CENTRACARE CLINIC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- CENTRACARE CLINIC (EIN 41-1806657)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-05-15
- IRS object ID
- 201841359349301029
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| 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 | 411806657 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRACARE CLINIC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CENT | BusinessNameControlTxt |
| Phone | 3202525131 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 6TH AVENUE NORTH | AddressLine1Txt |
| City | ST CLOUD | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56303 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID TILSTRA | PersonNm |
| Person Title | TREASURER & CFO | PersonTitleTxt |
| Phone | 3202525131 | PhoneNum |
| Signature | 2018-05-10 | 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 |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 108.171.131.171 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-05-10 | IPDt |
| IP Tm | 17:21:14 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 5AB5DFEC54AF030231DDAA57F2AFD57D98013E0B | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 46503DA264ECF0362741A52CFD0686219AC4FE5C | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KENNETH D HOLMEN MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 6TH AVENUE NORTH | AddressLine1Txt |
| City | ST CLOUD | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56303 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $214,007,719 | 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 | 1995 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | WE ARE DEDICATED TO PROVIDING EXCELLENT SERVICE AND THE HIGHEST QUALITY OF CARE TO THOSE WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 1194 | TotalEmployeeCnt |
| Total Volunteers | 13 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$50,572 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,286,692 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,060,659 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $181,683,318 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $180,218,994 | CYProgramServiceRevenueAmt |
| PY Investment Income | $141,829 | PYInvestmentIncomeAmt |
| CY Investment Income | $182,073 | CYInvestmentIncomeAmt |
| PY Other Revenue | $23,047,866 | PYOtherRevenueAmt |
| CY Other Revenue | $32,164,026 | CYOtherRevenueAmt |
| PY Total Revenue | $206,159,705 | PYTotalRevenueAmt |
| CY Total Revenue | $213,625,752 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $6,636 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,150 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $173,029,113 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $197,833,728 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $58,305,987 | PYOtherExpensesAmt |
| CY Other Expenses | $51,781,564 | CYOtherExpensesAmt |
| PY Total Expenses | $231,341,736 | PYTotalExpensesAmt |
| CY Total Expenses | $249,616,442 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$25,182,031 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$35,990,690 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $46,872,944 | TotalAssetsBOYAmt |
| Total Assets EOY | $44,178,993 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $37,730,810 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $41,857,730 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,142,134 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,321,263 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | CENTRACARE CLINIC WILL BE THE LEADER IN MINNESOTA FOR QUALITY, SAFETY, SERVICE AND VALUE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $131,105,185 | ExpenseAmt |
| Grant | $1,150 | GrantAmt |
| Revenue | $211,751,847 | RevenueAmt |
| Desc | MEDICAL PROFESSIONAL SERVICES - CENTRACARE CLINIC (CCC) PROVIDES A WIDE RANGE OF PRIMARY CARE AND SPECIALTY MEDICAL SERVICES THROUGH A MULTI-SPECIALTY CLINIC STRUCTURE AS THE PHYSICIAN COMPONENT OF CENTRACARE HEALTH, AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. CCC'S FORMALLY ADOPTED CORE VALUES ARE: PATIENT CENTERED: SERVING PATIENTS ABOVE ALL.INTEGRITY: ADHERING TO HONEST AND ETHICAL PRACTICES.COLLABORATION: WORKING JOINTLY WITH OTHERS TO IMPROVE HEALTH AND HEALTH CARE.COMPASSION: SERVING ALL WHO SEEK OUR CARE WITH KINDNESS, DIGNITY AND RESPECT.STEWARDSHIP: ENSURING RESPONSIBLE USE OF ALL RESOURCES TO BEST SERVE OUR COMMUNITIES. CCC ACHIEVES THESE VALUES THROUGH SERVICES PROVIDED BY A TEAM OF PHYSICIANS, ADVANCED PRACTICE PROVIDERS, NURSES, DIETICIANS, EDUCATORS AND OTHER HEALTH CARE PROFESSIONALS. MANY SERVICES ARE PROVIDED TO THE GROWING DIVERSE POPULATION IN CENTRAL MINNESOTA. CCC ALSO PROVIDES THE PROFESSIONAL STAFFING FOR DESIGNATED RURAL HEALTH CLINICS AND HEALTH MANPOWER SHORTAGE AREAS SERVED BY CENTRACARE HEALTH IN RURAL MINNESOTA.A SUMMARY OF THE MAJOR ACTIVITIES ACCOMPLISHED FOR THE YEAR ENDED JUNE 30, 2017:CLINIC VISITS - 316,412HOSPITAL VISITS - 161,726NURSING HOME VISITS - 5,830SURGICAL SERVICES - 168,966LABORATORY TESTS - 534,904IMMUNIZATION/INJECTION - 917,049RADIOLOGY TESTS - 25,520PROFESSIONAL INTERPRETATIONS - 59,498SURGICAL, MINOR - 33,378RADIATION ONCOLOGY - 3,307SPECIAL PROCEDURE - 35,016 | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $69,702,607 | ExpenseAmt |
| Desc | CCC PARTICIPATES IN A WIDE VARIETY OF GOVERNMENTAL HEALTHCARE PROGRAMS INCLUDING: MEDICARE, MEDICAID, MINNESOTA CARE, MINNESOTA GENERAL ASSISTANCE AND PROGRAMS FOR MILITARY, VETERANS AND THEIR FAMILIES. FOR THE YEAR ENDED JUNE 30, 2017, CCC INCURRED COSTS OF $69,702,607 IN EXCESS OF PAYMENTS RECEIVED FOR SERVICES TO PATIENTS COVERED UNDER THESE PROGRAMS AND TAXES AND FEES RELATING TO THESE PROGRAMS. GOVERNMENTAL HEALTHCARE PROGRAMS PROVIDER REIMBURSEMENT AMOUNTS ARE BELOW THE COSTS THE PROVIDER INCURS TO PROVIDE THESE SERVICES.MEDICARE COSTS IN EXCESS OF PAYMENTS $45,814,703MEDICAID COSTS IN EXCESS OF PAYMENTS $19,160,632SURCHARGES, FEES AND MINNESOTACARE TAX $2,015,018MILITARY COSTS IN EXCESS OF PAYMENTS $2,712,254 | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,390,881 | ExpenseAmt |
| Desc | CCC SUPPORTS A WIDE VARIETY OF PATIENTS WHO EXPRESS A WILLINGNESS TO PAY BUT ARE UNABLE TO DO SO DUE TO SOCIOECONOMIC FACTORS. ADDITIONALLY CCC RECORDS BAD DEBT AT TIMES WHEN IT IS UNABLE TO RECEIVE PAYMENT FOR SERVICES PROVIDED. FOR THE ENDED JUNE 30, 2017, $3,390,881 OF UNCOMPENSATED CARE WAS PROVIDED. $663,388 OF CHARITY CARE WAS PROVIDED UNDER THE ORGANIZATIONS FINANCIAL ASSISTANCE PROGRAM. THE FINANCIAL ASSISTANCE PROGRAM PROVIDES PATIENTS WILLING, BUT UNABLE TO PAY, TO HAVE PATIENT BALANCES OTHERWISE DUE, REDUCED OR WAIVED. THE FINANCIAL ASSISTANCE PROGRAM ENSURES THE PATIENTS OF THE COMMUNITIES SERVED BY CCC HAVE ACCESS TO QUALITY MEDICAL CARE SERVICES REGARDLESS OF THEIR ABILITY TO PAY. CCC PROVIDES SERVICES TO ALL IN NEED AND AT TIMES PATIENT ACCOUNT BALANCES GO UNPAID, KNOWN AS BAD DEBT, THESE BAD DEBT AMOUNT FOR THE YEAR ENDED JUNE 30, 2017 TOTALED $2,727,493. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $204,198,673 | 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 | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 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 | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 133 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1194 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 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 | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | 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 | THOMAS FELDHEGE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3202402152 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 SIXTH AVENUE NORTH | AddressLine1Txt |
| City | ST CLOUD | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56303 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| DAVID J TILSTRA MD CPE | ||||||||
| DIRECTOR & PRESIDENT | 37.00 | 3.00 | Yes (X) | Yes (X) | $563,499 | $0 | $90,054 | |
| DAVID ROBERTS MD | ||||||||
| DIRECTOR, CHAIR & GASTROENTEROLOGIST | 38.00 | 2.00 | Yes (X) | Yes (X) | $656,652 | $0 | $61,195 | |
| ROBERT STOCKER MD | ||||||||
| DIRECTOR & OBGYN | 38.00 | 2.00 | Yes (X) | $529,415 | $0 | $29,925 | ||
| SHARON J RUGGIERO MD | ||||||||
| DIRECTOR & INTERNIST | 30.00 | Yes (X) | $214,962 | $0 | $25,928 | |||
| DONALD J JURGENS MD | ||||||||
| DIRECTOR & ONCOLOGIST | 40.00 | Yes (X) | $693,724 | $0 | $60,869 | |||
| CHRISTIAN P SCHMIDT MD | ||||||||
| DIRECTOR & SURGEON | 38.00 | 2.00 | Yes (X) | $529,710 | $0 | $57,691 | ||
| DAVID AGERTER MD | ||||||||
| DIRECTOR | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| FREDERIC ENGMAN MD | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| PATRICK LYNCH | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| BRIDGET FABER | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS M FELDHEGE | ||||||||
| TREASURER & CFO | 35.00 | 5.00 | Yes (X) | $0 | $241,817 | $18,525 | ||
| GEORGE A MORRIS MD | ||||||||
| MEDICAL DIRECTOR | 40.00 | Yes (X) | $386,020 | $0 | $61,382 | |||
| WADE T SCHMIDT MD | ||||||||
| INTERVENTIONAL CARDIOLOGIST | 40.00 | $941,814 | $0 | $58,701 | Yes (X) | |||
| JEFFREY S GERDES MD | ||||||||
| NEUROSURGEON | 40.00 | $1,826,602 | $0 | $62,051 | Yes (X) | |||
| JOHN A SCHOENHARD | ||||||||
| EP CARDIOLOGIST | 40.00 | $982,470 | $0 | $62,375 | Yes (X) | |||
| JERONE D KENNEDY MD | ||||||||
| NEUROSURGEON | 40.00 | $1,184,085 | $0 | $44,089 | Yes (X) | |||
| RACHEL L SCHUNEMAN | ||||||||
| DERMATOLOGIST | 40.00 | $966,468 | $0 | $48,215 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $9,475,421 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $241,817 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $681,000 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 387 | 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 |
|---|---|---|---|---|---|
| WEATHERBY LOCUMS INC | |||||
| PO BOX 972633 | DALLAS | TX | 753972633 | LOCUM FEES | $1,398,393 |
| ARIF SOMANI | |||||
| 5210 UPLAND LANE NORTH | PLYMOUTH | MN | 55446 | LOCUM FEES | $321,353 |
| UNIVERSITY OF MINNESOTA | |||||
| SDS 12-1562 PO BOX 86 | MINNEAPOLIS | MN | 554861562 | LOCUM FEES | $260,678 |
| REGIONAL DIAGNOSTIC RADIOLOGY | |||||
| 1990 CONNECTICUT AVENUE SOUTH SUIT | SARTELL | MN | 56377 | RADIOLOGY FEES | $196,972 |
| AURORA DIAGNOSTICS | |||||
| PO BOX 281177 | ATLANTA | GA | 303841177 | LAB FEES | $179,804 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 11 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $438,498 | RelatedOrganizationsAmt |
| Government Grants | $267,032 | GovernmentGrantsAmt |
| All Other Contributions | $355,129 | AllOtherContributionsAmt |
| Total Contributions | $1,060,659 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | $159,388,728 | $159,388,728 | |
| OTHER PROGRAM REVENUE | 900099 | $20,359,469 | $20,330,613 | $28,856 |
| QUALITY & TECH INCENTIVE | 900099 | $266,638 | $266,638 | |
| SCHOOL REVENUE | 900099 | $204,159 | $204,159 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $180,218,994 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $175,021 | TotalRevenueColumnAmt |
| Exclusion | $175,021 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $7,052 | 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 | $7,052 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,052 | TotalRevenueColumnAmt |
| Exclusion | $7,052 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $1,013,140 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $381,967 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $631,173 | TotalRevenueColumnAmt |
| Exclusion | $631,173 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SHARED EXPENSE REIMBURSEMENT | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $31,532,853 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $31,532,853 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $31,532,853 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $213,625,752 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $211,722,991 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $842,102 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,150 | TotalAmt |
| Program Services | $1,150 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,975,759 | TotalAmt |
| Program Services | $3,193,276 | ProgramServicesAmt |
| Management And General | $782,483 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $165,484,699 | TotalAmt |
| Program Services | $132,915,072 | ProgramServicesAmt |
| Management And General | $32,569,627 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,946,742 | TotalAmt |
| Program Services | $5,579,529 | ProgramServicesAmt |
| Management And General | $1,367,213 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,245,271 | TotalAmt |
| Program Services | $11,441,609 | ProgramServicesAmt |
| Management And General | $2,803,662 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,181,257 | TotalAmt |
| Program Services | $5,767,888 | ProgramServicesAmt |
| Management And General | $1,413,369 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,298 | TotalAmt |
| Program Services | $74,936 | ProgramServicesAmt |
| Management And General | $18,362 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,408 | TotalAmt |
| Program Services | $13,982 | ProgramServicesAmt |
| Management And General | $3,426 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,158 | TotalAmt |
| Program Services | $1,158 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,714,832 | TotalAmt |
| Program Services | $12,621,941 | ProgramServicesAmt |
| Management And General | $3,092,891 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $195,746 | TotalAmt |
| Program Services | $157,221 | ProgramServicesAmt |
| Management And General | $38,525 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $637,369 | TotalAmt |
| Program Services | $511,926 | ProgramServicesAmt |
| Management And General | $125,443 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,641,264 | TotalAmt |
| Program Services | $7,743,733 | ProgramServicesAmt |
| Management And General | $1,897,531 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $221,750 | TotalAmt |
| Program Services | $178,107 | ProgramServicesAmt |
| Management And General | $43,643 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,327,280 | TotalAmt |
| Program Services | $1,066,053 | ProgramServicesAmt |
| Management And General | $261,227 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,479,635 | TotalAmt |
| Program Services | $1,188,423 | ProgramServicesAmt |
| Management And General | $291,212 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,641,208 | TotalAmt |
| Program Services | $1,318,196 | ProgramServicesAmt |
| Management And General | $323,012 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| SUPPLIES | $14,106,131 | $14,106,131 |
| BAD DEBT EXPENSE | $2,727,494 | $2,727,494 |
| MEDICAID/MN CARE | $2,015,018 | $2,015,018 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,961,973 | TotalAmt |
| Program Services | $1,575,830 | ProgramServicesAmt |
| Management And General | $386,143 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $249,616,442 | TotalAmt |
| Program Services | $204,198,673 | ProgramServicesAmt |
| Management And General | $45,417,769 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,266 | BOYAmt |
| EOY | $8,366 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,814,261 | BOYAmt |
| EOY | $5,372,894 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,784,805 | BOYAmt |
| EOY | $20,386,054 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,645,522 | BOYAmt |
| EOY | $1,707,649 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,175,823 | BOYAmt |
| EOY | $1,001,745 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $531,079 | BOYAmt |
| EOY | $508,646 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $17,680,424 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $9,919,315 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,241,614 | BOYAmt |
| EOY | $7,761,109 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $60,667 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,673,574 | BOYAmt |
| EOY | $7,371,863 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,872,944 | BOYAmt |
| EOY | $44,178,993 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,652,235 | BOYAmt |
| EOY | $33,221,728 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,078,575 | BOYAmt |
| EOY | $8,636,002 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,730,810 | BOYAmt |
| EOY | $41,857,730 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,142,134 | BOYAmt |
| EOY | $2,321,263 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,142,134 | BOYAmt |
| EOY | $2,321,263 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,872,944 | BOYAmt |
| EOY | $44,178,993 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$35,990,690 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $29,169,819 | 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 | $1,158 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,158 | 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 CLINIC PAID $1,158 TO STATE AND NATIONAL ASSOCIATIONS TO CONDUCT LOBBYING ACTIVITIES ON ITS BEHALF, AS A MEMBER OF THE ASSOCIATIONS. | ExplanationTxt |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,629,944 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,215,278 | DepreciationAmt |
| Book Value | $3,414,666 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,050,480 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,704,037 | DepreciationAmt |
| Book Value | $4,346,443 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,761,109 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| FUNDS HELD BY TRUSTEE | $3,214,080 |
| LONG TERM PREPAID EXPENSES | $1,093,889 |
| DUE FROM AFFILIATES | $3,063,894 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $7,371,863 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED COMPENSATION PLAN OBLIGATIONS | $1,100,208 |
| LT SETTLEMENT RESERVE | $2,043,000 |
| EXECUTIVE BENEFIT ACCRUAL | $195,872 |
| DUE TO AFFILIATES | $5,276,922 |
| LITIGATION ACCRUAL | $20,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $8,636,002 | 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 J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| 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 | 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 | Yes (1) | 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 (13 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID J TILSTRA MD CPE | ||||||||||||||
| DIRECTOR & PRESIDENT | $390,396 | $0 | $101,271 | $0 | $71,832 | $0 | $65,629 | $0 | $29,254 | $0 | $658,382 | $0 | $53,652 | $0 |
| DAVID ROBERTS MD | ||||||||||||||
| DIRECTOR, CHAIR & GASTROENTEROLOGIST | $601,936 | $0 | $33,549 | $0 | $21,167 | $0 | $34,920 | $0 | $29,238 | $0 | $720,810 | $0 | $0 | $0 |
| ROBERT STOCKER MD | ||||||||||||||
| DIRECTOR & OBGYN | $466,228 | $0 | $62,199 | $0 | $988 | $0 | $29,425 | $0 | $3,725 | $0 | $562,565 | $0 | $0 | $0 |
| SHARON J RUGGIERO MD | ||||||||||||||
| DIRECTOR & INTERNIST | $192,403 | $0 | $21,739 | $0 | $820 | $0 | $15,469 | $0 | $11,107 | $0 | $241,538 | $0 | $0 | $0 |
| DONALD J JURGENS MD | ||||||||||||||
| DIRECTOR & ONCOLOGIST | $659,474 | $0 | $16,062 | $0 | $18,188 | $0 | $35,593 | $0 | $27,463 | $0 | $756,780 | $0 | $0 | $0 |
| CHRISTIAN P SCHMIDT MD | ||||||||||||||
| DIRECTOR & SURGEON | $491,348 | $0 | $19,137 | $0 | $19,225 | $0 | $31,415 | $0 | $29,145 | $0 | $590,270 | $0 | $0 | $0 |
| THOMAS M FELDHEGE | ||||||||||||||
| TREASURER & CFO | $0 | $194,492 | $0 | $20,619 | $0 | $26,706 | $0 | $17,775 | $0 | $1,288 | $0 | $260,880 | $0 | $0 |
| GEORGE A MORRIS MD | ||||||||||||||
| MEDICAL DIRECTOR | $319,038 | $0 | $56,789 | $0 | $10,193 | $0 | $38,456 | $0 | $25,473 | $0 | $449,949 | $0 | $9,560 | $0 |
| WADE T SCHMIDT MD | ||||||||||||||
| INTERVENTIONAL CARDIOLOGIST | $803,489 | $0 | $135,302 | $0 | $3,023 | $0 | $35,775 | $0 | $25,715 | $0 | $1,003,304 | $0 | $0 | $0 |
| JEFFREY S GERDES MD | ||||||||||||||
| NEUROSURGEON | $1,783,364 | $0 | $23,040 | $0 | $20,198 | $0 | $35,775 | $0 | $29,832 | $0 | $1,892,209 | $0 | $0 | $0 |
| JOHN A SCHOENHARD | ||||||||||||||
| EP CARDIOLOGIST | $702,757 | $0 | $276,239 | $0 | $3,474 | $0 | $35,775 | $0 | $29,969 | $0 | $1,048,214 | $0 | $0 | $0 |
| JERONE D KENNEDY MD | ||||||||||||||
| NEUROSURGEON | $1,057,743 | $0 | $88,010 | $0 | $38,332 | $0 | $19,875 | $0 | $24,898 | $0 | $1,228,858 | $0 | $0 | $0 |
| RACHEL L SCHUNEMAN | ||||||||||||||
| DERMATOLOGIST | $924,891 | $0 | $23,040 | $0 | $18,537 | $0 | $35,775 | $0 | $14,989 | $0 | $1,017,232 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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: DAVID TILSTRA, MD - PAID $53,652; ACCRUED $35,053 GEORGE MORRIS, MD - PAID $9,560; ACCRUED $12,532 |
| 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 (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | CENTRACARE CLINIC AMENDED ITS BYLAWS TO INCREASE THE CENTRACARE HEALTH (CCH) BOARD AUTHORITY AND CONTROL TO OPERATE THE INTEGRATED HEALTH SYSTEM. THE CENTRACARE CLINIC (CCC) BOARD WAS ELIMINATED; THE CURRENT FOUR EMPLOYED PHYSICIANS WERE TRANSFERRED TO THE CCH BOARD, AND NEW BYLAWS WERE ADOPTED TO APPOINT THE INTERNAL CCH BOARD AS THE NEW CCC BOARD. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE ORGANIZATION IS CENTRACARE HEALTH SYSTEM, A MINNESOTA NON-PROFIT ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | PHYSICIAN AND CORPORATE DIRECTORS SHALL BE ELECTED OR APPOINTED AS FOLLOWS: (A) PRIMARY CARE PHYSICIAN DIRECTORS SHALL BE ELECTED BY THE PRIMARY CARE PHYSICIANS EMPLOYED BY CENTRACARE CLINIC. (B) SPECIALIST PHYSICIAN DIRECTORS SHALL BE ELECTED BY THE SPECIALIST PHYSICIANS EMPLOYED BY CENTRACARE CLINIC. (C) THE AT LARGE DIRECTORS SHALL BE ELECTED BY THE PHYSICIANS EMPLOYED BY CENTRACARE CLINIC. (D) THE CORPORATE DIRECTORS ARE APPOINTED BY THE SOLE MEMBER, CENTRACARE HEALTH SYSTEM. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING MATTERS ARE RESERVED TO THE SOLE MEMBER, CENTRACARE HEALTH SYSTEM, WHICH SHALL BE TAKEN BY A VOTE APPROVED BY AT LEAST 75% OF THE BOARD OF DIRECTORS OF CENTRACARE HEALTH SYSTEM: 1. ADOPTION OF AMENDMENTS TO THE ARTICLES OF CENTRACARE CLINIC. 2. APPROVE AMENDMENTS TO THE BYLAWS OF CENTRACARE CLINIC WHICH MAY AFFECT ANY POWERS OF FUNCTIONS RESERVED TO THE SOLE MEMBER. THE FOLLOWING MATTERS ARE RESERVED TO CENTRACARE HEALTH SYSTEM, WHICH SHALL BE TAKEN BY A VOTE APPROVED BY AT LEAST 51% OF THE BOARD OF DIRECTORS OF CENTRACARE HEALTH SYSTEM: 1. REVIEW AND APPROVE THE FOLLOWING: (I) THE ANNUAL OPERATING AND CAPITAL BUDGETS, (II) ANY CAPITAL EXPENDITURES IN EXCESS OF $1.0 MILLION WHETHER BUDGETED OR NOT BUDGETED, (III) ANY DEBTS TO BE INCURRED. 2. APPROVE ANY ENCUMBRANCE OF THE ASSETS OF CENTRACARE CLINIC. 3. REVIEW AND APPROVE ALL STRATEGIC PLANS OF CENTRACARE CLINIC. 4. REVIEW AND APPROVE ALL MEDICAL STAFF DEVELOPMENT PLANS FOR AN INTEGRATED DELIVERY STEM OF CENTRACARE CLINIC. 5. REVIEW AND APPROVE ALL THIRD PARTY CONTRACTS WHICH ARE FIRST APPROVED BY THE BOARD OF DIRECTORS OF CENTRACARE CLINIC. 6. APPROVE ANY APPOINTMENT OF THE PRESIDENT OF CENTRACARE CLINIC. 7. APPROVE CENTRACARE CLINIC'S ANNUAL BUDGET FOR ALL PROFESSIONAL COMPENSATION AND APPROVE ALL COMPENSATION POLICIES AND PLANS FOR PHYSICIANS EMPLOYED BY CENTRACARE CLINIC. 8. OVERSEE AND MONITOR ALL COMPLIANCE AND RISK MANAGEMENT PRACTICES OF CENTRACARE CLINIC. 9. REVIEW AND APPROVE ANY TRANSACTION OF CENTRACARE CLINIC WHICH MAY AFFECT (I) THE CORPORATION'S STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXATION OR (II) THE TAX EXEMPT STATUS OF ANY FINANCING OF CENTRACARE CLINIC. 10. APPROVE ANY USE OF ANY TRADE NAMES OR ANY INTELLECTUAL PROPERTY OF CENTRACARE CLINIC. 11. THE DETERMINATION OF THE DISSOLUTION OF OR THE DISCONTINUATION OF BUSINESS OF CENTRACARE CLINIC. 12. THE MERGERS WITH, THE ACQUISITION OF, OR THE AFFILIATION WITH ANY HOSPITAL, CLINIC, OR PHYSICIAN PROVIDER GROUP. 13. OVERSEE AUDITING AND ACCOUNTING PRACTICES OF CENTRACARE CLINIC. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE RETURN IS REVIEWED IN DETAIL BY MANAGEMENT AND LEGAL COUNSEL. IN ADDITION, THE FULL BOARD HAS AN OPPORTUNITY TO REVIEW FORM 990 WITH STAFF, ASK QUESTIONS, SEEK CLARIFICATIONS, AND APPROVE THE FINAL RETURN PRIOR TO FILING WITH THE IRS. |
| 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 QUESTIONNAIRE ARE THEN REVIEWED WITH THE EXECUTIVE COMMITTE 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 AND 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 DONE MAY 2017. THE THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT IS RETAINED BY ST. COULD HOSPITAL TO PERFORM SERVICES. THE ORGANIZATION'S EMPLOYED PRACTICING PHYSICIANS ARE SUBJECT TO ANNUAL FULL COMPENSATION AND BENEFITS REVIEW THROUGH COMPARABILITY STUDIES BY AN OUTSIDE, INDEPENDENT CONSULTANT USING NATIONAL AND REGIONAL DATA FROM MULTIPLE SOURCES. THIS STUDY IS REVIEWED BY THE COMPENSATION COMMITTEE AND APPROVED BY THE COMMITTEE AND THE BOARD. THE LAST FULL REVIEW WAS COMPLETED IN MAY 2017. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT OPEN TO PUBLIC DISCLOSURE. |
| FORM 990, PART XI, LINE 9: | NET EQUITY TRANSFERS FROM CENTRACARE HEALTH SYSTEM 29,169,819. |
| FORM 990, PART I, LINE 6 | CENTRACARE CLINIC HAD 13 VOLUNTEERS DURING FY17 WHO DONATED A TOTAL OF APPROXIMATELY 636 HOURS TO VARIOUS DEPARTMENTS. |
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 N | ST CLOUD | MN | 56303 | 411813221 | HEALTH CARE | MN | 501(C)(3) | 11- TYPE 3 FI | N/A | 0 | |
| CENTRACARE HEALTH SYSTEM - MELROSE | |||||||||||
| 11 NORTH 5TH AVE WEST | MELROSE | MN | 56352 | 411865315 | ACUTE & LONG-TERM CARE | MN | 501(C)(3) | LINE 3 | 0 | CENTRACARE HEALTH SYSTEM | |
| CENTRACARE HEALTH SYSTEM - LONG PRAIRIE | |||||||||||
| 20 SOUTHEAST 9TH STREET | LONG PRAIRIE | MN | 56347 | 411924645 | ACUTE & LONG-TERM CARE | MN | 501(C)(3) | LINE 3 | 0 | CENTRACARE HEALTH SYSTEM | |
| CENTRACARE HEALTH FOUNDATION | |||||||||||
| 1406 6TH AVE N | ST CLOUD | MN | 56303 | 411855173 | FUNDRAISING | MN | 501(C)(3) | LINE 7 | 0 | CENTRACARE HEALTH SYSTEM | |
| CENTRAL MINNESOTA EMERGENCY PHYSICIANS | |||||||||||
| 1406 6TH AVE N | ST CLOUD | MN | 56303 | 411708142 | EMERGENCY PHYSICIAN PRACTICE | MN | 501(C)(3) | LINE 3 | 0 | CENTRACARE HEALTH SYSTEM | |
| ST CLOUD HOSPITAL | |||||||||||
| 1406 6TH AVE N | ST CLOUD | MN | 56303 | 410695596 | ACUTE & LONG-TERM CARE | MN | 501(C)(3) | LINE 3 | 0 | CENTRACARE HEALTH SYSTEM | |
| CENTRACARE HEALTH SYSTEM - SAUK CENTRE | |||||||||||
| 425 ELM STREET NORTH | SAUK CENTRE | MN | 56378 | 452438973 | ACUTE 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 | MN | N/A | C | 0 |
| ST CLOUD MEDICAL GROUP PA | |||||||||
| 1406 6TH AVE NORTH | S CLOUD | MN | 56303 | 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 | 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 | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | 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 | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |