STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

LAKE REGION HEALTHCARE CORPORATION: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
LAKE REGION HEALTHCARE CORPORATION (EIN 41-1763968)
Tax period
2015-10-01 to 2016-09-30
Filed
2017-07-27
IRS object ID
201732089349300808
Schema version
2015v3.0
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2017-07-27T13:18:08-05:00ReturnTs
Tax Period End2016-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14310 17TH AVE S PO BOX 2545AddressLine1Txt
CityFARGOCityNm
State AbbreviationNDStateAbbreviationCd
ZIP581082545ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN411763968EIN

Business Name BusinessName

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJim GingerichPersonNm
Person TitleCEOPersonTitleTxt
Phone2186857300PhoneNum
Signature2017-07-26SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLISA CHAFFEE CPAPreparerPersonNm
PTINP00193453PTIN
Phone7012398500PhoneNum
Preparation2017-07-26PreparationDt
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJim GingerichPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11411 Highway 79 EAddressLine1Txt
CityElbow LakeCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56531ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$17,387,249GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.prairiehealth.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1993FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionAn acute care hospital and ambulatory outpatient facility.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee162TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$175,441PYContributionsGrantsAmt
CY Contributions Grants$128,886CYContributionsGrantsAmt
PY Program Service Revenue$14,204,946PYProgramServiceRevenueAmt
CY Program Service Revenue$17,165,270CYProgramServiceRevenueAmt
PY Investment Income$60,509PYInvestmentIncomeAmt
CY Investment Income$34,570CYInvestmentIncomeAmt
PY Other Revenue$3,383PYOtherRevenueAmt
CY Other Revenue$1,343CYOtherRevenueAmt
PY Total Revenue$14,444,279PYTotalRevenueAmt
CY Total Revenue$17,330,069CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$4,363,271PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$5,794,990CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$10,417,282PYOtherExpensesAmt
CY Other Expenses$12,297,272CYOtherExpensesAmt
PY Total Expenses$14,780,553PYTotalExpensesAmt
CY Total Expenses$18,092,262CYTotalExpensesAmt
PY Revenues Less Expenses-$336,274PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$762,193CYRevenuesLessExpensesAmt
Total Assets BOY$33,074,223TotalAssetsBOYAmt
Total Assets EOY$31,451,284TotalAssetsEOYAmt
Total Liabilities BOY$25,267,408TotalLiabilitiesBOYAmt
Total Liabilities EOY$24,321,710TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$7,806,815NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$7,129,574NetAssetsOrFundBalancesEOYAmt
MissionServing the healthcare needs of the people.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$14,195,184ExpenseAmt
Revenue$17,165,270RevenueAmt
DescPrairie Ridge Hospital and Health Services (Medical Center) maintains and operates a hospital and an ambulatory outpatient facility for the care and treatment of the sick, diseased, disabled, aged or indigent persons and participates in various activities to promote the general health of the community. The Medical Center operates various provider based clinics and a provider based surgery department. The Medical Center maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges foregone for services and supplies furnished under its charity care policy. The amount of charges foregone, based on established rates were $53,354 and $30,623 during the years ended September 30, 2016 and September 30, 2015.Desc
Total Program Service Expenses$14,195,184TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document35IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee162EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Alison ReinBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2186857337PhoneNum

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Shawn Larsen
Chair (Jan-Jun)1.000.00Yes (X)Yes (X)$1,200$0$0
Gene Wenstrom
Chair (Jul-Sept)1.000.00Yes (X)Yes (X)$0$0$0
David Bjork
Dir (Oct-Apr)/ Vice Chair (May-Sept)1.000.00Yes (X)Yes (X)$1,200$0$0
Sandy Alvstad
Secretary1.000.00Yes (X)Yes (X)$1,200$0$0
Scott SwensonTreasurer
Director (Oct-Apr)/Treas (May-Jun)1.000.10Yes (X)Yes (X)$600$0$0
Dustin Sperr
Director1.000.00Yes (X)$1,200$0$0
Gary Spies
Director1.000.00Yes (X)$1,200$0$0
Jay McNamar
Director1.000.00Yes (X)$900$0$0
Jim Gingerich
CEO (Aug-Sep)40.000.00Yes (X)$0$21,819$0
Brett Longtin
CFO (Oct-Sept)/CEO (Oct-Nov)(Jul)0.0040.00Yes (X)$0$232,513$18,842
Lawrence Blue
CEO (Nov-Jun)40.000.00Yes (X)$0$21,346$0
Dustin Sperr
CMO (Jan-Sep)1.400.00Yes (X)$0$0$0
David Bjork
CMO (Oct-Dec)9.000.00Yes (X)$0$0$0
Loraine Martineau
Controller (Oct-Aug)40.000.00Yes (X)$96,559$0$3,354
Barbara Moore
Physical Therapist40.000.00$110,015$0$12,474Yes (X)
Renae Lien
Pharmacy Director40.000.00$129,351$0$2,618Yes (X)
Thomas Kooiman
Former CEO40.000.00$0$219,828$941Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$343,425TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$495,506TotReportableCompRltdOrgAmt
Total Other Compensation$38,229TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Lake Region Healthcare Co
712 S Cascade StFergus FallsMN56538Professional/Physician Services$2,959,424
CPSI
6600 Wall StreetMobileAL36695IT Support$882,796
West Central Internal Medicine
PO Box 410MorrisMN56267Physician Services$454,178
Morris Electronics Inc
511 Atlantic AveMorrisMN56267IT Services$408,087
DMS Imagining Inc
PO Box 206143DallasTX75320Radiology Services$279,224
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K13CntrctRcvdGreaterThan100KCnt
Government Grants$30,000GovernmentGrantsAmt
All Other Contributions$98,886AllOtherContributionsAmt
Total Contributions$128,886TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Service Rev.622110$16,139,431$16,139,431
Pharmacy722320$760,666$760,666
Other Revenue900099$287,614$287,614
Rural Alliance Investment900099-$22,441-$22,441
FieldValueIRS element (for citing)
Total Program Service Revenue$17,165,270TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$91,750TotalRevenueColumnAmt
Exclusion$91,750ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$1,343RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$1,343RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,343TotalRevenueColumnAmt
Exclusion$1,343ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$57,180SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$57,180SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$57,180TotalRevenueColumnAmt
Exclusion-$57,180ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$17,330,069TotalRevenueColumnAmt
Related Or Exempt Func Income$17,165,270RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$35,913ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$123,885TotalAmt
Management And General$123,885ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$4,856,734TotalAmt
Program Services$3,383,510ProgramServicesAmt
Management And General$1,473,224ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$101,571TotalAmt
Program Services$70,761ProgramServicesAmt
Management And General$30,810ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$346,862TotalAmt
Program Services$241,646ProgramServicesAmt
Management And General$105,216ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$365,938TotalAmt
Program Services$249,187ProgramServicesAmt
Management And General$116,751ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$60,406TotalAmt
Management And General$60,406ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$74,863TotalAmt
Management And General$74,863ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,223,377TotalAmt
Program Services$4,001,858ProgramServicesAmt
Management And General$1,221,519ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$88,571TotalAmt
Management And General$88,571ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$592,145TotalAmt
Program Services$475,009ProgramServicesAmt
Management And General$117,136ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$425,976TotalAmt
Program Services$36,415ProgramServicesAmt
Management And General$389,561ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$53,212TotalAmt
Program Services$44,905ProgramServicesAmt
Management And General$8,307ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$23,617TotalAmt
Program Services$21,094ProgramServicesAmt
Management And General$2,523ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$847,432TotalAmt
Program Services$847,432ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,032,996TotalAmt
Program Services$2,032,996ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$133,491TotalAmt
Program Services$133,491ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$1,943,126$1,943,126
Repairs and Maintenance$436,682$382,511$54,171
MN Health Tax$179,595$179,595
Bad Debt Expense$104,715$104,715

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$77,068TotalAmt
Program Services$46,933ProgramServicesAmt
Management And General$30,135ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$18,092,262TotalAmt
Program Services$14,195,184ProgramServicesAmt
Management And General$3,897,078ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,206,366BOYAmt
EOY$1,901,977EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,268,596BOYAmt
EOY$4,295,865EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$153,189BOYAmt
EOY$290,536EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$201,230BOYAmt
EOY$225,525EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$28,678,751LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$6,640,861LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$23,928,347BOYAmt
EOY$22,037,890EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$2,120,665BOYAmt
EOY$2,402,252EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$98,208BOYAmt
EOY$81,094EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,097,622BOYAmt
EOY$216,145EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$33,074,223BOYAmt
EOY$31,451,284EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,064,181BOYAmt
EOY$1,412,097EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$23,203,227BOYAmt
EOY$22,532,713EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$376,900EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$25,267,408BOYAmt
EOY$24,321,710EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$7,534,281BOYAmt
EOY$6,845,750EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$42,986BOYAmt
EOY$54,276EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$7,806,815BOYAmt
EOY$7,129,574EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$33,074,223BOYAmt
EOY$31,451,284EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$762,193ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$84,952NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

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

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$284,404BeginningYearBalanceAmt
Investment Earnings Or Losses$25,221InvestmentEarningsOrLossesAmt
End Year Balance$309,625EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$281,494BeginningYearBalanceAmt
Investment Earnings Or Losses$2,910InvestmentEarningsOrLossesAmt
End Year Balance$284,404EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.80880PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.19120TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

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

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$21,340,855OtherCostOrOtherBasisAmt
Depreciation$2,925,163DepreciationAmt
Book Value$18,415,692BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,759,619OtherCostOrOtherBasisAmt
Depreciation$3,715,698DepreciationAmt
Book Value$3,043,921BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,000OtherCostOrOtherBasisAmt
Book Value$8,000BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$22,037,890TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDue to Third Party PayorDesc
Amt$376,900Amt
FieldValueIRS element (for citing)
Total Liability$376,900TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$17,310,306TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$84,952NetUnrealizedGainsInvstAmt
Other Revenue-$104,715OtherRevenueAmt
Revenue Not Reported-$19,763RevenueNotReportedAmt
Revenue Subtotal$17,330,069RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$17,330,069TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$17,987,547TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$17,987,547ExpensesSubtotalAmt
Other Expenses Not Included$104,715OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$104,715ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$18,092,262TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:Endowment funds are intended to earn investment income. The investment income is intended to be used for funding operational expenses.
Part X, Line 2:PRHHS is organized as a Minnesota nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). PRHHS is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, PRHHS is subject to income tax on net income that is derived from business activities that are unrelated to their exempt purpose. PRHHS has determined they are not subject to unrelated business income tax and has not filed an Exempt Organization Business Income Tax Return (Form 990T) with the IRS. PRHHS believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. PRHHS would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred.
Part XI, Line 2d - Other Adjustments:Bad Debt Expense Included in Expenses in Financial Statements -104,715.
Part XII, Line 4b - Other Adjustments:Bad Debt Expense Included in Revenue in Financial Statements 104,715.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other280.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance Budget0FinancialAssistanceBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$42,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$42,000NetCommunityBenefitExpnsAmt
Total Expense0.00230TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,740,938TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,300,085DirectOffsettingRevenueAmt
Net Community Benefit Expns$440,853NetCommunityBenefitExpnsAmt
Total Expense0.02450TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,782,938TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,300,085DirectOffsettingRevenueAmt
Net Community Benefit Expns$482,853NetCommunityBenefitExpnsAmt
Total Expense0.02680TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$115,105TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$13,395DirectOffsettingRevenueAmt
Net Community Benefit Expns$101,710NetCommunityBenefitExpnsAmt
Total Expense0.00570TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,934,655TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,231,367DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,703,288NetCommunityBenefitExpnsAmt
Total Expense0.09470TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,049,760TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,244,762DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,804,998NetCommunityBenefitExpnsAmt
Total Expense0.10040TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,832,698TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,544,847DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,287,851NetCommunityBenefitExpnsAmt
Total Expense0.12720TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$104,715BadDebtExpenseAmt
Bad Debt Expense Attributable$12,985BadDebtExpenseAttributableAmt
Reimbursed By Medicare$6,462,468ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$6,827,598CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$365,130MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

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

US Address USAddress

FieldValueIRS element (for citing)
Address Line11411 Highway 79 EAddressLine1Txt
CityElbow LakeCityNm
State AbbreviationMNStateAbbreviationCd
ZIP56531ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.prairiehealth.orgWebsiteAddressTxt
State License00154StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
Other4 provider based clinicsOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Prairie Ridge Hospital and Health ServicBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttp://www.prairiehealth.orgOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLhttp://www.prairiehealth.orgStrategyWebsiteURLTxt
Strategy Attached0StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care280.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttp://www.prairiehealth.orgFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttp://www.prairiehealth.orgFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttp://www.prairiehealth.orgFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Prairie Ridge Hospital and Health ServicePart V, Section B, Line 5: We put together a committee of community members comprised of:A Prairie Ridge board member, area director of public health, a licensed social worker with an area nursing home, a branch manager with a home healthcare agency, the facilitator with a child and youth council, the counselor for the area school district, a former teacher, the county social services director, and the dean of students for the local school district.We met several times in order to identify what needs our area has. We also conducted a public survey via handout and the internet in order to get outside feedback.
Prairie Ridge Hospital and Health ServicePart V, Section B, Line 11: The Hospital is addressing the needs listed below which were identified in the 2015 tax year CHNA. Due to the timing of the tax year end and the completion date of the CHNA and Implementation Strategy some initiatives were not taken by year end, but the future actions are addressed below.1) Preventative CareCurrent activities * Prairie Ridge has a practitioner with an interest in diabetes. * She holds a free monthly diabetic education support group that covers a variety of topics for those who have diabetes and their loved ones. * Through the diabetic education program we offer a free membership to the Prairie Ridge Fitness to qualifying members. * Prairie Ridge works with Lake Region Healthcare dieticians on addressing dietary issues in the community and with our patients. * Prairie Ridge has put into place additional screening for well child exams in order to identify potential issues early on. * Prairie Ridge operates a 24/7 fitness center that is open to the community. * We work with a wide variety of insurance programs in order to allow access to as many members of the community as we can. * Prairie Ridge contracts with 4 area school districts to provide school nursing. * Prairie Ridge has 5 locations in order to provide better access to care.Proposed activitiesConducted by hospital * Prairie Ridge will add a second evening clinic to allow better access to healthcare. * Resources Committed * Staff time * Financial resources * Anticipated Impact * Having additional extended hours will allow further access to our clinic and cut down on non-emergency ER visits. * Prairie Ridge will open an additional satellite clinic in Herman in March of 2017 which will increase access to healthcare. * Resources Committed * Staff time * Financial resources * Anticipated Impact * Increase access to healthcare services within the communities we serve.Collaboration with others (if applicable) * Prairie Ridge Fitness * Lake Region Healthcare2) Aging PopulationCurrent activities * Prairie Ridge hired a nurse specifically to work with our aging population. * The services provided by the nurse include annual wellness visit reminders. * Chronic Care Management provides a care coordinator for patients with multiple diagnoses. * This nurse visits with area senior groups to educate them on services available to them. * Prairie Ridge has partnered with the PAD PRAIRIE initiative and has received training to perform screenings on patients to better diagnose PAD. * Implemented Transitional Care Management which helps manage the care after discharge. * Prairie Ridge offers swing bed services.Conducted by others * Prairie Ridge has partnered with the PAD PRAIRIE initiative. * Promoted community awareness of PAD through community events * Facilitated screening and identification of PAD * Home health agency provides services in the area * City operates an elderly independent living facility * Nursing homes in Barret and Evansville provide assisted livingProposed activities * Prairie Ridge will continue to provide the services listed above. * Resources Committed * Staff time * Financial Resources * Anticipated Impact * This will help us to better serve the needs of our aging population. * Prairie Ridge does not plan to engage in any additional programs related to elderly care during the current period as it is not currently in a financial position to address this issue. In addition, as noted above, others in the community currently are addressing it.Collaboration with others (if applicable) * PAD PRAIRIE Initiative * Grant County Committee of Aging3) Mental and Behavioral Health ServicesCurrent activities * The school district has providers who come in to meet with students. * Prairie Ridge has a contract with Bridgeway Behavioral Health at Lake Region Healthcare. * Prairie Ridge works with the Region 4 Mental Health Crisis team. * Prairie Ridge conducts continued education with staff in dealing with mental health and behavior health patients.Proposed activities * Prairie Ridge is working on policies and procedures to turn one of our hospital rooms into a safe room for mental health and behavior health patients. * Resources Committed * Staff time * Financial Resources * Anticipated Impact * This will help us to create a safe environment for our patients dealing with mental and/or behavioral health issues. * Prairie Ridge will continue to contract with Bridgeway Behavioral Health to provide services for patients with mental/behavioral health issues * Resources Committed * Staff time * Anticipated Impact * This will allow us to better serve our patients by referring them to the care that will best serve their needs. * Prairie Ridge will continue to ensure practitioners are aware of the signs of mental health issues and encourage them to refer to specialists. * Resources Committed * Staff time * Anticipated Impact * This will help practitioners to better serve and treat our patients. * Prairie Ridge will continue to educate patients about the services available to them. * Resources Committed * Staff time * Anticipated Impact * This will allow us to better serve our patients by connecting them with the correct services to best address their needs.4) TransportationCurrent activities * Rainbow Rider provides transportation services in the community, however hours of service are limited * The Veteran's Association provides transportation services to its members. * Grant County Committee on Aging's Volunteer Driver Program exists to drive people to appointments. * Prairie Ridge educates patients as to what services are available to them to help them with transportation.Proposed activities * Prairie Ridge does not plan to engage in any additional programs related to transportation during the current period as it is not currently in a financial position to address this issue. In addition, as noted above, others in the community currently are addressing it.Collaboration with others (if applicable) * Rainbow Rider * Veteran's Association * Grant County COmmittee on Aging's Volunteer Driver Program5) Dental Care for Low Income FamiliesCurrent activities * Prairie Ridge helps promote the free dental services that are offered for area families.Proposed activities * Prairie Ridge does not plan to engage in any additional programs related to Dental Care during the current period as it is not currently in a financial position to address this issue.Collaboration with others (if applicable) * Grant County Child and Youth Council * Apple Tree Dental Outreach Clinic
Prairie Ridge Hospital and Health ServicePart V, Section B, Line 16i: The Hospital provided a summary of the financial assistance policy with the patient billing invoices, posted a summary in the emergency rooms and waiting rooms, as well as the admissions office and their website. The full policy was available upon request.
Prairie Ridge Hospital and Health ServicePart V, Section B, Line 22d: The Hospital uses the Lookback Method to calculate the amounts generally billed.

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c:If a patient's income exceeds 200% of the FPG, discounted care is provided on a pro-rated basis. For example, a patient with income of 220% of the FPG might be eligible for an 80% discount. Total income and liquid assets are analyzed when assessing a patient's eligibility for discounted care. Once a patient exceeds 280% of the FPG, they are no longer eligible for financial assistance.
Part I, Line 6a:The annual community benefit report is available to the public upon request and on the PRHHS website.
Part I, Line 7:Charity care was converted to cost by multiplying the ratio of cost to charges for the Hospital by the gross uncompensated charges associated with providing charity care to its patients. Medicaid is reported at cost according to the amounts on the Medicaid Cost Report. Community health improvement services and donations are reported based on actual expenses recorded to the general ledger. Subsidized health services are reported according to costs allocated to the relevant cost centers on the Medicare Cost Report.
Part I, Ln 7 Col(f):The amount of bad debt expense removed from the denominator of the calculation was $104,715.
Part III, Line 2:Bad debt expense on line 2 is reported at charges as presented on the financial statements. A payment on an account previously written off reduces bad debt expense in the current year.
Part III, Line 3:The estimated amount of bad debt expense attributable to patients eligible under the organization's charity care policy is calculated by using the ratio of the population in the service area that is below the FPG of 12.4% to the total population and multiplying that percentage times the bad debt expense at cost.
Part III, Line 4:The footnote to the Organization's financial statements can be found on page 9 of the attached audited financial statements.
Part III, Line 8:Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services.Prairie Ridge Hospital and Health Services is a critical access hospital and in prior years has not shown a Medicare shortfall. There was a shortfall for 2015 and 2014 due to sequestration. Even though Medicare was at a loss, the Hospital provides services to these patients because access to healthcare and individual's health is important to the Hospital. Therefore, the Medicare shortfall is considered a community benefit.
Part III, Line 9b:For patients unable to meet the collection guidelines of Prairie Ridge Hospital and Health Services, notice of the Charity Care Program and appropriate forms (including the financial disclosure statement) will be supplied to the patient for completion and consideration in satisfying the balance remaining due. Once the patient begins the application process, the Hospital ceases all collection action on the amounts being considered for financial assistance. If there is a payment made on the account during the application process, the payment is applied directly to the account balance. Individuals are given 240 days to complete the FAP application.
Part VI, Line 2:In addition to the CHNA process that took part in tax year 2015, the organization assesses the health care needs of the community based on feedback from physicians.
Part VI, Line 3:Information regarding charity care is available in admission areas and in clinic patient rooms. If a patient is past due on a bill, an additional notification is given to the patient to contact the hospital to discuss payment options, including charity care. The hospital provides counseling to patients to help them qualify for Medicaid.
Part VI, Line 4:Prairie Ridge Hospital and Health Services service area includes Grant County and surrounding counties in Minnesota. In 2015, the population for Grant County was estimated to be 5,903. In 2014, approximately 23.3% of the population is age 65 or older. The average per capita income is $27,195 and approximately in 2013 12.4% of the population is below the federal poverty level. The nearest hospital in the area is approximately 20 miles from Prairie Ridge Hospital and Health Services main campus.
Part VI, Line 5:The Organization's governing body is comprised of volunteer members who reside in the community. Medical staff privileges are extended to all qualified physicians in the community. Surplus funds are reinvested in facilities to improve patient care. The hospital operates an emergency room that is available to all, regardless of ability to pay.Prairie Ridge Hospital and Health Services (PRHHS) is the sole healthcare provider within the Elbow Lake Community. The satellite clinics located in Ashby, Evansville and Hoffman provide clinic and lab services. The Morris satellite clinic provides outpatient surgery, clinic, lab and radiology services to the Morris area.PRHHS supports the education and training of various healthcare professionals. Nurse Practitioner, Physician Assistant, Radiology, Physical Therapy and nursing professionals-in-training shadow PRHHS providers during their various internships.In keeping with the hospital's mission of "Serving the healthcare needs of the people" PRHHS provides:Support Groups - PRHHS provides free use of the facility for support groups on a monthly basis. Groups include: Grief Support and Diabetic SupportTransportation - To facilitate transportation for patients in Morris to the Prairie Ridge Morris facility, PRHHS pays a monthly stipend to a public transit that allows those patients to attend their appointments without paying transportation costs.Ambulance - PRHHS Ambulance and Emergency Staff are present in case of emergency at local school activities such as football, wrestling, etc. In addition they are present at county fairs and other local events.Blood Pressure Checks - Free blood pressure checks are available at all times in both the clinic and hospital setting at all PRHHS sites. These checks are at no cost to the patient whether or not they are an established patient.Expos - PRHHS participates in the Grant County and Stevens County Fairs where we provide various information.Sports Physicals - School sports physicals are performed at a reduced rate for the schools in our area.Spry - Spry is a publication sponsored by PRHHS that provides various health related information on various topics including a variety of conditions as well as information on maintaining good health.Community Pages - Listed through the community pages are the various support groups and any health related activities provided at various times for various occasions (i.e. Community Safety, Drug Education, etc.).
Part VI, Line 7, Reports Filed With StatesMN

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Brett Longtin
CFO (Oct-Sept)/CEO (Oct-Nov)(Jul)$0$208,111$0$24,402$0$0$0$7,636$0$11,206$0$251,355$0$0
Thomas Kooiman
Former CEO$0$219,828$0$0$0$0$0$0$0$941$0$220,769$0$0

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Morris Electronics IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionBoard Chair Shawn Larsen is 100% ownerRelationshipDescriptionTxt
Transaction$253,321TransactionAmt
TransactionIT ServicesTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 2Jim Gingerich, Dr. Dustin Sperr, Dr. David Bjork, Brett Longtin, and Gene Wenstrom all have a business relationship.
Form 990, Part VI, Section A, line 6Lake Region Healthcare Corporation ("Lake Region"), a Minnesota nonprofit corporation, shall be the sole corporate member of the Corporation.
Form 990, Part VI, Section A, line 7aLake Region has reserved exclusively to itself the power to appoint board members from a slate of candidates nominated by the Corporation's Board.
Form 990, Part VI, Section A, line 7bLake Region has reserved exclusively to itself the following reserved powers: a. Approval of Operating and Capital Budget recommended by the Corporation's Board; b. Approval of Strategic Plan recommended by the Corporation's Board; c. Approval of any recommendation by the Corporation's Board to substantially change its purpose or mission or to transfer assets; d. Amendment of Articles of Incorporation, Bylaws, and other Corporate Documents; e. Approval of Contracts involving Physicians or other Providers, for compliance purposes only; f. Board member appointment, for a slate of candidates nominated by the Corporation's Board; g. Approval of incurrence of debt in excess of thresholds established by Lake Region policy; h. Approval of joint ventures or partnerships proposed to be entered into by the Corporation; and i. Approval of the creation by the Corporation of any new corporation, limited liability company, or other entity.
Form 990, Part VI, Section A, line 8bCurrently the organization does not have any committees with the authority to act on behalf of the governing body.
Form 990, Part VI, Section B, line 11The return was reviewed by the CEO and CFO, followed by a review of the Board of Directors prior to filing.
Form 990, Part VI, Section B, line 12cThe conflict of interest policy is reviewed on an annual basis by the Board of Directors. Board members, officers and management personnel are asked to disclose any potential conflicts. Any potential conflicts are reviewed at that time, and any actual conflicts are noted in the meeting minutes. Any person with a conflict is restricted from voting on related matters.
Form 990, Part VI, Section B, line 15The compensation for the CEO is determined annually by the related management company, Lake Region Healthcare.
Form 990, Part VI, Section C, line 19The Organization's governing documents, conflict of interest policy, and financial statements are available to the public upon request.
Form 990, Part VII:The compensation reported on Part VII for the former CEO Thomas Kooiman is related to services he provides to the related organization, Lake Region Healthcare Corporation, as an employee to LRHC. It is not for services provided to the filing organization.
Form 990, Part IX, line 11gConsulting Services: Program service expenses 17,725. Management and general expenses 3,669. Fundraising expenses 0. Total expenses 21,394. Physician Fees: Program service expenses 2,476,079. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,476,079. Purchased Services: Program service expenses 1,477,456. Management and general expenses 1,194,315. Fundraising expenses 0. Total expenses 2,671,771. Miscellaneous: Program service expenses 30,598. Management and general expenses 23,535. Fundraising expenses 0. Total expenses 54,133.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1Pharm Care LLCBusinessNameLine1Txt

US Address USAddress

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

Direct Controlling Entity Name DirectControllingEntityName

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

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
Prairie Ridge Foundation Inc
1411 Highway 79 EElbow LakeMN56531455092280Supporting OrganizationMN501(c)(3)Line 7Prairie Ridge Hospital and Health Services IncYes (1)
Lake Region Healthcare Corporation
712 S Cascade StFergus FallsMN565380728410730602HospitalMN501(c)(3)Line 30N/A
Lake Region Hospital Foundation
712 S Cascade StFergus FallsMN565380728411677288FoundationMN501(c)(3)Line 11a, ILake Region Healthcare Corporation0
LRHC Long Term Care Facilities Inc
712 S Cascade StFergus FallsMN565380728411817549Assisted LivingMN501(c)(3)Line 9Lake Region Healthcare Corporation0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)

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