GLENCOE REGIONAL HEALTH SERVICES: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- GLENCOE REGIONAL HEALTH SERVICES (EIN 41-1949230)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-08-04
- IRS object ID
- 201442169349300149
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-08-04T13:30:28-05:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| 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 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411949230 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GLENCOE REGIONAL HEALTH SERVICES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GLEN | BusinessNameControlTxt |
| Phone | 3208643121 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1805 HENNEPIN AVENUE NORTH | AddressLine1 |
| City | GLENCOE | City |
| State | MN | State |
| ZIP Code | 553361416 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JON BRABAND | PersonNm |
| Person Title | PRESIDENT & CEO | PersonTitleTxt |
| Phone | 3208643121 | PhoneNum |
| Signature | 2014-07-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ROBERT E SCHILE | PreparerPersonNm |
| PTIN | P00369682 | PTIN |
| Phone | 6123764500 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JON BRABAND | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1805 HENNEPIN AVENUE NORTH | AddressLine1 |
| City | GLENCOE | City |
| State | MN | State |
| ZIP Code | 553361416 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $54,982,418 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GRHSONLINE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1999 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HIGH QUALITY, CONVENIENT AND PERSONAL HEALTH CARE TO THOSE WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 655 | TotalEmployeeCnt |
| Total Volunteers | 136 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $270,783 | PYContributionsGrantsAmt |
| CY Contributions Grants | $220,815 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $47,977,800 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $47,909,950 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,077,985 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,255,086 | CYInvestmentIncomeAmt |
| PY Other Revenue | $224,294 | PYOtherRevenueAmt |
| CY Other Revenue | -$173,354 | CYOtherRevenueAmt |
| PY Total Revenue | $49,550,862 | PYTotalRevenueAmt |
| CY Total Revenue | $49,212,497 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $29,215 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $19,084 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $29,661,362 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $31,587,547 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $17,426,763 | PYOtherExpensesAmt |
| CY Other Expenses | $18,378,280 | CYOtherExpensesAmt |
| PY Total Expenses | $47,117,340 | PYTotalExpensesAmt |
| CY Total Expenses | $49,984,911 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,433,522 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$772,414 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $79,212,619 | TotalAssetsBOYAmt |
| Total Assets EOY | $81,104,350 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $28,211,821 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $28,180,192 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $51,000,798 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $52,924,158 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | GLENCOE REGIONAL HEALTH SERVICES EXISTS TO PROVIDE HIGH QUALITY, CONVENIENT AND PERSONAL HEALTH CARE TO THOSE WE SERVE. WE DO SO BY PROVIDING COMPREHENSIVE, EVIDENCE-BASED, COST-EFFECTIVE HEALTH CARE SERVICES AND EDUCATION. WE COLLABORATE WITH OTHERS TO COORDINATE AND IMPROVE THE HEALTH OF OUR COMMUNITIES, AND COMMIT OUR SKILLS AND RESOURCES TO BENEFIT THE WHOLE PERSON THROUGH ALL STAGES OF LIFE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $36,723,899 | ExpenseAmt |
| Grant | $19,084 | GrantAmt |
| Revenue | $40,285,180 | RevenueAmt |
| Desc | HOSPITAL - THE FACILITY IS LICENSED FOR 49 BEDS. MEDICAL/SURGICAL SERVICES ARE PROVIDED FOR ACUTE AND SWING BED PATIENTS. MAJOR SERVICES PROVIDED INCLUDE ER, MEDICAL IMAGING, SURGERY, LABORATORY, REHABILITATION THERAPY AND CLINIC SERVICES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $6,765,188 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $7,162,063 | RevenueAmt |
| Desc | NURSING HOME - THE LONG-TERM CARE UNIT IS A 110-BED SKILLED NURSING FACILITY, WITH ALL BEDS MEDICARE AND MEDICAID CERTIFIED. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $437,067 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $462,707 | RevenueAmt |
| Desc | INDEPENDENT SENIOR LIVING - ORCHARD ESTATES IS A 40-UNIT SENIOR-HOUSING COMPLEX COMPRISED OF ONE AND TWO BEDROOM APARTMENTS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $43,926,154 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 25 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 655 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANGELA ERICKSON | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3208647797 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1805 HENNEPIN AVENUE NORTH | AddressLine1 |
| City | GLENCOE | City |
| State | MN | State |
| ZIP Code | 553361416 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| JEANNE CONKEL | ||||||||
| CHAIR | 0.50 | Yes (X) | Yes (X) | $1,000 | $0 | $0 | ||
| JAN BRATSCH | ||||||||
| VICE CHAIR | 0.50 | Yes (X) | Yes (X) | $1,100 | $0 | $0 | ||
| CAROL HAUKOS | ||||||||
| SECRETARY | 0.50 | Yes (X) | Yes (X) | $1,000 | $0 | $0 | ||
| STEVE OLMSTEAD | ||||||||
| DIRECTOR | 0.50 | Yes (X) | $1,000 | $0 | $0 | |||
| DR KRISTINE KNUDTEN | ||||||||
| DIRECTOR & PHYSICIAN | 40.50 | Yes (X) | $218,972 | $0 | $42,124 | |||
| DR BRYAN PETERSON | ||||||||
| DIRECTOR & PHYSICIAN | 40.50 | Yes (X) | $306,206 | $0 | $43,602 | |||
| DR JOHN TIEBEN | ||||||||
| DIRECTOR & PHYSICIAN | 40.50 | Yes (X) | $284,005 | $0 | $43,602 | |||
| JOHN BRABAND | ||||||||
| PRESIDENT & CEO | 40.00 | Yes (X) | $217,469 | $0 | $45,292 | |||
| JOHN DOIDGE | ||||||||
| VICE PRESIDENT OF FINANCE | 40.00 | Yes (X) | $145,653 | $0 | $37,643 | |||
| DR JOHN BERGSENG | ||||||||
| PHYSICIAN | 40.00 | $445,417 | $0 | $37,047 | Yes (X) | |||
| DR JOHN MARK JOHNSON | ||||||||
| PHYSICIAN | 40.00 | $378,616 | $0 | $43,602 | Yes (X) | |||
| DR CHAD ROBBINS | ||||||||
| PHYSICIAN | 40.00 | $364,370 | $0 | $43,602 | Yes (X) | |||
| DR JAMES JESSEN | ||||||||
| PHYSICIAN | 40.00 | $321,166 | $0 | $23,197 | Yes (X) | |||
| DR CHRISTA WAYMIRE | ||||||||
| PHYSICIAN | 40.00 | $266,988 | $0 | $36,938 | Yes (X) | |||
| DR DOUGLAS WAGONER | ||||||||
| PHYSICIAN & FORMER DIRECTOR | 40.00 | $257,664 | $0 | $28,495 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,210,626 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $425,144 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 34 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PREMIER STAFFING INC | |||||
| 243 WINKLER TRAIL | COLOGNE | MN | 55322 | PHYSICIAN SERVICES | $584,289 |
| ALLINA HEALTH SYSTEM | |||||
| PO BOX 9383 NW7710 | MINNEAPOLIS | MN | 55440 | TECHNICAL COMP SERVICES | $509,112 |
| REHABCARE GROUP EAST INC | |||||
| PO BOX 503534 | ST LOUIS | MO | 63150 | REHAB SERVICES | $343,398 |
| SHARED MEDICAL SERVICES | |||||
| PO BOX 330 | COTTAGE GROVE | WI | 53527 | MRI SERVICES | $304,815 |
| PARK NICOLLETMETHODIST HOSPITAL | |||||
| PO BOX 16300 | ST LOUIS PARK | MN | 55416 | MANAGEMENT FEES | $261,288 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 14 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $8,694 | GovernmentGrantsAmt |
| All Other Contributions | $212,121 | AllOtherContributionsAmt |
| Total Contributions | $220,815 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| HOSPITAL | 623000 | $38,878,281 | $38,878,281 |
| NURSING HOME | 623000 | $7,162,063 | $7,162,063 |
| OTHER PROGRAM REVENUES | 623000 | $1,272,075 | $1,272,075 |
| SENIOR LIVING | 623990 | $462,707 | $462,707 |
| EQUITY INVEST. INCOME | 623000 | $134,824 | $134,824 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $47,909,950 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $493,426 | TotalRevenueColumnAmt |
| Exclusion | $493,426 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $9,070 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $9,070 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,070 | TotalRevenueColumnAmt |
| Exclusion | $9,070 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $6,504,181 | SecuritiesAmt |
| Other | $27,400 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,748,806 | SecuritiesAmt |
| Other | $21,115 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $755,375 | SecuritiesAmt |
| Other | $6,285 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $761,660 | TotalRevenueColumnAmt |
| Exclusion | $761,660 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA REVENUE | 722210 | $179,346 | $179,346 |
| MISCELLANEOUS | 900099 | $24,749 | $24,749 |
| LOSS ON BOND REFINANCING | 900099 | -$386,519 | -$386,519 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | -$182,424 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $49,212,497 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $47,909,950 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,081,732 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,084 | TotalAmt |
| Program Services | $19,084 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,388,668 | TotalAmt |
| Program Services | $929,126 | ProgramServicesAmt |
| Management And General | $459,542 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,931,402 | TotalAmt |
| Program Services | $22,565,354 | ProgramServicesAmt |
| Management And General | $1,366,048 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $831,314 | TotalAmt |
| Program Services | $787,075 | ProgramServicesAmt |
| Management And General | $44,239 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,862,817 | TotalAmt |
| Program Services | $3,648,375 | ProgramServicesAmt |
| Management And General | $214,442 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,573,346 | TotalAmt |
| Program Services | $1,477,019 | ProgramServicesAmt |
| Management And General | $96,327 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,401 | TotalAmt |
| Management And General | $22,401 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,305 | TotalAmt |
| Management And General | $47,305 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,590,837 | TotalAmt |
| Program Services | $2,464,439 | ProgramServicesAmt |
| Management And General | $1,126,398 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $217,408 | TotalAmt |
| Program Services | $4,244 | ProgramServicesAmt |
| Management And General | $213,164 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,332,603 | TotalAmt |
| Program Services | $1,050,019 | ProgramServicesAmt |
| Management And General | $282,584 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $231,728 | TotalAmt |
| Management And General | $231,728 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,101,641 | TotalAmt |
| Program Services | $1,101,641 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $213,138 | TotalAmt |
| Program Services | $158,611 | ProgramServicesAmt |
| Management And General | $54,527 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,154 | TotalAmt |
| Management And General | $13,154 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $816,219 | TotalAmt |
| Program Services | $816,219 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,324,795 | TotalAmt |
| Program Services | $3,324,795 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $700,324 | TotalAmt |
| Program Services | $211,975 | ProgramServicesAmt |
| Management And General | $488,349 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL EXPENSES | $2,684,487 | $2,684,094 | $393 |
| DRUGS | $1,445,299 | $1,443,043 | $2,256 |
| LICENSES & TAXES | $1,184,151 | $90,562 | $1,093,589 |
| BAD DEBT EXPENSE | $629,313 | $629,313 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $823,477 | TotalAmt |
| Program Services | $521,166 | ProgramServicesAmt |
| Management And General | $302,311 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,984,911 | TotalAmt |
| Program Services | $43,926,154 | ProgramServicesAmt |
| Management And General | $6,058,757 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,260,922 | BOYAmt |
| EOY | $9,585,864 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,562,653 | BOYAmt |
| EOY | $30,454,258 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,906,510 | BOYAmt |
| EOY | $7,141,057 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $297,707 | BOYAmt |
| EOY | $321,509 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $748,767 | BOYAmt |
| EOY | $466,506 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $62,988,298 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $40,185,800 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,085,067 | BOYAmt |
| EOY | $22,802,498 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,790,826 | BOYAmt |
| EOY | $8,324,417 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $532,462 | BOYAmt |
| EOY | $667,286 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $325,582 | BOYAmt |
| EOY | $370,185 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $702,123 | BOYAmt |
| EOY | $970,770 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $79,212,619 | BOYAmt |
| EOY | $81,104,350 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,974,805 | BOYAmt |
| EOY | $4,134,185 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,505,169 | BOYAmt |
| EOY | $23,046,409 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,724 | BOYAmt |
| EOY | $28,828 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $702,123 | BOYAmt |
| EOY | $970,770 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,211,821 | BOYAmt |
| EOY | $28,180,192 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,000,798 | BOYAmt |
| EOY | $52,924,158 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,000,798 | BOYAmt |
| EOY | $52,924,158 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $79,212,619 | BOYAmt |
| EOY | $81,104,350 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$772,414 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $2,695,774 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $2,852 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $2,852 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | LOBBYING PORTION OF ASSOCIATION DUES PAID TO AHA AND MHA. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,202,257 | OtherCostOrOtherBasisAmt |
| Book Value | $1,202,257 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $31,481,909 | OtherCostOrOtherBasisAmt |
| Depreciation | $17,351,407 | DepreciationAmt |
| Book Value | $14,130,502 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,471,547 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,123,928 | DepreciationAmt |
| Book Value | $347,619 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $28,804,673 | OtherCostOrOtherBasisAmt |
| Depreciation | $21,710,465 | DepreciationAmt |
| Book Value | $7,094,208 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $27,912 | OtherCostOrOtherBasisAmt |
| Book Value | $27,912 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $22,802,498 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DEFERRED COMPENSATION | Desc |
| Amt | $970,770 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $970,770 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $47,401,380 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $2,695,774 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $2,695,774 | RevenueNotReportedAmt |
| Revenue Subtotal | $44,705,606 | RevenueSubtotalAmt |
| Other Revenues Not Included | $4,506,891 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $4,506,891 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $49,212,497 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $49,355,598 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $49,355,598 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $629,313 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $629,313 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $49,984,911 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | INDEPENDENT SENIOR LIVING TENANTS MAKE SECURITY DEPOSITS WHEN THEY MOVE IN TO THE FACILITY. DEPOSITS, WITH INTEREST, LESS ANY COSTS OF REPAIRS, ARE RETURNED TO TENANTS OR THEIR ESTATES WHEN THE TENANT LEAVES THE FACILITY. THE ORGANIZATION HOLDS SMALL AMOUNTS DEPOSITED BY RESIDENTS OF THE NURSING HOME ON THEIR BEHALF. RESIDENTS MAY MAKE DEPOSITS OR WITHDRAWALS AT ANY TIME. |
| PART X, LINE 2: | THE FACILITY QUALIFIES AS A TAX-EXEMPT ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, THE FACILITY IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(C)(3) OF THE CODE. THE FACILITY HAS ELECTED TO ADOPT GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE FACILITY FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES FOR EVALUATING UNCERTAIN TAX POSITIONS. THE ADOPTION OF THIS STANDARD HAS NO EFFECT ON THE FINANCIAL STATEMENTS. THE FACILITY'S TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES. THE TAX RETURNS FOR THE YEARS 2010 TO 2013 ARE OPEN TO EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | PROVISION FOR BAD DEBTS 629,313. UNRESTRICTED CONTRIBUTIONS AND GRANTS 98,971. INVESTMENT INCOME 3,944,575. EQUITY IN INCOME OF AFFILIATED ORGANIZATION 134,824. RENTAL PROPERTY 9,070. LOSS FROM REFINANCE OF DEBT -386,519. CAPITAL GRANTS AND CONTRIBUTIONS 70,372. GAIN ON DISPOSAL OF ASSETS 6,285. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | PROVISION FOR BAD DEBTS 629,313. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | 0 | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,584,930 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,584,930 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03170 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,737,495 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,074,557 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,662,938 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03330 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,322,425 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,074,557 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,247,868 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06500 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $291,864 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $24,397 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $267,467 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00540 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $121,279 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $51,472 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $69,807 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $44,834 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $43,983 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $851 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $67,079 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $67,079 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $525,056 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $119,852 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $405,204 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00810 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,847,481 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,194,409 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,653,072 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07310 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,531 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,531 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,666 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $9,666 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,197 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $12,197 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $629,313 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $10,939,035 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $11,120,293 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$181,258 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GLENCOE REGIONAL HEALTH SERVICES | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1805 HENNEPIN AVENUE NORTH | AddressLine1 |
| City | GLENCOE | City |
| State | MN | State |
| ZIP Code | 55336 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | 360844 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | NURSING HOME/SNF | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GLENCOE REGIONAL HEALTH SERVICES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://GRHSONLINE.ORG/CHNA/ | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | Yes (1) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Attached To Invoice | Yes (X) | AttachedToInvoiceInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| GLENCOE REGIONAL HEALTH SERVICES | PART V, SECTION B, LINE 3: INVITATIONS TO PARTICIPATE IN TWO HALF-DAY WORKSHOPS WERE SENT OUT TO OVER 100 PEOPLE AND AGENCIES IN OUR COMMUNITY, REPRESENTING PUBLIC HEALTH, EDUCATION, BUSINESS, LOCAL GOVERNMENT AND OTHER COMMUNITY SERVICE AGENCIES. APPROXIMATELY 60 INDIVIDUALS PARTICIPATED IN THE TWO FOCUS GROUP SESSIONS. IT WAS FELT THAT THE NEEDS AND INTEREST OF THE MEDICALLY UNDERSERVED, LOW INCOME AND MINORITY POPULATIONS WERE ABLE TO BE REPRESENTED THROUGH INPUT FROM REPRESENTATIVES FROM THE MCLEOD COUNTY FOOD SHELF, COUNTY PUBLIC HEALTH AND HUMAN SERVICES, CITY AND COUNTY GOVERNMENT OFFICIALS, AND OTHER COMMUNITY SERVICE AGENCIES. THE NEEDS OF THE MOST SIGNIFICANT MINORITY POPULATION IN THE AREA WERE ALSO FELT TO BE REPRESENTED THROUGH PARTICIPATION BY A SPANISH INTERPRETER EMPLOYED BY GLENCOE REGIONAL HEALTH SERVICES. |
| GLENCOE REGIONAL HEALTH SERVICES | PART V, SECTION B, LINE 4: HUTCHINSON HEALTH, MEEKER MEMORIAL HOSPITAL, SIBLEY HEALTH CENTER |
| GLENCOE REGIONAL HEALTH SERVICES | PART V, SECTION B, LINE 20D: MAXIMUM AMOUNT CHARGED IS THE NEGOTIATED RATE FROM THE HOSPITAL'S LARGEST COMMERCIAL INSURANCE CARRIER. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 4 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| GLENCOE REGIONAL HEALTH SERVICES | ||||
| 1024 CENTRAL AVENUE | LESTER PRAIRIE | MN | 55354 | CLINIC |
| GLENCOE REGIONAL HEALTH SERVICES | ||||
| 300 BOWMAN STREET | STEWART | MN | 55385 | CLINIC |
| GRHS LONG-TERM CARE | ||||
| 705 EAST 18TH STREET | GLENCOE | MN | 55336 | NURSING HOME |
| ORCHARD ESTATES | ||||
| 1900 FORD AVENUE NORTH | GLENCOE | MN | 55336 | SENIOR APARTMENTS |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE AMOUNTS IN PART I, LINE 7 WERE CALCULATED USING A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2 IN THE IRS INSTRUCTIONS TO FORM 990, SCHEDULE H. |
| PART I, LINE 7G: | THE ORGANIZATION DID NOT INCLUDE ANY COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC IN ITS SUBSIDIZED HEALTH SERVICES IN SCHEDULE H, PART I, LINE 7G. |
| PART I, LN 7 COL(F): | BAD DEBT EXPENSE REPORTED IN FORM 990, PART IX, LINE 24D WERE $629,313. THIS AMOUNT WAS SUBTRACTED IN CALCULATING THE PERCENTAGES IN SCHEDULE H, PART I, LINE 7, COLUMN F. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | OUR COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF OUR COMMUNITIES THROUGH DISASTER PREPAREDNESS EFFORTS, CASE MANAGEMENT OF UNDERINSURED AND UNINSURED PATIENTS, FINANCIAL AND IN-KIND SUPPORT, AND EDUCATION. FIRST, THROUGH DISASTER PREPAREDNESS TRAINING, WE SUPPORT AND PROTECT THE HEALTH OF OUR COMMUNITIES BY WORKING TO INSURE THAT THOSE NEEDING MEDICAL ATTENTION CAN ACCESS QUALITY CARE IN A SAFE AND TIMELY MANNER. DISASTER PREPAREDNESS EFFORTS ARE A YEAR-ROUND ACTIVITY, AS DISASTERS CAN INCLUDE PANDEMICS, NATURAL DISASTERS AND MASS CASUALTY SITUATIONS. SECOND, BY PROVIDING CASE MANAGEMENT OF UNDERINSURED AND UNINSURED PATIENTS, WE WORK TO HELP PATIENTS RETURN HOME AND REGAIN THEIR INDEPENDENCE AFTER AN ILLNESS, INJURY OR SURGERY. IN CASES WHERE IT IS NOT POSSIBLE FOR SOMEONE TO RETURN HOME, WE WORK TO MAKE SURE THEY HAVE ACCESS TO THE CARE AND RESOURCES THEY NEED TO CONTINUE THEIR RECOVERY OR LIVE WITH DIGNITY. THROUGH HELPING OUR PATIENTS OBTAIN FINANCIAL SUPPORT, AS WELL AS OBTAIN ACCESS TO COMMUNITY SUPPORT SYSTEMS, WE WORK TO ENSURE THAT THEY GET ADDITIONAL SERVICES THAT MAY BE NEEDED TO ASSIST IN THEIR RECOVERY. THIS PROMOTES THE HEALTH OF THE COMMUNITY BY INSURING THAT PATIENTS HAVE THE SUPPORT AND RESOURCES THEY NEED TO RETURN TO THE COMMUNITY AS PRODUCTIVE CITIZENS, AS WELL HELPING TO CREATE A COMMUNITY IN WHICH PEOPLE ARE VALUED AND TREATED WITH RESPECT. THIRD, BY PROVIDING FINANCIAL AND IN-KIND SUPPORT TO THE GLENCOE AREA CHAMBER OF COMMERCE, WE SUPPORT THE ECONOMIC HEALTH OF OUR REGION. A STRONG LOCAL ECONOMY CONTRIBUTES TO THE OVERALL HEALTH AND WELL-BEING OF ALL ITS RESIDENTS. BY PROVIDING FINANCIAL AND IN-KIND SUPPORT FOR COMMUNITY ACTIVITIES, SUCH AS THE MCLEOD COUNTY FOOD DRIVE CHALLENGE, WE ENHANCE THE QUALITY OF LIFE IN OUR COMMUNITY. FINALLY, BY PROVIDING EDUCATIONAL PRESENTATIONS AND TOURS TO OUR AREA SCHOOLS, WE ARE INVESTING IN A FUTURE GENERATION OF HEALTH CARE WORKERS WHO MAY SOMEDAY PROVIDE DIRECT CARE TO OUR PATIENTS AND OTHERS IN THE COMMUNITIES WE SERVE. WE ARE ALSO EDUCATING INDIVIDUALS ABOUT THE WORK WE DO, WHY WE DO IT, AND HOW OUR EFFORTS AFFECT THEIR LIVES AND THE LIVES OF OTHERS. |
| PART III, LINE 4: | SEE THE "PATIENT ACCOUNTS RECEIVABLE, NET" PARAGRAPH IN NOTE 1 (PAGES 8-9) TO THE ATTACHED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THE ORGANIZATION USES A COST-TO-CHARGE RATIO TO CALCULATE THE MEDICARE ALLOWABLE COSTS REPORTED IN ITS MEDICARE COST REPORT. THE ORGANIZATION USES THE MEDICARE REIMBURSEMENT PROVIDER MANUAL 15-2 TO DETERMINE ACCEPTABLE METHODOLOGIES. |
| PART III, LINE 9B: | OUR GENERAL DEBT COLLECTION POLICY FOR ALL PATIENTS IS AS FOLLOWS: TWO BILLING STATEMENTS ARE SENT OUT TO THE PATIENT. ACCOUNTS WITH NO SELF-PAY ACTIVITY WITHIN TWO MONTHS RECEIVE A FIRST REMINDER LETTER. IF NO PAYMENT IS RECEIVED WITHIN ONE MONTH OF THE FIRST LETTER A SECOND REMINDER IS SENT. IF NO PAYMENT IS MADE WITHIN THREE WEEKS OF THE SECOND LETTER BEING SENT, A PHONE CALL IS PLACED TO THE PATIENT IN ORDER TO SET UP PAYMENT ARRANGEMENTS. IF AN AGREEMENT IS NOT MET, THE ACCOUNT IS SENT TO COLLECTIONS. IN ALL, PATIENTS RECEIVE FOUR NOTICES BEFORE AN ACCOUNT IS SENT TO COLLECTIONS. PAYMENT PLANS ARE AVAILABLE TO ALL PATIENTS REGARDLESS OF INSURANCE COVERAGE OR FINANCIAL SITUATION. WE DO NO CHARGE INTEREST OR FEES ON PAYMENT PLANS. FOR 2013, THERE WAS A MINIMUM $50.00 PAYMENT REQUIRED ON PAYMENT PLANS. IF PATIENTS CONTACT US ABOUT THEIR BILL, WE WILL REFER THEM TO FINANCIAL ASSISTANCE PROGRAMS THAT ARE AVAILABLE OR DETERMINE IF THEY ARE ELIGIBLE FOR CHARITY CARE PROGRAMS OR UNINSURED DISCOUNT PROGRAMS. INFORMATION ABOUT THE DISCOUNTS AND PROGRAMS THAT ARE AVAILABLE TO PATIENTS CAN ALSO BE FOUND ON THE BACK OF EACH MONTHLY STATEMENT AND ON EACH PAYMENT REMINDER LETTER THAT IS SENT. WHEN INSURANCE COMPANIES NEED MORE INFORMATION FROM THE PATIENT TO PROCESS THE CLAIM, WE WILL CALL THE PATIENT AND SEND THE PATIENT A REMINDER LETTER ASKING THE PATIENT TO CONTACT THEIR INSURANCE COMPANY. |
| PART VI, LINE 2: | GRHS ASSESSES OUR COMMUNITIES' HEALTH NEEDS THROUGH VARIOUS METHODS. WE HAVE CONDUCTED COMMUNITY-BASED RESEARCH ON SEVERAL OCCASIONS, INCLUDING USE OF FOCUS GROUPS AND STATISTICALLY VALID TELEPHONIC SURVEYS. DURING OUR ANNUAL STRATEGIC PLANNING PROCESS, WE REVIEW UTILIZATION TRENDS, ALONG WITH THE RESULTS OF ANY COMMUNITY-BASED RESEARCH CONDUCTED THAT YEAR. WE SOLICIT FEEDBACK FROM OUR MEDICAL STAFF REGARDING ISSUES AND TRENDS THEY SEE. WE VERIFY THOSE TRENDS, AS WELL AS IDENTIFY OTHER ISSUES AND NEEDS BY CONDUCTING INTERNAL RESEARCH AND REVIEWS OF PATIENT DATA AND STATISTICS. WE ALSO MONITOR FEEDBACK RECEIVED THROUGH PATIENT SATISFACTION SURVEYS. IN ADDITION, WE SURVEY OUR PATIENTS AT ALL OF OUR COMMUNITY HEALTH EVENTS TO FIND OUT WHAT TOPICS THEY WOULD LIKE TO KNOW MORE ABOUT. WE ALSO COLLABORATE WITH LOCAL PUBLIC HEALTH AND OTHER AGENCIES AS APPROPRIATE TO LEARN ABOUT OUR COMMUNITIES' NEEDS. |
| PART VI, LINE 3: | GRHS EDUCATES AND INFORMS PATIENTS ABOUT FINANCIAL ASSISTANCE, CHARITY CARE AND UNINSURED DISCOUNT PROGRAMS IN ALL BILLING INVOICES SENT. THE INFORMATION IS LISTED ON THE BACK OF THE BILLING STATEMENT. WE ALSO POST THE INFORMATION IN OUR FACILITY AND INCLUDE IT ON OUR WEB SITE, WWW.GRHSONLINE.ORG. IN ADDITION, WE PROVIDE A REPORT BACK TO THE COMMUNITY ANNUALLY ABOUT OUR FINANCES AND CHARITY CARE AMOUNTS. THIS REPORT IS SENT TO ALL OF OUR PATIENTS, AS WELL AS THE RESIDENTS IN THE COMMUNITIES WE SERVE. |
| PART VI, LINE 4: | PATIENTS CARED FOR BY GRHS RESIDE, PRIMARILY, IN AN AREA WITHIN A RADIUS OF TWENTY MILES OF THE CITY OF GLENCOE, WHICH IS APPROXIMATELY 55 MILES WEST OF MINNEAPOLIS. THE POPULATION OF GRHS'S PRIMARY SERVICE AREA WAS PROJECTED TO BE 29,148 IN 2000, AN INCREASE OF 4.8% SINCE 1990. THE REPORTED POPULATION OF THE CITY OF GLENCOE FOR THE YEAR 2000 AND 2010 WERE 5,453 AND 5,631 RESPECTIVELY, AN INCREASE OF 3.3%. |
| PART VI, LINE 6: | THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | EMPLOYEE SCHOLARSHIPS | GrantTypeTxt |
| Recipient | 14 | RecipientCnt |
| Cash Grant | $18,926 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Valuation Method Used | COST | ValuationMethodUsedDesc |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PROVIDES TUITION REIMBURSEMENT ASSISTANCE TO EMPLOYEES. EMPLOYEES ARE REQUIRED TO COMPLETE THE REIMBURSEMENT REQUEST FORM, WHICH IS TO BE SIGNED BY THEIR SUPERVISOR, PRIOR TO BEGINNING THEIR COURSE(S) TO RESERVE FUNDS. THEY ARE TO INCLUDE A DESCRIPTION OF THE COURSE(S) THEY PLAN TO TAKE, AND RECEIPTS FOR TUITION AND BOOKS, (FEES ARE NOT ELIGIBLE FOR REIMBURSEMENT), WITH THEIR REQUEST. EMPLOYEES ARE REQUIRED TO COMPLETE THEIR COURSE WITH A GRADE OF C OR BETTER TO BE ELIGIBLE FOR REIMBURSEMENT. EMPLOYEES ARE RESPONSIBLE FOR ALL UP-FRONT COSTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR KRISTINE KNUDTEN | ||||||||||||||
| DIRECTOR & PHYSICIAN | $208,490 | $0 | $10,482 | $0 | $0 | $0 | $0 | $0 | $42,124 | $0 | $261,096 | $0 | $0 | $0 |
| DR BRYAN PETERSON | ||||||||||||||
| DIRECTOR & PHYSICIAN | $292,089 | $0 | $14,117 | $0 | $0 | $0 | $0 | $0 | $43,602 | $0 | $349,808 | $0 | $0 | $0 |
| DR JOHN TIEBEN | ||||||||||||||
| DIRECTOR & PHYSICIAN | $272,972 | $0 | $11,033 | $0 | $0 | $0 | $0 | $0 | $43,602 | $0 | $327,607 | $0 | $0 | $0 |
| JOHN BRABAND | ||||||||||||||
| PRESIDENT & CEO | $192,682 | $0 | $24,787 | $0 | $0 | $0 | $15,631 | $0 | $29,661 | $0 | $262,761 | $0 | $0 | $0 |
| JOHN DOIDGE | ||||||||||||||
| VICE PRESIDENT OF FINANCE | $118,458 | $0 | $6,933 | $0 | $20,262 | $0 | $7,092 | $0 | $30,551 | $0 | $183,296 | $0 | $0 | $0 |
| DR JOHN BERGSENG | ||||||||||||||
| PHYSICIAN | $427,095 | $0 | $18,322 | $0 | $0 | $0 | $0 | $0 | $37,047 | $0 | $482,464 | $0 | $0 | $0 |
| DR JOHN MARK JOHNSON | ||||||||||||||
| PHYSICIAN | $362,954 | $0 | $15,662 | $0 | $0 | $0 | $0 | $0 | $43,602 | $0 | $422,218 | $0 | $0 | $0 |
| DR CHAD ROBBINS | ||||||||||||||
| PHYSICIAN | $346,473 | $0 | $17,897 | $0 | $0 | $0 | $0 | $0 | $43,602 | $0 | $407,972 | $0 | $0 | $0 |
| DR JAMES JESSEN | ||||||||||||||
| PHYSICIAN | $311,726 | $0 | $9,440 | $0 | $0 | $0 | $0 | $0 | $23,197 | $0 | $344,363 | $0 | $0 | $0 |
| DR CHRISTA WAYMIRE | ||||||||||||||
| PHYSICIAN | $251,530 | $0 | $10,908 | $0 | $4,550 | $0 | $0 | $0 | $36,938 | $0 | $303,926 | $0 | $0 | $0 |
| DR DOUGLAS WAGONER | ||||||||||||||
| PHYSICIAN & FORMER DIRECTOR | $246,031 | $0 | $11,633 | $0 | $0 | $0 | $0 | $0 | $28,495 | $0 | $286,159 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4B | JOHN DOIDGE - 457(B) PLAN - $17,500 DR. CHRISTA WAYMIRE - 457(B) PLAN - $4,550 |
| SCHEDULE J, PART II: | JON BRABAND (CEO) IS EMPLOYED BY PARK NICOLLET, AN UNRELATED THIRD PARTY. HE OPERATES AS CEO OF GLENCOE REGIONAL HEALTH SERVICES UNDER A MANAGEMENT CONTRACT WITH PARK NICOLLET. AS SUCH, HIS COMPENSATION IS REPORTED ON FORM 990, PART VII AND ON SCHEDULE J, PART II. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF GLENCOE MINNESOTA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 416005185 | BondIssuerEIN |
| CUSIP | 378160BW4 | CUSIPNum |
| Bond Issued | 2013-02-27 | BondIssuedDt |
| Issue Price | $23,087,781 | IssuePriceAmt |
| Purpose | DEFEASE SERIES 2005 BONDS | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $23,087,781 | TotalProceedsAmt |
| In Reserve Fund | $1,737,800 | InReserveFundAmt |
| Issuance Costs From Proceeds | $388,068 | IssuanceCostsFromProceedsAmt |
| Other Spent Proceeds | $20,961,913 | OtherSpentProceedsAmt |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THERE SHALL BE AN EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS WHICH SHALL CONSIST OF THE CHAIRPERSON OF THE BOARD OF DIRECTORS, THE VICE CHAIRPERSON OF THE BOARD OF DIRECTORS, THE PRESIDENT AND THE SECRETARY OF THE BOARD OF DIRECTORS. THE CHAIRPERSON OF THE BOARD OF DIRECTORS SHALL BE THE CHAIRPERSON OF THE EXECUTIVE COMMITTEE AND THE SECRETARY SHALL ACT AS THE SECRETARY THEREOF. THE EXECUTIVE COMMITTEE SHALL ADVISE WITH AND AID THE OFFICERS OF THE CORPORATION IN ALL MATTERS CONCERNING THE MANAGEMENT OF ITS BUSINESS; AND BETWEEN MEETINGS OF DIRECTORS THE EXECUTIVE COMMITTEE SHALL POSSESS AND MAY EXERCISE ALL OF THE POWERS OF THE BOARD OF DIRECTORS EXCEPT WITH REFERENCE TO MAKING OR AMENDING THE BYLAWS FOR THE BOARD OF DIRECTORS, REMOVING ANY MEMBER OF THE BOARD OF DIRECTORS OR FILLING VACANCIES IN THEIR OWN MEMBERSHIP. |
| FORM 990, PART VI, SECTION A, LINE 3 | THE ORGANIZATION HAS A CONTRACTUAL ARRANGEMENT WITH PARK NICOLLET HEALTH SERVICES, UNDER WHICH PARK NICOLLET HEALTH SERVICES PROVIDES A CHIEF EXECUTIVE OFFICER, MANAGEMENT CONSULTATION, AND OTHER SERVICES TO THE FACILITY. THE ARRANGEMENT DOES NOT ALTER THE AUTHORITY OR RESPONSIBILITY OF THE BOARD OF DIRECTORS OF GLENCOE REGIONAL HEALTH SERVICES. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 REPORT WAS REVIEWED WITH THE BOARD MEMBERS AT A REGULARY SCHEDULED BOARD MEETING. THE BOARD WAS ASKED TO APPROVE THE DOCUMENT PRIOR TO SUBMISSION TO THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | GLENCOE REGIONAL HEALTH SERVICES HAS A CONFLICT OF INTEREST POLICY THAT APPLIES TO ALL MEMBERS OF THE BOARD OF DIRECTORS, MEMBERS OF A COMMITTEE OF THE BOARD OF DIRECTORS, AND SENIOR MANAGEMENT. ANNUALLY, THE BOARD MEMBERS AND SENIOR MANAGMENT ARE ASKED TO COMPLETE THE CONFLICT OF INTEREST DECLARATION. ANY INDIVIDUAL HAVING A CONFLICT OF INTEREST IS REQUIRED TO INFORM THE BOARD OR COMMITTEE. THE INDIVIDUAL ABSTAINS FROM VOTING ON THE MATTER, BUT IS PERMITTED TO BRIEFLY STATE THEIR POSITION AND ANSWER PERTINENT QUESTIONS. THE MINUTES OF THE MEETING REFLECT THAT THE DISCLOSURE WAS MADE AND THAT THE PERSON ABSTAINED FROM VOTING. THE PRESIDENT AND CEO IS RESPONSIBLE FOR MONITORING CONFLICTS OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO REVIEW PROCESS IS PERFORMED UNDER THE DIRECTION OF PARK NICOLLET AND INDEPENDENT COMPARISON DATA IS USED TO ESTABLISH COMPENSATION. THE BOARD OF DIRECTORS FINALIZES THE REVIEW AND COMPENSATION. THE VICE PRESIDENT OF FINANCE REVIEW IS CONDUCTED BY THE CEO AND COMPENSATION IS DETERMINED USING INDEPENDENT COMPARISON DATA. BOTH POSITIONS WERE REVIEWED IN 2013. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. ANNUAL FINANCIAL STATEMENTS ARE PUBLISHED ONCE PER YEAR IN THE FACILITY PUBLICATION TOUCHING LIVES. THE TOUCHING LIVES PUBLICATION IS MAILED TO ALL RESIDENTS IN THE FACILITY'S SERVICE AREA. |