART V, SECTION B, LINE 18E: THE ORGANIZATION EMPLOYS THE USE OF COLLECTION AGENCIES TO COLLECT A PATIENT'S BALANCE. AFTER THOSE EFFORTS ARE EXHAUSTED, THE ORGANIZATION DOES UTILIZE GARNISHMENTS & LAWSUITS AS WELL. ALL LEGAL ACTIONS ARE REVIEWED & APPROVED BY CCH MANAMGEMENT PRIOR TO INITIATING. |
| CENTRACARE HEALTH - LONG PRAIRIE | PART V, SECTION B, LINE 19E: THE ORGANIZATION EMPLOYS THE USE OF COLLECTION AGENCIES TO COLLECT A PATIENT'S BALANCE. AFTER THOSE EFFORTS ARE EXHAUSTED, THE ORGANIZATION DOES UTILIZE GARNISHMENTS & LAWSUITS AS WELL. ALL LEGAL ACTIONS ARE REVIEWED & APPROVED BY CCH MANAMGEMENT PRIOR TO INITIATING. |
| CENTRACARE HEALTH - LONG PRAIRIE | PART V, SECTION B, LINE 20E: OUR CREDIT COLLECTION AGENCIES ARE REQUIRED TO PROVIDE CHARITY INFORMATION AS PART OF THEIR COLLECTION PROCESS PRIOR TO ANY CONSIDERATION OF LEGAL ACTION AGAINST THE PATIENT. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - LONG PRAIRIE CARE CENTER | ||||
| 20 NINTH STREET SE | LONG PRAIRIE | MN | 56347 | SKILLED NURSING FACILITY |
| 2 - LONG PRAIRIE CLINIC | ||||
| 20 NINTH STREET SE | LONG PRAIRIE | MN | 56347 | CLINIC |
| 3 - EAGLE VALLEY CLINIC | ||||
| 815 HWY 71 SOUTH | EAGLE BEND | MN | 56446 | CLINIC |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | CENTRACARE HEALTH SYSTEM PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT THAT INCLUDES ALL RELATED ORGANIZATIONS. |
| PART I, LINE 7: | THE ORGANIZATIONS TOTAL EXPENSES WERE REDUCED BY THEIR NON-OPERATING REVENUE, MEDICAID SURCHARGE AND MN CARE TAX. THE NET TOTAL EXPENSES WERE THEN DIVIDED BY GROSS CHARGES TO DETERMINE THE COST TO CHARGE RATIO. |
| 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 $ 834,418. |
| PART III, LINE 2: | THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. |
| PART III, LINE 4: | THE FOLLOWING IS FROM THE "ACCOUNTS RECEIVABLE" PARAGRAPH INCLUDED IN NOTE 2 OF THE ORGANIZATION'S AUDITED FINANCIALS."PATIENT AND RESIDENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FORUNCOLLECTIBLE ACCOUNTS. THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF EXPECTED NET COLLECTIONS, CONSIDERING HISTORICAL NET COLLECTION, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, CENTRACARE FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY CENTRACARE." |
| PART III, LINE 8: | THE AMOUNT ON LINE 7 OF PART III WAS DETERMINED BY UTILIZING KEY SECTIONS OF THE MEDICARE COST REPORT, PRIMARILY THE D SERIES AND E SERIES. |
| PART III, LINE 9B: | THE COLLECTION POLICIES AT THE ORGANIZATION REQUIRE COLLECTION STAFF TO OFFER CHARITY CARE TO PATIENTS WHO INDICATE THAT PAYMENT MAY BE AN ISSUE. IF A PATIENT DOES QUALIFY FOR FULL CHARITY CARE, ALL OTHER COLLECTION EFFORTS MUST CEASE. IF A PATIENT QUALIFIES FOR PARTIAL CHARITY CARE, COLLECTION EFFORTS WILL CONTINUE ON THE BALANCE OF THE ACCOUNT. THESE PROVISIONS APPLY TO BOTH HOSPITAL EMPLOYED COLLECTION STAFF AND COLLECTION AGENCY STAFF. NO PATIENTS, WHETHER THEY QUALIFY FOR CHARITY CARE OR NOT, ARE REPORTED TO CREDIT REPORTING AGENCIES. |
| PART VI, LINE 2: | THE ORGANIZATIONS' STRATEGIC PLANNING ASSESSES THE NEEDS OF THE COMMUNITY AND PATIENTS THROUGH PATIENT SATISFACTION SURVEYS, COMMENT CARDS, COMMUNITY ASSESSMENTS AND A DIVERSE OPERATING COMMITTEE THAT REPRESENTS THE COMMUNITY AND BRINGS TO THE TABLE ISSUES, CONCERNS AND RECOMMENDATIONS FOR HEALTH CARE SERVICES. |
| PART VI, LINE 3: | INPATIENTS WHO ARE SELF PAY ARE IDENTIFIED, AND A REPRESENTATIVE OF THE ORGANIZATION'S BILLING DEPARTMENT EXPLAINS THE CHARITY CARE POLICY TO PATIENTS. THEY ALSO EXPLAIN THE SELF PAY DISCOUNT AND SCREENS THE PATIENT FOR ELIGIBILITY FOR ANY STATE OR FEDERAL PROGRAMS. THEY ALSO ASSIST THE PATIENT WITH ANY PAPERWORK REQUIRED TO APPLY FOR SUCH PROGRAMS. OUTPATIENTS WHO ARE SELF PAY RECEIVE AN AUTOMATIC SELF PAY DISCOUNT. IF THE PATIENT DOES NOT REMIT PAYMENT, COLLECTION STAFF ATTEMPT TO REACH THE PATIENT BY PHONE. PATIENTS ARE TOLD ABOUT THE CHARITY PROGRAM. FOR BOTH INPATIENTS AND OUTPATIENTS, ALL STATEMENTS CONTAIN A LETTER REGARDING THE AVAILABILITY OF CHARITY CARE. ALSO ALL PRECOLLECTION LETTERS HAVE THIS SAME LANGUAGE INDICATING THE AVAILABILITY AND PROCESS OF OBTAINING CHARITY CARE. |
| PART VI, LINE 4: | LONG PRAIRIE IS LOCATED IN TODD COUNTY, MINNESOTA. THE ESTIMATED 2017 POPULATION SHOWS 6,716 RESIDENTS WITH AN ESTIMATED DECLINE TO 6,675 BY 2022. THIS AREA HAS SEEN DECLINES IN ITS POPULATION AND PROJECTIONS INDICATE THAT WILL CONTINUE. THE PROJECTED GROWTH BY AGE BRACKET FROM 2017 TO 2022 IS AS FOLLOWS: 0-17: 2.5%, 18-44: 0.4%, 45-64: -10.0%, 65+: 5.9%. THE ESTIMATED 2017 ETHNIC MIX IS AS FOLLOWS: CAUCASIAN: 78.7%, AFRICAN AMERICAN: .5%, ASIAN: 1.3%, HISPANIC: 17.8%, OTHER: 1.8%. |
| PART VI, LINE 5: | THE ORGANIZATION HAS A COMMUNITY BASED OPERATING COMMITTEE THAT MEETS ON A MONTHLY BASIS TO REVIEW VARIOUS ASPECTS OF THE FACILITY AND PROVIDE INPUT ON THOSE ASPECTS FROM A COMMUNITY PERSPECTIVE. THE ORGANIZATION PARTICIPATES IN THE COMMUNITY BLOOD DRIVES BY PROVIDING FOOD AND SUPPLIES FOR BOTH THE WORKERS AND BLOOD DONORS. THE FACILITY ALSO SPONSORS A HEALTH FAIR ON AN ANNUAL BASIS FOR THE LOCAL AND SURROUNDING COMMUNITIES. |
| PART VI, LINE 6: | THE ORGANIZATION IS PART OF CENTRACARE HEALTH SYSTEM (CCHS) WHICH PROVIDES A BROAD RANGE OF HEALTH CARE SERVICES TO THE PATIENTS OF CENTRAL MINNESOTA. CCHS IS DEDICATED TO IMPROVING THE HEALTH OF PEOPLE LIVING AND WORKING IN THE COMMUNITIES IT SERVES. TO ACCOMPLISH ITS GOALS IT WORKS ACTIVELY WITH ITS AFFILIATE HEALTH CARE ORGANIZATIONS. CCHS CONTINUES TO FOCUS ON PROVIDING THE BEST CARE POSSIBLE AND IN REINVESTING INTO THE COMMUNITY. CCHS ALSO PROMOTES WELLNESS BY SPONSORING PROGRAMS AND EVENTS IN LOCAL COMMUNITIES THAT FOCUS ON HEALTHY EATING AND EXERCISE, AND BY CONDUCTING SCREENINGS FOR CONDITIONS SUCH AS HIGH BLOOD PRESSURE. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | MN |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRACARE FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1406 6TH AVE NORTH | AddressLine1Txt |
| City | ST CLOUD | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56303 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 411855173 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $65,000 | CashGrantAmt |
| Purpose Of Grant | PROGRAM SUPPORT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | CENTRACARE HEALTH SYSTEM, INCLUDING CCH - LONG PRAIRIE, HAS THE FOLLOWING POLICY REGARDING CHARITABLE CONTRIBUTIONS: CONTRIBUTIONS MUST BE IN KEEPING WITH THE MISSION OF CENTRACARE HEALTH, WHICH IS TO WORK TO IMPROVE THE HEALTH OF EVERY PATIENT, EVERY DAY. CONTRIBUTIONS WILL BE MADE TO ORGANIZATIONS RATHER THAN TO INDIVIDUALS WITHIN THE CENTRAL MINNESOTA REGION. CENTRACARE'S CHARITABLE FUNDS MAY NOT BE USED TO SUPPORT ANY ORGANIZATION OR EVENT THAT WOULD RESULT IN BENEFITS OF ANY KIND TO AN EMPLOYEE OF THE HEALTH SYSTEM OR A MEMBER OF THE VARIOUS BOARDS OF DIRECTORS, EITHER DIRECTLY OR INDIRECTLY. ONE EXCEPTION EXISTS TO THE GUIDELINE REGARDING BENEFIT TO EMPLOYEES: WE WILL SUPPORT, VIA SCHOLARSHIPS AND THE PURCHASE OF SUPPLIES, THE MEDICAL MISSION WORK OF OUR STAFF AND PHYSICIANS. THE CENTRACARE HEALTH CONTRIBUTIONS COMMITTEE IS MADE UP OF: ONE REPRESENTATIVE FROM CENTRACARE HEALTH FOUNDATION; ONE REPRESENTATIVE FROM ST. CLOUD HOSPITAL HUMAN RESOURCES/DIVERSITY COMMITTEE; THE DIRECTOR OF CENTRACARE HEALTH'S COMMUNICATIONS DEPARTMENT AND THE COMMUNICATIONS/MARKETING SPECIALIST RESPONSIBLE FOR CENTRACARE CLINIC; THE DIRECTOR OF COMMUNICATIONS/MARKETING FOR ST. BENEDICT'S SENIOR COMMUNITY; THE DIRECTOR OF CENTRACARE HEALTH'S MARKETING DEPARTMENT; THE DIRECTOR OF ST. CLOUD HOSPITAL VOLUNTEER SERVICES; AND ST. CLOUD HOSPITAL'S DIRECTOR OF MISSION & SPIRITUAL CARE. THE COMMITTEE MEETS MONTHLY TO ENSURE A STREAMLINED, COORDINATED PROCESS OF REVIEWING REQUESTS AND DETERMINING FUNDING. THE COMMITTEE MAINTAINS A DATABASE TO TRACK ALL CONTRIBUTIONS. OTHER CENTRACARE ENTITIES, INCLUDING CENTRACARE HEALTH - LONG PRAIRIE, MELROSE, MONTICELLO, PAYNESVILLE AND SAUK CENTRE, MAY DEVELOP A BUDGET FOR APPROVAL AND IMPLEMENT THEIR OWN CONTRIBUTIONS DECISIONS WITHIN THE GUIDELINES OF THIS DOCUMENT. CONTRIBUTIONS MAY NOT EXCEED THE STATED BUDGET AND NO MULTI-YEAR COMMITMENTS TO ORGANIZATIONS MAY BE MADE WITHOUT APPROVAL FROM THE CENTRACARE HEALTH EXECUTIVE COUNCIL. INDIVIDUALS AND DEPARTMENTS FROM THROUGHOUT ST. CLOUD HOSPITAL AND CENTRACARE CLINIC SHOULD FORWARD ALL OUTSIDE FUNDING REQUESTS TO A MEMBER OF THE COMMITTEE FOR THE FULL GROUP'S CONSIDERATION. THOSE REQUESTING FUNDS SHOULD BE ASKED TO SUBMIT REQUESTS IN WRITING. | ExplanationTxt |
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 | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KENNETH D HOLMEN MD | ||||||||||||||
| CEO | $0 | $1,056,216 | $0 | $218,278 | $0 | $19,259 | $0 | $9,275 | $0 | $23,212 | $0 | $1,326,240 | $0 | $0 |
| CRAIG J BROMAN | ||||||||||||||
| PRESIDENT | $0 | $774,848 | $0 | $141,148 | $0 | $166,541 | $0 | $35,775 | $0 | $22,555 | $0 | $1,140,867 | $0 | $128,772 |
| DAVID TILSTRA MD CPE | ||||||||||||||
| VICE PRESIDENT | $0 | $390,396 | $0 | $101,271 | $0 | $71,832 | $0 | $65,629 | $0 | $29,254 | $0 | $658,382 | $0 | $53,652 |
| PAUL R HARRIS ESQ | ||||||||||||||
| CORPORATE SECRETARY | $0 | $371,496 | $0 | $65,685 | $0 | $67,693 | $0 | $56,781 | $0 | $31,458 | $0 | $593,113 | $0 | $52,707 |
| GREGORY R KLUGHERZ | ||||||||||||||
| TREASURER/CFO, CCHS | $0 | $575,712 | $0 | $88,532 | $0 | $133,957 | $0 | $26,845 | $0 | $22,462 | $0 | $847,508 | $0 | $104,969 |
| DANIEL J SWENSON | ||||||||||||||
| ADMINISTRATOR - LONG PRAIRIE | $0 | $203,854 | $0 | $27,038 | $0 | $38,038 | $0 | $24,319 | $0 | $24,651 | $0 | $317,900 | $0 | $21,619 |
| WINN H GREGORY MD | ||||||||||||||
| PHYSICIAN | $0 | $382,708 | $0 | $0 | $0 | $1,590 | $0 | $14,769 | $0 | $22,433 | $0 | $421,500 | $0 | $0 |
| RYAN C SCOTT DO | ||||||||||||||
| PHYSICIAN | $0 | $320,901 | $0 | $70 | $0 | $48,373 | $0 | $15,130 | $0 | $25,985 | $0 | $410,459 | $0 | $0 |
| RENE ELDIDY MD | ||||||||||||||
| PHYSICIAN | $0 | $257,816 | $0 | $69,544 | $0 | $1,421 | $0 | $22,542 | $0 | $25,085 | $0 | $376,408 | $0 | $0 |
| DEBORAH P RASMUSSEN MD | ||||||||||||||
| PHYSICIAN | $0 | $250,863 | $0 | $69,194 | $0 | $974 | $0 | $21,779 | $0 | $22,700 | $0 | $365,510 | $0 | $0 |
| YUN CHAU B LEE MD | ||||||||||||||
| PHYSICIAN | $0 | $537,813 | $0 | $175 | $0 | $54,824 | $0 | $33,703 | $0 | $13,477 | $0 | $639,992 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE COMPENSATION PAID TO THE PRESIDENT AND VICE-PRESIDENTS (NON-MEDICAL PROVIDERS) IS DETERMINED BY CENTRACARE HEALTH SYSTEM, A RELATED ORGANIZATION. CENTRACARE HEALTH SYSTEM USES THE FOLLOWING METHODS TO DETERMINE COMPENSATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| PART I, LINE 4B | THE CORPORATIONS' EXECUTIVES ARE ELIGIBLE TO PARTICIPATE IN BENEFIT PLANS WHICH INCLUDE TAX DEFERRED NON-QUALIFIED INVESTMENT ACCOUNTS. THESE PLANS MAY PROVIDE, BUT ARE NOT CERTAIN TO PROVIDE, FOR PAYMENT OF TAX DEFERRED COMPENSATION TO THESE EXECUTIVES AT SOME TIME IN THE FUTURE. THE EXECUTIVE HAS NO LEGAL RIGHT TO THESE DOLLARS UNTIL, AND UNLESS, CERTAIN FUTURE EVENTS OCCUR. IN ACCORDANCE WITH THE INSTRUCTIONS TO FORM 990, THE AMOUNTS LISTED IN PART VII AND SCHEDULE J, PART II, COLUMN C, REFLECT TAX DEFERRED COMPENSATION. THIS COMPENSATION IS POTENTIALLY REPORTED TWICE ON FORM 990 - ONCE WHEN THE COMPENSATION IS DEFERRED OR ACCRUED AND AGAIN IF AND WHEN IT IS PAID TO THE EXECUTIVE. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE NON-QUALIFIED PLAN: KENNETH D. HOLMEN, MD - PAID $0; ACCRUED $0 DAVID TILSTRA, MD, CPE - PAID $53,652; ACCRUED $35,053 GREGORY R KLUGHERZ - PAID $104,969; ACCRUED $0 PAUL R HARRIS - PAID $52,707; ACCRUED $32,842 CRAIG J BROMAN - PAID $128,772; ACCRUED $0 DANIEL J SWENSON - PAID $43,238; ACCRUED $10,300 |
| PART I, LINE 6 | THE ORGANIZATION PROVIDES INCENTIVE COMPENSATION TO DESIGNATED INDIVIDUALS BASED ON FOUR DISCRETE AREAS: A COMPARISON BETWEEN BUDGETED AND ACTUAL NET OPERATING INCOME FOR CENTRACARE CLINIC OR CENTRACARE HEALTH SYSTEM; ACHIEVEMENT OF IMPROVEMENT IN PATIENT SATISFACTION GOALS AS COMPARED TO NATIONAL AND BASELINE RANKINGS; ACHIEVEMENT OF IMPROVEMENT IN OVERALL EMPLOYMENT ENGAGEMENT SCORES; AND ACHIEVEMENT OF UP TO THREE INDIVIDUAL GOALS WHICH ARE TIED TO THE CENTRACARE SYSTEM'S STRATEGIC PLAN. THE INCENTIVE COMPENSATION PAID OUT IS NOT A PORTION OR PERCENTAGE OF ACTUAL NET EARNINGS OF ANY CENTRACARE HEALTH SYSTEM AFFILIATE, HOWEVER NET EARNINGS GOALS ARE REQUIRED TO BE MET BEFORE INCENTIVE COMPENSATION IS PAID. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | CENTRACARE HEALTH SYSTEM, A MINNESOTA NONPROFIT ASSOCIATION, IS THE SOLE MEMBER OF CENTRACARE HEALTH SYSTEM - LONG PRAIRIE. |
| FORM 990, PART VI, SECTION A, LINE 7A | ALL BOARD MEMBERS ARE APPOINTED BY CENTRACARE HEALTH SYSTEM, THE SOLE CORPORATE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING MATTERS ARE RESERVED FOR ACTION BY CENTRACARE HEALTH SYSTEM, THE SOLE MEMBER: 1. ADOPTION OF AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS. 2. APPOINTMENT OF DIRECTORS AND OFFICERS. 3. APPROVAL OF THE CORPORATION'S ANNUAL OPERATING AND CAPITAL BUDGETS AND ANY DEBTS TO BE INCURRED. 4. APPROVAL OF ALL STRATEGIC PLANS. 5. DETERMINATION OF THE DISSOLUTION OF OR THE DISCONTINUATION OF THE BUSINESS OF THE CORPORATION. 6. APPROVAL OF ANY TRANSACTION WHICH MAY AFFECT THE CORPORATION'S STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | ANNUALLY, AT THE BOARD OF DIRECTORS' MEETING, PRIOR TO FILING WITH THE IRS, THE FULL BOARD HAS AN OPPORTUNITY TO REVIEW THE FORM 990 WITH STAFF TO ASK QUESTIONS AND SEEK CLARIFICATIONS AND TO APPROVE THE FINAL DOCUMENT. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD MEMBERS ARE REQUIRED TO REVIEW AND SIGN A CONFLICT OF INTEREST QUESTIONNAIRE TWICE A YEAR. ALL STAFF SIGN CONFLICTS OF INTEREST FORMS ON AN ANNUAL BASIS. THE QUESTIONNAIRES ARE REVIEWED BY THE CORPORATE COMPLIANCE OFFICER AS WELL AS THE CORPORATE COMPLIANCE GROUP (A COMPLIANCE COMMITTEE WHICH INCLUDES INTERNAL MEMBERS AND OUTSIDE COUNSEL). THE RESPONSES TO THE QUESTIONNAIRES ARE THEN REVIEWED WITH THE EXECUTIVE COMMITTEE OF THE BOARD. THE CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING CONFLICTS OF INTERESTS RELATED TO BOARD AND STAFF AND TO ALERT AFFECTED PARTIES WHEN A CONFLICT ARISES. WHEN AN ACTUAL CONFLICT ARISES, THE AFFECTED PARTY IS ASKED TO RECUSE HIM/HER SELF FROM THE DECISION MAKING PROCESS. THE CORPORATE COMPLIANCE OFFICER ATTENDS BOARD MEETINGS AND SPECIFIED BOARD COMMITTEE MEETINGS WHERE CONFLICT ISSUES MAY ARISE. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION AND BENEFITS OF THE PRESIDENT ARE SUBJECT TO FULL COMPENSATION AND BENEFITS COMPARABILITY STUDIES CONDUCTED BIENNIALLY BY A THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT. HOWEVER, THE COMPENSATION PORTION OF THE STUDY IS REVIEWED ANNUALLY BY THE CONSULTANT AND UPDATED FOR COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REVIEW AND APPROVAL. THE MOST RECENT FULL REVIEW WAS DONE MAY 2017. THE THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT IS RETAINED BY ST. COULD HOSPITAL TO PERFORM SERVICES. FORM 990, PART VI, QUESTION 15B: THE COMPENSATION AND BENEFITS OF THE VICE PRESIDENTS (NON-MEDICAL PROVIDERS) ARE SUBJECT TO FULL COMPENSATION AND BENEFITS COMPARABILITY STUDIES CONDUCTED BIENNIALLY BY A THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT. HOWEVER, THE COMPENSATION PORTION OF THE STUDY IS REVIEWED ANNUALLY BY THE CONSULTANT AND UPDATED FOR COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REVIEW AND APPROVAL. THE MOST RECENT FULL REVIEW WAS COMPLETED IN MAY 2017. THE THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT IS RETAINED BY ST. CLOUD HOSPITAL TO PERFORM THESE SERVICES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE HOSPITAL/CENTRACARE HEALTH SYSTEM DOES NOT GENERALLY MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. THE HOSPITAL/CENTRACARE HEALTH SYSTEM DOES DO AN ANNUAL REPORT TO THE COMMUNITY IN WHICH FINANCIAL RESULTS ARE REPORTED TO AND DISCUSSED WITH THE PUBLIC. THIS REPORT IS AVAILABLE TO THE PUBLIC ON THE ORGANIZATION'S WEBSITE. |
| FORM 990, PART IX, LINE 11G | MEDICAL FEES: PROGRAM SERVICE EXPENSES 2,232,015. MANAGEMENT AND GENERAL EXPENSES 546,935. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,778,950. CONTRACTED/PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,056,072. MANAGEMENT AND GENERAL EXPENSES 258,781. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,314,853. BANK CHARGES: PROGRAM SERVICE EXPENSES 14,940. MANAGEMENT AND GENERAL EXPENSES 3,661. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,601. |
| FORM 990, PART XI, LINE 9: | EQUITY TRANSFER TO CENTRACARE HEALTH SYSTEM -1,306,563. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CENTRACARE HEALTH SYSTEM | |||||||||||
| 1406 6TH AVE NORTH | ST CLOUD | MN | 56303 | 411813221 | HEALTHCARE HOLDING COMPANY | MN | 501(C)(3) | LINE 12C, III-FI | N/A | 0 | |
| CENTRACARE HEALTH SYSTEM-MELROSE | |||||||||||
| 11 NORTH 5TH AVENUE WEST | MELROSE | MN | 56352 | 411865315 | ACUTE/LT CARE | MN | 501(C)(3) | LINE 3 | Yes (1) | CENTRACARE HEALTH SYSTEM | |
| CENTRAL MINNESOTA EMERGENCY PHYSICIANS | |||||||||||
| 1406 6TH AVE NORTH | ST CLOUD | MN | 56303 | 411708142 | EMERGENCY PHYSICIANS | MN | 501(C)(3) | LINE 3 | 0 | CENTRACARE HEALTH SYSTEM | |
| CENTRACARE CLINIC | |||||||||||
| 1200 6TH AVE NORTH | ST CLOUD | MN | 56303 | 411806657 | MULTI-SPECIAL CLINIC | MN | 501(C)(3) | LINE 3 | 0 | CENTRACARE HEALTH SYSTEM | |
| CENTRACARE HEALTH FOUNDATION | |||||||||||
| 1406 6TH AVE NORTH | ST CLOUD | MN | 56303 | 411855173 | FUNDRAISING | MN | 501(C)(3) | LINE 7 | 0 | CENTRACARE HEALTH SYSTEM | |
| CENTRACARE HEALTH-SAUK CENTRE | |||||||||||
| 425 ELM STREET NORTH | SAUK CENTRE | MN | 56378 | 452438973 | ACUTE/LT CARE | MN | 501(C)(3) | LINE 3 | Yes (1) | CENTRACARE HEALTH SYSTEM | |
| ST CLOUD HOSPITAL | |||||||||||
| 1406 6TH AVE NORTH | ST CLOUD | MN | 56303 | 410695596 | ACUTE/LT CARE | MN | 501(C)(3) | LINE 3 | 0 | CENTRACARE HEALTH SYSTEM | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONTICELLO SURGERY CENTER LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1013 HART BOULEVARD | AddressLine1Txt |
| City | MONTICELLO | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55362 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 813593057 | EIN |
| Primary Activities | AMBULATORY SURGERY CENTER | PrimaryActivitiesTxt |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
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 |
|---|---|---|---|---|---|---|---|---|---|
| CENTRACARE HOLDINGS INC | |||||||||
| 1406 6TH AVE NORTH | ST CLOUD | MN | 56303 | 472688595 | INVESTING/PHARMACY | MN | N/A | C | 0 |
| ST CLOUD MEDICAL GROUP PA | |||||||||
| 1406 6TH AVE NORTH | ST CLOUD | MN | 56303 | 410986131 | PHYSICIAN SERVICES | MN | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | 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 | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRACARE HEALTH - SUAK CENTRE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | O | TransactionTypeTxt |
| Involved | $81,801 | InvolvedAmt |
| Method Of Amount Determination | ARMS LENGTH | MethodOfAmountDeterminationTxt |