LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC (EIN 41-0811697)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-14
- IRS object ID
- 201613199349302906
- Schema version
- 2015v2.1
- 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 C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-14T09:41:15-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135665207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4200 WELLS FARGO CTR 90 S 7TH | AddressLine1Txt |
| Address Line2 | STREET | AddressLine2Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410811697 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKEVIEW MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Business Name Line2 | ASSOCIATION INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LAKE | BusinessNameControlTxt |
| Phone | 9528836584 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8170 33RD AVENUE SOUTH PO BOX 1309 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554401309 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DOUGLAS E JOHNSON | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 9528836584 | PhoneNum |
| Signature | 2016-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ANN LAMOUREUX | PreparerPersonNm |
| PTIN | P00691316 | PTIN |
| Phone | 6123055000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DOUGLAS E JOHNSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8170 33RD AVENUE SOUTH PO BOX 1309 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554401309 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $102,659,056 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.LAKEVIEW.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1880 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 897 | TotalEmployeeCnt |
| Total Volunteers | 272 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,136,158 | PYContributionsGrantsAmt |
| CY Contributions Grants | $161,890 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $93,937,698 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $102,438,860 | CYProgramServiceRevenueAmt |
| PY Investment Income | $10,374 | PYInvestmentIncomeAmt |
| CY Investment Income | $11,806 | CYInvestmentIncomeAmt |
| PY Other Revenue | $16,859 | PYOtherRevenueAmt |
| CY Other Revenue | $21,241 | CYOtherRevenueAmt |
| PY Total Revenue | $95,101,089 | PYTotalRevenueAmt |
| CY Total Revenue | $102,633,797 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $167,909 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $164,340 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $48,241,504 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $50,555,039 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $40,976,793 | PYOtherExpensesAmt |
| CY Other Expenses | $41,941,176 | CYOtherExpensesAmt |
| PY Total Expenses | $89,386,206 | PYTotalExpensesAmt |
| CY Total Expenses | $92,660,555 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,714,883 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $9,973,242 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $48,852,437 | TotalAssetsBOYAmt |
| Total Assets EOY | $56,184,449 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $20,779,044 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $21,027,058 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $28,073,393 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $35,157,391 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO MEET THE HEALTHCARE NEEDS OF INDIVIDUALS, FAMILIES & COMMUNITIES OF THE ST. CROIX VALLEY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $81,783,495 | ExpenseAmt |
| Grant | $164,340 | GrantAmt |
| Revenue | $99,770,728 | RevenueAmt |
| Desc | SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS FOR A DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS | Desc |
| Total Program Service Expenses | $81,783,495 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 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 | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 897 | 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 | 8 | 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 | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOUGLAS JOHNSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6514304581 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 927 CHURCHILL STREET WEST | AddressLine1Txt |
| City | STILLWATER | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55082 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| ARBA-DELLA BECK | |||||||||
| DIRECTOR & SECRETARY | 0.08 | Yes (X) | $0 | $0 | $0 | ||||
| REBECCA BILLINGSLEY | |||||||||
| DIRECTOR & VICE CHAIR | 0.08 | Yes (X) | $0 | $0 | $0 | ||||
| BRUCE BARTIE DO | |||||||||
| DIRECTOR | 0.08 | Yes (X) | $0 | $0 | $0 | ||||
| ELIZABETH BRADSHAW | |||||||||
| DIRECTOR | 0.08 | Yes (X) | $0 | $0 | $0 | ||||
| PHIL DONALDSON | |||||||||
| DIRECTOR | 0.08 | Yes (X) | $0 | $0 | $0 | ||||
| DAVID REAMER | |||||||||
| DIRECTOR | 0.08 | Yes (X) | $0 | $0 | $0 | ||||
| C ANDREW ROLLWAGEN | |||||||||
| DIRECTOR | 0.08 | Yes (X) | $0 | $0 | $0 | ||||
| JIM SCHUG | |||||||||
| DIRECTOR & CHAIR | 0.08 | Yes (X) | $0 | $0 | $0 | ||||
| JOHN S MISA MD | |||||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $526,355 | $102,251 | 49.50 | |||
| TED WEGLEITNER | |||||||||
| CEO | 40.00 | Yes (X) | $0 | $415,596 | $84,220 | 15.00 | Yes (X) | ||
| KENNETH D HOLMEN MD | |||||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $312,555 | $22,124 | 39.50 | |||
| DOUGLAS E JOHNSON | |||||||||
| CFO & TREASURER | 24.70 | $296,775 | $0 | $36,439 | 30.30 | Yes (X) | |||
| PAUL L ERICKSON | |||||||||
| EXEC. DIR. - DEVELOPMENT | 51.00 | $119,070 | $0 | $30,984 | 2.00 | Yes (X) | |||
| THOMAS S ANDERSON | |||||||||
| VP - MEDICAL AFFAIRS | 42.00 | $0 | $343,791 | $43,302 | Yes (X) | ||||
| CYNTHIA A APPLESETH | |||||||||
| MANAGER - PHARMACY | 45.00 | $150,655 | $0 | $33,888 | Yes (X) | ||||
| JEFFREY W MAANUM | |||||||||
| LEAD ULTRASOUND TECH. | 40.00 | $149,565 | $0 | $34,187 | Yes (X) | ||||
| MARCIA A MCGOWAN | |||||||||
| PHARMACY COORDINATOR | 40.00 | $130,834 | $0 | $30,177 | Yes (X) | ||||
| MICHELLE A KRAFT | |||||||||
| DIRECTOR OF FINANCE | 47.00 | $136,311 | $0 | $13,823 | Yes (X) | ||||
| NEIL J BLAND | |||||||||
| PHARMACIST | 40.00 | $132,577 | $0 | $19,735 | Yes (X) | ||||
| JEFFREY J ROBERTSON | |||||||||
| FORMER CEO | 0.00 | $543,591 | $0 | $37,818 | Yes (X) | ||||
| CURT GEISSLER | |||||||||
| FORMER PRESIDENT | 0.00 | $169,546 | $0 | $18,907 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,828,924 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,598,297 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $507,855 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 41 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| KRAUS-ANDERSON CONSTRUCTION CO | |||||
| 525 S 8TH ST | MINNEAPOLIS | MN | 55404 | CONSTRUCTION SERVICES | $863,058 |
| REGIONS HOSPITAL | |||||
| 640 JACKSON ST | ST PAUL | MN | 551012595 | ANCILLARY TESTING SERVICES | $732,261 |
| NURSE ANESTHESIA SERVICES PA | |||||
| 8990 SPRINGBROOK DR | COON RAPIDS | MN | 55432 | PROFESSIONAL NURSE ANESTHESIA CALL | $433,329 |
| MOHAGEN HANSEN ARCHITECTURAL GROUP | |||||
| 1000 TWELVE OAKS CTR | WAYZATA | MN | 55391 | ARCHITECTURAL SERVICES | $398,719 |
| SIEMENS INDUSTRY INC | |||||
| 4400 ALAFAYA TRAIL | ORLANDO | FL | 32826 | EQUIPMENT REPAIR & MAINTENANCE | $289,356 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 19 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $161,890 | GovernmentGrantsAmt |
| Total Contributions | $161,890 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| NET PATIENT REVENUE | 623990 | $99,770,728 | $99,770,728 | |
| OTHER REVENUE | 900099 | $2,179,231 | $2,179,231 | |
| CAFETERIA | 722210 | $320,538 | $320,538 | |
| GIFT SHOP | 453220 | $122,565 | $122,565 | |
| CONTRACT REVENUE | 900099 | $45,798 | $45,798 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $102,438,860 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,806 | TotalRevenueColumnAmt |
| Exclusion | $11,806 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $46,500 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $25,259 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $21,241 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,241 | TotalRevenueColumnAmt |
| Exclusion | $21,241 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $102,633,797 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $99,770,728 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,701,179 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164,340 | TotalAmt |
| Program Services | $164,340 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $483,268 | TotalAmt |
| Management And General | $483,268 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,687,333 | TotalAmt |
| Program Services | $33,509,045 | ProgramServicesAmt |
| Management And General | $5,178,288 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,439,499 | TotalAmt |
| Program Services | $2,280,651 | ProgramServicesAmt |
| Management And General | $158,848 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,255,966 | TotalAmt |
| Program Services | $5,848,609 | ProgramServicesAmt |
| Management And General | $407,357 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,688,973 | TotalAmt |
| Program Services | $2,513,881 | ProgramServicesAmt |
| Management And General | $175,092 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,537 | TotalAmt |
| Program Services | $9,832 | ProgramServicesAmt |
| Management And General | $7,705 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,651,078 | TotalAmt |
| Program Services | $3,323,713 | ProgramServicesAmt |
| Management And General | $327,365 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,396 | TotalAmt |
| Program Services | $13,210 | ProgramServicesAmt |
| Management And General | $11,186 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,212,845 | TotalAmt |
| Program Services | $823,116 | ProgramServicesAmt |
| Management And General | $389,729 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $748,433 | TotalAmt |
| Program Services | $182,768 | ProgramServicesAmt |
| Management And General | $565,665 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,394,057 | TotalAmt |
| Program Services | $1,388,454 | ProgramServicesAmt |
| Management And General | $5,603 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,484 | TotalAmt |
| Program Services | $38,959 | ProgramServicesAmt |
| Management And General | $20,525 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,559 | TotalAmt |
| Program Services | $27,452 | ProgramServicesAmt |
| Management And General | $33,107 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $344,606 | TotalAmt |
| Program Services | $344,606 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,590,315 | TotalAmt |
| Program Services | $2,883,160 | ProgramServicesAmt |
| Management And General | $707,155 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $457,934 | TotalAmt |
| Program Services | $22,762 | ProgramServicesAmt |
| Management And General | $435,172 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL & PHARMACY SUPP | $23,680,602 | $23,680,225 | $377 |
| EQUIPMENT & MAINTENANCE | $3,485,461 | $2,015,316 | $1,470,145 |
| TAXES & ASSESSMENTS | $1,848,691 | $1,848,691 | |
| OTHER EXPENSE | $1,363,445 | $863,464 | $499,981 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,733 | TotalAmt |
| Program Services | $1,241 | ProgramServicesAmt |
| Management And General | $492 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,660,555 | TotalAmt |
| Program Services | $81,783,495 | ProgramServicesAmt |
| Management And General | $10,877,060 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,788,898 | BOYAmt |
| EOY | $16,861,991 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,049,801 | BOYAmt |
| EOY | $9,017,810 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,963,175 | BOYAmt |
| EOY | $2,142,993 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $505,844 | BOYAmt |
| EOY | $369,911 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $38,345,675 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $12,622,325 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,534,164 | BOYAmt |
| EOY | $25,723,350 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,151,392 | BOYAmt |
| EOY | $1,207,577 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $859,163 | BOYAmt |
| EOY | $860,817 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,852,437 | BOYAmt |
| EOY | $56,184,449 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,620,618 | BOYAmt |
| EOY | $10,873,009 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,158,426 | BOYAmt |
| EOY | $10,154,049 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,779,044 | BOYAmt |
| EOY | $21,027,058 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,073,393 | BOYAmt |
| EOY | $35,157,391 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,073,393 | BOYAmt |
| EOY | $35,157,391 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,852,437 | BOYAmt |
| EOY | $56,184,449 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $9,973,242 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$2,889,244 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Total Lobbying Expenditures | $0 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION PAYS FOR CERTAIN CORPORATE AND EMPLOYEE PROFESSIONAL ASSOCIATION MEMBERSHIPS. A PORTION OF SUCH MEMBERSHIP DUES POTENTIALLY COULD BE USED BY THE PROFESSIONAL ASSOCIATIONS FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,951,767 | OtherCostOrOtherBasisAmt |
| Book Value | $2,951,767 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,479,405 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,433,590 | DepreciationAmt |
| Book Value | $13,045,815 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $326,621 | OtherCostOrOtherBasisAmt |
| Depreciation | $116,601 | DepreciationAmt |
| Book Value | $210,020 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,462,677 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,335,678 | DepreciationAmt |
| Book Value | $9,126,999 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,125,205 | OtherCostOrOtherBasisAmt |
| Depreciation | $736,456 | DepreciationAmt |
| Book Value | $388,749 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $25,723,350 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PENSION LIABILITIES | Desc |
| Amt | $10,154,049 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $10,154,049 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $102,659,056 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $102,659,056 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$25,259 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$25,259 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $102,633,797 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $92,685,814 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $25,259 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $25,259 | ExpensesNotReportedAmt |
| Expenses Subtotal | $92,660,555 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $92,660,555 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC. IS INCLUDED IN THE HEALTHPARTNERS, INC. (HP) CONSOLIDATED AUDITED FINANCIAL STATEMENT. HP'S ACCOUNTING POLICY PROVIDES THAT A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. HP RECORDED NO LIABILITIES AT DECEMBER 31, 2015 OR 2014 FOR UNRECOGNIZED TAX BENEFITS. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RENTAL EXPENSE -25,259. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSE 25,259. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| 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 | $1,174,575 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,174,575 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01270 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,989,497 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $568,058 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,421,439 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01530 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,013,526 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,874,571 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,138,955 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02310 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,177,598 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,442,629 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,734,969 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05110 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $161,062 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,960 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $153,102 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $71,776 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $71,776 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,758,291 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,604,089 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,154,202 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03400 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $163,128 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $163,128 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,154,257 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,612,049 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,542,208 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03830 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,331,855 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,054,678 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,277,177 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08940 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,261,127 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $26,080,323 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $27,139,174 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,058,851 | 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 |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 EAST METRO ASC LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | AMBULATORY SURGERY | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.32700 | OrgProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.67300 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 927 CHURCHILL STREET W | AddressLine1Txt |
| City | STILLWATER | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55082 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.LAKEVIEWHEALTH.ORG/ | WebsiteAddressTxt |
| State License | 8029322 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION | 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 | Yes (1) | 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 | HTTP://WWW.LAKEVIEWHEALTH.ORG/CHNA | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | HTTP://WWW.LAKEVIEWHEALTH.ORG/CHNA | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://WWW.LAKEVIEWHEALTH.ORG/CHNA | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | 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 | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTP://WWW.LAKEVIEWHEALTH.ORG/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://WWW.LAKEVIEWHEALTH.ORG/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://WWW.LAKEVIEWHEALTH.ORG/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| 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 |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, | PART V, SECTION B, LINE 5: AS PART OF THE DATA COLLECTION PROCESS FOR THE MOST RECENT CHNA THAT WAS CONDUCTED IN 2015, LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION (HOSPITAL) CONDUCTED TWO COMMUNITY CONVERSATIONS DURING THE SUMMER OF 2015 TO GATHER INPUT FROM VARIOUS GROUPS IN THE COMMUNITY, INCLUDING REPRESENTATIVES OF UNDERSERVED POPULATIONS. THESE CONVERSATIONS INCLUDED INDIVIDUALS WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH; FEDERAL, STATE OR LOCAL HEALTH DEPARTMENT OR AGENCIES WITH INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY SERVED, INCLUDING PUBLIC SCHOOL REPRESENTATION; AND LEADERS, REPRESENTATIVES OR MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. |
| LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, | PART V, SECTION B, LINE 6A: OTHER HOSPITAL FACILITIES INCLUDED IN THE 2015 CHNA INCLUDED REGIONS HOSPITAL, HUDSON HOSPITAL, WESTFIELDS HOSPITAL, AMERY REGIONAL MEDICAL CENTER, AND PARK NICOLLET METHODIST HOSPITAL. |
| LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, | PART V, SECTION B, LINE 11: HEALTHPARTNERS ENGAGED THE RESOURCES OF COMMUNITY HOSPITAL CONSULTING (CHC CONSULTING) TO CONDUCT A COMPREHENSIVE, SIX-STEP COMMUNITY HEALTH NEEDS ASSESSMENT, ON BEHALF OF REGIONS HOSPITAL, THE HOSPITAL, HUDSON HOSPITAL, WESTFIELDS HOSPITAL, PARK NICOLLET METHODIST HOSPITAL, AND AMERY REGIONAL MEDICAL CENTER. THE STUDY UTILIZED A CURRENT DEMOGRAPHIC ANALYSIS, RELEVANT HEALTH DATA, FINDINGS FROM RECENTLY CONDUCTED COUNTY COMMUNITY HEALTH STUDIES, AND STAKEHOLDER INPUT TO IDENTIFY THE MAIN COMMUNITY HEALTH PRIORITIES THAT THE HEALTHPARTNERS SYSTEM AND ITS RESPECTIVE HOSPITALS SHOULD SEEK TO ADDRESS. THIS PROCESS CULMINATED IN FOUR MAIN FINDINGS: 1. MENTAL AND BEHAVIORAL HEALTH CONCERNS ARE PREVALENT IN THE COMMUNITIES SERVED BY HEALTHPARTNERS HOSPITALS. AS A PART OF THE STUDY, THE HOSPITAL GATHERED STAKEHOLDERS TO PARTICIPATE IN TWO COMMUNITY CONVERSATIONS DURING THE SUMMER OF 2015. ACCESS TO MENTAL HEALTH SERVICES, AS WELL AS CHEMICAL AND SUBSTANCE ABUSE ISSUES, WERE IDENTIFIED AS AREAS OF CONCERN. THE NEED TO DECREASE STIGMA, CLOSE THE GAP IN ACCESS TO SERVICES, IMPLEMENT PREVENTIVE EDUCATION AND CONNECT THE "NEED" WITH THE "HELP" WERE ALSO DISCUSSED. 2. LACK OF ACCESS TO AND AFFORDABILITY OF HEALTH CARE SERVICES ARE SIGNIFICANT CONCERNS. FINDINGS SUGGEST THAT IMPROVING ACCESS TO CARE FOR POPULATIONS WITH LIMITED SERVICES, INCREASING THE PROPORTION OF RESIDENTS WHO HAVE ACCESS TO HEALTH COVERAGE, AND CONNECTING PEOPLE TO SERVICES AND TO EACH OTHER SHOULD BE A FOCUS OF FUTURE INTERVENTIONS. 3. THE HIGH PREVALENCE OF CHRONIC DISEASES AND ILLNESSES WAS IDENTIFIED IN THIS STUDY. CONDITIONS THAT COULD BENEFIT FROM PREVENTION STRATEGIES INCLUDE OBESITY, DIABETES, CIRRHOSIS, CHRONIC LOWER RESPIRATORY DISEASE, CANCER AND VARIOUS COMMUNICABLE DISEASES. 4. THE STUDY ALSO IDENTIFIED A PERSISTENT FOCUS ON PROVIDING EQUITABLE CARE. THIS INCLUDES A FOCUS ON THE SOCIAL DETERMINANTS OF HEALTH (INCOME, POVERTY, TRANSPORTATION, ETC.) AND REDUCING DISPARITIES AMONG UNDERSERVED POPULATIONS. OUTCOMES THE COMMUNITY HEALTH NEEDS ASSESSMENT TEAM, CONSISTING OF LEADERSHIP FROM HEALTHPARTNERS, THE SIX HOSPITALS, AND CONSULTING STAFF FROM CHC CONSULTING MET ON AUGUST 24, 2015 TO REVIEW THE RESEARCH FINDINGS AND PRIORITIZE THE NEEDS THAT WERE IDENTIFIED. AFTER A FACILITATED DISCUSSION ABOUT THE FINDINGS, THE HOSPITALS DECIDED TO ADDRESS FOUR FINAL PRIORITIES. HEALTHPARTNERS AND HOSPITAL LEADERSHIP ALSO DEVELOPED THE FOLLOWING PRINCIPLE TO GUIDE THEIR WORK: THROUGH COLLABORATION, ENGAGEMENT AND PARTNERSHIP WITH OUR COMMUNITIES WE WILL ADDRESS THE FOLLOWING PRIORITIES WITH A SPECIFIC FOCUS ON HEALTH EQUITY IN SPECIAL POPULATIONS. 1. MENTAL AND BEHAVIORAL HEALTH 2. ACCESS AND AFFORDABILITY 3. CHRONIC DISEASE AND ILLNESS PREVENTION 4. EQUITABLE CARE ACTIONS THE HOSPITAL IS DEDICATED TO IMPROVING THE HEALTH OF THE COMMUNITY AND HAS USED THE ABOVE FINDINGS AND HEALTH PRIORITIES TO CREATE A HOSPITAL SPECIFIC IMPLEMENTATION PLAN. THE HOSPITAL'S IMPLEMENTATION PLAN IDENTIFIES OBJECTIVES AND ACTION STEPS FOR EACH PRIORITY. EACH OBJECTIVE IDENTIFIES ONE WAY THAT THE HOSPITAL WILL POSITIVELY IMPACT THE HEALTH OF THE COMMUNITY. THE ACTION STEPS DEMONSTRATE STRATEGIES THAT THE HOSPITAL WILL TAKE TO CARRY OUT EACH OBJECTIVE. |
| LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, | PART V, SECTION B, LINE 16I: THE FINANCIAL ASSISTANCE POLICY IS LISTED ON THE BACK OF THE PATIENT STATEMENT PER THE MINNESOTA ATTORNEY GENERAL (AG) AGREEMENT. |
| LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, | PART V, SECTION B, LINE 22D: THE HOSPITAL USES THE MOST FAVORABLE DISCOUNT BY VOLUME EXCLUDING GOVERNMENT PAYERS, PER THE MINNESOTA AG AGREEMENT. |
| LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, | PART V, SECTION B, LINE 24: WHEN A PATIENT IS UNINSURED THERE HAVE BEEN INSTANCES WHERE A PORTION OF THE BALANCE IS COVERED BY THE UNINSURED DISCOUNT AND THE REMAINING BALANCE IS COVERED BY CHARITY CARE. EXAMPLE: AN UNINSURED PATIENT HAS $1,000 IN GROSS CHARGES FOR AN EMERGENCY ROOM VISIT. THE PATIENT QUALIFIES FOR CHARITY CARE AND ALSO IS ELIGIBLE FOR THE UNINSURED DISCOUNT. A PORTION OF THE GROSS CHARGES IS COVERED BY THE UNINSURED DISCOUNT AND THE REMAINDER BY CHARITY CARE, WHICH MAY TOTAL AN AMOUNT EQUAL TO THE GROSS CHARGE FOR THAT VISIT. |
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | ACTUAL COSTS WERE ESTIMATED USING A COST-TO-CHARGE RATIO AND EXCLUDING BAD DEBT. |
| PART I, LINE 7E: COMMUNITY HEALTH IMPROVEMENT SERVICES | LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION (HOSPITAL) IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITY. THE HOSPITAL PROVIDED COMMUNITY ACTIVITIES AND PROGRAMS WHICH WERE SUBSIDIZED BY THE HOSPITAL IN ORDER TO IMPROVE COMMUNITY HEALTH. VARIOUS EVENTS INCLUDED, BUT WERE NOT LIMITED TO, THE FOLLOWING: TAKE CHARGE OF YOUR HEALTH DIABETES OPEN HOUSE; POWERUP FOR KIDS WEEK, INCLUDING FOUR VEGETABLE GIVEAWAYS, TO PROMOTE BETTER EATING AND ACTIVE LIVES SO YOUTH CAN REACH THEIR FULL POTENTIAL; LADIES NIGHT OUT TO SUPPORT AND PROMOTE WOMEN'S HEALTH; HOPS FOR HEALTH TO SUPPORT MEN'S HEALTH; AND THE TEDDY BEAR CLINIC PROGRAM WHICH HELPS KINDERGARTNERS LEARN MORE ABOUT THE HEALTH CARE ENVIRONMENT, ALLEVIATING THE STRESS AND ANXIETY THAT IS SOMETIMES ASSOCIATED WITH COMING TO THE HOSPITAL. SUPPORT CLASSES INCLUDED: BREAST CANCER SUPPORT GROUP, BETTER BREATHERS CLUB, DIABETES SUPPORT GROUP, WEATHERING LIFE'S LOSSES SUPPORT GROUP, BREASTFEEDING CLASS, TAI CHI FOR ARTHRITIS, VEIN SCREENING, FREEDOM FROM SMOKING, AND VARIOUS OTHER EDUCATIONAL CLASSES FOR THE COMMUNITY. THE NET COST OF PROVIDING COMMUNITY HEALTH IMPROVEMENT AND OPERATIONS ASSOCIATED WITH THIS WAS $153,102 IN 2015. |
| PART I, LINE 7F: HEALTH PROFESSIONS EDUCATION | THE HOSPITAL PROVIDED RESOURCES FOR CLINICAL CONTINUING MEDICAL EDUCATION AT A COST OF $71,776 DURING 2015. |
| PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES | THE HOSPITAL IS COMMITTED TO PROVIDING NEEDED SERVICES EVEN AT A FINANCIAL LOSS. IN 2015, LOSS ON SERVICES FOR HOSPITAL OUTPATIENT SERVICES INCLUDING HOME CARE, NEONATAL NURSE PRACTITIONERS, WOMEN'S CENTER, DIABETES AND ONCOLOGY TOTALING $3,154,202. |
| PART I, LINE 7I: CONTRIBUTIONS FOR COMMUNITY BENEFIT | THE HOSPITAL, VIA THE APPROVAL OF THE HOSPITAL'S GRANT COMMITTEE, PROVIDES GRANTS WHICH SUPPORT FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT ACTIVITIES. SOME OF THESE GRANTS IN 2015 INCLUDED THE AMERICAN DIABETES ASSOCIATION, CANVAS HEALTH, COMMUNITY THREAD, FAMILYMEANS, OUR COMMUNITY KITCHEN, PORTICO HEALTHNET, PROJECT LIFE, GRIEF AND CARE SUPPORT THROUGH ST. CROIX CHAPLAINCY, ST. MICHAEL'S CATHOLIC CHURCH, TREE HOUSE, VALLEY OUTREACH, YOUTH ADVANTAGE, YOUTH SERVICE BUREAU AND YOUNGLIFE. |
| PART III, LINE 4: | THE "ACTUAL COST" OF BAD DEBT INCLUDED IN COMMUNITY BENEFIT IS ESTIMATED. BAD DEBT EXPENSE REPRESENTS THOSE ACCOUNTS RECEIVABLE WRITTEN OFF FROM PATIENTS THAT HAVE THE ABILITY TO PAY, AS DETERMINED FROM CHARITY CARE APPLICATIONS AND OTHER DOCUMENTATION, BUT CHOOSE NOT TO. THE BAD DEBT AMOUNT IS THE RECEIVABLE AFTER INSURANCE PAYMENT AND ADJUSTMENTS HAVE ALREADY BEEN MADE, INCLUDING ADJUSTMENTS FOR SELF-PAY IN ACCORDANCE WITH THE AGREEMENT WITH THE MINNESOTA ATTORNEY GENERAL'S OFFICE. SINCE REDUCTIONS HAVE ALREADY BEEN MADE FOR DISCOUNTS AND OTHER ALLOWANCES, THE ENTIRE BALANCE IS CONSIDERED BAD DEBT AND NO FURTHER REDUCTIONS ARE CONSIDERED. |
| PART III, LINE 8: | THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT FOR THE FOLLOWING REASONS:1) IT PROVIDES SERVICES TO A SIGNIFICANT PORTION OF OUR SERVICE POPULATION AT A NEGATIVE MARGIN; 2) THE HOSPITAL WOULD DISCONTINUE PROVIDING SERVICES TO MEDICARE PATIENTS IF THE DECISION WERE BASED STRICTLY ON A FINANCIAL BASIS; 3) THERE IS A COMMUNITY NEED TO PROVIDE THESE SERVICES LOCALLY; 4) IF THE HOSPITAL DID NOT PROVIDE THESE SERVICES; THEY WOULD BECOME THE OBLIGATION OF THE GOVERNMENT. |
| PART III, LINE 9B: | IF A PATIENT WAS NOT IDENTIFIED AS A POTENTIAL CHARITY CARE CANDIDATE UPON REGISTRATION, THE FIRST COLLECTIONS CONTACT IS WITH THE HOSPITAL'S INTERNAL BUSINESS STAFF, WHO INTERVIEW THE PATIENT AND DETERMINE IF THE PATIENT IS A CANDIDATE FOR CHARITY CARE. IF THE NECESSARY PAPERWORK IS COMPLETED AND THEY DO QUALIFY FOR CHARITY CARE, THERE IS NO FURTHER COLLECTION ACTIVITY; HOWEVER IF THE PAPERWORK IS NOT COMPLETED, OR IS COMPLETED AND THEY DO NOT MEET THE CRITERIA, THEY ARE SUBJECT TO FURTHER COLLECTION ACTIVITY. THIS FIRST OCCURS INTERNALLY THROUGH HOSPITAL STAFF. IF INTERNAL ATTEMPTS ARE UNSUCCESSFUL, THIS SUBSEQUENTLY OCCURS THROUGH OUTSIDE COLLECTION AGENCIES. |
| PART III, SECTION A, LINE 2: BAD DEBT EXPENSE METHODOLOGY | SEE FINANCIAL STATEMENT FOOTNOTE PROVIDED IN RESPONSE TO PART III, SECTION A, LINE 4. |
| PART VI, LINE 2: | IN 2015, A COMPREHENSIVE, SIX-STEP COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") COLLABORATION WAS CONDUCTED FOR HEALTHPARTNERS AND ITS HOSPITALS (REGIONS HOSPITAL, THE HOSPITAL, HUDSON HOSPITAL , WESTFIELDS HOSPITAL, AMERY REGIONAL MEDICAL CENTER, AND PARK NICOLLET METHODIST HOSPITAL) BY COMMUNITY HOSPITAL CONSULTING TO DETERMINE THE GREATEST HEALTH NEEDS IN THE COMMUNITIES THEY SERVE. THESE HOSPITALS SERVE SIMILAR COMMUNITIES AND HAVE OVERLAPPING STUDY AREAS. THE SYSTEM'S STUDY AREA IS DEFINED AS DAKOTA, HENNEPIN, RAMSEY, SCOTT, AND WASHINGTON COUNTIES IN MINNESOTA AND POLK AND ST. CROIX COUNTIES IN WISCONSIN. THE HOSPITAL'S SPECIFIC STUDY AREA IS DEFINED AS: - WASHINGTON COUNTY - ST. CROIX COUNTY - RAMSEY COUNTY DATA ELEMENTS REGARDING ALL SEVEN COUNTIES IN THE SYSTEM'S STUDY AREA ARE INCLUDED IN THIS REPORT FOR COMPARISON, AND ARE ALSO PROVIDED AS AN OPPORTUNITY FOR THE HOSPITALS TO WORK TOGETHER TO MEET THE NEEDS IDENTIFIED IN THE OVERLAPPING COUNTIES.- DEMOGRAPHICS: CHC CONSULTING ANALYZED THE MOST CURRENT DEMOGRAPHICS OF RESIDENTS IN WASHINGTON, ST. CROIX, AND RAMSEY COUNTIES INCLUDING: OVERALL POPULATION, POPULATION BY RACE AND ETHNICITY, MEDIAN AGE, MEDIAN HOUSEHOLD INCOME, POVERTY LEVELS, FOOD INSECURITY, AND EDUCATIONAL ATTAINMENT.- HEALTH DATA COLLECTION: CHC CONSULTING ANALYZED THE MOST CURRENT HEALTH DATA AVAILABLE PERTAINING TO RESIDENTS IN WASHINGTON, ST. CROIX, AND RAMSEY COUNTIES INCLUDING: MORTALITY RATES, CHRONIC CONDITIONS, HEALTH BEHAVIORS, MENTAL HEALTH, COMMUNICABLE DISEASES, PREVENTION AND FATALITY.- COMMUNITY INPUT: AS A PART OF COUNTY-WIDE ASSESSMENTS, SURVEYS AND LISTENING SESSIONS WERE CONDUCTED TO GATHER INPUT FROM COMMUNITY RESIDENTS. IN ADDITION, THE HOSPITAL CONDUCTED COMMUNITY CONVERSATIONS ON MAY 15, 2015 AND JULY 15, 2015 TO GAIN INSIGHT SURROUNDING SIGNIFICANT HEALTH NEEDS.- FINAL PRIORITIZED NEEDS - MENTAL AND BEHAVIORAL HEALTH - ACCESS AND AFFORDABILITY - CHRONIC DISEASE AND ILLNESS PREVENTION - EQUITABLE CAREA FULL REPORT OF LAKEVIEW HOSPITAL'S CHNA AND IMPLEMENTATION PLAN IS POSTED ON THEIR WEBPAGE AT HTTP://WWW.LAKEVIEWHEALTH.ORG/CHNA. |
| PART VI, LINE 3: | TO INFORM AND EDUCATE PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE, EACH PATIENT BILLING STATEMENT AND COLLECTIONS LETTER PRODUCED BY THE HOSPITAL INCLUDE THE FOLLOWING NOTICE: THE HOSPITAL OFFERS FINANCIAL ASSISTANCE TO PATIENTS EXPERIENCING DIFFICULTY PAYING THEIR MEDICAL BILLS. IF YOU ARE INSURED AND ARE EXPERIENCING DIFFICULTY PAYING THE BALANCE OF YOUR MEDICAL BILL, PLEASE CONTACT OUR BUSINESS OFFICE FOR MORE INFORMATION ABOUT SETTING UP A PAYMENT PLAN OR ABOUT OUR CHARITY CARE PROGRAM. IF THE PATIENT IS UNINSURED AND RECEIVES MEDICALLY NECESSARY TREATMENT THAT IS NOT COSMETIC IN NATURE THEN THE PATIENT WILL BE ELIGIBLE TO RECEIVE AN UNINSURED DISCOUNT. |
| PART VI, LINE 4: | THE HOSPITAL SERVES THE EASTERN TWIN CITIES' METRO AREA AND WESTERN WISCONSIN. THE HOSPITAL'S CORE SERVICE AREA INCLUDES STILLWATER, BAYPORT, LAKE ELMO, LAKELAND, AND MARINE ON ST. CROIX, MN ALONG WITH HOULTON AND SOMERSET, WI. PRIMARY SERVICE AREAS ARE HUDSON, NEW RICHMOND AND STAR PRAIRIE, WI, AND AFTON, MN. SECONDARY SERVICE AREAS ARE NEARBY CITIES IN EASTERN MINNESOTA AND WESTERN WISCONSIN.CENSUS FIGURES FOR 2013 SHOW THE FOLLOWING FOR WASHINGTON COUNTY:TOTAL POPULATION: 246,683- PERSONS UNDER 5 YEARS: 6.2%- PERSONS UNDER 18 YEARS: 25.4%- PERSONS 65 YEARS AND OVER: 12.3% IT IS ESTIMATED THAT THE 65 AND OLDER GROUP IN WASHINGTON COUNTY WILL GROW BY 350% BY 2030.- POPULATION CHANGE FROM 2010 TO 2013: +3.6%- FEMALES: 50.5%- WHITE PERSONS: 87.9%- PERSONS OF COLOR: 12.1%- LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME: 9.3%- HIGH SCHOOL GRADUATES: 95.9%- BACHELOR'S DEGREE OR HIGHER: 40.5%- PERSONS BELOW POVERTY LEVEL 2009 - 2013: 5.7%- MEDIAN HOUSEHOLD INCOME IN WASHINGTON COUNTY FROM 2009 - 2013 WAS $81,540. |
| PART VI, LINE 5: | THE HOSPITAL PROVIDED EDUCATION SCHOLARSHIPS TO DIABETIC PATIENTS THAT REQUIRED NUTRITION AND LIFE-STYLE EDUCATION. THE HOSPITAL ALSO PROVIDED FREE LAB AND PHARMACY SERVICES FOR PATIENTS OF THE ST. CROIX FAMILY MEDICAL CENTER, A LOCAL MEDICAL CLINIC THAT PROVIDES FREE AND DISCOUNTED SERVICES FOR INDIGENT AND LOW INCOME PATIENTS OF THE AREA.FOR ADDITIONAL DISCUSSION, SEE FORM 990, SCHEDULE 0 - "EXEMPT PURPOSE AND ACHIEVEMENTS". |
| PART VI, LINE 6: | AS A MEMBER OF STILLWATER HEALTH SYSTEM, THE HOSPITAL PARTICIPATES WITH THE MULTI-SPECIALTY CLINIC AND HEALTH SYSTEM LEADERSHIP WITHIN OUR OVERALL ORGANIZATION IN PROVIDING ACCESS TO CARE, SUPPORT GROUPS, EDUCATIONAL ACTIVITIES, AND FINANCIAL CONTRIBUTIONS TO THE MARKET AREA DESCRIBED ABOVE. THE MULTI-SPECIALTY CLINIC FURTHER PARTICIPATES IN MINNESOTA COMMUNITY MEASUREMENT, PRACTICES AND MEASURES PROVIDER, PERFORMANCE WITH SPECIFIC PREVENTIVE CARE METRICS AND SPECIFIC CHRONIC DISEASE MANAGEMENT METRICS. IN 2011, THE STILLWATER HEALTH SYSTEM AFFILIATED WITH HEALTHPARTNERS. THE MISSION OF HEALTHPARTNERS IS TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | MN |
| PART VI, LINE 7: STATES RECEIVING COMMUNITY BENEFIT REPORT | THE HOSPITAL FILES A COMMUNITY BENEFIT REPORT WITH MINNESOTA THROUGH THE MINNESOTA HOSPITAL ASSOCIATION (MHA). |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Cash GrantCashGrantAmt | Valuation Method UsedValuationMethodUsedDesc | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|
| PORTICO HEALTHNET | ||||||
| 1690 UNIVERSITY AVE W STE 250 | ST PAUL | MN | 55104 | $30,822 | CASH AMOUNT | PROGRAM SUPPORT |
| FAMILY MEANS | ||||||
| 1875 NORTHWESTERN AVENUE | STILLWATER | MN | 55082 | $33,000 | CASH AMOUNT | PROGRAM SUPPORT |
| CANVAS HEALTH | ||||||
| 7066 STILLWATER BLVD N | OAKDALE | MN | 55128 | $13,750 | CASH AMOUNT | PROGRAM SUPPORT |
| COMMUNITY THREAD | ||||||
| 2300 W ORLEANS ST | STILLWATER | MN | 55082 | $8,000 | CASH AMOUNT | PROGRAM SUPPORT |
| TREEHOUSE | ||||||
| 5666 LINCOLN DRIVE SUITE 201 | EDINA | MN | 55436 | $8,000 | CASH AMOUNT | PROGRAM SUPPORT |
| VALLEY OUTREACH | ||||||
| 1911 CURVE CREST BLVD W | STILLWATER | MN | 55082 | $8,000 | CASH AMOUNT | PROGRAM SUPPORT |
| YOUNGLIFE OF ST CROIX VALLEY | ||||||
| 1151 PARKWOOD LANE | STILLWATER | MN | 55082 | $8,000 | CASH AMOUNT | PROGRAM SUPPORT |
| YOUTH ADVANTAGE | ||||||
| 5901 OMAHA AVE NORTH | STILLWATER | MN | 55082 | $8,000 | CASH AMOUNT | PROGRAM SUPPORT |
| YOUTH SERVICE BUREAU INC | ||||||
| 101 PINE STREET W | STILLWATER | MN | 55082 | $8,000 | CASH AMOUNT | PROGRAM SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 9 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC. (THE HOSPITAL) MANAGEMENT STAFF REVIEW THE MISSION AND PURPOSE OF POTENTIAL GRANTEE ORGANIZATIONS TO ASSURE CONSISTENCY WITH THE HOSPITAL'S MISSION AND PURPOSE. AMOUNTS SUBSEQUENTLY GRANTED ARE SUBJECT TO THE HOSPITAL'S FORMAL SPENDING APPROVAL AND DOCUMENTATION PROCESS BASED ON AMOUNT OF THE EXPENDITURE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | 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 (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN S MISA MD | ||||||||||||||
| DIRECTOR | $0 | $385,374 | $0 | $71,911 | $0 | $69,070 | $0 | $70,274 | $0 | $31,977 | $0 | $628,606 | $0 | $48,487 |
| TED WEGLEITNER | ||||||||||||||
| CEO | $0 | $343,418 | $0 | $72,178 | $0 | $0 | $0 | $48,981 | $0 | $35,239 | $0 | $499,816 | $0 | $0 |
| KENNETH D HOLMEN MD | ||||||||||||||
| DIRECTOR | $0 | $5,369 | $0 | $129,164 | $0 | $178,022 | $0 | $10,245 | $0 | $11,879 | $0 | $334,679 | $0 | $177,538 |
| DOUGLAS E JOHNSON | ||||||||||||||
| CFO & TREASURER | $273,514 | $0 | $9,643 | $0 | $13,618 | $0 | $5,300 | $0 | $31,139 | $0 | $333,214 | $0 | $0 | $0 |
| PAUL L ERICKSON | ||||||||||||||
| EXEC. DIR. - DEVELOPMENT | $113,570 | $0 | $5,500 | $0 | $0 | $0 | $2,480 | $0 | $28,504 | $0 | $150,054 | $0 | $0 | $0 |
| THOMAS S ANDERSON | ||||||||||||||
| VP - MEDICAL AFFAIRS | $0 | $341,704 | $0 | $0 | $0 | $2,087 | $0 | $15,231 | $0 | $28,071 | $0 | $387,093 | $0 | $0 |
| CYNTHIA A APPLESETH | ||||||||||||||
| MANAGER - PHARMACY | $143,659 | $0 | $6,996 | $0 | $0 | $0 | $3,128 | $0 | $30,760 | $0 | $184,543 | $0 | $0 | $0 |
| JEFFREY W MAANUM | ||||||||||||||
| LEAD ULTRASOUND TECH. | $149,565 | $0 | $0 | $0 | $0 | $0 | $2,918 | $0 | $31,269 | $0 | $183,752 | $0 | $0 | $0 |
| MARCIA A MCGOWAN | ||||||||||||||
| PHARMACY COORDINATOR | $129,748 | $0 | $0 | $0 | $1,086 | $0 | $2,720 | $0 | $27,457 | $0 | $161,011 | $0 | $0 | $0 |
| MICHELLE A KRAFT | ||||||||||||||
| DIRECTOR OF FINANCE | $131,311 | $0 | $5,000 | $0 | $0 | $0 | $362 | $0 | $13,461 | $0 | $150,134 | $0 | $0 | $0 |
| NEIL J BLAND | ||||||||||||||
| PHARMACIST | $132,577 | $0 | $0 | $0 | $0 | $0 | $2,632 | $0 | $17,103 | $0 | $152,312 | $0 | $0 | $0 |
| JEFFREY J ROBERTSON | ||||||||||||||
| FORMER CEO | $261,718 | $0 | $500 | $0 | $281,373 | $0 | $5,300 | $0 | $32,518 | $0 | $581,409 | $0 | $0 | $0 |
| CURT GEISSLER | ||||||||||||||
| FORMER PRESIDENT | $3,655 | $0 | $26,318 | $0 | $139,573 | $0 | $0 | $0 | $18,907 | $0 | $188,453 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | 990, SCHEDULE J, PART II, COLUMN F: PRIOR REPORTED COMPENSATION | FormAndLineReferenceDesc |
| Explanation | SCHEDULE J PART I, LINE 4A THE AMOUNT OF SEVERANCE COMPENSATION PROVIDED TO EACH OF THE INDIVIDUALS ON SEVERANCE DURING 2015 IS AS FOLLOWS: JEFFREY ROBERTSON $197,084 SCHEDULE J, PART I, LINE 4B COLUMN (F) INCLUDES AMOUNTS PAID TO PARTICIPANTS IN THE CURRENT YEAR, WHICH WERE PREVIOUSLY REPORTED IN COLUMN (C) OF PRIOR YEARS' 990'S, AS RETIREMENT AND DEFERRED COMPENSATION, FOR THE FOLLOWING DIRECTOR: JOHN S. MISA, MD $ 48,487 ANY ANALYSIS OF EARNINGS FOR THE CURRENT YEAR, FOR THESE PARTICIPANTS OF THE PLAN, SHOULD EXCLUDE THE AMOUNT IN COLUMN F AS PART OF THE ANALYSIS SINCE THOSE EARNINGS WERE ALREADY REPORTED IN COLUMN (C) OF PREVIOUS YEARS' 990'S. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 990, PART III, LINE 4A: EXEMPT PURPOSE AND ACHIEVEMENTS | CORPORATE STRUCTURE, PURPOSE, GOVERNANCE LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION (THE HOSPITAL) IS A MINNESOTA NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE ("IRC") SECTION 501(C)(3) AND IS PART OF THE FAMILY OF HEALTHPARTNERS ORGANIZATIONS "HEALTHPARTNERS". FOUNDED IN 1957, HEALTHPARTNERS IS AN INTEGRATED SYSTEM OF HEALTH CARE DELIVERY AND HEALTH CARE FINANCING ORGANIZATIONS, AND IS ONE OF THE LARGEST CONSUMER-GOVERNED ORGANIZATIONS IN THE COUNTRY. HEALTHPARTNERS' MISSION IS TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY. HEALTHPARTNERS SEEKS TO TRANSFORM HEALTHCARE THROUGH A RELENTLESS FOCUS ON THE TRIPLE AIM - PROVIDING EXCEPTIONAL EXPERIENCE FOR THE INDIVIDUAL, IMPROVING THE HEALTH OF THE POPULATION, AND MAINTAINING AFFORDABILITY, ALL AT THE SAME TIME. HEALTHPARTNERS INCLUDES AN ARRAY OF TAX-EXEMPT AND TAXABLE ORGANIZATIONS WITH HEALTH CARE ACTIVITIES PRIMARILY OPERATING IN MINNESOTA AND WESTERN WISCONSIN. HEALTHPARTNERS PROVIDES A FULL-RANGE OF HEALTH CARE DELIVERY AND HEALTH PLAN SERVICES INCLUDING INSURANCE, PATIENT CARE, ADMINISTRATION AND HEALTH AND WELL-BEING PROGRAMS. HEALTHPARTNERS HEALTH PLAN'S SERVE MORE THAN 1.5 MILLION MEDICAL AND DENTAL MEMBERS NATIONWIDE. HEALTHPARTNERS MEDICAL CARE SYSTEM INCLUDES MORE THAN 1,700 PHYSICIANS, SIX HOSPITALS WITH OVER 1,000 ACUTE CARE BEDS, AND 93 PRIMARY AND SPECIALTY CARE MEDICAL FACILITIES WITH PRACTICES IN MINNESOTA AND WESTERN WISCONSIN. IN ADDITION, HEALTHPARTNERS DENTAL CARE SYSTEM HAS MORE THAN 60 DENTISTS AND 24 DENTAL CLINICS. HEALTHPARTNERS ALSO CONTRACTS WITH OTHER PRIMARY AND SPECIALTY MEDICAL FACILITIES AND DENTAL FACILITIES, PHYSICIAN GROUPS, HOSPITALS AND RELATED HEALTHCARE PROVIDERS LOCATED PRIMARILY IN MINNESOTA AND WESTERN WISCONSIN. HEALTHPARTNERS ALSO PROVIDES MEDICAL EDUCATION AND TRAINING TO MEDICAL PROFESSIONALS AND CONDUCTS RESEARCH AND FUND RAISING ACTIVITIES THAT SUPPORT THE HEALTH CARE DELIVERY SYSTEM. A COMPLETE LISTING OF ALL ORGANIZATIONS WITHIN THE HEALTHPARTNERS FAMILY, AND THE RELATIONSHIP BETWEEN THEM, CAN BE FOUND ON SCHEDULE R WITHIN THIS 990 RETURN. DETAILED INFORMATION ABOUT THE COMMUNITY BENEFIT ACTIVITIES AND ACCOMPLISHMENTS OF EACH TAX-EXEMPT ORGANIZATION CAN BE FOUND IN THE INDIVIDUAL FORM 990 RETURN FOR THAT ORGANIZATION. HEALTHPARTNERS IS DRIVING CHANGE THAT HELPS OUR MEMBERS AND PATIENTS LIVE HEALTHIER LIVES. HEALTHPARTNERS COLLABORATE WITH OTHER PLANS, CARE PROVIDERS AND OTHER COMMUNITY AND BUSINESS ORGANIZATIONS IN THE REGION AND THROUGHOUT THE NATION TO INCREASE ACCESS, CREATE AND SHARE QUALITY MEASURES AND INITIATIVES, PARTICIPATE IN DEVELOPMENT OF PUBLIC POLICY, AND COLLABORATE IN IMPROVEMENTS THAT SUPPORT THE TRIPLE AIM. AMONG HEALTHPARTNERS' SIGNATURE INITIATIVES CONTINUING IN 2015 ARE TOTAL COST OF CARE MEASUREMENTS (DEVELOPMENT OF A NATIONALLY RECOGNIZED METRIC, ENDORSED BY THE NATIONAL QUALITY FORUM, ENABLING MEASUREMENT AND INCENTIVES BASED ON COORDINATION AND EVIDENCE-BASED PRACTICES), MENTAL HEALTH (REDUCING STIGMA, AND ASSURING ACCESS TO HIGH QUALITY CARE IN THE MOST APPROPRIATE SETTINGS), CHILDREN'S HEALTH (IMPROVING CHILD HEALTH BY PROMOTING EARLY BRAIN DEVELOPMENT, PROVIDING FAMILY CENTERED CARE, AND STRENGTHENING COMMUNITIES), AND SUSTAINABILITY (ENERGY EFFICIENCY, WASTE REDUCTION, AND RESOURCE MANAGEMENT). HEALTHPARTNERS, INC. (HPI) IS THE PARENT ENTITY OF HEALTHPARTNERS AND IS A MINNESOTA NON-PROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(4). HPI IS THE SOLE CORPORATE MEMBER OF HPI-RAMSEY, A MINNESOTA NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). IN TURN, HPI-RAMSEY IS THE SOLE CORPORATE MEMBER OF REGIONS HOSPITAL, REGIONS HOSPITAL FOUNDATION, CAPITOL VIEW TRANSITIONAL CARE CENTER, STILLWATER HEALTH SYSTEM (SHS), RAMSEY INTEGRATED HEALTH SERVICES AND RH-WISCONSIN, INC., ALL OF WHICH ARE NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). SHS IS THE SOLE CORPORATE MEMBER OF THE HOSPITAL. THE HOSPITAL AND SHS ARE PART OF THE LAKEVIEW HEALTH SYSTEM ALONG WITH THE LAKEVIEW MEMORIAL HOSPITAL FOUNDATION, A MINNESOTA 501(C) (3) TAX EXEMPT ORGANIZATION (THE FOUNDATION) AND STILLWATER MEDICAL GROUP (SMG), A MINNESOTA 501(C) (3) TAX EXEMPT ORGANIZATION. SHS IS ALSO THE SOLE CORPORATE MEMBER OF THE FOUNDATION AND SMG. HEALTHPARTNERS AND THE HOSPITAL ALSO PARTNER WITH OTHER PLANS, CARE PROVIDERS AND NON-PROFIT ORGANIZATIONS IN THE REGION AND THROUGHOUT THE NATION; TO INCREASE ACCESS, CREATE AND DISSEMINATE QUALITY MEASURES AND INITIATIVES, PARTICIPATE IN DEVELOPMENT OF PUBLIC POLICY AND COLLABORATE ON SYSTEM IMPROVEMENTS. THE HOSPITAL CONTINUES TO BE AN INTEGRAL PART OF THE STILLWATER COMMUNITY AND SURROUNDING AREA - A VITAL AND NECESSARY COMMUNITY RESOURCE SINCE 1880, THE FIFTH OLDEST HOSPITAL, AND SECOND OLDEST CONTINUALLY OPERATING HOSPITAL IN MINNESOTA. THE HOSPITAL IS DESIGNATED A LEVEL 3 TRAUMA HOSPITAL AND HAS MEDICAL STAFF IN A VARIETY OF SPECIALTIES, INCLUDING FAMILY MEDICINE, INTERNAL MEDICINE, PEDIATRICS, OB/GYN, GENERAL SURGERY, ORTHOPEDICS, OTOLARYNGOLOGY, OCCUPATIONAL HEALTH, EMERGENCY MEDICINE, PODIATRY, HOSPITALISTS, NEUROLOGY, GERIATRICS, ONCOLOGY, UROLOGY, CARDIOLOGY, SPORTS MEDICINE, ALLERGY/IMMUNOLOGY., OPHTHALMOLOGY, GASTROENTEROLOGY, DERMATOLOGY, RADIOLOGY, PATHOLOGY AND ANESTHESIOLOGY. COURTESY AND CONSULTING STAFF PROVIDE ADDITIONAL SERVICES, INCLUDING PLASTIC SURGERY, PAIN MANAGEMENT, AND INFECTIOUS DISEASE, PULMONARY/SLEEP MEDICINE AND ORAL SURGERY. CHARITY CARE: CHARITY CARE IS DEFINED AS THE COST OF CARE DELIVERED TO PATIENTS WHO ARE WILLING, BUT UNABLE TO PAY FOR THE SERVICES THEY RECEIVE. THIS INCLUDES: PATIENTS WHOSE CHARGES ARE FORGIVEN OR REDUCED BECAUSE OF INABILITY TO PAY; PATIENTS WHO ARE UNABLE TO PAY THE BALANCE LEFT BY ANY PAYER; AND PATIENTS FOR WHOM UNUSUAL CIRCUMSTANCES, OR SPECIAL FINANCIAL HARDSHIP, WARRANT SPECIAL CONSIDERATION. THE HOSPITAL PROVIDED $1,174,646 IN FREE OR DISCOUNTED CARE TO LOW-INCOME AND UNINSURED PATIENTS. GOVERNMENT-SPONSORED MEANS-TESTED HEALTH CARE: THE HOSPITAL PROVIDES INPATIENT AND OUTPATIENT CARE, INCLUDING EMERGENCY DEPARTMENT SERVICES TO MEDICAID PATIENTS. PAYMENTS RECEIVED FOR THESE SERVICES ARE BELOW THE COST OF CARE PROVIDED. THE HOSPITAL'S EXPENSE TO COVER UNREIMBURSED MEDICAID COSTS FOR PATIENTS TOTALED $1,422,143. BENEFIT TO THE COMMUNITY: THE HOSPITAL WORKS IN COLLABORATIVE PARTNERSHIP WITH THE COMMUNITY TO IMPROVE HEALTH AND WELL-BEING. THE LAKEVIEW HEALTH SYSTEM ORGANIZATIONS, THE COMMUNITY AND THE HOSPITAL ACCOMPLISHED A GREAT DEAL IN 2015. OUR PARTNERSHIP WAS ADVANCED ON APRIL 1, 2011, WITH A FORMAL AFFILIATION WITH HEALTHPARTNERS AND ITS FAMILY OF HEALTH CARE ORGANIZATIONS. ADVANCEMENTS WERE MADE TO ENSURE BETTER HEALTH FOR ALL, IMPROVED PATIENT EXPERIENCE AND AFFORDABLE HEALTH CARE. THE HOSPITAL CONTINUES TO GROW ITS REPUTATION FOR EXCELLENT CLINICAL OUTCOMES AND SERVICE. 1. COMMUNITY HEALTH SERVICES: THE HOSPITAL PARTICIPATED IN COMMUNITY-BASED COLLABORATIVE EFFORTS TO IMPROVE ACCESS TO COMMUNITY AND MENTAL HEALTH SERVICES: - THE COMMUNITY HEALTH ACTION TEAM (CHAT) FOCUSED DISCUSSION ON MENTAL HEALTH ACCESS AND STIGMA REDUCTION. - THE HOSPITAL AND CHAT BOTH SUPPORTED TRAINING FOR THE ANTI-STIGMA CAMPAIGN. MAKE IT OK. AMBASSADORS' TRAINING WAS HELD FOR 25 COMMUNITY MEMBERS IN MARCH 2015. - REPRESENTATION OCCURRED AT CONNECT COMMUNITY COLLABORATIVE FOR MENTAL AND CHEMICAL HEALTH. - BEHAVIORAL HEALTH SUMMIT GROUP: THE HOSPITAL IS AN ACTIVE PARTICIPANT IN THE WASHINGTON COUNTY SUMMIT WHICH EXPLORES PRIORITY NEEDS IN THE AREA OF BEHAVIORAL/MENTAL HEALTH AND SUBSTANCE ABUSE. - CONTINUED SUPPORT FOR POWERUP, A COMMUNITY-WIDE HEALTH INITIATIVE THAT INSPIRES AND ENGAGES THE ENTIRE COMMUNITY TO PROMOTE BETTER EATING AND ACTIVE LIVES SO YOUTH CAN REACH THEIR FULL POTENTIAL. |
| FORM 990, PART III, LINE 4A | - POWERUP HAS IMPLEMENTED A COMPREHENSIVE FRAMEWORK AND STRATEGY FOR THE INITIATIVE INCLUDING COMMUNITY ADVISORY COMMITTEES, COMMUNITY OUTREACH AND EDUCATION, AND PARTNERSHIPS WITH MULTIPLE COMMUNITY SECTORS TO CHANGE THE FOOD AND PHYSICAL ACTIVITY ENVIRONMENT. KEY ACTIVITIES INCLUDED: - POWERUP SCHOOL CHALLENGE REACHED MORE THAN 10,000 CHILDREN PLUS SCHOOL STAFF IN MORE THAN 25 SCHOOLS IN 4 COMMUNITIES THROUGHOUT THE SERVICE AREA. RESULTS INDICATE THAT TEACHERS, FAMILIES AND STUDENTS ARE HIGHLY ENGAGED IN THE PROGRAM WITH AN 80% PARTICIPATION RATE OF CHILDREN TRACKING FRUITS AND VEGETABLES. - MORE THAN 30,000 FAMILIES AND CHILDREN WERE REACHED THROUGH EVENTS, CLASSES, OUTREACH, PROGRAMS AND RESOURCES TO PROMOTE BETTER EATING, FAMILY MEALS, PHYSICAL ACTIVITY, REDUCED SCREEN TIME AND FEWER SUGARY DRINKS. - PARTNERSHIPS HAVE EXPANDED TO INCLUDE SCHOOLS, BUSINESS, NONPROFITS, FAMILIES, FAITH COMMUNITIES, PUBLIC HEALTH, FOOD SHELVES AND THE ENTIRE COMMUNITY. - OPEN GYMS, IN PARTNERSHIP WITH LOCAL SCHOOLS, HAVE EXPANDED TO INCLUDE MULTI-SITE OFFERINGS ON A WEEKLY BASIS. THIS FREE OPTION FOR PHYSICAL ACTIVITY RANKED AS ONE OF THE KEY NEEDS IDENTIFIED BY PARENTS OF CHILDREN ON THE FAMILY COMMUNITY SURVEY, JANUARY 2014. - BETTER SHELF FOR BETTER HEALTH PROJECTS CONTINUES TO TRANSFORM FOOD SHELVES AND INCREASE ACCESS TO HEALTHY CHOICES FOR LOW INCOME COMMUNITY MEMBERS. - THE HOSPITAL HELD TWO AMERICAN RED CROSS BLOOD DRIVES IN 2015, ON THE HOSPITAL CAMPUS, WITH OVER 40 STAFF AND COMMUNITY MEMBERS VOLUNTEERING FOR THIS CAUSE. - CONTINUED FACILITATION OF THE LOCAL CANCER SUPPORT GROUP, IN COLLABORATION WITH THE CANCER CENTER OF WESTERN WISCONSIN. - THE HOSPITAL SPONSORED AND COORDINATED OVER 200 COMMUNITY BENEFIT CLASSES, EVENTS AND SUPPORT GROUPS DURING THE YEAR AT A NET COST OF APPROXIMATELY $144,500. 2. HEALTH PROFESSIONAL EDUCATION: THE HOSPITAL COORDINATES AND SUPPORTS WEEKLY CONTINUING MEDICAL EDUCATION (CME) PROGRAMS FOR STAFF AND COMMUNITY EDUCATION. TOTAL DIRECT COSTS FOR STIPENDS, PURCHASED SERVICES, SUPPLIES, ROOM RENTALS AND INDIRECT COSTS FOR THE YEAR WERE $71,176. 3. SUBSIDIZED HEALTH SERVICES: THE HOSPITAL IS COMMITTED TO PROVIDING NEEDED SERVICES, EVEN AT A FINANCIAL LOSS. IN 2015, LOSS ON SERVICES FOR INPATIENT AND OUTPATIENT HEALTH SERVICES, INCLUDING HOSPITAL OUTPATIENT SERVICES (INFUSION THERAPY, CLINICAL DIABETES AND NUTRITION), OB/GYN SERVICES, AND HOMECARE AND HOSPICE SERVICES, TOTALED $3,154,000. GRANTS TO SUPPORT HEALTH SERVICES FOR YOUTH AND ADULTS IN THE COMMUNITY INCLUDED: AMERICAN DIABETES ASSOCIATION, CANVAS HEALTH, COMMUNITY THREAD, FAMILYMEANS, OUR COMMUNITY KITCHEN, PORTICO HEALTHNET, PROJECT LIFE, ST. CROIX VALLEY CHAPLAINCY, TREE HOUSE, VALLEY OUTREACH FOOD SHELF, YOUNGLIFE, YOUTH ADVANTAGE AND YOUTH SERVICE BUREAU. STILLWATER AREA SCHOOLS WELLNESS PROGRAM AND CENTER OPERATES AT THE LARGEST HIGH SCHOOL IN THE SERVICE AREA. THE WELLNESS CENTER IS A PHYSICAL SPACE IN THE HIGH SCHOOL IN COLLABORATION WITH FAMILYMEANS, YOUTH SERVICE BUREAU, THE HOSPITAL'S POWERUP INITIATIVE, LAKEVIEW HEALTH SYSTEM AND INDEPENDENT SCHOOL DISTRICT 834. THIS COLLABORATION PROVIDES SERVICES TO YOUTH AT LOW TO NO-COST FOR MENTAL HEALTH, CHEMICAL HEALTH AND NUTRITION ISSUES. THE WELLNESS CENTER PROGRAM REACHED 4,490 CONTACTS FOR CHEMICAL AND MENTAL HEALTH (2,469 STUDENTS, 1,340 STAFF AND 681 PARENT CONTACTS). NUTRITION COUNSELING WAS PROVIDED TO MORE THAN 100 STUDENTS, INCLUDING THE ALTERNATIVE LEARNING CENTER AND FEDERAL FOUR PROGRAM STUDENTS. IN ADDITION, REGISTERED DIETITIANS DID OUTREACH AND EDUCATION THROUGH PRESENTATIONS, CLASSES, HEALTH CLASSES, HEALTH FAIRS AND TO COACHES REACHING MORE THAN 2,000 PEOPLE. 4. FINANCIAL CONTRIBUTIONS: TO ADDRESS HEALTH CARE ACCESS FOR UNINSURED AND UNDER-INSURED PATIENTS, THE HOSPITAL PROVIDES FUNDING TO PORTICO HEALTHNET (PORTICO). PORTICO IS A NONPROFIT ORGANIZATION THAT HELPED 228 PEOPLE IN 2015 ENROLL IN FREE OR LOW-COST HEALTH COVERAGE PROGRAMS. IN ADDITION, THE FOLLOWING ORGANIZATIONS AND PROGRAMS WERE SUPPORTED FOR OVERALL COMMUNITY BENEFIT: AMERICAN CANCER SOCIETY, AMERICAN DIABETES ASSOCIATION, AMERY REGIONAL MEDICAL CENTER FOUNDATION, BREAST CANCER AWARENESS, CAMP ODAYIN, CHURCH OF ST. MARY, COURAGE CENTER SCV, EAST SUBURBAN RESOURCES, FAMILYMEANS, GLOBAL HEALTH MINISTRIES, GOOD SAMARITAN SOCIETY STILLWATER, HOPE HOUSE, MAHTOMEDI AREA EDUCATION FOUNDATION, MINNESOTA ORGANIZATION FOR FETAL ALCOHOL SYNDROME, MINNESOTA HOSPITAL ASSOCIATION, NORTHERN STAR COUNCIL BSA, PARTNERSHIP PLAN, RED CROSS, REGIONS HOSPITAL FOUNDATION, STILLWATER SUNRISE ROTARY, ST. ANNE'S CATHOLIC SCHOOL, STILLWATER HIGH SCHOOL, ST. CROIX COUNTY HEALTHIER TOGETHER, UNITED WAY WASHINGTON COUNTY EAST, VALLEY CHAMBER CHORALE, AND YOUNG LIFE . -THE HOSPITAL'S CASH DONATIONS TO OTHER TAX-EXEMPT COMMUNITY ORGANIZATIONS IN THE FORM OF SPONSORSHIPS OR CONTRIBUTIONS TOTALED $163,128. 5. COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL PROVIDES LEADERSHIP AND PARTICIPATES IN A NUMBER OF STRATEGIC COMMUNITY COLLABORATIONS AND INITIATIVES, INCLUDING: - CHAT (COMMUNITY HEALTH ACTION TEAM): CONVENES NONPROFIT AND COMMUNITY LEADERS ON A MONTHLY BASIS TO COLLABORATE ON ADDRESSING PRIORITY COMMUNITY HEALTH NEEDS. - CONNECT: COLLABORATIVE MISSION IS TO PREVENT AND REDUCE YOUTH ALCOHOL, TOBACCO AND OTHER DRUG USE THROUGH PARTNERSHIP, EDUCATION, INTERVENTION AND COMMUNITY CHANGE. - WASHINGTON COUNTY COMMUNITY LEADERSHIP TEAM (CLT): THE HOSPITAL COLLABORATES ON BOTH TOBACCO CESSATION AND OBESITY INITIATIVES. - HEALTHIER TOGETHER: FOCUSED ON A NUMBER OF HEALTH PRIORITIES, INCLUDING ALCOHOL AND SUBSTANCE ABUSE, IN ST. CROIX COUNTY, WI. - THE HOSPITAL PARTICIPATED IN COMMUNITY-BUILDING ACTIVITIES THAT SUPPORTED ECONOMIC DEVELOPMENT, EMERGENCY PREPAREDNESS, LEADERSHIP DEVELOPMENT, COALITION BUILDING, HEALTH IMPROVEMENT ADVOCACY AND WORKFORCE DEVELOPMENT. - THE HOSPITAL COLLECTED 169,500 POUNDS OF RECYCLING FOR A COST SAVINGS OF $3,173. - THE HOSPITAL PARTICIPATES IN A PROGRAM WHERE FOOD WASTE FROM THE CAFETERIA IS SAVED IN BARRELS AND PICKED UP BY AN AREA FARMER WHO FEEDS THE SCRAPS TO PIG LIVESTOCK. THIS HELPS THE ENVIRONMENT BY REDUCING WASTE, AND ALSO REDUCES THE TAXES THE HOSPITAL PAYS ON GARBAGE BASED ON WEIGHT. IN 2015, 50,000 POUNDS OF FOOD WASTE WAS DIVERTED FROM THE LANDFILL AT A TAX SAVINGS OF $2,209. - THE COMMUNITY PHARMACY GATHERED 75 LBS. OF MEDICATIONS FOR DISPOSAL IN 2015. - THE HOSPITAL INPATIENT/OUTPATIENT PHARMACY GATHERED 100 LBS. OF MEDICATIONS FOR DISPOSAL IN 2015. - EQUIPMENT AND SUPPLY DONATIONS TO MISSIONS AND CHARITIES TOTALED $6,500 IN 2015. - CONTINUED SUPPORT FOR THE ST. CROIX VALLEY PARISH NURSE PROGRAM, WHICH IS A HEALTH CARE MINISTRY PROVIDING PHYSICAL, EMOTIONAL AND SPIRITUAL CARE FOR INDIVIDUALS, FAMILIES AND COMMUNITIES SERVED BY LOCAL CONGREGATIONS. THE PARISH NURSE PROMOTES A GREATER UNDERSTANDING OF HEALTH-RELATED ISSUES AND ADDRESSES THESE CONCERNS THROUGH INFORMATION AND EDUCATION. IN 2015, THEY PROVIDED 3,300 1:1 CONTACTS, 1,471 GROUP CONTACTS, AND MORE THAN 620 REFERRALS TO CHURCH AND COMMUNITY RESOURCES BRIDGING PEOPLE TO THE WHOLE PERSON CARE, SERVICES AND SUPPORT THEY NEED FOR HEALING AND GREATER WELL-BEING. THE ST. CROIX VALLEY PARISH NURSES SERVED 744 CONTACTS WITH NEW CLIENTS AND 2,349 FOLLOW-UP CONTACTS IN NINE PARISHES THROUGHOUT THE ST. CROIX VALLEY. - NURSES SEE CLIENTS FOR VARIOUS, AND OFTEN MULTIPLE, ISSUES. THE PRIMARY ISSUES ADDRESSED ARE: PHYSICAL HEALTH (30% OF CONTACTS), EMOTIONAL HEALTH (25% OF CONTACTS), SPIRITUAL (20% OF CONTACTS) AND SAFETY (10% OF CONTACTS). NURSES CONNECT CLIENTS TO CHURCH AND COMMUNITY RESOURCES TO HELP SUPPORT THEM IN MULTIPLE WAYS. - SUPPORTED THE PRESCRIPTION ASSISTANCE PROGRAM. A STAFF MEMBER AT THE HOSPITAL, FUNDED BY THE FOUNDATION, ASSISTS PATIENTS WHO HAVE DIFFICULTY AFFORDING THEIR MEDICATIONS. IN 2015, THE PROGRAM PROVIDED ASSISTANCE FOR 296 QUALIFIED CLINIC PATIENTS WHO ARE COPING WITH CHRONIC DISEASES, TO HELP THEM GET FREE AND/OR REDUCED-COST MEDICATIONS. |
| FORM 990, PART III, LINE 4A | 6. COMMUNITY BENEFIT OPERATIONS: THE HOSPITAL STAFF TIME TO COLLECT, ANALYZE AND REPORT COMMUNITY BENEFITS FOR 2015 WAS APPROXIMATELY 80 HOURS. COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA); PLEASE REFER TO THE SCHEDULE H NARRATIVE IN THIS 990 REPORT. THE NET 2015 COMMUNITY BENEFIT CONTRIBUTION EQUALED $8,277,177 OR 8.9% OF TOTAL EXPENSES. THIS FIGURE IS REPORTED AT COST PER THE CATHOLIC HEALTH ASSOCIATION (CHA) COMMUNITY BENEFIT REPORTING GUIDELINES. 7. ORGANIZATION AWARDS AND ACHIEVEMENTS: - RECOGNIZED BY THE MINNESOTA HOSPITAL ASSOCIATION FOR ITS COMMITMENT TO PATIENT SAFETY THROUGH ITS PARTICIPATION IN THE THREE-YEAR PARTNERSHIP FOR PATIENTS HOSPITAL ENGAGEMENT NETWORK INITIATIVE. (2014) - INFLUENZA VACCINATION FOR HEALTH CARE WORKERS - THE HOSPITAL ACHIEVED FLU SAFE STATUS BY THE MINNESOTA DEPARTMENT OF HEALTH WITH A RATE OF 84% VACCINATIONS. THE CAMPAIGN INCLUDED EMPLOYEES, CONTRACTED WORKERS, LICENSED PROVIDERS (LIP), STUDENTS AND VOLUNTEERS. - PATIENT SATISFACTION SCORES - THE HOSPITAL CONTINUES TO PERFORM IN THE TOP DECILE FOR PATIENT EXPERIENCE. (SOURCE - NRC PICKER) - RECIPIENT OF A 2015 GREENHEALTH PARTNER FOR CHANGE AWARD BY PRACTICE GREENHEALTH FOR SIGNIFICANT ACHIEVEMENT IN SUSTAINABILITY - THE HOSPITAL WAS DESIGNATED BY THE MINNESOTA DEPARTMENT OF HEALTH AS A STROKE READY HOSPITAL - THE HOSPITAL ACHIEVED 2015 AND 2016 LEADER IN LGBT HEALTHCARE EQUALITY STATUS BY THE NATIONAL LGBT HEALTHCARE EQUALITY INDEX, HUMAN RIGHTS CAMPAIGN FOUNDATION - THE JOINT COMMISSION RECOGNITION OF THE HOSPITAL AS A TOP PERFORMER ON KEY QUALITY MEASURES (PNEUMONIA, SURGICAL CARE, VTE) - THE HOSPITAL RECEIVED THE HEALTHGRADES OUTSTANDING PATIENT EXPERIENCE AWARD - THE HOSPITAL RECEIVED THE "PATRIOTIC EMPLOYER" AWARD AND HONOR ON NOVEMBER 9, 2015 FROM THE OFFICE OF SECRETARY OF DEFENSE IN RECOGNITION OF OUR SUPPORT OF EMPLOYEE PARTICIPATION IN NATIONAL GUARD AND RESERVE FORCE - THE HOSPITAL WAS NAMED A FIVE-STAR HOSPITAL BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) (2015). ONLY 250 HOSPITALS OUT OF THE 3500 MEDICARE-CERTIFIED ACUTE READY HOSPITALS IN THE U.S. WERE AWARDED THIS DESIGNATION. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER IS SHS. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE MEMBER RATIFIES THE PERSONS ELECTED TO THE HOSPITAL BOARD, AT LEAST 75% OF WHOM MUST BE COMMUNITY LEADERS. THE CHIEF EXECUTIVE OFFICER OF THE SOLE MEMBER SERVES AS AN EX OFFICIO NON-VOTING HOSPITAL BOARD MEMBER. ADDITIONALLY, HEALTHPARTNERS AS THE SOLE MEMBER OF SHS APPOINTS ONE PERSON TO THE HOSPITAL BOARD. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE SOLE MEMBER HAS CUSTOMARY POWERS INCLUDING APPROVAL OF HIGHLY SIGNIFICANT ACTIONS OF THE HOSPITAL'S BOARD OF DIRECTORS. THESE INCLUDE AMENDMENT OF THE GOVERNING DOCUMENTS; APPROVAL OF STRATEGIC PLANS AND ANNUAL BUDGETS; MERGER, CONSOLIDATION OR SUBSTANTIAL AFFILIATION WITH ANOTHER ENTITY; APPOINTMENT OF THE PRESIDENT OF THE HOSPITAL; AND INCURRENCE OF DEBT. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE HOSPITAL'S 990 RETURN HAS A COMPREHENSIVE REVIEW PROCESS THAT IS FOLLOWED BEFORE IT IS PRESENTED TO THE GOVERNING BODY OF THE HOSPITAL. THE REVIEW PROCESS INCLUDES A LAYERED REVIEW BY THE TAX DEPARTMENT OF GROUP HEALTH PLAN, INC. (GHI), THE MANAGEMENT TEAM OF THE HOSPITAL, GHI'S INTERNAL LEGAL DEPARTMENT AND THE HOSPITAL'S OUTSIDE INDEPENDENT ACCOUNTANTS. EACH ONE OF THOSE AREAS HAS AN OPPORTUNITY TO REVIEW, ASK QUESTIONS AND MAKE COMMENTS BACK TO THE TAX DEPARTMENT OF GHI BEFORE THE FORM 990 IS COMPLETED AND PRESENTED TO THE GOVERNING BODY OF THE HOSPITAL. THE HOSPITAL MAKES AVAILABLE TO THE GOVERNING BODY (BOARD OF DIRECTORS) A COPY OF THE 990 FOR REVIEW AND COMMENT PRIOR TO THE FILING OF THE 990 RETURN. THIS COPY WILL BE PROVIDED IN A MAILING TO THE BOARD MEMBERS PRIOR TO THE FILING OF THE 990. EACH BOARD MEMBER WILL HAVE AN OPPORTUNITY TO COMMENT OR ASK QUESTIONS ABOUT THE 990 BEFORE IT IS FILED. THIS PROCESS WILL BE NOTED AND DOCUMENTED IN A WRITTEN MEMO IN THE FILES OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE HOSPITAL BOARD OF DIRECTORS MONITORS POTENTIAL CONFLICTS OF INTEREST OF ITS BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES, BY MAINTAINING A CONFLICT OF INTEREST POLICY. ANNUALLY, UNDER THE POLICY, ALL BOARD MEMBERS, PRINCIPAL OFFICERS, MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS AND KEY EMPLOYEES ARE PROVIDED WITH A COPY OF THE POLICY AND REQUESTED TO COMPLETE A QUESTIONNAIRE IDENTIFYING ANY POTENTIAL CONFLICTS OF INTERESTS. A REPORT OF THESE POTENTIAL CONFLICTS IS SHARED WITH THE GOVERNANCE COMMITTEE, THE CHAIR AND THE CEO. BOARD AGENDAS AND EXECUTIVE DECISIONS ARE DOCUMENTED IN RELATION TO THIS POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION (HOSPITAL) PRESIDENT AND ITS OFFICERS ARE EMPLOYED BY GROUP HEALTH PLAN, INC. (GHI), OR BY STILLWATER HEALTH SYSTEM (SHS), BOTH OF WHICH ARE RELATED ORGANIZATIONS OR BY THE HOSPITAL. GHI, SHS AND THE HOSPITAL HAVE AN ANNUAL PROCESS TO REVIEW THE MARKET COMPARABILITY OF THE TOTAL COMPENSATION OF THE HOSPITAL'S PRESIDENT AND OTHER OFFICERS. EVERY THREE YEARS, THE INDEPENDENT COMPENSATION COMMITTEE OF THE GHI BOARD OF DIRECTORS (THE "COMMITTEE"), RETAINS AN EXTERNAL COMPENSATION EXPERT TO CONDUCT AN EXTENSIVE MARKET COMPARABILITY REVIEW FOR ALL OFFICERS OF THE ORGANIZATION. THE REVIEW INCLUDES ALL COMPONENTS OF TOTAL COMPENSATION: BASE SALARY, ANNUAL INCENTIVES, BENEFITS AND PERQUISITES. THE MARKET SURVEY RESULTS ARE PRESENTED TO, REVIEWED BY AND APPROVED BY THE APPROPRIATE COMMITTEE. BASED ON THIS DATA, EITHER THE COMPENSATION COMMITTEE OF THE SHS OR THE COMPENSATION COMMITTEE OF GHI (THE "COMMITTEES") DETERMINE MINIMUM AND MAXIMUM TOTAL COMPENSATION RANGES ARE DETERMINED FOR EACH EMPLOYED OFFICER. IN INTERIM YEARS, GHI'S HUMAN RESOURCES STAFF, UNDER THE COMMITTEES' DIRECTION, UPDATES CHANGES IN THE SALARY STRUCTURE BASED ON THE SAME INDEPENDENT STUDIES PERFORMED BY THE COMPENSATION CONSULTANT FOR THE COMMITTEE. FOR CERTAIN POSITIONS FULL INDEPENDENT REVIEWS ARE PERFORMED TO SET SALARY RANGES BASED ON THE COMPETITIVE MARKET DATA SPECIFIC TO THOSE POSITIONS. THE COMMITTEES REVIEW AND APPROVE EACH YEAR'S COMPENSATION RESULTS. IN ALL CASES, THE COMMITTEES' MEMBERS COMPLETE AN ANNUAL CONFLICT OF INTEREST SURVEY TO ASSURE THE COMMITTEES MEMBERS' INDEPENDENCE AND THIS IS UPDATED AT ANY MEETING AT WHICH DECISIONS ARE BEING MADE. STAFF (OTHER THAN THE SECRETARY TO THE BOARD) IS NOT IN THE ROOM DURING DELIBERATIONS OR VOTE INCLUDING EXECUTIVE SESSIONS, AND CONTEMPORANEOUS MINUTES ARE KEPT. WITH THE HOSPITAL'S BOARD OF DIRECTORS INPUT, THE GHI EVP AND CHIEF ADMINISTRATIVE OFFICER CONDUCTS THE ANNUAL PERFORMANCE REVIEW AND, WITH THE COMPENSATION COMMITTEE OF THE SHS'S APPROVAL, DETERMINES THE COMPENSATION OF THE HOSPITAL PRESIDENT. THE HOSPITAL BOARD HAS DELEGATED TO THE PRESIDENT THE ACCOUNTABILITY TO CONDUCT ANNUAL PERFORMANCE REVIEWS AND DETERMINE THE COMPENSATION OF ALL HOSPITAL-EMPLOYED OFFICERS WITHIN THE COMPENSATION RANGES DETERMINED BY THE COMMITTEE. ANY EXCEPTIONS TO COMPENSATION IN EXCESS OF THE APPROVED RANGES ARE APPROVED BY THE COMPENSATION COMMITTEE OF THE SHS. TOTAL COMPENSATION IS APPROPRIATELY DOCUMENTED ON THE FORM 990 AND ON THE EMPLOYEE'S W-2. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE HOSPITAL'S FINANCIAL STATEMENTS AND 990 RETURNS ARE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION FROM THE HOSPITAL OR HEALTHPARTNERS. THE HOSPITAL'S ARTICLES OF INCORPORATION ARE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION THROUGH THE MINNESOTA SECRETARY OF STATE'S OFFICE. |
| 990, PART VII, SECT A, LN 1A, COL B: AVERAGE HOURS - RELATED ORGANIZATION | AVERAGE WEEKLY HOURS: THE COMPENSATED BOARD MEMBERS AND OFFICERS OF THE HOSPITAL ARE EMPLOYED AND COMPENSATED BY THE HOSPITAL, GHI OR PARK NICOLLET. THE COMPENSATED BOARD MEMBERS AND OFFICERS DEVOTE THEIR TIME TO MULTIPLE RELATED ORGANIZATIONS. REPORTED AVERAGE HOURS WORKED ARE BASED ON THEIR TOTAL COMPENSATION FROM ALL RELATED ORGANIZATIONS. |
| FORM 990, PART XI, LINE 9: | TRANSFER TO AFFILIATE - LAKEVIEW MEMORIAL HOSPITAL FOUNDATION -644,936. TRANSFER TO AFFILIATE - STILLWATER MEDICAL GROUP -3,857,764. CHANGE IN PENSION LIABILITY VALUATION 1,613,456. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (28 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| HEALTHPARTNERS INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411693838 | HYBRID STAFF MODEL/NETWORK MODEL HEALTH MAINTENANCE ORGANIZATION | MN | 501(C)(4) | N/A | 0 | ||
| HPI - RAMSEY | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411793333 | CORPORATE PLANNING AND OVERSIGHT | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | HEALTHPARTNERS INC | |
| GROUP HEALTH PLAN INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 410797853 | STAFF MODEL HEALTH MAINTENANCE ORGANIZATION | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | HEALTHPARTNERS INC | |
| HEALTHPARTNERS INSTITUTE FOR EDUCATION AND RESEARCH | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411670163 | HEALTHCARE EDUCATION & RESEARCH | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | HEALTHPARTNERS INC | |
| CAPITOL VIEW TRANSITIONAL CARE CENTER | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 412011453 | POST HOSPITALIZATION PATIENT CARE | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | HPI - RAMSEY | |
| REGIONS HOSPITAL | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 410956618 | HOSPITAL | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | HPI - RAMSEY | |
| REGIONS HOSPITAL FOUNDATION | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411888902 | PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT | MN | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | HPI - RAMSEY | |
| RHSC INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411891928 | HEALTHCARE STAFFING | MN | 501(C)(3) | 0 | 509(A)(3) TYPE II | HEALTHPARTNERS INC | |
| RH-WISCONSIN | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 202287016 | CORPORATE PLANNING AND OVERSIGHT | WI | 501(C)(3) | 0 | 509(A)(3) TYPE I1 | HPI - RAMSEY | |
| PHYSICIANS NECK AND BACK CLINICS | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 270684883 | SPECIALTY PATIENT CARE | MN | 501(C)(3) | 0 | 509(A)(3) TYPE II | GROUP HEALTH PLAN INC | |
| HUDSON HOSPITAL INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 390804125 | HOSPITAL | WI | 501(C)(3) | 0 | 170(B)(1) (A)(III) | RH-WISCONSIN & GROUP HEALTH PLAN INC | |
| HUDSON HOSPITAL FOUNDATION INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 391279567 | PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT | WI | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | HUDSON HOSPITAL INC | |
| WESTERN WISCONSIN EMERGENCY MEDICAL SERVICES COMPANY | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 263616590 | PROVIDE MEDICAL TRANSPORT SERVICES | WI | 501(C)(3) | 0 | 509(A)(3) TYPE II | RH-WISCONSIN | |
| LAKEVIEW MEMORIAL HOSPITAL FOUNDATION | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411386635 | PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT | MN | 501(C)(3) | 0 | 509(A)(3) TYPE II | STILLWATER HEALTH SYSTEM | |
| STILLWATER MEDICAL GROUP | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 830379473 | PHYSICIANS GROUP | MN | 501(C)(3) | 0 | 509(A)(2) | STILLWATER HEALTH SYSTEM | |
| STILLWATER HEALTH SYSTEM | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 300221189 | CORPORATE PLANNING AND OVERSIGHT | MN | 501(C)(3) | 0 | 509(A)(3) TYPE II | HPI - RAMSEY | |
| WESTFIELDS HOSPITAL INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 390808442 | HOSPITAL | WI | 501(C)(3) | 0 | 170(B)(1) (A)(III) | RH-WISCONSIN & GROUP HEALTH PLAN INC | |
| WESTFIELDS HOSPITAL FOUNDATION INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 391770913 | PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT | WI | 501(C)(3) | 0 | 509(A)(3) TYPE I | WESTFIELDS HOSPITAL INC | |
| RAMSEY INTEGRATED HEALTH SERVICES | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411503090 | IN-HOME PATIENT CARE | MN | 501(C)(3) | 0 | 509(A)(2) | HPI - RAMSEY | |
| PARK NICOLLET HEALTH SERVICES | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 363465840 | CORPORATE PLANNING AND OVERSIGHT | MN | 501(C)(3) | 0 | 509(A)(2) | HEALTHPARTNERS INC | |
| PARK NICOLLET FOUNDATION | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 237346465 | GRANTS TO SERVE THE COMMUNITY | MN | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | PARK NICOLLET HEALTH SERVICES | |
| PARK NICOLLET METHODIST HOSPITAL | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 410132080 | HOSPITAL | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | PARK NICOLLET HEALTH SERVICES | |
| PARK NICOLLET INSTITUTE | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 410961862 | HEALTHCARE RESEARCH | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | PARK NICOLLET HEALTH SERVICES | |
| PARK NICOLLET HEALTH CARE PRODUCTS | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 010638901 | HEALTHCARE PRODUCTS | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | PARK NICOLLET HEALTH SERVICES | |
| PARK NICOLLET CLINIC | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 410834920 | HEALTHCARE | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | PARK NICOLLET HEALTH SERVICES | |
| PNMC HOLDINGS | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 411741792 | HEALTHCARE REAL ESTATE | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | PARK NICOLLET CLINIC | |
| AMERY REGIONAL MEDICAL CENTER INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 390908320 | HOSPITAL | WI | 501(C)(3) | 0 | 170(B)(1) (A)(III) | RH-WISCONSIN | |
| AMERY REGIONAL MEDICAL CENTER FOUNDATION INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 391726539 | PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT | WI | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | AMERY REGIONAL MEDICAL CENTER INC & GROUP HEALTH PLAN INC | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| HEALTHPARTNERS ADMINISTRATORS INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411629390 | THIRD PARTY ADMINISTRATOR | MN | HEALTHPARTNERS INC | C | 0 |
| HEALTHPARTNERS ASSOCIATES INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 522365151 | MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 0 |
| HEALTHPARTNERS SERVICES INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411683568 | MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 0 |
| HEALTHPARTNERS INSURANCE COMPANY | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411683523 | MEDICAL AND DENTAL INSURANCE | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 0 |
| DENTAL SPECIALTIES INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 451297583 | PROFESSIONAL DENTAL SERVICES | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 0 |
| HEALTHPARTNERS CENTRAL MINNESOTA CLINICS INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411236798 | MEDICAL CLINIC STAFFING | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 0 |
| PARK NICOLLET ENTERPRISES | |||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 411656735 | REAL ESTATE FOR RELATED ORGANIZATIONS | MN | PARK NICOLLET HEALTH SERVICES | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | 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 | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | 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 | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTHPARTNERS INC - CLAIMSHEALTHCARE SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | L | TransactionTypeTxt |
| Involved | $4,009,809 | InvolvedAmt |
| Method Of Amount Determination | CASH AMOUNT | MethodOfAmountDeterminationTxt |