MADELIA HEALTH: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- MADELIA HEALTH (EIN 41-0758512)
- Tax period
- 2012-06-01 to 2013-05-31
- Filed
- 2014-01-08
- IRS object ID
- 201420139349300727
- Schema version
- 2012v2.1
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-01-08T15:07:34-06:00 | Timestamp |
| Tax Period End Date | 2013-05-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410746749 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 SOUTH SIXTH STREET SUITE 300 | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 55402 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-06-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410758512 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADELIA COMMUNITY HOSPITAL INCORPORATED | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MADE | NameControl |
| Phone | 5076423255 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 121 DREW AVENUE SOUTHEAST | AddressLine1 |
| City | MADELIA | City |
| State | MN | State |
| ZIP Code | 56062 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CANDACE FENSKE | Name |
| Title | CEO | Title |
| Phone | 5076423255 | Phone |
| Date Signed | 2013-12-23 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TRENT FAST | Name |
| PTIN | P00692704 | PTIN |
| Phone | 6123764500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADELIA COMMUNITY HOSPITAL & CLINIC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | CANDACE FENSKE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 121 DREW AVENUE SOUTHEAST | AddressLine1 |
| City | MADELIA | City |
| State | MN | State |
| ZIP Code | 56062 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 9765918 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MCHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1950 | YearFormation |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | PROVIDE QUALITY HEALTHCARE SERVICES TO THE LOCAL COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 118 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 563865 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 225608 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 8179944 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 9242206 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 163720 | InvestmentIncomePriorYear |
| Investment Income Current Year | 110304 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 98480 | OtherRevenuePriorYear |
| Other Revenue Current Year | 120242 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 9006009 | TotalRevenuePriorYear |
| Total Revenue Current Year | 9698360 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 5531948 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 6141943 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4832639 | OtherExpensePriorYear |
| Other Expenses Current Year | 4522628 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 10364587 | TotalExpensesPriorYear |
| Total Expenses Current Year | 10664571 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1358578 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -966211 | RevenuesLessExpensesCY |
| Total Assets BOY | 19542302 | TotalAssetsBOY |
| Total Assets EOY | 19090128 | TotalAssetsEOY |
| Total Liabilities BOY | 6732342 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 7061184 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 12809960 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 12028944 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE MISSION OF MADELIA COMMUNITY HOSPITAL TO PROVIDE SAFE AND QUALITY HEALTHCARE SERVICES TO THOSE WE SERVE IN AN ENVIRONMENT BASED ON RESPECT, DIGNITY, AND EXCELLENCE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 8433736 | Expense |
| Revenue | 9242206 | Revenue |
| Description | RURAL HEALTH CARE FACILITY PROVIDING GENERAL MEDICAL/SURGICAL SERVICES ON AN INPATIENT, OUTPATIENT, SWING BEDS, AND HOME CARE BASIS. FOR FISCAL YEAR 2013: 126 ACUTE CARE ADMISSIONS, 74 SWING BED ADMISSIONS, 14,754 HOME CARE VISITS, AND 4,039 OUTPATIENT VISITS. THE HOSPITAL ALSO PROVIDED $102,822 OF CHARITY CARE. MADELIA COMMUNITY HOSPITAL IS ALSO HEAVILY INVOLVED IN THEIR COMMUNITY, THEY OFFER A VARIETY OF COMMUNITY BENEFIT SERVICES BEYOND THE CORE HOSPITAL SERVICES. SOME OF THE BENEFIT SERVICES THAT THEY OFFER ARE; WATONWAN COUNTY SR. DRIVER PROGRAM, MEALS ON WHEELS, CULTURE OF WELLNESS PROGRAM, SPANISH INTERPRETIVE SERVICES, COLLABORATIVE HISPANIC OUTREACH SERVICES, DELIVERY OF PHARMACEUTICALS FOR HOME CARE PATIENTS, HOSPICE ADVISORY COMMITTEE, COMMUNITY EDUCATIONAL SERIES ON PALLIATIVE CARE AND HEALTHY LIFESTYLE WITH DIABETES, ELDERLY PATIENT EDUCATION SERIES SUCH AS LIVING WELL WITH CHRONIC CONDITIONS CLASS FOR 6 WEEKS, MATTER OF BALANCE CLASSES, FREE HEEL SCANS FOR THE PUBLIC, CLINICALS FOR STUDENTS OF SURROUNDING COLLEGES AND UNIVERSITIES, SKIN CHECKS AT WRESTLING TOURNAMENTS, BLOOD PRESSURE CLINIC AT COMMUNITY FUNDRAISING EVENTS AND ACTIVITIES, SENIOR HEALTH EXPO, NIMS (NATIONAL INCIDENT MANAGEMENT SYSTEM) DISASTER/BIOTERRORISM PREPAREDNESS, A.C.E.(ATHLETE CARE & IMPACT EVALUATION) STUDENT ATHLETIC ASSESSMENTS, HOME CARE FLU SHOT CLINICS, AND OTHER COMMUNITY AND SCHOOL HEALTH FAIRS THROUGH OUT THE YEAR. | Description |
| Total Program Service Expense | 8433736 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 59 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 118 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MN | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DONNA KLINKNER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5076423255 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 121 DREW AVENUE SOUTHEAST | AddressLine1 |
| City | MADELIA | City |
| State | MN | State |
| ZIP Code | 56062 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (12 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| STEVEN COOLING | |||||||
| BOARD PRESIDENT | 1.00 | X | X | 1800 | 0 | 0 | |
| TOM MCCABE | |||||||
| BOARD VICE PRESIDENT & TREASURER | 1.00 | X | X | 1800 | 0 | 0 | |
| BARBARA OVERLIE | |||||||
| BOARD SECRETARY | 1.00 | X | X | 1800 | 0 | 0 | |
| CHUCK VOSS | |||||||
| BOARD MEMBER | 1.00 | X | 1200 | 0 | 0 | ||
| DENNIS ARDUSER | |||||||
| BOARD MEMBER | 1.00 | X | 1200 | 0 | 0 | ||
| MARK CHRISTENSON | |||||||
| BOARD MEMBER | 1.00 | X | 1200 | 0 | 0 | ||
| NORMA KRUMWIEDE | |||||||
| BOARD MEMBER | 1.00 | X | 1200 | 0 | 0 | ||
| SHEILA SPITZNER | |||||||
| BOARD MEMBER | 1.00 | X | 700 | 0 | 0 | ||
| JEANNE BURKE | |||||||
| BOARD MEMBER | 1.00 | X | 600 | 0 | 0 | ||
| CANDACE FENSKE | |||||||
| CEO | 40.00 | X | 123531 | 0 | 23248 | ||
| DONNA KLINKNER | |||||||
| CFO | 40.00 | X | 95482 | 0 | 21069 | ||
| DEIDRE HRUBY | |||||||
| DIRECTOR OF PATIENT CARE | 40.00 | 106029 | 0 | 28662 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 336542 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 72979 | TotalOtherCompensation |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| WHITESELL MEDICAL STAFFING | |||||
| 1630 ANDERSON AVE | BUFFALO | MN | 55313 | ER & CLINIC PHYSICIAN COVERAGE | 1015986 |
| MANKATO CLINIC LTD | |||||
| 1230 E MAIN ST | MANKATO | MN | 56002 | PHYSICIAN CLINIC PROVIDERS | 584953 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| Government Grants | 82711 | GovernmentGrants |
| All Other Contributions | 142897 | AllOtherContributions |
| Total Contributions | 225608 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT REVENUE | 624100 | 9199009 | 9199009 |
| PHYSICAL THERAPY | 624310 | 38749 | 38749 |
| LABORATORY | 621500 | 4448 | 4448 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 9242206 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 114747 | TotalRevenueColumn |
| Exclusion | $114,747 | ExclusionAmount |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 36201 | TotalRevenueColumn |
| Exclusion | $36,201 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 42124 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 63115 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -20991 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -20991 | TotalRevenueColumn |
| Exclusion | -$20,991 | ExclusionAmount |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 4443 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -4443 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -4443 | TotalRevenueColumn |
| Exclusion | -$4,443 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| MISCELLANEOUS | 900099 | 49086 | $49,086 |
| INSURANCE PROCEEDS | 900099 | 30470 | $30,470 |
| EMPLOYEE MEALS | 900099 | 23403 | $23,403 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2073 | TotalRevenueColumn |
| Exclusion | $2,073 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 105032 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9698360 | TotalRevenueColumn |
| Related Or Exempt Function Income | 9242206 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $230,546 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 263330 | Total |
| Management And General | 263330 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4840703 | Total |
| Program Services | 4160323 | ProgramServices |
| Management And General | 680380 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 143860 | Total |
| Program Services | 108813 | ProgramServices |
| Management And General | 35047 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 618659 | Total |
| Program Services | 420688 | ProgramServices |
| Management And General | 197971 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 275391 | Total |
| Program Services | 217063 | ProgramServices |
| Management And General | 58328 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 110344 | Total |
| Program Services | 48159 | ProgramServices |
| Management And General | 62185 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 178744 | Total |
| Management And General | 178744 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 103824 | Total |
| Program Services | 73559 | ProgramServices |
| Management And General | 30265 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 297699 | Total |
| Program Services | 297699 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 799703 | Total |
| Program Services | 799703 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES | 1439457 | 1439457 | |
| ADMIN EXPENSES | 689701 | 689701 | |
| REPAIRS/MAINTENANCE | 352044 | 352044 | |
| CLINIC EXPENSES | 257458 | 257458 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 293654 | Total |
| Program Services | 258770 | ProgramServices |
| Management And General | 34884 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10664571 | Total |
| Program Services | 8433736 | ProgramServices |
| Management And General | 2230835 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 807883 | BOY |
| EOY | 1124370 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5210180 | BOY |
| EOY | 5578898 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3000 | BOY |
| EOY | 8694 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2627633 | BOY |
| EOY | 1715294 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 165658 | BOY |
| EOY | 152758 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 72490 | BOY |
| EOY | 150838 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 16948218 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 8355830 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8947263 | BOY |
| EOY | 8592388 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 899889 | BOY |
| EOY | 939222 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 808306 | BOY |
| EOY | 827666 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19542302 | BOY |
| EOY | 19090128 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 956869 | BOY |
| EOY | 1434232 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5650000 | BOY |
| EOY | 5530000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 85473 | BOY |
| EOY | 56952 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40000 | BOY |
| EOY | 40000 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6732342 | BOY |
| EOY | 7061184 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12809960 | BOY |
| EOY | 11885068 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 143876 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12809960 | BOY |
| EOY | 12028944 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19542302 | BOY |
| EOY | 19090128 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -966211 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 19361 | ReconciliationUnrealizedInvest |
| Reconcilation Prior Adjustment | 165834 | ReconcilationPriorAdjustment |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 185447 | OtherCostOrOtherBasis |
| Book Value | 185447 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6915366 | OtherCostOrOtherBasis |
| Depreciation | 3009370 | Depreciation |
| Book Value | 3905996 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4622239 | OtherCostOrOtherBasis |
| Depreciation | 1768897 | Depreciation |
| Book Value | 2853342 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5225166 | OtherCostOrOtherBasis |
| Depreciation | 3577563 | Depreciation |
| Book Value | 1647603 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 8592388 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ASSET RETIREMENT OBLIGATION | Description |
| Amount | $40,000 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 40000 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X, LINE 2: | ReturnReference |
| Explanation | THE HOSPITAL IS CLASSIFIED BY THE INTERNAL REVENUE SERVICES AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS SUBJECTED TO FEDERAL INCOME TAX ONLY ON NET UNRELATED BUSINESS INCOME. THE HOSPITAL HAS ELECTED TO ADOPT GUIDANCE IN THE INCOME TAX STANDARD REGARDING RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE HOSPITAL FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES FOR EVALUATING UNCERTAIN TAX POSITIONS. THE ADOPTION OF THIS STANDARD HAS NO EFFECT ON THE FINANCIAL STATEMENTS. THE HOSPITAL'S TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE TAX RETURNS FOR THE YEARS 2009 TO 2012 ARE OPEN TO EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 100.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 0 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 96159 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 96159 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00900 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 932353 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 512352 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 420001 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03940 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1028512 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 512352 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 516160 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04840 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 97188 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 97188 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00910 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 51423 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 51423 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00480 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 809 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 809 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 149420 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 149420 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01400 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1177932 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 512352 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 665580 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06240 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 4015 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 4015 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 5377 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 5377 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 8980 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 8980 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 2393 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2393 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 20765 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 20765 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00190 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $246,755 | BadDebtExpenseAmount |
| Amount Attributable To | 4935 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 4619749 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 4542766 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 76983 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADELIA COMMUNITY HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 121 DREW AVE SE | AddressLine1 |
| City | MADELIA | City |
| State | MN | State |
| ZIP Code | 56062 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADELIA COMMUNITY HOSPITAL INCORPORATED | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 0 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Other Method | X | OtherMethod |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| Other Needs Addressed | X | OtherNeedsAddressed |
| All Needs Addressed | 1 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 100.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Other Factors | X | OtherFactors |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Other Actions Taken | X | OtherActionsTaken |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: THE AMOUNTS REPORTED IN PART I, LINE 7 WERE COMPUTED USING A RATIO OF COST TO CHARGES THAT WAS DERIVED FROM WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. | ||
| PART I, L7 COL(F): BAD DEBT EXPENSE OF $246,755 WAS SUBTRACTED FROM TOTAL EXPENSES OF $10,664,571 IN CALCULATING THE PERCENTAGES IN PART I, LINE 7, COLUMN F. IN HOUSE UNINSURED/UNDERINSURED THAT QUALIFIED FOR FINANCIAL ASSISTANCE FOR THE YEAR END WAS 2% OF TOTAL BAD DEBTS ACCOUNT AS REFLECTED IN PART III, LINE 3. CHARITY CARE ACCOUNTS ARE NOT INCLUDED IN BAD DEBTS. | ||
| PART II: STAFF PARTICIPATE IN COMMUNITY ORGANIZATIONS TO PROVIDE HEALTHCARE REPRESENTATION AND INFORMATION TO ENHANCE THOSE ORGANIZATIONS EVENTS, ETC. THE CULTURE OF WELLNESS IS A COMMUNITY BASED PROJECT THAT MADELIA COMMUNITY HOSPITAL PARTICIPATED IN TO SUPPORT HEALTHY LIFE STYLES. | ||
| PART III, LINE 4: THE FOLLOWING IS FROM THE "PATIENT RECEIVABLES" PARAGRAPH IN NOTE 1 TO THE HOSPITAL'S FINANCIAL STATEMENTS:"PAYMENT FOR SERVICES IS REQUIRED UPON RECEIPT OF A BILL, AFTER PAYMENT BY INSURANCE, IF ANY. SELF-PAY ACCOUNTS ARE ANALYZED FOR COLLECTIBILITY BASED ON THE MONTHS PAST DUE AND PAYMENT HISTORY. AN ALLOWANCE IS ESTIMATED FOR THESE ACCOUNTS BASED ON THE HISTORICAL EXPERIENCE OF THE HOSPITAL. ACCOUNTS THAT ARE DETERMINED TO BE UNCOLLECTIBLE ARE SENT TO A COLLECTION AGENCY AND WRITTEN OFF AT THAT TIME."THE AMOUNT OF BAD DEBT EXPENSE REPORTED IN PART III, LINE 2 IS CALCULATED AS FOLLOWS: PAYMENT ARRANGEMENT INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES AND PER DIEM PAYMENTS. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS. | ||
| PART III, LINE 8: THERE WAS NO SHORTFALL REPORTED IN PART III, LINE 7. FROM PART III, LINE 6, THE TOTAL ALLOWABLE COST REPORTED TO MEDICARE WAS BASED ON THE 2013 FILED MEDICARE COST REPORT. | ||
| PART III, LINE 9B: EACH WEEK, STATEMENTS ARE SENT OUT THROUGH OUR EDI PROCESS WITH STATEMENTS BEING MAILED OUT TO THE PATIENT BY A CLEARINGHOUSE. PATIENTS ARE BILLED AFTER MEDICARE OR COMMERCIAL INSURANCE HAS BEEN FILED AND PAYMENT HAS BEEN RECEIVED WITHIN A SIX-WEEK PERIOD. PATIENTS WILL BE BILLED FOR THE REMAINING BALANCE MONTHLY. ACCOUNTS ARE VERIFIED INTERNALLY PRIOR TO COLLECTION LETTERS BEING SENT.IF NO PAYMENT IS RECEIVED WITHIN 2 MONTHS OF BILLINGS, THE STATEMENT IS SENT WITH A NOTICE LETTER REQUESTING PAYMENT. LETTERS WILL ALSO BE SENT SHOULD NO PAYMENT BE RECEIVED WITHIN 60 AND 90 DAYS.SHOULD NO RESPONSE BE RECEIVED WITHIN FIVE (5) DAYS OF THE LAST LETTER, A TELEPHONE CALL IS ISSUED TO NEGOTIATE A PAYMENT PLAN OR EXTEND A DISCOUNT OF 25% FOR ACCOUNT PAYOFF IN 60 DAYS; IF ACCOUNT HOLDER MAY QUALIFY FOR OUR HEALTHCARE FINANCIAL PROGRAM, AN APPLICATION IS SENT TO BE COMPLETED AND RETURNED TO US ALONG WITH TWO (2) DENIALS OF ALTERNATE COVERAGE OR PAYMENT ASSISTANCE.LACK OF RESPONSE TO THE TELEPHONE CALL WILL RESULT IN VERIFICATION OF THE ACCOUNT(S) BY THE INSURANCE BILLING CLERKS AND THEN REVIEWED BY THE BUSINESS OFFICE MANAGER FOR APPROVAL TO BEGIN FORMAL COLLECTION PROCESS. THESE ACCOUNTS ARE THEN TURNED IN TO A PROFESSIONAL COLLECTION AGENCY.CHARITY CARE CONSIDERATIONS WILL BE MADE BY BUSINESS OFFICE MANAGER WHEN ALL NECESSARY DOCUMENTATION IS PRESENTED AND SHOULD IT BE EVIDENT THAT THE PATIENTS LACK OF FINANCES WARRANT THIS AND CHARITY CARE THE BEST ETHICAL DECISION FOR THE PATIENT. | ||
| PART V, SECTION B, LINE 3: THERE WERE PUBLIC MEETINGS INFORMING THE COMMUNITY OF THE ASSESSMENT PROCESS AND ENCOURAGING THEIR PARTICIPATION. THIS WAS COMMUNICATED THRU THE NEWS MEDIA AND DIRECT CLIENT/FAMILY CONTACTS THRU MCH SERVICES. MADELIA COMMUNITY HOSPITAL (MCH) PARTNERED WITH THE MINNESOTA UNIVERSITY, MANKATO, NURSING STUDENTS TO DEVELOP AND CONDUCT A COMMUNITY WIDE HEATHCARE ASSESSMENT. THIS WILL BE AN ONGOING PROCESS WHICH STARTED IN THE FALL OF 2011 AND WILL BE A CONTINUATION OF FOLLOWUP TO MEASURE THE PROGRESS OF COMMUNITY WELLNESS PROGRAMS THAT HAVE BEEN IMPLEMENTED AND TO IDENTIFY AWARENESS OF ANY NEW COMMUNITY HEALTH NEEDS.IN ADDITION TO THE ABOVE, MCH COLLABORATED WITH OTHER LOCAL ORGANIZATIONS REFERRED TO AS THE MADELIA COMMUNITY BASED COLLABORATIVE (MCBC) WHICH INCLUDED THE FOLLOWING PARTICIPANT ORGANIZATIONS: MADELIA COMMUNITY HOSPITAL AND CLINICSMINNESOTA STATE UNIVERSITY, MANKATO SCHOOL OF NURSINGGLEN TAYLOR NURSING INSTITUTE FOR FAMILY AND SOCIETYWATONWAN COUNTY PUBLIC HEALTH DEPARTMENTMADELIA SCHOOL SYSTEMLUTHER MEMORIAL HOMEDOWNS FOOD GROUP (MAJOR INDUSTRY IN MADELIA AND WATONWAN COUNTY)MADELIA CITY COUNCILMADELIA CHAMBER OF COMMERCE | MADELIA COMMUNITY HOSPITAL, INCORPORATED | |
| PART V, SECTION B, LINE 5C: MCH MADE ITS COMMUNITY NEEDS HEALTH ASSESSMENT AVAILABLE ON ITS WEBSITE AT WWW.MCHOSPITAL.ORG/COMMUNITY-NEEDS-ASSESSMENT. THEY ALSO MADE IT AVAILABLE ON PUBLIC FORUMS. | MADELIA COMMUNITY HOSPITAL, INCORPORATED | |
| PART V, SECTION B, LINE 6I: THE OVERALL COMMUNITY PRIORITIES WERE DETERMINED TO BE OBESITY, CANCER AND DIABETES. THESE NEEDS WERE GIVEN HIGHEST PRIORITY BASED ON OVERWHELMING COMMUNITY RESPONSE, AS WELL AS THEIR COST AND THEIR IMPACT ON QUALITY OF LIFE. HEALTHY FAMILY WELLNESS PROGRAMS AND EDUCATION WERE DEVELOPMENT OF COMMUNITY WIDE WELLNESS PROGRAMS THAT HAVE BEEN IMPLEMENTED WITH MCH BEING ON THOSE COMMITTEES. MCH IS WORKING WITH THE CITY OF MADELIA AND THE MADELIA SCHOOL SYSTEMS IN THE DEVELOPMENT OF WALKING PATHS, HOSTED SPEAKERS ON VARIOUS WELLNESS TOPICS, AND COLLABORATING WITH FITNESS CENTERS IN MADELIA AND LAKE CRYSTAL. MCH IS PARTNERING WITH THE GLEN TAYLOR NURSING INSTITUTE FOR FAMILY AND SOCIETY TO FIND SUPPORT FOR EDUCATION ON WAYS TO IMPROVE HEALTH CARE FOR FAMILIES, LATINO, AND ELDERLY POPULATION. MCH HOME CARE ASSISTS WITH A PALLIATIVE CARE PROGRAM THRU REQUESTS FROM THE PATIENTS AND FAMILIES MCH SERVES. SEE THE 2013 ASSESSMENT AND PROGRESS MADE ON THE MCH WEBSITE. | MADELIA COMMUNITY HOSPITAL, INCORPORATED | |
| PART V, SECTION B, LINE 12H: ALL PATIENTS ARE CHARGED THE SAME FOR SERVICES RENDERED AT MCH NO MATTER WHAT THE PATIENT'S FINANCIAL STATUS CONSISTS OF. | MADELIA COMMUNITY HOSPITAL, INCORPORATED | |
| PART V, SECTION B, LINE 18E: PATIENTS ARE INFORMED OF THE STATUS OF THEIR ACCOUNT THROUGH BILLING STATEMENTS, LETTERS INDICATING THE AGING OF THEIR ACCOUNT AND THE AVAILABILITY TO MAKE PAYMENT ARRANGEMENTS WITH SEVERAL OPTIONS OF RECEIVING A DISCOUNT. | MADELIA COMMUNITY HOSPITAL, INCORPORATED | |
| PART V, SECTION B, LINE 20D: WE CALCULATE AMOUNTS GENERALLY BILLED IN ACCORDANCE WITH OUR AGREEMENT WITH THE MINNESOTA ATTORNEY GENERAL. AMOUNTS GENERALLY BILLED ARE BASED ON THE DISCOUNTED CHARGES TO OUR LARGEST INSURANCE PAYER, BY VOLUME. THE DISCOUNT GIVEN TO OUR LARGEST INSURANCE PAYER IS SMALLER THAN THE DISCOUNT AVAILABLE UNDER OUR FINANCIAL ASSISTANCE POLICY. | MADELIA COMMUNITY HOSPITAL, INCORPORATED | |
| PART VI, LINE 2: THRU THE COMMUNITY ASSESSMENT PROCESS, HEALTHCARE NEEDS & SERVICES WERE IDENTIFIED AND PROGRAMS WERE DEVELOPED (SEE MCH WEBSITE FOR THE 2013 COMMUNITY HEALTH DIALOGUE). STRATEGIC PLANNING ASSESSES THE NEEDS OF THE COMMUNITY AND PATIENTS THROUGH PATIENT SATISFACTION SURVEYS, COMMENT CARDS, COMMUNITY ASSESSMENTS, AND A DIVERSE MEMBERSHIP OF COMMUNITY ELECTED GOVERNING BOARD THAT REPRESENTS THE COMMUNITY AND BRINGS TO THE TABLE ISSUES, CONCERNS, RECCOMMENDATIONS FOR HEALTH CARE SERVICES. | ||
| PART VI, LINE 3: PATIENTS ARE INFORMED OF FINANCIAL ASSISTANCE UPON ADMISSION TO THE HOSPITAL, THROUGH BILLING CLERKS ASSISTANCE WITH PATIENT ACCOUNTS, STATEMENTS ON THE BILLS, AND PERSONAL LETTERS SENT TO ACCOUNTS IDENTIFIED AS UNINSURED AND UNDERINSURED. | ||
| PART VI, LINE 4: MADELIA COMMUNITY HOSPITAL SERVES A 25 MILE RADIUS OF RURAL COMMUNITIES CONSISTING MAJORLY OF A CULTURALLY DIVERSE AND SENIOR POLULATION. | ||
| PART VI, LINE 5: MADELIA COMMUNITY HOSPITAL PARTICIPATES AND ORGANIZES COMMUNITY EDUCATION AND SEMINARS TO PROVIDE HEALTHCARE INFORMATION TO ENHANCE THE QUALITY OF HEALTHY LIVING AND THE AVAILABILITY OF THESE SERVICES RIGHT IN THEIR OWN COMMUNITIES. RADIOLOGY STAFF MEMBERS HOSTED A "PRETTY IN PINK" MAMMOGRAM PARTY TO REMIND WOMEN TO FOLLOW THROUGH WITH THEIR PREVENTATIVE TESTS AS REGULAR MAMMOGRAMS REMAIN THE BEST TOOL FOR CATCHING BREAST CANCER IN ITS EARLIER, MORE TREATABLE STAGES AND AWARENESS OF BONE DENSITY TESTING. THE GUESTS FOR THIS PARTY WERE OFFERED REFRESHMENTS AND PAMPERED WITH A HAND MASSAGE, MANICURE, FOOT SOAK, AND FACIAL OR MAKE-UP CONSULTATION.MADELIA COMMUNITY HOSPITAL PHYSICAL THERAPISTS/ATHLETIC TRAINERS EXPANDED THEIR SPORTS MEDICINE DEPARTMENT AND TEAMED UP WITH THE SCHOOL DISTRICT TO ASSIST STUDENT ATHLETES. THEY ADMINISTERED IMPACT CONCUSSION TESTS TO LOCAL STUDENT ATHLETES; THE 20 MINUTE TEST MEASURES VERBAL AND VISUAL MEMORY WHILE PROCESSING SPEED AND REACTION TIME TO 1/100TH OF A SECOND AND HAS PROVEN TO BE A VALUABLE TOOL TO SHOW WHEN THE ATHLETE'S BRAIN HAS HEALED FROM A CONCUSSION. THE BASELINE TEST WAS ADMINISTERED TO 124 STUDENT ATHLETES IN GRADES 7-12TH FROM MADELIA AND TRUMAN. IF A PLAYER SUFFERS A HEAD INJURY, THEY ARE GIVEN THE TEST AGAIN TO MEASURE THE EXTENT OF THE DAMAGE AND TO MONITOR IF AN ATHLETE CAN SAFELY RETURN TO SPORT. THIS YEAR, THREE STUDENT ATHLETES WERE REFERRED FOR A FOLLOW UP TEST. OUR CERTIFIED PHYSICAL THERAPIST/ATHLETIC TRAINER ATTENDED MOST HOME FOOTBALL GAMES AS WELL AS OTHER CONTACT SPORTS INCLUDING WRESTLING, BASKETBALL AND SOFTBALL.MADELIA COMMUNITY HOSPITAL PHYSICAL THERAPY STAFF MEMBERS HOSTED FREE PROGRAMS FOR THE COMMUNITY. LIVING WELL WITH CHRONIC CONDITIONS IS A WORKSHOP DESIGNED TO "PUT LIFE BACK IN YOUR LIFE." A MATTER OF BALANCE IS A WORKSHOP DESIGNED TO REDUCE THE FEAR OF FALLING AND INCREASE ACTIVITY LEVELS AMONG OLDER ADULTS. THE FREE ATHLETE CARE AND EVALUATION (A.C.E.) CLINIC ASSESSED 29 ATHLETES THROUGH THE YEAR; PROVIDING PREVENTION, EVALUATION AND TREATMENT WITH THE FOCUS OF GETTING THE ATHLETES BACK IN THE GAME.A BIKE SAFETY CLINIC WAS HELD DURING THE TOWN CELEBRATION TO PROMOTE SAFE BIKING HABITS AND ENCOURAGE HELMET USAGE. OUR EMERGENCY DEPARTMENT LEVEL 4 TRAUMA DESIGNATION ENABLES US TO PROVIDE LIFE-SAVING MEASURES TO SEVERELY INJURED PERSONS. THE HOSPITAL STAFF PARTICIPATED IN THE SOUTH CENTRAL DISASTER PREPAREDNESS FOR BOTH REGIONAL AND STATE DISASTER DRILLS.SET UP A "FARMERS MARKET" WITH NO CHARGE TO THE LOCAL VENDORS TO PROVIDE THEIR GARDEN PRODUCE FOR THE COMMUNITY. THIS PROJECT WAS WELL RECEIVED AND PATRONS ARE REQUESTING THIS SERVICE ANNUALLY.THE MADELIA COMMUNITY HOSPITAL DEPARTMENTS OF NURSING, HOME CARE, AND PHYSICAL THERAPY PARTAKE IN OFFERING THEIR TECHNICAL KNOWLEDGE FOR A CLINICAL EXPERIENCE FOR STUDENTS FROM MINNESOTA STATE UNIVERSITY, PRESENTATION COLLEGE AND NORTH IOWA COMMUNITY COLLEGE, RASMUSSEN COLLEGE, AND SOUTH CENTRAL COLLEGE. THE CLINICAL STUDENTS ARE HERE IN THE SPRING AND FALL SEMESTERS.THE HOME CARE DEPARTMENT PARTICIPATED IN THE PALLIATIVE PROGRAM THAT ASSISTED FAMILIES WITH COPING SKILLS, AND SUPPORT SYSTEMS. THE HOME CARE NURSES DO BLOOD PRESSURE CLINICS AT THE HARTSHORN AND AMBERFIELD SENIOR HOUSING UNITS AND LOCAL CHURCHES, PARTICIPATED IN A SENIOR EXPO AT THE HARTSHORN SENIOR HOUSING, COLLABORATE WITH HOSPICE COMMUNITY WORKSHOPS AND ADVISORY COMMITTEE.OTHER COMMUNITY INVOLVEMENT : SPANISH TRANSLATION SERVICES COMMUNITY CPR CLASSES WERE PROVIDED PER THE REQUEST OF THE COMMUNITY PARTICIPATION IN HEALTH AND CAREER FAIRS AT THE ELEMENTARY AND HIGH SCHOOLS OPEN HOUSE OF FACILITY MEDICAL HEALTH SERVICES FOR COMMUNITY CHAMBER MEMBERS FLU VACCINE CLINICS ONSITE AT LOCAL FACTORY AND COMMERCIAL BUSINESSES PROMOTE MEDICATION RECONCILIATION AT ANY TIME FOR RESIDENTS MEALS ON WHEELS DELIVERY TO HOME BOUND RESIDENTS COLLABORATIVE HISPANIC OUTREACH SERVICES WITH LOCAL FACTORY AND WATONWAN COUNTY HUMAN SERVICES PARTICIPATE IN THE COMMUNITY ORGANIZATIONS SUCH AS ROTARY AND CHAMBER OF COMMERCE SCHEDULE DRIVERS FOR TRANSPORTATION FOR WATONWAN COUNTY SENIOR DRIVER PROGRAM TO ASSIST SENIORS TO TRAVEL TO MEDICAL APPOINTMENTS.OUR PRIMARY FOCUS IS TO MAKE HEALTHY LIFESTYLE AWARENESS AVAILABLE TO OUR SERVICE AREA - WE WILL BE HERE WHENEVER THEY NEED US WITH OPEN ARMS - "CARE FROM THE PEOPLE YOU KNOW"! | ||
| MN | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF MADELIA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 416005334 | IssuerEIN |
| CUSIP Number | 556401AR8 | CUSIPNumber |
| Date Issued | 2006-10-01 | DateIssued |
| Issue Price | 6495000 | IssuePrice |
| Description Of Purpose | CONSTRUCT HOSPITAL ADDITION | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Amount Retired | 965000 | AmountRetired |
| Total Proceeds | 6495000 | TotalProceeds |
| Capitalized Interest | 161893 | CapitalizedInterest |
| Issuance Costs From Proceeds | 16238 | IssuanceCostsFromProceeds |
| Credit Enhancement | 113662 | CreditEnhancement |
| Capital Expenditures | 6203207 | CapitalExpenditures |
| Year Of Subst Completion | 2008 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Bond Iss Meet Prvt Security Pay Test | 0 | BondIssMeetPrvtSecurityPayTest |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedProp |
| Non Qualified Bond Remed Procdrs | 0 | NonQualifiedBondRemedProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiled |
| Rebate Not Due Yet | 0 | RebateNotDueYet |
| Exception To Rebate | 1 | ExceptionToRebate |
| No Rebate Due | 0 | NoRebateDue |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqs |
Form990 Schedule K Part V Form990ScheduleKPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Proc To Undertk Corrective Action | 0 | ProcToUndertkCorrectiveAction |
Form990 Schedule K Part VI Form990ScheduleKPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE K, PART V | Identifier |
| Explanation | THE ORGANIZATION IS IN THE PROCESS OF ADOPTING THESE WRITTEN PROCEDURES. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERSHIP OF THIS CORPORATION SHALL BE OPEN TO ANY NATURAL PERSON WHO MEETS THE FOLLOWING QUALIFICATIONS AT THE TIME OF APPLICATION: 1) IS OF LEGAL VOTING AGE IN MINNESOTA; 2) IS A VOTING RESIDENT WITHIN THE PRIMARY SERVICE AREA OF THE HOSPITAL, BEING DEFINED AS THE COUNTIES OF WATONWAN, BLUE EARTH, BROWN, MARTIN AND NICOLLET, STATE OF MINNESOTA; 3) IS A NATURAL PERSON AND NOT A CORPORATION, PARTNERSHIP OR OTHER ASSOCIATION; 4) SUBMITS A WRITTEN APPLICATION FOR MEMBERSHIP TO THE BOARD OF TRUSTEES ON A FORM APPROVED BY THE BOARD OF TRUSTEES; AND 5) SUBMITS A MEMBERSHIP FEE OF $25 OR MORE, WITH SAID APPLICATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | ALL TRUSTEES ARE ELECTED BY THE CORPORATE MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 7B | CORPORATE MEMBERS HAVE THE AUTHORITY TO VOTE ON CHANGES IN OR OF THE ARTICLES OF INCORPORATION FOR MADELIA COMMUNITY HOSPITAL. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS REVIEWED BY THE GOVERNING BOARD OF DIRECTORS FOR APPROVAL BEFORE THE FORM 990 IS FILED. THE REVIEW WILL BE PRESENTED BY FINANCE AT THE REGULAR MEETING OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY IS REVIEWED AT THE ANNUAL BOARD MEETING BY THE BOARD AND DEPARTMENT HEADS. IF ANY CONFLICTS OF INTEREST ARISE, NOTIFICATIONS IS GIVEN TO ADMINISTRATION. A CONTRACT OR OTHER TRANSACTION THAT MAY INVOLVE A CONFLICT OF INTEREST IS NOT VOID OR VOIDABLE IF: 1) THE CONTRACT OR TRANSACTION WAS FAIR AND REASONABLE AS TO THE CORPORATION WHEN IT WAS AUTHORIZED, APPROVED, OR RATIFIED; 2) ALL MATERIAL FACTS ARE FULLY DISCLOSED TO THE MEMBERS AND THE CONTRACT OR TRANSACTION IS APPROVED BY TWO-THIRDS OF THE MEMBERS ENTITLED TO VOTE, OTHER THAN THE INTERESTED DIRECTOR OR TRUSTEE; AND 3) ALL MATERIAL FACTS ARE FULLLY DISCLOSED TO THE BOARD OF TRUSTEES OR A COMMITTEE, AND THE BOARD OR COMMITTEE APPROVES THE CONTRACT OR TRANSACTION BY A MAJORITY VOTE, BUT THE INTERESTED TRUSTEE MAY NOT TAKE PART IN THE DISCUSSION, AND MAY NOT VOTE. |
| FORM 990, PART VI, SECTION B, LINE 15 | MADELIA COMMUNITY HOSPITAL ENSURES THAT THE COMPENSATION PAID TO ITS EMPLOYEES AND ADMINISTRATIVE STAFF BE CONSISTENT WITH POLICY AND PROVIDE EQUITABLE STANDARDS FOR WAGE AND BENEFITS BASED ON ANNUAL REGIONAL SURVEY OF COMPARABLE ENTITIES. THE GOVERNING BOARD REVIEWS ANNUALLY THE CEO'S PERFORMANCE (LAST PERFORMED JANUARY 2013) AND THE BASIS IS ANNUAL MN HOSPITAL ASSOCIATION SURVEY AND RATE INCREASE AS AWARDED TO ALL STAFF. THE BOARD APPROVES BOTH STAFF AND ADMINISTRATIVE INCREASES THROUGH THE ANNUAL BUDGET. |
| FORM 990, PART VI, SECTION C, LINE 19 | MADELIA COMMUNITY HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AT THE ANNUAL CORPORATION MEETING AND UPON REQUEST. |
| FORM 990, PART XII, LINE 2C | THE ORGANIZATIONS BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF ITS INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEARS. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADELIA COMMUNITY HOSPITAL FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 121 DREW AVENUE SE | AddressLine1 |
| City | MADELIA | City |
| State | MN | State |
| ZIP Code | 56062 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 731719218 | EIN |
| Primary Activities | SOLICIT CONTRIBUTIONS ON BEHALF OF THE MADELIA COMMUNITY HOSPITAL. | PrimaryActivities |
| Legal Domicile State | MN | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | 11 - TYPE 1 | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MADELIA COMMUNITY HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NO TRANSACTIONS OVER 50000 | BusinessNameLine1 |