MADELIA HEALTH: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: MADELIA HEALTH (EIN 41-0758512)
Tax period: 2016-06-01 to 2017-05-31
Filed: 2018-04-17
IRS object ID: 201801079349301615
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 D
Schedule H
Schedule J
Schedule K
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-04-17T16:12:19-05:00	ReturnTs
Tax Period End	2017-05-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	410746749	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	CLIFTONLARSONALLEN LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	220 SOUTH SIXTH STREET SUITE 300	AddressLine1Txt
City	MINNEAPOLIS	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	55402	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-06-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	410758512	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MADELIA COMMUNITY HOSPITAL INCORPORATED	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	MADE	BusinessNameControlTxt
Phone	5076423255	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	121 DREW AVENUE SOUTHEAST	AddressLine1Txt
City	MADELIA	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	56062	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	CANDACE FENSKE	PersonNm
Person Title	CEO	PersonTitleTxt
Phone	5076423255	PhoneNum
Signature	2018-04-17	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	RYAN ENGEBRETSON	PreparerPersonNm
PTIN	P01585625	PTIN
Phone	6123764500	PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	67.137.57.251	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2018-04-17	IPDt
IP Tm	12:00:27	IPTm
IP Timezone	CD	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	C43F11DC38FDB773C4BD4FBCA7AA9CEFA61E85E3	AtSubmissionCreationDeviceId
At Submission Filing Device Id	18BC5E18286226E9DF068D3E208D48F3336BB66D	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	MADELIA COMMUNITY HOSPITAL & CLINIC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	CANDACE FENSKE	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	121 DREW AVENUE SOUTHEAST	AddressLine1Txt
City	MADELIA	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	56062	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$11,305,075	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.MCHOSPITAL.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1950	FormationYr
Legal Domicile State	MN	LegalDomicileStateCd
Activity Or Mission	PROVIDE QUALITY HEALTHCARE SERVICES TO THE LOCAL COMMUNITY AND SURROUNDING AREA.	ActivityOrMissionDesc
Voting Members Governing Body	9	VotingMembersGoverningBodyCnt
Voting Members Independent	9	VotingMembersIndependentCnt
Total Employee	136	TotalEmployeeCnt
Total Volunteers	0	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$85,861	PYContributionsGrantsAmt
CY Contributions Grants	$206,149	CYContributionsGrantsAmt
PY Program Service Revenue	$11,002,826	PYProgramServiceRevenueAmt
CY Program Service Revenue	$10,742,198	CYProgramServiceRevenueAmt
PY Investment Income	$149,949	PYInvestmentIncomeAmt
CY Investment Income	$144,850	CYInvestmentIncomeAmt
PY Other Revenue	$441,799	PYOtherRevenueAmt
CY Other Revenue	$152,205	CYOtherRevenueAmt
PY Total Revenue	$11,680,435	PYTotalRevenueAmt
CY Total Revenue	$11,245,402	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$6,953,398	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$6,893,780	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$4,659,262	PYOtherExpensesAmt
CY Other Expenses	$4,668,692	CYOtherExpensesAmt
PY Total Expenses	$11,612,660	PYTotalExpensesAmt
CY Total Expenses	$11,562,472	CYTotalExpensesAmt
PY Revenues Less Expenses	$67,775	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$317,070	CYRevenuesLessExpensesAmt
Total Assets BOY	$18,406,716	TotalAssetsBOYAmt
Total Assets EOY	$18,653,797	TotalAssetsEOYAmt
Total Liabilities BOY	$6,321,406	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$6,561,846	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$12,085,310	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$12,091,951	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	THE MISSION OF MADELIA COMMUNITY HOSPITAL IS TO PROVIDE SAFE AND QUALITY HEALTHCARE SERVICES TO THOSE WE SERVE IN AN ENVIRONMENT BASED ON RESPECT, DIGNITY, AND EXCELLENCE.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$7,864,511	ExpenseAmt
Revenue	$10,742,198	RevenueAmt
Desc	MADELIA COMMUNITY HOSPITAL & CLINIC PROVIDES GENERAL MEDICAL/SURGICAL SERVICES ON INPATIENTS, SWING BED PATIENTS, OUTPATIENTS AND HOME CARE CLIENTS. DURING THE FISCAL YEAR 2017 THERE WERE 165 ACUTE CARE ADMISSIONS, 59 SWING BED ADMISSIONS, 14,250 HOME CARE VISITS TO 1,284 HOME CARE CLIENTS AND 4,680 OUTPATIENT VISITS. DURING OUR FISCAL YEAR 2017, MADELIA COMMUNITY HOSPITAL AND CLINIC PROVIDED $28,460 IN CHARITY CARE. A VARIETY OF COMMUNITY BENEFIT SERVICES ARE DONE EACH YEAR BY VOLUNTEER HOSPITAL EMPLOYEES AND COMMUNITY VOLUNTEERS. COMMUNITY BENEFIT ACTIVITIES INCLUDED:- COORDINATION OF DRIVERS FOR THE WATONWAN COUNTY SENIOR DRIVER PROGRAM, A NONPROFIT GROUP FURNISHING TRANSPORTATION FOR THE ELDERLY SENIOR POPULATION.- DELIVERY OF MEALS FOR THE HOSPITAL PREPARED MEALS ON WHEELS IN MADELIA- INTERPRETIVE AND TRANSLATION FROM ENGLISH TO SPANISH-COLLABORATIVE HISPANIC OUTREACH SERVICES INCLUDING POPULATION HEALTH EDUCATIONAL SERVICES FOR THE PREVENTION OF DIABETES, OBESITY, HEART DISEASE, AND HYPERTENSION- HOSPICE ADVISORY COMMITTEE- SENIOR EDUCATION SERIES INCLUDING EVIDENCE BASED PROGRAM, "LIVING WELL WITH CHRONIC CONDITIONS AND "MATTER OF BALANCE"- FREE HEEL SCANS TO DETECT OSTEOPOROSIS- FREE BLOOD PRESSURE IN THE MADELIA COMMUNITY HOSPITAL & CLINIC AND AT HEALTH FAIRS IN THE AREA AND AT CHURCH EVENTS- WORKING SIDE BY WITH STUDENTS FROM AREA UNIVERSITIES AND COLLEGES FOR STUDENTS IN NURSING, LABORATORY TECHNICIANS AND PHYSICAL THERAPY ASSISTANTS.- DELIVERY OF PHARMACEUTICALS FOR HOME BOUND PATIENTS- PHYSICIAN PROVIDING SKIN CHECKS FOR THE MADELIA HIGH SCHOOL WRESTLING TEAM.- HIGH SCHOOL ATHLETE TRAINING AND CARE FOR SMALL AND NONLIFE THREATENING INJURIES. "IMPACT" (CONCUSSION) EVALUATION FOR MADELIA AND LAKE CRYSTAL STUDENTS- COMMUNITY AND SCHOOL HEALTH FAIR PARTICATION- SMALL FEE FOOT AND NAIL CLINIC (SOAKING FEET, TRIMMING TOE NAILS AND MASSAGING FEET OF ELDERLY PATIENTS). AN AVERAGE OF 60 PATIENTS PER MONTH PARTAKE IN THIS SERVICE.ACTIVE AND CHARTER MEMBERS OF THE MADELIA COMMUNITY BASED COLLABORATIVE (MCBC): THIS GROUP IS COMPRISED OF HOSPITAL STAFF, NURSING PROFESSORS FROM MINNESOTA STATE UNIVERSITY - MANKATO, MEMBERS OF THE MANKATO GLEN TAYLOR NURSING INSTITUTE FOR FAMILY AND SOCIETY, WATONWAN COUNTY PUBLIC HEALTH REPRESENTATIVES, STATEWIDE HEALTH INITIATIVE PROGRAM (SHIP) REPRESENTATIVE, UNIVERSITY OF MINNESOTA EXTENSION EDUCATOR, ADMINISTRATIVE STAFF FROM THE LOCAL SCHOOL DISTRICT, AND COMMUNITY MEMBERS. MEMBERS OF MCBC, INCLUDING HOSPITAL STAFF, ALSO PARTNER WITH THE WATONWAN COMMUNITY FOOD PARTNERSHIP WHICH FOCUSES ON BRINGING FRESH FRUITS AND VEGETABLES INTO THE COMMUNITIES OF WATONWAN COUNTY.THE VISION OF MCBC IS WORKING TOGETHER TO ACHIEVE A HEALTHIER COMMUNITY. ITS MISSION IS TO PROMOTE THE WELL-BEING OF MADELIA RESIDENTS THROUGH COMMUNITY-BASED PARTNERSHIPS AND THE VALUES ARE EQUITY, COLLABORATION, COMMUNITY ENGAGEMENT, HEALTH & WELL-BEING.USING DATA FROM THE 2015 - 2016 COMMUNITY HEALTH NEEDS ASSESSMENT, THIS GROUP DECIDED ON TWO STRATEGIC FOCUSED AREAS, 1) OBESITY AND 2) MENTAL HEALTH WELL-BEING. OBESITY CONTINUES TO BE THE NUMBER ONE HEALTH CONCERN IN THE COMMUNITY. RECOGNIZING THAT MENTAL HEALTH WELL-BEING PLAYS A ROLE IN OBESITY AND WAS ALSO IDENTIFIED AS A SIGNIFICANT CONCERN IN THE NEEDS ASSESSMENT, MCBC DECIDED TO WORK COLLABORATIVELY ON A PROJECT THAT WOULD ADDRESS PHYSICAL AND MENTAL HEALTH. THE PROJECT THEME IS "MADELIA RECHARGE YOURSELF," WITH A FOCUS ON THE IMPORTANCE OF EATING WELL, STAYING ACTIVE, AND GETTING GOOD SLEEP. THE GOAL IS TO DEMONSTRATE HOW THESE AREAS AFFECT YOUR PHYSICAL HEALTH AS WELL AS YOUR MENTAL HEALTH. IN ADDITION TO MADELIA RECHARGE YOURSELF, MCBC IS PLANNING WORK IN THE FOCUS AREA OF OBESITY THAT WILL BRING FRESH FRUITS AND VEGETABLES TO THOSE IN NEED. IN THE FOCUS AREA OF MENTAL HEALTH WELL-BEING, THE GROUP IS PLANNING COMMUNITY WIDE TRAINING AND EDUCATION THAT WILL TOUCH PEOPLE OF ALL AGES. THE ACCOMPLISHMENTS THIS YEAR INCLUDE: 1.EDUCATION PROVIDED TO ELEMENTARY STUDENTS ON EAT, MOVE, AND SLEEP. THIS WAS FOLLOWED BY A POSTER CONTEST. THE POSTER CONTEST INCLUDED PRIZES OF KID'S HEALTHY COOKBOOKS AND A GRAND PRIZE OF A POOL PARTY. 2.LET IT GROW BARRELS WERE PLACED IN THE MADELIA MOBILE HOME PARK PROVIDING ACCESS TO FREE FRESH TOMATOES, PEPPERS, AND HERBS FOR THE RESIDENTS OF THE MOBILE HOME PARK, THE MAJORITY OF WHICH ARE LOW-INCOME. 3.MCHC BECAME A REFERRAL SOURCE FOR THE MADELIA FOOD SHELF. 4.EDUCATION WAS PROVIDED DURING THE COMMUNITY CELEBRATION WHICH INCLUDED:A)RETHINK YOUR DRINK DISPLAY WITH VEGETABLE AND FRUIT INFUSED WATER SAMPLESB)FRUIT AND VEGETABLE DISPLAY WITH DEMONSTRATION OF CUTTING JICAMA AND MANGO WITH SAMPLES PROVIDEDC)JUMP ROPE ACTIVITY THAT ALLOWED PARTICIPANTS TO TAKE THE JUMP ROPE WITH THEMD)MENTAL HEALTH DISPLAY ADDRESSING FEELINGS WITH TAKE HOME PACKETS FOR KIDS, PARENTS, AND GRANDPARENTS5.PROVIDED QUESTION, PERSUADE, REFER (QPR) TRAINING TO OVER 140 ELEMENTARY AND HIGH SCHOOL STAFF, HOSPITAL STAFF, LAW ENFORCEMENT , SOCIAL SERVICE STAFF, AND COMMUNITY MEMBERS.6.PROVIDED MENTAL HEALTH FIRST AIDE TRAINING FOR HOSPITAL STAFF, LAW ENFORCEMENT, AND COMMUNITY MEMBERS ON THREE SEPARATE OCCASIONS.7.SET UP A TABLE DISPLAY AT THE MADELIA HIGH SCHOOL ABOUT DEPRESSION AND SUICIDE. INTERACTED WITH TEENS, GIVING THEM TEMPORARY SEMI COLON TATTOO'S.8.HOSTED A SUICIDE SURVIVOR 'GIFTS FOR THE HOLIDAYS' PROGRAM.9.HOSTED COMMUNITY FORUMS ON MENTAL HEALTH, DEPRESSION AND SUICIDE PREVENTION	Desc
Total Program Service Expenses	$7,864,511	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	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	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	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	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
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	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	69	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	136	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	9	GoverningBodyVotingMembersCnt
Independent Voting Member	9	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	0	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	0	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	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	MN	StatesWhereCopyOfReturnIsFldCd
Other Website	Yes (X)	OtherWebsiteInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MONIQUE HOFFMANN	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	5076423255	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	121 DREW AVENUE SOUTHEAST	AddressLine1Txt
City	MADELIA	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	56062	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
STEVEN COOLING
BOARD VP & TREASURER	1.00	0.20	Yes (X)	Yes (X)	$1,800	$0	$0
DENNIS ARDUSER
BOARD PRESIDENT	1.00		Yes (X)	Yes (X)	$1,800	$0	$0
BARBARA OVERLIE
BOARD SECRETARY	1.00		Yes (X)	Yes (X)	$1,800	$0	$0
KENNETH GRONEWOLD
BOARD MEMBER	1.00		Yes (X)		$1,200	$0	$0
NORMA KRUMWIEDE
BOARD MEMBER	1.00		Yes (X)		$1,200	$0	$0
BRIAN MCCABE
BOARD MEMBER	1.00		Yes (X)		$1,200	$0	$0
MELANIE RUNGE
BOARD MEMBER	1.00		Yes (X)		$1,200	$0	$0
STEVEN SORENSEN
BOARD MEMBER	1.00		Yes (X)		$1,200	$0	$0
RYAN VISHER
BOARD MEMBER	1.00		Yes (X)		$1,200	$0	$0
CANDACE FENSKE
CEO	40.00	0.20		Yes (X)	$151,216	$0	$19,092
MONIQUE HOFFMANN
CFO	40.00	0.20		Yes (X)	$101,920	$0	$7,950

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$265,736	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$27,042	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	2	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
MANKATO CLINIC LTD
1230 E MAIN ST	MANKATO	MN	56002	PHYSICIAN CLINIC PROVIDERS	$887,851
WHITESELL
1630 ANDERSON AVE SUITE 100	BUFFALO	MN	55313	MEDICAL STAFFING	$845,450
US BANK TRUST NATIONAL ASSN
60 LIVINGSTON AVE	ST PAUL	MN	55104	BOND PAYMENTS	$416,026
UHS
6625 W 78TH ST SUITE 300	MINNEAPOLIS	MN	55439	MEDICAL EQUIPMENT SUPPLIES	$193,346
MARCO
1423 N RIVERFRONT DRIVE	MANKATO	MN	56001	COPIES AND PRINTING	$154,187

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	5	CntrctRcvdGreaterThan100KCnt
Related Organizations	$83,966	RelatedOrganizationsAmt
Government Grants	$43,697	GovernmentGrantsAmt
All Other Contributions	$78,486	AllOtherContributionsAmt
Total Contributions	$206,149	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT REVENUE	624100	$10,671,961	$10,671,961
PHYSICAL THERAPY	624310	$55,321	$55,321
LABORATORY	621500	$7,837	$7,837
PHARMACY	446110	$7,079	$7,079

Field	Value	IRS element (for citing)
Total Program Service Revenue	$10,742,198	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$148,827	TotalRevenueColumnAmt
Exclusion	$148,827	ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$26,047	TotalRevenueColumnAmt
Exclusion	$26,047	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$55,857	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$55,696	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$161	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$161	TotalRevenueColumnAmt
Exclusion	$161	ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$3,977	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	-$3,977	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$3,977	TotalRevenueColumnAmt
Exclusion	-$3,977	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
MISCELLANEOUS	900099	$101,371	$101,371
EMPLOYEE MEALS	900099	$21,826	$21,826
MEDICAL RECORDS	900099	$2,800	$2,800

Field	Value	IRS element (for citing)
Other Revenue Total	$125,997	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$11,245,402	TotalRevenueColumnAmt
Related Or Exempt Func Income	$10,742,198	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$297,055	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$292,778	TotalAmt
Management And General	$292,778	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$5,521,800	TotalAmt
Program Services	$4,591,172	ProgramServicesAmt
Management And General	$930,628	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$165,863	TotalAmt
Program Services	$112,024	ProgramServicesAmt
Management And General	$53,839	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$609,903	TotalAmt
Management And General	$609,903	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$303,436	TotalAmt
Program Services	$221,707	ProgramServicesAmt
Management And General	$81,729	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$1,609	TotalAmt
Management And General	$1,609	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$59,061	TotalAmt
Management And General	$59,061	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$117,570	TotalAmt
Program Services	$69,671	ProgramServicesAmt
Management And General	$47,899	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$24,641	TotalAmt
Management And General	$24,641	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$447,028	TotalAmt
Management And General	$447,028	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$228,359	TotalAmt
Management And General	$228,359	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$93,287	TotalAmt
Program Services	$64,774	ProgramServicesAmt
Management And General	$28,513	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$287,396	TotalAmt
Management And General	$287,396	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$781,236	TotalAmt
Program Services	$781,236	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$1,482,536	$1,482,536
REPAIRS/MAINTENANCE	$392,099		$392,099
BAD DEBTS	$361,679	$361,679
CLINIC EXPENSES	$179,712	$179,712

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$212,479	TotalAmt
Management And General	$212,479	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$11,562,472	TotalAmt
Program Services	$7,864,511	ProgramServicesAmt
Management And General	$3,697,961	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$3,604,118	BOYAmt
EOY	$3,705,452	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$4,675,904	BOYAmt
EOY	$4,927,807	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$8,985	BOYAmt
EOY	$11,514	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,380,264	BOYAmt
EOY	$1,563,172	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$195,177	BOYAmt
EOY	$266,786	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$176,621	BOYAmt
EOY	$119,821	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$17,564,938	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$11,311,714	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$6,580,048	BOYAmt
EOY	$6,253,224	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$995,772	BOYAmt
EOY	$1,029,681	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$789,827	BOYAmt
EOY	$776,340	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$18,406,716	BOYAmt
EOY	$18,653,797	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$1,145,600	BOYAmt
EOY	$1,410,792	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$5,130,000	BOYAmt
EOY	$4,980,000	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$5,806	BOYAmt
EOY	$131,054	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$40,000	BOYAmt
EOY	$40,000	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$6,321,406	BOYAmt
EOY	$6,561,846	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$12,085,310	BOYAmt
EOY	$11,691,951	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
EOY	$400,000	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$12,085,310	BOYAmt
EOY	$12,091,951	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$18,406,716	BOYAmt
EOY	$18,653,797	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$317,070	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$7,576	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$316,135	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
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 D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$194,207	OtherCostOrOtherBasisAmt
Book Value	$194,207	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,915,228	OtherCostOrOtherBasisAmt
Depreciation	$3,794,985	DepreciationAmt
Book Value	$3,120,243	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,662,644	OtherCostOrOtherBasisAmt
Depreciation	$2,776,077	DepreciationAmt
Book Value	$1,886,567	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$5,792,859	OtherCostOrOtherBasisAmt
Depreciation	$4,740,652	DepreciationAmt
Book Value	$1,052,207	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$6,253,224	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	ASSET RETIREMENT OBLIGATION	Desc
Amt	$40,000	Amt

Field	Value	IRS element (for citing)
Total Liability	$40,000	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	THE HOSPITAL IS CLASSIFIED BY THE IRS AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE IRC AND IS SUBJECTED TO FEDERAL INCOME TAX ONLY ON NET UNRELATED BUSINESS INCOME. THE HOSPITAL FOLLOWS THE GUIDANCE IN THE INCOME TAX STANDARD REGARDING RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE APPLICATION OF THIS STANDARD HAS NO EFFECT ON THE FINANCIAL STATEMENTS.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent100	Yes (X)	Percent100Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent200 D	Yes (X)	Percent200DInd
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$75,804	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$75,804	NetCommunityBenefitExpnsAmt
Total Expense	0.00660	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,702,585	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$843,701	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$858,884	NetCommunityBenefitExpnsAmt
Total Expense	0.07430	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,778,389	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$843,701	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$934,688	NetCommunityBenefitExpnsAmt
Total Expense	0.08090	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$70,508	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$70,508	NetCommunityBenefitExpnsAmt
Total Expense	0.00610	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$62,350	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$62,350	NetCommunityBenefitExpnsAmt
Total Expense	0.00540	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$132,858	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$132,858	NetCommunityBenefitExpnsAmt
Total Expense	0.01150	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,911,247	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$843,701	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,067,546	NetCommunityBenefitExpnsAmt
Total Expense	0.09240	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,007	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$5,007	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$146	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$146	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$7,029	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$7,029	NetCommunityBenefitExpnsAmt
Total Expense	0.00060	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$15,565	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$15,565	NetCommunityBenefitExpnsAmt
Total Expense	0.00130	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,947	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,947	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$30,694	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$30,694	NetCommunityBenefitExpnsAmt
Total Expense	0.00260	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$361,679	BadDebtExpenseAmt
Reimbursed By Medicare	$3,457,586	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$4,107,868	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$650,282	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MADELIA COMMUNITY HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	121 DREW AVE SE	AddressLine1Txt
City	MADELIA	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	56062	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.MCHOSPITAL.ORG	WebsiteAddressTxt
State License	370999	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	MADELIA COMMUNITY HOSPITAL INCORPORATED	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	15	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	0	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	0	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WWW.MCHOSPITAL.ORG/COMMUNITY-NEEDS-ASSESSMENT	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	15	ImplementationStrategyAdptYr
Strategy Posted Website	0	StrategyPostedWebsiteInd
Strategy Attached	Yes (1)	StrategyAttachedInd
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	100.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	200.000000000000	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
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	HTTPS://WWW.MCHOSPITAL.ORG/FINANCIAL-ASSISTANCE	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	HTTPS://WWW.MCHOSPITAL.ORG/FINANCIAL-ASSISTANCE	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	HTTPS://WWW.MCHOSPITAL.ORG/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 No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Other Actions Taken	Yes (X)	OtherActionsTakenInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr Prvt	Yes (X)	LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
MADELIA COMMUNITY HOSPITAL, INCORPORATED	PART V, SECTION B, LINE 5: IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT, MCHC SOLICITED INPUT FROM THE COMMUNITY IN A VARIETY OF WAYS. IN 2015, MCHC DISTRIBUTED A SURVEY THROUGHOUT THE COMMUNITY. WE RECEIVED 164 RESPONSES, INCLUDING 83 FROM LOW-INCOME INDIVIDUALS AND 77 FROM ELDERLY INDIVIDUALS. TO SOLICIT INPUT FROM MEDICAL PROFESSIONALS, MINORITIES AND THE GOVERNMENT, INTERVIEWS WERE CONDUCTED IN MARCH 2016. INDIVIDUALS FROM THE FOLLOWING ORGANIZATIONS PARTICIPATED IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT THROUGH INTERVIEWS. - WATONWAN COUNTY PUBLIC HEALTH DEPARTMENT - WATONWAN COUNTY HUMAN SERVICES DEPARTMENT - MADELIA PUBLIC SCHOOLS, INDEPENDENT SCHOOL DISTRICT 837 - MADELIA COMMUNITY HOSPITAL & CLINIC FINALLY, IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT, MCHC CONSIDERED THE RESULTS OF TWO LOCAL HEALTH NEEDS ASSESSMENTS PUBLISHED IN 2015. - FARIBAULT, MARTIN & WATONWAN COUNTIES COMMUNITY NEEDS ASSESSMENT - MINNESOTA DEPARTMENT OF HEALTH'S ECONOMIC IMPACT OF MADELIA COMMUNITY HOSPITAL & CLINIC AND RELATED HEALTH SECTORS OF WATONWAN COUNTY
MADELIA COMMUNITY HOSPITAL, INCORPORATED	PART V, SECTION B, LINE 11: MCHC IS AN ACTIVE AND CHARTER MEMBER OF THE MADELIA COMMUNITY BASED COLLABORATIVE (MCBC). THIS GROUP IS COMPRISED OF HOSPITAL STAFF, NURSING PROFESSORS FROM MINNESOTA STATE UNIVERSITY - MANKATO, MEMBERS OF THE MANKATO GLEN TAYLOR NURSING INSTITUTE FOR FAMILY AND SOCIETY, WATONWAN COUNTY PUBLIC HEALTH REPRESENTATIVES, STATEWIDE HEALTH INITIATIVE PROGRAM (SHIP) REPRESENTATIVE, UNIVERSITY OF MINNESOTA EXTENSION EDUCATOR, ADMINISTRATIVE STAFF FROM THE LOCAL SCHOOL DISTRICT, AND COMMUNITY MEMBERS. MEMBERS OF MCBC, INCLUDING HOSPITAL STAFF, ALSO PARTNER WITH THE WATONWAN COMMUNITY FOOD PARTNERSHIP WHICH FOCUSES ON BRINGING FRESH FRUITS AND VEGETABLES INTO THE COMMUNITIES OF WATONWAN COUNTY.THE VISION OF MCBC IS WORKING TOGETHER TO ACHIEVE A HEALTHIER COMMUNITY. ITS MISSION IS TO PROMOTE THE WELL-BEING OF MADELIA RESIDENTS THROUGH COMMUNITY-BASED PARTNERSHIPS AND THE VALUES ARE EQUITY, COLLABORATION, COMMUNITY ENGAGEMENT, HEALTH & WELL-BEING.USING DATA FROM THE 2015-2016 COMMUNITY HEALTH NEEDS ASSESSMENT, THIS GROUP DECIDED ON TWO STRATEGIC FOCUSED AREAS: 1) OBESITY AND 2) MENTAL HEALTH WELL-BEING. OBESITY CONTINUES TO BE THE NUMBER ONE HEALTH CONCERN IN THE COMMUNITY. RECOGNIZING THAT MENTAL HEALTH WELL-BEING PLAYS A ROLE IN OBESITY AND WAS ALSO IDENTIFIED AS A SIGNIFICANT CONCERN IN THE NEEDS ASSESSMENT, MCBC DECIDED TO WORK COLLABORATIVELY ON PROJECTS THAT WOULD ADDRESS PHYSICAL AND MENTAL HEALTH. THE PROJECT THEME "MADELIA RECHARGE YOURSELF," WITH A FOCUS ON THE IMPORTANCE OF EATING WELL, STAYING ACTIVE, AND GETTING GOOD SLEEP, WAS STARTED IN THE FALL OF 2016 AND CONTINUED INTO 2017. THE GOAL WAS TO DEMONSTRATE HOW THESE AREAS AFFECT YOUR PHYSICAL HEALTH AS WELL AS YOUR MENTAL HEALTH. IN ADDITION TO MADELIA RECHARGE YOURSELF, MCBC'S SOCIAL NORMS GROUP IS CONTINUING TO WORK IN THE FOCUS AREA OF OBESITY THAT WILL BRING FRESH FRUITS AND VEGETABLES TO THOSE IN NEED. MCBC'S MENTAL HEALTH TASK FORCE IS PLANNING COMMUNITY WIDE TRAINING AND EDUCATION THAT WILL TOUCH PEOPLE OF ALL AGES. THE ACCOMPLISHMENTS THIS YEAR INCLUDE: 1. EDUCATION PROVIDED TO ELEMENTARY STUDENTS ON EAT, MOVE, AND SLEEP, INCLUDING A POSTER CONTEST FOR MADELIA ELEMENTARY IN THE FALL AND ST. MARY'S IN THE SPRING.2. LET IT GROW BARRELS WERE PLACED IN THE MADELIA MOBILE HOME PARK PROVIDING ACCESS TO FREE FRESH TOMATOES, PEPPERS, AND HERBS FOR THE RESIDENTS OF THE MOBILE HOME PARK, THE MAJORITY OF WHICH ARE LOW-INCOME. 3. MCHC CONTINUES TO BE A REFERRAL BASE FOR THE MADELIA FOOD SHELF.4. EDUCATION WAS PROVIDED DURING THE COMMUNITY CELEBRATION WHICH INCLUDED:A. RETHINK YOUR DRINK DISPLAY WITH VEGETABLE AND FRUIT INFUSED WATER SAMPLES;B. MENTAL HEALTH DISPLAY ADDRESSING FEELINGS WITH TAKE HOME PACKETS FOR KIDS, PARENTS, AND GRANDPARENTS; ANDC. RECHARGE YOURSELF DISPLAYS; I. JUMP ROPE FOR HEART II. EDUCATIONAL INFORMATION ON GETTING PROPER SLEEP III. FRUIT AND VEGETABLE DISPLAY WITH DEMONSTRATION OF CUTTING JICAMA AND MANGO WITH SAMPLES PROVIDED5. RECEIVED A GRANT AND HAD TWO MENTAL HEALTH TASK FORCE MEMBERS TRAINED AS INSTRUCTORS FOR MENTAL HEALTH FIRST AID FOR ADULTS ASSISTING YOUNG PEOPLE. 6. THE MADELIA CITY COUNCIL SIGNED A PROCLAMATION DECLARING MAY AS MENTAL HEALTH MONTH IN MADELIA.7. PREPARED CALENDARS FOR JUNE, JULY AND AUGUST FOR KIDS TO ENCOURAGE DAILY HEALTHY SUMMER ACTIVITIES. 8. HOSTED MONTHLY COMMUNITY FORUMS ON MENTAL HEALTH. TOPICS INCLUDED: OPTIMIZE YOUR MENTAL HEALTH, SLEEP AND MENTAL HEALTH: MAKING THE CONNECTION, COPING WITH STRESS DURING THE HOLIDAYS, SEASONAL AFFECTIVE DISORDER, SUICIDE AND GRIEF, MINDFULNESS, POST TRAUMATIC STRESS DISORDER AND MAY MENTAL HEALTH.
MADELIA COMMUNITY HOSPITAL, INCORPORATED	PART V, SECTION B, LINE 16J: THE FAP APPLICATION IS AUTOMATICALLY MAILED OUT TO UNINSURED AND UNDERINSURED PATIENTS.
MADELIA COMMUNITY HOSPITAL, INCORPORATED	PART V, SECTION B, LINE 20E: PATIENTS ARE INFORMED OF THE STATUS OF THEIR ACCOUNT THROUGH BILLING STATEMENTS AND LETTERS INDICATING THE AGING OF THEIR ACCOUNT AND THE AVAILABILITY TO MAKE PAYMENT ARRANGEMENTS WITH SEVERAL OPTIONS OF RECEIVING A DISCOUNT.

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C:	ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED ON THE FOLLOWING CRITERIA:1. TOTAL INCOME IS LESS THAN 200% OF FEDERAL POVERTY GUIDELINES;2. HOSPITAL MAY RQEUIRE LIQUIDATION OF RECREATIONAL VEHICLES WITH NO BUSINESS PURPOSE BEFORE GRANTING FINANCIAL ASSISTANCE;3. THE PATIENT'S HEALTH CARE SERVICES ARE MEDICALLY NECESSARY; AND4. THE PATIENT SUBMITS A COMPLETE APPLICATION WITHIN THE REQUIRED TIME PERIOD.
PART I, LINE 7:	THE FINANCIAL ASSISTANCE AT COST AND MEDICAID AMOUNTS REPORTED IN PART I, LINES 7A AND 7B, RESPECTIVELY, WERE COMPUTED USING A RATIO OF COST TO CHARGES THAT WAS DERIVED FROM WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS AND HEALTH PROFESSIONS EDUCATION AMOUNTS REPORTED IN PART I, LINES 7E AND 7F, RESPECTIVELY, WERE AT COST.
PART I, LN 7 COL(F):	BAD DEBT EXPENSE OF $361,679 WAS SUBTRACTED FROM TOTAL EXPENSES OF $11,562,472 IN CALCULATING THE PERCENTAGES IN PART I, LINE 7, COLUMN F.
PART II, COMMUNITY BUILDING ACTIVITIES:	STAFF PARTICIPATE IN COMMUNITY ORGANIZATIONS, PROVIDING HEALTHCARE REPRESENTATION AND INFORMATION TO ENHANCE THOSE ORGANIZATION'S EVENTS. SOME ORGANIZATIONS THAT OUR STAFF IS INVOLVED IN INCLUDE: MADELIA SCHOOL BOARD, AMBULANCE SERVICE, CHAMBER OF COMMERCE, ROTARY, WOMEN OF TODAY, AND MCH AUXILIARY. STAFF MEMBERS ARE COACHES, SCOUT LEADERS, AND MENTORS THROUGHOUT THE COMMUNITY. MANY OF OUR STAFF MEMBERS ARE INVOLVED IN THE MADELIA COMMUNITY BASED COLLABORATIVE (MCBC). MCHC AND THE MINNESOTA STATE UNIVERSITY, MANKATO SCHOOL OF NURSING COLLABORATED TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT IN MADELIA THAT WAS MANDATED BY THE AFFORDABLE CARE ACT IN 2012 AND AGAIN IN 2015. SINCE THAT INITIAL PROJECT, MCBC HAS GROWN TO INCLUDE MANY OTHER AREA PARTNERS, BUSINESSES AND COMMUNITY MEMBERS TO ADDRESS THE MAIN HEALTH CONCERNS IDENTIFIED IN THE ASSESSMENT: OBESITY, CANCER, HEART DISEASE AND DIABETES. MCBC MEETS ONCE A MONTH AT MCHC WITH OTHER SUB-COMMITTEES MEETING AS NEEDED. EVENT PLANNING AND COORDINATION IS ALSO DONE AT MCHC. PROMOTIONAL ACTIVITIES FOR MCBC ACTIVITIES ARE DONE BY MCHC STAFF AND INCLUDE: FACEBOOK PAGE MAINTENANCE, FLYER DESIGN AND DISTRIBUTION, ADVERTISING, PHOTOGRAPHY, ETC. THE VISION OF MCBC IS TO WORK TOGETHER TO ACHIEVE A HEALTHIER COMMUNITY. THE MISSION IS TO PROMOTE THE WELL-BEING OF MADELIA RESIDENTS THROUGH COMMUNITY-BASED PARTNERSHIPS, WITH THE CORE VALUES BEING: EQUITY, COLLABORATION, COMMUNITY ENGAGEMENT, HEALTH AND WELL-BEING. THE STRATEGIC FOCUS AREAS INCLUDE ENCOURAGING HEALTHY LIFESTYLE CHOICES AND MENTAL HEALTH WELL-BEING. HEALTHY LIFESTYLE CHOICES: IN 2014, MCBC LAUNCHED THE MADELIA RETHINK YOUR DRINK CAMPAIGN WITH THE GOAL OF IMPROVING THE HEALTH AND WELL-BEING OF MADELIA RESIDENTS. RETHINK YOUR DRINK IS NOT ABOUT BANNING OR TAKING ANYTHING AWAY, BUT EMPOWERING CITIZENS TO MAKE HEALTHY BEVERAGE CHOICES. THE RETHINK YOUR DRINK INITIATIVE HAS EVOLVED INTO MADELIA RECHARGE YOURSELF, AN INITIATIVE THAT ENCOURAGES STUDENTS AND FAMILIES TO BE SURE TO EAT, MOVE AND SLEEP TO STAY "CHARGED." POSTER CONTESTS WERE HELD AT THE ELEMENTARY SCHOOLS IN MADELIA, AND A JUMP ROPE FOR HEART ACTIVITY WAS HELD DURING THE MADELIA PARK DAYS CELEBRATION TO PROMOTE THIS INITIATIVE. NEW AVENUES ARE ALSO BEING EXPLORED TO PROVIDE BETTER ACCESS TO FRESH FRUITS AND VEGETABLES.MENTAL HEALTH: MCBC STARTED THE MENTAL HEALTH TASKFORCE IN RESPONSE TO COMMUNITY CONCERNS ABOUT SUICIDE AND UNMET MENTAL HEALTH NEEDS. THE TASKFORCE HOLDS FREE MENTAL HEALTH COMMUNITY FORUMS ON THE SECOND MONDAY OF EACH MONTH, PROVIDING EDUCATION ON SUICIDE, SUICIDE PREVENTION AND OTHER MENTAL HEALTH ISSUES. THROUGH MCBC, TWO MCHC STAFF MEMBERS HAVE BEEN TRAINED AS MENTAL HEALTH FIRST AID INSTRUCTORS, AND THESE TRAINERS OFFER MORE EXTENSIVE EDUCATIONAL CLASSES TO THE PUBLIC AT NO CHARGE. BEFORE THE SCHOOL YEAR STARTED IN 2017, THEY TRAINED ALL OF THE PARAPROFESSIONALS IN THE MADELIA SCHOOL DISTRICT IN MENTAL HEALTH FIRST AID. IN NOVEMBER, THEY ALSO TAUGHT A MENTAL HEALTH FIRST AID CLASS AT THE WATONWAN COUNTY HUMAN SERVICES COMMUNITY ROOM IN ST. JAMES.
PART III, LINE 2:	THE AMOUNT OF BAD DEBT EXPENSE REPORTED IN PART III, LINE 2 IS CALCULATED AS FOLLOWS: PAYMENT ARRANGEMENT INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES AND PER DIEM PAYMENTS. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS.
PART III, LINE 4:	THE FOLLOWING IS FROM THE "PATIENT RECEIVABLES" PARAGRAPH IN NOTE 1 TO THE HOSPITAL'S FINANCIAL STATEMENTS:"PAYMENT FOR SERVICES IS REQUIRED UPON RECEIPT OF AN INVOICE, AFTER PAYMENT BY INSURANCE, IF ANY. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. ACCOUNTS THAT ARE DETERMINED TO BE UNCOLLECTIBLE ARE SENT TO A COLLECTION AGENCY AND WRITTEN OFF AT THAT TIME."
PART III, LINE 8:	THE REVENUE RECEIVED AND ALLOWABLE COSTS WERE BASED ON THE 2017 FILED MEDICARE COST REPORT.THE MEDICARE SHORTFALL ON PART III, LINE 7 IS NOT TREATED AS A COMMUNITY BENEFIT.
PART III, LINE 9B:	EACH WEEK, STATEMENTS ARE SENT OUT THROUGH OUR EDI PROCESS WITH STATEMENTS BEING MAILED OUT TO THE PATIENT BY A CLEARINGHOUSE. PATIENTS ARE BILLED AFTER MEDICARE OR COMMERCIAL INSURANCE HAS BEEN FILED AND PAYMENT HAS BEEN RECEIVED WITHIN A SIX-WEEK PERIOD. PATIENTS WILL BE BILLED FOR THE REMAINING BALANCE MONTHLY. ACCOUNTS ARE VERIFIED INTERNALLY PRIOR TO COLLECTION LETTERS BEING SENT.IF NO PAYMENT IS RECEIVED WITHIN 2 MONTHS OF BILLINGS, THE STATEMENT IS SENT WITH A NOTICE LETTER REQUESTING PAYMENT. LETTERS WILL ALSO BE SENT SHOULD NO PAYMENT BE RECEIVED WITHIN 60 AND 90 DAYS.SHOULD NO RESPONSE BE RECEIVED WITHIN FIVE (5) DAYS OF THE LAST LETTER, A TELEPHONE CALL IS ISSUED TO NEGOTIATE A PAYMENT PLAN OR EXTEND A DISCOUNT OF 25% FOR ACCOUNT PAYOFF IN 60 DAYS; IF ACCOUNT HOLDER MAY QUALIFY FOR OUR HEALTHCARE FINANCIAL PROGRAM, AN APPLICATION IS SENT TO BE COMPLETED AND RETURNED TO US ALONG WITH TWO (2) DENIALS OF ALTERNATE COVERAGE OR PAYMENT ASSISTANCE.LACK OF RESPONSE TO THE TELEPHONE CALL WILL RESULT IN VERIFICATION OF THE ACCOUNT(S) BY THE INSURANCE BILLING CLERKS AND THEN REVIEWED BY THE BUSINESS OFFICE MANAGER FOR APPROVAL TO BEGIN FORMAL COLLECTION PROCESS. THESE ACCOUNTS ARE THEN TURNED IN TO A PROFESSIONAL COLLECTION AGENCY.CHARITY CARE CONSIDERATIONS WILL BE MADE BY BUSINESS OFFICE MANAGER WHEN ALL NECESSARY DOCUMENTATION IS PRESENTED AND SHOULD IT BE EVIDENT THAT THE PATIENT'S LACK OF FINANCES WARRANT THIS AND CHARITY CARE THE BEST ETHICAL DECISION FOR THE PATIENT.
PART VI, LINE 2:	THROUGH THE COMMUNITY ASSESSMENT PROCESS, HEALTHCARE NEEDS AND SERVICES WERE IDENTIFIED AND PROGRAMS WERE DEVELOPED (SEE MCH WEBSITE FOR THE 2016 COMMUNITY HEALTH DIALOGUE). STRATEGIC PLANNING ASSESSES THE NEEDS OF THE COMMUNITY AND PATIENTS THROUGH PATIENT SATISFACTION SURVEYS, COMMENT CARDS, COMMUNITY ASSESSMENTS, AND A DIVERSE MEMBERSHIP OF COMMUNITY ELECTED GOVERNING BOARD THAT REPRESENTS THE COMMUNITY AND BRINGS TO THE TABLE ISSUES, CONCERNS, RECCOMMENDATIONS FOR HEALTH CARE SERVICES.
PART VI, LINE 3:	PATIENTS ARE INFORMED OF FINANCIAL ASSISTANCE UPON ADMISSION TO THE HOSPITAL, THROUGH BILLING CLERKS ASSISTANCE WITH PATIENT ACCOUNTS, STATEMENTS ON THE BILLS, AND PERSONAL LETTERS SENT TO ACCOUNTS IDENTIFIED AS UNINSURED AND UNDERINSURED.
PART VI, LINE 4:	MADELIA COMMUNITY HOSPITAL SERVES A 25 MILE RADIUS OF RURAL COMMUNITIES CONSISTING MAJORLY OF A CULTURALLY DIVERSE AND SENIOR POPULATION.
PART VI, LINE 5:	THE MADELIA COMMUNITY HOSPITAL & CLINIC (MCHC) IS AN INTEGRAL PART OF THE COMMUNITY, PROVIDING HEALTHCARE AND SERVING AS A HUB FOR INFORMATION, PUBLIC HEALTH AND SOCIAL SERVICES. OUR RADIOLOGY DEPARTMENT STAFF REACHES OUT TO THE COMMUNITY IN MANY WAYS. DURING MAY, THEY OFFER FREE HEEL SCANS IN THE CLINIC TO HELP IDENTIFY BONE DENSITY ISSUES AT AN EARLY STAGE AND PREVENT OSTEOPOROSIS. THEY ATTEND THE HEALTH FAIR AT THE ELEMENTARY SCHOOL TO ENCOURAGE HEALTHY BONE DEVELOPMENT THROUGH DIET AND EXERCISE. DURING BREAST CANCER AWARENESS MONTH, THE DEPARTMENT PROMOTES MAMMOGRAMS BY OFFERING FREE GIFTS TO WOMEN WHO RECEIVE A MAMMOGRAM. THE RADIOLOGY STAFF ALSO CREATES DISPLAYS FOR THE MCHC EDUCATION TABLE DURING THESE MONTHS.MCHC PHYSICAL THERAPY DEPARTMENT ADMINISTERS IMPACT CONCUSSION TESTS TO LOCAL HIGH SCHOOL ATHLETES. THE 20-MINUTE TEST MEASURES VERBAL AND VISUAL MEMORY WHILE PROCESSING SPEED AND REACTION TIME TO 1/100TH OF A SECOND. IT HAS PROVEN TO BE A VALUABLE TOOL TO SHOW WHEN AN ATHLETE'S BRAIN HAS HEALED FROM A CONCUSSION. THE BASELINE TEST IS ADMINISTERED TO ALL STUDENT ATHLETES IN GRADES 7-12 IN MADELIA SCHOOLS. IF A PLAYER SUFFERS A HEAD INJURY, THEY ARE GIVEN THE TEST AGAIN TO MEASURE THE EXTENT OF THE DAMAGE AND TO MONITOR IF AN ATHLETE CAN SAFELY RETURN TO THEIR SPORT. IN ADDITION, THE PHYSICAL THERAPY STAFF ALSO OFFERS A STRENGTH AND CONDITIONING CLINIC FOR STUDENT ATHLETES AT THE NEARBY LAKE CRYSTAL WELLCOME MEMORIAL HIGH SCHOOL DURING THE SUMMER MONTHS. WE ALSO OFFER FREE ATHLETE CARE AND EVALUATION (A.C.E.) CLINIC ASSESSMENTS TO IDENTIFY AN ATHLETE'S SOURCE OF PAIN OR LIMITATION AND TO RECOMMEND POSSIBLE TREATMENT OR REFERRAL.BEFORE THE SPRING CONCERT AT THE MADELIA ELEMENTARY SCHOOL, CHILDREN AND ADULTS WERE FITTED FOR BIKE HELMETS WHICH WERE SOLD FOR A NOMINAL FEE BY OUR FOUNDATION. THE FOUNDATION ALSO SUPPLIES OUR LOCAL POLICE FORCE WITH FREE ICE CREAM COUPONS THAT ARE GIVEN TO CHILDREN SEEN WEARING THEIR HELMETS WHILE BIKING IN THE COMMUNITY. THE FOUNDATION AWARDS THREE COLLEGE SCHOLARSHIPS EACH YEAR TO AREA STUDENTS INTERESTED IN PURSUING AN EDUCATION IN A HEALTH CARE FIELD. IN THE SUMMER, THE FOUNDATION ORGANIZES A 5K RUN/WALK TO ENCOURAGE COMMUNITY MEMBERS TO GET OUTSIDE AND EXERCISE.OUR EMERGENCY DEPARTMENT LEVEL 4 TRAUMA DESIGNATION ENABLES US TO PROVIDE LIFE-SAVING MEASURES TO SEVERELY INJURED PERSONS. THE HOSPITAL STAFF PARTICIPATED IN THE SOUTH CENTRAL DISASTER PREPAREDNESS FOR BOTH REGIONAL AND STATE DISASTER DRILLS.WE CONTINUE TO HOST THE MADELIA FARMERS MARKET ON WEDNESDAYS FROM 3:30 TO 6:00 P.M. DURING THE SUMMER AND FALL IN A PARKING LOT OWNED BY THE HOSPITAL. THERE IS NO CHARGE FOR LOCAL VENDORS TO SET UP A TENT TO SELL THEIR GARDEN PRODUCE TO THE COMMUNITY. WE TYPICALLY HAVE FROM 3 TO 8 VENDORS IN OUR MARKET EACH WEEK. MCHC PAYS THE COST FOR A VENDOR LUNCH IN THE SPRING, LOCAL PROMOTIONS, AND MAINTAINS A MADELIA FARMERS MARKET FACEBOOK PAGE.THE MADELIA COMMUNITY HOSPITAL DEPARTMENTS OF NURSING, HOME CARE, AND PHYSICAL THERAPY OFFER THEIR TECHNICAL KNOWLEDGE FOR CLINICAL EXPERIENCE FOR STUDENTS FROM MINNESOTA STATE UNIVERSITY-MANKATO, PRESENTATION COLLEGE, CONCORDIA UNIVERSITY ST. PAUL, BRIAR CLIFF UNIVERSITY, RASMUSSEN COLLEGE, AND SOUTH CENTRAL COLLEGE. THE CLINICAL STUDENTS ARE HERE IN THE SPRING AND FALL SEMESTERS.THE HOSPITAL NURSING STAFF OFFER A MONTHLY FOOT CLINIC FOR ANYONE WISHING TO RECEIVE FOOT CARE, INCLUDING FOOT SOAK AND NAIL TRIMMING. THIS CLINIC IS OFFERED FOR A NOMINAL DONATION TO COVER THE COST OF SUPPLIES BUT NO ONE IS TURNED AWAY FOR INABILITY TO PAY. THIS FOOT CLINIC PROVIDES FOR UNMET PHYSICAL NEEDS AS WELL AS PSYCHOSOCIAL NEEDS. THOSE WHO COME TO THE FOOT CLINIC ENJOY THE COFFEE, COOKIES AND SOCIALIZING THAT OCCURS WITH STAFF AND EACH OTHER. THE NURSING STAFF ALSO ASSISTS IN A SIXTH GRADE HEALTH FAIR AT THE MADELIA ELEMENTARY SCHOOL. DURING THE HEALTH FAIR THEY RECORD THE STUDENT'S HEIGHT AND WEIGHT, AND DO A BLOOD SUGAR TEST TO HELP ASSESS THEIR RISK OF DEVELOPING DIABETES.THE HOME CARE DEPARTMENT ASSISTS FAMILIES WITH COPING SKILLS AND FINDING SUPPORT SYSTEMS TO MEET PATIENT NEEDS. THE DEPARTMENT HOSTS AN OPEN HOUSE EACH YEAR DURING HOME CARE MONTH AND INVITES THE PUBLIC IN FOR A LARGE BUFFET OF APPETIZERS AND TREATS, ALONG WITH PROVIDING THEM WITH INFORMATION ABOUT THE HOME CARE SERVICES OFFERED AT MCHC. THE HOME CARE NURSES EACH YEAR ADMINISTER FLU SHOTS AT HARTSHORN SENIOR HOUSING, AMBERFIELD SENIOR HOUSING, AND HOMESTEAD APARTMENTS. THEY ALSO PARTICIPATE IN HOSPICE COMMUNITY WORKSHOPS AND ADVISORY COMMITTEES THROUGHOUT THE YEAR.OTHER COMMUNITY INVOLVEMENT: - SPANISH TRANSLATION SERVICES;- FLU VACCINE CLINICS ONSITE AT LOCAL FACTORY AND COMMERCIAL BUSINESSES;- PROMOTE MEDICATION RECONCILIATION AT ANY TIME FOR RESIDENTS;- MEALS ON WHEELS DELIVERY TO HOME BOUND RESIDENTS;- COLLABORATIVE HISPANIC OUTREACH SERVICES WITH LOCAL FACTORY AND WATONWAN COUNTY HUMAN SERVICES;- PARTICIPATE IN THE COMMUNITY ORGANIZATIONS SUCH AS ROTARY AND CHAMBER OF COMMERCE; AND- SCHEDULE DRIVERS FOR TRANSPORTATION FOR WATONWAN COUNTY SENIOR DRIVER PROGRAM TO ASSIST SENIORS TO TRAVEL TO MEDICAL APPOINTMENTS.OUR PRIMARY FOCUS IS TO MAKE HEALTHY LIFESTYLE AWARENESS AVAILABLE TO OUR SERVICE AREA - WE WILL BE HERE WHENEVER THEY NEED US WITH OPEN ARMS OFFERING - "CARE FROM THE PEOPLE YOU KNOW!"
PART VI, LINE 7, REPORTS FILED WITH STATES	MN

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

Field	Value	IRS element (for citing)
Person	CANDACE FENSKE	PersonNm
Title	CEO	TitleTxt
Base Compensation Filing Org	$151,216	BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs	$0	CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization	$0	BonusFilingOrganizationAmount
Bonus Related Organizations	$0	BonusRelatedOrganizationsAmt
Other Compensation Filing Org	$0	OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs	$0	OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org	$10,585	DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs	$0	DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org	$8,507	NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs	$0	NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org	$170,308	TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs	$0	TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org	$0	CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs	$0	CompReportPrior990RltdOrgsAmt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	CITY OF MADELIA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	416005334	BondIssuerEIN
CUSIP	556401AR8	CUSIPNum
Bond Issued	2006-10-01	BondIssuedDt
Issue Price	$6,495,000	IssuePriceAmt
Purpose	CONSTRUCT HOSPITAL ADDITION	PurposeDesc
Defeased	0	DefeasedInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Pool Financing	0	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Retired	$1,515,000	RetiredAmt
Total Proceeds	$6,495,000	TotalProceedsAmt
Capitalized Interest	$161,893	CapitalizedInterestAmt
Issuance Costs From Proceeds	$16,238	IssuanceCostsFromProceedsAmt
Credit Enhancement	$113,662	CreditEnhancementAmt
Capital Expenditures	$6,203,207	CapitalExpendituresAmt
Substantial Completion	2008	SubstantialCompletionYr
Current Refunding	0	CurrentRefundingInd
Advance Refunding	0	AdvanceRefundingInd
Final Allocation Made	Yes (1)	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (1)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	0	OwningBondFinancedPropertyInd
Any Lease Arrangements	0	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	0	MgmtContractBondFincdPropInd
Any Research Agreements	0	AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test	0	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	0	ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd	0	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	0	Form8038TFiledInd
Rebate Not Due Yet	0	RebateNotDueYetInd
Exception To Rebate	Yes (1)	ExceptionToRebateInd
No Rebate Due	0	NoRebateDueInd
Variable Rate Issue	0	VariableRateIssueInd
Hedge Identified In Bks And Rec	0	HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGICInd
Gross Proceeds Invested	0	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	0	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	Yes (1)	ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1	THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE PRESIDENT, AS CHAIRPERSON, VICE PRESIDENT/TREASURER, SECRETARY, AND UP TWO (2) ADDITIONAL TRUSTEES. THE EXECUTIVE COMMITTEE SHALL HAVE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD OF TRUSTEES, SUBJECT TO ANY POWER LIMITATION IMPOSED BY THE BOARD OF TRUSTEES. A QUORUM FOR THE EXECUTIVE COMMITTEE CAN ONLY BE MADE UP OF EXECUTIVE COMMITTEE MEMBERS AND ONLY EXECUTIVE COMMITTEE MEMBERS MAY VOTE DURING EXECUTIVE COMMITTEE MEETINGS. MINUTES OF THE EXECUTIVE MEETINGS SHALL BE SUBMITTED TO THE BOARD OF TRUSTEES. THE EXECUTIVE COMMITTEE SHALL ANNUALLY EVALUATE THE CHIEF EXECUTIVE OFFICER'S PERFORMANCE AND RECOMMEND HIS/HER REMUNERATION TO THE FULL BOARD OF TRUSTEES BASED ON THE CHIEF EXECUTIVE OFFICER'S PERFORMANCE IN RELATION TO THE CORPORATION'S OBJECTIVES AND GOALS. THIS COMMITTEE SHALL MEET AS NECESSARY.
FORM 990, PART VI, SECTION A, LINE 6	MEMBERSHIP OF THIS CORPORATION SHALL BE OPEN TO ANY NATURAL PERSON WHO MEETS THE FOLLOWING QUALIFICATIONS AT THE TIME OF APPLICATION: 1) IS OF LEGAL VOTING AGE IN MINNESOTA; 2) IS A VOTING RESIDENT WITHIN THE PRIMARY SERVICE AREA OF THE HOSPITAL, BEING DEFINED AS THE COUNTIES OF WATONWAN, BLUE EARTH, BROWN, MARTIN AND NICOLLET, STATE OF MINNESOTA; 3) IS A NATURAL PERSON AND NOT A CORPORATION, PARTNERSHIP OR OTHER ASSOCIATION; 4) SUBMITS A WRITTEN APPLICATION FOR MEMBERSHIP TO THE BOARD OF TRUSTEES ON A FORM APPROVED BY THE BOARD OF TRUSTEES; AND 5) SUBMITS A MEMBERSHIP FEE OF $25 OR MORE, WITH SAID APPLICATION.
FORM 990, PART VI, SECTION A, LINE 7A	ALL TRUSTEES ARE ELECTED BY THE CORPORATE MEMBERS.
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 IS REVIEWED BY THE GOVERNING BOARD OF TRUSTEES SUBSEQUENT TO FILING THE FORM 990 WITH THE IRS. THE FORM 990 WILL BE PRESENTED BY FINANCE AT THE REGULAR MEETING OF THE BOARD OF TRUSTEES IMMEDIATELY FOLLOWING SUBMISSION TO THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	THE CONFLICT OF INTEREST POLICY IS REVIEWED AT THE ANNUAL BOARD MEETING BY THE BOARD AND DEPARTMENT HEADS. IF ANY CONFLICTS OF INTEREST ARISE, NOTIFICATION IS GIVEN TO ADMINISTRATION. A CONTRACT OR OTHER TRANSACTION THAT MAY INVOLVE A CONFLICT OF INTEREST IS NOT VOID OR VOIDABLE IF: 1) THE CONTRACT OR TRANSACTION WAS FAIR AND REASONABLE AS TO THE CORPORATION WHEN IT WAS AUTHORIZED, APPROVED, OR RATIFIED; 2) ALL MATERIAL FACTS ARE FULLY DISCLOSED TO THE MEMBERS AND THE CONTRACT OR TRANSACTION IS APPROVED BY TWO-THIRDS OF THE MEMBERS ENTITLED TO VOTE, OTHER THAN THE INTERESTED DIRECTOR OR TRUSTEE; AND 3) ALL MATERIAL FACTS ARE FULLLY DISCLOSED TO THE BOARD OF TRUSTEES OR A COMMITTEE, AND THE BOARD OR COMMITTEE APPROVES THE CONTRACT OR TRANSACTION BY A MAJORITY VOTE, BUT THE INTERESTED TRUSTEE MAY NOT TAKE PART IN THE DISCUSSION, AND MAY NOT VOTE.
FORM 990, PART VI, SECTION B, LINE 15	MADELIA COMMUNITY HOSPITAL ENSURES THAT THE COMPENSATION PAID TO ITS EMPLOYEES AND ADMINISTRATIVE STAFF TO BE CONSISTENT WITH POLICY AND PROVIDE EQUITABLE STANDARDS FOR WAGE AND BENEFITS BASED ON ANNUAL REGIONAL SURVEY OF COMPARABLE ENTITIES. THE BOARD APPROVES BOTH STAFF AND ADMINISTRATIVE INCREASES THROUGH THE ANNUAL BUDGET. THE GOVERNING BOARD REVIEWS ANNUALLY THE CEO'S PERFORMANCE (LAST PERFORMED SPRING 2017) WITH THE BASIS BEING THE ANNUAL MN HOSPITAL ASSOCIATION SURVEY AND RATE INCREASE AS AGREED UPON BY BOARD CONCENSUS BASED ON PERFORMANCE.
FORM 990, PART VI, SECTION C, LINE 19	MADELIA COMMUNITY HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AT THE ANNUAL CORPORATION MEETING AND UPON REQUEST.
FORM 990, PART XI, LINE 9:	PERM RESTRICTED NET ASSETS - GRANT RECIEVABLE 400,000. RECONCILIATION FOR CONTRIBUTION FROM RELATED ENTITY -83,966. ROUNDING 101.
FORM 990, PART XII, LINE 2C	THE ORGANIZATIONS BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF ITS INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEARS.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	MADELIA COMMUNITY HOSPITAL FOUNDATION	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	121 DREW AVENUE SE	AddressLine1Txt
City	MADELIA	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	56062	ZIPCd

Field	Value	IRS element (for citing)
EIN	731719218	EIN
Primary Activities	SOLICIT CONTRIBUTIONS ON BEHALF OF THE MADELIA COMMUNITY HOSPITAL.	PrimaryActivitiesTxt
Legal Domicile State	MN	LegalDomicileStateCd
Exempt Code Section	501(C)(3)	ExemptCodeSectionTxt
Public Charity Status	11 - TYPE 1	PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	MADELIA COMMUNITY HOSPITAL INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Controlled Organization	Yes (1)	ControlledOrganizationInd

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	MADELIA COMMUNITY HOSPITAL FOUNDATION	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Transaction Type	C	TransactionTypeTxt
Involved	$83,966	InvolvedAmt
Method Of Amount Determination	FMV	MethodOfAmountDeterminationTxt