MADELIA HEALTH: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- MADELIA HEALTH (EIN 41-0758512)
- Tax period
- 2015-06-01 to 2016-05-31
- Filed
- 2017-04-15
- IRS object ID
- 201741059349300509
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-04-15T09:58:10-05:00 | ReturnTs |
| Tax Period End | 2016-05-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 SOUTH SIXTH STREET SUITE 300 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-06-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410758512 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADELIA COMMUNITY HOSPITAL INCORPORATED | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MADE | BusinessNameControlTxt |
| Phone | 5076423255 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 121 DREW AVENUE SOUTHEAST | AddressLine1Txt |
| City | MADELIA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56062 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CANDACE FENSKE | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 5076423255 | PhoneNum |
| Signature | 2017-04-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TRENT FAST | PreparerPersonNm |
| PTIN | P00692704 | PTIN |
| Phone | 6123764500 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADELIA COMMUNITY HOSPITAL & CLINIC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CANDACE FENSKE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 121 DREW AVENUE SOUTHEAST | AddressLine1Txt |
| City | MADELIA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56062 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $11,764,014 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MCHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1950 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE QUALITY HEALTHCARE SERVICES TO THE LOCAL COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 136 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $146,383 | PYContributionsGrantsAmt |
| CY Contributions Grants | $85,861 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,642,251 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $11,002,826 | CYProgramServiceRevenueAmt |
| PY Investment Income | $107,278 | PYInvestmentIncomeAmt |
| CY Investment Income | $149,949 | CYInvestmentIncomeAmt |
| PY Other Revenue | $173,699 | PYOtherRevenueAmt |
| CY Other Revenue | $441,799 | CYOtherRevenueAmt |
| PY Total Revenue | $11,069,611 | PYTotalRevenueAmt |
| CY Total Revenue | $11,680,435 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,493,899 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,953,398 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,681,336 | PYOtherExpensesAmt |
| CY Other Expenses | $4,659,262 | CYOtherExpensesAmt |
| PY Total Expenses | $11,175,235 | PYTotalExpensesAmt |
| CY Total Expenses | $11,612,660 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$105,624 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $67,775 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $18,954,153 | TotalAssetsBOYAmt |
| Total Assets EOY | $18,406,716 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,936,719 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,321,406 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $12,017,434 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $12,085,310 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF MADELIA COMMUNITY HOSPITAL IS TO PROVIDE SAFE AND QUALITY HEALTHCARE SERVICES TO THOSE WE SERVE IN AN ENVIRONMENT BASED ON RESPECT, DIGNITY, AND EXCELLENCE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $8,163,772 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $11,002,826 | RevenueAmt |
| Desc | MADELIA COMMUNITY HOSPITAL & CLINIC PROVIDES GENERAL MEDICAL/SURGICAL SERVICES ON INPATIENTS, SWING BED PATIENTS, OUTPATIENTS AND HOME CARE CLIENTS. DURING THE FISCAL YEAR 2016 THERE WERE 134 ACUTE CARE ADMISSIONS, 63 SWING BED ADMISSIONS, 15,572 HOME CARE VISITS TO 1,243 HOME CARE CLIENTS AND 4,610 OUTPATIENT VISITS. DURING OUR FISCAL YEAR 2016, MADELIA COMMUNITY HOSPITAL AND CLINIC PROVIDED $103,657 IN CHARITY CARE. A VARIETY OF COMMUNITY BENEFIT SERVICES ARE DONE EACH YEAR BY VOLUNTEER HOSPITAL EMPLOYEES AND COMMUNITY VOLUNTEERS. COMMUNITY BENEFIT ACTIVITIES INCLUDED:- COORDINATION OF DRIVERS FOR THE WATONWAN COUNTY SENIOR DRIVER PROGRAM, A NONPROFIT GROUP FURNISHING TRANSPORTATION FOR THE ELDERLY SENIOR POPULATION.- DELIVERY OF MEALS FOR THE HOSPITAL PREPARED MEALS ON WHEELS IN MADELIA- INTERPRETIVE AND TRANSLATION FROM ENGLISH TO SPANISH- COLLABORATIVE HISPANIC OUTREACH SERVICES INCLUDING POPULATION HEALTH EDUCATIONAL SERVICES FOR THE PREVENTION OF DIABETES, OBESITY, HEART DISEASE, AND HYPERTENSION- HOSPICE ADVISORY COMMITTEE- SENIOR EDUCATION SERIES INCLUDING EVIDENCE BASED PROGRAM, "LIVING WELL WITH CHRONIC CONDITIONS AND "MATTER OF BALANCE"- FREE HEEL SCANS TO DETECT OSTEOPOROSIS- FREE BLOOD PRESSURE IN THE MADELIA COMMUNITY HOSPITAL & CLINIC AND AT HEALTH FAIRS IN THE AREA AND AT CHURCH EVENTS- WORKING SIDE BY WITH STUDENTS FROM AREA UNIVERSITIES AND COLLEGES FOR STUDENTS IN NURSING, LABORATORY TECHNICIANS AND PHYSICAL THERAPY ASSISTANTS.- DELIVERY OF PHARMACEUTICALS FOR HOME BOUND PATIENTS- PHYSICIAN PROVIDING SKIN CHECKS FOR THE MADELIA HIGH SCHOOL WRESTLING TEAM.- HIGH SCHOOL ATHLETE TRAINING AND CARE FOR SMALL AND NONLIFE THREATENING INJURIES. "IMPACT" (CONCUSSION) EVALUATION FOR MADELIA AND LAKE CRYSTAL STUDENTS- COMMUNITY AND SCHOOL HEALTH FAIR PARTICIPATION- SMALL FEE FOOT AND NAIL CLINIC (SOAKING FEET, TRIMMING TOE NAILS AND MASSAGING FEET OF ELDERLY PATIENTS). AN AVERAGE OF 60 PATIENTS PER MONTH PARTAKE IN THIS SERVICE.ACTIVE AND CHARTER MEMBERS OF THE MADELIA COMMUNITY BASED COLLABORATIVE (MCBC): THIS GROUP IS COMPRISED OF HOSPITAL STAFF, NURSING PROFESSORS FROM MINNESOTA STATE UNIVERSITY - MANKATO, MEMBERS OF THE MANKATO GLEN TAYLOR NURSING INSTITUTE FOR FAMILY AND SOCIETY, WATONWAN COUNTY PUBLIC HEALTH REPRESENTATIVES, STATEWIDE HEALTH INITIATIVE PROGRAM (SHIP) REPRESENTATIVE, UNIVERSITY OF MINNESOTA EXTENSION EDUCATOR, ADMINISTRATIVE STAFF FROM THE LOCAL SCHOOL DISTRICT, AND COMMUNITY MEMBERS. MEMBERS OF MCBC, INCLUDING HOSPITAL STAFF, ALSO PARTNER WITH THE WATONWAN COMMUNITY FOOD PARTNERSHIP WHICH FOCUSES ON BRINGING FRESH FRUITS AND VEGETABLES INTO THE COMMUNITIES OF WATONWAN COUNTY.THE VISION OF MCBC IS WORKING TOGETHER TO ACHIEVE A HEALTHIER COMMUNITY. ITS MISSION IS TO PROMOTE THE WELL-BEING OF MADELIA RESIDENTS THROUGH COMMUNITY-BASED PARTNERSHIPS AND THE VALUES ARE EQUITY, COLLABORATION, COMMUNITY ENGAGEMENT, HEALTH & WELL-BEING.USING DATA FROM THE 2015 - 2016 COMMUNITY HEALTH NEEDS ASSESSMENT, THIS GROUP DECIDED ON TWO STRATEGIC FOCUSED AREAS, 1) OBESITY AND 2) MENTAL HEALTH WELL-BEING. OBESITY CONTINUES TO BE THE NUMBER ONE HEALTH CONCERN IN THE COMMUNITY. RECOGNIZING THAT MENTAL HEALTH WELL-BEING PLAYS A ROLE IN OBESITY AND WAS ALSO IDENTIFIED AS A SIGNIFICANT CONCERN IN THE NEEDS ASSESSMENT, MCBC DECIDED TO WORK COLLABORATIVELY ON A PROJECT THAT WOULD ADDRESS PHYSICAL AND MENTAL HEALTH. THE PROJECT THEME IS "MADELIA RECHARGE YOURSELF," WITH A FOCUS ON THE IMPORTANCE OF EATING WELL, STAYING ACTIVE, AND GETTING GOOD SLEEP. THE GOAL IS TO DEMONSTRATE HOW THESE AREAS AFFECT YOUR PHYSICAL HEALTH AS WELL AS YOUR MENTAL HEALTH. IN ADDITION TO MADELIA RECHARGE YOURSELF, MCBC IS PLANNING WORK IN THE FOCUS AREA OF OBESITY THAT WILL BRING FRESH FRUITS AND VEGETABLES TO THOSE IN NEED. IN THE FOCUS AREA OF MENTAL HEALTH WELL-BEING, THE GROUP IS PLANNING COMMUNITY WIDE TRAINING AND EDUCATION THAT WILL TOUCH PEOPLE OF ALL AGES. THE ACCOMPLISHMENTS THIS YEAR INCLUDE: 1. EDUCATION PROVIDED TO ELEMENTARY STUDENTS ON EAT, MOVE, AND SLEEP. THIS WAS FOLLOWED BY A POSTER CONTEST. THE POSTER CONTEST INCLUDED PRIZES OF KID'S HEALTHY COOKBOOKS AND A GRAND PRIZE OF A POOL PARTY. 2. LET IT GROW BARRELS WERE PLACED IN THE MADELIA MOBILE HOME PARK PROVIDING ACCESS TO FREE FRESH TOMATOES, PEPPERS, AND HERBS FOR THE RESIDENTS OF THE MOBILE HOME PARK, THE MAJORITY OF WHICH ARE LOW-INCOME. 3. MCHC BECAME A REFERRAL SOURCE FOR THE MADELIA FOOD SHELF. 4. EDUCATION WAS PROVIDED DURING THE COMMUNITY CELEBRATION WHICH INCLUDED:A) RETHINK YOUR DRINK DISPLAY WITH VEGETABLE AND FRUIT INFUSED WATER SAMPLESB) FRUIT AND VEGETABLE DISPLAY WITH DEMONSTRATION OF CUTTING JICAMA AND MANGO WITH SAMPLES PROVIDEDC) JUMP ROPE ACTIVITY THAT ALLOWED PARTICIPANTS TO TAKE THE JUMP ROPE WITH THEMD) MENTAL HEALTH DISPLAY ADDRESSING FEELINGS WITH TAKE HOME PACKETS FOR KIDS, PARENTS, AND GRANDPARENTS5. PROVIDED QUESTION, PERSUADE, REFER (QPR) TRAINING TO OVER 140 ELEMENTARY AND HIGH SCHOOL STAFF, HOSPITAL STAFF, LAW ENFORCEMENT , SOCIAL SERVICE STAFF, AND COMMUNITY MEMBERS.6. PROVIDED MENTAL HEALTH FIRST AIDE TRAINING FOR HOSPITAL STAFF, LAW ENFORCEMENT, AND COMMUNITY MEMBERS ON THREE SEPARATE OCCASIONS.7. SET UP A TABLE DISPLAY AT THE MADELIA HIGH SCHOOL ABOUT DEPRESSION AND SUICIDE. INTERACTED WITH TEENS, GIVING THEM TEMPORARY SEMI COLON TATTOO'S.8. HOSTED A SUICIDE SURVIVOR 'GIFTS FOR THE HOLIDAYS' PROGRAM.9. HOSTED COMMUNITY FORUMS ON MENTAL HEALTH, DEPRESSION AND SUICIDE PREVENTION. | Desc |
| Total Program Service Expenses | $8,163,772 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 70 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 136 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONIQUE HOFFMANN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5076423255 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 121 DREW AVENUE SOUTHEAST | AddressLine1Txt |
| City | MADELIA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56062 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 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 |
|---|---|---|---|---|---|---|---|---|
| STEVEN COOLING | ||||||||
| BOARD PRESIDENT | 1.00 | 0.20 | Yes (X) | Yes (X) | $1,800 | $0 | $0 | |
| DENNIS ARDUSER | ||||||||
| BOARD VP & TREASURER | 1.00 | Yes (X) | Yes (X) | $1,800 | $0 | $0 | ||
| BARBARA OVERLIE | ||||||||
| BOARD SECRETARY | 1.00 | Yes (X) | Yes (X) | $1,800 | $0 | $0 | ||
| JEANNE BURKE | ||||||||
| BOARD MEMBER THRU NOV. 2015 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MARK CHRISTENSON | ||||||||
| BOARD MEMBER THRU NOV. 2015 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KENNETH GRONEWOLD | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $1,200 | $0 | $0 | |||
| NORMA KRUMWIEDE | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $1,200 | $0 | $0 | |||
| BRIAN MCCABE | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $1,200 | $0 | $0 | |||
| MELANIE RUNGE | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $1,200 | $0 | $0 | |||
| STEVEN SORENSEN | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $1,200 | $0 | $0 | |||
| RYAN STATESBERRY | ||||||||
| BOARD MEMBER THRU JULY 2015 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RYAN VISHER | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $1,200 | $0 | $0 | |||
| CANDACE FENSKE | ||||||||
| CEO | 40.00 | 0.20 | Yes (X) | $145,201 | $0 | $14,357 | ||
| DONNA KLINKNER | ||||||||
| CFO THRU APRIL 2016 | 40.00 | 0.20 | Yes (X) | $84,834 | $0 | $10,980 | ||
| MONIQUE HOFFMANN | ||||||||
| CFO AS OF APRIL 2016 | 40.00 | 0.20 | Yes (X) | $88,050 | $0 | $12,387 | ||
| JANE MALMSKOG | ||||||||
| PHARMACIST | 32.00 | $102,258 | $0 | $8,567 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $432,943 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $46,291 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| WHITESELL MEDICAL STAFFING | |||||
| 1630 ANDERSON AVE | BUFFALO | MN | 55313 | ER & CLINIC PHYSICIAN COVERAGE | $822,422 |
| MANKATO CLINIC LTD | |||||
| 1230 E MAIN ST | MANKATO | MN | 56002 | PHYSICIAN CLINIC PROVIDERS | $806,697 |
| READYLINK | |||||
| PO BOX 1047 | THOUSAND PALMS | CA | 92276 | CONTRACTED NURSING | $174,033 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $8,959 | GovernmentGrantsAmt |
| All Other Contributions | $76,902 | AllOtherContributionsAmt |
| Total Contributions | $85,861 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 624100 | $10,944,835 | $10,944,835 |
| PHYSICAL THERAPY | 624310 | $48,520 | $48,520 |
| LABORATORY | 621500 | $6,522 | $6,522 |
| PHARMACY | 446110 | $2,949 | $2,949 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $11,002,826 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $131,577 | TotalRevenueColumnAmt |
| Exclusion | $131,577 | ExclusionAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $35,798 | TotalRevenueColumnAmt |
| Exclusion | $35,798 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $49,262 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $52,275 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$3,013 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$3,013 | TotalRevenueColumnAmt |
| Exclusion | -$3,013 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $6 | SecuritiesAmt |
| Other | $49,670 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $31,304 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $6 | SecuritiesAmt |
| Other | $18,366 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,372 | TotalRevenueColumnAmt |
| Exclusion | $18,372 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| EHR INCENTIVE | 900099 | $336,938 | $336,938 |
| MISCELLANEOUS | 900099 | $45,009 | $45,009 |
| EMPLOYEE MEALS | 900099 | $24,001 | $24,001 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,066 | TotalRevenueColumnAmt |
| Exclusion | $3,066 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $409,014 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,680,435 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,002,826 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $591,748 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $429,346 | TotalAmt |
| Management And General | $429,346 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,471,463 | TotalAmt |
| Program Services | $4,454,920 | ProgramServicesAmt |
| Management And General | $1,016,543 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $171,088 | TotalAmt |
| Program Services | $111,786 | ProgramServicesAmt |
| Management And General | $59,302 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $578,778 | TotalAmt |
| Program Services | $436,959 | ProgramServicesAmt |
| Management And General | $141,819 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $302,723 | TotalAmt |
| Program Services | $212,873 | ProgramServicesAmt |
| Management And General | $89,850 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,085 | TotalAmt |
| Management And General | $9,085 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,185 | TotalAmt |
| Management And General | $66,185 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,141 | TotalAmt |
| Program Services | $48,721 | ProgramServicesAmt |
| Management And General | $44,420 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,065 | TotalAmt |
| Management And General | $29,065 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $417,008 | TotalAmt |
| Management And General | $417,008 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $291,993 | TotalAmt |
| Management And General | $291,993 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,698 | TotalAmt |
| Program Services | $69,591 | ProgramServicesAmt |
| Management And General | $35,107 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $280,650 | TotalAmt |
| Management And General | $280,650 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $866,297 | TotalAmt |
| Program Services | $866,297 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $1,487,281 | $1,487,281 | |
| REPAIRS/MAINTENANCE | $349,633 | $349,633 | |
| BAD DEBTS | $292,838 | $292,838 | |
| CLINIC EXPENSES | $182,506 | $182,506 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $188,882 | TotalAmt |
| Management And General | $188,882 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,612,660 | TotalAmt |
| Program Services | $8,163,772 | ProgramServicesAmt |
| Management And General | $3,448,888 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,325,910 | BOYAmt |
| EOY | $3,604,118 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,935,549 | BOYAmt |
| EOY | $4,675,904 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,036 | BOYAmt |
| EOY | $8,985 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,942,296 | BOYAmt |
| EOY | $1,380,264 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $177,411 | BOYAmt |
| EOY | $195,177 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $176,556 | BOYAmt |
| EOY | $176,621 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $17,195,164 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $10,615,116 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,408,609 | BOYAmt |
| EOY | $6,580,048 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $966,347 | BOYAmt |
| EOY | $995,772 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,013,439 | BOYAmt |
| EOY | $789,827 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,954,153 | BOYAmt |
| EOY | $18,406,716 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,603,642 | BOYAmt |
| EOY | $1,145,600 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,270,000 | BOYAmt |
| EOY | $5,130,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,077 | BOYAmt |
| EOY | $5,806 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,000 | BOYAmt |
| EOY | $40,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,936,719 | BOYAmt |
| EOY | $6,321,406 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,904,202 | BOYAmt |
| EOY | $12,085,310 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $113,232 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,017,434 | BOYAmt |
| EOY | $12,085,310 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,954,153 | BOYAmt |
| EOY | $18,406,716 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $67,775 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $101 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $181,407 | OtherCostOrOtherBasisAmt |
| Book Value | $181,407 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,825,194 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,582,302 | DepreciationAmt |
| Book Value | $3,242,892 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,640,054 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,527,755 | DepreciationAmt |
| Book Value | $2,112,299 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,537,227 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,505,059 | DepreciationAmt |
| Book Value | $1,032,168 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,282 | OtherCostOrOtherBasisAmt |
| Book Value | $11,282 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $6,580,048 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ASSET RETIREMENT OBLIGATION | Desc |
| Amt | $40,000 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $40,000 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL IS CLASSIFIED BY THE INTERNAL REVENUE SERVICES AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS SUBJECTED TO FEDERAL INCOME TAX ONLY ON NET UNRELATED BUSINESS INCOME. THE HOSPITAL FOLLOWS THE GUIDANCE IN THE INCOME TAX STANDARD REGARDING RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE APPLICATION OF THIS STANDARD HAS NO EFFECT ON THE FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 100.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $131,943 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $131,943 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01170 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,302,512 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $830,308 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $472,204 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04170 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,434,455 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $830,308 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $604,147 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05340 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $87,738 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $87,738 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00780 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $32,174 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $32,174 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00280 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $119,912 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $119,912 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01060 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,554,367 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $830,308 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $724,059 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06400 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,862 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,862 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $66 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $66 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,540 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,540 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,243 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $12,243 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,957 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,957 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $32,668 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $32,668 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00280 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $292,838 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $3,640,666 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $4,279,793 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$639,127 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADELIA COMMUNITY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 121 DREW AVE SE | AddressLine1Txt |
| City | MADELIA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56062 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.MCHOSPITAL.ORG | WebsiteAddressTxt |
| State License | 370999 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADELIA COMMUNITY HOSPITAL INCORPORATED | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.MCHOSPITAL.ORG/COMMUNITY-NEEDS-ASSESSMENT | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | 0 | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (1) | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 100.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MADELIA COMMUNITY HOSPITAL, INCORPORATED | PART V, SECTION B, LINE 5: IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT, MCHC SOLICITED INPUT FROM THE COMMUNITY IN A VARIETY OF WAYS. IN 2015, MCHC DISTRIBUTED A SURVEY THROUGHOUT THE COMMUNITY. WE RECEIVED 164 RESPONSES, INCLUDING 83 FROM LOW-INCOME INDIVIDUALS AND 77 FROM ELDERLY INDIVIDUALS. TO SOLICIT INPUT FROM MEDICAL PROFESSIONALS, MINORITIES AND THE GOVERNMENT, INTERVIEWS WERE CONDUCTED IN MARCH 2016. INDIVIDUALS FROM THE FOLLOWING ORGANIZATIONS PARTICIPATED IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT THROUGH INTERVIEWS. - WATONWAN COUNTY PUBLIC HEALTH DEPARTMENT - WATONWAN COUNTY HUMAN SERVICES DEPARTMENT - MADELIA PUBLIC SCHOOLS, INDEPENDENT SCHOOL DISTRICT 837 - MADELIA COMMUNITY HOSPITAL & CLINIC FINALLY, IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT, MCHC CONSIDERED THE RESULTS OF TWO LOCAL HEALTH NEEDS ASSESSMENTS PUBLISHED IN 2015. - FARIBAULT, MARTIN & WATONWAN COUNTIES COMMUNITY NEEDS ASSESSMENT - MINNESOTA DEPARTMENT OF HEALTH'S ECONOMIC IMPACT OF MADELIA COMMUNITY HOSPITAL & CLINIC AND RELATED HEALTH SECTORS OF WATONWAN COUNTY QUANTITATIVE DATA THE COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDED CONSIDERATION AND ANALYSIS OF THE FOLLOWING PUBLICLY AVAILABLE DATA. AMERICAN CANCER SOCIETY'S MINNESOTA CANCER STATISTICS AT A GLANCE HTTPS://CANCERSTATISTICSCENTER.CANCER.ORG/#/STATE/MINNESOTA AMERICAN DIABETES ASSOCIATION'S THE COST OF DIABETES HTTP://WWW.DIABETES.ORG/ADVOCACY/NEWS-EVENTS/COST-OF-DIABETES.HTML AMERICAN HEART ASSOCIATION'S DIRECT AND INDIRECT COSTS OF CARDIOVASCULAR DISEASE AND STROKE HTTPS://WWW.HEART.ORG/IDC/GROUPS/HEART-PUBLIC/@WCM/@SOP/@SMD/DOCUMENTS/DOWNLOADABLE/UCM_449849.PDF CENTERS FOR DISEASE CONTROL AND PREVENTION'S ADULT OBESITY CAUSES & CONSEQUENCES HTTP://WWW.CDC.GOV/OBESITY/ADULT/CAUSES.HTML CENTERS FOR DISEASE CONTROL AND PREVENTION'S DIABETES LATEST HTTP://WWW.CDC.GOV/FEATURES/DIABETESFACTSHEET/ ? CENTERS FOR DISEASE CONTROL AND PREVENTION'S HEART DISEASE FACTS HTTP://WWW.CDC.GOV/HEARTDISEASE/FACTS.HTM CITY-DATA.COM FOR MADELIA, MINNESOTA HTTP://WWW.CITY-DATA.COM/CITY/MADELIA-MINNESOTA.HTML MINNESOTA DEPARTMENT OF EDUCATION'S 2013 MINNESOTA STUDENT SURVEY HTTP://EDUCATION.STATE.MN.US/MDE/STUSUC/SAFESCH/MNSTUDENTSURVEY/ MINNESOTA DEPARTMENT OF HEALTH'S QUICK FACTS - DIABETES IN MINNESOTA HTTP://WWW.HEALTH.STATE.MN.US/DIVS/HEALTHIMPROVEMENT/DATA/QUICK-FACTS/DIABETES.HTML NATIONAL CANCER INSTITUTE'S NATIONAL EXPENDITURES FOR CANCER CARE HTTPS://COSTPROJECTIONS.CANCER.GOV/EXPENDITURES.HTML UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE'S COUNTY HEALTH RANKINGS HTTP://WWW.COUNTYHEALTHRANKINGS.ORG/APP/MINNESOTA/2016/RANKINGS/WATONWAN/COUNTY/OUTCOMES/OVERALL/SNAPSHOT U.S. CENSUS BUREAU'S QUICKFACTS HTTPS://WWW.CENSUS.GOV/QUICKFACTS/TABLE/PST045215/27,27165 MCHC CONTRACTED WITH CLIFTONLARSONALLEN LLP, A PROFESSIONAL SERVICES FIRM WITH HEADQUARTERS IN MINNEAPOLIS, TO ADVISE US ON THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS AND TO ASSIST IN WRITING THIS COMMUNITY HEALTH NEEDS ASSESSMENT REPORT. INFORMATION GAPS: OUR SURVEY DID NOT ASK INDIVIDUALS FOR THEIR RACE, SO WE ARE UNABLE TO IDENTIFY THE NUMBER OF MINORITY INDIVIDUALS WHO PARTICIPATED IN THE SURVEY. WE ARE CONFIDENT THAT THE HISPANIC COMMUNITY WAS WELL REPRESENTED IN THE SURVEY PROCESS, BUT WE INTERVIEWED INDIVIDUALS WHO REPRESENT THE HISPANIC COMMUNITY TO ENSURE A SPECIFIC UNDERSTANDING OF THIS SIGNIFICANT SEGMENT OF OUR COMMUNITY. ADDITIONALLY, BECAUSE WE DID NOT SPECIFICALLY INCLUDE INDIVIDUALS WHO LIVE IN THE AREA SURROUNDING MADELIA BUT WITHIN OUR SERVICE AREA, THEY MAY HAVE HEALTH NEEDS THAT WE DID NOT IDENTIFY. REQUEST FOR FEEDBACK: MCHC WAS WILLING TO CONSIDER WRITTEN COMMENTS RELATED TO ITS LAST COMMUNITY HEALTH NEEDS ASSESSMENT, BUT RECEIVED NO SUCH INPUT. IF ANY READER WOULD LIKE TO PROVIDE INPUT ON THIS COMMUNITY HEALTH NEEDS ASSESSMENT, THEY CAN SUBMIT THEIR COMMENT(S), IN WRITING, TO THE FOLLOWING ADDRESS: ATTENTION: JODI ULMEN, QUALITY/RISK MANAGEMENT DIRECTOR RE: COMMUNITY HEALTH NEEDS ASSESSMENT MADELIA COMMUNITY HOSPITAL & CLINIC 121 DREW AVENUE SE MADELIA, MN 56062 DETERMINATION OF SIGNIFICANCE AND PRIORITIZATION: WHILE MANY NEEDS WERE IDENTIFIED DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, THIS REPORT FOCUSES ON THOSE NEEDS THAT WERE DEEMED SIGNIFICANT BY MCHC. A HEALTH NEED'S SIGNIFICANCE WAS EVALUATED BASED ON MANY FACTORS. THE FACTORS GIVEN THE MOST CONSIDERATION WERE THE NUMBER OF INDIVIDUALS WHO IDENTIFIED A HEALTH NEED AND THE PRIORITIZATION INDICATED BY SURVEY PARTICIPANTS. THOSE SIGNIFICANT HEALTH NEEDS WERE THEN PRIORITIZED BY MCHC, RELYING MOSTLY ON THE PRIORITIZATION INDICATED BY SURVEY PARTICIPANTS. THE IDENTIFICATION AND PRIORITIZATION OF THE SIGNIFICANT HEALTH NEEDS WAS SUPPORTED BY THE FACT THAT THOSE NEEDS WERE MOSTLY UNCHANGED WHEN WE LOOKED AT PRIORITIZATION FOR VARIOUS SEGMENTS OF THE COMMUNITY-ELDERLY, LOW-INCOME AND MINORITY. |
| MADELIA COMMUNITY HOSPITAL, INCORPORATED | PART V, SECTION B, LINE 11: IT IS UNDERSTOOD THAT IT WILL TAKE A NUMBER OF YEARS TO TO OBTAIN MEASURABLE DATA TO DEMONSTRATE ACTUAL EDUCATION IN OBESITY. THE CURRENT STRATEGY FOCUSES ON SHORT TERM GOALS. THE FOLLOWING SHORT TERM GOALS HAVE BEEN ESTABLISHED TO REMOVE THE BARRIERS TO HEALTHY EATING AND INCREASE PHYSICAL EXERCISE: DEVELOP PARTNERSHIPS WITH COMMUNITY & COUNTY ORGANIZATIONS WHO SHARE THE SAME VISION TO IMPROVE THE ACCESS OF FRESH FRUITS AND VEGETABLES WITHIN THE COMMUNITY. DEVELOP OPPORTUNITIES TO PROVIDE LOW-COST OR NO-COST FRUITS AND VEGETABLES TO THOSE IN NEED. INCREASE COMMUNITY AWARENESS OF PROGRAMS THAT WILL ALLOW THEM TO OBTAIN FRESH FRUITS AND VEGETABLES AT LOW AND NO COST. EDUCATE CHILDREN ON HEALTHY EATING. EDUCATE CHILDREN ON THE RELATIONSHIP BETWEEN PHYSICAL ACTIVITY AND OVERALL HEALTH. PARTNER WITH MCHC ON THE JUMP ROPE FOR HEARTS PROJECT. PROVIDE OPPORTUNITIES FOR THE COMMUNITY TO TASTE FRUITS AND VEGETABLES COMMON TO DIFFERENT CULTURES REPRESENTED IN THE COMMUNITY. |
| MADELIA COMMUNITY HOSPITAL, INCORPORATED | PART V, SECTION B, LINE 13H: ELIGIBILITY IN MOST CASES IS DETERMINED BY MEASURING THE GROSS FAMILY INCOME AGAINST THE FEDERAL POVERY INCOME GUIDELINES. IN ADDITION OTHER RELEVANT NON-INCOME RESOURCES, INCLUDING BUT NOT BEING LIMITED TO REAL ESTATE, SAVINGS, LIFE INSURANCE, MOTOR VEHICLES, ETC. WILL BE CONSIDERED WHEN DETERMINING ELIGIBILITY. |
| MADELIA COMMUNITY HOSPITAL, INCORPORATED | PART V, SECTION B, LINE 15E: PATIENT BILLS HAVE A STATEMENT REGARDING THE FAP AVAILABILITY FOR FURTHER INQUIRY OF ASSISTANCE. |
| MADELIA COMMUNITY HOSPITAL, INCORPORATED | PART V, SECTION B, LINE 16I: THE FAP APPLICATION IS AUTOMATICALLY MAILED OUT TO UNINSURED AND UNDERINSURED PATIENTS. |
| MADELIA COMMUNITY HOSPITAL, INCORPORATED | PART V, SECTION B, LINE 20E: PATIENTS ARE INFORMED OF THE STATUS OF THEIR ACCOUNT THROUGH BILLING STATEMENTS, LETTERS INDICATING THE AGING OF THEIR ACCOUNT AND THE AVAILABILITY TO MAKE PAYMENT ARRANGEMENTS WITH SEVERAL OPTIONS OF RECEIVING A DISCOUNT. |
| MADELIA COMMUNITY HOSPITAL, INCORPORATED | PART V, SECTION B, LINE 22D: WE CALCULATE AMOUNTS GENERALLY BILLED IN ACCORDANCE WITH OUR AGREEMENT WITH THE MINNESOTA ATTORNEY GENERAL. AMOUNTS GENERALLY BILLED ARE BASED ON THE DISCOUNTED CHARGES TO OUR LARGEST INSURANCE PAYER, BY VOLUME. THE DISCOUNT GIVEN TO OUR LARGEST INSURANCE PAYER IS SMALLER THAN THE DISCOUNT AVAILABLE UNDER OUR FINANCIAL ASSISTANCE POLICY. |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE FINANCIAL ASSISTANCE AT COST AND MEDICAID AMOUNTS REPORTED IN PART I, LINES 7A AND 7B, RESPECTIVELY, WERE COMPUTED USING A RATIO OF COST TO CHARGES THAT WAS DERIVED FROM WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS AND HEALTH PROFESSIONS EDUCATION AMOUNTS REPORTED IN PART I, LINES 7E AND 7F, RESPECTIVELY, WERE AT COST. |
| PART I, LN 7 COL(F): | BAD DEBT EXPENSE OF $292,838 WAS SUBTRACTED FROM TOTAL EXPENSES OF $11,612,660 IN CALCULATING THE PERCENTAGES IN PART I, LINE 7, COLUMN F. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | STAFF PARTICIPATE IN COMMUNITY ORGANIZATIONS, PROVIDING HEALTHCARE REPRESENTATION AND INFORMATION TO ENHANCE THOSE ORGANIZATION'S EVENTS. SOME ORGANIZATIONS THAT OUR STAFF IS INVOLVED IN INCLUDE: MADELIA SCHOOL BOARD, AMBULANCE SERVICE, CHAMBER OF COMMERCE, ROTARY, WOMEN OF TODAY, AND MCH AUXILIARY. STAFF MEMBERS ARE COACHES, SCOUT LEADERS, AND MENTORS THROUGHOUT THE COMMUNITY. MANY OF OUR STAFF MEMBERS ARE INVOLVED IN THE MADELIA COMMUNITY BASED COLLABORATIVE (MCBC). MCHC AND THE MINNESOTA STATE UNIVERSITY, MANKATO SCHOOL OF NURSING COLLABORATED TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT IN MADELIA THAT WAS MANDATED BY THE AFFORDABLE CARE ACT IN 2012 AND AGAIN IN 2015. SINCE THAT INITIAL PROJECT, MCBC HAS GROWN TO INCLUDE MANY OTHER AREA PARTNERS, BUSINESSES AND COMMUNITY MEMBERS TO ADDRESS THE MAIN HEALTH CONCERNS IDENTIFIED IN THE ASSESSMENT: OBESITY, CANCER, HEART DISEASE AND DIABETES. MCBC MEETS ONCE A MONTH AT MCHC WITH OTHER SUB-COMMITTEES MEETING AS NEEDED. EVENT PLANNING AND COORDINATION IS ALSO DONE AT MCHC. PROMOTIONAL ACTIVITIES FOR MCBC ACTIVITIES ARE DONE BY MCHC STAFF AND INCLUDE: FACEBOOK PAGE MAINTENANCE, FLYER DESIGN AND DISTRIBUTION, ADVERTISING, PHOTOGRAPHY, ETC. THERE ARE CURRENTLY TWO MAIN MCBC INITIATIVES: MADELIA: RETHINK YOUR DRINK AND THE MENTAL HEALTH TASKFORCE. IN 2014, MCBC LAUNCHED THE MADELIA RETHINK YOUR DRINK CAMPAIGN WITH THE GOAL OF IMPROVING THE HEALTH AND WELL-BEING OF MADELIA RESIDENTS. RETHINK YOUR DRINK IS NOT ABOUT BANNING OR TAKING ANYTHING AWAY, BUT EMPOWERING CITIZENS TO MAKE HEALTHY BEVERAGE CHOICES. MCBC STARTED THE MENTAL HEALTH TASKFORCE IN RESPONSE TO COMMUNITY CONCERNS ABOUT SUICIDE AND UNMET MENTAL HEALTH NEEDS. THE TASKFORCE HOLDS FREE MENTAL HEALTH COMMUNITY FORUMS ON THE SECOND MONDAY OF EACH MONTH, PROVIDING EDUCATION ON SUICIDE, SUICIDE PREVENTION AND OTHER MENTAL HEALTH ISSUES. FREE SUICIDE PREVENTION TRAINING (QPR - QUESTION PERSUADE AND REFER) WAS PROVIDED TO ALL MCHC STAFF AND EMPLOYEES OF THE MADELIA SCHOOL DISTRICT, AS WELL AS OTHER KEY GATEKEEPERS IN MADELIA. THROUGH MCBC, TWO MCHC STAFF MEMBERS HAVE BEEN TRAINED AS MENTAL HEALTH FIRST AID INSTRUCTORS, AND THESE TRAINERS OFFER MORE EXTENSIVE EDUCATIONAL CLASSES TO THE PUBLIC AT NO CHARGE. |
| PART III, LINE 2: | THE AMOUNT OF BAD DEBT EXPENSE REPORTED IN PART III, LINE 2 IS CALCULATED AS FOLLOWS: PAYMENT ARRANGEMENT INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES AND PER DIEM PAYMENTS. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS. |
| PART III, LINE 4: | THE FOLLOWING IS FROM THE "PATIENT RECEIVABLES" PARAGRAPH IN NOTE 1 TO THE HOSPITAL'S FINANCIAL STATEMENTS:"PAYMENT FOR SERVICES IS REQUIRED UPON RECEIPT OF A BILL, AFTER PAYMENT BY INSURANCE, IF ANY. SELF-PAY ACCOUNTS ARE ANALYZED FOR COLLECTIBILITY BASED ON THE MONTHS PAST DUE AND PAYMENT HISTORY. AN ALLOWANCE IS ESTIMATED FOR THESE ACCOUNTS BASED ON THE HISTORICAL EXPERIENCE OF THE HOSPITAL. ACCOUNTS THAT ARE DETERMINED TO BE UNCOLLECTIBLE ARE SENT TO A COLLECTION AGENCY AND WRITTEN OFF AT THAT TIME." |
| PART III, LINE 8: | FROM PART III, LINE 6, THE TOTAL ALLOWABLE COST REPORTED TO MEDICARE WAS BASED ON THE 2016 FILED MEDICARE COST REPORT.THE MEDICARE SHORTFALL ON PART III, LINE 7 CONSISTS AS THE RESULT OF THE FEDERAL SEQUESTRATION ADJUSTMENTS AND A PORTION IS THE RESPONSIBILITY OF THE PATIENT AND WOULD NOT OTHERWISE BE TREATED AS A COMMUNITY BENEFIT. |
| PART III, LINE 9B: | EACH WEEK, STATEMENTS ARE SENT OUT THROUGH OUR EDI PROCESS WITH STATEMENTS BEING MAILED OUT TO THE PATIENT BY A CLEARINGHOUSE. PATIENTS ARE BILLED AFTER MEDICARE OR COMMERCIAL INSURANCE HAS BEEN FILED AND PAYMENT HAS BEEN RECEIVED WITHIN A SIX-WEEK PERIOD. PATIENTS WILL BE BILLED FOR THE REMAINING BALANCE MONTHLY. ACCOUNTS ARE VERIFIED INTERNALLY PRIOR TO COLLECTION LETTERS BEING SENT.IF NO PAYMENT IS RECEIVED WITHIN 2 MONTHS OF BILLINGS, THE STATEMENT IS SENT WITH A NOTICE LETTER REQUESTING PAYMENT. LETTERS WILL ALSO BE SENT SHOULD NO PAYMENT BE RECEIVED WITHIN 60 AND 90 DAYS.SHOULD NO RESPONSE BE RECEIVED WITHIN FIVE (5) DAYS OF THE LAST LETTER, A TELEPHONE CALL IS ISSUED TO NEGOTIATE A PAYMENT PLAN OR EXTEND A DISCOUNT OF 25% FOR ACCOUNT PAYOFF IN 60 DAYS; IF ACCOUNT HOLDER MAY QUALIFY FOR OUR HEALTHCARE FINANCIAL PROGRAM, AN APPLICATION IS SENT TO BE COMPLETED AND RETURNED TO US ALONG WITH TWO (2) DENIALS OF ALTERNATE COVERAGE OR PAYMENT ASSISTANCE.LACK OF RESPONSE TO THE TELEPHONE CALL WILL RESULT IN VERIFICATION OF THE ACCOUNT(S) BY THE INSURANCE BILLING CLERKS AND THEN REVIEWED BY THE BUSINESS OFFICE MANAGER FOR APPROVAL TO BEGIN FORMAL COLLECTION PROCESS. THESE ACCOUNTS ARE THEN TURNED IN TO A PROFESSIONAL COLLECTION AGENCY.CHARITY CARE CONSIDERATIONS WILL BE MADE BY BUSINESS OFFICE MANAGER WHEN ALL NECESSARY DOCUMENTATION IS PRESENTED AND SHOULD IT BE EVIDENT THAT THE PATIENT'S LACK OF FINANCES WARRANT THIS AND CHARITY CARE THE BEST ETHICAL DECISION FOR THE PATIENT. |
| PART VI, LINE 2: | THRU THE COMMUNITY ASSESSMENT PROCESS, HEALTHCARE NEEDS & SERVICES WERE IDENTIFIED AND PROGRAMS WERE DEVELOPED (SEE MCH WEBSITE FOR THE 2016 COMMUNITY HEALTH DIALOGUE). STRATEGIC PLANNING ASSESSES THE NEEDS OF THE COMMUNITY AND PATIENTS THROUGH PATIENT SATISFACTION SURVEYS, COMMENT CARDS, COMMUNITY ASSESSMENTS, AND A DIVERSE MEMBERSHIP OF COMMUNITY ELECTED GOVERNING BOARD THAT REPRESENTS THE COMMUNITY AND BRINGS TO THE TABLE ISSUES, CONCERNS, RECCOMMENDATIONS FOR HEALTH CARE SERVICES. |
| PART VI, LINE 3: | PATIENTS ARE INFORMED OF FINANCIAL ASSISTANCE UPON ADMISSION TO THE HOSPITAL, THROUGH BILLING CLERKS ASSISTANCE WITH PATIENT ACCOUNTS, STATEMENTS ON THE BILLS, AND PERSONAL LETTERS SENT TO ACCOUNTS IDENTIFIED AS UNINSURED AND UNDERINSURED. |
| PART VI, LINE 4: | MADELIA COMMUNITY HOSPITAL SERVES A 25 MILE RADIUS OF RURAL COMMUNITIES CONSISTING MAJORLY OF A CULTURALLY DIVERSE AND SENIOR POPULATION. |
| PART VI, LINE 5: | THE MADELIA COMMUNITY HOSPITAL & CLINIC (MCHC) IS AN INTEGRAL PART OF THE COMMUNITY, PROVIDING HEALTHCARE AND SERVING AS A HUB FOR INFORMATION, PUBLIC HEALTH, AND SOCIAL SERVICES. OUR RADIOLOGY DEPARTMENT STAFF REACHES OUT TO THE COMMUNITY IN MANY WAYS. DURING MAY, THEY OFFER FREE HEEL SCANS IN THE CLINIC TO HELP IDENTIFY BONE DENSITY ISSUES AT AN EARLY STAGE AND PREVENT OSTEOPOROSIS. THEY ATTEND THE HEALTH FAIR AT THE ELEMENTARY SCHOOL TO ENCOURAGE HEALTHY BONE DEVELOPMENT THROUGH DIET AND EXERCISE. DURING BREAST CANCER AWARENESS MONTH IN OCTOBER, THE DEPARTMENT PROMOTES MAMMOGRAMS BY OFFERING FREE GIFTS TO WOMEN WHO RECEIVE A MAMMOGRAM. THE DEPARTMENT SPEARHEADED A PUBLIC AWARENESS CAMPAIGN IN MADELIA CALLED BRAS FOR A CAUSE. BUSINESSES WERE INVITED TO DECORATE AND DISPLAY A BRA TO SHOW SUPPORT FOR BREAST CANCER SURVIVORS AND TO HELP SPREAD THE WORD ABOUT THE IMPORTANCE OF BREAST SELF-EXAMS AND MAMMOGRAMS. PHOTOS OF THE ENTRIES WERE POSTED ON THE MCHC FACEBOOK PAGE. THE RADIOLOGY STAFF ALSO CREATES DISPLAYS FOR THE MCHC EDUCATION TABLE DURING THESE MONTHS.MCHC PHYSICAL THERAPY DEPARTMENT ADMINISTERS IMPACT CONCUSSION TESTS TO LOCAL STUDENT ATHLETES. THE 20-MINUTE TEST MEASURES VERBAL AND VISUAL MEMORY WHILE PROCESSING SPEED AND REACTION TIME TO 1/100TH OF A SECOND. IT HAS PROVEN TO BE A VALUABLE TOOL TO SHOW WHEN AN ATHLETE'S BRAIN HAS HEALED FROM A CONCUSSION. THE BASELINE TEST IS ADMINISTERED TO ALL STUDENT ATHLETES IN GRADES 7-12 IN MADELIA SCHOOLS. IF A PLAYER SUFFERS A HEAD INJURY, THEY ARE GIVEN THE TEST AGAIN TO MEASURE THE EXTENT OF THE DAMAGE AND TO MONITOR IF AN ATHLETE CAN SAFELY RETURN TO THEIR SPORT. IN ADDITION, THE PHYSICAL THERAPY STAFF ALSO OFFERS A STRENGTH & CONDITIONING CLINIC FOR STUDENT ATHLETES AT THE NEARBY LAKE CRYSTAL WELLCOME MEMORIAL HIGH SCHOOL DURING THE SUMMER MONTHS. WE ALSO OFFER FREE ATHLETE CARE AND EVALUATION (A.C.E.) CLINIC ASSESSMENTS TO IDENTIFY AN ATHLETE'S SOURCE OF PAIN OR LIMITATION AND TO RECOMMEND POSSIBLE TREATMENT OR REFERRAL.MADELIA COMMUNITY HOSPITAL PHYSICAL THERAPY STAFF MEMBERS HOSTED FREE EDUCATIONAL PROGRAMS FOR THE COMMUNITY. LIVING WELL WITH CHRONIC CONDITIONS IS A WORKSHOP THAT TEACHES DIFFERENT TECHNIQUES THAT CAN BE USED TO MANAGE A VARIETY OF HEALTH ISSUES, AND TO PUT "LIVING" BACK IN LIFE. A MATTER OF BALANCE IS A WORKSHOP DESIGNED TO REDUCE THE FEAR OF FALLING AND INCREASE ACTIVITY LEVELS AMONG OLDER ADULTS.BEFORE THE SPRING CONCERT AT THE MADELIA ELEMENTARY SCHOOL, CHILDREN AND ADULTS WERE FITTED FOR BIKE HELMETS WHICH WERE SOLD AT A NOMINAL COST BY OUR FOUNDATION. THE FOUNDATION ALSO SUPPLIES OUR LOCAL POLICE FORCE WITH FREE ICE CREAM COUPONS THAT ARE GIVEN TO CHILDREN SEEN WEARING THEIR HELMETS WHILE BIKING IN THE COMMUNITY.OUR EMERGENCY DEPARTMENT LEVEL 4 TRAUMA DESIGNATION ENABLES US TO PROVIDE LIFE-SAVING MEASURES TO SEVERELY INJURED PERSONS. THE HOSPITAL STAFF PARTICIPATED IN THE SOUTH CENTRAL DISASTER PREPAREDNESS FOR BOTH REGIONAL AND STATE DISASTER DRILLS.WE CONTINUE TO HOST THE MADELIA FARMERS MARKET ON WEDNESDAYS FROM 3:30 TO 6 P.M. DURING THE SUMMER AND FALL IN A LOT OWNED BY THE HOSPITAL. THERE IS NO CHARGE FOR LOCAL VENDORS TO SET UP A TENT TO SELL THEIR GARDEN PRODUCE TO THE COMMUNITY. WE TYPICALLY HAVE FROM 3 TO 8 VENDORS IN OUR MARKET EACH WEEK. MCHC DEFRAYS THE COST FOR SOME LOCAL PROMOTIONS, AND MAINTAINS A FACEBOOK PAGE.THE MADELIA COMMUNITY HOSPITAL DEPARTMENTS OF NURSING, HOME CARE, AND PHYSICAL THERAPY OFFER THEIR TECHNICAL KNOWLEDGE FOR CLINICAL EXPERIENCE FOR STUDENTS FROM MINNESOTA STATE UNIVERSITY-MANKATO, PRESENTATION COLLEGE, CONCORDIA UNIVERSITY ST. PAUL, BRIAR CLIFF UNIVERSITY, NORTH IOWA COMMUNITY COLLEGE, RASMUSSEN COLLEGE, AND SOUTH CENTRAL COLLEGE. THE CLINICAL STUDENTS ARE HERE IN THE SPRING AND FALL SEMESTERS.THE HOSPITAL NURSING STAFF OFFER A MONTHLY FOOT CLINIC FOR ANYONE WISHING TO RECEIVE FOOT CARE, INCLUDING FOOT SOAK AND NAIL TRIMMING. THIS CLINIC IS OFFERED FOR A NOMINAL DONATION TO COVER THE COST OF SUPPLIES BUT NO ONE IS TURNED AWAY FOR INABILITY TO PAY. THIS FOOT CLINIC PROVIDES FOR UNMET PHYSICAL NEEDS AS WELL AS PSYCHOSOCIAL NEEDS. THOSE WHO COME TO THE FOOT CLINIC ENJOY THE COFFEE, COOKIES AND SOCIALIZING THAT OCCURS WITH STAFF AND EACH OTHER.THE HOME CARE DEPARTMENT ASSISTS FAMILIES WITH COPING SKILLS AND FINDING SUPPORT SYSTEMS TO MEET PATIENT NEEDS. THE HOME CARE NURSES DO BLOOD PRESSURE CLINICS AT THE HARTSHORN AND AMBERFIELD SENIOR HOUSING UNITS AND LOCAL CHURCHES; PARTICIPATE IN A SENIOR EXPO AT THE HARTSHORN SENIOR HOUSING; AND COLLABORATE WITH HOSPICE COMMUNITY WORKSHOPS AND ADVISORY COMMITTEES.OTHER COMMUNITY INVOLVEMENT: - SPANISH TRANSLATION SERVICES - FREE MASSAGES FOR DOWNTOWN BUSINESS WORKERS AND SAFETY PERSONNEL THAT WERE AFFECTED BY THE STRESS OF THE MADELIA FIRE. - COMMUNITY CPR CLASSES WERE PROVIDED PER THE REQUEST OF THE COMMUNITY - PARTICIPATION IN HEALTH AND CAREER FAIRS AT THE ELEMENTARY AND HIGH SCHOOLS - FLU VACCINE CLINICS ONSITE AT LOCAL FACTORY AND COMMERCIAL BUSINESSES - PROMOTE MEDICATION RECONCILIATION AT ANY TIME FOR RESIDENTS - MEALS ON WHEELS DELIVERY TO HOME BOUND RESIDENTS - COLLABORATIVE HISPANIC OUTREACH SERVICES WITH LOCAL FACTORY AND WATONWAN COUNTY HUMAN SERVICES - PARTICIPATE IN THE COMMUNITY ORGANIZATIONS SUCH AS ROTARY AND CHAMBER OF COMMERCE - SCHEDULE DRIVERS FOR TRANSPORTATION FOR WATONWAN COUNTY SENIOR DRIVER PROGRAM TO ASSIST SENIORS TO TRAVEL TO MEDICAL APPOINTMENTS.OUR PRIMARY FOCUS IS TO MAKE HEALTHY LIFESTYLE AWARENESS AVAILABLE TO OUR SERVICE AREA - WE WILL BE HERE WHENEVER THEY NEED US WITH OPEN ARMS OFFERING - "CARE FROM THE PEOPLE YOU KNOW!" |
| PART VI, LINE 7, REPORTS FILED WITH STATES | MN |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CANDACE FENSKE | PersonNm |
| Title | CEO | TitleTxt |
| Base Compensation Filing Org | $145,201 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $6,047 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $8,310 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $159,558 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF MADELIA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 416005334 | BondIssuerEIN |
| CUSIP | 556401AR8 | CUSIPNum |
| Bond Issued | 2006-10-01 | BondIssuedDt |
| Issue Price | $6,495,000 | IssuePriceAmt |
| Purpose | CONSTRUCT HOSPITAL ADDITION | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $1,365,000 | RetiredAmt |
| Total Proceeds | $6,495,000 | TotalProceedsAmt |
| Capitalized Interest | $161,893 | CapitalizedInterestAmt |
| Issuance Costs From Proceeds | $16,238 | IssuanceCostsFromProceedsAmt |
| Credit Enhancement | $113,662 | CreditEnhancementAmt |
| Capital Expenditures | $6,203,207 | CapitalExpendituresAmt |
| Substantial Completion | 2008 | SubstantialCompletionYr |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | Yes (1) | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE PRESIDENT, AS CHAIRPERSON, VICE PRESIDENT/TREASURER, SECRETARY, AND UP TWO (2) ADDITIONAL TRUSTEES. THE EXECUTIVE COMMITTEE SHALL HAVE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD OF TRUSTEES, SUBJECT TO ANY POWER LIMITATION IMPOSED BY THE BOARD OF TRUSTEES. A QUORUM FOR THE EXECUTIVE COMMITTEE CAN ONLY BE MADE UP OF EXECUTIVE COMMITTEE MEMBERS AND ONLY EXECUTIVE COMMITTEE MEMBERS MAY VOTE DURING EXECUTIVE COMMITTEE MEETINGS. MINUTES OF THE EXECUTIVE MEETINGS SHALL BE SUBMITTED TO THE BOARD OF TRUSTEES. THE EXECUTIVE COMMITTEE SHALL ANNUALLY EVALUATE THE CHIEF EXECUTIVE OFFICER'S PERFORMANCE AND RECOMMEND HIS/HER REMUNERATION TO THE FULL BOARD OF TRUSTEES BASED ON THE CHIEF EXECUTIVE OFFICER'S PERFORMANCE IN RELATION TO THE CORPORATION'S OBJECTIVES AND GOALS. THIS COMMITTEE SHALL MEET AS NECESSARY. |
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERSHIP OF THIS CORPORATION SHALL BE OPEN TO ANY NATURAL PERSON WHO MEETS THE FOLLOWING QUALIFICATIONS AT THE TIME OF APPLICATION: 1) IS OF LEGAL VOTING AGE IN MINNESOTA; 2) IS A VOTING RESIDENT WITHIN THE PRIMARY SERVICE AREA OF THE HOSPITAL, BEING DEFINED AS THE COUNTIES OF WATONWAN, BLUE EARTH, BROWN, MARTIN AND NICOLLET, STATE OF MINNESOTA; 3) IS A NATURAL PERSON AND NOT A CORPORATION, PARTNERSHIP OR OTHER ASSOCIATION; 4) SUBMITS A WRITTEN APPLICATION FOR MEMBERSHIP TO THE BOARD OF TRUSTEES ON A FORM APPROVED BY THE BOARD OF TRUSTEES; AND 5) SUBMITS A MEMBERSHIP FEE OF $25 OR MORE, WITH SAID APPLICATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | ALL TRUSTEES ARE ELECTED BY THE CORPORATE MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 WILL BE REVIEWED BY THE GOVERNING BOARD OF TRUSTEES SUBSEQUENT TO FILING THE FORM 990 WITH THE IRS. THE FORM 990 WILL BE PRESENTED BY FINANCE AT THE REGULAR MEETING OF THE BOARD OF TRUSTEES. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY IS REVIEWED AT THE ANNUAL BOARD MEETING BY THE BOARD AND DEPARTMENT HEADS. IF ANY CONFLICTS OF INTEREST ARISE, NOTIFICATION IS GIVEN TO ADMINISTRATION. A CONTRACT OR OTHER TRANSACTION THAT MAY INVOLVE A CONFLICT OF INTEREST IS NOT VOID OR VOIDABLE IF: 1) THE CONTRACT OR TRANSACTION WAS FAIR AND REASONABLE AS TO THE CORPORATION WHEN IT WAS AUTHORIZED, APPROVED, OR RATIFIED; 2) ALL MATERIAL FACTS ARE FULLY DISCLOSED TO THE MEMBERS AND THE CONTRACT OR TRANSACTION IS APPROVED BY TWO-THIRDS OF THE MEMBERS ENTITLED TO VOTE, OTHER THAN THE INTERESTED DIRECTOR OR TRUSTEE; AND 3) ALL MATERIAL FACTS ARE FULLLY DISCLOSED TO THE BOARD OF TRUSTEES OR A COMMITTEE, AND THE BOARD OR COMMITTEE APPROVES THE CONTRACT OR TRANSACTION BY A MAJORITY VOTE, BUT THE INTERESTED TRUSTEE MAY NOT TAKE PART IN THE DISCUSSION, AND MAY NOT VOTE. |
| FORM 990, PART VI, SECTION B, LINE 15 | MADELIA COMMUNITY HOSPITAL ENSURES THAT THE COMPENSATION PAID TO ITS EMPLOYEES AND ADMINISTRATIVE STAFF BE CONSISTENT WITH POLICY AND PROVIDE EQUITABLE STANDARDS FOR WAGE AND BENEFITS BASED ON ANNUAL REGIONAL SURVEY OF COMPARABLE ENTITIES. THE GOVERNING BOARD REVIEWS ANNUALLY THE CEO'S PERFORMANCE (LAST PERFORMED SPRING 2016) AND THE BASIS IS ANNUAL MN HOSPITAL ASSOCIATION SURVEY AND RATE INCREASE AS AWARDED TO ALL STAFF. THE BOARD APPROVES BOTH STAFF AND ADMINISTRATIVE INCREASES THROUGH THE ANNUAL BUDGET. |
| FORM 990, PART VI, SECTION C, LINE 19 | MADELIA COMMUNITY HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AT THE ANNUAL CORPORATION MEETING AND UPON REQUEST. |
| FORM 990, PART XII, LINE 2C | THE ORGANIZATIONS BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF ITS INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEARS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADELIA COMMUNITY HOSPITAL FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 121 DREW AVENUE SE | AddressLine1Txt |
| City | MADELIA | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 56062 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 731719218 | EIN |
| Primary Activities | SOLICIT CONTRIBUTIONS ON BEHALF OF THE MADELIA COMMUNITY HOSPITAL. | PrimaryActivitiesTxt |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 11 - TYPE 1 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADELIA COMMUNITY HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |