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LAKEWOOD HEALTH SYSTEM: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
LAKEWOOD HEALTH SYSTEM (EIN 41-1842965)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-11-12
IRS object ID
201413169349301956
Schema version
2013v3.0
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2014-11-12T09:42:10-06:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390758449PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line17601 FRANCE AVENUE SOUTH SUITE 400AddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55435ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN411842965EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LAKEWOOD HEALTH SYSTEMBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlLAKEBusinessNameControlTxt
Phone2188941515PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line149725 COUNTY 83AddressLine1
CitySTAPLESCity
StateMNState
ZIP Code56479ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJIM DREGNEYPersonNm
Person TitleCHIEF FINANCIAL OFFICERPersonTitleTxt
Phone2188941515PhoneNum
Signature2014-11-05SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTIM A RITTER CPAPreparerPersonNm
PTINP00732856PTIN
Phone9525483400PhoneNum
Preparation2014-11-05PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJIM DREGNEYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line149725 COUNTY 83AddressLine1
CitySTAPLESCity
StateMNState
ZIP Code56479ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$95,912,161GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.LAKEWOODHEALTHSYSTEM.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1996FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionTO PROVIDE PERSONALIZED HEALTHCARE FOR A LIFETIME.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee1054TotalEmployeeCnt
Total Volunteers150TotalVolunteersCnt
Total Gross UBI$23,990TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$291,186PYContributionsGrantsAmt
CY Contributions Grants$438,626CYContributionsGrantsAmt
PY Program Service Revenue$91,137,423PYProgramServiceRevenueAmt
CY Program Service Revenue$92,778,803CYProgramServiceRevenueAmt
PY Investment Income$19,310PYInvestmentIncomeAmt
CY Investment Income$394,642CYInvestmentIncomeAmt
PY Other Revenue$782,839PYOtherRevenueAmt
CY Other Revenue$2,009,398CYOtherRevenueAmt
PY Total Revenue$92,230,758PYTotalRevenueAmt
CY Total Revenue$95,621,469CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$47,975,460PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$49,193,428CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$111,467CYTotalFundraisingExpenseAmt
PY Other Expenses$40,673,909PYOtherExpensesAmt
CY Other Expenses$44,670,808CYOtherExpensesAmt
PY Total Expenses$88,649,369PYTotalExpensesAmt
CY Total Expenses$93,864,236CYTotalExpensesAmt
PY Revenues Less Expenses$3,581,389PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,757,233CYRevenuesLessExpensesAmt
Total Assets BOY$85,105,756TotalAssetsBOYAmt
Total Assets EOY$83,151,564TotalAssetsEOYAmt
Total Liabilities BOY$53,013,599TotalLiabilitiesBOYAmt
Total Liabilities EOY$49,338,462TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$32,092,157NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$33,813,102NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE MISSION OF LAKEWOOD HEALTH SYSTEM IS TO PROVIDE PERSONALIZED HEALTHCARE FOR A LIFETIME.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$67,176,482ExpenseAmt
Grant$0GrantAmt
Revenue$80,919,804RevenueAmt
DescHOSPITAL AND CLINICS -LAKEWOOD HEALTH SYSTEM(THE ORGANIZATION) OPERATES A 25-BED CRITICAL ACCESS HOSPITAL PROVIDING INPATIENT, OUTPATIENT, EMERGENCY, AND OTHER SPECIALTY HEALTH CARE SERVICES, INCLUDING A 10-BED MENTAL HEALTH UNIT IN STAPLES, MINNESOTA. THE ORGANIZATION ALSO OPERATES CLINICS LOCATED IN STAPLES, MOTLEY, PILLAGER, EAGLE BEND, AND BROWERVILLE, MINNESOTA. PHYSICIANS, PHYSICIAN'S ASSISTANTS, AND NURSE PRACTITIONERS PROVIDE CLINIC PATIENTS WITH PRIMARY CARE AND OTHER HEALTH CARE SERVICES.THE ORGANIZATION PROVIDED FOR 4,296 INPATIENT HOSPITAL AND SWING-BED DAYS, 3,163 INPATIENT GERIATRIC BEHAVIORAL HEALTH UNIT DAYS, 61,179 MEDICAL AND MENTAL HEALTH RURAL HEALTH CLINIC VISITS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$6,391,967ExpenseAmt
Grant$0GrantAmt
Revenue$13,179,281RevenueAmt
DescSENIOR SERVICES - THE ORGANIZATION OPERATES A 100-BED, MEDICARE-CERTIFIED SKILLED NURSING FACILITY IN STAPLES, MINNESOTA, THAT PROVIDES LONG-TERM AND REHABILITATIVE CARE TO RESIDENTS. IN ADDITION TO SKILLED NURSING CARE, THE ORGANIZATION ALSO OPERATES HOME HEALTH CARE AND HOSPICE PROGRAMS TO PROVIDE NURSING CARE AND ASSISTANCE AT THE PATIENT'S RESIDENCE. ASSISTED LIVING AND INDEPENDENT LIVING FACILITIES OPERATED BY THE ORGANIZATION, LOCATED IN STAPLES, MINNESOTA, PROVIDE COMBINATIONS OF HEALTH-RELATED AND SUPPORTIVE SERVICES FOR TENANTS. THE ORGANIZATION PROVIDED FOR 35,398 RESIDENT DAYS IN THE NURSING HOME, 666 ASSISTED LIVING UNIT RENTED MONTHS.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$73,568,449TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document83IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee1054EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JIM DREGNEY CHIEF FINANCIAL OFFICERBusinessNameLine1
FieldValueIRS element (for citing)
Phone2188941515PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line149725 COUNTY 83AddressLine1
CitySTAPLESCity
StateMNState
ZIP Code56479ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
CHRISTINE ALBRECHT MD
BOARD MEMBER1.00Yes (X)$0$0$0
JULIE BENSON MD
BOARD MEMBER1.00Yes (X)$0$0$0
BARB PETERSON
BOARD MEMBER1.00Yes (X)$0$0$0
CAROLYN BISEL
BOARD MEMBER1.00Yes (X)$0$0$0
WILLIAM MENNIS MD
BOARD MEMBER1.00Yes (X)$0$0$0
MARIE ROSE
BOARD MEMBER (THRU JUNE)1.00Yes (X)$0$0$0
RON STORBAKKEN
BOARD MEMBER1.00Yes (X)$0$0$0
PAUL WICK
BOARD MEMBER1.00Yes (X)$0$0$0
LOREN MOREY
CHAIRMAN1.00Yes (X)$0$0$0Yes (X)
JIM HOFER
VICE-CHAIRMAN1.00Yes (X)$0$0$0Yes (X)
SARAH ISRAELSON MD
SECRETARY1.00Yes (X)$0$0$0Yes (X)
LARRY LUNDBLAD
TREASURER1.00Yes (X)$0$0$0Yes (X)
TIM RICE
PRESIDENT40.00Yes (X)$370,747$0$44,092Yes (X)
JAMES DREGNEY
CHIEF FINANCIAL OFFICER40.00$200,764$0$37,865Yes (X)
CRAIG WOLHOWE
DIVISION DIRECTOR40.00$192,102$0$40,229Yes (X)
DANIEL DONAHUE
DIVISION DIRECTOR40.00$189,635$0$38,142Yes (X)
LAURIE BACH
DIVISION DIRECTOR40.00$225,810$0$16,876Yes (X)
LYNN NEWTON RICE
DIVISION DIRECTOR40.00$193,173$0$13,257Yes (X)
JEFFREY D OSEGARD
DIVISION DIRECTOR40.00$151,120$0$34,661Yes (X)
ROBERT SCHMIEG
DIRECTOR ANESTHESIA, CRNA40.00$320,427$0$27,389Yes (X)
SHERREE ENGEN
ANESTHETIST40.00$268,377$0$37,178Yes (X)
REBECCA LYNN BENNETT
PHYSICIAN ASSISTANT40.00$156,094$0$37,432Yes (X)
AMY LYNN WINKELS
PHYSICIAN ASSISTANT40.00$154,935$0$34,543Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,423,184TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$361,664TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K40IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
LAKEWOOD CLINIC PA
49725 COUNTY 83STAPLESMN56479PHYSICIAN SERVICES$10,705,193
WEATHERBY LOCUMS INC
PO BOX 972633DALLASTX75397LOCUM COVERAGE$689,887
CENTRAL MINNESOTA DIAGNOSTIC INC
PO BOX 158MILICAMN56353MRI & CT SERVICES$584,850
QUEST DIAGNOSTICS
12989 COLLECTION CENTER DRIVECHICAGOIL60693LAB TEST SERVICES$465,497
STATE COLLECTION SERVICE INC
PO BOX 6250MADISONWI53716COLLECTION SERVICES$420,568
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K23CntrctRcvdGreaterThan100KCnt
Fundraising$62,831FundraisingAmt
Government Grants$157,067GovernmentGrantsAmt
All Other Contributions$218,728AllOtherContributionsAmt
Total Contributions$438,626TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT AND RESIDENT SERVICE621110$91,480,165$91,480,165
OCCUPATIONAL HEALTH621300$439,228$439,228
RENT REVENUE531120$238,178$238,178
PHARMACY621300$235,540$235,540
OTHER SERVICE REVENUE621110$117,908$117,908

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$267,784TotalRevenueColumnAmt
Related Or Exempt Func Income$267,784RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$92,778,803TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$378,932TotalRevenueColumnAmt
Unrelated Business Revenue$23,990UnrelatedBusinessRevenueAmt
Exclusion$354,942ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$268,318OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$252,608OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$15,710OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$15,710TotalRevenueColumnAmt
Exclusion$15,710ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$25,187FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$62,831ContriRptFundraisingEventAmt
Fundraising Direct Expenses$38,084FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$12,897TotalRevenueColumnAmt
Exclusion-$12,897ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
EHR INCENTIVE900099$1,320,282$1,320,282
FOOD SERVICE900099$691,961$691,961

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$10,052TotalRevenueColumnAmt
Exclusion$10,052ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,022,295OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$95,621,469TotalRevenueColumnAmt
Related Or Exempt Func Income$94,099,085RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$23,990UnrelatedBusinessRevenueAmt
Exclusion$1,059,768ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,505,788TotalAmt
Management And General$1,505,788ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$35,814,990TotalAmt
Program Services$26,402,716ProgramServicesAmt
Management And General$9,392,642ManagementAndGeneralAmt
Fundraising$19,632FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$51,858TotalAmt
Program Services$40,280ProgramServicesAmt
Management And General$11,550ManagementAndGeneralAmt
Fundraising$28FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$9,186,666TotalAmt
Program Services$7,040,124ProgramServicesAmt
Management And General$2,141,507ManagementAndGeneralAmt
Fundraising$5,035FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,634,126TotalAmt
Program Services$2,045,994ProgramServicesAmt
Management And General$586,688ManagementAndGeneralAmt
Fundraising$1,444FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$123,240TotalAmt
Management And General$123,240ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$47,704TotalAmt
Management And General$47,704ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$8,692,135TotalAmt
Program Services$8,621,211ProgramServicesAmt
Management And General$51,665ManagementAndGeneralAmt
Fundraising$19,259FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$228,815TotalAmt
Program Services$177,571ProgramServicesAmt
Management And General$50,963ManagementAndGeneralAmt
Fundraising$281FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$10,193,963TotalAmt
Program Services$7,910,964ProgramServicesAmt
Management And General$2,270,460ManagementAndGeneralAmt
Fundraising$12,539FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$12,063TotalAmt
Program Services$9,361ProgramServicesAmt
Management And General$2,687ManagementAndGeneralAmt
Fundraising$15FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,591,199TotalAmt
Program Services$2,010,885ProgramServicesAmt
Management And General$577,127ManagementAndGeneralAmt
Fundraising$3,187FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$497,670TotalAmt
Program Services$386,214ProgramServicesAmt
Management And General$110,844ManagementAndGeneralAmt
Fundraising$612FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$35,818TotalAmt
Program Services$27,796ProgramServicesAmt
Management And General$7,978ManagementAndGeneralAmt
Fundraising$44FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,972,937TotalAmt
Program Services$1,531,086ProgramServicesAmt
Management And General$439,424ManagementAndGeneralAmt
Fundraising$2,427FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$5,321,651TotalAmt
Program Services$4,871,416ProgramServicesAmt
Management And General$443,689ManagementAndGeneralAmt
Fundraising$6,546FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$274,163TotalAmt
Management And General$274,163ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL FEES$8,439,658$8,439,658
PROVISION FOR BAD DEBTS$3,240,208$3,240,208
MN CARE TAX$1,230,907$67,866$1,163,041
SURCHARGES$862,729$862,729

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$905,948TotalAmt
Program Services$745,099ProgramServicesAmt
Management And General$120,431ManagementAndGeneralAmt
Fundraising$40,418FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$93,864,236TotalAmt
Program Services$73,568,449ProgramServicesAmt
Management And General$20,184,320ManagementAndGeneralAmt
Fundraising$111,467FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$11,117BOYAmt
EOY$10,735EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$4,334,388BOYAmt
EOY$11,471,553EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$20,410,976BOYAmt
EOY$13,799,394EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$1,529,945BOYAmt
EOY$224,858EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,302,882BOYAmt
EOY$1,717,900EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,674,745BOYAmt
EOY$1,878,093EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$87,934,869LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$38,479,098LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$51,751,372BOYAmt
EOY$49,455,771EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$680,129BOYAmt
EOY$580,931EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,410,202BOYAmt
EOY$4,012,329EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$85,105,756BOYAmt
EOY$83,151,564EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$8,631,584BOYAmt
EOY$6,684,059EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$1,939,420EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$38,934,881BOYAmt
EOY$39,653,995EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$33,073BOYAmt
EOY$38,226EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$5,414,061BOYAmt
EOY$1,022,762EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$53,013,599BOYAmt
EOY$49,338,462EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$31,940,899BOYAmt
EOY$33,466,220EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$151,258BOYAmt
EOY$346,882EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$32,092,157BOYAmt
EOY$33,813,102EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$85,105,756BOYAmt
EOY$83,151,564EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$1,757,233ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$36,288OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$1,020OtherActivitiesAmt
Total Lobbying Expenditures$1,020TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION IS A MEMBER OF MINNESOTA HOSPITAL ASSOCIATION AND 3.8% OF THE $26,822 MEMBERSHIP FEE WAS RELATED LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$838,858OtherCostOrOtherBasisAmt
Book Value$838,858BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$33,553,553OtherCostOrOtherBasisAmt
Depreciation$14,526,269DepreciationAmt
Book Value$19,027,284BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$165,063OtherCostOrOtherBasisAmt
Depreciation$35,346DepreciationAmt
Book Value$129,717BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$51,627,885OtherCostOrOtherBasisAmt
Depreciation$23,369,047DepreciationAmt
Book Value$28,258,838BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,749,510OtherCostOrOtherBasisAmt
Depreciation$548,436DepreciationAmt
Book Value$1,201,074BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$49,455,771TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$92,235,103TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$92,235,103RevenueSubtotalAmt
Other Revenues Not Included$3,386,366OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$3,386,366RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$95,621,469TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$90,477,870TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$90,477,870ExpensesSubtotalAmt
Other Expenses Not Included$3,386,366OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$3,386,366ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$93,864,236TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, LINE 2B:THE ORGANIZATION IS THE TRUSTEE OF TENANTS' FUNDS AND HAS FIDUCIARY RESPONSIBILITY FOR THE ADMINISTRATION AND DISTRIBUTION OF THESE FUNDS FOR TENANTS.
PART X, LINE 2:IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE ORGANIZATION DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE ORGANIZATION HAS NOT RECORDED ANY ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS AS OF DECEMBER 31, 2013 AND 2012. THE ORGANIZATION'S FEDERAL RETURNS FOR TAX YEARS 2010 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.
PART XI, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT EXPENSE 3,240,208. LOSS ON REFINANCING OF LONG TERM NOTE 146,158.
PART XII, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT EXPENSE 3,240,208. LOSS ON REFINANCING OF LONG TERM DEBT 146,158.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Name Of Event1DINNER AUCTIONNameOfEvent1Amt
Gross Receipts Event1$21,104GrossReceiptsEvent1Amt
Charitable Contri Event1$6,180CharitableContriEvent1Amt
Gross Revenue Event1$14,924GrossRevenueEvent1Amt
Other Direct Expenses Event1$3,496OtherDirectExpensesEvent1Amt
Name Of Event2GOLF TOURNAMENTNameOfEvent2Amt
Gross Receipts Event2$18,795GrossReceiptsEvent2Amt
Charitable Contri Event2$8,532CharitableContriEvent2Amt
Gross Revenue Event2$10,263GrossRevenueEvent2Amt
Other Direct Expenses Event2$3,622OtherDirectExpensesEvent2Amt
Other Events Total13OtherEventsTotalCnt
Gross Receipts Other Events$48,119GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$48,119CharitableContriOtherEventsAmt
Oth Direct Expnss Other Events$30,966OthDirectExpnssOtherEventsAmt
Gross Receipts Total$88,018GrossReceiptsTotalAmt
Charitable Contributions Tot$62,831CharitableContributionsTotAmt
Gross Revenue Total Events$25,187GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events$38,084OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$38,084DirectExpenseSummaryEventsAmt
Net Income Summary-$12,897NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other75.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other240.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically Indigent0FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically Available0ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,861,278TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,861,278NetCommunityBenefitExpnsAmt
Total Expense0.02050TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$21,470,104TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$19,709,488DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,760,616NetCommunityBenefitExpnsAmt
Total Expense0.01940TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$23,331,382TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$19,709,488DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,621,894NetCommunityBenefitExpnsAmt
Total Expense0.03990TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$227,476TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$227,476NetCommunityBenefitExpnsAmt
Total Expense0.00250TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,270TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$9,270NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,444,949TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,763,192DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,681,757NetCommunityBenefitExpnsAmt
Total Expense0.01860TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,326TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$19,326NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,701,021TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,763,192DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,937,829NetCommunityBenefitExpnsAmt
Total Expense0.02140TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$27,032,403TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$21,472,680DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,559,723NetCommunityBenefitExpnsAmt
Total Expense0.06130TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Persons Served1000PersonsServedCnt
Total Community Benefit Expns$4,674TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,674NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,973TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$7,973NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Persons Served1000PersonsServedCnt
Total Community Benefit Expns$12,647TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$12,647NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$1,979,114BadDebtExpenseAmt
Bad Debt Expense Attributable$760,514BadDebtExpenseAttributableAmt
Reimbursed By Medicare$14,398,438ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$15,577,537CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$1,179,099MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LAKEWOOD HEALTH SYSTEMBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line149725 COUNTY ROAD 83AddressLine1
CitySTAPLESCity
StateMNState
ZIP Code56479ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1LAKEWOOD HEALTH SYSTEMBusinessNameLine1
FieldValueIRS element (for citing)
Facility1FacilityNum
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLHTTP://LAKEWOODHEALTHSYSTEM.COM/COMMUNITYOwnWebsiteURLTxt
Rpt Available Upon RequestYes (X)RptAvailableUponRequestInd
Adopt Implementation StrategyYes (X)AdoptImplementationStrategyInd
Exec Implementation StrategyYes (X)ExecImplementationStrategyInd
Prioritize Health NeedsYes (X)PrioritizeHealthNeedsInd
Prioritize ServicesYes (X)PrioritizeServicesInd
All Needs Addressed0AllNeedsAddressedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Used Deter Elig Free CareYes (1)FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care75.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt CareYes (1)FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care240.000000000000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (1)ExplainedBasisInd
Income LevelYes (X)IncomeLevelInd
Uninsured DiscountYes (X)UninsuredDiscountInd
Other FactorsYes (X)OtherFactorsInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
Attached To InvoiceYes (X)AttachedToInvoiceInd
Posted In Emergency RoomYes (X)PostedInEmergencyRoomInd
Provided On AdmissionYes (X)ProvidedOnAdmissionInd
Available On RequestYes (X)AvailableOnRequestInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Collection Activities0CollectionActivitiesInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
LAKEWOOD HEALTH SYSTEMPART V, SECTION B, LINE 3: THE PRIMARY DATA COLLECTION WAS DONE IN PARTNERSHIP WITH TODD WADENA HEALTHY CONNECTIONS BY SENDING A SURVEY TO 1,200 RANDOMLY SELECTED RESIDENTS IN EACH OF THE 4 COUNTIES SERVED BY LHS (4800 TOTAL RESIDENTS). IN ADDITION, LHS MET WITH CIVIC GROUPS AND CONDUCTED FOCUS GROUPS TO GAIN A BETTER UNDERSTANDING WHAT THE PERCEPTION OF A HEALTHY COMMUNITY IS IN THE IMMEDIATE AREA. THESE GROUPS INCLUDED: BUSINESS LEADERS, CIVIC GROUPS, COLLEGE STUDENTS OVER 18 YEARS OF AGE, COMMUNITY MEMBERS FROM VARIOUS ECONOMIC AND SOCIAL BACKGROUNDS, EDUCATORS, PARENTS OF YOUNG CHILDREN, PUBLIC HEALTH, AND RELIGIOUS LEADERS.
LAKEWOOD HEALTH SYSTEMPART V, SECTION B, LINE 7: RATHER THAN INADEQUATELY ADDRESSING ALL HEALTH NEEDS, LHS WILL FOCUS RESOURCES, BOTH FINANCIAL AND OTHERWISE, ON ADULT & CHILDHOOD OBESITY AND MENTAL HEALTH IN ORDER TO ENHANCE POTENTIAL SUCCESS IN MEETING THESE HEALTH NEEDS. DESPITE NOT DIRECTLY FOCUSING ON THESE CONCERNS, INTERVENTIONS ADDRESSING THE PRIORITIZED HEALTH NEEDS MAY PARTIALLY OVERLAP, POSITIVELY IMPACTING ONE OR MORE NEEDS. OTHER NEEDS AND CONCERNS INCLUDE ISSUES RELATED TO POVERTY, UNDER OR UNINSURED PERSONS, ALCOHOL ABUSE, AND SMOKING AMONGST OTHER ITEMS.
LAKEWOOD HEALTH SYSTEMPART V, SECTION B, LINE 11: INCOME OF 75% TO 240% OF FPG WOULD BE ELIGIBLE FOR DISCOUNTED CARE.
LAKEWOOD HEALTH SYSTEMPART V, SECTION B, LINE 12I: THE AMOUNT INVOICED DOES NOT CHANGE, HOWEVER A DISCOUNT AMOUNT IS DETERMINED BY INCOME LEVEL AND UNINSURED STATUS THAT WILL RESULT IN THE AMOUNT OF PAYMENT, IF ANY, FROM THE FAP-ELIGIBLE PATIENT.
LAKEWOOD HEALTH SYSTEMPART V, SECTION B, LINE 14G: EACH APPLICABLE ADMISSION AREA HAS A POLICY AVAILABLE FOR THE PATIENT AS NEEDED AND UPON REQUEST.
LAKEWOOD HEALTH SYSTEMPART V, SECTION B, LINE 20D: UNINSURED PATIENTS MEETING INCOME GUIDELINES WILL NOT BE CHARGED MORE IN WHICH THE PROVIDER WOULD BE REIMBURSED FROM OUR MOST FAVORED INSURER. CHARITY CARE DISCOUNTS ARE DETERMINED BASED ON INCOME LEVELS USING THE FPG.
FieldValueIRS element (for citing)
Facility7FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeFacilityFacilityTxt
STAPLES CLINIC
49725 COUNTY ROAD 83STAPLESMN56479CLINIC
PILLAGER CLINIC
653 PILLSBURY ST N STE 1PILLAGERMN56473CLINIC
MOTLEY CLINIC
1233 HWY 10MOTLEYMN56466CLINIC
BROWERVILLE CLINIC
30535 241ST AVEBROWERVILLEMN56438CLINIC
EAGLE VALLEY CLINIC
815 HWY 71 SEAGLE BENDMN56446CLINIC
LHS CARE CENTER
401 PRAIRIE AVE NESTAPLESMN56479SKILLED NURSING FACILITY
ST CLOUD DERMATOLOGY CLINIC
2251 CONNETICUT AVE SO SUITE 3800SARTELLMN56377CLINIC

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7G:AMOUNTS USED FOR SUBSIDIZED SERVICES WERE CALCULATED USING DETAILED REPORT DATA KEPT BY THE ORGANIZATION. DATA INCLUDED THE TOTAL CHARGES, ALLOWANCES AND DISCOUNTS, MEDICAID, AND ACTUAL COST OF SERVICES PROVIDED. SUBSIDIZED SERVICES ARE DETERMINED BY THE ORGANIZATION DUE TO THE NEED IN THE COMMUNITY THAT CAN ONLY BE FILLED BY THE ORGANIZATION. THERE ARE NO PHYSICIANS CLINIC.
PART I, LINE 7, COLUMN (F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 3,240,208.
PART II, COMMUNITY BUILDING ACTIVITIES:LAKEWOOD HEALTH SYSTEM HAS SET ASIDE A SMALL AREA OF LAND ON WHICH A COMMUNITY PARK WAS ESTABLISHED. TO PROMOTE PHYSICAL ACTIVITY IN CHILDREN, LHS PURCHASED PLAYGROUND EQUIPMENT FOR THE PARK. THIS PARK IS THE ONE MOST OFTEN UTILIZED BY CHILDREN AND IS AFFECTIONATELY KNOWN AS THE "DINO PARK" DUE TO SOME OF THE EQUIPMENT HAVING A DINOSAUR THEME.
PART III, LINE 2:THIS AMOUNT IS CALCULATED BY MULTIPLYING THE TOTAL CHARGES FOR SERVICES WRITTEN OFF AS BAD DEBT BY THE COST TO CHARGE RATIO.
PART III, LINE 3:THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY FINANCIAL ASSISTANCE POLICY IS DETERMINED BY THE ORGANIZATION USING INFORMATION AVAILABLE TO MAKE AN EDUCATED ESTIMATE.
PART III, LINE 4:MANAGEMENT PROVIDES FOR PROBABLY UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE.FINANCIAL STATEMENT FOOTNOTE 3 ACCOUNTS RECEIVABLE: THE ORGANIZATION'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS DECREASED FROM 50.8% OF SELF-PAY ACCOUNTS RECEIVABLE AT DECEMBER 31, 2012, TO 41.3% OF SELF-PAY ACCOUNTS RECEIVABLE AT DECEMBER 31, 2013. BAD DEBT WRITE-OFFS WERE APPROXIMATELY $1,074,000 AND $4,079,000 FOR THE YEARS ENDED DECEMBER 31, 2013 AND 2012, RESPECTIVELY. IN 2013, THE ORGANIZATION ADDED ADDENDUMS TO THE CHARITY CARE AND UNINSURED DISCOUNT POLICIES THAT ARE EXPECTED TO INCREASE CHARITY CARE AMOUNTS THAT ARE AVAILABLE TO THE LOWEST-INCOME PATIENTS AND REDUCE CHARITY CARE AMOUNTS THAT ARE AVAILABLE TO THOSE PATIENTS WITH A GREATER ABILITY TO PAY.
PART III, LINE 8:THE MEDICARE ALLOWABLE COST OF CARE RELATING TO PAYMENTS ON LINE 5 WERE CALCULATED USING OUR FILED 2013 MEDICARE COST REPORT.
PART III, LINE 9B:PATIENTS ARE REQUIRED TO APPLY FOR MEDICAL ASSISTANCE IN ORDER TO RECEIVE A 50% OR GREATER DISCOUNT PER LAKEWOOD'S CUSTOMER ASSITANCE PROGRAM.
PART VI, LINE 2:THE ORGANIZATION CONDUCTS COMMUNITY SURVEYS AND USES PATIENT FEEDBACK TO ASSESS THE NEEDS OF THE COMMUNITIES IT SERVES.
PART VI, LINE 3:PATIENT FINANCIAL SERVICES (PFS) STAFF ARE AVAILABLE AND UTILIZED THROUGHOUT THE PATIENT EXPERIENCE. PFS STAFF EDUCATE PATIENTS ON MEANS-TESTED PROGRAMS AVAILABLE TO THE PATIENT AS WELL AS ASSIST THE PATIENT WITH THE CUSTOMER ASSISTANCE APPLICATION PROCESS. PAYMENT PLANS ARE ALSO ESTABLISHED TO ASSIST PATIENTS IN PAYING OFF OBLIGATIONS OWED TO THE ORGANIZATION.
PART VI, LINE 4:LAKEWOOD HEALTH SYSTEM OFFERS A BROAD SPECTRUM OF CARE. OUR SYSTEM INCLUDES A STATE-OF-THE-ART MAIN CAMPUS WITH A 25-BED, CRITICAL ACCESS HOSPITAL AND CLINIC (STAPLES, MN); FOUR MODERN SATELLITE CLINICS BROWERVILLE, PILLAGER, MOTLEY & EAGLE BEND, MN), SENIOR SERVICES, HOUSING AND A SPECIALIZED SENIOR BEHAVIORAL HEALTH UNIT (STAPLES, MN), AND A MEDICAL SPA (BAXTER, MN). WE ALSO HAVE ON-STAFF SPECIALISTS AND VISITING PARTNERS, WHICH ALLOWS US TO OFFER COMPREHENSIVE CARE IN THESE VARIOUS COMMUNITIES. ITS NEIGHBOR, MOTLEY, IS JUST A FEW MILES AWAY AND HAS ANOTHER 1,000 PEOPLE. THE TWO TOWNS COLLABORATE ON MANY COMMUNITY-WIDE INITIATIVES, INCLUDING THE LOCAL SCHOOL SYSTEM. STAPLES BOASTS MANY ATTRACTIVE STORE FRONTS AND BUSINESSES IN THE DOWNTOWN AREA, GIVING IT A "MAIN STREET USA" FEEL. STAPLES IS PROUD OF ITS RICH HISTORY AND ACCOMPLISHMENTS IN THE AREAS OF BUSINESS, EDUCATION, HEALTH CARE, ATHLETICS AND CULTURAL ACTIVITIES. COMMUNITY INVOLVEMENT, PASSION, AND LOYALTY IS ALIVE AND WELL IN STAPLES - FROM THE TOWN RALLYING AROUND LOCAL SPORTS TEAMS, TO ATTENDING CONCERTS AND OTHER FINE ARTS - RELATED EVENTS, TO SUPPORTING LOCAL PHILANTHROPIC EFFORTS, TO CULTURAL ACTIVITIES REPRESENTING THE STRONG SCANDINAVIAN & FINNISH ANCESTRIES IN THE AREA.
PART VI, LINE 5:A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE WITHIN LAKEWOOD'S PRIMARY SERVICE AREA.LHS PROVIDES SPECIAL SERVICES INCLUDING PALLIATIVE CARE, MEDICAL HOME, AND HOME HEATLH, FOR THE COMMUNITY. LHS'S EMERGENCY ROOM IS AVAILABLE TO ALL DESPITE PATIENT FINANCIAL IMPLICATIONS. THERE ARE NO LIMITS IN REGARDS TO THE AMOUNT OF CHARITY CARE OR CAP PROGRAM PARTICIPANTS. GOVERNMENT HEALTH SPONSORED PROGRAMS WOULD INCLUDE MEDICARE AND MEDICAID. LHS IS THE SOLE COMMUNITY PROVIDER IN THE STAPLES AREA.
PART VI, LINE 6:N/A

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
TIM RICE
PRESIDENT$370,747$0$0$0$0$0$15,883$0$28,209$0$414,839$0$0$0
JAMES DREGNEY
CHIEF FINANCIAL OFFICER$200,764$0$0$0$0$0$11,923$0$25,942$0$238,629$0$0$0
CRAIG WOLHOWE
DIVISION DIRECTOR$192,102$0$0$0$0$0$12,407$0$27,822$0$232,331$0$0$0
DANIEL DONAHUE
DIVISION DIRECTOR$189,635$0$0$0$0$0$12,314$0$25,828$0$227,777$0$0$0
LAURIE BACH
DIVISION DIRECTOR$110,668$0$0$0$115,142$0$12,409$0$4,467$0$242,686$0$0$0
LYNN NEWTON RICE
DIVISION DIRECTOR$193,173$0$0$0$0$0$11,933$0$1,324$0$206,430$0$0$0
JEFFREY D OSEGARD
DIVISION DIRECTOR$151,120$0$0$0$0$0$11,710$0$22,951$0$185,781$0$0$0
ROBERT SCHMIEG
DIRECTOR ANESTHESIA, CRNA$320,427$0$0$0$0$0$2,277$0$25,112$0$347,816$0$0$0
SHERREE ENGEN
ANESTHETIST$268,377$0$0$0$0$0$11,411$0$25,767$0$305,555$0$0$0
REBECCA LYNN BENNETT
PHYSICIAN ASSISTANT$156,094$0$0$0$0$0$9,987$0$27,445$0$193,526$0$0$0
AMY LYNN WINKELS
PHYSICIAN ASSISTANT$154,935$0$0$0$0$0$9,569$0$24,974$0$189,478$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 4AFormAndLineReferenceDesc
ExplanationLAURIE S. BACH, VICE PRESIDENT RECEIVED A SEVERANCE OF $115,142 UPON LEAVING THE ORGANIZATION DURING THE FISCAL YEAR.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
UNITED HOSPITAL DISTRICT TODD MORRISON CASS AND WADENA COUNTIES MN
A41600555888903ABXX2004-12-01$32,000,000NEW HOSPITAL CONSTRUCTION000
UNITED HOSPITAL DISTRICT TODD MORRISON CASS AND WADENA COUNTIES MN
B4160055582003-09-15$5,093,625CONSTRUCTION OF MEDICAL CLINIC AND REFINANCE DEBT000
UNITED HOSPITAL DISTRICT TODD MORRISON CASS AND WADENA COUNTIES MN
C4160055582003-09-15$612,000LAND OF NEW HOSPITAL000
UNITED HOSPITAL DISTRICT MEDICAL FACILITY MORTGAGE REVENUE NOTES SERIES 2
D4160055582013-04-24$7,846,512REFINANCING OF 2007 NOTE, 2009 NOTE, 2012 NOTE000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndOther Spent ProceedsOtherSpentProceedsAmt
A$3,285,000$32,000,000$549,307$31,450,693200600Yes (1)Yes (1)
B$2,153,445$5,093,625$101,872$1,275,5052004Yes (1)0Yes (1)Yes (1)$3,716,248
C$264,754$612,000$612,000200400Yes (1)Yes (1)
D$194,943$7,846,512$156,930$5,800,0102004Yes (1)0Yes (1)Yes (1)$1,889,572

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0Yes (1)000.004000.0040000Yes (1)
B0Yes (1)000.022900.0229000Yes (1)
C000000Yes (1)
D000000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A0Yes (1)00Yes (1)0000
B0Yes (1)00Yes (1)0000
C0Yes (1)00Yes (1)0000
D0Yes (1)00Yes (1)0000

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
A0
B0
C0
D0

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LAKEWOOD CLINICBusinessNameLine1
FieldValueIRS element (for citing)
Relationship DescriptionBOARD MEMBERS HAVE OWNERSHIP INTEREST IN LAKEWOOD CLINIC, PA.RelationshipDescriptionTxt
Transaction$10,705,193TransactionAmt
TransactionTHE ORGANIZATION HAS A MEDICAL SERVICE AGREEMENT WITH LAKEWOOD CLINIC, PA FOR THE PROVISION OF PHYSICIAN AND OTHER PROFESSIONAL MEDICAL SERVICES. THE AGREEMENT EXPIRES IN 2016. LAKEWOOD CLINIC, PA IS PAID PER A NEGOTIATED PRICE OF RELATIVE VALUE UNIT (RVU). THE RVU IS DETERMINED BASED ON THIRD-PARTY COMPENSATION DATA. IN ADDITION, THERE ARE COMPENSATION AGREEMENTS FOR SERVICES THAT USE HOURLY RATES DETERMINED USING MARKET DATA TO ENSURE COMPENSATION IS REASONABLE. THERE ARE SPECIALIST POSITIONS THAT RECEIVE AN ANNUAL COMPENSATION THAT IS ALSO DETERMINED USING MARKET DATA. THE FOLLOWING LAKEWOOD HEALTH SYSTEM BOARD MEMBERS HAVE OWNERSHIP IN LAKEWOOD CLINIC, PA: -CHRISTINE ALBRECHT MD -JULIE BENSON MD-SARAH ISRAELSON MD-WILLIAM MENNIS MDTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2TIM RICE, PRESIDENT/CEO, IS MARRIED TO LYNN NEWTON RICE, DIVISION DIRECTOR.
FORM 990, PART VI, SECTION B, LINE 11THE PREPARER OF FORM 990 EMAILS A COPY OF THE FINAL 990 TO THE ORGANIZATION'S CHIEF FINANCIAL OFFICER. THE CHIEF FINANCIAL OFFICER PERFORMS A DETAIL REVIEW OF FORM 990. THE CHIEF FINANCIAL OFFICER PROVIDES EACH VOTING BOARD MEMBER WITH A COPY OF FORM 990 BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12CANY INTERESTS WHICH WERE IDENTIFIED AS PART OF THE ANNUAL CONFLICT OF INTEREST DISCLOSURE WOULD BE DOCUMENTED IN THE BOARD OF DIRECTOR MEETING MINUTES. THE OFFICERS, DIRECTORS, AND KEY EMPLOYEES COMPLETE A FORMAL CONFLICT OF INTEREST DISCLOSURE ANNUALLY. INTERESTS THAT ARISE BETWEEN COMPLETING FORMS MUST BE DISCLOSED BY THE INTETERESTED MEMBER TO THE REST OF THE BOARD. FOR ANY BOARD ACTION THAT REQUIRED A VOTE AND COULD BE INFLUENCED BY A CONFLICT, THE AFFECTED BOARD MEMBER IS NOT PERMITTED TO VOTE ON THE ACTION. THE ORGANIZATION ALSO CONSIDERS WHETHER OTHER POTENTIAL CONFLICTS OF INTEREST COULD RESULT FOR ANY OF THESE INDIVIDUALS BASED ON POSSIBLE ACTIONS UNDER CONSIDERATION BY THE ORGANIZATION DURING THE YEAR.
FORM 990, PART VI, SECTION B, LINE 15FOR THE CEO, INITIAL COMPENSATION CONSIDERATION IS MADE BASED ON A REVIEW OF SALARY SURVEY DATA COMPILED BY THE MINNESOTA HOSPITAL ASSOCIATION. THIS DATA IS THEN REVIEWED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. AFTER THIS REVIEW, THE DATA IS SUBMITTED TO THE FULL FINANCE COMMITTEE OF THE BOARD OF DIRECTORS FOR REVIEW ALONG WITH THE ENTIRE ANNUAL BUDGET PACKAGE. FINALLY, THE FULL BUDGET PACKAGE, ALONG WITH ALL SPECIFIC SALARY PROPOSALS ARE SUBMITTED TO THE FULL BOARD OF DIRECTORS FOR FINAL APPROVAL. AT ANY TIME IN THIS PROCESS, ANY OF THE COMMITTEES OR BOARD COULD REQUEST ADDITIONAL INDEPENDENT SALARY INFORMATION SUPPORTING THE PROPOSED SALARY. THIS COMPENSATION AMOUNT IS INCLUDED IN THE CEO EMPLOYMENT CONTRACT WHICH IS PREPARED EACH YEAR WITH A ONE YEAR TERM. FOR THE CFO AND THE OTHER DIVISION DIRECTORS, THE PROCESS IS THE SAME EXCEPT THAT THE INDEPENDENT EXTERNAL DATA TYPICALLY STARTS WITH WHAT INTEGRATED HEALTHCARE SYSTEMS PROVIDES. ADDITIONALLY, WE HAVE INCLUDED THE MHA SALARY SURVEY DATA.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THESE DOCUMENTS CAN BE REQUESTED FROM THE ORGANIZATION'S CHIEF FINANCIAL OFFICER.
FORM 990, PART XI, LINE 9:NET ASSETS RELEASED FROM RESTRICTIONS -36,288.
FORM 990, PART XII, LINE 2CTHE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndUBI Code VUBICodeVAmtGeneral Or Managing PartnerGeneralOrManagingPartnerIndOwnershipOwnershipPct
MEDICAL SPA LLC
49725 CTY 83STAPLESMN56479800807773DERMATOLOGY CLINIC AND MEDICAL SPAMNN/AUNRELATED$23,990$323,9460$23,990Yes (1)0.50000
LAKEWOOD-CENTRACARE LLC
49725 CTY 83STAPLESMN56479411974939CLINICAL SERVICESMNN/ARELATED$14,481$299,5410Yes (1)0.50000
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd