2017-04-15T09:58:10-05:00 2016-05-31 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2015-06-01 410758512 MADELIA COMMUNITY HOSPITAL INCORPORATED MADE 5076423255 121 DREW AVENUE SOUTHEAST MADELIA MN 56062 CANDACE FENSKE CEO 5076423255 2017-04-11 1 TRENT FAST P00692704 6123764500 2015 2021-01-29 14:40:06Z MADELIA COMMUNITY HOSPITAL & CLINIC CANDACE FENSKE 121 DREW AVENUE SOUTHEAST MADELIA MN 56062 11764014 0 X WWW.MCHOSPITAL.ORG X 1950 MN PROVIDE QUALITY HEALTHCARE SERVICES TO THE LOCAL COMMUNITY. 9 9 136 0 0 0 146383 85861 10642251 11002826 107278 149949 173699 441799 11069611 11680435 0 0 0 0 6493899 6953398 0 0 0 4681336 4659262 11175235 11612660 -105624 67775 18954153 18406716 6936719 6321406 12017434 12085310 X 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. 0 0 8163772 0 11002826 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. 8163772 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 70 0 136 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 1 0 MN X X MONIQUE HOFFMANN 5076423255 121 DREW AVENUE SOUTHEAST MADELIA MN 56062 STEVEN COOLING BOARD PRESIDENT 1.00 0.20 X X 1800 0 0 DENNIS ARDUSER BOARD VP & TREASURER 1.00 X X 1800 0 0 BARBARA OVERLIE BOARD SECRETARY 1.00 X X 1800 0 0 JEANNE BURKE BOARD MEMBER THRU NOV. 2015 1.00 X 0 0 0 MARK CHRISTENSON BOARD MEMBER THRU NOV. 2015 1.00 X 0 0 0 KENNETH GRONEWOLD BOARD MEMBER 1.00 X 1200 0 0 NORMA KRUMWIEDE BOARD MEMBER 1.00 X 1200 0 0 BRIAN MCCABE BOARD MEMBER 1.00 X 1200 0 0 MELANIE RUNGE BOARD MEMBER 1.00 X 1200 0 0 STEVEN SORENSEN BOARD MEMBER 1.00 X 1200 0 0 RYAN STATESBERRY BOARD MEMBER THRU JULY 2015 1.00 X 0 0 0 RYAN VISHER BOARD MEMBER 1.00 X 1200 0 0 CANDACE FENSKE CEO 40.00 0.20 X 145201 0 14357 DONNA KLINKNER CFO THRU APRIL 2016 40.00 0.20 X 84834 0 10980 MONIQUE HOFFMANN CFO AS OF APRIL 2016 40.00 0.20 X 88050 0 12387 JANE MALMSKOG PHARMACIST 32.00 X 102258 0 8567 432943 0 46291 2 0 1 0 WHITESELL MEDICAL STAFFING 1630 ANDERSON AVE BUFFALO MN 55313 ER & CLINIC PHYSICIAN COVERAGE 822422 MANKATO CLINIC LTD 1230 E MAIN ST MANKATO MN 56002 PHYSICIAN CLINIC PROVIDERS 806697 READYLINK PO BOX 1047 THOUSAND PALMS CA 92276 CONTRACTED NURSING 174033 3 8959 76902 85861 NET PATIENT REVENUE 624100 10944835 10944835 PHYSICAL THERAPY 624310 48520 48520 LABORATORY 621500 6522 6522 PHARMACY 446110 2949 2949 11002826 131577 131577 35798 35798 49262 52275 -3013 -3013 -3013 6 49670 0 31304 6 18366 18372 18372 EHR INCENTIVE 900099 336938 336938 MISCELLANEOUS 900099 45009 45009 EMPLOYEE MEALS 900099 24001 24001 3066 3066 409014 11680435 11002826 0 591748 429346 429346 5471463 4454920 1016543 171088 111786 59302 578778 436959 141819 302723 212873 89850 9085 9085 66185 66185 93141 48721 44420 29065 29065 417008 417008 291993 291993 104698 69591 35107 280650 280650 866297 866297 MEDICAL SUPPLIES 1487281 1487281 REPAIRS/MAINTENANCE 349633 349633 BAD DEBTS 292838 292838 CLINIC EXPENSES 182506 182506 188882 188882 11612660 8163772 3448888 0 2325910 3604118 4935549 4675904 8036 8985 1942296 1380264 177411 195177 176556 176621 17195164 10615116 7408609 6580048 966347 995772 1013439 789827 18954153 18406716 1603642 1145600 5270000 5130000 23077 5806 40000 40000 6936719 6321406 X 11904202 12085310 113232 0 12017434 12085310 18954153 18406716 67775 101 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 181407 181407 6825194 3582302 3242892 4640054 2527755 2112299 5537227 4505059 1032168 11282 11282 6580048 ASSET RETIREMENT OBLIGATION 40000 40000 X PART X, LINE 2: 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. 1 1 X 1 X 1 X 100.000000000000 1 1 0 1 1 131943 131943 0.01170 1302512 830308 472204 0.04170 1434455 830308 604147 0.05340 87738 87738 0.00780 32174 32174 0.00280 119912 119912 0.01060 1554367 830308 724059 0.06400 5862 5862 0.00050 66 66 0.00000 10540 10540 0.00090 12243 12243 0.00110 3957 3957 0.00030 32668 32668 0.00280 1 292838 3640666 4279793 -639127 X 1 1 1 1 MADELIA COMMUNITY HOSPITAL 121 DREW AVE SE MADELIA MN 56062 WWW.MCHOSPITAL.ORG 370999 X X X X MADELIA COMMUNITY HOSPITAL INCORPORATED 1 0 0 1 X X X X X X X X X 15 1 0 0 1 X WWW.MCHOSPITAL.ORG/COMMUNITY-NEEDS-ASSESSMENT X 1 15 0 1 0 1 X 100.000000000000 100.000000000000 X X X X X X 1 1 X X X 1 X X X X X X 1 0 X X X X X 1 X 0 0 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. 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 X X X X 0 0 0 0 0 0 0 0 0 CANDACE FENSKE CEO 145201 0 0 0 0 0 6047 0 8310 0 159558 0 0 0 A CITY OF MADELIA 416005334 556401AR8 2006-10-01 6495000 CONSTRUCT HOSPITAL ADDITION 0 0 0 A 1365000 6495000 161893 16238 113662 6203207 2008 0 0 1 1 A 0 0 0 0 0 0 0 A 0 0 1 0 0 0 0 0 0 A 1 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. MADELIA COMMUNITY HOSPITAL FOUNDATION 121 DREW AVENUE SE MADELIA MN 56062 731719218 SOLICIT CONTRIBUTIONS ON BEHALF OF THE MADELIA COMMUNITY HOSPITAL. MN 501(C)(3) 11 - TYPE 1 MADELIA COMMUNITY HOSPITAL INC 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 1